Effect of Annealing Time on Microstructural Evolution and Deformation Characteristics in 10Mn1.5Al TRIP Steel

NASA Astrophysics Data System (ADS)

Han, Qihang; Zhang, Yulong; Wang, Li

2015-05-01

To investigate microstructural evolution and its effects on the deformation behaviors of cold-rolled 10Mn1.5Al TRIP steel, a series of intercritical annealing treatments with various holding times from 3 minutes to 48 hours were conducted. With the increase of the holding time from 3 minutes to 12 hours, the elongation was improved from 15 to 42 pct, while the tensile strength was only reduced from 1210 to 1095 MPa; the strength-ductility combination thus exceeded 45 GPa pct. Austenite was found to coexist with martensite within deformed grains, which reduced the strain concentration at the interface. The austenite transformation fraction, as measured from the {220} peaks, after 3 minutes annealing was half that after 12 hours annealing. This is an indication that the slip systems were more easily activated in the micro-scaled grains compared with nano-scaled grains. Therefore, although the stability of austenite would have increased during annealing, size-induced slip suppression was reduced. Thus, more strain was accommodated in the austenite, facilitating a greater strain-induced transformation and better ductility.

Hydrotherapy vs. conventional land-based exercise for improving walking and balance after stroke: a randomized controlled trial.

PubMed

Zhu, Zhizhong; Cui, Liling; Yin, Miaomiao; Yu, Yang; Zhou, Xiaona; Wang, Hongtu; Yan, Hua

2016-06-01

To investigate the effects of hydrotherapy on walking ability and balance in patients with chronic stroke. Single-blind, randomized controlled pilot trial. Outpatient rehabilitation clinic at a tertiary neurological hospital in China. A total of 28 participants with impairments in walking and controlling balance more than six months post-stroke. After baseline evaluations, participants were randomly assigned to a land-based therapy (control group, n = 14) or hydrotherapy (study group, n = 14). Participants underwent individual sessions for four weeks, five days a week, for 45 minutes per session. After four weeks of rehabilitation, all participants were evaluated by a blinded assessor. Functional assessments included the Functional Reach Test, Berg Balance Scale, 2-minute walk test, and Timed Up and Go Test. After four weeks of treatment, the Berg Balance Scale, functional reach test, 2-minute walk test, and the Timed Up and Go Test scores had improved significantly in each group (P < 0.05). The mean improvement of the functional reach test and 2-minute walk test were significantly higher in the aquatic group than in the control group (P < 0.01). The differences in the mean values of the improvements in the Berg Balance Scale and the Timed Up and Go Test were not statistically significant. The results of this study suggest that a relatively short programme (four weeks) of hydrotherapy exercise resulted in a large improvement in a small group (n = 14) of individuals with relatively high balance and walking function following a stroke. © The Author(s) 2015.

Assessment of abuse liability of Tramadol among experienced drug users: Double-blind crossover randomized controlled trial.

PubMed

Das, Mrinmay; Jain, Raka; Dhawan, Anju; Kaur, Amandeep

Tramadol is a widely used opioid analgesic. Different preclinical, clinical, and postmarketing surveillance studies show conflicting results regarding abuse potential of this drug. A randomized double-blind complete crossover study was conducted at National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi. Total subjects were 10, comprising total 120 observations (each subject assessed at baseline, 5, 45, and 240 minutes). Subjects with history of substance abuse were included after detoxification and informed consent. Assessment was done using modified single dose opiate questionnaire, morphine benzedrine group (MBG), pentobarbital chlorpromazine alcohol group (PCAG), and two bipolar visual analogue scales (VAS) after administration of three drugs-Tramadol (100 mg), Buprenorphine (0.6 mg), and Placebo (Normal Saline) intramuscularly, at 5-day interval. In intra-group analysis, there was statistically significant increase in scores of all four scales from baseline to all three time points after Tramadol and Buprenorphine administration. In inter-group analysis, statistically higher scores were seen for Buprenorphine in comparison to Tramadol at 5, 45, and 240 minutes for MBG scale; the score was significantly higher for Buprenorphine in VAS for pleasurable effect at 45 and 240 minutes, but not at baseline and 5 minutes. There was no significant difference in score at any point of time between Tramadol and Buprenorphine in PCAG scale and VAS for sedative/alertness effect. The scores were statistically insignificant in case of Placebo. All the subjects liked Buprenorphine most and then Tramadol followed by Placebo. Tramadol has abuse potential (even in therapeutic doses) more than Placebo but less than or comparable to Buprenorphine.

Transition from lognormal to χ2-superstatistics for financial time series

NASA Astrophysics Data System (ADS)

Xu, Dan; Beck, Christian

2016-07-01

Share price returns on different time scales can be well modelled by a superstatistical dynamics. Here we provide an investigation which type of superstatistics is most suitable to properly describe share price dynamics on various time scales. It is shown that while χ2-superstatistics works well on a time scale of days, on a much smaller time scale of minutes the price changes are better described by lognormal superstatistics. The system dynamics thus exhibits a transition from lognormal to χ2 superstatistics as a function of time scale. We discuss a more general model interpolating between both statistics which fits the observed data very well. We also present results on correlation functions of the extracted superstatistical volatility parameter, which exhibits exponential decay for returns on large time scales, whereas for returns on small time scales there are long-range correlations and power-law decay.

Evaluation of curing compound application time on concrete surface durability.

DOT National Transportation Integrated Search

2015-03-01

The effect of curing compound application time after concrete finishing was examined in the study. Times of 30 minutes, 2 hours and 4 hours were considered and repeatability was evaluated with comparisons to a Phase I portion of the study. Scaling re...

Interferometric Imaging of Geostationary Satellites: Signal-to-Noise Considerations

DTIC Science & Technology

2011-09-01

instrument a minute time -scale snapshot imager. Snapshot imaging is im- portant because it allows for resolving short time -scale changes of the satellite ...curves of fringe amplitude standard deviation as a function of satellite V-magnitude, giving the corresponding integration time . From this figure we can...combiner (in R-band). We conclude that it is possible to track fringes on typical highly resolved satellites to a magnitude of V = 14.5. This range

[Research on vigilance detection based on pulse wave].

PubMed

Cao, Yong; Jiao, Xuejun; Pan, Jinjin; Jiang, Jin; Fu, Jiahao; Xu, Fenggang; Yang, Hanjun

2017-12-01

This paper studied the rule for the change of vigilance based on pulse wave. 10 participants were recruited in a 95-minute Mackworth clock test (MCT) experiment. During the experiment, the vigilance of all participants were evaluated by Karolinska sleepiness scale (KSS) and Stanford sleepiness scale (SSS), and behavior data (the reaction time and the accuracy of target) and pulse wave signal of the participants were recorded simultaneously. The result indicated that vigilance of the participants can be divided into 3 classes: the first 30 minutes for high vigilance level, the middle 30 minutes for general vigilance level, and the last 30 minutes for low vigilance level. Besides, time domain features such as amplitude of secondary peak, amplitude of peak and the latency of secondary peak decreased with the decrease of vigilance, while the amplitude of troughs increased. In terms of frequency domain features, the energy of 4 frequency band including 8.600 ~ 9.375 Hz, 11.720 ~ 12.500 Hz, 38.280 ~ 39.060 Hz and 39.060 ~ 39.840 Hz decreased with the decrease of vigilance. Finally, under the recognition model established by the 8 characteristics mentioned above, the average accuracy of three-classification results over the 10 participants was as high as 88.7%. The results of this study confirmed the feasibility of pulse wave in the evaluation of vigilance, and provided a new way for the real-time monitoring of vigilance.

Geometry and Reynolds-Number Scaling on an Iced Business-Jet Wing

NASA Technical Reports Server (NTRS)

Lee, Sam; Ratvasky, Thomas P.; Thacker, Michael; Barnhart, Billy P.

2005-01-01

A study was conducted to develop a method to scale the effect of ice accretion on a full-scale business jet wing model to a 1/12-scale model at greatly reduced Reynolds number. Full-scale, 5/12-scale, and 1/12-scale models of identical airfoil section were used in this study. Three types of ice accretion were studied: 22.5-minute ice protection system failure shape, 2-minute initial ice roughness, and a runback shape that forms downstream of a thermal anti-ice system. The results showed that the 22.5-minute failure shape could be scaled from full-scale to 1/12-scale through simple geometric scaling. The 2-minute roughness shape could be scaled by choosing an appropriate grit size. The runback ice shape exhibited greater Reynolds number effects and could not be scaled by simple geometric scaling of the ice shape.

Stenting of the cervical internal carotid artery in acute stroke management: The Karolinska experience.

PubMed

Mpotsaris, Anastasios; Kabbasch, Christoph; Borggrefe, Jan; Gontu, Vamsi; Soderman, Michael

2017-04-01

Background Emergency stent placement in the extracranial internal carotid artery in combination with anterior circulation thrombectomy is a routine procedure. Yet, precise indications and clinical safety in this setting remains controversial. Present data for mechanical thrombectomy include few studies with acute stenting of tandem occlusions. We evaluated the feasibility, safety and clinical outcome of this endovascular treatment in a retrospective analysis of all consecutive cases at a comprehensive stroke centre. Methods This was a retrospective analysis of all consecutive patients with acute extracranial carotid artery occlusion including acute dissection or high-grade stenosis and concomitant intracranial large-vessel occlusion treated with emergency carotid stenting and intracranial mechanical thrombectomy between November 2007 and May 2015. Results A total of 63 patients with a median age of 67 years (range 33-84 years) were treated. Of these, 33 (52%) patients had concomitant intravenous thrombolysis with recombinant tissue-type plasminogen activator initially. Median admission National Institutes of Health Stroke Scale was 14 (range 1-29). Median time from stroke onset to recanalization was 408 minutes (range 165-1846 minutes). Procedure time was significantly shorter after intravenous thrombolysis (110 minutes [range 15-202 minutes] vs. 130 minutes [range 60-280 minutes]; p = 0.02). Three (5%) patients experienced post-procedural symptomatic intracerebral haemorrhage. In 55/63 (87%) patients, a score of ≥2b on the Thrombolysis in Cerebral Infarction scale could be achieved. Eight (13%) patients died, five (8%) during the acute phase. A total of 29/63 (46%) patients showed a favourable outcome (modified Rankin Scale score of 0-2) after three months. Conclusions Our single-centre retrospective analysis of emergency stent placement in the extracranial internal carotid artery in combination with anterior circulation thrombectomy demonstrated high technical success, reasonable clinical outcomes and acceptable rates of symptomatic intracranial haemorrhage in carefully chosen patients which are triaged interdisciplinary based on clinical and computed tomography imaging criteria. This warrants further study in a randomised prospective trial.

Minimum and Maximum Times Required to Obtain Representative Suspended Sediment Samples

NASA Astrophysics Data System (ADS)

Gitto, A.; Venditti, J. G.; Kostaschuk, R.; Church, M. A.

2014-12-01

Bottle sampling is a convenient method of obtaining suspended sediment measurements for the development of sediment budgets. While these methods are generally considered to be reliable, recent analysis of depth-integrated sampling has identified considerable uncertainty in measurements of grain-size concentration between grain-size classes of multiple samples. Point-integrated bottle sampling is assumed to represent the mean concentration of suspended sediment but the uncertainty surrounding this method is not well understood. Here we examine at-a-point variability in velocity, suspended sediment concentration, grain-size distribution, and grain-size moments to determine if traditional point-integrated methods provide a representative sample of suspended sediment. We present continuous hour-long observations of suspended sediment from the sand-bedded portion of the Fraser River at Mission, British Columbia, Canada, using a LISST laser-diffraction instrument. Spectral analysis suggests that there are no statistically significant peak in energy density, suggesting the absence of periodic fluctuations in flow and suspended sediment. However, a slope break in the spectra at 0.003 Hz corresponds to a period of 5.5 minutes. This coincides with the threshold between large-scale turbulent eddies that scale with channel width/mean velocity and hydraulic phenomena related to channel dynamics. This suggests that suspended sediment samples taken over a period longer than 5.5 minutes incorporate variability that is larger scale than turbulent phenomena in this channel. Examination of 5.5-minute periods of our time series indicate that ~20% of the time a stable mean value of volumetric concentration is reached within 30 seconds, a typical bottle sample duration. In ~12% of measurements a stable mean was not reached over the 5.5 minute sample duration. The remaining measurements achieve a stable mean in an even distribution over the intervening interval.

Stroke thrombolysis: save a minute, save a day.

PubMed

Meretoja, Atte; Keshtkaran, Mahsa; Saver, Jeffrey L; Tatlisumak, Turgut; Parsons, Mark W; Kaste, Markku; Davis, Stephen M; Donnan, Geoffrey A; Churilov, Leonid

2014-04-01

Stroke thrombolysis is highly time-critical, but data on long-term effects of small reductions in treatment delays have not been available. Our objective was to quantify patient lifetime benefits gained from faster treatment. Observational prospective data of consecutive stroke patients treated with intravenous thrombolysis in Australian and Finnish centers (1998-2011; n=2258) provided distributions of age, sex, stroke severity, onset-to-treatment times, and 3-month modified Rankin Scale in daily clinical practice. Treatment effects derived from a pooled analysis of thrombolysis trials were used to model the shift in 3-month modified Rankin Scale distributions with reducing treatment delays, from which we derived the expected lifetime and level of long-term disability with faster treatment. Each minute of onset-to-treatment time saved granted on average 1.8 days of extra healthy life (95% prediction interval, 0.9-2.7). Benefit was observed in all groups: each minute provided 0.6 day in old severe (age, 80 years; National Institutes of Health Stroke Scale [NIHSS] score, 20) patients, 0.9 day in old mild (age, 80 years; NIHSS score, 4) patients, 2.7 days in young mild (age, 50 years; NIHSS score, 4) patients, and 3.5 days in young severe (age, 50 years; NIHSS score, 20) patients. Women gained slightly more than men over their longer lifetimes. In the whole cohort, each 15 minute decrease in treatment delay provided an average equivalent of 1 month of additional disability-free life. Realistically achievable small reductions in stroke thrombolysis delays would result in significant and robust average health benefits over patients' lifetimes. The awareness of concrete importance of speed could promote practice change.

Serum Vitamin E Concentrations and Recovery of Physical Function During the Year After Hip Fracture

PubMed Central

Miller, Ram R.; Hicks, Gregory E.; Orwig, Denise L.; Hochberg, Marc C.; Semba, Richard D.; Yu-Yahiro, Janet A.; Ferrucci, Luigi; Magaziner, Jay; Shardell, Michelle D.

2011-01-01

Background. Poor nutritional status after hip fracture is common and may contribute to physical function decline. Low serum concentrations of vitamin E have been associated with decline in physical function among older adults, but the role of vitamin E in physical recovery from hip fracture has never been explored. Methods. Serum concentrations of α- and γ-tocopherol, the two major forms of vitamin E, were measured in female hip fracture patients from the Baltimore Hip Studies cohort 4 at baseline and at 2-, 6-, and 12-month postfracture follow-up visits. Four physical function measures—Six-Minute Walk Distance, Lower Extremity Gain Scale, Short Form-36 Physical Functioning Domain, and Yale Physical Activity Survey—were assessed at 2, 6, and 12 months postfracture. Generalized estimating equations modeled the relationship between baseline and time-varying serum tocopherol concentrations and physical function after hip fracture. Results. A total of 148 women aged 65 years and older were studied. After adjusting for covariates, baseline vitamin E concentrations were positively associated with Six-Minute Walk Distance, Lower Extremity Gain Scale, and Yale Physical Activity Survey scores (p < .1) and faster improvement in Lower Extremity Gain Scale and Yale Physical Activity Survey scores (p < .008). Time-varying vitamin E was also positively associated with Six-Minute Walk Distance, Lower Extremity Gain Scale, Yale Physical Activity Survey, and Short Form-36 Physical Functioning Domain (p < .03) and faster improvement in Six-Minute Walk Distance and Short Form-36 Physical Functioning Domain (p < .07). Conclusions. Serum concentrations of both α- and γ-tocopherol were associated with better physical function after hip fracture. Vitamin E may represent a potentially modifiable factor related to recovery of postfracture physical function. PMID:21486921

Tracking ongoing cognition in individuals using brief, whole-brain functional connectivity patterns

PubMed Central

Gonzalez-Castillo, Javier; Hoy, Colin W.; Handwerker, Daniel A.; Robinson, Meghan E.; Buchanan, Laura C.; Saad, Ziad S.; Bandettini, Peter A.

2015-01-01

Functional connectivity (FC) patterns in functional MRI exhibit dynamic behavior on the scale of seconds, with rich spatiotemporal structure and limited sets of whole-brain, quasi-stable FC configurations (FC states) recurring across time and subjects. Based on previous evidence linking various aspects of cognition to group-level, minute-to-minute FC changes in localized connections, we hypothesized that whole-brain FC states may reflect the global, orchestrated dynamics of cognitive processing on the scale of seconds. To test this hypothesis, subjects were continuously scanned as they engaged in and transitioned between mental states dictated by tasks. FC states computed within windows as short as 22.5 s permitted robust tracking of cognition in single subjects with near perfect accuracy. Accuracy dropped markedly for subjects with the lowest task performance. Spatially restricting FC information decreased accuracy at short time scales, emphasizing the distributed nature of whole-brain FC dynamics, beyond univariate magnitude changes, as valuable markers of cognition. PMID:26124112

Engineering-scale experiments of solar photocatalytic oxidation of trichloroethylene

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

Pacheco, J.; Prairie, M.; Evans, L.

1990-01-01

A photocatalytic process is being developed to destroy organic contaminants in water. Tests with a common water pollutant, trichlorethylene (TCE), were conducted at the Solar Thermal Test Facility at Sandia with trough systems. Tests at this scale provide verification of laboratory studies and allow examination of design and operation issues that only arise in experiments on a realistic scale. The catalyst, titanium dioxide (TiO{sub 2}), is a harmless material found in paint, cosmetics and even toothpaste. We examined the effect of initial contaminant concentration and the effect of hydrogen peroxide on the photocatalytic decomposition of trichlorethylene (TCE). An aqueous solutionmore » of 5000 parts per billion (ppB) TCE with 0.1 weight {percent} suspended titanium dioxide catalyst required approximately 4.2 minutes of exposure to destroy the TCE to a detection limit of 5 ppB. For a 300 ppB TCE solution, the time required was only 2.5 minutes to reach the same level of destruction. Adding 250 parts per million (ppM) of hydrogen peroxide reduced the time required by about 1 minute. A two parameter Langmuir Hinshelwood model was able to describe the data. A simple flow apparatus was built to test four fixed catalyst supports and to measure their pressure drop and assess their ability to withstand flow conditions typical of a full-sized system. In this paper, we summarize the engineering-scale testing and results. 16 refs., 5 figs.« less

Stomatal control and leaf thermal and hydraulic capacitances under rapid environmental fluctuations.

PubMed

Schymanski, Stanislaus J; Or, Dani; Zwieniecki, Maciej

2013-01-01

Leaves within a canopy may experience rapid and extreme fluctuations in ambient conditions. A shaded leaf, for example, may become exposed to an order of magnitude increase in solar radiation within a few seconds, due to sunflecks or canopy motions. Considering typical time scales for stomatal adjustments, (2 to 60 minutes), the gap between these two time scales raised the question whether leaves rely on their hydraulic and thermal capacitances for passive protection from hydraulic failure or over-heating until stomata have adjusted. We employed a physically based model to systematically study effects of short-term fluctuations in irradiance on leaf temperatures and transpiration rates. Considering typical amplitudes and time scales of such fluctuations, the importance of leaf heat and water capacities for avoiding damaging leaf temperatures and hydraulic failure were investigated. The results suggest that common leaf heat capacities are not sufficient to protect a non-transpiring leaf from over-heating during sunflecks of several minutes duration whereas transpirative cooling provides effective protection. A comparison of the simulated time scales for heat damage in the absence of evaporative cooling with observed stomatal response times suggested that stomata must be already open before arrival of a sunfleck to avoid over-heating to critical leaf temperatures. This is consistent with measured stomatal conductances in shaded leaves and has implications for water use efficiency of deep canopy leaves and vulnerability to heat damage during drought. Our results also suggest that typical leaf water contents could sustain several minutes of evaporative cooling during a sunfleck without increasing the xylem water supply and thus risking embolism. We thus submit that shaded leaves rely on hydraulic capacitance and evaporative cooling to avoid over-heating and hydraulic failure during exposure to typical sunflecks, whereas thermal capacitance provides limited protection for very short sunflecks (tens of seconds).

Rheological behavior of the crust and mantle in subduction zones in the time-scale range from earthquake (minute) to mln years inferred from thermomechanical model and geodetic observations

NASA Astrophysics Data System (ADS)

Sobolev, Stephan; Muldashev, Iskander

2016-04-01

The key achievement of the geodynamic modelling community greatly contributed by the work of Evgenii Burov and his students is application of "realistic" mineral-physics based non-linear rheological models to simulate deformation processes in crust and mantle. Subduction being a type example of such process is an essentially multi-scale phenomenon with the time-scales spanning from geological to earthquake scale with the seismic cycle in-between. In this study we test the possibility to simulate the entire subduction process from rupture (1 min) to geological time (Mln yr) with the single cross-scale thermomechanical model that employs elasticity, mineral-physics constrained non-linear transient viscous rheology and rate-and-state friction plasticity. First we generate a thermo-mechanical model of subduction zone at geological time-scale including a narrow subduction channel with "wet-quartz" visco-elasto-plastic rheology and low static friction. We next introduce in the same model classic rate-and state friction law in subduction channel, leading to stick-slip instability. This model generates spontaneous earthquake sequence. In order to follow in details deformation process during the entire seismic cycle and multiple seismic cycles we use adaptive time-step algorithm changing step from 40 sec during the earthquake to minute-5 year during postseismic and interseismic processes. We observe many interesting deformation patterns and demonstrate that contrary to the conventional ideas, this model predicts that postseismic deformation is controlled by visco-elastic relaxation in the mantle wedge already since hour to day after the great (M>9) earthquakes. We demonstrate that our results are consistent with the postseismic surface displacement after the Great Tohoku Earthquake for the day-to-4year time range.

Feasibility and reliability of the SHOT: A short scale for measuring pretreatment severity of alcohol withdrawal in the emergency department.

PubMed

Gray, Sara; Borgundvaag, Bjug; Sirvastava, Anita; Randall, Ian; Kahan, Meldon

2010-10-01

Use of a symptom-triggered scale to measure the severity of alcohol withdrawal could reduce the rate of seizures and other complications. The current standard scale, the Clinical Institute of Withdrawal Assessment (CIWA), takes a mean (±SD) of 5 minutes to complete, requiring 30 minutes of nursing time per patient when multiple measures are required. The objective was to assess the feasibility and reliability of a brief scale of alcohol withdrawal severity. The SHOT is a brief scale designed to assess alcohol withdrawal in the emergency department (ED). It includes four items: sweating, hallucinations, orientation, and tremor (SHOT). It was developed based on a literature review and a consensus process by emergency and addiction physicians. The SHOT was first piloted in one ED, and then a prospective observational study was conducted at a different ED to measure its feasibility and reliability. Subjects included patients who were in alcohol withdrawal. One nurse administered the SHOT and CIWA, and the physician repeated the SHOT independently. The SHOT was done only at baseline, before treatment was administered. In the pilot study (12 patients), the SHOT took 1 minute to complete on average, and the CIWA took 5 minutes. Sixty-one patients participated in the prospective study. For the SHOT and the CIWA done by the same nurse, the kappa was 0.88 (95% confidence interval [CI] = 0.52 to 1.0; p < 0.0001), and the Pearson's r was 0.71 (p < 0.001). The kappa for the nurse's CIWA score and the physician's SHOT score was 0.61 (95% CI = 0.25 to 0.97; p < 0.0006), and the Pearson's r was 0.48 (p = 0.002). The SHOTs performed by the nurse and physician agreed on the need for benzodiazepine treatment in 30 of 37 cases (82% agreement, kappa = 0.35, 95% CI = 0.03 to 0.67; p < 0.02). The mean (±SD) time taken by nurses and physicians to complete the SHOT was 1 (± 0.52) minute (median = 0.6 minutes). Seventeen percent of patients scored positive on the SHOT for hallucinations or disorientation. The SHOT has potential as a feasible and acceptable tool for measuring pretreatment alcohol withdrawal severity in the ED. Further research is needed to validate the SHOT, to assess the utility of serial measurements of the SHOT, and to demonstrate that its use reduces length of stay and improves clinical outcomes. © 2010 by the Society for Academic Emergency Medicine.

The multiple time scales of sleep dynamics as a challenge for modelling the sleeping brain.

PubMed

Olbrich, Eckehard; Claussen, Jens Christian; Achermann, Peter

2011-10-13

A particular property of the sleeping brain is that it exhibits dynamics on very different time scales ranging from the typical sleep oscillations such as sleep spindles and slow waves that can be observed in electroencephalogram (EEG) segments of several seconds duration over the transitions between the different sleep stages on a time scale of minutes to the dynamical processes involved in sleep regulation with typical time constants in the range of hours. There is an increasing body of work on mathematical and computational models addressing these different dynamics, however, usually considering only processes on a single time scale. In this paper, we review and present a new analysis of the dynamics of human sleep EEG at the different time scales and relate the findings to recent modelling efforts pointing out both the achievements and remaining challenges.

The effect of a VR exercise program on falls and depression in the elderly with mild depression in the local community.

PubMed

Yang, Jong-Eun; Lee, Tac-Young; Kim, Jin-Kyung

2017-12-01

[Purpose] The purpose of this study is to explore the effect of a VR exercise program on falls and depression in the elderly with mild depression who reside in the local community. [Subjects and Methods] This study was performed by targeting 15 elderly subjects with mild depression who resided in the local community. The targeted subjects voluntarily selected 3 VR exercise programs (each lasting 10 minutes) among 4 activities, and a resting time of 5 minutes was given for an interval after each activity. The VR exercise program was performed for total 12 weeks (36 times), 3 times a week, 45 minutes per session. [Results] After exercise, scores of static balance test (anteroposterior), Falls Efficacy Scale, and the Activities-specific Balance Confidence Scale in the test subjects were improved and depression and internal stress scores were significantly decreased after the intervention. [Conclusion] It can be concluded that the VR exercise program exerts a positive effect not only on the physical factor but also on the mental factor of the elderly subjects with mild depression who reside in the local community. It is expected that based on the VR exercise program, diversified home programs for the elderly should be developed in the future.

Efficacy of an Electromechanical Gait Trainer Poststroke in Singapore: A Randomized Controlled Trial.

PubMed

Chua, Joyce; Culpan, Jane; Menon, Edward

2016-05-01

To evaluate the longer-term effects of electromechanical gait trainers (GTs) combined with conventional physiotherapy on health status, function, and ambulation in people with subacute stroke in comparison with conventional physiotherapy given alone. Randomized controlled trial with intention-to-treat analysis. Community hospital in Singapore. Nonambulant individuals (N=106) recruited approximately 1 month poststroke. Both groups received 45 minutes of physiotherapy 6 times per week for 8 weeks as follows: the GT group received 20 minutes of GT training and 5 minutes of stance/gait training in contrast with 25 minutes of stance/gait training for the control group. Both groups completed 10 minutes of standing and 10 minutes of cycling. The primary outcome was the Functional Ambulation Category (FAC). Secondary outcomes were the Barthel Index (BI), gait speed and endurance, and Stroke Impact Scale (SIS). Measures were taken at baseline and 4, 8, 12, 24, and 48 weeks. Generalized linear model analysis showed significant improvement over time (independent of group) for the FAC, BI, and SIS physical and participation subscales. However, no significant group × time or group differences were observed for any of the outcome variables after generalized linear model analysis. The use of GTs combined with conventional physiotherapy can be as effective as conventional physiotherapy applied alone for people with subacute stroke. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A Census of Atmospheric Variability From Seconds to Decades

NASA Astrophysics Data System (ADS)

Williams, Paul D.; Alexander, M. Joan; Barnes, Elizabeth A.; Butler, Amy H.; Davies, Huw C.; Garfinkel, Chaim I.; Kushnir, Yochanan; Lane, Todd P.; Lundquist, Julie K.; Martius, Olivia; Maue, Ryan N.; Peltier, W. Richard; Sato, Kaoru; Scaife, Adam A.; Zhang, Chidong

2017-11-01

This paper synthesizes and summarizes atmospheric variability on time scales from seconds to decades through a phenomenological census. We focus mainly on unforced variability in the troposphere, stratosphere, and mesosphere. In addition to atmosphere-only modes, our scope also includes coupled modes, in which the atmosphere interacts with the other components of the Earth system, such as the ocean, hydrosphere, and cryosphere. The topics covered include turbulence on time scales of seconds and minutes, gravity waves on time scales of hours, weather systems on time scales of days, atmospheric blocking on time scales of weeks, the Madden-Julian Oscillation on time scales of months, the Quasi-Biennial Oscillation and El Niño-Southern Oscillation on time scales of years, and the North Atlantic, Arctic, Antarctic, Pacific Decadal, and Atlantic Multidecadal Oscillations on time scales of decades. The paper serves as an introduction to a special collection of Geophysical Research Letters on atmospheric variability. We hope that both this paper and the collection will serve as a useful resource for the atmospheric science community and will act as inspiration for setting future research directions.

The validity of a simple outcome measure to assess stuttering therapy.

PubMed

Huinck, Wendy; Rietveld, Toni

2007-01-01

The validity of a simple and not time-consuming self-assessment (SA) Scale was tested to establish progress after or during stuttering therapy. The scores on the SA scale were related to (1) objective measures (percentage of stuttered syllables, and syllables per minute) and (2) (self-)evaluation tests (self-evaluation questionnaires and perceptual evaluations or judgments of disfluency, naturalness and comfort by naïve listeners). Data were collected from two groups of stutterers at four measurement times: pretherapy, posttherapy, 12 months after therapy and 24 months after therapy. The first group attended the Comprehensive Stuttering Program: an integrated program based on fluency shaping techniques, and the second group participated in a Dutch group therapy: the Doetinchem Method that focuses on emotions and cognitions related to stuttering. Results showed similar score patterns on the SA scale, the self-evaluation questionnaires, the objective measures over time, and significant correlations between the SA scale and syllables per minute, percentage of stuttered syllables, Struggle subscale of the Perceptions of Stuttering Inventory and judged fluency on the T1-T2 difference scores. We concluded that the validity of the SA measure was proved and therefore encourage the use of such an instrument when (stuttering) treatment efficacy is studied.

Effects of intraoperative dexmedetomidine with intravenous anesthesia on postoperative emergence agitation/delirium in pediatric patients undergoing tonsillectomy with or without adenoidectomy: A CONSORT-prospective, randomized, controlled clinical trial.

PubMed

Cao, Jun-Li; Pei, Yu-Ping; Wei, Jing-Qiu; Zhang, Yue-Ying

2016-12-01

Postoperative emergence agitation/delirium (POED) is a common complication in pediatric surgery patients, which increases the risk of developing postoperative airway obstruction and respiratory depression. This study aims to investigate the safety and efficacy of intraoperative infusion of dexmedetomidine (DEX) and its effects on POED in pediatric patients undergoing tonsillectomy with or without adenoidectomy.Sixty patients scheduled for tonsillectomy with or without adenoidectomy, aged 2 to 8 years, were randomly allocated into 2 groups (n = 30). Pediatric patients in the group DEX received intravenous (IV) DEX 1 μg/kg over 10 minutes, followed by 0.5 μg/kg/h continuous infusion, and the same volume of 0.9% saline was administrated in the group control. Anesthesia was maintained with target-controlled infusion (TCI) of propofol and remifentanyl. Intraoperative heart rate (HR), noninvasive blood pressure (NIBP), blood oxygen saturation (SPO2), recovery time, and extubation time were recorded. Pain level was evaluated using the objective pain score (OPS), pediatric anesthesia emergence delirium (PAED) scale and Cole 5-point scale (CPS) was used to evaluate POED when patients at 0, 5, 15 minutes, and then at intervals of 15 minutes for 60 minutes after parents arrival at postanesthesia care unit (PACU).The results showed that intraoperative HR was significantly lower in group DEX (P <0.05), mean diastolic and systolic NIBP was not statistically different between groups. Time to wake and time to extubation were lengthened in group DEX as compared with group control (P <0.05). OPS and CPS were lower in group DEX at 15, 30, and 45 minutes time points (P <0.05); however, there were no significantly differences in the PAED score at different time points in the PACU.The present data suggested that intraoperative infusion of dexmedetomidine combined with intravenous anesthetics can provide satisfactory intraoperative conditions for pediatric patients undergoing tonsillectomy with or without adenoidectomy, without adverse hemodynamic effects, though the lower incidence of POED was not observed.

Treatment With Tissue Plasminogen Activator in the Golden Hour and the Shape of the 4.5-Hour Time-Benefit Curve in the National United States Get With The Guidelines-Stroke Population.

PubMed

Kim, Joon-Tae; Fonarow, Gregg C; Smith, Eric E; Reeves, Mathew J; Navalkele, Digvijaya D; Grotta, James C; Grau-Sepulveda, Maria V; Hernandez, Adrian F; Peterson, Eric D; Schwamm, Lee H; Saver, Jeffrey L

2017-01-10

Earlier tissue plasminogen activator treatment improves ischemic stroke outcome, but aspects of the time-benefit relationship still not well delineated are: (1) the degree of additional benefit accrued with treatment in the first 60 minutes after onset, and (2) the shape of the time-benefit curve through 4.5 hours. We analyzed patients who had acute ischemic stroke treated with intravenous tissue plasminogen activator within 4.5 hours of onset from the Get With The Guidelines-Stroke US national program. Onset-to-treatment time was analyzed as a continuous, potentially nonlinear variable and as a categorical variable comparing patients treated within 60 minutes of onset with later epochs. Among 65 384 tissue plasminogen activator-treated patients, the median onset-to-treatment time was 141 minutes (interquartile range, 110-173) and 878 patients (1.3%) were treated within the first 60 minutes. Treatment within 60 minutes, compared with treatment within 61 to 270 minutes, was associated with increased odds of discharge to home (adjusted odds ratio, 1.25; 95% confidence interval, 1.07-1.45), independent ambulation at discharge (adjusted odds ratio, 1.22; 95% confidence interval, 1.03-1.45), and freedom from disability (modified Rankin Scale 0-1) at discharge (adjusted odds ratio, 1.72; 95% confidence interval, 1.21-2.46), without increased hemorrhagic complications or in-hospital mortality. The pace of decline in benefit of tissue plasminogen activator from onset-to-treatment times of 20 through 270 minutes was mildly nonlinear for discharge to home, with more rapid benefit loss in the first 170 minutes than later, and linear for independent ambulation and in-hospital mortality. Thrombolysis started within the first 60 minutes after onset is associated with best outcomes for patients with acute ischemic stroke, and benefit declined more rapidly early after onset for the ability to be discharged home. These findings support intensive efforts to organize stroke systems of care to improve the timeliness of thrombolytic therapy in acute ischemic stroke. © 2016 American Heart Association, Inc.

Scaling behavior studies of Ar{sup +} ion irradiated ripple structured mica surfaces

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

Metya, Amaresh, E-mail: amaresh.metya@saha.ac.in; Ghose, Debabrata, E-mail: amaresh.metya@saha.ac.in

We have studied scaling behavior of ripple structured mica surfaces. Clean mica (001) surface is sputtered by 500 eV Ar{sup +} ion beam at 40° incidence angle for different time ranging from 28 minutes to 245 minutes to form ripples on it. The scaling of roughness of sputtered surface characterized by AFM is observed into two regime here; one is super roughening which is for above the crossover bombardment time (i.e, t{sub x} ≥ 105 min) with the scaling exponents α = α{sub s} = 1.45 ± 0.03, α{sub local} = 0.87 ± 0.03, β = 1.81 ± 0.01, β{submore » local} = 1.67 ± 0.07 and another is a new type of scaling dynamics for t{sub x} ≤ 105 min with the scaling exponents α = 0.95 (calculated), α{sub s} = 1.45 ± 0.03, α{sub local} = 0.87 ± 0.03, β = 1.81 ± 0.01, β{sub local} = 1.67 ± 0.07. In the super roughening scaling dynamics, two types of power law dependency is observed on spatial frequency of morphology (k): for higher k values PSD ∼ k{sup −4} describing diffusion controlled smoothening and for lower k values PSD ∼ k{sup −2} reflecting kinetic roughening.« less

Prehospital Emergency Care in Childhood Arterial Ischemic Stroke.

PubMed

Stojanovski, Belinda; Monagle, Paul T; Mosley, Ian; Churilov, Leonid; Newall, Fiona; Hocking, Grant; Mackay, Mark T

2017-04-01

Immediately calling an ambulance is the key factor in reducing time to hospital presentation for adult stroke. Little is known about prehospital care in childhood arterial ischemic stroke (AIS). We aimed to determine emergency medical services call-taker and paramedic diagnostic sensitivity and to describe timelines of care in childhood AIS. This is a retrospective study of ambulance-transported children aged <18 years with first radiologically confirmed AIS, from 2008 to 2015. Interhospital transfers of children with preexisting AIS diagnosis were excluded. Twenty-three children were identified; 4 with unavailable ambulance records were excluded. Nineteen children were included in the study. Median age was 8 years (interquartile range, 3-14); median Pediatric National Institutes of Stroke Severity Scale score was 8 (interquartile range, 3-16). Emergency medical services call-taker diagnosis was stroke in 4 children (21%). Priority code 1 (lights and sirens) ambulances were dispatched for 13 children (68%). Paramedic diagnosis was stroke in 5 children (26%), hospital prenotification occurred in 8 children (42%), and 13 children (68%) were transported to primary stroke centers. Median prehospital timelines were onset to emergency medical services contact 13 minutes, call to scene 12 minutes, time at scene 14 minutes, transport time 43 minutes, and total prehospital time 71 minutes (interquartile range, 60-85). Emergency medical services call-taker and paramedic diagnostic sensitivity and prenotification rates are low in childhood AIS. © 2017 American Heart Association, Inc.

Revisiting the “Golden Hour”: An Evaluation of Out-of-Hospital Time in Shock and Traumatic Brain Injury

PubMed Central

Newgard, Craig D.; Meier, Eric N.; Bulger, Eileen M.; Buick, Jason; Sheehan, Kellie; Lin, Steve; Minei, Joseph P.; Barnes-Mackey, Roxy A.; Brasel, Karen

2015-01-01

Study Objective We evaluated shock and traumatic brain injury (TBI) patients previously enrolled in an out-of-hospital clinical trial to test the association between out-of-hospital time and outcome. Methods This was a secondary analysis of shock and TBI patients ≥ 15 years enrolled in a Resuscitation Outcomes Consortium out-of-hospital clinical trial by 81 EMS agencies transporting to 46 Level I and II trauma centers in 11 sites (May 2006 through May 2009). Inclusion criteria were: SBP ≤ 70 mmHg or SBP 71 - 90 mmHg with heart rate ≥ 108 beats per minute (shock cohort) and Glasgow Coma Scale score ≤ 8 (TBI cohort); patients meeting both criteria were placed in the shock cohort. Primary outcomes were 28-day mortality (shock cohort) and 6-month Glasgow Outcome Scale - Extended (GOSE) ≤ 4 (TBI cohort). Results There were 778 patients in the shock cohort (26% 28-day mortality) and 1,239 patients in the TBI cohort (53% 6-month GOSE ≤ 4). Out-of-hospital time > 60 minutes was not associated with worse outcomes after accounting for important confounders in the shock cohort (adjusted odds ratio [aOR] 1.42, 95% CI 0.77-2.62) or TBI cohort (aOR 0.80, 95% CI 0.52-1.21). However, shock patients requiring early critical hospital resources and arriving > 60 minutes had higher 28-day mortality (aOR 2.37, 95% CI 1.05-5.37); this finding was not observed among a similar TBI subgroup. Conclusions Among out-of-hospital trauma patients meeting physiologic criteria for shock and TBI, there was no association between time and outcome. However, the subgroup of shock patients requiring early critical resources arriving after 60 minutes had higher mortality. PMID:25596960

Quantifying Stock Return Distributions in Financial Markets

PubMed Central

Botta, Federico; Moat, Helen Susannah; Stanley, H. Eugene; Preis, Tobias

2015-01-01

Being able to quantify the probability of large price changes in stock markets is of crucial importance in understanding financial crises that affect the lives of people worldwide. Large changes in stock market prices can arise abruptly, within a matter of minutes, or develop across much longer time scales. Here, we analyze a dataset comprising the stocks forming the Dow Jones Industrial Average at a second by second resolution in the period from January 2008 to July 2010 in order to quantify the distribution of changes in market prices at a range of time scales. We find that the tails of the distributions of logarithmic price changes, or returns, exhibit power law decays for time scales ranging from 300 seconds to 3600 seconds. For larger time scales, we find that the distributions tails exhibit exponential decay. Our findings may inform the development of models of market behavior across varying time scales. PMID:26327593

Quantifying Stock Return Distributions in Financial Markets.

PubMed

Botta, Federico; Moat, Helen Susannah; Stanley, H Eugene; Preis, Tobias

2015-01-01

Being able to quantify the probability of large price changes in stock markets is of crucial importance in understanding financial crises that affect the lives of people worldwide. Large changes in stock market prices can arise abruptly, within a matter of minutes, or develop across much longer time scales. Here, we analyze a dataset comprising the stocks forming the Dow Jones Industrial Average at a second by second resolution in the period from January 2008 to July 2010 in order to quantify the distribution of changes in market prices at a range of time scales. We find that the tails of the distributions of logarithmic price changes, or returns, exhibit power law decays for time scales ranging from 300 seconds to 3600 seconds. For larger time scales, we find that the distributions tails exhibit exponential decay. Our findings may inform the development of models of market behavior across varying time scales.

Formation of nitrogen-containing oligomers by methylglyoxal and amines in simulated evaporating cloud droplets.

PubMed

De Haan, David O; Hawkins, Lelia N; Kononenko, Julia A; Turley, Jacob J; Corrigan, Ashley L; Tolbert, Margaret A; Jimenez, Jose L

2011-02-01

Reactions of methylglyoxal with amino acids, methylamine, and ammonium sulfate can take place in aqueous aerosol and evaporating cloud droplets. These processes are simulated by drying droplets and bulk solutions of these compounds (at low millimolar and 1 M concentrations, respectively) and analyzing the residuals by scanning mobility particle sizing, nuclear magnetic resonance, aerosol mass spectrometry (AMS), and electrospray ionization MS. The results are consistent with imine (but not diimine) formation on a time scale of seconds, followed by the formation of nitrogen-containing oligomers, methylimidazole, and dimethylimidazole products on a time scale of minutes to hours. Measured elemental ratios are consistent with imidazoles and oligomers being major reaction products, while effective aerosol densities suggest extensive reactions take place within minutes. These reactions may be a source of the light-absorbing, nitrogen-containing oligomers observed in urban and biomass-burning aerosol particles.

Influence of spasticity on mobility and balance in persons with multiple sclerosis.

PubMed

Sosnoff, Jacob J; Gappmaier, Eduard; Frame, Amy; Motl, Robert W

2011-09-01

Spasticity is a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes that presumably affects mobility and balance. This investigation examined the hypothesis that persons with multiple sclerosis (MS) who have spasticity of the lower legs would have more impairment of mobility and balance compared to those without spasticity. Participants were 34 ambulatory persons with a definite diagnosis of MS. The expanded disability status scale (EDSS) was used to characterize disability in the study sample. All participants underwent measurements of spasticity in the gastroc-soleus muscles of both legs (modified Ashworth scale), walking speed (timed 25-foot walk), mobility (Timed Up and Go), walking endurance (6-minute walk test), self-reported impact of MS on walking ability (Multiple Sclerosis Walking Scale-12), and balance (Berg Balance Test and Activities-specific Balance Confidence Scale). Fifteen participants had spasticity of the gastroc-soleus muscles based on modified Ashworth scale scores. The spasticity group had lower median EDSS scores indicating greater disability (P=0.03). Mobility and balance were significantly more impaired in the group with spasticity compared to the group without spasticity: timed 25-foot walk (P = 0.02, d = -0.74), Timed Up and Go (P = 0.01, d = -0.84), 6-minute walk test (P < 0.01, d = 1.03), Multiple Sclerosis Walking Scale-12 (P = 0.04, d = -0.76), Berg Balance Test (P = 0.02, d = -0.84) and Activities-specific Balance Confidence Scale (P = 0.04, d = -0.59). Spasticity in the gastroc-soleus muscles appears to have negative effect on mobility and balance in persons with MS. The relationship between spasticity and disability in persons with MS requires further exploration.

Time scales involved in emergent market coherence

NASA Astrophysics Data System (ADS)

Kwapień, J.; Drożdż, S.; Speth, J.

2004-06-01

In addressing the question of the time scales characteristic for the market formation, we analyze high-frequency tick-by-tick data from the NYSE and from the German market. By using returns on various time scales ranging from seconds or minutes up to 2 days, we compare magnitude of the largest eigenvalue of the correlation matrix for the same set of securities but for different time scales. For various sets of stocks of different capitalization (and the average trading frequency), we observe a significant elevation of the largest eigenvalue with increasing time scale. Our results from the correlation matrix study can be considered as a manifestation of the so-called Epps effect. There is no unique explanation of this effect and it seems that many different factors play a role here. One of such factors is randomness in transaction moments for different stocks. Another interesting conclusion to be drawn from our results is that in the contemporary markets the emergence of significant correlations occurs on time scales much smaller than in the more distant history.

NUMERICAL SIMULATIONS OF CORONAL HEATING THROUGH FOOTPOINT BRAIDING

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

Hansteen, V.; Pontieu, B. De; Carlsson, M.

2015-10-01

Advanced three-dimensional (3D) radiative MHD simulations now reproduce many properties of the outer solar atmosphere. When including a domain from the convection zone into the corona, a hot chromosphere and corona are self-consistently maintained. Here we study two realistic models, with different simulated areas, magnetic field strength and topology, and numerical resolution. These are compared in order to characterize the heating in the 3D-MHD simulations which self-consistently maintains the structure of the atmosphere. We analyze the heating at both large and small scales and find that heating is episodic and highly structured in space, but occurs along loop-shaped structures, andmore » moves along with the magnetic field. On large scales we find that the heating per particle is maximal near the transition region and that widely distributed opposite-polarity field in the photosphere leads to a greater heating scale height in the corona. On smaller scales, heating is concentrated in current sheets, the thicknesses of which are set by the numerical resolution. Some current sheets fragment in time, this process occurring more readily in the higher-resolution model leading to spatially highly intermittent heating. The large-scale heating structures are found to fade in less than about five minutes, while the smaller, local, heating shows timescales of the order of two minutes in one model and one minutes in the other, higher-resolution, model.« less

Development of an Encompassing Questionnaire for Evaluating the Outcomes Following Total Knee Arthroplasty.

PubMed

Chughtai, Morad; Khlopas, Anton; Thomas, Melbin; Gwam, Chukwuweike U; Jauregui, Julio J; Elmallah, Randa K; Roche, Martin; Delanois, Ronald E

2017-01-10

There are many standardized scales and questionnaires used to evaluate TKA patients; however, individually they do not always assess patients adequately. Consequently, many are used in combinations to provide a thorough evaluation. However, this leads to redundancy, confusion, and an excessive patient time-burden. Therefore, the purpose of this study was to develop a usable combined knee questionnaire that combines questions in a non-redundant manner. Specifically, we aimed to: 1) create a combined knee questionnaire that encompasses questions from multiple systems, while eliminating redundancy; 2) correlate the new system with the existing validated questionnaires; and 3) determine the length of time it takes to administer this new questionnaire. In a previous study, it was determined that the six most commonly cited validated systems to assess the knee were the: Knee Society Score (KSS), The Western Ontario and McMaster Universities Arthritis Index (WOMAC), Knee injury and Osteoarthritis Outcome Score (KOOS), Lower Extremity Functional Scale (LEFS), Activity Rating Scale (ARS), and Short-Form-36 (SF-36). Therefore, we ensured that the new questionnaire encompassed all elements of these systems. After development of the combined questionnaire, we co-administered it to 20 subjects alongside the above validated questionnaires. We then transposed the corresponding answers from the combined questionnaire to each selected validated system to perform an intra-class correlation analysis. In addition, we recorded the length of time it took to administer the new questionnaire and compared it to the time it took to administer the individual validated questionnaires. Intra-class correlation analysis demonstrated statistically significant positive correlations between the KSS, WOMAC, KOOS, LEFS, ARS, SF-36, and the corresponding questions in the combined questionnaire. The mean length of time it took to administer the combined questionnaire (mean, 10.1 minutes, range, 6.6 to 12.6 minutes) was significantly shorter than the time it took to administer the selected validated questionnaires (mean, 21.3 minutes, range, 17.3 to 24.1 minutes). We have proposed an all-encompassing combined knee questionnaire that eliminates redundancy and inefficiency during the evaluation of TKA patients. It is a reliable, time-efficient system that can be utilized to fill out the most commonly used questionnaires for assessing TKA. Standardization and uniform use of this questionnaire may simplify future patient assessment following TKA.

Assessing self-care and social function using a computer adaptive testing version of the pediatric evaluation of disability inventory.

PubMed

Coster, Wendy J; Haley, Stephen M; Ni, Pengsheng; Dumas, Helene M; Fragala-Pinkham, Maria A

2008-04-01

To examine score agreement, validity, precision, and response burden of a prototype computer adaptive testing (CAT) version of the self-care and social function scales of the Pediatric Evaluation of Disability Inventory compared with the full-length version of these scales. Computer simulation analysis of cross-sectional and longitudinal retrospective data; cross-sectional prospective study. Pediatric rehabilitation hospital, including inpatient acute rehabilitation, day school program, outpatient clinics; community-based day care, preschool, and children's homes. Children with disabilities (n=469) and 412 children with no disabilities (analytic sample); 38 children with disabilities and 35 children without disabilities (cross-validation sample). Not applicable. Summary scores from prototype CAT applications of each scale using 15-, 10-, and 5-item stopping rules; scores from the full-length self-care and social function scales; time (in seconds) to complete assessments and respondent ratings of burden. Scores from both computer simulations and field administration of the prototype CATs were highly consistent with scores from full-length administration (r range, .94-.99). Using computer simulation of retrospective data, discriminant validity, and sensitivity to change of the CATs closely approximated that of the full-length scales, especially when the 15- and 10-item stopping rules were applied. In the cross-validation study the time to administer both CATs was 4 minutes, compared with over 16 minutes to complete the full-length scales. Self-care and social function score estimates from CAT administration are highly comparable with those obtained from full-length scale administration, with small losses in validity and precision and substantial decreases in administration time.

Effect of time to operation on mortality for hypotensive patients with gunshot wounds to the torso: The golden 10 minutes.

PubMed

Meizoso, Jonathan P; Ray, Juliet J; Karcutskie, Charles A; Allen, Casey J; Zakrison, Tanya L; Pust, Gerd D; Koru-Sengul, Tulay; Ginzburg, Enrique; Pizano, Louis R; Schulman, Carl I; Livingstone, Alan S; Proctor, Kenneth G; Namias, Nicholas

2016-10-01

Timely hemorrhage control is paramount in trauma; however, a critical time interval from emergency department arrival to operation for hypotensive gunshot wound (GSW) victims is not established. We hypothesize that delaying surgery for more than 10 minutes from arrival increases all-cause mortality in hypotensive patients with GSW. Data of adults (n = 309) with hypotension and GSW to the torso requiring immediate operation from January 2004 to September 2013 were retrospectively reviewed. Patients with resuscitative thoracotomies, traumatic brain injury, transfer from outside institutions, and operations occurring more than 1 hour after arrival were excluded. Survival analysis using multivariate Cox regression models was used for comparison. Hazard ratios (HRs) and 95% confidence intervals (CIs) are reported. Statistical significance was considered at p ≤ 0.05. The study population was aged 32 ± 12 years, 92% were male, Injury Severity Score was 24 ± 15, systolic blood pressure was 81 ± 29 mm Hg, Glasgow Coma Scale score was 13 ± 4. Overall mortality was 27%. Mean time to operation was 19 ± 13 minutes. After controlling for organ injury, patients who arrived to the operating room after 10 minutes had a higher likelihood of mortality compared with those who arrived in 10 minutes or less (HR, 1.89; 95% CI, 1.10-3.26; p = 0.02); this was also true in the severely hypotensive patients with systolic blood pressure of 70 mm Hg or less (HR, 2.67; 95% CI, 0.97-7.34; p = 0.05). The time associated with a 50% cumulative mortality was 16 minutes. Delay to the operating room of more than 10 minutes increases the risk of mortality by almost threefold in hypotensive patients with GSW. Protocols should be designed to shorten time in the emergency department. Further prospective observational studies are required to validate these findings. Therapeutic study, level IV.

Perceived exertion responses to changing resistance training programming variables.

PubMed

Hiscock, Daniel J; Dawson, Brian; Peeling, Peter

2015-06-01

This study examined the influence of intensity (%1 repetition maximum [1RM]), tonnage (sets × repetitions × load), rate of fatigue (percentage decrement in repetitions from set to set), work rate (total tonnage per unit of time), rest interval (time between sets), time under load, and session duration on session rating of perceived exertion (sRPE: Borg's CR-10 scale). Here, participants performed a standardized lifting session of 5 exercises (bench press, leg press, lat pulldown, leg curl, and triceps pushdown) as either: (a) 3 sets × 8 repetitions × 3-minute recovery at 70% 1RM, (b) 3 sets × 14 repetitions × 3-minute recovery at 40% 1RM, (c) 3 sets × MNR (maximum number of repetitions) × 1-minute recovery at 70% 1RM, (d) 3 sets × MNR × 3-minute recovery at 70% 1RM, (e) 3 sets × MNR × 1-minute recovery at 40% 1RM, or (f) 3 sets × MNR × 3-minute recovery at 40% 1RM. The sRPE for session A (4 ± 1) was significantly higher than session B (2.5 ± 1), despite matched tonnage. Protocols involving MNR showed no significant difference in sRPE. Work rate was the only variable to significantly relate with sRPE (r = 0.45). Additionally, sRPE at 15-minute postexercise (5 ± 2) was not different to 30-minute postexercise (5 ± 2). In resistance training with matched tonnage and rest duration between sets, sRPE increases with intensity. In sets to volitional failure, sRPE is likely to be similar, regardless of intensity or rest duration between sets.

Extending the time window for endovascular procedures according to collateral pial circulation.

PubMed

Ribo, Marc; Flores, Alan; Rubiera, Marta; Pagola, Jorge; Sargento-Freitas, Joao; Rodriguez-Luna, David; Coscojuela, Pilar; Maisterra, Olga; Piñeiro, Socorro; Romero, Francisco J; Alvarez-Sabin, Jose; Molina, Carlos A

2011-12-01

Good collateral pial circulation (CPC) predicts a favorable outcome in patients undergoing intra-arterial procedures. We aimed to determine if CPC status may be used to decide about pursuing recanalization efforts. Pial collateral score (0-5) was determined on initial angiogram. We considered good CPC when pial collateral score<3, defined total time of ischemia (TTI) as onset-to-recanalization time, and clinical improvement>4-point decline in admission-discharge National Institutes of Health Stroke Scale. We studied CPC in 61 patients (31 middle cerebral artery, 30 internal carotid artery). Good CPC patients (n=21 [34%]) had lower discharge National Institutes of Health Stroke Scale score (7 versus 21; P=0.02) and smaller infarcts (56 mL versus 238 mL; P<0.001). In poor CPC patients, a receiver operating characteristic curve defined a TTI cutoff point<300 minutes (sensitivity 67%, specificity 75%) that better predicted clinical improvement (TTI<300: 66.7% versus TTI>300: 25%; P=0.05). For good CPC patients, no temporal cutoff point could be defined. Although clinical improvement was similar for patients recanalizing within 300 minutes (poor CPC: 60% versus good CPC: 85.7%; P=0.35), the likelihood of clinical improvement was 3-fold higher after 300 minutes only in good CPC patients (23.1% versus 90.1%; P=0.01). Similarly, infarct volume was reduced 7-fold in good as compared with poor CPC patients only when TTI>300 minutes (TTI<300: poor CPC: 145 mL versus good CPC: 93 mL; P=0.56 and TTI>300: poor CPC: 217 mL versus good CPC: 33 mL; P<0.01). After adjusting for age and baseline National Institutes of Health Stroke Scale score, TTI<300 emerged as an independent predictor of clinical improvement in poor CPC patients (OR, 6.6; 95% CI, 1.01-44.3; P=0.05) but not in good CPC patients. In a logistic regression, good CPC independently predicted clinical improvement after adjusting for TTI, admission National Institutes of Health Stroke Scale score, and age (OR, 12.5; 95% CI, 1.6-74.8; P=0.016). Good CPC predicts better clinical response to intra-arterial treatment beyond 5 hours from onset. In patients with stroke receiving endovascular treatment, identification of good CPC may help physicians when considering pursuing recanalization efforts in late time windows.

Reversal of soft-tissue local anesthesia with phentolamine mesylate in adolescents and adults.

PubMed

Hersh, Elliot V; Moore, Paul A; Papas, Athena S; Goodson, J Max; Navalta, Laura A; Rogy, Siegfried; Rutherford, Bruce; Yagiela, John A

2008-08-01

The authors conducted two multicenter, randomized, double-blinded, controlled Phase III clinical trials to study the efficacy and safety of phentolamine mesylate (PM) in shortening the duration and burden of soft-tissue anesthesia. The study involved 484 subjects who received one of four commercially available local anesthetic solutions containing vasoconstrictors for restorative or scaling procedures. On completion of the dental procedure, subjects randomly received a PM or a sham injection (an injection in which a needle does not penetrate the soft tissue) in the same site as the local anesthetic injection. The investigators measured the duration of soft-tissue anesthesia by using standardized lip- and tongue-tapping procedures every five minutes for five hours. They also evaluated functional measures and subject-perceived altered function, sensation, appearance and safety. Median recovery times in the lower lip and tongue for subjects in the PM group were 70 minutes and 60 minutes, respectively. Median recovery times in the lower lip and tongue for subjects in the sham group were 155 minutes and 125 minutes, respectively. Upper lip median recovery times were 50 minutes for subjects in the PM group and 133 minutes for subjects in the sham group. These differences were significant (P < .0001). Recovery from actual functional deficits and subject-perceived altered function, sensation and appearance also showed significant differences between the PM and the sham groups. PM was efficacious and safe in reducing the duration of local anesthetic- induced soft-tissue numbness and its associated functional deficits. Clinicians can use PM to accelerate reversal of soft-tissue anesthesia and the associated functional deficits.

Metabolic Imaging in Multiple Time Scales

PubMed Central

Ramanujan, V Krishnan

2013-01-01

We report here a novel combination of time-resolved imaging methods for probing mitochondrial metabolism multiple time scales at the level of single cells. By exploiting a mitochondrial membrane potential reporter fluorescence we demonstrate the single cell metabolic dynamics in time scales ranging from milliseconds to seconds to minutes in response to glucose metabolism and mitochondrial perturbations in real time. Our results show that in comparison with normal human mammary epithelial cells, the breast cancer cells display significant alterations in metabolic responses at all measured time scales by single cell kinetics, fluorescence recovery after photobleaching and by scaling analysis of time-series data obtained from mitochondrial fluorescence fluctuations. Furthermore scaling analysis of time-series data in living cells with distinct mitochondrial dysfunction also revealed significant metabolic differences thereby suggesting the broader applicability (e.g. in mitochondrial myopathies and other metabolic disorders) of the proposed strategies beyond the scope of cancer metabolism. We discuss the scope of these findings in the context of developing portable, real-time metabolic measurement systems that can find applications in preclinical and clinical diagnostics. PMID:24013043

Prehospital Agitation and Sedation Trial (PhAST): A Randomized Control Trial of Intramuscular Haloperidol versus Intramuscular Midazolam for the Sedation of the Agitated or Violent Patient in the Prehospital Environment.

PubMed

Isenberg, Derek L; Jacobs, Dorian

2015-10-01

Violent patients in the prehospital environment pose a threat to health care workers tasked with managing their medical conditions. While research has focused on methods to control the agitated patient in the emergency department (ED), there is a paucity of data looking at the optimal approach to subdue these patients safely in the prehospital setting. Hypothesis This study evaluated the efficacy of two different intramuscular medications, midazolam and haloperidol, to determine their efficacy in sedating agitated patients in the prehospital setting. This was a prospective, randomized, observational trial wherein agitated patients were administered intramuscular haloperidol or intramuscular midazolam to control agitation. Agitation was quantified by the Richmond Agitation and Sedation Scale (RASS). Paramedics recorded the RASS and vital signs every five minutes during transport and again upon arrival to the ED. The primary outcome was mean time to achieve a RASS less than +1. Secondary outcomes included mean time for patients to return to baseline mental status and adverse events. Five patients were enrolled in each study group. In the haloperidol group, the mean time to achieve a RASS score of less than +1 was 24.8 minutes (95% CI, 8-49 minutes), and the mean time for the return of a normal mental status was 84 minutes (95% CI, 0-202 minutes). Two patients required additional prehospital doses for adequate sedation. There were no adverse events recorded in the patients administered haloperidol. In the midazolam group, the mean time to achieve a RASS score of less than +1 was 13.5 minutes (95% CI, 8-19 minutes) and the mean time for the return of normal mental status was 105 minutes (95% CI, 0-178 minutes). One patient required additional sedation in the ED. There were no adverse events recorded among the patients administered midazolam. Midazolam and haloperidol administered intramuscularly appear equally effective for sedating an agitated patient in the prehospital setting. Midazolam appears to have a faster onset of action, as evidenced by the shorter time required to achieve a RASS score of less than +1 in the patients who received midazolam. Haloperidol offers an alternative option for the sedation of an agitated patient. Further studies should focus on continued investigation into appropriate sedation of agitated patients in the prehospital setting.

Status of candidate materials for full-scale tests in the 737 fuselage

NASA Technical Reports Server (NTRS)

Supkis, D.

1979-01-01

The test program has the objectives to: (1) increase passenger evacuation time to a minimum of five minutes from commercial aircraft in case of a fire; (2) prevent an external fire from entering closed cabins for five minutes by using fire barrier materials in the exterior wall; (3) demonstrate that a closed cabin will not reach 400 F; and (4) prove that a fire near a cabin opening will not propagate through the cabin for a minimum of five minutes. The materials status is outlined for seat cushions, upholstery and associated seat materials, wall and ceiling panels, floor panels, carpet and carpet underlay, windows, cargo bay liners, insulation bagging, and thermal acoustical insulation.

Time-Resolved Photometry of V458 Vul

NASA Astrophysics Data System (ADS)

Bouzid, Samia; Garnavich, P.

2011-01-01

We observed V458 Vul (Nova Vul 2007) over four nights in June, 2010, nearly three years after its nova outburst. Time-resolved photometry was obtained at the Vatican Advanced Technology Telescope (VATT) on Mt. Graham, Arizona, covering 2 to 4 hour spans with a cadence of 30 sec. The first night of data shows a clear 20 minute periodicity with a 0.1 magnitude amplitude. On subsequent nights, power-spectral analysis continues to show variations with a time scale of 20 minutes, but the irregularity of the signal suggests that this is a quasi-periodic oscillation. The 98-minute orbital period is not evident in our observations. V458 Vul is the central star of a planetary nebula. Combining our CCD images suggests a light echo from the nova outburst is scattering off of material in the nebula to the northwest of the central star. Appreciation goes to the National Science Foundation for supporting this project through the Research Experience for Undergraduates program at Notre Dame.

Reliability and Clinical Significance of Mobility and Balance Assessments in Multiple Sclerosis

ERIC Educational Resources Information Center

Learmonth, Yvonne C.; Paul, Lorna; McFadyen, Angus K.; Mattison, Paul; Miller, Linda

2012-01-01

The aim of the study was to establish the test-retest reliability, clinical significance and precision of four mobility and balance measures--the Timed 25-Foot Walk, Six-minute Walk, Timed Up and Go and the Berg Balance Scale--in individuals moderately affected by multiple sclerosis. Twenty four participants with multiple sclerosis (Extended…

North Star Ambulatory Assessment, 6-minute walk test and timed items in ambulant boys with Duchenne muscular dystrophy.

PubMed

Mazzone, Elena; Martinelli, Diego; Berardinelli, Angela; Messina, Sonia; D'Amico, Adele; Vasco, Gessica; Main, Marion; Doglio, Luca; Politano, Luisa; Cavallaro, Filippo; Frosini, Silvia; Bello, Luca; Carlesi, Adelina; Bonetti, Anna Maria; Zucchini, Elisabetta; De Sanctis, Roberto; Scutifero, Marianna; Bianco, Flaviana; Rossi, Francesca; Motta, Maria Chiara; Sacco, Annalisa; Donati, Maria Alice; Mongini, Tiziana; Pini, Antonella; Battini, Roberta; Pegoraro, Elena; Pane, Marika; Pasquini, Elisabetta; Bruno, Claudio; Vita, Giuseppe; de Waure, Chiara; Bertini, Enrico; Mercuri, Eugenio

2010-11-01

The North Star Ambulatory Assessment is a functional scale specifically designed for ambulant boys affected by Duchenne muscular dystrophy (DMD). Recently the 6-minute walk test has also been used as an outcome measure in trials in DMD. The aim of our study was to assess a large cohort of ambulant boys affected by DMD using both North Star Assessment and 6-minute walk test. More specifically, we wished to establish the spectrum of findings for each measure and their correlation. This is a prospective multicentric study involving 10 centers. The cohort included 112 ambulant DMD boys of age ranging between 4.10 and 17 years (mean 8.18±2.3 DS). Ninety-one of the 112 were on steroids: 37/91 on intermittent and 54/91 on daily regimen. The scores on the North Star assessment ranged from 6/34 to 34/34. The distance on the 6-minute walk test ranged from 127 to 560.6 m. The time to walk 10 m was between 3 and 15 s. The time to rise from the floor ranged from 1 to 27.5 s. Some patients were unable to rise from the floor. As expected the results changed with age and were overall better in children treated with daily steroids. The North Star assessment had a moderate to good correlation with 6-minute walk test and with timed rising from floor but less with 10 m timed walk/run test. The 6-minute walk test in contrast had better correlation with 10 m timed walk/run test than with timed rising from floor. These findings suggest that a combination of these outcome measures can be effectively used in ambulant DMD boys and will provide information on different aspects of motor function, that may not be captured using a single measure. Copyright © 2010. Published by Elsevier B.V.

Lubiprostone decreases the small bowel transit time by capsule endoscopy: an exploratory, randomised, double-blind, placebo-controlled 3-way crossover study.

PubMed

Matsuura, Mizue; Inamori, Masahiko; Endo, Hiroki; Matsuura, Tetsuya; Kanoshima, Kenji; Inoh, Yumi; Fujita, Yuji; Umezawa, Shotaro; Fuyuki, Akiko; Uchiyama, Shiori; Higurashi, Takuma; Ohkubo, Hidenori; Sakai, Eiji; Iida, Hiroshi; Nonaka, Takashi; Futagami, Seiji; Kusakabe, Akihiko; Maeda, Shin; Nakajima, Atsushi

2014-01-01

The aim of this study was to investigate the usefulness of lubiprostone for bowel preparation and as a propulsive agent in small bowel endoscopy. Six healthy male volunteers participated in this randomized, 3-way crossover study. The subjects received a 24 μg tablet of lubiprostone 60 minutes prior to the capsule ingestion for capsule endoscopy (CE) and a placebo tablet 30 minutes before the capsule ingestion (L-P regimen), a placebo tablet 60 minutes prior to CE and a 24 μg tablet of lubiprostone 30 minutes prior to CE (P-L regimen), or a placebo tablet 60 minutes prior to r CE and a placebo tablet again 30 minutes prior to CE (P-P regimen). The quality of the capsule endoscopic images and the amount of water in the small bowel were assessed on 5-point scale. The median SBTT was 178.5 (117-407) minutes in the P-P regimen, 122.5 (27-282) minutes in the L-P regimen, and 110.5 (11-331) minutes in the P-L regimen (P = 0.042). This study showed that the use of lubiprostone significantly decreased the SBTT. We also confirmed that lubiprostone was effective for inducing water secretion into the small bowel during CE.

On Utilization of NEXRAD Scan Strategy Information to Infer Discrepancies Associated With Radar and Rain Gauge Surface Volumetric Rainfall Accumulations

NASA Technical Reports Server (NTRS)

Roy, Biswadev; Datta, Saswati; Jones, W. Linwood; Kasparis, Takis; Einaudi, Franco (Technical Monitor)

2000-01-01

To evaluate the Tropical Rainfall Measuring Mission (TRMM) monthly Ground Validation (GV) rain map, 42 quality controlled tipping bucket rain gauge data (1 minute interpolated rain rates) were utilized. We have compared the gauge data to the surface volumetric rainfall accumulation of NEXRAD reflectivity field, (converting to rain rates using a 0.5 dB resolution smooth Z-R table). The comparison was carried out from data collected at Melbourne, Florida during the month of July 98. GV operational level 3 (L3 monthly) accumulation algorithm was used to obtain surface volumetric accumulations for the radar. The gauge records were accumulated using the 1 minute interpolated rain rates while the radar Volume Scan (VOS) intervals remain less than or equal to 75 minutes. The correlation coefficient for the radar and gauge totals for the monthly time-scale remain at 0.93, however, a large difference was noted between the gauge and radar derived rain accumulation when the radar data interval is either 9 minute, or 10 minute. This difference in radar and gauge accumulation is being explained in terms of the radar scan strategy information. The discrepancy in terms of the Volume Coverage Pattern (VCP) of the NEXRAD is being reported where VCP mode is ascertained using the radar tilt angle information. Hourly radar and gauge accumulations have been computed using the present operational L3 method supplemented with a threshold period of +/- 5 minutes (based on a sensitivity analysis). These radar and gauge accumulations are subsequently improved using a radar hourly scan weighting factor (taking ratio of the radar scan frequency within a time bin to the 7436 total radar scans for the month). This GV procedure is further being improved by introducing a spatial smoothing method to yield reasonable bulk radar to gauge ratio for the hourly and daily scales.

Assessing self-care and social function using a computer adaptive testing version of the Pediatric Evaluation of Disability Inventory Accepted for Publication, Archives of Physical Medicine and Rehabilitation

PubMed Central

Coster, Wendy J.; Haley, Stephen M.; Ni, Pengsheng; Dumas, Helene M.; Fragala-Pinkham, Maria A.

2009-01-01

Objective To examine score agreement, validity, precision, and response burden of a prototype computer adaptive testing (CAT) version of the Self-Care and Social Function scales of the Pediatric Evaluation of Disability Inventory (PEDI) compared to the full-length version of these scales. Design Computer simulation analysis of cross-sectional and longitudinal retrospective data; cross-sectional prospective study. Settings Pediatric rehabilitation hospital, including inpatient acute rehabilitation, day school program, outpatient clinics; community-based day care, preschool, and children’s homes. Participants Four hundred sixty-nine children with disabilities and 412 children with no disabilities (analytic sample); 38 children with disabilities and 35 children without disabilities (cross-validation sample). Interventions Not applicable. Main Outcome Measures Summary scores from prototype CAT applications of each scale using 15-, 10-, and 5-item stopping rules; scores from the full-length Self-Care and Social Function scales; time (in seconds) to complete assessments and respondent ratings of burden. Results Scores from both computer simulations and field administration of the prototype CATs were highly consistent with scores from full-length administration (all r’s between .94 and .99). Using computer simulation of retrospective data, discriminant validity and sensitivity to change of the CATs closely approximated that of the full-length scales, especially when the 15- and 10-item stopping rules were applied. In the cross-validation study the time to administer both CATs was 4 minutes, compared to over 16 minutes to complete the full-length scales. Conclusions Self-care and Social Function score estimates from CAT administration are highly comparable to those obtained from full-length scale administration, with small losses in validity and precision and substantial decreases in administration time. PMID:18373991

Modelling of Sub-daily Hydrological Processes Using Daily Time-Step Models: A Distribution Function Approach to Temporal Scaling

NASA Astrophysics Data System (ADS)

Kandel, D. D.; Western, A. W.; Grayson, R. B.

2004-12-01

Mismatches in scale between the fundamental processes, the model and supporting data are a major limitation in hydrologic modelling. Surface runoff generation via infiltration excess and the process of soil erosion are fundamentally short time-scale phenomena and their average behaviour is mostly determined by the short time-scale peak intensities of rainfall. Ideally, these processes should be simulated using time-steps of the order of minutes to appropriately resolve the effect of rainfall intensity variations. However, sub-daily data support is often inadequate and the processes are usually simulated by calibrating daily (or even coarser) time-step models. Generally process descriptions are not modified but rather effective parameter values are used to account for the effect of temporal lumping, assuming that the effect of the scale mismatch can be counterbalanced by tuning the parameter values at the model time-step of interest. Often this results in parameter values that are difficult to interpret physically. A similar approach is often taken spatially. This is problematic as these processes generally operate or interact non-linearly. This indicates a need for better techniques to simulate sub-daily processes using daily time-step models while still using widely available daily information. A new method applicable to many rainfall-runoff-erosion models is presented. The method is based on temporal scaling using statistical distributions of rainfall intensity to represent sub-daily intensity variations in a daily time-step model. This allows the effect of short time-scale nonlinear processes to be captured while modelling at a daily time-step, which is often attractive due to the wide availability of daily forcing data. The approach relies on characterising the rainfall intensity variation within a day using a cumulative distribution function (cdf). This cdf is then modified by various linear and nonlinear processes typically represented in hydrological and erosion models. The statistical description of sub-daily variability is thus propagated through the model, allowing the effects of variability to be captured in the simulations. This results in cdfs of various fluxes, the integration of which over a day gives respective daily totals. Using 42-plot-years of surface runoff and soil erosion data from field studies in different environments from Australia and Nepal, simulation results from this cdf approach are compared with the sub-hourly (2-minute for Nepal and 6-minute for Australia) and daily models having similar process descriptions. Significant improvements in the simulation of surface runoff and erosion are achieved, compared with a daily model that uses average daily rainfall intensities. The cdf model compares well with a sub-hourly time-step model. This suggests that the approach captures the important effects of sub-daily variability while utilizing commonly available daily information. It is also found that the model parameters are more robustly defined using the cdf approach compared with the effective values obtained at the daily scale. This suggests that the cdf approach may offer improved model transferability spatially (to other areas) and temporally (to other periods).

Near-Surface Flow Fields Deduced Using Correlation Tracking and Time-Distance Analysis

NASA Technical Reports Server (NTRS)

DeRosa, Marc; Duvall, T. L., Jr.; Toomre, Juri

1999-01-01

Near-photospheric flow fields on the Sun are deduced using two independent methods applied to the same time series of velocity images observed by SOI-MDI on SOHO. Differences in travel times between f modes entering and leaving each pixel measured using time-distance helioseismology are used to determine sites of supergranular outflows. Alternatively, correlation tracking analysis of mesogranular scales of motion applied to the same time series is used to deduce the near-surface flow field. These two approaches provide the means to assess the patterns and evolution of horizontal flows on supergranular scales even near disk center, which is not feasible with direct line-of-sight Doppler measurements. We find that the locations of the supergranular outflows seen in flow fields generated from correlation tracking coincide well with the locations of the outflows determined from the time-distance analysis, with a mean correlation coefficient after smoothing of bar-r(sub s) = 0.840. Near-surface velocity field measurements can used to study the evolution of the supergranular network, as merging and splitting events are observed to occur in these images. The data consist of one 2048-minute time series of high-resolution (0.6" pixels) line-of-sight velocity images taken by MDI on 1997 January 16-18 at a cadence of one minute.

Pilates exercise training vs. physical therapy for improving walking and balance in people with multiple sclerosis: a randomized controlled trial.

PubMed

Kalron, Alon; Rosenblum, Uri; Frid, Lior; Achiron, Anat

2017-03-01

Evaluate the effects of a Pilates exercise programme on walking and balance in people with multiple sclerosis and compare this exercise approach to conventional physical therapy sessions. Randomized controlled trial. Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel. Forty-five people with multiple sclerosis, 29 females, mean age (SD) was 43.2 (11.6) years; mean Expanded Disability Status Scale (S.D) was 4.3 (1.3). Participants received 12 weekly training sessions of either Pilates ( n=22) or standardized physical therapy ( n=23) in an outpatient basis. Spatio-temporal parameters of walking and posturography parameters during static stance. Functional tests included the Time Up and Go Test, 2 and 6-minute walk test, Functional Reach Test, Berg Balance Scale and the Four Square Step Test. In addition, the following self-report forms included the Multiple Sclerosis Walking Scale and Modified Fatigue Impact Scale. At the termination, both groups had significantly increased their walking speed ( P=0.021) and mean step length ( P=0.023). According to the 2-minute and 6-minute walking tests, both groups at the end of the intervention program had increased their walking speed. Mean (SD) increase in the Pilates and physical therapy groups were 39.1 (78.3) and 25.3 (67.2) meters, respectively. There was no effect of group X time in all instrumented and clinical balance and gait measures. Pilates is a possible treatment option for people with multiple sclerosis in order to improve their walking and balance capabilities. However, this approach does not have any significant advantage over standardized physical therapy.

Effect of Environmental and Behavioral Interventions on Pain Intensity in Preterm Infants for Heel Prick Blood Sampling in the Neonatal Intensive Care Unit.

PubMed

Baharlooei, Fatemeh; Marofi, Maryam; Abdeyazdan, Zahra

2017-01-01

Recent researches suggest that preterm infants understand pain and stress. Because of the wide range of effects of pain on infants, the present study was conducted on the effect of environmental and behavioral interventions on pain due to heel-prick blood sampling in preterm infants. A clinical trial was conducted among 32 infants with gestational age of 32-37 weeks in the intervention and control groups. The effects of noise reduction by earplugs, light reduction by blindfolds, reduction of nursing manipulation, and creation of intrauterine position for neonates, 30 minutes before taking blood samples until 30 minutes after it, were measured during the intervention stage. Data were collected using the Neonatal Infant Pain Scale (NIPS) in 5 stages (before intervention, 2 minutes before sampling, during the sampling, and 5 minutes and 30 minutes after the sampling). The data were analyzed using analysis of variance (ANOVA) and paired t -test in SPSS software. The paired t -test results showed no significant differences between the control and intervention stages in terms of pain scores at base time ( P = 0.42) and 2 minutes before sampling ( P = 0.12). However, at the sampling time ( P = 0.0), and 5 minutes ( P = 0.001) and 30 minutes after the sampling ( P = 0.001), mean pain score in the intervention stage was significantly less than that in the control stage. Based on the findings, environmental and behavioral interventions reduced pain and facilitated heel-prick blood sampling in preterm infants.

Co-activation patterns in resting-state fMRI signals.

PubMed

Liu, Xiao; Zhang, Nanyin; Chang, Catie; Duyn, Jeff H

2018-02-08

The brain is a complex system that integrates and processes information across multiple time scales by dynamically coordinating activities over brain regions and circuits. Correlations in resting-state functional magnetic resonance imaging (rsfMRI) signals have been widely used to infer functional connectivity of the brain, providing a metric of functional associations that reflects a temporal average over an entire scan (typically several minutes or longer). Not until recently was the study of dynamic brain interactions at much shorter time scales (seconds to minutes) considered for inference of functional connectivity. One method proposed for this objective seeks to identify and extract recurring co-activation patterns (CAPs) that represent instantaneous brain configurations at single time points. Here, we review the development and recent advancement of CAP methodology and other closely related approaches, as well as their applications and associated findings. We also discuss the potential neural origins and behavioral relevance of CAPs, along with methodological issues and future research directions in the analysis of fMRI co-activation patterns. Copyright © 2018 Elsevier Inc. All rights reserved.

Role of Adsorbed Water on Charge Carrier Dynamics in Photoexcited TiO2

PubMed Central

2017-01-01

Overall photocatalytic water splitting is one of the most sought after processes for sustainable solar-to-chemical energy conversion. The efficiency of this process strongly depends on charge carrier recombination and interaction with surface adsorbates at different time scales. Here, we investigated how hydration of TiO2 P25 affects dynamics of photogenerated electrons at the millisecond to minute time scale characteristic for chemical reactions. We used rapid scan diffuse-reflectance infrared Fourier transform spectroscopy (DRIFTS). The decay of photogenerated electron absorption was substantially slower in the presence of associated water. For hydrated samples, the charge carrier recombination rates followed an Arrhenius-type behavior in the temperature range of 273–423 K; these became temperature-independent when the material was dehydrated at temperatures above 423 K or cooled below 273 K. A DFT+U analysis revealed that hydrogen bonding with adsorbed water stabilizes surface-trapped holes at anatase TiO2(101) facet and lowers the barriers for hole migration. Hence, hole mobility should be higher in the hydrated material than in the dehydrated system. This demonstrates that adsorbed associated water can efficiently stabilize photogenerated charge carriers in nanocrystalline TiO2 and suppress their recombination at the time scale up to minutes. PMID:28413570

Extended Operation of Turbojet Engine with Pentaborane

NASA Technical Reports Server (NTRS)

Useller, James W; Jones, William L

1957-01-01

A full-scale turbojet engine was operated with pentaborane fuel continuously for 22 minutes at conditions simulating flight at a Mach number of 0.8 at an altitude of 50,000 feet. This period of operation is approximately three times longer than previously reported operation times. Although the specific fuel consumption was reduced from 1.3 with JP-4 fuel to 0.98 with pentaborane, a 13.2-percent reduction in net thrust was also encountered. A portion of this thrust loss is potentially recoverable with proper design of the engine components. The boron oxide deposition and erosion processes within the engine approached an equilibrium condition after approximately 22 minutes of operation with pentaborane.

IR temperatures of Mauna Loa caldera obtained with multispectral thermal imager

NASA Astrophysics Data System (ADS)

Pendergast, Malcolm M.; O'Steen, Byron L.; Kurzeja, Robert J.

2002-01-01

A survey of surface temperatures of the Mauna Loa caldera during 7/14/00 and 7/15/00 was made by SRTC in conjunction with a MTI satellite image collection. The general variation of surface temperature appears quite predictable responding to solar heating. The analysis of detailed times series of temperature indicates systematic variations in temperature of 5 C corresponding to time scales of 3-5 minutes and space scales of 10-20 m. The average temperature patterns are consistent with those predicted by the Regional Atmospheric Modeling System (RAMS).

Short-Term Effect of Aerobic Exercise on Symptoms in Multiple Sclerosis and Chronic Fatigue Syndrome

PubMed Central

Paul, Lorna; McFadyen, Angus K.; Marshall-McKenna, Rebecca; Mattison, Paul; Miller, Linda; McFarlane, Niall G.

2014-01-01

Background: This pilot study was conducted to determine whether a 15-minute bout of moderate-intensity aerobic cycling exercise would affect symptoms (pain and fatigue) and function (Timed 25-Foot Walk test [T25FW] and Timed Up and Go test [TUG]) in people with multiple sclerosis (MS) or chronic fatigue syndrome (CFS), and to compare these results with those of a healthy control group. Methods: Eight people with MS (Expanded Disability Status Scale score 5–6; Karnofsky score 50–80), eight people with CFS (Karnofsky score 50–80), and eight healthy volunteers participated in the study. Pain and fatigue levels and results of the T25FW and TUG were established at baseline as well as at 30 minutes, 2 hours, and 24 hours following a 15-minute stationary cycling aerobic exercise test. Repeated-measures analysis of variance (ANOVA) and covariance (ANCOVA) were used to analyze the findings over time. Results: At baseline there were statistically significant differences between groups in fatigue (P = .039), T25FW (P = .034), and TUG (P = .010). A significant group/time interaction emerged for fatigue levels (P= .005). We found no significant group/time interaction for pain levels or function. Conclusions: Undertaking 15 minutes of moderate-intensity aerobic cycling exercise had no significant adverse effects on pain or function in people with MS and CFS (with a Karnofsky score of 50–80) within a 24-hour time period. These initial results suggest that people with MS or CFS may undertake 15 minutes of cycling as moderate aerobic exercise with no expected negative impact on pain or function. PMID:25061431

Reproducibility of the Self-Controlled Six-Minute Walking Test in Heart Failure Patients

PubMed Central

Guimarães, Guilherme Veiga; Carvalho, Vitor Oliveira; Bocchi, Edimar Alcides

2008-01-01

INTRODUCTION The six-minute walk test (6WT) has been proposed to be a submaximal test, but could actually demand a high level of exercise intensity from the patient, expressed by a respiratory quotient >1.0, following the guideline recommendations. Standardizing the 6WT using the Borg scale was proposed to make sure that all patients undergo a submaximal walking test. PURPOSE To test the reproducibility of the six-minute treadmill cardiopulmonary walk test (6CWT) using the Borg scale and to make sure that all patients undergo a submaximal test. METHODS Twenty-three male heart failure patients (50±9 years) were included; these patients had both ischemic (5) and non-ischemic (18) heart failure with a left ventricle ejection fraction of 23±7%, were diagnosed as functional class NYHA II-III and were undergoing optimized drug therapy. Patients were guided to walk at a pace between “relatively easy and slightly tiring” (11 and 13 on Borg scale). The 6CWT using the Borg scale was performed two times on a treadmill with zero inclination and patient control of speed with an interval of 24 hours. During the sixth minute, we analyzed ventilation (VE, L/min), respiratory quotient, Oxygen consumption (VO2, ml/kg/min), VE/VCO2 slope, heart rate (HR, bpm), systolic blood pressure (SBP, mmHg), diastolic (DBP, mmHg) blood pressure and distance. RESULTS The intraclass correlation coefficients at the sixth minute were: HR (ri=0.96, p<0.0001), VE (ri=0.84, p<0.0001), SBP (ri=0.72, p=0.001), distance (ri=0.88, p<0.0001), VO2 (ri=0.92, p<0.0001), SlopeVE/VCO2 (ri=0.86, p<0.0001) and RQ<1 (ri=0.6, p=0.004). CONCLUSION Using the 6CWT with the Borg scale was reproducible, and it seems to be an appropriate method to evaluate the functional capacity of heart failure patients while making sure that they undergo a submaximal walking test. PMID:18438574

Reproducibility of the self-controlled six-minute walking test in heart failure patients.

PubMed

Guimarães, Guilherme Veiga; Carvalho, Vitor Oliveira; Bocchi, Edimar Alcides

2008-04-01

The six-minute walk test (6WT) has been proposed to be a submaximal test, but could actually demand a high level of exercise intensity from the patient, expressed by a respiratory quotient >1.0, following the guideline recommendations. Standardizing the 6WT using the Borg scale was proposed to make sure that all patients undergo a submaximal walking test. To test the reproducibility of the six-minute treadmill cardiopulmonary walk test (6CWT) using the Borg scale and to make sure that all patients undergo a submaximal test. Twenty-three male heart failure patients (50+/-9 years) were included; these patients had both ischemic (5) and non-ischemic (18) heart failure with a left ventricle ejection fraction of 23+/-7%, were diagnosed as functional class NYHA II-III and were undergoing optimized drug therapy. Patients were guided to walk at a pace between "relatively easy and slightly tiring" (11 and 13 on Borg scale). The 6CWT using the Borg scale was performed two times on a treadmill with zero inclination and patient control of speed with an interval of 24 hours. During the sixth minute, we analyzed ventilation (VE, L/min), respiratory quotient, Oxygen consumption (VO2, ml/kg/min), VE/VCO2 slope, heart rate (HR, bpm), systolic blood pressure (SBP, mmHg), diastolic (DBP, mmHg) blood pressure and distance. The intraclass correlation coefficients at the sixth minute were: HR (r i=0.96, p<0.0001), VE (r i=0.84, p<0.0001), SBP (r i=0.72, p=0.001), distance (r i=0.88, p<0.0001), VO2 (r i=0.92, p<0.0001), SlopeVE/VCO2 (r i=0.86, p<0.0001) and RQ<1 (r i=0.6, p=0.004). Using the 6CWT with the Borg scale was reproducible, and it seems to be an appropriate method to evaluate the functional capacity of heart failure patients while making sure that they undergo a submaximal walking test.

From microseconds to seconds and minutes—time computation in insect hearing

PubMed Central

Hartbauer, Manfred; Römer, Heiner

2014-01-01

The computation of time in the auditory system of insects is of relevance at rather different time scales, covering a large range from microseconds to several minutes. At the one end of this range, only a few microseconds of interaural time differences are available for directional hearing, due to the small distance between the ears, usually considered too small to be processed reliably by simple nervous systems. Synapses of interneurons in the afferent auditory pathway are, however, very sensitive to a time difference of only 1–2 ms provided by the latency shift of afferent activity with changing sound direction. At a much larger time scale of several tens of milliseconds to seconds, time processing is important in the context species recognition, but also for those insects where males produce acoustic signals within choruses, and the temporal relationship between song elements strongly deviates from a random distribution. In these situations, some species exhibit a more or less strict phase relationship of song elements, based on phase response properties of their song oscillator. Here we review evidence on how this may influence mate choice decisions. In the same dimension of some tens of milliseconds we find species of katydids with a duetting communication scheme, where one sex only performs phonotaxis to the other sex if the acoustic response falls within a very short time window after its own call. Such time windows show some features unique to insects, and although its neuronal implementation is unknown so far, the similarity with time processing for target range detection in bat echolocation will be discussed. Finally, the time scale being processed must be extended into the range of many minutes, since some acoustic insects produce singing bouts lasting quite long, and female preferences may be based on total signaling time. PMID:24782783

Measuring Parent Time Scarcity and Fatigue as Barriers to Meal Planning and Preparation: Quantitative Scale Development

ERIC Educational Resources Information Center

Storfer-Isser, Amy; Musher-Eizenman, Dara

2013-01-01

Objective: To examine the psychometric properties of 9 quantitative items that assess time scarcity and fatigue as parent barriers to planning and preparing meals for their children. Methods: A convenience sample of 342 parents of children aged 2-6 years completed a 20-minute online survey. Exploratory factor analysis was used to examine the…

Space Environment Modelling with the Use of Artificial Intelligence Methods

NASA Astrophysics Data System (ADS)

Lundstedt, H.; Wintoft, P.; Wu, J.-G.; Gleisner, H.; Dovheden, V.

1996-12-01

Space based technological systems are affected by the space weather in many ways. Several severe failures of satellites have been reported at times of space storms. Our society also increasingly depends on satellites for communication, navigation, exploration, and research. Predictions of the conditions in the satellite environment have therefore become very important. We will here present predictions made with the use of artificial intelligence (AI) techniques, such as artificial neural networks (ANN) and hybrids of AT methods. We are developing a space weather model based on intelligence hybrid systems (IHS). The model consists of different forecast modules, each module predicts the space weather on a specific time-scale. The time-scales range from minutes to months with the fundamental time-scale of 1-5 minutes, 1-3 hours, 1-3 days, and 27 days. Solar and solar wind data are used as input data. From solar magnetic field measurements, either made on the ground at Wilcox Solar Observatory (WSO) at Stanford, or made from space by the satellite SOHO, solar wind parameters can be predicted and modelled with ANN and MHD models. Magnetograms from WSO are available on a daily basis. However, from SOHO magnetograms will be available every 90 minutes. SOHO magnetograms as input to ANNs will therefore make it possible to even predict solar transient events. Geomagnetic storm activity can today be predicted with very high accuracy by means of ANN methods using solar wind input data. However, at present real-time solar wind data are only available during part of the day from the satellite WIND. With the launch of ACE in 1997, solar wind data will on the other hand be available during 24 hours per day. The conditions of the satellite environment are not only disturbed at times of geomagnetic storms but also at times of intense solar radiation and highly energetic particles. These events are associated with increased solar activity. Predictions of these events are therefore also handled with the modules in the Lund Space Weather Model. Interesting Links: Lund Space Weather and AI Center

The Ultrasound-Guided Retroclavicular Block: A Prospective Feasibility Study.

PubMed

Charbonneau, Jasmin; Fréchette, Yannick; Sansoucy, Yanick; Echave, Pablo

2015-01-01

The aim of this feasibility study was to determine the success rate (sensory and surgical) of the novel retroclavicular block and to thoroughly describe the technique. In addition, needle tip and shaft visibility, needling time, procedural discomfort, motor block success rate, patient satisfaction at 48-hour follow-up, and complications were also recorded. Fifty patients scheduled for distal upper limb surgery received an in-plane, single-shot, ultrasound-guided retroclavicular block with 40 mL of mepivacaine 1.5% with epinephrine 2.5 μg/mL. Block success was defined as a sensory score of 10/10 for the 5 nerves supplying the distal upper limb at 30 minutes. Surgical success, needle visibility, needling time, axillary artery depth, motor block rate, patient discomfort with technique, satisfaction at 48 hours, and complications were also recorded. All blocks were video-recorded and timed for further independent assessment. A chest x-ray was obtained before discharge. Forty-five patients had a total sensory score of 10/10 at 30 minutes (90% success rate). Surgical success rate was 96%. Mean needling time was 3.77 minutes (25th-75th percentiles, 2.90-6.53 minutes) with a mean axillary artery depth of 3.1 ± 0.7 cm. Procedure-related discomfort (mean visual analog scale, 1.9 ± 1.2) was low. Mean 48-hour patient satisfaction rate (9.2 ± 1.1), mean needle tip (Likert scale, 3.0 ± 0.9), and shaft visibility (3.9 ± 0.9) were high. One vascular puncture and two transient paresthesias were recorded. No pneumothorax was revealed by chest x-ray. In this study, the novel retroclavicular block offered a quick, safe, and reliable alternative for distal arm block. Further studies, comparing this approach with the classic infraclavicular block, are required to validate its efficacy, safety, and reliability.

The Swift-BAT Hard X-ray Transient Monitor

NASA Technical Reports Server (NTRS)

Krimm, Hans; Markwardt, C. B.; Sanwal, D.; Tueller, J.

2006-01-01

The Burst Alert Telescope (BAT) on the Swift satellite is a large field of view instrument that continually monitors the sky to provide the gamma-ray burst trigger for Swift. An average of more than 70% of the sky is observed on a daily basis. The survey mode data is processed on two sets on time scales: from one minute to one day as part of the transient monitor program, and from one spacecraft pointing (approx.20 minutes) to the full mission duration for the hard X-ray survey program. The transient monitor has recently become public through the web site http:// swift.gsfc.nasa.gov/docs/swift/results/transients/. Sky images are processed to detect astrophysical sources in the 15-50 keV energy band and the detected flux or upper limit is calculated for >100 sources on time scales up to one day. Light curves are updated each time that new BAT data becomes available (approx.10 times daily). In addition, the monitor is sensitive to an outburst from a new or unknown source. Sensitivity as a function of time scale for catalog and unknown sources will be presented. The daily exposure for a typical source is approx.1500-3000 seconds, with a 1-sigma sensitivity of approx.4 mCrab. 90% of the sources are sampled at least every 16 days, but many sources are sampled daily. It is expected that the Swift-BAT transient monitor will become an important resource for the high energy astrophysics community.

Balance and mobility following stroke: effects of physical therapy interventions with and without biofeedback/forceplate training.

PubMed

Geiger, R A; Allen, J B; O'Keefe, J; Hicks, R R

2001-04-01

Visual biofeedback/forceplate systems are often used for treatment of balance disorders. In this study, the researchers investigated whether the addition of visual biofeedback/forceplate training could enhance the effects of other physical therapy interventions on balance and mobility following stroke. The study included a sample of convenience of 13 outpatients with hemiplegia who ranged in age from 30 to 77 years (mean=60.4, SD=15.4) and were 15 to 538 days poststroke. Subjects were assigned randomly to either an experimental group or a control group when the study began, and their cognitive and visual-perceptual skills were tested by a psychologist. Subjects were also assessed using the Berg Balance Scale and the Timed "Up & Go" Test before and after 4 weeks of physical therapy. Both groups received physical therapy interventions designed to improve balance and mobility 2 to 3 times per week. The experimental group trained on the NeuroCom Balance Master for 15 minutes of each 50-minute treatment session. The control group received other physical therapy for 50 minutes. Following intervention, both groups scored higher on the Berg Balance Scale and required less time to perform the Timed "Up & Go" Test. These improvements corresponded to increased independence of balance and mobility in the study population. However, a comparison of mean changes revealed no differences between groups. Although both groups demonstrated improvement following 4 weeks of physical therapy interventions, no additional effects were found in the group that received visual biofeedback/forceplate training combined with other physical therapy.

Evaluation of ultrasound-guided vascular access in dogs.

PubMed

Chamberlin, Scott C; Sullivan, Lauren A; Morley, Paul S; Boscan, Pedro

2013-01-01

To describe the technique and determine the feasibility, success rate, perceived difficulty, and time to vascular access using ultrasound guidance for jugular vein catheterization in a cardiac arrest dog model. Prospective descriptive study. University teaching hospital. Nine Walker hounds. A total of 27 jugular catheterizations were performed postcardiac arrest using ultrasound guidance. Catheterizations were recorded based on the order in which they were performed and presence/absence of a hematoma around the vein. Time (minutes) until successful vascular access and perceived difficulty in achieving vascular access (scale of 1 = easy to 10 = difficult) were recorded for each catheterization. Mean time to vascular access was 1.9 minutes (95% confidence interval, 1.1-3.4 min) for catheterizations without hematoma, versus 4.3 minutes (1.8-10.1 min) for catheterizations with hematoma (P = 0.1). Median perceived difficulty was 2 of 10 (range 1-7) for catheterizations without hematoma, versus 2 of 10 (range 1-8) for catheterizations with hematoma (P = 0.3). A learning curve was evaluated by comparing mean time to vascular access and perceived difficulty in initial versus subsequent catheterizations. Mean time to vascular access was 2.5 minutes (1.0-6.4 min) in the initial 13 catheterizations versus 3.3 minutes (1.5-7.5 min) in the subsequent 14 catheterizations (P = 0.6). Median perceived difficulty in the first 13 catheterizations (3, range 1-8) was significantly greater (P = 0.049) than median perceived difficulty in the subsequent 14 catheterizations (2, range 1-6). Ultrasound-guided jugular catheterization is associated with a learning curve but is successful in obtaining rapid vascular access in dogs. Further prospective studies are warranted to confirm the utility of this technique in a clinical setting. © Veterinary Emergency and Critical Care Society 2013.

mStroke: "Mobile Stroke"-Improving Acute Stroke Care with Smartphone Technology.

PubMed

Andrew, Benjamin Y; Stack, Colleen M; Yang, Julian P; Dodds, Jodi A

2017-07-01

This study aimed to evaluate the effect of method and time of system activation on clinical metrics in cases utilizing the Stop Stroke (Pulsara, Inc.) mobile acute stroke care coordination application. A retrospective cohort analysis of stroke codes at 12 medical centers using Stop Stroke from March 2013 to May 2016 was performed. Comparison of metrics (door-to-needle time [DTN] and door-to-CT time [DTC], and rate of DTN ≤ 60 minutes [goal DTN]) was performed between subgroups based on method (emergency medical service [EMS] versus emergency department [ED]) and time of activation. Effects were adjusted for confounders (age, sex, National Institutes of Health Stroke Scale [NIHSS] score) using multiple linear and logistic regression. The final dataset included 2589 cases. Cases activated by EMS were more severe (median NIHSS score 8 versus 4, P < .0001) and more likely to receive recombinant tissue plasminogen activator (20% versus 12%, P < .0001) than those with ED activation. After adjustment, cases with EMS activation had shorter DTC (6.1 minutes shorter, 95% CI [-10.3, -2]) and DTN (12.8 minutes shorter, 95% CI [-21, -4.6]) and were more likely to meet goal DTN (OR 1.83, 95% CI [1.1, 3]). Cases between 1200 and 1800 had longer DTC (7.7 minutes longer, 95% CI [2.4, 13]) and DTN (21.1 minutes longer, 95% CI [9.3, 33]), and reduced rate of goal DTN (OR .3, 95% CI [.15, .61]) compared to those between 0000 and 0600. Incorporating real-time prehospital data obtained via smartphone technology provides unique insight into acute stroke codes. Activation of mobile electronic stroke coordination in the field appears to promote a more expedited and successful care process. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Every-10-minute Refresh of Precipitation and Flood Risk Predictions by Assimilating Himawari-8 All-sky Satellite Radiances

NASA Astrophysics Data System (ADS)

Honda, T.; Kotsuki, S.; Lien, G. Y.; Maejima, Y.; Okamoto, K.; Miyoshi, T.

2017-12-01

To capture the flood risk, it is essential to obtain accurate precipitation forecasts in terms of intensity, location, and timing. In this regard, data assimilation plays an important role to provide better initial conditions for precipitation forecasts. In particular, geostationary satellites are among the most important data sources because of their broad coverage and high observing frequency. Recently, third-generation geostationary satellites, Himawari-8/9 of the Japan Meteorological Agency (JMA) and GOES-16 of the National Oceanic and Atmosphere Administration (NOAA), were launched, and among them, Himawari-8 was the first and has been fully operated since July 2015. Himawari-8 is capable of every-10-minute full disk observation similarly to GOES-16 and allows to refresh precipitation and flood predictions as frequently as every 10 minutes. This has a potential advantage in capturing the flood risk associated with a sudden torrential rainfall much earlier. This study aims to demonstrate the advantage of frequent updates of precipitation and flood risk predictions by assimilating all-sky Himawari-8 infrared (IR) radiances. We use an advanced regional data assimilation system known as the SCALE-LETKF, composed of a regional numerical weather prediction (NWP) model (SCALE-RM) developed in RIKEN, Japan and the Local Ensemble Transform Kalman Filter (LETKF). We focus on a major disaster case in Japan known as September 2015 Kanto-Tohoku heavy rainfall in which a meridional precipitation band associated with a tropical cyclone induced a record-breaking rainfall and eventually caused a collapse of a Kinu River levee. By assimilating a moisture sensitive IR band (band 9, 6.9 µm) of Himawari-8 every 10 minutes into a 6-km mesh SCALE-LETKF, the heavy precipitation forecasts are greatly improved. We run a rainfall-runoff model using the improved precipitation forecasts and obtain high risk of floods predicted with longer lead times.

Long-term, high-frequency water quality monitoring in an agricultural catchment: insights from spectral analysis

NASA Astrophysics Data System (ADS)

Aubert, Alice; Kirchner, James; Faucheux, Mikael; Merot, Philippe; Gascuel-Odoux, Chantal

2013-04-01

The choice of sampling frequency is a key issue in the design and operation of environmental observatories. The choice of sampling frequency creates a spectral window (or temporal filter) that highlights some timescales and processes, and de-emphasizes others (1). New online measurement technologies can monitor surface water quality almost continuously, allowing the creation of very rich time series. The question of how best to analyze such detailed temporal datasets is an important issue in environmental monitoring. In the present work, we studied water quality data from the AgrHys long-term hydrological observatory (located at Kervidy-Naizin, Western France) sampled at daily and 20-minute time scales. Manual sampling has provided 12 years of daily measurements of nitrate, dissolved organic carbon (DOC), chloride and sulfate (2), and 3 years of daily measurements of about 30 other solutes. In addition, a UV-spectrometry probe (Spectrolyser) provides one year of 20-minute measurements for nitrate and DOC. Spectral analysis of the daily water quality time series reveals that our intensively farmed catchment exhibits universal 1/f scaling (power spectrum slope of -1) for a large number of solutes, confirming and extending the earlier discovery of universal 1/f scaling in the relatively pristine Plynlimon catchment (3). 1/f time series confound conventional methods for assessing the statistical significance of trends. Indeed, conventional methods assume that there is a clear separation of scales between the signal (the trend line) and the noise (the scatter around the line). This is not true for 1/f noise, since it overestimates the occurrence of significant trends. Our results raise the possibility that 1/f scaling is widespread in water quality time series, thus posing fundamental challenges to water quality trend analysis. Power spectra of the 20-minute nitrate and DOC time series show 1/f scaling at frequencies below 1/day, consistent with the longer-term daily measurements. At higher frequencies, however, the spectra steepen to a slope of -2, indicating that at sub-daily time scales the concentration time series become relatively smooth. However, at time scales shorter than 2-3 hours, the spectra flatten to a slope near zero (white noise), reflecting analytical noise in the measurement probe. This result demonstrates that measuring water quality dynamics at high frequencies also requires high measurement precision, because as measurements are taken closer and closer together in time, the real-world differences that must be measured between adjacent measurements become smaller and smaller. Our results highlight the importance of quantifying the spectral properties of analytical noise in environmental measurements, to identify frequency ranges where measurements could be dominated by analytical noise instead of real-world signals. 1. Kirchner, J.W., Feng, X., Neal, C., Robson, A.J., 2004. The fine structure of water-quality dynamics: the (high-frequency) wave of the future. Hydrological Processes, 18(7): 1353-1359 2. Aubert, A.H. et al., 2012. The chemical signature of a livestock farming catchment: synthesis from a high-frequency multi-element long term monitoring. HESSD, 9(8): 9715 - 9741 3. Kirchner, J.W. and Neal, C., 2013. Universal fractal scaling in water quality dynamics across the periodic table. Manuscript in review.

Measuring recovery: An adapted Brief Assessment of Mood (BAM+) compared to biochemical and power output alterations.

PubMed

Shearer, David A; Sparkes, William; Northeast, Jonny; Cunningham, Daniel J; Cook, Christian J; Kilduff, Liam P

2017-05-01

Biochemical (e.g. creatine kinase (CK)) and neuromuscular (e.g. peak power output (PPO)) markers of recovery are expensive and require specialist equipment. Perceptual measures are an effective alternative, yet most validated scales are too long for daily use. This study utilises a longitudinal multi-level design to test an adapted Brief Assessment of Mood (BAM+), with four extra items and a 100mm visual analogue scale to measure recovery. Elite under-21 academy soccer players (N=11) were monitored across five games with data (BAM+, CK and PPO) collected for each game at 24h pre, 24h and 48h post-match. Match activity data for each participant was also collected using GPS monitors on players. BAM+, CK and PPO had significant (p<.05) linear and quadratic growth curves across time and games that matched the known time reports of fatigue and recovery. Multi-level linear modelling (MLM) with random intercepts for 'participant' and 'game' indicated only CK significantly contributed to the variance of BAM+ scores (p<.05). Significant correlations (p<.01) were found between changes in BAM+ scores from baseline at 24 and 48h post-match for total distance covered per minute, high intensity distance covered per minute, and total number of sprints per minute. Visual and inferential results indicate that the BAM+ appears effective for monitoring longitudinal recovery cycles in elite level athletes. Future research is needed to confirm both the scales reliability and validity. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Fully Endoscopic Freehand Evacuation of Spontaneous Supratentorial Intraparenchymal Hemorrhage.

PubMed

Angileri, Filippo Flavio; Esposito, Felice; Priola, Stefano Maria; Raffa, Giovanni; Marino, Daniele; Abbritti, Rosaria Viola; Giusa, Maria; Germanò, Antonino; Tomasello, Francesco

2016-10-01

A modification of other reported endoscopic techniques for intracerebral clot evacuation is described and illustrated. From January 2014 to December 2014, we operated on 6 patients harboring a spontaneous supratentorial intracerebral hemorrhage using a fully endoscopic freehand technique. Clinical chart and surgical videos were analyzed. Volumetric evaluation of the clot preoperatively and the residual hematoma postoperatively was performed. Clinical outcome was measured using the modified Rankin Scale and Glasgow Outcome Scale. The mean operative time was 96 minutes (range, 72-125 minutes). Clot evacuation was >90% in all patients. No patient experienced rebleeding after surgery. Two patients died. The Glasgow Outcome Scale score at 6 months was 4 in 2 patients, 3 in 2 patients, and 1 (death) in 2 patients. The modified Rankin Scale score at 6 months was 6 (death) in 2 patients, 4 in 2 patients, 3 in 1 patient and 2 in 1 patient. The proposed minimally invasive technique allows a good rate of hematoma evacuation and intraoperative bleeding control. Further studies in large series are needed to confirm the role of this freehand endoscopic technique. Copyright © 2016 Elsevier Inc. All rights reserved.

Ultrasonic Clothes Dryer Dries Clothes in Half the Time

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

None

Scientists at Oak Ridge National Laboratory are about to change the way that you do laundry. They recently developed an ultrasonic drying concept that uses vibrations instead of heat to dry clothes. This technology is expected to be up to five times more efficient than today’s products and will dry your clothes in half the time. In about two years, researchers took this basic science concept and recently developed it into a full-scale press dryer and clothes dryer drum – setting the stage for it to one day go to market through partners like General Electric Appliances. The ultrasonic dryer,more » which is supported by the Department of Energy’s Building Technologies Office, is expected to cut drying time to about 20 minutes per load – down significantly from the average 50 minutes it currently takes Americans to do their laundry.« less

25. FOLSOM, CALIFORNIA, 15 MINUTE QUADRANGLE. 1941. Scale 1:62,500. United ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

25. FOLSOM, CALIFORNIA, 15 MINUTE QUADRANGLE. 1941. Scale 1:62,500. United States Geological Survey. - Natomas Ditch System, Rhoades' Branch Ditch, Approximately 7 miles between Nesmith Court and White Rock Road, Folsom, Sacramento County, CA

Apomorphine Subcutaneous Injection for the Management of Morning Akinesia in Parkinson's Disease.

PubMed

Isaacson, Stuart; Lew, Mark; Ondo, William; Hubble, Jean; Clinch, Thomas; Pagan, Fernando

2017-01-01

In patients with motor fluctuations complicating Parkinson's disease (PD), delays in time-to-ON with levodopa are common. This open-label study aimed to assess the effect of apomorphine on time-to-ON in PD patients with morning akinesia. The safety population included 127 enrolled patients, and the full analysis set (FAS) included 88 patients. Patients completed a 7-day levodopa baseline period recording their time-to-ON following each morning dose of levodopa. Patients were titrated to an optimal dose of apomorphine (2-6 mg) while taking trimethobenzamide antiemetic therapy. Apomorphine was injected each morning for a 7-day treatment period and time-to-ON was self-recorded in 5-minute blocks. The primary efficacy variable was time-to-ON in the apomorphine treatment period versus the baseline levodopa period. Secondary assessments included and global impression scales. Safety and tolerability were assessed through adverse events (AEs). Patients receiving apomorphine achieved mean ± standard deviation (SD) time-to-ON 23.72 ± 14.55 minutes, reduced from 60.86 ± 18.11 minutes with levodopa ( P < 0.0001). Dose failures (defined as time-to-ON >60 minutes) were more commonly reported with levodopa versus apomorphine (46% vs. 7% of diary entries, respectively). Secondary endpoints supported the primary efficacy findings, with significant improvements from levodopa baseline to apomorphine treatment period (all P < 0.0001). The most common AEs were nausea and dizziness. Most patients who discontinued because of AEs did so in the titration phase. Apomorphine injections significantly reduced time-to-ON in PD patients experiencing delayed onset of their morning levodopa dose, and was well tolerated in most patients. After apomorphine treatment, fluctuating patients with morning akinesia experienced rapid and reliable improvement of time-to-ON.

Econophysics: A challenge to econometricians

NASA Astrophysics Data System (ADS)

Zapart, Christopher A.

2015-02-01

The study contrasts mainstream economics-operating on time scales of hours and days-with behavioural finance, econophysics and high-frequency trading, more applicable to short-term time scales of the order of minutes and seconds. We show how the central theoretical assumption underpinning prevailing economic theories is violated on small time scales. We also demonstrate how an alternative behavioural econophysics can model reactions of market participants to short-term movements in foreign exchange markets and, in a direct contradiction of the orthodox economics, design a rudimentary IsingFX automated trading system. By replacing costly human forex dealers with banks of Field-Programmable Gate Array (FPGA) devices that implement in hardware high-frequency behavioural trading models of the type described here, brokerages and forex liquidity providers can expect to gain significant reductions in operating costs.

Intra-day response of foreign exchange markets after the Tohoku-Oki earthquake

NASA Astrophysics Data System (ADS)

Nakano, Shuhei; Hirata, Yoshito; Iwayama, Koji; Aihara, Kazuyuki

2015-02-01

Although an economy is influenced by a natural disaster, the market response to the disaster during the first 24 hours is not clearly understood. Here we show that an earthquake quickly causes temporal changes in a foreign exchange market by examining the case of the Tohoku-Oki earthquake. Recurrence plots and statistical change point detection independently show that the United States dollar-Japanese yen market responded to the earthquake activity without delay and with the delay of about 2 minutes, respectively. These findings support that the efficient market hypothesis nearly holds now in the time scale of minutes.

Characteristic time scales of tick quotes on foreign currency markets: an empirical study and agent-based model

NASA Astrophysics Data System (ADS)

Sato, A.-H.

2006-03-01

Power spectrum densities for the number of tick quotes per minute (market activity) on three currency markets (USD/JPY, EUR/USD, and JPY/EUR) for periods from January 1999 to December 2000 are analyzed. We find some peaks on the power spectrum densities at a few minutes. We develop the double-threshold agent model and confirm that stochastic resonance occurs for the market activity of this model. We propose a hypothesis that the periodicities found on the power spectrum densities can be observed due to stochastic resonance.

Synaptic Scaling Enables Dynamically Distinct Short- and Long-Term Memory Formation

PubMed Central

Tetzlaff, Christian; Kolodziejski, Christoph; Timme, Marc; Tsodyks, Misha; Wörgötter, Florentin

2013-01-01

Memory storage in the brain relies on mechanisms acting on time scales from minutes, for long-term synaptic potentiation, to days, for memory consolidation. During such processes, neural circuits distinguish synapses relevant for forming a long-term storage, which are consolidated, from synapses of short-term storage, which fade. How time scale integration and synaptic differentiation is simultaneously achieved remains unclear. Here we show that synaptic scaling – a slow process usually associated with the maintenance of activity homeostasis – combined with synaptic plasticity may simultaneously achieve both, thereby providing a natural separation of short- from long-term storage. The interaction between plasticity and scaling provides also an explanation for an established paradox where memory consolidation critically depends on the exact order of learning and recall. These results indicate that scaling may be fundamental for stabilizing memories, providing a dynamic link between early and late memory formation processes. PMID:24204240

Synaptic scaling enables dynamically distinct short- and long-term memory formation.

PubMed

Tetzlaff, Christian; Kolodziejski, Christoph; Timme, Marc; Tsodyks, Misha; Wörgötter, Florentin

2013-10-01

Memory storage in the brain relies on mechanisms acting on time scales from minutes, for long-term synaptic potentiation, to days, for memory consolidation. During such processes, neural circuits distinguish synapses relevant for forming a long-term storage, which are consolidated, from synapses of short-term storage, which fade. How time scale integration and synaptic differentiation is simultaneously achieved remains unclear. Here we show that synaptic scaling - a slow process usually associated with the maintenance of activity homeostasis - combined with synaptic plasticity may simultaneously achieve both, thereby providing a natural separation of short- from long-term storage. The interaction between plasticity and scaling provides also an explanation for an established paradox where memory consolidation critically depends on the exact order of learning and recall. These results indicate that scaling may be fundamental for stabilizing memories, providing a dynamic link between early and late memory formation processes.

Roughness transitions of diamond(100) induced by hydrogen-plasma treatment

NASA Astrophysics Data System (ADS)

Koslowski, B.; Strobel, S.; Wenig, M. J.; Ziemann, P.

To investigate the influence of hydrogen-plasma treatment on diamond(100) surfaces, heavily boron (B)-doped HPHT diamond crystals were mechanically and chemo-mechanically polished, and exposed to a microwave-assisted hydrogen plasma on a time scale of several minutes. The resulting surface morphology was analyzed on macroscopic scales by stylus profilometry (PFM) and on microscopic scales by STM and AFM. The polished samples have a roughness of typically 100 pmrms (PFM), with no obvious anisotropic structures at the surface. After exposure of the B-doped diamond(100) to the H-plasma, the roughness increases dramatically, and pronounced anisotropic structures appear, these being closely aligned with the crystallographic axis' and planes. An exposure for 3 minutes to the plasma leads to an increase of the roughness to 2-4 nmrms (STM), and a `brick-wall' pattern appears, formed by weak cusps running along <110>. Very frequently, the cusps are replaced by `negative' pyramids that are bordered by {11X} facets. After an exposure of an additional 5 minutes, the surface roughness of the B-doped samples increases further to 20-40 nmrms (STM), and frequently exhibits a regular pattern with structures at a characteristic length scale of about 100 nm. Those structures are aligned approximately with <110> and they are faceted with faces of approximately {XX1}. These results will be discussed in terms of strain relaxation, similar to the surface roughening observed on SiGe/Si and anisotropic etching.

Is Period3 Genotype Associated With Sleep and Recovery in Patients With Disorders of Consciousness?

PubMed

Bedini, Gloria; Bersano, Anna; Sebastiano, Davide Rossi; Sattin, Davide; Ciaraffa, Francesca; Tosetti, Valentina; Brenna, Greta; Franceschetti, Silvana; Ciusani, Emilio; Leonardi, Matilde; Vela-Gomez, Jesus; Boncoraglio, Giorgio B; Parati, Eugenio A

2016-06-01

Background Sleep evaluation is increasingly being used as prognostic tool in patients with disorders of consciousness, but, surprisingly, the role of Period3 (Per3) gene polymorphism has never been evaluated. Objective The aim of this study was to investigate the contribution of Per3 genotype on sleep quantity and consciousness recovery level in patients with disorders of consciousness (DOC). Methods In this observational study, we evaluated 71 patients with DOC classified as vegetative state/unresponsive wakefulness syndrome or minimally conscious state. Demographic and clinical data were collected and a standardised diagnostic workup, including a polysomnographic record, was applied. After informed consent provided by proxy, genomic DNA was obtained and Per3 polymorphism was analysed by polymerase chain reaction to identify 5/5, 4/5, or 4/4 genotype. Results Per3(5/5) genotype was found in 12.7% of our DOC patients. The median total Coma Recovery Scale-revised score in Per3(5/5) carriers was significantly higher than 4/4 genotype (10, range 5-16 vs 7, range 4-11; post hoc P = .036). Moreover, total sleep time seemed to be higher in 5/5 genotype (5/5, 221 minutes, range 88-515 minutes; 4/4, 151.5 minutes, range 36-477 minutes; and 4/5, 188 minutes, range 44-422 minutes). Conclusion For the first time we have shown a possible association between Per3 polymorphism and consciousness recovery level in DOC patients. Even though the exact molecular mechanism has not been defined, we speculate that its effect is mediated by higher total sleep time and slow wave sleep, which would improve the preservation of main cerebral connections. © The Author(s) 2015.

A space-time multifractal analysis on radar rainfall sequences from central Poland

NASA Astrophysics Data System (ADS)

Licznar, Paweł; Deidda, Roberto

2014-05-01

Rainfall downscaling belongs to most important tasks of modern hydrology. Especially from the perspective of urban hydrology there is real need for development of practical tools for possible rainfall scenarios generation. Rainfall scenarios of fine temporal scale reaching single minutes are indispensable as inputs for hydrological models. Assumption of probabilistic philosophy of drainage systems design and functioning leads to widespread application of hydrodynamic models in engineering practice. However models like these covering large areas could not be supplied with only uncorrelated point-rainfall time series. They should be rather supplied with space time rainfall scenarios displaying statistical properties of local natural rainfall fields. Implementation of a Space-Time Rainfall (STRAIN) model for hydrometeorological applications in Polish conditions, such as rainfall downscaling from the large scales of meteorological models to the scale of interest for rainfall-runoff processes is the long-distance aim of our research. As an introduction part of our study we verify the veracity of the following STRAIN model assumptions: rainfall fields are isotropic and statistically homogeneous in space; self-similarity holds (so that, after having rescaled the time by the advection velocity, rainfall is a fully homogeneous and isotropic process in the space-time domain); statistical properties of rainfall are characterized by an "a priori" known multifractal behavior. We conduct a space-time multifractal analysis on radar rainfall sequences selected from the Polish national radar system POLRAD. Radar rainfall sequences covering the area of 256 km x 256 km of original 2 km x 2 km spatial resolution and 15 minutes temporal resolution are used as study material. Attention is mainly focused on most severe summer convective rainfalls. It is shown that space-time rainfall can be considered with a good approximation to be a self-similar multifractal process. Multifractal analysis is carried out assuming Taylor's hypothesis to hold and the advection velocity needed to rescale the time dimension is assumed to be equal about 16 km/h. This assumption is verified by the analysis of autocorrelation functions along the x and y directions of "rainfall cubes" and along the time axis rescaled with assumed advection velocity. In general for analyzed rainfall sequences scaling is observed for spatial scales ranging from 4 to 256 km and for timescales from 15 min to 16 hours. However in most cases scaling break is identified for spatial scales between 4 and 8, corresponding to spatial dimensions of 16 km to 32 km. It is assumed that the scaling break occurrence at these particular scales in central Poland conditions could be at least partly explained by the rainfall mesoscale gap (on the edge of meso-gamma, storm-scale and meso-beta scale).

The effect of rhythmic-cued motor imagery on walking, fatigue and quality of life in people with multiple sclerosis: A randomised controlled trial.

PubMed

Seebacher, Barbara; Kuisma, Raija; Glynn, Angela; Berger, Thomas

2017-02-01

Motor imagery and rhythmic auditory stimulation are physiotherapy strategies for walking rehabilitation. To investigate the effect of motor imagery combined with rhythmic cueing on walking, fatigue and quality of life (QoL) in people with multiple sclerosis (MS). Individuals with MS and Expanded Disability Status Scale scores of 1.5-4.5 were randomised into one of three groups: 17 minutes of motor imagery, six times per week, for 4 weeks, with music (A) or metronome cues (B), both with verbal cueing, and (C) controls. Primary outcomes were walking speed (Timed 25-Foot Walk) and distance (6-Minute Walk Test). Secondary outcomes were walking perception (Multiple Sclerosis Walking Scale-12), fatigue (Modified Fatigue Impact Scale) and QoL (Short Form-36 Health Survey, Multiple Sclerosis Impact Scale-29, Euroquol-5D-3L Questionnaire). Of the 112 participants randomised, 101 completed the study. Compared to controls, both interventions significantly improved walking speed, distance and perception. Significant improvements in cognitive but not psychosocial fatigue were seen in the intervention groups, and physical fatigue improved only in the music-based group. Both interventions improved QoL; however, music-cued motor imagery was superior at improving health-related QoL. Rhythmic-cued motor imagery improves walking, fatigue and QoL in people with MS, with music-cued motor imagery being more effective.

Development of analog watch with minute repeater

NASA Astrophysics Data System (ADS)

Okigami, Tomio; Aoyama, Shigeru; Osa, Takashi; Igarashi, Kiyotaka; Ikegami, Tomomi

A complementary metal oxide semiconductor with large scale integration was developed for an electronic minute repeater. It is equipped with the synthetic struck sound circuit to generate natural struck sound necessary for the minute repeater. This circuit consists of an envelope curve drawing circuit, frequency mixer, polyphonic mixer, and booster circuit made by using analog circuit technology. This large scale integration is a single chip microcomputer with motor drivers and input ports in addition to the synthetic struck sound circuit, and it is possible to make an electronic system of minute repeater at a very low cost in comparison with the conventional type.

Endovascular treatment outcomes using the Stroke Triage Education, Procedure Standardization, and Technology (STEPS-T) program.

PubMed

Hassan, Ameer E; Sanchez, Christina; Johnson, Angela N

2018-02-01

Background "Door to treatment" time affects outcomes of acute ischemic stroke (AIS) patients undergoing endovascular treatment (EVT). However, the correlation between staff education and accessible technology with stroke outcomes has not been demonstrated. Objective The objective of this paper is to demonstrate the five-year impact of the Stroke Triage Education, Procedure Standardization, and Technology (STEPS-T) program on time-to-treat and clinical outcomes. Methods The study analyzed a prospectively maintained database of AIS patients who benefited from EVT through implementation of STEPS-T. Demographics, clinical characteristics, and modified Rankin Score at three months were analyzed. Thrombolysis in Cerebral Infarction (TICI) scale was used to grade pre- and post-procedure angiographic recanalization. Using electronic hemodynamic recording, stepwise workflow times were collected for door time (T D ), entering angiography suite (T A ), groin puncture (T G ), first DSA (T DSA ), microcatheter placement (T M ), and final recanalization (T R ). Median intervention time (T A to T R ) and recanalization time (T G to T R ) were compared through Year 1 to Year 5. Results A total of 230 individuals (age 74 ± 12, between 30 to 95) were enrolled. Median intervention and recanalization times were significantly reduced, from 121 minutes to 52 minutes and from 83 minutes to 36 minutes respectively from Year 1 to Year 5, ( p < 0.001). Across the study period, annual recruitment went up from 12 to 66 patients, and modified Rankin Score between 0 and 2 increased from 36% to 59% ( p = 0.024). Conclusions STEPS-T improved time-to-treat in patients undergoing mechanical thrombectomy for AIS. During the observation period, clinical outcomes significantly improved.

Onset of action of a lozenge containing flurbiprofen 8.75 mg: a randomized, double-blind, placebo-controlled trial with a new method for measuring onset of analgesic activity.

PubMed

Schachtel, Bernard; Aspley, Sue; Shephard, Adrian; Shea, Timothy; Smith, Gary; Sanner, Kathleen; Savino, Laurie; Rezuke, Jeanne; Schachtel, Emily

2014-02-01

A new onset-of-action model was utilized to distinguish the pharmacologic activity of flurbiprofen 8.75mg delivered in a lozenge from the demulcent effect of the lozenge base. In a randomized, double-blind, placebo-controlled trial, patients with sore throat rated pain on a Sore Throat Pain Intensity Scale before taking one flurbiprofen or placebo lozenge and at frequent (2-minute) intervals over the first hour after treatment. Further ratings of the Sore Throat Pain Intensity Scale and other patient-reported outcomes (difficulty swallowing, swollen throat, pain relief) were obtained at varying intervals over 6 hours. Onset of pharmacologic activity was defined as the median time of first perceived pain reduction if a patient reported clinically meaningful (at least moderate) relief. The conventional method of comparing mean treatment responses at each time point was also implemented. Demulcent action was detected at the first 2-minute assessment. By the new method, 102 flurbiprofen-treated patients were identified as first perceiving pain relief at 12 minutes, compared with >120 minutes by 102 patients using placebo (P<0.001). By the conventional method, mean percentage pain reduction for flurbiprofen 8.75 mg was first significantly differentiated from placebo at 26 minutes (P<0.05). Efficacy of flurbiprofen lozenge was demonstrated for 3.5-4hours on the 4 patient-reported outcomes (all P<0.05 compared with placebo). There were no serious adverse events. This patient-centered onset-of-action model identifies the initiation of pain relief in patients who are definite drug responders, here demonstrating that a flurbiprofen 8.75-mg lozenge provides early relief of sore throat. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Effects of phase proprioceptive training on balance in patients with chronic stroke.

PubMed

Chae, Seung Hun; Kim, You Lim; Lee, Suk Min

2017-05-01

[Purpose] This study aimed to investigate the effect of phase proprioceptive training on balance in patients with chronic stroke. [Subjects and Methods] Participants included 30 patients with stroke who were randomly assigned to the proprioceptive training group (n=15) or control group (n=15). Participants in the proprioceptive training group underwent proprioceptive training and received general physical therapy each for a total of 20 thirty-minute sessions, five times per week, during a period of four weeks; the control group received general physical therapy for a total of 20 sixty-minute sessions, five times per week, during a period of four weeks. [Results] All participants were evaluated with the Berg Balance Scale, Timed Up and Go (TUG) test, and Activities-specific Balance Confidence (ABC) Scale instrument before and after intervention. After training, the differences in BBS, TUG, and ABC scores in the proprioceptive group were significantly greater than those in the control group. [Conclusion] In conclusion, proprioceptive training was effective on balance ability. Therefore, proprioceptive training may be efficient when combining general physical therapy with phase proprioceptive training for patients with impairments of balance. Further research is needed to investigate proprioceptive training methods.

Time to brain imaging in acute stroke is improving: secondary analysis of the INSTINCT trial.

PubMed

Sauser, Kori; Burke, James F; Levine, Deborah A; Scott, Phillip A; Meurer, William J

2014-01-01

Patients with acute ischemic stroke benefit from rapid evaluation and treatment, and timely brain imaging is a necessary component. We determined the effect of a targeted behavioral intervention on door-to-imaging time (DIT) among patients with ischemic stroke treated with tissue-type plasminogen activator. Second, we examined the variation in DIT accounted for by patient-level and hospital-level factors. The Increasing Stroke Treatment through Interventional behavioral Change Tactics (INSTINCT) trial was a cluster-randomized, controlled trial involving 24 Michigan hospitals. The intervention aimed to increase tissue-type plasminogen activator utilization. Detailed chart abstractions collected data for 557 patients with ischemic stroke. We used a series of hierarchical linear mixed-effects models to evaluate the effect of the intervention on DIT (difference-in-differences analysis) and used patient-level and hospital-level explanatory variables to decompose variation in DIT. DIT improved over time, without a difference between intervention and control hospitals (intervention: 23.7-19.3 minutes, control: 28.9-19.2 minutes; P=0.56). Adjusted DIT was faster in patients who arrived by ambulance (7.2 minutes; 95% confidence interval, 4.1-10.2), had severe strokes (1.0 minute per +5-point National Institutes of Health Stroke Scale; 95% confidence interval, 0.1-2.0), and presented in the postintervention period (4.9 minutes; 95% confidence interval, 2.3-7.4). After accounting for these factors, 13.8% of variation in DIT was attributable to hospital. Neither hospital stroke volume nor stroke center status was associated with DIT. Performance on DIT improved similarly in intervention and control hospitals, suggesting that nonintervention factors explain the improvement. Hospital-level factors explain a modest proportion of variation in DIT, but further research is needed to identify the hospital-level factors responsible.

Can we improve gait skills in chronic hemiplegics? A randomised control trial with gait trainer.

PubMed

Dias, D; Laíns, J; Pereira, A; Nunes, R; Caldas, J; Amaral, C; Pires, S; Costa, A; Alves, P; Moreira, M; Garrido, N; Loureiro, L

2007-12-01

Partial body weight support (PBWS) is an accepted treatment for hemiplegic patients. The aim of this study is to compare the efficiency of gait trainer with conventional treatment on the gait management after stroke. Forty chronic post-stroke hemiplegics were part of a prospective research. Inclusion criteria were: first ever stroke in a chronic stage with stabilised motor deficits; age >18 and <80 years; cognitive and communication skills to understand the treatment; absence of cardiac, psychological and orthopedic contraindications. Patients were randomised into two groups: the control group (CG) that used the Bobath method in 40 minutes sessions, 5 times a week, for 5 weeks, and the experimental group (EG) that used the gait trainer, for the same period of time and frequency. Assessment tools: Motricity Index (MI); Toulouse Motor Scale (TMS); modified Ashworth Spasticity Scale (mASS); Berg Balance Scale (BBS); Rivermead Mobility Index (RMI); Fugl-Meyer Stroke Scale (F-MSS); Functional Ambulation Category (FAC); Barthel Index (BI); 10 meters, time up and go (TUG), 6 minutes, and step tests. EG and CG did the assessments before treatment (T(0)), right after treatment (T(1)), and on follow-up, 3 months later (T(2)). CG and EG were homogenous in all the variables at T(0). CG and EG showed improvement in almost all the assessment scales after treatment, although only some with relevant differences. EG showed statistically relevant improvement on T(1) and on T(2) in several of the assessment tools, whereas CG only showed statistically significant improvement after T(1) and only in some of the assessment tools. Both groups of chronic hemiplegic patients improved after either PBWS with gait trainer or Bobath treatment. Only subjects undergoing PBWS with gait trainer maintained functional gain after 3 months.

Data Streaming for Metabolomics: Accelerating Data Processing and Analysis from Days to Minutes

PubMed Central

2016-01-01

The speed and throughput of analytical platforms has been a driving force in recent years in the “omics” technologies and while great strides have been accomplished in both chromatography and mass spectrometry, data analysis times have not benefited at the same pace. Even though personal computers have become more powerful, data transfer times still represent a bottleneck in data processing because of the increasingly complex data files and studies with a greater number of samples. To meet the demand of analyzing hundreds to thousands of samples within a given experiment, we have developed a data streaming platform, XCMS Stream, which capitalizes on the acquisition time to compress and stream recently acquired data files to data processing servers, mimicking just-in-time production strategies from the manufacturing industry. The utility of this XCMS Online-based technology is demonstrated here in the analysis of T cell metabolism and other large-scale metabolomic studies. A large scale example on a 1000 sample data set demonstrated a 10 000-fold time savings, reducing data analysis time from days to minutes. Further, XCMS Stream has the capability to increase the efficiency of downstream biochemical dependent data acquisition (BDDA) analysis by initiating data conversion and data processing on subsets of data acquired, expanding its application beyond data transfer to smart preliminary data decision-making prior to full acquisition. PMID:27983788

Data streaming for metabolomics: Accelerating data processing and analysis from days to minutes

DOE PAGES

Montenegro-Burke, J. Rafael; Aisporna, Aries E.; Benton, H. Paul; ...

2016-12-16

The speed and throughput of analytical platforms has been a driving force in recent years in the “omics” technologies and while great strides have been accomplished in both chromatography and mass spectrometry, data analysis times have not benefited at the same pace. Even though personal computers have become more powerful, data transfer times still represent a bottleneck in data processing because of the increasingly complex data files and studies with a greater number of samples. To meet the demand of analyzing hundreds to thousands of samples within a given experiment, we have developed a data streaming platform, XCMS Stream, whichmore » capitalizes on the acquisition time to compress and stream recently acquired data files to data processing servers, mimicking just-in-time production strategies from the manufacturing industry. The utility of this XCMS Online-based technology is demonstrated here in the analysis of T cell metabolism and other large-scale metabolomic studies. A large scale example on a 1000 sample data set demonstrated a 10 000-fold time savings, reducing data analysis time from days to minutes. Here, XCMS Stream has the capability to increase the efficiency of downstream biochemical dependent data acquisition (BDDA) analysis by initiating data conversion and data processing on subsets of data acquired, expanding its application beyond data transfer to smart preliminary data decision-making prior to full acquisition.« less

Data Streaming for Metabolomics: Accelerating Data Processing and Analysis from Days to Minutes.

PubMed

Montenegro-Burke, J Rafael; Aisporna, Aries E; Benton, H Paul; Rinehart, Duane; Fang, Mingliang; Huan, Tao; Warth, Benedikt; Forsberg, Erica; Abe, Brian T; Ivanisevic, Julijana; Wolan, Dennis W; Teyton, Luc; Lairson, Luke; Siuzdak, Gary

2017-01-17

The speed and throughput of analytical platforms has been a driving force in recent years in the "omics" technologies and while great strides have been accomplished in both chromatography and mass spectrometry, data analysis times have not benefited at the same pace. Even though personal computers have become more powerful, data transfer times still represent a bottleneck in data processing because of the increasingly complex data files and studies with a greater number of samples. To meet the demand of analyzing hundreds to thousands of samples within a given experiment, we have developed a data streaming platform, XCMS Stream, which capitalizes on the acquisition time to compress and stream recently acquired data files to data processing servers, mimicking just-in-time production strategies from the manufacturing industry. The utility of this XCMS Online-based technology is demonstrated here in the analysis of T cell metabolism and other large-scale metabolomic studies. A large scale example on a 1000 sample data set demonstrated a 10 000-fold time savings, reducing data analysis time from days to minutes. Further, XCMS Stream has the capability to increase the efficiency of downstream biochemical dependent data acquisition (BDDA) analysis by initiating data conversion and data processing on subsets of data acquired, expanding its application beyond data transfer to smart preliminary data decision-making prior to full acquisition.

Work intensity in sacroiliac joint fusion and lumbar microdiscectomy

PubMed Central

Frank, Clay; Kondrashov, Dimitriy; Meyer, S Craig; Dix, Gary; Lorio, Morgan; Kovalsky, Don; Cher, Daniel

2016-01-01

Background The evidence base supporting minimally invasive sacroiliac (SI) joint fusion (SIJF) surgery is increasing. The work relative value units (RVUs) associated with minimally invasive SIJF are seemingly low. To date, only one published study describes the relative work intensity associated with minimally invasive SIJF. No study has compared work intensity vs other commonly performed spine surgery procedures. Methods Charts of 192 patients at five sites who underwent either minimally invasive SIJF (American Medical Association [AMA] CPT® code 27279) or lumbar microdiscectomy (AMA CPT® code 63030) were reviewed. Abstracted were preoperative times associated with diagnosis and patient care, intraoperative parameters including operating room (OR) in/out times and procedure start/stop times, and postoperative care requirements. Additionally, using a visual analog scale, surgeons estimated the intensity of intraoperative care, including mental, temporal, and physical demands and effort and frustration. Work was defined as operative time multiplied by task intensity. Results Patients who underwent minimally invasive SIJF were more likely female. Mean procedure times were lower in SIJF by about 27.8 minutes (P<0.0001) and mean total OR times were lower by 27.9 minutes (P<0.0001), but there was substantial overlap across procedures. Mean preservice and post-service total labor times were longer in minimally invasive SIJF (preservice times longer by 63.5 minutes [P<0.0001] and post-service labor times longer by 20.2 minutes [P<0.0001]). The number of postoperative visits was higher in minimally invasive SIJF. Mean total service time (preoperative + OR time + postoperative) was higher in the minimally invasive SIJF group (261.5 vs 211.9 minutes, P<0.0001). Intraoperative intensity levels were higher for mental, physical, effort, and frustration domains (P<0.0001 each). After taking into account intensity, intraoperative workloads showed substantial overlap. Conclusion Compared to a commonly performed lumbar spine surgical procedure, lumbar microdiscectomy, that currently has a higher work RVU, preoperative, intraoperative, and postoperative workload for minimally invasive SIJF is higher. The work RVU for minimally invasive SIJF should be adjusted upward as the relative amount of work is comparable. PMID:27555790

Direct Observations of a Dynamically Driven Phase Transition with in situ X-Ray Diffraction in a Simple Ionic Crystal

NASA Astrophysics Data System (ADS)

Kalita, Patricia; Specht, Paul; Root, Seth; Sinclair, Nicholas; Schuman, Adam; White, Melanie; Cornelius, Andrew L.; Smith, Jesse; Sinogeikin, Stanislav

2017-12-01

We report real-time observations of a phase transition in the ionic solid CaF2 , a model A B2 structure in high-pressure physics. Synchrotron x-ray diffraction coupled with dynamic loading to 27.7 GPa, and separately with static compression, follows, in situ, the fluorite to cotunnite structural phase transition, both on nanosecond and on minute time scales. Using Rietveld refinement techniques, we examine the kinetics and hysteresis of the transition. Our results give insight into the kinetic time scale of the fluorite-cotunnite phase transition under shock compression, which is relevant to a number of isomorphic compounds.

Direct Observations of a Dynamically Driven Phase Transition with in situ X-Ray Diffraction in a Simple Ionic Crystal

DOE PAGES

Kalita, Patricia E.; Specht, Paul Elliot; Root, Seth; ...

2017-12-21

Here, we report real-time observations of a phase transition in the ionic solid CaF 2, a model AB 2 structure in high-pressure physics. Synchrotron x-ray diffraction coupled with dynamic loading to 27.7 GPa, and separately with static compression, follows, in situ, the fluorite to cotunnite structural phase transition, both on nanosecond and on minute time scales. Using Rietveld refinement techniques, we examine the kinetics and hysteresis of the transition. Our results give insight into the kinetic time scale of the fluorite-cotunnite phase transition under shock compression, which is relevant to a number of isomorphic compounds.

Slow speed—fast motion: time-lapse recordings in physics education

NASA Astrophysics Data System (ADS)

Vollmer, Michael; Möllmann, Klaus-Peter

2018-05-01

Video analysis with a 30 Hz frame rate is the standard tool in physics education. The development of affordable high-speed-cameras has extended the capabilities of the tool for much smaller time scales to the 1 ms range, using frame rates of typically up to 1000 frames s-1, allowing us to study transient physics phenomena happening too fast for the naked eye. Here we want to extend the range of phenomena which may be studied by video analysis in the opposite direction by focusing on much longer time scales ranging from minutes, hours to many days or even months. We discuss this time-lapse method, needed equipment and give a few hints of how to produce respective recordings for two specific experiments.

Physiological Responses and Hedonics During Prolonged Physically Interactive Videogame Play.

PubMed

Santo, Antonio S; Barkley, Jacob E; Hafen, Paul S; Navalta, James

2016-04-01

This study was designed to assess physiologic responses and hedonics (i.e., liking) during prolonged physically interactive videogame play. Participants (n = 24) completed three 30-minute videogame conditions on separate days in a random order. During two of the conditions participants played physically interactive videogames (Nintendo of America, Inc. [Redmond, WA] "Wii™ Fit" "Basic Run" and "Basic Step"). During the third condition participants played a traditional/sedentary game ("Tanks!"), which required minimal physical movement for gameplay. Oxygen consumption (VO2) was assessed using indirect calorimetry throughout each condition and averaged every 5 minutes. Liking was assessed via visual analog scale at the 15- and 30-minute time points during each condition. Mean VO2 was significantly (P < 0.001) greater during "Basic Run" (16.14 ± 5.8 mL/kg/minute, 4.6 ± 1.7 metabolic equivalents [METs]) than either "Basic Step" (11.4 ± 1.7 mL/kg/minute, 3.3 ± 0.5 METs) or the traditional/sedentary videogame (5.39 ± 1.0 mL/kg/minute, 1.5 ± 0.1 METs). "Basic Step" was also greater (P < 0.001) than the traditional/sedentary game. VO2 did not significantly (P = 0.25) fluctuate across the 30-minute session for any game. In other words, participants maintained a consistent physiologic intensity throughout each 30-minute condition. There were no differences (P ≥ 0.20) across gaming conditions or time for liking. Participants achieved and maintained moderate-intensity physical activity (≥3.0 METs) during both 30-minute physically interactive videogame conditions. Furthermore, because liking was similar across all gaming conditions, participants may be willing to substitute the physically interactive videogames in place of the traditional/sedentary game.

Elevations and distances in the United States

USGS Publications Warehouse

,

1991-01-01

The information in this booklet was compiled to answer inquiries received by the U.S. Geological Survey from students; teachers; writers; editors; publishers of encyclopedias, almanacs, and other reference books; and people in many other fields of work. The elevations of features and distances between points in the United States were determined from surveys and topographic maps of the U.S. Geological Survey or obtained from other sources. In most cases, the elevations were determined from surveys and from 1:24,000- and 1:25,000-scale, 7.5-minute topographic quadrangle maps. In Alaska, information was taken from 1:63,360-scale, 15-minute topographic quadrangle maps. In a few cases, data were obtained from older, 1:62,500-scale, 15-minute maps; these maps are being replaced with larger-scale 7.5-minute coverage. Further information about U.S. Geological Survey products can be obtained from: U.S. Geological Survey, Earth Science Information Center, 507 National Center, Reston, VA 22092 or phone 703-860-6045.

Ultrasound-guided transversus abdominis plane block in patients undergoing open inguinal hernia repair: 0.125% bupivacaine provides similar analgesic effect compared to 0.25% bupivacaine.

PubMed

Erdoğan Arı, Dilek; Yıldırım Ar, Arzu; Karadoğan, Firdevs; Özcabı, Yetkin; Koçoğlu, Ayşegül; Kılıç, Fatih; Akgün, Fatma Nur

2016-02-01

To evaluate the effectiveness of 0.125% bupivacaine compared to 0.25% bupivacaine for ultrasound-guided transversus abdominis plane (TAP) block in patients undergoing open inguinal hernia repair. Randomized, double-blind study. Educational and research hospital. Forty adult patients of American Society of Anesthesiologists physical status I-III undergoing elective primary unilateral open inguinal hernia repair under spinal anesthesia. Patients in group I received 20 mL of 0.25% bupivacaine, whereas patients in group II received 20 mL of 0.125% bupivacaine for TAP block at the end of the surgery. Pain intensity was assessed at rest and during coughing using 10-cm visual analog scale score at 5, 15, 30, and 45 minutes and 1, 2, 4, 6, 12, and 24 hours after TAP block. Morphine consumption and time to first morphine requirement were recorded. Visual analog scale scores at rest and during coughing were not significantly different between groups at all time points measured. Twenty-four hours of morphine consumption (7.72±7.33 mg in group I and 6.06±5.20 mg in group II; P=.437) and time to first morphine requirement (182.35±125.16 minutes in group I and 143.21±87.28 minutes in group II; P=.332) were not different between groups. 0.125% Bupivacaine provides similar analgesic effect compared to 0.25% bupivacaine for ultrasound-guided TAP block in patients undergoing open inguinal hernia repair. Copyright © 2016 Elsevier Inc. All rights reserved.

Comparison of the Effects of Thiopental Sodium and Propofol on Haemodynamics, Awareness and Newborns During Caesarean Section Under General Anaesthesia.

PubMed

Çakırtekin, Vedat; Yıldırım, Ahmet; Bakan, Nurten; Çelebi, Nevin; Bozkurt, Özkan

2015-04-01

To compare the effects of propofol and thiopental on haemodynamics, awareness and newborns in pregnant women undergoing elective caesarean section. Seventy pregnant women were assigned into two equal groups. For anaesthesia induction, 2 mg kg(-1) propofol (Group P) and 5 mg kg(-1) thiopental (Group T) were administered. Maternal haemodynamic parameters and bispectral index (BIS) values were recorded before induction, in 1-minute intervals within the first 10 minutes after induction and in 5-minute intervals thereafter, during skin incision, uterine incision, removal of infant, uterine sutures, skin sutures, eye opening and extubation in all cases. Cord blood gas analysis and 1- and 5-minute APGAR scores were recorded. In all cases, a keyword was spelled to ear during removal of the infant, and at the first postoperative hour, patients were questioned. Important time periods of surgery and anaesthesia and also the first postoperative hour haemodynamic values, pain scores, nausea and vomiting were noted. The demographic data were similar among cases. In Group T, systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and mean arterial pressure (MAP) at the first 2 minutes after induction and heart rate (HR) at almost all time points were significantly higher. BIS values from induction to the eighth minute and skin incision, uterine incision and removal of the infant were lower in Group P. No patient remembered the keyword spelled, while 4 patients reported dreaming during general anaesthesia. The effects of propofol and thiopental sodium on 1- and 5-minute APGAR scores, cord blood gas values and postoperative visual analogue scale (VAS) scores were similar. Propofol is a more appropriate anaesthetic agent than thiopental in anaesthesia for caesareans, since it provides better anaesthestic depth and more rapid recovery.

A clinical study to evaluate the efficacy of ELA-Max (4% liposomal lidocaine) as compared with eutectic mixture of local anesthetics cream for pain reduction of venipuncture in children.

PubMed

Eichenfield, Lawrence F; Funk, Ann; Fallon-Friedlander, Sheila; Cunningham, Bari B

2002-06-01

A double-randomized, blinded crossover trial was performed to assess the efficacy of ELA-Max (4% liposomal lidocaine) as compared with eutectic mixture of local anesthetics (EMLA) for pain relief during pediatric venipuncture procedures. Safety was assessed by evaluation for topical or systemic effects and measurement of serum lidocaine concentrations. A total of 120 children who were scheduled for repeat venipuncture for non-study-related reasons at 2 sites participated in the study. Patients were doubly randomized to treatment regimen (study medication application time of either 30 or 60 minutes) and to the order of application of the topical anesthetics for each venipuncture. The primary outcome measures were the child's rating of pain immediately after the venipuncture procedures using a 100-mm visual analog scale (VAS) tool and the parent's and blinded research observer's Observed Behavioral Distress scores. Both ELA-Max and EMLA seemed to alleviate venipuncture pain. There was no clinically or statistically significant difference in the patient VAS scores within the 30-minute or 60-minute treatment groups, and there was no clinical or statistical difference in VAS scores between the 30-minute ELA-Max treatment without occlusion and the 60-minute EMLA treatment with occlusion. There were no clinically or statistically significant differences between treatment with ELA-Max and EMLA in parental or blinded researcher Observed Behavioral Distress scores, the most frequent response at any observation time being "no distress." This study demonstrates that a 30-minute application of ELA-Max without occlusion is as safe and as effective for ameliorating pain associated with venipuncture as a 60-minute application of the prescription product EMLA requiring occlusion.

Endogenous and exogenous dynamics in the fluctuations of capital fluxes. An empirical analysis of the Chinese stock market

NASA Astrophysics Data System (ADS)

Jiang, Z.-Q.; Guo, L.; Zhou, W.-X.

2007-06-01

A phenomenological investigation of the endogenous and exogenous dynamics in the fluctuations of capital fluxes is carried out on the Chinese stock market using mean-variance analysis, fluctuation analysis, and their generalizations to higher orders. Non-universal dynamics have been found not only in the scaling exponent α, which is different from the universal values 1/2 and 1, but also in the distributions of the ratio η= σexo / σendo of individual stocks. Both the scaling exponent α of fluctuations and the Hurst exponent Hi increase in logarithmic form with the time scale Δt and the mean traded value per minute , respectively. We find that the scaling exponent αendo of the endogenous fluctuations is independent of the time scale. Multiscaling and multifractal features are observed in the data as well. However, the inhomogeneous impact model is not verified.

Recognition and treatment of unstable supraventricular tachycardia by pediatric residents in a simulation scenario.

PubMed

Shilkofski, Nicole A; Nelson, Kristen L; Hunt, Elizabeth A

2008-01-01

Supraventricular tachycardia (SVT) is the most frequent tachydysrhythmia in children. SVT with hemodynamic compromise should be terminated by immediate electrical cardioversion. Study objectives were to: (1) establish time to recognition and cardioversion of simulated unstable SVT; and (2) document delays and mistakes made during cardioversion. Ten teams of pediatric residents were presented with an unresponsive "patient" (Laerdal SimMan) in unstable SVT. Actions of team members and simulator timestamps of key events were recorded. A retrospective review of events and time logs was performed with primary outcome measure of time to successful cardioversion. Median time to cardioversion was 8.9 minutes (range, 5.3 minutes to unsuccessful scenario terminated at 15 minutes). In 20% of scenarios, the patient was never cardioverted. Ninety percent of teams administered adenosine, but 44% of attempts demonstrated incorrect administration technique. Other maneuvers before cardioversion: 70% administered fluid, 60% attempted vagal maneuvers, 30% requested electrocardiogram, 30% requested antiarrhythmics. In 20% of scenarios, the rhythm was misidentified. When cardioversion was performed, 25% failed to use gel, 37.5% failed to synchronize, 25% used inappropriate energy doses. In 60% of scenarios, no oxygen was administered. In 90% there was no assignment of Glasgow Coma Scale, and no assessment of mental status in 30%. In 60% perfusion was not assessed. Median time to cardioversion of 8.9 minutes is inconsistent with AHA recommendations for treatment of unstable SVT with "immediate cardioversion." Delays were secondary to lack of recognition of "unstable" SVT, due to failure to assess perfusion and mental status. Errors encountered during simulation identify curriculum reform targets.

Improving Palliative Care Team Meetings: Structure, Inclusion, and "Team Care".

PubMed

Brennan, Caitlin W; Kelly, Brittany; Skarf, Lara Michal; Tellem, Rotem; Dunn, Kathleen M; Poswolsky, Sheila

2016-07-01

Increasing demands on palliative care teams point to the need for continuous improvement to ensure teams are working collaboratively and efficiently. This quality improvement initiative focused on improving interprofessional team meeting efficiency and subsequently patient care. Meeting start and end times improved from a mean of approximately 9 and 6 minutes late in the baseline period, respectively, to a mean of 4.4 minutes late (start time) and ending early in our sustainability phase. Mean team satisfaction improved from 2.4 to 4.5 on a 5-point Likert-type scale. The improvement initiative clarified communication about patients' plans of care, thus positively impacting team members' ability to articulate goals to other professionals, patients, and families. We propose several recommendations in the form of a team meeting "toolkit." © The Author(s) 2015.

Properties of Superconductor-Normal Metal-Superconductor Microbridges.

DTIC Science & Technology

1980-07-21

H . A . Notarys, M. L. Yu, and J . E. Mercereau, Phys. Rev. Lett. 30, 743 ( 1973 ). 42. H . A . Notarys and J . E. Mercereau, Physica 55, 424... the mask. A high pressure mercury lamp with an incident flux of about 250 foot-candles gave exposure times of about three minutes. After the exposure... the I = 0 point. Both curves have the same current (horizontal) scale; the vertical scale for dV/dI is in arbitrary units. 56 fj -S 04) -

A Biological Perspective on the Meaning of Time

NASA Technical Reports Server (NTRS)

Rothschild, Lynn J.

2014-01-01

We have become impatient waiting for a web page to load, but the first member of our species evolved about 150,000 years ago - a geological instant as brief and as transitory as a text message. The shortest generation time of a bacterium is a sprint at under ten minutes, whereas a 200-year old whale, turtle or tree is not unknown. Life is a phenomenon that integrates processes ranging from the near instantaneous reactions of photosynthesis to the more stately pace of evolution. Here I will elucidate these processes with radically different time scales that go to creating and maintaining the diversity of life on earth, the clocks that nature uses to time them, and how modern biology is being used to alter the natural time scales.

Systemic Lidocaine Fails to Improve Postoperative Pain, But Reduces Time to Discharge Readiness in Patients Undergoing Laparoscopic Sterilization in Day-Case Surgery: A Double-Blind, Randomized, Placebo-Controlled Trial.

PubMed

Dewinter, Geertrui Barbara Erika; Teunkens, An; Vermeulen, Kristien; Al Tmimi, Layth; Van de Velde, Marc; Rex, Steffen

2016-01-01

Perioperative systemic lidocaine provides postoperative analgesia, decreases opioid consumption, and facilitates rehabilitation in abdominal surgery. We hypothesized that systemic lidocaine has analgesic effects in women undergoing day-case laparoscopic sterilization. Eighty women were randomized in this prospective, double-blind trial to receive either lidocaine (intravenous bolus of 1.5 mg/kg at induction of anesthesia, followed by an infusion of 1.5 mg · kg · h, which was continued until 30 minutes after arrival at the postanesthesia care unit [PACU]) or placebo. The primary end point was the proportion of patients with a numeric rating scale (NRS) of greater than 3, 30 minutes after arrival at the PACU. Secondary outcomes included total opioid consumption, postoperative pain scores, incidence of postoperative nausea and vomiting, and time to readiness for discharge. This clinical trial was registered (Eudra CT 2011-001315-31). Thirty minutes after PACU admission, the proportion of patients with an NRS score of greater than 3 did not differ between the groups (lidocaine group: 59% vs placebo group: 58%). The postoperative NRS for pain over the entire observation period was not significantly different between lidocaine and placebo groups (mean, 3.1 [SD, 0.7] vs 2.8 [SD, 0.6]; P = 0.4). Groups did not differ with respect to perioperative opioid consumption. Patients in the placebo group suffered significantly less from nausea (NRS: 0.1 [SD, 0.1] [placebo] vs 0.3 [SD, 0.1] [lidocaine]; P = 0.02) and required less postoperative nausea and vomiting rescue medication (1 patient in the placebo group vs 7 in the lidocaine group; P = 0.03). The time to meet hospital discharge criteria was significantly lower in the lidocaine group (median, 177 minutes [range, 96-408 minutes] vs 221 minutes [range, 121-420 minutes]; P = 0.02). The mean lidocaine plasma levels at the end of IV lidocaine infusion was 2.5 (SD, 1.1) μg/mL. In laparoscopic sterilization, systemic lidocaine reduces time to readiness for hospital discharge.

A Web-Based Graphical Food Frequency Assessment System: Design, Development and Usability Metrics.

PubMed

Franco, Rodrigo Zenun; Alawadhi, Balqees; Fallaize, Rosalind; Lovegrove, Julie A; Hwang, Faustina

2017-05-08

Food frequency questionnaires (FFQs) are well established in the nutrition field, but there remain important questions around how to develop online tools in a way that can facilitate wider uptake. Also, FFQ user acceptance and evaluation have not been investigated extensively. This paper presents a Web-based graphical food frequency assessment system that addresses challenges of reproducibility, scalability, mobile friendliness, security, and usability and also presents the utilization metrics and user feedback from a deployment study. The application design employs a single-page application Web architecture with back-end services (database, authentication, and authorization) provided by Google Firebase's free plan. Its design and responsiveness take advantage of the Bootstrap framework. The FFQ was deployed in Kuwait as part of the EatWellQ8 study during 2016. The EatWellQ8 FFQ contains 146 food items (including drinks). Participants were recruited in Kuwait without financial incentive. Completion time was based on browser timestamps and usability was measured using the System Usability Scale (SUS), scoring between 0 and 100. Products with a SUS higher than 70 are considered to be good. A total of 235 participants created accounts in the system, and 163 completed the FFQ. Of those 163 participants, 142 reported their gender (93 female, 49 male) and 144 reported their date of birth (mean age of 35 years, range from 18-65 years). The mean completion time for all FFQs (n=163), excluding periods of interruption, was 14.2 minutes (95% CI 13.3-15.1 minutes). Female participants (n=93) completed in 14.1 minutes (95% CI 12.9-15.3 minutes) and male participants (n=49) completed in 14.3 minutes (95% CI 12.6-15.9 minutes). Participants using laptops or desktops (n=69) completed the FFQ in an average of 13.9 minutes (95% CI 12.6-15.1 minutes) and participants using smartphones or tablets (n=91) completed in an average of 14.5 minutes (95% CI 13.2-15.8 minutes). The median SUS score (n=141) was 75.0 (interquartile range [IQR] 12.5), and 84% of the participants who completed the SUS classified the system either "good" (n=50) or "excellent" (n=69). Considering only participants using smartphones or tablets (n=80), the median score was 72.5 (IQR 12.5), slightly below the SUS median for desktops and laptops (n=58), which was 75.0 (IQR 12.5). No significant differences were found between genders or age groups (below and above the median) for the SUS or completion time. Taking into account all the requirements, the deployment used professional cloud computing at no cost, and the resulting system had good user acceptance. The results for smartphones/tablets were comparable with desktops/laptops. This work has potential to promote wider uptake of online tools that can assess dietary intake at scale. ©Rodrigo Zenun Franco, Balqees Alawadhi, Rosalind Fallaize, Julie A Lovegrove, Faustina Hwang. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 08.05.2017.

MO-G-BRF-06: Radiotherapy and Prompt Oxygen Dynamics

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

Kissick, M; Campos, D; Adamson, E

Purpose: Adaptive radiotherapy requires a knowledge of the changing local tumor oxygen concentrations for times on the order of the treatment time, a time scale far shorter than cell death and proliferation. This knowledge will be needed to guide hypofractionated radiotherapy. Methods: A diffuse optical probe system was developed to spatially average over the whole interior of athymic Sprague Dawley nude mouse xenografts of human head and neck cancers. The blood volume and hemoglobin saturation was measured in real time. The quantities were measured with spectral fitting before and after 10 Gy of radiation is applied. An MRI BOLD scanmore » is acquired before and after 10 Gy that measures regional changes in R2* which is inversely proportional to oxygen availability. Simulations were performed to fit the blood oxygen dynamics and infer changes in hypoxia within the tumor. Results: The optical probe measured nearly constant blood volume and a significant drop in hemoglobin saturation of about 30% after 10 Gy over the time scale of less than 30 minutes. The averaged R2* within the tumor volume increased by 15% after the 10 Gy dose, which is consistent with the optical results. The simulations and experiments support likely dynamic metabolic changes and/or fast vasoconstrictive signals are occurring that change the oxygen concentrations significantly, but not cell death or proliferation. Conclusion: Significant oxygen changes were observed to occur within 30 minutes, coinciding with the treatment time scale. This dynamic is very important for patient specific adaptive therapy. For hypofractionated therapy, the local instantaneous oxygen content is likely the most important variable to control. The invention of a bedside device for the purpose of measuring the instantaneous response to large radiation doses would be an important step to future improvements in outcome.« less

Field Validation of the Los Angeles Motor Scale as a Tool for Paramedic Assessment of Stroke Severity.

PubMed

Kim, Joon-Tae; Chung, Pil-Wook; Starkman, Sidney; Sanossian, Nerses; Stratton, Samuel J; Eckstein, Marc; Pratt, Frank D; Conwit, Robin; Liebeskind, David S; Sharma, Latisha; Restrepo, Lucas; Tenser, May-Kim; Valdes-Sueiras, Miguel; Gornbein, Jeffrey; Hamilton, Scott; Saver, Jeffrey L

2017-02-01

The Los Angeles Motor Scale (LAMS) is a 3-item, 0- to 10-point motor stroke-deficit scale developed for prehospital use. We assessed the convergent, divergent, and predictive validity of the LAMS when performed by paramedics in the field at multiple sites in a large and diverse geographic region. We analyzed early assessment and outcome data prospectively gathered in the FAST-MAG trial (Field Administration of Stroke Therapy-Magnesium phase 3) among patients with acute cerebrovascular disease (cerebral ischemia and intracranial hemorrhage) within 2 hours of onset, transported by 315 ambulances to 60 receiving hospitals. Among 1632 acute cerebrovascular disease patients (age 70±13 years, male 57.5%), time from onset to prehospital LAMS was median 30 minutes (interquartile range 20-50), onset to early postarrival (EPA) LAMS was 145 minutes (interquartile range 119-180), and onset to EPA National Institutes of Health Stroke Scale was 150 minutes (interquartile range 120-180). Between the prehospital and EPA assessments, LAMS scores were stable in 40.5%, improved in 37.6%, and worsened in 21.9%. In tests of convergent validity, against the EPA National Institutes of Health Stroke Scale, correlations were r=0.49 for the prehospital LAMS and r=0.89 for the EPA LAMS. Prehospital LAMS scores did diverge from the prehospital Glasgow Coma Scale, r=-0.22. Predictive accuracy (adjusted C statistics) for nondisabled 3-month outcome was as follows: prehospital LAMS, 0.76 (95% confidence interval 0.74-0.78); EPA LAMS, 0.85 (95% confidence interval 0.83-0.87); and EPA National Institutes of Health Stroke Scale, 0.87 (95% confidence interval 0.85-0.88). In this multicenter, prospective, prehospital study, the LAMS showed good to excellent convergent, divergent, and predictive validity, further establishing it as a validated instrument to characterize stroke severity in the field. © 2017 American Heart Association, Inc.

Computational Earth Science: Big Data Transformed Into Insight

NASA Astrophysics Data System (ADS)

Sellars, Scott; Nguyen, Phu; Chu, Wei; Gao, Xiaogang; Hsu, Kuo-lin; Sorooshian, Soroosh

2013-08-01

More than ever in the history of science, researchers have at their fingertips an unprecedented wealth of data from continuously orbiting satellites, weather monitoring instruments, ecological observatories, seismic stations, moored buoys, floats, and even model simulations and forecasts. With just an internet connection, scientists and engineers can access atmospheric and oceanic gridded data and time series observations, seismographs from around the world, minute-by-minute conditions of the near-Earth space environment, and other data streams that provide information on events across local, regional, and global scales. These data sets have become essential for monitoring and understanding the associated impacts of geological and environmental phenomena on society.

76 FR 18827 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-05

... individuals. Time to conduct study: 90 minutes. Estimated travel time to and from site: 30 minutes. Estimated... minutes. Estimated travel time to and from site: 30 minutes. Estimated floater burden: 84 hours (24 x 210... study: 90 minutes. Estimated travel time to and from site: 30 minutes. Estimated participant burden: 50...

Transport time and care processes for patients transferred with ST-segment-elevation myocardial infarction: the reperfusion in acute myocardial infarction in Carolina emergency rooms experience.

PubMed

Muñoz, Daniel; Roettig, Mayme L; Monk, Lisa; Al-Khalidi, Hussein; Jollis, James G; Granger, Christopher B

2012-08-01

For patients with ST-segment elevation myocardial infarction transferred for primary percutaneous coronary intervention, guidelines have called for device activation within 90 minutes of initial presentation. Fewer than 20% of transferred patients are treated in such a timely fashion. We examine the association between transfer drive times and door-to-device (D2D) times in a network of North Carolina hospitals. We compare the feasibility of timely percutaneous coronary intervention using ground versus air transfer. We perform a retrospective analysis of the relationship between transfer drive times and D2D times in a 119-hospital ST-segment-elevation myocardial infarction statewide network. Between July 2008 and December 2009, 1537 ST-segment-elevation myocardial infarction patients underwent interhospital transfer for reperfusion via primary percutaneous coronary intervention. For ground transfers, median D2D time was 93 minutes for drive times ≤30 minutes, 117 minutes for drive times of 31 to 45 minutes, and 121 minutes for drive times >45 minutes. For air transfers, median D2D time was 125 minutes for drive times of 31 to 45 minutes and 138 minutes for drive times >45 minutes. Helicopter transport was associated with longer door-in door-out times and, ultimately, was associated with median D2D times that exceeded guideline recommendations, no matter the transfer drive time category. In a well-developed ST-segment-elevation myocardial infarction system, D2D times within 90 to 120 minutes appear most feasible for hospitals within 30-minute transfer drive time. Helicopter transport did not offer D2D time advantages for transferred STEMI patients. This finding appears to be attributable to comparably longer door-in door-out times for air transfers.

Lower Leg Anterior and Lateral Intracompartmental Pressure Changes Before and After Classic Versus Skate Nordic Rollerskiing

PubMed Central

Woods, Katherine M.; Petron, David J.; Shultz, Barry B.; Hicks-Little, Charlie A.

2015-01-01

Context Chronic exertional compartment syndrome (CECS) is a debilitating condition resulting in loss of function and a decrease in athletic performance. Cases of CECS are increasing among Nordic skiers; therefore, analysis of intracompartmental pressures (ICPs) before and after Nordic skiing is warranted. Objective To determine if lower leg anterior and lateral ICPs and subjective lower leg pain levels increased after a 20-minute Nordic rollerskiing time trial and to examine if differences existed between postexercise ICPs for the 2 Nordic rollerskiing techniques, classic and skate. Design Crossover study. Setting Outdoor paved loop. Patients or Other Participants Seven healthy Division I Nordic skiers (3 men, 4 women; age = 22.71 ± 1.38 y, height = 175.36 ± 6.33 cm, mass = 70.71 ± 6.58 kg). Intervention(s) Participants completed two 20-minute rollerskiing time trials using the classic and skate technique in random order. The time trials were completed 7 days apart. Anterior and lateral ICPs and lower leg pain scores were obtained at baseline and at minutes 1 and 5 after rollerskiing. Main Outcome Measure(s) Anterior and lateral ICPs (mm Hg) were measured using a Stryker Quic STIC handheld monitor. Subjective measures of lower leg pain were recorded using the 11-point Numeric Rating Scale. Results Increases in both anterior (P = .000) and lateral compartment (P = .002) ICPs were observed, regardless of rollerskiing technique used. Subjective lower leg pain increased after the classic technique for the men from baseline to 1 minute postexercise and after the skate technique for the women. Significant 3-way interactions (technique × time × sex) were observed for the anterior (P = .002) and lateral (P = .009) compartment ICPs and lower leg pain (P = .005). Conclusions Postexercise anterior and lateral ICPs increased compared with preexercise ICPs after both classic and skate rollerskiing techniques. Lower leg pain is a primary symptom of CECS. The subjective lower leg pain 11-point Numeric Rating Scale results indicate that increases in lower leg ICPs sustained during Nordic rollerskiing may increase discomfort during activity. Our results therefore suggest that Nordic rollerskiing contributes to increases in ICPs, which may lead to the development of CECS. PMID:26090709

Lower Leg Anterior and Lateral Intracompartmental Pressure Changes Before and After Classic Versus Skate Nordic Rollerskiing.

PubMed

Woods, Katherine M; Petron, David J; Shultz, Barry B; Hicks-Little, Charlie A

2015-08-01

Chronic exertional compartment syndrome (CECS) is a debilitating condition resulting in loss of function and a decrease in athletic performance. Cases of CECS are increasing among Nordic skiers; therefore, analysis of intracompartmental pressures (ICPs) before and after Nordic skiing is warranted. To determine if lower leg anterior and lateral ICPs and subjective lower leg pain levels increased after a 20-minute Nordic rollerskiing time trial and to examine if differences existed between postexercise ICPs for the 2 Nordic rollerskiing techniques, classic and skate. Crossover study. Outdoor paved loop. Seven healthy Division I Nordic skiers (3 men, 4 women; age = 22.71 ± 1.38 y, height = 175.36 ± 6.33 cm, mass = 70.71 ± 6.58 kg). Participants completed two 20-minute rollerskiing time trials using the classic and skate technique in random order. The time trials were completed 7 days apart. Anterior and lateral ICPs and lower leg pain scores were obtained at baseline and at minutes 1 and 5 after rollerskiing. Anterior and lateral ICPs (mm Hg) were measured using a Stryker Quic STIC handheld monitor. Subjective measures of lower leg pain were recorded using the 11-point Numeric Rating Scale. Increases in both anterior (P = .000) and lateral compartment (P = .002) ICPs were observed, regardless of rollerskiing technique used. Subjective lower leg pain increased after the classic technique for the men from baseline to 1 minute postexercise and after the skate technique for the women. Significant 3-way interactions (technique × time × sex) were observed for the anterior (P = .002) and lateral (P = .009) compartment ICPs and lower leg pain (P = .005). Postexercise anterior and lateral ICPs increased compared with preexercise ICPs after both classic and skate rollerskiing techniques. Lower leg pain is a primary symptom of CECS. The subjective lower leg pain 11-point Numeric Rating Scale results indicate that increases in lower leg ICPs sustained during Nordic rollerskiing may increase discomfort during activity. Our results therefore suggest that Nordic rollerskiing contributes to increases in ICPs, which may lead to the development of CECS.

The influence of a seated break on prolonged standing induced low back pain development.

PubMed

Gallagher, Kaitlin M; Campbell, Troy; Callaghan, Jack P

2014-01-01

With the recent attention to 'sitting disease', health practitioners and scientists are promoting standing in the workplace to decrease sedentary time, despite a high prevalence of low back pain (LBP) development during prolonged standing. The purpose of this study was to assess how a seated break inserted between bouts of prolonged standing would influence LBP development, posture and movement. A total of 20 participants stood for 45 minutes, sat for 15 minutes and repeated this sequence while lumbar and thoracic angles were measured, and LBP visual analogue scale reports were taken. Of the sample, 55% participants reported LBP in standing. A stand to sit ratio of 3:1 did not provide lasting recovery of LBP from standing and pain developers utilised a limited range of their lumbar spine angle and increased thoracic extension, resulting in static postures that caused tissue aggravation that was not resolved after 15 minutes of sitting. Prolonged standing in the workplace has the potential to result in LBP for some workers and alternate ways to reduce sedentary time should be investigated.

Physical education and academic achievement in elementary school: data from the early childhood longitudinal study.

PubMed

Carlson, Susan A; Fulton, Janet E; Lee, Sarah M; Maynard, L Michele; Brown, David R; Kohl, Harold W; Dietz, William H

2008-04-01

We examined the association between time spent in physical education and academic achievement in a longitudinal study of students in kindergarten through fifth grade. We used data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998 to 1999, which employed a multistage probability design to select a nationally representative sample of students in kindergarten (analytic sample = 5316). Time spent in physical education (minutes per week) was collected from classroom teachers, and academic achievement (mathematics and reading) was scored on an item response theory scale. A small but significant benefit for academic achievement in mathematics and reading was observed for girls enrolled in higher amounts (70-300 minutes per week) of physical education (referent: 0-35 minutes per week). Higher amounts of physical education were not positively or negatively associated with academic achievement among boys. Among girls, higher amounts of physical education may be associated with an academic benefit. Physical education did not appear to negatively affect academic achievement in elementary school students. Concerns about adverse effects on achievement may not be legitimate reasons to limit physical education programs.

Real-Time Observation of Apathy in Long-Term Care Residents With Dementia: Reliability of the Person-Environment Apathy Rating Scale.

PubMed

Jao, Ying-Ling; Mogle, Jacqueline; Williams, Kristine; McDermott, Caroline; Behrens, Liza

2018-04-01

Apathy is prevalent in individuals with dementia. Lack of responsiveness to environmental stimulation is a key characteristic of apathy. The Person-Environment Apathy Rating (PEAR) scale consists of environment and apathy subscales, which allow for examination of environmental impact on apathy. The interrater reliability of the PEAR scale was examined via real-time observation. The current study included 45 observations of 15 long-term care residents with dementia. Each participant was observed at three time points for 10 minutes each. Two raters observed the participant and surrounding environment and independently rated the participant's apathy and environmental stimulation using the PEAR scale. Weighted Kappa was 0.5 to 0.82 for the PEAR-Environment subscale and 0.5 to 0.8 for the PEAR-Apathy subscale. Overall, with the exception of three items with relatively weak reliability (0.50 to 0.56), the PEAR scale showed moderate to strong interrater reliability (0.63 to 0.82). The results support the use of the PEAR scale to measure environmental stimulation and apathy via real-time observation in long-term care residents with dementia. [Journal of Gerontological Nursing, 44(4), 23-28.]. Copyright 2018, SLACK Incorporated.

Comparison of IPAQ-SF and Two Other Physical Activity Questionnaires with Accelerometer in Adolescent Boys.

PubMed

Rääsk, Triin; Mäestu, Jarek; Lätt, Evelin; Jürimäe, Jaak; Jürimäe, Toivo; Vainik, Uku; Konstabel, Kenn

2017-01-01

Self-report measures of physical activity (PA) are easy to use and popular but their reliability is often questioned. Therefore, the general aim of the present study was to investigate the association of PA questionnaires with accelerometer derived PA, in a sample of adolescent boys. In total, 191 pubertal boys (mean age 14.0 years) completed three self-report questionnaires and wore an accelerometer (ActiGraph GT1M) for 7 consecutive days. The PA questionnaires were: International Physical Activity Questionnaire-Short Form (IPAQ-SF), Tartu Physical Activity Questionnaire (TPAQ), and the Inactivity subscale from Domain-Specific Impulsivity (DSI) scale. All three questionnaires were significantly correlated with accelerometer derived MVPA: the correlations were 0.31 for the IPAQ-SF MVPA, 0.34 for the TPAQ MVPA and -0.29 for the DSI Inactivity scale. Nevertheless, none of the questionnaires can be used as a reliable individual-level estimate of MVPA in male adolescents. The boys underreported their MVPA in IPAQ-SF as compared to accelerometer-derived MVPA (respective averages 43 and 56 minutes); underreporting was more marked in active boys with average daily MVPA at least 60 minutes, and was not significant in less active boys. Conversely, MVPA index from TPAQ overestimated the MVPA in less active boys but underestimated it in more active boys. The sedentary time reported in IPAQ-SF was an underestimate as compared to accelerometer-derived sedentary time (averages 519 and 545 minutes, respectively).

The role of calling EMS versus using private transportation in improving the management of stroke in France.

PubMed

Gache, Kristel; Couralet, Melanie; Nitenberg, Gérard; Leleu, Henri; Minvielle, Etienne

2013-01-01

To compare the time from symptom onset to brain imaging between patients calling emergency medical services (EMS) and those using private means for transportation. We focused on symptom onset-to-brain imaging times of ≤2 hours and ≤3 hours 30 minutes, assuming a one-hour interval between imaging and thrombolysis. Other variables were the patient's age, gender, stroke type, National Institutes of Health Stroke Scale (NIHSS) score, presence of an on-site stroke unit, and period of symptom onset. Univariate analyses and a hierarchical linear regression model were used, as appropriate, and adjusted for these variables. A total of 1,105 stroke patients (28%) were included in the analyses, 40.6% of them transported by EMS. Patients using EMS were significantly older (72.8 vs. 70.5 years; p = 0.008), they had a higher NIHSS score (8 vs. 6.1; p = 0.0001), fewer were ischemic (85.1% vs. 90.6%; p = 0.005), and more of them reached hospitals with an on-site stroke unit (81.3% vs. 72.9%; p = 0.002). For the EMS-call patients, the median symptom onset-to-brain imaging time was significantly shorter (3 hours 21 minutes vs. 5 hours 57 minutes), and after adjustment, maximum delays of 2 hours and 3 hours 30 minutes were independently associated with EMS call: 28% vs. 18% (p = 0.015) and 66% vs. 45% (p < 0.0001) of patients, respectively, leading to an adjusted odds ratio of 2.77 (95% confidence interval, 2.007-3.828; p < 0.0001) for the threshold of 3 hours 30 minutes. The symptom onset-to-brain imaging time was significantly shorter in case of EMS transportation, but most patients did not reach the hospital in time to be eligible for thrombolysis. Efforts are still needed to reduce delays, especially public education and EMS activation. These efforts should be combined with new approaches for the quality management of stroke patients.

Swift-BAT: Transient Source Monitoring

NASA Astrophysics Data System (ADS)

Barbier, L. M.; Barthelmy, S.; Cummings, J.; Gehrels, N.; Krimm, H.; Markwardt, C.; Mushotzky, R.; Parsons, A.; Sakamoto, T.; Tueller, J.; Fenimore, E.; Palmer, D.; Skinner, G.; Swift-BAT Team

2005-12-01

The Burst Alert Telescope (BAT) on the Swift satellite is a large field of view instrument that continually monitors the sky to provide the gamma-ray burst trigger for Swift. An average of more than 70% of the sky is observed on a daily basis. The survey mode data is processed on two sets of time scales: from one minute to one day as part of the transient monitor program, and from one spacecraft pointing ( ˜20 minutes) to the full mission duration for the hard X-ray survey program. In the transient monitor program, sky images are processed to detect astrophysical sources in six energy bands covering 15-350 keV. The detected flux or upper limit in each energy band is calculated for >300 objects on time scales up to one day. In addition, the monitor is sensitive to an outburst from a new or unknown source. Sensitivity as a function of time scale for catalog and unknown sources will be presented. The daily exposure for a typical source is ˜1500 - 3000 seconds, with a 1-sigma sensitivity of ˜4mCrab. 90% of the sources are sampled at least every 16 days, but many sources are sampled daily. The BAT team will soon make the results of the transient monitor public to the astrophysical community through the Swift mission web page. It is expected that the Swift-BAT transient monitor will become an important resource for the high energy astrophysics community.

Identifying depression post-stroke in patients with aphasia: a systematic review of the reliability, validity and feasibility of available instruments.

PubMed

van Dijk, Mariska J; de Man-van Ginkel, Janneke M; Hafsteinsdóttir, Thóra B; Schuurmans, Marieke J

2016-08-01

To identify and critically appraise the evidence for instruments assessing depression in stroke patients with aphasia. The PubMed, CINAHL, Web of Science, Psych Info and Cochrane databases were searched from inception until May 2015. Of the 383 titles found in the search, 15 articles met the inclusion criteria and six instruments were identified: The Aphasic Depression Rating Scale, the Clinical Global Impression-Scale, the Stroke Aphasic Depression Questionnaire (four versions), the Signs of Depression Scale, the Visual Analogue Mood Scale (three versions) and the Visual Analogue Self Esteem Scale. Supporting evidence for reliability and validity was limited owing to methodological flaws in the studies influencing the ratings of methodological quality. Feasibility data were available for all instruments. Rating time of the instruments ranged from less than one minute to five minutes, two instruments required extensive training. A number of instruments to assess depressive symptoms in patients with aphasia are available. None of the instruments however, were found to be sufficiently investigated and most of the studies identified were of low methodological quality. Given the present evidence, the Stroke Aphasic Depression Questionnaire-10, the Stroke Aphasic Depression Questionnaire-H10 and the Signs of Depression Scale are the most feasible and can be recommended for clinical practice. © The Author(s) 2015.

A durable gain in motor and non-motor symptoms of Parkinson's Disease following repeated caloric vestibular stimulation: A single-case study.

PubMed

Wilkinson, David; Podlewska, Aleksandra; Sakel, Mohamed

2016-01-01

To gain 'first-in-man' evidence that repeated caloric vestibular stimulation (CVS), a non-invasive form of neuro-modulation, can induce a lasting and clinically-relevant reduction in Parkinson's Disease (PD) symptoms. A 70  yr old male, diagnosed with PD 7 years prior to study enrolment, self-administered CVS at home 2×20 minutes per day for three months using a solid-state portable device. Standardised neuropsychological assessments of motor, cognitive, affective and independent function were carried out prior to stimulation, at the start and end of the sham (month 1) and active (months 2-3) phases, and 5 months post-stimulation. Relative to the pre-stimulation baseline, behavioural improvements that exceeded the minimal detectable change were observed on the EQ5D, Unified Parkinson's Disease Rating Scale, Schwab and England scale, 2 minute walk, Timed up and go, Non-motor symptom assessment scale for PD, Montreal cognitive assessment, Hospital depression scale and Epworth sleepiness scale. The level of change exceeded the threshold for a minimal clinically important difference on all scales for which a threshold has been published. By contrast, little improvement was seen during the sham (i.e., placebo) phase. Caloric vestibular stimulation may offer a novel, home-based method of relieving everyday symptoms of PD, and merits further evaluative study.

Spinal anesthesia: a comparison of procaine and lidocaine.

PubMed

Le Truong, H H; Girard, M; Drolet, P; Grenier, Y; Boucher, C; Bergeron, L

2001-05-01

To compare spinal procaine to spinal lidocaine with regard to their main clinical characteristics and incidence of transient radicular irritation (TRI). In this randomized, double-blind, prospective study, patients (two groups, n=30 each) received either 100 mg of lidocaine 5% in 7.5% glucose (Group L) or 100 mg of procaine 10% diluted with 1 ml cerebrospinal fluid (Group P). After spinal anesthesia, segmental level of sensory block was assessed by pinprick. Blood pressure and the height of the block were noted each minute for the first ten minutes, then every three minutes for the next 35 min and finally every five minutes until regression of the block to L4. Motor blockade was evaluated using the Bromage scale. To evaluate the presence of TRI, each patient was questioned 48 hr after surgery. Time to highest sensory level and to maximum number of segments blocked showed no difference between groups. Mean time for sensory regression to T10 and for regression of the motor block were shorter in Group P. Eighty minutes following injection, sensory levels were lower in Group P. Five patients had inadequate surgical anesthesia in Group P and only one in Group L. No patient in Group P had TRI (95% CI 10-12%) while eight (27%) in Group L did (95% CI 12-46%). Procaine 10% was associated with a clinical failure rate of 14.2%. This characteristic must be balanced against an absence of TRI, which occurs more frequently with the use of lidocaine 5%.

An intensive virtual reality program improves functional balance and mobility of adolescents with cerebral palsy.

PubMed

Brien, Marie; Sveistrup, Heidi

2011-01-01

To examine functional balance and mobility in adolescents with cerebral palsy classified at Gross Motor Function Classification System (GMFCS) level I following an intensive short-duration virtual reality (VR) intervention. Single-subject, multiple-baseline design with 4 adolescents. Outcomes included the Community Balance and Mobility Scale (CB&M), the 6-Minute Walk Test (6MWT), the Timed Up and Down Stairs, and the Gross Motor Function Measure Dimension E. Assessments were recorded 3 to 6 times at baseline, 5 times during intervention, and 4 times at follow-up. Daily 90-minute VR intervention was completed for 5 consecutive days. Visual, statistical, and clinical significance analyses were used. Statistically significant improvements were shown in all adolescents on CB&M and 6MWT. True change was recorded in all for the CB&M and in 3 for the 6MWT. Functional balance and mobility in adolescents with cerebral palsy classified at GMFCS level I improve with intense, short duration VR intervention, and changes are maintained at 1-month posttraining.

Effects of large-scale wind driven turbulence on sound propagation

NASA Technical Reports Server (NTRS)

Noble, John M.; Bass, Henry E.; Raspet, Richard

1990-01-01

Acoustic measurements made in the atmosphere have shown significant fluctuations in amplitude and phase resulting from the interaction with time varying meteorological conditions. The observed variations appear to have short term and long term (1 to 5 minutes) variations at least in the phase of the acoustic signal. One possible way to account for this long term variation is the use of a large scale wind driven turbulence model. From a Fourier analysis of the phase variations, the outer scales for the large scale turbulence is 200 meters and greater, which corresponds to turbulence in the energy-containing subrange. The large scale turbulence is assumed to be elongated longitudinal vortex pairs roughly aligned with the mean wind. Due to the size of the vortex pair compared to the scale of the present experiment, the effect of the vortex pair on the acoustic field can be modeled as the sound speed of the atmosphere varying with time. The model provides results with the same trends and variations in phase observed experimentally.

Feasibility trial evaluation of a physical activity and screen-viewing course for parents of 6 to 8 year-old children: Teamplay

PubMed Central

2013-01-01

Background Many children spend too much time screen-viewing (watching TV, surfing the internet and playing video games) and do not meet physical activity (PA) guidelines. Parents are important influences on children’s PA and screen-viewing (SV). There is a shortage of parent-focused interventions to change children’s PA and SV. Methods Teamplay was a two arm individualized randomized controlled feasibility trial. Participants were parents of 6–8 year old children. Intervention participants were invited to attend an eight week parenting program with each session lasting 2 hours. Children and parents wore an accelerometer for seven days and minutes of moderate-to-vigorous intensity PA (MVPA) were derived. Parents were also asked to report the average number of hours per day that both they and the target child spent watching TV. Measures were assessed at baseline (time 0) at the end of the intervention (week 8) and 2 months after the intervention had ended (week 16). Results There were 75 participants who provided consent and were randomized but 27 participants withdrew post-randomization. Children in the intervention group engaged in 2.6 fewer minutes of weekday MVPA at Time 1 but engaged in 11 more minutes of weekend MVPA. At Time 1 the intervention parents engaged in 9 more minutes of weekday MVPA and 13 more minutes of weekend MVPA. The proportion of children in the intervention group watching ≥ 2 hours per day of TV on weekend days decreased after the intervention (time 0 = 76%, time 1 = 39%, time 2 = 50%), while the control group proportion increased slightly (79%, 86% and 87%). Parental weekday TV watching decreased in both groups. In post-study interviews many mothers reported problems associated with wearing the accelerometers. In terms of a future full-scale trial, a sample of between 80 and 340 families would be needed to detect a mean difference of 10-minutes of weekend MVPA. Conclusions Teamplay is a promising parenting program in an under-researched area. The intervention was acceptable to parents, and all elements of the study protocol were successfully completed. Simple changes to the trial protocol could result in more complete data collection and study engagement. PMID:23510646

Association of Door-to-Balloon Time and Mortality in Patients ≥65 Years With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

PubMed Central

Rathore, Saif S.; Curtis, Jeptha P.; Nallamothu, Brahmajee K.; Wang, Yongfei; Foody, JoAnne Micale; Kosiborod, Mikhail; Masoudi, Frederick A.; Havranek, Edward P; Krumholz, Harlan M.

2009-01-01

Current guidelines recommend ST-elevation myocardial infarction (STEMI) patients receive primary percutaneous coronary intervention (PCI) within 90 minutes of admission, although there is conflicting data regarding the relationship between time to treatment and mortality in these patients. We used logistic regression analyses employing fractional polynomial model to evaluate the association between door-to-balloon time and one-year mortality in STEMI patients age ≥65 years undergoing primary PCI in 1994–96 (n=1,932). Median door-to-balloon time was 128 minutes (interquartile range 92–178, 24.2% treated within 90 minutes). Overall one-year mortality was 21.1%. Longer door-to-balloon times were associated with higher one-year mortality in a continuous, nonlinear fashion (30 minutes 10.9%, 60 minutes 13.6%, 90 minutes 16.5%, 120 minutes 19.5%, 150 minutes 22.5%, 180 minutes 25.3%, 210 minutes 27.9%). The nature of the association between door-to-balloon time and one-year mortality was best modeled by a second-degree fractional polynomial (P<0.001). Findings were similar after multivariable adjustment as any increase in door-to-balloon time was associated with successive increases in patients’ one-year mortality (30 minutes 8.8%, 60 minutes 12.9%, 90 minutes 16.6%, 120 minutes 19.9%, 150 minutes 22.9%, 180 minutes 25.5%, 210 minutes 27.7%). In conclusion, any delay in primary PCI is associated with increased one-year mortality, suggesting efforts should focus on reducing time to treatment as much as possible, even among those centers currently providing primary PCI within 90 minutes. PMID:19840562

Development of Porosity Measurement Method in Shale Gas Reservoir Rock

NASA Astrophysics Data System (ADS)

Siswandani, Alita; Nurhandoko, BagusEndar B.

2016-08-01

The pore scales have impacts on transport mechanisms in shale gas reservoirs. In this research, digital helium porosity meter is used for porosity measurement by considering real condition. Accordingly it is necessary to obtain a good approximation for gas filled porosity. Shale has the typical effective porosity that is changing as a function of time. Effective porosity values for three different shale rocks are analyzed by this proposed measurement. We develop the new measurement method for characterizing porosity phenomena in shale gas as a time function by measuring porosity in a range of minutes using digital helium porosity meter. The porosity of shale rock measured in this experiment are free gas and adsorbed gas porosoty. The pressure change in time shows that porosity of shale contains at least two type porosities: macro scale porosity (fracture porosity) and fine scale porosity (nano scale porosity). We present the estimation of effective porosity values by considering Boyle-Gay Lussaac approximation and Van der Waals approximation.

Lower Learning Difficulty and Fluoroscopy Reduction of Transforaminal Percutaneous Endoscopic Lumbar Discectomy with an Accurate Preoperative Location Method.

PubMed

Fan, Guoxin; Gu, Xin; Liu, Yifan; Wu, Xinbo; Zhang, Hailong; Gu, Guangfei; Guan, Xiaofei; He, Shisheng

2016-01-01

Transforaminal percutaneous endoscopic lumbar discectomy (tPELD) poses great challenges for junior surgeons. Beginners often require repeated attempts using fluoroscopy causing more punctures, which may significantly undermine their confidence and increase the radiation exposure to medical staff and patients. Moreover, the impact of an accurate location on the learning curve of tPELD has not been defined. The study aimed to investigate the impact of an accurate preoperative location method on learning difficulty and fluoroscopy time of tPELD. Retrospective evaluation. Patients receiving tPELD by one surgeon with a novel accurate preoperative location method were regarded as Group A, and those receiving tPELD by another surgeon with a conventional fluoroscopy method were regarded as Group B. From January 2012 to August 2014, we retrospectively reviewed the first 80 tPELD cases conducted by 2 junior surgeons. The operation time, fluoroscopy times, preoperative location time, and puncture-channel time were thoroughly analyzed. The operation time of the first 20 patients were 99.75 ± 10.38 minutes in Group A and 115.7 ± 16.46 minutes in Group B, while the operation time of all 80 patients was 88.36 ± 11.56 minutes in Group A and 98.26 ± 14.90 minutes in Group B. Significant differences were detected in operation time between the 2 groups, both for the first 20 patients and total 80 patients (P < 0.05). The fluoroscopy times were 26.78 ± 4.17 in Group A and 33.98 ± 2.69 in Group B (P < 0.001). The preoperative location time was 3.43 ± 0.61 minutes in Group A and 5.59 ± 1.46 minutes in Group B (P < 0.001). The puncture-channel time was 27.20 ± 4.49 minutes in Group A and 34.64 ± 8.35 minutes in Group B (P < 0.001). There was a moderate correlation between preoperative location time and puncture-channel time (r = 0.408, P < 0.001), and a moderate correlation between preoperative location time and fluoroscopy times (r = 0.441, P < 0.001). Mild correlations were also observed between preoperative location time and operation time (r = 0.270, P = 0.001). There were no significant differences in preoperative back visual analogue scale (VAS) score, postoperative back VAS, preoperative leg VAS, postoperative leg VAS, preoperative Japanese Orthopaedic Association (JOA) score, postoperative JOA, preoperative Oswestry disability score (ODI), or postoperative ODI (P > 0.05). However, significant differences were all detected between preoperative abovementioned scores and postoperative scores (P < 0.05). Moreover, there was no significant differences in Macnab satisfaction between the 2 groups (P = 0.179). There were 2 patients with recurrence in Group A and 3 patients in Group B. Twelve patients with postoperative disc remnants were identified in Group A and 9 patients in Group B. No significant difference was identified between the 2 groups (P = 0.718). The preoperative lumbar location method is just a tiny step in tPELD, junior surgeons still need to focus on their subjective feelings during punctures and accumulating their experience in endoscopic discectomy. The accurate preoperative location method lowered the learning difficulty and reduced the fluoroscopy time of tPELD, which was also associated with lower preoperative location time and puncture-channel time. Key words: Learning difficulty, fluoroscopy reduction, transforamimal percutaneous endoscopic lumbar discectomy, preoperative locationLearning difficulty, fluoroscopy reduction, transforamimal percutaneous endoscopic lumbar discectomy, preoperative location.

The effect of modified trampoline training on balance, gait, and falls efficacy of stroke patients

PubMed Central

Hahn, Joohee; Shin, Seonhae; Lee, Wanhee

2015-01-01

[Purpose] This research was conducted to investigate the effects of modified trampoline training on the balance, gait, and falls efficacy of stroke patients. [Subjects] Twenty-four stroke patients participated in this study. The subjects were randomly allocated to one of two groups: the trampoline group (n=12) or the control group (n=12). [Methods] Both groups participated in conventional physical therapy for thirty minutes per day, three times a week for six weeks. The trampoline group also took part in trampoline training for thirty minutes per day, three times a week for six weeks. We evaluated balance (Berg balance scale, timed up and go test), gait (dynamic gait index), and falls efficacy (falls efficacy scale-K) to confirm the effects of the intervention. [Results] Both the trampoline and the control group showed significant improvements in balance, gait, and falls efficacy compared to before the intervention, and the improvements were significantly greater in the trampoline group than in the control group. [Conclusion] Modified trampoline training resulted in significantly improved balance, dynamic gait, and falls efficacy of stroke patients compared to the control group. These results suggest that modified trampoline training is feasible and effective at improving balance, dynamic gait, and falls efficacy after stroke. PMID:26696696

The effect of modified trampoline training on balance, gait, and falls efficacy of stroke patients.

PubMed

Hahn, Joohee; Shin, Seonhae; Lee, Wanhee

2015-11-01

[Purpose] This research was conducted to investigate the effects of modified trampoline training on the balance, gait, and falls efficacy of stroke patients. [Subjects] Twenty-four stroke patients participated in this study. The subjects were randomly allocated to one of two groups: the trampoline group (n=12) or the control group (n=12). [Methods] Both groups participated in conventional physical therapy for thirty minutes per day, three times a week for six weeks. The trampoline group also took part in trampoline training for thirty minutes per day, three times a week for six weeks. We evaluated balance (Berg balance scale, timed up and go test), gait (dynamic gait index), and falls efficacy (falls efficacy scale-K) to confirm the effects of the intervention. [Results] Both the trampoline and the control group showed significant improvements in balance, gait, and falls efficacy compared to before the intervention, and the improvements were significantly greater in the trampoline group than in the control group. [Conclusion] Modified trampoline training resulted in significantly improved balance, dynamic gait, and falls efficacy of stroke patients compared to the control group. These results suggest that modified trampoline training is feasible and effective at improving balance, dynamic gait, and falls efficacy after stroke.

Exercise Intervention for Cancer Survivors with Heart Failure: Two Case Reports

PubMed Central

Hughes, Daniel C.; Lenihan, Daniel J.; Harrison, Carol A.; Basen-Engquist, Karen M.

2011-01-01

Rationale Cardiotoxicity is a troubling long-term side effect of chemotherapy cancer treatment, affecting therapy and quality of life (QOL). Exercise is beneficial in heart failure (HF) patients and in cancer survivors without HF, but has not been tested in cancer survivors with treatment induced HF. Methods We present case studies for two survivors: a 56-year old female Hodgkin’s lymphoma survivor (Pt 1) and a 44-year old male leukemia survivor (Pt 2). We conducted a 16-week exercise program with the goal of 30 minutes of exercise performed 3 times per week at a minimum intensity of 50% heart rate reserve (HRR) or ‘12’ rating of perceived exertion (RPE). Results Pt 1 improved from 11.5 minutes of exercise split over two bouts at an RPE of 14 to a 30 minute bout at an RPE of 15. Pt 2 improved from 11 minutes of exercise split over two bouts at an RPE of 12 to an 18 minute bout at an RPE of 12. Both improved in VO2 peak (Pt 1: 13.9 to 14.3 mlO2/kg/min; Pt 2: 12.5 to 18.7 mlO2/kg/min). Ejection fraction increased for Pt 2 (25–30% to 35–40%) but not for Pt 1 (35–40%). QOL as assessed by the SF-36 Physical Component Scale (PCS) improved from 17.79 to 25.31 for Pt 1 and the Mental Component Scale (MCS) improved from 43.84 to 56.65 for Pt 1 and from 34.79 to 44.45 for Pt 2. Conclusions Properly designed exercise interventions can improve physical functioning and quality of life for this growing group of survivors. PMID:21709755

The Use of Telemedicine for Penicillin Allergy Skin Testing.

PubMed

Staicu, Mary L; Holly, Anne Marie; Conn, Kelly M; Ramsey, Allison

2018-05-08

Penicillin skin testing (PST) is increasingly used as a tool to evaluate penicillin allergy in patients with a reported history. The limited availability of allergists, however, may be an impeding factor. We sought to assess the clinical utility of telemedicine to facilitate PST. Penicillin-allergic inpatients receiving systemic antibiotics were prospectively identified between April and August 2017. Qualifying patients underwent PST performed by a trained allergy/immunology physician assistant (PA). On completion of PST, a telemedicine consultation, through the use of real-time interactive video conferencing (Microsoft Lync 2013, Redmond, Wash), was performed remotely by an allergist. Patients were surveyed regarding their satisfaction with the telemedicine experience. Fifty patients consented to PST through a telemedicine consultation. The average total time to complete a consultation was 128 minutes (standard deviation [SD] ± 33). Of this, the average PA travel time was 46 minutes (36%) with the remaining time spent on clinical services (82 minutes, 64%). The average physician telemedicine time per patient was 5 minutes (SD ± 2). Patients rated their experience as an average of 4.5 on a scale of 1 (highly unsatisfied) to 5 (highly satisfied). Of the 46 PST-negative patients, 33 were transitioned to a β-lactam antibiotic that reduced the use of vancomycin, metronidazole, aztreonam, aminoglycosides, and clindamycin (P < .05). More than $30,000 was saved throughout the study period. Telemedicine is an effective and novel approach to facilitate PST in the inpatient setting and carries a high degree of patient satisfaction. This method has the potential to optimize and improve access to allergy/immunology resources. Copyright © 2018 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Large scale cardiac modeling on the Blue Gene supercomputer.

PubMed

Reumann, Matthias; Fitch, Blake G; Rayshubskiy, Aleksandr; Keller, David U; Weiss, Daniel L; Seemann, Gunnar; Dössel, Olaf; Pitman, Michael C; Rice, John J

2008-01-01

Multi-scale, multi-physical heart models have not yet been able to include a high degree of accuracy and resolution with respect to model detail and spatial resolution due to computational limitations of current systems. We propose a framework to compute large scale cardiac models. Decomposition of anatomical data in segments to be distributed on a parallel computer is carried out by optimal recursive bisection (ORB). The algorithm takes into account a computational load parameter which has to be adjusted according to the cell models used. The diffusion term is realized by the monodomain equations. The anatomical data-set was given by both ventricles of the Visible Female data-set in a 0.2 mm resolution. Heterogeneous anisotropy was included in the computation. Model weights as input for the decomposition and load balancing were set to (a) 1 for tissue and 0 for non-tissue elements; (b) 10 for tissue and 1 for non-tissue elements. Scaling results for 512, 1024, 2048, 4096 and 8192 computational nodes were obtained for 10 ms simulation time. The simulations were carried out on an IBM Blue Gene/L parallel computer. A 1 s simulation was then carried out on 2048 nodes for the optimal model load. Load balances did not differ significantly across computational nodes even if the number of data elements distributed to each node differed greatly. Since the ORB algorithm did not take into account computational load due to communication cycles, the speedup is close to optimal for the computation time but not optimal overall due to the communication overhead. However, the simulation times were reduced form 87 minutes on 512 to 11 minutes on 8192 nodes. This work demonstrates that it is possible to run simulations of the presented detailed cardiac model within hours for the simulation of a heart beat.

Stochastic models for atomic clocks

NASA Technical Reports Server (NTRS)

Barnes, J. A.; Jones, R. H.; Tryon, P. V.; Allan, D. W.

1983-01-01

For the atomic clocks used in the National Bureau of Standards Time Scales, an adequate model is the superposition of white FM, random walk FM, and linear frequency drift for times longer than about one minute. The model was tested on several clocks using maximum likelihood techniques for parameter estimation and the residuals were acceptably random. Conventional diagnostics indicate that additional model elements contribute no significant improvement to the model even at the expense of the added model complexity.

Use of papain gel in disabled patients.

PubMed

Carrillo, C M; Tanaka, M H; Cesar, M F; Camargo, M A F; Juliano, Y; Novo, N F

2008-01-01

This study's purpose was to evaluate complete caries removal time (CCR) and patient acceptance of the chemomechanical caries removal agent and papain gel Papacárie in disabled patients. Fifty-one consecutive patients entered a prospective, controlled, randomized, open study. Patients were divided into 2 groups: (1) group 1=28 children 3 to 10 years old with or without visual or hearing impairments, motor disability on upper limbs, and inability to respond to simple orders; and (2) group 2=23 children, without visual or hearing impairments, with motor disability on the upper limbs and the ability to respond to simple orders. CCR time was measured in both groups. Patients' acceptance was assessed only in group 2 by using the visual analogy of face scale. The visual scale was presented in phase A--after the radiography with the child sitting on the dental chair before the beginning of the treatment, phase B--during the treatment, after total removal of the carious tissue and phase C--after the restoration was complete (treatment was finished). The total CCR average time was 8 minutes for each tooth when groups 1 and 2 were considered. Group 2 patients' acceptance in the first treatment was not statistically significant in all stages. Papacárie gel had a completed caries removal time of 8 minutes per tooth and is well accepted by the patients in all phases and in the first and subsequent visits.

Dentin hypersensitivity after teeth bleaching with in-office systems. Randomized clinical trial.

PubMed

Martin, Javier; Fernandez, Eduardo; Bahamondes, Valeria; Werner, Andrea; Elphick, Klaus; Oliveira, Osmir Batista; Moncada, Gustavo

2013-02-01

To comparatively and prospectively compare in a randomized clinical trial, dentin hypersensitivity after treatment with three in-office bleaching systems, based on hydrogen peroxide at different concentrations, with and without light source activation. 88 individuals were included according to inclusion and exclusion criteria. Subjects were randomly divided into the following three treatment groups: Group 1 was treated with three 15-minute applications of hydrogen peroxide at 15% with titanium dioxide (Lase Peroxide Lite) that was light-activated (Light Plus Whitening Lase) with five cycles of 1 minute and 30 seconds each cycle, giving a total treatment time of 45 minutes; Group 2 was treated with three 10-minute applications of hydrogen peroxide at 35% (Lase Peroxide Sensy), activated by light (LPWL) same activation cycles than Group 1, with a total treatment time of 30 minutes; Group 3 was treated with only one application for 45 minutes of hydrogen peroxide at 35% (Whitegold Office) without light activation. Each subject underwent one session of bleaching on the anterior teeth according to the manufacturers' instructions. Dentin sensitivity was recorded with a visual analogue scale (VAS) at baseline, immediately after, and at 7 and 30 days after treatment using a stimulus of an evaporative blowing triple syringe for 3 seconds on the upper central incisors from a distance of 1 cm. A Kruskal-Wallis test followed by Mann-Whitney test was performed for statistical analysis. All groups showed increased sensitivity immediately after treatment. Group 1 displayed less changes relative to baseline with no significant differences (P = 0.104). At 7 and 30 days after treatment, a comparison of VAS values indicated no significant differences between all groups (P = 0.598 and 0.489, respectively).

Return Intervals Approach to Financial Fluctuations

NASA Astrophysics Data System (ADS)

Wang, Fengzhong; Yamasaki, Kazuko; Havlin, Shlomo; Stanley, H. Eugene

Financial fluctuations play a key role for financial markets studies. A new approach focusing on properties of return intervals can help to get better understanding of the fluctuations. A return interval is defined as the time between two successive volatilities above a given threshold. We review recent studies and analyze the 1000 most traded stocks in the US stock markets. We find that the distribution of the return intervals has a well approximated scaling over a wide range of thresholds. The scaling is also valid for various time windows from one minute up to one trading day. Moreover, these results are universal for stocks of different countries, commodities, interest rates as well as currencies. Further analysis shows some systematic deviations from a scaling law, which are due to the nonlinear correlations in the volatility sequence. We also examine the memory in return intervals for different time scales, which are related to the long-term correlations in the volatility. Furthermore, we test two popular models, FIGARCH and fractional Brownian motion (fBm). Both models can catch the memory effect but only fBm shows a good scaling in the return interval distribution.

Estimating Anesthesia Time Using the Medicare Claim: A Validation Study

PubMed Central

Silber, Jeffrey H.; Rosenbaum, Paul R.; Even-Shoshan, Orit; Mi, Lanyu; Kyle, Fabienne; Teng, Yun; Bratzler, Dale W.; Fleisher, Lee A.

2012-01-01

Introduction Procedure length is a fundamental variable associated with quality of care, though seldom studied on a large scale. We sought to estimate procedure length through information obtained in the anesthesia claim submitted to Medicare to validate this method for future studies. Methods The Obesity and Surgical Outcomes Study enlisted 47 hospitals located across New York, Texas and Illinois to study patients undergoing hip, knee, colon and thoracotomy procedures. 15,914 charts were abstracted to determine body mass index and initial patient physiology. Included in this abstraction were induction, cut, close and recovery room times. This chart information was merged to Medicare claims which included anesthesia Part B billing information. Correlations between chart times and claim times were analyzed, models developed, and median absolute differences in minutes calculated. Results Of the 15,914 eligible patients, there were 14,369 where both chart and claim times were available for analysis. In these 14,369, the Spearman correlation between chart and claim time was 0.94 (95% CI 0.94, 0.95) and the median absolute difference between chart and claim time was only 5 minutes (95% CI: 5.0, 5.5). The anesthesia claim can also be used to estimate surgical procedure length, with only a modest increase in error. Conclusion The anesthesia bill found in Medicare claims provides an excellent source of information for studying operative time on a vast scale throughout the United States. However, errors in both chart abstraction and anesthesia claims can occur. Care must be taken in the handling of outliers in this data. PMID:21720242

Combining Quick-Turnaround and Batch Workloads at Scale

NASA Technical Reports Server (NTRS)

Matthews, Gregory A.

2012-01-01

NAS uses PBS Professional to schedule and manage the workload on Pleiades, an 11,000+ node 1B cluster. At this scale the user experience for quick-turnaround jobs can degrade, which led NAS initially to set up two separate PBS servers, each dedicated to a particular workload. Recently we have employed PBS hooks and scheduler modifications to merge these workloads together under one PBS server, delivering sub-1-minute start times for the quick-turnaround workload, and enabling dynamic management of the resources set aside for that workload.

Development of the Environmental Observation scale for the Visual Impaired.

PubMed

Sinoo, Marianne; Kort, Helianthe

2015-01-01

In order to raise awareness of professional care, an Environmental Observation scale for the Visual Impaired (EOVI) was developed. It is the purpose of this tool that professional caregivers learn to observe the nursing home environment and consequently propose and discuss potential changes in the short and long term. The mean time of filling out the EOVI in eight wards of a nursing home by two student researchers was 17 minutes (min mean 12, max mean 22,5). All of 10 optometry students reported that the EOVI changed their awareness.

Activity in descending dopaminergic neurons represents but is not required for leg movements in the fruit fly Drosophila

PubMed Central

Tschida, Katherine; Bhandawat, Vikas

2015-01-01

Modulatory descending neurons (DNs) that link the brain to body motor circuits, including dopaminergic DNs (DA-DNs), are thought to contribute to the flexible control of behavior. Dopamine elicits locomotor-like outputs and influences neuronal excitability in isolated body motor circuits over tens of seconds to minutes, but it remains unknown how and over what time scale DA-DN activity relates to movement in behaving animals. To address this question, we identified DA-DNs in the Drosophila brain and developed an electrophysiological preparation to record and manipulate the activity of these cells during behavior. We find that DA-DN spike rates are rapidly modulated during a subset of leg movements and scale with the total speed of ongoing leg movements, whether occurring spontaneously or in response to stimuli. However, activating DA-DNs does not elicit leg movements in intact flies, nor do acute bidirectional manipulations of DA-DN activity affect the probability or speed of leg movements over a time scale of seconds to minutes. Our findings indicate that in the context of intact descending control, changes in DA-DN activity are not sufficient to influence ongoing leg movements and open the door to studies investigating how these cells interact with other descending and local neuromodulatory inputs to influence body motor output. PMID:25742959

Comparison of 7.5-minute and 1-degree digital elevation models

NASA Technical Reports Server (NTRS)

Isaacson, Dennis L.; Ripple, William J.

1995-01-01

We compared two digital elevation models (DEM's) for the Echo Mountain SE quadrangle in the Cascade Mountains of Oregon. Comparisons were made between 7.5-minute (1:24,000-scale) and 1-degree (1:250,000-scale) images using the variables of elevation, slope aspect, and slope gradient. Both visual and statistical differences are presented.

Comparison of 7.5-minute and 1-degree digital elevation models

NASA Technical Reports Server (NTRS)

Isaacson, Dennis L.; Ripple, William J.

1990-01-01

Two digital elevation models are compared for the Echo Mountain SE quadrangle in the Cascade Mountains of Oregon. Comparisons were made between 7.5-minute (1:24,000-scale) and 1-degree (1:250,000-scale) images using the variables of elevation, slope aspect, and slope gradient. Both visual and statistical differences are presented.

Runoff Response at Three Spatial Scale from a Burned Watershed

NASA Astrophysics Data System (ADS)

Moody, J. A.; Kinner, D. A.

2007-12-01

The hypothesis that the magnitude and timing of runoff from burned watersheds are functions of the properties of flow paths at multiple scales was investigated at three nested spatial scales within an area burned by the 2005 Harvard Fire near Burbank, California. Water depths were measured using pressure sensors: at the outlet of a subwatershed (10000 m2); in 3-inch Parshall flumes near the outlets of three mini-watersheds (820-1780 m2) within the subwatershed; and by 12 overland-flow detectors in 6 micro-watersheds (~11-15 m2) within one of the mini-watersheds. Rainfall intensities were measured using recording raingages deployed around the perimeter of the mini-watersheds and at the subwatershed outlet. Time-to-concentration, TC, and lag time, TL, were computed for the 15 largest of 30 rainstorms (maximum 30- minute intensities were 3.3-13.0 mm/h) between December 2005 and April 2006. TC , elapsed time from the beginning of the rain until the first increase in water depth, averaged 1.0 hours at the micro-scale, 1.7 hours at the mini-scale, and 1.5 hours at the subwatershed scale. TL is the lag time that produced the maximum cross- correlation coefficient between the time series of rainfall intensities and the series of water depths. TL averaged 0.15 hours at the micro-scale, 0.35 hours at the mini-scale, and 0.39 hours at the subwatershed scale. The coefficient was >0.50 for 43% (N=168) of the measurements at the micro-scale, for 61% (N=54) at the mini- scale, and for 67% (N=6) at the subwatershed scale indicating the runoff response lagged but was often well correlated with the time-varying rainfall intensity.

Brief communication: patient satisfaction with the use of tablet computers: a pilot study in two outpatient home dialysis clinics.

PubMed

Schick-Makaroff, Kara; Molzahn, Anita

2014-01-01

Electronic capture of patients' reports of their health is significant in clinical nephrology research because health-related quality of life (HRQOL) for patients with end-stage renal disease is compromised and assessment by patients of their HRQOL in practice is relatively uncommon. The purpose of this study was to evaluate patient satisfaction with and time involved in administering HRQOL and symptom assessment measures using tablet computers in two outpatient home dialysis clinics. A cross-sectional observational study design was employed. The study was conducted in two home dialysis clinics. Fifty-six patients participated in the study; 35 males (63%) and 21 females (37%) with a mean age of 66 ± 12 (36-90 years old) were included. Forty-nine participants were on peritoneal dialysis (87%), 6 on home hemodialysis (11%), and 1 on nocturnal home hemodialysis (2%). Measures included the Kidney Disease Quality of Life-36 (KDQOL-36), the Edmonton Symptom Assessment Scale (ESAS) and Participant's Level of Satisfaction in Using a Tablet Computer. Using a tablet computer, participants completed the three measures. Descriptive statistics and bivariate correlations were calculated. Participants' satisfaction with use of the tablet computer was high; 66% were "very satisfied", 7% "satisfied", 2% "slightly satisfied", and 18% "neutral". On the 7-point Likert-type scale, the mean satisfaction score was 5.11 (SD = 1.6). Mean time to complete the measures was: Level of Satisfaction 1.15 minutes (SD = 0.41), ESAS 2.55 minutes (SD = 1.04), and KDQOL 9.56 minutes (SD = 2.03); the mean time to complete all three instruments was 13.19 minutes (SD = 2.42). There were no significant correlations between level of satisfaction and age, gender, HRQOL, time taken to complete surveys, computer experience, or comfort with technology. Comfort with technology and computer experience were highly correlated, r = .7, p (one-tailed) < 0.01. Limitations include lack of generalizability because of a small self-selected sample of relatively healthy patients and a lack of psychometric testing on the measure of satisfaction. Participants were satisfied with the platform and the time involved for completion of instruments was modest. Routine use of HRQOL measures for clinical purposes may be facilitated through use of tablet computers.

Statistical analysis and modeling of the temperature-dependent sleep behavior of drosophila

NASA Astrophysics Data System (ADS)

Shih, Chi-Tin; Lin, Hsuan-Wen; Chiang, Ann-Shyn

2011-01-01

The sleep behavior of drosophila is analyzed under different temperatures. The activity per minute of the flies is recorded automatically. Sleep for a fruit fly is defined as the periods without any activity and longer than 5 minutes. Several parameters such as total sleep time, circadian sleep profile, quality of sleep are analyzed. The sleep behaviors are significantly different for flies at different temperature. Interestingly, the durations of daytime sleep periods show a common scale-free power law distribution. We propose a stochastic model to simulate the activities of the population of neurons which regulate the dynamics of sleep-wake process to explain the distribution of daytime sleep.

Predation Risk Shapes Social Networks in Fission-Fusion Populations

PubMed Central

Kelley, Jennifer L.; Morrell, Lesley J.; Inskip, Chloe; Krause, Jens; Croft, Darren P.

2011-01-01

Predation risk is often associated with group formation in prey, but recent advances in methods for analysing the social structure of animal societies make it possible to quantify the effects of risk on the complex dynamics of spatial and temporal organisation. In this paper we use social network analysis to investigate the impact of variation in predation risk on the social structure of guppy shoals and the frequency and duration of shoal splitting (fission) and merging (fusion) events. Our analyses revealed that variation in the level of predation risk was associated with divergent social dynamics, with fish in high-risk populations displaying a greater number of associations with overall greater strength and connectedness than those from low-risk sites. Temporal patterns of organisation also differed according to predation risk, with fission events more likely to occur over two short time periods (5 minutes and 20 minutes) in low-predation fish and over longer time scales (>1.5 hours) in high-predation fish. Our findings suggest that predation risk influences the fine-scale social structure of prey populations and that the temporal aspects of organisation play a key role in defining social systems. PMID:21912627

Comparison of the sedative effects of nalbuphine and butorphanol, alone or in combination with acepromazine in dogs.

PubMed

Gomes, Viviane H; Oliveira, Renato Ls; Marques, Juliana Lr; Coelho, Cassia Mm; Silva, Marta Fa

2018-01-01

To compare sedation and effects on heart rate (HR), mean arterial pressure (MAP) and respiratory rate (f R ) of nalbuphine and butorphanol, alone or combined with acepromazine in dogs. Prospective, randomized experimental trial. Eight healthy Beagle dogs, aged (mean ± standard deviation) 3.4 ± 0.5 years and weighing 11.0 ± 1.3 kg. Each dog was treated four times: physiological saline (1 mL) combined with nalbuphine (0.5 mg kg -1 ; SAL-NAL) or butorphanol (0.15 mg kg -1 ; SAL-BUT), and acepromazine (0.05 mg kg -1 ) combined with nalbuphine (0.5 mg kg -1 ; ACP-NAL) or butorphanol (0.15 mg kg -1 ; ACP-BUT), intravenously (IV). The degree of sedation, assessed by a numeric descriptive scale (NDS) and simple numerical scale (SNS), HR, MAP, f R and rectal temperature (RT), were recorded before and 20 minutes after administration of saline or acepromazine, then 15, 30, 60, 90 and 120 minutes after nalbuphine or butorphanol. Values were compared with baseline and among treatments. Mild sedation was recorded for SAL-NAL and SAL-BUT, and moderate sedation for ACP-NAL and ACP-BUT. NDS and SNS scores were higher for SAL-BUT and ACP-BUT at some time points when compared with SAL-NAL and ACP-NAL, respectively (p < 0.001). HR was lower in ACP-NAL than in ACP-BUT at 120 minutes and f R was lower in SAL-BUT than in SAL-NAL at 30 and 120 minutes (p < 0.05). RT was lower in SAL-BUT (37.5 ± 0.5 °C) compared with SAL-NAL (38.0 ± 0.5 °C) at 60-120 minutes (p < 0.05). Butorphanol promoted a higher sedative effect than nalbuphine when alone and combined with acepromazine. IV administration of nalbuphine or butorphanol, with or without acepromazine, at the doses studied, resulted in minimal decreases in MAP, HR, f R and RT. Copyright © 2017. Published by Elsevier Ltd.

Effects of lek count protocols on greater sage-grouse population trend estimates

USGS Publications Warehouse

Monroe, Adrian; Edmunds, David; Aldridge, Cameron L.

2016-01-01

Annual counts of males displaying at lek sites are an important tool for monitoring greater sage-grouse populations (Centrocercus urophasianus), but seasonal and diurnal variation in lek attendance may increase variance and bias of trend analyses. Recommendations for protocols to reduce observation error have called for restricting lek counts to within 30 minutes of sunrise, but this may limit the number of lek counts available for analysis, particularly from years before monitoring was widely standardized. Reducing the temporal window for conducting lek counts also may constrain the ability of agencies to monitor leks efficiently. We used lek count data collected across Wyoming during 1995−2014 to investigate the effect of lek counts conducted between 30 minutes before and 30, 60, or 90 minutes after sunrise on population trend estimates. We also evaluated trends across scales relevant to management, including statewide, within Working Group Areas and Core Areas, and for individual leks. To further evaluate accuracy and precision of trend estimates from lek count protocols, we used simulations based on a lek attendance model and compared simulated and estimated values of annual rate of change in population size (λ) from scenarios of varying numbers of leks, lek count timing, and count frequency (counts/lek/year). We found that restricting analyses to counts conducted within 30 minutes of sunrise generally did not improve precision of population trend estimates, although differences among timings increased as the number of leks and count frequency decreased. Lek attendance declined >30 minutes after sunrise, but simulations indicated that including lek counts conducted up to 90 minutes after sunrise can increase the number of leks monitored compared to trend estimates based on counts conducted within 30 minutes of sunrise. This increase in leks monitored resulted in greater precision of estimates without reducing accuracy. Increasing count frequency also improved precision. These results suggest that the current distribution of count timings available in lek count databases such as that of Wyoming (conducted up to 90 minutes after sunrise) can be used to estimate sage-grouse population trends without reducing precision or accuracy relative to trends from counts conducted within 30 minutes of sunrise. However, only 10% of all Wyoming counts in our sample (1995−2014) were conducted 61−90 minutes after sunrise, and further increasing this percentage may still bias trend estimates because of declining lek attendance. 

Underlying dynamics of typical fluctuations of an emerging market price index: The Heston model from minutes to months

NASA Astrophysics Data System (ADS)

Vicente, Renato; de Toledo, Charles M.; Leite, Vitor B. P.; Caticha, Nestor

2006-02-01

We investigate the Heston model with stochastic volatility and exponential tails as a model for the typical price fluctuations of the Brazilian São Paulo Stock Exchange Index (IBOVESPA). Raw prices are first corrected for inflation and a period spanning 15 years characterized by memoryless returns is chosen for the analysis. Model parameters are estimated by observing volatility scaling and correlation properties. We show that the Heston model with at least two time scales for the volatility mean reverting dynamics satisfactorily describes price fluctuations ranging from time scales larger than 20 min to 160 days. At time scales shorter than 20 min we observe autocorrelated returns and power law tails incompatible with the Heston model. Despite major regulatory changes, hyperinflation and currency crises experienced by the Brazilian market in the period studied, the general success of the description provided may be regarded as an evidence for a general underlying dynamics of price fluctuations at intermediate mesoeconomic time scales well approximated by the Heston model. We also notice that the connection between the Heston model and Ehrenfest urn models could be exploited for bringing new insights into the microeconomic market mechanics.

Efficiency and cross-correlation in equity market during global financial crisis: Evidence from China

NASA Astrophysics Data System (ADS)

Ma, Pengcheng; Li, Daye; Li, Shuo

2016-02-01

Using one minute high-frequency data of the Shanghai Composite Index (SHCI) and the Shenzhen Composite Index (SZCI) (2007-2008), we employ the detrended fluctuation analysis (DFA) and the detrended cross correlation analysis (DCCA) with rolling window approach to observe the evolution of market efficiency and cross-correlation in pre-crisis and crisis period. Considering the fat-tail distribution of return time series, statistical test based on shuffling method is conducted to verify the null hypothesis of no long-term dependence. Our empirical research displays three main findings. First Shanghai equity market efficiency deteriorated while Shenzhen equity market efficiency improved with the advent of financial crisis. Second the highly positive dependence between SHCI and SZCI varies with time scale. Third financial crisis saw a significant increase of dependence between SHCI and SZCI at shorter time scales but a lack of significant change at longer time scales, providing evidence of contagion and absence of interdependence during crisis.

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

PubMed

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

2009-04-01

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

Inferring multi-scale neural mechanisms with brain network modelling

PubMed Central

Schirner, Michael; McIntosh, Anthony Randal; Jirsa, Viktor; Deco, Gustavo

2018-01-01

The neurophysiological processes underlying non-invasive brain activity measurements are incompletely understood. Here, we developed a connectome-based brain network model that integrates individual structural and functional data with neural population dynamics to support multi-scale neurophysiological inference. Simulated populations were linked by structural connectivity and, as a novelty, driven by electroencephalography (EEG) source activity. Simulations not only predicted subjects' individual resting-state functional magnetic resonance imaging (fMRI) time series and spatial network topologies over 20 minutes of activity, but more importantly, they also revealed precise neurophysiological mechanisms that underlie and link six empirical observations from different scales and modalities: (1) resting-state fMRI oscillations, (2) functional connectivity networks, (3) excitation-inhibition balance, (4, 5) inverse relationships between α-rhythms, spike-firing and fMRI on short and long time scales, and (6) fMRI power-law scaling. These findings underscore the potential of this new modelling framework for general inference and integration of neurophysiological knowledge to complement empirical studies. PMID:29308767

Dosage dependent effect of high-resistance straw exercise in dysphonic and non-dysphonic women.

PubMed

Paes, Sabrina Mazzer; Behlau, Mara

2017-03-09

to study the dosage dependent effect of high-resistance straw exercise in women with behavioral dysphonia and in vocally healthy women. 25 dysphonic women (DG), with average age of 35 years (SD = 10.5) and 30 vocally healthy women (VHG), with average age of 31.6 years (SD = 10.3). The participants produced a continuous sound into a thin high-resistance straw for seven minutes, being interrupted after the first, third, fifth and seventh minute. At each interval, speech samples were recorded (sustained vowel and counting up to 20) and subsequently acoustically analyzed. Each participant reported the effort necessary to perform exercise and to speak, indicating their ratings on visual analog scales (VAS). with regard to the DG, the exercise caused positive vocal changes, especially between the third and fifth minute: less phonatory effort, increase in MPT, and reduction of F0 variability; these voice parameters deteriorated after five minutes. This fact associated with the increased effort to perform the exercise indicates a possible overload of the phonatory system. As to the VHG, MPT improved after one minute of exercise, while the other parameters did not change over time, probably due to the fact that the voices were not deviant; seven minutes did not seem to impose an overload in this population. positive vocal changes were observed with the high-resistance straw exercise; however, there are dosage restrictions, especially for dysphonic women.

Twelve-month experience of acute stroke thrombolysis in Christchurch, New Zealand: emergency department screening and acute stroke service treatment.

PubMed

Fink, John

2005-05-06

To determine the safety and efficiency of an acute stroke thrombolysis service in a New Zealand public hospital setting. A 12-month audit of patients referred to the Christchurch Hospital Stroke Thrombolysis Service (STS) between 1 April 2002 and 31 March 2003 was undertaken. Sixty-one patients were referred to the STS during the study period, of whom 16 were treated with tissue plasminogen activator (t-PA). For treated patients, the median time from stroke onset to hospital presentation was 60 minutes, 'door-to-CT' time was 60 minutes, and the 'door-to-needle' time was 99 minutes. Minor protocol violations were recorded in two patients, but did not influence outcome. No patient was treated after 3 hours of stroke onset. Intracerebral haemorrhage occurred in two patients: one patient was significantly improved compared with pre-treatment status; a minor temporary deterioration occurred in the other patient. Eight of 16 patients had improved by 4 or more points on the NIH Stroke Scale Score at 24 hours. Acute stroke thrombolysis can be delivered safely and in accordance with internationally accepted guidelines using the Christchurch Hospital STS model of emergency department screening and acute stroke service treatment. Further improvements in performance of the STS remain possible.

X-Ray Fluctuation Power Spectral Densities of Seyfert 1 Galaxies

NASA Technical Reports Server (NTRS)

Markowitz, A.; Edelson, R.; Vaughan, S.; Uttley, P.; George, I. M.; Griffiths, R. E.; Kaspi, S.; Lawrence, A.; McHandy, I.; Nandra, K.

2003-01-01

By combining complementary monitoring observations spanning long, medium and short time scales, we have constructed power spectral densities (PSDs) of six Seyfert 1 galaxies. These PSDs span approx. greater than 4 orders of magnitude in temporal frequency, sampling variations on time scales ranging from tens of minutes to over a year. In at least four cases, the PSD shows a "break," a significant departure from a power law, typically on time scales of order a few days. This is similar to the behavior of Galactic X-ray binaries (XRBs), lower mass compact systems with breaks on time scales of seconds. NGC 3783 shows tentative evidence for a doubly-broken power law, a feature that until now has only been seen in the (much better-defined) PSDs of low-state XRBs. It is also interesting that (when one previously-observed object is added to make a small sample of seven), an apparently significant correlation is seen between the break time scale T and the putative black hole mass M(sub BH), while none is seen between break time scale and luminosity. The data are consistent with the linear relation T = M(sub BH) /10(exp 6.5) solar mass; extrapolation over 6-7 orders of magnitude is in reasonable agreement with XRBs. All of this strengthens the case for a physical similarity between Seyfert 1s and XRBs.

A randomised controlled trial of coblation, diode laser and cold dissection in paediatric tonsillectomy.

PubMed

Elbadawey, M R; Hegazy, H M; Eltahan, A E; Powell, J

2015-11-01

This study aimed to compare the efficacy of diode laser, coblation and cold dissection tonsillectomy in paediatric patients. A total of 120 patients aged 10-15 years with recurrent tonsillitis were recruited. Participants were prospectively randomised to diode laser, coblation or cold dissection tonsillectomy. Operative time and blood loss were recorded. Pain was recorded on a Wong-Baker FACES(®) pain scale. The operative time (10 ± 0.99 minutes), blood loss (20 ± 0.85 ml) and pain were significantly lower with coblation tonsillectomy than with cold dissection tonsillectomy (20 ± 1.0 minutes and 30 ± 1.0 ml; p = 0.0001) and diode laser tonsillectomy (15 ± 0.83 minutes and 25 ± 0.83 ml; p = 0.0001). Diode laser tonsillectomy had a shorter operative time (p = 0.0001) and less blood loss (p = 0.001) compared with cold dissection tonsillectomy. However, at post-operative day seven, the diode laser tonsillectomy group had significantly higher pain scores compared with the cold dissection (p = 0.042) and coblation (p = 0.04) tonsillectomy groups. Both coblation and diode laser tonsillectomy are associated with significantly reduced blood loss and shorter operative times compared with cold dissection tonsillectomy. However, we advocate coblation tonsillectomy because of the lower post-operative pain scores compared with diode laser and cold dissection tonsillectomy.

Research on the Effect of the Foot Bath and Foot Massage on Residual Schizophrenia Patients.

PubMed

Kito, Kazuko; Suzuki, Keiko

2016-06-01

Researchers performed foot baths and massages for residual schizophrenia patients to gauge the effects on psychiatric symptoms. Subjects were six residual schizophrenia patients hospitalized in a psychiatric hospital. Three times a week for 4weeks, they received an 8-minute effleurage massage to their legs after a 10-minute foot bath. The effect of physiological relaxation was identified by a significant decline in heart rate in all cases. The results of the Positive and Negative Symptom Scale are as follows: a mean score of 29.0 was measured before treatment, which lowered to 21.5 after treatment, indicating that foot care improved their negative symptoms (p<0.05).The results of the Quality of Life Scale before the foot care intervention, were 10.5 and increased to 34.0 after the intervention, indicating improvement in their quality of life (p<0.05). The results of the two measurements indicate that foot baths and massages were effective in improving psychiatric symptoms. Copyright © 2016 Elsevier Inc. All rights reserved.

Effect of Performance Time of the Semi-Occluded Vocal Tract Exercises in Dysphonic Children.

PubMed

Ramos, Lorena de Almeida; Gama, Ana Cristina Côrtes

2017-05-01

This study aimed to verify the effects of execution time on auditory-perceptual and acoustic responses in children with dysphonia completing straw phonation exercises. A randomized, prospective, comparative intra-subject study design was used. Twenty-seven children, ranging from 5 to 10 years of age, diagnosed with vocal cord nodules or cysts, were enrolled in the study. All subjects included in the Experimental Group were also included in the Control Group which involved complete voice rest. Sustained vowels (/a/e/ε/e/) counting from 1 to 10 were recorded before the exercises (m0) and then again after the first (m1), third (m3), fifth (m5), and seventh (m7) minutes of straw phonation exercises. The recordings were randomized and presented to five speech therapists, who evaluated vocal quality based on the Grade Roughness Breathiness Asthenia/Strain Instability scale. For acoustic analysis, fundamental frequency, jitter, shimmer, glottal to noise excitation ratio, and noise parameters were analyzed. Reduced roughness, breathiness, and noise measurements as well as increased glottal to noise excitation ratio were observed in the Experimental Group after 3 minutes of exercise. Reduced grade of dysphonia and breathiness were noted after 5 minutes. The ideal duration of straw phonation in children with dysphonia is from 3 to 5 minutes. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Early or delayed provision of an ankle-foot orthosis in patients with acute and subacute stroke: a randomized controlled trial.

PubMed

Nikamp, Corien Dm; Buurke, Jaap H; van der Palen, Job; Hermens, Hermie J; Rietman, Johan S

2017-06-01

(1) To study the effects of providing ankle-foot orthoses in subjects with (sub)acute stroke; and (2) to study whether the point in time at which an ankle-foot orthosis is provided post-stroke (early or delayed) influences these effects. Randomized controlled trial. Rehabilitation centre. Unilateral hemiparetic stroke subjects with indication for use of an ankle-foot orthosis and maximal six weeks post-stroke. Subjects were randomly assigned to: early provision (at inclusion; Week 1) or delayed provision (eight weeks later; Week 9). 10-metre walk test, 6-minute walk test, Timed Up and Go Test, stairs test, Functional Ambulation Categories, Berg Balance Scale, Rivermead Mobility Index and Barthel Index; assessed in Weeks 1, 3, 9 and 11. A total of 33 subjects were randomized (16 early, 17 delayed). Positive effects of ankle-foot orthoses were found two weeks after provision, both when provided early (significant effects on all outcomes) or delayed (Berg Balance Scale p = 0.011, Functional Ambulation Categories p = 0.008, 6-minute walk test p = 0.005, Timed Up and Go Test p = 0.028). Comparing effects after early and delayed provision showed that early provision resulted in increased levels of improvement on Berg Balance Scale (+5.1 points, p = 0.002), Barthel Index (+1.9 points, p = 0.002) and non-significant improvements on 10-metre walk test (+0.14 m/s, p = 0.093) and Timed Up and Go Test (-5.4 seconds, p = 0.087), compared with delayed provision. We found positive effects of providing ankle-foot orthoses in (sub)acute stroke subjects that had not used these orthoses before.

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

Ackermann, M.; Buehler, R.; Anantua, R.

On 2015 June 16, Fermi -LAT observed a giant outburst from the flat spectrum radio quasar 3C 279 with a peak >100 MeV flux of ∼3.6 × 10{sup −5} photons cm{sup −2} s{sup −1}, averaged over orbital period intervals. It is historically the highest γ -ray flux observed from the source, including past EGRET observations, with the γ -ray isotropic luminosity reaching ∼10{sup 49} erg s{sup −1}. During the outburst, the Fermi spacecraft, which has an orbital period of 95.4 minutes, was operated in a special pointing mode to optimize the exposure for 3C 279. For the first time, significantmore » flux variability at sub-orbital timescales was found in blazar observations by Fermi -LAT. The source flux variability was resolved down to 2-minute binned timescales, with flux doubling times of less than 5 minutes. The observed minute-scale variability suggests a very compact emission region at hundreds of Schwarzschild radii from the central engine in conical jet models. A minimum bulk jet Lorentz factor (Γ) of 35 is necessary to avoid both internal γ -ray absorption and super-Eddington jet power. In the standard external radiation Comptonization scenario, Γ should be at least 50 to avoid overproducing the synchrotron self-Compton component. However, this predicts extremely low magnetization (∼5 × 10{sup −4}). Equipartition requires Γ as high as 120, unless the emitting region is a small fraction of the dissipation region. Alternatively, we consider γ rays originating as synchrotron radiation of γ {sub e} ∼ 1.6 × 10{sup 6} electrons, in a magnetic field B ∼ 1.3 kG, accelerated by strong electric fields E ∼ B in the process of magnetoluminescence. At such short distance scales, one cannot immediately exclude the production of γ -rays in hadronic processes.« less

Massage Therapy for Osteoarthritis of the Knee: A Randomized Dose-Finding Trial

PubMed Central

Perlman, Adam I.; Ali, Ather; Njike, Valentine Yanchou; Hom, David; Davidi, Anna; Gould-Fogerite, Susan; Milak, Carl; Katz, David L.

2012-01-01

Background In a previous trial of massage for osteoarthritis (OA) of the knee, we demonstrated feasibility, safety and possible efficacy, with benefits that persisted at least 8 weeks beyond treatment termination. Methods We performed a RCT to identify the optimal dose of massage within an 8-week treatment regimen and to further examine durability of response. Participants were 125 adults with OA of the knee, randomized to one of four 8-week regimens of a standardized Swedish massage regimen (30 or 60 min weekly or biweekly) or to a Usual Care control. Outcomes included the Western Ontario and McMaster Universities Arthritis Index (WOMAC), visual analog pain scale, range of motion, and time to walk 50 feet, assessed at baseline, 8-, 16-, and 24-weeks. Results WOMAC Global scores improved significantly (24.0 points, 95% CI ranged from 15.3–32.7) in the 60-minute massage groups compared to Usual Care (6.3 points, 95% CI 0.1–12.8) at the primary endpoint of 8-weeks. WOMAC subscales of pain and functionality, as well as the visual analog pain scale also demonstrated significant improvements in the 60-minute doses compared to usual care. No significant differences were seen in range of motion at 8-weeks, and no significant effects were seen in any outcome measure at 24-weeks compared to usual care. A dose-response curve based on WOMAC Global scores shows increasing effect with greater total time of massage, but with a plateau at the 60-minute/week dose. Conclusion Given the superior convenience of a once-weekly protocol, cost savings, and consistency with a typical real-world massage protocol, the 60-minute once weekly dose was determined to be optimal, establishing a standard for future trials. Trial Registration ClinicalTrials.gov NCT00970008 PMID:22347369

Super Ensemble-based Aviation Turbulence Guidance (SEATG) for Air Traffic Management (ATM)

NASA Astrophysics Data System (ADS)

Kim, Jung-Hoon; Chan, William; Sridhar, Banavar; Sharman, Robert

2014-05-01

Super Ensemble (ensemble of ten turbulence metrics from time-lagged ensemble members of weather forecast data)-based Aviation Turbulence Guidance (SEATG) is developed using Weather Research and Forecasting (WRF) model and in-situ eddy dissipation rate (EDR) observations equipped on commercial aircraft over the contiguous United States. SEATG is a sequence of five procedures including weather modeling, calculating turbulence metrics, mapping EDR-scale, evaluating metrics, and producing final SEATG forecast. This uses similar methodology to the operational Graphic Turbulence Guidance (GTG) with three major improvements. First, SEATG use a higher resolution (3-km) WRF model to capture cloud-resolving scale phenomena. Second, SEATG computes turbulence metrics for multiple forecasts that are combined at the same valid time resulting in an time-lagged ensemble of multiple turbulence metrics. Third, SEATG provides both deterministic and probabilistic turbulence forecasts to take into account weather uncertainties and user demands. It is found that the SEATG forecasts match well with observed radar reflectivity along a surface front as well as convectively induced turbulence outside the clouds on 7-8 Sep 2012. And, overall performance skill of deterministic SEATG against the observed EDR data during this period is superior to any single turbulence metrics. Finally, probabilistic SEATG is used as an example application of turbulence forecast for air-traffic management. In this study, a simple Wind-Optimal Route (WOR) passing through the potential areas of probabilistic SEATG and Lateral Turbulence Avoidance Route (LTAR) taking into account the SEATG are calculated at z = 35000 ft (z = 12 km) from Los Angeles to John F. Kennedy international airports. As a result, WOR takes total of 239 minutes with 16 minutes of SEATG areas for 40% of moderate turbulence potential, while LTAR takes total of 252 minutes travel time that 5% of fuel would be additionally consumed to entirely avoid the moderate SEATG regions.

Improving door-to-needle times: a single center validation of the target stroke hypothesis.

PubMed

Ruff, Ilana M; Ali, Syed F; Goldstein, Joshua N; Lev, Michael; Copen, William A; McIntyre, Joyce; Rost, Natalia S; Schwamm, Lee H

2014-02-01

National guidelines recommend imaging within 25 minutes of emergency department arrival and intravenous tissue-type plasminogen activator within 60 minutes of emergency department arrival for patients with acute stroke. In 2007, we implemented a new institutional acute stroke care model to include 10 best practices and evaluated the effect of this intervention on improving door-to-computed tomography (CT) and door-to-needle (DTN) times at our hospital. We compared patients who presented directly to our hospital with acute ischemic stroke in the preintervention (2003-2006) and postintervention (2008-2011) periods. We did not include 2007, the year that the new protocol was established. Predictors of DTN ≤60 minutes before and after the intervention were assessed using χ(2) for categorical variables, and t test and Wilcoxon signed-rank test for continuous variables. Among 2595 patients with acute stroke, 284 (11%) received intravenous tissue-type plasminogen activator. For patients arriving within an intravenous tissue-type plasminogen activator window, door-to-CT <25 improved from 26.7% pre intervention to 52.3% post intervention (P<0.001). Similarly, the percentage of patients with DTN <60 doubled from 32.4% to 70.3% (P<0.001). Patients with DTN ≤60 did not differ significantly with respect to demographics, comorbidities, or National Institutes of Health Stroke Scale score in comparison with those treated after 60 minutes. Door-to-CT and DTN times improved dramatically after applying 10 best practices, all of which were later incorporated into the Target Stroke Guidelines created by the American Heart Association. The only factor that significantly affected DTN60 was the intervention itself, indicating that these best practices can result in improved DTN times.

Validity, Sensitivity, and Responsiveness of the 11-Face Faces Pain Scale to Postoperative Pain in Adult Orthopedic Surgery Patients.

PubMed

Van Giang, Nguyen; Chiu, Hsiao-Yean; Thai, Duong Hong; Kuo, Shu-Yu; Tsai, Pei-Shan

2015-10-01

Pain is common in patients after orthopedic surgery. The 11-face Faces Pain Scale has not been validated for use in adult patients with postoperative pain. To assess the validity of the 11-face Faces Pain Scale and its ability to detect responses to pain medications, and to determine whether the sensitivity of the 11-face Faces Pain Scale for detecting changes in pain intensity over time is associated with gender differences in adult postorthopedic surgery patients. The 11-face Faces Pain Scale was translated into Vietnamese using forward and back translation. Postoperative pain was assessed using an 11-point numerical rating scale and the 11-face Faces Pain Scale on the day of surgery, and before (Time 1) and every 30 minutes after (Times 2-5) the patients had taken pain medications on the first postoperative day. The 11-face Faces Pain Scale highly correlated with the numerical rating scale (r = 0.78, p < .001). When the scores from each follow-up test (Times 2-5) were compared with those from the baseline test (Time 1), the effect sizes were -0.70, -1.05, -1.20, and -1.31, and the standardized response means were -1.17, -1.59, -1.66, and -1.82, respectively. The mean change in pain intensity, but not gender-time interaction effect, over the five time points was significant (F = 182.03, p < .001). Our results support that the 11-face Faces Pain Scale is appropriate for measuring acute postoperative pain in adults. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Effects of Minute Contextual Experience on Realistic Assessment of Proportional Reasoning

ERIC Educational Resources Information Center

Matney, Gabriel; Jackson, Jack L., II; Bostic, Jonathan

2013-01-01

This mixed methods study describes the effects of a "minute contextual experience" on students' ability to solve a realistic assessment problem involving scale drawings and proportional reasoning. Minute contextual experience (MCE) is defined to be a brief encounter with a context in which aspects of the context are explored openly. The…

Effects of Twice-Weekly Intense Aerobic Exercise in Early Subacute Stroke: A Randomized Controlled Trial.

PubMed

Sandberg, Klas; Kleist, Marie; Falk, Lars; Enthoven, Paul

2016-08-01

To examine the effects of 12 weeks of twice-weekly intensive aerobic exercise on physical function and quality of life after subacute stroke. Randomized controlled trial. Ambulatory care. Patients (N=56; 28 women) aged ≥50 years who had a mild stroke (98% ischemic) and were discharged to independent living and enrolled 20 days (median) after stroke onset. Sixty minutes of group aerobic exercise, including 2 sets of 8 minutes of exercise with intensity up to exertion level 14 or 15 of 20 on the Borg rating of perceived exertion scale, twice weekly for 12 weeks (n=29). The nonintervention group (n=27) received no organized rehabilitation or scheduled physical exercise. Primary outcome measures included aerobic capacity on the standard ergometer exercise stress test (peak work rate) and walking distance on the 6-minute walk test (6MWT). Secondary outcome measures included maximum walking speed for 10m, balance on the timed Up and Go (TUG) test and single leg stance (SLS), health-related quality of life on the European Quality of Life Scale (EQ-5D), and participation and recovery after stroke on the Stroke Impact Scale (SIS) version 2.0 domains 8 and 9. Participants were evaluated pre- and postintervention. Patient-reported measures were also evaluated at 6-month follow-up. The following improved significantly more in the intervention group (pre- to postintervention): peak work rate (group × time interaction, P=.006), 6MWT (P=.011), maximum walking speed for 10m (P<.001), TUG test (P<.001), SLS right and left (eyes open) (P<.001 and P=.022, respectively), and SLS right (eyes closed) (P=.019). Aerobic exercise was associated with improved EQ-5D scores (visual analog scale, P=.008) and perceived recovery (SIS domain 9, P=.002). These patient-reported improvements persisted at 6-month follow-up. Intensive aerobic exercise twice weekly early in subacute mild stroke improved aerobic capacity, walking, balance, health-related quality of life, and patient-reported recovery. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Universal behavior of the interoccurrence times between losses in financial markets: independence of the time resolution.

PubMed

Ludescher, Josef; Bunde, Armin

2014-12-01

We consider representative financial records (stocks and indices) on time scales between one minute and one day, as well as historical monthly data sets, and show that the distribution P(Q)(r) of the interoccurrence times r between losses below a negative threshold -Q, for fixed mean interoccurrence times R(Q) in multiples of the corresponding time resolutions, can be described on all time scales by the same q exponentials, P(Q)(r)∝1/{[1+(q-1)βr](1/(q-1))}. We propose that the asset- and time-scale-independent analytic form of P(Q)(r) can be regarded as an additional stylized fact of the financial markets and represents a nontrivial test for market models. We analyze the distribution P(Q)(r) as well as the autocorrelation C(Q)(s) of the interoccurrence times for three market models: (i) multiplicative random cascades, (ii) multifractal random walks, and (iii) the generalized autoregressive conditional heteroskedasticity [GARCH(1,1)] model. We find that only one of the considered models, the multifractal random walk model, approximately reproduces the q-exponential form of P(Q)(r) and the power-law decay of C(Q)(s).

Universal behavior of the interoccurrence times between losses in financial markets: Independence of the time resolution

NASA Astrophysics Data System (ADS)

Ludescher, Josef; Bunde, Armin

2014-12-01

We consider representative financial records (stocks and indices) on time scales between one minute and one day, as well as historical monthly data sets, and show that the distribution PQ(r ) of the interoccurrence times r between losses below a negative threshold -Q , for fixed mean interoccurrence times RQ in multiples of the corresponding time resolutions, can be described on all time scales by the same q exponentials, PQ(r ) ∝1 /{[1+(q -1 ) β r ] 1 /(q -1 )} . We propose that the asset- and time-scale-independent analytic form of PQ(r ) can be regarded as an additional stylized fact of the financial markets and represents a nontrivial test for market models. We analyze the distribution PQ(r ) as well as the autocorrelation CQ(s ) of the interoccurrence times for three market models: (i) multiplicative random cascades, (ii) multifractal random walks, and (iii) the generalized autoregressive conditional heteroskedasticity [GARCH(1,1)] model. We find that only one of the considered models, the multifractal random walk model, approximately reproduces the q -exponential form of PQ(r ) and the power-law decay of CQ(s ) .

Disposal of Industrial and Domestic Wastes: Land and Sea Alternatives.

DTIC Science & Technology

1984-01-01

square kilometers. The rough classification of physical, chemical , and biological processes into near field versus far field and short term versus...contaminants by sedimentation is slowed. Chemical Precipitation and Dissolution During the few minutes of the initial dilution of a buoyant plume ...model. Time and space scales of physical, chemical , and biological processes often provide natural divisions in such modeling. Near -field and far-field

Hydrologic conditions and terrestrial laser scanning of post-fire debris flows in the San Gabriel Mountains, CA, U.S.A.

USGS Publications Warehouse

Schmidt, Kevin M.; Hanshaw, M.N.; Howle, James F.; Kean, Jason W.; Staley, Dennis M.; Stock, Jonathan D.; Bawden, Gerald W.

2011-01-01

To investigate rainfall-runoff conditions that generate post-wildfire debris flows, we instrumented and surveyed steep, small watersheds along the tectonically active front of the San Gabriel Mountains, California. Fortuitously, we recorded runoff-generated debris-flows triggered by one spatially restricted convective event with 28 mm of rainfall falling over 62 minutes. Our rain gages, nested hillslope overland-flow sensors and soil-moisture probes, as well as a time series of terrestrial laser scanning (TLS) revealed the effects of the storm. Hillslope overland-flow response, along two ~10-m long flow lines perpendicular to and originating from a drainage divide, displayed only a 10 to 20 minute delay from the onset of rainfall with accumulated totals of merely 5-10 mm. Depth-stratified soil-moisture probes displayed a greater time delay, roughly 20- 30 minutes, indicating that initial overland flow was Hortonian. Furthermore, a downstream channel-monitoring array recorded a pronounced discharge peak generated by the passage of a debris flow after 18 minutes of rainfall. At this time, only four of the eleven hillslope overlandflow sensors confirmed the presence of surface-water flow. Repeat TLS and detailed field mapping using GPS document how patterns of rainsplash, overland-flow scour, and rilling contributed to the generation of meter-scale debris flows. In response to a single small storm, the debris flows deposited irregular levees and lobate terminal snouts on hillslopes and caused widespread erosion of the valley axis with ground surface lowering exceeding 1.5 m.

Effect of virtual reality training on laparoscopic surgery: randomised controlled trial

PubMed Central

Soerensen, Jette L; Grantcharov, Teodor P; Dalsgaard, Torur; Schouenborg, Lars; Ottosen, Christian; Schroeder, Torben V; Ottesen, Bent S

2009-01-01

Objective To assess the effect of virtual reality training on an actual laparoscopic operation. Design Prospective randomised controlled and blinded trial. Setting Seven gynaecological departments in the Zeeland region of Denmark. Participants 24 first and second year registrars specialising in gynaecology and obstetrics. Interventions Proficiency based virtual reality simulator training in laparoscopic salpingectomy and standard clinical education (controls). Main outcome measure The main outcome measure was technical performance assessed by two independent observers blinded to trainee and training status using a previously validated general and task specific rating scale. The secondary outcome measure was operation time in minutes. Results The simulator trained group (n=11) reached a median total score of 33 points (interquartile range 32-36 points), equivalent to the experience gained after 20-50 laparoscopic procedures, whereas the control group (n=10) reached a median total score of 23 (22-27) points, equivalent to the experience gained from fewer than five procedures (P<0.001). The median total operation time in the simulator trained group was 12 minutes (interquartile range 10-14 minutes) and in the control group was 24 (20-29) minutes (P<0.001). The observers’ inter-rater agreement was 0.79. Conclusion Skills in laparoscopic surgery can be increased in a clinically relevant manner using proficiency based virtual reality simulator training. The performance level of novices was increased to that of intermediately experienced laparoscopists and operation time was halved. Simulator training should be considered before trainees carry out laparoscopic procedures. Trial registration ClinicalTrials.gov NCT00311792. PMID:19443914

Evaluating rainfall kinetic energy - intensity relationships with observed disdrometric data

NASA Astrophysics Data System (ADS)

Angulo-Martinez, Marta; Begueria, Santiago; Latorre, Borja

2016-04-01

Rainfall kinetic energy is required for determining erosivity, the ability of rainfall to detach soil particles and initiate erosion. Its determination relay on the use of disdrometers, i.e. devices capable of measuring the drop size distribution and velocity of falling raindrops. In the absence of such devices, rainfall kinetic energy is usually estimated with empirical expressions relating rainfall energy and intensity. We evaluated the performance of 14 rainfall energy equations in estimating one-minute rainfall energy and event total energy, in comparison with observed data from 821 rainfall episodes (more than 100 thousand one-minute observations) by means of an optical disdrometer. In addition, two sources of bias when using such relationships were evaluated: i) the influence of using theoretical terminal raindrop fall velocities instead of measured values; and ii) the influence of time aggregation (rainfall intensity data every 5-, 10-, 15-, 30-, and 60-minutes). Empirical relationships did a relatively good job when complete events were considered (R2 > 0.82), but offered poorer results for within-event (one-minute resolution) variation. Also, systematic biases where large for many equations. When raindrop size distribution was known, estimating the terminal fall velocities by empirical laws produced good results even at fine time resolution. The influence of time aggregation was very high in the estimated kinetic energy, although linear scaling may allow empirical correction. This results stress the importance of considering all these effects when rainfall energy needs to be estimated from more standard precipitation records. , and recommends the use of disdrometer data to locally determine rainfall kinetic energy.

Short timescale photometric and polarimetric behavior of two BL Lacertae type objects

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

Covino, S.; Baglio, M. C.; Foschini, L.

Context. Blazars are astrophysical sources whose emission is dominated by non-thermal processes, typically interpreted as synchrotron and inverse Compton emission. Although the general picture is rather robust and consistent with observations, many aspects are still unexplored. Aims. Polarimetric monitoring can offer a wealth of information about the physical processes in blazars. Models with largely different physical ingredients can often provide almost indistinguishable predictions for the total flux, but usually are characterized by markedly different polarization properties. We explore, with a pilot study, the possibility to derive structural information about the emitting regions of blazars by means of a joint analysismore » of rapid variability of the total and polarized flux at optical wavelengths. Methods. Short timescale (from tens of seconds to a couple of minutes) optical linear polarimetry and photometry for two blazars, BL Lacertae and PKS 1424+240, was carried out with the PAOLO polarimeter at the 3.6 m Telescopio Nazionale Galileo. Several hours of almost continuous observations were obtained for both sources. Results. Our intense monitoring allowed us to draw strongly different scenarios for BL Lacertae and PKS 1424+240, with the former characterized by intense variability on time-scales from hours to a few minutes and the latter practically constant in total flux. Essentially the same behavior is observed for the polarized flux and the position angle. The variability time-scales turned out to be as short as a few minutes, although involving only a few percent variation of the flux. The polarization variability time-scale is generally consistent with the total flux variability. Total and polarized flux appear to be essentially uncorrelated. However, even during our relatively short monitoring, different regimes can be singled out. Conclusions. No simple scenario is able to satisfactorily model the very rich phenomenology exhibited in our data. As a result, detailed numerical simulations show that the emitting region should be characterized by some symmetry, and the inclusion of turbulence for the magnetic field may constitute the missing ingredient for a more complete interpretation of the data.« less

Short timescale photometric and polarimetric behavior of two BL Lacertae type objects

DOE PAGES

Covino, S.; Baglio, M. C.; Foschini, L.; ...

2015-06-05

Context. Blazars are astrophysical sources whose emission is dominated by non-thermal processes, typically interpreted as synchrotron and inverse Compton emission. Although the general picture is rather robust and consistent with observations, many aspects are still unexplored. Aims. Polarimetric monitoring can offer a wealth of information about the physical processes in blazars. Models with largely different physical ingredients can often provide almost indistinguishable predictions for the total flux, but usually are characterized by markedly different polarization properties. We explore, with a pilot study, the possibility to derive structural information about the emitting regions of blazars by means of a joint analysismore » of rapid variability of the total and polarized flux at optical wavelengths. Methods. Short timescale (from tens of seconds to a couple of minutes) optical linear polarimetry and photometry for two blazars, BL Lacertae and PKS 1424+240, was carried out with the PAOLO polarimeter at the 3.6 m Telescopio Nazionale Galileo. Several hours of almost continuous observations were obtained for both sources. Results. Our intense monitoring allowed us to draw strongly different scenarios for BL Lacertae and PKS 1424+240, with the former characterized by intense variability on time-scales from hours to a few minutes and the latter practically constant in total flux. Essentially the same behavior is observed for the polarized flux and the position angle. The variability time-scales turned out to be as short as a few minutes, although involving only a few percent variation of the flux. The polarization variability time-scale is generally consistent with the total flux variability. Total and polarized flux appear to be essentially uncorrelated. However, even during our relatively short monitoring, different regimes can be singled out. Conclusions. No simple scenario is able to satisfactorily model the very rich phenomenology exhibited in our data. As a result, detailed numerical simulations show that the emitting region should be characterized by some symmetry, and the inclusion of turbulence for the magnetic field may constitute the missing ingredient for a more complete interpretation of the data.« less

Use of Radio Frequency Identification to Establish Emergency Medical Service Offload Times.

PubMed

Steer, Sheila; Bhalla, Mary C; Zalewski, Jon; Frey, Jennifer; Nguyen, Victor; Mencl, Francis

2016-01-01

Emergency medical services (EMS) crews often wait for emergency department (ED) beds to become available to offload their patients. Presently there is no national benchmark for EMS turnaround or offload times, or method for objectively and reliably measuring this. This study introduces a novel method for monitoring offload times and identifying variance. We performed a descriptive, observational study in a large urban community teaching hospital. We affixed radio frequency identification (RFID) tags (Confidex Survivor™, Confidex, Inc., Glen Ellyn, IL) to 65 cots from 19 different EMS agencies and placed a reader (CaptureTech Weatherproof RFID Interpreter, Barcoding Inc., Baltimore, Maryland) in the ED ambulance entrance, allowing for passive recording of traffic. We recorded data for 16 weeks starting December 2009. Offload times were calculated for each visit and analyzed using STATA to show variations in individual and cumulative offload times based on the time of day and day of the week. Results are presented as median times, confidence intervals (CIs), and interquartile ranges (IQRs). We collected data on 2,512 visits. Five hundred and ninety-two were excluded because of incomplete data, leaving 1,920 (76%) complete visits. Average offload time was 13.2 minutes. Median time was 10.7 minutes (IQR 8.1 minutes to 15.4 minutes). A total of 43% of the patients (833/1,920, 95% CI 0.41-0.46) were offloaded in less than 10 minutes, while 27% (513/1,920, 95% CI 0.25-0.29) took greater than 15 minutes. Median times were longest on Mondays (11.5 minutes) and shortest on Wednesdays (10.3 minutes). Longest daily median offload time occurred between 1600 and 1700 (13.5 minutes), whereas the shortest median time was between 0800 and 0900 (9.3 minutes). Cumulative time spent waiting beyond 15 minutes totaled 72.5 hours over the study period. RFID monitoring is a simple and effective means of monitoring EMS traffic and wait times. At our institution, most squads are able to offload their patients within 15 minutes, with many in less than 10 minutes. Variations in wait times are seen and are a topic for future study.

On the scaling features of high-latitude geomagnetic field fluctuations during a large geomagnetic storm

NASA Astrophysics Data System (ADS)

De Michelis, Paola; Federica Marcucci, Maria; Consolini, Giuseppe

2015-04-01

Recently we have investigated the spatial distribution of the scaling features of short-time scale magnetic field fluctuations using measurements from several ground-based geomagnetic observatories distributed in the northern hemisphere. We have found that the scaling features of fluctuations of the horizontal magnetic field component at time scales below 100 minutes are correlated with the geomagnetic activity level and with changes in the currents flowing in the ionosphere. Here, we present a detailed analysis of the dynamical changes of the magnetic field scaling features as a function of the geomagnetic activity level during the well-known large geomagnetic storm occurred on July, 15, 2000 (the Bastille event). The observed dynamical changes are discussed in relationship with the changes of the overall ionospheric polar convection and potential structure as reconstructed using SuperDARN data. This work is supported by the Italian National Program for Antarctic Research (PNRA) - Research Project 2013/AC3.08 and by the European Community's Seventh Framework Programme ([FP7/2007-2013]) under Grant no. 313038/STORM and

Lagrangian Statistics and Intermittency in Gulf of Mexico.

PubMed

Lin, Liru; Zhuang, Wei; Huang, Yongxiang

2017-12-12

Due to the nonlinear interaction between different flow patterns, for instance, ocean current, meso-scale eddies, waves, etc, the movement of ocean is extremely complex, where a multiscale statistics is then relevant. In this work, a high time-resolution velocity with a time step 15 minutes obtained by the Lagrangian drifter deployed in the Gulf of Mexico (GoM) from July 2012 to October 2012 is considered. The measured Lagrangian velocity correlation function shows a strong daily cycle due to the diurnal tidal cycle. The estimated Fourier power spectrum E(f) implies a dual-power-law behavior which is separated by the daily cycle. The corresponding scaling exponents are close to -1.75 and -2.75 respectively for the time scale larger (resp. 0.1 ≤ f ≤ 0.4 day -1 ) and smaller (resp. 2 ≤ f ≤ 8 day -1 ) than 1 day. A Hilbert-based approach is then applied to this data set to identify the possible multifractal property of the cascade process. The results show an intermittent dynamics for the time scale larger than 1 day, while a less intermittent dynamics for the time scale smaller than 1 day. It is speculated that the energy is partially injected via the diurnal tidal movement and then transferred to larger and small scales through a complex cascade process, which needs more studies in the near future.

A photometric study of the nova-like variable TT Arietis with the MOST satellite

NASA Astrophysics Data System (ADS)

Vogt, N.; Chené, A.-N.; Moffat, A. F. J.; Matthews, J. M.; Kuschnig, R.; Guenther, D. B.; Rowe, J. F.; Rucinski, S. M.; Sasselov, D.; Weiss, W. W.

2013-12-01

Variability on all time scales between seconds and decades is typical for cataclysmic variables (CVs). One of the brightest and best studied CVs is TT Ari, a nova-like variable which belongs to the VY Scl subclass, characterized by occasional low states in their light curves. It is also known as a permanent superhumper at high state, revealing ``positive'' (PS> P0) as well as ``negative'' (PS< P0) superhumps, where PS is the period of the superhump and P0 the orbital period. TT Ari was observed by the Canadian space telescope MOST for about 230 hours nearly continuously in 2007, with a time resolution of 48 seconds. Here we analyze these data, obtaining a dominant ``negative'' superhump signal with a period PS = 0.1331 days and a mean amplitude of 0.09 mag. Strong flickering with amplitudes up to 0.2 mag and peak-to-peak time scales of 15-20 minutes is superimposed on the periodic variations. We found no indications for significant quasi-periodic oscillations with periods around 15 minutes, reported by other authors. We discuss the known superhump behaviour of TT Ari during the last five decades and conclude that our period value is at the upper limit of all hitherto determined ``negative'' superhump periods of TT Ari, before and after the MOST run.

Uphill and Downhill Walking in Multiple Sclerosis

PubMed Central

Samaei, Afshin; Hajihasani, Abdolhamid; Fatemi, Elham; Motaharinezhad, Fatemeh

2016-01-01

Background: Various exercise protocols have been recommended for patients with multiple sclerosis (MS). We investigated the effects of uphill and downhill walking exercise on mobility, functional activities, and muscle strength in MS patients. Methods: Thirty-four MS patients were randomly allocated to either the downhill or uphill treadmill walking group for 12 sessions (3 times/wk) of 30 minutes' walking on a 10% negative slope (n = 17) or a 10% positive slope (n = 17), respectively. Measurements were taken before and after the intervention and after 4-week follow-up and included fatigue by Modified Fatigue Impact Scale; mobility by Modified Rivermead Mobility Index; disability by Guy's Neurological Disability Scale; functional activities by 2-Minute Walk Test, Timed 25-Foot Walk test, and Timed Up and Go test; balance indices by Biodex Balance System; and quadriceps and hamstring isometric muscles by torque of left and right knee joints. Analysis of variance with repeated measures was used to investigate the intervention effects on the measurements. Results: After the intervention, significant improvement was found in the downhill group versus the uphill group in terms of fatigue, mobility, and disability indices; functional activities; balance indices; and quadriceps isometric torque (P < .05). The results were stable at 4-week follow-up. Conclusions: Downhill walking on a treadmill may improve muscle performance, functional activity, and balance control in MS patients. These findings support the idea of using eccentric exercise training in MS rehabilitation protocols. PMID:26917996

Decreased Stress Levels in Nurses: A Benefit of Quiet Time.

PubMed

Riemer, Heather C; Mates, Joanna; Ryan, Linda; Schleder, Bonnie J

2015-09-01

The benefits of quiet time, a therapeutic method of improving the health care environment, have been evaluated in patients, but only a few studies have examined the effects of quiet time on intensive care nurses. To evaluate the effects of implementing quiet time in a medical-surgical intensive care unit on levels of light, noise, and nurses' stress. Quiet time consisted of turning down the unit lights for a designated time. Levels of light, noise, and nurses' stress were measured. Nurses' stress levels were measured by using a 100-point visual analog scale; unit noise, by using a digital sound level meter (model 407736, Extech Instruments); and unit light, by using an illumination light meter (model 615, Huygen Corporation). Measurements were obtained 30 minutes before and 30 minutes, 1 hour, and 2 hours after implementation of quiet time. Analysis of variance and comparisons of means indicated that both light levels and nurses' stress levels were significantly decreased after quiet time (both P < .001). Noise levels were also decreased after quiet time, but the decrease was not significant (P = .08). Use of quiet time resulted in decreased light levels and decreased stress levels among nurses. Quiet time is an easily performed energy-saving intervention to promote a healthy work environment. ©2015 American Association of Critical-Care Nurses.

Mobile Interventional Stroke Teams Lead to Faster Treatment Times for Thrombectomy in Large Vessel Occlusion.

PubMed

Wei, Daniel; Oxley, Thomas J; Nistal, Dominic A; Mascitelli, Justin R; Wilson, Natalie; Stein, Laura; Liang, John; Turkheimer, Lena M; Morey, Jacob R; Schwegel, Claire; Awad, Ahmed J; Shoirah, Hazem; Kellner, Christopher P; De Leacy, Reade A; Mayer, Stephan A; Tuhrim, Stanley; Paramasivam, Srinivasan; Mocco, J; Fifi, Johanna T

2017-12-01

Endovascular recanalization treatment for acute ischemic stroke is a complex, time-sensitive intervention. Trip-and-treat is an interhospital service delivery model that has not previously been evaluated in the literature and consists of a shared mobile interventional stroke team that travels to primary stroke centers to provide on-site interventional capability. We compared treatment times between the trip-and-treat model and the traditional drip-and-ship model. We performed a retrospective analysis on 86 consecutive eligible patients with acute ischemic stroke secondary to large vessel occlusion who received endovascular treatment at 4 hospitals in Manhattan. Patients were divided into 2 cohorts: trip-and-treat (n=39) and drip-and-ship (n=47). The primary outcome was initial door-to-puncture time, defined as the time between arrival at any hospital and arterial puncture. We also recorded and analyzed the times of last known well, IV-tPA (intravenous tissue-type plasminogen activator) administration, transfer, and reperfusion. Mean initial door-to-puncture time was 143 minutes for trip-and-treat and 222 minutes for drip-and-ship ( P <0.0001). Although there was a trend in longer puncture-to-recanalization times for trip-and-treat ( P =0.0887), initial door-to-recanalization was nonetheless 79 minutes faster for trip-and-treat ( P <0.0001). There was a trend in improved admission-to-discharge change in National Institutes of Health Stroke Scale for trip-and-treat compared with drip-and-ship ( P =0.0704). Compared with drip-and-ship, the trip-and-treat model demonstrated shorter treatment times for endovascular therapy in our series. The trip-and-treat model offers a valid alternative to current interhospital stroke transfers in urban environments. © 2017 American Heart Association, Inc.

Ketamine versus alfentanil combined with propofol for sedation in colonoscopy procedures: a randomized prospective study.

PubMed

Türk, Hacer Şebnem; Aydoğmuş, Meltem; Ünsal, Oya; Işıl, Canan Tülay; Citgez, Bülent; Oba, Sibel; Açık, Mehmet Eren

2014-12-01

Different drug combinations are used for sedation in colonoscopy procedures. A ketamine-propofol (ketofol) mixture provides effective sedation and has minimal adverse effects. Alfentanil also provides anesthesia for short surgical procedures by incremental injection as an adjunct. However, no study has investigated the use of ketofol compared with an opioid-propofol combination in colonoscopic procedures. A total of 70 patients, ASA physical status I-II, scheduled to undergo elective colonoscopy, were enrolled in this prospective randomized study and allocated to two groups. After premedication, sedation induction was performed with 0.5 mg/kg ketamine +1 mg/kg propofol in Group KP, and 10 mg/kg alfentanil +1 mg/kg propofol in Group AP. Propofol was added when required. Demographic data, colonoscopy duration, recovery time, discharge time, mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation, Ramsey Sedation Scale values, colonoscopy patients' satisfaction scores, and complications were recorded. The need for additional propofol doses was significantly higher in Group AP than in Group KP. MAP at minute 1 and 5, Ramsey Sedation Scale at minute 5, and discharge time were significantly higher in Group KP than in Group AP. Additional propofol doses and total propofol dose were significantly lower in Group KP than in Group AP. Ketofol provided better hemodynamic stability and quality of sedation compared with alfentanil-propofol combination in elective colonoscopy, and required fewer additional propofol; however, it prolonged discharge time. Both combinations can safely be used in colonoscopy sedation.

Scale-specific effects: A report on multiscale analysis of acupunctured EEG in entropy and power

NASA Astrophysics Data System (ADS)

Song, Zhenxi; Deng, Bin; Wei, Xile; Cai, Lihui; Yu, Haitao; Wang, Jiang; Wang, Ruofan; Chen, Yingyuan

2018-02-01

Investigating acupuncture effects contributes to improving clinical application and understanding neuronal dynamics under external stimulation. In this report, we recorded electroencephalography (EEG) signals evoked by acupuncture at ST36 acupoint with three stimulus frequencies of 50, 100 and 200 times per minutes, and selected non-acupuncture EEGs as the control group. Multiscale analyses were introduced to investigate the possible acupuncture effects on complexity and power in multiscale level. Using multiscale weighted-permutation entropy, we found the significant effects on increased complexity degree in EEG signals induced by acupuncture. The comparison of three stimulation manipulations showed that 100 times/min generated most obvious effects, and affected most cortical regions. By estimating average power spectral density, we found decreased power induced by acupuncture. The joint distribution of entropy and power indicated an inverse correlation, and this relationship was weakened by acupuncture effects, especially under the manipulation of 100 times/min frequency. Above findings are more evident and stable in large scales than small scales, which suggests that multiscale analysis allows evaluating significant effects in specific scale and enables to probe the inherent characteristics underlying physiological signals.

A combined inspiratory and expiratory muscle training program improves respiratory muscle strength and fatigue in multiple sclerosis.

PubMed

Ray, Andrew D; Udhoji, Supriya; Mashtare, Terry L; Fisher, Nadine M

2013-10-01

To determine the effects of a short-duration, combined (inspiratory and expiratory), progressive resistance respiratory muscle training (RMT) protocol on respiratory muscle strength, fatigue, health-related quality of life, and functional performance in individuals with mild-to-moderate multiple sclerosis (MS). Quasi-experimental before-after trial. University rehabilitation research laboratory. Volunteers with MS (N=21) were divided into 2 groups: RMT (n=11; 9 women, 2 men; mean age ± SD, 50.9 ± 5.7y, mean Expanded Disability Status Scale score ± SD, 3.2 ± 1.9) and a control group that did not train (n=10; 7 women, 3 men; mean age ± SD, 56.2 ± 8.8y, mean Expanded Disability Status Scale score ± SD, 4.4 ± 2.1). Expanded Disability Status Scale scores ranged from 1 to ≤6.5. No patients withdrew from the study. Training was a 5-week combined progressive resistance RMT program, 3d/wk, 30 minutes per session. The primary outcome measures were maximal inspiratory pressure and expiratory pressure and the Modified Fatigue Impact Scale. All subjects completed secondary measures of pulmonary function, the six-minute walk test, the timed stair climb, the Multiple Sclerosis Self-Efficacy Scale, the Medical Outcomes Study 36-Item Short-Form Health Survey, and the Physical Activity Disability Scale. Maximal inspiratory pressure and expiratory pressure (mean ± SD) increased 35% ± 22% (P<.001) and 26% ± 17% (P<.001), respectively, whereas no changes were noted in the control group (12% ± 23% and -4% ± 17%, respectively). RMT improved fatigue (Modified Fatigue Impact Scale, P<.029), with no change or worsening in the control group. No changes were noted in the six-minute walk test, stair climb, Multiple Sclerosis Self-Efficacy Scale, or Physical Activity Disability Scale in the RMT group. The control group had decreases in emotional well-being and general health (Medical Outcomes Study 36-Item Short-Form Health Survey). A short-duration, combined RMT program improved inspiratory and expiratory muscle strength and reduced fatigue in patients with mild to moderate MS. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A wavelet analysis of scaling laws and long-memory in stock market volatility

NASA Astrophysics Data System (ADS)

Vuorenmaa, Tommi A.

2005-05-01

This paper studies the time-varying behavior of scaling laws and long-memory. This is motivated by the earlier finding that in the FX markets a single scaling factor might not always be sufficient across all relevant timescales: a different region may exist for intradaily time-scales and for larger time-scales. In specific, this paper investigates (i) if different scaling regions appear in stock market as well, (ii) if the scaling factor systematically differs from the Brownian, (iii) if the scaling factor is constant in time, and (iv) if the behavior can be explained by the heterogenuity of the players in the market and/or by intraday volatility periodicity. Wavelet method is used because it delivers a multiresolution decomposition and has excellent local adaptiviness properties. As a consequence, a wavelet-based OLS method allows for consistent estimation of long-memory. Thus issues (i)-(iv) shed light on the magnitude and behavior of a long-memory parameter, as well. The data are the 5-minute volatility series of Nokia Oyj at the Helsinki Stock Exchange around the burst of the IT-bubble. Period one represents the era of "irrational exuberance" and another the time after it. The results show that different scaling regions (i.e. multiscaling) may appear in the stock markets and not only in the FX markets, the scaling factor and the long-memory parameter are systematically different from the Brownian and they do not have to be constant in time, and that the behavior can be explained for a significant part by an intraday volatility periodicity called the New York effect. This effect was magnified by the frenzy trading of short-term speculators in the bubble period. The found stronger long-memory is also attributable to irrational exuberance.

A randomized trial to determine the duration of analgesia following a 15- and a 30-minute application of acupuncture-like TENS on patients with chronic low back pain.

PubMed

Tousignant-Laflamme, Yannick; Laroche, Claudia; Beaulieu, Christine; Bouchard, Ann-Julie; Boucher, Sabrina; Michaud-Létourneau, Mélanie

2017-05-01

Acupuncture-like TENS (AL-TENS) has been shown to produce prolonged pain relief, but no study has yet investigated its duration on a population suffering from chronic low back pain (CLPB). Our objective was to quantify the duration and magnitude of analgesia induced by a 15- or 30-minute application of AL-TENS. We recruited a sample of 11 participants presenting with CLBP and conducted a randomized, crossover study, where participants were given AL-TENS for 15 and 30 minutes on two separate occasions. The pain intensity of their CLBP was assessed with a visual analogue scale before, during, and after AL-TENS applications. Magnitude and duration of analgesia were determined for each subject and for both AL-TENS application times. The AL-TENS applications induced a clinically and statistically significant (p = 0.003) analgesia in all participants. Median duration of analgesia was 9 hours and 10 hours 30 minutes following the 15- and 30-minute AL-TENS applications, respectively; this 1.5-hour difference was not statistically significant (p = 0.55). Furthermore, we observed no significant difference in the magnitude of analgesia between both applications of AL-TENS (p > 0.56), suggesting that the duration of application of AL-TENS does not influence the magnitude of analgesia. Our results suggest that clinicians could use a 15-minute AL-TENS application to provide significant analgesia in patients presenting with low back pain since if provides a comparable analgesia versus a 30-minute application.

The origins of multifractality in financial time series and the effect of extreme events

NASA Astrophysics Data System (ADS)

Green, Elena; Hanan, William; Heffernan, Daniel

2014-06-01

This paper presents the results of multifractal testing of two sets of financial data: daily data of the Dow Jones Industrial Average (DJIA) index and minutely data of the Euro Stoxx 50 index. Where multifractal scaling is found, the spectrum of scaling exponents is calculated via Multifractal Detrended Fluctuation Analysis. In both cases, further investigations reveal that the temporal correlations in the data are a more significant source of the multifractal scaling than are the distributions of the returns. It is also shown that the extreme events which make up the heavy tails of the distribution of the Euro Stoxx 50 log returns distort the scaling in the data set. The most extreme events are inimical to the scaling regime. This result is in contrast to previous findings that extreme events contribute to multifractality.

Revealing the fast atomic motion of network glasses.

PubMed

Ruta, B; Baldi, G; Chushkin, Y; Rufflé, B; Cristofolini, L; Fontana, A; Zanatta, M; Nazzani, F

2014-05-19

Still very little is known on the relaxation dynamics of glasses at the microscopic level due to the lack of experiments and theories. It is commonly believed that glasses are in a dynamical arrested state, with relaxation times too large to be observed on human time scales. Here we provide the experimental evidence that glasses display fast atomic rearrangements within a few minutes, even in the deep glassy state. Following the evolution of the structural relaxation in a sodium silicate glass, we find that this fast dynamics is accompanied by the absence of any detectable aging, suggesting a decoupling of the relaxation time and the viscosity in the glass. The relaxation time is strongly affected by the network structure with a marked increase at the mesoscopic scale associated with the ion-conducting pathways. Our results modify the conception of the glassy state and asks for a new microscopic theory.

Reaction dynamics analysis of a reconstituted Escherichia coli protein translation system by computational modeling

PubMed Central

Matsuura, Tomoaki; Tanimura, Naoki; Hosoda, Kazufumi; Yomo, Tetsuya; Shimizu, Yoshihiro

2017-01-01

To elucidate the dynamic features of a biologically relevant large-scale reaction network, we constructed a computational model of minimal protein synthesis consisting of 241 components and 968 reactions that synthesize the Met-Gly-Gly (MGG) peptide based on an Escherichia coli-based reconstituted in vitro protein synthesis system. We performed a simulation using parameters collected primarily from the literature and found that the rate of MGG peptide synthesis becomes nearly constant in minutes, thus achieving a steady state similar to experimental observations. In addition, concentration changes to 70% of the components, including intermediates, reached a plateau in a few minutes. However, the concentration change of each component exhibits several temporal plateaus, or a quasi-stationary state (QSS), before reaching the final plateau. To understand these complex dynamics, we focused on whether the components reached a QSS, mapped the arrangement of components in a QSS in the entire reaction network structure, and investigated time-dependent changes. We found that components in a QSS form clusters that grow over time but not in a linear fashion, and that this process involves the collapse and regrowth of clusters before the formation of a final large single cluster. These observations might commonly occur in other large-scale biological reaction networks. This developed analysis might be useful for understanding large-scale biological reactions by visualizing complex dynamics, thereby extracting the characteristics of the reaction network, including phase transitions. PMID:28167777

The role of massage in scar management: a literature review.

PubMed

Shin, Thuzar M; Bordeaux, Jeremy S

2012-03-01

Many surgeons recommend postoperative scar massage to improve aesthetic outcome, although scar massage regimens vary greatly. To review the regimens and efficacy of scar massage. PubMed was searched using the following key words: "massage" in combination with "scar," or "linear," "hypertrophic," "keloid," "diasta*," "atrophic." Information on study type, scar type, number of patients, scar location, time to onset of massage therapy, treatment protocol, treatment duration, outcomes measured, and response to treatment was tabulated. Ten publications including 144 patients who received scar massage were examined in this review. Time to treatment onset ranged from after suture removal to longer than 2 years. Treatment protocols ranged from 10 minutes twice daily to 30 minutes twice weekly. Treatment duration varied from one treatment to 6 months. Overall, 65 patients (45.7%) experienced clinical improvement based on Patient Observer Scar Assessment Scale score, Vancouver Scar Scale score, range of motion, pruritus, pain, mood, depression, or anxiety. Of 30 surgical scars treated with massage, 27 (90%) had improved appearance or Patient Observer Scar Assessment Scale score. The evidence for the use of scar massage is weak, regimens used are varied, and outcomes measured are neither standardized nor reliably objective, although its efficacy appears to be greater in postsurgical scars than traumatic or postburn scars. Although scar massage is anecdotally effective, there is scarce scientific data in the literature to support it. © 2011 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Database for the geologic map of the Chelan 30-minute by 60-minute quadrangle, Washington (I-1661)

USGS Publications Warehouse

Tabor, R.W.; Frizzell, V.A.; Whetten, J.T.; Waitt, R.B.; Swanson, D.A.; Byerly, G.R.; Booth, D.B.; Hetherington, M.J.; Zartman, R.E.

2006-01-01

This digital map database has been prepared by R. W. Tabor from the published Geologic map of the Chelan 30-Minute Quadrangle, Washington. Together with the accompanying text files as PDF, it provides information on the geologic structure and stratigraphy of the area covered. The database delineates map units that are identified by general age and lithology following the stratigraphic nomenclature of the U.S. Geological Survey. The authors mapped most of the bedrock geology at 1:100,000 scale, but compiled Quaternary units at 1:24,000 scale. The Quaternary contacts and structural data have been much simplified for the 1:100,000-scale map and database. The spatial resolution (scale) of the database is 1:100,000 or smaller. This database depicts the distribution of geologic materials and structures at a regional (1:100,000) scale. The report is intended to provide geologic information for the regional study of materials properties, earthquake shaking, landslide potential, mineral hazards, seismic velocity, and earthquake faults. In addition, the report contains information and interpretations about the regional geologic history and framework. However, the regional scale of this report does not provide sufficient detail for site development purposes.

The reliability and validity of flight task workload ratings

NASA Technical Reports Server (NTRS)

Childress, M. E.; Hart, S. G.; Bortolussi, M. R.

1982-01-01

Twelve instrument-rated general aviation pilots each flew two scenarios in a motion-base simulator. During each flight, the pilots verbally estimated their workload every three minutes. Following each flight, they again estimated workload for each flight segment and also rated their overall workload, perceived performance, and 13 specific factors on a bipolar scale. The results indicate that time (a priori, inflight, or postflight) of eliciting ratings, period to be covered by the ratings (a specific moment in time or a longer period), type of rating scale, and rating method (verbal, written, or other) may be important variables. Overall workload ratings appear to be predicted by different specific scales depending upon the situation, with activity level the best predictor. Perceived performance seems to bear little relationship to observer-rated performance when pilots rate their overall performance and an observer rates specific behaviors. Perceived workload and performance also seem unrelated.

Levels of physical activity and sedentary time among 10- to 12-year-old boys and girls across 5 European countries using accelerometers: an observational study within the ENERGY-project.

PubMed

Verloigne, Maïté; Van Lippevelde, Wendy; Maes, Lea; Yıldırım, Mine; Chinapaw, Mai; Manios, Yannis; Androutsos, Odysseas; Kovács, Eva; Bringolf-Isler, Bettina; Brug, Johannes; De Bourdeaudhuij, Ilse

2012-03-31

The study aim was to objectively assess levels of sedentary time, light, moderate and vigorous physical activity (PA) among 10-12 year olds across five European countries and to examine differences in sedentary time and PA according to gender and country. 686 children (mean age = 11.6 ± 0.8 years, 53% girls, mean BMI = 19.0 ± 3.4 kg/m(2)) from Belgium, Greece, Hungary, the Netherlands and Switzerland wore Actigraph accelerometers and had at least 2 weekdays with minimum 10 h-wearing time and 1 weekend day with minimum 8 h-wearing time. Data were analyzed using multivariate analyses of covariance. Girls spent significantly more time sedentary (500 minutes/day) than boys (474 minutes/day) and significantly less time in light (267 minutes/day) and moderate-to-vigorous PA (32 minutes/day) than boys (284 minutes/day; 43 minutes/day respectively; p < 0.001). 4.6% of the girls and 16.8% of the boys met moderate-to-vigorous PA recommendations of at least 60 minutes/day. Greek boys were more sedentary (510 minutes/day; all at p < 0.05) than other boys. Dutch girls were less sedentary (457 minutes/day; all at p < 0.05) than other girls. Swiss girls displayed more moderate-to-vigorous PA (43 minutes/day; at p < 0.05) than other girls. Large proportions of children across different European countries did not meet PA recommendations and spent a lot of time sedentary. Mean time spent in moderate-to-vigorous PA was significantly lower than the recommended 60 minutes. Obesity prevention programmes focusing on both decreasing sedentary time and increasing light, moderate and vigorous PA are needed for European children, particularly girls.

Note: electronic circuit for two-way time transfer via a single coaxial cable with picosecond accuracy and precision.

PubMed

Prochazka, Ivan; Kodet, Jan; Panek, Petr

2012-11-01

We have designed, constructed, and tested the overall performance of the electronic circuit for the two-way time transfer between two timing devices over modest distances with sub-picosecond precision and a systematic error of a few picoseconds. The concept of the electronic circuit enables to carry out time tagging of pulses of interest in parallel to the comparison of the time scales of these timing devices. The key timing parameters of the circuit are: temperature change of the delay is below 100 fs/K, timing stability time deviation better than 8 fs for averaging time from minutes to hours, sub-picosecond time transfer precision, and a few picoseconds time transfer accuracy.

Investigation of aquifer-estuary interaction using wavelet analysis of fiber-optic temperature data

USGS Publications Warehouse

Henderson, R.D.; Day-Lewis, Frederick D.; Harvey, Charles F.

2009-01-01

Fiber-optic distributed temperature sensing (FODTS) provides sub-minute temporal and meter-scale spatial resolution over kilometer-long cables. Compared to conventional thermistor or thermocouple-based technologies, which measure temperature at discrete (and commonly sparse) locations, FODTS offers nearly continuous spatial coverage, thus providing hydrologic information at spatiotemporal scales previously impossible. Large and information-rich FODTS datasets, however, pose challenges for data exploration and analysis. To date, FODTS analyses have focused on time-series variance as the means to discriminate between hydrologic phenomena. Here, we demonstrate the continuous wavelet transform (CWT) and cross-wavelet transform (XWT) to analyze FODTS in the context of related hydrologic time series. We apply the CWT and XWT to data from Waquoit Bay, Massachusetts to identify the location and timing of tidal pumping of submarine groundwater.

Pain and cardiorespiratory responses of children during physiotherapy after heart surgery.

PubMed

Araujo, Adriana Sanches Garcia; Klamt, Jyrson Guilherme; Vicente, Walter Villela de Andrade; Garcia, Luis Vicente

2014-01-01

The aim of the present study was to determine the occurrence of pain and changes in blood pressure, heart rate, respiratory rate, and arterial oxygen saturation associated with physiotherapy in children undergoing cardiac surgery. Eighteen extubated children were assessed for the presence of pain using the face, legs, activity, cry, consolability scale, and blood pressure, heart rate, respiratory rate and arterial oxygen saturation were simultaneously recorded. The physiological parameters were measured at the following time periods: immediately before physiotherapy, five and 10 minutes after the beginning of physiotherapy, and five minutes after its end. Pain was assessed immediately before physiotherapy, ten minutes after the beginning of physiotherapy and five minutes after its end. Pain and physiological changes were assessed by the Friedman test and the correlation between the physiological parameters and the pain scores was assessed by the Spearman test. Pain increased during physiotherapy and decreased significantly after it compared to pre-physiotherapy scores. Systolic blood pressure and heart rate increased significantly after 10 minutes of the beginning of physiotherapy. Arterial oxygen saturation tended to decrease during physiotherapy and to increase after it, although without significance. The correlation between pain scores and the physiological variables was significant only for systolic blood pressure and heart rate ten minutes after the beginning of physiotherapy. Manipulation after the beginning of physiotherapy seems to be accompanied by significant pain and by important associated cardiovascular changes. Apparent analgesia and improved respiratory function were observed after respiratory physiotherapy.

Scale size-dependent characteristics of the nightside aurora

NASA Astrophysics Data System (ADS)

Humberset, B. K.; Gjerloev, J. W.; Samara, M.; Michell, R. G.

2017-02-01

We have determined the spatiotemporal characteristics of the magnetosphere-ionosphere (M-I) coupling using auroral imaging. Observations at fixed positions for an extended period of time are provided by a ground-based all-sky imager measuring the 557.7 nm auroral emissions. We report on a single event of nightside aurora (˜22 magnetic local time) preceding a substorm onset. To determine the spatiotemporal characteristics, we perform an innovative analysis of an all-sky imager movie (19 min duration, images at 3.31 Hz) that combines a two-dimensional spatial fast Fourier transform with a temporal correlation. We find a scale size-dependent variability where the largest scale sizes are stable on timescales of minutes while the small scale sizes are more variable. When comparing two smaller time intervals of different types of auroral displays, we find a variation in their characteristics. The characteristics averaged over the event are in remarkable agreement with the spatiotemporal characteristics of the nightside field-aligned currents during moderately disturbed times. Thus, two different electrodynamical parameters of the M-I coupling show similar behavior. This gives independent support to the claim of a system behavior that uses repeatable solutions to transfer energy and momentum from the magnetosphere to the ionosphere.

Determining Whether a Dosage-Specific and Individualized Home Exercise Program With Consults Reduces Fall Risk and Falls in Community-Dwelling Older Adults With Difficulty Walking: A Randomized Control Trial.

PubMed

Gallo, Estelle; Stelmach, Maria; Frigeri, Fernanda; Ahn, Dong-Hyun

The development and implementation of effective interventions to prevent falls in older adults is a public health priority. The purpose of this study was to compare the efficacy of a new practice model, incorporating Shubert's evidence-based fall prevention recommendations, with the usual ambulatory physical therapy (PT) at Rusk Rehabilitation, to decrease fall risk among older adults living in the community. The hypotheses were (1) the proposed program would decrease participants' fall risk, (2) it would be more effective than our usual PT, and (3) the addition of 4 consults after discharge would improve compliance with a home exercise program. This was a randomized controlled trial. Sixty-nine participants who were independent community dwellers, were 65 years or older, had difficulty walking or complaints of instability, and had 1 or more risk of falls were randomly assigned into a usual care group (UCG, n = 43) or an experimental group (EG, n = 26). Both groups received PT 2 times per week for 30 minutes for 10 to 32 visits. The UCG received the usual PT delivered at Rusk. The EG was instructed in a moderate- to high-intensity home exercise program designed after completing the mini-Balance Evaluation Systems Test to assist with exercise prescription. The EG was educated on performing a recommended dosage of exercise over 6 months using a diary. The EG received 4 additional 30-minute consults every 2 to 4 weeks postdischarge to reinforce compliance. Self-report of number of falls, number of minutes of exercise per week, and performance on outcome measures (Timed Up and Go, 5-times sit-to-stand, Berg Balance Scale, and Activity Balance Confidence Scale) were monitored at evaluation, 2, 4, and 6 months. Thirty-five participants completed the study (UCG n = 22; EG n = 13). Both groups were similar at baseline on outcome measures and number of visits. Random effect model analyses demonstrated that both groups made significant reductions in fall risk over 6 months as identified by performance on outcome measures. However, the EG improved significantly more compared with the UCG over time (P < .05). Linear regression analyses showed that the EG exercised significantly more compared with the UCG at all times (P < .05). The EG exceeded the target of 115 min/wk of exercise (154 minutes, standard deviation [SD] 68.5; 170 minutes, SD 96.8; and 143 minutes, SD 68.5) at 2, 4, and 6 months, respectively. This study demonstrated that the experimental program is effective in decreasing fall risk in community-dwelling older adults and is more effective than our usual care. Moreover, it suggests that the overall experimental protocol may offer an effective strategy to foster adherence to an exercise program without the increasing number of visits. This study supports the efficacy of the experimental program in decreasing fall risk and being more effective than our usual care, as well as fostering greater compliance with an exercise regimen. It provides some preliminary evidence to support Shubert's recommendation on exercise prescription for fall prevention.

Time spent by people managing chronic obstructive pulmonary disease indicates biographical disruption

PubMed Central

Jowsey, Tanisha; Yen, Laurann E; Bagheri, Nasser; McRae, Ian S

2014-01-01

Since Bury’s 1982 proposal that chronic illness creates biographical disruption for those who are living with it, there has been no effort to quantitatively measure such disruption. “Biographical disruption” refers to the substantial and directive influence that chronic illness can have over the course of a person’s life. Qualitative research and time use studies have demonstrated that people with chronic illnesses spend considerable amounts of time managing their health, and that these demands may change over time. This study was designed to measure the time that older people with chronic illnesses spend on selected health practices as one indicator of biographical disruption. We look specifically at the time use of people with chronic obstructive pulmonary disease (COPD). As part of a larger time use survey, a recall questionnaire was mailed to 3,100 members of Lung Foundation Australia in 2011. A total of 681 responses were received (22.0% response rate), 611 of which were from people with COPD. Descriptive analyses were undertaken on the amount of time spent on selected health-related activities including personal care, nonclinical health-related care, and activity relating to health services. Almost all people with COPD report spending some time each day on personal or home-based health-related tasks, with a median time of 15 minutes per day spent on these activities. At the median, people also report spending about 30 minutes per day exercising, 2.2 hours per month (the equivalent of 4.4 minutes per day) on nonclinical health-related activities, and 4.1 hours per month (equivalent to 8.2 minutes per day) on clinical activities. Excluding exercise, the median total time spent on health-related activities was 17.8 hours per month (or 35.6 minutes per day). For people in the top 10% of time use, the total amount of time was more than 64.6 hours per month (or 2.2 hours per day) excluding exercise, and 104 hours per month (or 3.5 hours per day) including exercise. The amount of time spent on health-related activity, such as engaging in personal care tasks, may be regular and predictable. The execution of these tasks generally takes relatively small amounts of time, and might be incorporated into daily life (biography) without causing significant disruption. Other activities may require large blocks of time, and they may be disruptive in a practical way that almost inevitably disrupts biography. The amount of time required does not appear to alter in relation to the time since diagnosis. The scale of time needed to manage one’s health could easily be interpreted as disruptive, and for some people, even overwhelming. PMID:24477271

Determination of Gastrointestinal Transit Times in Barred Owls ( Strix varia ) by Contrast Fluoroscopy.

PubMed

Doss, Grayson A; Williams, Jackie M; Mans, Christoph

2017-06-01

Contrast imaging studies are routinely performed in avian patients when an underlying abnormality of the gastrointestinal (GI) tract is suspected. Fluoroscopy offers several advantages over traditional radiography and can be performed in conscious animals with minimal stress and restraint. Although birds of prey are commonly encountered as patients, little is known about GI transit times and contrast imaging studies in these species, especially owls. Owls are commonly encountered in zoological, educational, and wildlife settings. In this study, 12 adult barred owls ( Strix varia ) were gavage fed a 30% weight-by-volume barium suspension (25 mL/kg body weight). Fluoroscopic exposures were recorded at 5, 15, 30, 60, 120, 180, 240, and 300 minutes after administration. Overall GI transit time and transit times of various GI organs were recorded. Median (interquartile range [IQR]) overall GI transit time was 60 minutes (IQR: 19-60 minutes) and ranged from 5-120 minutes. Ventricular and small intestinal contrast filling was rapid. Ventricular emptying was complete by a median of 60 minutes (IQR: 30-120 minutes; range: 30-240 minutes), whereas small intestinal emptying was not complete in 9/12 birds by 300 minutes. Median small intestinal contraction rate was 15 per minute (IQR: 13-16 minutes; range: 10-19 minutes). Median overall GI transit time in barred owls is more rapid than mean transit times reported for psittacine birds and red-tailed hawks ( Buteo jamaicensis ). Fluoroscopy is a safe, suitable method for investigating GI motility and transit in this species.

Improvements in door-to-balloon time in the United States, 2005 to 2010.

PubMed

Krumholz, Harlan M; Herrin, Jeph; Miller, Lauren E; Drye, Elizabeth E; Ling, Shari M; Han, Lein F; Rapp, Michael T; Bradley, Elizabeth H; Nallamothu, Brahmajee K; Nsa, Wato; Bratzler, Dale W; Curtis, Jeptha P

2011-08-30

Registry studies have suggested improvements in door-to-balloon times, but a national assessment of the trends in door-to-balloon times is lacking. Moreover, we do not know whether improvements in door-to-balloon times were shared equally among patient and hospital groups. This analysis includes all patients reported by hospitals to the Centers for Medicare & Medicaid Services for inclusion in the time to percutaneous coronary intervention (acute myocardial infarction-8) inpatient measure from January 1, 2005, through September 30, 2010. For each calendar year, we summarized the characteristics of patients reported for the measure, including the number and percentage in each group, the median time to primary percutaneous coronary intervention, and the percentage with time to primary percutaneous coronary intervention within 75 minutes and within 90 minutes. Door-to-balloon time declined from a median of 96 minutes in the year ending December 31, 2005, to a median of 64 minutes in the 3 quarters ending September 30, 2010. There were corresponding increases in the percentage of patients who had times <90 minutes (44.2% to 91.4%) and <75 minutes (27.3% to 70.4%). The declines in median times were greatest among groups that had the highest median times during the first period: patients >75 years of age (median decline, 38 minutes), women (35 minutes), and blacks (42 minutes). National progress has been achieved in the timeliness of treatment of patients with ST-segment-elevation myocardial infarction who undergo primary percutaneous coronary intervention.

Use of time series and harmonic constituents of tidal propagation to enhance estimation of coastal aquifer heterogeneity

USGS Publications Warehouse

Hughes, Joseph D.; White, Jeremy T.; Langevin, Christian D.

2010-01-01

A synthetic two‐dimensional model of a horizontally and vertically heterogeneous confined coastal aquifer system, based on the Upper Floridan aquifer in south Florida, USA, subjected to constant recharge and a complex tidal signal was used to generate 15‐minute water‐level data at select locations over a 7‐day simulation period.   “Observed” water‐level data were generated by adding noise, representative of typical barometric pressure variations and measurement errors, to 15‐minute data from the synthetic model. Permeability was calibrated using a non‐linear gradient‐based parameter inversion approach with preferred‐value Tikhonov regularization and 1) “observed” water‐level data, 2) harmonic constituent data, or 3) a combination of “observed” water‐level and harmonic constituent data.    In all cases, high‐frequency data used in the parameter inversion process were able to characterize broad‐scale heterogeneities; the ability to discern fine‐scale heterogeneity was greater when harmonic constituent data were used.  These results suggest that the combined use of highly parameterized‐inversion techniques and high frequency time and/or processed‐harmonic constituent water‐level data could be a useful approach to better characterize aquifer heterogeneities in coastal aquifers influenced by ocean tides.

Effect of Fixed Versus Adjusted Transcutaneous Electrical Nerve Stimulation Amplitude on Chronic Mechanical Low Back Pain.

PubMed

Elserty, Noha; Kattabei, Omaima; Elhafez, Hytham

2016-07-01

This study aimed to investigate the effect of adjusting pulse amplitude of transcutaneous electrical nerve stimulation versus fixed pulse amplitude in treatment of chronic mechanical low back pain. Randomized clinical trial. El-sahel Teaching Hospital, Egypt. Forty-five patients with chronic low back pain assigned to three equal groups. Their ages ranged from 20 to 50 years. The three groups received the same exercise program. Group A received transcutaneous electrical nerve stimulation with fixed pulse amplitude for 40 minutes. Group B received transcutaneous electrical nerve stimulation with adjusted pulse amplitude for 40 minutes, with the pulse amplitude adjusted every 5 minutes. Group C received exercises only. Treatment sessions were applied three times per week for 4 weeks for the three groups. A visual analogue scale was used to assess pain severity, the Oswestry Disability Index was used to assess functional level, and a dual inclinometer was used to measure lumbar range of motion. Evaluations were performed before and after treatment. Visual analogue scale, Oswestry Disability Index, and back range of motion significantly differed between the two groups that received transcutaneous electrical nerve stimulation and the control group and did not significantly differ between fixed and adjusted pulse amplitude of transcutaneous electrical nerve stimulation. Adjusting pulse amplitude of transcutaneous electrical nerve stimulation does not produce a difference in the effect of transcutaneous electrical nerve stimulation used to treat chronic low back pain.

Virtual Rehabilitation through Nintendo Wii in Poststroke Patients: Follow-Up.

PubMed

Carregosa, Adriani A; Aguiar Dos Santos, Luan Rafael; Masruha, Marcelo R; Coêlho, Marília Lira da S; Machado, Tácia C; Souza, Daniele Costa B; Passos, Gustavo Luan L; Fonseca, Erika P; Ribeiro, Nildo Manoel da S; de Souza Melo, Ailton

2018-02-01

To evaluate in the follow-up the sensory-motor recovery and quality of life patients 2 months after completion of the Nintendo Wii console intervention and determine whether learning retention was obtained through the technique. Five hemiplegics patients participated in the study, of whom 3 were male with an average age of 54.8 years (SD = 4.6). Everyone practiced Nintendo Wii therapy for 2 months (50 minutes/day, 2 times/week, during 16 sessions). Each session lasting 60 minutes, under a protocol in which only the games played were changed, plus 10 minutes of stretching. In the first session, tennis and hula hoop games were used; in the second session, football (soccer) and boxing were used. For the evaluation, the Fulg-Meyer and Short Form Health Survey 36 (SF-36) scales were utilized. The patients were immediately evaluated upon the conclusion of the intervention and 2 months after the second evaluation (follow-up). Values for the upper limb motor function sub-items and total score in the Fugl-Meyer scale evaluation and functional capacity in the SF-36 questionnaire were sustained, indicating a possible maintenance of the therapeutic effects. The results suggest that after Nintendo Wii therapy, patients had motor learning retention, achieving a sustained benefit through the technique. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Five-Week Outcomes From a Dosing Trial of Therapeutic Massage for Chronic Neck Pain

PubMed Central

Sherman, Karen J.; Cook, Andrea J.; Wellman, Robert D.; Hawkes, Rene J.; Kahn, Janet R.; Deyo, Richard A.; Cherkin, Daniel C.

2014-01-01

PURPOSE This trial was designed to evaluate the optimal dose of massage for individuals with chronic neck pain. METHODS We recruited 228 individuals with chronic nonspecific neck pain from an integrated health care system and the general population, and randomized them to 5 groups receiving various doses of massage (a 4-week course consisting of 30-minute visits 2 or 3 times weekly or 60-minute visits 1, 2, or 3 times weekly) or to a single control group (a 4-week period on a wait list). We assessed neck-related dysfunction with the Neck Disability Index (range, 0–50 points) and pain intensity with a numerical rating scale (range, 0–10 points) at baseline and 5 weeks. We used log-linear regression to assess the likelihood of clinically meaningful improvement in neck-related dysfunction (≥5 points on Neck Disability Index) or pain intensity (≥30% improvement) by treatment group. RESULTS After adjustment for baseline age, outcome measures, and imbalanced covariates, 30-minute treatments were not significantly better than the wait list control condition in terms of achieving a clinically meaningful improvement in neck dysfunction or pain, regardless of the frequency of treatments. In contrast, 60-minute treatments 2 and 3 times weekly significantly increased the likelihood of such improvement compared with the control condition in terms of both neck dysfunction (relative risk = 3.41 and 4.98, P = .04 and .005, respectively) and pain intensity (relative risk = 2.30 and 2.73; P = .007 and .001, respectively). CONCLUSIONS After 4 weeks of treatment, we found multiple 60-minute massages per week more effective than fewer or shorter sessions for individuals with chronic neck pain. Clinicians recommending massage and researchers studying this therapy should ensure that patients receive a likely effective dose of treatment. PMID:24615306

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

PubMed

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

2012-12-01

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

Development of a GNSS-Enhanced Tsunami Early Warning System

NASA Astrophysics Data System (ADS)

Bawden, G. W.; Melbourne, T. I.; Bock, Y.; Song, Y. T.; Komjathy, A.

2015-12-01

The past decade has witnessed a terrible loss of life and economic disruption caused by large earthquakes and resultant tsunamis impacting coastal communities and infrastructure across the Indo-Pacific region. NASA has funded the early development of a prototype real-time Global Navigation Satellite System (RT-GNSS) based rapid earthquake and tsunami early warning (GNSS-TEW) system that may be used to enhance seismic tsunami early warning systems for large earthquakes. This prototype GNSS-TEW system geodetically estimates fault parameters (earthquake magnitude, location, strike, dip, and slip magnitude/direction on a gridded fault plane both along strike and at depth) and tsunami source parameters (seafloor displacement, tsunami energy scale, and 3D tsunami initials) within minutes after the mainshock based on dynamic numerical inversions/regressions of the real-time measured displacements within a spatially distributed real-time GNSS network(s) spanning the epicentral region. It is also possible to measure fluctuations in the ionosphere's total electron content (TEC) in the RT-GNSS data caused by the pressure wave from the tsunami. This TEC approach can detect if a tsunami has been triggered by an earthquake, track its waves as they propagate through the oceanic basins, and provide upwards of 45 minutes early warning. These combined real-time geodetic approaches will very quickly address a number of important questions in the immediate minutes following a major earthquake: How big was the earthquake and what are its fault parameters? Could the earthquake have produced a tsunami and was a tsunami generated?

Multi-Center Evaluation of the Automated Immunohematology Instrument, the ORTHO VISION Analyzer.

PubMed

Aysola, Agnes; Wheeler, Leslie; Brown, Richard; Denham, Rebecca; Colavecchia, Connie; Pavenski, Katerina; Krok, Elizabeth; Hayes, Chelsea; Klapper, Ellen

2017-02-01

ORTHO VISION Analyzer (Vision), is an immunohematology instrument using ID-MT gel card technology with digital image processing. It has a continuous, random sample access with STAT priority processing. The efficiency and ease of operation of Vision was evaluated at 5 medical centers. De-identified patient samples were tested on the ORTHO ProVue Analyzer (ProVue) and repeated on the Vision mimicking the daily workload pattern. Turnaround times (TAT) were collected and compared. Operators rated key features of the analyzer on a scale of 1 to 5. A total of 507 samples were tested on both instruments at the 5 trial sites. The mean TAT (SD) were 31.6 minutes (5.5) with Vision and 35.7 minutes (8.4) with ProVue, which renders a 12% reduction. Type and screens were performed on 381 samples; the mean TAT (SD) was 32.2 minutes (4.5) with Vision and 37.0 minutes (7.4) with ProVue. Antibody identification with eleven panel cells was performed on 134 samples on Vision; TAT (SD) was 43.2 minutes (8.3). The installation, training, configuration, maintenance and validation processes are all streamlined to provide a short implementation time. The average rating of main functions by the operators was 4.1 to 4.8. Opportunities for improvement, such as flexibility with editing QC results, maintenance schedule, and printing options were identified. The capabilities to perform serial dilutions, to accept pediatric tubes, and review results by e-Connectivity are enhancements over the ProVue. Vision provides shorter TAT compared to ProVue. Every site described a positive experience using Vision. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The effect of simulated ostracism on physical activity behavior in children.

PubMed

Barkley, Jacob E; Salvy, Sarah-Jeanne; Roemmich, James N

2012-03-01

To assess the effects of simulated ostracism on children's physical activity behavior, time allocated to sedentary behavior, and liking of physical activity. Nineteen children (11 boys, 8 girls; age 11.7 ± 1.3 years) completed 2 experimental sessions. During each session, children played a virtual ball-toss computer game (Cyberball). In one session, children played Cyberball and experienced ostracism; in the other session, they were exposed to the inclusion/control condition. The order of conditions was randomized. After playing Cyberball, children were taken to a gymnasium where they had free-choice access to physical and sedentary activities for 30 minutes. Children could participate in the activities, in any pattern they chose, for the entire period. Physical activity during the free-choice period was assessed via accelerometery and sedentary time via observation. Finally, children reported their liking for the activity session via a visual analog scale. Children accumulated 22% fewer (P < .01) accelerometer counts and 41% more (P < .04) minutes of sedentary activity in the ostracized condition (8.9(e+4) ± 4.5(e+4) counts, 11.1 ± 9.3 minutes) relative to the included condition (10.8(e+4) ± 4.7(e+4) counts, 7.9 ± 7.9 minutes). Liking (8.8 ± 1.5 cm included, 8.1 ± 1.9 cm ostracized) of the activity sessions was not significantly different (P > .10) between conditions. Simulated ostracism elicits decreased subsequent physical activity participation in children. Ostracism may contribute to children's lack of physical activity.

How Do Residents Spend Their Shift Time? A Time and Motion Study With a Particular Focus on the Use of Computers

PubMed Central

Mamykina, Lena; Vawdrey, David K.; Hripcsak, George

2016-01-01

Purpose To understand how much time residents spend using computers as compared with other activities, and what residents use computers for. Method This time and motion study was conducted in June and July 2010 at NewYork-Presbyterian/Columbia University Medical Center with seven residents (first-, second-, and third-year) on the general medicine service. An experienced observer shadowed residents during a single day shift, captured all their activities using an iPad application, and took field notes. The activities were captured using a validated taxonomy of clinical activities, expanded to describe computer-based activities with a greater level of detail. Results Residents spent 364.5 minutes (50.6%) of their shift time using computers, compared with 67.8 minutes (9.4%) interacting with patients. In addition, they spent 292.3 minutes (40.6%) talking with others in person, 186.0 minutes (25.8%) handling paper notes, 79.7 minutes (11.1%) in rounds, 80.0 minutes (11.1%) walking or waiting, and 54.0 minutes (7.5%) talking on the phone. Residents spent 685 minutes (59.6%) multitasking. Computer-based documentation activities amounted to 189.9 minutes (52.1%) of all computer-based activities time, with 128.7 minutes (35.3%) spent writing notes and 27.3 minutes (7.5%) reading notes composed by others. Conclusions The study showed residents spent considerably more time interacting with computers (over 50% of their shift time), than in direct contact with patients (less than 10% of their shift time). Some of this may be due to an increasing reliance on computing systems for access to patient data, further exacerbated by inefficiencies in the design of the electronic health record. PMID:27028026

How Do Residents Spend Their Shift Time? A Time and Motion Study With a Particular Focus on the Use of Computers.

PubMed

Mamykina, Lena; Vawdrey, David K; Hripcsak, George

2016-06-01

To understand how much time residents spend using computers compared with other activities, and what residents use computers for. This time and motion study was conducted in June and July 2010 at NewYork-Presbyterian/Columbia University Medical Center with seven residents (first-, second-, and third-year) on the general medicine service. An experienced observer shadowed residents during a single day shift, captured all their activities using an iPad application, and took field notes. The activities were captured using a validated taxonomy of clinical activities, expanded to describe computer-based activities with a greater level of detail. Residents spent 364.5 minutes (50.6%) of their shift time using computers, compared with 67.8 minutes (9.4%) interacting with patients. In addition, they spent 292.3 minutes (40.6%) talking with others in person, 186.0 minutes (25.8%) handling paper notes, 79.7 minutes (11.1%) in rounds, 80.0 minutes (11.1%) walking or waiting, and 54.0 minutes (7.5%) talking on the phone. Residents spent 685 minutes (59.6%) multitasking. Computer-based documentation activities amounted to 189.9 minutes (52.1%) of all computer-based activities time, with 128.7 minutes (35.3%) spent writing notes and 27.3 minutes (7.5%) reading notes composed by others. The study showed that residents spent considerably more time interacting with computers (over 50% of their shift time) than in direct contact with patients (less than 10% of their shift time). Some of this may be due to an increasing reliance on computing systems for access to patient data, further exacerbated by inefficiencies in the design of the electronic health record.

Variability of interconnected wind plants: correlation length and its dependence on variability time scale

DOE PAGES

St. Martin, Clara M.; Lundquist, Julie K.; Handschy, Mark A.

2015-04-02

The variability in wind-generated electricity complicates the integration of this electricity into the electrical grid. This challenge steepens as the percentage of renewably-generated electricity on the grid grows, but variability can be reduced by exploiting geographic diversity: correlations between wind farms decrease as the separation between wind farms increases. However, how far is far enough to reduce variability? Grid management requires balancing production on various timescales, and so consideration of correlations reflective of those timescales can guide the appropriate spatial scales of geographic diversity grid integration. To answer 'how far is far enough,' we investigate the universal behavior of geographic diversity by exploring wind-speed correlations using three extensive datasets spanning continents, durations and time resolution. First, one year of five-minute wind power generation data from 29 wind farms span 1270 km across Southeastern Australia (Australian Energy Market Operator). Second, 45 years of hourly 10 m wind-speeds from 117 stations span 5000 km across Canada (National Climate Data Archive of Environment Canada). Finally, four years of five-minute wind-speeds from 14 meteorological towers span 350 km of the Northwestern US (Bonneville Power Administration). After removing diurnal cycles and seasonal trends from all datasets, we investigate dependence of correlation length on time scale by digitally high-pass filtering the data on 0.25–2000 h timescales and calculating correlations between sites for each high-pass filter cut-off. Correlations fall to zero with increasing station separation distance, but the characteristic correlation length varies with the high-pass filter applied: the higher the cut-off frequency, the smaller the station separation required to achieve de-correlation. Remarkable similarities between these three datasets reveal behavior that, if universal, could be particularly useful for grid management. For high-pass filter time constants shorter than about τ = 38 h, all datasets exhibit a correlation lengthmore » $$\\xi $$ that falls at least as fast as $${{\\tau }^{-1}}$$ . Since the inter-site separation needed for statistical independence falls for shorter time scales, higher-rate fluctuations can be effectively smoothed by aggregating wind plants over areas smaller than otherwise estimated.« less

Variability of interconnected wind plants: correlation length and its dependence on variability time scale

NASA Astrophysics Data System (ADS)

St. Martin, Clara M.; Lundquist, Julie K.; Handschy, Mark A.

2015-04-01

The variability in wind-generated electricity complicates the integration of this electricity into the electrical grid. This challenge steepens as the percentage of renewably-generated electricity on the grid grows, but variability can be reduced by exploiting geographic diversity: correlations between wind farms decrease as the separation between wind farms increases. But how far is far enough to reduce variability? Grid management requires balancing production on various timescales, and so consideration of correlations reflective of those timescales can guide the appropriate spatial scales of geographic diversity grid integration. To answer ‘how far is far enough,’ we investigate the universal behavior of geographic diversity by exploring wind-speed correlations using three extensive datasets spanning continents, durations and time resolution. First, one year of five-minute wind power generation data from 29 wind farms span 1270 km across Southeastern Australia (Australian Energy Market Operator). Second, 45 years of hourly 10 m wind-speeds from 117 stations span 5000 km across Canada (National Climate Data Archive of Environment Canada). Finally, four years of five-minute wind-speeds from 14 meteorological towers span 350 km of the Northwestern US (Bonneville Power Administration). After removing diurnal cycles and seasonal trends from all datasets, we investigate dependence of correlation length on time scale by digitally high-pass filtering the data on 0.25-2000 h timescales and calculating correlations between sites for each high-pass filter cut-off. Correlations fall to zero with increasing station separation distance, but the characteristic correlation length varies with the high-pass filter applied: the higher the cut-off frequency, the smaller the station separation required to achieve de-correlation. Remarkable similarities between these three datasets reveal behavior that, if universal, could be particularly useful for grid management. For high-pass filter time constants shorter than about τ = 38 h, all datasets exhibit a correlation length ξ that falls at least as fast as {{τ }-1} . Since the inter-site separation needed for statistical independence falls for shorter time scales, higher-rate fluctuations can be effectively smoothed by aggregating wind plants over areas smaller than otherwise estimated.

Use of patient flow analysis to improve patient visit efficiency by decreasing wait time in a primary care-based disease management programs for anticoagulation and chronic pain: a quality improvement study.

PubMed

Potisek, Nicholas M; Malone, Robb M; Shilliday, Betsy Bryant; Ives, Timothy J; Chelminski, Paul R; DeWalt, Darren A; Pignone, Michael P

2007-01-15

Patients with chronic conditions require frequent care visits. Problems can arise during several parts of the patient visit that decrease efficiency, making it difficult to effectively care for high volumes of patients. The purpose of the study is to test a method to improve patient visit efficiency. We used Patient Flow Analysis to identify inefficiencies in the patient visit, suggest areas for improvement, and test the effectiveness of clinic interventions. At baseline, the mean visit time for 93 anticoagulation clinic patient visits was 84 minutes (+/- 50 minutes) and the mean visit time for 25 chronic pain clinic patient visits was 65 minutes (+/- 21 minutes). Based on these data, we identified specific areas of inefficiency and developed interventions to decrease the mean time of the patient visit. After interventions, follow-up data found the mean visit time was reduced to 59 minutes (+/-25 minutes) for the anticoagulation clinic, a time decrease of 25 minutes (t-test 39%; p < 0.001). Mean visit time for the chronic pain clinic was reduced to 43 minutes (+/- 14 minutes) a time decrease of 22 minutes (t-test 34 %; p < 0.001). Patient Flow Analysis is an effective technique to identify inefficiencies in the patient visit and efficiently collect patient flow data. Once inefficiencies are identified they can be improved through brief interventions.

Efficiency of the Penumbra 5MAX ACE Reperfusion Catheter in Acute Ischemic Stroke Patients.

PubMed

Suzuki, Kentaro; Aoki, Junya; Sakamoto, Yuki; Kanamaru, Takuya; Abe, Arata; Suda, Satoshi; Okubo, Seiji; Kimura, Kazumi

2016-12-01

This study was performed to investigate whether the Penumbra 5MAX ACE is superior to other Penumbra systems. We performed a retrospective, single center analysis of patients with acute ischemic stroke with occlusion of the internal carotid artery or middle cerebral artery (M1 segment) who underwent endovascular therapy using a Penumbra system. The reperfusion success rate, puncture-to-revascularization time, and number of passes were assessed. Multivariate regression analysis was conducted to evaluate independent factors related to revascularization within 60 minutes. Successful revascularization was defined by a thrombolysis in cerebral infarction score ≥2b. The Penumbra 5MAX ACE was used in 24 of the 40 patients (60%). Although the revascularization success rate was similar between patient groups (P = .229), the number of passes was significantly lower (1.5 ± .8 versus 2.6 ± 1.3, P = .006) and the puncture-to-revascularization time was shorter (50 ± 26 minutes versus 116 ± 69 minutes, P = .002) in patients treated with the Penumbra 5MAX ACE. The Penumbra 5MAX ACE was identified as an independent factor for early revascularization (odds ratio, 5.80; P = .041). Among patients with a premorbid modified Rankin Scale score of 0-1, a modified Rankin Scale score of 0-2 at 3 months was observed in 15 of the 19 patients (79%) treated with the Penumbra 5MAX ACE and in 8 of the 16 (50%) who were not (P = .072). Acute revascularization therapy using the Penumbra 5MAX ACE can achieve rapid successful recanalization and tend to improve clinical outcomes. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Effects of Reiki on Pain and Vital Signs When Applied to the Incision Area of the Body After Cesarean Section Surgery: A Single-Blinded, Randomized, Double-Controlled Study.

PubMed

Sagkal Midilli, Tulay; Ciray Gunduzoglu, Nazmiye

This study was conducted to determine the effects of Reiki on pain and vital signs when applied for 15 minutes to the incision area of the body after cesarean section surgery. The study was single-blinded, randomized, and double-controlled (Reiki, sham Reiki, and control groups). Forty-five patients, equalized by age and number of births, were randomly assigned to the Reiki, sham Reiki, and control groups. The treatment, which was applied to the patients in these 3 groups, was applied for 15 minutes to the incision area of body in the first 24 and 48 hours after the operation within 4 to 8 hours of the application of standard analgesics. The study data were collected using a patient follow-up form and a visual analog scale. Mean visual analog scale measurement values were significantly different from each other according to groups and times (P < .05). A reduction in pain of 76.06% was determined in the Reiki group patients between day 1 pre-tx and after application on the second day (day 2 post-tx) measurements. Mean breathing rate and systolic blood pressure measurement values were significantly different from each other according to groups (P < .05). The Reiki group was observed to use fewer analgesics throughout the study and to need them after a longer time than the sham Reiki and control groups (P < .05). It was concluded that Reiki applied for 15 minutes to the incision area after a cesarean operation had the expected effects on pain and the need for the use of analgesics, but it had no effect on vital signs.

The Urbana coherent-scatter radar: Synthesis and first results

NASA Technical Reports Server (NTRS)

Gibbs, K. P.; Bowhill, S. A.

1979-01-01

A coherent scatter radar system was synthesized and several hundred hours of echo power and line of sight velocity data obtained. The coherent scatter radar utilizes a diode array and components from meteor radar. The receiving system permits a time resolution of one minute in the data. Echo power from the D region shows a high degree of variability from day to day. Examples of changes in power level at shorter time scales are observed. Velocity data show the existence of gravity waves and occasionally exhibit vertical standing wave characteristics.

External validation of the clinical dehydration scale for children with acute gastroenteritis.

PubMed

Bailey, Benoit; Gravel, Jocelyn; Goldman, Ran D; Friedman, Jeremy N; Parkin, Patricia C

2010-06-01

The objective was to validate the clinical dehydration scale (CDS) for children with gastroenteritis in a different pediatric emergency department (ED) from where it was initially derived and validated. A prospective cohort study was performed in a tertiary care pediatric ED over a 1-year period. A sample of triage nurses were trained in applying the CDS. The CDS consists of four clinical characteristics (general appearance, eyes, mucous membranes, and tears), each of which are scored 0, 1, or 2 for a total score of 0 to 8, with 0 representing no dehydration; 1 to 4, some dehydration; and 5 to 8, moderate/severe dehydration. Children 1 month to 5 years of age with vomiting and/or diarrhea who had the CDS documented at triage and a final diagnosis of gastroenteritis, gastritis, or enteritis were enrolled. Exclusion criteria included a chronic disease, treatment with intravenous (IV) rehydration within the previous 24 hours, visit to the ED for the same illness in the 7 days prior to arrival, and diarrhea of more than 10 days' duration. The primary outcome was the length of stay (LOS) in the ED from the time of seeing a physician to discharge, analyzed with a Kruskal-Wallis test. From April 2008 to March 2009, 150 patients with a mean (+/-SD) age of 22 (+/-14) months (range = 4 months to 4 years) were enrolled. Fifty-six patients had no dehydration, 74 had some dehydration, and 20 had moderate/severe dehydration. The median LOS in the ED after being seen by a physician was significantly longer as children appeared more dehydrated according to the CDS: 54 minutes (interquartile range [IQR] = 26-175 minutes), 128 minutes (IQR = 25-334 minutes), and 425 minutes (IQR = 218-673 minutes) for the no, some, and moderate/severe dehydration groups, respectively (p < 0.001). The CDS has been further validated in children with gastroenteritis in a different pediatric center than the original one where it was developed. It is a good predictor of LOS in the ED after being seen by a physician. (c) 2010 by the Society for Academic Emergency Medicine.

Electrical, optical and structural properties of FTO thin films fabricated by spray ultrasonic nebulizer technique from SnCl4 precursor

NASA Astrophysics Data System (ADS)

Lalasari, Latifa Hanum; Arini, Tri; Andriyah, Lia; Firdiyono, F.; Yuwono, Akhmad Herman

2018-05-01

Thin films of fluorine-doped tin oxide on glass were prepared by spray ultrasonic nebulizer technique from an economic anhydrous tin (IV) chloride (SnCl4) precursor. The effect of deposition time on the structural, electrical and optical properties of tin oxide thin films was investigated. This research a purpose to find an optimum deposition time during spray pyrolysis technique in order to produce FTO with the desired characteristics. For this purpose, soda lime glasses are heated at 350 °C on deposition time of 10, 15, 20 and 25 minutes. NH4F was doped at a ratio of 2 wt% in the SnCl4 precursor and methanol solvent. The results revealed that longer deposition times created decreased the electrical resistivity and optical transmittance of FTO layers. The highest optical transmittance was 84.808% and the lowest resistivity was 4.01×10-5 Ω.cm, obtained from FTO glass subjected to a 15-minute deposition time at deposition temperature of 350 °C. This is accordance to the TCO conductive glass requirements for the minimum resistivity value on scale 10-4 Ω.cm and optical transmittance value of 80-85%.

Improvements in Door-to-Balloon Time in the United States: 2005-2010 Krumholz: Trends in D2B Time: 2005-2010

PubMed Central

Krumholz, Harlan M.; Herrin, Jeph; Miller, Lauren E.; Drye, Elizabeth E.; Ling, Shari M.; Han, Lein F.; Rapp, Michael T.; Bradley, Elizabeth H.; Nallamothu, Brahmajee K.; Nsa, Wato; Bratzler, Dale W.; Curtis, Jeptha P.

2012-01-01

Background Registry studies have suggested improvements in door-to-balloon times, but a national assessment of the trends in door-to-balloon times is lacking. Moreover, we do not know if improvements in door-to-balloon times were shared equally among patient and hospital groups. Methods and Results This analysis includes all patients reported by hospitals to the Centers for Medicare & Medicaid Services for inclusion in the time to percutaneous coronary intervention acute myocardial infarction-8 (AMI-8) inpatient measure from January 1, 2005 through September 30, 2010. For each calendar year, we summarized the characteristics of patients reported for the measure including the number and percentage in each group as well as the median time to primary percutaneous coronary intervention, and the percentage with time to primary percutaneous coronary intervention within 75 minutes and within 90 minutes. Door-to-balloon time declined from a median of 96 minutes in the year ending December 31, 2005 to a median of 64 minutes in the three quarters ending September 30, 2010. There were corresponding increases in the percentage of patients who had times <90 minutes (44.2% to 91.4%) and <75 minutes (27.3% to 70.4%). The declines in median times were greatest among groups that had the highest median times during the first period: Patients >75 years of age (median decline 38 minutes); women (35 minutes); and African Americans (42 minutes). Conclusion National progress has been achieved in the treatment of patients with ST-segment elevation myocardial infarction who undergo primary percutaneous coronary intervention. PMID:21859971

Initial clinical experience with cardiac resynchronization therapy utilizing a magnetic navigation system.

PubMed

Gallagher, Peter; Martin, Laura; Angel, Lori; Tomassoni, Gery

2007-02-01

The placement of left ventricular (LV) leads during cardiac resynchronization therapy (CRT) involves many technical difficulties. These difficulties increase procedural times and decrease procedural success rates. A total of 50 patients with severe cardiomyopathy (mean LV ejection fraction was 21 +/- 6%) and a wide QRS underwent CRT implantation. Magnetic navigation (Stereotaxis, Inc.) was used to position a magnet-tipped 0.014'' guidewire (Cronus guidewire) within the coronary sinus (CS) vasculature. LV leads were placed in a lateral CS branch, either using a standard CS delivery sheath or using a "bare-wire" approach without a CS delivery sheath. The mean total procedure time was 98.1 +/- 29.1 minutes with a mean fluoroscopy time of 22.7 +/- 15.1 minutes. The mean LV lead positioning time was 10.4 +/- 7.6 minutes. The use of a delivery sheath was associated with longer procedure times 98 +/- 32 minutes vs 80 +/- 18 minutes (P = 0.029), fluoroscopy times 23 +/- 15 minutes vs 13 +/- 4 minutes (P = 0.0007) and LV lead positioning times 10 +/- 6 minutes vs 4 +/- 2 minutes (P = 0.015) when compared to a "bare-wire" approach. When compared with 52 nonmagnetic-assisted control CRT cases, magnetic navigation reduced total LV lead positioning times (10.4 +/- 7.6 minutes vs 18.6 +/- 18.9 minutes; P = 0.005). If more than one CS branch vessel was tested, magnetic navigation was associated with significantly shorter times for LV lead placement (16.2 +/- 7.7 minutes vs 36.4 +/- 23.4 minutes; P = 0.004). Magnetic navigation is a safe, feasible, and efficient tool for lateral LV lead placement during CRT. Magnetic navigation during CRT allows for control of the tip direction of the Cronus 0.014'' guidewire using either a standard CS delivery sheath or "bare-wire" approach. Although there are some important limitations to the 0.014'' Cronus magnetic navigation can decrease LV lead placement times compared with nonmagnetic-assisted control CRT cases, particularly if multiple CS branches are to be tested.

Synthesis and characterization of colloidal CdTe nanocrystals

NASA Astrophysics Data System (ADS)

Semendy, Fred; Jaganathan, Gomatam; Dhar, Nibir; Trivedi, Sudhir; Bhat, Ishwara; Chen, Yuanping

2008-08-01

We synthesized CdTe nano crystals (NCs) in uniform sizes and in good quality as characterized by photoluminescence (PL), AFM, and X-ray diffraction. In this growth procedure, CdTe nano-crystal band gap is strongly dependent on the growth time and not on the injection temperature or organic ligand concentration. This is very attractive because of nano-crystal size can be easily controlled by the growth time only and is very attractive for large scale synthesis. The color of the solution changes from greenish yellow to light orange then to deep orange and finally grayish black to black over a period of one hour. This is a clear indication of the gradual growth of different size (and different band gap) of CdTe nano-crystals as a function of the growth time. In other words, the size of the nano-crystal and its band gap can be controlled by adjusting the growth time after injection of the tellurium. The prepared CdTe NCs were characterized by absorption spectra, photoluminescence (PL), AFM and X-ray diffraction. Measured absorption maxima are at 521, 560, 600 and 603 nm corresponding to band gaps of 2.38, 2.21,2,07 and 2.04 eV respectively for growth times of 15, 30, 45 and 60 minutes. From the absorption data nano-crystal growth size saturates out after 45 minutes. AFM scanning of these materials indicate that the size of these particles is between 4 - 10 nm in diameter for growth time of 45 minutes. XD-ray diffraction indicates that these nano crystals are of cubic zinc blende phase. This paper will present growth and characterization data on CdTe nano crystals for various growth times.

Estimated Impact of Emergency Medical Service Triage of Stroke Patients on Comprehensive Stroke Centers: An Urban Population-Based Study.

PubMed

Katz, Brian S; Adeoye, Opeolu; Sucharew, Heidi; Broderick, Joseph P; McMullan, Jason; Khatri, Pooja; Widener, Michael; Alwell, Kathleen S; Moomaw, Charles J; Kissela, Brett M; Flaherty, Matthew L; Woo, Daniel; Ferioli, Simona; Mackey, Jason; Martini, Sharyl; De Los Rios la Rosa, Felipe; Kleindorfer, Dawn O

2017-08-01

The American Stroke Association recommends that Emergency Medical Service bypass acute stroke-ready hospital (ASRH)/primary stroke center (PSC) for comprehensive stroke centers (CSCs) when transporting appropriate stroke patients, if the additional travel time is ≤15 minutes. However, data on additional transport time and the effect on hospital census remain unknown. Stroke patients ≥20 years old who were transported from home to an ASRH/PSC or CSC via Emergency Medical Service in 2010 were identified in the Greater Cincinnati area population of 1.3 million. Addresses of all patients' residences and hospitals were geocoded, and estimated travel times were calculated. We estimated the mean differences between the travel time for patients taken to an ASRH/PSC and the theoretical time had they been transported directly to the region's CSC. Of 929 patients with geocoded addresses, 806 were transported via Emergency Medical Service directly to an ASRH/PSC. Mean additional travel time of direct transport to the CSC, compared with transport to an ASRH/PSC, was 7.9±6.8 minutes; 85% would have ≤15 minutes added transport time. Triage of all stroke patients to the CSC would have added 727 patients to the CSC's census in 2010. Limiting triage to the CSC to patients with National Institutes of Health Stroke Scale score of ≥10 within 6 hours of onset would have added 116 patients (2.2 per week) to the CSC's annual census. Emergency Medical Service triage to CSCs based on stroke severity and symptom duration may be feasible. The impact on stroke systems of care and patient outcomes remains to be determined and requires prospective evaluation. © 2017 American Heart Association, Inc.

Dutch normal-pressure hydrocephalus study: prediction of outcome after shunting by resistance to outflow of cerebrospinal fluid.

PubMed

Boon, A J; Tans, J T; Delwel, E J; Egeler-Peerdeman, S M; Hanlo, P W; Wurzer, H A; Avezaat, C J; de Jong, D A; Gooskens, R H; Hermans, J

1997-11-01

The authors examined whether measurement of resistance to outflow of cerebrospinal fluid (Rcsf) predicts outcome after shunting for patients with normal-pressure hydrocephalus (NPH). In four centers 101 patients (most of whom had idiopathic NPH) who fulfilled strict entry criteria underwent shunt placement irrespective of their level of Rcsf obtained by lumbar constant flow infusion. Gait disturbance and dementia were quantified by using an NPH scale and the patient's level of disability was assessed by using the modified Rankin scale (mRS). In addition the Modified Mini-Mental State Examination was performed. Patients were assessed prior to and 1, 3, 6, 9, and 12 months after surgery. Primary outcome measures were based on differences between the preoperative and last NPH scale scores and mRS grades. Improvement was defined as a change measuring at least 15% in the NPH scale score and at least one mRS grade. Intention-to-treat analysis of all patients at 1 year yielded improvement for 57% in NPH scale score and 59% in mRS grade. Efficacy analysis, excluding serious events and deaths that were unrelated to NPH, was performed for 95 patients. Improvement rose to 76% in NPH scale score and 69% in mRS grade. Six cut-off levels of Rcsf were related to improvement in NPH scale score using two-by-two tables. Positive predictive values were approximately 80% for an Rcsf of 10, 12, or 15 mm Hg/ml/minute, 92% for an Rcsf of 18 mm Hg/ml/minute, and 100% for an Rcsf of 24 mm Hg/ml/minute. Negative predictive values were low. More important was the highest likelihood ratio of 3.5 for an Rcsf of 18 mm Hg/ml/minute. Extensive comorbidity was a major prognostic factor. Measurement of Rcsf reliably predicts outcome if the limit for shunting is raised to 18 mm Hg/ml/minute. At lower Rcsf values the decision depends mainly on the extent to which clinical and computerized tomography findings are typical of NPH.

The transient behavior of whole-canopy fluxes during dynamic light conditions for midlatitude and tropical forests

NASA Astrophysics Data System (ADS)

Fitzjarrald, D. R.; Kivalov, S. N.

2017-12-01

Cloud shadows lead to alternating light and dark periods at the surface. Understanding how clouds affect whole-canopy fluxes suffer from two knowledge gaps that limit scaling from leaf to canopy scales, an effort currently done by assertion alone. First, there is a lack a clear quantitative definition of the incident light time series that occur on specific types of cloudy days. Second, the characteristic time scales for leaves to respond to for stomatal opening and closing is 1-10 minutes, a period too short to allow accurate eddy fluxes. We help to close the first gap by linking the durations of alternating light and dark periods statistically to conventional meteorological sky types at a midlatitude mixed deciduous forest (Harvard Forest, MA, USA: 42.53N, 72.17W) and in a tropical rain forest (Tapajós National Forest, Brazil; 2.86S, 54.96W). The second gap is narrowed by measuring the dynamic response whole canopy exchanges in the flux footprint at intervals of only a few seconds using the classical ensemble average method, keying on step changes in light intensity. Combining light and shadow periods of different lengths we estimate ensemble fluxes sensible heat (H), net ecosystem exchange (NEE), and latent heat (LE) fluxes initiated by abrupt radiation changes at intervals of 30 s over 20 minutes. We present composite results of the transient behavior of whole-canopy fluxes at each forest, showing distinct features of each forest type. Observed time constants and transient flux parameterizations are then used to force a simple model to yield NEE, LE, WUE, and Bowen ratio extrema under periodic shadow-light conditions and given cloud amount. We offer the hypothesis that, at least on certain types of cloudy days, the well-known correlation between diffuse light and WUE does not represent a causal connection at the canopy scale.

Sleep, activity and fatigue reported by postgraduate year 1 residents: a prospective cohort study comparing the effects of night-float versus traditional overnight on-call.

PubMed

Low, Jia Ming; Tan, Mae Yue; See, Kay Choong; Aw, Marion M

2018-03-19

As traditional overnight on-call was shown to contribute to fatigue, Singapore moved to implement a shift system in 2014. We aimed to compare activity levels, sleep (using a wrist actigraph), fatigue and professional quality-of-life between residents working on night-float and those working on traditional overnight on-call. All postgraduate year 1 (PGY1) residents at our institution were invited to participate. Participants were required to wear a wrist actigraph for four months, and complete two validated surveys (Epworth Sleepiness Scale [ESS] and Professional Quality of Life Scale [ProQOL]) once each at the start and at the end of study. 49 residents were recruited. Residents on night-float and on-call showed comparable median (range) number of steps (10,061 [1,195-15,923] vs. 10,649 [308-21,910]; p = 0.429), amount of sleep logged (361 [149-630] minutes vs. 380 [175-484] minutes; p = 0.369) and time taken to fall asleep (6 [0-14] minutes vs. 6 [range 0-45] minutes; p = 0.726) respectively. Residents on night-float had less efficient sleep, with 90.5% participants having over 85% sleep efficiency compared to 100% of residents on on-call (p = 0.127). More residents on night-float reported ESS > 10 (73.8% vs. 38.5%) and higher burnout scores on ProQOL (41.4% vs. 21.4%) at the start of the study. However, this was similar to the end of the study and was not statistically significant. The physical activity and amount of sleep of residents on night-float and on-call rota were not significantly different. Residents on night-float reported comparatively higher fatigue and burnout.

Modelling the water balance of a precise weighable lysimeter for short time scales

NASA Astrophysics Data System (ADS)

Fank, Johann; Klammler, Gernot; Rock, Gerhard

2015-04-01

Precise knowledge of the water fluxes between the atmosphere and the soil-plant system and the percolation to the groundwater system is of great importance for understanding and modeling water, solute and energy transfer in the atmosphere-plant-soil-groundwater system. Weighable lysimeters yield the most precise and realistic measures for the change of stored water volume (ΔS), Precipitation (P) which can be rain, irrigation, snow and dewfall and evapotranspiration (ET) as the sum of soil evaporation, evaporation of intercepted water and transpiration. They avoid systematic errors of standard gauges and class-A pans. Lysimeters with controlled suction at the lower boundary allow estimation of capillary rise (C) and leachate (L) on short time scales. Precise weighable large scale (surface >= 1 m2) monolithic lysimeters avoiding oasis effects allow to solve the water balance equation (P - ET - L + C ± ΔS = 0) for a 3D-section of a natural atmosphere-plant-soil-system for a certain time period. Precision and accuracy of the lysimeter measurements depend not only on the precision of the weighing device but also on external conditions, which cannot be controlled or turned off. To separate the noise in measured data sets from signals the adaptive window and adaptive threshold (AWAT) filter (Peters et al., 2014) is used. The data set for the years 2010 and 2011 from the HYDRO-lysimeter (surface = 1 m2, depth = 1 m) in Wagna, Austria (Klammler and Fank, 2014) with a resolution of 0,01 mm for the lysimeter scale and of 0,001 mm for the leachate tank scale is used to evaluate the water balance. The mass of the lysimeter and the mass of the leachate tank is measured every two seconds. The measurements are stored as one minute arithmetic means. Based on calculations in a calibration period from January to May 2010 with different widths of moving window the wmax - Parameter for the AWAT filter was set to 41 minutes. A time series for the system mass ('upper boundary') of the lysimeter has been calculated by adding lysimeter mass and the leachate tank mass for every minute. Based on the resolution of the scales and an evaluation of noise in periods without precipitation and evaporation a dmin-value of 0.002 to filter the leachate tank measurements and a dmin-value of 0.012 was used to filter the lysimeter weight data and the upper boundary data. A mandatory requirement for the quantification of P or ET from lysimeter measurements is that in a reasonably small time interval, either P or ET is negligible. With this assumption, every increase in upper boundary data is interpreted as P. Every increase of seepage mass is interpreted as L, every decrease as C. ΔS is evaluated from filtered lysimeter mass. ET is calculated using the water balance equation. The evaluation results are given as water balance components time series on a minute scale. P measured with the lysimeter for the two years 2010 and 2011 is 105 % of precipitation measured with a standard tipping bucket gauge 100 m beside the lysimeter. While P during the summer season (April to September) is very close to standard precipitation measurement, P during the winter season is more than 120 % of tipping bucket precipitation. Meissner et al. (2007) showed that P includes precipitation of dewfall and rime. A detailed evaluation of the HYDRO-Lysimeter in Wagna showed, that precipitation in the night and not recognized with the standard tipping bucket (interpreted as dew or rime) is about 1 % of P, the highest monthly sums (> 1 mm) are recognized from August to November. Klammler, G. and Fank, J.: Determining water and nitrogen balances for beneficial management practices using lysimeters at Wagna test site (Austria). Science of the Total Environment 499 (2014) 448-462. Meissner, R., Seeger, J., Rupp, H., Seyfarth, M., and Borg, H.: Measurement of dew, fog, and rime with a high-precision gravitation lysimeter, J. Plant Nutr. Soil Sci. 2007, 170, 335-344. Peters, A., Nehls, T., Schonsky, H., and Wessolek, G.: Separating precipitation and evapotranspiration from noise - a new filter routine for high-resolution lysimeter data. Hydrol. Earth Syst. Sci., 18, 1189-1198, 2014.

Transferability of Virtual Reality, Simulation-Based, Robotic Suturing Skills to a Live Porcine Model in Novice Surgeons: A Single-Blind Randomized Controlled Trial.

PubMed

Vargas, Maria V; Moawad, Gaby; Denny, Kathryn; Happ, Lindsey; Misa, Nana Yaa; Margulies, Samantha; Opoku-Anane, Jessica; Abi Khalil, Elias; Marfori, Cherie

To assess whether a robotic simulation curriculum for novice surgeons can improve performance of a suturing task in a live porcine model. Randomized controlled trial (Canadian Task Force classification I). Academic medical center. Thirty-five medical students without robotic surgical experience. Participants were enrolled in an online session of training modules followed by an in-person orientation. Baseline performance testing on the Mimic Technologies da Vinci Surgical Simulator (dVSS) was also performed. Participants were then randomly assigned to the completion of 4 dVSS training tasks (camera clutching 1, suture sponge 1 and 2, and tubes) versus no further training. The intervention group performed each dVSS task until proficiency or up to 10 times. A final suturing task was performed on a live porcine model, which was video recorded and blindly assessed by experienced surgeons. The primary outcomes were Global Evaluative Assessment of Robotic Skills (GEARS) scores and task time. The study had 90% power to detect a mean difference of 3 points on the GEARS scale, assuming a standard deviation (SD) of 2.65, and 80% power to detect a mean difference of 3 minutes, assuming an SD of 3 minutes. There were no differences in demographics and baseline skills between the 2 groups. No significant differences in task time in minutes or GEARS scores were seen for the final suturing task between the intervention and control groups, respectively (9.2 [2.65] vs 9.9 [2.07] minutes, p = .406; and 15.37 [2.51] vs 15.25 [3.38], p = .603). The 95% confidence interval for the difference in mean task times was -2.36 to .96 minutes and for mean GEARS scores -1.91 to 2.15 points. Live suturing task performance was not improved with a proficiency-based virtual reality simulation suturing curriculum compared with standard orientation to the da Vinci robotic console in a group of novice surgeons. Published by Elsevier Inc.

Use of mobile high-resolution device for remote frozen section evaluation of whole slide images.

PubMed

Ramey, Joel; Fung, Kar Ming; Hassell, Lewis A

2011-01-01

With recent advances, it is now possible to view whole slide images (WSI) on mobile, high-resolution, viewing devices (MVD). This creates a new paradigm in which MVDs may be used for consultation and/or diagnosis. Validation of the results with devices is important for practitioners and regulators. We evaluated the use of MVDs in frozen section (FS) interpretation. A series of 72 consecutive FS cases were selected for potential inclusion in the study. A 67 case subset of these were successfully scanned at 20x magnification. Scan times were recorded. A sample of WSI FS cases, with gross and clinical information, was presented to six pathologists on an iPad MVD using the Interpath application. Times to diagnosis were recorded. Results were compared with the original reported and final diagnosis. Participants also completed a survey assessing image quality, interface, and diagnostic comfort level. Scan times averaged two minutes and 46 seconds per slide, (standard deviation [SD] 2 minutes 46 seconds). Evaluation times averaged 4 minutes and 59 seconds per case, range to 13 minutes and 50 seconds, SD 3 minutes 48 seconds. Concordance between initial FS diagnosis and rendered through the MVD was 89%. Minor discrepancies made up 8% and major disagreements 3%. The kappa statistic for this series is 0.85. Participants rated the experience at 5 on a 10-point scale, range 3 to 7. Two-thirds found the image quality to be adequate, half were satisfied with image resolution, and 33% would be willing to make a diagnosis on the iPad, plus one only for special cases. Five of six respondents (83%) found the navigation with the study software difficult. Image fidelity and resolution makes the iPad potentially suitable for WSI evaluation of FS. Acceptable accuracy is attainable for FS interpretation. But, although possible to obtain acceptable results, use of the iPad with Interpath to view WSI is not easy and meets user resistance. The obstacle of slide navigation at high magnification could introduce frustrations, delays, or errors.

Ionospheric acoustic and gravity waves associated with midlatitude thunderstorms

DOE PAGES

Lay, Erin H.; Shao, Xuan -Min; Kendrick, Alexander K.; ...

2015-07-30

Acoustic waves with periods of 2 - 4 minutes and gravity waves with periods of 6 - 16 minutes have been detected at ionospheric heights (250-350 km) using GPS Total Electron Content (TEC) measurements. The area disturbed by these waves and the wave amplitudes have been associated with underlying thunderstorm activity. A statistical study comparing NEXRAD radar thunderstorm measurements with ionospheric acoustic and gravity waves in the mid-latitude U.S. Great Plains region was performed for the time period of May - July 2005. An increase of ionospheric acoustic wave disturbed area and amplitude is primarily associated with large thunderstorms (mesoscalemore » convective systems). Ionospheric gravity wave disturbed area and amplitude scale with thunderstorm activity, with even small storms (i.e. individual storm cells) producing an increase of gravity waves.« less

Perceptual responses while wearing an American football uniform in the heat.

PubMed

Johnson, Evan C; Ganio, Matthew S; Lee, Elaine C; Lopez, Rebecca M; McDermott, Brendon P; Casa, Douglas J; Maresh, Carl M; Armstrong, Lawrence E

2010-01-01

The protective equipment worn during American football has been shown to increase thermal strain; however, the perception of this increased heat has not been examined. To evaluate perceptual responses of American football players while wearing different uniforms during exercise in the heat and to evaluate how these responses may be used to monitor athlete safety. Randomized controlled trial. Human Performance Laboratory. Ten men with more than 3 years of competitive experience as football linemen (age = 23.8 +/- 1.3 years, height = 183.9 +/- 1.8 cm, mass = 117.4 +/- 3.5 kg, body fat = 30.1% +/- 1.7%) participated. On 3 occasions in hot, humid (33 degrees C, 48%-49% relative humidity) environmental conditions, participants completed 10 minutes of strenuous repetitive box lifting (RBL), 10 minutes of seated rest, and up to 60 minutes of treadmill walking. At each trial, they wore a different uniform condition: control (CON) clothing comprising shorts, socks, and sneakers; partial (PART) National Football League (NFL) uniform comprising the uniform without helmet or shoulder pads; or full (FULL) NFL uniform. Exercise, meals, and hydration status were controlled. Rectal temperature (T(re)), skin temperature (T(sk)), rating of perceived exertion (RPE), thermal perception (THM), perception of thirst (TST), and perception of muscle pain (MPN) were obtained for time points matched across trials. Nineteen of the 30 trials ended before 60 minutes of treadmill walking as a result of participant exhaustion. Mean treadmill time was longer for the CON condition (51.7 +/- 13.4 minutes) than for the PART (43.1 +/- 15.6 minutes; t(9) = 3.092, P = .01) or the FULL (36.2 +/- 13.2 minutes; t(9) = 4.393, P = .002) conditions. Neck and forearm T(sk) increased between the initial time point and the end of exercise in the PART (33.6 +/- 0.9 degrees C and 35.0 +/- 0.6 degrees C, respectively; F(2,18) = 9.034, P < .001) and the FULL (33.4 +/- 0.9 degrees C and 35.2 +/- 0.6 degrees C, respectively; F(2,18) = 21.011, P = .002) conditions. Rate of T(re) rise was greater in the FULL (0.042 +/- 0.010 degrees C/min) than in the PART (0.034 +/- 0.006 degrees C/min) condition (F(2,27) = 10.69, P = .04). We found a relationship at the post-RBL and final time points between RPE and THM (r = 0.75, P < .001 and r = 0.59, P < .001, respectively), RPE and TST (r = 0.76, P < .001 and r = 0.61, P < .001, respectively), and RPE and MPN (r = 0.63, P < .001 and r = 0.64, P < .001, respectively). The RPE was greater at the end of exercise in the PART (17 +/- 2) and FULL (18 +/- 1) conditions than in the CON (15 +/- 3) condition (F(2,18) = 7.403, P = .005). Although no differences in perceptual scales existed between the PART and FULL conditions, the T(sk) and rate of T(re) increase differed, indicating that football athletes find it difficult to perceptually rate exercise conditions as potentially dangerous hyperthermia develops. In addition, correlations between the perceptual scales further defined perceptual responses during exercise in the heat.

Tailoring magnetic domains in Gd-Fe thin films

NASA Astrophysics Data System (ADS)

Talapatra, A.; Chelvane, J. Arout; Mohanty, J.

2018-05-01

This paper presents the global modification of magnetic domains and magnetic properties in amorphous Gd19Fe81 thin films with rapid thermal processing at two distinct temperatures (250oC and 450oC), and with different time intervals viz., 2, 5, 10 and 20 minutes. 100 nm thick as-prepared films display nano-scale meandering stripe domains with high magnetic phase contrast which is the signature of perpendicular magnetic anisotropy. The films processed at 250oC for various time intervals show successive reduction in magnetic phase contrast and domain size. The domain pattern completely disappeared, and topography dominated mixed magnetic phase has been obtained for the films processed at 450oC for time intervals greater than 2 minutes. The magnetization measurements indicate the reduction in perpendicular magnetic anisotropy with increase in saturation magnetization for all the rapid thermal processed films. The experimental outputs have been used to simulate the domain pattern. Reduction in uniaxial anisotropy along with the increase in saturation magnetization successfully explain the experimental trend of decrease in domain size and magnetic contrast.

Ionosonde observations of the northern magnetospheric cleft during December 1974 and January 1975

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

Stiles, G.S.; Hones Jr., E.W.; Lepping, R.P.

1977-01-01

During December 1974 and January 1975 the northern magnetospheric cleft was monitored by ionosondes at Cape Parry and Sachs Harbor, Northwest Territories, Canada, in support of rocket shots into the cleft. Ionograms were taken nominally at 15-min intervals but as rapidly as two per minute during times of particular interest. Analysis of 5 days of data shows the ionosphere at cleft latitudes to be very complex and dynamic. The ionograms often show considerable structure and can change appearance significantly in a minute or two. The cleft at times appears to move equatorward in response either to a southward turning ofmore » the interplanetary magnetic field or to the occurrence of geomagnetic disturbances. This response is in agreement with the conclusions of previous satellite studies. Behavior contrary to this generalization is not uncommon, however, and therefore it may not always hold on time scales considerably shorter than the satellite orbital period of approximately-greater-than 1 hour. The rate of the cleft's motion may vary from approx.0.05 to approx.0.5 deg/min. (AIP)« less

LOSS OF BLOOD AT OPERATION—A Method for Continuous Measurement

PubMed Central

Borden, Fred W.

1957-01-01

A method for continuous measurement of surgical blood loss has been devised and has been used clinically in some 400 cases. The method combines volumetric measure of the suction loss and gravimetric measure of the sponge loss. The volumetric device automatically deducts the volume of rinse water used and thus measures the amount of blood collected in a metering cylinder. The suction loss scale shows continuously the amount of blood in the metering cylinder. The gravimetric device requires counting sponges into the weighing pan, and turning a dial scale to deduct the initial weight of the sponges. The volume of blood in the sponges is then read directly on the dial scale. Use of the instrument, which is under the supervision of the anesthesiologist, adds about two minutes per hour to the time normally required for counting the sponges; and about three minutes per hour is required for tending the volumetric instrument. In clinical use, knowing constantly the amount of blood loss permits the starting of transfusion before serious deficit develops, and then maintaining the patient's blood volume at a predetermined optimum level. In some 400 cases the continuous measurement of the blood loss served as a reliable guide for carrying out the loss-replacement plan within close limits of accuracy. ImagesFigure 2.p97-a PMID:13446754

Near surface gamma-ray and electric field enhancements during disturbed weather: combined signatures from convective clouds, lightning and rain

NASA Astrophysics Data System (ADS)

Reuveni, Yuval; Yair, Yoav; Price, Colin; Steinitz, Gideon

2017-04-01

We present correlations found between ground-level gamma-ray enhancements with precipitation and strong electric fields typical of thunderstorms. The data was obtained at the Cosmic Ray Observatory located on the western slopes of Mt. Hermon in northern Israel (altitude 2020 m ASL). During several thunderstorms in October and November 2015, we recorded extended periods of gamma ray enhancements, which lasted tens of minutes and coincided with peaks both in precipitation and the vertical electric field (Ez). We distinguish between two types of events based on the behavior of these parameters: (a) slow increase (up to 300 minutes) of atmospheric gamma ray radiation due to radon progeny washout along with minutes of Ez enhancement, which were not associated with the occurrences of near-by CG lightning discharges, and (b) rapid 30 minutes-long bursts of gamma rays, coinciding with much shorter Ez enhancements that were associated with the occurrences of near-by CG lightning discharges, and were superimposed on the radiation from radon daughters at ground level washed out by precipitation. We conclude that the superposition of accelerated high energy electrons by thunderstorm electric fields with the radon progeny washout explains the relatively fast gamma-ray increase observed at ground level, where the minutes-scale vertical electric field enhancement are presumably caused due to near-by convective clouds. Our results show that the mean half-life depletion times of the residual nuclei that were produced during events without lightning occurrences were between 25-65 minutes, compared to 55-100 minutes when lightning were present, indicating that different types of nuclei were involved.

The effects of cognitive activity combined with active extremity exercise on balance, walking activity, memory level and quality of life of an older adult sample with dementia.

PubMed

Yoon, Jung Eun; Lee, Suk Min; Lim, Hee Sung; Kim, Tae Hoon; Jeon, Ji Kyeng; Mun, Mee Hyang

2013-12-01

[Purpose] The purpose of this study was to compare the effectiveness of cognitive activity combined with active physical exercise for a sample of older adults with dementia. [Subjects] A convenience sample of 30 patients with dementia (Mini-Mental State Examination score between 16 and 23) was used. Participants were randomly allocated to one of two groups: cognitive activity combined with physical exercise CAE, n=11), and only cognitive activity CA, n=9). [Methods] Both groups participated in a therapeutic exercise program for 30 minutes, three days a week for 12 weeks. The CAE group performed an additional exercise for 30 minutes a day, three days a week for 12 weeks. A Wii Balance Board (WBB, Nintendo, Japan) was used to evaluate postural sway as an assessment of balance. The Berg Balance Scale (BBS) and Modified Falls Efficacy Scale (MFES) were used to assess dynamic balance abilities. The Timed Up-and-Go test (TUG) was used to assess gait, and the Digit Span Test (DST) and 7 Minute Screening Test (7MST) were used to measure memory performance. The Mini-Mental Status Exam-Korean version (MMSE-K), Kenny Self-Care Evaluation (KSCE), and Short Geriatric Depression Scale (GDS) were used to assess quality of life (QOL). [Results] There were significant beneficial effects of the therapeutic program on balance (velocity in EOWB, path length in ECNB, BBS, and MMFE), QOL (MMSE-KC, GDS, KSCE), and memory performance (DSB) in the CAE group compared to CA group, and between pre-test and post-test. [Conclusion] A 12-week CAE program resulted in improvements in balance, memory and QOL. Therefore, some older adults with dementia have the ability to acquire effective skills relevant to daily living.

Efficiency and Safety: The Best Time to Valve a Plaster Cast.

PubMed

Steiner, Samuel R H; Gendi, Kirollos; Halanski, Matthew A; Noonan, Kenneth J

2018-04-18

The act of applying, univalving, and spreading a plaster cast to accommodate swelling is commonly performed; however, cast saws can cause thermal and/or abrasive injury to the patient. This study aims to identify the optimal time to valve a plaster cast so as to reduce the risk of cast-saw injury and increase spreading efficiency. Plaster casts were applied to life-sized pediatric models and were univalved at set-times of 5, 8, 12, or 25 minutes. Outcome measures included average and maximum force applied during univalving, blade-to-skin touches, cut time, force needed to spread, number of spread attempts, spread completeness, spread distance, saw blade temperature, and skin surface temperature. Casts allowed to set for ≥12 minutes had significantly fewer blade-to-skin touches compared with casts that set for <12 minutes (p < 0.001). For average and maximum saw blade force, no significant difference was observed between individual set-times. However, in a comparison of the shorter group (<12 minutes) and the longer group (≥12 minutes), the longer group had a higher average force (p = 0.009) but a lower maximum force (p = 0.036). The average temperature of the saw blade did not vary between groups. The maximum force needed to "pop," or spread, the cast was greater for the 5-minute and 8-minute set-times. Despite requiring more force to spread the cast, 0% of attempts at 5 minutes and 54% of attempts at 8 minutes were successful in completely spreading the cast, whereas 100% of attempts at 12 and 25 minutes were successful. The spread distance was greatest for the 12-minute set-time at 5.7 mm. Allowing casts to set for 12 minutes is associated with decreased blade-to-skin contact, less maximum force used with the saw blade, and a more effective spread. Adherence to the 12-minute interval could allow for fewer cast-saw injuries and more effective spreading.

Database for the geologic map of the Sauk River 30-minute by 60-minute quadrangle, Washington (I-2592)

USGS Publications Warehouse

Tabor, R.W.; Booth, D.B.; Vance, J.A.; Ford, A.B.

2006-01-01

This digital map database has been prepared by R.W. Tabor from the published Geologic map of the Sauk River 30- by 60 Minute Quadrangle, Washington. Together with the accompanying text files as PDF, it provides information on the geologic structure and stratigraphy of the area covered. The database delineates map units that are identified by general age and lithology following the stratigraphic nomenclature of the U.S. Geological Survey. The authors mapped most of the bedrock geology at 1:100,000 scale, but compiled most Quaternary units at 1:24,000 scale. The Quaternary contacts and structural data have been much simplified for the 1:100,000-scale map and database. The spatial resolution (scale) of the database is 1:100,000 or smaller. This database depicts the distribution of geologic materials and structures at a regional (1:100,000) scale. The report is intended to provide geologic information for the regional study of materials properties, earthquake shaking, landslide potential, mineral hazards, seismic velocity, and earthquake faults. In addition, the report contains information and interpretations about the regional geologic history and framework. However, the regional scale of this report does not provide sufficient detail for site development purposes.

Acquisition of Ice-Tethered Profilers with Velocity (ITP-V) Instruments for Future Arctic Studies

DTIC Science & Technology

2015-09-30

jacketed wire rope tether and end weight should the ice fracture or melt , and to provide modest protection in the event of ice ridging. The profiler...1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Acquisition of Ice -Tethered Profilers with Velocity (ITP...evolving thermohaline stratification, the ocean currents and air- ice -sea interactions on time scales of minutes to seasonal and longer. OBJECTIVES

Predicting Clinical Gains and Side Effects of Stimulant Medication in Pediatric Attention-Deficit/Hyperactivity Disorder by Combining Measures From qEEG and ERPs in a Cued GO/NOGO Task.

PubMed

Ogrim, Geir; Kropotov, Juri D

2018-06-01

The study aim was to develop 2 scales: predicting clinical gains and risk of acute side effects of stimulant medication in pediatric attention-deficit/hyperactivity disorder (ADHD), combining measures from EEG spectra, event-related potentials (ERPs), and a cued visual GO/NOGO task. Based on 4-week systematic medication trials, 87 ADHD patients aged 8 to 17 years were classified as responders (REs, n = 62) or non-REs (n = 25), and belonging to the side effects (SEs, n = 42) or no-SEs (n = 45) groups. Before starting the trial, a 19-channel EEG was registered twice: Test 1 (T1) without medication and T2 on a single dose of stimulant medication a few days before the trial. EEG was registered T1 and T2: 3 minutes eyes-closed, 3 minutes eyes-open, and 20 minutes cued GO/NOGO. EEG spectra, ERPs, omissions, commissions, reaction time (RT), and RT variability were computed. Groups were compared at T1 and T2 on quantitative EEG (qEEG), ERPs and behavioral parameters; effect sizes ( d) were estimated. Variables with d > 0.5 were converted to quartiles, multiplied by corresponding d, and summed to obtain 2 global scales. Six variables differed significantly between REs and non-REs (T1: theta/alpha ratio, P3NOGO amplitude. Differences T2-T1: Omissions, RT variability, P3NOGO, contingent negative variation [CNV]). The global scale d was 1.86. Accuracy (receiver operating characteristic) was 0.92. SEs and no-SEs differed significantly on 4 variables. (T1: RT, T2: novelty component and alpha peak frequency, and RT changes. Global scale d = 1.08 and accuracy = 0.78. Gains and side effects of stimulants in pediatric ADHD can be predicted with high accuracy by combining EEG spectra, ERPs, and behavior from baseline and single-dose tests. ClinicalTrials.gov identifier: NCT02695355.

Mass spectrometric-based stable isotopic 2-aminobenzoic acid glycan mapping for rapid glycan screening of biotherapeutics.

PubMed

Prien, Justin M; Prater, Bradley D; Qin, Qiang; Cockrill, Steven L

2010-02-15

Fast, sensitive, robust methods for "high-level" glycan screening are necessary during various stages of a biotherapeutic product's lifecycle, including clone selection, process changes, and quality control for lot release testing. Traditional glycan screening involves chromatographic or electrophoretic separation-based methods, and, although reproducible, these methods can be time-consuming. Even ultrahigh-performance chromatographic and microfluidic integrated LC/MS systems, which work on the tens of minute time scale, become lengthy when hundreds of samples are to be analyzed. Comparatively, a direct infusion mass spectrometry (MS)-based glycan screening method acquires data on a millisecond time scale, exhibits exquisite sensitivity and reproducibility, and is amenable to automated peak annotation. In addition, characterization of glycan species via sequential mass spectrometry can be performed simultaneously. Here, we demonstrate a quantitative high-throughput MS-based mapping approach using stable isotope 2-aminobenzoic acid (2-AA) for rapid "high-level" glycan screening.

Acute glucoregulatory and vascular outcomes of three strategies for interrupting prolonged sitting time in postmenopausal women: A pilot, laboratory-based, randomized, controlled, 4-condition, 4-period crossover trial.

PubMed

Kerr, Jacqueline; Crist, Katie; Vital, Daniela G; Dillon, Lindsay; Aden, Sabrina A; Trivedi, Minaxi; Castellanos, Luis R; Godbole, Suneeta; Li, Hongying; Allison, Matthew A; Khemlina, Galina L; Takemoto, Michelle L; Schenk, Simon; Sallis, James F; Grace, Megan; Dunstan, David W; Natarajan, Loki; LaCroix, Andrea Z; Sears, Dorothy D

2017-01-01

Prolonged sitting is associated with cardiometabolic and vascular disease. Despite emerging evidence regarding the acute health benefits of interrupting prolonged sitting time, the effectiveness of different modalities in older adults (who sit the most) is unclear. In preparation for a future randomized controlled trial, we enrolled 10 sedentary, overweight or obese, postmenopausal women (mean age 66 years ±9; mean body mass index 30.6 kg/m2 ±4.2) in a 4-condition, 4-period crossover feasibility pilot study in San Diego to test 3 different sitting interruption modalities designed to improve glucoregulatory and vascular outcomes compared to a prolonged sitting control condition. The interruption modalities included: a) 2 minutes standing every 20 minutes; b) 2 minutes walking every hour; and c) 10 minutes standing every hour. During each 5-hr condition, participants consumed two identical, standardized meals. Blood samples, blood pressure, and heart rate were collected every 30 minutes. Endothelial function of the superficial femoral artery was measured at baseline and end of each 5-hr condition using flow-mediated dilation (FMD). Participants completed each condition on separate days, in randomized order. This feasibility pilot study was not powered to detect statistically significant differences in the various outcomes, however, analytic methods (mixed models) were used to test statistical significance within the small sample size. Nine participants completed all 4 study visits, one participant completed 3 study visits and then was lost to follow up. Net incremental area under the curve (iAUC) values for postprandial plasma glucose and insulin during the 5-hr sitting interruption conditions were not significantly different compared to the control condition. Exploratory analyses revealed that the 2-minute standing every 20 minutes and the 2-minute walking every hour conditions were associated with a significantly lower glycemic response to the second meal compared to the first meal (i.e., condition-matched 2-hour post-lunch glucose iAUC was lower than 2-hour post-breakfast glucose iAUC) that withstood Bonferroni correction (p = 0.0024 and p = 0.0084, respectively). Using allometrically scaled data, the 10-minute standing every hour condition resulted in an improved FMD response, which was significantly greater than the control condition after Bonferroni correction (p = 0.0033). This study suggests that brief interruptions in prolonged sitting time have modality-specific glucoregulatory and vascular benefits and are feasible in an older adult population. Larger laboratory and real-world intervention studies of pragmatic and effective methods to change sitting habits are needed. ClinicalTrials.gov NCT02743286.

Scale-up of recombinant cutinase recovery by whole broth extraction with PEG-phosphate aqueous two-phase.

PubMed

Costa, M J; Cunha, M T; Cabral, J M; Aires-Barros, M R

2000-01-01

A whole broth extraction using an aqueous two-phase system (ATPS) composed by 5% (w/w) PEG 3350 and 15% (w/w) phosphate was used for the scale-up extraction and isolation of a recombinant Fusarium solani pisi cutinase, an extracellular mutant enzyme expressed in Saccharomyces cerevisiae, containing a fusion peptide (WP)4. The experiments were carried out at three different scales (10 ml, 1 l and 30 l). Mixing time and stirrer speed were evaluated at lab scale (1 l) with two different system compositions. Stirrer speed between 400 and 800 rpm and mixing time between 2 and 5 min led to the highest recoveries of cutinase. In all cases, inclusive of pilot scale (30 l), the equilibrium was reached after a few minutes. The performance of ATPS was reproducible within the scale range of 0.010-30 l and provided a standard deviation of the yield lower than 8%, leading to (i) a partition coefficient over 50, (ii) a yield over 95% and (iii) a concentration factor over 5. The fusion of the peptide (WP)4 to the cutinase protein enabled a 400 increase of the partition coefficient relative to the wild-type strain.

A rainfall disaggregation scheme for sub-hourly time scales: Coupling a Bartlett-Lewis based model with adjusting procedures

NASA Astrophysics Data System (ADS)

Kossieris, Panagiotis; Makropoulos, Christos; Onof, Christian; Koutsoyiannis, Demetris

2018-01-01

Many hydrological applications, such as flood studies, require the use of long rainfall data at fine time scales varying from daily down to 1 min time step. However, in the real world there is limited availability of data at sub-hourly scales. To cope with this issue, stochastic disaggregation techniques are typically employed to produce possible, statistically consistent, rainfall events that aggregate up to the field data collected at coarser scales. A methodology for the stochastic disaggregation of rainfall at fine time scales was recently introduced, combining the Bartlett-Lewis process to generate rainfall events along with adjusting procedures to modify the lower-level variables (i.e., hourly) so as to be consistent with the higher-level one (i.e., daily). In the present paper, we extend the aforementioned scheme, initially designed and tested for the disaggregation of daily rainfall into hourly depths, for any sub-hourly time scale. In addition, we take advantage of the recent developments in Poisson-cluster processes incorporating in the methodology a Bartlett-Lewis model variant that introduces dependence between cell intensity and duration in order to capture the variability of rainfall at sub-hourly time scales. The disaggregation scheme is implemented in an R package, named HyetosMinute, to support disaggregation from daily down to 1-min time scale. The applicability of the methodology was assessed on a 5-min rainfall records collected in Bochum, Germany, comparing the performance of the above mentioned model variant against the original Bartlett-Lewis process (non-random with 5 parameters). The analysis shows that the disaggregation process reproduces adequately the most important statistical characteristics of rainfall at wide range of time scales, while the introduction of the model with dependent intensity-duration results in a better performance in terms of skewness, rainfall extremes and dry proportions.

The Glittre-ADL Test Cut-Off Point to Discriminate Abnormal Functional Capacity in Patients with COPD.

PubMed

Gulart, Aline Almeida; Munari, Anelise Bauer; Klein, Suelen Roberta; Santos da Silveira, Lucas; Mayer, Anamaria Fleig

2018-02-01

The study objective was to determine a cut-off point for the Glittre activities of daily living (ADL)test (TGlittre) to discriminate patients with normal and abnormal functional capacity. Fifty-nine patients with moderate to very severe COPD (45 males; 65 ± 8.84 years; BMI: 26 ± 4.78 kg/m 2 ; FEV 1 : 35.3 ± 13.4% pred) were evaluated for spirometry, TGlittre, 6-minute walk test (6 MWT), physical ADL, modified Medical Research Council scale (mMRC), BODE index, Saint George's Respiratory Questionnaire (SGRQ), and COPD Assessment Test (CAT). The receiver operating characteristic (ROC) curve was used to determine the cut-off point for TGlittre in order to discriminate patients with 6 MWT < 82% pred. The ROC curve indicated a cut-off point of 3.5 minutes for the TGlittre (sensitivity = 92%, specificity = 83%, and area under the ROC curve = 0.95 [95% CI: 0.89-0.99]). Patients with abnormal functional capacity had higher mMRC (median difference 1 point), CAT (mean difference: 4.5 points), SGRQ (mean difference: 12.1 points), and BODE (1.37 points) scores, longer time of physical activity <1.5 metabolic equivalent of task (mean difference: 47.9 minutes) and in sitting position (mean difference: 59.4 minutes) and smaller number of steps (mean difference: 1,549 minutes); p < 0.05 for all. In conclusion, the cut-off point of 3.5 minutes in the TGlittre is sensitive and specific to distinguish COPD patients with abnormal and normal functional capacity.

Vaginoscopy compared to traditional hysteroscopy for hysteroscopic sterilization. A randomized trial.

PubMed

Chapa, Hector O; Venegas, Gonzalo

2015-01-01

To compare vaginoscopic hysteroscopic sterilization with traditional hysteroscopic approach for differences in pain, bilateral microinsert placement rates, and procedure time. We performed a prospective, randomized, single-blinded study of hysteroscopic sterilization using the Essure System. The study setting was an inner city ObGyn clinic. Ninety patients were randomized to either vaginoscopy or traditional approach. The traditional approach was speculum insertion, paracervical analgesia, and tenaculum. All procedures were done with a 5 mm, 30 degree rigid hysteroscope. Main outcome measures were pain scores (10-point visual analog scale), bilateral placement rates, and procedure times. Vaginoscopy was successful in 42/45 patients (93%). There was no statistically significant difference in pain-scores for microinsert placement between the groups (p = 0.71). First attempt, bilateral microinsert placement rate was 95% (40/42) with vaginoscopy and 95% (43/45) with traditional (p = 0.89). Time for treatment completion was 16 minutes (mean) (range, 13-21) in the traditional group versus vaginoscopy time of 9 minutes (mean) (range, 7-11) (p = 0.03). Hysteroscopic sterilization via vaginoscopy is feasible with bilateral microinsert rates comparable to those of traditional hysteroscopy. Vaginoscopy is associated with less overall discomfort and is faster to perform.

915-MHz Wind Profiler for Cloud Forecasting at Brookhaven National Laboratory

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

Jensen, M.; Bartholomew, M. J.; Giangrande, S.

When considering the amount of shortwave radiation incident on a photovoltaic solar array and, therefore, the amount and stability of the energy output from the system, clouds represent the greatest source of short-term (i.e., scale of minutes to hours) variability through scattering and reflection of incoming solar radiation. Providing estimates of this short-term variability is important for determining and regulating the output from large solar arrays as they connect with the larger power infrastructure. In support of the installation of a 37-MW solar array on the grounds of Brookhaven National Laboratory (BNL), a study of the impacts of clouds onmore » the output of the solar array has been undertaken. The study emphasis is on predicting the change in surface solar radiation resulting from the observed/forecast cloud field on a 5-minute time scale. At these time scales, advection of cloud elements over the solar array is of particular importance. As part of the BNL Aerosol Life Cycle Intensive Operational Period (IOP), a 915-MHz Radar Wind Profiler (RWP) was deployed to determine the profile of low-level horizontal winds and the depth of the planetary boundary layer. The initial deployment mission of the 915-MHz RWP for cloud forecasting has been expanded the deployment to provide horizontal wind measurements for estimating and constraining cloud advection speeds. A secondary focus is on the observation of dynamics and microphysics of precipitation during cold season/winter storms on Long Island. In total, the profiler was deployed at BNL for 1 year from May 2011 through May 2012.« less

915-Mhz Wind Profiler for Cloud Forecasting at Brookhaven National Laboratory

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

Jensen, M.; Bartholomew, M. J.; Giangrande, S.

When considering the amount of shortwave radiation incident on a photovoltaic solar array and, therefore, the amount and stability of the energy output from the system, clouds represent the greatest source of short-term (i.e., scale of minutes to hours) variability through scattering and reflection of incoming solar radiation. Providing estimates of this short-term variability is important for determining and regulating the output from large solar arrays as they connect with the larger power infrastructure. In support of the installation of a 37-MW solar array on the grounds of Brookhaven National Laboratory (BNL), a study of the impacts of clouds onmore » the output of the solar array has been undertaken. The study emphasis is on predicting the change in surface solar radiation resulting from the observed/forecast cloud field on a 5-minute time scale. At these time scales, advection of cloud elements over the solar array is of particular importance. As part of the BNL Aerosol Life Cycle Intensive Operational Period (IOP), a 915-MHz Radar Wind Profiler (RWP) was deployed to determine the profile of low-level horizontal winds and the depth of the planetary boundary layer. The initial deployment mission of the 915-MHz RWP for cloud forecasting has been expanded the deployment to provide horizontal wind measurements for estimating and constraining cloud advection speeds. A secondary focus is on the observation of dynamics and microphysics of precipitation during cold season/winter storms on Long Island. In total, the profiler was deployed at BNL for 1 year from May 2011 through May 2012.« less

Outpatient Office Wait Times and Quality of Care for Medicaid Patients

PubMed Central

Oostrom, Tamar; Einav, Liran; Finkelstein, Amy

2018-01-01

Time spent in the doctor’s waiting room captures an important aspect of the healthcare experience. We analyzed data on 21 million outpatient visits obtained from electronic health record systems, allowing us to measure time spent in the waiting room beyond the scheduled appointment time. Median wait time was just over 4 minutes. Almost one-fifth of visits had waits longer than 20 minutes, and 10% were over 30 minutes. Waits were shorter for early morning appointments, younger patients, and at larger practices. Median wait time was 4.1 minutes for privately-insured and 4.6 minutes for Medicaid patients; adjusting for patient and appointment characteristics, Medicaid patients were 20% more likely than the privately-insured to wait longer than 20 minutes (P<0.001), with most of this disparity explained by differences in practices and providers they saw. Wait time for Medicaid patients relative to the privately-insured was longer in states with relatively lower Medicaid reimbursement rates. PMID:28461348

National performance on door-in to door-out time among patients transferred for primary percutaneous coronary intervention.

PubMed

Herrin, Jeph; Miller, Lauren E; Turkmani, Dima F; Nsa, Wato; Drye, Elizabeth E; Bernheim, Susannah M; Ling, Shari M; Rapp, Michael T; Han, Lein F; Bratzler, Dale W; Bradley, Elizabeth H; Nallamothu, Brahmajee K; Ting, Henry H; Krumholz, Harlan M

2011-11-28

Delays in treatment time are commonplace for patients with ST-segment elevation acute myocardial infarction who must be transferred to another hospital for percutaneous coronary intervention. Experts have recommended that door-in to door-out (DIDO) time (ie, time from arrival at the first hospital to transfer from that hospital to the percutaneous coronary intervention hospital) should not exceed 30 minutes. We sought to describe national performance in DIDO time using a new measure developed by the Centers for Medicare & Medicaid Services. We report national median DIDO time and examine associations with patient characteristics (age, sex, race, contraindication to fibrinolytic therapy, and arrival time) and hospital characteristics (number of beds, geographic region, location [rural or urban], and number of cases reported) using a mixed effects multivariable model. Among 13,776 included patients from 1034 hospitals, only 1343 (9.7%) had a DIDO time within 30 minutes, and DIDO exceeded 90 minutes for 4267 patients (31.0%). Mean estimated times (95% CI) to transfer based on multivariable analysis were 8.9 (5.6-12.2) minutes longer for women, 9.1 (2.7-16.0) minutes longer for African Americans, 6.9 (1.6-11.9) minutes longer for patients with contraindication to fibrinolytic therapy, shorter for all age categories (except >75 years) relative to the category of 18 to 35 years, 15.3 (7.3-23.5) minutes longer for rural hospitals, and 14.4 (6.6-21.3) minutes longer for hospitals with 9 or fewer transfers vs 15 or more in 2009 (all P < .001). Among patients presenting to emergency departments and requiring transfer to another facility for percutaneous coronary intervention, the DIDO time rarely met the recommended 30 minutes.

National Performance on Door-In to Door-Out Time Among Patients Transferred for Primary Percutaneous Coronary Intervention

PubMed Central

Herrin, Jeph; Miller, Lauren E.; Turkmani, Dima F.; Nsa, Wato; Drye, Elizabeth E.; Bernheim, Susannah M.; Ling, Shari M.; Rapp, Michael T.; Han, Lein F.; Bratzler, Dale W.; Bradley, Elizabeth H.; Nallamothu, Brahmajee K.; Ting, Henry H.; Krumholz, Harlan M.

2015-01-01

Background Delays in treatment time are commonplace for patients with ST-segment elevation acute myocardial infarction who must be transferred to another hospital for per-cutaneous coronary intervention. Experts have recommended that door-in to door-out (DIDO) time(ie, time from arrival at the first hospital to transfer from that hospital to the percutaneous coronary intervention hospital) should not exceed 30 minutes. We sought to describe national performance in DIDO time using a new measure developed by the Centers for Medicare & Medicaid Services. Methods We report national median DIDO time and examine associations with patient characteristics (age, sex, race, contraindication to fibrinolytic therapy, and arrival time) and hospital characteristics (number of beds, geographic region, location [rural or urban], and number of cases reported) using a mixed effects multivariable model. Results Among 13 776 included patients from 1034 hospitals, only 1343 (9.7%) had a DIDO time within 30 minutes, and DIDO exceeded 90 minutes for 4267 patients (31.0%). Mean estimated times (95% CI) to transfer based on multivariable analysis were 8.9 (5.6-12.2) minutes longer for women, 9.1 (2.7-16.0) minutes longer for African Americans, 6.9 (1.6-11.9) minutes longer for patients with contraindication to fibrinolytic therapy, shorter for all age categories (except >75 years) relative to the category of 18 to 35 years, 15.3 (7.3-23.5) minutes longer for rural hospitals, and 14.4 (6.6-21.3) minutes longer for hospitals with 9 or fewer transfers vs 15 or more in 2009 (all P<.001). Conclusion Among patients presenting to emergency departments and requiring transfer to another facility for percutaneous coronary intervention, the DIDO time rarely met the recommended 30 minutes. PMID:22123793

A comparison of hysteroscopic mechanical tissue removal with bipolar electrical resection for the management of endometrial polyps in an ambulatory care setting: preliminary results.

PubMed

Pampalona, Jennifer Rovira; Bastos, Maria Degollada; Moreno, Gemma Mancebo; Pust, Andrea Buron; Montesdeoca, Gemma Escribano; Guerra Garcia, Angel; Pruñonosa, Juan Carles Mateu; Collado, Ramon Carreras; Torras, Pere Bresco

2015-01-01

To assess and compare efficacy, pain, and the learning curve associated with diagnostic therapeutic hysteroscopy using mechanical tissue removal versus bipolar electrical resection in the management of endometrial polyps in an ambulatory care setting. A randomized controlled clinical trial (Canadian Task Force classification I). Hospital de Igulada, Barcelona, Spain. A total of 133 patients diagnosed with endometrial polyp(s) were included and randomly assigned to 1 of the 2 hysteroscopic methods. Criteria assessed were total hysteroscopy time, full polypectomy procedure time, pain experienced by patients, and learning curve of staff in training. The average time to perform total hysteroscopy using the mechanical tissue removal system (TRUCLEAR 5.0 System; Smith & Nephew Inc., Andover, MD) was 6 minutes 49 seconds versus 11 minutes 37 seconds required for the bipolar electrosurgery system (GYNECARE VERSAPOINT; Ethicon Inc, Somerville, NJ) (p < .01). Results for complete polypectomy time favored the TRUCLEAR System at 3 minutes 7 seconds over the VERSAPOINT System at 8 minutes 25 seconds (p < .01). If a successful procedure is predicated on access to cavity, visualization, and complete resection and excision of endometrial polyp, the mechanical TRUCLEAR Tissue Removal System shows a higher success rate than the VERSAPOINT Bipolar Electrosurgery System at 92% and 77%, respectively. Analysis of pain using the visual analog scale revealed no significant differences between the 2 techniques (p > .05). A study of the residents' learning curve showed a higher level of autonomy with hysteroscopy using the TRUCLEAR Tissue Removal System with which residents showed a higher level of confidence compared with hysteroscopy with the VERSAPOINT Bipolar Electrosurgery System. In hysteroscopic polypectomy, the mechanical tissue removal system was significantly faster, achieved a greater success rate for complete polypectomy, and required a shorter learning curve from staff being trained in the management of endometrial polyps when compared with bipolar electrical resection. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

Whole-Body Vibration Intensities in Chronic Stroke: A Randomized Controlled Trial.

PubMed

Liao, Lin-Rong; Ng, Gabriel Y F; Jones, Alice Y M; Huang, Mei-Zhen; Pang, Marco Y C

2016-07-01

A single-blinded randomized controlled study was conducted to investigate the effects of different whole-body vibration (WBV) intensities on body functions/structures, activity, and participation in individuals with stroke. Eighty-four individuals with chronic stroke (mean age = 61.2 yr, SD = 9.2) with mild to moderate motor impairment (Chedoke-McMaster Stroke Assessment lower limb motor score: median = 9 out of 14, interquartile range = 7-11.8) were randomly assigned to a low-intensity WBV, high-intensity WBV, or control group. The former two groups performed various leg exercises while receiving low-intensity and high-intensity WBV, respectively. Controls performed the same exercises without WBV. All individuals received 30 training sessions over an average period of 75.5 d (SD = 5.2). Outcome measurements included knee muscle strength (isokinetic dynamometry), knee and ankle joint spasticity (Modified Ashworth Scale), balance (Mini Balance Evaluation Systems Test), mobility (Timed-Up-and-Go test), walking endurance (6-Minute Walk Test), balance self-efficacy (Activities-specific Balance Confidence scale), participation in daily activities (Frenchay Activity Index), perceived environmental barriers to societal participation (Craig Hospital Inventory of Environmental Factors), and quality of life (Short-Form 12 Health Survey). Assessments were performed at baseline and postintervention. Intention-to-treat analysis revealed a significant time effect for muscle strength, Timed-Up-and-Go distance, and oxygen consumption rate achieved during the 6-Minute Walk Test, the Mini Balance Evaluation Systems Test, the Activities-specific Balance Confidence scale, and the Short-Form 12 Health Survey physical composite score domain (P < 0.05). However, the time-group interaction was not significant for any of the outcome measures (P > 0.05). The addition of the 30-session WBV paradigm to the leg exercise protocol was no more effective in enhancing body functions/structures, activity, and participation than leg exercises alone in chronic stroke patients with mild to moderate motor impairments.

Effect of bright light and melatonin on cognitive and noncognitive function in elderly residents of group care facilities: a randomized controlled trial.

PubMed

Riemersma-van der Lek, Rixt F; Swaab, Dick F; Twisk, Jos; Hol, Elly M; Hoogendijk, Witte J G; Van Someren, Eus J W

2008-06-11

Cognitive decline, mood, behavioral and sleep disturbances, and limitations of activities of daily living commonly burden elderly patients with dementia and their caregivers. Circadian rhythm disturbances have been associated with these symptoms. To determine whether the progression of cognitive and noncognitive symptoms may be ameliorated by individual or combined long-term application of the 2 major synchronizers of the circadian timing system: bright light and melatonin. A long-term, double-blind, placebo-controlled, 2 x 2 factorial randomized trial performed from 1999 to 2004 with 189 residents of 12 group care facilities in the Netherlands; mean (SD) age, 85.8 (5.5) years; 90% were female and 87% had dementia. Random assignment by facility to long-term daily treatment with whole-day bright (+/- 1000 lux) or dim (+/- 300 lux) light and by participant to evening melatonin (2.5 mg) or placebo for a mean (SD) of 15 (12) months (maximum period of 3.5 years). Standardized scales for cognitive and noncognitive symptoms, limitations of activities of daily living, and adverse effects assessed every 6 months. Light attenuated cognitive deterioration by a mean of 0.9 points (95% confidence interval [CI], 0.04-1.71) on the Mini-Mental State Examination or a relative 5%. Light also ameliorated depressive symptoms by 1.5 points (95% CI, 0.24-2.70) on the Cornell Scale for Depression in Dementia or a relative 19%, and attenuated the increase in functional limitations over time by 1.8 points per year (95% CI, 0.61-2.92) on the nurse-informant activities of daily living scale or a relative 53% difference. Melatonin shortened sleep onset latency by 8.2 minutes (95% CI, 1.08-15.38) or 19% and increased sleep duration by 27 minutes (95% CI, 9-46) or 6%. However, melatonin adversely affected scores on the Philadelphia Geriatric Centre Affect Rating Scale, both for positive affect (-0.5 points; 95% CI, -0.10 to -1.00) and negative affect (0.8 points; 95% CI, 0.20-1.44). Melatonin also increased withdrawn behavior by 1.02 points (95% CI, 0.18-1.86) on the Multi Observational Scale for Elderly Subjects scale, although this effect was not seen if given in combination with light. Combined treatment also attenuated aggressive behavior by 3.9 points (95% CI, 0.88-6.92) on the Cohen-Mansfield Agitation Index or 9%, increased sleep efficiency by 3.5% (95% CI, 0.8%-6.1%), and improved nocturnal restlessness by 1.00 minute per hour each year (95% CI, 0.26-1.78) or 9% (treatment x time effect). Light has a modest benefit in improving some cognitive and noncognitive symptoms of dementia. To counteract the adverse effect of melatonin on mood, it is recommended only in combination with light. controlled-trials.com/isrctn Identifier: ISRCTN93133646.

Intrinsic vs. spurious long-range memory in high-frequency records of environmental radioactivity. Critical re-assessment and application to indoor 222Rn concentrations from Coimbra, Portugal

NASA Astrophysics Data System (ADS)

Donner, R. V.; Potirakis, S. M.; Barbosa, S. M.; Matos, J. A. O.; Pereira, A. J. S. C.; Neves, L. J. P. F.

2015-05-01

The presence or absence of long-range correlations in the environmental radioactivity fluctuations has recently attracted considerable interest. Among a multiplicity of practically relevant applications, identifying and disentangling the environmental factors controlling the variable concentrations of the radioactive noble gas radon is important for estimating its effect on human health and the efficiency of possible measures for reducing the corresponding exposition. In this work, we present a critical re-assessment of a multiplicity of complementary methods that have been previously applied for evaluating the presence of long-range correlations and fractal scaling in environmental radon variations with a particular focus on the specific properties of the underlying time series. As an illustrative case study, we subsequently re-analyze two high-frequency records of indoor radon concentrations from Coimbra, Portugal, each of which spans several weeks of continuous measurements at a high temporal resolution of five minutes.Our results reveal that at the study site, radon concentrations exhibit complex multi-scale dynamics with qualitatively different properties at different time-scales: (i) essentially white noise in the high-frequency part (up to time-scales of about one hour), (ii) spurious indications of a non-stationary, apparently long-range correlated process (at time scales between some hours and one day) arising from marked periodic components, and (iii) low-frequency variability indicating a true long-range dependent process. In the presence of such multi-scale variability, common estimators of long-range memory in time series are prone to fail if applied to the raw data without previous separation of time-scales with qualitatively different dynamics.

Robotically Assembled Aerospace Structures: Digital Material Assembly using a Gantry-Type Assembler

NASA Technical Reports Server (NTRS)

Trinh, Greenfield; Copplestone, Grace; O'Connor, Molly; Hu, Steven; Nowak, Sebastian; Cheung, Kenneth; Jenett, Benjamin; Cellucci, Daniel

2017-01-01

This paper evaluates the development of automated assembly techniques for discrete lattice structures using a multi-axis gantry type CNC machine. These lattices are made of discrete components called digital materials. We present the development of a specialized end effector that works in conjunction with the CNC machine to assemble these lattices. With this configuration we are able to place voxels at a rate of 1.5 per minute. The scalability of digital material structures due to the incremental modular assembly is one of its key traits and an important metric of interest. We investigate the build times of a 5x5 beam structure on the scale of 1 meter (325 parts), 10 meters (3,250 parts), and 30 meters (9,750 parts). Utilizing the current configuration with a single end effector, performing serial assembly with a globally fixed feed station at the edge of the build volume, the build time increases according to a scaling law of n4, where n is the build scale. Build times can be reduced significantly by integrating feed systems into the gantry itself, resulting in a scaling law of n3. A completely serial assembly process will encounter time limitations as build scale increases. Automated assembly for digital materials can assemble high performance structures from discrete parts, and techniques such as built in feed systems, parallelization, and optimization of the fastening process will yield much higher throughput.

Robotically Assembled Aerospace Structures: Digital Material Assembly using a Gantry-Type Assembler

NASA Technical Reports Server (NTRS)

Trinh, Greenfield; Copplestone, Grace; O'Connor, Molly; Hu, Steven; Nowak, Sebastian; Cheung, Kenneth; Jenett, Benjamin; Cellucci, Daniel

2017-01-01

This paper evaluates the development of automated assembly techniques for discrete lattice structures using a multi-axis gantry type CNC machine. These lattices are made of discrete components called "digital materials." We present the development of a specialized end effector that works in conjunction with the CNC machine to assemble these lattices. With this configuration we are able to place voxels at a rate of 1.5 per minute. The scalability of digital material structures due to the incremental modular assembly is one of its key traits and an important metric of interest. We investigate the build times of a 5x5 beam structure on the scale of 1 meter (325 parts), 10 meters (3,250 parts), and 30 meters (9,750 parts). Utilizing the current configuration with a single end effector, performing serial assembly with a globally fixed feed station at the edge of the build volume, the build time increases according to a scaling law of n4, where n is the build scale. Build times can be reduced significantly by integrating feed systems into the gantry itself, resulting in a scaling law of n3. A completely serial assembly process will encounter time limitations as build scale increases. Automated assembly for digital materials can assemble high performance structures from discrete parts, and techniques such as built in feed systems, parallelization, and optimization of the fastening process will yield much higher throughput.

A randomised placebo-controlled trial to differentiate the acute cognitive and mood effects of chlorogenic acid from decaffeinated coffee.

PubMed

Camfield, David A; Silber, Beata Y; Scholey, Andrew B; Nolidin, Karen; Goh, Antionette; Stough, Con

2013-01-01

In the current study, sixty healthy older adults aged 50 years or older, and who were light to moderate coffee drinkers, were administered 6g of a decaffeinated green coffee blend (NESCAFÉ Green Blend coffee; GB) or 540mg pure chlorogenic acids (CGA) or placebo in a double-blind acute cross-over design, with cognitive and mood assessments pre-dose, 40-mins and 120-mins post-dose. The primary outcome measure was accuracy in Rapid Visual Information Processing (RVIP). Secondary cognitive outcome measures included RVIP reaction time as well as Inspection time (IT), Jensen Box decision/reaction times, serial subtraction and N-Back working memory. Secondary mood measures included Bond-Lader and caffeine Research visual analogue scales (VAS). No significant treatment effects were found for the primary outcome measure, although significant effects were found amongst secondary measures. Overall, CGA in isolation was not found to significantly improve cognitive function relative to placebo whereas the GB was found to improve sustained attention as measured by the N-Back task in comparison to placebo overall (t=2.45,p=.05), as well as decision time on a 2-choice reaction time task (Jensen box) in comparison to placebo at 40 minutes post-dose (t=2.45,p=.05). Similarly, GB was found to improve alertness on both the Bond-Lader at 120 minutes relative to CGA (t=2.86, p=0.02) and the caffeine Research VAS relative to CGA (t=3.09, p=0.009) and placebo (t=2.75,p=0.02) at 120 minutes post-dose. Both the GB and CGA were also found to significantly improve symptoms of headache at 120 minutes relative to placebo (t=2.51,p=0.03 and t=2.43,p=.04 respectively), whilst there was a trend towards a reduction in jitteriness with GB and CGA in comparison to placebo at 40 minutes post-dose (t=2.24,p=0.06 and t=2.20,p=0.06 respectively). These findings suggest that the improvements in mood observed with GB, but not the improvements in cognitive function, are likely to some extent to be attributable to CGAs. Australia New Zealand Clinical Trials Registry ACTRN12611000067976 www.anzctr.org.au.

A Randomised Placebo-Controlled Trial to Differentiate the Acute Cognitive and Mood Effects of Chlorogenic Acid from Decaffeinated Coffee

PubMed Central

Camfield, David A.; Silber, Beata Y.; Scholey, Andrew B.; Nolidin, Karen; Goh, Antionette; Stough, Con

2013-01-01

In the current study, sixty healthy older adults aged 50 years or older, and who were light to moderate coffee drinkers, were administered 6g of a decaffeinated green coffee blend (NESCAFÉ Green Blend coffee; GB) or 540mg pure chlorogenic acids (CGA) or placebo in a double-blind acute cross-over design, with cognitive and mood assessments pre-dose, 40-mins and 120-mins post-dose. The primary outcome measure was accuracy in Rapid Visual Information Processing (RVIP). Secondary cognitive outcome measures included RVIP reaction time as well as Inspection time (IT), Jensen Box decision/reaction times, serial subtraction and N-Back working memory. Secondary mood measures included Bond-Lader and caffeine Research visual analogue scales (VAS). No significant treatment effects were found for the primary outcome measure, although significant effects were found amongst secondary measures. Overall, CGA in isolation was not found to significantly improve cognitive function relative to placebo whereas the GB was found to improve sustained attention as measured by the N-Back task in comparison to placebo overall (t=2.45,p=.05), as well as decision time on a 2-choice reaction time task (Jensen box) in comparison to placebo at 40 minutes post-dose (t=2.45,p=.05). Similarly, GB was found to improve alertness on both the Bond-Lader at 120 minutes relative to CGA (t=2.86, p=0.02) and the caffeine Research VAS relative to CGA (t=3.09, p=0.009) and placebo (t=2.75,p=0.02) at 120 minutes post-dose. Both the GB and CGA were also found to significantly improve symptoms of headache at 120 minutes relative to placebo (t=2.51,p=0.03 and t=2.43,p=.04 respectively), whilst there was a trend towards a reduction in jitteriness with GB and CGA in comparison to placebo at 40 minutes post-dose (t=2.24,p=0.06 and t=2.20,p=0.06 respectively). These findings suggest that the improvements in mood observed with GB, but not the improvements in cognitive function, are likely to some extent to be attributable to CGAs. Trial Registration: Australia New Zealand Clinical Trials Registry ACTRN12611000067976 www.anzctr.org.au PMID:24349389

A randomized, placebo-controlled trial of an amino acid preparation on timing and quality of sleep.

PubMed

Shell, William; Bullias, Debbie; Charuvastra, Elizabeth; May, Lawrence A; Silver, David S

2010-01-01

This study was an outpatient, randomized, double-blind, placebo-controlled trial of a combination amino acid formula (Gabadone) in patients with sleep disorders. Eighteen patients with sleep disorders were randomized to either placebo or active treatment group. Sleep latency and duration of sleep were measured by daily questionnaires. Sleep quality was measured using a visual analog scale. Autonomic nervous system function was measured by heart rate variability analysis using 24-hour electrocardiographic recordings. In the active group, the baseline time to fall asleep was 32.3 minutes, which was reduced to 19.1 after Gabadone administration (P = 0.01, n = 9). In the placebo group, the baseline latency time was 34.8 minutes compared with 33.1 minutes after placebo (P = nonsignificant, n = 9). The difference was statistically significant (P = 0.02). In the active group, the baseline duration of sleep was 5.0 hours (mean), whereas after Gabadone, the duration of sleep increased to 6.83 (P = 0.01, n = 9). In the placebo group, the baseline sleep duration was 7.17 +/- 7.6 compared with 7.11 +/- 3.67 after placebo (P = nonsignificant, n = 9). The difference between the active and placebo groups was significant (P = 0.01). Ease of falling asleep, awakenings, and am grogginess improved. Objective measurement of parasympathetic function as measured by 24-hour heart rate variability improved in the active group compared with placebo. An amino acid preparation containing both GABA and 5-hydroxytryptophan reduced time to fall asleep, decreased sleep latency, increased the duration of sleep, and improved quality of sleep.

New solar irradiances for use in space research

NASA Astrophysics Data System (ADS)

Tobiska, W.; Bouwer, D.; Jones, A.

Space environment research applications require solar irradiances in a variety of time scales and spectral formats We describe the development of research grade modeled solar irradiances using four models and systems that are also used for space weather operations The four models systems include SOLAR2000 S2K SOLARFLARE SFLR APEX and IDAR which are used by Space Environment Technologies SET to provide solar irradiances from the soft X-rays through the visible spectrum SFLR uses the GOES 0 1--0 8 nm X-rays in combination with a Mewe model subroutine to provide 0 1--30 0 nm irradiances at 0 1 nm spectral resolution at 1 minute time resolution and in a 6-hour XUV--EUV spectral solar flare evolution forecast with a 7 minute latency and a 2 minute cadence These irradiances have been calibrated with the SORCE XPS observations and we report on the inclusion of these irradiances in the S2K model There are additional developments with S2K that we discuss particularly the method by which S2K is emerging as a hybrid model empirical plus physics-based and real-time data integration platform Numerous new solar indices have been recently developed for the operations community and we describe their inclusion in S2K The APEX system is a real-time data retrieval system developed under contract to the University of Southern California Space Sciences Center SSC to provide SOHO SEM data processing and distribution SSC provides the updated SEM data to the research community and SET provides the operational data to the space operations community We

Statistical regularities in the return intervals of volatility

NASA Astrophysics Data System (ADS)

Wang, F.; Weber, P.; Yamasaki, K.; Havlin, S.; Stanley, H. E.

2007-01-01

We discuss recent results concerning statistical regularities in the return intervals of volatility in financial markets. In particular, we show how the analysis of volatility return intervals, defined as the time between two volatilities larger than a given threshold, can help to get a better understanding of the behavior of financial time series. We find scaling in the distribution of return intervals for thresholds ranging over a factor of 25, from 0.6 to 15 standard deviations, and also for various time windows from one minute up to 390 min (an entire trading day). Moreover, these results are universal for different stocks, commodities, interest rates as well as currencies. We also analyze the memory in the return intervals which relates to the memory in the volatility and find two scaling regimes, ℓ<ℓ* with α1=0.64±0.02 and ℓ> ℓ* with α2=0.92±0.04; these exponent values are similar to results of Liu et al. for the volatility. As an application, we use the scaling and memory properties of the return intervals to suggest a possibly useful method for estimating risk.

Time-Resolved Small-Angle X-ray Scattering Reveals Millisecond Transitions of a DNA Origami Switch.

PubMed

Bruetzel, Linda K; Walker, Philipp U; Gerling, Thomas; Dietz, Hendrik; Lipfert, Jan

2018-04-11

Self-assembled DNA structures enable creation of specific shapes at the nanometer-micrometer scale with molecular resolution. The construction of functional DNA assemblies will likely require dynamic structures that can undergo controllable conformational changes. DNA devices based on shape complementary stacking interactions have been demonstrated to undergo reversible conformational changes triggered by changes in ionic environment or temperature. An experimentally unexplored aspect is how quickly conformational transitions of large synthetic DNA origami structures can actually occur. Here, we use time-resolved small-angle X-ray scattering to monitor large-scale conformational transitions of a two-state DNA origami switch in free solution. We show that the DNA device switches from its open to its closed conformation upon addition of MgCl 2 in milliseconds, which is close to the theoretical diffusive speed limit. In contrast, measurements of the dimerization of DNA origami bricks reveal much slower and concentration-dependent assembly kinetics. DNA brick dimerization occurs on a time scale of minutes to hours suggesting that the kinetics depend on local concentration and molecular alignment.

Behavioural improvement in a minimally conscious state after caloric vestibular stimulation: evidence from two single case studies.

PubMed

Vanzan, Serena; Wilkinson, David; Ferguson, Heather; Pullicino, Patrick; Sakel, Mohamed

2017-04-01

To investigate whether caloric vestibular stimulation, a non-invasive form of neuro-modulation, alters the level of awareness in people residing in a minimally conscious state. Single-case ( n = 2), prospective, controlled (ABAB) efficacy study. Tertiary, neuro-rehabilitation inpatient ward within a university hospital. Two individuals in a minimally conscious state. Left ear caloric vestibular stimulation was performed in two four/five-week blocks interleaved with two four/five-week blocks of sham stimulation. Session duration and frequency gradually increased within each block from once per day for 10 minutes (Week 1) to once per day for 20 minutes (Week 2) to 20 minutes twice per day in the remaining weeks. Wessex Head Injury Matrix, JFK Coma Recovery Scale - Revised. Both participants' Wessex Head Injury Matrix scores indicated a transition from involuntary (i.e. mechanical vocalization) to voluntary (i.e. gesture making, selective responses to family members) behaviour that was time-locked to the onset of active stimulation. In one participant, this improvement persisted for at least four weeks after active stimulation, while in the other it diminished two weeks after stimulation. Allied, although less dramatic, changes were seen on the arousal and auditory subscales of the JFK Coma Recovery Scale - Revised. The data provide the first evidence that vestibular stimulation may help improve outcome in a low awareness state, although further studies are needed to replicate effect and determine longer-term benefit.

Coherent structure in solar wind C{sup 6+}/C{sup 4+} ionic composition data during the quiet-sun conditions of 2008

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

Edmondson, J. K.; Lepri, S. T.; Zurbuchen, T. H.

2013-11-20

This analysis offers evidence of characteristic scale sizes in solar wind charge state data measured in situ for 13 quiet-Sun Carrington rotations in 2008. Using a previously established novel methodology, we analyze the wavelet power spectrum of the charge state ratio C{sup 6+}/C{sup 4+} measured in situ by ACE/SWICS for 2 hr and 12 minute cadence. We construct a statistical significance level in the wavelet power spectrum to quantify the interference effects arising from filling missing data in the time series, allowing extraction of significant power from the measured data to a resolution of 24 minutes. We analyze each waveletmore » power spectrum for transient coherency and global periodicities resulting from the superposition of repeating coherent structures. From the significant wavelet power spectra, we find evidence for a general upper limit on individual transient coherency of ∼10 days. We find evidence for a set of global periodicities between 4-5 hr and 35-45 days. We find evidence for the distribution of individual transient coherency scales consisting of two distinct populations. Below the ∼2 day timescale, the distribution is reasonably approximated by an inverse power law, whereas for scales ≳2 days, the distribution levels off, showing discrete peaks at common coherency scales. In addition, by organizing the transient coherency scale distributions by wind type, we find that these larger, common coherency scales are more prevalent and well defined in coronal hole wind. Finally, we discuss the implications of our results for current theories of solar wind generation and describe future work for determining the relationship between the coherent structures in our ionic composition data and the structure of the coronal magnetic field.« less

Effects of the sliding rehabilitation machine on balance and gait in chronic stroke patients - a controlled clinical trial.

PubMed

Byun, Seung-Deuk; Jung, Tae-Du; Kim, Chul-Hyun; Lee, Yang-Soo

2011-05-01

To investigate the effects of a sliding rehabilitation machine on balance and gait in chronic stroke patients. A non-randomized crossover design. Inpatient rehabilitation in a general hospital. Thirty patients with chronic stroke who had medium or high falling risk as determined by the Berg Balance Scale. Participants were divided into two groups and underwent four weeks of training. Group A (n = 15) underwent training with the sliding rehabilitation machine for two weeks with concurrent conventional training, followed by conventional training only for another two weeks. Group B (n = 15) underwent the same training in reverse order. The effect of the experimental period was defined as the sum of changes during training with sliding rehabilitation machine in each group, and the effect of the control period was defined as those during the conventional training only in each group. Functional Ambulation Category, Berg Balance Scale, Six-Minute Walk Test, Timed Up and Go Test, Korean Modified Barthel Index, Modified Ashworth Scale and Manual Muscle Test. Statistically significant improvements were observed in all parameters except Modified Ashworth Scale in the experimental period, but only in Six-Minute Walk Test (P < 0.01) in the control period. There were also statistically significant differences in the degree of change in all parameters in the experimental period as compared to the control period. The sliding rehabilitation machine may be a useful tool for the improvement of balance and gait abilities in chronic stroke patients.

Summary of types of radiation belt electron precipitation observed by BARREL

NASA Astrophysics Data System (ADS)

Halford, Alexa

2016-07-01

The Balloon Array for Relativistic Radiation belt Electron Loss (BARREL) was able to infer precipitation of radiation belt electrons on multiple time scales and due to multiple loss mechanisms. One storm will be specifically highlighted which occurred on 26 January 2013 when a solar wind shock hit the Earth. Although MeV electrons were observed to be lost due to an EMIC wave event [Zhang et al in prep], and multiple periods of electron loss during substorms were observed [Rae et al submitted JGR, Mann et al in prep], we will consider an event period where loss associated with multiple time scales, and thus possibly different loss mechanisms was observed from 1000 - 1200 UT on 26 January 2013. At about 1005 UT on 26 January 2013 an injection of radiation belt electrons followed by drift echoes for energies of ˜80 - 400 keV. BARREL observed X-rays with energies less than 180 keV associated with multiple temporal structures during the drift echo event period. The Van Allen Probes were at similar L-values but upwards of 2 hours away in MLT. Upper band chorus and ULF waves were observed during the event period. Throughout the beginning of the event period, microbursts were clearly observed. During this time lower band chorus waves as well as time domain structures were observed at Van Allen Probe A located upwards of 2 hours away in MLT. This large difference in MLT meant that neither potential loss mechanism was able to be clearly associated with the microbursts. As the lower band chorus and time domain structures were observed to recede, the microbursts were also observed to subside. ULF time scale modulation of the X-rays was also observed throughout most of the event period. We will examine if the ULF waves are the cause of the precipitation themselves, or are modulating the loss of particles from a secondary loss mechanism [Brito et al 2015 JGR, Rae et al Submitted JGR]. Although the 100s ms and ULF time scales are clearly observed, there is an ˜20 minute overarching structure observed in the X-rays at BARREL. This longer time scale appears to match the drift period of the ˜300 keV electrons observed by the Van Allen probes. However the inferred energy of the precipitating electrons is ˜150 keV. It is unclear what may be causing the ˜20 minute structure in the X-rays. At the time of writing this abstract, it is unclear if the drifting of the 300 keV electrons is related to the precipitation of the lower energy electrons (< 180 keV) or if it is just coincidence that they have the same temporal structure.

Design and fabrication of a fixed-bed batch type pyrolysis reactor for pilot scale pyrolytic oil production in Bangladesh

NASA Astrophysics Data System (ADS)

Aziz, Mohammad Abdul; Al-khulaidi, Rami Ali; Rashid, MM; Islam, M. R.; Rashid, MAN

2017-03-01

In this research, a development and performance test of a fixed-bed batch type pyrolysis reactor for pilot scale pyrolysis oil production was successfully completed. The characteristics of the pyrolysis oil were compared to other experimental results. A solid horizontal condenser, a burner for furnace heating and a reactor shield were designed. Due to the pilot scale pyrolytic oil production encountered numerous problems during the plant’s operation. This fixed-bed batch type pyrolysis reactor method will demonstrate the energy saving concept of solid waste tire by creating energy stability. From this experiment, product yields (wt. %) for liquid or pyrolytic oil were 49%, char 38.3 % and pyrolytic gas 12.7% with an operation running time of 185 minutes.

Intermediate Palomar Transient Factory: Realtime Image Subtraction Pipeline

DOE PAGES

Cao, Yi; Nugent, Peter E.; Kasliwal, Mansi M.

2016-09-28

A fast-turnaround pipeline for realtime data reduction plays an essential role in discovering and permitting followup observations to young supernovae and fast-evolving transients in modern time-domain surveys. In this paper, we present the realtime image subtraction pipeline in the intermediate Palomar Transient Factory. By using highperformance computing, efficient databases, and machine-learning algorithms, this pipeline manages to reliably deliver transient candidates within 10 minutes of images being taken. Our experience in using high-performance computing resources to process big data in astronomy serves as a trailblazer to dealing with data from large-scale time-domain facilities in the near future.

Intermediate Palomar Transient Factory: Realtime Image Subtraction Pipeline

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

Cao, Yi; Nugent, Peter E.; Kasliwal, Mansi M.

A fast-turnaround pipeline for realtime data reduction plays an essential role in discovering and permitting followup observations to young supernovae and fast-evolving transients in modern time-domain surveys. In this paper, we present the realtime image subtraction pipeline in the intermediate Palomar Transient Factory. By using highperformance computing, efficient databases, and machine-learning algorithms, this pipeline manages to reliably deliver transient candidates within 10 minutes of images being taken. Our experience in using high-performance computing resources to process big data in astronomy serves as a trailblazer to dealing with data from large-scale time-domain facilities in the near future.

Nebula: reconstruction and visualization of scattering data in reciprocal space.

PubMed

Reiten, Andreas; Chernyshov, Dmitry; Mathiesen, Ragnvald H

2015-04-01

Two-dimensional solid-state X-ray detectors can now operate at considerable data throughput rates that allow full three-dimensional sampling of scattering data from extended volumes of reciprocal space within second to minute time-scales. For such experiments, simultaneous analysis and visualization allows for remeasurements and a more dynamic measurement strategy. A new software, Nebula , is presented. It efficiently reconstructs X-ray scattering data, generates three-dimensional reciprocal space data sets that can be visualized interactively, and aims to enable real-time processing in high-throughput measurements by employing parallel computing on commodity hardware.

Nebula: reconstruction and visualization of scattering data in reciprocal space

PubMed Central

Reiten, Andreas; Chernyshov, Dmitry; Mathiesen, Ragnvald H.

2015-01-01

Two-dimensional solid-state X-ray detectors can now operate at considerable data throughput rates that allow full three-dimensional sampling of scattering data from extended volumes of reciprocal space within second to minute time­scales. For such experiments, simultaneous analysis and visualization allows for remeasurements and a more dynamic measurement strategy. A new software, Nebula, is presented. It efficiently reconstructs X-ray scattering data, generates three-dimensional reciprocal space data sets that can be visualized interactively, and aims to enable real-time processing in high-throughput measurements by employing parallel computing on commodity hardware. PMID:25844083

Printed dose-recording tag based on organic complementary circuits and ferroelectric nonvolatile memories

PubMed Central

Nga Ng, Tse; Schwartz, David E.; Mei, Ping; Krusor, Brent; Kor, Sivkheng; Veres, Janos; Bröms, Per; Eriksson, Torbjörn; Wang, Yong; Hagel, Olle; Karlsson, Christer

2015-01-01

We have demonstrated a printed electronic tag that monitors time-integrated sensor signals and writes to nonvolatile memories for later readout. The tag is additively fabricated on flexible plastic foil and comprises a thermistor divider, complementary organic circuits, and two nonvolatile memory cells. With a supply voltage below 30 V, the threshold temperatures can be tuned between 0 °C and 80 °C. The time-temperature dose measurement is calibrated for minute-scale integration. The two memory bits are sequentially written in a thermometer code to provide an accumulated dose record. PMID:26307438

Spatial and Temporal Extent of Ion Spectral Structures at the Inner Edge of the Plasma Sheet

NASA Astrophysics Data System (ADS)

Ferradas, C.; Reeves, G. D.; Zhang, J.; Spence, H. E.; Kistler, L. M.; Larsen, B.; Skoug, R. M.; Funsten, H. O.

2017-12-01

Several ion spectral structures are observed near the inner edge of the plasma sheet and constitute the signatures of ion drift and loss in the highly dynamic environment of the inner magnetosphere. Their study helps us understand ion access and losses in this region. Several studies have found that these structures vary with geomagnetic activity, local time, and ion species, but their spatial and temporal extent remain undetermined. We use data from the Helium, Oxygen, Proton, and Electron (HOPE) mass spectrometers onboard the Van Allen Probes to analyze the spectral structures in the energy range of 1- 50 keV. HOPE measurements on both Van Allen Probes spacecraft enable us to resolve the extent of these ion structures in space and time. As the structures respond to changes in the convection electric field on a variety of time scales, the lapping of the two spacecraft on time scales of minutes to hours helps determine their spatial and temporal evolution.

Preschoolers' Cognitive Performance Improves Following Massage.

ERIC Educational Resources Information Center

Hart, Sybil; Field, Tiffany; Hernandez-Reif, Maria; Lundy, Brenda

1998-01-01

Effects of massage on preschoolers' cognitive performance were assessed. Preschoolers were given Wechsler Preschool and Primary Scale of Intelligence-Revised subtests before and after receiving 15-minute massage or spending 15 minutes reading stories with the experimenter. Children's performance on Block Design improved following massage, and…

Does increased emergency medical services prehospital time affect patient mortality in rural motor vehicle crashes? A statewide analysis.

PubMed

Gonzalez, Richard P; Cummings, Glenn R; Phelan, Herbert A; Mulekar, Madhuri S; Rodning, Charles B

2009-01-01

Fatality rates from rural vehicular trauma are almost double those found in urban settings. It has been suggested that increased prehospital time is a factor that adversely affects fatality rates in rural vehicular trauma. By linking and analyzing Alabama's statewide prehospital data, emergency medical services (EMS) prehospital time was assessed for rural and urban vehicular crashes. An imputational methodology permitted linkage of data from police motor vehicle crash (MVC) and EMS records. MVCs were defined as rural or urban by crash location using the United States Census Bureau criteria. Areas within Alabama that fell outside the Census Bureau definition of urban were defined as rural. Prehospital data were analyzed to determine EMS response time, scene time, and transport time in rural and urban settings. Over a 2-year period from January 2001 through December 2002, data were collected from EMS Patient Care Reports and police crash reports for the entire state of Alabama. By using an imputational methodology and join specifications, 45,763 police crash reports were linked to EMS Patient Care Reports. Of these, 34,341 (75%) were injured in rural settings and 11,422 (25%) were injured in urban settings. A total of 714 mortalities were identified, of which 611 (1.78%) occurred in rural settings and 103 (.90%) occurred in urban settings (P < .0001). When mortalities occurred, the mean EMS response time in rural settings was 10.67 minutes and 6.50 minutes in urban settings (P < .0001). When mortalities occurred, the mean EMS scene time in rural settings was 18.87 minutes and 10.83 minutes in urban settings (patients who were dead on scene and extrication patients were excluded from both settings) (P < .0001). When mortalities occurred, the mean EMS transport time in rural settings was 12.45 minutes and 7.43 minutes in urban settings (P < .0001). When mortalities occurred, the overall mean prehospital time in rural settings was 42.0 minutes and 24.8 minutes in urban settings (P < .0001). The mean EMS response time for rural MVCs with survivors was 8.54 minutes versus a mean of 10.67 minutes with mortalities (P < .0001). The mean EMS scene time for rural MVCs with survivors was 14.81 minutes versus 18.87 minutes with mortalities (patients who were dead on scene and extrication patients were excluded) (P = .0014). Based on this statewide analysis of MVCs, increased EMS prehospital time appears to be associated with higher mortality rates in rural settings.

Atmospheres

NASA Astrophysics Data System (ADS)

Bott, June; Yin, Hongbin; Sridhar, Seetharaman

2014-12-01

When high Al containing Fe alloys such as TRIP steels are exposed to atmospheres that contain N2 during re-heating, sub-surface nitrides form and these can be detrimental to mechanical properties. Nitride precipitation can be controlled by minimizing the access of the gaseous atmosphere to the metal surface, which can be achieved by a rapid growth of a continuous and adherent surface scale. This investigation utilizes a Au-image furnace attached to a confocal scanning microscope to simulate the annealing temperature vs time while Fe-Al alloys (with Al contents varying from 1 to 8 wt pct) are exposed to a O2-N2 atm with 10-6 atm O2. The heating times of 1, 10, and 100 minutes to the isothermal temperature of 1558 K (1285 °C) were used. It was found that fewer sub-surface nitride precipitates formed when the heating time was lowered and when Al content in the samples was increased. In the 8 wt pct samples, no internal nitride precipitates were present regardless of heating time. In the 3 and 5 wt pct samples, internal nitride precipitates were nearly more or less absent at heating times less than 10 minutes. The decrease in internal precipitates was governed by the evolving structure of the external oxide-scale. At low heating rates and/or low Al contents, significant Fe-oxide patches formed and these appeared to allow for ingress of gaseous N2. For the slow heating rates, ingress could have happened during the longer time spent in lower temperatures where non-protective alumina was present. As Al content in the alloy was increased, the external scale was Al2O3 and/or FeAl2O4 and more continuous and consequently hindered the N2 from accessing the metal surface. Increasing the Al content in the alloy had the effect of promoting the outward diffusion of Al in the alloy and thereby assisting the formation of the continuous external layer of Al2O3 and/or FeAl2O4.

Analysis and stochastic modelling of Intensity-Duration-Frequency relationship from 88 years of 10 min rainfall data in North Spain

NASA Astrophysics Data System (ADS)

Delgado, Oihane; Campo-Bescós, Miguel A.; López, J. Javier

2017-04-01

Frequently, when we are trying to solve certain hydrological engineering problems, it is often necessary to know rain intensity values related to a specific probability or return period, T. Based on analyses of extreme rainfall events at different time scale aggregation, we can deduce the relationships among Intensity-Duration-Frequency (IDF), that are widely used in hydraulic infrastructure design. However, the lack of long time series of rainfall intensities for smaller time periods, minutes or hours, leads to use mathematical expressions to characterize and extend these curves. One way to deduce them is through the development of synthetic rainfall time series generated from stochastic models, which is evaluated in this work. From recorded accumulated rainfall time series every 10 min in the pluviograph of Igueldo (San Sebastian, Spain) for the time period between 1927-2005, their homogeneity has been checked and possible statistically significant increasing or decreasing trends have also been shown. Subsequently, two models have been calibrated: Bartlett-Lewis and Markov chains models, which are based on the successions of storms, composed for a series of rainfall events, separated by a short interval of time each. Finally, synthetic ten-minute rainfall time series are generated, which allow to estimate detailed IDF curves and compare them with the estimated IDF based on the recorded data.

From door-to-balloon time to contact-to-device time: predictors of achieving target times in patients with ST-elevation myocardial infarction.

PubMed

Roswell, Robert O; Greet, Brian; Parikh, Parin; Mignatti, Andrea; Freese, John; Lobach, Iryna; Guo, Yu; Keller, Norma; Radford, Martha; Bangalore, Sripal

2014-07-01

The 2013 American College of Cardiology Foundation/American Heart Association ST-segment elevation myocardial infarction (STEMI) guidelines have shifted focus from door-to-balloon (D2B) time to the time from first medical contact to device activation (contact-to-device time [C2D] ). This study investigates the impact of prehospital wireless electrocardiogram transmission (PHT) on reperfusion times to assess the impact of the new guidelines. From January 2009 to December 2012, data were collected on STEMI patients who received percutaneous coronary interventions; 245 patients were included for analysis. The primary outcome was median C2D time in the PHT group and the secondary outcome was D2B time. Prehospital wireless electrocardiogram transmission was associated with reduced C2D times vs no PHT: 80 minutes (interquartile range [IQR], 64-94) vs 96 minutes (IQR, 79-118), respectively, P < 0.0001. The median D2B time was lower in the PHT group vs the no-PHT group: 45 minutes (IQR, 34-56) vs 63 minutes (IQR, 49-81), respectively, P < 0.0001. Multivariate analysis showed PHT to be the strongest predictor of a C2D time of <90 minutes (odds ratio: 3.73, 95% confidence interval: 1.65-8.39, P = 0.002). Female sex was negatively predictive of achieving a C2D time <90 minutes (odds ratio: 0.23, 95% confidence interval: 0.07-0.73, P = 0.01). In STEMI patients, PHT was associated with significantly reduced C2D and D2B times and was an independent predictor of achieving a target C2D time. As centers adapt to the new guidelines emphasizing C2D time, targeting a shorter D2B time (<50 minutes) is ideal to achieve a C2D time of <90 minutes. © 2014 Wiley Periodicals, Inc.

The effects of a home-based arm ergometry exercise programme on physical fitness, fatigue and activity in Polio survivors: a randomised controlled trial.

PubMed

Murray, D; Hardiman, O; Campion, A; Vance, R; Horgan, F; Meldrum, D

2017-07-01

To investigate the effect of an eight-week home-based arm ergometry aerobic exercise programme on physical fitness, fatigue, activity and quality of life in Polio Survivors. An assessor blinded randomised controlled trial. Home-based exercise. Fifty-five Polio survivors randomised to exercise or control groups. Home-based arm ergometry at an intensity of 50%-70% maximum heart rate, compared with usual physiotherapy care. The Six-minute Arm Test, Fatigue Severity Scale, Physical Activity Scale for Individuals with Physical Disabilities and SF-36. Assessments were completed at baseline and at eight weeks. There was no significant difference in the primary outcome, exercising heart rate during the Six-minute Arm Test, between the groups at follow-up [97.6 (SD10.1) compared to 102.4 (SD13.7) beats per minute ( P=0.20)]. Blood pressure was significantly lower in the intervention group at follow-up [systolic blood pressure 132(18.6)mmHg compared to 144.1(14.6)mmHg ( P=0.002)]. There were no between group differences in the Fatigue Severity Scale ( P=0.25) or Physical Activity Scale for Individuals with Physical Disabilities ( P=0.49), with a small difference in SF-36 physical component score ( P=0.04). This home-based arm ergometry programme successfully facilitated aerobic exercise in Polio Survivors, but did not result in a significant change in physical fitness, measured by the Six-minute Arm Test.

Fast laboratory-based micro-computed tomography for pore-scale research: Illustrative experiments and perspectives on the future

NASA Astrophysics Data System (ADS)

Bultreys, Tom; Boone, Marijn A.; Boone, Matthieu N.; De Schryver, Thomas; Masschaele, Bert; Van Hoorebeke, Luc; Cnudde, Veerle

2016-09-01

Over the past decade, the wide-spread implementation of laboratory-based X-ray micro-computed tomography (micro-CT) scanners has revolutionized both the experimental and numerical research on pore-scale transport in geological materials. The availability of these scanners has opened up the possibility to image a rock's pore space in 3D almost routinely to many researchers. While challenges do persist in this field, we treat the next frontier in laboratory-based micro-CT scanning: in-situ, time-resolved imaging of dynamic processes. Extremely fast (even sub-second) micro-CT imaging has become possible at synchrotron facilities over the last few years, however, the restricted accessibility of synchrotrons limits the amount of experiments which can be performed. The much smaller X-ray flux in laboratory-based systems bounds the time resolution which can be attained at these facilities. Nevertheless, progress is being made to improve the quality of measurements performed on the sub-minute time scale. We illustrate this by presenting cutting-edge pore scale experiments visualizing two-phase flow and solute transport in real-time with a lab-based environmental micro-CT set-up. To outline the current state of this young field and its relevance to pore-scale transport research, we critically examine its current bottlenecks and their possible solutions, both on the hardware and the software level. Further developments in laboratory-based, time-resolved imaging could prove greatly beneficial to our understanding of transport behavior in geological materials and to the improvement of pore-scale modeling by providing valuable validation.

Intraperitoneal pressure and volume of gas injected as effective parameters of the correct position of the Veress needle during creation of pneumoperitoneum.

PubMed

Azevedo, João L M C; Azevedo, Otavio C; Sorbello, Albino A; Becker, Otavio M; Hypolito, Otavio; Freire, Dalmer; Miyahira, Susana; Guedes, Afonso; Azevedo, Glicia C

2009-12-01

The aim of this work was to establish reliable parameters of the correct position of the Veress needle in the peritoneal cavity during creation of pneumoperitoneum. The Veress needle was inserted into the peritoneal cavity of 100 selected patients, and a carbon-dioxide flow rate of 1.2 L/min and a maximum pressure of 12 mm Hg were established. Intraperitoneal pressure (IP) and the volume of gas injected (VG) were recorded at the beginning of insufflation and at every 20 seconds. Correlations were established for pressure and volume in function of time. Values of IP and VG were predicted at 1, 2, 3, and 4 minutes of insufflation, by applying the following formulas: IP = 2.3083 + 0.0266 x time +8.3 x 10(-5) x time(2) - 2.44 x 10(-7) x time(3); and VG = 0.813 + 0.0157 x time. A strong correlation was observed between IP and preestablished time points during creation of the pneumoperitoneum, as well as between VG and preestablished time points during creation of the pneumoperitoneum, with a coefficient of determination of 0.8011 for IP and of 0.9604 for VG. The predicted values were as follows: 1 minute = 4.15; 2 minutes = 6.27; 3 minutes = 8.36; and 4 minutes = 10.10 for IP (mm Hg); and 1 minute = 1.12; 2 minutes = 2.07; 3 minutes = 3.01; and 4 minutes = 3.95 for VG (L). Values of IP and VG at given time points during insufflation for creation of the pneumoperitoneum, using the Veress needle, can be effective parameters to determine whether the needle is correctly positioned in the peritoneal cavity.

Saline Flush After Rocuronium Bolus Reduces Onset Time and Prolongs Duration of Effect: A Randomized Clinical Trial.

PubMed

Ishigaki, Sayaka; Masui, Kenichi; Kazama, Tomiei

2016-03-01

Circulatory factors modify the onset time of neuromuscular-blocking drugs. Therefore, we hypothesized that infusion of a saline flush immediately after rocuronium administration would shorten the onset time without influencing the duration of the rocuronium effect. Forty-eight patients were randomly allocated to the control or saline flush group. Anesthesia was induced and maintained with propofol and remifentanil, and all patients received 0.6 mg/kg rocuronium in 10 mL of normal saline. In the saline flush group, 20 mL normal saline was immediately infused after rocuronium administration. Neuromuscular blockade was assessed using acceleromyography at the adductor pollicis muscle with train-of-four (TOF) stimulation. The neuromuscular indices for rocuronium were calculated as follows: the latent onset time, defined as the time from the start of rocuronium infusion until first occurrence of depression of the first twitch of the TOF (T1) ≥5%; onset time, defined as the time from the start of rocuronium infusion until first occurrence of depression of the T1 ≥95%; clinical duration, defined as the time from the start of rocuronium administration until T1 recovered to 25% of the final T1 value; recovery index, defined as the time for recovery of T1 from 25% to 75% of the final T1 value; and the total recovery time, defined as the time from the start of rocuronium administration until reaching a TOF ratio of 0.9. Significance was designated at P <0.05. The measured latent onset time and onset time were significantly shorter in the saline flush group than the control group by 15 seconds (95.2% confidence interval, 0-15, P = 0.007) and 15 seconds (0-30, P = 0.018), respectively. Saline flush significantly depressed the T1 height at 30, 45, and 60 seconds after the rocuronium bolus by 17%, 24%, and 14%, respectively. In addition, the recovery phase was significantly prolonged in the saline flush group. The mean clinical duration (5th-95th percentile range) in the saline flush group and control group was 35 minutes (27-63 minutes) and 31 minutes (19-48 minutes; P = 0.032), respectively; the recovery index was 13 minutes (8-25 minutes) and 10 minutes (7-19 minutes; P = 0.019), respectively; and the total recovery time was 61 minutes (44-108 minutes) and 50 minutes (35-93 minutes; P = 0.048), respectively. Administering a 20-mL saline flush immediately after infusion of 0.6 mg/kg rocuronium in 10 mL normal saline shortened the onset time and prolonged the recovery phase of neuromuscular blockade.

Physiologic variability at the verge of systemic inflammation: multi-scale entropy of heart rate variability is affected by very low doses of endotoxin

PubMed Central

Herlitz, Georg N.; Sanders, Renee L.; Cheung, Nora H.; Coyle, Susette M.; Griffel, Benjamin; Macor, Marie A.; Lowry, Stephen F.; Calvano, Steve E.; Gale, Stephen C.

2014-01-01

Introduction Human injury or infection induces systemic inflammation with characteristic neuro-endocrine responses. Fluctuations in autonomic function during inflammation are reflected by beat-to-beat variation in heart rate, termed heart rate variability (HRV). In the present study, we determine threshold doses of endotoxin needed to induce observable changes in markers of systemic inflammation, we investigate whether metrics of HRV exhibit a differing threshold dose from other inflammatory markers, and we investigate the size of data sets required for meaningful use of multi-scale entropy (MSE) analysis of HRV. Methods Healthy human volunteers (n=25) were randomized to receive placebo (normal saline) or endotoxin/lipopolysaccharide (LPS): 0.1, 0.25, 0.5, 1.0, or 2.0 ng/kg administered intravenously. Vital signs were recorded every 30 minutes for 6 hours and then at 9, 12, and 24 hours after LPS. Blood samples were drawn at specific time points for cytokine measurements. HRV analysis was performed using EKG epochs of 5 minutes. MSE for HRV was calculated for all dose groups to scale factor 40. Results The lowest significant threshold dose was noted in core temperature at 0.25ng/kg. Endogenous TNF-α and IL-6 were significantly responsive at the next dosage level (0.5ng/kg) along with elevations in circulating leukocytes and heart rate. Responses were exaggerated at higher doses (1 and 2 ng/kg). Time domain and frequency domain HRV metrics similarly suggested a threshold dose, differing from placebo at 1.0 and 2.0 ng/kg, below which no clear pattern in response was evident. By applying repeated-measures ANOVA across scale factors, a significant decrease in MSE was seen at 1.0 and 2.0 ng/kg by 2 hours post exposure to LPS. While not statistically significant below 1.0 ng/kg, MSE unexpectedly decreased across all groups in an orderly dose-response pattern not seen in the other outcomes. Conclusions By usingrANOVA across scale factors, MSE can detect autonomic change after LPS challenge in a group of 25 subjects using EKG epochs of only 5 minutes and entropy analysis to scale factor of only 40, potentially facilitating MSE’s wider use as a research tool or bedside monitor. Traditional markers of inflammation generally exhibit threshold dose behavior. In contrast, MSE’s apparent continuous dose-response pattern, while not statistically verifiable in this study, suggests a potential subclinical harbinger of infectious or other insult. The possible derangement of autonomic complexity prior to or independent of the cytokine surge cannot be ruled out. Future investigation should focus on confirmation of overt inflammation following observed decreases in MSE in a clinical setting. PMID:25526373

Does acetaminophen/hydrocodone affect cold pulpal testing in patients with symptomatic irreversible pulpitis? A prospective, randomized, double-blind, placebo-controlled study.

PubMed

Fowler, Sara; Fullmer, Spencer; Drum, Melissa; Reader, Al

2014-12-01

The purpose of this prospective randomized, double-blind, placebo-controlled study was to determine the effects of a combination dose of 1000 mg acetaminophen/10 mg hydrocodone on cold pulpal testing in patients experiencing symptomatic irreversible pulpitis. One hundred emergency patients in moderate to severe pain diagnosed with symptomatic irreversible pulpitis of a mandibular posterior tooth randomly received, in a double-blind manner, identical capsules of either a combination of 1000 mg acetaminophen/10 hydrocodone or placebo. Cold testing with Endo-Ice (1,1,1,2 tetrafluoroethane; Hygenic Corp, Akron, OH) was performed at baseline and every 10 minutes for 60 minutes. Pain to cold testing was recorded by the patient using a Heft-Parker visual analog scale. Patients' reaction to the cold application was also rated. Cold testing at baseline and at 10 minutes resulted in severe pain for both the acetaminophen/hydrocodone and placebo groups. Although pain ratings decreased from 20-60 minutes, the ratings still resulted in moderate pain. Patient reaction to cold testing showed that 56%-62% had a severe reaction. Although the reactions decreased in severity over the 60 minutes, 20%-34% still had severe reactions at 60 minutes. Regarding pain and patients' reactions to cold testing, there were no significant differences between the combination acetaminophen/hydrocodone and placebo groups at any time period. A combination dose of 1000 mg of acetaminophen/10 mg of hydrocodone did not statistically affect cold pulpal testing in patients presenting with symptomatic irreversible pulpitis. Patients experienced moderate to severe pain and reactions to cold testing. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Efficacy and Tolerability of Indiplon in Transient Insomnia

PubMed Central

Rosenberg, Russell; Roth, Thomas; Scharf, Martin B.; Lankford, D. Alan; Farber, Robert

2007-01-01

Objectives: The efficacy of indiplon was evaluated by polysomnography (PSG) in an experimental model of transient insomnia consisting of the first night effect combined with a 2-hour phase advance. Methods: Healthy volunteers age 21–64 years (N=593; 62% female; mean (± SEM) years, 32±0.39) were randomized to double-blind treatment with a single nighttime dose of indiplon (10 mg or 20 mg) or placebo. PSG assessments included latency to persistent sleep (LPS, primary endpoint) and total sleep time (TST); self-report assessments included sleep quality (SQ); next day residual effects were evaluated by the Digit Symbol Substitution Test (DSST), Symbol Copying Test (SCT), and a Visual Analog Scale of sleepiness (VAS). Results: LPS mean (± SEM) values were significantly reduced on indiplon 10 mg (21.2±1.5 minutes) and indiplon 20 mg (16.8±1.1 minutes) compared to placebo (33.1±2.5minutes; p <0.0001 for both comparisons to placebo). TST mean (± SEM) values were significantly increased on indiplon 10 mg (414.5±3.9 minutes) and indiplon 20 mg (423.5±3.1 minutes) compared to placebo (402.9±3.9 minutes; p <0.005 for the 10 mg dose; p <0.0001 for the 20 mg dose). SQ was also significantly improved on both doses. There were no differences between indiplon and placebo on next day DSST, SCT, or VAS. Conclusions: Indiplon was effective in inducing sleep, increasing sleep duration, and improving overall sleep quality without next day residual effects in healthy volunteers in a model of transient insomnia. Citation: Rosenberg R; Roth T; Scharf MB et al. Efficacy and tolerability of indiplon in transient insomnia. J Clin Sleep Med 2007;3(4):374-379. PMID:17694726

Resuscitation quality of rotating chest compression providers at one-minute vs. two-minute intervals: A mannequin study.

PubMed

Kılıç, D; Göksu, E; Kılıç, T; Buyurgan, C S

2018-05-01

The aim of this randomized cross-over study was to compare one-minute and two-minute continuous chest compressions in terms of chest compression only CPR quality metrics on a mannequin model in the ED. Thirty-six emergency medicine residents participated in this study. In the 1-minute group, there was no statistically significant difference in the mean compression rate (p=0.83), mean compression depth (p=0.61), good compressions (p=0.31), the percentage of complete release (p=0.07), adequate compression depth (p=0.11) or the percentage of good rate (p=51) over the four-minute time period. Only flow time was statistically significant among the 1-minute intervals (p<0.001). In the 2-minute group, the mean compression depth (p=0.19), good compression (p=0.92), the percentage of complete release (p=0.28), adequate compression depth (p=0.96), and the percentage of good rate (p=0.09) were not statistically significant over time. In this group, the number of compressions (248±31 vs 253±33, p=0.01) and mean compression rates (123±15 vs 126±17, p=0.01) and flow time (p=0.001) were statistically significant along the two-minute intervals. There was no statistically significant difference in the mean number of chest compressions per minute, mean chest compression depth, the percentage of good compressions, complete release, adequate chest compression depth and percentage of good compression between the 1-minute and 2-minute groups. There was no statistically significant difference in the quality metrics of chest compressions between 1- and 2-minute chest compression only groups. Copyright © 2017 Elsevier Inc. All rights reserved.

Solar Mean Magnetic Field Observed by GONG

NASA Astrophysics Data System (ADS)

Harvey, J. W.; Petrie, G.; Clark, R.; GONG Team

2009-05-01

The average line-of-sight (LOS) magnetic field of the Sun has been observed for decades, either by measuring the circular polarization across a selected spectrum line using integrated sunlight or by averaging such measurements in spatially resolved images. The GONG instruments produce full-disk LOS magnetic images every minute, which can be averaged to yield the mean magnetic field nearly continuously. Such measurements are well correlated with the heliospheric magnetic field observed near Earth about 4 days later. They are also a measure of solar activity on long and short time scales. Averaging a GONG magnetogram, with nominal noise of 3 G per pixel, results in a noise level of about 4 mG. This is low enough that flare-related field changes have been seen in the mean field signal with time resolution of 1 minute. Longer time scales readily show variations associated with rotation of magnetic patterns across the solar disk. Annual changes due to the varying visibility of the polar magnetic fields may also be seen. Systematic effects associated with modulator non-uniformity require correction and limit the absolute accuracy of the GONG measurements. Comparison of the measurements with those from other instruments shows high correlation but suggest that GONG measurements of field strength are low by a factor of about two. The source of this discrepancy is not clear. Fourier analysis of 2007 and 2008 time series of the GONG mean field measurements shows strong signals at 27.75 and 26.84/2 day (synodic) periods with the later period showing more power. The heliospheric magnetic field near Earth shows the same periods but with reversed power dominance. The Global Oscillation Network Group (GONG) project is managed by NSO, which is operated by AURA, Inc. under a cooperative agreement with the National Science Foundation.

Making long-term memories in minutes: a spaced learning pattern from memory research in education

PubMed Central

Kelley, Paul; Whatson, Terry

2013-01-01

Memory systems select from environmental stimuli those to encode permanently. Repeated stimuli separated by timed spaces without stimuli can initiate Long-Term Potentiation (LTP) and long-term memory (LTM) encoding. These processes occur in time scales of minutes, and have been demonstrated in many species. This study reports on using a specific timed pattern of three repeated stimuli separated by 10 min spaces drawn from both behavioral and laboratory studies of LTP and LTM encoding. A technique was developed based on this pattern to test whether encoding complex information into LTM in students was possible using the pattern within a very short time scale. In an educational context, stimuli were periods of highly compressed instruction, and spaces were created through 10 min distractor activities. Spaced Learning in this form was used as the only means of instruction for a national curriculum Biology course, and led to very rapid LTM encoding as measured by the high-stakes test for the course. Remarkably, learning at a greatly increased speed and in a pattern that included deliberate distraction produced significantly higher scores than random answers (p < 0.00001) and scores were not significantly different for experimental groups (one hour spaced learning) and control groups (four months teaching). Thus learning per hour of instruction, as measured by the test, was significantly higher for the spaced learning groups (p < 0.00001). In a third condition, spaced learning was used to replace the end of course review for one of two examinations. Results showed significantly higher outcomes for the course using spaced learning (p < 0.0005). The implications of these findings and further areas for research are briefly considered. PMID:24093012

Canine ovariectomy by hybrid or total natural orifice transluminal endoscopic surgery: technical feasibility study and pain assessment.

PubMed

Linhares, Marcella Teixeira; Feranti, João Pedro Scussel; Coradini, Gabriela Pesamosca; Martins, Letícia Reginato; Martins, Arthur Rodrigues; Sarturi, Vanessa Zanchi; Gavioli, Felipe Baldissarella; Machado Silva, Marco Augusto; de Ataíde, Michelli Westphal; Teixeira, Luciana Gonçalves; Brun, Maurício Veloso

2018-06-13

To compare technical feasibility, surgical time, surgical complications, and postoperative pain in ovariectomy (OVE) by hybrid and total natural orifice transluminal endoscopic surgery (NOTES). Prospective randomized clinical trial. Sixteen healthy and sexually intact bitches. Dogs were randomly assigned to the hybrid NOTES group (HNG; n = 8) and the total NOTES group (TNG; n = 8) to compare surgical time, pain scores and complications. Pain was assessed by using the visual analog scale (VAS) and the Melbourne pain scale (MPS). Surgical time did not differ between the experimental groups (HNG = 46.3 ± 18.5 minutes, TNG = 54.6 ± 31.1 minutes). Exteriorization of the ovaries through the vaginal wound was the major difficulty. Complications were minor in both groups and occurred intraoperatively only in the HNG, and in both groups post operatively. No dogs required rescue analgesia in the intraoperative or postoperative period. There were no differences in VAS or MPS scores between the groups for any surgical times except for the VAS assessment at 72 hours after extubation (HNG = 1.1 ± 0.3, TNG = 0.7 ± 0.4, P = .0221). Both NOTES techniques were comparable for canine OVE, with no requirement for additional analgesia in the postoperative periods. It was not possible to determine whether there was a clear advantage of one technique rather than the other. The minimally invasive techniques proposed for laparoscopic OVE are feasible for dogs with low pain scores and low rates of complications for both groups. © 2018 The American College of Veterinary Surgeons.

Intrinsic vs. spurious long-range memory in high-frequency records of environmental radioactivity - Critical re-assessment and application to indoor 222Rn concentrations from Coimbra, Portugal

NASA Astrophysics Data System (ADS)

Donner, Reik V.; Potirakis, Stelios M.; Barbosa, Susana M.; Matos, Jose A. O.

2015-04-01

The presence or absence of long-range correlations in environmental radioactivity fluctuations has recently attracted considerable interest. Among a multiplicity of practically relevant applications, identifying and disentangling the environmental factors controlling the variable concentrations of the radioactive noble gas Radon is important for estimating its effect on human health and the efficiency of possible measures for reducing the corresponding exposition. In this work, we present a critical re-assessment of a multiplicity of complementary methods that have been previously applied for evaluating the presence of long-range correlations and fractal scaling in environmental Radon variations with a particular focus on the specific properties of the underlying time series. As an illustrative case study, we subsequently re-analyze two high-frequency records of indoor Radon concentrations from Coimbra, Portugal, each of which spans several months of continuous measurements at a high temporal resolution of five minutes. Our results reveal that at the study site, Radon concentrations exhibit complex multi-scale dynamics with qualitatively different properties at different time-scales: (i) essentially white noise in the high-frequency part (up to time-scales of about one hour), (ii) spurious indications of a non-stationary, apparently long-range correlated process (at time scales between hours and one day) arising from marked periodic components probably related to tidal frequencies, and (iii) low-frequency variability indicating a true long-range dependent process, which might be dominated by a response to meteorological drivers. In the presence of such multi-scale variability, common estimators of long-range memory in time series are necessarily prone to fail if applied to the raw data without previous separation of time-scales with qualitatively different dynamics. We emphasize that similar properties can be found in other types of geophysical time series (for example, tide gauge records), calling for a careful application of time series analysis tools when studying such data.

3-D structure of ionospheric anomalies immediately before large earthquakes: the 2015 Illapel (Mw8.3) and 2016 Kumamoto (Mw7.0) cases

NASA Astrophysics Data System (ADS)

Heki, K.; He, L.; Muafiry, I. N.

2016-12-01

We developed a simple program to perform three-dimensional (3-D) tomography of ionospheric anomalies observed using Global Navigation Satellite System (GNSS), and applied it for cases of ionospheric anomalies prior to two recent earthquakes, i.e. (1) positive and negative TEC anomalies starting 20 minutes before the 2015 September Illapel earthquake, Central Chile, and (2) stagnant MSTID that appeared 20-30 minutes before the 2016 April Kumamoto earthquake (mainshock), Kyushu, SW Japan, and stayed there until the earthquake occurred. Regarding (1), we analyzed GNSS data before and after three large earthquakes in Chile, and have reported that both positive and negative anomalies of ionospheric Total Electron Content (TEC) started 40 minutes (2010 Maule) and 20 minutes (2014 Iquique and 2015 Illapel) before earthquakes in He and Heki (2016 GRL). For the 2015 event, we further suggested that positive and negative anomalies occurred at altitudes of 200 and 400 km, respectively. This makes the epicenter, the positive anomaly, and the negative anomaly line up along the local geomagnetic field, consistent with the structure expected to occur in response to surface positive charges (e.g. Kuo et al., 2014 JGR). As for (2), we looked for ionospheric anomalies before the foreshock (Mw6.2) and the mainshock (Mw7.0) of the 2016 Kumamoto earthquakes, shallow inland earthquakes, using TEC derived from the Japanese dense GNSS network. Although we did not find anomalies as often seen before larger earthquakes (e.g. Heki and Enomoto, 2015 JGR), we found that a stationary linear positive TEC anomaly, with a shape similar to a night-time medium-scale traveling ionospheric disturbance (MSTID), emerged just above the epicenter 20 minutes before the mainshock. Unlike typical night-time MSTID, it did not propagate southwestward; instead, its positive crest stayed above the epicenter for 30 min. (see attached figure). This unusual behavior might be linked to crust-origin electric fields.

Posterior Bilateral Intermuscular Approach for Upper Cervical Spine Injuries.

PubMed

Xu, Yong; Xiong, Wei; Han, Sung I I; Fang, Zhong; Li, Feng

2017-08-01

To investigate a novel intermuscular surgical approach for posterior upper cervical spine fixation. Twenty-three healthy volunteers underwent magnetic resonance imaging. By using the magnetic resonance imaging scans in transverse view at the level of lower edge of atlas, the distances from the posterior midline to lateral margin of trapezius, to the medial margin of splenius capitis, and to middle line of semispinalis capitis were recorded. The angle between posterior middle line and the line crossing the lateral margin of trapezius and middle point of ipsilateral pedicles. From October 2009 to May 2013, 12 patients with upper cervical spine injuries were operated via the bilateral intermuscular approach. The time required for surgery, blood loss, and pre- and postoperative visual analogue scale scores were analyzed. The average distance of 0-T was 39.2 ± 7.5 mm, the angle between the approach and posterior middle line was 33.2 ± 8.4°. The surgical time was 78.3 ± 22.5 minutes (45-140 minutes), and the mean intraoperative blood loss was 87.5 ± 44.2 mL (30-200 mL). Preoperative and postoperative visual analogue scale scores were 6.4 ± 0.8 and 1.8 ± 0.7, respectively. The average follow-up time was 19.7 ± 11.5 months (9-48 months). The posterior bilateral intermuscular approach for upper cervical spine injuries is a valid alternative for Hangmans' fractures type I, type II, and type Ia according to Levine and Edwards classification as well as atlantoaxial subluxation caused by upper cervical spine trauma. Copyright © 2017 Elsevier Inc. All rights reserved.

Continuous wind measurement in the tropical Pacific using VHF radars

NASA Technical Reports Server (NTRS)

Balsley, B. B.; Ecklund, W. L.; Carter, D. A.

1986-01-01

Very High Frequency (VHF) Radar Wind Profilers are being installed on Ponape, East Caroline Islands and Christmas Island, Republic of Kiribati to continuously monitor winds aloft. The purpose of this experiment is to study wind fluctuations on time scales between minutes and days, to determine the longitudinal character of these fluctuations, and to examine their relationship to climate variability. Six-hourly wind profiles will be provided via satellite to the scientific community for Project TOGA (Tropical Ocean Global Atmosphere).

Evolution of proto-neutron stars with quarks.

PubMed

Pons, J A; Steiner, A W; Prakash, M; Lattimer, J M

2001-06-04

Neutrino fluxes from proto-neutron stars with and without quarks are studied. Observable differences become apparent after 10-20 s of evolution. Sufficiently massive stars containing negatively charged, strongly interacting, particles collapse to black holes during the first minute of evolution. Since the neutrino flux vanishes when a black hole forms, this is the most obvious signal that quarks (or other types of strange matter) have appeared. The metastability time scales for stars with quarks are intermediate between those containing hyperons and kaon condensates.

Challenges of correlating pH change with relief of clinical symptoms in gastro esophageal reflux disease: a phase III, randomized study of Zegerid versus Losec.

PubMed

Walker, Dave; Ng Kwet Shing, Richard; Jones, Deborah; Gruss, Hans-Jurgen; Reguła, Jarosław

2015-01-01

Zegerid (on demand immediate-release omeprazole and sodium bicarbonate combination therapy) has demonstrated earlier absorption and more rapid pH change compared with Losec (standard enteric coated omeprazole), suggesting more rapid clinical relief of heartburn. This Phase III, multicenter, double-blind, double-dummy, randomized study assessed the clinical superiority of Zegerid versus Losec for rapid relief of heartburn associated with gastro-esophageal reflux disease (GERD). Patients with a history of frequent (2 3 days/week) uncomplicated GERD, were randomized to receive Zegerid (20 mg) or Losec (20 mg) with corresponding placebo. Study medication was self-administered on the first episode of heartburn, and could be taken for up to 3 days within a 14 day study period. Heartburn severity was self assessed up to 180 minutes post dose (9 point Likert scale). Primary endpoint was median time to sustained response (≥3 point reduction in heartburn severity for ≥45 minutes). Of patients randomized to Zegerid (N=122) or Losec (N=117), 228/239 had recorded ≥1 evaluable heartburn episodes and were included in the modified intent-to-treat population. No significant between-group differences were observed for median time to sustained response (60.0 vs. 52.2 minutes, Zegerid [N=117] and Losec [N=111], respectively), sustained partial response (both, 37.5 minutes) and sustained total relief (both, 105 minutes). Significantly more patients treated with Zegerid reached sustained total relief within 0-30 minutes post dose in all analysis sets (p<0.05). Both treatments were well tolerated and did not raise any safety concerns. Superiority of Zegerid over Losec for rapid heartburn relief was not demonstrated; both treatments were equally effective however the rapid onset of action of Losec was unexpected. Factors, including aspects of study design may have contributed to this. This study supports previously reported difficulty in correlating intra-gastric pH change with clinical effect in GERD therapy, highlighting the significance of several technical considerations for studies of this type. ClinicalTrials.gov NCT01493089.

Challenges of Correlating pH Change with Relief of Clinical Symptoms in Gastro Esophageal Reflux Disease: A Phase III, Randomized Study of Zegerid versus Losec

PubMed Central

Walker, Dave; Ng Kwet Shing, Richard; Jones, Deborah; Gruss, Hans-Jurgen; Reguła, Jarosław

2015-01-01

Background Zegerid (on demand immediate-release omeprazole and sodium bicarbonate combination therapy) has demonstrated earlier absorption and more rapid pH change compared with Losec (standard enteric coated omeprazole), suggesting more rapid clinical relief of heartburn. This Phase III, multicenter, double-blind, double-dummy, randomized study assessed the clinical superiority of Zegerid versus Losec for rapid relief of heartburn associated with gastro-esophageal reflux disease (GERD). Methods Patients with a history of frequent (2 3 days/week) uncomplicated GERD, were randomized to receive Zegerid (20mg) or Losec (20mg) with corresponding placebo. Study medication was self-administered on the first episode of heartburn, and could be taken for up to 3 days within a 14 day study period. Heartburn severity was self assessed up to 180 minutes post dose (9 point Likert scale). Primary endpoint was median time to sustained response (≥3 point reduction in heartburn severity for ≥45 minutes). Results Of patients randomized to Zegerid (N=122) or Losec (N=117), 228/239 had recorded ≥1 evaluable heartburn episodes and were included in the modified intent-to-treat population. No significant between-group differences were observed for median time to sustained response (60.0 vs. 52.2 minutes, Zegerid [N=117] and Losec [N=111], respectively), sustained partial response (both, 37.5 minutes) and sustained total relief (both, 105 minutes). Significantly more patients treated with Zegerid reached sustained total relief within 0–30 minutes post dose in all analysis sets (p<0.05). Both treatments were well tolerated and did not raise any safety concerns. Conclusions Superiority of Zegerid over Losec for rapid heartburn relief was not demonstrated; both treatments were equally effective however the rapid onset of action of Losec was unexpected. Factors, including aspects of study design may have contributed to this. This study supports previously reported difficulty in correlating intra-gastric pH change with clinical effect in GERD therapy, highlighting the significance of several technical considerations for studies of this type. Trial registration ClinicalTrials.gov NCT01493089 PMID:25706883

A task analysis of emergency physician activities in academic and community settings.

PubMed

Chisholm, Carey D; Weaver, Christopher S; Whenmouth, Laura; Giles, Beverly

2011-08-01

We characterize and compare the work activities, including peak patient loads, associated with the workplace in the academic and community emergency department (ED) settings. This allows assessment of the effect of future ED system operational changes and identifies potential sources contributing to medical error. This was an observational, time-motion study. Trained observers shadowed physicians, recording activities. Data included total interactions, distances walked, time sitting, patients concurrently treated, interruptions, break in tasks, physical contact with patients, hand washing, diagnostic tests ordered, and therapies rendered. Activities were classified as direct patient care, indirect patient care, or personal time with a priori definitions. There were 203 2-hour observation periods of 85 physicians at 2 academic EDs with 100,000 visits per year at each (N=160) and 2 community EDs with annual visits of 19,000 and 21,000 (N=43). Reported data present the median and minimum-maximum values per 2-hour period. Emergency physicians spent the majority of time on indirect care activities (academic 64 minutes, 29 to 91 minutes; community 55 min, 25 to 95 minutes), followed by direct care activities (academic 36 minutes, 6 to 79 minutes; community 41 minutes, 5 to 60 minutes). Personal time differed by location type (academic 6 minutes, 0 to 66 minutes; community 13 minutes, 0 to 69 minutes). All physicians simultaneously cared for multiple patients, with a median number of patients greater than 5 (academic 7 patients, 2 to 16 patients; community 6 patients, 2 to 12 patients). Emergency physicians spend the majority of their time involved in indirect patient care activities. They are frequently interrupted and interact with a large number of individuals. They care for a wide range of patients simultaneously, with surges in multiple patient care responsibilities. Physicians working in academic settings are interrupted at twice the rate of their community counterparts. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Comparing the effects of whole-body vibration to standard exercise in ambulatory people with Multiple Sclerosis: a randomised controlled feasibility study.

PubMed

Uszynski, Marcin Kacper; Purtill, Helen; Donnelly, Alan; Coote, Susan

2016-07-01

This study aimed firstly to investigate the feasibility of the study protocol and outcome measures, secondly to obtain data in order to inform the power calculations for a larger randomised controlled trial, and finally to investigate if whole-body vibration (WBV) is more effective than the same duration and intensity of standard exercises (EXE) in people with Multiple Sclerosis (PwMS). Randomised controlled feasibility study. Outpatient MS centre. Twenty seven PwMS (age mean (SD) 48.1 (11.2)) with minimal gait impairments. Twelve weeks of WBV or standard EXE, three times weekly. Participants were measured with isokinetic muscle strength, vibration threshold, Timed Up and Go test (TUG), Mini-BESTest (MBT), 6 Minute Walk test (6MWT), Multiple Sclerosis Impact Scale 29 (MSIS 29), Modified Fatigue Impact Scale (MFIS) and Verbal Analogue scale for sensation (VAS) pre and post 12 week intervention. WBV intervention was found feasible with low drop-out rate (11.1%) and high compliance (90%). Data suggest that a sample of 52 in each group would be sufficient to detect a moderate effect size, with 80% power and 5% significance for 6 minute walk test. Large effect sizes in favour of standard exercise were found for vibration threshold at 5th metatarsophalangeal joint and heel (P=0.014, r= 0.5 and P=0.005, r=0.56 respectively). No between group differences were found for muscle strength, balance or gait (P>0.05). Data suggest that the protocol is feasible, there were no adverse effects. A trial including 120 people would be needed to detect an effect on walking endurance. © The Author(s) 2015.

Caudal ropivacaine and bupivacaine for postoperative analgesia in infants undergoing lower abdominal surgery.

PubMed

Cinar, Surhan Ozer; Isil, Canan Tulay; Sahin, Sevtap Hekimoglu; Paksoy, Inci

2015-01-01

To compare the postoperative analgesic efficacy of ropivacaine 0.175% and bupivacaine 0.175% injected caudally into infants for lower abdominal surgery. Eighty infants, aged 3-12 months, ASA I-II scheduled to undergo lower abdominal surgery were randomly allocated to one of the two groups: Group R received 1ml.kg(-1) 0.175% ropivacaine and Group B received 1ml.kg(-1) 0.175% bupivacaine via caudal route. Postoperative analgesia, sedation and motor block were evaluated with modified objective pain scale, three-point scale and modified Bromage scale respectively. Postoperative measurements including mean arterial pressure (MAP), heart rate (HR), pain (OPS), sedation and motor block score were recorded for four hours in the postoperative recovery room. Parents were contacted by telephone after 24 hours to question duration of analgesia and side effects. No significant differences were found among the groups in demographic data, MAP, HR, OPS and sedation scores during four hours postoperatively. The duration of analgesia was 527.5±150.62 minutes in Group R, 692.77±139.01 minutes in Group B (p=0.004). Twelve (30%) patients in Group R, 16 (40%) patients in groupB needed rescue analgesics (p=0.348). Rescue analgesics were administered (1 time/2 times) (9/3) (22.5/7.5%) in Group R and 16/0 (40/0%) in Group B, where no statistically significant difference was determined between the groups (p=0.071). Motor blockade was observed in 7 (17.5%) patients in Group R, and 8 (20%) patients in Group B (p=0.774). This study indicated, that a concentration of 0.175% ropivacaine and 0.175% bupivacaine administered to the infants via caudal route both provided effective and similar postoperative pain relief in infants, who underwent lower abdominal surgery.

Advancing solar energy forecasting through the underlying physics

NASA Astrophysics Data System (ADS)

Yang, H.; Ghonima, M. S.; Zhong, X.; Ozge, B.; Kurtz, B.; Wu, E.; Mejia, F. A.; Zamora, M.; Wang, G.; Clemesha, R.; Norris, J. R.; Heus, T.; Kleissl, J. P.

2017-12-01

As solar power comprises an increasingly large portion of the energy generation mix, the ability to accurately forecast solar photovoltaic generation becomes increasingly important. Due to the variability of solar power caused by cloud cover, knowledge of both the magnitude and timing of expected solar power production ahead of time facilitates the integration of solar power onto the electric grid by reducing electricity generation from traditional ancillary generators such as gas and oil power plants, as well as decreasing the ramping of all generators, reducing start and shutdown costs, and minimizing solar power curtailment, thereby providing annual economic value. The time scales involved in both the energy markets and solar variability range from intra-hour to several days ahead. This wide range of time horizons led to the development of a multitude of techniques, with each offering unique advantages in specific applications. For example, sky imagery provides site-specific forecasts on the minute-scale. Statistical techniques including machine learning algorithms are commonly used in the intra-day forecast horizon for regional applications, while numerical weather prediction models can provide mesoscale forecasts on both the intra-day and days-ahead time scale. This talk will provide an overview of the challenges unique to each technique and highlight the advances in their ongoing development which come alongside advances in the fundamental physics underneath.

Observations of Total Lightning Associated with Severe Convection During the Wet Season in Central Florida

NASA Technical Reports Server (NTRS)

Sharp, D.; Williams, E.; Weber, M.; Goodman, Steven J.; Raghavan, R.; Matlin, A.; Boldi, B.

1998-01-01

This paper will discuss findings of a collaborative lightning research project between National Aeronautics and Space Administration, the Massachusetts Institute of Technology and the National Weather Service office In Melbourne Florida. In August 1996, NWS/MLB received a workstation which incorporates data from the KMLB WSR-88D, Cloud to Ground (CG) stroke data from the National Lightning Detection Network (NLDN), and 3D volumetric lightning data collected from the Kennedy Space Centers' Lightning Detection And Ranging (LDAR) lightning system. The two primary objectives of this lightning workstation, called Lightning Imaging Sensor Data Applications Display (USDAD), are to: observe how total lightning relates to severe convective storm morphology over central Florida, and compare ground based total lightning data (LDAR) to a satellite based lightning detection system. This presentation will focus on objective #1. The LISDAD system continuously displays CG and total lighting activity overlaid on top of the KMLB composite reflectivity product. This allows forecasters to monitor total lightning activity associated with convective cells occurring over the central Florida peninsula and adjacent coastal waters. The LISDAD system also keeps track of the amount of total lightning data, and associated KMLB radar products with individual convective cells occurring over the region. By clicking on an individual cell, a history table displays flash rate information (CG and total lightning) in one minute increments, along with radar parameter trends (echo tops, maximum dBz and height of maximum dBz) every 5 minutes. This history table Is updated continuously, without user intervention, as long as the cell is identified. Reviewing data collected during the 1997 wet season (21 cases) revealed that storms which produced severe weather (hall greater or = 0.75 in. or wind damage) typically showed a rapid rise In total lightning prior to the onset of severe weather. On average, flash rate increases of 25 FPM per minute over a time scale of approximately 5 minutes were common. These pulse severe storms typically reached values of 150 to 200 FPM with some cells exceeding 400 FPM. One finding which could have a direct application to the warning process is that the rapid increase in lightning typically occurred in advance of the warning issuance time. Comparisons between the ending time of the rapid rate increase and the time of when the warning was issued by NWS/MLB meteorologist exhibited a lead time of 8 minutes. It is conceivable that if close monitoring of the LISDAD system by operational meteorologist is routinely performed, warnings for pulse severe storms could be issued up to 4 to 6 minutes earlier than what is issued currently.

In Vitro UV-Visible Spectroscopy Study of Yellow Laser Irradiation on Human Blood

NASA Astrophysics Data System (ADS)

Fuad, Siti Sakinah Mohd; Suardi, N.; Mustafa, I. S.

2018-04-01

This experimental study was performed to investigate the effect of low level yellow laser of 589nm wavelength with various laser irradiation time. Human blood samples with random diseases are irradiated with yellow laser of power density of 450mW/cm2 from 10 minutes to 60 minutes at 10 minutes intervals. The morphology of the red blood cell were also observed for different irradiation time. The result shows that there is a significant different in the absorption of light with varying laser irradiation time (p<0.01). The maximum absorption recorded at 40 minutes of irradiation at 340nm peak. Blood smear of the samples reveals that there are observable changes in the morphology of the red blood cell at 40 minutes and 60 minutes of irradiation.

Cross-Scale Modelling of Subduction from Minute to Million of Years Time Scale

NASA Astrophysics Data System (ADS)

Sobolev, S. V.; Muldashev, I. A.

2015-12-01

Subduction is an essentially multi-scale process with time-scales spanning from geological to earthquake scale with the seismic cycle in-between. Modelling of such process constitutes one of the largest challenges in geodynamic modelling today.Here we present a cross-scale thermomechanical model capable of simulating the entire subduction process from rupture (1 min) to geological time (millions of years) that employs elasticity, mineral-physics-constrained non-linear transient viscous rheology and rate-and-state friction plasticity. The model generates spontaneous earthquake sequences. The adaptive time-step algorithm recognizes moment of instability and drops the integration time step to its minimum value of 40 sec during the earthquake. The time step is then gradually increased to its maximal value of 5 yr, following decreasing displacement rates during the postseismic relaxation. Efficient implementation of numerical techniques allows long-term simulations with total time of millions of years. This technique allows to follow in details deformation process during the entire seismic cycle and multiple seismic cycles. We observe various deformation patterns during modelled seismic cycle that are consistent with surface GPS observations and demonstrate that, contrary to the conventional ideas, the postseismic deformation may be controlled by viscoelastic relaxation in the mantle wedge, starting within only a few hours after the great (M>9) earthquakes. Interestingly, in our model an average slip velocity at the fault closely follows hyperbolic decay law. In natural observations, such deformation is interpreted as an afterslip, while in our model it is caused by the viscoelastic relaxation of mantle wedge with viscosity strongly varying with time. We demonstrate that our results are consistent with the postseismic surface displacement after the Great Tohoku Earthquake for the day-to-year time range. We will also present results of the modeling of deformation of the upper plate during multiple earthquake cycles at times of hundred thousand and million years and discuss effect of great earthquakes in changing long-term stress field in the upper plate.

High-powered microwave ablation with a small-gauge, gas-cooled antenna: initial ex vivo and in vivo results.

PubMed

Lubner, Meghan G; Hinshaw, J Louis; Andreano, Anita; Sampson, Lisa; Lee, Fred T; Brace, Christopher L

2012-03-01

To evaluate the performance of a gas-cooled, high-powered microwave system. Investigators performed 54 ablations in ex vivo bovine livers using three devices-a single 17-gauge cooled radiofrequency(RF) electrode; a cluster RF electrode; and a single 17-gauge, gas-cooled microwave (MW) antenna-at three time points (n = 6 at 4 minutes, 12 minutes, and 16 minutes). RF power was applied using impedance-based pulsing with maximum 200 W generator output. MW power of 135 W at 2.45 GHz was delivered continuously. An approved in vivo study was performed using 13 domestic pigs. Hepatic ablations were performed using single applicators and the above-mentioned MW and RF generator systems at treatment times of 2 minutes (n = 7 MW, n = 6 RF), 5 minutes (n = 23 MW, n = 8 RF), 7 minutes (n = 11 MW, n = 6 RF), and 10 minutes (n = 7 MW, n = 9 RF). Mean transverse diameter and length of the ablation zones were compared using analysis of variance (ANOVA) with post-hoc t tests and Wilcoxon rank-sum tests. Single ex vivo MW ablations were larger than single RF ablations at all time points (MW mean diameter range 3.5-4.8 cm 4-16 minutes; RF mean diameter range 2.6-3.1 cm 4-16 minutes) (P < .05). There was no difference in mean diameter between cluster RF and MW ablations (RF 3.3-4.4 cm 4-16 minutes; P = .4-.9). In vivo lesion diameters for MW (and RF) were as follows: 2.6 cm ± 0.72 (RF 1.5 cm ± 0.14), 3.6 cm ± 0.89 (RF 2.0 cm ± 0.4), 3.4 cm ± 0.87 (RF 1.8 cm ± 0.23), and 3.8 cm ± 0.74 (RF 2.1 cm ± 0.3) at 2 minutes, 5 minutes, 7 minutes, and 10 minutes (P < .05 all time points). Gas-cooled, high-powered MW ablation allows the generation of large ablation zones in short times. Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.

Pharmacokinetics and effects of alfaxalone after intravenous and intramuscular administration to cats.

PubMed

Rodrigo-Mocholí, D; Escudero, E; Belda, E; Laredo, F G; Hernandis, V; Marín, P

2018-07-01

To determine the pharmacokinetics, and anaesthetic and sedative effects of alfaxalone after I/V and I/M administration to cats. Six European shorthair cats, three males and three females, with a mean weight of 4.21 (SD 0.53) kg and aged 3.8 (SD 0.9) years were enrolled in this crossover, two-treatment, two-period study. Alfaxalone at a dose of 5 mg/kg was administered either I/V or I/M. Blood samples were collected between 2-480 minutes after drug administration and analysed for concentrations of alfaxalone by HPLC. The plasma concentration-time curves were analysed by non-compartmental analysis. Sedation scores were evaluated between 5-120 minutes after drug administration using a numerical rating scale (from 0-18). Intervals from drug administration to sit, sternal and lateral recumbency during the induction phase, and to head-lift, sternal recumbency and standing position during recovery were recorded. The mean half-life and mean residence time of alfaxalone were longer after I/M (1.28 (SD 0.21) and 2.09 (SD 0.36) hours, respectively) than after I/V (0.49 (SD 0.07) and 0.66 (SD 0.16) hours, respectively) administration (p<0.05). Bioavailability after I/M injection of alfaxalone was 94.7 (SD 19.8)%. The mean intervals to sternal and lateral recumbency were longer in the I/M (3.73 (SD 1.99) and 6.12 (SD 0.90) minutes, respectively) compared to I/V (0 minutes for all animals) treated cats (p<0.01). Sedation scores indicative of general anaesthesia (scores >15) were recorded from 5-15 minutes after I/V administration and deep sedation (scores 11-15) at 20 and 30 minutes. Deep sedation was observed from 10-45 minutes after I/M administration. One cat from each group showed hyperkinesia during recovery, and the remainder had an uneventful recovery. Alfaxalone administered I/V in cats provides rapid and smooth induction of anaesthesia. After I/M administration, a longer exposure to the drug and an extended half life were obtained compared to I/V administration. Therefore I/M administration of alfaxalone could be a reliable, suitable and easy route in cats, taking into account that alfaxalone has a slower onset of sedation than when given I/V and achieves deep sedation rather than general anaesthesia.

Criticality and Phase Transition in Stock-Price Fluctuations

NASA Astrophysics Data System (ADS)

Kiyono, Ken; Struzik, Zbigniew R.; Yamamoto, Yoshiharu

2006-02-01

We analyze the behavior of the U.S. S&P 500 index from 1984 to 1995, and characterize the non-Gaussian probability density functions (PDF) of the log returns. The temporal dependence of fat tails in the PDF of a ten-minute log return shows a gradual, systematic increase in the probability of the appearance of large increments on approaching black Monday in October 1987, reminiscent of parameter tuning towards criticality. On the occurrence of the black Monday crash, this culminates in an abrupt transition of the scale dependence of the non-Gaussian PDF towards scale-invariance characteristic of critical behavior. These facts suggest the need for revisiting the turbulent cascade paradigm recently proposed for modeling the underlying dynamics of the financial index, to account for time varying—phase transitionlike and scale invariant-critical-like behavior.

Reduction of admit wait times: the effect of a leadership-based program.

PubMed

Patel, Pankaj B; Combs, Mary A; Vinson, David R

2014-03-01

Prolonged admit wait times in the emergency department (ED) for patients who require hospitalization lead to increased boarding time in the ED, a significant cause of ED congestion. This is associated with decreased quality of care, higher morbidity and mortality, decreased patient satisfaction, increased costs for care, ambulance diversion, higher numbers of patients who leave without being seen (LWBS), and delayed care with longer lengths of stay (LOS) for other ED patients. The objective was to assess the effect of a leadership-based program to expedite hospital admissions from the ED. This before-and-after observational study was undertaken from 2006 through 2011 at one community hospital ED. A team of ED and hospital leaders implemented a program to reduce admit wait times, using a computerized hospital-wide tracking system to monitor inpatient and ED bed status. The team collaboratively and consistently moved ED patients to their inpatient beds within an established goal of 60 minutes after an admission decision was reached. Top leadership actively intervened in real time by contacting staff whenever delays occurred to expedite immediate solutions to achieve the 60-minute goal. The primary outcome measures were the percentage of ED patients who were admitted to inpatient beds within 60 minutes from the time the beds were requested and ED boarding time. LOS, patient satisfaction, LWBS rate, and ambulance diversion hours were also measured. After ED census, hospital admission rates, and ED bed capacity were controlled for using a multivariable linear regression analysis, the admit wait time reduction program contributed to an increase in patients being admitted to the hospital within 60 minutes by 16 percentage points (95% confidence intervals [CI] = 10 to 22 points; p < 0.0001) and a decrease in boarding time per admission of 46 minutes (95% CI = 63 to 82 minutes; p < 0.0001). LOS decreased for admitted patients by 79 minutes (95% CI = 55 to 104 minutes; p < 0.0001), for discharged patients by 17 minutes (95% CI = 12 to 23 minutes; p < 0.0001), and for all patients by 34 minutes (95% CI = 25 to 43 minutes; p < 0.0001). Patient satisfaction increased 4.9 percentage points (95% CI = 3.8 to 6.0 points; p < 0.0001). LWBS patients decreased 0.9 percentage points (95% CI = 0.6 to 1.2 points; p < 0.0001) and monthly ambulance diversion decreased 8.2 hours (95% CI = 4.6 to 11.8 hours; p < 0.0001). A leadership-based program to reduce admit wait times and boarding times was associated with a significant increase in the percentage of patients admitted to the hospital within 60 minutes and a significant decrease in boarding time. Also associated with the program were decreased ED LOS, LWBS rate, and ambulance diversion, as well as increased patient satisfaction. © 2014 by the Society for Academic Emergency Medicine.

[Prevention of spinal disorders in dentistry].

PubMed

Iordache, Cristina; Scutariu, Monica; Ancuţa, Codrina

2010-01-01

Professional activity in dentistry account for excessive request of the spine and peripheral joints. We performed an observational prospective study on ten physicians (six women, four men) aiming to evaluate the time used in vicious positions during a working day and to establish a specific kinetic program directed to relaxation and rebalancing lumbo-abdomino-pelvic muscles. The working time in a typical day either using orthostatic or sitting position was assessed according to a standard protocol. Left dorsal scoliosis with rotation lasting over 97 minutes of daily working time, sinistro-concave dorsal scoliosis with a typical duration of 42.5 minutes, dextro-concave kyphoscoliosis with a mean time of 37 minutes and dorsal scoliosis with right rotation lasting 31 minutes were reported. Moreover, both left and right rotations were demonstrated during the working time accounting for about 22.5 minutes and 29 minutes respectively, while a lesser time deal with the side of right-left uncombined movement. Almost three quarters of working time (71%) takes place in vicious positions, suggesting that, unfortunately, the ergonomic position is seldom maintained in current dentistry practice. A complex rehabilitation program is therefore mandatory in order to prevent muscle imbalance.

Treatment comfort, time perception, and preference for conventional and digital impression techniques: A comparative study in young patients.

PubMed

Burhardt, Lukasz; Livas, Christos; Kerdijk, Wouter; van der Meer, Wicher Joerd; Ren, Yijin

2016-08-01

The aim of this crossover study was to assess perceptions and preferences for impression techniques in young orthodontic patients receiving alginate and 2 different digital impressions. Thirty-eight subjects aged 10 to 17 years requiring impressions for orthodontic treatment were randomly allocated to 3 groups that differed in the order that an alginate impressions and 2 different intraoral scanning procedures were administered. After each procedure, the patients were asked to score their perceptions on a 5-point Likert scale for gag reflex, queasiness, difficulty to breathe, uncomfortable feeling, perception of the scanning time, state of anxiety, and use of a powder, and to select the preferred impression system. Chairside time and maximal mouth opening were also registered. More queasiness (P = 0.00) and discomfort (P = 0.02) during alginate impression taking of the maxilla were perceived compared with the scans with the CEREC Omnicam (Sirona Dental Systems, Bensheim, Germany). There were no significant differences in perceptions between the alginate impressions and the Lava C.O.S. (3M ESPE, St Paul, Minn) and between the 2 scanners. Chairside times for the alginate impressions (9.7 ± 1.8 minutes) and the CEREC Omnicam (10.7 ± 1.8 minutes) were significantly lower (P <0.001) than for the Lava C.O.S. (17.8 ± 4.0 minutes). Digital impressions were favored by 51% of the subjects, whereas 29% chose alginate impressions, and 20% had no preference. Regardless of the significant differences in the registered times among the 3 impression-taking methods, the distributions of the Likert scores of time perception and maximal mouth opening were similar in all 3 groups. Young orthodontic patients preferred the digital impression techniques over the alginate method, although alginate impressions required the shortest chairside time. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Concurrent Validation of the Clinical Opiate Withdrawal Scale (COWS) and Single-Item Indices against the Clinical Institute Narcotic Assessment (CINA) Opioid Withdrawal Instrument

PubMed Central

Tompkins, D. Andrew; Bigelow, George E.; Harrison, Joseph A.; Johnson, Rolley E.; Fudala, Paul J.; Strain, Eric C.

2009-01-01

Introduction The Clinical Opiate Withdrawal Scale (COWS) is an 11-item clinician-administered scale assessing opioid withdrawal. Though commonly used in clinical practice, it has not been systematically validated. The present study validated the COWS in comparison to the validated Clinical Institute Narcotic Assessment (CINA) scale. Method Opioid-dependent volunteers were enrolled in a residential trial and stabilized on morphine 30 mg given subcutaneously four times daily. Subjects then underwent double-blind, randomized challenges of intramuscularly administered placebo and naloxone (0.4 mg) on separate days, during which the COWS, CINA, and visual analog scale (VAS) assessments were concurrently obtained. Subjects completing both challenges were included (N=46). Correlations between mean peak COWS and CINA scores as well as self-report VAS questions were calculated. Results Mean peak COWS and CINA scores of 7.6 and 24.4, respectively, occurred on average 30 minutes post-injection of naloxone. Mean COWS and CINA scores 30 minutes after placebo injection were 1.3 and 18.9, respectively. The Pearson correlation coefficient for peak COWS and CINA scores during the naloxone challenge session was 0.85 (p<0.001). Peak COWS scores also correlated well with peak VAS self-report scores of bad drug effect (r=0.57, p<0.001) and feeling sick (r=0.57, p<0.001), providing additional evidence of concurrent validity. Placebo was not associated with any significant elevation of COWS, CINA, or VAS scores, indicating discriminant validity. Cronbach’s alpha for the COWS was 0.78, indicating good internal consistency (reliability). Discussion COWS, CINA, and certain VAS items are all valid measurement tools for acute opiate withdrawal. PMID:19647958

PROPELLER technique to improve image quality of MRI of the shoulder.

PubMed

Dietrich, Tobias J; Ulbrich, Erika J; Zanetti, Marco; Fucentese, Sandro F; Pfirrmann, Christian W A

2011-12-01

The purpose of this article is to evaluate the use of the periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) technique for artifact reduction and overall image quality improvement for intermediate-weighted and T2-weighted MRI of the shoulder. One hundred eleven patients undergoing MR arthrography of the shoulder were included. A coronal oblique intermediate-weighted turbo spin-echo (TSE) sequence with fat suppression and a sagittal oblique T2-weighted TSE sequence with fat suppression were obtained without (standard) and with the PROPELLER technique. Scanning time increased from 3 minutes 17 seconds to 4 minutes 17 seconds (coronal oblique plane) and from 2 minutes 52 seconds to 4 minutes 10 seconds (sagittal oblique) using PROPELLER. Two radiologists graded image artifacts, overall image quality, and delineation of several anatomic structures on a 5-point scale (5, no artifact, optimal diagnostic quality; and 1, severe artifacts, diagnostically not usable). The Wilcoxon signed rank test was used to compare the data of the standard and PROPELLER images. Motion artifacts were significantly reduced in PROPELLER images (p < 0.001). Observer 1 rated motion artifacts with diagnostic impairment in one patient on coronal oblique PROPELLER images compared with 33 patients on standard images. Ratings for the sequences with PROPELLER were significantly better for overall image quality (p < 0.001). Observer 1 noted an overall image quality with diagnostic impairment in nine patients on sagittal oblique PROPELLER images compared with 23 patients on standard MRI. The PROPELLER technique for MRI of the shoulder reduces the number of sequences with diagnostic impairment as a result of motion artifacts and increases image quality compared with standard TSE sequences. PROPELLER sequences increase the acquisition time.

Effect of Commuter Time on Emergency Medicine Residents.

PubMed

Sampson, Christopher; Borenstein, Marc

2018-01-12

Background The impact of resident work hours on resident well-being and patient safety has long been a controversial issue. Objectives What has not been considered in resident work hour limitations is whether resident commuting time has any impact on a resident's total work hours or well-being. Methods A self-administered electronic survey was distributed to emergency medicine residents in 2016. Results The survey response was 8% (569/6828). Commuter time was 30 minutes or less in 70%. Two residents reported a commuter time of 76 to 90 minutes and one resident had a commuter time of 91 to 105 minutes. None reported commuter times greater than 105 minutes. Of most concern was that 29.3% of the residents reported falling asleep while driving their car home from work. We found 12% of respondents reporting being involved in a car collision while commuting. For residents with commute times greater than one hour, 66% reported they had fallen asleep while driving. When asked their opinion on the effect of commute time, those with commute times greater than one hour (75% of residents) responded that it was detrimental. Conclusions While the majority of emergency medicine residents in this survey have commuter times of 30 minutes or less, there is a small population of residents with commuter times of 76 to 105 minutes. At times, residents whose commute is up to 105 minutes each way could be traveling a total of more than 3.5 hours for each round trip. Given that these residents often work 12-hour shifts, these extended commuter times may be having detrimental effects on their health and well-being.

Effect of Commuter Time on Emergency Medicine Residents

PubMed Central

Borenstein, Marc

2018-01-01

Background The impact of resident work hours on resident well-being and patient safety has long been a controversial issue. Objectives What has not been considered in resident work hour limitations is whether resident commuting time has any impact on a resident's total work hours or well-being. Methods A self-administered electronic survey was distributed to emergency medicine residents in 2016. Results The survey response was 8% (569/6828). Commuter time was 30 minutes or less in 70%. Two residents reported a commuter time of 76 to 90 minutes and one resident had a commuter time of 91 to 105 minutes. None reported commuter times greater than 105 minutes. Of most concern was that 29.3% of the residents reported falling asleep while driving their car home from work. We found 12% of respondents reporting being involved in a car collision while commuting. For residents with commute times greater than one hour, 66% reported they had fallen asleep while driving. When asked their opinion on the effect of commute time, those with commute times greater than one hour (75% of residents) responded that it was detrimental. Conclusions While the majority of emergency medicine residents in this survey have commuter times of 30 minutes or less, there is a small population of residents with commuter times of 76 to 105 minutes. At times, residents whose commute is up to 105 minutes each way could be traveling a total of more than 3.5 hours for each round trip. Given that these residents often work 12-hour shifts, these extended commuter times may be having detrimental effects on their health and well-being. PMID:29545979

Withdrawal times and associated factors in colonoscopy: a quality assurance multicenter assessment.

PubMed

Overholt, Bergein F; Brooks-Belli, Linda; Grace, Michael; Rankin, Kristin; Harrell, Royce; Turyk, Mary; Rosenberg, Fred B; Barish, Robert W; Gilinsky, Norman H

2010-04-01

To evaluate the use and impact of the recommended withdrawal time of at least 6 minutes from the cecum in colonoscopy in multiple gastroenterology endoscopy ambulatory surgery centers serving a wide geographical area. An observational prospective multicenter quality assurance review was conducted in 49 ambulatory surgery centers in 17 states with 315 gastroenterologists. There was no intervention with this quality assessment program as care of patients and the routine of gastroenterologists continued as standard practice. Multivariable analysis was applied to the database to examine factors affecting withdrawal time and polyp detection. There were 15,955 consecutive qualified patients receiving colonoscopies in a designated 4-week period. Gastroenterologists with average withdrawal times of 6 minutes or more in patients with no polyps were 1.8 times more likely to detect 1 or more polyps and had a significantly higher rate (P<0.0001) of polyp detection in patients with findings of polyps compared to gastroenterologists with average withdrawal times of less than 6 minutes in patients with no polyps. For patients with no pathology, the mean time of withdrawal was 6.98 (SD=4.34) minutes and for patients with pathology mean time of withdrawal was 11.27 (SD=6.71) minutes. Strongest predictors of withdrawal time of 6 minutes or more were presence of carcinoma (3.7 times more likely than those with no pathology), adenoma (2.0 times more likely than those with no pathology), and number of polyps visualized (1.7 times more likely for each polyp). This quality assurance assessment from standard colonoscopy practices of 315 gastroenterologists in 49 endoscopic ambulatory surgery centers serving a wide geographical area provides support for the merits of a colonoscopy withdrawal time from the cecum of 6 minutes or more to improve the detection of polyps.

Factors Associated with Failure of Non-invasive Positive Pressure Ventilation in a Critical Care Helicopter Emergency Medical Service.

PubMed

Lee, James S; O'Dochartaigh, Domhnall; MacKenzie, Mark; Hudson, Darren; Couperthwaite, Stephanie; Villa-Roel, Cristina; Rowe, Brian H

2015-06-01

Non-invasive positive pressure ventilation (NIPPV) is used to treat severe acute respiratory distress. Prehospital NIPPV has been associated with a reduction in both in-hospital mortality and the need for invasive ventilation. The authors of this study examined factors associated with NIPPV failure and evaluated the impact of NIPPV on scene times in a critical care helicopter Emergency Medical Service (HEMS). Non-invasive positive pressure ventilation failure was defined as the need for airway intervention or alternative means of ventilatory support. A retrospective chart review of consecutive patients where NIPPV was completed in a critical care HEMS was conducted. Factors associated with NIPPV failure in univariate analyses and from published literature were included in a multivariable, logistic regression model. From a total of 44 patients, NIPPV failed in 14 (32%); a Glasgow Coma Scale (GCS)<15 at HEMS arrival was associated independently with NIPPV failure (adjusted odds ratio 13.9; 95% CI, 2.4-80.3; P=.003). Mean scene times were significantly longer in patients who failed NIPPV when compared with patients in whom NIPPV was successful (95 minutes vs 51 minutes; 39.4 minutes longer; 95% CI, 16.2-62.5; P=.001). Patients with a decreased level of consciousness were more likely to fail NIPPV. Furthermore, patients who failed NIPPV had significantly longer scene times. The benefits of NIPPV should be balanced against risks of long scene times by HEMS providers. Knowing risk factors of NIPPV failure could assist HEMS providers to make the safest decision for patients on whether to initiate NIPPV or proceed directly to endotracheal intubation prior to transport.

A prospective study of ketamine versus haloperidol for severe prehospital agitation.

PubMed

Cole, Jon B; Moore, Johanna C; Nystrom, Paul C; Orozco, Benjamin S; Stellpflug, Samuel J; Kornas, Rebecca L; Fryza, Brandon J; Steinberg, Lila W; O'Brien-Lambert, Alex; Bache-Wiig, Peter; Engebretsen, Kristin M; Ho, Jeffrey D

2016-08-01

Ketamine is an emerging drug for the treatment of acute undifferentiated agitation in the prehospital environment, however no prospective comparative studies have evaluated its effectiveness or safety in this clinical setting. We hypothesized 5 mg/kg of intramuscular ketamine would be superior to 10 mg of intramuscular haloperidol for severe prehospital agitation, with time to adequate sedation as the primary outcome measure. This was a prospective open label study of all patients in an urban EMS system requiring chemical sedation for severe acute undifferentiated agitation that were subsequently transported to the EMS system's primary Emergency Department. All paramedics were trained in the Altered Mental Status Scale and prospectively recorded agitation scores on all patients. Two 6-month periods where either ketamine or haloperidol was the first-line therapy for severe agitation were prospectively compared primarily for time to adequate sedation. Secondary outcomes included laboratory data and adverse medication events. 146 subjects were enrolled; 64 received ketamine, 82 received haloperidol. Median time to adequate sedation for the ketamine group was 5 minutes (range 0.4-23) vs. 17 minutes (range 2-84) in the haloperidol group (difference 12 minutes, 95% CI 9-15). Complications occurred in 49% (27/55) of patients receiving ketamine vs. 5% (4/82) in the haloperidol group. Complications specific to the ketamine group included hypersalivation (21/56, 38%), emergence reaction (5/52, 10%), vomiting (5/57, 9%), and laryngospasm (3/55, 5%). Intubation was also significantly higher in the ketamine group; 39% of patients receiving ketamine were intubated vs. 4% of patients receiving haloperidol. Ketamine is superior to haloperidol in terms of time to adequate sedation for severe prehospital acute undifferentiated agitation, but is associated with more complications and a higher intubation rate.

Prompting technologies: A comparison of time-based and context-aware transition-based prompting

PubMed Central

Robertson, Kayela; Rosasco, Cody; Feuz, Kyle; Schmitter-Edgecombe, Maureen; Cook, Diane

2016-01-01

BACKGROUND While advancements in technology have encouraged the development of novel prompting systems to support cognitive interventions, little research has evaluated the best time to deliver prompts, which may impact the effectiveness of these interventions. OBJECTIVE This study examined whether transition-based context prompting (prompting an individual during task transitions) is more effective than traditional fixed time-based prompting. METHODS Participants were 42 healthy adults who completed 12 different everyday activities, each lasting 1–7 minutes, in an experimental smart home testbed and received prompts to record the completed activities from an electronic memory notebook. Half of the participants were delivered prompts during activity transitions, while the other half received prompts every 5 minutes. Participants also completed Likert-scale ratings regarding their perceptions of the prompting system. RESULTS Results revealed that participants in the transition-based context prompting condition responded to the first prompt more frequently and rated the system as more convenient, natural, and appropriate compared to participants in the time-based condition. CONCLUSIONS Our findings suggest that prompting during activity transitions produces higher adherence to the first prompt and more positive perceptions of the prompting system. This is an important finding given the benefits of prompting technology and the possibility of improving cognitive interventions by using context-aware transition prompting. PMID:26409520

Long-lived 1H singlet spin states originating from para-hydrogen in Cs-symmetric molecules stored for minutes in high magnetic fields.

PubMed

Franzoni, María Belén; Buljubasich, Lisandro; Spiess, Hans W; Münnemann, Kerstin

2012-06-27

Nuclear magnetic resonance (NMR) is a very powerful tool in physics, chemistry, and life sciences, although limited by low sensitivity. This problem can be overcome by hyperpolarization techniques dramatically enhancing the NMR signal. However, this approach is restricted to relatively short time scales depending on the nuclear spin-lattice relaxation time T(1) in the range of seconds. This makes long-lived singlet states very useful as a way to extend the hyperpolarization lifetimes. Para-hydrogen induced polarization (PHIP) is particularly suitable, because para-H(2) possesses singlet symmetry. Most PHIP experiments, however, are performed on asymmetric molecules, and the initial singlet state is directly converted to a NMR observable triplet state decaying with T(1), in the order of seconds. We demonstrate that in symmetric molecules, a long-lived singlet state created by PHIP can be stored for several minutes on protons in high magnetic fields. Subsequently, it is converted into observable high nonthermal magnetization by controlled singlet-triplet conversion via level anticrossing.

Short duration flares in GALEX data

NASA Astrophysics Data System (ADS)

Brasseur, Clara; Osten, Rachel A.

2018-06-01

Flares on cool stars indicate short time-scale magnetic reconnection processes that provide temporary increases in the stellar radiative output. While recent work has focused on long-duration flares from solar-like stars and those of lower mass, the existence of short-duration flares in the ultraviolet has not been systematically probed before. We will present an interesting population of short duration flares we discovered in a sample of ~37,000 light curves observed from 2009-2012 by the GALEX and Kepler missions. These flares range in duration from under a minute to a few minutes and are almost entirely distinct from a previous flare survey of Kepler data. We were able to detect this unique population of flares because the time resolution of the GALEX data allowed us to construct light curves with a 10 second cadence and thus detect shorter duration flares than could be detected within Kepler data. We applied algorithmic flare detection to a sample of ~37,000 stars, and identified a final count of 2,065 flares on 1,121 stars. We discuss the implication of these events for the flare frequency distributions of solar-like stars.

Initiation of labor analgesia with injection of local anesthetic through the epidural needle compared to the catheter.

PubMed

Ristev, Goran; Sipes, Angela C; Mahoney, Bryan; Lipps, Jonathan; Chan, Gary; Coffman, John C

2017-01-01

The rationale for injection of epidural medications through the needle is to promote sooner onset of pain relief relative to dosing through the epidural catheter given that needle injection can be performed immediately after successful location of the epidural space. Some evidence indicates that dosing medications through the epidural needle results in faster onset and improved quality of epidural anesthesia compared to dosing through the catheter, though these dosing techniques have not been compared in laboring women. This investigation was performed to determine whether dosing medication through the epidural needle improves the quality of analgesia, level of sensory blockade, or onset of pain relief measured from the time of epidural medication injection. In this double-blinded prospective investigation, healthy term laboring women (n=60) received labor epidural placement upon request. Epidural analgesia was initiated according to the assigned randomization group: 10 mL loading dose (0.125% bupivacaine with fentanyl 2 µg/mL) through either the epidural needle or the catheter, given in 5 mL increments spaced 2 minutes apart. Verbal rating scale (VRS) pain scores (0-10) and pinprick sensory levels were documented to determine the rates of analgesic and sensory blockade onset. No significant differences were observed in onset of analgesia or sensory blockade from the time of injection between study groups. The estimated difference in the rate of pain relief (VRS/minute) was 0.04 (95% CI: -0.01 to 0.11; p =0.109), and the estimated difference in onset of sensory blockade (sensory level/minute) was 0.63 (95% CI: -0.02 to 0.15; p =0.166). The time to VRS ≤3 and level of sensory block 20 minutes after dosing were also similar between groups. No differences in patient satisfaction, or maternal or fetal complications were observed. This investigation observed that epidural needle and catheter injection of medications result in similar onset of analgesia and sensory blockade, quality of labor analgesia, patient satisfaction, and complication rates.

SU-E-T-545: A MLC-Equipped Robotic Radiosurgery-Radiotherapy Combined System in Treating Hepatic Lesions: Delivery Efficiency as Compared to a Standard Linac for Treating Hepatic Lesions

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

Jin, L; Price, R; Wang, L

Purpose: The CyberKnife (CK) M6 Series introduced a mulitleaf collimator (MLC) beam for extending its capability to the conventional radiotherapy. This work is to investigate delivery efficiency of this system as compared to a standard Varian linac when treating hepatic lesions. Methods: Nine previously treated patients were divided into three groups with three patients in each. Group one: fractionated radiotherapy; Group two: SBRT-like treatments and Group three: fractionated radiotherapy targeting two PTVs. The clinically used plans were generated with the Eclipse treatment planning system (TPS). We re-planned these cases using a Mulitplan (MP) TPS for the CK M6 and normalizedmore » to the same PTV dose coverage. CK factors (CF) (defined as modulation scaling factor in this work), number of nodes (NN), number of MLC segments (NS) and beam delivery time (BT) with an estimated image interval of 60 seconds, were used for evaluation of delivery efficiency. Results: Generated plans from the MP and Eclipse TPS demonstrated the similar quality in terms of PTV confomality index, minimum and maximum PTV doses, and doses received by critical structures. Group one: CF ranged from 8.1 to 8.7, NN from 30 to 40, NS from 120 to 155 and BT from 20 to 23 minutes; group two: CF from 4.7 to 8.5, NN from 15 to 19, NS from 82 to 141 and BT from 18 to 24 minutes; and group three: CF from 7.9 to 10, NN from 47 to 49, NS from 110 to 113 and BT from 20 to 22 minutes. Conclusions: Delivery time is longer for the CK M6 than for the Varian linac (7.8 to 13.7 minutes). Further investigation will be necessary to determine if a PTV reduction from the tracking feature will shorten the delivery time without decreasing plan quality.« less

A concept for major incident triage: full-scaled simulation feasibility study.

PubMed

Rehn, Marius; Andersen, Jan E; Vigerust, Trond; Krüger, Andreas J; Lossius, Hans M

2010-08-11

Efficient management of major incidents involves triage, treatment and transport. In the absence of a standardised interdisciplinary major incident management approach, the Norwegian Air Ambulance Foundation developed Interdisciplinary Emergency Service Cooperation Course (TAS). The TAS-program was established in 1998 and by 2009, approximately 15 500 emergency service professionals have participated in one of more than 500 no-cost courses. The TAS-triage concept is based on the established triage Sieve and Paediatric Triage Tape models but modified with slap-wrap reflective triage tags and paediatric triage stretchers. We evaluated the feasibility and accuracy of the TAS-triage concept in full-scale simulated major incidents. The learners participated in two standardised bus crash simulations: without and with competence of TAS-triage and access to TAS-triage equipment. The instructors calculated triage accuracy and measured time consumption while the learners participated in a self-reported before-after study. Each question was scored on a 7-point Likert scale with points labelled "Did not work" (1) through "Worked excellent" (7). Among the 93 (85%) participating emergency service professionals, 48% confirmed the existence of a major incident triage system in their service, whereas 27% had access to triage tags. The simulations without TAS-triage resulted in a mean over- and undertriage of 12%. When TAS-Triage was used, no mistriage was found. The average time from "scene secured to all patients triaged" was 22 minutes (range 15-32) without TAS-triage vs. 10 minutes (range 5-21) with TAS-triage. The participants replied to "How did interdisciplinary cooperation of triage work?" with mean 4,9 (95% CI 4,7-5,2) before the course vs. mean 5,8 (95% CI 5,6-6,0) after the course, p < 0,001. Our modified triage Sieve tool is feasible, time-efficient and accurate in allocating priority during simulated bus accidents and may serve as a candidate for a future national standard for major incident triage.

A Global Landslide Nowcasting System using Remotely Sensed Information

NASA Astrophysics Data System (ADS)

Kirschbaum, Dalia; Stanely, Thomas

2017-04-01

A global Landslide Hazard Assessment model for Situational Awareness (LHASA) has been developed that combines susceptibility information with satellite-based precipitation to provide an indication of potential landslide activity at the global scale every 30 minutes. This model utilizes a 1-km global susceptibility map derived from information on slope, geology, road networks, fault zones, and forest loss. A multi-satellite dataset from the Global Precipitation Measurement (GPM) mission is used to identify the current and antecedent rainfall conditions from the past 7 days. When both rainfall and susceptibility are high, a "nowcast" is issued to indicate areas where a landslide may be likely. The global LHASA model is currently being run in near real-time every 30 minutes and the outputs are available in several different formats at https://pmm.nasa.gov/precip-apps. This talk outlines the LHASA system, discusses the performance metrics and potential applications of the LHASA system.

Solar burst precursors and energy build-up at microwave wavelengths

NASA Technical Reports Server (NTRS)

Lang, Kenneth R.; Wilson, Robert F.

1986-01-01

We summarize high-resolution microwave observations (VLA) of heating and magnetic triggering in coronal loops. Magnetic changes that precede solar eruptions on time scales of tens of minutes involve primarily emerging coronal loops and the interaction of two or more loops. Thermal cyclotron lines have been detected in coronal loops, suggesting the presence of hot current sheets that enhance emission from relatively thin layers of enhanced temperature and constant magnetic field. These current sheets may play a role in the excitation of solar bursts. A filament-associated source with a high brightness temperature and steep radiation spectrum occurs above a region of apparently weak photospheric field. This source might be attributed to currents that enhance coronal magnetic fields. Compact (phi=5 sec) transient sources with lifetimes of 30 to 60 minutes have also been detected in regions of apparently weak photospheric field. We conclude by comparing VLA observations of coronal loops with simultaneous SMM-XRP observations.

Solar burst precursors and energy build-up at microwave wavelengths

NASA Astrophysics Data System (ADS)

Lang, Kenneth R.; Wilson, Robert F.

We summarize high-resolution microwave observations (VLA) of heating and magnetic triggering in coronal loops. Magnetic changes that precede solar eruptions on time scales of tens of minutes involve primarily emerging coronal loops and the interaction of two or more loops. Thermal cyclotron lines have been detected in coronal loops, suggesting the presence of hot current sheets that enhance emission from relatively thin layers of enhanced temperature and constant magnetic field. These current sheets may play a role in the excitation of solar bursts. A filament-associated source with a high brightness temperature and steep radiation spectrum occurs above a region of apparently weak photospheric field. This source might be attributed to currents that enhance coronal magnetic fields. Compact (phi=5 sec) transient sources with lifetimes of 30 to 60 minutes have also been detected in regions of apparently weak photospheric field. We conclude by comparing VLA observations of coronal loops with simultaneous SMM-XRP observations.

RESPONSE OF GRANULATION TO SMALL-SCALE BRIGHT FEATURES IN THE QUIET SUN

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

Andic, A.; Chae, J.; Goode, P. R.

2011-04-10

We detected 2.8 bright points (BPs) per Mm{sup 2} in the quiet Sun with the New Solar Telescope at Big Bear Solar Observatory, using the TiO 705.68 nm spectral line at an angular resolution {approx}0.''1 to obtain a 30 minute data sequence. Some BPs formed knots that were stable in time and influenced the properties of the granulation pattern around them. The observed granulation pattern within {approx}3'' of knots presents smaller granules than those observed in a normal granulation pattern, i.e., around the knots a suppressed convection is detected. Observed BPs covered {approx}5% of the solar surface and were notmore » homogeneously distributed. BPs had an average size of 0.''22, they were detectable for 4.28 minutes on average, and had an averaged contrast of 0.1% in the deep red TiO spectral line.« less

Test-retest reliability and minimal detectable change scores for the timed "up & go" test, the six-minute walk test, and gait speed in people with Alzheimer disease.

PubMed

Ries, Julie D; Echternach, John L; Nof, Leah; Gagnon Blodgett, Michelle

2009-06-01

With the increasing incidence of Alzheimer disease (AD), determining the validity and reliability of outcome measures for people with this disease is necessary. The goals of this study were to assess test-retest reliability of data for the Timed "Up & Go" Test (TUG), the Six-Minute Walk Test (6MWT), and gait speed and to calculate minimal detectable change (MDC) scores for each outcome measure. Performance differences between groups with mild to moderate AD and moderately severe to severe AD (as determined by the Functional Assessment Staging [FAST] scale) were studied. This was a prospective, nonexperimental, descriptive methodological study. Background data collected for 51 people with AD included: use of an assistive device, Mini-Mental Status Examination scores, and FAST scale scores. Each participant engaged in 2 test sessions, separated by a 30- to 60-minute rest period, which included 2 TUG trials, 1 6MWT trial, and 2 gait speed trials using a computerized gait assessment system. A specific cuing protocol was followed to achieve optimal performance during test sessions. Test-retest reliability values for the TUG, the 6MWT, and gait speed were high for all participants together and for the mild to moderate AD and moderately severe to severe AD groups separately (intraclass correlation coefficients > or = .973); however, individual variability of performance also was high. Calculated MDC scores at the 90% confidence interval were: TUG=4.09 seconds, 6MWT=33.5 m (110 ft), and gait speed=9.4 cm/s. The 2 groups were significantly different in performance of clinical tests, with the participants who were more cognitively impaired being more physically and functionally impaired. A single researcher for data collection limited sample numbers and prohibited blinding to dementia level. The TUG, the 6MWT, and gait speed are reliable outcome measures for use with people with AD, recognizing that individual variability of performance is high. Minimal detectable change scores at the 90% confidence interval can be used to assess change in performance over time and the impact of treatment.

Autonomous calibration of single spin qubit operations

NASA Astrophysics Data System (ADS)

Frank, Florian; Unden, Thomas; Zoller, Jonathan; Said, Ressa S.; Calarco, Tommaso; Montangero, Simone; Naydenov, Boris; Jelezko, Fedor

2017-12-01

Fully autonomous precise control of qubits is crucial for quantum information processing, quantum communication, and quantum sensing applications. It requires minimal human intervention on the ability to model, to predict, and to anticipate the quantum dynamics, as well as to precisely control and calibrate single qubit operations. Here, we demonstrate single qubit autonomous calibrations via closed-loop optimisations of electron spin quantum operations in diamond. The operations are examined by quantum state and process tomographic measurements at room temperature, and their performances against systematic errors are iteratively rectified by an optimal pulse engineering algorithm. We achieve an autonomous calibrated fidelity up to 1.00 on a time scale of minutes for a spin population inversion and up to 0.98 on a time scale of hours for a single qubit π/2 -rotation within the experimental error of 2%. These results manifest a full potential for versatile quantum technologies.

Brightness Variations in the Solar Atmosphere as Seen by SOHO

NASA Astrophysics Data System (ADS)

Brkovic, A.; Rüedi, I.; Solanki, S. K.; Huber, M. C. E.; Stenflo, J. O.; Stucki, K.; Harrison, R.; Fludra, A.

We present preliminary results of a statistical analysis of the brightness variations of solar features at different levels in the solar atmosphere. We observed quiet Sun regions at disc centre using the Coronal Diagnostic Spectrometer (CDS) onboard the Solar and Heliospheric Observatory (SOHO). We find significant variability at all time scales in all parts of the quiet Sun, from darkest intranetwork to brightest network. Such variations are observed simultaneously in the chromospheric He I 584.33 Angstroms (2 \\cdot 10^4 K) line, the transition region O V 629.74 Angstroms (2.5 \\cdot 10^5 K) and coronal Mg IX 368.06 Angstroms (10^6 K) line. The relative variability is independent of brightness and most of the variability appears to take place on time scales longer than 5 minutes for all 3 spectral lines. No significant differences are observed between the different data sets.

Rapid variations of balmer line strengths in the spectra of Be stars. Ph.D. Thesis; [photoelectric spectrophotometric measurements

NASA Technical Reports Server (NTRS)

Mcbeath, K. B.

1974-01-01

Low resolution photoelectric spectrophotometric measurements of the first four members of the Balmer series in the spectra of one Be and five Be (shell) stars were obtained with the 92-cm telescope and image dissecting scanner. Equivalent widths were computed for each observation, and their standard deviations from the mean values were examined. Results indicate that in three of the program stars, at least one of the Balmer lines shows significant fluctuations in equivalent width. These fluctuations amount to a few per cent of total line strength and the time scales appear to be on the order of three to thirty minutes. The fluctuations are not always present in a given star, indicating that the mechanism producing them may not be continuous. The noncontinuous and nonperiodic nature of the variations, along with their short time scale suggest some form of flare-like or shock origin for the phenomenon.

Ultrarapid Multimode Microwave Synthesis of Nano/Submicron β-SiC

PubMed Central

Johnson, Michael; He, Wenzhi; Li, Guangming; Zhao, Chen; Yu, Luling; Huang, Juwen; Zhu, Haochen

2018-01-01

This paper presents the design, development and realization of a fast and novel process for the synthesis of 3C silicon carbide (β-SiC) nanorods and submicron powder. Using SiO2 (or Si) and activated carbon (AC), this process allows β-SiC to be synthesized with almost 100% purity in timeframes of seconds or minutes using multimode microwave rotary tube reactors under open-air conditions. The synthesis temperature used was 1460 ± 50 °C for Si + AC and 1660 ± 50 °C for SiO2 + AC. The shortest β-SiC synthesis time achieved was about 20 s for Si + AC and 100 s for SiO2 + AC. This novel synthesis method allows for scaled-up flow processes in the rapid industrial-scale production of β-SiC, having advantages of time/energy saving and carbon dioxide emission reduction over comparable modern processes. PMID:29470417

Working-for-Food Behaviors: A Preclinical Study in Prader-Willi Mutant Mice.

PubMed

Lassi, Glenda; Maggi, Silvia; Balzani, Edoardo; Cosentini, Ilaria; Garcia-Garcia, Celina; Tucci, Valter

2016-11-01

Abnormal feeding behavior is one of the main symptoms of Prader-Willi syndrome (PWS). By studying a PWS mouse mutant line, which carries a paternally inherited deletion of the small nucleolar RNA 116 (Snord116), we observed significant changes in working-for-food behavioral responses at various timescales. In particular, we report that PWS mutant mice show a significant delay compared to wild-type littermate controls in responding to both hour-scale and seconds-to-minutes-scale time intervals. This timing shift in mutant mice is associated with better performance in the working-for-food task, and results in better decision making in these mutant mice. The results of our study reveal a novel aspect of the organization of feeding behavior, and advance the understanding of the interplay between the metabolic functions and cognitive mechanisms of PWS. Copyright © 2016 by the Genetics Society of America.

A critical time window for organismal interactions in a pelagic ecosystem.

PubMed

Benoit-Bird, Kelly J; McManus, Margaret A

2014-01-01

To measure organismal coherence in a pelagic ecosystem, we used moored sensors to describe the vertical dynamics of each step in the food chain in shelf waters off the west shore of Oahu, Hawaii. Horizontally extensive, intense aggregations of phytoplankton, zooplankton, and micronekton exhibited strong diel patterns in abundance and vertical distribution, resulting in a highly variable potential for interaction amongst trophic levels. Only around dusk did zooplankton layers overlap with phytoplankton layers. Shortly after sunset, micronekton ascended from the deep, aggregating on the island's shelf. Short-lived departures in migration patterns were detected in depth, vertical distribution, density, and total abundance of micronekton when zooplankton layers were present with typical patterns resuming within one hour. Layers of zooplankton began to disappear within 20 minutes of the arrival of micronekton with no layers present after 50 minutes. The effects of zooplankton layers cascaded even further up the food chain, affecting many behaviors of dolphins observed at dusk including their depth, group size, and inter-individual spacing. As a result of these changes in behavior, during a 30-minute window just after dusk, the number of feeding events observed for each dolphin and consequently the feeding time for each individual more than doubled when zooplankton layers were present. Dusk is a critical period for interactions amongst species in this system from phytoplankton to top predators. Our observations that short time windows can drive the structure and function of a complex suite of organisms highlight the importance of explicitly adding a temporal dimension at a scale relevant to individual organisms to our descriptions of heterogeneity in ocean ecosystems.

Evaluation of STAT medication ordering process in a community hospital.

PubMed

Abdelaziz, Hani; Richardson, Sandra; Walsh, Kim; Nodzon, Jessica; Schwartz, Barbara

2016-01-01

In most health care facilities, problems related to delays in STAT medication order processing time are of common concern. The purpose of this study was to evaluate processing time for STAT orders at Kimball Medical Center. All STAT orders were reviewed to determine processing time; order processing time was also stratified by physician order entry (physician entered (PE) orders vs. non-physician entered (NPE) orders). Collected data included medication ordered, indication, time ordered, time verified by pharmacist, time sent from pharmacy, and time charted as given to the patient. A total of 502 STAT orders were reviewed and 389 orders were included for analysis. Overall, median time was 29 minutes, IQR 16-63; p<0.0001.). The time needed to process NPE orders was significantly less than that needed for PE orders (median 27 vs. 34 minutes; p=0.026). In terms of NPE orders, the median total time required to process STAT orders for medications available in the Automated Dispensing Devices (ADM) was within 30 minutes, while that required to process orders for medications not available in the ADM was significantly greater than 30 minutes. For PE orders, the median total time required to process orders for medications available in the ADM (i.e., not requiring pharmacy involvement) was significantly greater than 30 minutes. [Median time = 34 minutes (p<0.001)]. We conclude that STAT order processing time may be improved by increasing the availability of medications in ADM, and pharmacy involvement in the verification process.

A comparison of septal stapler to suture closure in septoplasty: a prospective, randomized trial evaluating the effect on operative time.

PubMed

Sowerby, Leigh J; Wright, Erin D

2013-11-01

Septoplasty requires coaptation of the mucosal flaps at the conclusion of the procedure; classically this is done with nasal packing. Quilting sutures provide a welcome alternative to packing, but can be time-consuming to place. A septal stapler has recently been developed that provides a rapid alternative to quilting sutures but the timesaving has not been quantified. This study was a prospective, randomized trial comparing a septal stapler to quilting suture for coaptation of mucosal flaps in septoplasty. After meeting inclusion criteria, patients underwent septoplasty and inferior turbinoplasty. The total operative time, surgical segment times, including time for closure was recorded. Preoperative and postoperative Nasal Obstruction Symptom Evaluation (NOSE) scores were recorded. A sample size of 16 was determined to detect a difference of 5 minutes in closure time. A total of 16 patients were enrolled in the study. The mean time for closure with septal stapler was 35 ± 22 seconds vs 7 minutes ± 1 minute 10 seconds for suture closure (p < 0.0001). The mean total operative time using the septal stapler was 28 minutes ± 6 minutes whereas 43 minutes ± 13 minutes was required for suture (p = 0.014). No difference in postoperative complications or mucosal healing was seen; preoperative and postoperative improvement in NOSE scores was comparable. Coaptation of the mucosal flaps in septoplasty with a septal stapler affords a timesaving in the operating room with no difference in operative outcome. © 2013 ARS-AAOA, LLC.

Implementation and Operational Research: A Time-Motion Analysis of HIV Transmission Prevention Counseling and Antiretroviral Adherence Messages in Western Kenya.

PubMed

Were, Martin C; Kessler, Jason; Shen, Changyu; Sidle, John; Macharia, Stephen; Lizcano, John; Siika, Abraham; Wools-Kaloustian, Kara; Kurth, Ann

2015-08-01

Shortages of health workers and large number of HIV-infected persons in Africa mean that time to provide antiretroviral therapy (ART) adherence and other messages to patients is limited. Using time-motion methodology, we documented the intensity and nature of counseling delivered to patients. The study was conducted at a rural and an urban HIV clinic in western Kenya. We recorded all activities of 190 adult patients on ART during their return clinic visits to assess type, frequency, and duration of counseling messages. Mean visit length for patients at the rural clinic was 44.5 (SD = 27.9) minutes and at urban clinic was 78.2 (SD = 42.1) minutes. Median time spent receiving any counseling during a visit was 4.07 minutes [interquartile range (IQR), 1.57-7.33] at rural and 3.99 (IQR, 2.87-6.25) minutes at urban, representing 11% and 8% of total mean visit time, respectively. Median time patients received ART adherence counseling was 1.29 (IQR, 0.77-2.83) minutes at rural and 1.76 (IQR, 1.23-2.83) minutes at urban (P = 0.001 for difference). Patients received a median time of 0.18 (0-0.72) minutes at rural and 0.28 (IQR, 0-0.67) minutes at urban clinic of counseling regarding contraception and pregnancy. Most patients in the study did not receive any counseling regarding alcohol/substance use, emerging risks for ongoing HIV transmission. Although ART adherence was discussed with most patients, time was limited. Reproductive counseling was provided to only half of the patients, and "positive prevention" messaging was minimal. There are strategic opportunities to enhance counseling and information received by clients within HIV programs in resource-limited settings.

Comparison of lornoxicam and low-dose tramadol for management of post-thyroidectomy pain.

PubMed

Yücel, Ali; Yazıcı, Alper; Müderris, Togay; Gül, Fatih

2016-10-01

The present study sought to compare the analgesic efficacy and adverse effects of intravenous (IV) lornoxicam and tramadol to investigate if lornoxicam is a reasonable alternative to a weak opioid for post-thyroidectomy pain. Fifty patients of American Society of Anesthesiologists class I or II, 18 to 65 years of age, and who underwent thyroidectomy were assigned to 2 groups in a randomized manner. Group L received 8 mg of lornoxicam IV and Group T received 1 mg/kg of tramadol IV at conclusion of the operation. Pain intensity of patients was recorded at 15 and 30 minutes, and at 1, 2, 3, 4, 6, 12, and 24 hours after the initial dose with Numerical Rating Scale (NRS) and Ramsey Sedation Scale. Electrocardiogram, heart rate, systolic/diastolic and average artery pressure and peripheral oxygen saturations were monitored continuously during this period. Patients completed satisfaction questionnaires at 24th hour. Both drugs produced acceptable analgesia; however, significantly fewer patients reported 1 or more adverse events with lornoxicam than with tramadol. Most commonly seen in Group T was nausea/vomiting. NRS scores at 15 minutes, 30 minutes, and 1 hour were lower in Group L than in Group T (p<0.05), but there was no significant difference between groups after postoperative first hour. First analgesic requirement time was significantly longer in Group L compared to Group T (p<0.001). No serious complications were seen in either group. Lornoxicam is a safe and effective analgesic that may be used with fewer complications than low-dose tramadol for treatment of moderate to severe postoperative pain.

Influence of contrast shower and water immersion on recovery in elite netballers.

PubMed

Juliff, Laura E; Halson, Shona L; Bonetti, Darrell L; Versey, Nathan G; Driller, Matthew W; Peiffer, Jeremiah J

2014-08-01

Contrast water therapy is a popular recovery modality in sport; however, appropriate facilities can often be difficult to access. Therefore, the present study examined the use of contrast showers as an alternative to contrast water therapy for team sport recovery. In a randomized, crossover design, 10 elite female netball athletes (mean ± SD: age, 20 ± 0.6 years; height, 1.82 ± 0.05 m; body mass, 77.0 ± 9.3 kg) completed 3 experimental trials of a netball specific circuit followed by one of the following 14-minute recovery interventions: (a) contrast water therapy (alternating 1 minute 38° C and 1 minute 15° C water immersion), (b) contrast showers (alternating 1 minute 38° C and 1 minute 18° C showers), or (c) passive recovery (seated rest in 20° C). Repeated agility, skin and core temperature, and perception scales were measured before, immediately after, 5 and 24 hours postexercise. No significant differences in repeated agility were evident between conditions at any time point. No significant differences in core temperature were observed between conditions; however, skin temperature was significantly lower immediately after contrast water therapy and contrast showers compared with the passive condition. Overall perceptions of recovery were superior after contrast water therapy and contrast showers compared with passive recovery. The findings indicate contrast water therapy and contrast showers did not accelerate physical recovery in elite netballers after a netball specific circuit; however, the psychological benefit from both interventions should be considered when determining the suitability of these recovery interventions in team sport.

Physical activity, bowel function, and quality of life among rectal cancer survivors.

PubMed

Krouse, Robert S; Wendel, Christopher S; Garcia, David O; Grant, Marcia; Temple, Larissa K F; Going, Scott B; Hornbrook, Mark C; Bulkley, Joanna E; McMullen, Carmit K; Herrinton, Lisa J

2017-11-01

Physical activity (PA) is positively associated with numerous health benefits among cancer survivors. This study examined insufficiently investigated relationships among PA, health-related quality of life (HRQOL), and bowel function (BF) in rectal cancer survivors. RC survivors (n = 1063) ≥5 years from diagnosis in two Kaiser permanente regions were mailed a multidimensional survey to assess HRQOL and BF. PA was assessed by a modified Godin Leisure-Time Exercise Questionnaire. PA minutes were categorized into weighted categories based on guidelines: (1) not active (zero PA minutes); (2) insufficiently active (1-149 PA minutes); (3) meeting guidelines (150-299 PA minutes); and (4) above guidelines (≥300 PA minutes). Relationships of PA with HRQOL and BF were evaluated using multiple linear regression, stratified by sex and ostomy status for BF. Types of PA identified as helpful for BF and symptoms addressed were summarized. Response rate was 60.5%. Of 557 participants, 40% met or exceeded PA guidelines, 34% were not active, and 26% were insufficiently active. Aerobic activities, specifically walking and cycling, were most commonly reported to help BF. Higher PA was associated with better psychological wellbeing and multiple SF12 scales, worse BF scores in men with ostomies, and better BF scores in women. Meeting or exceeding PA guidelines was associated with higher HRQOL. Although the BF findings are exploratory, they suggest women may benefit from increased PA, whereas men with ostomies may face challenges that require more study. Identifying PA strategies that will lead to improved patient compliance and benefit are needed.

Harbour porpoise distribution can vary at small spatiotemporal scales in energetic habitats

NASA Astrophysics Data System (ADS)

Benjamins, Steven; van Geel, Nienke; Hastie, Gordon; Elliott, Jim; Wilson, Ben

2017-07-01

Marine habitat heterogeneity underpins species distribution and can be generated through interactions between physical and biological drivers at multiple spatiotemporal scales. Passive acoustic monitoring (PAM) is used worldwide to study potential impacts of marine industrial activities on cetaceans, but understanding of animals' site use at small spatiotemporal scales (<1 km, <1 day) remains limited. Small-scale variability in vocalising harbour porpoise (Phocoena phocoena) distribution within two Scottish marine renewable energy development (MRED) sites was investigated by deploying dense arrays of C-POD passive acoustic detectors at a wave energy test site (the European Marine Energy Centre [Billia Croo, Orkney]) and by a minor tidal-stream site (Scarba [Inner Hebrides]). Respective arrays consisted of 7 and 11 moorings containing two C-PODs each and were deployed for up to 55 days. Minimum inter-mooring distances varied between 300-600 m. All C-POD data were analysed at a temporal resolution of whole minutes, with each minute classified as 1 or 0 on the basis of presence/absence of porpoise click trains (Porpoise-Positive Minutes/PPMs). Porpoise detection rates were analysed using Generalised Additive Models (GAMs) with Generalised Estimation Equations (GEEs). Although there were many porpoise detections (wave test site: N=3,432; tidal-stream site: N=17,366), daily detection rates varied significantly within both arrays. Within the wave site array (<1 km diameter), average daily detection rates varied from 4.3 to 14.8 PPMs/day. Within the tidal-stream array (<2 km diameter), average daily detection rates varied from 10.3 to 49.7 PPMs/day. GAM-GEE model results for individual moorings within both arrays indicated linkages between porpoise presence and small-scale heterogeneity among different environmental covariates (e.g., tidal phase, time of day). Porpoise detection rates varied considerably but with coherent patterns between moorings only several hundred metres apart and within hours. These patterns presumably have ecological relevance. These results indicate that, in energetically active and heterogeneous areas, porpoises can display significant spatiotemporal variability in site use at scales of hundreds of metres and hours. Such variability will not be identified when using solitary moored PAM detectors (a common practice for site-based cetacean monitoring), but may be highly relevant for site-based impact assessments of MRED and other coastal developments. PAM arrays encompassing several detectors spread across a site therefore appear to be a more appropriate tool to study site-specific cetacean use of spatiotemporally heterogeneous habitat and assess the potential impacts of coastal and nearshore developments at small scales.

Time threshold for second positive phototropism is decreased by a preirradiation with red light.

PubMed Central

Janoudi A-K; Konjevic, R; Apel, P; Poff, K L

1992-01-01

A second positive phototropic response is exhibited by a plant after the time of irradiation has exceeded a time threshold. The time threshold of dark-grown seedlings is about 15 minutes for Arabidopsis thaliana. This threshold is decreased to about 4 minutes by a 669-nanometer preirradiation. Tobacco (Nicotiana tabacum) seedlings show a similar response. The time threshold of dark-grown seedlings is about 60 minutes for tobacco, and is decreased to about 15 minutes after a preirradiation with either 450- or 669- nanometer light. The existence of a time threshold for second positive phototropism and the dependence of this threshold on the irradiation history of the seedling contribute to the complexity of the fluence response relationship for phototropism. PMID:11537887

Time threshold for second positive phototropism is decreased by a preirradiation with red light

NASA Technical Reports Server (NTRS)

Konjevic, R.; Apel, P.; Poff, K. L.

1992-01-01

A second positive phototropic response is exhibited by a plant after the time of irradiation has exceeded a time threshold. The time threshold of dark-grown seedlings is about 15 minutes for Arabidopsis thaliana. This threshold is decreased to about 4 minutes by a 669-nanometer preirradiation. Tobacco (Nicotiana tabacum) seedlings show a similar response. The time threshold of dark-grown seedlings is about 60 minutes for tobacco, and is decreased to about 15 minutes after a preirradiation with either 450- or 669- nanometer light. The existence of a time threshold for second positive phototropism and the dependence of this threshold on the irradiation history of the seedling contribute to the complexity of the fluence response relationship for phototropism.

Dwarf novae

NASA Technical Reports Server (NTRS)

Ladous, Constanze

1993-01-01

Dwarf novae are defined on grounds of their semi-regular brightness variations of some two to five magnitudes on time scales of typically 10 to 100 days. Historically several different classification schemes have been used. Today, dwarf novae are divided into three sub-classes: the U Geminorum stars, the SU Ursae Majoris stars, and the Z Camelopardalis stars. Outbursts of dwarf novae occur at semi-periodic intervals of time, typically every 10 to 100 days; amplitudes range from typically 2 to 5 mag. Within certain limits values are characteristic for each object. Relations between the outburst amplitude, or the total energy released during outburst, and the recurrence time have been found, as well as relations between the orbital period and the outburst decay time, the absolute magnitude during outburst maximum, and the widths of long and short outbursts, respectively. Some dwarf novae are known to have suspended their normal outburst activity altogether for a while. They later resumed it without having undergone any observable changes. The optical colors of dwarf novae all are quite similar during outburst, considerably bluer than during the quiescent state. During the outburst cycle, characteristic loops in the two color diagram are performed. At a time resolution on the order of minutes, strictly periodic photometric changes due to orbital motion become visible in the light curves of dwarf novae. These are characteristic for each system. Remarkably little is known about orbital variations during the course of an outburst. On time-scales of minutes and seconds, further more or less periodic types of variability are seen in dwarf novae. Appreciable flux is emitted by dwarf novae at all wavelengths from the X-rays to the longest IR wavelengths, and in some cases even in the radio. Most dwarf novae exhibit strong emission line spectra in the optical and UV during quiescence, although some have only very weak emissions in the optical and/or weak absorptions at UV wavelengths.

Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy.

PubMed

Patel, Anuradha; Davidson, Melissa; Tran, Minh C J; Quraishi, Huma; Schoenberg, Catherine; Sant, Manasee; Lin, Albert; Sun, Xiuru

2010-10-01

Dexmedetomidine, a specific α(2) agonist, has an analgesic-sparing effect and reduces emergence agitation. We compared an intraoperative dexmedetomidine infusion with bolus fentanyl to reduce perioperative opioid use and decrease emergence agitation in children with obstructive sleep apnea syndrome undergoing adenotonsillectomy (T&A). One hundred twenty-two patients with obstructive sleep apnea syndrome undergoing T&A, ages 2 to 10 years, completed this prospective, randomized, U.S. Food and Drug Administration-approved study. After mask induction with sevoflurane, group D received IV dexmedetomidine 2 μg · kg(-1) over 10 minutes, followed by 0.7 μg · kg(-1) · h(-1), and group F received IV fentanyl bolus 1 μg · kg(-1). Anesthesia was maintained with sevoflurane, oxygen, and nitrous oxide. Fentanyl 0.5 to 1 μg · kg(-1) was given to subjects in both groups for an increase in heart rate or systolic blood pressure 30% above preincision values that continued for 5 minutes. Observers in the postanesthesia care unit (PACU) were blinded to treatment groups. Pain was evaluated using the objective pain score in the PACU on arrival, at 5 minutes, at 15 minutes, then every 15 minutes for 120 minutes. Emergence agitation was evaluated at the same intervals by 2 scales: the Pediatric Anesthesia Emergence Delirium scale and a 5-point scale described by Cole. Morphine (0.05 to 0.1 mg · kg(-1)) was given for pain (score >4) or severe agitation (score 4 or 5) lasting more than 5 minutes. In group D, 9.8% patients needed intraoperative rescue fentanyl in comparison with 36% in group F (P = 0.001). Mean systolic blood pressure and heart rate were significantly lower in group D (P < 0.05). Minimum alveolar concentration values were significantly different between the 2 groups (P = 0.015). The median objective pain score was 3 for group D and 5 for group F (P = 0.001). In group D, 10 (16.3%) patients required rescue morphine, in comparison with 29 (47.5%) in group F (P = 0.002). The frequency of severe emergence agitation on arrival in the PACU was 18% in group D and 45.9% in group F (P = 0.004); at 5 minutes and at 15 minutes, it was lower in group D (P = 0.028). The duration of agitation on the Cole scale was statistically lower in group D (P = 0.004). In group D, 18% of patients and 40.9% in group F had an episode of Spo(2) below 95% (P = 0.01). An intraoperative infusion of dexmedetomidine combined with inhalation anesthetics provided satisfactory intraoperative conditions for T&A without adverse hemodynamic effects. Postoperative opioid requirements were significantly reduced, and the incidence and duration of severe emergence agitation was lower with fewer patients having desaturation episodes.

Insect repellent activity of medicinal plant oils against Aedes aegypti (Linn.), Anopheles minimus (Theobald) and Culex quinquefasciatus Say based on protection time and biting rate.

PubMed

Phasomkusolsil, Siriporn; Soonwera, Mayura

2010-07-01

This study investigated insect bite protection and length of the protection with 30 repellents which were divided into 3 categories: plant oil, essential oil and essential oil with ethyl alcohol, tested against three mosquito species, Aedes aegypti, Anopheles minimus and Culex quinquefasciatus, under laboratory conditions. The plant oil group was comprised of Phlai (Zingiber cassumunar) and Sweet basil (Ocimum basilicum). Both substances were effective as repellents and feeding deterrents against An. minimus (205 minutes protection time and a biting rate of 0.9%), Cx. quinquefasciatus (165 minutes protection time and 0.9% biting rate) and Ae. aegypti (90 minutes protection time and 0.8% biting rate). Essential oil from citronella grass (Cymbopogon nardus) exhibited protection against biting from all 3 mosquito species: for An. minimus, Cx. quinquefasciatus and Ae. aegypti, the results were 130 minutes and 0.9%, 140 minutes and 0.8%, and 115 minutes and 0.8%, respectively. The period of protection time against Ae. aegypti for all repellent candidates tested was lower than the Thai Industrial Standards Institute (TISI) determined time of greater than 2 hours.

The origin of Total Solar Irradiance variability on timescales less than a day

NASA Astrophysics Data System (ADS)

Shapiro, Alexander; Krivova, Natalie; Schmutz, Werner; Solanki, Sami K.; Leng Yeo, Kok; Cameron, Robert; Beeck, Benjamin

2016-07-01

Total Solar Irradiance (TSI) varies on timescales from minutes to decades. It is generally accepted that variability on timescales of a day and longer is dominated by solar surface magnetic fields. For shorter time scales, several additional sources of variability have been proposed, including convection and oscillation. However, available simplified and highly parameterised models could not accurately explain the observed variability in high-cadence TSI records. We employed the high-cadence solar imagery from the Helioseismic and Magnetic Imager onboard the Solar Dynamics Observatory and the SATIRE (Spectral And Total Irradiance Reconstruction) model of solar irradiance variability to recreate the magnetic component of TSI variability. The recent 3D simulations of solar near-surface convection with MURAM code have been used to calculate the TSI variability caused by convection. This allowed us to determine the threshold timescale between TSI variability caused by the magnetic field and convection. Our model successfully replicates the TSI measurements by the PICARD/PREMOS radiometer which span the period of July 2010 to February 2014 at 2-minute cadence. Hence, we demonstrate that solar magnetism and convection can account for TSI variability at all timescale it has ever been measured (sans the 5-minute component from p-modes).

Individual consistency in the behaviors of newly-settled reef fish

PubMed Central

Meekan, Mark G.; McCormick, Mark I.

2015-01-01

Flexibility in behavior is advantageous for organisms that transition between stages of a complex life history. However, various constraints can set limits on plasticity, giving rise to the existence of personalities that have associated costs and benefits. Here, we document a field and laboratory experiment that examines the consistency of measures of boldness, activity, and aggressive behavior in the young of a tropical reef fish, Pomacentrus amboinensis (Pomacentridae) immediately following their transition between pelagic larval and benthic juvenile habitats. Newly-settled fish were observed in aquaria and in the field on replicated patches of natural habitat cleared of resident fishes. Seven behavioral traits representing aspects of boldness, activity and aggression were monitored directly and via video camera over short (minutes), medium (hours), and long (3 days) time scales. With the exception of aggression, these behaviors were found to be moderately or highly consistent over all time scales in both laboratory and field settings, implying that these fish show stable personalities within various settings. Our study is the first to examine the temporal constancy of behaviors in both field and laboratory settings in over various time scales at a critically important phase during the life cycle of a reef fish. PMID:26020013

Individual consistency in the behaviors of newly-settled reef fish.

PubMed

White, James R; Meekan, Mark G; McCormick, Mark I

2015-01-01

Flexibility in behavior is advantageous for organisms that transition between stages of a complex life history. However, various constraints can set limits on plasticity, giving rise to the existence of personalities that have associated costs and benefits. Here, we document a field and laboratory experiment that examines the consistency of measures of boldness, activity, and aggressive behavior in the young of a tropical reef fish, Pomacentrus amboinensis (Pomacentridae) immediately following their transition between pelagic larval and benthic juvenile habitats. Newly-settled fish were observed in aquaria and in the field on replicated patches of natural habitat cleared of resident fishes. Seven behavioral traits representing aspects of boldness, activity and aggression were monitored directly and via video camera over short (minutes), medium (hours), and long (3 days) time scales. With the exception of aggression, these behaviors were found to be moderately or highly consistent over all time scales in both laboratory and field settings, implying that these fish show stable personalities within various settings. Our study is the first to examine the temporal constancy of behaviors in both field and laboratory settings in over various time scales at a critically important phase during the life cycle of a reef fish.

An integrative neuroscience model of "significance" processing.

PubMed

Williams, Leanne M

2006-03-01

The Gordon [37-40] framework of Integrative Neuroscience is used to develop a continuum model for understanding the central role of motivationally-determined "significance" in organizing human information processing. Significance is defined as the property which gives a stimulus relevance to our core motivation to minimize danger and maximize pleasure. Within this framework, the areas of cognition and emotion, theories of motivational arousal and orienting, and the current understanding of neural systems are brought together. The basis of integration is a temporal continuum in which significance processing extends from the most rapid millisecond time scale of automatic, nonconscious mechanisms to the time scale of seconds, in which memory is shaped, to the controlled and conscious mechanisms unfolding over minutes. Over this continuum, significant stimuli are associated with a spectrum of defensive (or consumptive) behaviors through to volitional regulatory behaviors for danger (versus pleasure) and associated brainstem, limbic, medial forebrain bundle and prefrontal circuits, all of which reflect a balance of excitatory (predominant at rapid time scales) to inhibitory mechanisms. Across the lifespan, the negative and positive outcomes of significance processing, coupled with constitutional and genetic factors, will contribute to plasticity, shaping individual adaptations and maladaptions in the balance of excitatory-inhibitory mechanisms.

Rapid developing of Ektaspeed dental film by increase of temperature.

PubMed

Fredholm, U; Julin, P

1987-01-01

Three rapid developing solutions and one standard solution were tested for contrast and fog with Ektaspeed film at temperatures ranging from 15 degrees to 30 degrees C. Temperatures below 18 degrees C were found to give extremely long developing times, more than 3 minutes with rapid developers, and were not recommended. In the interval between 21 degrees C and 24 degrees C the standard developer needed 3.5-2.5 minutes to get optimum contrast. Two rapid developers needed 1.5 minutes and the fastest 1 minute to get satisfactory contrast throughout this temperature range. A further increase of the temperature gave only a marginal time saving with the rapid solutions and was not considered worthwhile. The relation between developing time and temperature for the rapid developers had a very steep gradient below 21 degrees C, while it levelled out at room temperature. For the standard developer the time/temperature function had a more even gradient from 7.5 minutes at 15 degrees C to 1.5 minutes at 27 degrees C, i.e. an average reduction of 0.5 minute per degree. Between 27 degrees C and 30 degrees C the gradient levelled out. The fog did not increase significantly until at 30 degrees C or at more than double the optimal developing time at room temperature. Recommendations of optimal developing time of Ektaspeed film at different temperatures are given for the four tested developing solutions.

An observational search for large-scale organization of five-minute oscillations on the sun. [coronal holes or sector structure relationships

NASA Technical Reports Server (NTRS)

Dittmer, P. H.; Scherrer, P. H.; Wilcox, J. M.

1978-01-01

The large-scale solar velocity field has been measured over an aperture of radius 0.8 solar radii on 121 days between April and September, 1976. Measurements are made in the line Fe I 5123.730 A, employing a velocity subtraction technique similar to that of Severny et al. (1976). Comparisons of the amplitude and frequency of the five-minute resonant oscillation with the geomagnetic C9 index and magnetic sector boundaries show no evidence of any relationship between the oscillations and coronal holes or sector structure.

Oxidant-Antioxidant Balance during On-Pump Coronary Artery Bypass Grafting

PubMed Central

Mentese, Umit; Dogan, Orhan Veli; Turan, Ibrahim; Usta, Sefer; Dogan, Emre; Oztas Mentese, Seda; Demir, Selim; Ozer, Tanil; Aykan, Ahmet Cagri; Alver, Ahmet

2014-01-01

Backround. The aim of this study was to evaluate the changes in perioperative oxidant-antioxidant balance in ONCABG. Methods. Twenty-three patients were included in this study. Serum total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI) values were assessed preoperatively, at 20 minutes after aortic clamping and at 30 minutes, 6 hours, and 48 hours after declamping (reperfusion). The patients were divided into 2 groups according to the median aortic cross clamping (XC) time: group 1 (XC time < 42 minutes) and group 2 (XC time ≥ 42 minutes). Results. TOS and OSI values of whole patients at 30 minutes after reperfusion were higher than preoperative values (P = 0.045, P = 0.015), while perioperative TAS levels of the patients were similar to the preoperative levels (P = 0.173). XC time was correlated with TOS levels at 30 minutes after reperfusion (r = 0.43, P = 0.041). In group 2, TOS and OSI values at 30 minutes after reperfusion were higher than preoperative values (P = 0.023, P = 0.048), whereas a significant difference was not found in group 1 (P = 0.601, P = 0.327). Conclusions. Oxidative imbalance and increase in TOS at reperfusion in ONCABG may be associated with XC time. PMID:25302318

Computational Fluid Dynamics Modeling of the John Day Dam Tailrace

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

Rakowski, Cynthia L.; Perkins, William A.; Richmond, Marshall C.

US Army Corps of Engineers - Portland District required that a two-dimensional (2D) depth-averaged and a three-dimensional (3D) free-surface numerical models to be developed and validated for the John Day tailrace. These models were used to assess potential impact of a select group of structural and operational alternatives to tailrace flows aimed at improving fish survival at John Day Dam. The 2D model was used for the initial assessment of the alternatives in conjunction with a reduced-scale physical model of the John Day Project. A finer resolution 3D model was used to more accurately model the details of flow inmore » the stilling basin and near-project tailrace hydraulics. Three-dimensional model results were used as input to the Pacific Northwest National Laboratory particle tracking software, and particle paths and times to pass a downstream cross section were used to assess the relative differences in travel times resulting from project operations and structural scenarios for multiple total river flows. Streamlines and neutrally-buoyant particles were seeded in all turbine and spill bays with flows. For a Total River of 250 kcfs running with the Fish Passage Plan spill pattern and a spillwall, the mean residence times for all particles were little changed; however the tails of the distribution were truncated for both spillway and powerhouse release points, and, for the powerhouse releases, reduced the residence time for 75% of the particles to pass a downstream cross section from 45.5 minutes to 41.3 minutes. For a total river of 125 kcfs configured with the operations from the Fish Passage Plan for the temporary spillway weirs and for a proposed spillwall, the neutrally-buoyant particle tracking data showed that the river with a spillwall in place had the overall mean residence time increase; however, the residence time for 75% of the powerhouse-released particles to pass a downstream cross section was reduced from 102.4 min to 89 minutes.« less

T700 Blisk and Impeller Manufacturing Process Development Program.

DTIC Science & Technology

1979-11-01

700(40) Reworked Media Temperature - 790 F Average Media Pressure - 200 psi Total Cycles (Test No. 1) - 40 Total Cycles (Test No. 2) - 20 Total Time...36A(73), - 700(40" Media Temperature - 80F Average Media Pressure - 150 psi Total Cycles - 52 Total Time - 95 Minutes Some difficulty was...61)-36A(73)-700( 4O)Media Temperature - 79OF average Media Pressure - 200 psi Time - 40 cycles - 72 minutes Time - 60 cycles - 109 minutes Time - 80

Objective structured assessment of technical skills evaluation of theoretical compared with hands-on training of shoulder dystocia management: a randomized controlled trial.

PubMed

Buerkle, Bernd; Pueth, Julia; Hefler, Lukas A; Tempfer-Bentz, Eva-Katrin; Tempfer, Clemens B

2012-10-01

To compare the skills of performing a shoulder dystocia management algorithm after hands-on training compared with demonstration. We randomized medical students to a 30-minute hands-on (group 1) and a 30-minute demonstration (group 2) training session teaching a standardized shoulder dystocia management scheme on a pelvic training model. Participants were tested with a 22-item Objective Structured Assessment of Technical Skills scoring system after training and 72 hours thereafter. Objective Structured Assessment of Technical Skills scores were the primary outcome. Performance time, self-assessment, confidence, and global rating scale were the secondary outcomes. Statistics were performed using Mann-Whitney U test, χ test, and multiple linear regression analysis. Two hundred three participants were randomized. Objective Structured Assessment of Technical Skills scores were significantly higher in group 1 (n=103) compared with group 2 (n=100) (17.95±3.14 compared with 15.67±3.18, respectively; P<.001). The secondary outcomes global rating scale (GRS; 10.94±2.71 compared with 8.57±2.61, respectively; P<.001), self-assessment (3.15±0.94 compared with 2.72±1.01; P=.002), and confidence (3.72±0.98 compared with 3.34±0.90, respectively; P=.005), but not performance time (3:19±0:48 minutes compared with 3:31±1:05 minutes; P=.1), were also significantly different, favoring group 1. After 72 hours, Objective Structured Assessment of Technical Skills scores were still significantly higher in group 1 (n=67) compared with group 2 (n=60) (18.17±2.76 compared with 14.98±3.03, respectively; P<.001) as were GRS (10.80±2.62 compared with 8.15±2.59; P<.001) and self assessment (SA; 3.44±0.87 compared with 2.95±0.94; P=.003). In a multiple linear regression analysis, group assignment (group 1 compared with 2; P<.001) and sex (P=.002) independently influenced Objective Structured Assessment of Technical Skills scores. Hands-on training helps to achieve a significant improvement of shoulder dystocia management on a pelvic training model. www.ClinicalTrials.gov, NCT01618565. I.

4D porosity evolution during solid-solid replacement reaction in mineral system (KBr, KCl)

NASA Astrophysics Data System (ADS)

Beaudoin, Nicolas; Hamilton, Andrea; Koehn, Daniel; Shipton, Zoe

2017-04-01

An extensive understanding of the controlling mechanisms of phase transformation is key in geosciences to better predicting the evolution of the physical parameters of rocks (porosity, permeability, and rheology) from centimetre-scale (e.g. fingering in siltstones) to kilometer-scale (e.g. Dolostone geobodies), in both the diagenetic and metamorphic domains. This contribution reports the 4D monitoring of a KBr crystal at different time steps during an experimental, fluid-mediated replacement reaction with KCl. Volumes are reconstructed based on density contrast using non-destructive X-ray Computed Tomography (XCT) at a resolution of 3 microns. A sample of KBr was immersed in a static bath of saturated KCl at room temperature and pressure. 5 scans were performed during the reaction at 5, 10, 20, 35 and 55 minutes, until 50% of the original crystal was replaced. As a control experiment, two samples reacted continuously for 15 and 55 minutes, respectively. Each 3D dataset was reconstructed to visualize and quantify the different mineral phases, the porosity distribution and connectivity, along with the reaction front morphology. In the case of successive baths, results show that the front morphology evolves from rough with small fingers to flat and thick during the reaction, suggesting a switch between advection and diffusion controlled reactant distribution through time. This switch is also reflected in the mass evolution and the rate of propagation of the replaced zone, being rapid in the first 20 minutes before reaching steady state. The porosity develops perpendicular to the crystal wall, suggesting a self-organization process governed by advection, before connecting laterally. While the reaction changes from advection controlled to diffusion controlled, the direction of the connected pores becomes parallel to the crystal walls. This phenomenon is not observed when the crystal is reacting discontinuously for 55 minutes. In the latter case, self-organization similar to extended fingering is observed, suggesting the advection to diffusion switch is related to the successive stop of reaction progress for scanning. In both cases, when considering only the reacting zone of the crystal, we can estimate the porosity created by Br-Cl substitution at 30%. The evolution of connected porosity distribution helps to understand how fluid flow can migrate in a transforming rock, for example during dolomitisation, a phenomenon extensively observed in sedimentary basins.

Impact of a logistics management program on admitted patient boarders within an emergency department.

PubMed

Healy-Rodriguez, Mary Anne; Freer, Chris; Pontiggia, Laura; Wilson, Rula; Metraux, Steve; Lord, Lyndsey

2014-03-01

ED crowding is a public health issue, and hospitals across the country must pursue aggressive strategies to improve patient flow to help solve this growing problem. The logistics management program (LMP) is an expansion of the bed management process to include a systematic approach to patient flow management throughout the facility and a clinical liaison or field agent to drive throughput at all points of care. The purpose of this study was to examine the effects of an LMP on ED length of stay (ED evaluation times and ED placement times), as well as inpatient length of stay (IPLOS). This is a quasi-experimental study of 28,684 ED admissions in a suburban, tertiary medical center before and after implementing an LMP (2008 vs 2009). The median ED evaluation time was 219 minutes (interquartile range [IQR], 178 minutes) in 2008 versus 207 minutes (IQR, 171 minutes) in 2009 (P < .001). The median ED placement time was 219 minutes (IQR, 259 minutes) in 2008 versus 193 minutes (IQR, 158 minutes) in 2009 (P < .001). The median IPLOS was 3.93 days (IQR, 4.9 days) in 2008 versus 3.83 days (IQR, 4.7 days) in 2009 (P < .001), which represents a reduction of 1,483 inpatient days in 2009. The results provide strong evidence to support the impact of an LMP on decreasing ED evaluation times, ED placement times, and IPLOS. Further exploration is needed to examine the program as a best practice, as well as its applicability for other facilities. Copyright © 2014 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

PROTOCOL FOR REDUCING TIME TO ANTIBIOTICS IN FEBRILE NEONATES PRESENTING TO THE EMERGENCY DEPARTMENT: A QUALITY IMPROVEMENT INITIATIVE

PubMed Central

Boutin, A

2017-01-01

Abstract BACKGROUND: Febrile neonates are at high risk of morbidity and mortality from infectious causes. This risk further increases if antibiotics are not received in a timely manner. Current guidelines recommend early initiation (less than 1 hour) of antibiotics for patients with severe sepsis. Time-to-antibiotic administration (TAA) should also be targeted as a quality-of-care (QOC) measure for febrile neonates. A previous evaluation showed that most of these patients were not receiving antibiotics in the first hour at our emergency department (ED). OBJECTIVES: We evaluated whether a simple quality improvement protocol would improve the proportion of febrile neonates receiving antibiotics within 60 minutes of arrival to the ED. DESIGN/METHODS: This was a pre-post intervention study conducted in the ED of an academic pediatric tertiary care hospital with an annual volume of approximately 83,000 patients in 2014-2016. Participants were a random sample of all children younger than 28 days old visiting the ED for a febrile illness. The new protocol, which consisted for the nurses, after triage, to place the patients directly in the resuscitation room for immediate assessment by a physician, was implemented in February 2016. Previously, these children were triaged level 2 on the Canadian Triage and Acuity Scale (CTAS), flagged and placed in a regular examination room waiting for the physician assessment. With the new protocol, IV access, blood culture, urine analysis and culture were immediately obtained by the nurse in charge with the concomitant assessment by the attending physician. Forty charts prior to and 50 charts after protocol initiation were reviewed by an archivist using a standardized form between 2014-2015 and 2016, respectively. The primary outcome was TAA. This was defined as the time from initial ED registration to the beginning of antibiotics infusion. As a secondary outcome, all cases were reviewed individually to determine barriers to rapid antibiotic administration (day, evening, or night shifts, other treatments or investigations, number of attempts for intravenous access) and to elicit new quality improvement strategies. RESULTS: During the study periods a total of 178 (pre) and 135 (post) patients fulfilled the inclusion criteria. Among the random samples, 6/50 (12%) of patients received their antibiotics within 60 minutes in the post-intervention period compared to 0/40 (0%) in the pre-implementation period (difference 12%; 95 CI: 1-24%). Within 90 minutes, the proportion improved from 1/40 (2.5%) to 29/50 (58%) (difference 56%; 95 CI: 38-68%). Median TAA in febrile neonates decreased from 182 minutes (interquartile range, 147-219 minutes) in the pre-implementation period to 85 minutes (interquartile range, 73-115 minutes) in the post-implementation period. The main obstacle to the goal of 60 minutes for TAA was the difficulty to get IV access as well as antibiotic availability. CONCLUSION: In this study, a new protocol mandating the immediate transfer of febrile neonate from triage to the resuscitation room improved proportion of febrile neonates receiving antibiotics in less than 60 minutes in our ED. Our results suggest that simple interventions can reduce TAA in a selected group of patients presenting to the ED.

Evaluation of Operating Time and Patient Perception Using Conventional Impression Taking and Intraoral Scanning for Crown Manufacture: A Split-mouth, Randomized Clinical Study.

PubMed

Haddadi, Yasser; Bahrami, Golnosh; Isidor, Flemming

To compare operating time and patient perception of conventional impression (CI) taking and intraoral scanning (IOS) for manufacture of a tooth-supported crown. A total of 19 patients needing indirect full-coverage restorations fitting the requirements for a split-mouth design were recruited. Each patient received two lithium disilicate crowns, one manufactured from CI taking and one from IOS. Both teeth were prepared following the manufacturers' recommendations. For both impression techniques, two retraction cords soaked in 15% ferric sulphate were used for tissue management. CIs were taken in a full-arch metallic tray using one-step, two-viscosity technique with polyvinyl siloxane silicone. The operating time for each step of the two impression methods was registered. Patient perception associated with each method was scored using a 100-mm visual analog scale (VAS), with 100 indicating maximum discomfort. Median total operating time for CI taking was 15:47 minutes (interquartile range [IQR] 15:18 to 17:30), and for IOS was 5:05 minutes (IQR 4:35 to 5:23). The median VAS score for patient perception was 73 (IQR 16 to 89) for CI taking and 6 (IQR 2 to 9) for IOS. The differences between the two groups were statistically significant (P < .05) for both parameters. IOS was less time consuming than CI taking, and patient perception was in favor of IOS.

Outpatient Office Wait Times And Quality Of Care For Medicaid Patients.

PubMed

Oostrom, Tamar; Einav, Liran; Finkelstein, Amy

2017-05-01

The time patients spend in a doctor's waiting room prior to a scheduled appointment is an important component of the quality of the overall health care experience. We analyzed data on twenty-one million outpatient visits obtained from electronic health record systems, which allowed us to measure time spent in the waiting room beyond the scheduled appointment time. Median wait time was a little more than four minutes. Almost one-fifth of visits had waits longer than twenty minutes, and 10 percent were more than thirty minutes. Waits were shorter for early-morning appointments, for younger patients, and at larger practices. Median wait time was 4.1 minutes for privately insured patients and 4.6 minutes for Medicaid patients. After adjustment for patient and appointment characteristics, Medicaid patients were 20 percent more likely than the privately insured patients to wait longer than twenty minutes, with most of this disparity explained by differences in practices and providers they saw. Wait times for Medicaid patients relative to privately insured patients were longer in states with relatively lower Medicaid reimbursement rates. The study complements other work that suggests that Medicaid patients face some additional barriers in the receipt of care. Project HOPE—The People-to-People Health Foundation, Inc.

Calcium Signaling enhancement during oocyte maturation

NASA Astrophysics Data System (ADS)

Jung, Peter; Ullah, Ghanim; Machaca, Khaled

2006-03-01

A Ca2+ signal with a special spatial and temporal characteristic universally removes cell-cycle arrest after fertilization of a mature egg cell. The Ca2+ signal is characterized by a fast rise of intracellular Ca2+ and a slow decay on the time scale of minutes. We use computational modeling of Ca2+ release on the microscale (Ca2+ puffs) and cell-scale in conjunction with experimental knowledge of the changes in the Ca2+ signaling apparatus during oocyte maturation and changing signaling patterns to explore the relationship between organization and sensitivity of IP3 receptors and SERCA pumps and the resulting signaling patterns. We hypothesize that potentiation of the IP3 receptors during oocyte maturation is the main cause for the differentiation in the signaling patterns.

Reducing the time rabbit sperm are held at 5 °C negatively affects their fertilizing ability after cryopreservation.

PubMed

Mocé, E; Blanch, E; Talaván, A; Viudes de Castro, M P

2014-10-15

Cooling sperm to and equilibrating the sperm at 5 °C require the most time in any sperm cryopreservation protocol. Reducing the time required for these phases would simplify sperm freezing protocols and allow greater number of ejaculates to be processed and frozen in a given time. This study determined how holding rabbit sperm at 5 °C for different lengths of time (0, 10, 15, 20, 30, or 45 minutes) affected the quality of rabbit sperm, measured by in vitro assays, and if reducing the cooling time to only 10 minutes affected the fertilizing ability of the sperm. Reducing the time sperm were held at 5 °C to 10 minutes did not affect the in vitro quality of the sperm (percent motile and with intact plasma membranes), although eliminating the cooling phase completely (directly freezing the sperm from room temperature) decreased in vitro assessed sperm quality (P<0.01). However, reducing the time sperm were held at 5 °C, from 45 to 10 minutes, negatively affected the fertilizing ability of sperm in vivo (P<0.05). In conclusion, completely eliminating cooling rabbit sperm to 5 °C before freezing is detrimental for rabbit sperm cryosurvival, and although shortening the time sperm are held at 5 °C to 10 minutes does not reduce in vitro sperm quality, it does reduce the fertility of rabbit sperm. Therefore, the length of time rabbit sperm equilibrate at 5 °C is crucial to the fertilizing ability of rabbit sperm and must be longer than 10 minutes. Currently, it is not known if holding rabbit sperm at 5 °C for less than 45 minutes will affect sperm fertilizing ability. Copyright © 2014 Elsevier Inc. All rights reserved.

Effectiveness of a myocardial infarction protocol in reducing door-to-ballon time.

PubMed

Correia, Luis Cláudio Lemos; Brito, Mariana; Kalil, Felipe; Sabino, Michael; Garcia, Guilherme; Ferreira, Felipe; Matos, Iracy; Jacobs, Peter; Ronzoni, Liliana; Noya-Rabelo, Márcia

2013-07-01

An adequate door-to-balloon time (<120 minutes) is the necessary condition for the efficacy of primary angioplasty in infarction to translate into effectiveness. To describe the effectiveness of a quality of care protocol in reducing the door-to-balloon time. Between May 2010 and August 2012, all individuals undergoing primary angioplasty in our hospital were analyzed. The door time was electronically recorded at the moment the patient took a number to be evaluated in the emergency room, which occurred prior to filling the check-in forms and to the triage. The balloon time was defined as the beginning of artery opening (introduction of the first device). The first 5 months of monitoring corresponded to the period of pre-implementation of the protocol. The protocol comprised the definition of a flowchart of actions from patient arrival at the hospital, the team's awareness raising in relation to the prioritization of time, and provision of a periodic feedback on the results and possible inadequacies. A total of 50 individuals were assessed. They were divided into five groups of 10 sequential patients (one group pre- and four groups post-protocol). The door-to-balloon time regarding the 10 cases recorded before protocol implementation was 200 ± 77 minutes. After protocol implementation, there was a progressive reduction of the door-to-balloon time to 142±78 minutes in the first 10 patients, then to 150±50 minutes, 131±37 minutes and, finally, 116±29 minutes in the three sequential groups of 10 patients, respectively. Linear regression between sequential patients and the door-to-balloon time (r = - 0.41) showed a regression coefficient of - 1.74 minutes. The protocol implementation proved effective in the reduction of the door-to-balloon time.

Kinetic study of ferronickel slag grinding at variation of ball filling and ratio of feed to grinding balls

NASA Astrophysics Data System (ADS)

Sanwani, Edy; Ikhwanto, Muhammad

2017-01-01

The objective of this paper is to investigate the effect of ball filling and ratio of feed to grinding balls on the kinetic of grinding of ferronickel slag in a laboratory scale ball mill. The experiments were started by crushing the ferronickel slag samples using a roll crusher to produce -3 mesh (-6.7 mm) product. This product, after sampling and sample dividing processes, was then used as feed for grinding process. The grinding was performed with variations of ball filling and ratio of feed to grinding balls for 150 minutes. At every certain time interval, particle size analysis was carried out on the grinding product. The results of the experiments were also used to develop linear regression model of the effect of grinding variables on the P80 of the product. Based on this study, it was shown that P80 values of the grinding products declined sharply until 70 minutes of grinding time due to the dominant mechanism of impact breakage and then decreased slowly after 70 minutes until 150 minutes of grinding time due to dominant mechanism of attrition breakage. Kinetics study of the grinding process on variations of grinding ball filling showed that the optimum rate of formation of fine particles for 20%, 30%, 40% and 50% mill volume was achieved at a particle size of 400 µm in which the best initial rate of formation occurred at 50% volume of mill. At the variations of ratio of feed to grinding balls it was shown that the optimum rate of grinding for the ratio of 1:10, 1: 8 and 1: 6 was achieved at a particle size of 400 µm and for the ratio of 1: 4 was at 841 µm in which the best initial rate of formation occurred at a 1:10 ratio. In this study, it was also produced two regression models that can predict the P80 value of the grinding product as a function of the variables of grinding time, ball filling and the ratio of the feed to grinding balls.

Correlates of accelerometer-assessed physical activity and sedentary time among adults with type 2 diabetes.

PubMed

Mathe, Nonsikelelo; Boyle, Terry; Al Sayah, Fatima; Mundt, Clark; Vallance, Jeff K; Johnson, Jeffrey A; Johnson, Steven T

2017-11-09

The aims of this study were to describe the volume and patterns of objectively assessed sedentary behaviour, light intensity physical activity (LPA) and moderate-vigorous physical activity (MVPA), and to examine socio-demographic correlates, among adults living with type 2 diabetes. Participants (n = 166) wore an accelerometer (Actigraph® GT3X+) for seven consecutive days during waking hours and completed a questionnaire. Physical activity (PA) and sedentary time were described, and multivariable linear regression was used to estimate associations between socio-demographic characteristics and sedentary time and PA. Participants, 46% of whom were female, had a mean age of 65.4 years (standard deviation (SD) = 9.5), body mass index (BMI) of 31.5 (6.6) kg/m2 and had been living with diabetes for an average of 13.1 (7.6) years. Participants were sedentary for 543.6 minutes/day, spent 273.4 minutes/day and 22.4 minutes/day in LPA and MVPA respectively. BMI was associated with increased sedentary time and reduced LPA (-2.5 minutes/day, 95% CI: -4.33 to -0.70) and MVPA (-0.62 minutes/day, 95% CI: -1.05 to -0.18) time. Compared with males, females had more LPA (34.4 minutes/day, 95% CI: 10.21-58.49) and less MVPA (-6.2 minutes/day, 95% CI: -12.04 to -0.41) time. Unemployed participants had 30.05 minutes more MVPA (95% CI: 3.35-56.75) than those who were employed or homemakers, and those not reporting income had 13 minutes/day more MVPA time than participants in the lowest income category (95% CI: 3.46-22.40). Adults living with type 2 diabetes were not sufficiently active and were highly sedentary. Our results emphasize the need for more research exploring the diabetes-related health outcomes of sedentary behaviour and physical inactivity among people living with type 2 diabetes.

Evaluation of STAT medication ordering process in a community hospital

PubMed Central

Walsh., Kim; Schwartz., Barbara

Background: In most health care facilities, problems related to delays in STAT medication order processing time are of common concern. Objective: The purpose of this study was to evaluate processing time for STAT orders at Kimball Medical Center. Methods: All STAT orders were reviewed to determine processing time; order processing time was also stratified by physician order entry (physician entered (PE) orders vs. non-physician entered (NPE) orders). Collected data included medication ordered, indication, time ordered, time verified by pharmacist, time sent from pharmacy, and time charted as given to the patient. Results: A total of 502 STAT orders were reviewed and 389 orders were included for analysis. Overall, median time was 29 minutes, IQR 16–63; p<0.0001.). The time needed to process NPE orders was significantly less than that needed for PE orders (median 27 vs. 34 minutes; p=0.026). In terms of NPE orders, the median total time required to process STAT orders for medications available in the Automated Dispensing Devices (ADM) was within 30 minutes, while that required to process orders for medications not available in the ADM was significantly greater than 30 minutes. For PE orders, the median total time required to process orders for medications available in the ADM (i.e., not requiring pharmacy involvement) was significantly greater than 30 minutes. [Median time = 34 minutes (p<0.001)]. Conclusion: We conclude that STAT order processing time may be improved by increasing the availability of medications in ADM, and pharmacy involvement in the verification process. PMID:27382418

Clinical Digital Libraries Project: design approach and exploratory assessment of timely use in clinical environments*

PubMed Central

MacCall, Steven L.

2006-01-01

Objective: The paper describes and evaluates the use of Clinical Digital Libraries Project (CDLP) digital library collections in terms of their facilitation of timely clinical information seeking. Design: A convenience sample of CDLP Web server log activity over a twelve-month period (7/2002 to 6/2003) was analyzed for evidence of timely information seeking after users were referred to digital library clinical topic pages from Web search engines. Sample searches were limited to those originating from medical schools (26% North American and 19% non-North American) and from hospitals or clinics (51% North American and 4% non-North American). Measurement: Timeliness was determined based on a calculation of the difference between the timestamps of the first and last Web server log “hit” during each search in the sample. The calculated differences were mapped into one of three ranges: less than one minute, one to three minutes, and three to five minutes. Results: Of the 864 searches analyzed, 48% were less than 1 minute, 41% were 1 to 3 minutes, and 11% were 3 to 5 minutes. These results were further analyzed by environment (medical schools versus hospitals or clinics) and by geographic location (North America versus non-North American). Searches reflected a consistent pattern of less than 1 minute in these environments. Though the results were not consistent on a month-by-month basis over the entire time period, data for 8 of 12 months showed that searches shorter than 1 minute predominated and data for 1 month showed an equal number of less than 1 minute and 1 to 3 minute searches. Conclusions: The CDLP digital library collections provided timely access to high-quality Web clinical resources when used for information seeking in medical education and hospital or clinic environments from North American and non–North American locations and consistently provided access to the sought information within the documented two-minute standard. The limitations of the use of Web server data warrant an exploratory assessment. This research also suggests the need for further investigation in the area of timely digital library collection services to clinical environments. PMID:16636712

Clinical Digital Libraries Project: design approach and exploratory assessment of timely use in clinical environments.

PubMed

Maccall, Steven L

2006-04-01

The paper describes and evaluates the use of Clinical Digital Libraries Project (CDLP) digital library collections in terms of their facilitation of timely clinical information seeking. A convenience sample of CDLP Web server log activity over a twelve-month period (7/2002 to 6/2003) was analyzed for evidence of timely information seeking after users were referred to digital library clinical topic pages from Web search engines. Sample searches were limited to those originating from medical schools (26% North American and 19% non-North American) and from hospitals or clinics (51% North American and 4% non-North American). Timeliness was determined based on a calculation of the difference between the timestamps of the first and last Web server log "hit" during each search in the sample. The calculated differences were mapped into one of three ranges: less than one minute, one to three minutes, and three to five minutes. Of the 864 searches analyzed, 48% were less than 1 minute, 41% were 1 to 3 minutes, and 11% were 3 to 5 minutes. These results were further analyzed by environment (medical schools versus hospitals or clinics) and by geographic location (North America versus non-North American). Searches reflected a consistent pattern of less than 1 minute in these environments. Though the results were not consistent on a month-by-month basis over the entire time period, data for 8 of 12 months showed that searches shorter than 1 minute predominated and data for 1 month showed an equal number of less than 1 minute and 1 to 3 minute searches. The CDLP digital library collections provided timely access to high-quality Web clinical resources when used for information seeking in medical education and hospital or clinic environments from North American and non-North American locations and consistently provided access to the sought information within the documented two-minute standard. The limitations of the use of Web server data warrant an exploratory assessment. This research also suggests the need for further investigation in the area of timely digital library collection services to clinical environments.

The analysis of the possibility of using 10-minute rainfall series to determine the maximum rainfall amount with 5 minutes duration

NASA Astrophysics Data System (ADS)

Kaźmierczak, Bartosz; Wartalska, Katarzyna; Wdowikowski, Marcin; Kotowski, Andrzej

2017-11-01

Modern scientific research in the area of heavy rainfall analysis regarding to the sewerage design indicates the need to develop and use probabilistic rain models. One of the issues that remains to be resolved is the length of the shortest amount of rain to be analyzed. It is commonly believed that the best time is 5 minutes, while the least rain duration measured by the national services is often 10 or even 15 minutes. Main aim of this paper is to present the difference between probabilistic rainfall models results given from rainfall time series including and excluding 5 minutes rainfall duration. Analysis were made for long-time period from 1961-2010 on polish meteorological station Legnica. To develop best fitted to measurement rainfall data probabilistic model 4 probabilistic distributions were used. Results clearly indicates that models including 5 minutes rainfall duration remains more appropriate to use.

Laboratory sample turnaround times: do they cause delays in the ED?

PubMed

Gill, Dipender; Galvin, Sean; Ponsford, Mark; Bruce, David; Reicher, John; Preston, Laura; Bernard, Stephani; Lafferty, Jessica; Robertson, Andrew; Rose-Morris, Anna; Stoneham, Simon; Rieu, Romelie; Pooley, Sophie; Weetch, Alison; McCann, Lloyd

2012-02-01

Blood tests are requested for approximately 50% of patients attending the emergency department (ED). The time taken to obtain the results is perceived as a common reason for delay. The objective of this study was therefore to investigate the turnaround time (TAT) for blood results and whether this affects patient length of stay (LOS) and to identify potential areas for improvement. A time-in-motion study was performed at the ED of the John Radcliffe Hospital (JRH), Oxford, UK. The duration of each of the stages leading up to receipt of 101 biochemistry and haematology results was recorded, along with the corresponding patient's LOS. The findings reveal that the mean time for haematology results to become available was 1 hour 6 minutes (95% CI: 29 minutes to 2 hours 13 minutes), while biochemistry samples took 1 hour 42 minutes (95% CI: 1 hour 1 minute to 4 hours 21 minutes), with some positive correlation noted with the patient LOS, but no significant variation between different days or shifts. With the fastest 10% of samples being reported within 35 minutes (haematology) and 1 hour 5 minutes (biochemistry) of request, our study showed that delays can be attributable to laboratory TAT. Given the limited ability to further improve laboratory processes, the solutions to improving TAT need to come from a collaborative and integrated approach that includes strategies before samples reach the laboratory and downstream review of results. © 2010 Blackwell Publishing Ltd.

Measuring Teachers' Assessment for Learning (AfL) Classroom Practices in Elementary Schools

ERIC Educational Resources Information Center

Lysaght, Zita; O'Leary, Michael; Ludlow, Larry

2017-01-01

Assessment for Learning (AfL) may be conceptualized as minute-to-minute, day-by-day interactions between learners and teachers with the improvement of learning as the principal focus. This paper traces the development of an AfL measurement instrument (scale) that can be used for research purposes prior to, during and following professional…

Comparison of closed and open methods of pneumoperitonium in laparoscopic cholecystectomy.

PubMed

Akbar, Mohammad; Khan, Ishtiaq Ali; Naveed, Danish; Khattak, Irfanuddin; Zafar, Arshad; Wazir, Muhammad Salim; Khan, Asif Nawaz; Zia-ur-Rehman

2008-01-01

Pneumoperitonium is the first step in laparoscopic surgery including cholecystectomy. Two commonly used methods to create pneumoperitonium are closed and open technique. Both have advantages and disadvantages. The current study was designed to compare these two techniques in terms of safety and time required to complete the procedure. This was a randomized controlled prospective study conducted at Department of Surgery, Ayub Hospital Complex Abbottabad, from 1st June 2007 to 31st May 2008. Randomization was done into two groups randomly using sealed envelopes containing the questionnaire. Seventy envelopes were kept in the cupboard, containing 35 proformas for group A and 35 for group B. An envelope was randomly fetched and opened upon selection of the patient after taking the informed consent. Pneumoperitonium was created by closed technique in group A, and by open technique in group B. Time required for successful pneumoperitonium was calculated in each group. Failure to induce pneumoperitonium was determined for each technique. Time required to close the wounds at completion, total operating time and injuries sustained during induction of pneumoperitonium were compared in both techniques. Out of the total 70 patients included in study, 35 were in group A and 35 in group B. Mean time required for successful pneumoperitonium was 9.17 minutes in group A and 8.11 minutes in group B. Total operating time ranged from 55 minutes to 130 minutes in group A and from 45 minutes to 110 minutes in group B. Mean of total operating time was 78.34 and 67 minutes in group A and B respectively. Mean time needed to close the wound was 9.88 minutes in group A and 4.97 minutes in group B. Failure of technique was noted in three patients in group A while no failure was experienced in group B. In two cases in group A minor complications during creation of pneumoperitonium were observed while in group B no complication occurred. No patient died in the study. We concluded from this study that open technique of pneumoperitonium was, less time consuming and safer than the closed technique.

Reduction in STEMI transfer times utilizing a municipal "911" ambulance service.

PubMed

Tennyson, Joseph C; Quale, Mark R

2014-02-01

The time interval from diagnosis to reperfusion therapy for patients experiencing ST-segment elevation myocardial infarction (STEMI) has a significant impact on morbidity and mortality. It is hypothesized that the time required for interfacility patient transfers from a community hospital to a regional percutaneous coronary intervention (PCI) center using an Advanced Life Support (ALS) transfer ambulance service is no different than utilizing the "911" ALS ambulance. Quality assurance data collected by a tertiary care center cardiac catheterization program were reviewed retrospectively. Data were collected on all patients with STEMI requiring interfacility transfer from a local community hospital to the tertiary care center's PCI suite, approximately 16 miles away by ground, 12 miles by air. In 2009, transfers of patients with STEMI were redirected to the municipal ALS ambulance service, instead of the hospital's contracted ALS transfer service. Data were collected from January 2007 through May 2013. Temporal data were compared between transports initiated through the contracted ALS ambulance service and the municipal ALS service. Data points included time of initial transport request and time of ambulance arrival to the sending facility and the receiving PCI suite. During the 4-year study period, 63 patients diagnosed with STEMI and transferred to the receiving hospital's PCI suite were included in this study. Mean times from the transport request to arrival of the ambulance at the sending hospital's emergency department were six minutes (95% CI, 4-7 minutes) via municipal ALS and 13 minutes (95% CI, 9-16 minutes) for the ALS transfer service. The mean times from the ground transport request to arrival at the receiving hospital's PCI suite when utilizing the municipal ALS ambulance and hospital contracted ALS ambulance services were 48 minutes (95% CI, 33-64 minutes) and 56 minutes (95% CI 52-59 minutes), respectively. This eight-minute period represented a 14% (P = .001) reduction in the mean transfer time to the PCI suite for patients transported via the municipal ALS ambulance. In the appropriate setting, the use of the municipal "911" ALS ambulance service for the interfacility transport of patients with STEMI appears advantageous in reducing door-to-catheterization times.

Stabilization and treatment of dental avulsions and fractures by emergency physicians using just-in-time training.

PubMed

McIntosh, Mark S; Konzelmann, Jason; Smith, Jeffrey; Kalynych, Colleen J; Wears, Robert L; Schneider, Howard; Wylie, Todd; Kaminski, Anne; Matar-Joseph, Madeline

2009-10-01

The objective of this investigation is to use a dental simulation model to compare splinting and bandaging methods for managing tooth avulsions and fractures, as measured by dentist evaluators for quality and time to complete each stabilization procedure. This was a randomized crossover study comparing 3 splinting techniques for managing a traumatically avulsed tooth (periodontal pack, wire, and bondable reinforcement ribbon) and 2 bandage techniques for managing a fractured tooth (calcium hydroxide paste and light-cured composite). After viewing a Just-in-Time training video, a convenience sample of emergency physicians performed the 5 stabilization techniques on dental models containing extracted teeth embedded in clay to simulate a segment of the human dentition. Data collected included time to complete each procedure, the evaluation of dentists about whether the procedure was performed satisfactorily or unsatisfactorily, and the ranking of dentists' and participants' preferred technique. Twenty-five emergency physicians participated in the study: 17 residents, 2 pediatric emergency medicine fellows, and 6 attending physicians. Reported median time, as well as minimum and maximum times to complete each splinting technique for an avulsed tooth, was as follows: periodontal pack 4.4 minutes (2.5 to 6.5 minutes), wire 8.6 minutes (5.8 to 12.9 minutes), and bondable reinforcement ribbon 8.9 minutes (5.6 to 15 minutes). Median time (and minimum and maximum times) to complete each protective bandaging technique for a fractured tooth was calcium hydroxide paste 4.6 minutes (3 to 9.6 minutes) and light-cured composite 7.1 minutes (5.5 to 14.1 minutes). When asked to choose a preferred splinting and bandaging technique according to the performance of the physicians, the dentists chose the bondable reinforcement ribbon 96% (24/25) and the light-cured composite 100% (25/25) of the time. Study participants had no measurable or agreeable preference for a particular splinting or bandaging technique. The results of this study suggest that of the stabilization procedures completed by emergency physicians, dentists preferred the bondable reinforcement ribbon for managing an avulsed tooth and the light-cured composite technique for managing a fractured tooth over the commonly taught and more frequently used procedures in emergency medicine.

Accelerometer profiles of physical activity and inactivity in normal weight, overweight, and obese U.S. men and women.

PubMed

Tudor-Locke, Catrine; Brashear, Meghan M; Johnson, William D; Katzmarzyk, Peter T

2010-08-03

The 2005-2006 National Health and Nutrition Examination Survey (NHANES) is used to describe an accelerometer-derived physical activity/inactivity profile in normal weight (BMI < 25 kg/m2), overweight (25 /= 30 kg/m2) U.S. adults. We computed physical activity volume indicators (activity counts/day, uncensored and censored steps/day), rate indicators (e.g., steps/minute), time indicators (employing NHANES activity counts/minute cut points to infer time in non-wear, sedentary, low, light, moderate, and vigorous intensities), the number of breaks in sedentary time (occasions when activity counts rose from < 100 activity/counts in one minute to >/= 100 activity counts in the subsequent minute), achievement of public health guidelines, and classification by step-defined physical activity levels. Data were examined for evidence of consistent and significant gradients across BMI-defined categories. In 2005-2006, U.S adults averaged 6,564 +/- SE 107 censored steps/day, and after considering non-wear time, they spent approximately 56.8% of the rest of the waking day in sedentary time, 23.7% in low intensity, 16.7% in light intensity, 2.6% in moderate intensity, and 0.2% in vigorous intensity. Overall, approximately 3.2% of U.S. adults achieved public health guidelines. The normal weight category took 7,190 +/- SE 157 steps/day, and spent 25.7 +/- 0.9 minutes/day in moderate intensity and 7.3 +/- 0.4 minutes/day in vigorous intensity physical activity. The corresponding numbers for the overweight category were 6,879 +/- 140 steps/day, 25.3 +/- 0.9 minutes/day, and 5.3 +/- 0.5 minutes/day and for the obese category 5,784 +/- 124 steps/day, 17.3 +/- 0.7 minutes/day and 3.2 +/- 0.4 minutes/day. Across BMI categories, increasing gradients and significant trends were apparent in males for sedentary time and decreasing gradients and significant trends were evident in time spent in light intensity, moderate intensity, and vigorous intensity. For females, there were only consistent gradients and significant trends apparent for decreasing amounts of time spent in moderate and vigorous intensity. Simple indicators of physical activity volume (i.e., steps/day) and time in light, moderate or vigorous intensity physical activity differ across BMI categories for both sexes, suggesting that these should continue to be targets for surveillance.

Sleep Deprivation and Time-Based Prospective Memory.

PubMed

Esposito, Maria José; Occhionero, Miranda; Cicogna, PierCarla

2015-11-01

To evaluate the effect of sleep deprivation on time-based prospective memory performance, that is, realizing delayed intentions at an appropriate time in the future (e.g., to take a medicine in 30 minutes). Between-subjects experimental design. The experimental group underwent 24 h of total sleep deprivation, and the control group had a regular sleep-wake cycle. Participants were tested at 08:00. Laboratory. Fifty healthy young adults (mean age 22 ± 2.1, 31 female). 24 h of total sleep deprivation. Participants were monitored by wrist actigraphy for 3 days before the experimental session. The following cognitive tasks were administered: one time-based prospective memory task and 3 reasoning tasks as ongoing activity. Objective and subjective vigilance was assessed by the psychomotor vigilance task and a visual analog scale, respectively. To measure the time-based prospective memory task we assessed compliance and clock checking behavior (time monitoring). Sleep deprivation negatively affected time-based prospective memory compliance (P < 0.001), objective vigilance (mean RT: P < 0.001; slowest 10% RT: P < 0.001; lapses: P < 0.005), and subjective vigilance (P < 0.0001). Performance on reasoning tasks and time monitoring behavior did not differ between groups. The results highlight the potential dangerous effects of total sleep deprivation on human behavior, particularly the ability to perform an intended action after a few minutes. Sleep deprivation strongly compromises time-based prospective memory compliance but does not affect time check frequency. Sleep deprivation may impair the mechanism that allows the integration of information related to time monitoring with the prospective intention. © 2015 Associated Professional Sleep Societies, LLC.

Supercomputers ready for use as discovery machines for neuroscience.

PubMed

Helias, Moritz; Kunkel, Susanne; Masumoto, Gen; Igarashi, Jun; Eppler, Jochen Martin; Ishii, Shin; Fukai, Tomoki; Morrison, Abigail; Diesmann, Markus

2012-01-01

NEST is a widely used tool to simulate biological spiking neural networks. Here we explain the improvements, guided by a mathematical model of memory consumption, that enable us to exploit for the first time the computational power of the K supercomputer for neuroscience. Multi-threaded components for wiring and simulation combine 8 cores per MPI process to achieve excellent scaling. K is capable of simulating networks corresponding to a brain area with 10(8) neurons and 10(12) synapses in the worst case scenario of random connectivity; for larger networks of the brain its hierarchical organization can be exploited to constrain the number of communicating computer nodes. We discuss the limits of the software technology, comparing maximum filling scaling plots for K and the JUGENE BG/P system. The usability of these machines for network simulations has become comparable to running simulations on a single PC. Turn-around times in the range of minutes even for the largest systems enable a quasi interactive working style and render simulations on this scale a practical tool for computational neuroscience.

Supercomputers Ready for Use as Discovery Machines for Neuroscience

PubMed Central

Helias, Moritz; Kunkel, Susanne; Masumoto, Gen; Igarashi, Jun; Eppler, Jochen Martin; Ishii, Shin; Fukai, Tomoki; Morrison, Abigail; Diesmann, Markus

2012-01-01

NEST is a widely used tool to simulate biological spiking neural networks. Here we explain the improvements, guided by a mathematical model of memory consumption, that enable us to exploit for the first time the computational power of the K supercomputer for neuroscience. Multi-threaded components for wiring and simulation combine 8 cores per MPI process to achieve excellent scaling. K is capable of simulating networks corresponding to a brain area with 108 neurons and 1012 synapses in the worst case scenario of random connectivity; for larger networks of the brain its hierarchical organization can be exploited to constrain the number of communicating computer nodes. We discuss the limits of the software technology, comparing maximum filling scaling plots for K and the JUGENE BG/P system. The usability of these machines for network simulations has become comparable to running simulations on a single PC. Turn-around times in the range of minutes even for the largest systems enable a quasi interactive working style and render simulations on this scale a practical tool for computational neuroscience. PMID:23129998

A 30-Minute, but Not a 10-Minute Nighttime Nap is Associated with Sleep Inertia

PubMed Central

Hilditch, Cassie J.; Centofanti, Stephanie A.; Dorrian, Jillian; Banks, Siobhan

2016-01-01

Study Objectives: To assess sleep inertia following 10-min and 30-min naps during a simulated night shift. Methods: Thirty-one healthy adults (aged 21–35 y; 18 females) participated in a 3-day laboratory study that included one baseline (BL) sleep (22:00–07:00) and one experimental night involving randomization to either: total sleep deprivation (NO-NAP), a 10-min nap (10-NAP) or a 30-min nap (30-NAP). Nap opportunities ended at 04:00. A 3-min psychomotor vigilance task (PVT-B), digit-symbol substitution task (DSST), fatigue scale, sleepiness scale, and self-rated performance scale were undertaken pre-nap (03:00) and at 2, 17, 32, and 47 min post-nap. Results: The 30-NAP (14.7 ± 5.7 min) had more slow wave sleep than the 10-NAP (0.8 ± 1.5 min; P < 0.001) condition. In the NO-NAP condition, PVT-B performance was worse than pre-nap (4.6 ± 0.3 1/sec) at 47 min post-nap (4.1 ± 0.4 1/sec; P < 0.001). There was no change across time in the 10-NAP condition. In the 30-NAP condition, performance immediately deteriorated from pre-nap (4.3 ± 0.3 1/sec) and was still worse at 47 min post-nap (4.0 ± 0.5 1/sec; P < 0.015). DSST performance deteriorated in the NO-NAP (worse than pre-nap from 17 to 47 min; P < 0.008), did not change in the 10-NAP, and was impaired 2 min post-nap in the 30-NAP condition (P = 0.028). All conditions self-rated performance as better than pre-nap for all post-nap test points (P < 0.001). Conclusions: This study is the first to show that a 10-min (but not a 30-min) nighttime nap had minimal sleep inertia and helped to mitigate short-term performance impairment during a simulated night shift. Self-rated performance did not reflect objective performance following a nap. Citation: Hilditch CJ, Centofanti SA, Dorrian J, Banks S. A 30-minute, but not a 10-minute nighttime nap is associated with sleep inertia. SLEEP 2016;39(3):675–685. PMID:26715234

Wake losses from averaged and time-resolved power measurements at full scale wind turbines

NASA Astrophysics Data System (ADS)

Castellani, Francesco; Astolfi, Davide; Mana, Matteo; Becchetti, Matteo; Segalini, Antonio

2017-05-01

This work deals with the experimental analysis of wake losses fluctuations at full-scale wind turbines. The test case is a wind farm sited on a moderately complex terrain: 4 turbines are installed, having 2 MW of rated power each. The sources of information are the time-resolved data, as collected from the OPC server, and the 10-minutes averaged SCADA data. The objective is to compare the statistical distributions of wake losses for far and middle wakes, as can be observed through the “fast” lens of time-resolved data, for certain selected test-case time series, and through the “slow” lens of SCADA data, on a much longer time basis that allow to set the standards of the mean wake losses along the wind farm. Further, time-resolved data are used for an insight into the spectral properties of wake fluctuations, highlighting the role of the wind turbine as low-pass filter. Summarizing, the wind rose, the layout of the site and the structure of the data sets at disposal allow to study middle and far wake behavior, with a “slow” and “fast” perspective.

[Effects of an intensive thalassotherapy and aquatic therapy program in stroke patients. A pilot study].

PubMed

Morer, C; Boestad, C; Zuluaga, P; Alvarez-Badillo, A; Maraver, F

2017-09-16

Stroke remains the leading cause of acquired disability. Health and social planning and management may vary and although prevention is crucial, having better treatments and strategies to reduce disability is needed. To determine the effect of an intensive program of thalassotherapy and aquatic therapy in stroke patients, valuing clinical parameters and functional validated scales. A quasi-experimental prospective study consisting of a specific program assessed pre- and post- 3 weeks treatment to 26 stroke patients with a mild-moderate disability. The outcomes measured were: Berg Balance scale, Timed Up and Go test, 10-meter walking test, 6-minute walking test and pain Visual Analogue Scale. After intervention, participants had a significant improvement in all outcomes measured. Our results suggest that an intensive program of thalassotherapy and aquatic therapy could be useful during stroke rehabilitation to improve balance, gait and pain.

Performance and age of African and non-African runners in half- and full marathons held in Switzerland, 2000–2010

PubMed Central

Aschmann, André; Knechtle, Beat; Cribari, Marco; Rüst, Christoph Alexander; Onywera, Vincent; Rosemann, Thomas; Lepers, Romuald

2013-01-01

Background Endurance running performance of African (AF) and non-African (NAF) athletes is investigated, with better performances seen for Africans. To date, no study has compared the age of peak performance between AF and NAF runners. The present research is an analysis of the age and running performance of top AF and NAF athletes, using the hypothesis that AF athletes were younger and faster than NAF athletes. Methods Age and performance of male and female AF and NAF athletes in half-marathons and marathons held in Switzerland in 2000–2010 were investigated using single and multilevel hierarchical regression analyses. Results For half-marathons, male NAF runners were older than male AF runners (P = 0.02; NAF, 31.1 years ± 6.4 years versus AF, 26.2 years ± 4.9 years), and their running time was longer (P = 0.02; NAF, 65.3 minutes ± 1.7 minutes versus AF, 64.1 minutes ± 0.9 minutes). In marathons, differences between NAF and AF male runners in age (NAF, 33.0 years ± 4.8 years versus AF, 28.6 years ± 3.8 years; P < 0.01) and running time (NAF, 139.5 minutes ± 5.6 minutes versus AF, 133.3 minutes ± 2.7 minutes; P < 0.01) were more pronounced. There was no difference in age (NAF, 31.0 years ± 7.0 years versus AF, 26.7 years ± 6.0 years; P > 0.05) or running time (NAF, 75.0 minutes ± 3.7 minutes versus AF, 75.6 minutes ± 5.3 minutes; P > 0.05) between NAF and AF female half-marathoners. For marathoners, NAF women were older than AF female runners (P = 0.03; NAF, 31.6 years ± 4.8 years versus AF, 27.8 years ± 5.3 years), but their running times were similar (NAF, 162.4 minutes ± 7.2 minutes versus AF, 163.0 minutes ± 7.0 minutes; P > 0.05). Conclusion In Switzerland, the best AF male half-marathoners and marathoners were younger and faster than the NAF counterpart runners. In contrast to the results seen in men, AF and NAF female runners had similar performances. Future studies need to investigate performance and age of AF and NAF marathoners in the World Marathon Majors Series. PMID:24379724

Measurement of Global Radiation using Photovoltaic Panels

NASA Astrophysics Data System (ADS)

Veroustraete, Frank; Bronders, Jan; Lefevre, Filip; Mensink, Clemens

2014-05-01

The Vito Unit - Environmental and Spatial Aspects (RMA) - for many of its models makes use of global solar radiation. From this viewpoint and also from the notion that this variable is seldom measured or available at the local scale and at high multi-temporal frequencies, it can be stated that many models are fed with low quality estimates of global solar radiation at the local to regional scales. A project was initiated called SUNSPIDER with the following objective. To make use of photovoltaic solar panels to measure solar radiation at the highest spatio-temporal resolution, from the local to the regional scales and from minutes to years. To integrate the measured solar fields in different application fields like, plant systems and agriculture, agro-meteorology and hydrology and last but not least solar energy applications. In Belgium about 250.000 PV installations have been built leading to about 6% electric power supply from photovoltaics on a yearly basis. Last year in June, the supply reached a peak of more than 20% of the total power input on the Belgian grid. A database of Belgian residential solar panel sites will be compiled. The database will serve as an input to an inverted PV model to be able to perform radiation calculations specifically for each of the validated panel sites based on minutely logged power data. Data acquisition for these sites will start each time a site is validated and hence imported in the database. Keywords: Photovoltaic Panels; PV modelling; Global Radiation.

Comparison of intracoronary versus intravenous administration of adenosine for measurement of coronary fractional flow reserve.

PubMed

Schlundt, Christian; Bietau, Christian; Klinghammer, Lutz; Wiedemann, Ricarda; Rittger, Harald; Ludwig, Josef; Achenbach, Stephan

2015-05-01

Measurement of fractional flow reserve (FFR) constitutes the current gold standard to evaluate the hemodynamic significance of coronary stenoses. Limited data validate the intracoronary application of adenosine against standard intravenous infusion. We systematically compared FFR measurements during intracoronary and intravenous application of adenosine about agreement and reproducibility. We included 114 patients with an intermediate degree of stenosis in coronary angiography. Two FFR measurements were performed during intracoronary bolus injection (40 μg for the right and 80 μg for the left coronary artery, FFRic), and 2 FFR measurements during continuous intravenous infusion of adenosine (140 μg/kg per minute, FFRiv). FFR value, the time to reach FFR and patient discomfort (on a subjective scale from 0 for no symptoms to 5 for maximal discomfort) were recorded for each measurement. Mean time to FFR was 100 ± 27 s for continuous intravenous infusion versus 23 ± 14 s for intracoronary bolus administration of adenosine (P < 0.001). Reported discomfort after intracoronary application was significantly lower compared with intravenous adenosine (subjective scale > 0 in 35.1% versus 87.7% of the patients; P < 0.001). Correlation between FFRiv and FFRic was extremely close (r = 0.99; P < 0.001) with no systematic bias in Bland-Altman analysis (bias 0.002 [confidence interval, -0.001 to 0.005]) and low intermethod variability (1.56%). Intramethod variability was not different between intravenous and intracoronary administration (1.47% versus 1.33%; P=0.5). Intracoronary bolus injection of adenosine (40 μg for the right and 80 μg for the left coronary artery) yields identical FFR results compared with intravenous infusion (140 μg/kg per minute), while requiring less time and offering superior patient comfort. © 2015 American Heart Association, Inc.

Topographic mapping of a hierarchy of temporal receptive windows using a narrated story

PubMed Central

Lerner, Y.; Honey, C.J.; Silbert, L.J.; Hasson, U.

2011-01-01

Real life activities, such as watching a movie or engaging in conversation, unfold over many minutes. In the course of such activities the brain has to integrate information over multiple time scales. We recently proposed that the brain uses similar strategies for integrating information across space and over time. Drawing a parallel with spatial receptive fields (SRF), we defined the temporal receptive window(TRW) of a cortical microcircuit as the length of time prior to a response during which sensory information may affect that response. Our previous findings in the visual system are consistent with the hypothesis that TRWs become larger when moving from low-level sensory to high-level perceptual and cognitive areas. In this study, we mapped TRWs in auditory and language areas by measuring fMRI activity in subjects listening to a real life story scrambled at the time scales of words, sentences and paragraphs. Our results revealed a hierarchical topography of TRWs. In early auditory cortices (A1+), brain responses were driven mainly by the momentary incoming input and were similarly reliable across all scrambling conditions. In areas with an intermediate TRW, coherent information at the sentence time scale or longer was necessary to evoke reliable responses. At the apex of the TRW hierarchy we found parietal and frontal areas which responded reliably only when intact paragraphs were heard in a meaningful sequence. These results suggest that the time scale of processing is a functional property that may provide a general organizing principle for the human cerebral cortex. PMID:21414912

Radar - ESRL Wind Profiler with RASS, Wasco Airport - Derived Data

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

McCaffrey, Katherine

Profiles of turbulence dissipation rate for 15-minute intervals, time-stamped at the beginning of the 15-minute period, during the final 30 minutes of each hour. During that time, the 915-MHz wind profiling radar was in an optimized configuration with a vertically pointing beam only for measuring accurate spectral widths of vertical velocity. A bias-corrected dissipation rate also was profiled (described in McCaffrey et al. 2017). Hourly files contain two 15-minute profiles.

Presentation of a High Resolution Time Lapse 3D Groundwater Model of Metsähovi for Calculating the Gravity Effect of Groundwater in Local Scale

NASA Astrophysics Data System (ADS)

Hokkanen, T. M.; Hartikainen, A.; Raja-Halli, A.; Virtanen, H.; Makinen, J.

2015-12-01

INTRODUCTION The aim of this study is to construct a fine resolution time lapse groundwater (GW) model of Metsähovi (MH). GW, geological, and soil moisture (SM) data were collected for several years to achieve the goal. The knowledge of the behavior of the GW at local scale is essential for superconductive gravimeter (SG) investigations performing in MH. DESCRIPTION OF THE DATA Almost 50 sensors have been recorded SM data some 6 years with 1 to 5 minutes sampling frequency. The GW table has been monitored, both in bedrock and in soil, in many stages with all together 15 piezometers. Two geological sampling campaigns were conducted to get the knowledge of hydrological properties of soil in the study area of 200×200 m2 around SG station in MH. PRINCIPLE OF TIME LAPSE 3D HYDROGEOLOGICAL MODEL The model of study site consists of the surfaces of ground and bedrock gridded with 2×2 m2 resolution. The height of GW table was interpolated to 2×2×0.1 m3 grid between GW and SM monitoring points. Close to the outline of the study site and areas lacking of sensors GW table was defined by extrapolation and considering the geological information of the area. The bedrock porosity is 2% and soil porosity determined by geological information and SM recordings is from 5 to 35%. Only fully saturated media is considered in the time lapse model excluding unsaturated one. BENEFICIERS With a new model the fluctuation of GW table can be followed with ranging time lapses from 1 minute to 1 month. The gravity effect caused by the variation of GW table can be calculated more accurate than before in MH. Moreover, the new model can be validated and refined by measured gravity, i.e. hydrological model can be improved by SG recordings (Figure 1).

A Comparison of Change in the 0–10 Numeric Rating Scale to a Pain Relief Scale and Global Medication Performance Scale in a Short-term Clinical Trial of Breakthrough Pain Intensity

PubMed Central

Farrar, John T.; Polomano, Rosemary C.; Berlin, Jesse A.; Strom, Brian L.

2010-01-01

Background Pain intensity is commonly reported using a 0–10 numeric rating scale in breakthrough pain clinical trials. Analysis of the change on the Pain Intensity Numerical Rating Scale as a proportion as most consistently correlated with clinically important differences reported on the Patient Global Impression of Change. The analysis of data using a different global outcome measures and the pain relief scale will extend our understanding of these measures. Use of the pain relief scale is also explored in this study Methods Data came from the open titration phase of a multiple crossover, randomized, double-blind clinical trial comparing oral transmucosal fentanyl citrate to immediate-release oral morphine sulfate for treatment of cancer-related breakthrough pain. Raw and percent changes in the pain intensity scores on 1,307 from 134 oral transmucosal fentanyl citrate-naive patients were compared to the clinically relevant secondary outcomes of the pain relief verbal response scale and the global medication performance. The changes in raw and percent change were assessed over time and compared to the ordinal pain relief verbal response scale and global medication performance scales. Results The p-value of the interaction between the raw pain intensity difference was significant but not for the percent pain intensity difference score over 4 15 minute time periods (p = 0.034 and p = 0.26 respectively), in comparison with the ordinal pain relief verbal response scale (p = 0.0048 and p = 0.36 respectively), and global medication performance categories (p = 0.048 and p = 0.45 respectively). Conclusion The change in pain intensity in breakthrough pain was more consistent over time and when compared to both the pain relief verbal response scale and global medication performance scale when the percent change is used rather than raw pain intensity difference. PMID:20463579

Urgent Virtual Machine Eviction with Enlightened Post-Copy

DTIC Science & Technology

2015-12-01

memory is in use, almost all of which is by Memcached. MySQL : The VMs run MySQL 5.6, and the clients execute OLTPBenchmark [3] using the Twitter...workload with scale factor of 960. The VMs are each allocated 16 cores and 30 GB of memory, and MySQL is configured with a 16 GB buffer pool in memory. The...operation mix for 5 minutes as a warm-up. At the time of migration, MySQL uses approximately 17 GB of memory, and almost all of the 30 GB memory is

Renal histopathology features according to various warm ischemia times in porcine laparoscopic and open surgery model

PubMed Central

Sabbagh, Robert; Chawla, Arun; Tisdale, Britton; Kwan, Kevin; Chatterjee, Suman; Kwiecien, Jacek M.; Kapoor, Anil

2011-01-01

Background Thirty minutes has been considered as the threshold for tolerable warm ischemic time (WIT). Recent reports demonstrate recovery of renal function after longer WIT. We assessed renal histology according to different WIT in a 2-kidney porcine model. Methods Twelve female pigs were randomized to an open or laparoscopic group. Each pig was further randomized within each group to clamping the left renal artery for 5, 15, 30, 45, 60 or 180 minutes. Preclamping left renal biopsies were performed on each pig. The contralateral kidney in each animal was used as an individual control. On postoperative day 14, all animals underwent bilateral nephrectomies. Preclamping left renal biopsies and all renal specimens were evaluated by a blinded veterinary pathologist. Results One pig died in the open group after 180 minutes of clamping. Histopathology did not show any significant changes between the two groups and across clamp times from 5 to 60 minutes. After 180 minutes of laparoscopic clamping, there was evidence of diffuse necrosis. Interpretation Sixty minutes of ischemia did not show any permanent renal damage in both groups. Further studies are needed to verify these findings in humans. A prolonged ischemic time without permanent renal damage would be helpful in partial nephrectomy. Warm ischemic time of 180 minutes exceeded the renal ischemic burden based on histological features. PMID:21470513

A comparative assessment of R. M. Young and tipping bucket rain gauges

NASA Technical Reports Server (NTRS)

Goldhirsh, Julius; Gebo, Norman E.

1992-01-01

Rain rates as derived from standard tipping bucket rain gauges have variable integration times corresponding to the interval between bucket tips. For example, the integration time for the Weathertronics rain gauge is given by delta(T) = 15.24/R (min), where R is the rain rate expressed in mm/h and delta(T) is the time between tips expressed in minutes. It is apparent that a rain rate of 1 mm/h has an integration time in excess of 15 minutes. Rain rates larger than 15.24 mm/h will have integration times smaller than 1 minute. The integration time is dictated by the time it takes to fill a small tipping bucket where each tip gives rise to 0.254 mm of rainfall. Hence, a uniform rain rate of 1 mm/h over a 15 minute period will give rise to the same rain rate as 0 mm/h rainfall over the first 14 minutes and 15 mm/h between 14 to 15 minutes from the reference tip. Hence, the rain intensity fluctuations may not be captured with the tipping bucket rain gauge for highly variable rates encompassing lower and higher values over a given integration time. The objective of this effort is to provide an assessment of the features of the R. M. Young capacitive gauge and to compare these features with those of the standard tipping bucket rain gauge. A number of rain rate-time series derived from measurements with approximately co-located gauges are examined.

A method for improving arrival-to-electrocardiogram time in emergency department chest pain patients and the effect on door-to-balloon time for ST-segment elevation myocardial infarction.

PubMed

Takakuwa, Kevin M; Burek, Gregory A; Estepa, Adrian T; Shofer, Frances S

2009-10-01

The objectives were to determine if an emergency department (ED) could improve the adherence to a door-to-electrocardiogram (ECG) time goal of 10 minutes or less for patients who presented to an ED with chest pain and the effect of this adherence on door-to-balloon (DTB) time for ST-segment elevation myocardial infarction (STEMI) cardiac catheterization (cath) alert patients. This was a planned 1-month before-and-after interventional study design for implementing a new process for obtaining ECGs in patients presenting to the study ED with chest pain. Prior to the change, patients were registered and triaged before an ECG was obtained. The new procedure required registration clerks to identify those with chest pain and directly overhead page or call a designated ECG technician. This technician had other ED duties, but prioritized performing ECGs and delivering them to attending physicians. A full registration process occurred after the clinical staff performed their initial assessment. The primary outcome was the total percentage of patients with chest pain who received an ECG within 10 minutes of ED arrival. The secondary outcome was DTB time for patients with STEMI who were emergently cath alerted. Data were analyzed using mean differences, 95% confidence intervals (CIs), and relative risk (RR) regression to adjust for possible confounders. A total of 719 patients were studied: 313 before and 405 after the intervention. The mean (+/-standard deviation [SD]) age was 50 (+/-16) years, 54% were women, 57% were African American, and 36% were white. Patients walked in 89% of the time; 11% arrived by ambulance. Thirty-nine percent were triaged as emergent and 61% as nonemergent. Patients presented during daytime 68% of the time, and 32% presented during the night. Before the intervention, 16% received an ECG at 10 minutes or less. After the intervention, 64% met the time requirement, for a mean difference of 47.3% (95% CI = 40.8% to 53.3%, p < 0.0001). Results were not affected by age, sex, race, mode of arrival, triage classification, or time of arrival. For patients with STEMI cath alerts, four were seen before and seven after the intervention. No patients before the intervention had ECG time within 10 minutes, and one of four had DTB time of <90 minutes. After the intervention, all seven patients had ECG time within 10 minutes; the three arriving during weekday hours when the cath team was on site had DTB times of <90 minutes, but the four arriving at night and on weekends when the cath team was off site had DTB times of >90 minutes. The overall percentage of patients with a door-to-ECG time within 10 minutes improved without increasing staffing. An ECG was performed within 10 minutes of arrival for all patients who were STEMI cath alerted, but DTB time under 90 minutes was achieved only when the cath team was on site.

Regional "Call 911" Emergency Department Protocol to Reduce Interfacility Transfer Delay for Patients With ST-Segment-Elevation Myocardial Infarction.

PubMed

Bosson, Nichole; Baruch, Terrence; French, William J; Fang, Andrea; Kaji, Amy H; Gausche-Hill, Marianne; Rock, Alisa; Shavelle, David; Thomas, Joseph L; Niemann, James T

2017-12-23

We evaluated the first-medical-contact-to-balloon (FMC2B) time after implementation of a "Call 911" protocol for ST-segment-elevation myocardial infarction (STEMI) interfacility transfers in a regional system. This is a retrospective cohort study of consecutive patients with STEMI requiring interfacility transfer from a STEMI referring hospital, to one of 35 percutaneous coronary intervention-capable STEMI receiving centers (SRCs). The Call 911 protocol allows the referring physician to activate 911 to transport a patient with STEMI to the nearest SRC for primary percutaneous coronary intervention. Patients with interfacility transfers were identified over a 4-year period (2011-2014) from a registry to which SRCs report treatment and outcomes for all patients with STEMI transported via 911. The primary outcomes were median FMC2B time and the proportion of patients achieving the 120-minute goal. FMC2B for primary 911 transports were calculated to serve as a system reference. There were 2471 patients with STEMI transferred to SRCs by 911 transport during the study period, of whom 1942 (79%) had emergent coronary angiography and 1410 (73%) received percutaneous coronary intervention. The median age was 61 years (interquartile range [IQR] 52-71) and 73% were men. The median FMC2B time was 111 minutes (IQR 88-153) with 56% of patients meeting the 120-minute goal. The median STEMI referring hospital door-in-door-out time was 53 minutes (IQR 37-89), emergency medical services transport time was 9 minutes (IQR 7-12), and SRC door-to-balloon time was 44 minutes (IQR 32-60). For primary 911 patients (N=4827), the median FMC2B time was 81 minutes (IQR 67-97). Using a Call 911 protocol in this regional cardiac care system, patients with STEMI requiring interfacility transfers had a median FMC2B time of 111 minutes, with 56% meeting the 120-minute goal. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

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

M. P. Jensen; Toto, T.

Standard Atmospheric Radiation Measurement (ARM) Climate Research Facility sounding files provide atmospheric state data in one dimension of increasing time and height per sonde launch. Many applications require a quick estimate of the atmospheric state at higher time resolution. The INTERPOLATEDSONDE (i.e., Interpolated Sounding) Value-Added Product (VAP) transforms sounding data into continuous daily files on a fixed time-height grid, at 1-minute time resolution, on 332 levels, from the surface up to a limit of approximately 40 km. The grid extends that high so the full height of soundings can be captured; however, most soundings terminate at an altitude between 25more » and 30 km, above which no data is provided. Between soundings, the VAP linearly interpolates atmospheric state variables in time for each height level. In addition, INTERPOLATEDSONDE provides relative humidity scaled to microwave radiometer (MWR) observations.« less

[Development of an Atypical Response Scale.

ERIC Educational Resources Information Center

Mendelsohn, Mark; Linden, James

The development of an objective diagnostic scale to measure atypical behavior is discussed. The Atypical Response Scale (ARS) is a structured projective test consisting of 17 items, each weighted 1, 2, or 3, that were tested for convergence and reliability. ARS may be individually or group administered in 10-15 minutes; hand scoring requires 90…

Timescales of Massive Human Entrainment

PubMed Central

Fusaroli, Riccardo; Perlman, Marcus; Mislove, Alan; Paxton, Alexandra; Matlock, Teenie; Dale, Rick

2015-01-01

The past two decades have seen an upsurge of interest in the collective behaviors of complex systems composed of many agents entrained to each other and to external events. In this paper, we extend the concept of entrainment to the dynamics of human collective attention. We conducted a detailed investigation of the unfolding of human entrainment—as expressed by the content and patterns of hundreds of thousands of messages on Twitter—during the 2012 US presidential debates. By time-locking these data sources, we quantify the impact of the unfolding debate on human attention at three time scales. We show that collective social behavior covaries second-by-second to the interactional dynamics of the debates: A candidate speaking induces rapid increases in mentions of his name on social media and decreases in mentions of the other candidate. Moreover, interruptions by an interlocutor increase the attention received. We also highlight a distinct time scale for the impact of salient content during the debates: Across well-known remarks in each debate, mentions in social media start within 5–10 seconds after it occurs; peak at approximately one minute; and slowly decay in a consistent fashion across well-known events during the debates. Finally, we show that public attention after an initial burst slowly decays through the course of the debates. Thus we demonstrate that large-scale human entrainment may hold across a number of distinct scales, in an exquisitely time-locked fashion. The methods and results pave the way for careful study of the dynamics and mechanisms of large-scale human entrainment. PMID:25880357

Effect of surgical hand scrub time on subsequent bacterial growth.

PubMed

Wheelock, S M; Lookinland, S

1997-06-01

In this experimental study, the researchers evaluated the effect of surgical hand scrub time on subsequent bacterial growth and assessed the effectiveness of the glove juice technique in a clinical setting. In a randomized crossover design, 25 perioperative staff members scrubbed for two or three minutes in the first trial and vice versa in the second trial, after which the wore sterile surgical gloves for one hour under clinical conditions. The researchers then sampled the subjects' nondominant hands for bacterial growth, cultured aliquots from the sampling solution, and counted microorganisms. Scrubbing for three minutes produced lower mean log bacterial counts than scrubbing for two minutes. Although the mean bacterial count differed significantly (P = .02) between the two-minute and three-minute surgical hand scrub times, it fell below 0.5 log, which is the threshold for practical and clinical significance. This finding suggests that a two-minute surgical hand scrub is clinically as effective as a three-minute surgical had scrub. The glove juice technique demonstrated sensitivity and reliability in enumerating bacteria on the hands of perioperative staff members in a clinical setting.

The sleep of healthy people--a diary study

NASA Technical Reports Server (NTRS)

Monk, T. H.; Buysse, D. J.; Rose, L. R.; Hall, J. A.; Kupfer, D. J.

2000-01-01

To provide baseline data for various research studies at the University of Pittsburgh over a 10-year period, 266 healthy subjects (144 male, 122 female, aged 20-50 years) meeting certain criteria each completed a 14-night sleep diary. For each night, the diary allowed the subjective measurement of bedtime, wake time, time in bed (TIB), sleep efficiency, number of minutes of wake after sleep onset (WASO), alertness on awakening, and percentage of morning needing an alarm (or a person functioning as one). Weeknight versus weekend night differences in TIB (TIBdiff), weekday altertness, and reliance on alarms were examined as possible indicators of sleep debt. In addition, general descriptive data were tabulated. On average, bedtimes were at 23:48 and wake times at 07:23, yielding a mean TIB of 7 hours 35 minutes. As expected, bedtimes and wake times were later on weekend nights than on weeknights. Bedtimes were 26 minutes later, wake times 53 minutes later, yielding a mean weekend TIB increase of 27 minutes. Overall, subjects perceived their sleep latency to be 10.5 minutes, reported an average of one awakening during the night (with an average of 6.4 minutes of WASO), had a diary sleep efficiency of 96.3%, and awoke with an alterness rating of 69.5%. These variables differed little between weeknight and weekend nights. Subjects used an alarm (or a person functioning as an alarm) on 60.9% nights overall, 68.3% on weeknights, 42.5% on weekends. When TIBdiff was used as an estimate of sleep debt (comparing subjects with TIBdiff > 75 minutes with those with a TIBdiff < 30 minutes), the group with more "catch-up sleep" on weekends had shorter weeknight TIB durations (by about 24 minutes) and relied more on an alarm for weekday waking (by about 22%), indicating the possible utility of these variables as sleep debt indices.

Using lean principles to improve outpatient adult infusion clinic chemotherapy preparation turnaround times.

PubMed

Lamm, Matthew H; Eckel, Stephen; Daniels, Rowell; Amerine, Lindsey B

2015-07-01

The workflow and chemotherapy preparation turnaround times at an adult infusion clinic were evaluated to identify opportunities to optimize workflow and efficiency. A three-phase study using Lean Six Sigma methodology was conducted. In phase 1, chemotherapy turnaround times in the adult infusion clinic were examined one year after the interim goal of a 45-minute turnaround time was established. Phase 2 implemented various experiments including a five-day Kaizen event, using lean principles in an effort to decrease chemotherapy preparation turnaround times in a controlled setting. Phase 3 included the implementation of process-improvement strategies identified during the Kaizen event, coupled with a final refinement of operational processes. In phase 1, the mean turnaround time for all chemotherapy preparations decreased from 60 to 44 minutes, and a mean of 52 orders for adult outpatient chemotherapy infusions was received each day. After installing new processes, the mean turnaround time had improved to 37 minutes for each chemotherapy preparation in phase 2. In phase 3, the mean turnaround time decreased from 37 to 26 minutes. The overall mean turnaround time was reduced by 26 minutes, representing a 57% decrease in turnaround times in 19 months through the elimination of waste and the implementation of lean principles. This reduction was accomplished through increased efficiencies in the workplace, with no addition of human resources. Implementation of Lean Six Sigma principles improved workflow and efficiency at an adult infusion clinic and reduced the overall chemotherapy turnaround times from 60 to 26 minutes. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Evaluation of wireless sensor networks (WSNs) for remote wetland monitoring: design and initial results.

PubMed

Watras, Carl J; Morrow, Michael; Morrison, Ken; Scannell, Sean; Yaziciaglu, Steve; Read, Jordan S; Hu, Yu-Hen; Hanson, Paul C; Kratz, Tim

2014-02-01

Here, we describe and evaluate two low-power wireless sensor networks (WSNs) designed to remotely monitor wetland hydrochemical dynamics over time scales ranging from minutes to decades. Each WSN (one student-built and one commercial) has multiple nodes to monitor water level, precipitation, evapotranspiration, temperature, and major solutes at user-defined time intervals. Both WSNs can be configured to report data in near real time via the internet. Based on deployments in two isolated wetlands, we report highly resolved water budgets, transient reversals of flow path, rates of transpiration from peatlands and the dynamics of chromophoric-dissolved organic matter and bulk ionic solutes (specific conductivity)-all on daily or subdaily time scales. Initial results indicate that direct precipitation and evapotranspiration dominate the hydrologic budget of both study wetlands, despite their relatively flat geomorphology and proximity to elevated uplands. Rates of transpiration from peatland sites were typically greater than evaporation from open waters but were more challenging to integrate spatially. Due to the high specific yield of peat, the hydrologic gradient between peatland and open water varied with precipitation events and intervening periods of dry out. The resultant flow path reversals implied that the flux of solutes across the riparian boundary varied over daily time scales. We conclude that WSNs can be deployed in remote wetland-dominated ecosystems at relatively low cost to assess the hydrochemical impacts of weather, climate, and other perturbations.

Social support may buffer the effect of intrafamilial stressors on preschool children's television viewing time in low-income families.

PubMed

Li, Kaigang; Jurkowski, Janine M; Davison, Kirsten K

2013-12-01

Excessive television (TV) viewing in preschool children has been linked to negative outcomes during childhood, including childhood obesity. In a sample of low-income families, this study examined associations between intrafamilial factors and preschool children's TV-viewing time and the moderating effect of social support from nonfamily members on this association. In 2010, 129 mothers/female guardians of 2- to 5-year-old children enrolled at five Head Start centers in Rensselaer County, New York, completed a self-report survey. The survey assessed child TV-viewing time (including TV, DVDs, and videos) and intrafamilial risk factors, including maternal perceived stress, depressive symptoms, TV viewing, leisure-time physical activity (inactivity), and family functioning. Social support from nonfamily members (nonfamily social support) was also measured and examined as an effect modifier. Children watched TV an average of 160 minutes per day. Moderate depressive symptoms (Personal Health Questionnaire depression scale scores ≥10), higher perceived stress, poorer family functioning, and higher maternal TV-viewing were significantly and independently associated with greater minutes of child TV viewing, controlling for covariates. In all instances, nonfamily social support moderated these associations, such that negative experiences within the family environment were linked with higher child TV-viewing time under conditions of low nonfamily social support, but not high nonfamily support. Social support from nonfamily members may buffer potentially negative effects of intrafamilial factors on preschool children's TV-viewing time.

Applying the Lean principles of the Toyota Production System to reduce wait times in the emergency department.

PubMed

Ng, David; Vail, Gord; Thomas, Sophia; Schmidt, Nicki

2010-01-01

In recognition of patient wait times, and deteriorating patient and staff satisfaction, we set out to improve these measures in our emergency department (ED) without adding any new funding or beds. In 2005 all staff in the ED at Hôtel-Dieu Grace Hospital began a transformation, employing Toyota Lean manufacturing principles to improve ED wait times and quality of care. Lean techniques such as value-stream mapping, just-in-time delivery techniques, workplace organization, reduction of systemic wastes, use of the worker as the source of quality improvement and ongoing refinement of our process steps formed the basis of our project. Our ED has achieved major improvements in departmental flow without adding any additional ED or inpatient beds. The mean registration to physician time has decreased from 111 minutes to 78 minutes. The number of patients who left without being seen has decreased from 7.1% to 4.3%. The length of stay (LOS) for discharged patients has decreased from a mean of 3.6 to 2.8 hours, with the largest decrease seen in our patients triaged at levels 4 or 5 using the Canadian Emergency Department Triage and Acuity Scale. We noted an improvement in ED patient satisfaction scores following the implementation of Lean principles. Lean manufacturing principles can improve the flow of patients through the ED, resulting in greater patient satisfaction along with reduced time spent by the patient in the ED.

Detection of a long-duration solar gamma-ray flare on Jun. 11, 1991 with EGRET on Compton-GRO

NASA Technical Reports Server (NTRS)

Kanbach, G.; Bertsch, D. L.; Fitchel, C. E.; Hartman, R. C.; Hunter, S. D.; Kniffen, D. A.; Kwok, P. W.; Lin, Y. C.; Mattox, J. R.; Mayer-Hasslewander, H. A.

1992-01-01

On 11 Jun. 1991, the Energetic Gamma Ray Experiment Telescope (EGRET) on the Compton Gamma Ray Observatory (Comption-GRO) observed high energy gamma radiation above 30 MeV from the Sun following an intense flare around 2:00 Universal Time (UT). After the decay of most of the x ray flare, which caused nearly complete deadtime losses in EGRET, high energy emission was registered during the interval from about 3:30 UT to at least 10:30 UT. Gamma rays were detected up to energies above 1 GeV. The solar origin of the emission is assured by the time profile of the gamma ray count rate and by time resolved sky maps, which show a clear maximum at the position of the sun. The gamma ray lightcurve of the flare can be described with two components: a fast decaying emission with an e-folding time constant of about 25 minutes and a slow decay with about 255 minutes. There are indications for a spectral evolution with time, such that the emission below 100 MeV fades away earlier than the 100 to 300 MeV radiation, roughly in the time scale of the fast component. The spectrum of the flare can be fitted with a composite of a proton generated pion neutral spectrum and an electron bremsstrahlung component. The latter can be identified with the fast decaying component of the lightcurve.

Efficient high light acclimation involves rapid processes at multiple mechanistic levels.

PubMed

Dietz, Karl-Josef

2015-05-01

Like no other chemical or physical parameter, the natural light environment of plants changes with high speed and jumps of enormous intensity. To cope with this variability, photosynthetic organisms have evolved sensing and response mechanisms that allow efficient acclimation. Most signals originate from the chloroplast itself. In addition to very fast photochemical regulation, intensive molecular communication is realized within the photosynthesizing cell, optimizing the acclimation process. Current research has opened up new perspectives on plausible but mostly unexpected complexity in signalling events, crosstalk, and process adjustments. Within seconds and minutes, redox states, levels of reactive oxygen species, metabolites, and hormones change and transmit information to the cytosol, modifying metabolic activity, gene expression, translation activity, and alternative splicing events. Signalling pathways on an intermediate time scale of several minutes to a few hours pave the way for long-term acclimation. Thereby, a new steady state of the transcriptome, proteome, and metabolism is realized within rather short time periods irrespective of the previous acclimation history to shade or sun conditions. This review provides a time line of events during six hours in the 'stressful' life of a plant. © The Author 2015. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Relationship Between the Duration of Cardiopulmonary Resuscitation and Favorable Neurological Outcomes After Out-of-Hospital Cardiac Arrest: A Prospective, Nationwide, Population-Based Cohort Study.

PubMed

Goto, Yoshikazu; Funada, Akira; Goto, Yumiko

2016-03-18

The determination of appropriate duration of in-the-field cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) patients is one of the biggest challenges for emergency medical service providers and clinicians. The appropriate CPR duration before termination of resuscitation remains unclear and may differ based on initial rhythm. We aimed to determine the relationship between CPR duration and post-OHCA outcomes. We analyzed the records of 17 238 OHCA patients (age ≥18 years) who achieved prehospital return of spontaneous circulation. Data were prospectively recorded in a nationwide, Japanese database between 2011 and 2012. The time from CPR initiation to prehospital return of spontaneous circulation (CPR duration) was calculated. The primary end point was 1-month survival with favorable neurological outcomes (Cerebral Performance Category [CPC] scale; CPC 1-2). The 1-month CPC 1-2 rate was 21.8% (n=3771). CPR duration was inversely associated with 1-month CPC 1-2 (adjusted unit odds ratio: 0.95, 95% CI: 0.94-0.95). Among all patients, a cumulative proportion of >99% of 1-month CPC 1-2 was achieved with a CPR duration of 35 minutes. When sorted by the initial rhythm, the CPR duration producing more than 99% of survivors with CPC 1-2 was 35 minutes for shockable rhythms and pulseless electrical activity, and 42 minutes for asystole. CPR duration was independently and inversely associated with favorable 1-month neurological outcomes. The critical prehospital CPR duration for OHCA was 35 minutes in patients with initial shockable rhythms and pulseless electrical activity, and 42 minutes in those with initial asystole. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Ketorolac for Pain Control With Intrauterine Device Placement: A Randomized Controlled Trial

PubMed Central

Ngo, Lynn L.; Ward, Kristy K.; Mody, Sheila K.

2015-01-01

Objective To evaluate intramuscular ketorolac compared to placebo saline injection for pain control with intrauterine device (IUD) placement. Methods We conducted a randomized, double-blind, placebo controlled trial between July 2012 and March 2014. Patients received ketorolac 30mg or placebo saline intramuscular injection 30 minutes prior to IUD placement. The primary outcome was pain with IUD placement on a 10cm visual analog scale (VAS). Sample size was calculated to provide 80% power to show a 2.0cm difference (α=0.05) in the primary outcome. Secondary outcomes included pain with study drug injection, speculum insertion, tenaculum placement, uterine sounding, and at 5 and 15 minutes after IUD placement. Results A total of 67 women participated in the study, 33 in the ketorolac arm and 34 in the placebo arm. There were no differences in baseline demographics including age, BMI, and race. There were no differences in median pain scores for IUD placement in the placebo versus ketorolac groups (5.2cm vs 3.6cm, p=0.99). There was a decrease in median pain scores at 5 minutes (2.2cm vs 0.3cm, p=<0.001) and 15 minutes (1.6cm vs 0.1cm, p=<0.001) after IUD placement but no difference for all other time points. Nulliparous participants (n=16, 8 per arm) had a decrease in pain scores with IUD placement (8.1cm vs 5.4cm, p=0.02). In this study, 22% of participants in the placebo group and 18% in the ketorolac group reported injection pain was as painful as IUD placement. Conclusions Ketorolac does not reduce pain with IUD placement but does reduce pain at 5 and 15 minutes after placement. PMID:26241253

Ketorolac for Pain Control With Intrauterine Device Placement: A Randomized Controlled Trial.

PubMed

Ngo, Lynn L; Ward, Kristy K; Mody, Sheila K

2015-07-01

To evaluate intramuscular ketorolac compared with placebo saline injection for pain control with intrauterine device (IUD) placement. We conducted a randomized, double-blind, placebo-controlled trial between July 2012 and March 2014. Patients received 30 mg ketorolac or placebo saline intramuscular injection 30 minutes before IUD placement. The primary outcome was pain with IUD placement on a 10-cm visual analog scale. Sample size was calculated to provide 80% power to show a 2.0-cm difference (α=0.05) in the primary outcome. Secondary outcomes included pain with study drug injection, speculum insertion, tenaculum placement, uterine sounding, and at 5 and 15 minutes after IUD placement. A total of 67 women participated in the study, 33 in the ketorolac arm and 34 in the placebo arm. There were no differences in baseline demographics including age, body mass index, and race. There were no differences in median pain scores for IUD placement in the placebo compared with ketorolac groups (5.2 compared with 3.6 cm, P=.99). There was a decrease in median pain scores at 5 minutes (2.2 compared with 0.3 cm, P≤.001) and 15 minutes (1.6 compared with 0.1 cm, P≤.001) after IUD placement but no difference for all other time points. Nulliparous participants (n=16, eight per arm) had a decrease in pain scores with IUD placement (8.1 compared with 5.4 cm, P=.02). In this study, 22% of participants in the placebo group and 18% in the ketorolac group reported injection pain was as painful as IUD placement. Ketorolac does not reduce pain with IUD placement but does reduce pain at 5 and 15 minutes after placement. ClinicalTrials.gov; www.clinicaltrials.gov, NCT01664559. I.

The effect of tibio-femoral traction mobilization on passive knee flexion motion impairment and pain: a case series

PubMed Central

Maher, Sara; Creighton, Doug; Kondratek, Melodie; Krauss, John; Qu, Xianggui

2010-01-01

The purpose of this case series was to explore the effects of tibio-femoral (TF) manual traction on pain and passive range of motion (PROM) in individuals with unilateral motion impairment and pain in knee flexion. Thirteen participants volunteered for the study. All participants received 6 minutes of TF traction mobilization applied at end-range passive knee flexion. PROM measurements were taken before the intervention and after 2, 4, and 6 minutes of TF joint traction. Pain was measured using a visual analog scale with the TF joint at rest, at end-range passive knee flexion, during the application of joint traction, and immediately post-treatment. There were significant differences in PROM after 2 and 4 minutes of traction, with no significance noted after 4 minutes. A significant change in knee flexion of 25.9°, which exceeded the MDC95, was found when comparing PROM measurements pre- to final intervention. While pain did not change significantly over time, pain levels did change significantly during each treatment session. Pain significantly increased when the participant’s knee was passively flexed to end range; it was reduced, although not significantly, during traction mobilization; and it significantly decreased following traction. This case series supports TF joint traction as a means of stretching shortened articular and periarticular tissues without increasing reported levels of pain during or after treatment. In addition, this is the first study documenting the temporal aspects of treatment effectiveness in motion restoration. PMID:21655421

Determining Resident Sleep During and After Call With Commercial Sleep Monitoring Devices.

PubMed

Morhardt, Duncan R; Luckenbaugh, Amy; Goldstein, Cathy; Faerber, Gary J

2017-08-01

To demonstrate that commercial activity monitoring devices (CAMDs) are practical for monitoring resident sleep while on call. Studies that have directly monitored resident sleep are limited, likely owing to both cost and difficulty in study interpretation. The advent of wearable CAMDs that estimate sleep presents the opportunity to more readily evaluate resident sleep in physically active settings and "home call," a coverage arrangement familiar to urology programs. Twelve urology residents were outfitted with Fitbit Flex devices during "home call" for a total of 57 (out of 64, or 89%) call or post-call night pairs. Residents were surveyed with the Stanford Sleepiness Scale (SSS), a single-question alertness survey. Time in bed (TIB) was "time to bed" to "rise for day." Fitbit accelerometers register activity as follows: (1) not moving; (2) minimal movement or restless; or (3) above threshold for accelerometer to register steps. Total sleep time (TST) was the number of minutes in level 1 activity during TIB. Sleep efficiency (SE) was defined as TST divided by TIB. While on call, 10 responding (of 12 available, 83%) residents on average reported TIB as 347 minutes, TST as 165 minutes, and had an SE of 47%. Interestingly, SSS responses did not correlate with sleep parameters. Post-call sleep demonstrated increases in TIB, SE, and TST (+23%, +15%, and +44%, respectively) while sleepiness was reduced by 22%. We demonstrate that urologic residents can consistently wear CAMDs while on home call. SSS did not correlate with Fitbit-estimated sleep duration. Further study with such devices may enhance sleep deprivation recognition to improve resident sleep. Copyright © 2017 Elsevier Inc. All rights reserved.

A combination of levobupivacaine and lidocaine for paravertebral block in breast cancer patients undergoing quadrantectomy causes greater hemodynamic oscillations than levobupivacaine alone

PubMed Central

Župčić, Miroslav; Graf, Sandra; Župčić; Duzel, Viktor; Šimurina, Tatjana; Šakić, Livija; Fudurić, Jurica; Peršec, Jasminka; Milošević, Milan; Stanec, Zdenko; Korušić, Anđelko; Barišin, Stjepan

2017-01-01

Aim To test for differences in hemodynamic and analgesic properties in patients with breast cancer undergoing quadrantectomy with paravertebral block (PVB) induced with a solution of either one or two local anesthetics. Method A prospective, single-center, randomized, double-blinded, controlled trial was conducted from June 2014 until September 2015. A total of 85 women with breast cancer were assigned to receive PVB with either 0.5% levobupivacaine (n = 42) or 0.5% levobupivacaine with 2% lidocaine (n = 43). Hemodynamic variables of interest included intraoperative stroke volume variation (SVV), mean arterial pressure, heart rate, cardiac output, episodes of hypotension, use of crystalloids, and use of inotropes. Analgesic variables of interest were time to block onset, duration of analgesia, and postoperative serial pain assessment using a visual analogue scale. Results Although the use of 0.5% levobupivacaine with 2% lidocaine solution for PVB decreased the mean time-to-block onset (14 minutes; P < 0.001), it also caused significantly higher SVV values over the 60 minutes of monitoring (mean difference: 4.33; P < 0.001). Furthermore, the patients who received 0.5% levobupivacaine with 2% lidocaine experienced shorter mean duration of analgesia (105 minutes; P = 0.006) and more episodes of hypotension (17.5%; P = 0.048) and received more intraoperative crystalloids (mean volume: 550 mL; P < 0.001). Conclusion The use of 0.5% levobupivacaine in comparison with 0.5% levobupivacaine with 2% lidocaine solution for PVB had a longer time-to-block onset, but it also reduced hemodynamic disturbances and prolonged the analgesic effect. Registration No.: NTC02004834 PMID:28857520

Accuracy of self-reported sleep parameters compared with actigraphy in young people with mental ill-health.

PubMed

Biddle, Daniel J; Robillard, Rébecca; Hermens, Daniel F; Hickie, Ian B; Glozier, Nicholas

2015-09-01

Validation of self-report assessment of habitual sleep duration and onset time in young people with mental ill-health. Validation sample. Specialized early intervention centers for young people in Sydney, Australia. One hundred and forty-six young people with mental ill-health. N/A. Self-reported habitual sleep duration and onset time were compared against at least 7 days of actigraphy monitoring. Average bias in and calibration of subjective measures were assessed, along with correlation of subjective and objective measures. Differences by age, sex, mental-disorder type, and reported insomnia were also explored. On average, subjective estimates of sleep were unbiased. Overall, each additional hour of objective habitual sleep duration predicted 41 minutes more subjective habitual sleep duration, and each hour later objective habitual sleep onset occurred predicted a 43-minute later subjective habitual sleep onset. There were subgroup differences: subjective habitual sleep duration in self-reported insomnia was shorter than objective duration by 30 minutes (SD = 119), on average. Calibration of habitual sleep duration was worse for those with mood disorders than with other primary diagnoses (t = -2.39, P = .018). Correlation between subjective and objective measures was strong for sleep onset time (Á = .667, P < .001) and moderate for sleep duration (r = .332, P < .001). For the mood disorder group, subjective and objective sleep durations were uncorrelated. Self-reports seem valid for large-scale studies of habitual sleep duration and onset in help-seeking young people, but assessment of habitual sleep duration requires objective measures where individual accuracy is important. Copyright © 2015 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

The accuracy of eyelid movement parameters for drowsiness detection.

PubMed

Wilkinson, Vanessa E; Jackson, Melinda L; Westlake, Justine; Stevens, Bronwyn; Barnes, Maree; Swann, Philip; Rajaratnam, Shantha M W; Howard, Mark E

2013-12-15

Drowsiness is a major risk factor for motor vehicle and occupational accidents. Real-time objective indicators of drowsiness could potentially identify drowsy individuals with the goal of intervening before an accident occurs. Several ocular measures are promising objective indicators of drowsiness; however, there is a lack of studies evaluating their accuracy for detecting behavioral impairment due to drowsiness in real time. In this study, eye movement parameters were measured during vigilance tasks following restricted sleep and in a rested state (n = 33 participants) at three testing points (n = 71 data points) to compare ocular measures to a gold standard measure of drowsiness (OSLER). The utility of these parameters for detecting drowsiness-related errors was evaluated using receiver operating characteristic curves (ROC) (adjusted by clustering for participant) and identification of optimal cutoff levels for identifying frequent drowsiness-related errors (4 missed signals in a minute using OSLER). Their accuracy was tested for detecting increasing frequencies of behavioral lapses on a different task (psychomotor vigilance task [PVT]). Ocular variables which measured the average duration of eyelid closure (inter-event duration [IED]) and the ratio of the amplitude to velocity of eyelid closure were reliable indicators of frequent errors (area under the curve for ROC of 0.73 to 0.83, p < 0.05). IED produced a sensitivity and specificity of 71% and 88% for detecting ≥ 3 lapses (PVT) in a minute and 100% and 86% for ≥ 5 lapses. A composite measure of several eye movement characteristics (Johns Drowsiness Scale) provided sensitivities of 77% and 100% for detecting 3 and ≥ 5 lapses in a minute, with specificities of 85% and 83%, respectively. Ocular measures, particularly those measuring the average duration of episodes of eye closure are promising real-time indicators of drowsiness.

An integrated gait rehabilitation training based on Functional Electrical Stimulation cycling and overground robotic exoskeleton in complete spinal cord injury patients: Preliminary results.

PubMed

Mazzoleni, S; Battini, E; Rustici, A; Stampacchia, G

2017-07-01

The aim of this study is to investigate the effects of an integrated gait rehabilitation training based on Functional Electrical Stimulation (FES)-cycling and overground robotic exoskeleton in a group of seven complete spinal cord injury patients on spasticity and patient-robot interaction. They underwent a robot-assisted rehabilitation training based on two phases: n=20 sessions of FES-cycling followed by n= 20 sessions of robot-assisted gait training based on an overground robotic exoskeleton. The following clinical outcome measures were used: Modified Ashworth Scale (MAS), Numerical Rating Scale (NRS) on spasticity, Penn Spasm Frequency Scale (PSFS), Spinal Cord Independence Measure Scale (SCIM), NRS on pain and International Spinal Cord Injury Pain Data Set (ISCI). Clinical outcome measures were assessed before (T0) after (T1) the FES-cycling training and after (T2) the powered overground gait training. The ability to walk when using exoskeleton was assessed by means of 10 Meter Walk Test (10MWT), 6 Minute Walk Test (6MWT), Timed Up and Go test (TUG), standing time, walking time and number of steps. Statistically significant changes were found on the MAS score, NRS-spasticity, 6MWT, TUG, standing time and number of steps. The preliminary results of this study show that an integrated gait rehabilitation training based on FES-cycling and overground robotic exoskeleton in complete SCI patients can provide a significant reduction of spasticity and improvements in terms of patient-robot interaction.

Impact of a feedback device on chest compression quality during extended manikin CPR: a randomized crossover study.

PubMed

Buléon, Clément; Delaunay, Julie; Parienti, Jean-Jacques; Halbout, Laurent; Arrot, Xavier; Gérard, Jean-Louis; Hanouz, Jean-Luc

2016-09-01

Chest compressions require physical effort leading to increased fatigue and rapid degradation in the quality of cardiopulmonary resuscitation overtime. Despite harmful effect of interrupting chest compressions, current guidelines recommend that rescuers switch every 2 minutes. The impact on the quality of chest compressions during extended cardiopulmonary resuscitation has yet to be assessed. We conducted randomized crossover study on manikin (ResusciAnne; Laerdal). After randomization, 60 professional emergency rescuers performed 2 × 10 minutes of continuous chest compressions with and without a feedback device (CPRmeter). Efficient compression rate (primary outcome) was defined as the frequency target reached along with depth and leaning at the same time (recorded continuously). The 10-minute mean efficient compression rate was significantly better in the feedback group: 42% vs 21% (P< .001). There was no significant difference between the first (43%) and the tenth minute (36%; P= .068) with feedback. Conversely, a significant difference was evident from the second minute without feedback (35% initially vs 27%; P< .001). The efficient compression rate difference with and without feedback was significant every minute, from the second minute onwards. CPRmeter feedback significantly improved chest compression depth from the first minute, leaning from the second minute and rate from the third minute. A real-time feedback device delivers longer effective, steadier chest compressions over time. An extrapolation of these results from simulation may allow rescuer switches to be carried out beyond the currently recommended 2 minutes when a feedback device is used. Copyright © 2016 Elsevier Inc. All rights reserved.

Minute ventilation of cyclists, car and bus passengers: an experimental study.

PubMed

Zuurbier, Moniek; Hoek, Gerard; van den Hazel, Peter; Brunekreef, Bert

2009-10-27

Differences in minute ventilation between cyclists, pedestrians and other commuters influence inhaled doses of air pollution. This study estimates minute ventilation of cyclists, car and bus passengers, as part of a study on health effects of commuters' exposure to air pollutants. Thirty-four participants performed a submaximal test on a bicycle ergometer, during which heart rate and minute ventilation were measured simultaneously at increasing cycling intensity. Individual regression equations were calculated between heart rate and the natural log of minute ventilation. Heart rates were recorded during 280 two hour trips by bicycle, bus and car and were calculated into minute ventilation levels using the individual regression coefficients. Minute ventilation during bicycle rides were on average 2.1 times higher than in the car (individual range from 1.3 to 5.3) and 2.0 times higher than in the bus (individual range from 1.3 to 5.1). The ratio of minute ventilation of cycling compared to travelling by bus or car was higher in women than in men. Substantial differences in regression equations were found between individuals. The use of individual regression equations instead of average regression equations resulted in substantially better predictions of individual minute ventilations. The comparability of the gender-specific overall regression equations linking heart rate and minute ventilation with one previous American study, supports that for studies on the group level overall equations can be used. For estimating individual doses, the use of individual regression coefficients provides more precise data. Minute ventilation levels of cyclists are on average two times higher than of bus and car passengers, consistent with the ratio found in one small previous study of young adults. The study illustrates the importance of inclusion of minute ventilation data in comparing air pollution doses between different modes of transport.

Facilitating Dental Student Reflections: Using Mentor Groups to Discuss Clinical Experiences and Personal Development.

PubMed

Koole, Sebastiaan; Christiaens, Veronique; Cosyn, Jan; De Bruyn, Hugo

2016-10-01

Despite the consensus on the importance of reflection for dental professionals, a lack of understanding remains about how students and clinicians should develop their ability to reflect. The aim of this study was to investigate dental students' and mentors' perceptions of mentor groups as an instructional method to facilitate students' reflection in terms of the strategy's learning potential, role of the mentor, group dynamics, and feasibility. At Ghent University in Belgium, third- and fourth-year dental students were encouraged to reflect on their clinical experiences and personal development in three reflective mentor sessions. No preparation or reports afterwards were required; students needed only to participate in the sessions. Sessions were guided by trained mentors to establish a safe environment, frame clinical discussions, and stimulate reflection. Students' and mentors' perceptions of the experience were assessed with a 17-statement questionnaire with response options on a five-point Likert scale (1=totally disagree to 5=totally agree). A total of 50 students and eight mentors completed the questionnaire (response rates 81% and 89%, respectively). Both students and mentors had neutral to positive perceptions concerning the learning potential, role of the mentor, group dynamics, and feasibility. The mean ideal total time for sessions in a year was 99 minutes (third-year students), 111 minutes (fourth-year students), and 147 minutes (mentors). Reported reflective topics related to patient management, frustrations, and practice of dentistry. Overall mean appreciation for the experience ranged from 14.50 to 15.14 on the 20-point scale. These findings about students' and mentors' positive perceptions of the experience suggest that mentor groups may be a potentially valuable strategy to promote dental students' reflection.

Blink rate is associated with drug-induced parkinsonism in patients with severe mental illness, but does not meet requirements to serve as a clinical test: the Curacao extrapyramidal syndromes study XIII.

PubMed

Mentzel, Charlotte L; Bakker, P Roberto; van Os, Jim; Drukker, Marjan; Matroos, Glenn E; Tijssen, Marina A J; van Harten, Peter N

2017-08-25

Drug-induced parkinsonism (DIP) has a high prevalence and is associated with poorer quality of life. To find a practical clinical tool to assess DIP in patients with severe mental illness (SMI), the association between blink rate and drug-induced parkinsonism (DIP) was assessed. In a cohort of 204 SMI patients receiving care from the only mental health service of the previous Dutch Antilles, blink rate per minute during conversation was assessed by an additional trained movement disorder specialist. DIP was rated on the Unified Parkinson's Disease Rating Scale (UPDRS) in 878 assessments over a period of 18 years. Diagnostic values of blink rate were calculated. DIP prevalence was 36%, average blink rate was 14 (standard deviation (SD) 11) for patients with DIP, and 19 (SD 14) for patients without. There was a significant association between blink rate and DIP (p < 0.001). With a blink rate cut-off of 20 blinks per minute, sensitivity was 77% and specificity was 38%. A 10% percentile cut-off model resulted in an area under the ROC curve of 0.61. A logistic prediction model between dichotomous DIP and continuous blink rate per minute an area under the ROC curve of 0.70. There is a significant association between blink rate and DIP as diagnosed on the UPDRS. However, blink rate sensitivity and specificity with regard to DIP are too low to replace clinical rating scales in routine psychiatric practice. The study was started over 20 years ago in 1992, at the time registering a trial was not common practice, therefore the study was never registered.

Exercise addiction.

PubMed

Landolfi, Emilio

2013-02-01

This article examines the nature of exercise addiction. It presents a broad, congruent and discerning narrative literature review with the aim of providing a deeper understanding of the condition 'exercise addiction', including symptoms and options for treatment. In addition, guidelines are provided with respect to 'healthy' levels of exercise. Criteria used for determining the eligibility of studies evaluated in the review included the provision of relevant information in studies identified using pertinent search terms. The review highlights some of the key distinctions between healthy levels of exercise and exercise addiction. The findings suggest that an individual who is addicted to exercise will continue exercising regardless of physical injury, personal inconvenience or disruption to other areas of life including marital strain, interference with work and lack of time for other activities. 'Addicted' exercisers are more likely to exercise for intrinsic rewards and experience disturbing deprivation sensations when unable to exercise. In contrast, 'committed' exercisers engage in physical activity for extrinsic rewards and do not suffer severe withdrawal symptoms when they cannot exercise. Exercisers must acquire a sense of life-balance while embracing an attitude conducive to sustainable long-term physical, psychological and social health outcomes. Implementation of recommendations by the Canadian Society for Exercise Physiology, which states that all apparently healthy adults between 18 and 64 years of age should accumulate at least 150 minutes of moderate (5 or 6 on a scale of 0-10) to vigorous (7 or 8 on a scale of 0-10) intensity aerobic physical activity per week in bouts of 10 minutes or more, also expressed as 30 minutes per day distributed over 5 days per week, would be a good start.

Lean methodology improves efficiency in outpatient academic uro-oncology clinics.

PubMed

Skeldon, Sean C; Simmons, Andrea; Hersey, Karen; Finelli, Antonio; Jewett, Michael A; Zlotta, Alexandre R; Fleshner, Neil E

2014-05-01

To determine if lean methodology, an industrial engineering tool developed to optimize manufacturing efficiency, can successfully be applied to improve efficiencies and quality of care in a hospital-based high-volume uro-oncology clinic. Before the lean initiative, baseline data were collected on patient volumes, wait times, cycle times (patient arrival to discharge), nursing assessment time, patient teaching, and physician ergonomics (via spaghetti diagram). Value stream analysis and a rapid improvement event were carried out, and significant changes were made to patient check-in, work areas, and nursing face time. Follow-up data were obtained at 30, 60, and 90 days. The Student t test was used for analysis to compare performance metrics with baseline. The median cycle time before the lean initiative was 46 minutes. This remained stable at 46 minutes at 30 days but improved to 35 minutes at 60 days and 41 minutes at 90 days. Shorter wait times allowed for increased nursing and physician face time. The average length of the physician assessment increased from 7.5 minutes at baseline to 10.6 minutes at 90 days. The average proportion of value-added time compared with the entire clinic visit increased from 30.6% at baseline to 66.3% at 90 days. Using lean methodology, we were able to shorten the patient cycle time and the time to initial assessment as well as integrate both an initial registered nurse assessment and registered nurse teaching to each visit. Lean methodology can effectively be applied to improve efficiency and patient care in an academic outpatient uro-oncology clinic setting. Copyright © 2014 Elsevier Inc. All rights reserved.

Disparity between Physical Capacity and Participation in Seniors with Chronic Disease

PubMed Central

Ashe, Maureen C.; Eng, Janice J.; Miller, William C.; Soon, Judith A.

2011-01-01

Consistently low rates of physical activity are reported for older adults and there is even lower participation if a chronic disease is present. Purpose To explore the predictors of physical capacity and participation in older community-dwelling individuals living with multiple chronic diseases. Methods This was a descriptive cross-sectional investigation of physical capacity (physiological potential) and physical activity participation (recorded engagement in physical activity). Multiple regression and odds ratios were used to investigate determinants of physical capacity (6 Minute Walk Test) and physical activity participation (Physical Activity Scale for Individuals with Physical Disabilities Questionnaire; pedometer steps/day). Results 200 community dwelling ambulatory participants living with 2 or more chronic disease were assessed. Sixty-five percent (65%) were women and the mean age was 74 ± 6 years (range 65–90 years). Mobility (Timed Up and Go) was a consistent determinant across all 3 primary outcomes. For the Six Minute Walk Test, determinants included mobility, BMI, grip strength, number of medications, leg strength, balance and Chronic Disease Management Self Efficacy Scale (r2=0.58; P=.000). The determinants for the self-reported participation measure (Physical Activity Scale for Individuals with Physical Disabilities Questionnaire) was mobility (r2=0.04; P=.007). For the mean daily pedometer steps, the determinants included mobility, body mass index (BMI), age and Chronic Disease Management Self-Efficacy Scale (r2=0.27; P=.000). There were higher risks for inactivity associated with impairments compared with the presence of a chronic disease. In addition, over 1/3 of participants had sufficient physical capacity, but did not meet minimal recommendations of physical activity. Conclusion This study suggests that it is easier to predict an individual’s physical capacity than their actual physical participation. PMID:17596782

Feasibility and short-term impact of the "case study in-house group training program for family nursing" at medical facilities.

PubMed

Yamazaki, Akemi; Tsumura, Akemi; Mine, Hiroko; Kimura, Chisato; Soeda, Akemi; Odatsu, Kazumi; Kiwado, Wataru

2017-02-01

The aim of this study was to evaluate the feasibility and short-term impact of case study training in family nursing care targeting midlevel nursing professionals. The intervention group participated in four 90-minute case study training sessions over 6 months, while the control group participated in two 90-minute lectures. Using primary outcome variables as evaluation indexes, we measured the participants' total scores on the Family Importance in Nursing Care Scale and 4 subitems 3 times (before, immediately after and 1 month after training) from May 2014 to March 2015 and then conducted 2-way repeated-measure analysis of variance. We asked the participants and training planners/managers to provide feedback on their evaluation and then performed content analysis on their responses. Although the primary impact due to the different measurement times was significant, no significant difference was observed in the interaction between measurement time and training differences. Of the 4 subitems, significant interactions because of measurement time and training differences were observed only in Fam-B. Feedback data showed all participants felt that their understanding of the importance of family nursing care was strengthened, and participants in the intervention group specifically described how they were utilizing what they had learned from training in practice. © 2016 John Wiley & Sons Australia, Ltd.

Lubiprostone improves visualization of small bowel for capsule endoscopy: a double-blind, placebo-controlled 2-way crossover study.

PubMed

Matsuura, Mizue; Inamori, Masahiko; Inou, Yumi; Kanoshima, Kenji; Higurashi, Takuma; Ohkubo, Hidenori; Iida, Hiroshi; Endo, Hiroki; Nonaka, Takashi; Kusakabe, Akihiko; Maeda, Shin; Nakajima, Atsushi

2017-06-01

 Lubiprostone has been reported to be an anti-constipation drug. The aim of the study was to investigate the usefulness of lubiprostone both for bowel preparation and as a propulsive agent in small bowel endoscopy.  This was a double-blind, placebo-controlled, 2-way crossover study of subjects who volunteered to undergo capsule endoscopy (CE). A total of 20 subjects (16 male and 4 female volunteers) were randomly assigned to receive a 24-μg tablet of lubiprostone 120 minutes prior to capsule ingestion for CE (L regimen), or a placebo tablet 120 minutes prior to capsule ingestion for CE (P regimen). Main outcome was gastric transit time (GTT) and small-bowel transit time (SBTT). Secondary outcome was adequacy of small-bowel cleansing and the fluid score in the small bowel. The quality of the capsule endoscopic images and fluid in the small bowel were assessed on 5-point scale.  The capsule passed into the small bowel in all cases. Median GTT was 57.3 (3 - 221) minutes for the P regimen and 61.3 (10 - 218) minutes for the L regimen ( P  = 0.836). Median SBTT was 245.0 (164 - 353) minutes for the P regimen and 228.05 (116 - 502) minutes for the L regimen ( P  = 0.501). The image quality score in the small bowel was 3.05 ± 1.08 for the P regimen and 3.80 ± 0.49 for the L regimen ( P  < 0.001). The fluid score in the small bowel was 2.04 ± 1.58 for the P regimen and 2.72 ± 1.43 for the L regimen ( P  < 0.001). There was a significant difference between the 2 regimens with regard to image quality. The fluid score was more plentiful for the L regimen than for the P regimen. There were no cases of capsule retention or serious adverse events in this study.  Our study showed that use of lubiprostone prior to CE significantly improved visualization of the small bowel during CE as a result of inducing fluid secretion into the small bowel.

Detection of CO2 leakage by the surface-soil CO2-concentration monitoring (SCM) system in a small scale CO2 release test

NASA Astrophysics Data System (ADS)

Chae, Gitak; Yu, Soonyoung; Sung, Ki-Sung; Choi, Byoung-Young; Park, Jinyoung; Han, Raehee; Kim, Jeong-Chan; Park, Kwon Gyu

2015-04-01

Monitoring of CO2 release through the ground surface is essential to testify the safety of CO2 storage projects. We conducted a feasibility study of the multi-channel surface-soil CO2-concentration monitoring (SCM) system as a soil CO2 monitoring tool with a small scale injection. In the system, chambers are attached onto the ground surface, and NDIR sensors installed in each chamber detect CO2 in soil gas released through the soil surface. Before injection, the background CO2 concentrations were measured. They showed the distinct diurnal variation, and were positively related with relative humidity, but negatively with temperature. The negative relation of CO2 measurements with temperature and the low CO2 concentrations during the day imply that CO2 depends on respiration. The daily variation of CO2 concentrations was damped with precipitation, which can be explained by dissolution of CO2 and gas release out of pores through the ground surface with recharge. For the injection test, 4.2 kg of CO2 was injected 1 m below the ground for about 30 minutes. In result, CO2 concentrations increased in all five chambers, which were located less than 2.5 m of distance from an injection point. The Chamber 1, which is closest to the injection point, showed the largest increase of CO2 concentrations; while Chamber 2, 3, and 4 showed the peak which is 2 times higher than the average of background CO2. The CO2 concentrations increased back after decreasing from the peak around 4 hours after the injection ended in Chamber 2, 4, and 5, which indicated that CO2 concentrations seem to be recovered to the background around 4 hours after the injection ended. To determine the leakage, the data in Chamber 2 and 5, which had low increase rates in the CO2 injection test, were used for statistical analysis. The result shows that the coefficient of variation (CV) of CO2 measurements for 30 minutes is efficient to determine a leakage signal, with reflecting the abnormal change in CO2 concentrations. The CV of CO2 measurements for 30 minutes exceeded 5% about 5 minutes before the maximum CO2 concentration was detected. The contributions of this work are as follows: (1) SCM is an efficient monitoring tool to detect the CO2 release through the ground surface. (2) The statistical analysis method to determine the leakage and a monitoring frequency are provided, with analyzing background concentrations and CO2 increases in a small-scale injection test. (3) The 5% CV of CO2 measurements for 30 minutes can be used for the early warning in CO2 storage sites.

Ad libitum fluid intake and plasma responses after pickle juice, hypertonic saline, or deionized water ingestion.

PubMed

Allen, Scott; Miller, Kevin C; Albrecht, Jay; Garden-Robinson, Julie; Blodgett-Salafia, Elizabeth

2013-01-01

Adding sodium (Na(+)) to drinks improves rehydration and ad libitum fluid consumption. Clinicians (∼25%) use pickle juice (PJ) to treat cramping. Scientists warn against PJ ingestion, fearing it will cause rapid plasma volume restoration and thereby decrease thirst and delay rehydration. Advice about drinking PJ has been developed but never tested. To determine if drinking small volumes of PJ, hypertonic saline (HS), or deionized water (DIW) affects ad libitum DIW ingestion, plasma variables, or perceptual indicators. Crossover study. Laboratory. Fifteen, euhydrated (urine specific gravity ≤ 1.01) men (age = 22 ± 2 years, height = 178 ± 6 cm, mass = 82.9 ± 8.4 kg). Participants completed 3 testing days (≥ 72 hours between days). After a 30-minute rest, a blood sample was collected. Participants completed 60 minutes of hard exercise (temperature = 36 ± 2°C, relative humidity = 16 ± 1%). Postexercise, they rested for 30 minutes; had a blood sample collected; rated thirst, fullness, and nausea; and ingested 83 ± 8 mL of PJ, HS, or DIW. They rated drink palatability (100-mm visual analog scale) and were allowed to drink DIW ad libitum for 60 minutes. Blood samples and thirst, fullness, and nausea ratings (100-mm visual analog scales) were collected at 15, 30, 45, and 60 minutes posttreatment drink ingestion. Ad libitum DIW volume, percentage change in plasma volume, plasma osmolality (OSMp,) plasma sodium concentration ([Na(+)]p), and thirst, fullness, nausea, and palatability ratings. Participants consumed more DIW ad libitum after HS (708.03 ± 371.03 mL) than after DIW (532.99 ± 337.14 mL, P < .05). Ad libitum DIW ingested after PJ (700.35 ± 366.15 mL) was similar to that after HS and DIW (P > .05). Plasma sodium concentration, OSMp, percentage change in plasma volume, thirst, fullness, and nausea did not differ among treatment drinks over time (P > .05). Deionized water (73 ± 14 mm) was more palatable than HS (17 ± 13 mm) or PJ (26 ± 16 mm, P < .05). The rationale behind advice about drinking PJ is questionable. Participants drank more, not less, after PJ ingestion, and plasma variables and perceptual indicators were similar after PJ and DIW ingestion. Pickle juice did not inhibit short-term rehydration.

Orthopedic resident work-shift analysis: are we making the best use of resident work hours?

PubMed

Hamid, Kamran S; Nwachukwu, Benedict U; Hsu, Eugene; Edgerton, Colston A; Hobson, David R; Lang, Jason E

2014-01-01

Surgery programs have been tasked to meet rising demands in patient surgical care while simultaneously providing adequate resident training in the midst of increasing resident work-hour restrictions. The purpose of this study was to quantify orthopedic surgery resident workflow and identify areas needing improved resident efficiency. We hypothesize that residents spend a disproportionate amount of time involved in activities that do not relate directly to patient care or maximize resident education. We observed 4 orthopedic surgery residents on the orthopedic consult service at a major tertiary care center for 72 consecutive hours (6 consecutive shifts). We collected minute-by-minute data using predefined work-task criteria: direct new patient contact, direct existing patient contact, communications with other providers, documentation/administrative time, transit time, and basic human needs. A seventh category comprised remaining less-productive work was termed as standby. In a 720-minute shift, residents spent on an average: 191 minutes (26.5%) performing documentation/administrative duties, 167.0 minutes (23.2%) in direct contact with new patient consults, 129.6 minutes (17.1%) in communication with other providers regarding patients, 116.2 (16.1%) minutes in standby, 63.7 minutes (8.8%) in transit, 32.6 minutes (4.5%) with existing patients, and 20 minutes (2.7%) attending to basic human needs. Residents performed an additional 130 minutes of administrative work off duty. Secondary analysis revealed residents were more likely to perform administrative work rather than directly interact with existing patients (p = 0.006) or attend to basic human needs (p = 0.003). Orthopedic surgery residents spend a large proportion of their time performing documentation/administrative-type work and their workday can be operationally optimized to minimize nonvalue-adding tasks. Formal workflow analysis may aid program directors in systematic process improvements to better align resident skills with tasks. III. Published by Elsevier Inc.

Measurement instruments to assess posture, gait, and balance in Parkinson's disease: Critique and recommendations.

PubMed

Bloem, Bastiaan R; Marinus, Johan; Almeida, Quincy; Dibble, Lee; Nieuwboer, Alice; Post, Bart; Ruzicka, Evzen; Goetz, Christopher; Stebbins, Glenn; Martinez-Martin, Pablo; Schrag, Anette

2016-09-01

Disorders of posture, gait, and balance in Parkinson's disease (PD) are common and debilitating. This MDS-commissioned task force assessed clinimetric properties of existing rating scales, questionnaires, and timed tests that assess these features in PD. A literature review was conducted. Identified instruments were evaluated systematically and classified as "recommended," "suggested," or "listed." Inclusion of rating scales was restricted to those that could be used readily in clinical research and practice. One rating scale was classified as "recommended" (UPDRS-derived Postural Instability and Gait Difficulty score) and 2 as "suggested" (Tinetti Balance Scale, Rating Scale for Gait Evaluation). Three scales requiring equipment (Berg Balance Scale, Mini-BESTest, Dynamic Gait Index) also fulfilled criteria for "recommended" and 2 for "suggested" (FOG score, Gait and Balance Scale). Four questionnaires were "recommended" (Freezing of Gait Questionnaire, Activities-specific Balance Confidence Scale, Falls Efficacy Scale, Survey of Activities, and Fear of Falling in the Elderly-Modified). Four tests were classified as "recommended" (6-minute and 10-m walk tests, Timed Up-and-Go, Functional Reach). We identified several questionnaires that adequately assess freezing of gait and balance confidence in PD and a number of useful clinical tests. However, most clinical rating scales for gait, balance, and posture perform suboptimally or have been evaluated insufficiently. No instrument comprehensively and separately evaluates all relevant PD-specific gait characteristics with good clinimetric properties, and none provides separate balance and gait scores with adequate content validity for PD. We therefore recommend the development of such a PD-specific, easily administered, comprehensive gait and balance scale that separately assesses all relevant constructs. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

Time Management in the Operating Room: An Analysis of the Dedicated Minimally Invasive Surgery Suite

PubMed Central

Hsiao, Kenneth C.; Machaidze, Zurab

2004-01-01

Background: Dedicated minimally invasive surgery suites are available that contain specialized equipment to facilitate endoscopic surgery. Laparoscopy performed in a general operating room is hampered by the multitude of additional equipment that must be transported into the room. The objective of this study was to compare the preparation times between procedures performed in traditional operating rooms versus dedicated minimally invasive surgery suites to see whether operating room efficiency is improved in the specialized room. Methods: The records of 50 patients who underwent laparoscopic procedures between September 2000 and April 2002 were retrospectively reviewed. Twenty-three patients underwent surgery in a general operating room and 18 patients in an minimally invasive surgery suite. Nine patients were excluded because of cystoscopic procedures undergone prior to laparoscopy. Various time points were recorded from which various time intervals were derived, such as preanesthesia time, anesthesia induction time, and total preparation time. A 2-tailed, unpaired Student t test was used for statistical analysis. Results: The mean preanesthesia time was significantly faster in the minimally invasive surgery suite (12.2 minutes) compared with that in the traditional operating room (17.8 minutes) (P=0.013). Mean anesthesia induction time in the minimally invasive surgery suite (47.5 minutes) was similar to time in the traditional operating room (45.7 minutes) (P=0.734). The average total preparation time for the minimally invasive surgery suite (59.6 minutes) was not significantly faster than that in the general operating room (63.5 minutes) (P=0.481). Conclusion: The amount of time that elapses between the patient entering the room and anesthesia induction is statically shorter in a dedicated minimally invasive surgery suite. Laparoscopic surgery is performed more efficiently in a dedicated minimally invasive surgery suite versus a traditional operating room. PMID:15554269

Effects of self-etching primer on shear bond strength of orthodontic brackets at different debond times.

PubMed

Turk, Tamer; Elekdag-Turk, Selma; Isci, Devrim

2007-01-01

To evaluate the effect of a self-etching primer on shear bond strengths (SBS) at the different debond times of 5, 15, 30, and 60 minutes and 24 hours. Brackets were bonded to human premolars with different etching protocols. In the control group (conventional method [CM]) teeth were etched with 37% phosphoric acid. In the study group, a self-etching primer (SEP; Transbond Plus Self Etching Primer; 3M Unitek, Monrovia, Calif) was applied as recommended by the manufacturer. Brackets were bonded with light-cure adhesive paste (Transbond XT; 3M Unitek) and light-cured for 20 seconds in both groups. The shear bond test was performed at the different debond times of 5, 15, 30 and 60 minutes and 24 hours. Lowest SBS was attained with a debond time of 5 minutes for the CM group (9.51 MPa) and the SEP group (8.97 MPa). Highest SBS was obtained with a debond time of 24 hours for the CM group (16.82 MPa) and the SEP group (19.11 MPa). Statistically significant differences between the two groups were not observed for debond times of 5, 15, 30, or 60 minutes. However, the SBS values obtained at 24 hours were significantly different (P < .001). Adequate SBS was obtained with self-etching primer during the first 60 minutes (5, 15, 30 and 60 minutes) when compared with the conventional method. It is reliable to load the bracket 5 minutes after bonding using self-etching primer (Transbond Plus) with the light-cure adhesive (Transbond XT).

The temporal structure of behaviour and sleep homeostasis.

PubMed

Vyazovskiy, Vladyslav V; Tobler, Irene

2012-01-01

The amount and architecture of vigilance states are governed by two distinct processes, which occur at different time scales. The first, a slow one, is related to a wake/sleep dependent homeostatic Process S, which occurs on a time scale of hours, and is reflected in the dynamics of NREM sleep EEG slow-wave activity. The second, a fast one, is manifested in a regular alternation of two sleep states--NREM and REM sleep, which occur, in rodents, on a time scale of ~5-10 minutes. Neither the mechanisms underlying the time constants of these two processes--the slow one and the fast one, nor their functional significance are understood. Notably, both processes are primarily apparent during sleep, while their potential manifestation during wakefulness is obscured by ongoing behaviour. Here, we find, in mice provided with running wheels, that the two sleep processes become clearly apparent also during waking at the level of behavior and brain activity. Specifically, the slow process was manifested in the total duration of waking periods starting from dark onset, while the fast process was apparent in a regular occurrence of running bouts during the waking periods. The dynamics of both processes were stable within individual animals, but showed large interindividual variability. Importantly, the two processes were not independent: the periodic structure of waking behaviour (fast process) appeared to be a strong predictor of the capacity to sustain continuous wakefulness (slow process). The data indicate that the temporal organization of vigilance states on both the fast and the slow time scales may arise from a common neurophysiologic mechanism.

The efficacy of corneal cross-linking shows a sudden decrease with very high intensity UV light and short treatment time.

PubMed

Wernli, Jeremy; Schumacher, Silvia; Spoerl, Eberhard; Mrochen, Michael

2013-02-01

Standard treatment in cases of progressive keratectasia is UV-triggered corneal cross-linking. For irradiances larger than 10 mW/cm(2) and treatment times below 10 minutes, the scientific proof of a biomechanical strengthening effect is insufficient. The authors investigated the biomechanical strengthening of ex vivo corneal tissue treated with irradiances between 3 mW/cm(2) and 90 mW/cm(2) and illumination times from 30 minutes to 1 minute, respectively. A total of 100 porcine eyes received riboflavin + UV treatment (constant irradiation dose of 5.4 J/cm(2)) with different intensities and illumination times and were randomly assigned into 10 groups. A control group (80 eyes) was not irradiated but underwent the same treatment otherwise. Young's modulus at 10% strain was determined for each strip after uniaxial stress-strain measurement. A Kruskal-Wallis test was used for statistical analysis. A statistically significant difference (α = 0.01) was found between the median value of Young's modulus of the treatment groups up to 45 mW/cm(2) (illumination times from 30 minutes to 2 minutes) compared with the control group. There was no statistically significant difference between the treatment groups from 50 mW/cm(2) up to 90 mW/cm(2) (illumination times of less than 2 minutes) and the control group. The ex vivo results of corneal cross-linking performed in porcine corneas show that the Bunsen-Roscoe reciprocity law is only valid for illumination intensities up to 40 to 50 mW/cm(2) and illumination times of more than 2 minutes. Further experiments are necessary to validate these results for in vivo human corneal tissue. Additionally, safety aspects at high intensities must be investigated.

Biphasic Activation of Ribulose Bisphosphate Carboxylase in Spinach Leaves as Determined from Nonsteady-State CO2 Exchange 1

PubMed Central

Woodrow, Ian E.; Mott, Keith A.

1992-01-01

The activation kinetics of ribulose 1,5-bisphosphate carboxylase/oxygenase (Rubisco) following an increase in photon flux density (PFD) were studied by analyzing CO2 assimilation time courses in spinach leaves (Spinacia oleracea). When leaves were exposed to 45 minutes of darkness before illumination at 690 micromoles per square meter per second, Rubisco activation followed apparent first-order kinetics with a relaxation time of about 3.8 minutes. But when leaves were illuminated for 45 minutes at 160 micromoles per square meter per second prior to illumination at 690 micromoles per square meter per second the relaxation time for Rubisco activation was only 2.1 minutes. The kinetics of this change in relaxation times were investigated by exposing dark-adapted leaves to 160 micromoles per square meter per second for different periods before increasing the PFD to 690 micromoles per square meter per second. It was found that the apparent relaxation time for Rubisco activation changed from 3.8 to 2.1 minutes slowly, requiring at least 8 minutes for completion. This result indicates that at least two sequential, slow processes are involved in light-mediated activation of Rubisco in spinach leaves and that the relaxation times characterizing these two processes are about 4 and 2 minutes, respectively. The kinetics of the first process in the reverse direction and the dependence of the relaxation time for the second process on the magnitude of the increase in PFD were also determined. Evidence that the first slow process is activation of the enzyme Rubisco activase and that the second slow process is the catalytic activation of Rubisco by activase is discussed. PMID:16668865

Statistical physics approaches to financial fluctuations

NASA Astrophysics Data System (ADS)

Wang, Fengzhong

2009-12-01

Complex systems attract many researchers from various scientific fields. Financial markets are one of these widely studied complex systems. Statistical physics, which was originally developed to study large systems, provides novel ideas and powerful methods to analyze financial markets. The study of financial fluctuations characterizes market behavior, and helps to better understand the underlying market mechanism. Our study focuses on volatility, a fundamental quantity to characterize financial fluctuations. We examine equity data of the entire U.S. stock market during 2001 and 2002. To analyze the volatility time series, we develop a new approach, called return interval analysis, which examines the time intervals between two successive volatilities exceeding a given value threshold. We find that the return interval distribution displays scaling over a wide range of thresholds. This scaling is valid for a range of time windows, from one minute up to one day. Moreover, our results are similar for commodities, interest rates, currencies, and for stocks of different countries. Further analysis shows some systematic deviations from a scaling law, which we can attribute to nonlinear correlations in the volatility time series. We also find a memory effect in return intervals for different time scales, which is related to the long-term correlations in the volatility. To further characterize the mechanism of price movement, we simulate the volatility time series using two different models, fractionally integrated generalized autoregressive conditional heteroscedasticity (FIGARCH) and fractional Brownian motion (fBm), and test these models with the return interval analysis. We find that both models can mimic time memory but only fBm shows scaling in the return interval distribution. In addition, we examine the volatility of daily opening to closing and of closing to opening. We find that each volatility distribution has a power law tail. Using the detrended fluctuation analysis (DFA) method, we show long-term auto-correlations in these volatility time series. We also analyze return, the actual price changes of stocks, and find that the returns over the two sessions are often anti-correlated.

Moving image analysis to the cloud: A case study with a genome-scale tomographic study

NASA Astrophysics Data System (ADS)

Mader, Kevin; Stampanoni, Marco

2016-01-01

Over the last decade, the time required to measure a terabyte of microscopic imaging data has gone from years to minutes. This shift has moved many of the challenges away from experimental design and measurement to scalable storage, organization, and analysis. As many scientists and scientific institutions lack training and competencies in these areas, major bottlenecks have arisen and led to substantial delays and gaps between measurement, understanding, and dissemination. We present in this paper a framework for analyzing large 3D datasets using cloud-based computational and storage resources. We demonstrate its applicability by showing the setup and costs associated with the analysis of a genome-scale study of bone microstructure. We then evaluate the relative advantages and disadvantages associated with local versus cloud infrastructures.

The 2060 Chiron: CCD photometry

NASA Technical Reports Server (NTRS)

Bus, Schelte J.; Bowell, Edward; Harris, Alan W.

1987-01-01

R-band CCD photometry of 2060 was carried out on nine nights in Nov. and Dec. 1986. The rotation period is 5.9181 + or - 0.0003 hr and the peak to peak lightcurve amplitude is 0.088 + or - 0.0003 mag. Photometric parameters are H sub R = 6.24 + or - 0.02 mag and G sub R = + or - 0.15, though formal errors may not be realistic. The lightcurve has two pairs of extrema, but its asymmetry, as evidenced by the presence of significant odd Fourier harmonics, suggests macroscopic surface irregularities and/or the presence of some large scale albedo variegation. The observational rms residual is + or - 0.015 mag. On time scales from minutes to days there is no evidence for nonperiodic (cometary) brightness changes at the level of a few millimagnitudes.

Longitudinal Outcomes of Start Time Delay on Sleep, Behavior, and Achievement in High School.

PubMed

Thacher, Pamela V; Onyper, Serge V

2016-02-01

To establish whether sleep, health, mood, behavior, and academics improved after a 45-minute delay in high school start time, and whether changes persisted longitudinally. We collected data from school records and student self-report across a number of domains at baseline (May 2012) and at two follow-up time points (November 2012 and May 2013), at a public high school in upstate New York. Students enrolled during academic years (AY) 2011-2012 and 2012-2013 completed the Pittsburgh Sleep Quality Index; the DASS-21; the "Owl-Lark" Scale; the Daytime Sleepiness Index; and a brief self-report of health. Reports from school records regarding attendance, tardiness, disciplinary violations, and academic performance were collected for AY 2010-2011 through 2013-2014. Students delayed but did not extend their sleep period; we found lasting improvements in tardiness and disciplinary violations after the start-time delay, but no changes to other variables. At the first follow-up, students reported 20 minutes longer sleep, driven by later rise times and stable bed times. At the second follow-up, students maintained later rise times but delayed bedtimes, returning total sleep to baseline levels. A delay in rise time, paralleling the delay in the start time that occurred, resulted in less tardiness and decreased disciplinary incidents, but larger improvements to sleep patterns may be necessary to affect health, attendance, sleepiness, and academic performance. Later start times improved tardiness and disciplinary issues at this school district. A delay in start time may be a necessary but not sufficient means to increase sleep time and may depend on preexisting individual differences. A commentary on this article appears in this issue on page 267. © 2016 Associated Professional Sleep Societies, LLC.

A procedure for rapid issue of red cells for emergency use.

PubMed

Weiskopf, Richard B; Webb, Mary; Stangle, Deena; Klinbergs, Gunter; Toy, Pearl

2005-04-01

A College of American Pathologists Q-Probe revealed that the median turnaround times for emergency requests for red blood cells from the operating room were 30 minutes to release of cells from the blood bank and 34 minutes to delivery to the operating room. These times may not be adequate to permit the red cells to provide sufficiently rapid delivery of oxygen in massively bleeding patients. To improve the time from emergency request for red cells to delivery to the operating room. A new emergency issue program was implemented for only the operating rooms; emergency issue to all other hospital locations remained unchanged. Six units of group O Rh-negative red blood cells (RBCs) are maintained in the blood bank in a separate basket with transfusion forms containing the unit numbers and expiration dates and a bag with one blood tubing segment from each unit. The times to issue and to delivery to the operating room suite were compared with time to issue of 2 group O Rh-negative RBCs for other hospital locations using the older system during the same time period and with the time to issue of 2 units to all other hospital locations during the preceding 2 years. A university hospital. Time between emergency request for red cells and delivery to the operating room. The time between blood bank notification and arrival in the operating room of the 6 units of RBCs was significantly shorter than the time required to just issue (not including delivery time) 2 units of RBCs to other hospital locations. With the new procedure, 82% of units issued reached the operating room within 2 minutes of request, 91% arrived within 3 minutes, and 100% arrived within 4 minutes. These percentages are significantly higher than those for only issue of blood (without delivery) using the older issuing procedure for all hospital locations during the previous 2 years (37%, 49%, and 66%, respectively; P = .007, .009, and .02, respectively) and for other locations during the same 7-month period (29%, 46%, and 73%, respectively; P = .004, .01, and .09, respectively). Time (mean [95% confidence interval]) from blood bank notification to delivery of RBCs to the operating room suite (2.1 [1.6-2.6] minutes, of which approximately 50-60 seconds is attributable to delivery time) was less than issue times (not including delivery times) using the older issuing procedure for other hospital locations during the same period (4.1 [3.1-5.0] minutes; P = .007). An emergency issue procedure can be used to issue several units of RBCs within 1 minute and have them delivered to the operating room within 2 minutes while maintaining sufficient controls and providing required information to satisfy patient and blood bank requirements.

Effects of Point Count Duration, Time-of-Day, and Aural Stimuli on Detectability of Migratory and Resident Bird Species in Quintana Roo, Mexico

Treesearch

James F. Lynch

1995-01-01

Effects of count duration, time-of-day, and aural stimuli were studied in a series of unlimited-radius point counts conducted during winter in Quintana Roo, Mexico. The rate at which new species were detected was approximately three times higher during the first 5 minutes of each 15- minute count than in the final 5 minutes. The number of individuals and species...

Missing data imputation of solar radiation data under different atmospheric conditions.

PubMed

Turrado, Concepción Crespo; López, María Del Carmen Meizoso; Lasheras, Fernando Sánchez; Gómez, Benigno Antonio Rodríguez; Rollé, José Luis Calvo; Juez, Francisco Javier de Cos

2014-10-29

Global solar broadband irradiance on a planar surface is measured at weather stations by pyranometers. In the case of the present research, solar radiation values from nine meteorological stations of the MeteoGalicia real-time observational network, captured and stored every ten minutes, are considered. In this kind of record, the lack of data and/or the presence of wrong values adversely affects any time series study. Consequently, when this occurs, a data imputation process must be performed in order to replace missing data with estimated values. This paper aims to evaluate the multivariate imputation of ten-minute scale data by means of the chained equations method (MICE). This method allows the network itself to impute the missing or wrong data of a solar radiation sensor, by using either all or just a group of the measurements of the remaining sensors. Very good results have been obtained with the MICE method in comparison with other methods employed in this field such as Inverse Distance Weighting (IDW) and Multiple Linear Regression (MLR). The average RMSE value of the predictions for the MICE algorithm was 13.37% while that for the MLR it was 28.19%, and 31.68% for the IDW.

The effect of the inspiratory muscle training on functional ability in stroke patients.

PubMed

Jung, Nam-Jin; Na, Sang-Su; Kim, Seung-Kyu; Hwangbo, Gak

2017-11-01

[Purpose] This study was to find out an inspiratory muscle training (IMT) program therapeutic effects on stroke patients' functional ability. [Subjects and Methods] Twenty stroke patients were assigned to one of two groups: inspiratory muscle training (n=10), and control (n=10), randomization. The inspiratory muscle training participants undertook an exercise program for 30 minute per times, 5 times a week for 6 weeks. The investigator measured the patients' trunk impairment scale (TIS) and 6 minute walking test (6MW) for functional ability before and after IMT. [Results] The TIS appeared some significant differences in both groups before and after the training. The 6MW test showed some significant differences in the inspiratory muscle training group, but didn't show any significant difference in the control group. And the differences in both groups after depending the inspiratory muscle training were significantly found in the tests of TIS and 6MW test [Conclusion] The results showed that the inspiratory muscle training in stroke patients are correlated with the trunk stability and locomotion ability, suggesting that physical therapist must take into consideration the inspiratory muscle training, as well as functional training to improve physical function in stroke patients.

Missing Data Imputation of Solar Radiation Data under Different Atmospheric Conditions

PubMed Central

Turrado, Concepción Crespo; López, María del Carmen Meizoso; Lasheras, Fernando Sánchez; Gómez, Benigno Antonio Rodríguez; Rollé, José Luis Calvo; de Cos Juez, Francisco Javier

2014-01-01

Global solar broadband irradiance on a planar surface is measured at weather stations by pyranometers. In the case of the present research, solar radiation values from nine meteorological stations of the MeteoGalicia real-time observational network, captured and stored every ten minutes, are considered. In this kind of record, the lack of data and/or the presence of wrong values adversely affects any time series study. Consequently, when this occurs, a data imputation process must be performed in order to replace missing data with estimated values. This paper aims to evaluate the multivariate imputation of ten-minute scale data by means of the chained equations method (MICE). This method allows the network itself to impute the missing or wrong data of a solar radiation sensor, by using either all or just a group of the measurements of the remaining sensors. Very good results have been obtained with the MICE method in comparison with other methods employed in this field such as Inverse Distance Weighting (IDW) and Multiple Linear Regression (MLR). The average RMSE value of the predictions for the MICE algorithm was 13.37% while that for the MLR it was 28.19%, and 31.68% for the IDW. PMID:25356644

Sequential Double lonization: The Timing of Release

NASA Astrophysics Data System (ADS)

Pfeiffer, A.

2011-05-01

The timing of electron release in strong field double ionization poses great challenges both for conceptual definition and for conducting experimental measurement. Here we present coincidence momentum measurements of the doubly charged ion and of the two electrons arising from double ionization of Argon using elliptically (close to circularly) polarized laser pulses. Based on a semi-classical model, the ionization times are calculated from the measured electron momenta across a large intensity range. Exploiting the attoclock technique we have direct access to timings on a coarse and on a fine scale, similar to the hour and the minute hand of a clock. In our attoclock, the magnitude of the electron momenta follows the envelope of the laser pulse and gives a coarse timing for the electron releases (the hour hand), while the fine timing (the minute hand) is provided by the emission angle of the electrons. The first of our findings is that due to depletion the averaged ionization time moves towards the beginning of the pulse with increasing intensity, confirming the results of Maharjan et al., and that the ion momentum distribution projected onto the minor polarization axis shows a bifurcation from a 3-peak to a 4-peak structure. This effect can be fully understood by modeling the process semi-classically in the independent electron approximation following the simple man's model. The ionization time measurement performed with the attoclock shows that the release time of the first electron is in good agreement with the semi-classical simulation performed on the basis of Sequential Double lonization (SDI), whereas the ionization of the second electron occurs significantly earlier than predicted. This observation suggests that electron correlation and other Non-Sequential Double lonization (NSDI) mechanisms may play an important role also in the case of strong field double ionization by close-to-circularly polarized laser pulses. The timing of electron release in strong field double ionization poses great challenges both for conceptual definition and for conducting experimental measurement. Here we present coincidence momentum measurements of the doubly charged ion and of the two electrons arising from double ionization of Argon using elliptically (close to circularly) polarized laser pulses. Based on a semi-classical model, the ionization times are calculated from the measured electron momenta across a large intensity range. Exploiting the attoclock technique we have direct access to timings on a coarse and on a fine scale, similar to the hour and the minute hand of a clock. In our attoclock, the magnitude of the electron momenta follows the envelope of the laser pulse and gives a coarse timing for the electron releases (the hour hand), while the fine timing (the minute hand) is provided by the emission angle of the electrons. The first of our findings is that due to depletion the averaged ionization time moves towards the beginning of the pulse with increasing intensity, confirming the results of Maharjan et al., and that the ion momentum distribution projected onto the minor polarization axis shows a bifurcation from a 3-peak to a 4-peak structure. This effect can be fully understood by modeling the process semi-classically in the independent electron approximation following the simple man's model. The ionization time measurement performed with the attoclock shows that the release time of the first electron is in good agreement with the semi-classical simulation performed on the basis of Sequential Double lonization (SDI), whereas the ionization of the second electron occurs significantly earlier than predicted. This observation suggests that electron correlation and other Non-Sequential Double lonization (NSDI) mechanisms may play an important role also in the case of strong field double ionization by close-to-circularly polarized laser pulses. In collaboration with C. Cirelli and M. Smolarski, Physics Department, ETH Zurich, 8093 Zurich, Switzerland; R. Doerner, Institut fiir Kernphysik, Johann Wolfgang Goethe Universitat, 60438 Frankfurt am Main, Germany; and U. Keller, ETH Zurich.

Pharmacological targeting of chemokine (C-X-C motif) receptor 4 in porcine polytrauma and hemorrhage models

PubMed Central

Bach, Harold H.; Wong, Yee M.; LaPorte, Heather M.; Gamelli, Richard L.; Majetschak, Matthias

2016-01-01

BACKGROUND Recent evidence suggests that chemokine receptor CXCR4 regulates vascular α1-adrenergic receptor function and that the noncognate CXCR4 agonist ubiquitin has therapeutic potential after trauma/hemorrhage. Pharmacologic properties of ubiquitin in large animal trauma models, however, are poorly characterized. Thus, the aims of the present study were to determine the effects of CXCR4 modulation on resuscitation requirements after polytrauma, to assess whether ubiquitin influences survival times after lethal polytrauma-hemorrhage, and to characterize its dose-effect profile in porcine models. METHODS Anesthetized pigs underwent polytrauma (PT, femur fractures/lung contusion) alone (Series 1) or PT/hemorrhage (PT/H) to a mean arterial blood pressure of 30 mmHg with subsequent fluid resuscitation (Series 2 and 3) or 40% blood volume hemorrhage within 15 minutes followed by 2.5% blood volume hemorrhage every 15 minutes without fluid resuscitation (Series 4). In Series 1, ubiquitin (175 and 350 nmol/kg), AMD3100 (CXCR4 antagonist, 350 nmol/kg), or vehicle treatment 60 minutes after PT was performed. In Series 2, ubiquitin (175, 875, and 1,750 nmol/kg) or vehicle treatment 60 minutes after PT/H was performed. In Series 3, ubiquitin (175 and 875 nmol/kg) or vehicle treatment at 60 and 180 minutes after PT/H was performed. In Series 4, ubiquitin (875 nmol/kg) or vehicle treatment 30 minutes after hemorrhage was performed. RESULTS In Series 1, resuscitation fluid requirements were significantly reduced by 40% with 350-nmol/kg ubiquitin and increased by 25% with AMD3100. In Series 2, median survival time was 190 minutes with vehicle, 260 minutes with 175-nmol/kg ubiquitin, and longer than 420 minutes with 875-nmol/kg and 1,750-nmol/kg ubiquitin (p < 0.05 vs. vehicle). In Series 3, median survival time was 288 minutes with vehicle and 336 minutes and longer than 420 minutes (p < 0.05 vs. vehicle) with 175-nmol/kg and 875-nmol/kg ubiquitin, respectively. In Series 4, median survival time was 147.5 minutes and 150 minutes with vehicle and ubiquitin, respectively (p > 0.05). CONCLUSION These findings further suggest CXCR4 as a drug target after PT/H. Ubiquitin treatment reduces resuscitation fluid requirements and provides survival benefits after PT/H. The pharmacological effects of ubiquitin treatment occur dose dependently. PMID:26683396

Feasibility of a real-time self-monitoring device for sitting less and moving more: a randomised controlled trial

PubMed Central

Martin, Anne; Adams, Jacob M; Bunn, Christopher; Gill, Jason M R; Gray, Cindy M; Hunt, Kate; Maxwell, Douglas J; van der Ploeg, Hidde P; Wyke, Sally

2017-01-01

Objectives Time spent inactive and sedentary are both associated with poor health. Self-monitoring of walking, using pedometers for real-time feedback, is effective at increasing physical activity. This study evaluated the feasibility of a new pocket-worn sedentary time and physical activity real-time self-monitoring device (SitFIT). Methods Forty sedentary men were equally randomised into two intervention groups. For 4 weeks, one group received a SitFIT providing feedback on steps and time spent sedentary (lying/sitting); the other group received a SitFIT providing feedback on steps and time spent upright (standing/stepping). Change in sedentary time, standing time, stepping time and step count was assessed using activPAL monitors at baseline, 4-week follow-up (T1) and 12-week (T2) follow-up. Semistructured interviews were conducted after 4 and 12 weeks. Results The SitFIT was reported as acceptable and usable and seen as a motivating tool to reduce sedentary time by both groups. On average, participants reduced their sedentary time by 7.8 minutes/day (95% CI −55.4 to 39.7) (T1) and by 8.2 minutes/day (95% CI −60.1 to 44.3) (T2). They increased standing time by 23.2 minutes/day (95% CI 4.0 to 42.5) (T1) and 16.2 minutes/day (95% CI −13.9 to 46.2) (T2). Stepping time was increased by 8.5 minutes/day (95% CI 0.9 to 16.0) (T1) and 9.0 minutes/day (95% CI 0.5 to 17.5) (T2). There were no between-group differences at either follow-up time points. Conclusion The SitFIT was perceived as a useful tool for self-monitoring of sedentary time. It has potential as a real-time self-monitoring device to reduce sedentary and increase upright time. PMID:29081985

Changes in Pilot Behavior with Predictive System Status Information

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.

1998-01-01

Research has shown a strong pilot preference for predictive information of aircraft system status in the flight deck. However, changes in pilot behavior associated with using this predictive information have not been ascertained. The study described here quantified these changes using three types of predictive information (none, whether a parameter was changing abnormally, and the time for a parameter to reach an alert range) and three initial time intervals until a parameter alert range was reached (ITIs) (1 minute, 5 minutes, and 15 minutes). With predictive information, subjects accomplished most of their tasks before an alert occurred. Subjects organized the time they did their tasks by locus-of-control with no predictive information and for the 1-minute ITI, and by aviatenavigate-communicate for the time for a parameter to reach an alert range and the 15-minute conditions. Overall, predictive information and the longer ITIs moved subjects to performing tasks before the alert actually occurred and had them more mission oriented as indicated by their tasks grouping of aviate-navigate-communicate.

Decrease of spasticity after hybrid assistive limb® training for a patient with C4 quadriplegia due to chronic SCI.

PubMed

Ikumi, Akira; Kubota, Shigeki; Shimizu, Yukiyo; Kadone, Hideki; Marushima, Aiki; Ueno, Tomoyuki; Kawamoto, Hiroaki; Hada, Yasushi; Matsumura, Akira; Sankai, Yoshiyuki; Yamazaki, Masashi

2017-09-01

Recently, locomotor training with robotic assistance has been found effective in treating spinal cord injury (SCI). Our case report examined locomotor training using the robotic suit hybrid assistive limb (HAL) in a patient with complete C4 quadriplegia due to chronic SCI. This is the first report examining HAL in complete C4 quadriplegia. The patient was a 19-year-old man who dislocated C3/4 during judo 4 years previously. Following the injury, he underwent C3/4 posterior spinal fusion but remained paralyzed despite rehabilitation. There was muscle atrophy under C5 level and no sensation around the anus, but partial sensation of pressure remained in the limbs. The American Spinal Injury Association impairment scale was Grade A (complete motor C4 lesion). HAL training was administered in 10 sessions (twice per week). The training sessions consisted of treadmill walking with HAL. For safety, 2 physicians and 1 therapist supported the subject for balance and weight-bearing. The device's cybernic autonomous control mode provides autonomic physical support based on predefined walking patterns. We evaluated the adverse events, walking time and distance, and the difference in muscle spasticity before and after HAL-training using a modified Ashworth scale (mAs). No adverse events were observed that required discontinuation of rehabilitation. Walking distance and time increased from 25.2 meters/7.6 minutes to 148.3 meter/15 minutes. The mAs score decreased after HAL training. Our case report indicates that HAL training is feasible and effective for complete C4 quadriplegia in chronic SCI.

Implementing an obstetric triage acuity scale: interrater reliability and patient flow analysis.

PubMed

Smithson, David S; Twohey, Rachel; Rice, Tim; Watts, Nancy; Fernandes, Christopher M; Gratton, Robert J

2013-10-01

A 5-category Obstetric Triage Acuity Scale (OTAS) was developed with a comprehensive set of obstetrical determinants. The objectives of this study were as follows: (1) to test the interrater reliability of OTAS and (2) to determine the distribution of patient acuity and flow by OTAS level. To test the interrater reliability, 110 triage charts were used to generate vignettes and the consistency of the OTAS level assigned by 8 triage nurses was measured. OTAS performed with substantial (Kappa, 0.61 - 0.77, OTAS 1-4) and near perfect correlation (0.87, OTAS 5). To assess patient flow, the times to primary and secondary health care provider assessments and lengths of stay stratified by acuity were abstracted from the patient management system. Two-thirds of triage visits were low acuity (OTAS 4, 5). There was a decrease in length of stay (median [interquartile range], minutes) as acuity decreased from OTAS 1 (120.0 [156.0] minutes) to OTAS 3 (75.0 [120.8]). The major contributor to length of stay was time to secondary health care provider assessment and this did not change with acuity. The percentage of patients admitted to the antenatal or birthing unit decreased from 80% (OTAS 1) to 12% (OTAS 5). OTAS provides a reliable assessment of acuity and its implementation has allowed for triaging of obstetric patients based on acuity, and a more in-depth assessment of the patient flow. By standardizing assessment, OTAS allows for opportunities to improve performance and make comparisons of patient care and flow across organizations. Copyright © 2013 Mosby, Inc. All rights reserved.

Piezosurgery versus conventional osteotomy in orthognathic surgery: a paradigm shift in treatment.

PubMed

Bertossi, Dario; Lucchese, Alessandra; Albanese, Massimo; Turra, Matteo; Faccioni, Fiorenzo; Nocini, Pierfrancesco; Rodriguez Y Baena, Ruggero

2013-01-01

The aim of the study was to compare in a randomized controlled clinical trial the use of the piezoelectric osteotomy as an alternative to the conventional approach in terms of surgery time, intraoperative blood loss, cut quality, nerve injury, and costs.One hundred ten patients who had orthognathic surgery procedures with bimaxillary osteotomy were divided into 2 groups: group A was treated with a piezosurgery device, and group B, with a reciprocating saw and bur.The piezosurgical bone osteotomy permitted individualized cut designs. The surgical time in group A was reduced, with a mean for the mandibular osteotomy (1 side) between 3 minutes 31 seconds and 5 minutes 2 seconds, whereas in group B, the surgical time was between 7 minutes 23 seconds and 10 minutes 22 seconds. The surgical time in group A for the Le Fort I osteotomy was between 5 minutes 17 seconds and 7 minutes 55 seconds in group A and between 8 minutes 38 seconds and 15 minutes 11 seconds in group B. All patients in group A had a low blood loss (<300 mL) versus patients of group B who had a medium to high blood loss (medium loss: 400 mL, high loss: >500 mL). Inferior alveolar nerve sensation was retained in 98.2% of group A versus 92.7% in group B at 6 months postoperative testing.Piezoelectric osteotomy reduced surgical time, blood loss, and inferior alveolar nerve injury in bimaxillary osteotomy. Absence of macrovibrations makes the instrument more manageable and easy to use and allows greater intraoperative control with higher safety in cutting in difficult anatomical regions.

Properties of a Small-scale Short-duration Solar Eruption with a Driven Shock

NASA Astrophysics Data System (ADS)

Ying, Beili; Feng, Li; Lu, Lei; Zhang, Jie; Magdalenic, Jasmina; Su, Yingna; Su, Yang; Gan, Weiqun

2018-03-01

Large-scale solar eruptions have been extensively explored over many years. However, the properties of small-scale events with associated shocks have rarely been investigated. We present analyses of a small-scale, short-duration event originating from a small region. The impulsive phase of the M1.9-class flare lasted only four minutes. The kinematic evolution of the CME hot channel reveals some exceptional characteristics, including a very short duration of the main acceleration phase (<2 minutes), a rather high maximal acceleration rate (∼50 km s‑2), and peak velocity (∼1800 km s‑1). The fast and impulsive kinematics subsequently results in a piston-driven shock related to a metric type II radio burst with a high starting frequency of ∼320 MHz of the fundamental band. The type II source is formed at a low height of below 1.1 R ⊙ less than ∼2 minutes after the onset of the main acceleration phase. Through the band-split of the type II burst, the shock compression ratio decreases from 2.2 to 1.3, and the magnetic field strength of the shock upstream region decreases from 13 to 0.5 Gauss at heights of 1.1–2.3 R ⊙. We find that the CME (∼4 × 1030 erg) and flare (∼1.6 × 1030 erg) consume similar amounts of magnetic energy. The same conclusion for large-scale eruptions implies that small- and large-scale events possibly share a similar relationship between CMEs and flares. The kinematic particularities of this event are possibly related to the small footpoint-separation distance of the associated magnetic flux rope, as predicted by the Erupting Flux Rope model.

How do you manage early or late clock-ins? .

PubMed

Marlowe, Cathy L

2013-08-01

My current practice has historically been very strict with hourly employees. The workday is 8:30 a.m. to 5 p.m. for most employees. They are to clock in and out at exactly those times unless overtime has been approved. (Staff working with late patients are exempt.) My business manager is constantly fighting over clock-ins 15 to 20 minutes early or late, with similar clock-outs. Staff may have a stop to make and would like to make up those 15 minutes. We do grant paid time off in an initial minimum block of 30 minutes to assist with some of this. ... The issue is not overtime, as we're well aware that we have to pay for it when appropriate. It's simply to streamline our policy and make it fair. ... I'm looking for practice policies that deal with employee variances from the 8 a.m. to 4:30 p.m. clock-ins. For example, someone wants to come in 30 minutes early in order to leave 30 minutes early for an appointment. Or someone comes in 22 minutes late due to traffic and wants either to make it up or to take the minimal half-hour paid-time-off time.

Remote third shift EAST operation: a new paradigm

NASA Astrophysics Data System (ADS)

Schissel, D. P.; Coviello, E.; Eidietis, N.; Flanagan, S.; Garcia, F.; Humphreys, D.; Kostuk, M.; Lanctot, M.; Lee, X.; Margo, M.; Miller, D.; Parker, C.; Penaflor, B.; Qian, J. P.; Sun, X.; Tan, H.; Walker, M.; Xiao, B.; Yuan, Q.

2017-05-01

General Atomics’ (GA) scientists in the United States remotely conducted experimental operation of the experimental advanced superconducting tokamak (EAST) in China during its third shift. Scientists led these experiments in a dedicated remote control room that utilized a novel computer science hardware and software infrastructure to allow data movement, visualization, and communication on the time scale of EAST’s pulse cycle. This Fusion Science Collaboration Zone infrastructure allows the movement of large amounts of data between continents in a short time scale with a 300-fold increase in data transfer rate over that available using the traditional transmission protocol. Real-time data from control systems is moved almost instantaneously. An event system tied to the EAST pulse cycle allows automatic initiation of data transfers, resulting in bulk EAST data to be transferred to GA within minutes. The EAST data at GA is served via MDSplus to approved US collaborators avoiding multiple US clients from requesting data from EAST and competing for the long-haul network’s bandwidth. At present there are 37 approved scientists from 8 US research institutions.

A Large number of fast cosmological simulations

NASA Astrophysics Data System (ADS)

Koda, Jun; Kazin, E.; Blake, C.

2014-01-01

Mock galaxy catalogs are essential tools to analyze large-scale structure data. Many independent realizations of mock catalogs are necessary to evaluate the uncertainties in the measurements. We perform 3600 cosmological simulations for the WiggleZ Dark Energy Survey to obtain the new improved Baron Acoustic Oscillation (BAO) cosmic distance measurements using the density field "reconstruction" technique. We use 1296^3 particles in a periodic box of 600/h Mpc on a side, which is the minimum requirement from the survey volume and observed galaxies. In order to perform such large number of simulations, we developed a parallel code using the COmoving Lagrangian Acceleration (COLA) method, which can simulate cosmological large-scale structure reasonably well with only 10 time steps. Our simulation is more than 100 times faster than conventional N-body simulations; one COLA simulation takes only 15 minutes with 216 computing cores. We have completed the 3600 simulations with a reasonable computation time of 200k core hours. We also present the results of the revised WiggleZ BAO distance measurement, which are significantly improved by the reconstruction technique.

Silicon Nanoparticles as Hyperpolarized Magnetic Resonance Imaging Agents

PubMed Central

Aptekar, Jacob W.; Cassidy, Maja C.; Johnson, Alexander C.; Barton, Robert A.; Lee, Menyoung; Ogier, Alexander C.; Vo, Chinh; Anahtar, Melis N.; Ren, Yin; Bhatia, Sangeeta N.; Ramanathan, Chandrasekhar; Cory, David G.; Hill, Alison L.; Mair, Ross W.; Rosen, Matthew S.; Walsworth, Ronald L.

2014-01-01

Magnetic resonance imaging of hyperpolarized nuclei provides high image contrast with little or no background signal. To date, in-vivo applications of pre-hyperpolarized materials have been limited by relatively short nuclear spin relaxation times. Here, we investigate silicon nanoparticles as a new type of hyperpolarized magnetic resonance imaging agent. Nuclear spin relaxation times for a variety of Si nanoparticles are found to be remarkably long, ranging from many minutes to hours at room temperature, allowing hyperpolarized nanoparticles to be transported, administered, and imaged on practical time scales. Additionally, we demonstrate that Si nanoparticles can be surface functionalized using techniques common to other biologically targeted nanoparticle systems. These results suggest that Si nanoparticles can be used as a targetable, hyperpolarized magnetic resonance imaging agent with a large range of potential applications. PMID:19950973

Silicon nanoparticles as hyperpolarized magnetic resonance imaging agents.

PubMed

Aptekar, Jacob W; Cassidy, Maja C; Johnson, Alexander C; Barton, Robert A; Lee, Menyoung; Ogier, Alexander C; Vo, Chinh; Anahtar, Melis N; Ren, Yin; Bhatia, Sangeeta N; Ramanathan, Chandrasekhar; Cory, David G; Hill, Alison L; Mair, Ross W; Rosen, Matthew S; Walsworth, Ronald L; Marcus, Charles M

2009-12-22

Magnetic resonance imaging of hyperpolarized nuclei provides high image contrast with little or no background signal. To date, in vivo applications of prehyperpolarized materials have been limited by relatively short nuclear spin relaxation times. Here, we investigate silicon nanoparticles as a new type of hyperpolarized magnetic resonance imaging agent. Nuclear spin relaxation times for a variety of Si nanoparticles are found to be remarkably long, ranging from many minutes to hours at room temperature, allowing hyperpolarized nanoparticles to be transported, administered, and imaged on practical time scales. Additionally, we demonstrate that Si nanoparticles can be surface functionalized using techniques common to other biologically targeted nanoparticle systems. These results suggest that Si nanoparticles can be used as a targetable, hyperpolarized magnetic resonance imaging agent with a large range of potential applications.

[Time-dependent heart rate variability in the head-up tilt test in children with postural orthostatic tachycardia syndrome].

PubMed

Ran, Jing; Wang, Cheng; Zou, Run-Mei; Wu, Li-Jia; Lin, Ping; Li, Fang; Xu, Yi

2015-10-01

To study the time-dependent heart rate (HR) variability in the head-up tilt test (HUTT) in children with postural orthostatic tachycardia syndrome (POTS) and to explore the HR diagnostic criteria for POTS in children. A retrospective analysis was performed on the clinical data of 105 children diagnosed with POTS with HR≥120 beats per minute (bpm) within the first 10 minutes of HUTT between January 2007 and December 2014. Their HR variability within the first 10 minutes of HUTT was analyzed. The HR of children with POTS increased gradually from the supine position to a 60° head-up tilt position, and the increase in HR was 24±12 bpm at the beginning of HUTT, 30±14 bpm at 3 minutes of HUTT, 32±13 bpm at 5 minutes of HUTT, and 38±12 bpm at 10 minutes of HUTT. The average maximal HR increase within the first 10 minutes of HUTT was 43±10 bpm. In children with POTS, the HR variability gradually increases with time, and therefore, it is suggested that HR increase ≥40 bpm is more suitable for diagnosis of POTS in children.

Aromatherapy with peppermint, isopropyl alcohol, or placebo is equally effective in relieving postoperative nausea.

PubMed

Anderson, Lynn A; Gross, Jeffrey B

2004-02-01

To determine whether aromatherapy can reduce postoperative nausea, the investigators studied 33 ambulatory surgery patients who complained of nausea in the PACU. After indicating the severity of nausea on a 100-mm visual analogue scale (VAS), subjects received randomized aromatherapy with isopropyl alcohol, oil of peppermint, or saline (placebo). The vapors were inhaled deeply through the nose from scented gauze pads held directly beneath the patients' nostrils and exhaled slowly through the mouth. Two and 5 minutes later, the subjects rated their nausea on the VAS. Overall nausea scores decreased from 60.6 +/- 4.3 mm (mean +/- SE) before aromatherapy to 43.1 +/- 4.9 mm 2 minutes after aromatherapy (P <.005), and to 28.0 +/- 4.6 mm 5 minutes after aromatherapy (P < 10(-6)). Nausea scores did not differ between the treatments at any time. Only 52% of the patients required conventional intravenous (IV) antiemetic therapy during their PACU stay. Overall satisfaction with postoperative nausea management was 86.9 +/- 4.1 mm and was independent of the treatment group. Aromatherapy effectively reduced the perceived severity of postoperative nausea. The fact that a saline "placebo" was as effective as alcohol or peppermint suggests that the beneficial effect may be related more to controlled breathing patterns than to the actual aroma inhaled.

The Importance of Rotational Time-scales in Accretion Variability

NASA Astrophysics Data System (ADS)

Costigan, Gráinne; Vink, Joirck; Scholz, Aleks; Testi, Leonardo; Ray, Tom

2013-07-01

For the first few million years, one of the dominant sources of emission from a low mass young stellar object is from accretion. This process regulates the flow of material and angular moments from the surroundings to the central object, and is thought to play an important role in the definition of the long term stellar properties. Variability is a well documented attribute of accretion, and has been observed on time-scales of from days to years. However, where these variations come from is not clear. Th current model for accretion is magnetospheric accretion, where the stellar magnetic field truncates the disc, allowing the matter to flow from the disc onto the surface of the star. This model allows for variations in the accretion rate to come from many different sources, such as the magnetic field, the circumstellar disc and the interaction of the different parts of the system. We have been studying unbiased samples of accretors in order to identify the dominant time-scales and typical magnitudes of variations. In this way different sources of variations can be excluded and any missing physics in these systems identified. Through our previous work with the Long-term Accretion Monitoring Program (LAMP), we found 10 accretors in the ChaI region, whose variability is dominated by short term variations of 2 weeks. This was the shortest time period between spectroscopic observations which spanned 15 months, and rules out large scale processes in the disk as origins of this variability. On the basis of this study we have gone further to study the accretion signature H-alpha, over the time-scales of minutes and days in a set of Herbig Ae and T Tauri stars. Using the same methods as we used in LAMP we found the dominant time-scales of variations to be days. These samples both point towards rotation period of these objects as being an important time-scale for accretion variations. This allows us to indicate which are the most likely sources of these variations.

[Influence of active commuting on happiness, well-being, psychological distress and body shape in adolescents].

PubMed

Ruiz-Ariza, Alberto; de la Torre-Cruz, Manuel J; Redecillas-Peiró, María T; Martínez-López, Emilio J

2015-01-01

To analyse the association between active commuting to secondary school and indicators of psychological health in a sample of 1012 adolescents. Active commuting was assessed through a questionnaire, subjective happiness with the Subjective Happiness Scale, well-being and psychological distress with the General Well-Being Scale, and body shape was assessed using the short version of the Body Shape Questionnaire. Adolescents who spent more than 15 minutes per day actively commuting to secondary school had higher levels of subjective happiness (p=0.032) and psychological well-being (p=0.021) and lower levels of psychological distress (p=0.021) than adolescents who spent 15 minutes or less per day. There were no differences in body shape between less and more active adolescents (p >0.05). Active commuting to secondary school for more of 15 minutes per day is recommended because it is associated with higher levels of happiness and well-being in adolescents. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

A Multiplicative Cascade Model for High-Resolution Space-Time Downscaling of Rainfall

NASA Astrophysics Data System (ADS)

Raut, Bhupendra A.; Seed, Alan W.; Reeder, Michael J.; Jakob, Christian

2018-02-01

Distributions of rainfall with the time and space resolutions of minutes and kilometers, respectively, are often needed to drive the hydrological models used in a range of engineering, environmental, and urban design applications. The work described here is the first step in constructing a model capable of downscaling rainfall to scales of minutes and kilometers from time and space resolutions of several hours and a hundred kilometers. A multiplicative random cascade model known as the Short-Term Ensemble Prediction System is run with parameters from the radar observations at Melbourne (Australia). The orographic effects are added through multiplicative correction factor after the model is run. In the first set of model calculations, 112 significant rain events over Melbourne are simulated 100 times. Because of the stochastic nature of the cascade model, the simulations represent 100 possible realizations of the same rain event. The cascade model produces realistic spatial and temporal patterns of rainfall at 6 min and 1 km resolution (the resolution of the radar data), the statistical properties of which are in close agreement with observation. In the second set of calculations, the cascade model is run continuously for all days from January 2008 to August 2015 and the rainfall accumulations are compared at 12 locations in the greater Melbourne area. The statistical properties of the observations lie with envelope of the 100 ensemble members. The model successfully reproduces the frequency distribution of the 6 min rainfall intensities, storm durations, interarrival times, and autocorrelation function.

Increased mean time from end of surgery to operating room exit in a historical cohort of cases with prolonged time to extubation.

PubMed

Dexter, Franklin; Epstein, Richard H

2013-12-01

Prolonged time to extubation has been defined as the occurrence of a ≥ 15-minute interval from the end of surgery to removal of the tracheal tube. We quantified the increases in the mean times from end of surgery to exit from the OR associated with prolonged extubations and tested whether the increases were economically important (≥ 5 minutes). Anesthesia information management system data from 1 tertiary hospital were collected from November 2005 through December 2012 (i.e., sample sizes were N = 22 sequential quarters). Cases were excluded in which the patient's trachea was not intubated or extubated while physically in the operating room (OR). For each combination of stratification variable (below) and quarter, the mean time from end of surgery to OR exit was calculated for the extubations that were not prolonged and for those that were prolonged. Results are reported as mean ± SEM, with "at least" denoting the lower 95% confidence interval. The mean times from end of surgery to OR exit were at least 12.6 minutes longer for prolonged extubations when calculated with stratification by duration of surgery and prone or other positioning (13.0 ± 0.1 minutes), P < 0.0001 compared to 5 minutes (i.e., times were substantively long economically). The mean times were at least 11.7 minutes longer when calculated stratified by anesthesia procedure code (12.4 ± 0.4, P < 0.0001) and at least 11.3 minutes longer when calculated stratified by surgeon (12.4 ± 0.6, P < 0.0001). We recommend that anesthesia providers document the times of extubations and monitor the incidence of prolonged extubations as an economic measure. This would be especially important for providers at facilities with many ORs that have at least 8 hours of cases and turnovers.

Constructing Optimal Coarse-Grained Sites of Huge Biomolecules by Fluctuation Maximization.

PubMed

Li, Min; Zhang, John Zenghui; Xia, Fei

2016-04-12

Coarse-grained (CG) models are valuable tools for the study of functions of large biomolecules on large length and time scales. The definition of CG representations for huge biomolecules is always a formidable challenge. In this work, we propose a new method called fluctuation maximization coarse-graining (FM-CG) to construct the CG sites of biomolecules. The defined residual in FM-CG converges to a maximal value as the number of CG sites increases, allowing an optimal CG model to be rigorously defined on the basis of the maximum. More importantly, we developed a robust algorithm called stepwise local iterative optimization (SLIO) to accelerate the process of coarse-graining large biomolecules. By means of the efficient SLIO algorithm, the computational cost of coarse-graining large biomolecules is reduced to within the time scale of seconds, which is far lower than that of conventional simulated annealing. The coarse-graining of two huge systems, chaperonin GroEL and lengsin, indicates that our new methods can coarse-grain huge biomolecular systems with up to 10,000 residues within the time scale of minutes. The further parametrization of CG sites derived from FM-CG allows us to construct the corresponding CG models for studies of the functions of huge biomolecular systems.

International Study of Objectively-measured Physical Activity and Sedentary Time with Body Mass Index and Obesity: IPEN Adult Study

PubMed Central

Van Dyck, Delfien; Cerin, Ester; De Bourdeaudhuij, Ilse; Hinckson, Erica; Reis, Rodrigo S; Davey, Rachel; Sarmiento, Olga Lucia; Mitas, Josef; Troelsen, Jens; MacFarlane, Duncan; Salvo, Deborah; Aguinaga-Ontoso, Ines; Owen, Neville; Cain, Kelli L; Sallis, James F

2014-01-01

Background Physical activity (PA) has been consistently implicated in the etiology of obesity, while recent evidence on the importance of sedentary time remains inconsistent. Understanding of dose-response associations of PA and sedentary time with overweight and obesity in adults can be improved with large-scale studies using objective measures of PA and sedentary time. The purpose of this study was to examine the strength, direction and shape of dose-response associations of accelerometer-based PA and sedentary time with BMI and weight status in 10 countries, and the moderating effects of study site and gender. Methods Data from the International Physical activity and the Environment Network (IPEN) Adult study were used. IPEN Adult is an observational multi-country cross-sectional study, and 12 sites in 10 countries are included. Participants wore an accelerometer for seven consecutive days, completed a socio-demographic questionnaire and reported height and weight. In total, 5712 adults (18–65 years) were included in the analyses. Generalized additive mixed models, conducted in R, were used to estimate the strength and shape of the associations. Results A curvilinear relationship of accelerometer-based moderate-to-vigorous PA and total counts/minute with BMI and the probability of being overweight/obese was identified. The associations were negative, but weakened at higher levels of moderate-to-vigorous PA (>50 min/day) and higher counts/minute. No associations between sedentary time and weight outcomes were found. Complex site- and gender-specific findings were revealed for BMI, but not for weight status. Conclusions Based on these results, the current Institute of Medicine recommendation of 60 minutes/day of moderate-to-vigorous PA to prevent weight gain in normal-weight adults was supported. No relationship between sedentary time and the weight outcomes was present, calling for further examination. If moderator findings are confirmed, the relationship between PA and BMI may be country- and gender-dependent, which could have important implications for country-specific health guidelines. PMID:24984753

Decoupling the effects of primary production and residence time variation on nitrogen retention in a tidally-influenced spring run

NASA Astrophysics Data System (ADS)

Hensley, R. T.; Cohen, M. J.; Korhnak, L. V.

2013-12-01

Models of nitrogen (N) retention in river networks suggest biogeochemical as well as hydraulic properties exert considerable control on reach scale nutrient retention rates. Freshwater tidally influenced rivers provide a model system for decoupling metabolic vs. hydraulic controls on retention. The clear diurnal N retention signal in response to assimilatory uptake observed in other rivers becomes convoluted as the solar day moves in and out of phase with the semi-diurnal (~12.5 hr) tidal cycle. We used an upstream-downstream mass balance approach to estimate N retention at 15 minute intervals over an entire lunar month in Manatee Springs, a tidally varying, spring-fed stream in North Florida. Retention rates varied markedly with tidal forcing. Contrary to our expectations, higher retention rates and shorter uptake lengths were observed at low tide, corresponding to the shortest residence times, which varied between 22 and 71 minutes in this 350m reach. By profiling a continuously injected conservative tracer under both high and low tide conditions, we determined this was not the result of variation in lateral inflow (e.g., dilution from denitrified hyporheic porewater at lower channel stage). This increased retention at shorter residence times (and hence higher velocity) may be the result of greater turbulent mixing, which drives river water into the benthic reactive zone where the principal retention pathway, denitrification, occurs. After controlling for residence time effects, the residual retention signal exhibited a strong diel pattern. This assimilatory N retention was highly correlated with daily primary production (using the diel oxygen method), and estimated ecosystem molar C:N ratios (8.55×0.83:1) were comparable to observed tissue stoichiometry of the dominant autotrophs (9:1). N retention (blue) and residence time (red) calculated at 15 minute intervals. Note the inverse correlation; highest retention rates occur at the shortest residence times. N retention versus residence time separated into daytime (yellow) and nighttime (blue) data points. Note the daytime data points generally lie above the nighttime regression as a result of higher daytime retention due to assimilatory uptake.

The efficacy of dexmedetomidine-remifentanil versus dexmedetomidine-propofol in children undergoing flexible bronchoscopy

PubMed Central

Zhang, Hongquan; Fang, Baojun; Zhou, Wenjing

2017-01-01

Abstract Flexible bronchoscopy has been more and more used for diagnosis and management diseases of respiratory system in pediatrics. Previous studies have reported that remifentanil (RF) and propofol are safe and effective for flexible bronchoscopy in adults, however, there have no trials evaluate the efficacy of DEX-RF versus dexmedetomidine-propofol in children undergoing flexible bronchoscopy. We divided 123 children undergoing flexible bronchoscopy with DEX-RF or dexmedetomidine-propofol into 2 groups: Group DR (n = 63, DEX infusion at 1.0 μg kg−1 for 10 minutes, then adjusted to 0.5–0.7 μg kg−1 h−1; RF infusion at 1.0 μg kg−1 for 5 minutes, then adjusted to 0.05–0.2 μg kg−1 min−1), Group DP (n = 60, DEX infusion at 1.0 μg kg−1 for 10 minutes, then adjusted to 0.5–0.7 μg kg−1 h−1; propofol infusion at 10 μg kg−1 for 5 minutes, then adjusted to 0.05–0.1 μg kg−1 min−1). Ramsay sedation scale of the 2 groups was maintained at 3. Anesthesia onset time; total number of intraoperative patient movements; hemodynamics; total cumulative dose of DEX; amount of and time to first-dose rescue midazolam and lidocaine; postoperative recovery time; adverse events; and bronchoscopist satisfaction score were recorded. Anesthesia onset time was significantly shorter in DP (8.22 ± 2.48 vs 12.25 ± 6.43 minutes, respectively, for DP, DR, P = 0.015). The perioperative hemodynamic profile was more stable in DR than DP group. More children moved during flexible bronchoscopy in DP group (P = 0.009). Total dose of rescue midazolam and lidocaine was significantly higher in DR than in DP (P < 0.001). Similarly, the time to first dose of rescue midazolam and lidocaine was significantly longer in DP than in DR (P < 0.001). Total cumulative dose of DEX was more in DR than DP group (P < 0.001). The time to recovery for discharge from the postanesthesia care unit (PACU) was significantly shorter in DP than in DR group (P < 0.001). The bronchoscopist-satisfaction scores were higher for DR than DP (P = 0.036). There were significant differences between the 2 groups in terms of the overall incidence of hypertension, tachycardia, and hypoxemia (P < 0.05). Although underwent longer recovery time and more incidence of rescue scheme, DEX-RF resulted in more stable hemodynamic profiles and bronchoscopist-satisfaction scores, lesser patient movements, and can hence be more effectively used in children undergoing flexible bronchoscopy than dexmedetomidine-propofol. PMID:28072737

Effects of computerized prescriber order entry on pharmacy order-processing time.

PubMed

Wietholter, Jon; Sitterson, Susan; Allison, Steven

2009-08-01

The effect of computerized prescriber order entry (CPOE) on the efficiency of medication-order-processing time was evaluated. This study was conducted at a 761-bed, tertiary care hospital. A total of 2988 medication orders were collected and analyzed before (n = 1488) and after CPOE implementation (n = 1500). Data analyzed included the time the prescriber ordered the medication, the time the pharmacy received the order, and the time the order was completed by a pharmacist. The mean order-processing time before CPOE implementation was 115 minutes from prescriber composition to pharmacist verification. After CPOE implementation, the mean order-processing time was reduced to 3 minutes (p < 0.0001). The time that an order was received by the pharmacy to the time it was verified by a pharmacist was reduced from 31 minutes before CPOE implementation to 3 minutes after CPOE implementation (p < 0.0001). The implementation of CPOE reduced the order-processing time (from order composition to verification) by 97%. Additionally, pharmacy-specific order-processing time (from order receipt in the pharmacy to pharmacist verification) was reduced by 90%. This reduction in order-processing time improves patient care by shortening the interval between physician prescribing and medication availability and may allow pharmacists to explore opportunities for enhanced clinical activities that will further positively impact patient care. CPOE implementation reduced the mean pharmacy order-processing time from composition to verification by 97%. After CPOE implementation, a new medication order was verified as appropriate by a pharmacist in three minutes, on average.

Ultraviolet continuum variability and visual flickering in the peculiar object MWC 560

NASA Technical Reports Server (NTRS)

Michalitsianos, A. G.; Perez, M.; Shore, S. N.; Maran, S. P.; Karovska, M.; Sonneborn, G.; Webb, J. R.; Barnes, Thomas G., III; Frueh, Marian L.; Oliversen, R. J.

1993-01-01

High-speed U-band photometry of the peculiar emission object MWC 560 obtained with the ground-based instrumentation, and V-band photometry obtained with the International Ultraviolet Explorer-Fine Error Sensor indicates irregular brightness variations are quasi-periodic. Multiple peaks of relative brightness power indicate statistically significant quasi periods existing in a range of 3-35 minutes, that are superposed on slower hourly varying components. We present a preliminary model that explains the minute and hourly time-scale variations in MWC 560 in terms of a velocity-shear instability that arises because a white dwarf magnetosphere impinges on an accretion disk. We also find evidence for Fe II multiplet pseudocontinuum absorption opacity in far-UV spectra of CH Cygni which is also present in MWC 560. Both CH Cyg and MWC 560 may be in an evolutionary stage that is characterized by strong UV continuum opacity which changes significantly during outburst, occurring before they permanently enter the symbiotic nebular emission phase.

Comparison of Topical Anesthetics for Radiofrequency Ablation of Achrocordons: Eutectic Mixture of Lignocaine/Prilocaine versus Lidocaine/Tetracaine

PubMed Central

Mishra, Nitin; Chauhan, Sandhya; Rastogi, Madhur Kant

2014-01-01

Introduction. Topical application of local anesthetics is currently considered to be the easiest, most effective, and convenient way for treatment of patients who may be undergoing superficial dermatosurgical procedures. Materials and Methods. This study compares the anesthetic potential of 2.5% lidocaine and 2.5% prilocaine topical cream with 7% lignocaine and 7% tetracaine combination cream for radio ablative dermatosurgery when applied, under occlusion, for 30 minutes. 40 subjects of achrocordons were enrolled in this split-side randomized trial. Result. The pain severity experienced by subjects in terms of visual analogue scale score was significantly lesser for lignocaine/tetracaine combination cream as compared to lidocaine/prilocaine combination. Conclusion. This small study proves the efficacy of lidocaine/tetracaine combination as a topical anesthetic cream when applied for a short time interval of 30 minutes. This will help a dermatosurgeon to perform various dermatological procedures in a better and efficient manner with a shorter waiting period for analgesia to set in. PMID:24600520

Mesolimbic Dopamine Signals the Value of Work

PubMed Central

Hamid, Arif A.; Pettibone, Jeffrey R.; Mabrouk, Omar S.; Hetrick, Vaughn L.; Schmidt, Robert; Vander Weele, Caitlin M.; Kennedy, Robert T.; Aragona, Brandon J.; Berke, Joshua D.

2015-01-01

Dopamine cell firing can encode errors in reward prediction, providing a learning signal to guide future behavior. Yet dopamine is also a key modulator of motivation, invigorating current behavior. Existing theories propose that fast (“phasic”) dopamine fluctuations support learning, while much slower (“tonic”) dopamine changes are involved in motivation. We examined dopamine release in the nucleus accumbens across multiple time scales, using complementary microdialysis and voltammetric methods during adaptive decision-making. We first show that minute-by-minute dopamine levels covary with reward rate and motivational vigor. We then show that second-by-second dopamine release encodes an estimate of temporally-discounted future reward (a value function). We demonstrate that changing dopamine immediately alters willingness to work, and reinforces preceding action choices by encoding temporal-difference reward prediction errors. Our results indicate that dopamine conveys a single, rapidly-evolving decision variable, the available reward for investment of effort, that is employed for both learning and motivational functions. PMID:26595651

Solar-burst precursors and energy buildup at microwave wavelengths

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

Lang, K.R.; Willson, R.F.

High-resolution microwave observations (VLA) of heating and magnetic triggering in coronal loops are summarized. Magnetic changes that precede solar eruptions on time scales of tens of minutes involve primarily emerging coronal loops and the interaction of two or more loops. Thermal cyclotron lines were detected in coronal loops, suggesting the presence of hot current sheets that enhance emission from relatively thin layers of enhanced temperature and constant magnetic field. These current sheets may play a role in the excitation of solar bursts. A filament-associated source with a high brightness temperature and steep radiation spectrum occurs above a region of apparentlymore » weak photospheric field. This source might be attributed to currents that enhance coronal magnetic fields. Compact (phi=5 sec) transient sources with lifetimes of 30 to 60 minutes were also detected in regions of apparently weak photospheric field. VLA observations of coronal loops are compared with simultaneous SMM-XRP observations in conclusion.« less

Contrast fluoroscopic evaluation of gastrointestinal transit times with and without the use of falconry hoods in red-tailed hawks (Buteo jamaicensis).

PubMed

Doss, Grayson A; Williams, Jackie M; Mans, Christoph

2017-11-01

OBJECTIVE To evaluate gastrointestinal transit times in red-tailed hawks (Buteo jamaicensis) by use of contrast fluoroscopic imaging and investigate the effect of falconry hooding in these hawks on gastrointestinal transit time. DESIGN Prospective, randomized, blinded, complete crossover study. ANIMALS 9 healthy red-tailed hawks. PROCEDURES Hawks were gavage-fed a 30% weight-by-volume barium suspension (25 mL/kg [11.3 mL/lb]) into the crop. Fluoroscopic images were obtained at multiple time points after barium administration. Time to filling and emptying of various gastrointestinal tract organs and overall transit time were measured. The effect of hooding (hooded vs nonhooded) on these variables was assessed in a randomized complete crossover design. RESULTS In nonhooded birds, overall gastrointestinal transit time ranged from 30 to 180 minutes (mean ± SD, 100 ± 52 min). Time to complete crop emptying ranged from 30 to 180 minutes (83 ± 49 min). Contrast medium was present in the ventriculus in all birds within 5 minutes of administration and in the small intestines within 5 to 15 minutes (median, 5 min). Hooding of red-tailed hawks resulted in a significant delay of complete crop emptying (no hood, 83 ± 49 minutes; hood, 133 ± 48 minutes), but no significant effects of hooding were found on other measured variables. CONCLUSIONS AND CLINICAL RELEVANCE These results indicated that overall gastrointestinal transit times are faster in red-tailed hawks than has been reported for psittacines and that the use of a falconry hood in red-tailed hawks may result in delayed crop emptying. Hooding did not exert significant effects on overall gastrointestinal transit time in this raptorial species.

Air Medical Evacuations From the German North Sea Wind Farm Bard Offshore 1: Traumatic Injuries, Acute Diseases, and Rescue Process Times (2011-2013).

PubMed

Dethleff, Dirk; Weinrich, Nils; Kowald, Birgitt; Hory, Dorothea; Franz, Rüdiger; Nielsen, Maja Verena; Seide, Klaus; Jürgens, Christian; Stuhr, Markus

2016-01-01

Our purpose was 2-fold: 1) to show emergency-related traumatic injury and acute disease patterns and 2) to evaluate air rescue process times in a remotely located German offshore wind farm. Optimally, this will support methodologies to reduce offshore help time (time from the incoming emergency call until offshore arrival of the helicopter). The type and severity of traumatic injuries and acute diseases were retrospectively analyzed for 39 air medevacs from August 2011 to December 2013, and the process times of air rescue missions were evaluated in detail. Forty-nine percent of the medevacs were related to traumatic injuries, whereas 41% were associated with acute diseases and 10% remained unclear. Cardiovascular and gastrointestinal disorders accounted for 90% of internal medical cases. About 69% of the trauma was related to contusions, lacerations, and cuts. The main body regions injured were limbs (∼59%) and head (∼32%). The total rescue time until arrival at the destination facility averaged 175.3 minutes (standard deviation = 54.4 minutes). The mean helicopter offshore arrival time was 106.9 minutes (standard deviation = 57.4 minutes) after the incoming emergency call. In 64% of the medevacs, the helicopter arrived on scene within a help time of 90 minutes. A reduction of help time (≤ 60 minutes) for time-critical severe trauma and acute diseases may be anticipated through rapid and focused medical and logistic decision-making processes by the onshore dispatch center combined with professional, qualified, and well-trained flight and rescue personnel. Copyright © 2016 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

Comparison of Unmanned Aerial Vehicle Technology Versus Standard Practice in Identification of Hazards at a Mass Casualty Incident Scenario by Primary Care Paramedic Students.

PubMed

Jain, Trevor; Sibley, Aaron; Stryhn, Henrik; Hubloue, Ives

2018-01-31

Introduction The proliferation of unmanned aerial vehicles (UAV) has the potential to change the situational awareness of incident commanders allowing greater scene safety. The aim of this study was to compare UAV technology to standard practice (SP) in hazard identification during a simulated multi-vehicle motor collision (MVC) in terms of time to identification, accuracy and the order of hazard identification. A prospective observational cohort study was conducted with 21 students randomized into UAV or SP group, based on a MVC with 7 hazards. The UAV group remained at the UAV ground station while the SP group approached the scene. After identifying hazards the time and order was recorded. The mean time (SD, range) to identify the hazards were 3 minutes 41 seconds (1 minute 37 seconds, 1 minute 48 seconds-6 minutes 51 seconds) and 2 minutes 43 seconds (55 seconds, 1 minute 43 seconds-4 minutes 38 seconds) in UAV and SP groups corresponding to a mean difference of 58 seconds (P=0.11). A non-parametric permutation test showed a significant (P=0.04) difference in identification order. Both groups had 100% accuracy in hazard identification with no statistical difference in time for hazard identification. A difference was found in the identification order of hazards. (Disaster Med Public Health Preparedness. 2018;page 1 of 4).

Finding the signal in the noise: Could social media be utilized for early hospital notification of multiple casualty events?

PubMed Central

Moore, Sara; Wakam, Glenn; Hubbard, Alan E.; Cohen, Mitchell J.

2017-01-01

Introduction Delayed notification and lack of early information hinder timely hospital based activations in large scale multiple casualty events. We hypothesized that Twitter real-time data would produce a unique and reproducible signal within minutes of multiple casualty events and we investigated the timing of the signal compared with other hospital disaster notification mechanisms. Methods Using disaster specific search terms, all relevant tweets from the event to 7 days post-event were analyzed for 5 recent US based multiple casualty events (Boston Bombing [BB], SF Plane Crash [SF], Napa Earthquake [NE], Sandy Hook [SH], and Marysville Shooting [MV]). Quantitative and qualitative analysis of tweet utilization were compared across events. Results Over 3.8 million tweets were analyzed (SH 1.8 m, BB 1.1m, SF 430k, MV 250k, NE 205k). Peak tweets per min ranged from 209–3326. The mean followers per tweeter ranged from 3382–9992 across events. Retweets were tweeted a mean of 82–564 times per event. Tweets occurred very rapidly for all events (<2 mins) and represented 1% of the total event specific tweets in a median of 13 minutes of the first 911 calls. A 200 tweets/min threshold was reached fastest with NE (2 min), BB (7 min), and SF (18 mins). If this threshold was utilized as a signaling mechanism to place local hospitals on standby for possible large scale events, in all case studies, this signal would have preceded patient arrival. Importantly, this threshold for signaling would also have preceded traditional disaster notification mechanisms in SF, NE, and simultaneous with BB and MV. Conclusions Social media data has demonstrated that this mechanism is a powerful, predictable, and potentially important resource for optimizing disaster response. Further investigated is warranted to assess the utility of prospective signally thresholds for hospital based activation. PMID:28982201

The Substructure of the Solar Corona Observed in the Hi-C Telescope

NASA Technical Reports Server (NTRS)

Winebarger, A.; Cirtain, J.; Golub, L.; DeLuca, E.; Savage, S.; Alexander, C.; Schuler, T.

2014-01-01

In the summer of 2012, the High-resolution Coronal Imager (Hi-C) flew aboard a NASA sounding rocket and collected the highest spatial resolution images ever obtained of the solar corona. One of the goals of the Hi-C flight was to characterize the substructure of the solar corona. We therefore calculate how the intensity scales from a low-resolution (AIA) pixels to high-resolution (Hi-C) pixels for both the dynamic events and "background" emission (meaning, the steady emission over the 5 minutes of data acquisition time). We find there is no evidence of substructure in the background corona; the intensity scales smoothly from low-resolution to high-resolution Hi-C pixels. In transient events, however, the intensity observed with Hi-C is, on average, 2.6 times larger than observed with AIA. This increase in intensity suggests that AIA is not resolving these events. This result suggests a finely structured dynamic corona embedded in a smoothly varying background.

Temporal and Cross Correlations in Business News

NASA Astrophysics Data System (ADS)

Mizuno, T.; Takei, K.; Ohnishi, T.; Watanabe, T.

We empirically investigate temporal and cross correlations inthe frequency of news reports on companies, using a dataset of more than 100 million news articles reported in English by around 500 press agencies worldwide for the period 2003--2009. Our first finding is that the frequency of news reports on a company does not follow a Poisson process, but instead exhibits long memory with a positive autocorrelation for longer than one year. The second finding is that there exist significant correlations in the frequency of news across companies. Specifically, on a daily time scale or longer the frequency of news is governed by external dynamics, while on a time scale of minutes it is governed by internal dynamics. These two findings indicate that the frequency of news reports on companies has statistical properties similar to trading volume or price volatility in stock markets, suggesting that the flow of information through company news plays an important role in price dynamics in stock markets.

Multiple-scale neuroendocrine signals connect brain and pituitary hormone rhythms

PubMed Central

Romanò, Nicola; Guillou, Anne; Martin, Agnès O; Mollard, Patrice

2017-01-01

Small assemblies of hypothalamic “parvocellular” neurons release their neuroendocrine signals at the median eminence (ME) to control long-lasting pituitary hormone rhythms essential for homeostasis. How such rapid hypothalamic neurotransmission leads to slowly evolving hormonal signals remains unknown. Here, we show that the temporal organization of dopamine (DA) release events in freely behaving animals relies on a set of characteristic features that are adapted to the dynamic dopaminergic control of pituitary prolactin secretion, a key reproductive hormone. First, locally generated DA release signals are organized over more than four orders of magnitude (0.001 Hz–10 Hz). Second, these DA events are finely tuned within and between frequency domains as building blocks that recur over days to weeks. Third, an integration time window is detected across the ME and consists of high-frequency DA discharges that are coordinated within the minutes range. Thus, a hierarchical combination of time-scaled neuroendocrine signals displays local–global integration to connect brain–pituitary rhythms and pace hormone secretion. PMID:28193889

Scale invariance of temporal order discrimination using complex, naturalistic events

PubMed Central

Kwok, Sze Chai; Macaluso, Emiliano

2015-01-01

Recent demonstrations of scale invariance in cognitive domains prompted us to investigate whether a scale-free pattern might exist in retrieving the temporal order of events from episodic memory. We present four experiments using an encoding-retrieval paradigm with naturalistic stimuli (movies or video clips). Our studies show that temporal order judgement retrieval times were negatively correlated with the temporal separation between two events in the movie. This relation held, irrespective of whether temporal distances were on the order of tens of minutes (Exp 1−2) or just a few seconds (Exp 3−4). Using the SIMPLE model, we factored in the retention delays between encoding and retrieval (delays of 24 h, 15 min, 1.5–2.5 s, and 0.5 s for Exp 1–4, respectively) and computed a temporal similarity score for each trial. We found a positive relation between similarity and retrieval times; that is, the more temporally similar two events, the slower the retrieval of their temporal order. Using Bayesian analysis, we confirmed the equivalence of the RT/similarity relation across all experiments, which included a vast range of temporal distances and retention delays. These results provide evidence for scale invariance during the retrieval of temporal order of episodic memories. PMID:25909581