How many steps/day are enough? for children and adolescents

PubMed Central

2011-01-01

Worldwide, public health physical activity guidelines include special emphasis on populations of children (typically 6-11 years) and adolescents (typically 12-19 years). Existing guidelines are commonly expressed in terms of frequency, time, and intensity of behaviour. However, the simple step output from both accelerometers and pedometers is gaining increased credibility in research and practice as a reasonable approximation of daily ambulatory physical activity volume. Therefore, the purpose of this article is to review existing child and adolescent objectively monitored step-defined physical activity literature to provide researchers, practitioners, and lay people who use accelerometers and pedometers with evidence-based translations of these public health guidelines in terms of steps/day. In terms of normative data (i.e., expected values), the updated international literature indicates that we can expect 1) among children, boys to average 12,000 to 16,000 steps/day and girls to average 10,000 to 13,000 steps/day; and, 2) adolescents to steadily decrease steps/day until approximately 8,000-9,000 steps/day are observed in 18-year olds. Controlled studies of cadence show that continuous MVPA walking produces 3,300-3,500 steps in 30 minutes or 6,600-7,000 steps in 60 minutes in 10-15 year olds. Limited evidence suggests that a total daily physical activity volume of 10,000-14,000 steps/day is associated with 60-100 minutes of MVPA in preschool children (approximately 4-6 years of age). Across studies, 60 minutes of MVPA in primary/elementary school children appears to be achieved, on average, within a total volume of 13,000 to 15,000 steps/day in boys and 11,000 to 12,000 steps/day in girls. For adolescents (both boys and girls), 10,000 to 11,700 may be associated with 60 minutes of MVPA. Translations of time- and intensity-based guidelines may be higher than existing normative data (e.g., in adolescents) and therefore will be more difficult to achieve (but not impossible nor contraindicated). Recommendations are preliminary and further research is needed to confirm and extend values for measured cadences, associated speeds, and MET values in young people; continue to accumulate normative data (expected values) for both steps/day and MVPA across ages and populations; and, conduct longitudinal and intervention studies in children and adolescents required to inform the shape of step-defined physical activity dose-response curves associated with various health parameters. PMID:21798014

Cadence Feedback With ECE PEDO to Monitor Physical Activity Intensity: A Pilot Study.

PubMed

Ardic, Fusun; Göcer, Esra

2016-03-01

The purpose of this study was to examine the monitoring capabilities of the equipment for clever exercise pedometer (ECE PEDO) that provides audible feedback when the person exceeds the upper and lower limits of the target step numbers per minute and to compare step counts with Yamax SW-200 (YX200) as the criterion pedometer.A total of 30 adult volunteers (15 males and 15 females) were classified as normal weight (n = 10), overweight (n = 10), and obese (n = 10). After the submaximal exercise test on a treadmill, the moderate intensity for walking was determined by using YX200 pedometer and then the number of steps taken in a minute was measured. Lower and upper limits of steps per minute (cadence) were recorded in ECE PEDO providing audible feedback when the person's walking speed gets out of the limits. Volunteers walked for 30 minutes in the individual step count range by attaching the ECE PEDO and YX200 pedometer on both sides of the waist belt in the same session. Step counts of the volunteers were recorded. Wilcoxon, Spearman correlation, and Bland-Altman analyses were performed to show the relationship and agreement between the results of 2 devices.Subjects took an average of 3511 ± 426 and 3493 ± 399 steps during 30 minutes with ECE PEDO and criterion pedometer, respectively. About 3500 steps taken by ECE PEDO reflected that this pedometer has capability of identifying steps per minute to meet moderate intensity of physical activity. There was a strong correlation between step counts of both devices (P < 0.001, r = 0.96). Correlations across all three BMI categories and both sex remained consistently high ranging from 0.92 to 0.95. There was a high level of agreement between the ECE PEDO and YX200 pedometer in the Bland-Altman analysis.Although both devices showed a strong similarity in counting steps, the ECE PEDO provides monitoring of intensity such that a person can walk in a specified time with a desired speed.

Cadence Feedback With ECE PEDO to Monitor Physical Activity Intensity

PubMed Central

Ardic, Fusun; Göcer, Esra

2016-01-01

Abstract The purpose of this study was to examine the monitoring capabilities of the equipment for clever exercise pedometer (ECE PEDO) that provides audible feedback when the person exceeds the upper and lower limits of the target step numbers per minute and to compare step counts with Yamax SW-200 (YX200) as the criterion pedometer. A total of 30 adult volunteers (15 males and 15 females) were classified as normal weight (n = 10), overweight (n = 10), and obese (n = 10). After the submaximal exercise test on a treadmill, the moderate intensity for walking was determined by using YX200 pedometer and then the number of steps taken in a minute was measured. Lower and upper limits of steps per minute (cadence) were recorded in ECE PEDO providing audible feedback when the person's walking speed gets out of the limits. Volunteers walked for 30 minutes in the individual step count range by attaching the ECE PEDO and YX200 pedometer on both sides of the waist belt in the same session. Step counts of the volunteers were recorded. Wilcoxon, Spearman correlation, and Bland–Altman analyses were performed to show the relationship and agreement between the results of 2 devices. Subjects took an average of 3511 ± 426 and 3493 ± 399 steps during 30 minutes with ECE PEDO and criterion pedometer, respectively. About 3500 steps taken by ECE PEDO reflected that this pedometer has capability of identifying steps per minute to meet moderate intensity of physical activity. There was a strong correlation between step counts of both devices (P < 0.001, r = 0.96). Correlations across all three BMI categories and both sex remained consistently high ranging from 0.92 to 0.95. There was a high level of agreement between the ECE PEDO and YX200 pedometer in the Bland–Altman analysis. Although both devices showed a strong similarity in counting steps, the ECE PEDO provides monitoring of intensity such that a person can walk in a specified time with a desired speed. PMID:26962822

Six Sigma process utilization in reducing door-to-balloon time at a single academic tertiary care center.

PubMed

Kelly, Elizabeth W; Kelly, Jonathan D; Hiestand, Brian; Wells-Kiser, Kathy; Starling, Stephanie; Hoekstra, James W

2010-01-01

Rapid reperfusion in patients with ST-elevation myocardial infarction (STEMI) is associated with lower mortality. Reduction in door-to-balloon (D2B) time for percutaneous coronary intervention requires multidisciplinary cooperation, process analysis, and quality improvement methodology. Six Sigma methodology was used to reduce D2B times in STEMI patients presenting to a tertiary care center. Specific steps in STEMI care were determined, time goals were established, and processes were changed to reduce each step's duration. Outcomes were tracked, and timely feedback was given to providers. After process analysis and implementation of improvements, mean D2B times decreased from 128 to 90 minutes. Improvement has been sustained; as of June 2010, the mean D2B was 56 minutes, with 100% of patients meeting the 90-minute window for the year. Six Sigma methodology and immediate provider feedback result in significant reductions in D2B times. The lessons learned may be extrapolated to other primary percutaneous coronary intervention centers. Copyright © 2010 Elsevier Inc. All rights reserved.

Classification of daily solar irradiation by fractional analysis of 10-min-means of solar irradiance

NASA Astrophysics Data System (ADS)

Harrouni, S.; Guessoum, A.; Maafi, A.

2005-02-01

This paper deals with fractal analysis of daily solar irradiances measured with a time step of 10 minutes at Golden and Boulder located in Colorado. The aim is to estimate the fractal dimensions in order to perform classification of daily solar irradiances. The estimated fractal dimension hat{D} and the clearness index KT are used as classification criteria. The results show that these criteria lead to three classes: clear sky, partially covered sky and overcast sky. The results also show that the evaluation of the fractal dimension of the irradiance signal based on a data set with 10 minutes time step is possible.

Year-round effects of a four-week randomized controlled trial using different types of feedback on employees' physical activity.

PubMed

Van Hoye, Karen; Wijtzes, Anne I; Lefevre, Johan; De Baere, Stijn; Boen, Filip

2018-04-12

This follow-up study investigated the year-round effects of a four-week randomized controlled trial using different types of feedback on employees' physical activity, including a need-supportive coach intervention. Participants (n = 227) were randomly assigned to a Minimal Intervention Group (MIG; no feedback), a Pedometer Group (PG; feedback on daily steps only), a Display Group (DG; feedback on daily steps, on daily moderate-to-vigorous physical activity [MVPA] and on total energy expenditure [EE]), or a Coaching Group (CoachG; same as DG with need supportive coaching). Daily physical activity level (PAL; Metabolic Equivalent of Task [MET]), number of daily steps, daily minutes of moderate to vigorous physical activity (MVPA), active daily EE (EE > 3 METs) and total daily EE were measured at five time points: before the start of the 4-week intervention, one week after the intervention, and 3, 6, and 12 months after the intervention. For minutes of MVPA, MIG showed higher mean change scores compared with the DG. For steps and daily minutes of MVPA, significantly lower mean change scores emerged for MIG compared with the PG. Participants of the CoachG showed significantly higher change scores in PAL, steps, minutes of MVPA, active EE, total EE compared with the MIG. As hypothesized, participants of the CoachG had significantly higher mean change scores in PAL and total EE compared with groups that only received feedback. However, no significant differences were found for steps, minutes of MVPA and active EE between CoachG and PG. Receiving additional need-supportive coaching resulted in a higher PAL and active EE compared with measurement (display) feedback only. These findings suggest to combine feedback on physical activity with personal coaching in order to facilitate long-term behavioral change. When it comes to increasing steps, minutes of MVPA or active EE, a pedometer constitutes a sufficient tool. Clinical Trails.gov NCT01432327 . Date registered: 12 September 2011.

Effects of 12-week brisk walking training on exercise blood pressure in elderly patients with essential hypertension: a pilot study.

PubMed

He, L I; Wei, Wang Ren; Can, Zhao

2018-01-24

Essential hypertension (EP) is characterized by blood pressure (BP) elevations, which often lead to target organ damage and cardiovascular illness. The following study investigates whether aerobic exercise programs with different intensities could reduce the magnitude of BP rise. Patients with essential hypertension were recruited from the Baoshan Community Health Service Center. A total of 46 patients were finally selected and randomly assigned into two groups: control group (CON) included patients who did not participate in exercise intervention training; treatment group (TRG) included patients who participated in 12-week brisk walking training (60-min of brisk walking, three times a week for a total of 12 weeks). 3-minute step tests of low and high intensity were conducted pre- and post-intervention. To compare the effects of exercise intervention, 23 subjects with normal blood pressure (NBP) who did not participate in 12-week brisk walking training, were recruited. After 12 weeks of brisk walking, SBP of TRG during resting, low and high-intensity exercise was significantly reduced by 8.3mmHg, 15.6mmHg, and 22.6mmHg, respectively; while HR of TRG's during resting, low and high intensity was significantly reduced by 3.6beats/minute, 8.7beats/minute and 11.3beats/minute, respectively. Meanwhile, after 12 weeks of brisk walking, TRG's steps per day, [Formula: see text]o 2max , moderate physical activity time and physical activity energy expenditure significantly increased by 6000 steps, 2.4 ml/kg/m, 40 minutes and 113 kcal, respectively. At the same time, TRG's body fat rate and sedentary time significantly reduced by 2% and 60 minutes per day. Brisk walking can reduce the magnitude of BP rise during exercise of different intensities and may be reduced the risk of acute cardiovascular incidents in elderly patients with essential hypertension. EP: Essential hypertension; BP: blood pressure; CON: control group; TRG: treatment group; NBP: normal blood pressure; PA: physical activity.

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.

Affordable Hybrid Heat Pump Clothes Dryer

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

TeGrotenhuis, Ward E.; Butterfield, Andrew; Caldwell, Dustin D.

This project was successful in demonstrating the feasibility of a step change in residential clothes dryer energy efficiency by demonstrating heat pump technology capable of 50% energy savings over conventional standard-size electric dryers with comparable drying times. A prototype system was designed from off-the-shelf components that can meet the project’s efficiency goals and are affordable. An experimental prototype system was built based on the design that reached 50% energy savings. Improvements have been identified that will reduce drying times of over 60 minutes to reach the goal of 40 minutes. Nevertheless, the prototype represents a step change in efficiency overmore » heat pump dryers recently introduced to the U.S. market, with 30% improvement in energy efficiency at comparable drying times.« less

LAPS Lidar Measurements at the ARM Alaska Northslope Site (Support to FIRE Project)

NASA Technical Reports Server (NTRS)

Philbrick, C. Russell; Lysak, Daniel B., Jr.; Petach, Tomas M.; Esposito, Steven T.; Mulik, Karoline R.

1998-01-01

This report consists of data summaries of the results obtained during the May 1998 measurement period at Barrow Alaska. This report does not contain any data interpretation or analysis of the results which will follow this activity. This report is forwarded with a data set on magnetic media which contains the reduced data from the LAPS lidar in 15 minute intervals. The data was obtained during the period 15-30 May 1998. The measurement period overlapped with several aircraft flights conducted by NASA as part of the FIRE project. The report contains a summary list of the data obtained plus figures that have been prepared to help visualize the measurement periods. The order of the presentation is as follows: Section 1. A copy of the Statement of Work for the planned activity of the second measurement period at the ARM Northslope site is provided. Section 2. A list of the data collection periods shows the number of one minute data records stored during each hour of operation and the corresponding size (Mbytes) of the one hour data folders. The folder and file names are composed from the year, month, day, hour and minute. The date/time information is given in UTC for easier comparison with other data sets. Section 3. A set of 4 comparisons between the LAPS lidar results and the sondes released by the ARM scientists from a location nearby the lidar. The lidar results show the +/- 1 sigma statistical error on each of the independent 75 m altitude bins of the data. This set of 4 comparisons was used to set and validate the calibration value which was then used for the complete data set. Section 4. A set of false color figures with up to 10 hours of specific humidity measurements are shown in each graph. Two days of measurements are shown on each page. These plots are crude representations of the data and permit a survey which indicates when the clouds were very low or where interesting events may occur in the results. These plots are prepared using the real time sequence plot program which has no smoothing in either the altitude or time (except that you are allowed to pick the integration time and time step. All of these plots were prepared with 15 minute integration and 5 minute time step. Section 5. A set of time sequence data for all of the extended observation periods are shown with a smoothing algorithm from the Matlab plotting library. Most of these data are integrated for 5 minutes and stepped at I minute intervals but several plots are shown with both 15 minute integration and 5 minute steps. The upper level on these data was selected and converted to the white background where the error in the specific humidity reached 25%. Section 6. The set of one hour integrated plots shown with up to 4 hours per page are provided- from the real time analysis snapshot program. The only difference in these plots and the real time display is that the plots are stopped at an altitude where the error appears to be too large for the data to contain any meaningful information.

An approach to predict Sudden Cardiac Death (SCD) using time domain and bispectrum features from HRV signal.

PubMed

Houshyarifar, Vahid; Chehel Amirani, Mehdi

2016-08-12

In this paper we present a method to predict Sudden Cardiac Arrest (SCA) with higher order spectral (HOS) and linear (Time) features extracted from heart rate variability (HRV) signal. Predicting the occurrence of SCA is important in order to avoid the probability of Sudden Cardiac Death (SCD). This work is a challenge to predict five minutes before SCA onset. The method consists of four steps: pre-processing, feature extraction, feature reduction, and classification. In the first step, the QRS complexes are detected from the electrocardiogram (ECG) signal and then the HRV signal is extracted. In second step, bispectrum features of HRV signal and time-domain features are obtained. Six features are extracted from bispectrum and two features from time-domain. In the next step, these features are reduced to one feature by the linear discriminant analysis (LDA) technique. Finally, KNN and support vector machine-based classifiers are used to classify the HRV signals. We used two database named, MIT/BIH Sudden Cardiac Death (SCD) Database and Physiobank Normal Sinus Rhythm (NSR). In this work we achieved prediction of SCD occurrence for six minutes before the SCA with the accuracy over 91%.

Shear Bond Strengths of Different Adhesive Systems to Biodentine

PubMed Central

Odabaş, Mesut Enes; Bani, Mehmet; Tirali, Resmiye Ebru

2013-01-01

The aim of this study was to measure the shear bond strength of different adhesive systems to Biodentine with different time intervals. Eighty specimens of Biodentine were prepared and divided into 8 groups. After 12 minutes, 40 samples were randomly selected and divided into 4 groups of 10 each: group 1: (etch-and-rinse adhesive system) Prime & Bond NT; group 2: (2-step self-etch adhesive system) Clearfil SE Bond; group 3: (1-step self-etch adhesive systems) Clearfil S3 Bond; group 4: control (no adhesive). After the application of adhesive systems, composite resin was applied over Biodentine. This procedure was repeated 24 hours after mixing additional 40 samples, respectively. Shear bond strengths were measured using a universal testing machine, and the data were subjected to 1-way analysis of variance and Scheffé post hoc test. No significant differences were found between all of the adhesive groups at the same time intervals (12 minutes and 24 hours) (P > .05). Among the two time intervals, the lowest value was obtained for group 1 (etch-and-rinse adhesive) at a 12-minute period, and the highest was obtained for group 2 (two-step self-etch adhesive) at a 24-hour period. The placement of composite resin used with self-etch adhesive systems over Biodentine showed better shear bond strength. PMID:24222742

Shear bond strengths of different adhesive systems to biodentine.

PubMed

Odabaş, Mesut Enes; Bani, Mehmet; Tirali, Resmiye Ebru

2013-01-01

The aim of this study was to measure the shear bond strength of different adhesive systems to Biodentine with different time intervals. Eighty specimens of Biodentine were prepared and divided into 8 groups. After 12 minutes, 40 samples were randomly selected and divided into 4 groups of 10 each: group 1: (etch-and-rinse adhesive system) Prime & Bond NT; group 2: (2-step self-etch adhesive system) Clearfil SE Bond; group 3: (1-step self-etch adhesive systems) Clearfil S(3) Bond; group 4: control (no adhesive). After the application of adhesive systems, composite resin was applied over Biodentine. This procedure was repeated 24 hours after mixing additional 40 samples, respectively. Shear bond strengths were measured using a universal testing machine, and the data were subjected to 1-way analysis of variance and Scheffé post hoc test. No significant differences were found between all of the adhesive groups at the same time intervals (12 minutes and 24 hours) (P > .05). Among the two time intervals, the lowest value was obtained for group 1 (etch-and-rinse adhesive) at a 12-minute period, and the highest was obtained for group 2 (two-step self-etch adhesive) at a 24-hour period. The placement of composite resin used with self-etch adhesive systems over Biodentine showed better shear bond strength.

Physical activity in low-income postpartum women.

PubMed

Wilkinson, Susan; Huang, Chiu-Mieh; Walker, Lorraine O; Sterling, Bobbie Sue; Kim, Minseong

2004-01-01

To validate the 7-day physical activity recall (PAR), including alternative PAR scoring algorithms, using pedometer readings with low-income postpartum women, and to describe physical activity patterns of a low-income population of postpartum women. Forty-four women (13 African American, 19 Hispanic, and 12 White) from the Austin New Mothers Study (ANMS) were interviewed at 3 months postpartum. Data were scored alternatively according to the Blair (sitting treated as light activity) and Welk (sitting excluded from light activity and treated as rest) algorithms. Step counts based on 3 days of wearing pedometers served as the validation measure. Using the Welk algorithm, PAR components significantly correlated with step counts were: minutes spent in light activity, total activity (sum of light to very hard activity), and energy expenditure. Minutes spent in sitting were negatively correlated with step counts. No PAR component activities derived with the Blair algorithm were significantly related to step counts. The largest amount of active time was spent in light activity: 384.4 minutes with the Welk algorithm. Mothers averaged fewer than 16 minutes per day in moderate or high intensity activity. Step counts measured by pedometers averaged 6,262 (SD = 2,712) per day. The findings indicate support for the validity of the PAR as a measure of physical activity with low-income postpartum mothers when scored according to the Welk algorithm. On average, low-income postpartum women in this study did not meet recommendations for amount of moderate or high intensity physical activity.

Evaluation of a workplace treadmill desk intervention: a randomized controlled trial.

PubMed

Schuna, John M; Swift, Damon L; Hendrick, Chelsea A; Duet, Megan T; Johnson, William D; Martin, Corby K; Church, Timothy S; Tudor-Locke, Catrine

2014-12-01

To evaluate the effectiveness of a 3-month treadmill desk intervention in eliciting changes in physical activity and sedentary behavior among overweight/obese office workers. A randomized controlled trial was conducted among overweight/obese office workers (n = 41; mean age = 40.1 ± 10.1 years) at a private workplace. Participants were randomly assigned to a shared-treadmill desk intervention (n = 21) or a usual working condition control group (n = 20). Accelerometer-determined physical activity and sedentary behavior were measured before and after the intervention. Compared with the control group, the intervention group increased daily steps (1622 steps/day; P = 0.013) and light physical activity (1.6 minutes/hour; P = 0.008), and decreased sedentary time (-3.6 minutes/hour; P = 0.047) during working hours. Shared-treadmill desks in the workplace can be effective at promoting favorable changes in light physical activity (specifically 40 to 99 steps/minute) and sedentary behavior among overweight/obese office workers.

How Long Is a Minute? The Importance of a Measured Plan of Response to Crisis Situations

ERIC Educational Resources Information Center

Bickel, Perry S.

2010-01-01

Physical interventions for special education students in crisis remains a controversial concept. The first minute of a crisis situation represents the most crucial time to prevent injury or the exacerbation of injury. Although preventing violence and escalation of negative emotions is the first step in crisis management, school staff also must be…

Correlates of Active Videogame Use in Children.

PubMed

Schneider, Kristin L; Carter, Jocelyn Smith; Putnam, Cynthia; Keeney, Jacey; DeCator, Draycen D; Kern, Daniel; Aylward, Laura

2018-04-01

Active videogames (AVGs) could provide a novel approach to increasing physical activity and decreasing sedentary activity in children, but little is known about which children are likely to use AVGs. This study examined whether youth demographics, social support, and AVG engagement influence use of AVGs and physical activity. A diverse sample of youth participants (42.4% non-Hispanic white), aged 8-14 years (n = 85), who owned an AVG console, completed surveys, wore an activity monitor, and logged AVG use for 1 week. Regression analyses were used to examine variables associated with daily AVG minutes and to examine the relationship between daily AVG minutes and daily steps. Older and non-Hispanic white children played AVGs for fewer minutes per day (P's < 0.03). Greater peer support for playing AVGs was associated with greater daily AVG minutes (P = 0.003). Daily AVG minutes were not associated with daily steps. Results suggest that younger children and children who do not identify as non-Hispanic white may be more open to playing AVGs. Targeting social support in AVG interventions may increase time spent playing AVGs.

[Psoriasis: the clinical use of "minute therapy" with Cignolin].

PubMed

Runne, U; Kunze, J

1983-02-15

The so called "minutes" therapy is a fundamental new method of psoriasis treatment with dithranol (anthralin). Dithranol is applied to the lesions for only 10 to 20 minutes and thereafter washed off thoroughly under a shower. We use an ointment of 0.5 to 3% dithranol with 2% salicylic acid in yellow soft paraffin which is applied with a plastic glove to the lesions. This regimen makes it now possible to offer dithranol routinely for home treatment. The patient should be well informed and must consult the dermatologist weekly. The course of treatment usually starts with 1% dithranol for 10 minutes. Depending on the healing effect and the degree of irritation, the concentration and the contact time is increased step by step. Up to now, 200 patients have been treated, 64 of them as in-patients and 136 carrying out the treatment at home. The clearance rate was 77.5% (84% for the in-patients and 74% for the outpatients). The average clearing time for out-patients was 5.5 days longer than for in-patients (31.5 to 26 days). The rate of non-responders in both groups was 10%. The application of corticosteroids or oral retinoids in addition to the "minutes" therapy showed no better therapeutic results. The "minutes" therapy has medical, social and financial advantages. Dithranol is very effective and has no permanent side-effects. Therefore, corticosteroids, retinoids and PUVA can be restricted. Treatment at home enables the patients to enjoy normal family and professional life. Finally, the "minutes" therapy saves large amounts of money in comparison to a hospital stay for several weeks.

Exoskeleton Training May Improve Level of Physical Activity After Spinal Cord Injury: A Case Series.

PubMed

Gorgey, Ashraf S; Wade, Rodney; Sumrell, Ryan; Villadelgado, Lynette; Khalil, Refka E; Lavis, Timothy

2017-01-01

Objectives: To determine whether the use of a powered exoskeleton can improve parameters of physical activity as determined by walking time, stand up time, and number of steps in persons with spinal cord injury (SCI). Methods: Three men with complete (1 C5 AIS A and 2 T4 AIS A) and one man with incomplete (C5 AIS D) SCI participated in a clinical rehabilitation program. In the training program, the participants walked once weekly using a powered exoskeleton (Ekso) for approximately 1 hour over the course of 10 to 15 weeks. Walking time, stand up time, ratio of walking to stand up time, and number of steps were determined. Oxygen uptake (L/min), energy expenditure, and body composition were measured in one participant after training. Results: Over the course of 10 to 15 weeks, the maximum walking time increased from 12 to 57 minutes and the number of steps increased from 59 to 2,284 steps. At the end of the training, the 4 participants were able to exercise for 26 to 59 minutes. For one participant, oxygen uptake increased from 0.27 L/min during rest to 0.55 L/min during walking. Maximum walking speed was 0.24 m/s, and delta energy expenditure increased by 1.4 kcal/min during walking. Body composition showed a modest decrease in absolute fat mass in one participant. Conclusion: Exoskeleton training may improve parameters of physical activity after SCI by increasing the number of steps and walking time. Other benefits may include increasing energy expenditure and improving the profile of body composition.

Sensitivity of The High-resolution Wam Model With Respect To Time Step

NASA Astrophysics Data System (ADS)

Kasemets, K.; Soomere, T.

The northern part of the Baltic Proper and its subbasins (Bothnian Sea, the Gulf of Finland, Moonsund) serve as a challenge for wave modellers. In difference from the southern and the eastern parts of the Baltic Sea, their coasts are highly irregular and contain many peculiarities with the characteristic horizontal scale of the order of a few kilometres. For example, the northern coast of the Gulf of Finland is extremely ragged and contains a huge number of small islands. Its southern coast is more or less regular but has up to 50m high cliff that is frequently covered by high forests. The area also contains numerous banks that have water depth a couple of meters and that may essentially modify wave properties near the banks owing to topographical effects. This feature suggests that a high-resolution wave model should be applied for the region in question, with a horizontal resolution of an order of 1 km or even less. According to the Courant-Friedrich-Lewy criterion, the integration time step for such models must be of the order of a few tens of seconds. A high-resolution WAM model turns out to be fairly sensitive with respect to the particular choice of the time step. In our experiments, a medium-resolution model for the whole Baltic Sea was used, with the horizontal resolution 3 miles (3' along latitudes and 6' along longitudes) and the angular resolution 12 directions. The model was run with steady wind blowing 20 m/s from different directions and with two time steps (1 and 3 minutes). For most of the wind directions, the rms. difference of significant wave heights calculated with differ- ent time steps did not exceed 10 cm and typically was of the order of a few per cents. The difference arose within a few tens of minutes and generally did not increase in further computations. However, in the case of the north wind, the difference increased nearly monotonously and reached 25-35 cm (10-15%) within three hours of integra- tion whereas mean of significant wave heights over the whole Baltic Sea was 2.4 m (1 minute) and 2.04 m (3 minutes), respectively. The most probable reason of such difference is that the WAM model with a relatively large time step poorly describes wave field evolution in the Aland area with extremely ragged bottom topography and coastal line. In earlier studies, it has been reported that the WAM model frequently underestimates wave heights in the northern Baltic Proper by 20-30% in the case of strong north storms (Tuomi et al, Report series of the Finnish Institute of Marine Re- search, 1999). The described results suggest that a part of this underestimation may be removed through a proper choice of the time step.

Workflow in interventional radiology: uterine fibroid embolization (UFE)

NASA Astrophysics Data System (ADS)

Lindisch, David; Neumuth, Thomas; Burgert, Oliver; Spies, James; Cleary, Kevin

2008-03-01

Workflow analysis can be used to record the steps taken during clinical interventions with the goal of identifying bottlenecks and streamlining the procedure efficiency. In this study, we recorded the workflow for uterine fibroid embolization (UFE) procedures in the interventional radiology suite at Georgetown University Hospital in Washington, DC, USA. We employed a custom client/server software architecture developed by the Innovation Center for Computer Assisted Surgery (ICCAS) at the University of Leipzig, Germany. This software runs in a JAVA environment and enables an observer to record the actions taken by the physician and surgical team during these interventions. The data recorded is stored as an XML document, which can then be further processed. We recorded data from 30 patients and found a mean intervention time of 01:49:46 (+/- 16:04) minutes. The critical intervention step, the embolization, had a mean time of 00:15:42 (+/- 05:49) minutes, which was only 15% of the total intervention time.

Combining fast walking training and a step activity monitoring program to improve daily walking activity after stroke: a preliminary study

PubMed Central

Danks, Kelly A.; Pohlig, Ryan; Reisman, Darcy S.

2016-01-01

Objective To determine preliminary efficacy and to identify baseline characteristics predicting who would benefit most from fast walking training plus a step activity monitoring program (FAST+SAM) compared to fast walking training alone (FAST) in persons with chronic stroke. Design Randomized controlled trial with blinded assessors Setting Outpatient clinical research laboratory Participants 37 individuals greater than 6 months post-stroke. Interventions Subjects were assigned to either FAST which was walking training at their fastest possible speed on the treadmill (30 minutes) and over ground 3 times/week for 12 weeks or FAST plus a step activity monitoring program (FAST+SAM). The step activity monitoring program consisted of daily step monitoring with a StepWatch Activity monitor, goal setting, and identification of barriers to activity and strategies to overcome barriers. Main Outcome Measures Daily step activity metrics (steps/day, time walking/day), walking speed and six minute walk test distance (6MWT). Results There was a significant effect of time for both groups with all outcomes improving from pre to post-training, (all p<0.05). The FAST+SAM was superior to FAST for 6MWT (p=0.018), with a larger increase in the FAST+SAM group. The interventions had differential effectiveness based on baseline step activity. Sequential moderated regression models demonstrated that for subjects with baseline levels of step activity and 6MWT distances that were below the mean, the FAST+SAM intervention was more effective than FAST (1715±1584 vs. 254±933 steps/day, respectively; p<0.05 for overall model and ΔR2 for steps/day and 6MWT). Conclusions The addition of a step activity monitoring program to a fast walking training intervention may be most effective in persons with chronic stroke that have initial low levels of walking endurance and activity. Regardless of baseline performance, the FAST + SAM intervention was more effective for improving walking endurance. PMID:27240430

Exoskeleton Training May Improve Level of Physical Activity After Spinal Cord Injury: A Case Series

PubMed Central

Wade, Rodney; Sumrell, Ryan; Villadelgado, Lynette; Khalil, Refka E.; Lavis, Timothy

2017-01-01

Objectives: To determine whether the use of a powered exoskeleton can improve parameters of physical activity as determined by walking time, stand up time, and number of steps in persons with spinal cord injury (SCI). Methods: Three men with complete (1 C5 AIS A and 2 T4 AIS A) and one man with incomplete (C5 AIS D) SCI participated in a clinical rehabilitation program. In the training program, the participants walked once weekly using a powered exoskeleton (Ekso) for approximately 1 hour over the course of 10 to 15 weeks. Walking time, stand up time, ratio of walking to stand up time, and number of steps were determined. Oxygen uptake (L/min), energy expenditure, and body composition were measured in one participant after training. Results: Over the course of 10 to 15 weeks, the maximum walking time increased from 12 to 57 minutes and the number of steps increased from 59 to 2,284 steps. At the end of the training, the 4 participants were able to exercise for 26 to 59 minutes. For one participant, oxygen uptake increased from 0.27 L/min during rest to 0.55 L/min during walking. Maximum walking speed was 0.24 m/s, and delta energy expenditure increased by 1.4 kcal/min during walking. Body composition showed a modest decrease in absolute fat mass in one participant. Conclusion: Exoskeleton training may improve parameters of physical activity after SCI by increasing the number of steps and walking time. Other benefits may include increasing energy expenditure and improving the profile of body composition. PMID:29339900

A financial analysis of operating room charges for robot-assisted gynaecologic surgery: Efficiency strategies in the operating room for reducing the costs

PubMed Central

Zeybek, Burak; Öge, Tufan; Kılıç, Cemil Hakan; Borahay, Mostafa A.; Kılıç, Gökhan Sami

2014-01-01

Objective To analyse the steps taking place in the operating room (OR) before the console time starts in robot-assisted gynaecologic surgery and to identify potential ways to decrease non-operative time in the OR. Material and Methods Thirteen consecutive robotic cases for benign gynaecologic disease at the Department of Obstetrics and Gynecology at University of Texas Medical Branch (UTMB) were retrospectively reviewed. The collected data included the specific terms ‘Anaesthesia Done’ (step 1), ‘Drape Done’ (step 2), and ‘Trocar In’ (step 3), all of which refer to the time before the actual surgery began and OR charges were evaluated as level 3, 4, and 5 for open abdominal/vaginal hysterectomy, laparoscopic hysterectomy, and robot-assisted hysterectomy, respectively. Results The cost of the OR for 0–30 minutes and each additional 30 minutes were $3,693 and $1,488, $4,961 and $2,426, $5,513 and $2,756 in level 3, 4, and 5 surgeries, respectively. The median time for step 1 was 12.1 min (5.25–23.3), for step 2 was 19 (4.59–44) min, and for step 3 was 25.3 (16.45–45) min. The total median time until the actual operation began was 54.58 min (40–100). The total cost was $6948.7 when the charge was calculated according to level 4 and $7771.1 when the charge was calculated according to level 5. Conclusion Robot-assisted surgery is already ‘cost-expensive’ in the preparation stage of a surgical procedure during anaesthesia induction and draping of the patient because of charging levels. Every effort should be made to shorten the time and reduce the number of instruments used without compromising care. (J Turk Ger Gynecol Assoc 2014; 15: 25–9) PMID:24790513

Sleep Duration, Sedentary Behavior, Physical Activity, and Quality of Life after Inpatient Stroke Rehabilitation.

PubMed

Ezeugwu, Victor E; Manns, Patricia J

2017-09-01

The aim of this study was to describe accelerometer-derived sleep duration, sedentary behavior, physical activity, and quality of life and their association with demographic and clinical factors within the first month after inpatient stroke rehabilitation. Thirty people with stroke (mean ± standard deviation, age: 63.8 ± 12.3 years, time since stroke: 3.6 ± 1.1 months) wore an activPAL3 Micro accelerometer (PAL Technologies, Glasgow, Scotland) continuously for 7 days to measure whole-day activity behavior. The Stroke Impact Scale and the Functional Independence Measure were used to assess quality of life and function, respectively. Sleep duration ranged from 6.6 to 11.6 hours/day. Fifteen participants engaged in long sleep greater than 9 hours/day. Participants spent 74.8% of waking hours in sedentary behavior, 17.9% standing, and 7.3% stepping. Of stepping time, only a median of 1.1 (interquartile range: .3-5.8) minutes were spent walking at a moderate-to-vigorous intensity (≥100 steps/minute). The time spent sedentary, the stepping time, and the number of steps differed significantly by the hemiparetic side (P < .05), but not by sex or the type of stroke. There were moderate to strong correlations between the stepping time and the number of steps with gait speed (Spearman r = .49 and .61 respectively, P < .01). Correlations between accelerometer-derived variables and age, time since stroke, and cognition were not significant. People with stroke sleep for longer than the normal duration, spend about three quarters of their waking hours in sedentary behaviors, and engage in minimal walking following stroke rehabilitation. Our findings provide a rationale for the development of behavior change strategies after stroke. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Physical and social contextual influences on children's leisure-time physical activity: an ecological momentary assessment study.

PubMed

Dunton, Genevieve F; Liao, Yue; Intille, Stephen; Wolch, Jennifer; Pentz, Mary Ann

2011-01-01

This study used real-time electronic surveys delivered through mobile phones, known as Ecological Momentary Assessment (EMA), to determine whether level and experience of leisure-time physical activity differ across children's physical and social contexts. Children (N = 121; ages 9 to 13 years; 52% male, 32% Hispanic/Latino) participated in 4 days (Fri.-Mon.) of EMA during nonschool time. Electronic surveys (20 total) assessed primary activity (eg, active play/sports/exercise), physical location (eg, home, outdoors), social context (eg, friends, alone), current mood (positive and negative affect), and enjoyment. Responses were time-matched to the number of steps and minutes of moderate-to-vigorous physical activity (MVPA; measured by accelerometer) in the 30 minutes before each survey. Mean steps and MVPA were greater outdoors than at home or at someone else's house (all P < .05). Steps were greater with multiple categories of company (eg, friends and family together) than with family members only or alone (all P < .05). Enjoyment was greater outdoors than at home or someone else's house (all P < .05). Negative affect was greater when alone and with family only than friends only (all P < .05). Results describing the value of outdoor and social settings could inform context-specific interventions in this age group.

Light sensitometry of mammography films at varying development temperatures and times

PubMed Central

Sharma, Reena; Sharma, Sunil Dutt; Mayya, Y. S.

2012-01-01

Kodak MinR-2000 mammography film is widely used for mammography imaging. The sensitometric indices like base plus fog level (B + F), maximum optical density (ODmax), average gradient (AG) and speed of this film at varying development temperatures and times were evaluated using a light sensitometer. Totally 33 film strips were cut from a single Kodak MinR-2000 mammography film box and exposed in a light sensitometer operated in the green light spectrum to produce a 21-step sensitometric strip. These exposed film strips were processed at temperatures in the range of 32°C–37°C in the step of 1°C and at processing times in the range of 1–6 minutes in the step of 1 minute. The results of the present study show that the measured base plus fog level of the mammography film was not affected much, whereas significant changes were seen in the ODmax, AG and speed with varying development temperatures and times. The ODmax values of the film were found in the range of 3.67–3.76, AG values were in the range of 2.48–3.4 and speed values were in the range of 0.015–0.0236 when the processing temperature was varied from 32°C to 37°C. With processing time variation from 1 to 6 minutes, the observed changes in ODmax values were in the range of 3.54-3.71, changes in AG were in the range of 2.66–3.27 and changes in speed were in the range of 0.011–0.025. Based on these observations, recommendations for optimum processing parameters to be used for this film are made. PMID:22363111

Increased walking variability in elderly persons with congestive heart failure

NASA Technical Reports Server (NTRS)

Hausdorff, J. M.; Forman, D. E.; Ladin, Z.; Goldberger, A. L.; Rigney, D. R.; Wei, J. Y.

1994-01-01

OBJECTIVES: To determine the effects of congestive heart failure on a person's ability to walk at a steady pace while ambulating at a self-determined rate. SETTING: Beth Israel Hospital, Boston, a primary and tertiary teaching hospital, and a social activity center for elderly adults living in the community. PARTICIPANTS: Eleven elderly subjects (aged 70-93 years) with well compensated congestive heart failure (NY Heart Association class I or II), seven elderly subjects (aged 70-79 years) without congestive heart failure, and 10 healthy young adult subjects (aged 20-30 years). MEASUREMENTS: Subjects walked for 8 minutes on level ground at their own selected walking rate. Footswitches were used to measure the time between steps. Step rate (steps/minute) and step rate variability were calculated for the entire walking period, for 30 seconds during the first minute of the walk, for 30 seconds during the last minute of the walk, and for the 30-second period when each subject's step rate variability was minimal. Group means and 5% and 95% confidence intervals were computed. MAIN RESULTS: All measures of walking variability were significantly increased in the elderly subjects with congestive heart failure, intermediate in the elderly controls, and lowest in the young subjects. There was no overlap between the three groups using the minimal 30-second variability (elderly CHF vs elderly controls: P < 0.001, elderly controls vs young: P < 0.001), and no overlap between elderly subjects with and without congestive heart failure when using the overall variability. For all four measures, there was no overlap in any of the confidence intervals, and all group means were significantly different (P < 0.05).

Time Demand and Radiation Dose in 3D-Fluoroscopy-based Navigation-assisted 3D-Fluoroscopy-controlled Pedicle Screw Instrumentations.

PubMed

Balling, Horst

2018-05-01

Prospective single-center cohort study to record additional time requirements and radiation dose in navigation-assisted O-arm-controlled pedicle screw (PS) instrumentations. The aim of this study was to evaluate amount of extra-time and radiation dose for navigation-assisted PS instrumentations of the thoracolumbosacral spine using O-arm 3D-real-time-navigation (O3DN) compared to non-navigated spinal procedures (NNSPs) with a single C-arm and postoperative computed tomography (CT) scan for controlling PS positions. 3D-navigation is reported to enhance PS insertion accuracy. But time-consuming navigational steps and considerable additional radiation doses seem to limit this modern technique's attraction. A detailed analysis of additional time demand and extra-radiation dose in 3D-navigated spine surgery is not provided in literature, yet. From February 2011 through July 2015, 306 consecutive posterior instrumentations were performed in vertebral levels T10-S1 using O3DN for PS insertion. The duration of procedure-specific navigational steps of the overall collective (I) and the last cohort of 50 consecutive O3DN-surgeries (II) was compared to the average duration of analogous surgical steps in 100 consecutive NNSP using a single C-arm. 3D-radiation dose (dose-length-product, DLP) of navigational and postinstrumentation O-arm scans in group I and II was compared to the average DLP of 100 diagnostic lumbar CT scans. The average presurgical time from patient positioning on the operating table to skin incision was 46.2 ± 10.1 minutes (O3DN, I) and 40.6 ± 9.8 minutes (O3DN, II) versus 30.6 ± 8.3 minutes (NNSP) (P < 0.001, each). Intraoperative interruptions for scanning and data processing took 3.0 ± 0.6 minutes. DLPs averaged 865.1 ± 360.8 mGycm (O3DN, I) and 562.1 ± 352.6 mGycm (O3DN, II) compared to 575.5 ± 316.5 mGycm in diagnostic lumbar CT scans (P < 0.001 (I), P ≈ 0.81 [II]). After procedural experience, navigated surgeries can be performed with an additional time demand of 13.0 minutes compared to NNSP, and with a total DLP below that of a diagnostic lumbar CT scan (P ≈ 0.81). 4.

Using lean methodology to improve productivity in a hospital oncology pharmacy.

PubMed

Sullivan, Peter; Soefje, Scott; Reinhart, David; McGeary, Catherine; Cabie, Eric D

2014-09-01

Quality improvements achieved by a hospital pharmacy through the use of lean methodology to guide i.v. compounding workflow changes are described. The outpatient oncology pharmacy of Yale-New Haven Hospital conducted a quality-improvement initiative to identify and implement workflow changes to support a major expansion of chemotherapy services. Applying concepts of lean methodology (i.e., elimination of non-value-added steps and waste in the production process), the pharmacy team performed a failure mode and effects analysis, workflow mapping, and impact analysis; staff pharmacists and pharmacy technicians identified 38 opportunities to decrease waste and increase efficiency. Three workflow processes (order verification, compounding, and delivery) accounted for 24 of 38 recommendations and were targeted for lean process improvements. The workflow was decreased to 14 steps, eliminating 6 non-value-added steps, and pharmacy staff resources and schedules were realigned with the streamlined workflow. The time required for pharmacist verification of patient-specific oncology orders was decreased by 33%; the time required for product verification was decreased by 52%. The average medication delivery time was decreased by 47%. The results of baseline and postimplementation time trials indicated a decrease in overall turnaround time to about 70 minutes, compared with a baseline time of about 90 minutes. The use of lean methodology to identify non-value-added steps in oncology order processing and the implementation of staff-recommended workflow changes resulted in an overall reduction in the turnaround time per dose. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Pre- to Post-operative Changes in Physical Activity: Report from the Longitudinal Assessment of Bariatric Surgery-2

PubMed Central

King, Wendy C; Hsu, Jesse Y; Belle, Steven H; Courcoulas, Anita P; Eid, George M; Flum, David R; Mitchell, James E; Pender, John R; Smith, Mark D; Steffen, Kristine J; Wolfe, Bruce M

2011-01-01

Background Numerous studies report that bariatric surgery patients report more physical activity (PA) after surgery than before, but the quality of PA assessment has been questionable. Methods The Longitudinal Assessment of Bariatric Surgery-2 is a 10-center longitudinal study of adults undergoing bariatric surgery. Of 2458 participants, 455 were given an activity monitor, which records steps/minute, and an exercise diary before and 1 year after surgery. Mean step/day, active minutes/day, and high-cadence minutes/week were calculated for 310 participants who wore the monitor at least 10 hours/day for at least 3 days at both time points. Pre- and post-surgery PA were compared for differences using the Wilcoxon signed-rank test. Generalized Estimating Equations identified independent pre-operative predictors of post-operative PA. Results PA increased significantly (p<.0001) pre- to post-operative for all PA measures. Median values pre- and post-operative were: 7563 and 8788 steps/day; 309 and 340 active minutes/day; and 72 and 112 high-cadence minutes/week, respectively. However, depending on the PA measure, 24–29% of participants were at least 5% less active post-operative than pre-operative. Controlling for surgical procedure, sex, age and BMI, higher PA preoperative independently predicted higher PA post-operative (p<.0001, all PA measures). Less pain, not having asthma and self-report of increasing PA as a weight loss strategy pre-operative also independently predicted more high-cadence minutes/week post-operative (p<.05). Conclusion The majority of adults increase their PA level following bariatric surgery. However, most remain insufficiently active and some become less active. Increasing PA, addressing pain and treating asthma prior to surgery may have a positive impact on post-operative PA. PMID:21944951

Visual impairment, uncorrected refractive error, and accelerometer-defined physical activity in the United States.

PubMed

Willis, Jeffrey R; Jefferys, Joan L; Vitale, Susan; Ramulu, Pradeep Y

2012-03-01

To examine how accelerometer-measured physical activity is affected by visual impairment (VI) and uncorrected refractive error (URE). Cross-sectional study using data from the 2003-2004/2005-2006 National Health and Nutritional Examination Survey. Visual impairment was defined as better-eye postrefraction visual acuity worse than 20/40. Uncorrected refractive error was defined as better-eye presenting visual acuity of 20/50 or worse, improving to 20/40 or better with refraction. Adults older than 20 years with normal sight, URE, and VI were analyzed. The main outcome measures were steps per day and daily minutes of moderate or vigorous physical activity (MVPA). Five thousand seven hundred twenty-two participants (57.1%) had complete visual acuity and accelerometer data. Individuals with normal sight took an average of 9964 steps per day and engaged in an average of 23.5 minutes per day of MVPA, as compared with 9742 steps per day and 23.1 minutes per day of MVPA in individuals with URE (P > .50 for both) and 5992 steps per day and 9.3 minutes/d of MVPA in individuals with VI (P < .01 for both). In multivariable models, individuals with VI took 26% fewer steps per day (P < .01; 95% CI, 18%-34%) and spent 48% less time in MVPA (P < .01; 95% CI, 37%-57%) than individuals with normal sight. The decrement in steps and MVPA associated with VI equaled or exceeded that associated with self-reported chronic obstructive pulmonary disease, diabetes mellitus, arthritis, stroke, or congestive heart failure. Visual impairment, but not URE, impacts physical activity equal to or greater than other serious medical conditions. The substantial decrement in physical activity observed in nonrefractive vision loss highlights a need for better strategies to safely improve mobility and increase physical activity in this group.

Effects of fentanyl administration on locomotor response in horses with the G57C μ-opioid receptor polymorphism.

PubMed

Wetmore, Lois A; Pascoe, Peter J; Shilo-Benjamini, Yael; Lindsey, Jane C

2016-08-01

OBJECTIVE To determine the locomotor response to the administration of fentanyl in horses with and without the G57C polymorphism of the μ-opioid receptor. ANIMALS 20 horses of various breeds and ages (10 horses heterozygous for the G57C polymorphism and 10 age-, breed-, and sex-matched horses that did not have the G57C polymorphism). PROCEDURES The number of steps each horse took was counted over consecutive 2-minute periods for 20 minutes to determine a baseline value. The horse then received a bolus of fentanyl (20 μg/kg, IV), and the number of steps was again counted during consecutive 2-minute periods for 60 minutes. The mean baseline value was subtracted from each 2-minute period after fentanyl administration; step counts with negative values were assigned a value of 0. Data were analyzed by use of a repeated-measures ANOVA. RESULTS Data for 19 of 20 horses (10 horses with the G57C polymorphism and 9 control horses without the G57C polymorphism) were included in the analysis. Horses with the G57C polymorphism had a significant increase in locomotor activity, compared with results for horses without the polymorphism. There was a significant group-by-time interaction. CONCLUSIONS AND CLINICAL RELEVANCE Horses heterozygous for the G57C polymorphism of the μ-opioid receptor had an increased locomotor response to fentanyl administration, compared with the response for horses without this polymorphism. The clinical impact of this finding should be investigated.

Carbon activation process for increased surface accessibility in electrochemical capacitors

DOEpatents

Doughty, Daniel H.; Eisenmann, Erhard T.

2001-01-01

A process for making carbon film or powder suitable for double capacitor electrodes having a capacitance of up to about 300 F/cm.sup.3 is disclosed. This is accomplished by treating in aqueous nitric acid for a period of about 5 to 15 minutes thin carbon films obtained by carbonizing carbon-containing polymeric material having a high degree of molecular directionality, such as polyimide film, then heating the treated carbon film in a non-oxidizing atmosphere at a non-graphitizing temperature of at least 350.degree. C. for about 20 minutes, and repeating alternately the nitric acid step and the heating step from 7 to 10 times. Capacitors made with this carbon may find uses ranging from electronic devices to electric vehicle applications.

Dissolvable fluidic time delays for programming multi-step assays in instrument-free paper diagnostics.

PubMed

Lutz, Barry; Liang, Tinny; Fu, Elain; Ramachandran, Sujatha; Kauffman, Peter; Yager, Paul

2013-07-21

Lateral flow tests (LFTs) are an ingenious format for rapid and easy-to-use diagnostics, but they are fundamentally limited to assay chemistries that can be reduced to a single chemical step. In contrast, most laboratory diagnostic assays rely on multiple timed steps carried out by a human or a machine. Here, we use dissolvable sugar applied to paper to create programmable flow delays and present a paper network topology that uses these time delays to program automated multi-step fluidic protocols. Solutions of sucrose at different concentrations (10-70% of saturation) were added to paper strips and dried to create fluidic time delays spanning minutes to nearly an hour. A simple folding card format employing sugar delays was shown to automate a four-step fluidic process initiated by a single user activation step (folding the card); this device was used to perform a signal-amplified sandwich immunoassay for a diagnostic biomarker for malaria. The cards are capable of automating multi-step assay protocols normally used in laboratories, but in a rapid, low-cost, and easy-to-use format.

Dissolvable fluidic time delays for programming multi-step assays in instrument-free paper diagnostics

PubMed Central

Lutz, Barry; Liang, Tinny; Fu, Elain; Ramachandran, Sujatha; Kauffman, Peter; Yager, Paul

2013-01-01

Lateral flow tests (LFTs) are an ingenious format for rapid and easy-to-use diagnostics, but they are fundamentally limited to assay chemistries that can be reduced to a single chemical step. In contrast, most laboratory diagnostic assays rely on multiple timed steps carried out by a human or a machine. Here, we use dissolvable sugar applied to paper to create programmable flow delays and present a paper network topology that uses these time delays to program automated multi-step fluidic protocols. Solutions of sucrose at different concentrations (10-70% of saturation) were added to paper strips and dried to create fluidic time delays spanning minutes to nearly an hour. A simple folding card format employing sugar delays was shown to automate a four-step fluidic process initiated by a single user activation step (folding the card); this device was used to perform a signal-amplified sandwich immunoassay for a diagnostic biomarker for malaria. The cards are capable of automating multi-step assay protocols normally used in laboratories, but in a rapid, low-cost, and easy-to-use format. PMID:23685876

Effect of increased exposure times on amount of residual monomer released from single-step self-etch adhesives.

PubMed

Altunsoy, Mustafa; Botsali, Murat Selim; Tosun, Gonca; Yasar, Ahmet

2015-10-16

The aim of this study was to evaluate the effect of increased exposure times on the amount of residual Bis-GMA, TEGDMA, HEMA and UDMA released from single-step self-etch adhesive systems. Two adhesive systems were used. The adhesives were applied to bovine dentin surface according to the manufacturer's instructions and were polymerized using an LED curing unit for 10, 20 and 40 seconds (n = 5). After polymerization, the specimens were stored in 75% ethanol-water solution (6 mL). Residual monomers (Bis-GMA, TEGDMA, UDMA and HEMA) that were eluted from the adhesives (after 10 minutes, 1 hour, 1 day, 7 days and 30 days) were analyzed by high-performance liquid chromatography (HPLC). The data were analyzed using 1-way analysis of variance and Tukey HSD tests. Among the time periods, the highest amount of released residual monomers from adhesives was observed in the 10th minute. There were statistically significant differences regarding released Bis-GMA, UDMA, HEMA and TEGDMA between the adhesive systems (p<0.05). There were no significant differences among the 10, 20 and 40 second polymerization times according to their effect on residual monomer release from adhesives (p>0.05). Increasing the polymerization time did not have an effect on residual monomer release from single-step self-etch adhesives.

Oxygen cost and physiological responses of recreational badminton match play.

PubMed

Deka, Pallav; Berg, Kris; Harder, Jeanette; Batelaan, Herman; McGRATH, Melanie

2017-06-01

Badminton, as an Olympic sport, is popular worldwide. However, the benefits of recreational badminton match play are not well known. The purpose of the study was to determine the oxygen cost of recreational badminton match play. Heart rate (HR), blood lactate (BL), rating of perceived exertion (RPE), step count and energy expenditure were also assessed. Fourteen male recreational badminton players aged 35.9±6.62 years participated in test sessions to assess oxygen uptake (VO2) and the related physiological responses of match play. During the match play sessions, participants played singles badminton matches for 30 min while wearing a portable metabolic system. VO2 and HR were continuously recorded while blood lactate and RPE were determined following warm-up, at 15 minutes and 30 minutes of match play. Step count was recorded at 15 minutes and 30 minutes of play. VO2 over 30 minutes was 34.4±5.8 mL/kg/min which was 76.1% of maximal oxygen uptake. Across three 10-minute periods of play, VO2 was not significantly different while HR was higher in the third 10-minute period than the first and second 10-minute periods (P=0.001). Mean HR over 30 minutes was 167.9±9.4 bpm. BL was significantly higher at 15 and 30 minutes than following warm-up while RPE of 17.57±1.91 after 30 minutes was significantly higher (P=0.009) than RPE of 15.79±1.63 at 15 minutes. Step count did not vary between the two 15-minute periods of play with a total of 2404±360 steps while energy expenditure over 30 minutes of play was 391.7±66 kcal. Recreational badminton match play can be categorized as vigorous intensity suggesting that it can be a viable means of achieving recommended physical activity and improving aerobic fitness.

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).

Time to Translate: Deciphering the Codon in the Classroom

ERIC Educational Resources Information Center

Firooznia, Fardad

2015-01-01

I describe and evaluate a fun and simple role-playing exercise that allows students to actively work through the process of translation. This exercise can easily be completed during a 50-minute class period, with time to review the steps and contemplate complications such as the effects of various types of mutations.

The association between daily steps and health, and the mediating role of body composition: a pedometer-based, cross-sectional study in an employed South African population.

PubMed

Pillay, Julian D; van der Ploeg, Hidde P; Kolbe-Alexander, Tracy L; Proper, Karin I; van Stralen, Maartje; Tomaz, Simone A; van Mechelen, Willem; Lambert, Estelle V

2015-02-22

Walking is recognized as an easily accessible mode of physical activity and is therefore supported as a strategy to promote health and well-being. To complement walking, pedometers have been identified as a useful tool for monitoring ambulatory physical activity, typically measuring total steps/day. There is, however, little information concerning dose-response for health outcomes in relation to intensity or duration of sustained steps. We aimed to examine this relationship, along with factors that mediate it, among employed adults. A convenience sample, recruited from work-site health risk screening (N = 312, 37 ± 9 yrs), wore a pedometer for at least three consecutive days. Steps were classified as "aerobic" (≥100 steps/minute and ≥10 consecutive minutes) or "non-aerobic" (<100 steps/minute and/or <10 consecutive minutes). The data were sub-grouped according to intensity-based categories i.e. "no aerobic activity", "low aerobic activity" (1-20 minutes/day of aerobic activity) and "high aerobic activity" (≥21 minutes/day of aerobic activity), with the latter used as a proxy for current PA guidelines (150-minutes of moderate-intensity PA per week). Health outcomes included blood pressure, body mass index, percentage body fat, waist circumference, blood cholesterol and blood glucose. Analysis of covariance, adjusting for age, gender and total steps/day were used to compare groups according to volume and intensity-based steps categories. A further analysis compared the mediation effect of body fat estimates (percentage body fat, body mass index and waist circumference) on the association between steps and health outcomes, independently. Average steps/day were 6,574 ± 3,541; total steps/day were inversely associated with most health outcomes in the expected direction (p < 0.05). The "no aerobic activity" group was significantly different from the "low aerobic activity" and "high aerobic activity" in percentage body fat and diastolic blood pressure only (P < 0.05). Percentage body fat emerged as the strongest mediator of the relationship between steps and outcomes, while body mass index showed the least mediation effect. The study provides a presentation of cross-sectional pedometer data that relate to a combination of intensity and volume-based steps/day and its relationship to current guidelines. The integration of volume, intensity and duration of ambulatory physical activity in pedometer-based messages is of emerging relevance.

Making a Computer Model of the Most Complex System Ever Built - Continuum

Science.gov Websites

Eastern Interconnection, all as a function of time. All told, that's about 1,000 gigabytes of data the modeling software steps forward in time, those decisions affect how the grid operates under Interconnection at five-minute intervals for one year would have required more than 400 days of computing time

Cosmic rays and other space phenomena dangerous for the Earth's civilization: Foundation of cosmic ray warning system and beginning steps

NASA Astrophysics Data System (ADS)

Lev, Dorman

2016-07-01

This report is an example how fundamental research in Cosmic Ray (CR) Astrophysics and Geophysics can be applied to very important modern practical problem: monitoring by CR space weather and prediction by using on-line CR data space phenomena dangerous for satellites electronics and astronauts health in the space, for crew and passengers health on commercial jets in atmosphere (altitude about 10 km and higher), and in some rare cases for technology and people health on the ground, prediction on the role of CR and other space weather factors in climate change and influence on agriculture production. It is well known that in periods of great SEP (Solar Energetic Particle) events, the fluxes can be so big that memory of computers and other electronics in space may be destroyed, satellites and spaceships became dead (each year Insurance Companies paid billions dollars for these failures (if will be event as February 23, 1956, will be destroyed about all satellites in few hours, the price of this will be more than 10-20 billion dollars, will be total destroying satellite communications and a rose a lot of other problems). In periods of great SEP events is necessary to switch off some part of electronics for short time to protect computer memories. These periods are also dangerous for astronauts on space-ships, and International Space Station (ISS), passengers and crew in commercial jets (especially during S5-S7 radiation storms). The problem is how to forecast exactly these dangerous phenomena. We show that exact forecast can be made by using high-energy particles (about 2-10 GeV/nucleon and higher) which transportation from the Sun is characterized by much bigger diffusion coefficient than for small and middle energy particles. Therefore high energy particles came from the Sun much more early (8-20 minutes after acceleration and escaping into solar wind) than main part of smaller energy particles caused dangerous situation for electronics and people health (about 60 and more minutes later). We describe here principles and experience of automatically working program "SEP-Start", supposed, developed and checked in the Emilio Segre' Observatory of Israel Cosmic Ray and Space Weather Center (Mt. Hermon, 2050 m above sea level, cut-off rigidity 10.8 GV). Using of this program on many CR stations and on satellites allowed determining automatically the beginning of SEP event. It is the First Step of our program. The Second Step is "SEP-Space" - transformation obtained at different altitudes and cutoff rigidities data on CR intensity to the space and calculation CR energy spectrum and angle distribution out of the Earth's atmosphere and magnetosphere, directly in the interplanetary space near the Earth. Before we made these complicated operations step by step on the basis of historical SEP events data during long time and determined flare energetic particle spectrum in the interplanetary space and its change with time by method of coupling functions (in scientific literature called as Dorman functions). Now we prepared algorithms and try to create program which will be made these calculations automatically after each new minute of CR data very quickly for time not more than few seconds. The Third Step "SEP-Inverse Problem" is based on theoretically solved by Lev Dorman about 15 years ago inverse problem and determine time of ejection energetic particles, source function and transport parameters in dependence from particle energy and distance from the Sun. Before we made corresponding calculations very long time, so obtained results cannot be practically used for forecasting. Now we prepared all algorithms and try to create program which will be made these calculations automatically after each new minute of CR data very quickly for time not more than few seconds. The Fourth Step "SEP-Forecasting" based on the theoretically solved direct problem and parameters founded in the Third Step and known coupling functions, we calculate time evolution of solar CR spectrum with time and expected total fluence (radiation hazards) in the interplanetary space for spaceships at different distances from the Sun in dependence of shielding, in the Earth's magnetosphere for satellites with different orbits, in the Earth's atmosphere for airplanes on different airlines in dependence of altitude and cutoff rigidities, and for ground at different air pressure and cutoff rigidities. Again, we checked all these mathematical procedures basing on real data of historical SEP events and it need so long time that it was not possible to use these results for forecasting of expected radiation hazards. Now we for this step also prepared all algorithms and try to create program which will be made these calculations automatically after each new minute of CR data very quickly for time not more than few seconds. To determine the quality of obtained results, after 5-10 minutes from beginning starts to work the final, Fives Step. The Fives Step "Checking of Forecasting Quality and Alerts" starts to work at 5-10 minutes after beginning. In this Step we compare expected (calculated in the Fourth Step by using coupling functions CR intensity for neutron monitors on different stations and on satellites) with observed. If the difference will be small enough (smaller than 10-20%) and the radiation hazards expected to be dangerous for spaceships in the interplanetary space, for some satellites in the Earth's magnetosphere, for airplanes on some airlines or for some objects on the ground, will be send corresponding Alerts with detail information on the expected radiation hazards calculated in the Fourth Step. After few minutes a new, more exact Alerts will be sent. More and more exact new Alerts will be repeated each few minutes during the dangerous event. Let us outline that Step 1 finished to work after determining the beginning of SEP event, but Steps 2 - 5 continued to work for each new minute. They will be finished to work only when the difference between consequences Alerts became much smaller than errors. In our report "Cosmic Rays and other Space Weather Effects Influenced on Satellites Operation, Technologies, Biosphere and People Health" it was shown that very important element of Space Weather, influenced on satellites operation, technologies, and people health are strong magnetic storms, accompanied usually by CR Forbush effects. We discuss here on the possibility to include in the "Cosmic Ray Warning System" possibility to forecast this phenomenon, also dangerous for the Earth's Civilization. In the report "Cosmic Rays and other Space Phenomena Influenced on the Earth's Climate" on this Conference it was shown that very big changes in climate, dangerous for the Earth's Civilization, are caused by interactions of Solar system with molecular-dust clouds (caused the Great Ice Periods during many thousand years). Very dangerous for the Earth's Civilization are also nearby supernova explosions with great influence on biosphere and climate. We show that by CR data in the frame of "Cosmic Ray Warning System" is possible to forecast for many years before starting these dangerous phenomena, so the Earth's Civilization will have enough time for preparing to the new type of life. For this forecasting we need to add to the "Cosmic Ray Warning System" in near future several CR stations for continue measuring CR with much higher energies (1013 - 1014 eV). We hope to organize the mostly automatic working "Cosmic Ray Warning System" in cooperation with Azerbaijan, Israel, and many CR stations in the World. The Project will be open for any country and organizations (ESA, NASA and so on) and will be start as soon as possible. In the first 3 - 5 years we hope that forecasting of radiation hazards will be made fully automatically as it was described in this report. In the next 5-10 years the Project will be expanded for forecasting dangerous magnetic storms (in this case we need to use also muon telescopes data), and then for forecasting of the Solar System collisions with molecular-dust clouds and forecasting of dangerous nearby Supernova explosions (in these two cases we need to add continue measurements on several stations CR with energies 10^13 - 10^14 eV).

Optimizing Fungal DNA Extraction Methods from Aerosol Filters

NASA Astrophysics Data System (ADS)

Jimenez, G.; Mescioglu, E.; Paytan, A.

2016-12-01

Fungi and fungal spores can be picked up from terrestrial ecosystems, transported long distances, and deposited into marine ecosystems. It is important to study dust-borne fungal communities, because they can stay viable and effect the ambient microbial populations, which are key players in biogeochemical cycles. One of the challenges of studying dust-borne fungal populations is that aerosol samples contain low biomass, making extracting good quality DNA very difficult. The aim of this project was to increase DNA yield by optimizing DNA extraction methods. We tested aerosol samples collected from Haifa, Israel (polycarbonate filter), Monterey Bay, CA (quartz filter) and Bermuda (quartz filter). Using the Qiagen DNeasy Plant Kit, we tested the effect of altering bead beating times and incubation times, adding three freeze and thaw steps, initially washing the filters with buffers for various lengths of time before using the kit, and adding a step with 30 minutes of sonication in 65C water. Adding three freeze/thaw steps, adding a sonication step, washing with a phosphate buffered saline overnight, and increasing incubation time to two hours, in that order, resulted in the highest increase in DNA for samples from Israel (polycarbonate). DNA yield of samples from Monterey (quart filter) increased about 5 times when washing with buffers overnight (phosphate buffered saline and potassium phophate buffer), adding a sonication step, and adding three freeze and thaw steps. Samples collected in Bermuda (quartz filter) had the highest increase in DNA yield from increasing incubation to 2 hours, increasing bead beating time to 6 minutes, and washing with buffers overnight (phosphate buffered saline and potassium phophate buffer). Our results show that DNA yield can be increased by altering various steps of the Qiagen DNeasy Plant Kit protocol, but different types of filters collected at different sites respond differently to alterations. These results can be used as preliminary results to continue developing fungi DNA extraction methods. Developing these methods will be important as dust storms are predicted to increase due to increased draughts and anthropogenic activity, and the fungal communities of these dust-storms are currently relatively understudied.

Applying the Principles of Lean Production to Gastrointestinal Biopsy Handling: From the Factory Floor to the Anatomic Pathology Laboratory.

PubMed

Sugianto, Jessica Z; Stewart, Brian; Ambruzs, Josephine M; Arista, Amanda; Park, Jason Y; Cope-Yokoyama, Sandy; Luu, Hung S

2015-01-01

To implement Lean principles to accommodate expanding volumes of gastrointestinal biopsies and to improve laboratory processes overall. Our continuous improvement (kaizen) project analyzed the current state for gastrointestinal biopsy handling using value-stream mapping for specimens obtained at a 487-bed tertiary care pediatric hospital in Dallas, Texas. We identified non-value-added time within the workflow process, from receipt of the specimen in the histology laboratory to the delivery of slides and paperwork to the pathologist. To eliminate non-value-added steps, we implemented the changes depicted in a revised-state value-stream map. Current-state value-stream mapping identified a total specimen processing time of 507 minutes, of which 358 minutes were non-value-added. This translated to a process cycle efficiency of 29%. Implementation of a revised-state value stream resulted in a total process time reduction to 238 minutes, of which 89 minutes were non-value-added, and an improved process cycle efficiency of 63%. Lean production principles of continuous improvement and waste elimination can be successfully implemented within the clinical laboratory.

Impact of temporal resolution of inputs on hydrological model performance: An analysis based on 2400 flood events

NASA Astrophysics Data System (ADS)

Ficchì, Andrea; Perrin, Charles; Andréassian, Vazken

2016-07-01

Hydro-climatic data at short time steps are considered essential to model the rainfall-runoff relationship, especially for short-duration hydrological events, typically flash floods. Also, using fine time step information may be beneficial when using or analysing model outputs at larger aggregated time scales. However, the actual gain in prediction efficiency using short time-step data is not well understood or quantified. In this paper, we investigate the extent to which the performance of hydrological modelling is improved by short time-step data, using a large set of 240 French catchments, for which 2400 flood events were selected. Six-minute rain gauge data were available and the GR4 rainfall-runoff model was run with precipitation inputs at eight different time steps ranging from 6 min to 1 day. Then model outputs were aggregated at seven different reference time scales ranging from sub-hourly to daily for a comparative evaluation of simulations at different target time steps. Three classes of model performance behaviour were found for the 240 test catchments: (i) significant improvement of performance with shorter time steps; (ii) performance insensitivity to the modelling time step; (iii) performance degradation as the time step becomes shorter. The differences between these groups were analysed based on a number of catchment and event characteristics. A statistical test highlighted the most influential explanatory variables for model performance evolution at different time steps, including flow auto-correlation, flood and storm duration, flood hydrograph peakedness, rainfall-runoff lag time and precipitation temporal variability.

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.

Running DNA Mini-Gels in 20 Minutes or Less Using Sodium Boric Acid Buffer

ERIC Educational Resources Information Center

Jenkins, Kristin P.; Bielec, Barbara

2006-01-01

Providing a biotechnology experience for students can be challenging on several levels, and time is a real constraint for many experiments. Many DNA based methods require a gel electrophoresis step, and although some biotechnology procedures have convenient break points, gel electrophoresis does not. In addition to the time required for loading…

Efficacy of Intravenous Mannitol in the Management of Orbital Compartment Syndrome: A Nonhuman Primate Model.

PubMed

Johnson, Davin; Winterborn, Andrew; Kratky, Vladimir

2016-01-01

To report the efficacy of intravenous mannitol in the treatment of orbital compartment syndrome. An experimental study was conducted on 4 nonhuman primates (8 orbits). Orbital compartment syndrome was simulated by injecting autologous blood into both orbits of each nonhuman primate until a pressure of 80 mm Hg was reached (time 0). After 10 minutes, nonhuman primates were randomized to receive an infusion of either mannitol or saline, given over 15 minutes. Five minutes after the infusion was complete, lateral canthotomy and cantholysis was performed on both orbits in isolated steps every 5 minutes. During the study protocol, orbital and intraocular pressures were recorded every 5 minutes, with a final set of measurements at 60 minutes. The primary outcome measures were the mean change in pressure from time 0 to 60 minutes, as well as the mean change in pressure during the infusion period. There was no statistically significant difference in the mean changes in orbital or intraocular pressure from time 0 to 60 minutes of the protocol. However, during the infusion period there was significantly greater decrease in both orbital and intraocular pressure in the mannitol compared with saline group (-34.0 vs. -9.3 mm Hg for orbital pressure [p = 0.03]; -34.8 vs. -9.7 mm Hg for intraocular pressure [p = 0.04]). While the definitive treatment of orbital compartment syndrome is lateral canthotomy and cantholysis, mannitol results in a rapid and clinically meaningful drop in orbital and intraocular pressure. The authors believe that their data support the routine use of mannitol in orbital compartment syndrome, especially when there is a delay in timely surgical management.

Human-in-the-loop Bayesian optimization of wearable device parameters

PubMed Central

Malcolm, Philippe; Speeckaert, Jozefien; Siviy, Christoper J.; Walsh, Conor J.; Kuindersma, Scott

2017-01-01

The increasing capabilities of exoskeletons and powered prosthetics for walking assistance have paved the way for more sophisticated and individualized control strategies. In response to this opportunity, recent work on human-in-the-loop optimization has considered the problem of automatically tuning control parameters based on realtime physiological measurements. However, the common use of metabolic cost as a performance metric creates significant experimental challenges due to its long measurement times and low signal-to-noise ratio. We evaluate the use of Bayesian optimization—a family of sample-efficient, noise-tolerant, and global optimization methods—for quickly identifying near-optimal control parameters. To manage experimental complexity and provide comparisons against related work, we consider the task of minimizing metabolic cost by optimizing walking step frequencies in unaided human subjects. Compared to an existing approach based on gradient descent, Bayesian optimization identified a near-optimal step frequency with a faster time to convergence (12 minutes, p < 0.01), smaller inter-subject variability in convergence time (± 2 minutes, p < 0.01), and lower overall energy expenditure (p < 0.01). PMID:28926613

First steps towards the development of regional magnetic indices designed for South America

NASA Astrophysics Data System (ADS)

Denardini, Clezio Marcos; Moro, Juliano; Araujo Resende, Laysa Cristina; Chen, Sony Su

In the present paper we present the first steps towards the development of regional magnetic indices designed for South America, based on data collected by the EMBRACE Magnetometer Network, which so far is planned to cover most of the Easter Southern American longitudinal sector. Thereafter, we provide details of the development of the region K, named Ksa (K South America), and of the proxy for the Dst Index, obtained in near real-time (1 minute cadence with 5 minutes latency). We also compare the evolution of our indices with the evolution of the Kp and Dst index during geomagnetic storms occurred in 2012 and 2013. We will show some similarities representing the accuracy of our measurements and some dissimilarity that may be attributed the presence of the South American Magnetic Anomaly (SAMA). This, in turn, may reflect in the global models that use such indices for disturbance time estimates during different solar cycles. Contacting Author: C. M. Denardini (clezio.denardin@inpe.br)

Are Active Australia physical activity questions valid for older adults?

PubMed

Heesch, Kristiann C; Hill, Robert L; van Uffelen, Jannique G Z; Brown, Wendy J

2011-05-01

The Active Australia Survey (AAS) is used for physical activity (PA) surveillance in the general Australian adult population, but its validity in older adults has not been evaluated. Our aim was to examine the convergent validity of the AAS questions in older adults. The AAS was validated against pedometer step counts as an objective measure of PA, self-reported physical function, and a step-test to assess cardiorespiratory fitness. Participants were community-dwelling adults, aged 65-89 y, with the ability to walk 100 m. They completed a self-administered AAS and the step-test in one interview. One week earlier, they completed the Short Form-36 physical function subscale. Between these two interviews, they each wore a YAMAX Digiwalker SW200 pedometer and recorded daily steps. Using the AAS data, daily walking minutes and total PA minutes (walking, moderate-intensity PA and vigorous-intensity PA) were compared with the validity measures using Spearman rank-order correlations. Fifty-three adults completed the study. Median daily walking minutes were 34.2 (interquartile range [IQR] 17.1, 60.0), and median daily total PA minutes were 68.6 (IQR 31.4, 113.6). Walking and total PA minutes were both moderately correlated with pedometer steps (Spearman correlation r=0.42, p=0.003, for each) but not with step-test seconds to completion (r=-0.11, p=0.44; r=-0.25, p=0.08, respectively). Total PA minutes were significantly correlated with physical function scores (r=0.39, p=0.004), but walking minutes were not (r=0.15, p=0.29). This initial examination of the psychometric properties of the AAS for older adults suggests that this surveillance tool has acceptable convergent validity for ambulatory, community-dwelling older adults. Copyright © 2010 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

How many steps/day are enough? For adults.

PubMed

Tudor-Locke, Catrine; Craig, Cora L; Brown, Wendy J; Clemes, Stacy A; De Cocker, Katrien; Giles-Corti, Billie; Hatano, Yoshiro; Inoue, Shigeru; Matsudo, Sandra M; Mutrie, Nanette; Oppert, Jean-Michel; Rowe, David A; Schmidt, Michael D; Schofield, Grant M; Spence, John C; Teixeira, Pedro J; Tully, Mark A; Blair, Steven N

2011-07-28

Physical activity guidelines from around the world are typically expressed in terms of frequency, duration, and intensity parameters. Objective monitoring using pedometers and accelerometers offers a new opportunity to measure and communicate physical activity in terms of steps/day. Various step-based versions or translations of physical activity guidelines are emerging, reflecting public interest in such guidance. However, there appears to be a wide discrepancy in the exact values that are being communicated. It makes sense that step-based recommendations should be harmonious with existing evidence-based public health guidelines that recognize that "some physical activity is better than none" while maintaining a focus on time spent in moderate-to-vigorous physical activity (MVPA). Thus, the purpose of this review was to update our existing knowledge of "How many steps/day are enough?", and to inform step-based recommendations consistent with current physical activity guidelines. Normative data indicate that healthy adults typically take between 4,000 and 18,000 steps/day, and that 10,000 steps/day is reasonable for this population, although there are notable "low active populations." Interventions demonstrate incremental increases on the order of 2,000-2,500 steps/day. The results of seven different controlled studies demonstrate that there is a strong relationship between cadence and intensity. Further, despite some inter-individual variation, 100 steps/minute represents a reasonable floor value indicative of moderate intensity walking. Multiplying this cadence by 30 minutes (i.e., typical of a daily recommendation) produces a minimum of 3,000 steps that is best used as a heuristic (i.e., guiding) value, but these steps must be taken over and above habitual activity levels to be a true expression of free-living steps/day that also includes recommendations for minimal amounts of time in MVPA. Computed steps/day translations of time in MVPA that also include estimates of habitual activity levels equate to 7,100 to 11,000 steps/day. A direct estimate of minimal amounts of MVPA accumulated in the course of objectively monitored free-living behaviour is 7,000-8,000 steps/day. A scale that spans a wide range of incremental increases in steps/day and is congruent with public health recognition that "some physical activity is better than none," yet still incorporates step-based translations of recommended amounts of time in MVPA may be useful in research and practice. The full range of users (researchers to practitioners to the general public) of objective monitoring instruments that provide step-based outputs require good reference data and evidence-based recommendations to be able to design effective health messages congruent with public health physical activity guidelines, guide behaviour change, and ultimately measure, track, and interpret steps/day.

How many steps/day are enough? for adults

PubMed Central

2011-01-01

Physical activity guidelines from around the world are typically expressed in terms of frequency, duration, and intensity parameters. Objective monitoring using pedometers and accelerometers offers a new opportunity to measure and communicate physical activity in terms of steps/day. Various step-based versions or translations of physical activity guidelines are emerging, reflecting public interest in such guidance. However, there appears to be a wide discrepancy in the exact values that are being communicated. It makes sense that step-based recommendations should be harmonious with existing evidence-based public health guidelines that recognize that "some physical activity is better than none" while maintaining a focus on time spent in moderate-to-vigorous physical activity (MVPA). Thus, the purpose of this review was to update our existing knowledge of "How many steps/day are enough?", and to inform step-based recommendations consistent with current physical activity guidelines. Normative data indicate that healthy adults typically take between 4,000 and 18,000 steps/day, and that 10,000 steps/day is reasonable for this population, although there are notable "low active populations." Interventions demonstrate incremental increases on the order of 2,000-2,500 steps/day. The results of seven different controlled studies demonstrate that there is a strong relationship between cadence and intensity. Further, despite some inter-individual variation, 100 steps/minute represents a reasonable floor value indicative of moderate intensity walking. Multiplying this cadence by 30 minutes (i.e., typical of a daily recommendation) produces a minimum of 3,000 steps that is best used as a heuristic (i.e., guiding) value, but these steps must be taken over and above habitual activity levels to be a true expression of free-living steps/day that also includes recommendations for minimal amounts of time in MVPA. Computed steps/day translations of time in MVPA that also include estimates of habitual activity levels equate to 7,100 to 11,000 steps/day. A direct estimate of minimal amounts of MVPA accumulated in the course of objectively monitored free-living behaviour is 7,000-8,000 steps/day. A scale that spans a wide range of incremental increases in steps/day and is congruent with public health recognition that "some physical activity is better than none," yet still incorporates step-based translations of recommended amounts of time in MVPA may be useful in research and practice. The full range of users (researchers to practitioners to the general public) of objective monitoring instruments that provide step-based outputs require good reference data and evidence-based recommendations to be able to design effective health messages congruent with public health physical activity guidelines, guide behaviour change, and ultimately measure, track, and interpret steps/day. PMID:21798015

[Effects of modified three-step procedure for anatrophic nephrolithotomy in the treatment of complex staghorn renal calculi].

PubMed

Yang, C L; Wang, W; Zhou, W E; Xue, Y P; Wang, B Q; Nie, H B; Hu, W L

2017-10-01

Objective: To investigate the effects of modified three-step procedure for anatrophic nephrolithotomy in the treatment of complex staghorn renal calculi. Methods: A total of 22 patients with complex staghorn renal calculi between June 2013 and June 2016 at Department of Urology in Guangzhou General Hospital of Guangzhou Military Command were retrospective analyzed. There were 13 males and 9 females, ranging from 35 to 62 years old with mean age of 47 years. There were 17 patients with dull pain, and 5 patients who were found through physical examinations. Kidney calculi located in left kidney in 15 patients, right kidney in 7 patients. All patients were treated with modified three-step procedure for anatrophic nephrolithotomy. The operation time, blood loss, time of intraoperative renal ischemia, and postoperative complications were recorded. Serum creatinine (Scr), blood urea nitrogen(BUN), β(2)-microglobulin(β(2)-MG), diseased side glomerular filtration rate(GFR) , and renal cortical thickness of the diseased kidney in preoperative and postoperative were compared. The clinical data were compared by paired sample t test between pre-operation and post-operation. Results: The calculi were completely removed in 22 patients, the mean operation time was 84 minutes (50 to 126 minutes), the mean time of intraoperative renal ischemia was 31 minutes (20 to 56 minutes), the mean blood loss was 246 ml (150 to 360 ml). There were no secondary bleeding or urinary fistula happened, the perinephric drainage tub was removed in 3 to 7 days postoperative, the mean hospitalization time was 7 days.Compared with the preoperative, the Scr ((172.7±21.3)μmol/L vs . (146.4±22.8)μmol/L, t =7.197, P =0.000), BUN ((9.2±1.8)mmol/L vs . (8.0±0.5)mmol/L, t =3.798, P =0.001) and β(2)-MG ((203.0±32.0)μg/L vs . (175.6±23.8)μg/L, t =5.009, P =0.000) in postoperative decreased, the diseased side GFR increased ((28.6±4.0) ml/min(31.8±3.3) ml/min, t =-3.521, P =0.002). There were no significant difference of diseased renal cortical thickness between preoperative and postoperative( t =-1.323, P =0.200). There were 12 patients with postoperative pain, 2 patients with vomiting, 3 patients with fever, and 2 patients with wound infection. The follow-up time was 6 months, no residual stones in 22 patients. Conclusion: The modified three-step procedure for anatrophic nephrolithotomy has high stone free rates with less effects on renal function and fewer complications, the method could be widely applied.

GPS or travel diary: Comparing spatial and temporal characteristics of visits to fast food restaurants and supermarkets

PubMed Central

Vernez Moudon, Anne; Hurvitz, Philip M.; Aggarwal, Anju; Drewnowski, Adam

2017-01-01

To assess differences between GPS and self-reported measures of location, we examined visits to fast food restaurants and supermarkets using a spatiotemporal framework. Data came from 446 participants who responded to a survey, filled out travel diaries of places visited, and wore a GPS receiver for seven consecutive days. Provided by Public Health Seattle King County, addresses from food permit data were matched to King County tax assessor parcels in a GIS. A three-step process was used to verify travel-diary reported visits using GPS records: (1) GPS records were temporally matched if their timestamps were within the time window created by the arrival and departure times reported in the travel diary; (2) the temporally matched GPS records were then spatially matched if they were located in a food establishment parcel of the same type reported in the diary; (3) the travel diary visit was then GPS-sensed if the name of food establishment in the parcel matched the one reported in the travel diary. To account for errors in reporting arrival and departure times, GPS records were temporally matched to three time windows: the exact time, +/- 10 minutes, and +/- 30 minutes. One third of the participants reported 273 visits to fast food restaurants; 88% reported 1,102 visits to supermarkets. Of these, 77.3 percent of the fast food and 78.6 percent supermarket visits were GPS-sensed using the +/-10-minute time window. At this time window, the mean travel-diary reported fast food visit duration was 14.5 minutes (SD 20.2), 1.7 minutes longer than the GPS-sensed visit. For supermarkets, the reported visit duration was 23.7 minutes (SD 18.9), 3.4 minutes longer than the GPS-sensed visit. Travel diaries provide reasonably accurate information on the locations and brand names of fast food restaurants and supermarkets participants report visiting. PMID:28388619

GPS or travel diary: Comparing spatial and temporal characteristics of visits to fast food restaurants and supermarkets.

PubMed

Scully, Jason Y; Vernez Moudon, Anne; Hurvitz, Philip M; Aggarwal, Anju; Drewnowski, Adam

2017-01-01

To assess differences between GPS and self-reported measures of location, we examined visits to fast food restaurants and supermarkets using a spatiotemporal framework. Data came from 446 participants who responded to a survey, filled out travel diaries of places visited, and wore a GPS receiver for seven consecutive days. Provided by Public Health Seattle King County, addresses from food permit data were matched to King County tax assessor parcels in a GIS. A three-step process was used to verify travel-diary reported visits using GPS records: (1) GPS records were temporally matched if their timestamps were within the time window created by the arrival and departure times reported in the travel diary; (2) the temporally matched GPS records were then spatially matched if they were located in a food establishment parcel of the same type reported in the diary; (3) the travel diary visit was then GPS-sensed if the name of food establishment in the parcel matched the one reported in the travel diary. To account for errors in reporting arrival and departure times, GPS records were temporally matched to three time windows: the exact time, +/- 10 minutes, and +/- 30 minutes. One third of the participants reported 273 visits to fast food restaurants; 88% reported 1,102 visits to supermarkets. Of these, 77.3 percent of the fast food and 78.6 percent supermarket visits were GPS-sensed using the +/-10-minute time window. At this time window, the mean travel-diary reported fast food visit duration was 14.5 minutes (SD 20.2), 1.7 minutes longer than the GPS-sensed visit. For supermarkets, the reported visit duration was 23.7 minutes (SD 18.9), 3.4 minutes longer than the GPS-sensed visit. Travel diaries provide reasonably accurate information on the locations and brand names of fast food restaurants and supermarkets participants report visiting.

A Four-Feet Walking-Type Rotary Piezoelectric Actuator with Minute Step Motion.

PubMed

Liu, Yingxiang; Wang, Yun; Liu, Junkao; Xu, Dongmei; Li, Kai; Shan, Xiaobiao; Deng, Jie

2018-05-08

A four-feet walking-type rotary piezoelectric actuator with minute step motion was proposed. The proposed actuator used the rectangular motions of four driving feet to push the rotor step-by-step; this operating principle was different with the previous non-resonant actuators using direct-driving, inertial-driving, and inchworm-type mechanisms. The mechanism of the proposed actuator was discussed in detail. Transient analyses were accomplished by ANSYS software to simulate the motion trajectory of the driving foot and to find the response characteristics. A prototype was manufactured to verify the mechanism and to test the mechanical characteristics. A minimum resolution of 0.095 μrad and a maximum torque of 49 N·mm were achieved by the prototype, and the output speed was varied by changing the driving voltage and working frequency. This work provides a new mechanism for the design of a rotary piezoelectric actuator with minute step motion.

A Four-Feet Walking-Type Rotary Piezoelectric Actuator with Minute Step Motion

PubMed Central

Wang, Yun; Liu, Junkao; Xu, Dongmei; Li, Kai; Shan, Xiaobiao; Deng, Jie

2018-01-01

A four-feet walking-type rotary piezoelectric actuator with minute step motion was proposed. The proposed actuator used the rectangular motions of four driving feet to push the rotor step-by-step; this operating principle was different with the previous non-resonant actuators using direct-driving, inertial-driving, and inchworm-type mechanisms. The mechanism of the proposed actuator was discussed in detail. Transient analyses were accomplished by ANSYS software to simulate the motion trajectory of the driving foot and to find the response characteristics. A prototype was manufactured to verify the mechanism and to test the mechanical characteristics. A minimum resolution of 0.095 μrad and a maximum torque of 49 N·mm were achieved by the prototype, and the output speed was varied by changing the driving voltage and working frequency. This work provides a new mechanism for the design of a rotary piezoelectric actuator with minute step motion. PMID:29738495

Development and validation of trauma surgical skills metrics: Preliminary assessment of performance after training.

PubMed

Shackelford, Stacy; Garofalo, Evan; Shalin, Valerie; Pugh, Kristy; Chen, Hegang; Pasley, Jason; Sarani, Babak; Henry, Sharon; Bowyer, Mark; Mackenzie, Colin F

2015-07-01

Maintaining trauma-specific surgical skills is an ongoing challenge for surgical training programs. An objective assessment of surgical skills is needed. We hypothesized that a validated surgical performance assessment tool could detect differences following a training intervention. We developed surgical performance assessment metrics based on discussion with expert trauma surgeons, video review of 10 experts and 10 novice surgeons performing three vascular exposure procedures and lower extremity fasciotomy on cadavers, and validated the metrics with interrater reliability testing by five reviewers blinded to level of expertise and a consensus conference. We tested these performance metrics in 12 surgical residents (Year 3-7) before and 2 weeks after vascular exposure skills training in the Advanced Surgical Skills for Exposure in Trauma (ASSET) course. Performance was assessed in three areas as follows: knowledge (anatomic, management), procedure steps, and technical skills. Time to completion of procedures was recorded, and these metrics were combined into a single performance score, the Trauma Readiness Index (TRI). Wilcoxon matched-pairs signed-ranks test compared pretraining/posttraining effects. Mean time to complete procedures decreased by 4.3 minutes (from 13.4 minutes to 9.1 minutes). The performance component most improved by the 1-day skills training was procedure steps, completion of which increased by 21%. Technical skill scores improved by 12%. Overall knowledge improved by 3%, with 18% improvement in anatomic knowledge. TRI increased significantly from 50% to 64% with ASSET training. Interrater reliability of the surgical performance assessment metrics was validated with single intraclass correlation coefficient of 0.7 to 0.98. A trauma-relevant surgical performance assessment detected improvements in specific procedure steps and anatomic knowledge taught during a 1-day course, quantified by the TRI. ASSET training reduced time to complete vascular control by one third. Future applications include assessing specific skills in a larger surgeon cohort, assessing military surgical readiness, and quantifying skill degradation with time since training.

Applying Lean/Toyota production system principles to improve phlebotomy patient satisfaction and workflow.

PubMed

Melanson, Stacy E F; Goonan, Ellen M; Lobo, Margaret M; Baum, Jonathan M; Paredes, José D; Santos, Katherine S; Gustafson, Michael L; Tanasijevic, Milenko J

2009-12-01

Our goals were to improve the overall patient experience and optimize the blood collection process in outpatient phlebotomy using Lean principles. Elimination of non-value-added steps and modifications to operational processes resulted in increased capacity to handle workload during peak times without adding staff. The result was a reduction of average patient wait time from 21 to 5 minutes, with the goal of drawing blood samples within 10 minutes of arrival at the phlebotomy station met for 90% of patients. In addition, patient satisfaction increased noticeably as assessed by a 5-question survey. The results have been sustained for 10 months with staff continuing to make process improvements.

Objectively Measured Patterns of Activities of Different Intensity Categories and Steps Taken Among Working Adults in a Multi-ethnic Asian Population.

PubMed

Müller-Riemenschneider, Falk; Ng, Sheryl Hui Xian; Koh, David; Chu, Anne Hin Yee

2016-06-01

To objectively assess sedentary behavior (SB), light- and moderate-to-vigorous intensity physical activity (MVPA), and steps among Singaporean office-based workers across days of the week. A convenience sample of office-based employees of a public University was recruited. Time spent for SB, light-, and MVPA using different validated accelerometry counts per minute (CPM), and step count were determined. Depending on applied CPM for SB (less than 100, less than 150 and less than 200 CPM), 107 working adults spent between 69.2% and 76.4% of their daily wakeful time in SB. Time spent in SB and MVPA were higher on weekdays than weekends. The hourly analysis highlights patterns of greater SB during usual working hours on weekdays but not on weekends. SB at work contributes greatly toward total daily sitting time. Low PA levels and high SB levels were found on weekends.

Elementary ELA/Social Studies Integration: Challenges and Limitations

ERIC Educational Resources Information Center

Heafner, Tina L.

2018-01-01

Adding instructional time and holding teachers accountable for teaching social studies are touted as practical, logical steps toward reforming the age-old tradition of marginalization. This qualitative case study of an urban elementary school, examines how nine teachers and one administrator enacted district reforms that added 45 minutes to the…

Initial polishing time affects gloss retention in resin composites.

PubMed

Waheeb, Nehal; Silikas, Nick; Watts, David

2012-10-01

To determine the effect of finishing and polishing time on the surface gloss of various resin-composites before and after simulated toothbrushing. Eight representative resin-composites (Ceram X mono, Ceram X duo, Tetric EvoCeram, Venus Diamond, EsteliteSigma Quick, Esthet.X HD, Filtek Supreme XT and Spectrum TPH) were used to prepare 80 disc-shaped (12 mm x 2 mm) specimens. The two step system Venus Supra was used for polishing the specimens for 3 minutes (Group A) and 10 minutes (Group B). All specimens were subjected to 16,000 cycles of simulated toothbrushing. The surface gloss was measured after polishing and after brushing using the gloss meter. Results were evaluated using one way ANOVA, two ways ANOVA and Dennett's post hoc test (P = 0.05). Group B (10-minute polishing) resulted in higher gloss values (GV) for all specimens compared to Group A (3 minutes). Also Group B showed better gloss retention compared to Group A after simulated toothbrushing. In each group, there was a significant difference between the polished composite resins (P < 0.05). For all specimens there was a decrease in gloss after the simulated toothbrushing.

Does pedometer goal setting improve physical activity among Native elders? Results from a randomized pilot study.

PubMed

Sawchuk, Craig N; Russo, Joan E; Charles, Steve; Goldberg, Jack; Forquera, Ralph; Roy-Byrne, Peter; Buchwald, Dedra

2011-01-01

We examined if step-count goal setting resulted in increases in physical activity and walking compared to only monitoring step counts with pedometers among American Indian/Alaska Native elders. Outcomes included step counts, self-reported physical activity and well-being, and performance on the 6-minute walk test. Although no significant between-group differences were found, within-group analyses indicated that elders significantly improved on the majority of step count, physical activity, health-related quality of life, and 6-minute walk outcomes.

Is Virtual Surgical Planning in Orthognathic Surgery Faster Than Conventional Planning? A Time and Workflow Analysis of an Office-Based Workflow for Single- and Double-Jaw Surgery.

PubMed

Steinhuber, Thomas; Brunold, Silvia; Gärtner, Catherina; Offermanns, Vincent; Ulmer, Hanno; Ploder, Oliver

2018-02-01

The purpose of this study was to measure and compare the working time for virtual surgical planning (VSP) in orthognathic surgery in a largely office-based workflow in comparison with conventional surgical planning (CSP) regarding the type of surgery, staff involved, and working location. This prospective cohort study included patients treated with orthognathic surgery from May to December 2016. For each patient, both CSP with manual splint fabrication and VSP with fabrication of computer-aided design-computer-aided manufacturing splints were performed. The predictor variables were planning method (CSP or VSP) and type of surgery (single or double jaw), and the outcome was time. Descriptive and analytic statistics, including analysis of variance for repeated measures, were computed. The sample was composed of 40 patients (25 female and 15 male patients; mean age, 24.6 years) treated with single-jaw surgery (n = 18) or double-jaw surgery (n = 22). The mean times for planning single-jaw surgery were 145.5 ± 11.5 minutes for CSP and 109.3 ± 10.8 minutes for VSP, and those for planning double-jaw surgery were 224.1 ± 11.2 minutes and 149.6 ± 15.3 minutes, respectively. Besides the expected result that the working time was shorter for single-versus double-jaw surgery (P < .001), it was shown that VSP shortened the working time significantly versus CSP (P < .001). The reduction of time through VSP was relatively stronger for double-jaw surgery (P < .001 for interaction). All differences between CSP and VSP regarding profession (except for the surgeon's time investment) and location were statistically significant (P < .01). The surgeon's time to plan single-jaw surgery was 37.0 minutes for CSP and 41.2 minutes for VSP; for double-jaw surgery, it was 53.8 minutes and 53.6 minutes, respectively. Office-based VSP for orthognathic surgery was significantly faster for single- and double-jaw surgery. The time investment of the surgeon was equal for both methods, and all other steps of the workflow differed significantly compared with CSP. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Variations in automatically recorded rumination time as explained by variations in intake of dietary fractions and milk production, and between-cow variation.

PubMed

Byskov, M V; Nadeau, E; Johansson, B E O; Nørgaard, P

2015-06-01

Individual recording of rumination time (RT) is now possible in commercial dairy herds, through development of a microphone-based sensor, which is able to record RT by the sound of rumination activity. The objectives of this study were to examine the relationship between daily RT and intakes of different dietary fractions, the relationship between RT in minutes per kilogram of dry matter intake (DMI) and milk production, and to examine the variation in RT within and between mid-lactating dairy cows. Data from 3 production trials were used in which a total of 27 different diets were fed. The data contained 761, 290, and 203 daily recordings of RT, milk yield, milk components, DMI, and intake of dietary fractions recorded on 29, 26, and 24 Holstein and Swedish Red cows from trials 1, 2, and 3, respectively. The dietary fractions included forage neutral detergent fiber (NDF), concentrate NDF, crude protein, sugar, starch, and the remaining fraction represented by organic matter--(forage NDF+concentrate NDF+crude protein+sugar+starch). The relationship between the dietary fractions and RT was analyzed in 2 steps. In step 1, the dietary fractions, which were significantly related to RT, were selected and simultaneously checked for multicollinearity between the dietary components; in step 2, a multivariate model, including the effect of repeated measurements, the main effect of the selected dietary fractions from step 1, random effects of cow(trial) and trial, and information on breed, days in milk, and parity was used to analyze the relationship between RT and the selected dietary fractions. Relationships between RT in minutes per kilogram of DMI and milk yield and milk components were analyzed, using the same multivariate model as in step 2. Approximately 32% of the variation in daily RT could be explained by variations in intakes of the dietary fractions, whereas 48% of the total variation in RT was accounted for by individual variations between cows. Intakes of forage NDF and starch were positively related to daily RT, whereas intakes of sugar and the remaining fraction were negatively related to daily RT. Rumination time in minutes per kilogram of DMI was negatively related to milk yield and protein percentage, but positively related to milk fat percentage. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Exercise and the cardiac patient-success is just steps away.

PubMed

Coke, Lola A; Fletcher, Gerald F

2010-01-01

Physical activity is an essential lifestyle intervention for the patient with existing cardiovascular disease. National guidelines describe the importance of and define the minimal doses of daily physical activity including walking 10,000 steps a day (equivalent to 5 miles) or performing 30 minutes of moderate-intensity aerobic activity most days of the week in 10- to 15-minute bouts. However, cardiac patients are often fearful that increasing physical activity would be detrimental and cause chest pain or myocardial infarction. Research has shown that cardiac patients can perform a walking program safely. Patient education; development of a realistic plan; measurement of the frequency, intensity, duration, and type of physical activity attained; and consistent follow-up over time are key strategies. This article provides important information for healthcare providers to plan a safe and efficacious walking plan to increase physical activity in the cardiac patient.

The immediate effects of a novel auditory and proprioceptive training device on gait after stroke.

PubMed

Johnson, Eric G; Lohman, Everett B; Rendon, Abel; Dobariya, Ektaben G; Ramani, Shubhada S; Mayer, Lissie E

2011-07-01

This case report describes the immediate effects of a new rehabilitation tool on gait in a chronic stroke patient. Specifically, we measured step length symmetry and gait velocity in a 47 year-old male stroke patient who was currently receiving outpatient physical therapy. Objective gait measurements were taken using the GAITRite before, during, and after a 5 minute training session. Step length symmetry improved 26% during the first minute of training, 71% by the fifth minute of training, and 72% after a 5 minute rest period post-training. Gait velocity increased by 5.5% after 5 minutes of training. Clinical research is warranted to validate this new training tool as a useful adjunctive rehabilitation activity for improving spatial and temporal aspects of gait after stroke.

Effect of Variations in IRU Integration Time Interval On Accuracy of Aqua Attitude Estimation

NASA Technical Reports Server (NTRS)

Natanson, G. A.; Tracewell, Dave

2003-01-01

During Aqua launch support, attitude analysts noticed several anomalies in Onboard Computer (OBC) rates and in rates computed by the ground Attitude Determination System (ADS). These included: 1) periodic jumps in the OBC pitch rate every 2 minutes; 2) spikes in ADS pitch rate every 4 minutes; 3) close agreement between pitch rates computed by ADS and those derived from telemetered OBC quaternions (in contrast to the step-wise pattern observed for telemetered OBC rates); 4) spikes of +/- 10 milliseconds in telemetered IRU integration time every 4 minutes (despite the fact that telemetered time tags of any two sequential IRU measurements were always 1 second apart from each other). An analysis presented in the paper explains this anomalous behavior by a small average offset of about 0.5 +/- 0.05 microsec in the time interval between two sequential accumulated angle measurements. It is shown that errors in the estimated pitch angle due to neglecting the aforementioned variations in the integration time interval by the OBC is within +/- 2 arcseconds. Ground attitude solutions are found to be accurate enough to see the effect of the variations on the accuracy of the estimated pitch angle.

How To Dance through Time. Volume II: Dances of the Ragtime Era, 1910-1920. [Videotape].

ERIC Educational Resources Information Center

Teten, Carol

This 59-minute VHS videotape is the second in a series of "How To Dance Through Time" videos. It provides 44 step combinations and how-to instructions to help viewers learn to dance the most popular dances of the early 20th century (the ragtime era), including: the wild animal dances (fox trot, horse trot, kangaroo hop, duck waddle, squirrel,…

Associations between physical activity and mental health among bariatric surgical candidates

PubMed Central

King, Wendy C.; Kalarchian, Melissa A.; Steffen, Kristine J.; Wolfe, Bruce M.; Elder, Katherine A.; Mitchell, James E.

2013-01-01

Objective This study aimed to examine associations between physical activity (PA) and mental health among adults undergoing bariatric surgery. Methods Cross sectional analysis was conducted on pre-operative data of 850 adults with ≥ class 2 obesity. PA was measured with a step activity monitor; mean daily steps, active minutes, and high-cadence minutes (proxy for moderate-vigorous intensity PA) were determined. Mental health functioning, depressive symptoms and treatment for depression or anxiety were measured with the Medical Outcomes Study 36-item Short Form, Beck Depression Inventory, and a study-specific questionnaire, respectively. Logistic regression analyses tested associations between PA and mental health indicators, controlling for potential confounders. Receiver operative characteristic analysis determined PA thresholds that best differentiated odds of each mental health indicator. Results Each PA parameter was significantly (P<.05) associated with a decreased odds of depressive symptoms and/or treatment for depression or anxiety, but not with impaired mental health functioning. After controlling for sociodemographics and physical health, only associations with treatment for depression and anxiety remained statistically significant. PA thresholds that best differentiated those who had vs. had not recently received treatment for depression or anxiety were <191 active minutes/day, <4750 steps/day, and <8 high-cadence minutes/day. Utilizing high-cadence minutes, compared to active minutes or steps, yielded the highest classification accuracy. Conclusion Adults undergoing bariatric surgery who meet relatively low thresholds of PA (e.g., ≥ 8 high-cadence minutes/day, representative of approximately one hour/week of moderate-vigorous intensity PA) are less likely to have recently received treatment for depression or anxiety compared to less active counterparts. PMID:23332532

Reducing Office Workers' Sitting Time at Work Using Sit-Stand Protocols: Results From a Pilot Randomized Controlled Trial.

PubMed

Li, Ingrid; Mackey, Martin G; Foley, Bridget; Pappas, Evangelos; Edwards, Kate; Chau, Josephine Y; Engelen, Lina; Voukelatos, Alexander; Whelan, Anna; Bauman, Adrian; Winkler, Elisabeth; Stamatakis, Emmanuel

2017-06-01

To examine the effects of different sit-stand protocols on work-time sitting and physical activity (PA) of office workers. Participants (n = 26, 77% women, mean age 42) were randomly allocated to usual sitting (control) or one of three sit-stand protocols (intervention) facilitated by height-adjustable workstations for a 4-week period between June and August 2015. Sitting, standing, and stepping time were assessed by inclinometry (activPAL); leisure-time physical activity (LTPA) by self-report. One-way analysis of covariance (ANCOVA) and post-hoc (Bonferroni) tests explored between-group differences. Compared with baseline, intervention groups reduced work sitting time by 113 minutes/8-hour workday (95% confidence interval [CI] [-147,-79]) and increased work standing time by 96 minutes/8-hour workday (95% CI [67,125]) without significantly impacting LTPA/sleep time. Sit-stand protocols facilitated by height-adjustable workstations appear to reduce office workers' sitting time without significant adverse effects on LTPA.

Benchmarking, benchmarks, or best practices? Applying quality improvement principles to decrease surgical turnaround time.

PubMed

Mitchell, L

1996-01-01

The processes of benchmarking, benchmark data comparative analysis, and study of best practices are distinctly different. The study of best practices is explained with an example based on the Arthur Andersen & Co. 1992 "Study of Best Practices in Ambulatory Surgery". The results of a national best practices study in ambulatory surgery were used to provide our quality improvement team with the goal of improving the turnaround time between surgical cases. The team used a seven-step quality improvement problem-solving process to improve the surgical turnaround time. The national benchmark for turnaround times between surgical cases in 1992 was 13.5 minutes. The initial turnaround time at St. Joseph's Medical Center was 19.9 minutes. After the team implemented solutions, the time was reduced to an average of 16.3 minutes, an 18% improvement. Cost-benefit analysis showed a potential enhanced revenue of approximately $300,000, or a potential savings of $10,119. Applying quality improvement principles to benchmarking, benchmarks, or best practices can improve process performance. Understanding which form of benchmarking the institution wishes to embark on will help focus a team and use appropriate resources. Communicating with professional organizations that have experience in benchmarking will save time and money and help achieve the desired results.

Evaluation of real-world mobility in age-related macular degeneration.

PubMed

Sengupta, Sabyasachi; Nguyen, Angeline M; van Landingham, Suzanne W; Solomon, Sharon D; Do, Diana V; Ferrucci, Luigi; Friedman, David S; Ramulu, Pradeep Y

2015-01-30

Previous research has suggested an association between poor vision and decreased mobility, including restricted levels of physical activity and travel away from home. We sought to determine the impact of age-related macular degeneration (AMD) on these measures of mobility. Fifty-seven AMD patients with bilateral, or severe unilateral, visual impairment were compared to 59 controls with normal vision. All study subjects were between the ages of 60 and 80. Subjects wore accelerometers and cellular network-based tracking devices over 7 days of normal activity. Number of steps taken, time spent in moderate-to-vigorous physical activity (MVPA), number of excursions from home, and time spent away from home were the primary outcome measures. In multivariate negative binomial regression models adjusted for age, gender, race, comorbidities, and education, AMD participants took fewer steps than controls (18% fewer steps per day, p = 0.01) and spent significantly less time in MVPA (35% fewer minutes, p < 0.001). In multivariate logistic regression models adjusting for age, sex, race, cognition, comorbidities, and grip strength, AMD subjects showed an increased likelihood of not leaving their home on a given day (odds ratio = 1.36, p = 0.04), but did not show a significant difference in the magnitude of time spent away from home (9% fewer minutes, p = 0.11). AMD patients with poorer vision engage in significantly less physical activity and take fewer excursions away from the home. Further studies identifying the factors mediating the relationship between vision loss and mobility are needed to better understand how to improve mobility among AMD patients.

Accelerated x-ray scatter projection imaging using multiple continuously moving pencil beams

NASA Astrophysics Data System (ADS)

Dydula, Christopher; Belev, George; Johns, Paul C.

2017-03-01

Coherent x-ray scatter varies with angle and photon energy in a manner dependent on the chemical composition of the scattering material, even for amorphous materials. Therefore, images generated from scattered photons can have much higher contrast than conventional projection radiographs. We are developing a scatter projection imaging prototype at the BioMedical Imaging and Therapy (BMIT) facility of the Canadian Light Source (CLS) synchrotron in Saskatoon, Canada. The best images are obtained using step-and-shoot scanning with a single pencil beam and area detector to capture sequentially the scatter pattern for each primary beam location on the sample. Primary x-ray transmission is recorded simultaneously using photodiodes. The technological challenge is to acquire the scatter data in a reasonable time. Using multiple pencil beams producing partially-overlapping scatter patterns reduces acquisition time but increases complexity due to the need for a disentangling algorithm to extract the data. Continuous sample motion, rather than step-and-shoot, also reduces acquisition time at the expense of introducing motion blur. With a five-beam (33.2 keV, 3.5 mm2 beam area) continuous sample motion configuration, a rectangular array of 12 x 100 pixels with 1 mm sampling width has been acquired in 0.4 minutes (3000 pixels per minute). The acquisition speed is 38 times the speed for single beam step-and-shoot. A system model has been developed to calculate detected scatter patterns given the material composition of the object to be imaged. Our prototype development, image acquisition of a plastic phantom and modelling are described.

Consistency of internal fluxes in a hydrological model running at multiple time steps

NASA Astrophysics Data System (ADS)

Ficchi, Andrea; Perrin, Charles; Andréassian, Vazken

2016-04-01

Improving hydrological models remains a difficult task and many ways can be explored, among which one can find the improvement of spatial representation, the search for more robust parametrization, the better formulation of some processes or the modification of model structures by trial-and-error procedure. Several past works indicate that model parameters and structure can be dependent on the modelling time step, and there is thus some rationale in investigating how a model behaves across various modelling time steps, to find solutions for improvements. Here we analyse the impact of data time step on the consistency of the internal fluxes of a rainfall-runoff model run at various time steps, by using a large data set of 240 catchments. To this end, fine time step hydro-climatic information at sub-hourly resolution is used as input of a parsimonious rainfall-runoff model (GR) that is run at eight different model time steps (from 6 minutes to one day). The initial structure of the tested model (i.e. the baseline) corresponds to the daily model GR4J (Perrin et al., 2003), adapted to be run at variable sub-daily time steps. The modelled fluxes considered are interception, actual evapotranspiration and intercatchment groundwater flows. Observations of these fluxes are not available, but the comparison of modelled fluxes at multiple time steps gives additional information for model identification. The joint analysis of flow simulation performance and consistency of internal fluxes at different time steps provides guidance to the identification of the model components that should be improved. Our analysis indicates that the baseline model structure is to be modified at sub-daily time steps to warrant the consistency and realism of the modelled fluxes. For the baseline model improvement, particular attention is devoted to the interception model component, whose output flux showed the strongest sensitivity to modelling time step. The dependency of the optimal model complexity on time step is also analysed. References: Perrin, C., Michel, C., Andréassian, V., 2003. Improvement of a parsimonious model for streamflow simulation. Journal of Hydrology, 279(1-4): 275-289. DOI:10.1016/S0022-1694(03)00225-7

A high-throughput semi-automated preparation for filtered synaptoneurosomes.

PubMed

Murphy, Kathryn M; Balsor, Justin; Beshara, Simon; Siu, Caitlin; Pinto, Joshua G A

2014-09-30

Synaptoneurosomes have become an important tool for studying synaptic proteins. The filtered synaptoneurosomes preparation originally developed by Hollingsworth et al. (1985) is widely used and is an easy method to prepare synaptoneurosomes. The hand processing steps in that preparation, however, are labor intensive and have become a bottleneck for current proteomic studies using synaptoneurosomes. For this reason, we developed new steps for tissue homogenization and filtration that transform the preparation of synaptoneurosomes to a high-throughput, semi-automated process. We implemented a standardized protocol with easy to follow steps for homogenizing multiple samples simultaneously using a FastPrep tissue homogenizer (MP Biomedicals, LLC) and then filtering all of the samples in centrifugal filter units (EMD Millipore, Corp). The new steps dramatically reduce the time to prepare synaptoneurosomes from hours to minutes, increase sample recovery, and nearly double enrichment for synaptic proteins. These steps are also compatible with biosafety requirements for working with pathogen infected brain tissue. The new high-throughput semi-automated steps to prepare synaptoneurosomes are timely technical advances for studies of low abundance synaptic proteins in valuable tissue samples. Copyright © 2014 Elsevier B.V. All rights reserved.

Linking quality of care and training costs: cost-effectiveness in health professions education.

PubMed

Tolsgaard, Martin G; Tabor, Ann; Madsen, Mette E; Wulff, Camilla B; Dyre, Liv; Ringsted, Charlotte; Nørgaard, Lone N

2015-12-01

To provide a model for conducting cost-effectiveness analyses in medical education. The model was based on a randomised trial examining the effects of training midwives to perform cervical length measurement (CLM) as compared with obstetricians on patients' waiting times. (CLM), as compared with obstetricians. The model included four steps: (i) gathering data on training outcomes, (ii) assessing total costs and effects, (iii) calculating the incremental cost-effectiveness ratio (ICER) and (iv) estimating cost-effectiveness probability for different willingness to pay (WTP) values. To provide a model example, we conducted a randomised cost-effectiveness trial. Midwives were randomised to CLM training (midwife-performed CLMs) or no training (initial management by midwife, and CLM performed by obstetrician). Intervention-group participants underwent simulation-based and clinical training until they were proficient. During the following 6 months, waiting times from arrival to admission or discharge were recorded for women who presented with symptoms of pre-term labour. Outcomes for women managed by intervention and control-group participants were compared. These data were then used for the remaining steps of the cost-effectiveness model. Intervention-group participants needed a mean 268.2 (95% confidence interval [CI], 140.2-392.2) minutes of simulator training and a mean 7.3 (95% CI, 4.4-10.3) supervised scans to attain proficiency. Women who were scanned by intervention-group participants had significantly reduced waiting time compared with those managed by the control group (n = 65; mean difference, 36.6 [95% CI 7.3-65.8] minutes; p = 0.008), which corresponded to an ICER of 0.45 EUR minute(-1) . For WTP values less than EUR 0.26 minute(-1) , obstetrician-performed CLM was the most cost-effective strategy, whereas midwife-performed CLM was cost-effective for WTP values above EUR 0.73 minute(-1) . Cost-effectiveness models can be used to link quality of care to training costs. The example used in the present study demonstrated that different training strategies could be recommended as the most cost-effective depending on administrators' willingness to pay per unit of the outcome variable. © 2015 Medical Education Published by John Wiley & Sons Ltd.

Evaluation of the Effect of Light and Scanning Time Delay on The Image Quality of Intra Oral Photostimulable Phosphor Plates

PubMed Central

Eskandarloo, Amir; Yousefi, Arman; Soheili, Setareh; Ghazikhanloo, Karim; Amini, Payam; Mohammadpoor, Haniyeh

2017-01-01

Background: Nowadays, digital radiography is widely used in dental practice. One of the most common types is Photo Stimulated Phosphor Plate (PSP). Objective: The aims of this experimental study were to evaluate the impacts of different combinations of storage conditions and varying delays in reading of digital images captured using PSPs. Methods: Standardized images of a step wedges were obtained using PSPs from the Digora digital systems. Plates were exposed and immediately scanned to produce the baseline gold standard. The plates were re-exposed and stored in four different storage conditions: white light, yellow light, natural light environment and dark room, then scanned after 10 and 30 minutes and 4 and 8 hours. Objective analysis was conducted by density measurements and the data were analyzed statistically using GEE test. Subjective analysis was performed by two oral and maxillofacial radiologists and the results were analyzed using McNemar’s test. Results: The results from GEE analysis show that in the natural light environment, the densities in 10 minutes did not differ from the baseline. The mean densities decreased significantly during the time in all environments. The mean densities in step 2 for the dark room environment decreased with a slighter slope in comparison to yellow environment significantly. Conclusion: PSP images showed significant decrease in the density in plates scanned for 10 minutes or longer after exposure which may not be detected clinically. The yellow light environment had a different impact on the quality of PSP images. The spatial resolution did not change significantly with time. PMID:29430262

Evaluation of the Effect of Light and Scanning Time Delay on The Image Quality of Intra Oral Photostimulable Phosphor Plates.

PubMed

Eskandarloo, Amir; Yousefi, Arman; Soheili, Setareh; Ghazikhanloo, Karim; Amini, Payam; Mohammadpoor, Haniyeh

2017-01-01

Nowadays, digital radiography is widely used in dental practice. One of the most common types is Photo Stimulated Phosphor Plate (PSP). The aims of this experimental study were to evaluate the impacts of different combinations of storage conditions and varying delays in reading of digital images captured using PSPs. Standardized images of a step wedges were obtained using PSPs from the Digora digital systems. Plates were exposed and immediately scanned to produce the baseline gold standard. The plates were re-exposed and stored in four different storage conditions: white light, yellow light, natural light environment and dark room, then scanned after 10 and 30 minutes and 4 and 8 hours. Objective analysis was conducted by density measurements and the data were analyzed statistically using GEE test. Subjective analysis was performed by two oral and maxillofacial radiologists and the results were analyzed using McNemar's test. The results from GEE analysis show that in the natural light environment, the densities in 10 minutes did not differ from the baseline. The mean densities decreased significantly during the time in all environments. The mean densities in step 2 for the dark room environment decreased with a slighter slope in comparison to yellow environment significantly. PSP images showed significant decrease in the density in plates scanned for 10 minutes or longer after exposure which may not be detected clinically. The yellow light environment had a different impact on the quality of PSP images. The spatial resolution did not change significantly with time.

A Cluster Randomized Controlled Trial to Reduce Office Workers' Sitting Time: Effect on Activity Outcomes.

PubMed

Healy, Genevieve N; Eakin, Elizabeth G; Owen, Neville; Lamontagne, Anthony D; Moodie, Marj; Winkler, Elisabeth A H; Fjeldsoe, Brianna S; Wiesner, Glen; Willenberg, Lisa; Dunstan, David W

2016-09-01

This study aimed to evaluate the initial and long-term effectiveness of a workplace intervention compared with usual practice, targeting the reduction of sitting on activity outcomes. Office worksites (≥1 km apart) from a single organization in Victoria, Australia, were cluster randomized to intervention (n = 7) or control (n = 7). Participants were 231 desk-based office workers (5-39 participants per worksite) working at least 0.6 full-time equivalent. The workplace-delivered intervention addressed organizational, physical environment, and individual behavioral changes to reduce sitting time. Assessments occurred at baseline, 3 months, and 12 months, with the primary outcome participants' objectively measured (activPAL3 device) workplace sitting time (minutes per 8-h workday). Secondary activity outcomes were workplace time spent standing, stepping (light, moderate to vigorous, and total), and in prolonged (≥30 min) sitting bouts (hours per 8-h workday); usual duration of workplace sitting bouts; and overall sitting, standing, and stepping time (minutes per 16-h day). Analysis was by linear mixed models, accounting for repeated-measures and clustering and adjusting for baseline values and potential confounders. At baseline, on average, participants (68% women; mean ± SD age = 45.6 ± 9.4 yr) sat, stood, and stepped for 78.8% ± 9.5%, 14.3% ± 8.2%, and 6.9% ± 2.9% of work hours, respectively. Workplace sitting time was significantly reduced in the intervention group compared with the controls at 3 months (-99.1 [95% confidence interval = -116.3 to -81.8] min per 8-h workday) and 12 months (-45.4 [-64.6 to -26.2] min per 8-h workday). Significant intervention effects (all favoring intervention) were observed for standing, prolonged sitting, and usual sitting bout duration at work, as well as overall sitting and standing time, with no significant or meaningful effects observed for stepping. This workplace-delivered multicomponent intervention was successful at reducing workplace and overall daily sitting time in both the short term and the long term.

Physiologic responses to forward and retrograde simulated stair stepping.

PubMed

Ryan, P T; Plowman, S A; Ball, T E; Looney, M A

1994-07-01

This study compared the physiologic responses to forward and retrograde simulated stair stepping on the StairMaster 4000 PT. Twenty male subjects (mean age 23.65 +/- 1.63 years) volunteered for this study. Subjects completed a practice trial of 6 minutes of both forward and retrograde stepping at Level 5. Each experimental trial was divided into four 3-minute stages: Level 3, Level 5, Level 7, and Level 9. Heart rate, blood pressure, and rating of perceived exertion (RPE) were recorded during the second minute of each stage. Expired gases were analyzed and averaged over the last 2 minutes of each stage. Caloric expenditure and delta efficiency were later calculated. Data were analyzed using a 2 x 4 ANOVA (direction by level) and 2 x 3 ANOVA (for delta efficiency). Compared to forward responses, retrograde heart rates were significantly higher at Levels 7 and 9 (p < 0.01). Retrograde responses for RPE, metabolic equivalents (METS), and caloric expenditure were significantly higher at (p < 0.01) Levels 5, 7, and 9 when compared to forward responses. However, the results of this study show that these differences between forward and retrograde stepping are not practically meaningful.

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.

The Techy Teacher/Don't Waste the First Week

ERIC Educational Resources Information Center

Tucker, Catlin

2016-01-01

The minute students first step into any classroom, they begin assessing the environment, the teacher, and one another for clues about what to expect in the upcoming school year. Yet what do they usually encounter the first day? A teacher who's busy assigning seats, reviewing rules, and assessing various skills. However, it is during this time that…

Effect of Bonding Time on Interfacial Reaction and Mechanical Properties of Diffusion-Bonded Joint Between Ti-6Al-4V and 304 Stainless Steel Using Nickel as an Intermediate Material

NASA Astrophysics Data System (ADS)

Thirunavukarasu, Gopinath; Kundu, Sukumar; Mishra, Brajendra; Chatterjee, Subrata

2014-04-01

In the current study, solid-state diffusion bonding between Ti-6Al-4V (TiA) and 304 stainless steel (SS) using pure nickel (Ni) of 200- μm thickness as an intermediate material was carried out in vacuum. Uniaxial compressive pressure and temperature were kept at 4 MPa and 1023 K (750 °C), respectively, and the bonding time was varied from 30 to 120 minutes in steps of 15 minutes. Scanning electron microscopy images, in backscattered electron mode, revealed the layerwise Ti-Ni-based intermetallics like either Ni3Ti or both Ni3Ti and NiTi at titanium alloy-nickel (TiA/Ni) interface, whereas nickel-stainless steel (Ni/SS) interface was free from intermetallic phases for all the joints. Chemical composition of the reaction layers was determined by energy dispersive spectroscopy (SEM-EDS) and confirmed by X-ray diffraction study. Maximum tensile strength of ~382 MPa along with ~3.7 pct ductility was observed for the joints processed for 60 minutes. It was found that the extent of diffusion zone at Ni/SS interface was greater than that of TiA/Ni interface. From the microhardness profile, fractured surfaces, and fracture path, it was demonstrated that the failure of the joints was initiated and propagated apparently at TiA/Ni interface near Ni3Ti intermetallic for bonding time less than 90 minutes, and through Ni for bonding time 90 minutes and greater.

Training Rapid Stepping Responses in an Individual With Stroke

PubMed Central

Inness, Elizabeth L.; Komar, Janice; Biasin, Louis; Brunton, Karen; Lakhani, Bimal; McIlroy, William E.

2011-01-01

Background and Purpose Compensatory stepping reactions are important responses to prevent a fall following a postural perturbation. People with hemiparesis following a stroke show delayed initiation and execution of stepping reactions and often are found to be unable to initiate these steps with the more-affected limb. This case report describes a targeted training program involving repeated postural perturbations to improve control of compensatory stepping in an individual with stroke. Case Description Compensatory stepping reactions of a 68-year-old man were examined 52 days after left hemorrhagic stroke. He required assistance to prevent a fall in all trials administered during his initial examination because he showed weight-bearing asymmetry (with more weight borne on the more-affected right side), was unable to initiate stepping with the right leg (despite blocking of the left leg in some trials), and demonstrated delayed response times. The patient completed 6 perturbation training sessions (30–60 minutes per session) that aimed to improve preperturbation weight-bearing symmetry, to encourage stepping with the right limb, and to reduce step initiation and completion times. Outcomes Improved efficacy of compensatory stepping reactions with training and reduced reliance on assistance to prevent falling were observed. Improvements were noted in preperturbation asymmetry and step timing. Blocking the left foot was effective in encouraging stepping with the more-affected right foot. Discussion This case report demonstrates potential short-term adaptations in compensatory stepping reactions following perturbation training in an individual with stroke. Future work should investigate the links between improved compensatory step characteristics and fall risk in this vulnerable population. PMID:21511992

Synthesis of 2,4,8,10-tetroxaspiro5,5undecane

NASA Technical Reports Server (NTRS)

Poshkus, A. C. (Inventor)

1985-01-01

Pentaerythritol is converted to its diformal, 2,4,8,10-tetroxaspirol5.5undecane, by heating it to a temperature within the range of about 110 to 150 C, for a period of up to 10 minutes, in the presence of a slight excess of paraformaldehyde and of a catalytic quantity of an acid catalyst such as sulfuric acid. The reaction may be carried out in two steps, by forming first the monoformal, then the diformal. In any case, total reaction time is about 10 minutes, and yield of diformal are greater than 90%. Previous processes require hours or days, and often, tedious operating procedures.

Monitoring sedentary patterns in office employees: validity of an m-health tool (Walk@Work-App) for occupational health.

PubMed

Bort-Roig, Judit; Puig-Ribera, Anna; Contreras, Ruth S; Chirveches-Pérez, Emilia; Martori, Joan C; Gilson, Nicholas D; McKenna, Jim

2017-09-15

This study validated the Walk@Work-Application (W@W-App) for measuring occupational sitting and stepping. The W@W-App was installed on the smartphones of office-based employees (n=17; 10 women; 26±3 years). A prescribed 1-hour laboratory protocol plus two continuous hours of occupational free-living activities were performed. Intra-class correlation coefficients (ICC) compared mean differences of sitting time and step count measurements between the W@W-App and criterion measures (ActivPAL3TM and SW200Yamax Digi-Walker). During the protocol, agreement between self-paced walking (ICC=0.85) and active working tasks step counts (ICC=0.80) was good. The smallest median difference was for sitting time (1.5seconds). During free-living conditions, sitting time (ICC=0.99) and stepping (ICC=0.92) showed excellent agreement, with a difference of 0.5minutes and 18 steps respectively. The W@W-App provided valid measures for monitoring occupational sedentary patterns in real life conditions; a key issue for increasing awareness and changing occupational sedentariness. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Note: Quasi-real-time analysis of dynamic near field scattering data using a graphics processing unit

NASA Astrophysics Data System (ADS)

Cerchiari, G.; Croccolo, F.; Cardinaux, F.; Scheffold, F.

2012-10-01

We present an implementation of the analysis of dynamic near field scattering (NFS) data using a graphics processing unit. We introduce an optimized data management scheme thereby limiting the number of operations required. Overall, we reduce the processing time from hours to minutes, for typical experimental conditions. Previously the limiting step in such experiments, the processing time is now comparable to the data acquisition time. Our approach is applicable to various dynamic NFS methods, including shadowgraph, Schlieren and differential dynamic microscopy.

Contextual factors related to physical activity during daily middle school physical education.

PubMed

Brusseau, Timothy A; Burns, Ryan D; Fu, You

2016-09-01

Given the importance of optimizing physical activity in adolescents, the purpose of this study was to examine the effect of activity mode, environment, and semester on step counts/minute and MVPA during daily middle-school physical education (PE). A prospective and observational research design. Participants included 232 students (Mean age=13.3±0.4 years) recruited from the seventh and eighth grades from one public middle-school in the U.S. Activity modes were employed across the school year including motor skills, games, and fitness activities located in indoor and outdoor environments. Step counts/minute and MVPA were monitored across 132 PE lessons during Fall and Spring semesters using NL-1000 piezoelectric pedometers. A three-way Multivariate Analysis of Covariance (MANCOVA) was employed to examine the effect of activity mode (skill games vs. fitness), environment (indoors vs. outdoors), and semester (Fall vs. Spring) on student step counts/minute and MVPA. MANCOVA was followed by separate ANCOVA tests. MANCOVA yielded a statistically significant three-way interaction (Wilks' Λ=0.98 F(2, 1153)=8.9, P<0.001). Follow-up tests supported that physical activity was higher during outdoor fitness activities in the Fall compared to indoor motor skills in the Spring for step counts/minute (Mean difference=27.0 steps/minute, P<0.001, Cohen's d=1.6) and MVPA (Mean difference=7.8min, P<0.001, Cohen's d=2.0). Daily middle-school physical activity was the highest during outdoor fitness activities in the Fall and the lowest during indoor motor skill games in the Spring. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Six-minute-walk distance and accelerometry predict outcomes in chronic obstructive pulmonary disease independent of Global Initiative for Chronic Obstructive Lung Disease 2011 Group.

PubMed

Durheim, Michael T; Smith, Patrick J; Babyak, Michael A; Mabe, Stephanie K; Martinu, Tereza; Welty-Wolf, Karen E; Emery, Charles F; Palmer, Scott M; Blumenthal, James A

2015-03-01

The 2011 combined Global Initiative for Chronic Obstructive Lung Disease (GOLD) assessment incorporates symptoms, exacerbation history, and spirometry in discriminating risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD). Six-minute-walk distance (6MWD) and accelerometry also have been used to assess disease severity in COPD. The association between these measures and the risks of hospitalization and mortality in the context of GOLD 2011 is unknown. To describe changes in exercise tolerance and physical activity over time in patients with COPD and to test the hypothesis that lower baseline 6MWD or accelerometry step count is associated with increased risk of COPD-related hospitalization or all-cause mortality, independent of GOLD 2011 group. Physical function and medical outcomes were prospectively assessed in 326 patients with moderate to severe COPD in INSPIRE-II, a randomized controlled trial of a coping skills training intervention. Cox models were used to determine if GOLD 2011 group, 6MWD, or accelerometry steps were associated with risk of COPD-related hospitalization or all-cause mortality. Physical function declined over time in GOLD group D but remained stable in groups A, B, and C. GOLD classification was associated with time to death or first COPD-related hospitalization. Baseline 6MWD was more strongly associated with time to death or first COPD-related hospitalization (hazard ratio, 0.50 [95% confidence interval, 0.34, 0.73] per 150 m, P=0.0003) than GOLD 2011 classification. A similar relationship was observed for accelerometry steps (hazard ratio, 0.80 [95% confidence interval, 0.70, 0.92] per 1,000 steps, P=0.002). Exercise tolerance and daily physical activity are important predictors of hospitalization and mortality in COPD, independent of GOLD 2011 classification. Physical function may represent a modifiable risk factor that warrants increased attention as a target for interventions to improve clinically meaningful outcomes in COPD.

Uprising: An examination of sit-stand workstations, mental health and work ability in sedentary office workers, in Western Australia.

PubMed

Tobin, Rochelle; Leavy, Justine; Jancey, Jonine

2016-10-17

Office-based staff spend around three quarters of their work day sitting. People who sit for long periods while at work are at greater risk of adverse health outcomes. The pilot study aimed to determine the effect of sit-stand workstations on office-based staff sedentary and physical activity behaviors, work ability and self-reported physical and mental health outcomes. A two-group pre-post study design assessed changes in sedentary and physical activity behaviors (time spent sitting, standing and stepping and sit-stand transitions and number of steps taken) work ability and physical and mental health. Physical activity behaviors were measured using activPAL activity monitors and self-reported data on work ability and physical and mental health were collected using an online questionnaire. Relative to the controls (n=19), the intervention group (n=18) significantly decreased time spent sitting by 100 minutes (p<0.001) and increased standing time by 99 minutes (p<0.001). There was a decrease in self-reported current work ability when compared to lifetime best (p=0.008). There were no significant differences for all other sedentary behavior, other workability outcomes, physical health or mental health outcomes at follow-up. The Uprising Study found that sit-stand workstations are an effective strategy to reduce occupational sitting time in office-based workers over a one month period.

Physical Activity Measurement Device Agreement: Pedometer Steps/Minute and Physical Activity Time

ERIC Educational Resources Information Center

Scruggs, Philip W.; Mungen, Jonathan D.; Oh, Yoonsin

2010-01-01

The purpose of this study was to examine agreement between the Walk4Life DUO pedometer (W4L; Walk4Life, Plainfield, Illinois, USA) and two criterion instruments in the measurement of physical activity. Participants (N = 189, M = 16.74 years, SD = 0.99) in high school physical education concurrently wore the DUO (i.e., comparison instrument) and…

When a Step Is Not a Step! Specificity Analysis of Five Physical Activity Monitors.

PubMed

O'Connell, Sandra; ÓLaighin, Gearóid; Quinlan, Leo R

2017-01-01

Physical activity is an essential aspect of a healthy lifestyle for both physical and mental health states. As step count is one of the most utilized measures for quantifying physical activity it is important that activity-monitoring devices be both sensitive and specific in recording actual steps taken and disregard non-stepping body movements. The objective of this study was to assess the specificity of five activity monitors during a variety of prescribed non-stepping activities. Participants wore five activity monitors simultaneously for a variety of prescribed activities including deskwork, taking an elevator, taking a bus journey, automobile driving, washing and drying dishes; functional reaching task; indoor cycling; outdoor cycling; and indoor rowing. Each task was carried out for either a specific duration of time or over a specific distance. Activity monitors tested were the ActivPAL micro™, NL-2000™ pedometer, Withings Smart Activity Monitor Tracker (Pulse O2)™, Fitbit One™ and Jawbone UP™. Participants were video-recorded while carrying out the prescribed activities and the false positive step count registered on each activity monitor was obtained and compared to the video. All activity monitors registered a significant number of false positive steps per minute during one or more of the prescribed activities. The Withings™ activity performed best, registering a significant number of false positive steps per minute during the outdoor cycling activity only (P = 0.025). The Jawbone™ registered a significant number of false positive steps during the functional reaching task and while washing and drying dishes, which involved arm and hand movement (P < 0.01 for both). The ActivPAL™ registered a significant number of false positive steps during the cycling exercises (P < 0.001 for both). As a number of false positive steps were registered on the activity monitors during the non-stepping activities, the authors conclude that non-stepping physical activities can result in the false detection of steps. This can negatively affect the quantification of physical activity with regard to step count as an output. The Withings™ activity monitor performed best with regard to specificity during the activities of daily living tested.

Demographic, Physiologic, and Psychosocial Correlates of Physical Activity in Structured Exercise and Sports Among Low-Income, Overweight Children.

PubMed

Hatfield, Daniel P; Chomitz, Virginia R; Chui, Kenneth K H; Sacheck, Jennifer M; Economos, Christina D

2015-01-01

To describe correlates of physical activity (PA) in structured exercise and structured sports sessions among low-income, overweight children participating in a community-based PA program. A total of 93 children (55% male; 91% Hispanic) aged 8-14 years were included. Participants wore pedometers in a sample of 10 of 59 total sessions offered; mean steps per minute were calculated for structured exercise and sports sessions. Separate multivariable regression models tested associations between steps per minute in exercise and sports sessions and 5 potential correlates: baseline body mass index z-score, aerobic fitness (Progressive Aerobic Cardiorespiratory Endurance Run laps), perceived athletic competence (Harter self-perception profile), sex, and age. Only age (ß = -2.9; P = .02) significantly predicted steps per minute in exercise sessions. Age (ß = -4.3; P = .007), fitness (ß = 0.45; P = .03), and male sex (ß = 8.7; P = .02) significantly predicted steps per minute in sports. In structured exercise and sports, perceived competence may not influence overweight and obese children's PA. However, girls and older or less fit children may engage less actively, especially in sports. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

GADRAS-DRF 18.6 User's Manual

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

Horne, Steve M.; Thoreson, Greg G.; Theisen, Lisa A.

2016-05-01

The Gamma Detector Response and Analysis Software–Detector Response Function (GADRAS-DRF) application computes the response of gamma-ray and neutron detectors to incoming radiation. This manual provides step-by-step procedures to acquaint new users with the use of the application. The capabilities include characterization of detector response parameters, plotting and viewing measured and computed spectra, analyzing spectra to identify isotopes, and estimating source energy distributions from measured spectra. GADRAS-DRF can compute and provide detector responses quickly and accurately, giving users the ability to obtain usable results in a timely manner (a matter of seconds or minutes).

Grinding Wear Behaviour of Stepped Austempered Ductile Iron as Media Material During Comminution of Iron Ore in Ball Mills

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

Raghavendra, H.; Bhat, K. L.; Udupa, K. Rajendra

2011-01-17

An attempt has been made to evaluate the suitability of austempered ductile iron (ADI) as media material for grinding iron ore in a ball mill. Spheroidal graphite (S.G) iron balls are austenitised at 900 deg. C for 60 minutes and given stepped austempering treatment at 280 deg. C for 30 minutes and 60 minutes followed by 380 deg. C for 60 minutes in each case. These materials are characterised by measuring hardness, analysing X-ray diffraction (X-RD), studying microstructure using optical and scanning electron microscope (SEM). Grinding wear behaviour of these materials was assessed for wear loss in wet condition atmore » different pH value of the mineral slurry and found that the wear rate of grinding media material decreases with increase in pH of the slurry. The wear resistance of ADI balls were compared with forged En31 steel balls and found that the stepped austempered ductile iron is superior to forged En31 steel balls.« less

Visual field loss and accelerometer-measured physical activity in the United States.

PubMed

van Landingham, Suzanne W; Willis, Jeffrey R; Vitale, Susan; Ramulu, Pradeep Y

2012-12-01

To determine whether visual field (VF) loss is associated with lower levels of accelerometer-defined walking or physical activity in a nationally representative sample of American adults. Cross-sectional study. A total of 2934 adults aged 40 years or older who participated in the examination component of the 2005-2006 National Health and Nutritional Examination Survey. Frequency-doubling technology (FDT) testing was performed in both eyes and used to categorize subjects as having no VF loss, unilateral VF loss, or bilateral VF loss. Accelerometer data were collected over 7 days of normal activity. Steps per day and daily minutes of moderate or vigorous physical activity (MVPA). A total of 1468 participants (50.0%) had complete FDT and accelerometer data. Individuals without VF loss averaged 9751 steps/day and 20.8 minutes/day of MVPA, compared with 8023 steps/day and 14.5 minutes/day for subjects with unilateral VF loss (age-adjusted P = 0.11 and P = 0.51) and 6840 steps/day and 10.1 minutes/day for subjects with bilateral VF loss (age-adjusted P = 0.02 and 0.09, respectively). In multivariable models adjusted for age, sex, race/ethnicity, education, and several comorbid illnesses, individuals with bilateral VF loss took 17% fewer steps per day (P < 0.01) and engaged in 30% less MVPA (P = 0.02) than individuals without VF loss. No significant difference in steps per day or MVPA was observed between individuals with unilateral VF loss and no VF loss (P > 0.05). In addition to VF loss, older age, female sex, arthritis, diabetes, congestive heart failure (CHF), and stroke were significantly associated with fewer daily steps and minutes of MVPA (P < 0.05). Bilateral VF loss is associated with less walking and physical activity in American adults. Patients with bilateral VF loss should be encouraged to engage safely in more physical activity. The author(s) have no proprietary or commercial interest in any materials discussed in this article. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Learning curve for peroral endoscopic myotomy

PubMed Central

El Zein, Mohamad; Kumbhari, Vivek; Ngamruengphong, Saowanee; Carson, Kathryn A.; Stein, Ellen; Tieu, Alan; Chaveze, Yamile; Ismail, Amr; Dhalla, Sameer; Clarke, John; Kalloo, Anthony; Canto, Marcia Irene; Khashab, Mouen A.

2016-01-01

Background and study aims: Although peroral endoscopic myotomy (POEM) is being performed more frequently, the learning curve for gastroenterologists performing the procedure has not been well studied. The aims of this study were to define the learning curve for POEM and determine which preoperative and intraoperative factors predict the time that will be taken to complete the procedure and its different steps. Patients and methods: Consecutive patients who underwent POEM performed by a single expert gastroenterologist for the treatment of achalasia or spastic esophageal disorders were included. The POEM procedure was divided into four steps: mucosal entry, submucosal tunneling, myotomy, and closure. Nonlinear regression was used to determine the POEM learning plateau and calculate the learning rate. Results: A total of 60 consecutive patients underwent POEM in an endoscopy suite. The median length of procedure (LOP) was 88 minutes (range 36 – 210), and the mean (± standard deviation [SD]) LOP per centimeter of myotomy was 9 ± 5 minutes. The total operative time decreased significantly as experience increased (P < 0.001), with a “learning plateau” at 102 minutes and a “learning rate” of 13 cases. The mucosal entry, tunneling, and closure times decreased significantly with experience (P < 0.001). The myotomy time showed no significant decrease with experience (P = 0.35). When the mean (± SD) total procedure times for the learning phase and the corresponding comparator groups were compared, a statistically significant difference was observed between procedures 11 – 15 and procedures 16 – 20 (15.5 ± 2.4 min/cm and 10.1 ± 2.7 min/cm, P = 0.01) but not thereafter. A higher case number was significantly associated with a decreased LOP (P < 0.001). Conclusion: In this single-center retrospective study, the minimum threshold number of cases required for an expert interventional endoscopist performing POEM to reach a plateau approached 13. PMID:27227118

New Near-Real Time Monitoring of the Ionosphere over Europe Available On-line

NASA Astrophysics Data System (ADS)

Chevalier, J. M.; Bergeot, N.; Bruyninx, C.; Pottiaux, E.; Aerts, W.; Baire, Q.; Legrand, J.; Defraigne, P.

2012-04-01

With the beginning of the 24th Solar cycle, the increased Solar activity requires having a close eye on the ionosphere for better understanding Space Weather physics and its effects on radio communications. In that frame, near-real time ionospheric models over Europe are now routinely generated at the Royal Observatory of Belgium (ROB). These models are made available to the public through new interactive web pages at the web site of the GNSS team (www.gnss.be) and the Solar Influences Data Analysis Center (www.sidc.be) of ROB. The models are ionospheric Vertical Total Electron Content (VTEC) maps estimated every 15 minutes on a 0.5°x0.5° grid. They use the high-rate GPS observations of the real-time stations in the EUREF Permanent Network (EPN) provided by the ROB NTRIP broadcaster. The maps are published on the ROB web site with a latency of 7-15 minutes with respect to the last GPS measurement included in the 15-minute observation files. In a first step, this paper presents the processing strategy used to generate the VTEC maps: input data, parameter estimation, data cleaning and interpolation method. In addition, the tools developed to further exploit the product are introduced, e.g. on-demand animated VTEC maps. In a second step, the VTEC maps are compared with external ionospheric products and models such as Global Ionospheric Maps and IRI 2011. These new near-real time VTEC maps will allow any user within the geographical scope of the maps to estimate in near-real time the ionospheric delay induced along the signal of any observed satellite. In the future, the web site will continuously be updated in response to evolving user needs. This paper opens doors to discussions with the user community to target their needs.

Process Evaluation of Making HEPA Policy Practice: A Group Randomized Trial.

PubMed

Weaver, Robert G; Moore, Justin B; Huberty, Jennifer; Freedman, Darcy; Turner-McGrievy, Brie; Beighle, Aaron; Ward, Diane; Pate, Russell; Saunders, Ruth; Brazendale, Keith; Chandler, Jessica; Ajja, Rahma; Kyryliuk, Becky; Beets, Michael W

2016-09-01

This study examines the link between implementation of Strategies to Enhance Practice (STEPs) and outcomes. Twenty after-school programs (ASPs) participated in an intervention to increase children's accumulation of 30 minutes/day of moderate to vigorous physical activity (MVPA) and quality of snacks served during program time. Outcomes were measured via accelerometer (MVPA) and direct observation (snacks). STEPs implementation data were collected via document review and direct observation. Based on implementation data, ASPs were divided into high/low implementers. Differences between high/low implementers' change in percentage of boys accumulating 30 minutes/day of MVPA were observed. There was no difference between high/low implementers for girls. Days fruits and/or vegetables and water were served increased in the high/low implementation groups, while desserts and sugar-sweetened beverages decreased. Effect sizes (ES) for the difference in changes between the high and low group ranged from low (ES = 0.16) to high (ES = 0.97). Higher levels of implementation led to increased MVPA for boys, whereas girls MVPA benefited from the intervention regardless of high/low implementation. ESs of the difference between high/low implementers indicate that increased implementation of STEPs increases days healthier snacks are served. Programs in the high-implementation group implemented a variety of STEPs strategies, suggesting local adoption/adaptation is key to implementation. © 2016 Society for Public Health Education.

Faster, better, cheaper: lean labs are the key to future survival.

PubMed

Bryant, Patsy M; Gulling, Richard D

2006-03-28

Process improvement techniques have been used in manufacturing for many years to rein in costs and improve quality. Health care is now grappling with similar challenges. The Department of Laboratory Services at Good Samaritan Hospital, a 560-bed facility in Dayton, OH, used the Lean process improvement method in a 12-week project to streamline its core laboratory processes. By analyzing the flow of samples through the system and identifying value-added and non-value-added steps, both in the laboratory and during the collection process, Good Samaritan's project team redesigned systems and reconfigured the core laboratory layout to trim collection-to-results time from 65 minutes to 40 minutes. As a result, virtually all morning results are available to physicians by 7 a.m., critical values are called to nursing units within 30 minutes, and core laboratory services are optimally staffed for maximum cost-effectiveness.

Screening for physical inactivity among adults: the value of distance walked in the six-minute walk test. A cross-sectional diagnostic study.

PubMed

Sperandio, Evandro Fornias; Arantes, Rodolfo Leite; da Silva, Rodrigo Pereira; Matheus, Agatha Caveda; Lauria, Vinícius Tonon; Bianchim, Mayara Silveira; Romiti, Marcello; Gagliardi, Antônio Ricardo de Toledo; Dourado, Victor Zuniga

2016-01-01

Accelerometry provides objective measurement of physical activity levels, but is unfeasible in clinical practice. Thus, we aimed to identify physical fitness tests capable of predicting physical inactivity among adults. Diagnostic test study developed at a university laboratory and a diagnostic clinic. 188 asymptomatic subjects underwent assessment of physical activity levels through accelerometry, ergospirometry on treadmill, body composition from bioelectrical impedance, isokinetic muscle function, postural balance on a force platform and six-minute walk test. We conducted descriptive analysis and multiple logistic regression including age, sex, oxygen uptake, body fat, center of pressure, quadriceps peak torque, distance covered in six-minute walk test and steps/day in the model, as predictors of physical inactivity. We also determined sensitivity (S), specificity (Sp) and area under the curve of the main predictors by means of receiver operating characteristic curves. The prevalence of physical inactivity was 14%. The mean number of steps/day (≤ 5357) was the best predictor of physical inactivity (S = 99%; Sp = 82%). The best physical fitness test was a distance in the six-minute walk test and ≤ 96% of predicted values (S = 70%; Sp = 80%). Body fat > 25% was also significant (S = 83%; Sp = 51%). After logistic regression, steps/day and distance in the six-minute walk test remained predictors of physical inactivity. The six-minute walk test should be included in epidemiological studies as a simple and cheap tool for screening for physical inactivity.

Community Sediment Transport Model

DTIC Science & Technology

2007-01-01

Woods Hole, MA 02543-1598 Phone: (508) 457-2269 Fax: (508) 457-2310 email: csherwood@usgs.gov Timothy Keen Naval Research Laboratory, Code...intended to be used as both a research tool and for practical applications. An accurate and useful model will require coupling sediment-transport with...and time steps range from seconds to minutes. We include higher-resolution sediment- transport calculation modules for research problems but, for

Using a divided-attention stepping accuracy task to improve balance and functional outcomes in an individual with incomplete spinal cord injury: A case report.

PubMed

Leach, Susan J; Magill, Richard A; Maring, Joyce R

2017-01-01

A spinal cord injury (SCI) frequently results in impaired balance, endurance, and strength with subsequent limitations in functional mobility and community participation. The purpose of this case report was to implement a training program for an individual with a chronic incomplete SCI using a novel divided-attention stepping accuracy task (DASAT) to determine if improvements could be made in impairments, activities, and participation. The client was a 51-year-old male with a motor incomplete C4 SCI sustained 4 years prior. He presented with decreased quality of life (QOL) and functional independence, and deficits in balance, endurance, and strength consistent with central cord syndrome. The client completed the DASAT intervention 3 times per week for 6 weeks. Each session incorporated 96 multi-directional steps to randomly-assigned targets in response to 3-step verbal commands. QOL, measured using the SF-36, was generally enhanced but fluctuated. Community mobility progressed from close supervision to independence. Significant improvement was achieved in all balance scores: Berg Balance Scale by 9 points [Minimal Detectable Change (MDC) = 4.9 in elderly]; Functional Reach Test by 7.62 cm (MDC = 5.16 in C5/C6 SCI); and Timed Up-and-Go by 0.53 s (MDC not established). Endurance increased on the 6-Minute Walk Test, with the client achieving an additional 47 m (MDC = 45.8 m). Lower extremity isokinetic peak torque strength measures were mostly unchanged. Six minutes of DASAT training per session provided an efficient, low-cost intervention utilizing multiple trials of variable practice, and resulted in better performance in activities, balance, and endurance in this client.

Gait characteristics before hardware removal in patients operated upon for tibial plateau fractures.

PubMed

Deleanu, Bogdan; Prejbeanu, Radu; Crisan, Dan; Predescu, Vlad; Popa, Iulian; Poenaru, Dan V

2015-07-01

The reporting of gait analysis data on operated fractures of the tibial plateau, while extensive for studies of knee osteoarthritis of mostly undisclosed aetiology and ACL deficient knees, is rather limited in literature. In the present study we investigated 25 tibial plateau fractures classified as Schatzker II, IV, V and VI that underwent operative reduction and lateral plate osteosynthesis. Apart from routine radiographic exploration and patient completed (KOOS) scores at three (mean of 3.2 months), six (mean of 5.6 months) and 12 months (mean of 11.3 months) postoperatively, gait analysis was performed at these intervals as well. Cadence, step time and knee flexion were the gait parameters that were selected for the comparison at six and 12 months postoperatively. The analysed gait parameters were significantly improved between the six and the 12-month session and statistically significant differences were found between the two groups of values. Cadence had a mean value of 41 steps/minute at six months and 45 steps/minute at 12 months (p = 0.99). Step time was a mean of 0.74 seconds at six months while at 12 months the median value was 0.66 seconds (p = 0.94). Knee flexion angles evolved in a similar manner with mean values of 58° at six months and 69° at 12 months (p = 0.95). The mean KOOS scores were 42.4, 56.3 and 67.99 at three, six and 12 months postoperatively, respectively. Complex intra-articular fractures, classified as Schatzker IV, V and VI, had a higher impact on joint function than Schatzker II fractures treated with similar techniques and implants. There were statistically significant improvements in the recovery status at 12 months postoperatively compared to six months with extended chances for improvement.

Achieving 10,000 steps: a comparison of public transport users and drivers in a university setting.

PubMed

Villanueva, Karen; Giles-Corti, Billie; McCormack, Gavin

2008-09-01

To compare pedometer steps of university students who used public transport and private motor vehicles to travel to and or from The University of Western Australia (UWA). 103 undergraduate students in 2006 recruited by e-mail and snowballing wore a pedometer for five consecutive university days, and completed a travel and physical activity diary. Compared with private motor vehicle users, public transport users performed more daily steps (11443 vs. 10242 steps/day, p=0.04) After adjusting for gender, age group and average daily minutes of self-reported leisure-time physical activity, the odds of achieving 10,000 steps/day was higher in public transport users compared with private motor vehicle users (OR 3.55; 95% CI 1.34-9.38, p=0.01). Walking associated with public transport use appeared to contribute to university students achieving higher levels of daily steps. Encouraging public transport use could help increase and maintain community physical activity levels.

A systematic review of evidence for older adults' sedentary behavior and physical activity after hip fracture.

PubMed

Zusman, Enav Z; Dawes, Martin G; Edwards, Nicola; Ashe, Maureen C

2018-05-01

To synthesize evidence on older adults' sedentary behavior and physical activity during rehabilitation and recovery for hip fracture (1) across the care continuum and (2) from clinical interventions. We conducted a systematic review of peer-reviewed publications using CINAHL, Embase, Ovid MEDLINE, PsycINFO, and SportDiscus (last search: 17 October 2017). We included studies that measured sedentary behavior and physical activity of older adults with hip fracture using activity monitors (e.g. accelerometers). We identified literature at Level 1 (title and abstract) and Level 2 (full text), and conducted forward and backward searches. We assessed observational studies' adherence to reporting guidelines and intervention studies' risk of bias. We included 14 studies (882 participants). Four studies reported sedentary behavior data, while all studies reported information on physical activity. Settings included hospital, rehabilitation centers, and the community. Nine studies were observational; five were experimental design. Older adults had excessive sedentary time (>10 hours/day) and low physical activity. Participants' average upright time differed across settings. During hospital stay, it ranged 16-52 minutes/day, while in the community, it ranged 51-261 minutes/day. Data from five interventions reported on physical activity change: two studies increased between 14 and 27 minutes/day. Another study reported participants accumulated 6994 steps/day at the end of the intervention, but for two other interventions, activity was below 5000 steps/day. Based on available evidence, older adults with hip fracture engage in prolonged sedentary behavior and have low levels of physical activity during rehabilitation and recovery.

Efficiency of performing pulmonary procedures in a shared endoscopy unit: procedure time, turnaround time, delays, and procedure waiting time.

PubMed

Verma, Akash; Lee, Mui Yok; Wang, Chunhong; Hussein, Nurmalah B M; Selvi, Kalai; Tee, Augustine

2014-04-01

The purpose of this study was to assess the efficiency of performing pulmonary procedures in the endoscopy unit in a large teaching hospital. A prospective study from May 20 to July 19, 2013, was designed. The main outcome measures were procedure delays and their reasons, duration of procedural steps starting from patient's arrival to endoscopy unit, turnaround time, total case durations, and procedure wait time. A total of 65 procedures were observed. The most common procedure was BAL (61%) followed by TBLB (31%). Overall procedures for 35 (53.8%) of 65 patients were delayed by ≥ 30 minutes, 21/35 (60%) because of "spillover" of the gastrointestinal and surgical cases into the time block of pulmonary procedure. Time elapsed between end of pulmonary procedure and start of the next procedure was ≥ 30 minutes in 8/51 (16%) of cases. In 18/51 (35%) patients there was no next case in the room after completion of the pulmonary procedure. The average idle time of the room after the end of pulmonary procedure and start of next case or end of shift at 5:00 PM if no next case was 58 ± 53 minutes. In 17/51 (33%) patients the room's idle time was >60 minutes. A total of 52.3% of patients had the wait time >2 days and 11% had it ≥ 6 days, reason in 15/21 (71%) being unavailability of the slot. Most pulmonary procedures were delayed due to spillover of the gastrointestinal and surgical cases into the block time allocated to pulmonary procedures. The most common reason for difficulty encountered in scheduling the pulmonary procedure was slot unavailability. This caused increased procedure waiting time. The strategies to reduce procedure delays and turnaround times, along with improved scheduling methods, may have a favorable impact on the volume of procedures performed in the unit thereby optimizing the existing resources.

Vector Autoregressive Models and Granger Causality in Time Series Analysis in Nursing Research: Dynamic Changes Among Vital Signs Prior to Cardiorespiratory Instability Events as an Example.

PubMed

Bose, Eliezer; Hravnak, Marilyn; Sereika, Susan M

Patients undergoing continuous vital sign monitoring (heart rate [HR], respiratory rate [RR], pulse oximetry [SpO2]) in real time display interrelated vital sign changes during situations of physiological stress. Patterns in this physiological cross-talk could portend impending cardiorespiratory instability (CRI). Vector autoregressive (VAR) modeling with Granger causality tests is one of the most flexible ways to elucidate underlying causal mechanisms in time series data. The purpose of this article is to illustrate the development of patient-specific VAR models using vital sign time series data in a sample of acutely ill, monitored, step-down unit patients and determine their Granger causal dynamics prior to onset of an incident CRI. CRI was defined as vital signs beyond stipulated normality thresholds (HR = 40-140/minute, RR = 8-36/minute, SpO2 < 85%) and persisting for 3 minutes within a 5-minute moving window (60% of the duration of the window). A 6-hour time segment prior to onset of first CRI was chosen for time series modeling in 20 patients using a six-step procedure: (a) the uniform time series for each vital sign was assessed for stationarity, (b) appropriate lag was determined using a lag-length selection criteria, (c) the VAR model was constructed, (d) residual autocorrelation was assessed with the Lagrange Multiplier test, (e) stability of the VAR system was checked, and (f) Granger causality was evaluated in the final stable model. The primary cause of incident CRI was low SpO2 (60% of cases), followed by out-of-range RR (30%) and HR (10%). Granger causality testing revealed that change in RR caused change in HR (21%; i.e., RR changed before HR changed) more often than change in HR causing change in RR (15%). Similarly, changes in RR caused changes in SpO2 (15%) more often than changes in SpO2 caused changes in RR (9%). For HR and SpO2, changes in HR causing changes in SpO2 and changes in SpO2 causing changes in HR occurred with equal frequency (18%). Within this sample of acutely ill patients who experienced a CRI event, VAR modeling indicated that RR changes tend to occur before changes in HR and SpO2. These findings suggest that contextual assessment of RR changes as the earliest sign of CRI is warranted. Use of VAR modeling may be helpful in other nursing research applications based on time series data.

Can solvent induced surface modifications applied to screen-printed platforms enhance their electroanalytical performance?

PubMed

Blanco, Elias; Foster, Christopher W; Cumba, Loanda R; do Carmo, Devaney R; Banks, Craig E

2016-04-25

In this paper the effect of solvent induced chemical surface enhancements upon graphitic screen-printed electrodes (SPEs) is explored. Previous literature has indicated that treating the working electrode of a SPE with the solvent N,N-dimethylformamide (DMF) offers improvements within the electroanalytical response, resulting in a 57-fold increment in the electrode surface area compared to their unmodified counterparts. The protocol involves two steps: (i) the SPE is placed into DMF for a selected time, and (ii) it is cured in an oven at a selected time and temperature. Beneficial electroanalytical outputs are reported to be due to the increased surface area attributed to the binder within the bulk surface of the SPEs dissolving out during the immersion step (step i). We revisit this exciting concept and explore these solvent induced chemical surface enhancements using edge- and basal-plane like SPEs and a new bespoke SPE, utilising the solvent DMF and explore, in detail, the parameters utilised in steps (i) and (ii). The electrochemical performance following steps (i) and (ii) is evaluated using the outer-sphere redox probe hexaammineruthenium(iii) chloride/0.1 M KCl, where it is found that the largest improvement is obtained using DMF with an immersion time of 10 minutes and a curing time of 30 minutes at 100 °C. Solvent induced chemical surface enhancement upon the electrochemical performance of SPEs is also benchmarked in terms of their electroanalytical sensing of NADH (dihydronicotinamide adenine dinucleotide reduced form) and capsaicin both of which are compared to their unmodified SPE counterparts. In both cases, it is apparent that a marginal improvement in the electroanalytical sensitivity (i.e. gradient of calibration plots) of 1.08-fold and 1.38-fold are found respectively. Returning to the original exciting concept, interestingly it was found that when a poor experimental technique was employed, only then significant increases within the working electrode area are evident. In this case, the insulating layer that defines the working electrode surface, which was not protected from the solvent (step (i)) creates cracks within the insulating layer exposing the underlying carbon connections and thus increasing the electrode area by an unknown quantity. We infer that the origin of the response reported within the literature, where an extreme increase in the electrochemical surface area (57-fold) was reported, is unlikely to be solely due to the binder dissolving but rather poor experimental control over step (i).

STP (Solar-Terrestrial Physics) Newsletter 87-1

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

Not Available

1987-01-01

Contents include: SCOSTEP organization; draft minutes of SCOSTEP Bureau meeting, August 20-21, 1987; solar-terrestrial energy program (STEP), preliminary report; USSR participation in STEP; STEP Steering Committee meeting, August 1987; CEDAR Steering Committee report; future meetings; and SCOSTEP adherents, secretaries and correspondents.

Comparative evaluation of heart rate-based monitors: Apple Watch vs Fitbit Charge HR.

PubMed

Bai, Yang; Hibbing, Paul; Mantis, Constantine; Welk, Gregory J

2018-08-01

The purpose of this investigation was to examine the validity of energy expenditure (EE), steps, and heart rate measured with the Apple Watch 1 and Fitbit Charge HR. Thirty-nine healthy adults wore the two monitors while completing a semi-structured activity protocol consisting of 20 minutes of sedentary activity, 25 minutes of aerobic exercise, and 25 minutes of light intensity physical activity. Criterion measures were obtained from an Oxycon Mobile for EE, a pedometer for steps, and a Polar heart rate strap worn on the chest for heart rate. For estimating whole-trial EE, the mean absolute percent error (MAPE) from Fitbit Charge HR (32.9%) was more than twice that of Apple Watch 1 (15.2%). This trend was consistent for the individual conditions. Both monitors accurately assessed steps during aerobic activity (MAPE Apple : 6.2%; MAPE Fitbit : 9.4%) but overestimated steps in light physical activity. For heart rate, Fitbit Charge HR produced its smallest MAPE in sedentary behaviors (7.2%), followed by aerobic exercise (8.4%), and light activity (10.1%). The Apple Watch 1 had stronger validity than the Fitbit Charge HR for assessing overall EE and steps during aerobic exercise. The Fitbit Charge HR provided heart rate estimates that were statistically equivalent to Polar monitor.

The dissemination of clinical practice guidelines over an intranet: an evaluation.

PubMed Central

Stolte, J. J.; Ash, J.; Chin, H.

1999-01-01

This study compares two clinical practice guideline dissemination systems. It was hypothesized that placing guidelines on an intranet would make this information easier to retrieve. Retrieval time, retrieval accuracy, and ease of use were empirically evaluated. Sixteen clinicians from Kaiser Permanente volunteered to complete tasks that measured these variables. Time values were significantly longer for tasks completed with intranet guidelines (Intranet = 6.7 minutes, Paper = 5.7 minutes). Tasks completed with paper guidelines had a significantly higher percentage of perfect scores than those completed with the intranet (Paper = 85%, Intranet = 59%). There was no significant difference in reported ease of use. Simply placing clinical information on an electronic system does not guarantee that the information will be easier to retrieve. Such information needs to be fully integrated into the clinical decision making process. Computerizing guidelines may provide a necessary initial step toward this goal, but it does not represent the final solution. PMID:10566503

Combined subcritical water and enzymatic hydrolysis for reducing sugar production from coconut husk

NASA Astrophysics Data System (ADS)

Muharja, Maktum; Junianti, Fitri; Nurtono, Tantular; Widjaja, Arief

2017-05-01

Coconut husk wastes are abundantly available in Indonesia. It has a potential to be used into alternative renewable energy sources such as hydrogen using enzymatic hydrolysis followed by a fermentation process. Unfortunately, enzymatic hydrolysis is hampered by the complex structure of lignocellulose, so the cellulose component is hard to degrade. In this study, Combined Subcritical Water (SCW) and enzymatic hydrolysis are applied to enhance fermentable, thereby reducing production of sugar from coconut husk. There were two steps in this study, the first step was coconut husk pretreated by SCW in batch reactor at 80 bar and 150-200°C for 60 minutes reaction time. Secondly, solid fraction from the results of SCW was hydrolyzed using the mixture of pure cellulose and xylanase enzymes. Analysis was conducted on untreated and SCW-treated by gravimetric assay, liquid fraction after SCW and solid fraction after enzymatic hydrolysis using DNS assay. The maximum yield of reducing sugar (including xylose, arabinose glucose, galactose, mannose) was 1.254 gr per 6 gr raw material, representing 53.95% of total sugar in coconut husk biomass which was obtained at 150°C 80 bar for 60 minutes reaction time of SCW-treated and 6 hour of enzymatic hydrolysis using mixture of pure cellulose and xylanase enzymes (18.6 U /gram of coconut husk).

It is more efficient to type: innovative self-registration and appointment self-arrival system improves the patient reception process.

PubMed

Knight, Vickie; Guy, Rebecca J; Handan, Wand; Lu, Heng; McNulty, Anna

2014-06-01

In 2010, we introduced an express sexually transmitted infection/HIV testing service at a large metropolitan sexual health clinic, which significantly increased clinical service capacity. However, it also increased reception staff workload and caused backlogs of patients waiting to register or check in for appointments. We therefore implemented a new electronic self-registration and appointment self-arrival system in March 2012 to increase administrative efficiency and reduce waiting time for patients. We compared the median processing time overall and for each step of the registration and arrival process as well as the completeness of patient contact information recorded, in a 1-week period before and after the redesign of the registration system. χ2 Test and rank sum tests were used. Before the redesign, the median processing time was 8.33 minutes (interquartile range [IQR], 6.82-15.43), decreasing by 30% to 5.83 minutes (IQR, 4.75-7.42) when the new electronic self-registration and appointment self-arrival system was introduced (P < 0.001). The largest gain in efficiency was in the time taken to prepare the medical record for the clinician, reducing from a median of 5.31 minutes (IQR, 4.02-8.29) to 0.57 minutes (IQR, 0.38-1) in the 2 periods. Before implementation, 20% of patients provided a postal address and 31% an e-mail address, increasing to 60% and 70% post redesign, respectively (P < 0.001). Our evaluation shows that an electronic patient self-registration and appointment self-arrival system can improve clinic efficiency and save patient time. Systems like this one could be used by any outpatient service with large patient volumes as an integrated part of the electronic patient management system or as a standalone feature.

Decreasing the Preincision Time for Pulmonary Lobectomy: The Process of Lean and Value Stream Mapping.

PubMed

Cerfolio, Robert James; Steenwyk, Brad L; Watson, Caroline; Sparrow, James; Belopolsky, Victoria; Townsley, Matthew; Lyerly, Ralph; Downing, Michelle; Bryant, Ayesha; Gurley, William Quinton; Henling, Colleen; Crawford, Jack; Gayeski, Thomas E

2016-03-01

Our objective was to evaluate our results after the implementation of lean (the elimination of wasteful parts of a process). After meetings with our anesthesiologists, we standardized our "in the operating room-to-skin incision protocols" before pulmonary lobectomy. Patients were divided into consecutive cohorts of 300 lobectomy patients. Several protocols were slowly adopted and outcomes were evaluated. One surgeon performed 2,206 pulmonary lobectomies, of which 84% were for cancer. Protocols for lateral decubitus positioning changed over time. We eliminated axillary rolls, arm boards, and beanbags. Monitoring devices were slowly eliminated. Central catheters decreased from 75% to 0% of patients, epidurals from 84% to 3%, arterial catheters from 93% to 4%, and finally, Foley catheters were reduced from 99% to 11% (p ≤ 0.001 for all). A protocol for the insertion of double-lumen endotracheal tubes was established and times decreased (mean, 14 minutes to 1 minute; p = 0.001). After all changes were made, the time between operating room entry and incision decreased from a mean of 64 minutes to 37 minutes (p < 0.001). Outcomes improved, mortality decreased from 3.2% to 0.26% (p = 0.015), and major morbidity decreased from 15.2% to 5.3% (p = 0.042). Lean and value stream mapping can be safely applied to the clinical algorithms of high-risk patient care. We demonstrate that elimination of non-value-added steps can safely decrease preincision time without increasing patient risk in patients who undergo pulmonary lobectomy. Selected centers may be able to adopt some of these lean-driven protocols. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Six-Minute-Walk Distance and Accelerometry Predict Outcomes in Chronic Obstructive Pulmonary Disease Independent of Global Initiative for Chronic Obstructive Lung Disease 2011 Group

PubMed Central

Smith, Patrick J.; Babyak, Michael A.; Mabe, Stephanie K.; Martinu, Tereza; Welty-Wolf, Karen E.; Emery, Charles F.; Palmer, Scott M.; Blumenthal, James A.

2015-01-01

Rationale: The 2011 combined Global Initiative for Chronic Obstructive Lung Disease (GOLD) assessment incorporates symptoms, exacerbation history, and spirometry in discriminating risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD). Six-minute-walk distance (6MWD) and accelerometry also have been used to assess disease severity in COPD. The association between these measures and the risks of hospitalization and mortality in the context of GOLD 2011 is unknown. Objectives: To describe changes in exercise tolerance and physical activity over time in patients with COPD and to test the hypothesis that lower baseline 6MWD or accelerometry step count is associated with increased risk of COPD-related hospitalization or all-cause mortality, independent of GOLD 2011 group. Methods: Physical function and medical outcomes were prospectively assessed in 326 patients with moderate to severe COPD in INSPIRE-II, a randomized controlled trial of a coping skills training intervention. Cox models were used to determine if GOLD 2011 group, 6MWD, or accelerometry steps were associated with risk of COPD-related hospitalization or all-cause mortality. Measurements and Main Results: Physical function declined over time in GOLD group D but remained stable in groups A, B, and C. GOLD classification was associated with time to death or first COPD-related hospitalization. Baseline 6MWD was more strongly associated with time to death or first COPD-related hospitalization (hazard ratio, 0.50 [95% confidence interval, 0.34, 0.73] per 150 m, P = 0.0003) than GOLD 2011 classification. A similar relationship was observed for accelerometry steps (hazard ratio, 0.80 [95% confidence interval, 0.70, 0.92] per 1,000 steps, P = 0.002). Conclusions: Exercise tolerance and daily physical activity are important predictors of hospitalization and mortality in COPD, independent of GOLD 2011 classification. Physical function may represent a modifiable risk factor that warrants increased attention as a target for interventions to improve clinically meaningful outcomes in COPD. PMID:25568929

Circadian phase and its relationship to nighttime sleep in toddlers.

PubMed

LeBourgeois, Monique K; Carskadon, Mary A; Akacem, Lameese D; Simpkin, Charles T; Wright, Kenneth P; Achermann, Peter; Jenni, Oskar G

2013-10-01

Circadian phase and its relation to sleep are increasingly recognized as fundamental factors influencing human physiology and behavior. Dim light melatonin onset (DLMO) is a reliable marker of the timing of the circadian clock, which has been used in experimental, clinical, and descriptive studies in the past few decades. Although DLMO and its relationship to sleep have been well documented in school-aged children, adolescents, and adults, very little is known about these processes in early childhood. The purpose of this study was 1) to describe circadian phase and phase angles of entrainment in toddlers and 2) to examine associations between DLMO and actigraphic measures of children's nighttime sleep. Participants were 45 healthy toddlers aged 30 to 36 months (33.5 ± 2.2 months; 21 females). After sleeping on a parent-selected schedule for 5 days (assessed with actigraphy and diaries), children participated in an in-home DLMO assessment involving the collection of saliva samples every 30 minutes for 6 hours. Average bedtime was 2015 ± 0036 h, average sleep onset time was 2043 ± 0043 h, average midsleep time was 0143 ± 0038 h, and average wake time was 0644 ± 0042 h. Average DLMO was 1929 ± 0051 h, with a 3.5-hour range. DLMO was normally distributed; however, the distribution of the bedtime, sleep onset time, and midsleep phase angles of entrainment were skewed. On average, DLMO occurred 47.8 ± 47.6 minutes (median = 39.4 minutes) before bedtime, 74.6 ± 48.0 minutes (median = 65.4 minutes) before sleep onset time, 6.2 ± 0.7 hours (median = 6.1 hours) before midsleep time, and 11.3 ± 0.7 hours before wake time. Toddlers with later DLMOs had later bedtimes (r = 0.46), sleep onset times (r = 0.51), midsleep times (r = 0.66), and wake times (r = 0.65) (all p < 0.001). Interindividual differences in toddlers' circadian phase are large and associated with their sleep timing. The early DLMOs of toddlers indicate a maturational delay in the circadian timing system between early childhood and adolescence. These findings are a first step in describing the fundamental properties of the circadian system in toddlers and have important implications for understanding the emergence of sleep problems and the consequences of circadian misalignment in early childhood.

Responsiveness and Minimally Important Difference of the 6-Minute Stepper Test in Patients with Chronic Obstructive Pulmonary Disease.

PubMed

Pichon, Romain; Couturaud, Francis; Mialon, Philippe; Le Ber-Moy, Catherine; Péran, Loïc; Lochon, Chantal; Nowak, Emmanuel; Beaumont, Marc

2016-01-01

The validity and reproducibility of the 6-minute stepper test (6MST) have already been demonstrated in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the responsiveness of the 6MST to pulmonary rehabilitation (PR) in patients with COPD, to determine a minimal important difference (MID) for the 6MST, and to compare the 6MST and the 6-minute walk test (6MWT). Sixty-two patients with COPD were included in a prospective experimental study. Participants underwent a 3-week inpatient PR program. The primary outcome was the change in the number of steps during the 6MST measured before and after PR. The secondary outcome included the change in the 6-minute walking distance (6MWD) pulse oximetry, heart rate, dyspnea, and leg discomfort during the tests measured before and after PR. MID was determined by anchor-based and distribution approaches. After PR, we observed a significant increase in the number of steps during the 6MST (22.5 steps; 95% CI 13.8-31.3; p < 0.0001) and in the 6MWD (26.6 m; 95% CI 17.6-35.5; p < 0.0001). The 6MST and 6MWT were improved by 10.1 and 6.5%, respectively. The number of steps during the 6MST was significantly correlated with the 6MWD before (r = 0.72; p < 0.0001) and after PR (r = 0.66; p < 0.0001). MID was estimated to be around 20 steps. The 6MST appears to be as responsive as the 6MWT in assessing functional improvement during PR in patients with COPD. The 6MST is a low-cost assessment and requires limited space. © 2016 S. Karger AG, Basel.

Coal liquefaction process

DOEpatents

Maa, Peter S.

1978-01-01

A process for liquefying a particulate coal feed to produce useful petroleum-like liquid products which comprises contacting; in a series of two or more coal liquefaction zones, or stages, graded with respect to temperature, an admixture of a polar compound; or compounds, a hydrogen donor solvent and particulate coal, the total effluent being passed in each instance from a low temperature zone, or stage to the next succeeding higher temperature zone, or stage, of the series. The temperature within the initial zone, or stage, of the series is maintained about 70.degree. F and 750.degree. F and the temperature within the final zone, or stage, is maintained between about 750.degree. F and 950.degree. F. The residence time within the first zone, or stage, ranges, generally, from about 20 to about 150 minutes and residence time within each of the remaining zones, or stages, of the series ranges, generally, from about 10 minutes to about 70 minutes. Further steps of the process include: separating the product from the liquefaction zone into fractions inclusive of a liquid solvent fraction; hydrotreating said liquid solvent fraction in a hydrogenation zone; and recycling the hydrogenated liquid solvent mixture to said coal liquefaction zones.

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.

Patients with Chronic Obstructive Pulmonary Disease Walk with Altered Step Time and Step Width Variability as Compared with Healthy Control Subjects.

PubMed

Yentes, Jennifer M; Rennard, Stephen I; Schmid, Kendra K; Blanke, Daniel; Stergiou, Nicholas

2017-06-01

Compared with control subjects, patients with chronic obstructive pulmonary disease (COPD) have an increased incidence of falls and demonstrate balance deficits and alterations in mediolateral trunk acceleration while walking. Measures of gait variability have been implicated as indicators of fall risk, fear of falling, and future falls. To investigate whether alterations in gait variability are found in patients with COPD as compared with healthy control subjects. Twenty patients with COPD (16 males; mean age, 63.6 ± 9.7 yr; FEV 1 /FVC, 0.52 ± 0.12) and 20 control subjects (9 males; mean age, 62.5 ± 8.2 yr) walked for 3 minutes on a treadmill while their gait was recorded. The amount (SD and coefficient of variation) and structure of variability (sample entropy, a measure of regularity) were quantified for step length, time, and width at three walking speeds (self-selected and ±20% of self-selected speed). Generalized linear mixed models were used to compare dependent variables. Patients with COPD demonstrated increased mean and SD step time across all speed conditions as compared with control subjects. They also walked with a narrower step width that increased with increasing speed, whereas the healthy control subjects walked with a wider step width that decreased as speed increased. Further, patients with COPD demonstrated less variability in step width, with decreased SD, compared with control subjects at all three speed conditions. No differences in regularity of gait patterns were found between groups. Patients with COPD walk with increased duration of time between steps, and this timing is more variable than that of control subjects. They also walk with a narrower step width in which the variability of the step widths from step to step is decreased. Changes in these parameters have been related to increased risk of falling in aging research. This provides a mechanism that could explain the increased prevalence of falls in patients with COPD.

30 min of treadmill walking at self-selected speed does not increase gait variability in independent elderly.

PubMed

Da Rocha, Emmanuel S; Kunzler, Marcos R; Bobbert, Maarten F; Duysens, Jacques; Carpes, Felipe P

2018-06-01

Walking is one of the preferred exercises among elderly, but could a prolonged walking increase gait variability, a risk factor for a fall in the elderly? Here we determine whether 30 min of treadmill walking increases coefficient of variation of gait in elderly. Because gait responses to exercise depend on fitness level, we included 15 sedentary and 15 active elderly. Sedentary participants preferred a lower gait speed and made smaller steps than the actives. Step length coefficient of variation decreased ~16.9% by the end of the exercise in both the groups. Stride length coefficient of variation decreased ~9% after 10 minutes of walking, and sedentary elderly showed a slightly larger step width coefficient of variation (~2%) at 10 min than active elderly. Active elderly showed higher walk ratio (step length/cadence) than sedentary in all times of walking, but the times did not differ in both the groups. In conclusion, treadmill gait kinematics differ between sedentary and active elderly, but changes over time are similar in sedentary and active elderly. As a practical implication, 30 min of walking might be a good strategy of exercise for elderly, independently of the fitness level, because it did not increase variability in step and stride kinematics, which is considered a risk of fall in this population.

Increasing accuracy of pulse transit time measurements by automated elimination of distorted photoplethysmography waves.

PubMed

van Velzen, Marit H N; Loeve, Arjo J; Niehof, Sjoerd P; Mik, Egbert G

2017-11-01

Photoplethysmography (PPG) is a widely available non-invasive optical technique to visualize pressure pulse waves (PWs). Pulse transit time (PTT) is a physiological parameter that is often derived from calculations on ECG and PPG signals and is based on tightly defined characteristics of the PW shape. PPG signals are sensitive to artefacts. Coughing or movement of the subject can affect PW shapes that much that the PWs become unsuitable for further analysis. The aim of this study was to develop an algorithm that automatically and objectively eliminates unsuitable PWs. In order to develop a proper algorithm for eliminating unsuitable PWs, a literature study was conducted. Next, a '7Step PW-Filter' algorithm was developed that applies seven criteria to determine whether a PW matches the characteristics required to allow PTT calculation. To validate whether the '7Step PW-Filter' eliminates only and all unsuitable PWs, its elimination results were compared to the outcome of manual elimination of unsuitable PWs. The '7Step PW-Filter' had a sensitivity of 96.3% and a specificity of 99.3%. The overall accuracy of the '7Step PW-Filter' for detection of unsuitable PWs was 99.3%. Compared to manual elimination, using the '7Step PW-Filter' reduces PW elimination times from hours to minutes and helps to increase the validity, reliability and reproducibility of PTT data.

RiseTx: testing the feasibility of a web application for reducing sedentary behavior among prostate cancer survivors receiving androgen deprivation therapy.

PubMed

Trinh, Linda; Arbour-Nicitopoulos, Kelly P; Sabiston, Catherine M; Berry, Scott R; Loblaw, Andrew; Alibhai, Shabbir M H; Jones, Jennifer M; Faulkner, Guy E

2018-06-07

Given the high levels of sedentary time and treatment-related side effects in prostate cancer survivors (PCS), interventions targeting sedentary behavior (SED) may be more sustainable compared to physical activity (PA). To examine the feasibility of a web-based intervention (RiseTx) for reducing SED and increasing moderate-to-vigorous physical activity (MVPA) among PCS undergoing ADT. Secondary outcomes include changes in SED, MVPA, light intensity PA, and quality of life. Forty-six PCS were recruited from two cancer centres in Toronto, Ontario, Canada between July 2015-October 2016. PCS were given an activity tracker (Jawbone), access to the RiseTx website program, and provided with a goal of increasing walking by 3000 daily steps above baseline levels over a 12-week period. A range of support tools were progressively released to reduce SED time (e.g., self-monitoring of steps) during the five-phase program. Objective measures of SED, MVPA, and daily steps were compared across the 12-week intervention using linear mixed models. Of the 46 PCS enrolled in the study, 42 completed the SED intervention, representing a 9% attrition rate. Measurement completion rates were 97 and 65% at immediately post-intervention and 12-week follow-up for all measures, respectively. Overall adherence was 64% for total number of logins (i.e., > 3 visits each week). Sample mean age was 73.2 ± 7.3 years, mean BMI was 28.0 ± 3.0 kg/m 2 , mean number of months since diagnosis was 93.6 ± 71.2, and 72% had ADT administered continuously. Significant reductions of 455.4 weekly minutes of SED time were observed at post-intervention (p = .005). Significant increases of + 44.1 for weekly minutes of MVPA was observed at immediately post-intervention (p = .010). There were significant increases in step counts of + 1535 steps from baseline to post-intervention (p < .001). RiseTx was successful in reducing SED and increasing MVPA in PCS. PCS were satisfied with the intervention and its components. Additional strategies may be needed though for maintenance of behavior change. The next step for RiseTx is to replicate these findings in a larger, randomized controlled trial that will have the potential for reducing sedentary time among PCS. NCT03321149 (ClinicalTrials.gov Identifier).

SU-G-JeP3-07: Real-Time Image Guided Radiation Therapy for Heterotopic Ossification in Patients After Hip Replacement

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

Le, A; Jiang, S; Timmerman, R

Purpose: To demonstrate the feasibility of using CBCT in a real-time image guided radiation therapy (IGRT) for single fraction heterotopic ossification (HO) in patients after hip replacement. In this real-time procedure, all steps, from simulation, imaging, planning to treatment delivery, are performed at the treatment unit in one appointment time slot. This work promotes real-time treatment to create a paradigm shift in the single fraction radiation therapy. Methods: An integrated real-time IGRT for HO was developed and tested for radiation treatment of heterotopic ossification for patient after hip replacement. After CBCT images are acquired at the linac, and sent tomore » the treatment planning system, the physician determines the field and/or draws a block. Subsequently, a simple 2D AP/PA plan with prescription of 700 cGy is created on-the-fly for physician to review. Once the physician approves the plan, the patient is treated on the same simulation position. This real-time treatment requires the team of attending physician, physicist, therapists, and dosimetrist to work in harmony to achieve all the steps in a timely manner. Results: Ten patients have been treated with this real-time treatment, having the same beams arrangement treatment plan and prescription as our clinically regular CT-based 2D plans. The average time for these procedures are 52.9 ±10.7 minutes from the time patient entered the treatment room until s/he exited, and 37.7 ±8.6 minutes from starting CBCT until last beam delivered. Conclusion: The real-time IGRT for HO treatment has been tested and implemented to be a clinically accepted procedure. This one-time appointment greatly enhances the waiting time, especially when patients in high level of pain, and provides a convenient approach for the whole clinical staff. Other disease sites will be also tested with this new technology.« less

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.

The One-Minute Preceptor: a five-step tool to improve clinical teaching skills.

PubMed

Kertis, Margo

2007-01-01

The One-Minute Preceptor (OMP) is a teaching tool that has been used successfully for over 10 years in family practice residency programs. It was designed to enhance the teaching skills of physicians involved in the clinical education of new residents. This article describes the five steps of the OMP and how it was taught to a group of nurse preceptors and reports their evaluations of the impact that this education had on their ability to instruct and offer feedback to the novice nurse.

True cadence and step accumulation are not equivalent: the effect of intermittent claudication on free-living cadence.

PubMed

Stansfield, B; Clarke, C; Dall, P; Godwin, J; Holdsworth, R; Granat, M

2015-02-01

'True cadence' is the rate of stepping during the period of stepping. 'Step accumulation' is the steps within an epoch of time (e.g. 1min). These terms have been used interchangeably in the literature. These outcomes are compared within a population with intermittent claudication (IC). Multiday, 24h stepping activity of those with IC (30) and controls (30) was measured objectively using the activPAL physical activity monitor. 'True cadence' and 'step accumulation' outcomes were calculated. Those with IC took fewer steps/d 6531±2712 than controls 8692±2945 (P=0.003). However, these steps were taken within approximately the same number of minute epochs (IC 301±100min/d; controls 300±70min/d, P=0.894) with only slightly lower true cadence (IC 69 (IQ 66,72) steps/min; controls 72 (IQ 68,76) steps/min, P=0.026), giving substantially lower step accumulation (IC 22 (IQ 19,24) steps/min; controls 30 (IQ 23,34) steps/min) (P<0.001). However, the true cadence of stepping within the blocks of the 1, 5, 20, 30 and 60min with the maximum number of steps accumulated was lower for those with IC than controls (P<0.05). Those with IC took 1300 steps fewer per day above a true cadence of 90 steps/min. True cadence and step accumulation outcomes were radically different for the outcomes examined. 'True cadence' and 'step accumulation' were not equivalent in those with IC or controls. The measurement of true cadence in the population of people with IC provides information about their stepping rate during the time they are stepping. True cadence should be used to correctly describe the rate of stepping as performed. Copyright © 2014 Elsevier B.V. All rights reserved.

A simple and efficient method for poly-3-hydroxybutyrate quantification in diazotrophic bacteria within 5 minutes using flow cytometry.

PubMed

Alves, L P S; Almeida, A T; Cruz, L M; Pedrosa, F O; de Souza, E M; Chubatsu, L S; Müller-Santos, M; Valdameri, G

2017-01-16

The conventional method for quantification of polyhydroxyalkanoates based on whole-cell methanolysis and gas chromatography (GC) is laborious and time-consuming. In this work, a method based on flow cytometry of Nile red stained bacterial cells was established to quantify poly-3-hydroxybutyrate (PHB) production by the diazotrophic and plant-associated bacteria, Herbaspirillum seropedicae and Azospirillum brasilense. The method consists of three steps: i) cell permeabilization, ii) Nile red staining, and iii) analysis by flow cytometry. The method was optimized step-by-step and can be carried out in less than 5 min. The final results indicated a high correlation coefficient (R2=0.99) compared to a standard method based on methanolysis and GC. This method was successfully applied to the quantification of PHB in epiphytic bacteria isolated from rice roots.

Sun Exposure and Protection Habits in Pediatric Patients with a History of Malignancy

PubMed Central

Levy-Shraga, Yael; Cohen, Rinat; Ben Ami, Michal; Yeshayahu, Yonatan; Temam, Vered; Modan-Moses, Dalit

2015-01-01

Background Survivors of childhood cancer are at high risk for developing non-melanoma skin cancer and therefore are firmly advised to avoid or minimize sun exposure and adopt skin protection measures. We aimed to compare sun exposure and protection habits in a cohort of pediatric patients with a history of malignancy to those of healthy controls. Methods Case-control study of 143 pediatric patients with a history of malignancy (aged 11.2±4.6y, Male = 68, mean interval from diagnosis 4.4±3.8y) and 150 healthy controls (aged 10.4±4.8y, Male = 67). Sun exposure and protection habits were assessed using validated questionnaires. Results Patients and controls reported similar sun exposure time during weekdays (94±82minutes/day vs. 81±65minutes/day; p = 0.83), while during weekends patients spent significantly less time outside compared to controls (103±85minutes/day vs. 124±87minutes/day; p = 0.02). Time elapsed from diagnosis positively correlated with time spent outside both during weekdays (r = 0.194, p = 0.02) and weekends (r = 0.217, p = 0.01), and there was a step-up in sun exposure starting three years after diagnosis. There was no significant difference regarding composite sun protection score between patients and controls. Age was positively correlated with number of sunburns per year and sun exposure for the purpose of tanning, and was negatively correlated with the use of sun protection measures. Conclusions Although childhood cancer survivors are firmly instructed to adopt sun protection habits, the adherence to these instructions is incomplete, and more attention should be paid to improve these habits throughout their lives. Since sunlight avoidance may results in vitamin D deficiency, dietary supplementation will likely be needed. PMID:26348212

A cross-sectional study of the individual, social, and built environmental correlates of pedometer-based physical activity among elementary school children.

PubMed

McCormack, Gavin R; Giles-Corti, Billie; Timperio, Anna; Wood, Georgina; Villanueva, Karen

2011-04-12

Children who participate in regular physical activity obtain health benefits. Preliminary pedometer-based cut-points representing sufficient levels of physical activity among youth have been established; however limited evidence regarding correlates of achieving these cut-points exists. The purpose of this study was to identify correlates of pedometer-based cut-points among elementary school-aged children. A cross-section of children in grades 5-7 (10-12 years of age) were randomly selected from the most (n = 13) and least (n = 12) 'walkable' public elementary schools (Perth, Western Australia), stratified by socioeconomic status. Children (n = 1480; response rate = 56.6%) and parents (n = 1332; response rate = 88.8%) completed a survey, and steps were collected from children using pedometers. Pedometer data were categorized to reflect the sex-specific pedometer-based cut-points of ≥15000 steps/day for boys and ≥12000 steps/day for girls. Associations between socio-demographic characteristics, sedentary and active leisure-time behavior, independent mobility, active transportation and built environmental variables - collected from the child and parent surveys - and meeting pedometer-based cut-points were estimated (odds ratios: OR) using generalized estimating equations. Overall 927 children participated in all components of the study and provided complete data. On average, children took 11407 ± 3136 steps/day (boys: 12270 ± 3350 vs. girls: 10681 ± 2745 steps/day; p < 0.001) and 25.9% (boys: 19.1 vs. girls: 31.6%; p < 0.001) achieved the pedometer-based cut-points.After adjusting for all other variables and school clustering, meeting the pedometer-based cut-points was negatively associated (p < 0.05) with being male (OR = 0.42), parent self-reported number of different destinations in the neighborhood (OR 0.93), and a friend's (OR 0.62) or relative's (OR 0.44, boys only) house being at least a 10-minute walk from home. Achieving the pedometer-based cut-points was positively associated with participating in screen-time < 2 hours/day (OR 1.88), not being driven to school (OR 1.48), attending a school located in a high SES neighborhood (OR 1.33), the average number of steps among children within the respondent's grade (for each 500 step/day increase: OR 1.29), and living further than a 10-minute walk from a relative's house (OR 1.69, girls only). Comprehensive multi-level interventions that reduce screen-time, encourage active travel to/from school and foster a physically active classroom culture might encourage more physical activity among children.

A cross-sectional study of the individual, social, and built environmental correlates of pedometer-based physical activity among elementary school children

PubMed Central

2011-01-01

Background Children who participate in regular physical activity obtain health benefits. Preliminary pedometer-based cut-points representing sufficient levels of physical activity among youth have been established; however limited evidence regarding correlates of achieving these cut-points exists. The purpose of this study was to identify correlates of pedometer-based cut-points among elementary school-aged children. Method A cross-section of children in grades 5-7 (10-12 years of age) were randomly selected from the most (n = 13) and least (n = 12) 'walkable' public elementary schools (Perth, Western Australia), stratified by socioeconomic status. Children (n = 1480; response rate = 56.6%) and parents (n = 1332; response rate = 88.8%) completed a survey, and steps were collected from children using pedometers. Pedometer data were categorized to reflect the sex-specific pedometer-based cut-points of ≥15000 steps/day for boys and ≥12000 steps/day for girls. Associations between socio-demographic characteristics, sedentary and active leisure-time behavior, independent mobility, active transportation and built environmental variables - collected from the child and parent surveys - and meeting pedometer-based cut-points were estimated (odds ratios: OR) using generalized estimating equations. Results Overall 927 children participated in all components of the study and provided complete data. On average, children took 11407 ± 3136 steps/day (boys: 12270 ± 3350 vs. girls: 10681 ± 2745 steps/day; p < 0.001) and 25.9% (boys: 19.1 vs. girls: 31.6%; p < 0.001) achieved the pedometer-based cut-points. After adjusting for all other variables and school clustering, meeting the pedometer-based cut-points was negatively associated (p < 0.05) with being male (OR = 0.42), parent self-reported number of different destinations in the neighborhood (OR 0.93), and a friend's (OR 0.62) or relative's (OR 0.44, boys only) house being at least a 10-minute walk from home. Achieving the pedometer-based cut-points was positively associated with participating in screen-time < 2 hours/day (OR 1.88), not being driven to school (OR 1.48), attending a school located in a high SES neighborhood (OR 1.33), the average number of steps among children within the respondent's grade (for each 500 step/day increase: OR 1.29), and living further than a 10-minute walk from a relative's house (OR 1.69, girls only). Conclusions Comprehensive multi-level interventions that reduce screen-time, encourage active travel to/from school and foster a physically active classroom culture might encourage more physical activity among children. PMID:21486475

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.

Vector Autoregressive (VAR) Models and Granger Causality in Time Series Analysis in Nursing Research: Dynamic Changes Among Vital Signs Prior to Cardiorespiratory Instability Events as an Example

PubMed Central

Bose, Eliezer; Hravnak, Marilyn; Sereika, Susan M.

2016-01-01

Background Patients undergoing continuous vital sign monitoring (heart rate [HR], respiratory rate [RR], pulse oximetry [SpO2]) in real time display inter-related vital sign changes during situations of physiologic stress. Patterns in this physiological cross-talk could portend impending cardiorespiratory instability (CRI). Vector autoregressive (VAR) modeling with Granger causality tests is one of the most flexible ways to elucidate underlying causal mechanisms in time series data. Purpose The purpose of this article is to illustrate development of patient-specific VAR models using vital sign time series (VSTS) data in a sample of acutely ill, monitored, step-down unit (SDU) patients, and determine their Granger causal dynamics prior to onset of an incident CRI. Approach CRI was defined as vital signs beyond stipulated normality thresholds (HR = 40–140/minute, RR = 8–36/minute, SpO2 < 85%) and persisting for 3 minutes within a 5-minute moving window (60% of the duration of the window). A 6-hour time segment prior to onset of first CRI was chosen for time series modeling in 20 patients using a six-step procedure: (a) the uniform time series for each vital sign was assessed for stationarity; (b) appropriate lag was determined using a lag-length selection criteria; (c) the VAR model was constructed; (d) residual autocorrelation was assessed with the Lagrange Multiplier test; (e) stability of the VAR system was checked; and (f) Granger causality was evaluated in the final stable model. Results The primary cause of incident CRI was low SpO2 (60% of cases), followed by out-of-range RR (30%) and HR (10%). Granger causality testing revealed that change in RR caused change in HR (21%) (i.e., RR changed before HR changed) more often than change in HR causing change in RR (15%). Similarly, changes in RR caused changes in SpO2 (15%) more often than changes in SpO2 caused changes in RR (9%). For HR and SpO2, changes in HR causing changes in SpO2 and changes in SpO2 causing changes in HR occurred with equal frequency (18%). Discussion Within this sample of acutely ill patients who experienced a CRI event, VAR modeling indicated that RR changes tend to occur before changes in HR and SpO2. These findings suggest that contextual assessment of RR changes as the earliest sign of CRI is warranted. Use of VAR modeling may be helpful in other nursing research applications based on time series data. PMID:27977564

Two-step irradiance schedule versus single-dose tramadol sustained-release tablets for pain control during topical 5-aminolevulinic acid-photodynamic therapy of condyloma acuminatum in Chinese patients: a randomized comparative study.

PubMed

Mchepange, Uwesu O; Huang, Chun-Yan; Sun, Yi; Tu, Ya-Ting; Tao, Juan

2014-07-01

Photodynamic therapy with 5-aminolevulinic acid (ALA-PDT) offers promising results for the treatment of condyloma acuminatum. However, patients have to dwell with pain to benefit from this otherwise effective and safe "off-label" treatment modality. Several techniques have been explored to control ALA-PDT-induced pain, but the desperate search for a universally accepted method is still ongoing. This study compares the two-step irradiance approach with single-dose administration of 100 mg tramadol sustained-release tablets for pain induced by ALA-PDT of condyloma acuminatum in Chinese patients. Adult Chinese patients with condyloma acuminatum were enrolled in a randomized comparative study. Pain levels were compared using the Numeric Rating Scale (NRS) at pre-defined assessment points during and after irradiation. The pain was dominated by characteristics such as burning and pricking and was almost always local and superficial. The median pain scores were lower in the two-step irradiance group at 1 minute (U = 621.5, P = 0.002) but higher at 20 minutes (U = 585.5, P = 0.002). The median pain scores between the two groups did not differ significantly at other assessment points. The pain was moderate in both groups and peaked earlier in the analgesics group (median: 5 minutes) but later in the two-step irradiance group (median: 15 minutes). The pain was generally mild. The median pain scores were equal at each assessment point, except at 3 hours where the median was lower in the analgesics group (1.0) as compared with the two-step irradiance group (2.0) (U = 725.0, P = 0.056). Pain in the two-step irradiance protocol is irradiance-dependent. The two-step irradiance approach produces significant benefits over analgesics during the initial stages of therapy but analgesics offer significant benefits thereafter. There are potential benefits of combining the two approaches in minimizing ALA-PDT-induced pain. © 2014 Wiley Periodicals, Inc.

elPrep: High-Performance Preparation of Sequence Alignment/Map Files for Variant Calling

PubMed Central

Decap, Dries; Fostier, Jan; Reumers, Joke

2015-01-01

elPrep is a high-performance tool for preparing sequence alignment/map files for variant calling in sequencing pipelines. It can be used as a replacement for SAMtools and Picard for preparation steps such as filtering, sorting, marking duplicates, reordering contigs, and so on, while producing identical results. What sets elPrep apart is its software architecture that allows executing preparation pipelines by making only a single pass through the data, no matter how many preparation steps are used in the pipeline. elPrep is designed as a multithreaded application that runs entirely in memory, avoids repeated file I/O, and merges the computation of several preparation steps to significantly speed up the execution time. For example, for a preparation pipeline of five steps on a whole-exome BAM file (NA12878), we reduce the execution time from about 1:40 hours, when using a combination of SAMtools and Picard, to about 15 minutes when using elPrep, while utilising the same server resources, here 48 threads and 23GB of RAM. For the same pipeline on whole-genome data (NA12878), elPrep reduces the runtime from 24 hours to less than 5 hours. As a typical clinical study may contain sequencing data for hundreds of patients, elPrep can remove several hundreds of hours of computing time, and thus substantially reduce analysis time and cost. PMID:26182406

Estimating Physical Activity and Sedentary Behavior in a Free-Living Context: A Pragmatic Comparison of Consumer-Based Activity Trackers and ActiGraph Accelerometry.

PubMed

Gomersall, Sjaan R; Ng, Norman; Burton, Nicola W; Pavey, Toby G; Gilson, Nicholas D; Brown, Wendy J

2016-09-07

Activity trackers are increasingly popular with both consumers and researchers for monitoring activity and for promoting positive behavior change. However, there is a lack of research investigating the performance of these devices in free-living contexts, for which findings are likely to vary from studies conducted in well-controlled laboratory settings. The aim was to compare Fitbit One and Jawbone UP estimates of steps, moderate-to-vigorous physical activity (MVPA), and sedentary behavior with data from the ActiGraph GT3X+ accelerometer in a free-living context. Thirty-two participants were recruited using convenience sampling; 29 provided valid data for this study (female: 90%, 26/29; age: mean 39.6, SD 11.0 years). On two occasions for 7 days each, participants wore an ActiGraph GT3X+ accelerometer on their right hip and either a hip-worn Fitbit One (n=14) or wrist-worn Jawbone UP (n=15) activity tracker. Daily estimates of steps and very active minutes were derived from the Fitbit One (n=135 days) and steps, active time, and longest idle time from the Jawbone UP (n=154 days). Daily estimates of steps, MVPA, and longest sedentary bout were derived from the corresponding days of ActiGraph data. Correlation coefficients and Bland-Altman plots with examination of systematic bias were used to assess convergent validity and agreement between the devices and the ActiGraph. Cohen's kappa was used to assess the agreement between each device and the ActiGraph for classification of active versus inactive (≥10,000 steps per day and ≥30 min/day of MVPA) comparable with public health guidelines. Correlations with ActiGraph estimates of steps and MVPA ranged between .72 and .90 for Fitbit One and .56 and .75 for Jawbone UP. Compared with ActiGraph estimates, both devices overestimated daily steps by 8% (Fitbit One) and 14% (Jawbone UP). However, mean differences were larger for daily MVPA (Fitbit One: underestimated by 46%; Jawbone UP: overestimated by 50%). There was systematic bias across all outcomes for both devices. Correlations with ActiGraph data for longest idle time (Jawbone UP) ranged from .08 to .19. Agreement for classifying days as active or inactive using the ≥10,000 steps/day criterion was substantial (Fitbit One: κ=.68; Jawbone UP: κ=.52) and slight-fair using the criterion of ≥30 min/day of MVPA (Fitbit One: κ=.40; Jawbone UP: κ=.14). There was moderate-strong agreement between the ActiGraph and both Fitbit One and Jawbone UP for the estimation of daily steps. However, due to modest accuracy and systematic bias, they are better suited for consumer-based self-monitoring (eg, for the public consumer or in behavior change interventions) rather than to evaluate research outcomes. The outcomes that relate to health-enhancing MVPA (eg, "very active minutes" for Fitbit One or "active time" for Jawbone UP) and sedentary behavior ("idle time" for Jawbone UP) should be used with caution by consumers and researchers alike.

The association between the maximum step length test and the walking efficiency in children with cerebral palsy.

PubMed

Kimoto, Minoru; Okada, Kyoji; Sakamoto, Hitoshi; Kondou, Takanori

2017-05-01

[Purpose] To improve walking efficiency could be useful for reducing fatigue and extending possible period of walking in children with cerebral palsy (CP). For this purpose, current study compared conventional parameters of gross motor performance, step length, and cadence in the evaluation of walking efficiency in children with CP. [Subjects and Methods] Thirty-one children with CP (21 boys, 10 girls; mean age, 12.3 ± 2.7 years) participated. Parameters of gross motor performance, including the maximum step length (MSL), maximum side step length, step number, lateral step up number, and single leg standing time, were measured in both dominant and non-dominant sides. Spatio-temporal parameters of walking, including speed, step length, and cadence, were calculated. Total heart beat index (THBI), a parameter of walking efficiency, was also calculated from heartbeats and walking distance in 10 minutes of walking. To analyze the relationships between these parameters and the THBI, the coefficients of determination were calculated using stepwise analysis. [Results] The MSL of the dominant side best accounted for the THBI (R 2 =0.759). [Conclusion] The MSL of the dominant side was the best explanatory parameter for walking efficiency in children with CP.

Glucose diffusion in pancreatic islets of Langerhans.

PubMed Central

Bertram, R; Pernarowski, M

1998-01-01

We investigate the time required for glucose to diffuse through an isolated pancreatic islet of Langerhans and reach an equilibrium. This question is relevant in the context of in vitro electrophysiological studies of the response of an islet to step changes in the bath glucose concentration. Islet cells are electrically coupled by gap junctions, so nonuniformities in islet glucose concentration may be reflected in the activity of cells on the islet periphery, where electrical recordings are made. Using a mathematical model of hindered glucose diffusion, we investigate the effects of the islet porosity and the permeability of a surrounding layer of acinar cells. A major factor in the determination of the equilibrium time is the transport of glucose into islet beta-cells, which removes glucose from the interstitial spaces where diffusion occurs. This transport is incorporated by using a model of the GLUT-2 glucose transporter. We find that several minutes are required for the islet to equilibrate to a 10 mM change in bath glucose, a typical protocol in islet experiments. It is therefore likely that in electrophysiological islet experiments the glucose distribution is nonuniform for several minutes after a step change in bath glucose. The delay in glucose penetration to the inner portions of the islet may be a major contributing factor to the 1-2-min delay in islet electrical activity typically observed after bath application of a stimulatory concentration of glucose. PMID:9545035

Necessity of purification during bacterial DNA extraction with environmental soils

PubMed Central

Choi, Jung-Hyun

2017-01-01

Complexity and heterogeneity of soil samples have often implied the inclusion of purification steps in conventional DNA extraction for polymerase chain reaction (PCR) assays. Unfortunately the purification steps are also time and labor intensive. Therefore the necessity of DNA purification was re-visited and investigated for a variety of environmental soil samples that contained various amounts of PCR inhibitors. Bead beating and centrifugation was used as the baseline (without purification) method for DNA extraction. Its performance was compared with that of conventional DNA extraction kit (with purification). The necessity criteria for DNA purification were established with environmental soil samples. Using lysis conditions at 3000 rpm for 3 minutes with 0.1 mm glass beads, centrifugation time of 10 minutes and 1:10 dilution ratio, the baseline method outperformed conventional DNA extraction on cell seeded sand samples. Further investigation with PCR inhibitors (i.e., humic acids, clay, and magnesium [Mg]) showed that sand samples containing less than 10 μg/g humic acids and 70% clay may not require purifications. Interestingly, the inhibition pattern of Mg ion was different from other inhibitors due to the complexation interaction of Mg ion with DNA fragments. It was concluded that DNA extraction method without purification is suitable for soil samples that have less than 10 μg/g of humic acids, less than 70% clay content and less than 0.01% Mg ion content. PMID:28793754

Internet for Educators[TM]: A Step-by-Step Guide To Help Educators Understand and Use the Internet. [Videotape].

ERIC Educational Resources Information Center

1996

This 66-minute videotape is part of an ongoing Internet education series, exploring the fascinating resources of the Internet. It is a step-by-step guide demonstrating effective techniques for using the World Wide Web, e-mail, file transfer protocol and other technologies. The program examines the Internet phenomenon from the educator's point of…

The effect of a worksite based walking programme on cardiovascular risk in previously sedentary civil servants [NCT00284479].

PubMed

Murphy, Marie H; Murtagh, Elaine M; Boreham, Colin Ag; Hare, Lesley G; Nevill, Alan M

2006-05-22

A significant proportion of Europeans do not meet the recommendations for 30 mins of physical activity 5 times per week. Whether lower frequency, moderate intensity exercise alters cardiovascular disease (CVD) risk has received little attention. This study examined the effects of 45 minutes self-paced walking, 2 d. wk(-1) on aerobic fitness, blood pressure (BP), body composition, lipids and C-Reactive Protein (CRP) in previously sedentary civil servants. 37 subjects (24 women) aged 41.5 +/- 9.3 years were randomly assigned to either two 45 minute walks per week (walking group) or no training (control group). Aerobic fitness, body composition, blood pressure (BP), CRP and lipoprotein variables were measured at baseline and following 8 weeks. Steps counts were measured at baseline and during weeks 4 and 8 of the intervention. Compared to the control group, the walking group showed a significant reduction in systolic BP and maintained body fat levels (P < 0.05). There were no changes other risk factors. Subjects took significantly more steps on the days when prescribed walking was performed (9303 +/- 2665) compared to rest days (5803 +/- 2749; P < 0.001). These findings suggest that walking twice per week for 45 minutes at approximately 62% HRmax, improves activity levels, reduces systolic BP and prevents an increase in body fat in previously sedentary adults. This walking prescription, however, failed to induce significant improvements in other markers of cardiovascular disease risk following eight weeks of training.

Relationship between physical function and biomechanical gait patterns in boys with haemophilia.

PubMed

Stephensen, D; Taylor, S; Bladen, M; Drechsler, W I

2016-11-01

The World Federation of Haemophilia recommends joint and muscle health is evaluated using X-ray and magnetic resonance imaging, together with clinical examination scores. To date, inclusion of performance-based functional activities to monitor children with the condition has received little attention. To evaluate test-retest repeatability of physical function tests and quantify relationships between physical function, lower limb muscle strength and gait patterns in young boys with haemophilia. Timed 6-minute walk, timed up and down stairs, timed single leg stance, muscle strength of the knee extensors, ankle dorsi and plantar flexors, together with joint biomechanics during level walking were collected from 21 boys aged 6-12 years with severe haemophilia. Measures of physical function and recording of muscle strength with a hand-held myometer were repeatable (ICC > 0.78). Distances walked in six minutes, time taken to go up and down a flight of stairs and lower limb muscle strength correlated closely with ankle range of motion, together with peak knee flexion and ankle dorsi and plantarflexion moments during walking (P < 0.05). Alterations in gait patterns of boys with haemophilia appear to be associated with changes in performance of physical function and performance seems to depend on their muscle strength. Timed 6-minute walk test, timed up and down steps test and muscle strength of the knee extensors showed the strongest correlation with biomechanical joint function, and hence might serve as a basis for the clinical monitoring of physical function outcomes in children with haemophilia. © 2016 John Wiley & Sons Ltd.

Effect of gender, cadence, and water immersion on ground reaction forces during stationary running.

PubMed

de Brito Fontana, Heiliane; Haupenthal, Alessandro; Ruschel, Caroline; Hubert, Marcel; Ridehalgh, Colette; Roesler, Helio

2012-05-01

Controlled laboratory study. To analyze the vertical and anteroposterior components of the ground reaction force during stationary running performed in water and on dry land, focusing on the effect of gender, level of immersion, and cadence. Stationary running, as a fundamental component of aquatic rehabilitation and training protocols, is little explored in the literature with regard to biomechanical variables, which makes it difficult to determine and control the mechanical load acting on the individuals. Twenty-two subjects performed 1 minute of stationary running on land, immersed to the hip, and immersed to the chest at 3 different cadences: 90 steps per minute, 110 steps per minute, and 130 steps per minute. Force data were acquired with a force plate, and the variables were vertical peak (Fy), loading rate (LR), anterior peak (Fx anterior), and posterior peak (Fx posterior). Data were normalized to subjects' body weight (BW) and analyzed using repeated-measures analysis of variance. Fy ranged from 0.98 to 2.11 BW, LR ranged from 5.38 to 11.52 BW/s, Fx anterior ranged from 0.07 to 0.14 BW, and Fx posterior ranged from 0.06 to 0.09 BW. The gender factor had no effect on the variables analyzed. A significant interaction between level of immersion and cadence was observed for Fy, Fx anterior, and Fx posterior. On dry land, Fy increased with increasing cadence, whereas in water this effect was seen only between 90 steps per minute and the 2 higher cadences. The higher the level of immersion, the lower the magnitude of Fy. LR was reduced under both water conditions and increased with increasing cadence, regardless of the level of immersion. Ground reaction forces during stationary running are similar between genders. Fy and LR are lower in water, though the values are increased at higher cadences.

Optimal Exploitation of the Temporal and Spatial Resolution of SEVIRI for the Nowcasting of Clouds

NASA Astrophysics Data System (ADS)

Sirch, Tobias; Bugliaro, Luca

2015-04-01

Optimal Exploitation of the Temporal and Spatial Resolution of SEVIRI for the Nowcasting of Clouds An algorithm was developed to forecast the development of water and ice clouds for the successive 5-120 minutes separately using satellite data from SEVIRI (Spinning Enhanced Visible and Infrared Imager) aboard Meteosat Second Generation (MSG). In order to derive cloud cover, optical thickness and cloud top height of high ice clouds "The Cirrus Optical properties derived from CALIOP and SEVIRI during day and night" (COCS, Kox et al. [2014]) algorithm is applied. For the determination of the liquid water clouds the APICS ("Algorithm for the Physical Investigation of Clouds with SEVIRI", Bugliaro e al. [2011]) cloud algorithm is used, which provides cloud cover, optical thickness and effective radius. The forecast rests upon an optical flow method determining a motion vector field from two satellite images [Zinner et al., 2008.] With the aim of determining the ideal time separation of the satellite images that are used for the determination of the cloud motion vector field for every forecast horizon time the potential of the better temporal resolution of the Meteosat Rapid Scan Service (5 instead of 15 minutes repetition rate) has been investigated. Therefore for the period from March to June 2013 forecasts up to 4 hours in time steps of 5 min based on images separated by a time interval of 5 min, 10 min, 15 min, 30 min have been created. The results show that Rapid Scan data produces a small reduction of errors for a forecast horizon up to 30 minutes. For the following time steps forecasts generated with a time interval of 15 min should be used and for forecasts up to several hours computations with a time interval of 30 min provide the best results. For a better spatial resolution the HRV channel (High Resolution Visible, 1km instead of 3km maximum spatial resolution at the subsatellite point) has been integrated into the forecast. To detect clouds the difference of the measured albedo from SEVIRI and the clear-sky albedo provided by MODIS has been used and additionally the temporal development of this quantity. A pre-requisite for this work was an adjustment of the geolocation accuracy for MSG and MODIS by shifting the MODIS data and quantifying the correlation between both data sets.

Fortran programs for the time-dependent Gross-Pitaevskii equation in a fully anisotropic trap

NASA Astrophysics Data System (ADS)

Muruganandam, P.; Adhikari, S. K.

2009-10-01

Here we develop simple numerical algorithms for both stationary and non-stationary solutions of the time-dependent Gross-Pitaevskii (GP) equation describing the properties of Bose-Einstein condensates at ultra low temperatures. In particular, we consider algorithms involving real- and imaginary-time propagation based on a split-step Crank-Nicolson method. In a one-space-variable form of the GP equation we consider the one-dimensional, two-dimensional circularly-symmetric, and the three-dimensional spherically-symmetric harmonic-oscillator traps. In the two-space-variable form we consider the GP equation in two-dimensional anisotropic and three-dimensional axially-symmetric traps. The fully-anisotropic three-dimensional GP equation is also considered. Numerical results for the chemical potential and root-mean-square size of stationary states are reported using imaginary-time propagation programs for all the cases and compared with previously obtained results. Also presented are numerical results of non-stationary oscillation for different trap symmetries using real-time propagation programs. A set of convenient working codes developed in Fortran 77 are also provided for all these cases (twelve programs in all). In the case of two or three space variables, Fortran 90/95 versions provide some simplification over the Fortran 77 programs, and these programs are also included (six programs in all). Program summaryProgram title: (i) imagetime1d, (ii) imagetime2d, (iii) imagetime3d, (iv) imagetimecir, (v) imagetimesph, (vi) imagetimeaxial, (vii) realtime1d, (viii) realtime2d, (ix) realtime3d, (x) realtimecir, (xi) realtimesph, (xii) realtimeaxial Catalogue identifier: AEDU_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEDU_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 122 907 No. of bytes in distributed program, including test data, etc.: 609 662 Distribution format: tar.gz Programming language: FORTRAN 77 and Fortran 90/95 Computer: PC Operating system: Linux, Unix RAM: 1 GByte (i, iv, v), 2 GByte (ii, vi, vii, x, xi), 4 GByte (iii, viii, xii), 8 GByte (ix) Classification: 2.9, 4.3, 4.12 Nature of problem: These programs are designed to solve the time-dependent Gross-Pitaevskii nonlinear partial differential equation in one-, two- or three-space dimensions with a harmonic, circularly-symmetric, spherically-symmetric, axially-symmetric or anisotropic trap. The Gross-Pitaevskii equation describes the properties of a dilute trapped Bose-Einstein condensate. Solution method: The time-dependent Gross-Pitaevskii equation is solved by the split-step Crank-Nicolson method by discretizing in space and time. The discretized equation is then solved by propagation, in either imaginary or real time, over small time steps. The method yields the solution of stationary and/or non-stationary problems. Additional comments: This package consists of 12 programs, see "Program title", above. FORTRAN77 versions are provided for each of the 12 and, in addition, Fortran 90/95 versions are included for ii, iii, vi, viii, ix, xii. For the particular purpose of each program please see the below. Running time: Minutes on a medium PC (i, iv, v, vii, x, xi), a few hours on a medium PC (ii, vi, viii, xii), days on a medium PC (iii, ix). Program summary (1)Title of program: imagtime1d.F Title of electronic file: imagtime1d.tar.gz Catalogue identifier: Program summary URL: Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Distribution format: tar.gz Computers: PC/Linux, workstation/UNIX Maximum RAM memory: 1 GByte Programming language used: Fortran 77 Typical running time: Minutes on a medium PC Unusual features: None Nature of physical problem: This program is designed to solve the time-dependent Gross-Pitaevskii nonlinear partial differential equation in one-space dimension with a harmonic trap. The Gross-Pitaevskii equation describes the properties of a dilute trapped Bose-Einstein condensate. Method of solution: The time-dependent Gross-Pitaevskii equation is solved by the split-step Crank-Nicolson method by discretizing in space and time. The discretized equation is then solved by propagation in imaginary time over small time steps. The method yields the solution of stationary problems. Program summary (2)Title of program: imagtimecir.F Title of electronic file: imagtimecir.tar.gz Catalogue identifier: Program summary URL: Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Distribution format: tar.gz Computers: PC/Linux, workstation/UNIX Maximum RAM memory: 1 GByte Programming language used: Fortran 77 Typical running time: Minutes on a medium PC Unusual features: None Nature of physical problem: This program is designed to solve the time-dependent Gross-Pitaevskii nonlinear partial differential equation in two-space dimensions with a circularly-symmetric trap. The Gross-Pitaevskii equation describes the properties of a dilute trapped Bose-Einstein condensate. Method of solution: The time-dependent Gross-Pitaevskii equation is solved by the split-step Crank-Nicolson method by discretizing in space and time. The discretized equation is then solved by propagation in imaginary time over small time steps. The method yields the solution of stationary problems. Program summary (3)Title of program: imagtimesph.F Title of electronic file: imagtimesph.tar.gz Catalogue identifier: Program summary URL: Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Distribution format: tar.gz Computers: PC/Linux, workstation/UNIX Maximum RAM memory: 1 GByte Programming language used: Fortran 77 Typical running time: Minutes on a medium PC Unusual features: None Nature of physical problem: This program is designed to solve the time-dependent Gross-Pitaevskii nonlinear partial differential equation in three-space dimensions with a spherically-symmetric trap. The Gross-Pitaevskii equation describes the properties of a dilute trapped Bose-Einstein condensate. Method of solution: The time-dependent Gross-Pitaevskii equation is solved by the split-step Crank-Nicolson method by discretizing in space and time. The discretized equation is then solved by propagation in imaginary time over small time steps. The method yields the solution of stationary problems. Program summary (4)Title of program: realtime1d.F Title of electronic file: realtime1d.tar.gz Catalogue identifier: Program summary URL: Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Distribution format: tar.gz Computers: PC/Linux, workstation/UNIX Maximum RAM memory: 2 GByte Programming language used: Fortran 77 Typical running time: Minutes on a medium PC Unusual features: None Nature of physical problem: This program is designed to solve the time-dependent Gross-Pitaevskii nonlinear partial differential equation in one-space dimension with a harmonic trap. The Gross-Pitaevskii equation describes the properties of a dilute trapped Bose-Einstein condensate. Method of solution: The time-dependent Gross-Pitaevskii equation is solved by the split-step Crank-Nicolson method by discretizing in space and time. The discretized equation is then solved by propagation in real time over small time steps. The method yields the solution of stationary and non-stationary problems. Program summary (5)Title of program: realtimecir.F Title of electronic file: realtimecir.tar.gz Catalogue identifier: Program summary URL: Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Distribution format: tar.gz Computers: PC/Linux, workstation/UNIX Maximum RAM memory: 2 GByte Programming language used: Fortran 77 Typical running time: Minutes on a medium PC Unusual features: None Nature of physical problem: This program is designed to solve the time-dependent Gross-Pitaevskii nonlinear partial differential equation in two-space dimensions with a circularly-symmetric trap. The Gross-Pitaevskii equation describes the properties of a dilute trapped Bose-Einstein condensate. Method of solution: The time-dependent Gross-Pitaevskii equation is solved by the split-step Crank-Nicolson method by discretizing in space and time. The discretized equation is then solved by propagation in real time over small time steps. The method yields the solution of stationary and non-stationary problems. Program summary (6)Title of program: realtimesph.F Title of electronic file: realtimesph.tar.gz Catalogue identifier: Program summary URL: Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Distribution format: tar.gz Computers: PC/Linux, workstation/UNIX Maximum RAM memory: 2 GByte Programming language used: Fortran 77 Typical running time: Minutes on a medium PC Unusual features: None Nature of physical problem: This program is designed to solve the time-dependent Gross-Pitaevskii nonlinear partial differential equation in three-space dimensions with a spherically-symmetric trap. The Gross-Pitaevskii equation describes the properties of a dilute trapped Bose-Einstein condensate. Method of solution: The time-dependent Gross-Pitaevskii equation is solved by the split-step Crank-Nicolson method by discretizing in space and time. The discretized equation is then solved by propagation in real time over small time steps. The method yields the solution of stationary and non-stationary problems. Program summary (7)Title of programs: imagtimeaxial.F and imagtimeaxial.f90 Title of electronic file: imagtimeaxial.tar.gz Catalogue identifier: Program summary URL: Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Distribution format: tar.gz Computers: PC/Linux, workstation/UNIX Maximum RAM memory: 2 GByte Programming language used: Fortran 77 and Fortran 90 Typical running time: Few hours on a medium PC Unusual features: None Nature of physical problem: This program is designed to solve the time-dependent Gross-Pitaevskii nonlinear partial differential equation in three-space dimensions with an axially-symmetric trap. The Gross-Pitaevskii equation describes the properties of a dilute trapped Bose-Einstein condensate. Method of solution: The time-dependent Gross-Pitaevskii equation is solved by the split-step Crank-Nicolson method by discretizing in space and time. The discretized equation is then solved by propagation in imaginary time over small time steps. The method yields the solution of stationary problems. Program summary (8)Title of program: imagtime2d.F and imagtime2d.f90 Title of electronic file: imagtime2d.tar.gz Catalogue identifier: Program summary URL: Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Distribution format: tar.gz Computers: PC/Linux, workstation/UNIX Maximum RAM memory: 2 GByte Programming language used: Fortran 77 and Fortran 90 Typical running time: Few hours on a medium PC Unusual features: None Nature of physical problem: This program is designed to solve the time-dependent Gross-Pitaevskii nonlinear partial differential equation in two-space dimensions with an anisotropic trap. The Gross-Pitaevskii equation describes the properties of a dilute trapped Bose-Einstein condensate. Method of solution: The time-dependent Gross-Pitaevskii equation is solved by the split-step Crank-Nicolson method by discretizing in space and time. The discretized equation is then solved by propagation in imaginary time over small time steps. The method yields the solution of stationary problems. Program summary (9)Title of program: realtimeaxial.F and realtimeaxial.f90 Title of electronic file: realtimeaxial.tar.gz Catalogue identifier: Program summary URL: Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Distribution format: tar.gz Computers: PC/Linux, workstation/UNIX Maximum RAM memory: 4 GByte Programming language used: Fortran 77 and Fortran 90 Typical running time Hours on a medium PC Unusual features: None Nature of physical problem: This program is designed to solve the time-dependent Gross-Pitaevskii nonlinear partial differential equation in three-space dimensions with an axially-symmetric trap. The Gross-Pitaevskii equation describes the properties of a dilute trapped Bose-Einstein condensate. Method of solution: The time-dependent Gross-Pitaevskii equation is solved by the split-step Crank-Nicolson method by discretizing in space and time. The discretized equation is then solved by propagation in real time over small time steps. The method yields the solution of stationary and non-stationary problems. Program summary (10)Title of program: realtime2d.F and realtime2d.f90 Title of electronic file: realtime2d.tar.gz Catalogue identifier: Program summary URL: Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Distribution format: tar.gz Computers: PC/Linux, workstation/UNIX Maximum RAM memory: 4 GByte Programming language used: Fortran 77 and Fortran 90 Typical running time: Hours on a medium PC Unusual features: None Nature of physical problem: This program is designed to solve the time-dependent Gross-Pitaevskii nonlinear partial differential equation in two-space dimensions with an anisotropic trap. The Gross-Pitaevskii equation describes the properties of a dilute trapped Bose-Einstein condensate. Method of solution: The time-dependent Gross-Pitaevskii equation is solved by the split-step Crank-Nicolson method by discretizing in space and time. The discretized equation is then solved by propagation in real time over small time steps. The method yields the solution of stationary and non-stationary problems. Program summary (11)Title of program: imagtime3d.F and imagtime3d.f90 Title of electronic file: imagtime3d.tar.gz Catalogue identifier: Program summary URL: Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Distribution format: tar.gz Computers: PC/Linux, workstation/UNIX Maximum RAM memory: 4 GByte Programming language used: Fortran 77 and Fortran 90 Typical running time: Few days on a medium PC Unusual features: None Nature of physical problem: This program is designed to solve the time-dependent Gross-Pitaevskii nonlinear partial differential equation in three-space dimensions with an anisotropic trap. The Gross-Pitaevskii equation describes the properties of a dilute trapped Bose-Einstein condensate. Method of solution: The time-dependent Gross-Pitaevskii equation is solved by the split-step Crank-Nicolson method by discretizing in space and time. The discretized equation is then solved by propagation in imaginary time over small time steps. The method yields the solution of stationary problems. Program summary (12)Title of program: realtime3d.F and realtime3d.f90 Title of electronic file: realtime3d.tar.gz Catalogue identifier: Program summary URL: Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Distribution format: tar.gz Computers: PC/Linux, workstation/UNIX Maximum Ram Memory: 8 GByte Programming language used: Fortran 77 and Fortran 90 Typical running time: Days on a medium PC Unusual features: None Nature of physical problem: This program is designed to solve the time-dependent Gross-Pitaevskii nonlinear partial differential equation in three-space dimensions with an anisotropic trap. The Gross-Pitaevskii equation describes the properties of a dilute trapped Bose-Einstein condensate. Method of solution: The time-dependent Gross-Pitaevskii equation is solved by the split-step Crank-Nicolson method by discretizing in space and time. The discretized equation is then solved by propagation in real time over small time steps. The method yields the solution of stationary and non-stationary problems.

Discrepancy between functional exercise capacity and daily physical activity: a cross-sectional study in patients with mild to moderate COPD.

PubMed

Fastenau, Annemieke; van Schayck, Onno C P; Gosselink, Rik; Aretz, Karin C P M; Muris, Jean W M

2013-12-01

In patients with moderate to severe chronic obstructive pulmonary disease (COPD) the six-minute walk distance reflects the functional exercise level for daily physical activity. It is unknown if this also applies to patients with mild to moderate COPD in primary care. To assess the relationship between functional exercise capacity and physical activity in patients with mild to moderate COPD. A cross-sectional study was performed in 51 patients with mild to moderate COPD in primary care. Functional exercise capacity was assessed by the six-minute walk test and physical activity was measured with an accelerometer-based activity monitor. Functional exercise capacity was close to normal values. However, the daily physical activity of the patients could be classified as 'sedentary' and 'low active'. No significant correlations were observed between six-minute walk distance (% predicted) and any of the physical activity variables (steps per day, movement intensity during walking, total active time, total walking time, physical activity level, and time spent in moderate physical activity). A discrepancy was found between functional exercise capacity and daily physical activity in patients with mild to moderate COPD recruited and assessed in primary care. We conclude that these variables represent two different concepts. Our results reinforce the importance of measuring daily physical activity in order to fine-tune treatment (i.e. focusing on enhancement of exercise capacity or behavioural change, or both).

One-step laparoscopic and endoscopic treatment of gallbladder and common bile duct stones: our experience of the last 9 years in a retrospective study.

PubMed

Liverani, Andrea; Muroni, Mirko; Santi, Francesco; Neri, Tiziano; Anastasio, Gerardo; Moretti, Marco; Favi, Francesco; Solinas, Luigi

2013-12-01

The optimal timing and best method for removal of common bile duct stones (CBDS) associated with gallbladder stones (GBS) is still controversial. The aim of this study is to investigate the outcomes of a single-step procedure combining laparoscopic cholecystectomy (LC), intraoperative cholangiography (IOC), and endoscopic retrograde cholangiopancreatography (ERCP). Between January 2003 and January 2012, 1972 patients underwent cholecystectomy at our hospital. Of those, 162 patients (8.2%; male/female 72/90) presented with GBS and suspected CBDS. We treated 54 cases (Group 1) with ERCP and LC within 48 to 72 hours. In 108 patients (Group 2) we performed LC with IOC and, if positive, was associated with IO-ERCP and sphincterotomy. In Group 1, a preoperative ERCP and LC were completed in 50 patients (30%). In four cases (2%), an ERCP and endobiliary stents were performed without cholecystectomy and then patients were discharged because of the severity of clinical conditions and advanced American Society of Anesthesiologists score (III to IV). Two months later a preoperative ERCP and removal of biliary stents were performed followed by LC 48 to 72 hours later. In Group 2, the IOC was performed in all cases and CBDS were extracted in 94 patients (87%). In two cases, the laparoscopic choledochotomy was necessary to remove large stones. In another two cases, an open choledochotomy was performed to remove safely the stones with T-tube drainage. In three cases, conversion was necessary to safely complete the procedure. The mean operative time was 95 minutes (range, 45 to 150 minutes) in Group 1 and 130 minutes (range, 50 to 300 minutes) in Group 2. The mean hospital stay was 6.5 days (range, 4 to 21 days) in Group 1 and 4.7 days (range, 3 to 14 days) in Group 2. Five cases (two in Group 2 and three in Group 1) presented with CBDS at 12 to 18 months after surgery. They were treated successfully with a second ERCP. There was no perioperative mortality. Our experience suggests that when clinically and technically feasible, a single-stage approach combining LC, IOC, and ERCP to the patients diagnosed with chole-choledocholithiasis is indicated. The IO-ERCP with CBDS extraction is a safe and effective method with low risk of postoperative pancreatitis. One-step treatment is more comfortable for the patient and also reduces the mean hospital stay.

Reducing door-to-needle times using Toyota's lean manufacturing principles and value stream analysis.

PubMed

Ford, Andria L; Williams, Jennifer A; Spencer, Mary; McCammon, Craig; Khoury, Naim; Sampson, Tomoko R; Panagos, Peter; Lee, Jin-Moo

2012-12-01

Earlier tissue-type plasminogen activator (tPA) treatment for acute ischemic stroke increases efficacy, prompting national efforts to reduce door-to-needle times. We used lean process improvement methodology to develop a streamlined intravenous tPA protocol. In early 2011, a multidisciplinary team analyzed the steps required to treat patients with acute ischemic stroke with intravenous tPA using value stream analysis (VSA). We directly compared the tPA-treated patients in the "pre-VSA" epoch with the "post-VSA" epoch with regard to baseline characteristics, protocol metrics, and clinical outcomes. The VSA revealed several tPA protocol inefficiencies: routing of patients to room, then to CT, then back to the room; serial processing of workflow; and delays in waiting for laboratory results. On March 1, 2011, a new protocol incorporated changes to minimize delays: routing patients directly to head CT before the patient room, using parallel process workflow, and implementing point-of-care laboratories. In the pre and post-VSA epochs, 132 and 87 patients were treated with intravenous tPA, respectively. Compared with pre-VSA, door-to-needle times and percent of patients treated ≤60 minutes from hospital arrival were improved in the post-VSA epoch: 60 minutes versus 39 minutes (P<0.0001) and 52% versus 78% (P<0.0001), respectively, with no change in symptomatic hemorrhage rate. Lean process improvement methodology can expedite time-dependent stroke care without compromising safety.

Retzus-sparing robotic-assisted laparoscopic radical prostatectomy: a step-by-step technique description of this first brazilian experience.

PubMed

Tobias-Machado, Marcos; Nunes-Silva, Igor; Hidaka, Alexandre Kiyoshi; Sato, Leticia Lumy Kanawa; Almeida, Roberto; Colombo, Jose Roberto; Zampolli, Hamilton de Campos; Pompeo, Antonio Carlos Lima

2016-01-01

Retzus-sparing robotic-assisted radical prostatectomy(RARP) is a newly approach that preserve the Retzus structures and provide better recovery of continence and erectile function. In Brazil, this approach has not yet been pre¬viously reported. Our goal is to describe Step-by-Step the Retzus-sparing RARP surgical technique and report our first Brazilian experience. We present a case of a 60-year-old white man with low risk prostate cancer. Surgical materials were four arms Da Vinci robotic platform system, six transperitoneal portals, two prolene wires and Polymer Clips. This surgical tech¬nique was step-by-step described according to Galfano et al. One additional step was added as a modification of Galfano et al. Primary technique description: The closure of the Denovellier fascia. We have operated one patient with this technique. The operative time was 180minutes, console time was135 min, the blood loss was 150ml, none perioperative or postoperative complications was found, hospital stay of 01 day. The anatomopathological classification revealed a pT2aN0M0 specimen with free surgical margins. The patient achieved continence immediately after bladder stent retrieval. Full erection reported after 30 days of surgery. Retzus-sparing RARP approach is feasible and reproducible. However, further comparative studies are neces¬sary to demonstrate potential benefits in continence and sexual outcomes over the standard approaches. Copyright® by the International Brazilian Journal of Urology.

Physical activity levels early after lung transplantation.

PubMed

Wickerson, Lisa; Mathur, Sunita; Singer, Lianne G; Brooks, Dina

2015-04-01

Little is known of the early changes in physical activity after lung transplantation. The purposes of this study were: (1) to describe physical activity levels in patients up to 6 months following lung transplantation and (2) to explore predictors of the change in physical activity in that population. This was a prospective cohort study. Physical activity (daily steps and time spent in moderate-intensity activity) was measured using an accelerometer before and after transplantation (at hospital discharge, 3 months, and 6 months). Additional functional measurements included submaximal exercise capacity (measured with the 6-Minute Walk Test), quadriceps muscle torque, and health-related quality of life (measured with the Medical Outcomes Study 36-Item Short-Form Health Survey 36 [SF-36] and the St George's Respiratory Questionnaire). Thirty-six lung transplant recipients (18 men, 18 women; mean age=49 years, SD=14) completed posttransplant measurements. Before transplant, daily steps were less than a third of the general population. By 3 months posttransplant, the largest improvement in physical activity had occurred, and level of daily steps reached 55% of the general population. The change in daily steps (pretransplant to 3 months posttransplant) was inversely correlated with pretransplant 6-minute walk distance (r=-.48, P=.007), daily steps (r=-.36, P=.05), and SF-36 physical functioning (SF-36 PF) score (r=-.59, P=.0005). The SF-36 PF was a significant predictor of the change in physical activity, accounting for 35% of the variation in change in daily steps. Only individuals who were ambulatory prior to transplant and discharged from the hospital in less than 3 months were included in the study. Physical activity levels improve following lung transplantation, particularly in individuals with low self-reported physical functioning. However, the majority of lung transplant recipients remain sedentary between 3 to 6 months following transplant. The role of exercise training, education, and counseling in further improving physical activity levels in lung transplant recipients should be further explored. © 2015 American Physical Therapy Association.

People with stroke spend more time in active task practice, but similar time in walking practice, when physiotherapy rehabilitation is provided in circuit classes compared to individual therapy sessions: an observational study.

PubMed

English, Coralie; Hillier, Susan; Kaur, Gurpreet; Hundertmark, Laura

2014-03-01

Do people with stroke spend more time in active task practice during circuit class therapy sessions versus individual physiotherapy sessions? Do people with stroke practise different tasks during circuit class therapy sessions versus individual physiotherapy sessions? Prospective, observational study. Twenty-nine people with stroke in inpatient rehabilitation settings. Individual therapy sessions and circuit class therapy sessions provided within a larger randomised controlled trial. Seventy-nine therapy sessions were video-recorded and the footage was analysed for time spent engaged in various categories of activity. In a subsample of 28 videos, the number of steps taken by people with stroke per therapy session was counted. Circuit class therapy sessions were of a longer duration (mean difference 38.0minutes, 95% CI 29.9 to 46.1), and participants spent more time engaged in active task practice (mean difference 23.8minutes, 95% CI 16.1 to 31.4) compared with individual sessions. A greater percentage of time in circuit class therapy sessions was spent practising tasks in sitting (mean difference 5.3%, 95% CI 2.4 to 8.2) and in sit-to-stand practice (mean difference 2.7%, 95% CI 1.4 to 4.1), and a lower percentage of time in walking practice (mean difference 19.1%, 95% CI 10.0 to 28.1) compared with individual sessions. PARTICIPANTS took an average of 371 steps (SD 418) during therapy sessions and this did not differ significantly between group and individual sessions. People with stroke spent more time in active task practice, but a similar amount of time in walking practice when physiotherapy was offered in circuit class therapy sessions versus individual therapy sessions. There is a need for effective strategies to increase the amount of walking practice during physiotherapy sessions for people after stroke. Copyright © 2014 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Does Pedometer Goal Setting Improve Physical Activity among Native Elders? Results from a Randomized Pilot Study

ERIC Educational Resources Information Center

Sawchuk, Craig N.; Russo, Joan E.; Charles, Steve; Goldberg, Jack; Forquera, Ralph; Roy-Byrne, Peter; Buchwald, Dedra

2011-01-01

We examined if step-count goal setting resulted in increases in physical activity and walking compared to only monitoring step counts with pedometers among American Indian/Alaska Native elders. Outcomes included step counts, self-reported physical activity and well-being, and performance on the 6-minute walk test. Although no significant…

A simple and efficient method for poly-3-hydroxybutyrate quantification in diazotrophic bacteria within 5 minutes using flow cytometry

PubMed Central

Alves, L.P.S.; Almeida, A.T.; Cruz, L.M.; Pedrosa, F.O.; de Souza, E.M.; Chubatsu, L.S.; Müller-Santos, M.; Valdameri, G.

2017-01-01

The conventional method for quantification of polyhydroxyalkanoates based on whole-cell methanolysis and gas chromatography (GC) is laborious and time-consuming. In this work, a method based on flow cytometry of Nile red stained bacterial cells was established to quantify poly-3-hydroxybutyrate (PHB) production by the diazotrophic and plant-associated bacteria, Herbaspirillum seropedicae and Azospirillum brasilense. The method consists of three steps: i) cell permeabilization, ii) Nile red staining, and iii) analysis by flow cytometry. The method was optimized step-by-step and can be carried out in less than 5 min. The final results indicated a high correlation coefficient (R2=0.99) compared to a standard method based on methanolysis and GC. This method was successfully applied to the quantification of PHB in epiphytic bacteria isolated from rice roots. PMID:28099582

Sleep Tracking and Exercise in Patients With Type 2 Diabetes Mellitus (Step-D): Pilot Study to Determine Correlations Between Fitbit Data and Patient-Reported Outcomes

PubMed Central

2018-01-01

Background Few studies assessing the correlation between patient-reported outcomes and patient-generated health data from wearable devices exist. Objective The aim of this study was to determine the direction and magnitude of associations between patient-generated health data (from the Fitbit Charge HR) and patient-reported outcomes for sleep patterns and physical activity in patients with type 2 diabetes mellitus (T2DM). Methods This was a pilot study conducted with adults diagnosed with T2DM (n=86). All participants wore a Fitbit Charge HR for 14 consecutive days and completed internet-based surveys at 3 time points: day 1, day 7, and day 14. Patient-generated health data included minutes asleep and number of steps taken. Questionnaires assessed the number of days of exercise and nights of sleep problems per week. Means and SDs were calculated for all data, and Pearson correlations were used to examine associations between patient-reported outcomes and patient-generated health data. All respondents provided informed consent before participating. Results The participants were predominantly middle-aged (mean 54.3, SD 13.3 years), white (80/86, 93%), and female (50/86, 58%). Use of oral T2DM medication correlated with the number of mean steps taken (r=.35, P=.001), whereas being unaware of the glycated hemoglobin level correlated with the number of minutes asleep (r=−.24, P=.04). On the basis of the Fitbit data, participants walked an average of 4955 steps and slept 6.7 hours per day. They self-reported an average of 2.0 days of exercise and 2.3 nights of sleep problems per week. The association between the number of days exercised and steps walked was strong (r=.60, P<.001), whereas the association between the number of troubled sleep nights and minutes asleep was weaker (r=.28, P=.02). Conclusions Fitbit and patient-reported data were positively associated for physical activity as well as sleep, with the former more strongly correlated than the latter. As extensive patient monitoring can guide clinical decisions regarding T2DM therapy, passive, objective data collection through wearables could potentially enhance patient care, resulting in better patient-reported outcomes. PMID:29871856

Light regulation of the growth response in corn root gravitropism

NASA Technical Reports Server (NTRS)

Kelly, M. O.; Leopold, A. C.

1992-01-01

Roots of Merit variety corn (Zea mays L.) require red light for orthogravitropic curvature. Experiments were undertaken to identify the step in the pathway from gravity perception to asymmetric growth on which light may act. Red light was effective in inducing gravitropism whether it was supplied concomitant with or as long as 30 minutes after the gravity stimulus (GS). The presentation time was the same whether the GS was supplied in red light or in darkness. Red light given before the GS slightly enhanced the rate of curvature but had little effect on the lag time or on the final curvature. This enhancement was expanded by a delay between the red light pulse and the GS. These results indicate that gravity perception and at least the initial transduction steps proceed in the dark. Light may regulate the final growth (motor) phase of gravitropism. The time required for full expression of the light enhancement of curvature is consistent with its involvement in some light-stimulated biosynthetic event.

"Go home, sit less: The impact of home versus hospital rehabilitation environment on activity levels of stroke survivors".

PubMed

Simpson, Dawn B; Breslin, Monique; Cumming, Toby; de Zoete, Sam; Gall, Seana L; Schmidt, Matthew; English, Coralie; Callisaya, Michele L

2018-05-08

To examine whether change in rehabilitation environment (hospital or home) and other factors, influence time spent sitting, upright and walking after stroke. Observational study. Two inpatient rehabilitation units, and community residences following discharge. Thirty-four participants with stroke were recruited. An activity monitor was worn continuously for 7 days during the final week in hospital, and first week home. Other covariates included mood, fatigue, physical function, pain and cognition. Linear mixed models were performed to examine the associations between the environment (exposure) and physical activity levels (outcome) in hospital and at home. Interaction terms between the exposure and other covariates were added to the model to determine whether they modified activity with change in environment. The mean age of participants was 68 [SD 13] years and 53% were male. At home, participants spent 45 fewer minutes sitting (95% CI -84.8, -6.1; p=0.02), 45 more minutes upright (95% CI 6.1, 84.8; p=0.02), 12 more minutes walking (95% CI 5, 19; p=0.001) and completed 724 additional steps (95% CI 199, 1250; p=0.01) each day compared to in hospital. Depression at discharge predicted greater sitting time and less upright time (p=0.03 respectively) at home. Environmental change from hospital to home was associated with reduced sitting time and increased the time spent physically active, though depression modified this change. The rehabilitation environment may be a target to reduce sitting and promote physical activity. Copyright © 2018. Published by Elsevier Inc.

Staff walking program: a quasi-experimental trial of maintenance newsletters to maintain walking following a pedometer program.

PubMed

Borg, Janelle; Merom, Dafna; Rissel, Chris

2010-04-01

The Step by Step self-help walking program plus a pedometer previously motivated a community sample of adults to be physically active for up to three months. This study evaluates the effect of enhancement of this program over an additional nine months in a workplace. A quasi-experimental trial was conducted. Staff defined as inactive received the three month walking program and a pedometer (standard), or the three month program plus four maintenance newsletters over nine months (standard+maintenance). After 12 months a follow-up interview was conducted. Measures included changes in self-reported minutes walking, minutes of moderate-vigorous physical activity (MVPA), total physical activity (PA) in the past week, and the proportion meeting public health recommendations by walking and total PA. Significant increases on all outcome measures were noted for all participants. There were no between group differences in walking minutes. However, the change in MVPA minutes was significantly higher in the standard+maintenance group compared with the standard group (118 min vs 69 min, P=0.029). No significant between group differences were observed for total PA (161 min vs 117 min, P=0.187). Wearing the pedometer at the month of the follow-up interview, and thinking that the pedometer was very useful, increased the likelihood of meeting public health recommendations (AOR=2.7 and 2.5) adjusting for other covariates. Dissemination of the Step by Step guidebook with pedometers in the workplace resulted in a long-term increase in PA of inactive employees with no extra support. Newsletters as a maintenance strategy had no additional benefits. Better outcomes were noted if the pedometer was used and was perceived as being very useful.

A Two-Step Process of Nitrous Oxide before Carbon Dioxide for Humanely Euthanizing Piglets: On-Farm Trials

PubMed Central

Smith, Rebecca K.; Lay, Donald C.

2018-01-01

Simple Summary The current approved method of using carbon dioxide (CO2) to euthanize newborn piglets is raising animal welfare concerns on whether the method is truly humane. A new form of euthanasia that is humane, practical, and socially acceptable is needed. Nitrous oxide (N2O), also known as laughing gas, has been shown to induce narcosis in piglets. We used a novel two-step system of exposing compromised piglets for six minutes to N2O followed by carbon dioxide and compared it to using CO2 alone. After exposure to nitrous oxide, all piglets lost posture, a sign of the onset of loss of consciousness, before being exposed to CO2 when they showed behavioral distress. On-farm use of a two-step method reduced the amount of time the piglets were exposed to CO2 but did not reduce the amount of distressful behaviors. Therefore, the results do not support the hypothesis that using N2O in a two-step system is more humane than CO2 alone. Abstract Current methods of euthanizing piglets are raising animal welfare concerns. Our experiment used a novel two-step euthanasia method, using nitrous oxide (N2O) for six minutes and then carbon dioxide (CO2) on compromised 0- to 7-day-old piglets. A commercial euthanasia chamber was modified to deliver two euthanasia treatments: the two-step method using N2O then CO2 (N2O treatment) or only CO2 (CO2 treatment). In Experiment 1, 18 piglets were individually euthanized. In Experiment 2, 18 groups of four to six piglets were euthanized. In the N2O treatment, piglets lost posture, indicating the onset of losing consciousness, before going into CO2 where they showed heavy breathing and open-mouth breathing; whereas piglets in the CO2 treatment did not lose posture until after exhibiting these behaviors (p ≤ 0.004). However, piglets in the N2O treatment took longer to lose posture compared to the CO2 treatment (p < 0.001). Piglets in the N2O treatment displayed more behavioral signs of stress and aversion: squeals/minute (p = 0.004), escape attempts per pig (p = 0.021), and righting responses per pig (p = 0.084) in a group setting. In these regards, it cannot be concluded that euthanizing piglets for 6 min with N2O and then CO2 is more humane than euthanizing with CO2 alone. PMID:29617328

Improvement of a respiratory ozone analyzer.

PubMed

Ultman, J S; Ben-Jebria, A; Mac Dougall, C S; Rigas, M L

1997-10-01

The breath-to-breath measurement of total respiratory ozone (O3) uptake requires monitoring O3 concentration at the airway opening with an instrument that responds rapidly relative to the breathing frequency. Our original chemiluminescent analyzer, using 2-methyl-2-butene as the reactant gas, had a 10% to 90% step-response time of 110 msec and a minimal detectable concentration of 0.018 parts per million (ppm) O3 (Ben-Jebria et al. 1990). This instrument was suitable for respiratory O3 monitoring during quiet breathing and light exercise. For this study, we constructed a more self-contained analyzer with a faster response time using ethylene as the reactant gas. When the analyzer was operated at a reaction chamber pressure of 350 torr, an ethylene-to-sample flow ratio of 4:1, and a sampling flow of 0.6 liters per minute (Lpm), it had a 10% to 90% step-response time of 70 msec and a minimal detectable concentration of 0.006 ppm. These specifications make respiratory O3 monitoring possible during moderate-to-heavy exercise. In addition, the nonlinear calibration and the carbon dioxide (CO2) interference exhibited by the original analyzer were eliminated. In breath-to-breath measurements in two healthy men, the fractional uptake of O3 during one minute of quiet breathing was comparable to the results obtained by using a slowly responding commercial analyzer with a quasi-steady material balance method (Wiester et al. 1996). In fact, fractional uptake was about 0.8 regardless of O3 exposure concentration (0.11 to 0.43 ppm) or ventilation rate (4 to 41 Lpm/m2).

Validity and Reliability of Fitbit Flex for Step Count, Moderate to Vigorous Physical Activity and Activity Energy Expenditure

PubMed Central

Sushames, Ashleigh; Edwards, Andrew; Thompson, Fintan; McDermott, Robyn; Gebel, Klaus

2016-01-01

Objectives To examine the validity and reliability of the Fitbit Flex against direct observation for measuring steps in the laboratory and against the Actigraph for step counts in free-living conditions and for moderate-to-vigorous physical activity (MVPA) and activity energy expenditure (AEE) overall. Methods Twenty-five adults (12 females, 13 males) wore a Fitbit Flex and an Actigraph GT3X+ during a laboratory based protocol (including walking, incline walking, running and stepping) and free-living conditions during a single day period to examine measurement of steps, AEE and MVPA. Twenty-four of the participants attended a second session using the same protocol. Results Intraclass correlations (ICC) for test-retest reliability of the Fitbit Flex were strong for walking (ICC = 0.57), moderate for stair stepping (ICC = 0.34), and weak for incline walking (ICC = 0.22) and jogging (ICC = 0.26). The Fitbit significantly undercounted walking steps in the laboratory (absolute proportional difference: 21.2%, 95%CI 13.0–29.4%), but it was more accurate, despite slightly over counting, for both jogging (6.4%, 95%CI 3.7–9.0%) and stair stepping (15.5%, 95%CI 10.1–20.9%). The Fitbit had higher coefficients of variation (Cv) for step counts compared to direct observation and the Actigraph. In free-living conditions, the average MVPA minutes were lower in the Fitbit (35.4 minutes) compared to the Actigraph (54.6 minutes), but AEE was greater from the Fitbit (808.1 calories) versus the Actigraph (538.9 calories). The coefficients of variation were similar for AEE for the Actigraph (Cv = 36.0) and Fitbit (Cv = 35.0), but lower in the Actigraph (Cv = 25.5) for MVPA against the Fitbit (Cv = 32.7). Conclusion The Fitbit Flex has moderate validity for measuring physical activity relative to direct observation and the Actigraph. Test-rest reliability of the Fitbit was dependant on activity type and had greater variation between sessions compared to the Actigraph. Physical activity surveillance studies using the Fitbit Flex should consider the potential effect of measurement reactivity and undercounting of steps. PMID:27589592

Objectively assessing treadmill walking during the second and third pregnancy trimesters.

PubMed

DiNallo, Jennifer M; Downs, Danielle Symons; Le Masurier, Guy

2012-01-01

To effectively promote physical activity (PA) and quantify the effects of PA interventions for pregnant women, PA measurement during pregnancy needs improvement. The purpose of this study was to assess PA monitor output during a controlled, treadmill walking protocol among pregnant women at 20- and 32-weeks gestation. Women (N = 43) wore an Actigraph accelerometer, NL1000, and Yamax pedometer during a 20-minute treadmill walking test [5-minute periods at 4 different speeds (54, 67, 80, and 94 m·min(-1))] at 20- and 32-weeks gestation. Repeated-measures ANOVAs indicated that Actigraph total counts/minute and minutes of moderate-vigorous PA (MVPA), NL1000 steps and minutes MVPA, and Yamax steps decreased from 20- to 32-weeks gestation (P ≤ .05), while body girth circumference and activity monitor tilt increased (P ≤ .05). Repeated measures ANCOVAs, controlling for changes in body girth and monitor tilt, yielded no significant differences in any outcome measures from 20- to 32-weeks gestation. Preliminary results suggest physical changes during pregnancy impact activity monitor output in controlled settings. Accurately measuring and statistically controlling for changes in body girth at monitor placement site and monitor tilt may improve the accuracy of activity monitors for use with pregnant populations.

Will Nintendo "Wii Fit" Get You Fit? An Evaluation of the Energy Expenditure from Active-Play Videogames.

PubMed

Xian, Ying; Kakinami, Lisa; Peterson, Eric D; Mustian, Karen M; Fernandez, I Diana

2014-04-01

This study aimed to determine whether Nintendo(®) (Redmond, WA) "Wii Fit™" games can help individuals meet physical activity recommendations. Thirty young healthy volunteers were recruited for this randomized crossover study to evaluate the energy expenditure associated with (1) a 30-minute "Wii Fit Free Run," (2) three 10-minute bouts of "Wii Fit" aerobic games ("Rhythm Boxing," "Super Hula Hoop," and "Advanced Steps"), and (3) 30-minute treadmill running/walking. Energy expenditure was measured by indirect calorimetry using breath-by-breath analyses of O2 consumption and CO2 production. The "Wii Fit" conditions produced a moderate exercise intensity (5.0, 4.1, 3.9, and 3.8 metabolic equivalents [METs] in "Free Run," "Rhythm Boxing," "Super Hula Hoop," and "Advanced Steps"), whereas the treadmill running/walking produced a vigorous exercise intensity (METs=8.0). Based on federal guidelines, an individual could achieve the minimum weekly goal of 500 MET-minutes by playing selected "Wii Fit" aerobics games for 20-26 minutes a day, 5 days a week. Although not as vigorous as the treadmill, active-play videogames such as "Wii Fit" may provide an alternative way to encourage exercise and increase adoption and adherence to the physical activity guidelines.

Mood and Ambulatory Monitoring of Physical Activity Patterns in Youth with Polycystic Ovary Syndrome.

PubMed

Michael, Julie C; El Nokali, Nermeen E; Black, Jessica J; Rofey, Dana L

2015-10-01

To provide initial insight into physical activity patterns and predictors of moderate to vigorous physical activity (MVPA) in youth with polycystic ovary syndrome (PCOS) by using a multisensor activity monitor. Cross-sectional study analyzing baseline MVPA data using real-time continuous monitoring of physical activity. Body mass index (BMI) and depressive symptoms were examined as predictors of MVPA. A large, urban children's hospital in the United States. Thirty-five youth (aged 12 to 21 years) previously diagnosed with PCOS (mean BMI = 38.0 kg/m(2); mean age = 15.4 years, 79% white) who were participants in a behavioral lifestyle intervention. Total steps, total MVPA, longest continuous bout of MVPA, and frequency of MVPA bouts lasting for 5 to 9 minutes and 10 or more minutes. Sixty percent of youth averaged at least 1 daily MVPA bout lasting 10 or more minutes, and 14% averaged a daily MVPA bout lasting 30 or more minutes. BMI was negatively correlated with MVPA bout duration (P = .04). Parental ratings of depression, but not self-report ratings, were predictive of participants' total MVPA (β = -.46; P = .01), number of 5- to 9-minute bouts (β = -.39; P = .03), and bouts of 10 or more minutes (β = -.35; P = .05). Youth with PCOS may benefit from being prescribed multiple bouts of MVPA lasting less than 30 continuous minutes to meet national recommendations and achieve health benefits. BMI and parental endorsement of child's depression symptoms may be important to consider when assessing and prescribing MVPA to youth with PCOS. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Biological response in vitro of skeletal muscle cells treated with different intensity continuous and pulsed ultrasound fields

NASA Astrophysics Data System (ADS)

Abrunhosa, Viviane M.; Mermelstein, Claudia S.; Costa, Manoel L.; Costa-Felix, Rodrigo P. B.

2011-02-01

Therapeutic ultrasound has been used in physiotherapy to accelerate tissue healing. Although the ultrasonic wave is widely used in clinical practice, not much is known about the biological effects of ultrasound on cells and tissues. This study aims to evaluate the biological response of ultrasound in primary cultures of chick myogenic cells. To ensure the metrological reliability of whole measurement process, the ultrasound equipment was calibrated in accordance with IEC 61689:2007. The skeletal muscle cells were divided in four samples. One sample was used as a control group and the others were submitted to different time and intensity and operation mode of ultrasound: 1) 0.5 W/cm2 continuous for 5 minutes, 2) 0.5 W/cm2 pulsed for 5 minutes, 3) 1.0 W/cm2 pulsed for 10 minutes. The samples were analyzed with phase contrast optical microscopy before and after the treatment. The results showed alignment of myogenic cells in the sample treated with 0.5 W/cm2 continuous during 5 minutes when compared with the control group and the other samples. This study is a first step towards a metrological and scientific based protocol to cells and tissues treatment under different ultrasound field exposures.

Effects of physical guidance on short-term learning of walking on a narrow beam.

PubMed

Domingo, Antoinette; Ferris, Daniel P

2009-11-01

Physical guidance is often used in rehabilitation when teaching patients to re-learn movements. However, the effects of guidance on motor learning of complex skills, such as walking balance, are not clear. We tested four groups of healthy subjects that practiced walking on a narrow (1.27 cm) or wide (2.5 cm) treadmill-mounted balance beam, with or without physical guidance. Assistance was given by springs attached to a hip belt that applied restoring forces towards beam center. Subjects were evaluated while walking unassisted before and after training by calculating the number of times subjects stepped off of the beam per minute of successful walking on the beam (Failures per Minute). Subjects in Unassisted groups had greater performance improvements in walking balance from pre to post compared to subjects in Assisted groups. During training, Unassisted groups had more Failures per Minute than Assisted groups. Performance improvements were smaller in Narrow Beam groups than in Wide Beam groups. The Unassisted-Wide and Assisted-Narrow groups had similar Failures per Minute during training, but the Unassisted-Wide group had much greater performance gains after training. These results suggest that physical assistance can hinder motor learning of walking balance, assistance appears less detrimental for more difficult tasks, and task-specific dynamics are important to learning independent of error experience.

Appointment Template Redesign in a Women's Health Clinic Using Clinical Constraints to Improve Service Quality and Efficiency.

PubMed

Huang, Y; Verduzco, S

2015-01-01

Patient wait time is a critical element of access to care that has long been recognized as a major problem in modern outpatient health care delivery systems. It impacts patient and medical staff productivity, stress, quality and efficiency of medical care, as well as health-care cost and availability. This study was conducted in a Women's Health Clinic. The objective was to improve clinic service quality by redesigning patient appointment template using the clinical constraints. The proposed scheduling template consisted of two key elements: the redesign of appointment types and the determination of the length of time slots using defined constraints. The re-classification technique was used for the redesign of appointment visit types to capture service variation for scheduling purposes. Then, the appointment length was determined by incorporating clinic constraints or goals, such as patient wait time, physician idle time, overtime, finish time, lunch hours, when the last appointment was scheduled, and the desired number of appointment slots, to converge the optimal length of appointment slots for each visit type. The redesigned template was implemented and the results indicated a 73% reduction in average patient waiting from the reported 40 to 11 minutes. The patient no-show rate was reduced by 4% from 24% to 20%. The morning section on average finished about 11:50 am. The clinic day was finished around 4:45 pm. Provider average idle time was estimated to be about 5 minutes, which can be used for charting/documenting patients. This study provided an alternative method of redesigning appointment scheduling templates using only the clinical constraints rather than the traditional way that required an objective function. This paper also documented the employed methods step by step in a real clinic setting. The implementation results concluded a significant improvement on patient wait time and no-show rate.

Appointment Template Redesign in a Women’s Health Clinic Using Clinical Constraints to Improve Service Quality and Efficiency

PubMed Central

Verduzco, S.

2015-01-01

Summary Background Patient wait time is a critical element of access to care that has long been recognized as a major problem in modern outpatient health care delivery systems. It impacts patient and medical staff productivity, stress, quality and efficiency of medical care, as well as health-care cost and availability. Objectives This study was conducted in a Women’s Health Clinic. The objective was to improve clinic service quality by redesigning patient appointment template using the clinical constraints. Methods The proposed scheduling template consisted of two key elements: the redesign of appointment types and the determination of the length of time slots using defined constraints. The re-classification technique was used for the redesign of appointment visit types to capture service variation for scheduling purposes. Then, the appointment length was determined by incorporating clinic constraints or goals, such as patient wait time, physician idle time, overtime, finish time, lunch hours, when the last appointment was scheduled, and the desired number of appointment slots, to converge the optimal length of appointment slots for each visit type. Results The redesigned template was implemented and the results indicated a 73% reduction in average patient waiting from the reported 40 to 11 minutes. The patient no-show rate was reduced by 4% from 24% to 20%. The morning section on average finished about 11:50 am. The clinic day was finished around 4:45 pm. Provider average idle time was estimated to be about 5 minutes, which can be used for charting/documenting patients. Conclusions This study provided an alternative method of redesigning appointment scheduling templates using only the clinical constraints rather than the traditional way that required an objective function. This paper also documented the employed methods step by step in a real clinic setting. The implementation results concluded a significant improvement on patient wait time and no-show rate. PMID:26171075

Combining Fast-Walking Training and a Step Activity Monitoring Program to Improve Daily Walking Activity After Stroke: A Preliminary Study.

PubMed

Danks, Kelly A; Pohlig, Ryan; Reisman, Darcy S

2016-09-01

To determine preliminary efficacy and to identify baseline characteristics predicting who would benefit most from fast walking training plus a step activity monitoring program (FAST+SAM) compared with fast walking training (FAST) alone in persons with chronic stroke. Randomized controlled trial with blinded assessors. Outpatient clinical research laboratory. Individuals (N=37) >6 months poststroke. Subjects were assigned to either FAST, which was walking training at their fastest possible speed on the treadmill (30min) and overground 3 times per week for 12 weeks, or FAST+SAM. The step activity monitoring program consisted of daily step monitoring with an activity monitor, goal setting, and identification of barriers to activity and strategies to overcome barriers. Daily step activity metrics (steps/day [SPD], time walking per day), walking speed, and 6-minute walk test (6MWT) distance. There was a significant effect of time for both groups, with all outcomes improving from pre- to posttraining (all P values <.05). The FAST+SAM was superior to FAST for 6MWT (P=.018), with a larger increase in the FAST+SAM group. The interventions had differential effectiveness based on baseline step activity. Sequential moderated regression models demonstrated that for subjects with baseline levels of step activity and 6MWT distances that were below the mean, the FAST+SAM intervention was more effective than FAST (1715±1584 vs 254±933 SPD; P<.05 for overall model and ΔR(2) for SPD and 6MWT). The addition of a step activity monitoring program to a fast walking training intervention may be most effective in persons with chronic stroke who have initial low levels of walking endurance and activity. Regardless of baseline performance, the FAST+SAM intervention was more effective for improving walking endurance. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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.

Using operations research to plan improvement of the transport of critically ill patients.

PubMed

Chen, Jing; Awasthi, Anjali; Shechter, Steven; Atkins, Derek; Lemke, Linda; Fisher, Les; Dodek, Peter

2013-01-01

Operations research is the application of mathematical modeling, statistical analysis, and mathematical optimization to understand and improve processes in organizations. The objective of this study was to illustrate how the methods of operations research can be used to identify opportunities to reduce the absolute value and variability of interfacility transport intervals for critically ill patients. After linking data from two patient transport organizations in British Columbia, Canada, for all critical care transports during the calendar year 2006, the steps for transfer of critically ill patients were tabulated into a series of time intervals. Statistical modeling, root-cause analysis, Monte Carlo simulation, and sensitivity analysis were used to test the effect of changes in component intervals on overall duration and variation of transport times. Based on quality improvement principles, we focused on reducing the 75th percentile and standard deviation of these intervals. We analyzed a total of 3808 ground and air transports. Constraining time spent by transport personnel at sending and receiving hospitals was projected to reduce the total time taken by 33 minutes with as much as a 20% reduction in standard deviation of these transport intervals in 75% of ground transfers. Enforcing a policy of requiring acceptance of patients who have life- or limb-threatening conditions or organ failure was projected to reduce the standard deviation of air transport time by 63 minutes and the standard deviation of ground transport time by 68 minutes. Based on findings from our analyses, we developed recommendations for technology renovation, personnel training, system improvement, and policy enforcement. Use of the tools of operations research identifies opportunities for improvement in a complex system of critical care transport.

Time spent by Belgian hospital pharmacists on supply disruptions and drug shortages: An exploratory study.

PubMed

De Weerdt, Elfi; De Rijdt, Thomas; Simoens, Steven; Casteels, Minne; Huys, Isabelle

2017-01-01

Supply problems of drugs are an increasing and worldwide problem, also in Belgium. Hospital pharmacists try to manage drug supply problems to minimize the impact on patient care. This study aims to quantify in a detailed manner how much time employees of 17 Belgian hospital pharmacies spend on drug supply problems. During six months, employees of Belgian hospital pharmacies filled in the daily time spent on drug supply problems using a template containing all steps which can be executed to manage drug supply problems. Additionally, Belgian hospital pharmacists were asked to report the drugs which experienced drug supply problems together with the solution for this problem. Hospital pharmacists spent a median of 109 minutes a week on drug supply problems, with a minimum of 40 minutes per week and a maximum of 216 minutes per week. Fifty-nine percent of the total time spent on drug supply problems was executed by hospital pharmacists, 27% by pharmacy technicians; the rest was performed by logistic or administrative personnel. About one third of the total time spent was invested in gathering information on the supply problem. About two third of the supply disruptions caused drug shortages, meaning there was a need to switch to another (generic) therapeutic alternative. For most drug shortages, a Belgian generic medicine could be found. However in some cases, the alternative had to be ordered abroad or for some drug shortages, no alternative was available. These exploratory results on time spent by hospital pharmacists on drug supply problems in Belgium highlight the economic impact of drug supply problems for hospital pharmacies. A fully reliable, daily updated list on the federal agencies websites would be a major help to hospital pharmacists.

Time spent by Belgian hospital pharmacists on supply disruptions and drug shortages: An exploratory study

PubMed Central

De Weerdt, Elfi; De Rijdt, Thomas; Simoens, Steven; Casteels, Minne; Huys, Isabelle

2017-01-01

Introduction Supply problems of drugs are an increasing and worldwide problem, also in Belgium. Hospital pharmacists try to manage drug supply problems to minimize the impact on patient care. This study aims to quantify in a detailed manner how much time employees of 17 Belgian hospital pharmacies spend on drug supply problems. Methods During six months, employees of Belgian hospital pharmacies filled in the daily time spent on drug supply problems using a template containing all steps which can be executed to manage drug supply problems. Additionally, Belgian hospital pharmacists were asked to report the drugs which experienced drug supply problems together with the solution for this problem. Results Hospital pharmacists spent a median of 109 minutes a week on drug supply problems, with a minimum of 40 minutes per week and a maximum of 216 minutes per week. Fifty-nine percent of the total time spent on drug supply problems was executed by hospital pharmacists, 27% by pharmacy technicians; the rest was performed by logistic or administrative personnel. About one third of the total time spent was invested in gathering information on the supply problem. About two third of the supply disruptions caused drug shortages, meaning there was a need to switch to another (generic) therapeutic alternative. For most drug shortages, a Belgian generic medicine could be found. However in some cases, the alternative had to be ordered abroad or for some drug shortages, no alternative was available. Conclusion These exploratory results on time spent by hospital pharmacists on drug supply problems in Belgium highlight the economic impact of drug supply problems for hospital pharmacies. A fully reliable, daily updated list on the federal agencies websites would be a major help to hospital pharmacists. PMID:28350827

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.

Barriers to physical activity between adults with stroke and their care partners.

PubMed

Zalewski, Kathryn R; Dvorak, Leah

2011-10-01

Healthy living includes meeting daily physical activity guidelines. This study compares daily physical activity rates and barriers to physical activity for people with stroke and their partners (spouse or significant other). Physical abilities, energy expenditure, daily steps, and barriers to physical activity are evaluated in people who have completed stroke rehabilitation and their partners. Twenty pairs of adults (mean age 69.7 years) participated. Participants with stroke were classified as sedentary, averaging 2,990 (± 2,488) steps per day. Their partners are classified as low active, averaging 6,378 (± 2,149) steps per day. For stroke survivors, physical abilities were positively correlated to daily activity rates. The number of steps walked per day was moderately correlated to 6-minute walk tests (r = 0.550, P < .05), comfortable gait speeds (r = 0.588, P < .05), and fast gait speeds (r = 0.677, P < .01). For care partners, physical abilities were not correlated to daily physical activity. People with stroke report lack of skill as a primary barrier; their partners report lack of time. The relationship between physical ability and physical activity is reinforced with this study. The impact of stroke on the family, particularly on time demands of the primary caregiver, suggests the needs of the care partner may not be adequately addressed in the rehabilitation process.

Changes in the physical activity of acute stroke survivors between inpatient and community living with early supported discharge: an observational cohort study.

PubMed

Kerr, A; Rowe, P; Esson, D; Barber, M

2016-12-01

To describe and compare patterns of physical activity among stroke survivors during their hospital stay and community living with early supported discharge. Observational cohort study of physical activity before and after early supported discharge. UK National Health Service stroke units and participants' homes. Forty-one stroke survivors with a mean age of 69 (standard deviation 11) years, and a median Modified Rivermead Mobility Index of 33.5 [interquartile range (IQR) 25.8 to 35.3]. The primary outcome measures were time spent in sitting/standing/walking and number of steps taken, as recorded by a physical activity monitor. There were statistical differences (P<0.001) for all categories of physical activity. After early supported discharge to the community, participants took more than twice the number of steps {median 474 (IQR 189 to 773) vs. 1193 (IQR 512 to 2856), median difference 636 [95% confidence interval (CI) 262 to 931]} and spent more than double the time in standing [median 51 (IQR 22 to 128) minutes vs. 100 (IQR 51 to 178) minutes, median difference 28 (95% CI 11 to 68)] compared with their hospital stay. Community living with early supported discharge promoted higher levels of physical activity in medically stable stroke survivors. The near-doubling of activity may serve as a guideline for what is achievable during stroke rehabilitation. Number UKCRN 15472. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Destination Math. What Works Clearinghouse Intervention Report

ERIC Educational Resources Information Center

What Works Clearinghouse, 2009

2009-01-01

"Destination Math" is a series of computer-based curricula designed to be used for at least 90 minutes a week. Featuring sequenced, prescriptive, step-by-step instruction, "Destination Math" is designed for the development of fluency in critical skills, math reasoning, conceptual understanding, and problem-solving skills.…

Evaluation of Delivery Costs for External Beam Radiation Therapy and Brachytherapy for Locally Advanced Cervical Cancer Using Time-Driven Activity-Based Costing.

PubMed

Bauer-Nilsen, Kristine; Hill, Colin; Trifiletti, Daniel M; Libby, Bruce; Lash, Donna H; Lain, Melody; Christodoulou, Deborah; Hodge, Constance; Showalter, Timothy N

2018-01-01

To evaluate the delivery costs, using time-driven activity-based costing, and reimbursement for definitive radiation therapy for locally advanced cervical cancer. Process maps were created to represent each step of the radiation treatment process and included personnel, equipment, and consumable supplies used to deliver care. Personnel were interviewed to estimate time involved to deliver care. Salary data, equipment purchasing information, and facilities costs were also obtained. We defined the capacity cost rate (CCR) for each resource and then calculated the total cost of patient care according to CCR and time for each resource. Costs were compared with 2016 Medicare reimbursement and relative value units (RVUs). The total cost of radiation therapy for cervical cancer was $12,861.68, with personnel costs constituting 49.8%. Brachytherapy cost $8610.68 (66.9% of total) and consumed 423 minutes of attending radiation oncologist time (80.0% of total). External beam radiation therapy cost $4055.01 (31.5% of total). Personnel costs were higher for brachytherapy than for the sum of simulation and external beam radiation therapy delivery ($4798.73 vs $1404.72). A full radiation therapy course provides radiation oncologists 149.77 RVUs with intensity modulated radiation therapy or 135.90 RVUs with 3-dimensional conformal radiation therapy, with total reimbursement of $23,321.71 and $16,071.90, respectively. Attending time per RVU is approximately 4-fold higher for brachytherapy (5.68 minutes) than 3-dimensional conformal radiation therapy (1.63 minutes) or intensity modulated radiation therapy (1.32 minutes). Time-driven activity-based costing was used to calculate the total cost of definitive radiation therapy for cervical cancer, revealing that brachytherapy delivery and personnel resources constituted the majority of costs. However, current reimbursement policy does not reflect the increased attending physician effort and delivery costs of brachytherapy. We hypothesize that the significant discrepancy between treatment costs and physician effort versus reimbursement may be a potential driver of reported national trends toward poor compliance with brachytherapy, and we suggest re-evaluation of payment policies to incentivize quality care. Copyright © 2017 Elsevier Inc. All rights reserved.

Novel algorithm for a smartphone-based 6-minute walk test application: algorithm, application development, and evaluation.

PubMed

Capela, Nicole A; Lemaire, Edward D; Baddour, Natalie

2015-02-20

The 6-minute walk test (6MWT: the maximum distance walked in 6 minutes) is used by rehabilitation professionals as a measure of exercise capacity. Today's smartphones contain hardware that can be used for wearable sensor applications and mobile data analysis. A smartphone application can run the 6MWT and provide typically unavailable biomechanical information about how the person moves during the test. A new algorithm for a calibration-free 6MWT smartphone application was developed that uses the test's inherent conditions and smartphone accelerometer-gyroscope data to report the total distance walked, step timing, gait symmetry, and walking changes over time. This information is not available with a standard 6MWT and could help with clinical decision-making. The 6MWT application was evaluated with 15 able-bodied participants. A BlackBerry Z10 smartphone was worn on a belt at the mid lower back. Audio from the phone instructed the person to start and stop walking. Digital video was independently recorded during the trial as a gold-standard comparator. The average difference between smartphone and gold standard foot strike timing was 0.014 ± 0.015 s. The total distance calculated by the application was within 1 m of the measured distance for all but one participant, which was more accurate than other smartphone-based studies. These results demonstrated that clinically relevant 6MWT results can be achieved with typical smartphone hardware and a novel algorithm.

Use of electronic games by young children and fundamental movement skills?

PubMed

Barnett, Lisa M; Hinkley, Trina; Okely, Anthony D; Hesketh, Kylie; Salmon, Jo

2012-06-01

This study investigated associations between pre-school children's time spent playing electronic games and their fundamental movement skills. In 2009, 53 children had physical activity (Actigraph accelerometer counts per minute), parent proxy-report of child's time in interactive and non-interactive electronic games (min./week), and movement skill (Test of Gross Motor Development-2) assessed. Hierarchical linear regression, adjusting for age (range = 3-6 years), sex (Step 1), and physical activity (cpm; M=687, SD=175.42; Step 2), examined the relationship between time in (a) non-interactive and (b) interactive electronic games and locomotor and object control skill. More than half (59%, n=31) of the children were female. Adjusted time in interactive game use was associated with object control but not locomotor skill. Adjusted time in non-interactive game use had no association with object control or locomotor skill. Greater time spent playing interactive electronic games is associated with higher object control skill proficiency in these young children. Longitudinal and experimental research is required to determine if playing these games improves object control skills or if children with greater object control skill proficiency prefer and play these games.

GENERAL: A modified weighted probabilistic cellular automaton traffic flow model

NASA Astrophysics Data System (ADS)

Zhuang, Qian; Jia, Bin; Li, Xin-Gang

2009-08-01

This paper modifies the weighted probabilistic cellular automaton model (Li X L, Kuang H, Song T, et al 2008 Chin. Phys. B 17 2366) which considered a diversity of traffic behaviors under real traffic situations induced by various driving characters and habits. In the new model, the effects of the velocity at the last time step and drivers' desire for acceleration are taken into account. The fundamental diagram, spatial-temporal diagram, and the time series of one-minute data are analyzed. The results show that this model reproduces synchronized flow. Finally, it simulates the on-ramp system with the proposed model. Some characteristics including the phase diagram are studied.

Fair Play Game: A Group Contingency Strategy to Increase Students' Active Behaviours in Physical Education

ERIC Educational Resources Information Center

Vidoni, Carla; Lee, Chang-Hung; Azevedo, L. B.

2014-01-01

A dependent group contingency strategy called Fair Play Game was applied to promote increase in number of steps during physical education classes for sixth-grade students. Results from a multiple baseline design across three classes showed that the mean number of steps for baseline vs. intervention were: Class 1: 43 vs. 64 steps/minute; Class 2:…

Multimodality Non-Rigid Image Registration for Planning, Targeting and Monitoring during CT-guided Percutaneous Liver Tumor Cryoablation

PubMed Central

Elhawary, Haytham; Oguro, Sota; Tuncali, Kemal; Morrison, Paul R.; Tatli, Servet; Shyn, Paul B.; Silverman, Stuart G.; Hata, Nobuhiko

2010-01-01

Rationale and Objectives To develop non-rigid image registration between pre-procedure contrast enhanced MR images and intra-procedure unenhanced CT images, to enhance tumor visualization and localization during CT-guided liver tumor cryoablation procedures. Materials and Methods After IRB approval, a non-rigid registration (NRR) technique was evaluated with different pre-processing steps and algorithm parameters and compared to a standard rigid registration (RR) approach. The Dice Similarity Coefficient (DSC), Target Registration Error (TRE), 95% Hausdorff distance (HD) and total registration time (minutes) were compared using a two-sided Student’s t-test. The entire registration method was then applied during five CT-guided liver cryoablation cases with the intra-procedural CT data transmitted directly from the CT scanner, with both accuracy and registration time evaluated. Results Selected optimal parameters for registration were section thickness of 5mm, cropping the field of view to 66% of its original size, manual segmentation of the liver, B-spline control grid of 5×5×5 and spatial sampling of 50,000 pixels. Mean 95% HD of 3.3mm (2.5x improvement compared to RR, p<0.05); mean DSC metric of 0.97 (13% increase); and mean TRE of 4.1mm (2.7x reduction) were measured. During the cryoablation procedure registration between the pre-procedure MR and the planning intra-procedure CT took a mean time of 10.6 minutes, the MR to targeting CT image took 4 minutes and MR to monitoring CT took 4.3 minutes. Mean registration accuracy was under 3.4mm. Conclusion Non-rigid registration allowed improved visualization of the tumor during interventional planning, targeting and evaluation of tumor coverage by the ice ball. Future work is focused on reducing segmentation time to make the method more clinically acceptable. PMID:20817574

Laboratory layered latte.

PubMed

Xue, Nan; Khodaparast, Sepideh; Zhu, Lailai; Nunes, Janine K; Kim, Hyoungsoo; Stone, Howard A

2017-12-12

Inducing thermal gradients in fluid systems with initial, well-defined density gradients results in the formation of distinct layered patterns, such as those observed in the ocean due to double-diffusive convection. In contrast, layered composite fluids are sometimes observed in confined systems of rather chaotic initial states, for example, lattes formed by pouring espresso into a glass of warm milk. Here, we report controlled experiments injecting a fluid into a miscible phase and show that, above a critical injection velocity, layering emerges over a time scale of minutes. We identify critical conditions to produce the layering, and relate the results quantitatively to double-diffusive convection. Based on this understanding, we show how to employ this single-step process to produce layered structures in soft materials, where the local elastic properties vary step-wise along the length of the material.

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

Laparoscopic Common Bile Duct Exploration in Patients With Gallstones and Choledocholithiasis

PubMed Central

Rodriguez, Omaira; Bellorín, Omar; Sánchez, Renata; Benítez, Gustavo

2010-01-01

Objectives: To compare the effectiveness of laparoscopic common bile duct exploration in patients with failed endoscopic retrograde cholangiopancreatography (ERCP). Methods: This is a descriptive, comparative study. Patients with an indication of common bile duct exploration between February 2005 and October 2008 were included. We studied 2 groups: Group A: patients with failed ERCP who underwent LCBDE plus LC. Group B: patients with common bile duct stones managed with the 1-step approach (LCBDE + LC) with no prior ERCP. Results: Twenty-five patients were included. Group A: 9 patients, group B: 16 patients. Success rate, operative time, and hospital stay were as follows: group A 66% vs group B 87.5%; group A 187 minutes vs 106 minutes; group A 4.5 days vs 2.3 days; respectively. Conclusion: Patients with failed ERCP should be considered as high-complex cases in which the laparoscopic procedure success rate decreases, and the conversion rate increases considerably. PMID:20932377

Real time monitoring of the minute dynamic variation at the crude oil-water interface.

PubMed

Duan, Ming; Ding, Ziling; Wang, Hu; Xiong, Yan

2018-02-21

Quantitative recording of the minute dynamic variation at an oil-water interface is always a great challenge. Dual polarization interferometry (DPI) presents an approach in monitoring the variations of mass, thickness, and density at the interface with high resolution. In this study, a planar crude oil-water interface was established by spin-coating on a DPI chip surface. Different concentrations of sodium dodecyl sulphate (SDS) and polyacrylamide (PAM) were injected into the interface. The absorption of free SDS molecules, in low concentrations, can be interpreted as a two-step absorption. With the existence of micelles in higher concentrations, the crude oil molecules tend to be taken away by the micelles. The absorptions of the polymers at the interface are different from SDS. The crude oil can hardly be taken away by the polymers. Instead, the hydrophobic segments of polymers insert into the oil film and hydrophilic groups stretch into the solution.

A triggered mechanism retrieves membrane in seconds after Ca(2+)- stimulated exocytosis in single pituitary cells

PubMed Central

1994-01-01

In neuroendocrine cells, cytosolic Ca2+ triggers exocytosis in tens of milliseconds, yet known pathways of endocytic membrane retrieval take minutes. To test for faster retrieval mechanisms, we have triggered short bursts of exocytosis by flash photolysis of caged Ca2+, and have tracked subsequent retrieval by measuring the plasma membrane capacitance. We find that a limited amount of membrane can be retrieved with a time constant of 4 s at 21-26 degrees C, and that this occurs partially via structures larger than coated vesicles. This novel mechanism may be arrested at a late step. Incomplete retrieval structures then remain on the cell surface for minutes until the consequences of a renewed increase in cytosolic [Ca2+] disconnect them from the cell surface in < 1 s. Our results provide evidence for a rapid, triggered membrane retrieval pathway in excitable cells. PMID:8120090

Hibiscus sabdariffa L extract drying with different carrier agent: Drying rate evaluation and color analysis

NASA Astrophysics Data System (ADS)

Djaeni, M.; Utari, F. D.; Kumoro, A. C.

2017-03-01

The aim of this study was to investigate the effect of different carrier agents on roselle or Hibiscus sabdariffa L.extract drying. Carrier agent was used for reducing stickiness of material and avoiding agglomeration as well as improving stability. The method consisted of two steps involving roselle extraction and drying process. The liquid roselle extract was mixed with carrier agent (maltodextrin-arabic gum) in various composition. The mixture was then dried at different air temperature ranging 40 - 80°C. As a response, moisture content in the extract was observed by gravimetry every 10 minutes during90 minutes. The procedurewas repeated for the drying without carrieragent. The result showed that constant rate of drying with carrier agent was higher up to l.7 times than that of without carrier agent. Based on the color analysis,roselle extract drying with carrier agent also showed reasonable quality.

Numerical modeling and optimization of the Iguassu gas centrifuge

NASA Astrophysics Data System (ADS)

Bogovalov, S. V.; Borman, V. D.; Borisevich, V. D.; Tronin, V. N.; Tronin, I. V.

2017-07-01

The full procedure of the numerical calculation of the optimized parameters of the Iguassu gas centrifuge (GC) is under discussion. The procedure consists of a few steps. On the first step the problem of a hydrodynamical flow of the gas in the rotating rotor of the GC is solved numerically. On the second step the problem of diffusion of the binary mixture of isotopes is solved. The separation power of the gas centrifuge is calculated after that. On the last step the time consuming procedure of optimization of the GC is performed providing us the maximum of the separation power. The optimization is based on the BOBYQA method exploring the results of numerical simulations of the hydrodynamics and diffusion of the mixture of isotopes. Fast convergence of calculations is achieved due to exploring of a direct solver at the solution of the hydrodynamical and diffusion parts of the problem. Optimized separative power and optimal internal parameters of the Iguassu GC with 1 m rotor were calculated using the developed approach. Optimization procedure converges in 45 iterations taking 811 minutes.

Direct coal liquefaction process

DOEpatents

Rindt, John R.; Hetland, Melanie D.

1993-01-01

An improved multistep liquefaction process for organic carbonaceous mater which produces a virtually completely solvent-soluble carbonaceous liquid product. The solubilized product may be more amenable to further processing than liquid products produced by current methods. In the initial processing step, the finely divided organic carbonaceous material is treated with a hydrocarbonaceous pasting solvent containing from 10% and 100% by weight process-derived phenolic species at a temperature within the range of 300.degree. C. to 400.degree. C. for typically from 2 minutes to 120 minutes in the presence of a carbon monoxide reductant and an optional hydrogen sulfide reaction promoter in an amount ranging from 0 to 10% by weight of the moisture- and ash-free organic carbonaceous material fed to the system. As a result, hydrogen is generated via the water/gas shift reaction at a rate necessary to prevent condensation reactions. In a second step, the reaction product of the first step is hydrogenated.

Direct coal liquefaction process

DOEpatents

Rindt, J.R.; Hetland, M.D.

1993-10-26

An improved multistep liquefaction process for organic carbonaceous mater which produces a virtually completely solvent-soluble carbonaceous liquid product. The solubilized product may be more amenable to further processing than liquid products produced by current methods. In the initial processing step, the finely divided organic carbonaceous material is treated with a hydrocarbonaceous pasting solvent containing from 10% and 100% by weight process-derived phenolic species at a temperature within the range of 300 C to 400 C for typically from 2 minutes to 120 minutes in the presence of a carbon monoxide reductant and an optional hydrogen sulfide reaction promoter in an amount ranging from 0 to 10% by weight of the moisture- and ash-free organic carbonaceous material fed to the system. As a result, hydrogen is generated via the water/gas shift reaction at a rate necessary to prevent condensation reactions. In a second step, the reaction product of the first step is hydrogenated.

Effects of Age on Maximal Work Capacity in Women Aged 18-48 Years.

ERIC Educational Resources Information Center

Hartung, G. Harley; And Others

Fifty-six healthy nontrained women aged 18 to 48 were tested for maximal work capacity on a bicycle ergometer. The women were divided into three age groups. A continuous step-increment bicycle ergometer work test was administered with the workload starting at 150 kpm (kilometers per minute) and 50 pedal rpm (revolutions per minute). The workload…

Influence of wind speed averaging on estimates of dimethylsulfide emission fluxes

DOE PAGES

Chapman, E. G.; Shaw, W. J.; Easter, R. C.; ...

2002-12-03

The effect of various wind-speed-averaging periods on calculated DMS emission fluxes is quantitatively assessed. Here, a global climate model and an emission flux module were run in stand-alone mode for a full year. Twenty-minute instantaneous surface wind speeds and related variables generated by the climate model were archived, and corresponding 1-hour-, 6-hour-, daily-, and monthly-averaged quantities calculated. These various time-averaged, model-derived quantities were used as inputs in the emission flux module, and DMS emissions were calculated using two expressions for the mass transfer velocity commonly used in atmospheric models. Results indicate that the time period selected for averaging wind speedsmore » can affect the magnitude of calculated DMS emission fluxes. A number of individual marine cells within the global grid show DMS emissions fluxes that are 10-60% higher when emissions are calculated using 20-minute instantaneous model time step winds rather than monthly-averaged wind speeds, and at some locations the differences exceed 200%. Many of these cells are located in the southern hemisphere where anthropogenic sulfur emissions are low and changes in oceanic DMS emissions may significantly affect calculated aerosol concentrations and aerosol radiative forcing.« less

Effect of a combination of whole body vibration exercise and squat training on body balance, muscle power, and walking ability in the elderly.

PubMed

Osugi, Tomohiro; Iwamoto, Jun; Yamazaki, Michio; Takakuwa, Masayuki

2014-01-01

A randomized controlled trial was conducted to clarify the beneficial effect of whole body vibration (WBV) exercise plus squat training on body balance, muscle power, and walking ability in the elderly with knee osteoarthritis and/or spondylosis. Of 35 ambulatory patients (14 men and 21 women) who were recruited at our outpatient clinic, 28 (80.0%, 12 men and 16 women) participated in the trial. The subjects (mean age 72.4 years) were randomly divided into two groups (n=14 in each group), ie, a WBV exercise alone group and a WBV exercise plus squat training group. A 4-minute WBV exercise (frequency 20 Hz) was performed 2 days per week in both groups; squat training (20 times per minute) was added during the 4-minute WBV training session in the WBV exercise plus squat training group. The duration of the trial was 6 months. The exercise and training program was safe and well tolerated. WBV exercise alone improved indices of body balance and walking velocity from baseline values. However, WBV exercise plus squat training was more effective for improving tandem gait step number and chair-rising time compared with WBV exercise alone. These results suggest the benefit and safety of WBV exercise plus squat training for improving physical function in terms of body balance and muscle power in the elderly.

Precompetition warm-up in elite and subelite rhythmic gymnastics.

PubMed

Guidetti, Laura; Di Cagno, Alessandra; Gallotta, Maria Chiara; Battaglia, Claudia; Piazza, Marina; Baldari, Carlo

2009-09-01

The aim of this study was to investigate which precompetition warm-up methodologies resulted in the best overall performance in rhythmic gymnastics. The coaches of national and international clubs (60 elite and 90 subelite) were interviewed. The relationship between sport performance and precompetition warm-up routines was examined. A total of 49% of the coaches interviewed spent more than 1 hour to prepare their athletes for the competition, including 45 minutes dedicated to warm-up exercises. In spite of previous studies' suggestions, the time between the end of warm-up and the beginning of competition was more than 5 minutes for 68% of those interviewed. A slow run was the activity of choice used to begin the warm-up (96%). Significant differences between elite and subelite gymnasts were found concerning the total duration of warm-up, duration of slow running, utilization of rhythmic steps and leaps during the warm-up, the use of dynamic flexibility exercises, competition performances repetition (p < 0.01), and utilization of imagery (p < 0.05). A precompetition warm-up in rhythmic gymnastics would include static stretching exercises at least 60 minutes prior to the competition starting time and the active stretching exercises alternated with analytic muscle strengthening aimed at increasing muscle temperature. Rhythmic gymnastics coaches at all levels can use this data as a review of precompetition warm-up practices and a possible source of new ideas.

EFFECTS OF AGE AND ACUTE MUSCLE FATIGUE ON REACTIVE POSTURAL CONTROL IN HEALTHY ADULTS

PubMed Central

Papa, Evan V.; Foreman, K. Bo; Dibble, Lee E.

2015-01-01

BACKGROUND Falls can cause moderate to severe injuries such as hip fractures and head trauma in older adults. While declines in muscle strength and sensory function contribute to increased falls in older adults, skeletal muscle fatigue is often overlooked as an additional contributor to fall risk. The purpose of this investigation was to examine the effects of acute lower extremity muscle fatigue and age on reactive postural control in healthy adults. METHODS A sample of 16 individuals participated in this study (8 healthy older adults and 8 healthy young persons). Whole body kinematic and kinetic data were collected during anterior and posterior reproducible fall tests before (T0) and immediately after (T1) eccentric muscle fatiguing exercise, as well as after 15-minutes (T15) and 30-minutes (T30) of rest. FINDINGS Lower extremity joint kinematics of the stepping limb during the support (landing) phase of the anterior fall were significantly altered by the presence of acute muscle fatigue. Step velocity was significantly decreased during the anterior falls. Statistically significant main effects of age were found for step length in both fall directions. Effect sizes for all outcomes were small. No statistically significant interaction effects were found. INTERPRETATION Muscle fatigue has a measurable effect on lower extremity joint kinematics during simulated falls. These alterations appear to resolve within 15 minutes of recovery. The above deficits, coupled with a reduced step length, may help explain the increased fall risk in older adults. PMID:26351001

Magnetic scavengers as carriers of analytes for flowing atmospheric pressure afterglow mass spectrometry (FAPA-MS).

PubMed

Cegłowski, Michał; Kurczewska, Joanna; Smoluch, Marek; Reszke, Edward; Silberring, Jerzy; Schroeder, Grzegorz

2015-09-07

In this paper, a procedure for the preconcentration and transport of mixtures of acids, bases, and drug components to a mass spectrometer using magnetic scavengers is presented. Flowing atmospheric pressure afterglow mass spectrometry (FAPA-MS) was used as an analytical method for identification of the compounds by thermal desorption from the scavengers. The proposed procedure is fast and cheap, and does not involve time-consuming purification steps. The developed methodology can be applied for trapping harmful substances in minute quantities, to transport them to specialized, remotely located laboratories.

A simulation trainer for complex articular fracture surgery.

PubMed

Yehyawi, Tameem M; Thomas, Thaddeus P; Ohrt, Gary T; Marsh, J Lawrence; Karam, Matthew D; Brown, Thomas D; Anderson, Donald D

2013-07-03

The purposes of this study were (1) to develop a physical model to improve articular fracture reduction skills, (2) to develop objective assessment methods to evaluate these skills, and (3) to assess the construct validity of the simulation. A surgical simulation was staged utilizing surrogate tibial plafond fractures. Multiple three-segment radio-opacified polyurethane foam fracture models were produced from the same mold, ensuring uniform surgical complexity between trials. Using fluoroscopic guidance, five senior and seven junior orthopaedic residents reduced the fracture through a limited anterior window. The residents were assessed on the basis of time to completion, hand movements (tracked with use of a motion capture system), and quality of the obtained reduction. All but three of the residents successfully reduced and fixed the fracture fragments (one senior resident and two junior residents completed the reduction but were unsuccessful in fixating all fragments). Senior residents had an average time to completion of 13.43 minutes, an average gross articular step-off of 3.00 mm, discrete hand motions of 540 actions, and a cumulative hand motion distance of 79 m. Junior residents had an average time to completion of 14.75 minutes, an average gross articular step-off of 3.09 mm, discrete hand motions of 511 actions, and a cumulative hand motion distance of 390 m. The large difference in cumulative hand motion distance, despite comparable numbers of discrete hand motion events, indicates that senior residents were more precise in their hand motions. The present experiment establishes the basic construct validity of the simulation trainer. Further studies are required to demonstrate that this laboratory-based model for articular fracture reduction training, along with an objective assessment of performance, can be used to improve resident surgical skills.

Study on Sumbawa gold ore liberation using rod mill: effect of rod-number and rotational speed on particle size distribution

NASA Astrophysics Data System (ADS)

Prasetya, A.; Mawadati, A.; Putri, A. M. R.; Petrus, H. T. B. M.

2018-01-01

Comminution is one of crucial steps in gold ore processing used to liberate the valuable minerals from gaunge mineral. This research is done to find the particle size distribution of gold ore after it has been treated through the comminution process in a rod mill with various number of rod and rotational speed that will results in one optimum milling condition. For the initial step, Sumbawa gold ore was crushed and then sieved to pass the 2.5 mesh and retained on the 5 mesh (this condition was taken to mimic real application in artisanal gold mining). Inserting the prepared sample into the rod mill, the observation on effect of rod-number and rotational speed was then conducted by variating the rod number of 7 and 10 while the rotational speed was varied from 60, 85, and 110 rpm. In order to be able to provide estimation on particle distribution of every condition, the comminution kinetic was applied by taking sample at 15, 30, 60, and 120 minutes for size distribution analysis. The change of particle distribution of top and bottom product as time series was then treated using Rosin-Rammler distribution equation. The result shows that the homogenity of particle size and particle size distribution is affected by rod-number and rotational speed. The particle size distribution is more homogeneous by increasing of milling time, regardless of rod-number and rotational speed. Mean size of particles do not change significantly after 60 minutes milling time. Experimental results showed that the optimum condition was achieved at rotational speed of 85 rpm, using rod-number of 7.

Dual Motor-Cognitive Virtual Reality Training Impacts Dual-Task Performance in Freezing of Gait.

PubMed

Killane, Isabelle; Fearon, Conor; Newman, Louise; McDonnell, Conor; Waechter, Saskia M; Sons, Kristian; Lynch, Timothy; Reilly, Richard B

2015-11-01

Freezing of gait (FOG), an episodic gait disturbance characterized by the inability to generate effective stepping, occurs in more than half of Parkinson's disease patients. It is associated with both executive dysfunction and attention and becomes most evident during dual tasking (performing two tasks simultaneously). This study examined the effect of dual motor-cognitive virtual reality training on dual-task performance in FOG. Twenty community dwelling participants with Parkinson's disease (13 with FOG, 7 without FOG) participated in a pre-assessment, eight 20-minute intervention sessions, and a post-assessment. The intervention consisted of a virtual reality maze (DFKI, Germany) through which participants navigated by stepping-in-place on a balance board (Nintendo, Japan) under time pressure. This was combined with a cognitive task (Stroop test), which repeatedly divided participants' attention. The primary outcome measures were pre- and post-intervention differences in motor (stepping time, symmetry, rhythmicity) and cognitive (accuracy, reaction time) performance during single- and dual-tasks. Both assessments consisted of 1) a single cognitive task 2) a single motor task, and 3) a dual motor-cognitive task. Following the intervention, there was significant improvement in dual-task cognitive and motor parameters (stepping time and rhythmicity), dual-task effect for those with FOG and a noteworthy improvement in FOG episodes. These improvements were less significant for those without FOG. This is the first study to show benefit of a dual motor-cognitive approach on dual-task performance in FOG. Advances in such virtual reality interventions for home use could substantially improve the quality of life for patients who experience FOG.

Adherence to Insulin Pump Behaviors in Young Children With Type 1 Diabetes Mellitus.

PubMed

Patton, Susana R; Driscoll, Kimberly A; Clements, Mark A

2017-01-01

Parents of young children are responsible for daily type 1 diabetes (T1DM) cares including insulin bolusing. For optimal insulin pump management, parents should enter a blood glucose result (SMBG) and a carbohydrate estimate (if food will be consumed) into the bolus advisor in their child's pump to assist in delivering the recommended insulin bolus. Previously, pump adherence behaviors were described in adolescents; we describe these behaviors in a sample of young children. Pump data covering between 14-30 consecutive days were obtained for 116 children. Assessed adherence to essential pump adherence behaviors (eg, SMBG, carbohydrate entry, and insulin use) and adherence to 3 Wizard/Bolus Advisor steps: SMBG-carbohydrate entry-insulin bolus delivered. Parents completed SMBG ≥4 times on 99% of days, bolused insulin ≥3 times on 95% of days, and entered carbohydrates ≥3 times on 93% of days, but they corrected for hyperglycemia (≥250 mg/dl or 13.9 mmol/l) only 63% of the time. Parents completed Wizard/Bolus Advisor steps (SMBG, carbohydrate entry, insulin bolus) within 30 minutes for 43% of boluses. Inverse correlations were found between children's mean daily glucose and the percentage of days with ≥4 SMBG and ≥3 carbohydrate entries as well as the percentage of boluses where all Wizard/Bolus Advisor steps were completed. Parents of young children adhered to individual pump behaviors, but showed some variability in their adherence to Wizard/Bolus Advisor steps. Parents showed low adherence to recommendations to correct for hyperglycemia. Like adolescents, targeting pump behaviors in young children may have the potential to optimize glycemic control.

Tests of stepping as indicators of mobility, balance, and fall risk in balance-impaired older adults.

PubMed

Cho, Be-long; Scarpace, Diane; Alexander, Neil B

2004-07-01

To determine the relationships between two tests of stepping ability (the maximal step length (MSL) and rapid step test (RST)) and standard tests of standing balance, gait, mobility, and functional impairment in a group of at-risk older adults. Cross-sectional study. University-based laboratory. One hundred sixty-seven mildly balance-impaired older adults recruited for a balance-training and fall-reduction program (mean age 78, range 65-90). Measures of stepping maximally (MSL, the ability to maximally step out and return to the initial position) and rapidly (RST, the time taken to step out and return in multiple directions as fast as possible); standard measures of balance, gait, and mobility including timed tandem stance (TS), tandem walk (TW, both timing and errors), timed unipedal stance (US), timed up and go (TUG), performance oriented mobility assessment (POMA), and 6-minute walk (SMW); measures of leg strength (peak knee and ankle torque and power at slow and fast speeds); self-report measures of frequent falls (>2 per 12 months), disability (Established Population for Epidemiologic Studies of the Elderly (EPESE) physical function), and confidence to avoid falls (Activity-specific Balance Confidence (ABC) Scale). Spearman and Pearson correlation, intraclass correlation coefficient, logistic regression, and linear regression were used for data analysis. MSL consistently predicted a number of self-report and performance measures at least as well as other standard balance measures. MSL correlations with EPESE physical function, ABC, TUG, and POMA scores; SMW; and peak maximum knee and ankle torque and power were at least as high as those correlations seen with TS, TW, or US. MSL score was associated with the risk of being a frequent faller. In addition, the six MSL directions were highly correlated (up to 0.96), and any one of the leg directions yielded similar relationships with functional measures and a history of falls. Relationships between RST and these measures were relatively modest. MSL is as good a predictor of mobility performance, frequent falls, self-reported function, and balance confidence as standard stance tests such as US. MSL simplified to one direction may be a useful clinical indicator of mobility, balance, and fall risk in older adults.

Evaluation of viral removal by nanofiltration using real-time quantitative polymerase chain reaction.

PubMed

Zhao, Xiaowen; Bailey, Mark R; Emery, Warren R; Lambooy, Peter K; Chen, Dayue

2007-06-01

Nanofiltration is commonly introduced into purification processes of biologics produced in mammalian cells to serve as a designated step for removal of potential exogenous viral contaminants and endogenous retrovirus-like particles. The LRV (log reduction value) achieved by nanofiltration is often determined by cell-based infectivity assay, which is time-consuming and labour-intensive. We have explored the possibility of employing QPCR (quantitative PCR) to evaluate LRV achieved by nanofiltration in scaled-down studies using two model viruses, namely xenotropic murine leukemia virus and murine minute virus. We report here the successful development of a QPCR-based method suitable for quantification of virus removal by nanofiltration. The method includes a nuclease treatment step to remove free viral nucleic acids, while viral genome associated with intact virus particles is shielded from the nuclease. In addition, HIV Armored RNA was included as an internal control to ensure the accuracy and reliability of the method. The QPCRbased method described here provides several advantages such as better sensitivity, faster turnaround time, reduced cost and higher throughput over the traditional cell-based infectivity assays.

Real-time monitoring of river water quality using in-line continuous acquisition of fluorescence excitation and emission matrices

NASA Astrophysics Data System (ADS)

Carstea, E.; Baker, A.; Johnson, R.; Reynolds, D. M.

2009-12-01

In-line fluorescence EEM monitoring has been performed over an eleven-day period for Bournbrook River, Birmingham, UK. River water was diverted to a portable laboratory via a continuous flow pump and filter system. Fluorescence excitation-emission matrices data was recorded every 3 minutes using a flow cell (1cm pathlength) coupled to a fiber optic probe. This real-time fluorescence EEM data (Excitation, 225-400 nm at 5 nm steps, emission, 280-500 nm at 2 nm steps) was collected 'in-line'and directly compared with the spectrophotometric properties and physical and chemical parameters of river water samples collected off-line at known time intervals. Over the monitoring period, minor pollution pulses from cross connections were detected and identified hourly along with a random diesel pollution event. This work addresses the practicalities of measuring and detecting fluorescence EEM in the field and discusses the potential of this technological approach for further understanding important hydrological and biogeochemical processes. Problems associated with fouling and system failure are also reported. Example of the data generated from the continuous fluorescence EEM monitoring.

Improving the Desulfurization Degree of High-Grade Nickel Matte via a Two-Step Oxidation Roasting Process

NASA Astrophysics Data System (ADS)

Xi, Zhao; Wang, Zhixing; Li, Xinhai; Guo, Huajun; Yan, Guochun; Wang, Jiexi

2018-05-01

Generally, sulfur elimination from nickel matte was incomplete in the one-step oxidation roasting process. In this work, X-ray diffraction, scanning electron microscopy/energy-dispersive X-ray spectroscopy, and chemical analysis of the roasted products were carried out to explain this phenomenon. The results indicated that the melting of heazlewoodite was the main limiting factor. Thereafter, the oxidation mechanism of high-grade nickel matte from room temperature to 1000 °C was studied. It was found that the transformation from heazlewoodite (Ni3S2) to nickel sulfide (NiS) took place from 400 °C to 520 °C. Considering that the melting temperature of NiS was much higher than that of Ni3S2, a low-temperature roasting step was suggested to suppress the melting of heazlewoodite. Under the optimum conditions (520 °C for 120 minutes followed by 800 °C for 80 minutes), the degree of desulfurization reached 99.52 pct. These results indicated that the two-step oxidation roasting method could be a promising process for producing low-sulfur calcine from high-grade nickel matte.

Comparison of four Fitbit and Jawbone activity monitors with a research-grade ActiGraph accelerometer for estimating physical activity and energy expenditure.

PubMed

Imboden, Mary T; Nelson, Michael B; Kaminsky, Leonard A; Montoye, Alexander Hk

2017-05-08

Consumer-based physical activity (PA) monitors have become popular tools to track PA behaviours. Currently, little is known about the validity of the measurements provided by consumer monitors. We aimed to compare measures of steps, energy expenditure (EE) and active minutes of four consumer monitors with one research-grade accelerometer within a semistructured protocol. Thirty men and women (18-80 years old) wore Fitbit One (worn at the waist), Fitbit Zip (waist), Fitbit Flex (wrist), Jawbone UP24 (wrist) and one waist-worn research-grade accelerometer (ActiGraph) while participating in an 80 min protocol. A validated EE prediction equation and active minute cut-points were applied to ActiGraph data. Criterion measures were assessed using direct observation (step count) and portable metabolic analyser (EE, active minutes). A repeated measures analysis of variance (ANOVA) was used to compare differences between consumer monitors, ActiGraph, and criterion measures. Similarly, a repeated measures ANOVA was applied to a subgroup of subjects who didn't cycle. Participants took 3321±571 steps, had 28±6 active min and expended 294±56 kcal based on criterion measures. Comparatively, all monitors underestimated steps and EE by 13%-32% (p<0.01); additionally the Fitbit Flex, UP24, and ActiGraph underestimated active minutes by 35%-65% (p<0.05). Underestimations of PA and EE variables were found to be similar in the subgroup analysis. Consumer monitors had similar accuracy for PA assessment as the ActiGraph, which suggests that consumer monitors may serve to track personal PA behaviours and EE. However, due to discrepancies among monitors, individuals should be cautious when comparing relative and absolute differences in PA values obtained using different monitors. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Measuring Teachers' Knowledge and Use of Data and Assessments: Creating a Measure as a First Step toward Effective Professional Development

ERIC Educational Resources Information Center

Vidacovich, Courtney

2015-01-01

Current teaching standards and practices are dictated, at least in part, by state- and district-mandated standardized tests. Yet, despite being surrounded by data, teachers receive only basic trainings on how to use assessments. In reality, teachers use data and assessments daily--even minute by minute--through the assessment process, which uses…

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.

Factors influencing Recombinase Polymerase Amplification (RPA) assay outcomes at point of care

PubMed Central

Lillis, Lorraine; Siverson, Joshua; Lee, Arthur; Cantera, Jason; Parker, Matthew; Piepenburg, Olaf; Lehman, Dara A.; Boyle, David S.

2016-01-01

Recombinase Polymerase Amplification (RPA) can be used to detect pathogen-specific DNA or RNA in under 20 minutes without the need for complex instrumentation. These properties enable its potential use in resource limited settings. However, there are concerns that deviations from the manufacturer’s protocol and/or storage conditions could influence its performance in low resource settings. RPA amplification relies upon viscous crowding agents for optimal nucleic acid amplification, and thus an interval mixing step after 3–6 minutes of incubation is recommended to distribute amplicons and improve performance. In this study we used a HIV-1 RPA assay to evaluate the effects of this mixing step on assay performance. A lack of mixing led to a longer time to amplification and inferior detection signal, compromising the sensitivity of the assay. However lowering the assay volume from 50 μL to 5 μL showed similar sensitivity with or without mixing. We present the first peer-reviewed study that assesses long term stability of RPA reagents without a cold chain. Reagents stored at −20°C, and 25°C for up to 12 weeks were able to detect 10 HIV-1 DNA copies. Reagents stored at 45°C for up to 3 weeks were able to detect 10 HIV-1 DNA copies, with reduced sensitivity only after >3 weeks at 45°C. Together our results show that reducing reaction volumes bypassed the need for the mixing step and that RPA reagents were stable even when stored for 3 weeks at very high temperatures. PMID:26854117

Effects of physical guidance on short-term learning of walking on a narrow beam

PubMed Central

Domingo, Antoinette; Ferris, Daniel P.

2009-01-01

Physical guidance is often used in rehabilitation when teaching patients to re-learn movements. However, the effects of guidance on motor learning of complex skills, such as walking balance, are not clear. We tested four groups of healthy subjects that practiced walking on a narrow (1.27 cm) or wide (2.5 cm) treadmill-mounted balance beam, with or without physical guidance. Assistance was given by springs attached to a hip belt that applied restoring forces towards beam center. Subjects were evaluated while walking unassisted before and after training by calculating the number of times subjects stepped off of the beam per minute of successful walking on the beam (Failures per Minute). Subjects in Unassisted groups had greater performance improvements in walking balance from pre to post compared to subjects in Assisted groups. During training, Unassisted groups had more Failures per Minute than Assisted groups. Performance improvements were smaller in Narrow Beam groups than in Wide Beam groups. The Unassisted-Wide and Assisted-Narrow groups had similar Failures per Minute during training, but the Unassisted-Wide group had much greater performance gains after training. These results suggest that physical assistance can hinder motor learning of walking balance, assistance appears less detrimental for more difficult tasks, and task-specific dynamics are important to learning independent of error experience. PMID:19674900

Extending computer technology to hospice research: interactive pentablet measurement of symptoms by hospice cancer patients in their homes.

PubMed

Wilkie, Diana J; Kim, Young Ok; Suarez, Marie L; Dauw, Colleen M; Stapleton, Stephen J; Gorman, Geraldine; Storfjell, Judith; Zhao, Zhongsheng

2009-07-01

We aimed to determine the acceptability and feasibility of a pentablet-based software program, PAINReportIt-Plus, as a means for patients with cancer in home hospice to report their symptoms and differences in acceptability by demographic variables. Of the 131 participants (mean age = 59 +/- 13, 58% women, 48.1% African American), 44% had never used a computer, but all participants easily used the computerized tool and reported an average computer acceptability score of 10.3 +/- 1.8, indicating high acceptability. Participants required an average of 19.1 +/- 9.5 minutes to complete the pain section, 9.8 +/- 6.5 minutes for the medication section, and 4.8 +/- 2.3 minutes for the symptom section. The acceptability scores were not statistically different by demographic variables but time to complete the tool differed by racial/ethnic groups. Our findings demonstrate that terminally ill patients with cancer are willing and able to utilize computer pentablet technology to record and describe their pain and other symptoms. Visibility of pain and distress is the first step necessary for the hospice team to develop a care plan for improving control of noxious symptoms.

Physical activity in chronic home-living and sub-acute hospitalized stroke patients using objective and self-reported measures.

PubMed

Vanroy, Christel; Vissers, Dirk; Vanlandewijck, Yves; Feys, Hilde; Truijen, Steven; Michielsen, Marc; Cras, Patrick

2016-04-01

Despite confirmed reduced physical activity (PA) after stroke in various stages of recovery, the type of activities stroke patients executed and the time spent at different activity levels have not been sufficiently verified with stroke-validated assessment tools. Observational study. To determine PA of sub-acute stroke patients hospitalized in a rehabilitation centre (HOS) compared to chronic home-living stroke patients (HOM) using objective and self-reported measures during 2 weekdays and 1 weekend day. Fifteen HOS and 15 HOM patients wore a Sense Wear Pro 2 accelerometer (METs*minutes/24 h) and a knee-worn pedometer Yamax Digi Walker SW 200 (steps) and filled in a coded activity diary (kcal/24 h; METs*minutes/24 h) during three consecutive days. In HOM significantly more steps (stepstotal HOM = 18722.6 ± 10063.6; stepstotal HOS = 7097.8 ± 5850.5) and higher energy expenditure (EE) levels (EEtotal HOM = 7759.34 ± 2243.04; EEtotal HOS = 5860.15 ± 1412.78) were measured. In this group less moderate activity (≥3-6 ≤ METs) was performed on a weekday (pday1 = 0.006; pday2 = 0.027) and in total (p = 0.037). Few therapy hours (physical, occupational and speech therapy, and psychological support) were provided in HOM compared to HOS (p < 0.001). Vigorous activities were only seen in HOM. In both groups few patients executed sport activities. In HOM significantly more steps were performed and higher EE values were measured. However, participation in moderate activities and time spent on therapy were less in HOM. Evaluating PA with quantitative measures is feasible in both chronic home-living and sub-acute hospitalized patients with stroke.

Evaluation of physiological standard pressures of the forearm flexor muscles during sport specific ergometry in sport climbers

PubMed Central

Schoeffl, V; Klee, S; Strecker, W

2004-01-01

Background: Chronic exertional compartment syndromes (CECS) are well known in sports medicine. Most commonly affected is the tibialis anterior muscle compartment in runners and walkers. Only a few cases of CECS of the forearm flexor muscles have been reported. Objectives: To determine pressure levels inside the deep flexor compartment of the forearms during a sport specific stress test. Method: Ten healthy, high level climbers were enrolled in a prospective study. All underwent climbing specific ergometry, using a rotating climbing wall (step test, total climbing time 9–15 minutes). Pressure was measured using a slit catheter placed in the deep flexor compartment of the forearm. Pressure, blood lactate, and heart rate were recorded every three minutes and during recovery. Results: In all the subjects, physical exhaustion of the forearms defined the end point of the climbing ergometry. Blood lactate increased with physical stress, reaching a mean of 3.48 mmol/l. Compartment pressure was related to physical stress, exceeding 30 mm Hg in only three subjects. A critical pressure of more than 40 mm Hg was never observed. After the test, the pressure decreased to normal levels within three minutes in seven subjects. The three with higher pressure levels (>30 mm Hg) required a longer time to recover. Conclusions: For further clinical and therapeutic consequences, an algorithm was derived. Basic pressure below 15 mm Hg and stress pressure below 30 mm Hg as well as pressures during the 15 minute recovery period below 15 mm Hg are physiological. Pressures of 15–30 mm Hg during recovery suggest high risk of CECS, and pressures above 30 mm Hg confirm CECS. PMID:15273176

Efficacy and retention of Basic Life Support education including Automated External Defibrillator usage during a physical education period.

PubMed

Watanabe, Kae; Lopez-Colon, Dalia; Shuster, Jonathan J; Philip, Joseph

2017-03-01

The American Heart Association (AHA) advocates for CPR education as a requirement of secondary school curriculum. Unfortunately, many states have not adopted CPR education. Our aim was to investigate a low-cost, time effective method to educate students on Basic Life Support (BLS), including reeducation. This is a prospective, randomized study. Retention was assessed at 4 months post-initial education. Education was performed by AHA-certified providers during a 45-minute physical education class in a middle school in Florida. This age provides opportunities for reinforcement through high school, with ability for efficient learning. The study included 41 Eighth grade students. Students were randomized into two groups; one group received repeat education 2 months after the first education, the second group did not. All students received BLS education limited to chest compressions and usage of an Automated External Defibrillator. Students had skills and knowledge tests administered pre- and post-education after initial education, and repeated 2 and 4 months later to assess retention. There was a significant increase in CPR skills and knowledge when comparing pre- and post-education results for all time-points ( p  < 0.001). When assessing reeducation, a significant improvement was noted in total knowledge scores but not during the actual steps of CPR. Our study indicates significant increase in CPR knowledge and skills following a one-time 45-minute session. Reeducation may be useful, but the interval needs further investigation. If schools across the United States invested one 45-60-minute period every school year, this would ensure widespread CPR knowledge with minimal cost and loss of school time.

Near-real time orbit determination for the GPS, CHAMP, GRACE, TerraSAR-X, and TanDEM-X satellites

NASA Astrophysics Data System (ADS)

Michalak, Grzegorz; Koenig, Rolf

The GFZ German Research Centre for Geosciences developed a near-real time (NRT) orbit gen-eration system for GPS and Low Earth Orbiting (LEO) satellites to support radio occultation data processing for the CHAMP, GRACE, Terra-SAR-X and the upcoming TanDEM-X mis-sions and fast baseline determination for the TanDEM-X mission. Precise NRT orbits are being generated for the CHAMP and GRACE-A satellites since August 2006 and for TerraSAR-X since August 2007. For each LEO, the system consists of three independent chains delivering NRT orbits with different latencies and accuracies. The first chain generates in a preceding step NRT GPS orbits and clock biases and based thereon LEO orbits with delays of 30 minutes counted from the last measurement point to the time the orbit product is available. The orbit accuracies can be assessed via Satellite Laser Ranging (SLR) to 7 cm. The second chain is based on predicted GPS orbits from the International GNSS Service (IGS) but endowed with in-house estimated clock biases. This chain generates orbits with the same latency of 30 minutes but with better accuracies of 5 cm SLR RMS. The third chain, the least accurate but the fastest, is based on predicted IGS GPS orbits and clocks and delivers LEO orbits with latencies of 13 minutes and accuracies of 10 cm SLR RMS. The system design is such that it can easily be extended to cope with new satellites like TanDEM-X requiring precise and fast available orbits.

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.

Effect of an Active Video Gaming Classroom Curriculum on Health-Related Fitness, School Day Step Counts, and Motivation in Sixth Graders.

PubMed

Fu, You; Burns, Ryan D

2018-05-09

The purpose of this study was to explore the effect of an active video gaming (AVG) classroom curriculum on health-related fitness, school day steps, and motivation in sixth graders. A convenience sample of 65 sixth graders were recruited from 2 classrooms from a school located in the Western United States. One classroom served as the comparison group (n = 32) that participated in active free play, and one classroom served as the intervention group (n = 33) that participated in an AVG curriculum for 30 minutes per day, 3 days per week, for 18 weeks. Cardiorespiratory endurance was assessed using Progressive Aerobic Cardiovascular Endurance Run laps. School day steps were recorded, and motivational variables were collected using questionnaires. Measures were collected at baseline and an 18-week posttest time point. There was a significant group × time interaction for Progressive Aerobic Cardiovascular Endurance Run laps (b = 20.7 laps; 95% confidence interval, 14.6 to 26.8; P < .001). No statistically significant interactions were found for step counts or any of the motivational variables. An 18-week AVG classroom curriculum improved cardiorespiratory endurance relative to the comparison group in sixth graders. This study supports the use of low-cost AVG curricula to improve the health-related fitness of youth.

Workplace interventions for reducing sitting at work.

PubMed

Shrestha, Nipun; Ijaz, Sharea; Kukkonen-Harjula, Katriina T; Kumar, Suresh; Nwankwo, Chukwudi P

2015-01-26

The number of people working whilst seated at a desk keeps increasing worldwide. As sitting increases, occupational physical strain declines at the same time. This has contributed to increases in cardiovascular disease, obesity and diabetes. Therefore, reducing and breaking up the time that people spend sitting while at work is important for health. To evaluate the effects of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, OSH UPDATE, PsycINFO, Clinical trials.gov and the World Health Organization (WHO) search trial portal up to 14 February, 2014. We also searched reference lists of articles and contacted authors. We included randomised controlled trials (RCT), cluster-randomised controlled trials (cRCTs), and quasi-randomised controlled trials of interventions to reduce sitting at work. For changes of workplace arrangements, we also included controlled before-and-after studies (CBAs) with a concurrent control group. The primary outcome was time spent sitting at work per day, either self-reported or objectively measured by means of an accelerometer coupled with an inclinometer. We considered energy expenditure, duration and number of sitting episodes lasting 30 minutes or more, work productivity and adverse events as secondary outcomes. Two review authors independently screened titles, abstracts and full-text articles for study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required. We included eight studies, four RCTs, three CBAs and one cRCT, with a total of 1125 participants. The studies evaluated physical workplace changes (three studies), policy changes (one study) and information and counselling (four studies). No studies investigated the effect of treadmill desks, stepping devices, periodic breaks or standing or walking meetings. All the studies were at high risk of bias. The quality of the evidence was very low to low. Half of the studies were from Australia and the other half from Europe, with none from low- or middle-income countries. Physical workplace changesWe found very low quality evidence that sit-stand desks with or without additional counselling reduced sitting time at work per workday at one week follow-up (MD -143 minutes (95% CI -184 to -102, one study, 31 participants) and at three months' follow-up (MD - 113 minutes, 95% CI -143 to -84, two studies, 61 participants) compared to no intervention. Total sitting time during the whole day decreased also with sit-stand desks compared to no intervention (MD -78 minutes, 95% CI -125 to -30, one study, 31 participants) as did the duration of sitting episodes lasting 30 minutes or more (MD -52 minutes, 95% CI -79 to -26, two studies, 74 participants). Sit-stand desks did not have a considerable effect on work performance and had an inconsistent effect on musculoskeletal symptoms and sick leave. Policy changesWalking strategies had no considerable effect on sitting at work (MD -16 minutes, 95% CI -54 to 23, one study, 179 participants, low quality evidence). Information and counsellingGuideline-based counselling by occupational physicians reduced sitting time at work (MD -28 minutes, 95% CI -54 to -2, one study, 396 participants, low quality evidence). There was no considerable effect on reduction in total sitting time during the whole day.Mindfulness training induced a non-significant reduction in workplace sitting time (MD -2 minutes, 95% CI -22 to 18) at six months' follow-up and at 12 months' follow-up (MD -16 minutes, 95% CI -45 to 12, one study, 257 participants, low quality evidence).There was an inconsistent effect of computer prompting on sitting time at work. One study found no considerable effect on sitting at work (MD -18 minutes, 95% CI -53 to 17, 28 participants, low quality evidence) at 10 days' follow-up, while another study reported a significant reduction in sitting at work (MD -55 minutes, 95% CI -96 to -14, 34 participants, low quality evidence) at 13 weeks' follow-up. Computer prompting software also led to a non-significant increase in energy expenditure at work (MD 278 calories/workday, 95% CI 0 to 556, one study, 34 participants, low quality evidence) at 13 weeks' follow-up. At present there is very low quality evidence that sit-stand desks can reduce sitting time at work, but the effects of policy changes and information and counselling are inconsistent. There is a need for high quality cluster-randomised trials to assess the effects of different types of interventions on objectively measured sitting time. There are many ongoing trials that might change these conclusions in the near future.

National Advisory Commission on Work-Based Learning. Minutes of Full Commission Meeting (5th, Washington, District of Columbia, April 7, 1992).

ERIC Educational Resources Information Center

National Commission on Work-Based Learning (DOL), Washington, DC.

This document contains minutes of the fifth meeting of the National Advisory Commission on Work-Based Learning. The meeting's stated objective was to produce a set of specific action steps for the U.S. Department of Labor to promote work-based learning. A summary of introductory remarks (Jack MacAllister) is followed by a description of the…

77 FR 34967 - Notice of Issuance of Final Determination Concerning Digital Projectors

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-12

... six function tests in the ``post test'', the EDID firmware is programmed into the digital projectors... tests and consists of at least 97 steps taking approximately 137.8 minutes. After the whole projector is... includes 11 kinds of function tests and consists of at least 97 steps which will take approximately 11...

Identifying Beneficial Physical Activity during School Recess: Utility and Feasibility of the Fitbit

ERIC Educational Resources Information Center

Van Camp, Carole M.; Hayes, Lynda B.

2017-01-01

The purpose of the current study was to assess the utility, feasibility, and reliability of Fitbit accelerometers to measure physical activity (via steps) of 15 young children simultaneously during recess. Fitbit-recorded steps per minute (SPM) were used as the primary measure to assess levels of activity in children playing in various structured…

Step-based translation of physical activity guidelines in the Lower Mississippi Delta

USDA-ARS?s Scientific Manuscript database

To determine how many steps/day equate to current moderate-to-vigorous physical activity (MVPA) guidelines in a population from the Lower Mississippi Delta (LMD) of the United States, 58 overweight adults wore an Actigraph accelerometer (GT3X) for up to two weeks. Minutes/day in MVPA was a good pred...

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.

Energy Cost and Enjoyment of Active Videogames in Children and Teens: Xbox 360 Kinect.

PubMed

Clevenger, Kimberly A; Howe, Cheryl A

2015-08-01

New active videogames (AVGs) may provide youth an alternative to traditional play. The purpose of this study was to compare the physical activity energy expenditure (PAEE), intensity, and enjoyment of AVGs with those of seated videogames (SVGs). Youth (8-17 years old) volunteered to play a random selection of six (two SVGs, four AVGs) videogames for 6-10 minutes each. Prior to participation, height, weight, and resting metabolic rate (RMR) were measured. A portable metabolic analyzer was worn during the games to measure total energy expenditure, and PAEE was calculated as (total energy expenditure - measured RMR). An accelerometer was worn on the right hip to measure intensity in counts/minute and steps/minute. Youth were classified as child (8-12 years old) versus teen (13-17 years old), healthy weight (body mass index [BMI] <85th percentile) versus overweight (BMI ≥85th percentile), and male versus female. A three-way mixed-model analysis of variance was used to compare differences in PAEE (metabolic equivalents [METs] and kcal/minute) with sex, weight status, and age group as main effects, including Bonferroni's adjustment. Most AVGs were moderate to vigorous intensity (4.6±0.1 METs; range, 2.8-6.6 METs), where steps/minute (lower-body movement) was positively related to PAEE (R(2)=0.68). All SVGs were classified as light intensity (1.7±0.0 METs). PAEE (kcal/minute) was significantly higher during AVGs and for teens, males, and overweight youth. There was no significant difference in enjoyment between AVGs and SVGs. AVGs elicited sufficient energy cost to be a suitable alternative for traditional play and may contribute to the recommended dose of physical activity, particularly in teens, males, and overweight youth.

Using education on irradiated foods to change behavior of Korean elementary, middle, and high school students

PubMed Central

Kim, Jaerok; Choi, Yoonseok

2014-01-01

BACKGROUND/OBJECTIVES Educational interventions targeted food selection perception, knowledge, attitude, and behavior. Education regarding irradiated food was intended to change food selection behavior specific to it. SUBJECTS AND METHODS There were 43 elementary students (35.0%), 45 middle school students (36.6%), and 35 high school students (28.5%). The first step was research design. Educational targets were selected and informed consent was obtained in step two. An initial survey was conducted as step three. Step four was a 45 minute-long theoretical educational intervention. Step five concluded with a survey and experiment on food selection behavior. RESULTS As a result of conducting a 45 minute-long education on the principles, actual state of usage, and pros and cons of irradiated food for elementary, middle, and high-school students in Korea, perception, knowledge, attitude, and behavior regarding the irradiated food was significantly higher after the education than before the education (P < 0.000). CONCLUSIONS The behavior of irradiated food selection shows high correlation with all variables of perception, knowledge, and attitude, and it is necessary to provide information of each level of change in perception, knowledge, and attitude in order to derive proper behavior change, which is the ultimate goal of the education. PMID:25324942

Feasibility of Focused Stepping Practice During Inpatient Rehabilitation Poststroke and Potential Contributions to Mobility Outcomes.

PubMed

Hornby, T George; Holleran, Carey L; Leddy, Abigail L; Hennessy, Patrick; Leech, Kristan A; Connolly, Mark; Moore, Jennifer L; Straube, Donald; Lovell, Linda; Roth, Elliot

2015-01-01

Optimal physical therapy strategies to maximize locomotor function in patients early poststroke are not well established. Emerging data indicate that substantial amounts of task-specific stepping practice may improve locomotor function, although stepping practice provided during inpatient rehabilitation is limited (<300 steps/session). The purpose of this investigation was to determine the feasibility of providing focused stepping training to patients early poststroke and its potential association with walking and other mobility outcomes. Daily stepping was recorded on 201 patients <6 months poststroke (80% < 1 month) during inpatient rehabilitation following implementation of a focused training program to maximize stepping practice during clinical physical therapy sessions. Primary outcomes included distance and physical assistance required during a 6-minute walk test (6MWT) and balance using the Berg Balance Scale (BBS). Retrospective data analysis included multiple regression techniques to evaluate the contributions of demographics, training activities, and baseline motor function to primary outcomes at discharge. Median stepping activity recorded from patients was 1516 steps/d, which is 5 to 6 times greater than that typically observed. The number of steps per day was positively correlated with both discharge 6MWT and BBS and improvements from baseline (changes; r = 0.40-0.87), independently contributing 10% to 31% of the total variance. Stepping activity also predicted level of assistance at discharge and discharge location (home vs other facility). Providing focused, repeated stepping training was feasible early poststroke during inpatient rehabilitation and was related to mobility outcomes. Further research is required to evaluate the effectiveness of these training strategies on short- or long-term mobility outcomes as compared with conventional interventions. © The Author(s) 2015.

Effect of Tai Chi on physical function, fall rates and quality of life among older stroke survivors.

PubMed

Taylor-Piliae, Ruth E; Hoke, Tiffany M; Hepworth, Joseph T; Latt, L Daniel; Najafi, Bijan; Coull, Bruce M

2014-05-01

To examine the effect of a 12-week Tai Chi (TC) intervention on physical function and quality of life. Single-blind, randomized controlled trial. General community. Community-dwelling survivors of stroke (N=145; 47% women; mean age, 70y; time poststroke: 3y; ischemic stroke: 66%; hemiparesis: 73%) who were aged ≥50 years and were ≥3 months poststroke. Yang style 24-posture short-form TC (n=53), strength and range of movement exercises (SS) (n=44), or usual care (UC) (n=48) for 12 weeks. The TC and SS groups attended a 1-hour class 3 times per week, whereas the UC group had weekly phone calls. Physical function: Short Physical Performance Battery, fall rates, and 2-minute step test; quality of life: Medical Outcomes Study 36-Item Short-Form Health Survey, Center for Epidemiologic Studies Depression Scale, and Pittsburgh Sleep Quality Index. During the intervention, TC participants had two thirds fewer falls (5 falls) than the SS (14 falls) and UC (15 falls) groups (χ(2)=5.6, P=.06). There was a significant group by time interaction for the 2-minute step test (F2,142=4.69, P<.01). Post hoc tests indicated that the TC (t53=2.45, P=.02) and SS (t44=4.63, P<.01) groups had significantly better aerobic endurance over time, though not in the UC group (t48=1.58, P=.12). Intervention adherence rates were 85%. TC and SS led to improved aerobic endurance, and both are suitable community-based programs that may aid in stroke recovery and community reintegration. Our data suggest that a 12-week TC intervention was more effective in reducing fall rates than SS or UC interventions. Future studies examining the effectiveness of TC as a fall prevention strategy for community-dwelling survivors of stroke are recommended. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Rainfall Stochastic models

NASA Astrophysics Data System (ADS)

Campo, M. A.; Lopez, J. J.; Rebole, J. P.

2012-04-01

This work was carried out in north of Spain. San Sebastian A meteorological station, where there are available precipitation records every ten minutes was selected. Precipitation data covers from October of 1927 to September of 1997. Pulse models describe the temporal process of rainfall as a succession of rainy cells, main storm, whose origins are distributed in time according to a Poisson process and a secondary process that generates a random number of cells of rain within each storm. Among different pulse models, the Bartlett-Lewis was used. On the other hand, alternative renewal processes and Markov chains describe the way in which the process will evolve in the future depending only on the current state. Therefore they are nor dependant on past events. Two basic processes are considered when describing the occurrence of rain: the alternation of wet and dry periods and temporal distribution of rainfall in each rain event, which determines the rainwater collected in each of the intervals that make up the rain. This allows the introduction of alternative renewal processes and Markov chains of three states, where interstorm time is given by either of the two dry states, short or long. Thus, the stochastic model of Markov chains tries to reproduce the basis of pulse models: the succession of storms, each one composed for a series of rain, separated by a short interval of time without theoretical complexity of these. In a first step, we analyzed all variables involved in the sequential process of the rain: rain event duration, event duration of non-rain, average rainfall intensity in rain events, and finally, temporal distribution of rainfall within the rain event. Additionally, for pulse Bartlett-Lewis model calibration, main descriptive statistics were calculated for each month, considering the process of seasonal rainfall in each month. In a second step, both models were calibrated. Finally, synthetic series were simulated with calibration parameters; series were recorded every ten minutes and hourly, aggregated. Preliminary results show adequate simulation of the main features of rain. Main variables are well simulated for time series of ten minutes, also over one hour precipitation time series, which are those that generate higher rainfall hydrologic design. For coarse scales, less than one hour, rainfall durations are not appropriate under the simulation. A hypothesis may be an excessive number of simulated events, which causes further fragmentation of storms, resulting in an excess of rain "short" (less than 1 hour), and therefore also among rain events, compared with the ones that occur in the actual series.

Off-line real-time FTIR analysis of a process step in imipenem production

NASA Astrophysics Data System (ADS)

Boaz, Jhansi R.; Thomas, Scott M.; Meyerhoffer, Steven M.; Staskiewicz, Steven J.; Lynch, Joseph E.; Egan, Richard S.; Ellison, Dean K.

1992-08-01

We have developed an FT-IR method, using a Spectra-Tech Monit-IR 400 systems, to monitor off-line the completion of a reaction in real-time. The reaction is moisture-sensitive and analysis by more conventional methods (normal-phase HPLC) is difficult to reproduce. The FT-IR method is based on the shift of a diazo band when a conjugated beta-diketone is transformed into a silyl enol ether during the reaction. The reaction mixture is examined directly by IR and does not require sample workup. Data acquisition time is less than one minute. The method has been validated for specificity, precision and accuracy. The results obtained by the FT-IR method for known mixtures and in-process samples compare favorably with those from a normal-phase HPLC method.

Workplace interventions for reducing sitting at work.

PubMed

Shrestha, Nipun; Kukkonen-Harjula, Katriina T; Verbeek, Jos H; Ijaz, Sharea; Hermans, Veerle; Pedisic, Zeljko

2018-06-20

A large number of people are employed in sedentary occupations. Physical inactivity and excessive sitting at workplaces have been linked to increased risk of cardiovascular disease, obesity, and all-cause mortality. To evaluate the effectiveness of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, OSH UPDATE, PsycINFO, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal up to 9 August 2017. We also screened reference lists of articles and contacted authors to find more studies. We included randomised controlled trials (RCTs), cross-over RCTs, cluster-randomised controlled trials (cluster-RCTs), and quasi-RCTs of interventions to reduce sitting at work. For changes of workplace arrangements, we also included controlled before-and-after studies. The primary outcome was time spent sitting at work per day, either self-reported or measured using devices such as an accelerometer-inclinometer and duration and number of sitting bouts lasting 30 minutes or more. We considered energy expenditure, total time spent sitting (including sitting at and outside work), time spent standing at work, work productivity and adverse events as secondary outcomes. Two review authors independently screened titles, abstracts and full-text articles for study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required. We found 34 studies - including two cross-over RCTs, 17 RCTs, seven cluster-RCTs, and eight controlled before-and-after studies - with a total of 3,397 participants, all from high-income countries. The studies evaluated physical workplace changes (16 studies), workplace policy changes (four studies), information and counselling (11 studies), and multi-component interventions (four studies). One study included both physical workplace changes and information and counselling components. We did not find any studies that specifically investigated the effects of standing meetings or walking meetings on sitting time.Physical workplace changesInterventions using sit-stand desks, either alone or in combination with information and counselling, reduced sitting time at work on average by 100 minutes per workday at short-term follow-up (up to three months) compared to sit-desks (95% confidence interval (CI) -116 to -84, 10 studies, low-quality evidence). The pooled effect of two studies showed sit-stand desks reduced sitting time at medium-term follow-up (3 to 12 months) by an average of 57 minutes per day (95% CI -99 to -15) compared to sit-desks. Total sitting time (including sitting at and outside work) also decreased with sit-stand desks compared to sit-desks (mean difference (MD) -82 minutes/day, 95% CI -124 to -39, two studies) as did the duration of sitting bouts lasting 30 minutes or more (MD -53 minutes/day, 95% CI -79 to -26, two studies, very low-quality evidence).We found no significant difference between the effects of standing desks and sit-stand desks on reducing sitting at work. Active workstations, such as treadmill desks or cycling desks, had unclear or inconsistent effects on sitting time.Workplace policy changesWe found no significant effects for implementing walking strategies on workplace sitting time at short-term (MD -15 minutes per day, 95% CI -50 to 19, low-quality evidence, one study) and medium-term (MD -17 minutes/day, 95% CI -61 to 28, one study) follow-up. Short breaks (one to two minutes every half hour) reduced time spent sitting at work on average by 40 minutes per day (95% CI -66 to -15, one study, low-quality evidence) compared to long breaks (two 15-minute breaks per workday) at short-term follow-up.Information and counsellingProviding information, feedback, counselling, or all of these resulted in no significant change in time spent sitting at work at short-term follow-up (MD -19 minutes per day, 95% CI -57 to 19, two studies, low-quality evidence). However, the reduction was significant at medium-term follow-up (MD -28 minutes per day, 95% CI -51 to -5, two studies, low-quality evidence).Computer prompts combined with information resulted in no significant change in sitting time at work at short-term follow-up (MD -10 minutes per day, 95% CI -45 to 24, two studies, low-quality evidence), but at medium-term follow-up they produced a significant reduction (MD -55 minutes per day, 95% CI -96 to -14, one study). Furthermore, computer prompting resulted in a significant decrease in the average number (MD -1.1, 95% CI -1.9 to -0.3, one study) and duration (MD -74 minutes per day, 95% CI -124 to -24, one study) of sitting bouts lasting 30 minutes or more.Computer prompts with instruction to stand reduced sitting at work on average by 14 minutes per day (95% CI 10 to 19, one study) more than computer prompts with instruction to walk at least 100 steps at short-term follow-up.We found no significant reduction in workplace sitting time at medium-term follow-up following mindfulness training (MD -23 minutes per day, 95% CI -63 to 17, one study, low-quality evidence). Similarly a single study reported no change in sitting time at work following provision of highly personalised or contextualised information and less personalised or contextualised information. One study found no significant effects of activity trackers on sitting time at work.Multi-component interventions Combining multiple interventions had significant but heterogeneous effects on sitting time at work (573 participants, three studies, very low-quality evidence) and on time spent in prolonged sitting bouts (two studies, very low-quality evidence) at short-term follow-up. At present there is low-quality evidence that the use of sit-stand desks reduce workplace sitting at short-term and medium-term follow-ups. However, there is no evidence on their effects on sitting over longer follow-up periods. Effects of other types of interventions, including workplace policy changes, provision of information and counselling, and multi-component interventions, are mostly inconsistent. The quality of evidence is low to very low for most interventions, mainly because of limitations in study protocols and small sample sizes. There is a need for larger cluster-RCTs with longer-term follow-ups to determine the effectiveness of different types of interventions to reduce sitting time at work.

A continuous arc delivery optimization algorithm for CyberKnife m6.

PubMed

Kearney, Vasant; Descovich, Martina; Sudhyadhom, Atchar; Cheung, Joey P; McGuinness, Christopher; Solberg, Timothy D

2018-06-01

This study aims to reduce the delivery time of CyberKnife m6 treatments by allowing for noncoplanar continuous arc delivery. To achieve this, a novel noncoplanar continuous arc delivery optimization algorithm was developed for the CyberKnife m6 treatment system (CyberArc-m6). CyberArc-m6 uses a five-step overarching strategy, in which an initial set of beam geometries is determined, the robotic delivery path is calculated, direct aperture optimization is conducted, intermediate MLC configurations are extracted, and the final beam weights are computed for the continuous arc radiation source model. This algorithm was implemented on five prostate and three brain patients, previously planned using a conventional step-and-shoot CyberKnife m6 delivery technique. The dosimetric quality of the CyberArc-m6 plans was assessed using locally confined mutual information (LCMI), conformity index (CI), heterogeneity index (HI), and a variety of common clinical dosimetric objectives. Using conservative optimization tuning parameters, CyberArc-m6 plans were able to achieve an average CI difference of 0.036 ± 0.025, an average HI difference of 0.046 ± 0.038, and an average LCMI of 0.920 ± 0.030 compared with the original CyberKnife m6 plans. Including a 5 s per minute image alignment time and a 5-min setup time, conservative CyberArc-m6 plans achieved an average treatment delivery speed up of 1.545x ± 0.305x compared with step-and-shoot plans. The CyberArc-m6 algorithm was able to achieve dosimetrically similar plans compared to their step-and-shoot CyberKnife m6 counterparts, while simultaneously reducing treatment delivery times. © 2018 American Association of Physicists in Medicine.

Ageostrophic winds in the severe strom environment

NASA Technical Reports Server (NTRS)

Moore, J. T.

1982-01-01

The period from 1200 GMT 10 April to 0000 GMT 11 April 1979, during which time several major tornadoes and severe thunderstorms, including the Wichita Falls tornado occurred was studied. A time adjusted, isentropic data set was used to analyze key parameters. Fourth order centered finite differences were used to compute the isallobaric, inertial advective, tendency, inertial advective geostrophic and ageostrophic winds. Explicit isentropic trajectories were computed through the isentropic, inviscid equations of motion using a 15 minute time step. Ageostrophic, geostrophic and total vertical motion fields were computed to judge the relative importance of ageostrophy in enhancing the vertical motion field. It is found that ageostrophy is symptomatic of those mass adjustments which take place during upper level jet streak propagation and can, in a favorable environment, act to increase and release potential instability over meso alpha time periods.

Process for producing a high emittance coating and resulting article

NASA Technical Reports Server (NTRS)

Le, Huong G. (Inventor); O'Brien, Dudley L. (Inventor)

1993-01-01

Process for anodizing aluminum or its alloys to obtain a surface particularly having high infrared emittance by anodizing an aluminum or aluminum alloy substrate surface in an aqueous sulfuric acid solution at elevated temperature and by a step-wise current density procedure, followed by sealing the resulting anodized surface. In a preferred embodiment the aluminum or aluminum alloy substrate is first alkaline cleaned and then chemically brightened in an acid bath The resulting cleaned substrate is anodized in a 15% by weight sulfuric acid bath maintained at a temperature of 30.degree. C. Anodizing is carried out by a step-wise current density procedure at 19 amperes per square ft. (ASF) for 20 minutes, 15 ASF for 20 minutes and 10 ASF for 20 minutes. After anodizing the sample is sealed by immersion in water at 200.degree. F. and then air dried. The resulting coating has a high infrared emissivity of about 0.92 and a solar absorptivity of about 0.2, for a 5657 aluminum alloy, and a relatively thick anodic coating of about 1 mil.

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.

The Effects of Physical Conditioning on Mental Performance

DTIC Science & Technology

1984-10-04

Effect of one-minute and five-minute step-ups on performance of simple addition. Research Quarterly 39: 81-85, 1968. Halberg, F. Chronobiology . Annual... performance , vol.8: 73-80, 1955. Terjung, R.L., and W.W. Winder. Exercise and thyroid function. Med. Sci. Sports 7: 20, 1975. Thompson, E.G., I.T...MEDICAL CENTER WILFORD HALL AIR FORCE MEDICAL CENTER Title of Thesis: "The Effects of Physical Conditioning on Mental Performance " Name of

Impact of SCBA size and fatigue from different firefighting work cycles on firefighter gait.

PubMed

Kesler, Richard M; Bradley, Faith F; Deetjen, Grace S; Angelini, Michael J; Petrucci, Matthew N; Rosengren, Karl S; Horn, Gavin P; Hsiao-Wecksler, Elizabeth T

2018-04-04

Risk of slips, trips and falls in firefighters maybe influenced by the firefighter's equipment and duration of firefighting. This study examined the impact of a four self-contained breathing apparatus (SCBA) three SCBA of increasing size and a prototype design and three work cycles one bout (1B), two bouts with a five-minute break (2B) and two bouts back-to-back (BB) on gait in 30 firefighters. Five gait parameters (double support time, single support time, stride length, step width and stride velocity) were examined pre- and post-firefighting activity. The two largest SCBA resulted in longer double support times relative to the smallest SCBA. Multiple bouts of firefighting activity resulted in increased single and double support time and decreased stride length, step width and stride velocity. These results suggest that with larger SCBA or longer durations of activity, firefighters may adopt more conservative gait patterns to minimise fall risk. Practitioner Summary: The effects of four self-contained breathing apparatus (SCBA) and three work cycles on five gait parameters were examined pre- and post-firefighting activity. Both SCBA size and work cycle affected gait. The two largest SCBA resulted in longer double support times. Multiple bouts of activity resulted in more conservative gait patterns.

Correlated time-variation of bulk microstructure and rheology in asphalt binders.

PubMed

Ramm, A; Sakib, N; Bhasin, A; Downer, M C

2018-05-22

We use near-infrared dark-field optical microscopy to probe isothermal time variation of the volume fraction of naturally-occurring, subsurface microstructures in PG 64-22 asphalt binders at temperature T=30∘C, following a rapid heating (cooling) increment |ΔT|=20∘C from initial temperature T0=10∘C(50∘C). We compare these microstructure variations with isothermal time variations of the magnitude |G30∗(t)| of the bulk complex shear modulus measured for identical sample conditions with a Dynamic Shear Rheometer. The main findings are: (1) Microstructure volume fraction (inferred from intensity I(t) of near-infrared optical scatter) and |G∗(t)| both continue to change appreciably long after measurable changes of binder temperature cease. Moreover, delayed time variations in I(t) and |G∗(t)| (2) correlate closely with each other; (3) evolve on three distinct time scales - several minutes, ∼1 h, >1 day; (4) depend on binder aging; (5) are more pronounced after a cooling step (ΔT=-20∘C) than after a heating step (ΔT=+20∘C); and (6) account for hysteresis in I(t) and |G∗(t)| curves observed during heating-cooling cycles. © 2018 The Authors Journal of Microscopy © 2018 Royal Microscopical Society.

The effect of a pedometer-based community walking intervention "Walking for Wellbeing in the West" on physical activity levels and health outcomes: a 12-week randomized controlled trial.

PubMed

Baker, Graham; Gray, Stuart R; Wright, Annemarie; Fitzsimons, Claire; Nimmo, Myra; Lowry, Ruth; Mutrie, Nanette

2008-09-05

Recent systematic reviews have suggested that pedometers may be effective motivational tools to promote walking. However, studies tend to be of a relatively short duration, with small clinical based samples. Further research is required to demonstrate their effectiveness in adequately powered, community based studies. Using a randomized controlled trial design, this study assessed the impact of a 12-week graduated pedometer-based walking intervention on daily step-counts, self-reported physical activity and health outcomes in a Scottish community sample not meeting current physical activity recommendations. Sixty-three women and 16 men (49.2 years +/- 8.8) were randomly assigned to either an intervention (physical activity consultation and 12-week pedometer-based walking program) or control (no action) group. Measures for step-counts, 7-day physical activity recall, affect, quality of life (n = 79), body mass, BMI, % body fat, waist and hip circumference (n = 76), systolic/diastolic blood pressure, total cholesterol and HDL cholesterol (n = 66) were taken at baseline and week 12. Analyses were performed on an intention to treat basis using 2-way mixed factorial analyses of variance for parametric data and Mann Whitney and Wilcoxon tests for non-parametric data. Significant increases were found in the intervention group for step-counts (p < .001), time spent in leisure walking (p = .02) and positive affect (p = .027). Significant decreases were found in this group for time spent in weekday (p = .003), weekend (p = .001) and total sitting (p = .001) with no corresponding changes in the control group. No significant changes in any other health outcomes were found in either group. In comparison with the control group at week 12, the intervention group reported a significantly greater number of minutes spent in leisure time (p = .008), occupational (p = .045) and total walking (p = .03), and significantly fewer minutes in time spent in weekend (p = .003) and total sitting (p = .022). A pedometer-based walking program, incorporating a physical activity consultation, is effective in promoting walking and improving positive affect over 12 weeks in community based individuals. The discussion examines possible explanations for the lack of significant changes in health outcomes. Continued follow-up of this study will examine adherence to the intervention and possible resulting effects on health outcomes.

A two-step process of nitrous oxide before carbon dioxide for humanely euthanizing piglets: on-farm trials

USDA-ARS?s Scientific Manuscript database

The current methods of euthanizing neonatal piglets are raising concerns from the public and scientists. Our experiment tests the use of a two-step euthanasia method using nitrous oxide (N2O) for six minutes and then carbon dioxide (CO2) as a more humane way to euthanize piglets compared to just usi...

America Dances! 1897-1948. A Collector's Edition of Social Dance in Film.

ERIC Educational Resources Information Center

Teten, Carol

This 75-minute VHS videotape provides original film clips of social dances that have been lost to the public for many years. It focuses on four eras: 1897-1919: "From the Cakewalk to the Castle Walk" (e.g., charity ball, comedy cakewalk, one step, airplane waltz, and two-step); 1920-1929: "From the Blackbottom to the Lindy Hop"…

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.

Value-based neurosurgery: measuring and reducing the cost of microvascular decompression surgery.

PubMed

McLaughlin, Nancy; Upadhyaya, Pooja; Buxey, Farzad; Martin, Neil A

2014-09-01

Care providers have put significant effort into optimizing patient safety and quality of care. Value, defined as meaningful outcomes achieved per dollar spent, is emerging as a promising framework to redesign health care. Scarce data exist regarding cost measurement and containment for episodes of neurosurgical care. The authors assessed how cost measurement and strategic containment could be used to optimize the value of delivered care after the implementation and maturation of quality improvement initiatives. A retrospective study of consecutive patients undergoing microvascular decompression was performed. Group 1 comprised patients treated prior to the implementation of quality improvement interventions, and Group 2 consisted of those treated after the implementation and maturation of quality improvement processes. A third group, Group 3, represented a contemporary group studied after the implementation of cost containment interventions targeting the three most expensive activities: pre-incision time in the operating room (OR) and total OR time, intraoperative neuromonitoring (IOM), and bed assignment (and overall length of stay [LOS]). The value of care was assessed for all three groups. Forty-four patients were included in the study. Average preparation time pre-incision decreased from 73 to 65 to 45 minutes in Groups 1, 2, and 3, respectively. The average total OR time and OR cost were 434 minutes and $8513 in Group 1; 348 minutes and $7592 in Group 2; and 407 minutes and $8333 in Group 3. The average cost for IOM, excluding electrode needles, was $1557, $1585, and $1263, respectively, in Groups 1, 2, and 3. Average total cost for bed assignment was $5747, $5198, and $4535, respectively, in Groups 1, 2, and 3. The average total LOS decreased from 3.16 days in Group 1 to 2.14 days in Group 3. Complete relief of or a significant decrease in preoperative symptomatology was achieved in 42 of the 44 patients, respectively. Overall, the average cost of a surgical care episode (index hospitalization + readmission/reoperation) decreased 25% from Group 1 to 3. Linking cost-containment and cost-reduction strategies to ongoing outcome improvement measures is an important step toward the optimization of value-based delivery of care.

Clinical usefulness of augmented reality using infrared camera based real-time feedback on gait function in cerebral palsy: a case study.

PubMed

Lee, Byoung-Hee

2016-04-01

[Purpose] This study investigated the effects of real-time feedback using infrared camera recognition technology-based augmented reality in gait training for children with cerebral palsy. [Subjects] Two subjects with cerebral palsy were recruited. [Methods] In this study, augmented reality based real-time feedback training was conducted for the subjects in two 30-minute sessions per week for four weeks. Spatiotemporal gait parameters were used to measure the effect of augmented reality-based real-time feedback training. [Results] Velocity, cadence, bilateral step and stride length, and functional ambulation improved after the intervention in both cases. [Conclusion] Although additional follow-up studies of the augmented reality based real-time feedback training are required, the results of this study demonstrate that it improved the gait ability of two children with cerebral palsy. These findings suggest a variety of applications of conservative therapeutic methods which require future clinical trials.

Microwave-Accelerated Method for Ultra-Rapid Extraction of Neisseria gonorrhoeae DNA for Downstream Detection

PubMed Central

Melendez, Johan H.; Santaus, Tonya M.; Brinsley, Gregory; Kiang, Daniel; Mali, Buddha; Hardick, Justin; Gaydos, Charlotte A.; Geddes, Chris D.

2016-01-01

Nucleic acid-based detection of gonorrhea infections typically require a two-step process involving isolation of the nucleic acid, followed by the detection of the genomic target often involving PCR-based approaches. In an effort to improve on current detection approaches, we have developed a unique two-step microwave-accelerated approach for rapid extraction and detection of Neisseria gonorrhoeae (GC) DNA. Our approach is based on the use of highly-focused microwave radiation to rapidly lyse bacterial cells, release, and subsequently fragment microbial DNA. The DNA target is then detected by a process known as microwave-accelerated metal-enhanced fluorescence (MAMEF), an ultra-sensitive direct DNA detection analytical technique. In the present study, we show that highly focused microwaves at 2.45 GHz, using 12.3 mm gold film equilateral triangles, are able to rapidly lyse both bacteria cells and fragment DNA in a time- and microwave power-dependent manner. Detection of the extracted DNA can be performed by MAMEF, without the need for DNA amplification in less than 10 minutes total time or by other PCR-based approaches. Collectively, the use of a microwave-accelerated method for the release and detection of DNA represents a significant step forward towards the development of a point-of-care (POC) platform for detection of gonorrhea infections. PMID:27325503

Immobilization techniques to avoid enzyme loss from oxidase-based biosensors: a one-year study.

PubMed

House, Jody L; Anderson, Ellen M; Ward, W Kenneth

2007-01-01

Continuous amperometric sensors that measure glucose or lactate require a stable sensitivity, and glutaraldehyde crosslinking has been used widely to avoid enzyme loss. Nonetheless, little data is published on the effectiveness of enzyme immobilization with glutaraldehyde. A combination of electrochemical testing and spectrophotometric assays was used to study the relationship between enzyme shedding and the fabrication procedure. In addition, we studied the relationship between the glutaraldehyde concentration and sensor performance over a period of one year. The enzyme immobilization process by glutaraldehyde crosslinking to glucose oxidase appears to require at least 24-hours at room temperature to reach completion. In addition, excess free glucose oxidase can be removed by soaking sensors in purified water for 20 minutes. Even with the addition of these steps, however, it appears that there is some free glucose oxidase entrapped within the enzyme layer which contributes to a decline in sensitivity over time. Although it reduces the ultimate sensitivity (probably via a change in the enzyme's natural conformation), glutaraldehyde concentration in the enzyme layer can be increased in order to minimize this instability. After exposure of oxidase enzymes to glutaraldehyde, effective crosslinking requires a rinse step and a 24-hour incubation step. In order to minimize the loss of sensor sensitivity over time, the glutaraldehyde concentration can be increased.

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.

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.

Gait pattern alteration by functional sensory substitution in healthy subjects and in diabetic subjects with peripheral neuropathy.

PubMed

Walker, S C; Helm, P A; Lavery, L A

1997-08-01

To evaluate the ability of diabetic and nondiabetic individuals to learn to use a lower extremity sensory substitution device to cue gait pattern changes. Case-control study. Gait laboratory. Thirty diabetic persons and 20 age- and education-matched nondiabetic controls responded to advertisements for study participation. Participants walked on a treadmill at three speeds (1, 2, and 2.5mph) with auditory sensory feedback to cue ground contact greater than 80% duration of baseline. The variables measured included gait cycle (steps per minute) and number of times per minute that any step during a trial exceeded 80% duration of ground contacted compared with a measured baseline step length for each speed. Persons in both groups were able to rapidly and significantly alter their gait patterns in response to signals from the sensory substitution device, by changing their gait cycles (nondiabetic group, F(17,124) = 5.27, p < .001; diabetic group, F(5,172) = 3.45, p < .001). Post hoc analyses showed early gait cycle modification and error reduction among both groups. The nondiabetic group learned to use the device significantly more quickly than the diabetic group during the slow (1mph, t = 3.57, p < .001) and average (2mph, t = 2.97, p < .05) trials. By the fast (2.5mph) ambulation trial, both groups were performing equally, suggesting a rapid rate of adjustment to the device. No technical failures from gait trainer malfunction occurred during the study. Diabetic persons with neuropathy effectively used lower extremity sensory substitution, and the technology is now available to manufacture a durable, effective lower extremity sensory substitution system.

Effect of long term high altitude exposure on cardiovascular autonomic adjustment during rest and post-exercise recovery.

PubMed

Bhattarai, Prem; Paudel, Bishnu H; Thakur, Dilip; Bhattarai, Balkrishna; Subedi, Bijay; Khadka, Rita

2018-01-01

Despite the successful adaptation to high altitude, some differences do occur due to long term exposure to the hypoxic environment. The effect of long term high altitude exposure on cardiac autonomic adjustment during basal and post-exercise recovery is less known. Thus we aimed to study the differences in basal cardiac autonomic adjustment and its response to exercise in highlanders and to compare it with lowlanders. The study was conducted on 29 healthy highlander males who were born and brought up at altitude of 3000 m and above from the sea level, their cardiac autonomic adjustment was compared with age, sex, physical activity and ethnicity-matched 29 healthy lowlanders using Heart Rate Variability (HRV) during rest and recovery from sub-maximal exercise (3 m step test). Intergroup comparison between the highlanders and lowlanders and intragroup comparison between the rest and the postexercise recovery conditions were done. Resting heart rate and HRV during rest was comparable between the groups. However, heart rate recovery after 3 min step test was faster in highlanders ( p  < 0.05) along with significantly higher LF power and total power during the recovery phase. Intragroup comparison of highlanders showed higher SDNN ( p  < 0.05) and lower LF/HF ratio ( p  < 0.05) during recovery phase compared to rest which was not significantly different in two phases in lowlanders. Further highlander showed complete recovery of RMSSD, NN50, pNN50 and HF power back to resting level within five minutes, whereas, these parameters failed to return back to resting level in lowlanders within the same time frame. Highlanders completely recovered back to their resting state within five minutes from cessation of step test with parasympathetic reactivation; however, recovery in lowlanders was delayed.

The Polar Cusp Observed by Cluster Under Constant Imf-Bz Southward

NASA Astrophysics Data System (ADS)

Escoubet, C. P.; Berchem, J.; Pitout, F.; Trattner, K. J.; Richard, R. L.; Taylor, M. G.; Soucek, J.; Grison, B.; Laakso, H. E.; Masson, A.; Dunlop, M. W.; Dandouras, I. S.; Reme, H.; Fazakerley, A. N.; Daly, P. W.

2011-12-01

The Earth's magnetic field is influenced by the interplanetary magnetic field (IMF), specially at the magnetopause where both magnetic fields enter in direct contact and magnetic reconnection can be initiated. In the polar regions, the polar cusp that extends from the magnetopause down to the ionosphere is also directly influenced. The reconnection not only allow ions and electrons from the solar wind to enter the polar cusp but also give an impulse to the magnetic field lines threading the polar cusp through the reconnection electric field. A dispersion in energy of the ions is subsequently produced by the motion of field lines and the time-of-flight effect on down-going ions. If reconnection is continuous and operates at constant rate, the ion dispersion is smooth and continuous. On the other hand if the reconnection rate varies, we expect interruption in the dispersion forming energy steps or staircase. Similarly, multiple entries near the magnetopause could also produce steps at low or mid-altitude when a spacecraft is crossing subsequently the field lines originating from these multiple sources. Cluster with four spacecraft following each other in the mid-altitude cusp can be used to distinguish between these "temporal" and "spatial" effects. We will show two Cluster cusp crossings where the spacecraft were separated by a few minutes. The energy dispersions observed in the first crossing were the same during the few minutes that separated the spacecraft. In the second crossing, two ion dispersions were observed on the first spacecraft and only one of the following spacecraft, about 10 min later. The detailed analysis indicates that these steps result from spatial structures.

Aerobic Fitness Does Not Contribute to Prediction of Orthostatic Intolerance

NASA Technical Reports Server (NTRS)

Convertino, Victor A.; Sather, Tom M.; Goldwater, Danielle J.; Alford, William R.

1986-01-01

Several investigations have suggested that orthostatic tolerance may be inversely related to aerobic fitness (VO (sub 2max)). To test this hypothesis, 18 males (age 29 to 51 yr) underwent both treadmill VO(sub 2max) determination and graded lower body negative pressures (LBNP) exposure to tolerance. VO(2max) was measured during the last minute of a Bruce treadmill protocol. LBNP was terminated based on pre-syncopal symptoms and LBNP tolerance (peak LBNP) was expressed as the cumulative product of LBNP and time (torr-min). Changes in heart rate, stroke volume cardiac output, blood pressure and impedance rheographic indices of mid-thigh-leg initial accumulation were measured at rest and during the final minute of LBNP. For all 18 subjects, mean (plus or minus SE) fluid accumulation index and leg venous compliance index at peak LBNP were 139 plus or minus 3.9 plus or minus 0.4 ml-torr-min(exp -2) x 10(exp 3), respectively. Pearson product-moment correlations and step-wise linear regression were used to investigate relationships with peak LBNP. Variables associated with endurance training, such as VO(sub 2max) and percent body fat were not found to correlate significantly (P is less than 0.05) with peak LBNP and did not add sufficiently to the prediction of peak LBNP to be included in the step-wise regression model. The step-wise regression model included only fluid accumulation index leg venous compliance index, and blood volume and resulted in a squared multiple correlation coefficient of 0.978. These data do not support the hypothesis that orthostatic tolerance as measured by LBNP is lower in individuals with high aerobic fitness.

Reliability of wireless monitoring using a wearable patch sensor in high-risk surgical patients at a step-down unit in the Netherlands: a clinical validation study.

PubMed

Breteler, Martine J M; Huizinga, Erik; van Loon, Kim; Leenen, Luke P H; Dohmen, Daan A J; Kalkman, Cor J; Blokhuis, Taco J

2018-02-27

Intermittent vital signs measurements are the current standard on hospital wards, typically recorded once every 8 hours. Early signs of deterioration may therefore be missed. Recent innovations have resulted in 'wearable' sensors, which may capture patient deterioration at an earlier stage. The objective of this study was to determine whether a wireless 'patch' sensor is able to reliably measure respiratory and heart rate continuously in high-risk surgical patients. The secondary objective was to explore the potential of the wireless sensor to serve as a safety monitor. In an observational methods comparisons study, patients were measured with both the wireless sensor and bedside routine standard for at least 24 hours. University teaching hospital, single centre. Twenty-five postoperative surgical patients admitted to a step-down unit. Primary outcome measures were limits of agreement and bias of heart rate and respiratory rate. Secondary outcome measures were sensor reliability, defined as time until first occurrence of data loss. 1568 hours of vital signs data were analysed. Bias and 95% limits of agreement for heart rate were -1.1 (-8.8 to 6.5) beats per minute. For respiration rate, bias was -2.3 breaths per minute with wide limits of agreement (-15.8 to 11.2 breaths per minute). Median filtering over a 15 min period improved limits of agreement of both respiration and heart rate. 63% of the measurements were performed without data loss greater than 2 min. Overall data loss was limited (6% of time). The wireless sensor is capable of accurately measuring heart rate, but accuracy for respiratory rate was outside acceptable limits. Remote monitoring has the potential to contribute to early recognition of physiological decline in high-risk patients. Future studies should focus on the ability to detect patient deterioration on low care environments and at home after discharge. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Process for making silicon carbide reinforced silicon carbide composite

NASA Technical Reports Server (NTRS)

Lau, Sai-Kwing (Inventor); Calandra, Salavatore J. (Inventor); Ohnsorg, Roger W. (Inventor)

1998-01-01

A process comprising the steps of: a) providing a fiber preform comprising a non-oxide ceramic fiber with at least one coating, the coating comprising a coating element selected from the group consisting of carbon, nitrogen, aluminum and titanium, and the fiber having a degradation temperature of between 1400.degree. C. and 1450.degree. C., b) impregnating the preform with a slurry comprising silicon carbide particles and between 0.1 wt % and 3 wt % added carbon c) providing a cover mix comprising: i) an alloy comprising a metallic infiltrant and the coating element, and ii) a resin, d) placing the cover mix on at least a portion of the surface of the porous silicon carbide body, e) heating the cover mix to a temperature between 1410.degree. C. and 1450.degree. C. to melt the alloy, and f) infiltrating the fiber preform with the melted alloy for a time period of between 15 minutes and 240 minutes, to produce a ceramic fiber reinforced ceramic composite.

Minute synthesis of extremely stable gold nanoparticles.

PubMed

Zhou, Min; Wang, Baoxiang; Rozynek, Zbigniew; Xie, Zhaohui; Fossum, Jon Otto; Yu, Xiaofeng; Raaen, Steinar

2009-12-16

We describe a rapid environmentally friendly wet-chemical approach to synthesize extremely stable non-toxic, biocompatible, water-soluble monodispersed gold nanoparticles (AuNPs) in one step at room temperature. The particles have been successfully achieved in just a few minutes by merely adding sodium hydroxide (NaOH) acting as an initiator for the reduction of HAuCl(4) in aqueous solution in the presence of polyvinylpyrrolidone (PVP) without the use of any reducing agent. It is also proved to be highly efficient for the preparation of AuNPs with controllable sizes. The AuNPs show remarkable stability in water media with high concentrations of salt, various buffer solutions and physiological conditions in biotechnology and biomedicine. Moreover, the AuNPs are also non-toxic at high concentration (100 microM). Therefore, it provides great opportunities to use these AuNPs for biotechnology and biomedicine. This new approach also involved several green chemistry concepts, such as the selection of environmentally benign reagents and solvents, without energy consumption, and less reaction time.

Silicon carbide reinforced silicon carbide composite

NASA Technical Reports Server (NTRS)

Lau, Sai-Kwing (Inventor); Calandra, Salvatore J. (Inventor); Ohnsorg, Roger W. (Inventor)

2001-01-01

This invention relates to a process comprising the steps of: a) providing a fiber preform comprising a non-oxide ceramic fiber with at least one coating, the coating comprising a coating element selected from the group consisting of carbon, nitrogen, aluminum and titanium, and the fiber having a degradation temperature of between 1400.degree. C. and 1450.degree. C., b) impregnating the preform with a slurry comprising silicon carbide particles and between 0.1 wt % and 3 wt % added carbon c) providing a cover mix comprising: i) an alloy comprising a metallic infiltrant and the coating element, and ii) a resin, d) placing the cover mix on at least a portion of the surface of the porous silicon carbide body, e) heating the cover mix to a temperature between 1410.degree. C. and 1450.degree. C. to melt the alloy, and f) infiltrating the fiber preform with the melted alloy for a time period of between 15 minutes and 240 minutes, to produce a ceramic fiber reinforced ceramic composite.

Comparison of the efficacy of disinfectants in automated endoscope reprocessors for colonoscopes: tertiary amine compound (Sencron2®) versus ortho-phthalaldehyde (Cidex®OPA)

PubMed Central

Seo, Hyun Il; Lee, Dae Sung; Yoon, Eun Mi; Kwon, Min-Jung; Park, Hyosoon; Jung, Yoon Suk; Park, Jung Ho; Sohn, Chong Il

2016-01-01

Background/Aims To prevent the transmission of pathogens by endoscopes, following established reprocessing guidelines is critical. An ideal reprocessing step is simple, fast, and inexpensive. Here, we evaluated and compared the efficacy and safety of two disinfectants, a tertiary amine compound (TAC) and ortho-phthalaldehyde (OPA). Methods A total of 100 colonoscopes were randomly reprocessed using two same automated endoscope reprocessors, according to disinfectant. The exposure time was 10 minutes for 0.55% OPA (Cidex® OPA, Johnson & Johnson) and 5 minutes for 4% TAC (Sencron2®, Bab Gencel Pharma & Chemical Ind. Co.). Three culture samples were obtained from each colonoscope after reprocessing. Results A total of nine samples were positive among the 300 culture samples. The positive culture rate was not statistically different between the two groups (4% for OPA and 2% for TAC, P=0.501). There were no incidents related to safety during the study period. Conclusions TAC was non-inferior in terms of reprocessing efficacy to OPA and was safe to use. Therefore, TAC seems to be a good alternative disinfectant with a relatively short exposure time and is also less expensive than OPA. PMID:27175119

Analyzing Sensor-Based Time Series Data to Track Changes in Physical Activity during Inpatient Rehabilitation.

PubMed

Sprint, Gina; Cook, Diane; Weeks, Douglas; Dahmen, Jordana; La Fleur, Alyssa

2017-09-27

Time series data collected from sensors can be analyzed to monitor changes in physical activity as an individual makes a substantial lifestyle change, such as recovering from an injury or illness. In an inpatient rehabilitation setting, approaches to detect and explain changes in longitudinal physical activity data collected from wearable sensors can provide value as a monitoring, research, and motivating tool. We adapt and expand our Physical Activity Change Detection (PACD) approach to analyze changes in patient activity in such a setting. We use Fitbit Charge Heart Rate devices with two separate populations to continuously record data to evaluate PACD, nine participants in a hospitalized inpatient rehabilitation group and eight in a healthy control group. We apply PACD to minute-by-minute Fitbit data to quantify changes within and between the groups. The inpatient rehabilitation group exhibited greater variability in change throughout inpatient rehabilitation for both step count and heart rate, with the greatest change occurring at the end of the inpatient hospital stay, which exceeded day-to-day changes of the control group. Our additions to PACD support effective change analysis of wearable sensor data collected in an inpatient rehabilitation setting and provide insight to patients, clinicians, and researchers.

Short-burst interval treadmill training walking capacity and performance in cerebral palsy: a pilot study.

PubMed

Bjornson, Kristie F; Moreau, Noelle; Bodkin, Amy Winter

2018-04-16

To examine the effect of short-burst interval locomotor treadmill training (SBLTT) on walking capacity and performance in cerebral palsy (CP). Twelve children with spastic diplegic CP (average 8.6 years) across Gross Motor Function Classification System levels II (8) and III (4) were randomized to 20 SBLTT sessions over 4 or 10 weeks. SBLTT consisted of alternating 30 seconds of slow and fast walking for 30 minutes/session. Outcomes included the 10 m walk test, one-minute walk test (1MWT), and timed-up-and go (TUG) (capacity) and StepWatch (performance) collected at baseline, post, and 6 weeks post. Fast speed (+.11, p = .04; +.11 m/s, p = .006), 1MWT (+11.2; +11.7 m, p = .006) and TUG (-1.7; -1.9 seconds, p = .006) improved post SBLTT and 6 weeks, respectively. Walking performance increased: average strides/day (+948; +1712, p < .001) and percent time in high strides rates (+0.4, p = 0.07; +0.2, p = .008). Pilot study suggests SBLTT may improve short-term walking capacity and performance.

Physiologic effects of alveolar recruitment and inspiratory pauses during moderately-high-frequency ventilation delivered by a conventional ventilator in a severe lung injury model

PubMed Central

Costa, Eduardo Leite Vieira; Azevedo, Luciano Cesar Pontes; Gomes, Susimeire; Amato, Marcelo Britto Passos; Park, Marcelo

2017-01-01

Background and aims To investigate whether performing alveolar recruitment or adding inspiratory pauses could promote physiologic benefits (VT) during moderately-high-frequency positive pressure ventilation (MHFPPV) delivered by a conventional ventilator in a porcine model of severe acute respiratory distress syndrome (ARDS). Methods Prospective experimental laboratory study with eight pigs. Induction of acute lung injury with sequential pulmonary lavages and injurious ventilation was initially performed. Then, animals were ventilated on a conventional mechanical ventilator with a respiratory rate (RR) = 60 breaths/minute and PEEP titrated according to ARDS Network table. The first two steps consisted of a randomized order of inspiratory pauses of 10 and 30% of inspiratory time. In final step, we removed the inspiratory pause and titrated PEEP, after lung recruitment, with the aid of electrical impedance tomography. At each step, PaCO2 was allowed to stabilize between 57–63 mmHg for 30 minutes. Results The step with RR of 60 after lung recruitment had the highest PEEP when compared with all other steps (17 [16,19] vs 14 [10, 17]cmH2O), but had lower driving pressures (13 [13,11] vs 16 [14, 17]cmH2O), higher P/F ratios (212 [191,243] vs 141 [105, 184] mmHg), lower shunt (23 [20, 23] vs 32 [27, 49]%), lower dead space ventilation (10 [0, 15] vs 30 [20, 37]%), and a more homogeneous alveolar ventilation distribution. There were no detrimental effects in terms of lung mechanics, hemodynamics, or gas exchange. Neither the addition of inspiratory pauses or the alveolar recruitment maneuver followed by decremental PEEP titration resulted in further reductions in VT. Conclusions During MHFPPV set with RR of 60 bpm delivered by a conventional ventilator in severe ARDS swine model, neither the inspiratory pauses or PEEP titration after recruitment maneuver allowed reduction of VT significantly, however the last strategy decreased driving pressures and improved both shunt and dead space. PMID:28961282

Effect of rhythm on the recovery from intense exercise.

PubMed

Eliakim, Michal; Bodner, Ehud; Meckel, Yoav; Nemet, Dan; Eliakim, Alon

2013-04-01

Motivational music (music that stimulates physical activity) was previously shown to enhance the recovery from intense exercise. The aim of the present study was to isolate the effect of rhythm (presumed to be the most effective factor of motivational music) on the recovery from intense exercise. Ten young adult active men (age: 26.1 ± 1.7 years) performed 6-minute run at peak oxygen consumption speed, at 3 separate visits (random order). At 1 visit, no music was played during the recovery after exercise. In the other visits, participants listened to motivational music that was previously shown to enhance recovery (a Western CD collection of greatest hits of all times converted to dance style, 140 b·min, strong bit, played by portable MP3 device using headphones at a volume of 70 dB) or only to the rhythm beats derived from the same songs. Mean heart rate (HR), rating of perceived exertion (RPE), number of steps (measured by step counter) and blood lactate concentrations were determined at 3, 6, 9, 12, and 15 minutes of the recovery. There was no difference in HR changes during the recovery at all conditions. Compared with the recovery without music, listening to motivational music during recovery was associated with significant greater number of steps, lower absolute lactate levels, and greater mean decrease of RPE. Listening only to rhythm beats, derived from the same music, during the recovery was associated with significant greater number of steps and lower absolute lactate levels compared to recovery without music. Music was significantly more effective than rhythm only in the absolute mean number of steps. The beneficial effect of both music and rhythm was greater toward the end of the recovery period. Results suggest that listening to music during nonstructured recovery can be used by professional athletes to enhance recovery from intense exercise. Rhythm plays a very important role in the effect of music on recovery and can be used to enhance nonstructured recovery when music is unavailable or when cultural barriers and individual music preferences may apply. The optimal music and rhythm selection is yet to be determined.

Preliminary efficacy of prize-based contingency management to increase activity levels in healthy adults.

PubMed

Washington, Wendy Donlin; Banna, Kelly M; Gibson, Amanda L

2014-01-01

An estimated 30% of Americans meet the criteria for obesity. Effective, low-cost interventions to increase physical activity are needed to prevent and treat obesity. In this study, 11 healthy adults wore Fitbit accelerometers for 3 weeks. During the initial baseline, subjects earned prize draws for wearing the Fitbit. During intervention, percentile schedules were used to calculate individual prize-draw criteria. The final week was a return to baseline. Four subjects increased step counts as a result of the intervention. A bout analysis of interresponse times revealed that subjects increased overall step counts by increasing daily minutes active and within-bout response rates and decreasing pauses between bouts of activity. Strategies to improve effectiveness are suggested, such as modification of reinforcement probability and amount and identification of the function of periods of inactivity. © Society for the Experimental Analysis of Behavior.

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.

Combined effect of whole-body vibration and ambient lighting on human discomfort, heart rate, and reaction time.

PubMed

Monazzam, Mohammad Reza; Shoja, Esmaeil; Zakerian, Seyed Abolfazl; Foroushani, Abbas Rahimi; Shoja, Mohsen; Gharaee, Masoumeh; Asgari, Amin

2018-07-01

This study aimed to investigate the effect of whole-body vibration and ambient lighting, as well as their combined effect on human discomfort, heart rate, and reaction time in laboratory conditions. 44 men were recruited with an average age of 25.4 ± 1.9 years. Each participant was subjected to 12 experimental steps, each step lasting five minutes for four different vibration accelerations in X, Y, and Z axes at a fixed frequency; three different lighting intensities of 50, 500, and 1000 lx were also considered. At each step, a visual computerized reaction test was taken from subjects and their heart rate recorded by pulse oximeter. In addition, the discomfort rate of subjects was measured using Borg scale. Increasing vibration acceleration significantly increased the discomfort rate and heart beat but not the reaction time. Lack of lighting caused more discomfort in the subjects, but there was no significant correlation between lighting intensity with heart rate and reaction time. The results also showed that the combined effect of vibration and lighting had no significant effect on any of the discomfort, heart rate, and reaction time variables. Whole-body vibration is an important factor in the development of human subjective and physiological reactions compared to lighting. Therefore, consideration of the level of vibration to which an individual is exposed in workplaces subject to vibration plays an important role in reducing the level of human discomfort, but its interaction with ambient lighting does not have a significant effect on human subjective and physiological responses.

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.

Treadmill sideways gait training with visual blocking for patients with brain lesions.

PubMed

Kim, Tea-Woo; Kim, Yong-Wook

2014-09-01

[Purpose] The aim of this study was to verify the effect of sideways treadmill training with and without visual blocking on the balance and gait function of patients with brain lesions. [Subjects] Twenty-four stroke and traumatic brain injury subjects participated in this study. They were divided into two groups: an experimental group (12 subjects) and a control group (12 subjects). [Methods] Each group executed a treadmill training session for 20 minutes, three times a week, for 6 weeks. The sideways gait training on the treadmill was performed with visual blocking by the experimental group and with normal vision by the control group. A Biodex Gait Trainer 2 was used to assess the gait function. It was used to measure walking speed, walking distance, step length, and stance time on each foot. The Five-Times-Sit-To-Stand test (FTSST) and Timed Up and Go test (TUG) were used as balance measures. [Results] The sideways gait training with visual blocking group showed significantly improved walking speed, walking distance, step length, and stance time on each foot after training; FTSST and TUG times also significantly improved after training in the experimental group. Compared to the control group, the experimental group showed significant increases in stance time on each foot. [Conclusion] Sideways gait training on a treadmill with visual blocking performed by patients with brain lesions significantly improved their balance and gait function.

The Correlates of Body Composition with Heart Rate Recovery after Step Test: An Exploratory Study of Malaysian Adolescents

PubMed Central

Abu Hanifah, Redzal; Mohamed, Mohd. Nahar Azmi; Jaafar, Zulkarnain; Abdul Mohsein, Nabilla Al-Sadat; Jalaludin, Muhammad Yazid; Abdul Majid, Hazreen; Murray, Liam; Cantwell, Marie; Su, Tin Tin

2013-01-01

Background In adults, heart rate recovery is a predictor of mortality, while in adolescents it is associated with cardio-metabolic risk factors. The aim of this study was to examine the relationship between body composition measures and heart rate recovery (HRR) after step test in Malaysian secondary school students. Methods In the Malaysian Health and Adolescents Longitudinal Research Team (MyHEART) study, 1071 healthy secondary school students, aged 13 years old, participated in the step test. Parameters for body composition measures were body mass index z-score, body fat percentage, waist circumference, and waist height ratio. The step test was conducted by using a modified Harvard step test. Heart rate recovery of 1 minute (HRR1min) and heart rate recovery of 2 minutes (HRR2min) were calculated by the difference between the peak pulse rate during exercise and the resting pulse rate at 1 and 2 minutes, respectively. Analysis was done separately based on gender. Pearson correlation analysis was used to determine the association between the HRR parameters with body composition measures, while multiple regression analysis was used to determine which body composition measures was the strongest predictor for HRR. Results For both gender groups, all body composition measures were inversely correlated with HRR1min. In girls, all body composition measures were inversely correlated with HRR2min, while in boys all body composition measures, except BMI z-score, were associated with HRR2min. In multiple regression, only waist circumference was inversely associated with HRR2min (p=0.024) in boys, while in girls it was body fat percentage for HRR2min (p=0.008). Conclusion There was an inverse association between body composition measurements and HRR among apparently healthy adolescents. Therefore, it is important to identify cardio-metabolic risk factors in adolescent as an early prevention of consequent adulthood morbidity. This reiterates the importance of healthy living which should start from young. PMID:24349388

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

Six-minute Stepper Test to Set Pulmonary Rehabilitation Intensity in Patients with COPD - A Retrospective Study.

PubMed

Bonnevie, Tristan; Gravier, Francis-Edouard; Leboullenger, Marie; Médrinal, Clément; Viacroze, Catherine; Cuvelier, Antoine; Muir, Jean-François; Tardif, Catherine; Debeaumont, David

2017-06-01

Pulmonary rehabilitation (PR) improves outcomes in patients with chronic obstructive pulmonary disease (COPD). Optimal assessment includes cardiopulmonary exercise testing (CPET), but consultations are limited. Field tests could be used to individualize PR instead of CPET. The six-minute stepper test (6MST) is easy to set up and its sensitivity and reproducibility have previously been reported in patients with COPD. The aim of this study was to develop a prediction equation to set intensity in patients attending PR, based on the 6MST. The following relationships were analyzed: mean heart rate (HR) during the first (HR 1-3 ) and last (HR 4-6 ) 3 minutes of the 6MST and HR at the ventilatory threshold (HRvt) from CPET; step count at the end of the 6MST and workload at the Ventilatory threshold (VT) (Wvt); and forced expiratory volume in 1 second and step count during the 6MST. This retrospective study included patients with COPD referred for PR who underwent CPET, pulmonary function evaluations and the 6MST. Twenty-four patients were included. Prediction equations were HRvt = 0.7887 × HR 1-3 + 20.83 and HRvt = 0.6180 × HR 4-6 + 30.77. There was a strong correlation between HR 1-3 and HR 4-6 and HRvt (r = 0.69, p < 0.001 and r = 0.57, p < 0.01 respectively). A significant correlation was also found between step count and LogWvt (r = 0.63, p < 0.01). The prediction equation was LogWvt = 0.001722 × step count + 1.248. The 6MST could be used to individualize aerobic training in patients with COPD. Further prospective studies are needed to confirm these results.

An Analysis on the Detection of Biological Contaminants Aboard Aircraft

PubMed Central

Hwang, Grace M.; DiCarlo, Anthony A.; Lin, Gene C.

2011-01-01

The spread of infectious disease via commercial airliner travel is a significant and realistic threat. To shed some light on the feasibility of detecting airborne pathogens, a sensor integration study has been conducted and computational investigations of contaminant transport in an aircraft cabin have been performed. Our study took into consideration sensor sensitivity as well as the time-to-answer, size, weight and the power of best available commercial off-the-shelf (COTS) devices. We conducted computational fluid dynamics simulations to investigate three types of scenarios: (1) nominal breathing (up to 20 breaths per minute) and coughing (20 times per hour); (2) nominal breathing and sneezing (4 times per hour); and (3) nominal breathing only. Each scenario was implemented with one or seven infectious passengers expelling air and sneezes or coughs at the stated frequencies. Scenario 2 was implemented with two additional cases in which one infectious passenger expelled 20 and 50 sneezes per hour, respectively. All computations were based on 90 minutes of sampling using specifications from a COTS aerosol collector and biosensor. Only biosensors that could provide an answer in under 20 minutes without any manual preparation steps were included. The principal finding was that the steady-state bacteria concentrations in aircraft would be high enough to be detected in the case where seven infectious passengers are exhaling under scenarios 1 and 2 and where one infectious passenger is actively exhaling in scenario 2. Breathing alone failed to generate sufficient bacterial particles for detection, and none of the scenarios generated sufficient viral particles for detection to be feasible. These results suggest that more sensitive sensors than the COTS devices currently available and/or sampling of individual passengers would be needed for the detection of bacteria and viruses in aircraft. PMID:21264266

Feasibility study of mid-infrared absorption spectroscopy using electrospray ionization

NASA Astrophysics Data System (ADS)

Ahmed, Tahsin; Foster, Erick; Bohn, Paul; Howard, Scott

2016-09-01

Precise detection of trace amount of molecules, such as the disease biomarkers present in biofluids or explosive residues, requires high sensitivity detection. electrospray ionization-mass spectrometry (ESI-MS) is a common and effective technique for sensitive trace molecular detection in small-volume liquid samples. In ESI-MS, nano-liter volume samples are ionized and aerosolized by ESI, and fed into MS for mass analysis. ESI-MS has proven to be a reliable ionization technique for coupling liquid phase separations like liquid chromatography (LC) and capillary zone electrophoresis (CE) with the highly specific resolving power of MS. While CE and ESI can be performed on a microfluidic chip having a footprint of a few cm2, MS is typically at least 100 times bigger in size than a micro-chip. A reduced size, weight, and power profile would enable semi-portable applications in forensics, environmental monitoring, defense, and biological/pharmaceutical applications. To achieve this goal, we present an initial study evaluating the use of mid-infrared absorption spectroscopy (MIRAS) in place of MS to create a ESI-MIRAS system. To establish feasibility, we perform ESI-MIRAS on phospholipid samples, which have been previously demonstrated to be separable by CE. Phospholipids are biomarkers of degenerative neurological, kidney, and bone diseases and can be found in biofluids such as blood, urine and cerebrospinal fluid. To establish sensitivity limits, calibration samples of 100 μM concentration are electrospray deposited on to a grounded Si wafer for different times (1 minutes to 4 minutes with a 1 minute step). The minimum detectable concentration-time product, where a FTIR globar is used as the MIR source, is found 200 μM·s.

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.

[Extra longtime continuous chest compression to rescue cardiopulmonary arrest: a case report and the literature review].

PubMed

Zhang, Yan; Yue, Tianxue; Sun, Kexin; Wang, Jiang; Zhu, Ruiwu

2018-05-01

The new cardiopulmonary resuscitation (CPR) guideline emphasize the importance of chest compression, which was considered as the first step to CPR. The duration for CPR is usually limited to 30 minutes. With the development of new technology and evidence-based medicine, the success of extra longtime CPR has become possible, which is of great significance to some patients with cardiac arrest (CA), but the time limit has not been determined. On February 23rd in 2016, a 76-year-old female patient with respiratory and cardiac arrest who was on the third day after transurethral resection of bladder tumor (TUR-BT) was admitted to the intensive care unit of the General Hospital of Fushun Mining Bureau. On the basis of the comprehensive treatment measures such as ventilator support ventilation, physical cooling with ice cap, 1 mg adrenaline for intravenous injection, low molecular heparin of 5 000 U for subcutaneous injection, and the continuous chest compression were carried out in a timely and effective manner for 125 minutes, which make the patient recover to sinus rhythm and her brain function recovered well without any sequelae, and follow-up of the patient in 1 year showed well. The key to success or failure of CPR depend on the patient's condition. If the patients in healthy, single cause, a good response to the resuscitation, the pulsation of the large artery can be seen now and then during the rescue, and the recovery of the spontaneous breathing, CPR should be kept on. In the process of CPR, individualized assessment of the disease progression without the 30-minute time limit, may benefit the patients in maximum. In the future clinical practice, we should actively explore more favorable evidence, so that CA patients can be rescued more.

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.

Alcohol Use and Problems in Mandated College Students: A Randomized Clinical Trial Using Stepped Care

PubMed Central

Borsari, Brian; Hustad, John T.P.; Mastroleo, Nadine R.; Tevyaw, Tracy O’Leary; Barnett, Nancy P.; Kahler, Christopher W.; Short, Erica Eaton; Monti, Peter M.

2012-01-01

Objective Over the past two decades, colleges and universities have seen a large increase in the number of students referred to the administration for alcohol policies violations. However, a substantial portion of mandated students may not require extensive treatment. Stepped care may maximize treatment efficiency and greatly reduce the demands on campus alcohol programs. Method Participants in the study (N = 598) were college students mandated to attend an alcohol program following a campus-based alcohol citation. All participants received Step 1: a 15-minute Brief Advice session that included the provision of a booklet containing advice to reduce drinking. Participants were assessed six weeks after receiving the Brief Advice, and those who continued to exhibit risky alcohol use (n = 405) were randomized to Step 2, a 60–90 minute brief motivational intervention (BMI) (n = 211) or an assessment-only control (n = 194). Follow-up assessments were conducted 3, 6, and 9 months after Step 2. Results Results indicated that the participants who received a BMI significantly reduced the number of alcohol-related problems compared to those who received assessment-only, despite no significant group differences in alcohol use. In addition, low risk drinkers (n = 102; who reported low alcohol use and related harms at 6-week follow-up and were not randomized to stepped care) showed a stable alcohol use pattern throughout the follow-up period, indicating they required no additional intervention. Conclusion Stepped care is an efficient and cost-effective method to reduce harms associated with alcohol use by mandated students. PMID:22924334

Demographic and individual correlates of achieving 10,000 steps/day: use of pedometers in a population-based study.

PubMed

McCormack, Gavin; Giles-Corti, Billie; Milligan, Rex

2006-04-01

The 10,000 steps per day message has become popular, yet few studies have examined correlates associated with achieving this behaviour target. This paper examines demographic and individual factors associated with adults achieving 10,000 steps/day. Participants in a state-wide, cross-sectional physical activity survey were invited to take part in a pedometer study (n=603, 45% response rate). A pedometer was worn for one week and daily steps recorded in a diary. Participants providing four or more days of pedometer data (n=428) were dichotomised based on achievement of > or =10,000 steps/day. Men performed significantly more daily steps than women on average (10,079+/-3,848 and 9,169+/-3,800, p=0.01). In males, those less likely to achieve > or =10,000 steps/day were > or =60 years of age (OR=0.21) and overweight (i.e. body mass index > or =25kgm2) (OR=0.40), while men who regularly walked in the workplace (OR=1.44), who did vigorous activity at work (OR= 3.75), or who were employed in a blue-collar occupation (OR=4.45) were more likely to report reaching this target. In women, being overweight (OR=0.55) was negatively associated with achieving > or =10,000 steps/day, while participating in > or =150 minutes of leisure-time physical activity/week (OR=2.26) was positively associated with reaching this target. Workplace physical activity and working in blue-collar occupations contributes to the achievement of 10,000 steps/day in males. People who achieve current national physical activity guidelines also achieve 10,000 steps/day. Older adults and those overweight are less likely to achieve this behaviour target.

Improvement of the matching speed of AIMS for development of an automatic totally tuning system for hyperthermia treatment using a resonant cavity applicator.

PubMed

Shindo, Y; Kato, K; Tsuchiya, K; Hirashima, T; Suzuki, M

2009-01-01

In this paper, we discuss the improvement of the speed of AIMS (Automatic Impedance Matching System) to automatically make impedance matching for a re-entrant resonant cavity applicator for non-invasive deep brain tumors hyperthermia treatments. We have already discussed the effectiveness of the heating method using the AIMS, with experiments of heating agar phantoms. However, the operating time of AIMS was about 30 minutes. To develop the ATT System (Automatic Totally Tuning System) including the automatic frequency tuning system, we must improve this problem. Because, when using the ATTS, the AIMS is used repeatedly to find the resonant frequency. In order to improve the speed of impedance matching, we developed the new automatic impedance matching system program (AIMS2). In AIMS, the stepping motors were connected to the impedance matching unit's dials. These dials were turned to reduce the reflected power. AIMS consists of two phases: all range searching and detailed searching. We focused on the three factors affecting the operating speed and improved them. The first factor is the interval put between the turning of the motors and AD converter. The second factor is how the steps of the motor when operating all range searching. The third factor is the starting position of the motor when detail searching. We developed the simple ATT System (ATT-beta) based on the AIMS2. To evaluate the developed AIMS2 and ATT- beta, experiments with an agar phantom were performed. From these results, we found that the operating time of the AIMS2 is about 4 minutes, which was approximately 12% of AIMS. From ATT-beta results, it was shown that it is possible to tune frequency and automatically match impedance with the program based on the AIMS2.

Outdoor time, physical activity, sedentary time, and health indicators at ages 7 to 14: 2012/2013 Canadian Health Measures Survey.

PubMed

Larouche, Richard; Garriguet, Didier; Gunnell, Katie E; Goldfield, Gary S; Tremblay, Mark S

2016-09-21

International data show that the majority of children and youth are not sufficiently active. According to recent research, children who spend more time outdoors accumulate more daily moderate-to-vigorous physical activity and engage in less sedentary behaviour. However, the generalizability of these findings is uncertain, and few studies investigated whether outdoor time is associated with other physical and psychosocial health indicators. This study examined associations between outdoor time and measures of physical activity, sedentary time, and physical and psychosocial health in a nationally representative sample of 7-to-14-year-olds (n = 1,159) who participated in the 2012/2013 Canadian Health Measures Survey. Physical activity and sedentary time were measured with Actical accelerometers. Direct measures of height, weight, waist circumference, grip strength, blood pressure, cholesterol, and glycohemoglobin were obtained. The Strengths and Difficulties Questionnaire was used to assess psychosocial health. Relationships between outdoor time and physical health measures were examined with multi-variable linear regression models adjusted for age, sex, parental education, and household income. Logistic regression models controlling for the same variables were used for psychosocial health. Each additional hour spent outdoors per day was associated with 7.0 more minutes of moderate-to-vigorous physical activity, 762 more steps, and 13 fewer minutes of sedentary time. As well, each hour outdoors was associated with lower odds of negative psychosocial outcomes (specifically, peer relationship problems and total difficulties score). Outdoor time was not associated with any of the measures of physical health. Children reporting more time outdoors are more active, less sedentary, and less likely to have peer relationship problems, compared with those who spend less time outdoors.

Reallocating bouted sedentary time to non-bouted sedentary time, light activity and moderate-vigorous physical activity in adults with prediabetes and type 2 diabetes.

PubMed

Rossen, Jenny; Buman, Matthew P; Johansson, Unn-Britt; Yngve, Agneta; Ainsworth, Barbara; Brismar, Kerstin; Hagströmer, Maria

2017-01-01

The aim of this study was to investigate the potential associations of reallocating 30 minutes sedentary time in long bouts (>60 min) to sedentary time in non-bouts, light intensity physical activity (LPA) and moderate- to vigorous physical activity (MVPA) with cardiometabolic risk factors in a population diagnosed with prediabetes or type 2 diabetes. Participants diagnosed with prediabetes and type 2 diabetes (n = 124, 50% men, mean [SD] age = 63.8 [7.5] years) were recruited to the physical activity intervention Sophia Step Study. For this study baseline data was used with a cross-sectional design. Time spent in sedentary behaviors in bouts (>60 min) and non-bouts (accrued in <60 min bouts) and physical activity was measured using the ActiGraph GT1M. Associations of reallocating bouted sedentary time to non-bouted sedentary time, LPA and MVPA with cardiometabolic risk factors were examined using an isotemporal substitution framework with linear regression models. Reallocating 30 minutes sedentary time in bouts to MVPA was associated with lower waist circumference (b = -4.30 95% CI:-7.23, -1.38 cm), lower BMI (b = -1.46 95% CI:-2.60, -0.33 kg/m2) and higher HDL cholesterol levels (b = 0.11 95% CI: 0.02, 0.21 kg/m2. Similar associations were seen for reallocation of sedentary time in non-bouts to MVPA. Reallocating sedentary time in bouts to LPA was associated only with lower waist circumference. Reallocation of sedentary time in bouts as well as non-bouts to MVPA, but not to LPA, was beneficially associated with waist circumference, BMI and HDL cholesterol in individuals with prediabetes and type 2 diabetes. The results of this study confirm the importance of reallocation sedentary time to MVPA.

Brain Activation in Response to Personalized Behavioral and Physiological Feedback From Self-Monitoring Technology: Pilot Study

PubMed Central

Morgan, Paul S; Sherar, Lauren B; Kingsnorth, Andrew P; Magistro, Daniele; Esliger, Dale W

2017-01-01

Background The recent surge in commercially available wearable technology has allowed real-time self-monitoring of behavior (eg, physical activity) and physiology (eg, glucose levels). However, there is limited neuroimaging work (ie, functional magnetic resonance imaging [fMRI]) to identify how people’s brains respond to receiving this personalized health feedback and how this impacts subsequent behavior. Objective Identify regions of the brain activated and examine associations between activation and behavior. Methods This was a pilot study to assess physical activity, sedentary time, and glucose levels over 14 days in 33 adults (aged 30 to 60 years). Extracted accelerometry, inclinometry, and interstitial glucose data informed the construction of personalized feedback messages (eg, average number of steps per day). These messages were subsequently presented visually to participants during fMRI. Participant physical activity levels and sedentary time were assessed again for 8 days following exposure to this personalized feedback. Results Independent tests identified significant activations within the prefrontal cortex in response to glucose feedback compared with behavioral feedback (P<.001). Reductions in mean sedentary time (589.0 vs 560.0 minutes per day, P=.014) were observed. Activation in the subgyral area had a moderate correlation with minutes of moderate-to-vigorous physical activity (r=0.392, P=.043). Conclusion Presenting personalized glucose feedback resulted in significantly more brain activation when compared with behavior. Participants reduced time spent sedentary at follow-up. Research on deploying behavioral and physiological feedback warrants further investigation. PMID:29117928

Developing a performance data suite to facilitate lean improvement in a chemotherapy day unit.

PubMed

Lingaratnam, Senthil; Murray, Danielle; Carle, Amber; Kirsa, Sue W; Paterson, Rebecca; Rischin, Danny

2013-07-01

A multidisciplinary team from the Peter MacCallum Cancer Centre in Melbourne, Australia, developed a performance data suite to support a service improvement project based on lean manufacturing principles in its 19-chair chemotherapy day unit (CDU) and cytosuite chemotherapy production facility. The aims of the project were to reduce patient wait time and improve equity of access to the CDU. A project team consisting of a pharmacist and CDU nurse supported the management team for 10 months in engaging staff and customers to identify waste in processes, analyze root causes, eliminate non-value-adding steps, reduce variation, and level workloads to improve quality and flow. Process mapping, staff and patient tracking and opinion surveys, medical record audits, and interrogation of electronic treatment records were undertaken. This project delivered a 38% reduction in median wait time on the day (from 32 to 20 minutes; P < .01), 7-day reduction in time to commencement of treatment for patients receiving combined chemoradiotherapy regimens (from 25 to 18 days; P < .01), and 22% reduction in wastage associated with expired drug and pharmacy rework (from 29% to 7%; P < .01). Improvements in efficiency enabled the cytosuite to increase the percentage of product manufactured within 10 minutes of appointment times by 29% (from 47% to 76%; P < .01). A lean improvement methodology provided a robust framework for improved understanding and management of complex system constraints within a CDU, resulting in improved access to treatment and reduced waiting times on the day.

A longitudinal study on the ammonia threshold in junior cyclists

PubMed Central

Yuan, Y; Chan, K

2004-01-01

Objectives: To identify the effect of a one year non-specific training programme on the ammonia threshold of a group of junior cyclists and to correlate ammonia threshold with other common physiological variables. Methods: The cyclists performed tests at three time points (T1, T2, T3) during the year. Follow up tests were conducted every six months after the original test. Ammonia threshold was obtained from a graded exercise with four minute steps. Results: The relatively non-specific one year training programme was effective in inducing an increase in peak VO2 (60.6 (5.9), 65.9 (7.4), and 64.6 (6.5) ml/min/kg at T1, T2, and T3 respectively) and endurance time (18.3 (4.5), 20.1 (5.2), and 27.0 (6.1) minutes at T1, T2, and T3 respectively), but was not effective for the sprint related variables. Ammonia threshold, together with lactate threshold and ventilatory threshold, was not significantly different at the three test times. Only endurance time correlated significantly with ammonia threshold (r  =  0.915, p  =  0.001). Conclusions: The findings suggest that a relatively non-specific one year training programme does not modify the ammonia threshold of junior cyclists. The significant correlation between ammonia threshold and endurance time further confirms that ammonia threshold is a measure of the ability to sustain exercise at submaximal intensities. PMID:15039242

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.

Workplace interventions for reducing sitting at work.

PubMed

Shrestha, Nipun; Kukkonen-Harjula, Katriina T; Verbeek, Jos H; Ijaz, Sharea; Hermans, Veerle; Bhaumik, Soumyadeep

2016-03-17

Office work has changed considerably over the previous couple of decades and has become sedentary in nature. Physical inactivity at workplaces and particularly increased sitting has been linked to increase in cardiovascular disease, obesity and overall mortality. To evaluate the effects of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, OSH UPDATE, PsycINFO, Clinical trials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal up to 2 June, 2015. We also screened reference lists of articles and contacted authors to find more studies to include. We included randomised controlled trials (RCTs), cluster-randomised controlled trials (cRCTs), and quasi-randomised controlled trials of interventions to reduce sitting at work. For changes of workplace arrangements, we also included controlled before-and-after studies (CBAs) with a concurrent control group. The primary outcome was time spent sitting at work per day, either self-reported or objectively measured by means of an accelerometer-inclinometer. We considered energy expenditure, duration and number of sitting episodes lasting 30 minutes or more, work productivity and adverse events as secondary outcomes. Two review authors independently screened titles, abstracts and full-text articles for study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required. We included 20 studies, two cross-over RCTs, 11 RCTs, three cRCTs and four CBAs, with a total of 2180 participants from high income nations. The studies evaluated physical workplace changes (nine studies), policy changes (two studies), information and counselling (seven studies) and interventions from multiple categories (two studies). One study had both physical workplace changes and information and counselling components. We did not find any studies that had investigated the effect of periodic breaks or standing or walking meetings. Physical workplace changesA sit-stand desk alone compared to no intervention reduced sitting time at work per workday with between thirty minutes to two hours at short term (up to three months) follow-up (six studies, 218 participants, very low quality evidence). In two studies, sit-stand desks with additional counselling reduced sitting time at work in the same range at short-term follow-up (61 participants, very low quality evidence). One study found a reduction at six months' follow-up of -56 minutes (95% CI -101 to -12, very low quality evidence) compared to no intervention. Also total sitting time at work and outside work decreased with sit-stand desks compared to no intervention (MD -78 minutes, 95% CI -125 to -31, one study) as did the duration of sitting episodes lasting 30 minutes or more (MD -52 minutes, 95% CI -79 to -26, two studies). This is considerably less than the two to four hours recommended by experts. Sit-stand desks did not have a considerable effect on work performance, musculoskeletal symptoms or sick leave. It remains unclear if standing can repair the harms of sitting because there is hardly any extra energy expenditure.The effects of active workstations were inconsistent. Treadmill desks combined with counselling reduced sitting time at work (MD -29 minutes, 95% CI -55 to -2, one study) compared to no intervention at 12 weeks' follow-up. Pedalling workstations combined with information did not reduce inactive sitting at work considerably (MD -12 minutes, 95% CI -24 to 1, one study) compared to information alone at 16 weeks' follow-up. The quality of evidence was low for active workstations. Policy changesTwo studies with 443 participants provided low quality evidence that walking strategies did not have a considerable effect on workplace sitting time at 10 weeks' (MD -16 minutes, 95% CI -54 to 23) or 21 weeks' (MD -17 minutes, 95% CI -58 to 25) follow-up respectively. Information and counsellingCounselling reduced sitting time at work (MD -28 minutes, 95% CI -52 to -5, two studies, low quality evidence) at medium term (three months to 12 months) follow-up. Mindfulness training did not considerably reduce workplace sitting time (MD -2 minutes, 95% CI -22 to 18) at six months' follow-up and at 12 months' follow-up (MD -16 minutes, 95% CI -45 to 12, one study, low quality evidence). There was no considerable increase in work engagement with counselling.There was an inconsistent effect of computer prompting on sitting time at work. One study found no considerable effect on sitting at work (MD -17 minutes, 95% CI -48 to 14, low quality evidence) at 10 days' follow-up, while another study reported a significant reduction in sitting at work (MD -55 minutes, 95% CI -96 to -14, low quality evidence) at 13 weeks' follow-up. Computer prompts to stand reduced sitting at work by 14 minutes more (95% CI 10 to 19, one study) compared to computer prompts to step at six days' follow-up. Computer prompts did not change the number of sitting episodes that last 30 minutes or longer. Interventions from multiple categories Interventions combining multiple categories had an inconsistent effect on sitting time at work, with a reduction in sitting time at 12 weeks' (25 participants, very low quality evidence) and six months' (294 participants, low quality evidence) follow-up in two studies but no considerable effect at 12 months' follow-up in one study (MD -47.98, 95% CI -103 to 7, 294 participants, low quality evidence). At present there is very low to low quality evidence that sit-stand desks may decrease workplace sitting between thirty minutes to two hours per day without having adverse effects at the short or medium term. There is no evidence on the effects in the long term. There were no considerable or inconsistent effects of other interventions such as changing work organisation or information and counselling. There is a need for cluster-randomised trials with a sufficient sample size and long term follow-up to determine the effectiveness of different types of interventions to reduce objectively measured sitting time at work.

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.

Optimal Electromechanical Reshaping of the Auricular Ear and Long-term Outcomes in an In Vivo Rabbit Model

PubMed Central

Manuel, Cyrus T.; Tjoa, Tjoson; Nguyen, Tony; Su, Erica; Wong, Brian J. F.

2016-01-01

IMPORTANCE The prominent ear is a common external ear anomaly that is usually corrected through surgery. Electromechanical reshaping (EMR) may provide the means to reshape cartilage through the use of direct current (in milliamperes) applied percutaneously with needle electrodes and thus to reduce reliance on open surgery. OBJECTIVE To determine the long-term outcomes (shape change, cell viability, and histology) of a more refined EMR voltage and time settings for reshaping rabbit auricle. DESIGN, SETTING, AND SUBJECTS The intact ears of 14 New Zealand white rabbits were divided into 2 groups. Group 1 received 4 V for 5 minutes (5 ears), 5 V for 4 minutes (5 ears), or no voltage for 5 minutes (control; 4 ears). Group 2 received an adjusted treatment of 4 V for 4 minutes (7 ears) or 5 V for 3 minutes (7 ears). A custom mold with platinum electrodes was used to bend the pinna and to perform EMR. Pinnae were splinted for 6 months along the region of the bend. Rabbits were killed humanely and the ears were harvested the day after splint removal. Data were collected from March 14, 2013, to July 8, 2014, and analyzed from August 29, 2013, to March 1, 2015. MAIN OUTCOMES AND MEASURES Bend angle and mechanical behavior via palpation were recorded through photography and videography. Tissue was sectioned for histologic examination and confocal microscopy to assess changes to microscopic structure and cell viability. RESULTS Rabbits ranged in age from 6 to 8 months and weighed 3.8 to 4.0 g. The mean (SD) bend angles were 81° (45°) for the controls and, in the 5 EMR groups, 72° (29°) for 4 V for 4 minutes, 101° (19°) for 4 V for 5 minutes, 78° (18°) for 5 V for 3 minutes, and 126° (21°) for 5 V for 4 minutes. At 5 V, an increase in application time from 3 to 4 minutes provided significant shape change (78° [18°] and 126° [21°], respectively; P = .003). Pinnae stained with hematoxylin-eosin displayed localized areas of cell injury and fibrosis in and around electrode insertion sites. This circumferential zone of injury (range, 1.3–2.1 mm) corresponded to absence of red florescence on the cell viability assay. CONCLUSIONS AND RELEVANCE In this in vivo study, EMR produces shape changes in the intact pinnae of rabbits. A short application of 4 V or 5 V can achieve adequate reshaping of the pinnae. Tissue injury around the electrodes is modest in spatial distribution. This study provides a more optimal set of EMR variables and a critical step toward evaluation of EMR in clinical trials. LEVEL OF EVIDENCE NA. PMID:27101542

Drilling, construction, and testing of water-supply wells 21 and 22, White Sands Missle Range, Dona Ana County, New Mexico

USGS Publications Warehouse

Wilson, Clyde A.; White, R.R.; Roybal, R.G.; Gonzales, J.L.

1978-01-01

During the spring and summer of 1976, two municipal-supply wells (designated as well 21 and well 22 - 2,000 feet apart) were drilled at the Post Headquarters area of White Sands Missile Range, New Mexico. The design specifications for both wells called for 24-inch diameter surface casing cemented in place to a depth of about 430 feet, with 16-inch liner and slotted casing from the surface to a depth of about 700 feet. Each well was pumped continuously for 32 hours in a step-drawdown test. This test consisted of four steps, with discharge rates varying from about 500 to 1,150 gallons per minute. The drawdown test for well 21 gave an estimated transmissivity of 17,300 gallons per day per foot, and a final specific capacity of slightly less than 11 gallons per minute per foot of drawdown. The step-drawdown test and later drawdown and recovery test on well 22 gave an average transmissivity of 32,600 gallons per day per foot, and a final specific capacity of about 15 gallons per minute per foot of drawdown. The data collected indicated that the aquifer in the vicinity of well 22 is more permeable than the aquifer around well 21. Both wells furnish a satisfactory quantity of excellent-quality water. The dissolved-solids content of water from wells 21 and 22 is 232 and 301 mg/liter respectively. (Woodard-USGS)

Rapid identification of Yersinia pestis and Brucella melitensis by chip-based continuous flow PCR

NASA Astrophysics Data System (ADS)

Dietzsch, Michael; Hlawatsch, Nadine; Melzer, Falk; Tomaso, Herbert; Gärtner, Claudia; Neubauer, Heinrich

2012-06-01

To combat the threat of biological agents like Yersinia pestis and Brucella melitensis in bioterroristic scenarios requires fast, easy-to-use and safe identification systems. In this study we describe a system for rapid amplification of specific genetic markers for the identification of Yersinia pestis and Brucella melitensis. Using chip based PCR and continuous flow technology we were able to amplify the targets simultaneously with a 2-step reaction profile within 20 minutes. The subsequent analysis of amplified fragments by standard gel electrophoresis requires another 45 minutes. We were able to detect both pathogens within 75 minutes being much faster than most other nucleic acid amplification technologies.

The application of foraging theory to the information searching behaviour of general practitioners.

PubMed

Dwairy, Mai; Dowell, Anthony C; Stahl, Jean-Claude

2011-08-23

General Practitioners (GPs) employ strategies to identify and retrieve medical evidence for clinical decision making which take workload and time constraints into account. Optimal Foraging Theory (OFT) initially developed to study animal foraging for food is used to explore the information searching behaviour of General Practitioners. This study is the first to apply foraging theory within this context.Study objectives were: 1. To identify the sequence and steps deployed in identifiying and retrieving evidence for clinical decision making. 2. To utilise Optimal Foraging Theory to assess the effectiveness and efficiency of General Practitioner information searching. GPs from the Wellington region of New Zealand were asked to document in a pre-formatted logbook the steps and outcomes of an information search linked to their clinical decision making, and fill in a questionnaire about their personal, practice and information-searching backgrounds. A total of 115/155 eligible GPs returned a background questionnaire, and 71 completed their information search logbook. GPs spent an average of 17.7 minutes addressing their search for clinical information. Their preferred information sources were discussions with colleagues (38% of sources) and books (22%). These were the two most profitable information foraging sources (15.9 min and 9.5 min search time per answer, compared to 34.3 minutes in databases). GPs nearly always accessed another source when unsuccessful (95% after 1st source), and frequently when successful (43% after 2nd source). Use of multiple sources accounted for 41% of searches, and increased search success from 70% to 89%. By consulting in foraging terms the most 'profitable' sources of information (colleagues, books), rapidly switching sources when unsuccessful, and frequently double checking, GPs achieve an efficient trade-off between maximizing search success and information reliability, and minimizing searching time. As predicted by foraging theory, GPs trade time-consuming evidence-based (electronic) information sources for sources with a higher information reward per unit time searched. Evidence-based practice must accommodate these 'real world' foraging pressures, and Internet resources should evolve to deliver information as effectively as traditional methods of information gathering.

TU-AB-303-03: CBCT-Based On-Site Simulation, Planning, and Delivery (OSPD) for Whole Brain Radiotherapy

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

Le, A; Choe, K; Jiang, S

2015-06-15

Purpose: To demonstrate the feasibility of a CBCT-based on-site simulation, planning, and delivery (OSPD) for whole brain radiotherapy, in which all steps from imaging, planning to treatment delivery are performed at the treatment unit in one appointment time slot. This work serves as the proof of concept for future OSPD single fraction radiation therapy. Methods: An integrated on-site imaging, planning and delivery workflow was developed and tested for whole brain radiotherapy. An automated two-opposed-oblique-beam plan is created by utilizing the treatment planning system scripting and simple field-in-field IMRT. The IMRT plan is designed with maximum 8 control points to covermore » the target volume consisting of the brain to C1/C2 of the spinal cord, with dose homogeneity criteria from −5% to +7% of the prescription dose. Due to inaccuracy of reconstructed Hounsfield unit numbers in CBCT images, the dose distribution is calculated with non-heterogeneity correction introducing only clinically insignificant dose discrepancy. A coherent and synchronized workflow was designed for a team of attending physician, physicist, therapists, and dosimetrist to work closely with the ability to quickly modify, approve, and implement the treatment. Results: Thirty-one patients have been treated with this OSPD treatment, without compromising the plan quality compared to our regular clinically used parallel apposed 2D plans. The average time for these procedures are 48.02 ±11.55 minutes from the time patient entered the treatment room until s/he exited, and 35.09 ±10.35 minutes from starting CBCT until last beam delivered. This time duration is comparable to the net time when individual tasks are summed up during our regular CT- based whole brain planning and delivery. Conclusions: The OSPD whole brain treatment has been tested to be clinically feasible. The next step is to further improve the efficiency and to streamline the workflow. Other disease sites will be also tested with this new technology.« less

Comparison of recovery parameters for xenon versus other inhalation anesthetics: systematic review and meta-analysis.

PubMed

Hou, Bingzong; Li, Fujing; Ou, Shanshan; Yang, Lukun; Zhou, Shaopeng

2016-03-01

To summarize and evaluate the available data describing the recovery parameters of xenon anesthesia. Systematic review and meta-analysis. Anesthesia for elective surgeries. Systematic review of randomized controlled trials (RCTs) from databases including Medline (1964-2013), the Cochrane Central Register of Controlled Trials (CENTRAL, 1990-2012), and Google Scholar (1966-2013). Inhalation of xenon or other anesthetics was administered in elective surgery. Recovery parameters (time to recovery, alertness/sedation scale scores at "eye opening," bispectral index at "reaction on demand," time to extubation, and time to orientation). Eleven RCTs (N = 661 patients) met the inclusion criteria. Recovery from xenon anesthesia was significantly faster in terms of the time to eye opening (mean difference [MD], -4.18 minutes; 95% confidence interval [CI], -5.03 to -3.32 minutes; P < .00001), the time to reaction on demand (MD, -5.35 minutes; 95% CI, -6.59 to -4.11 minutes; P < .00001), the time to extubation (MD, -4.49 minutes; 95% CI, -5.40 to -3.58 minutes; P < .00001), and the time to orientation (MD, -4.99 minutes; 95% CI, -6.45 to -3.52 minutes; P < .00001). This meta-analysis confirmed that recovery from xenon anesthesia is faster than other inhalation anesthesia. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Algae to Bio-Crude in Less Than 60 Minutes

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

Elliott, Doug

Engineers have created a chemical process that produces useful crude oil just minutes after engineers pour in harvested algae -- a verdant green paste with the consistency of pea soup. The PNNL team combined several chemical steps into one continuous process that starts with an algae slurry that contains as much as 80 to 90 percent water. Most current processes require the algae to be dried -- an expensive process that takes a lot of energy. The research has been licensed by Genifuel Corp.

Algae to Bio-Crude in Less Than 60 Minutes

ScienceCinema

Elliott, Doug

2018-01-16

Engineers have created a chemical process that produces useful crude oil just minutes after engineers pour in harvested algae -- a verdant green paste with the consistency of pea soup. The PNNL team combined several chemical steps into one continuous process that starts with an algae slurry that contains as much as 80 to 90 percent water. Most current processes require the algae to be dried -- an expensive process that takes a lot of energy. The research has been licensed by Genifuel Corp.

A Study of Emergency Room Health CAre Providers and the Fixed Facility Physical Capabilities to Manage the Presenting Radiologically Injured Patient

DTIC Science & Technology

1984-08-01

large areas 6. Contaminated hair 35 a. Shampoo with mild soap for three minutes and rinse b. Monitor and repeat step a as needed c. If contamination...M counters are generally used for surveying low-level radiation and are calibrated either in counts per minute (CPM) or milloroentgens per hours (mR... surveyed for contamination? Decontaminated D. Nature of accident: Type radiation source Other Details: E. Person in charge of radiation evaluation: F

Quadriceps muscle function after exercise in men and women with a history of anterior cruciate ligament reconstruction.

PubMed

Kuenze, Christopher M; Hertel, Jay; Hart, Joseph M

2014-01-01

Sex differences in lower extremity neuromuscular function have been reported after anterior cruciate ligament reconstruction (ACLR). Research evidence supports different levels of fatigability in men and women and between patients with ACLR and healthy controls. The influence of sex on the response to continuous exercise in patients with ACLR is not clear. To compare quadriceps neuromuscular function after exercise between men and women with ACLR. Descriptive laboratory study. Laboratory. Twenty-six active volunteers (13 men [50%]: age = 24.1 ± 4.4 years, height = 179.1 ± 9.8 cm, mass = 80.1 ± 9.4 kg, months since surgery = 43.5 ± 37.0; 13 women [50%]: age = 24.2 ± 5.6 years, height = 163.0 ± 5.9 cm, mass = 62.3 ± 8.3 kg, months since surgery = 45.8 ± 42.7) with a history of unilateral primary ACLR at least 6 months earlier. Thirty minutes of continuous exercise comprising 5 separate 6-minute cycles, including 5 minutes of uphill walking and 1 minute of body-weight squatting and step-ups. Normalized knee-extension maximal voluntary isometric contraction torque, quadriceps superimposed-burst torque, and quadriceps central activation ratio before and after exercise. We performed separate 2 (sex: men, women) × 2 (time: preexercise, postexercise) repeated-measures analyses of variance for the 3 variables. Separate, independent-samples t tests were calculated to compare preexercise with postexercise change in all dependent variables between sexes. A significant group-by-time interaction was present for knee-extension torque (P = .04). The percentage reduction in knee-extension maximal voluntary isometric contraction torque (men = 1.94%, women = -10.32%; P = .02) and quadriceps central activation ratio (men = -1.45%, women = -8.69%; P = .03) experienced by men was less than that observed in women. In the presence of quadriceps dysfunction, female participants experienced greater-magnitude reductions in quadriceps function after 30 minutes of exercise than male participants. This indicates a reduced ability to absorb knee-joint loads, which may have significant implications for reinjury and joint osteoarthritis in women after ACLR.

New monitoring technology to objectively assess adherence to prescribed footwear and assistive devices during ambulatory activity.

PubMed

Bus, Sicco A; Waaijman, Roelof; Nollet, Frans

2012-11-01

To assess the validity and feasibility of a new temperature-based adherence monitor to measure footwear use. Observational study. University medical center and participants' homes. Convenience sample of healthy subjects (n=11) and neuropathic diabetic patients at high risk for foot ulceration (n=14). In healthy subjects, the validity of the in-shoe attached adherence monitor was investigated by comparing its registrations of donning and doffing of footwear during 7 days to an accurately kept log registration. In diabetic patients, the feasibility of using the adherence monitor for 7 days in conjunction with a time-synchronized ankle-worn step activity monitor to register prescribed footwear use during walking was assessed. Furthermore, a usability questionnaire was completed. For validity, the mean time difference and 95% confidence interval (CI) between moments of donning/doffing footwear recorded with the adherence monitor and in the log were calculated. For feasibility, technical performance, usability, and the percentage of steps that the footwear was worn (adherence) were assessed. The mean time difference between the adherence monitor and log recordings was 0.4 minutes (95% CI, 0.2-0.6min). One erroneous recording and 2 incomplete recordings were obtained in diabetic patients. Three patients reported discomfort with the step activity monitor, and 4 patients would not favor repeated testing. Patients used their footwear for between 9% and 99% of their walking steps. The adherence monitor shows good validity in measuring when footwear is used or not, and is, together with instrumented monitoring of walking activity, a feasible and objective method to assess treatment adherence. This method can have wide application in clinical practice and research regarding prescribed footwear and other body-worn assistive devices. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Investigating children's physical activity and sedentary behavior using ecological momentary assessment with mobile phones.

PubMed

Dunton, Genevieve F; Liao, Yue; Intille, Stephen S; Spruijt-Metz, Donna; Pentz, Maryann

2011-06-01

The risk of obesity during childhood can be significantly reduced through increased physical activity and decreased sedentary behavior. Recent technological advances have created opportunities for the real-time measurement of these behaviors. Mobile phones are ubiquitous and easy to use, and thus have the capacity to collect data from large numbers of people. The present study tested the feasibility, acceptability, and validity of an electronic ecological momentary assessment (EMA) protocol using electronic surveys administered on the display screen of mobile phones to assess children's physical activity and sedentary behaviors. A total of 121 children (ages 9-13, 51% male, 38% at risk for overweight/overweight) participated in EMA monitoring from Friday afternoon to Monday evening during children's nonschool time, with 3-7 surveys/day. Items assessed current activity (e.g., watching TV/movies, playing video games, active play/sports/exercising). Children simultaneously wore an Actigraph GT2M accelerometer. EMA survey responses were time-matched to total step counts and minutes of moderate-to-vigorous physical activity (MVPA) occurring in the 30 min before each EMA survey prompt. No significant differences between answered and unanswered EMA surveys were found for total steps or MVPA. Step counts and the likelihood of 5+ min of MVPA were significantly higher during EMA-reported physical activity (active play/sports/exercising) vs. sedentary behaviors (reading/computer/homework, watching TV/movies, playing video games, riding in a car) (P < 0.001). Findings generally support the acceptability and validity of a 4-day EMA protocol using mobile phones to measure physical activity and sedentary behavior in children during leisure time.

Promoting ADL independence in vulnerable, community-dwelling older adults: a pilot RCT comparing 3-Step Workout for Life versus resistance exercise

PubMed Central

Liu, Chiung-ju; Xu, Huiping; Keith, NiCole R; Clark, Daniel O

2017-01-01

Background Resistance exercise is effective to increase muscle strength for older adults; however, its effect on the outcome of activities of daily living is often limited. The purpose of this study was to examine whether 3-Step Workout for Life (which combines resistance exercise, functional exercise, and activities of daily living exercise) would be more beneficial than resistance exercise alone. Methods A single-blind randomized controlled trial was conducted. Fifty-two inactive, community-dwelling older adults (mean age =73 years) with muscle weakness and difficulty in activities of daily living were randomized to receive 3-Step Workout for Life or resistance exercise only. Participants in the 3-Step Workout for Life Group performed functional movements and selected activities of daily living at home in addition to resistance exercise. Participants in the Resistance Exercise Only Group performed resistance exercise only. Both groups were comparable in exercise intensity (moderate), duration (50–60 minutes each time for 10 weeks), and frequency (three times a week). Assessment of Motor and Process Skills, a standard performance test on activities of daily living, was administered at baseline, postintervention, and 6 months after intervention completion. Results At postintervention, the 3-Step Workout for Life Group showed improvement on the outcome measure (mean change from baseline =0.29, P=0.02), but the improvement was not greater than the Resistance Exercise Only Group (group mean difference =0.24, P=0.13). However, the Resistance Exercise Only Group showed a significant decline (mean change from baseline =−0.25, P=0.01) 6 months after the intervention completion. Meanwhile, the superior effect of 3-Step Workout for Life was observed (group mean difference =0.37, P<0.01). Conclusion Compared to resistance exercise alone, 3-Step Workout for Life improves the performance of activities of daily living and attenuates the disablement process in older adults. PMID:28769559

Formation of silicon nanowire packed films from metallurgical-grade silicon powder using a two-step metal-assisted chemical etching method.

PubMed

Ouertani, Rachid; Hamdi, Abderrahmen; Amri, Chohdi; Khalifa, Marouan; Ezzaouia, Hatem

2014-01-01

In this work, we use a two-step metal-assisted chemical etching method to produce films of silicon nanowires shaped in micrograins from metallurgical-grade polycrystalline silicon powder. The first step is an electroless plating process where the powder was dipped for few minutes in an aqueous solution of silver nitrite and hydrofluoric acid to permit Ag plating of the Si micrograins. During the second step, corresponding to silicon dissolution, we add a small quantity of hydrogen peroxide to the plating solution and we leave the samples to be etched for three various duration (30, 60, and 90 min). We try elucidating the mechanisms leading to the formation of silver clusters and silicon nanowires obtained at the end of the silver plating step and the silver-assisted silicon dissolution step, respectively. Scanning electron microscopy (SEM) micrographs revealed that the processed Si micrograins were covered with densely packed films of self-organized silicon nanowires. Some of these nanowires stand vertically, and some others tilt to the silicon micrograin facets. The thickness of the nanowire films increases from 0.2 to 10 μm with increasing etching time. Based on SEM characterizations, laser scattering estimations, X-ray diffraction (XRD) patterns, and Raman spectroscopy, we present a correlative study dealing with the effect of the silver-assisted etching process on the morphological and structural properties of the processed silicon nanowire films.

Formation of silicon nanowire packed films from metallurgical-grade silicon powder using a two-step metal-assisted chemical etching method

PubMed Central

2014-01-01

In this work, we use a two-step metal-assisted chemical etching method to produce films of silicon nanowires shaped in micrograins from metallurgical-grade polycrystalline silicon powder. The first step is an electroless plating process where the powder was dipped for few minutes in an aqueous solution of silver nitrite and hydrofluoric acid to permit Ag plating of the Si micrograins. During the second step, corresponding to silicon dissolution, we add a small quantity of hydrogen peroxide to the plating solution and we leave the samples to be etched for three various duration (30, 60, and 90 min). We try elucidating the mechanisms leading to the formation of silver clusters and silicon nanowires obtained at the end of the silver plating step and the silver-assisted silicon dissolution step, respectively. Scanning electron microscopy (SEM) micrographs revealed that the processed Si micrograins were covered with densely packed films of self-organized silicon nanowires. Some of these nanowires stand vertically, and some others tilt to the silicon micrograin facets. The thickness of the nanowire films increases from 0.2 to 10 μm with increasing etching time. Based on SEM characterizations, laser scattering estimations, X-ray diffraction (XRD) patterns, and Raman spectroscopy, we present a correlative study dealing with the effect of the silver-assisted etching process on the morphological and structural properties of the processed silicon nanowire films. PMID:25349554

Practical quantification of necrosis in histological whole-slide images.

PubMed

Homeyer, André; Schenk, Andrea; Arlt, Janine; Dahmen, Uta; Dirsch, Olaf; Hahn, Horst K

2013-06-01

Since the histological quantification of necrosis is a common task in medical research and practice, we evaluate different image analysis methods for quantifying necrosis in whole-slide images. In a practical usage scenario, we assess the impact of different classification algorithms and feature sets on both accuracy and computation time. We show how a well-chosen combination of multiresolution features and an efficient postprocessing step enables the accurate quantification necrosis in gigapixel images in less than a minute. The results are general enough to be applied to other areas of histological image analysis as well. Copyright © 2013 Elsevier Ltd. All rights reserved.

Cardiorespiratory endurance evaluation using heart rate analysis during ski simulator exercise and the Harvard step test in elementary school students.

PubMed

Lee, Hyo Taek; Roh, Hyo Lyun; Kim, Yoon Sang

2016-01-01

[Purpose] Efficient management using exercise programs with various benefits should be provided by educational institutions for children in their growth phase. We analyzed the heart rates of children during ski simulator exercise and the Harvard step test to evaluate the cardiopulmonary endurance by calculating their post-exercise recovery rate. [Subjects and Methods] The subjects (n = 77) were categorized into a normal weight and an overweight/obesity group by body mass index. They performed each exercise for 3 minutes. The cardiorespiratory endurance was calculated using the Physical Efficiency Index formula. [Results] The ski simulator and Harvard step test showed that there was a significant difference in the heart rates of the 2 body mass index-based groups at each minute. The normal weight and the ski-simulator group had higher Physical Efficiency Index levels. [Conclusion] This study showed that a simulator exercise can produce a cumulative load even when performed at low intensity, and can be effectively utilized as exercise equipment since it resulted in higher Physical Efficiency Index levels than the Harvard step test. If schools can increase sport durability by stimulating students' interests, the ski simulator exercise can be used in programs designed to improve and strengthen students' physical fitness.

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

Aluminum-Silicon Alloy Having Improved Properties At Elevated Temperatures and Process for Producing Cast Articles Therefrom

NASA Technical Reports Server (NTRS)

Lee, Jonathan A. (Inventor); Chen, Po-Shou (Inventor)

2002-01-01

A process for making a cast article from an aluminum alloy includes first casting an article from an alloy having the following composition, in weight percent: Silicon 11.0-14.0, Copper 5.6-8.0, Iron 0-0.8, Magnesium 0.5-1.5, Nickel 0.05-0.9, Manganese 0-1.0, Titanium 0.05-1.2, Zirconium 0.12-1.2, Vanadium 0.05-1.2, Zinc 0.05-0.9, Strontium 0.001-0.1, Aluminum balance . In this alloy the ratio of silicon to magnesium is 10 to 25, and the ratio of copper to magnesium is 4 to 15. After an article is cast from the alloy, the cast article is aged at a temperature within the range of 400F to 500F for a time period within the range of four to 16 hours. It has been found especially advantageous if the cast article is first exposed to a solutionizing step prior to the aging step. This solutionizing step is carried out by exposing the cast article to a temperature within the range of 900F to 1000F for a time period of fifteen minutes to four hours. It has also been found to be especially advantageous if the solutionizing step is followed directly with a quenching step, wherein the cast article is quenched in a quenching medium such as water at a temperature within the range of 120F to 300F. The resulting cast article is suitable in a number of high temperature applications, such as heavy-duty pistons for internal combustion engines.

Cluster observations of ion dispersion discontinuities in the polar cusp

NASA Astrophysics Data System (ADS)

Escoubet, C. P.; Berchem, J.; Pitout, F.; Richard, R. L.; Trattner, K. J.; Grison, B.; Taylor, M. G.; Masson, A.; Dunlop, M. W.; Dandouras, I. S.; Reme, H.; Fazakerley, A. N.

2009-12-01

The reconnection between the interplanetary magnetic field (IMF) and the Earth’s magnetic field is taking place at the magnetopause on magnetic field lines threading through the polar cusp. When the IMF is southward, reconnection occurs near the subsolar point, which is magnetically connected to the equatorward boundary of the polar cusp. Subsequently the ions injected through the reconnection point precipitate in the cusp and are dispersed poleward. If reconnection is continuous and operates at constant rate, the ion dispersion is smooth and continuous. On the other hand if the reconnection rate varies, we expect interruption in the dispersion forming energy steps or staircase. Similarly, multiple entries near the magnetopause could also produce steps at low or mid-altitude when a spacecraft is crossing subsequently the field lines originating from these multiple sources. In addition, motion of the magnetopause induced by solar wind pressure changes or erosion due to reconnection can also induce a motion of the polar cusp and a disruption of the ions dispersion observed by a spacecraft. Cluster with four spacecraft following each other in the mid-altitude cusp can be used to distinguish between these “temporal” and “spatial” effects. We will present a cusp crossing with two spacecraft, separated by around two minutes. The two spacecraft observed a very similar dispersion with a step in energy in its centre and two other dispersions poleward. We will show that the steps could be temporal (assuming that the time between two reconnection bursts corresponds to the time delay between the two spacecraft) but it would be a fortuitous coincidence. On the other hand the steps and the two poleward dispersions could be explained by spatial effects if we take into account the motion of the open-closed boundary between the two spacecraft crossings.

Process for Producing a Cast Article from a Hypereutectic Aluminum-Silicon Alloy

NASA Technical Reports Server (NTRS)

Lee, Jonathan A. (Inventor); Chen, Po-Shou (Inventor)

2003-01-01

A process for making a cast article from an aluminum alloy includes first casting an article from an alloy having the following composition, in weight percent: Silicon (Si) 14.0-25.0, Copper (CU) 5.5-8.0, Iron (Fe) 0-0.8, Magnesium (Mg) 0.5-1.5, Nickel (Ni) 0.05-1.2, Manganese (Mn) 0-1.0, Titanium (Ti) 0.05-1.2, Zirconium (Zr) 0.12-1.2, Vanadium (V) 0.05-1.2, Zinc (Zn) 0-0.9, Phosphorus (P) 0.001-0.1, Aluminum, balance. In this alloy the ration of Si:Mg is 15-35, and the ratio of Cu:Mg is 4-15. After an article is cast from the alloy, the cast article is aged at a temperature within the range of 400 F to 500 F for a time period within the range of four to 16 hours. It has been found especially advantageous if the cast article is first exposed to a solutionizing step prior to the aging step. This solutionizing step is carried out by exposing the cast article to a temperature within the range of 875 F to 1025 F for a time period of fifteen minutes to four hours. It has also been found to be especially advantageous if the solutionizing step is followed directly with a quenching step, wherein the cast article is quenched in a quenching medium such as water at a temperature within the range of 120 F to 300 F. The resulting cast article is highly suitable in a number of high temperature applications, such as heavy-duty pistons for internal combustion engines.

Ethnic and gender differences in physical activity levels among 9-10-year-old children of white European, South Asian and African-Caribbean origin: the Child Heart Health Study in England (CHASE Study).

PubMed

Owen, Christopher G; Nightingale, Claire M; Rudnicka, Alicja R; Cook, Derek G; Ekelund, Ulf; Whincup, Peter H

2009-08-01

Ethnic differences in physical activity in children in the UK have not been accurately assessed. We made objective measurements of physical activity in 9-10-year-old British children of South Asian, black African-Caribbean and white European origin. Cross-sectional study of urban primary school children (2006-07). Actigraph-GT1M activity monitors were worn by 2071 children during waking hours on at least 1 full day. Ethnic differences in mean daily activity [counts, counts per minute of registered time (CPM) and steps] were adjusted for age, gender, day of week and month. Multilevel modelling allowed for repeated days within individual and clustering within school. In white Europeans, mean daily counts, CPM and mean daily steps were 394,785, 498 and 10,220, respectively. South Asian and black Caribbean children recorded more registered time per day than white Europeans (34 and 36 min, respectively). Compared with white Europeans, South Asians recorded 18 789 fewer counts [95% confidence interval (CI) 6390-31 187], 41 fewer CPM 95% CI 26-57) and 905 fewer steps (95% CI 624-1187). Black African-Caribbeans recorded 25 359 more counts (95% CI 14 273-36 445), and similar CPM, but fewer steps than white Europeans. Girls recorded less activity than boys in all ethnic groups, with 74 782 fewer counts (95% CI 66 665-82 899), 84 fewer CPM (95% CI 74-95) and 1484 fewer steps (95% CI 1301-1668). British South Asian children have lower objectively measured physical activity levels than European whites and black African-Caribbeans.

Synthesis and positron emission tomographic (PET) baboon studies of [{sup 11}C]methadone and R-(-)-[{sup 11}C]methandone

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

Ding, Y.S.; Fowler, J.S.; Volkow, N.D.

1996-05-01

Methadone (MET) maintenance has been used successfully for many years in the rehabilitation of heroin addicts. MET, a typical m{mu}-opioid receptor agonist, exists as two enantiomers and is used clinically as the racemic mixture. However, R-(-)-MET has a 10-fold higher affinity for m{mu} receptors than S-(+)-MET (IC{sub 50}: 3.0 nM and 26.4 nM, respectively) and R-(-)-MET is almost entirely responsible for the therapeutic actions of the racemate. In order to examine the pharmacokinetics and stereoselectivity of the drug, we have synthesized both [{sup 11}C]MET and R-(-)-[{sup 11}C]MET. Preparing the precursor by one-step approach to the N-demethylated methadone was precluded asmore » other investigators cited problems with intramolecular cyclization. Therefore, a four-step synthesis using MET (or R-(-)-MET) as starting material was required to obtain the precursor, followed by a two-step radiolabeling synthesis (N-methylation followed by oxidation) to obtain [{sup 11}C]MET (or R-(-)-[{sup 11}C]MET). Comparative PET studies in the same baboon showed peak striatal uptake was 0.022%/cc at 5 minutes with a half time of clearance from peak of 100 minutes for R-(-)-[{sup 11}C]MET and a peak uptake of 0.013%/cc with a half time of 90 min for [{sup 11}C]MET. R-(-)-[{sup 11}C]MET also showed a slower disappearance in plasma. Both tracers showed higher C-11 in basal ganglia (BG), thalamus and midbrain relative to the cerebellum (CB) and occipital cortex (OC) but the BG/OC ratio was higher for R-(-)-[{sup 11}C]MET (1.3 vs 1.1). Pretreatment with naloxone (1 mg/kg, iv) increased R-(-)-[{sup 11}C]MET uptake in all brain regions whereas unlabeled MET slightly increased C-11 clearance in BG, OC and CB. These initial results show higher brain concentration and specificity of the pharmacologically active enantiomer of methadone along with significant non-specific binding.« less

MO-F-CAMPUS-I-01: EIT Imaging to Monitor Human Salivary Gland Functionality: A Feasibility Study

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

Kohli, K; Karvat, A; Liu, J

Purpose: Clinically, there exists a need to develop a non-invasive technique for monitoring salivary activity. In this study, we investigate the feasibility of a using the electrical conductivity information from Electrical Impedance Tomography (EIT) to monitor salivary flow activity. Methods: To acquire EIT data, eight Ag/AgCl ECG electrodes were placed around the mandible of the subject. An EIT scan was obtained by injecting current at 50 KHz, 0.4 mA through each pair of electrodes and recording voltage across other electrode pairs. The functional conductivity image was obtained through reconstruction of the voltage data, using Electrical Impedance Tomography and Diffuse Opticalmore » Tomography Reconstruction Software (EIDORS) in Matlab. In using EIDORS, forward solution was obtained using a user-defined finite element model shape and inverse solution was obtained using one-step Gaussian solver. EIT scans of volunteer research team members were acquired for three different physiological states: pre-stimulation, stimulation and post-stimulation. For pre-stimulation phase, data were collected in intervals of 5 minutes for 15 minutes. The salivary glands were then stimulated in the subject using lemon and the data were collected immediately. Post-stimulation data were collected at 4 different timings after stimulation. Results: Variations were observed in the electrical conductivity patterns near parotid regions between the pre- and post-stimulation stages. The three images acquired during the 15 minute pre-stimulation phase showed no major changes in the conductivity. Immediately after stimulation, electrical conductivity increased near parotid regions and 15 minutes later slowly returned to pre-stimulation level. Conclusion: In the present study involving human subjects, the change in electrical conductivity pattern shown in the EIT images, acquired at different times with and without stimulation of salivary glands, appeared to be consistent with the change in salivary gland activity. The conductivity changes imaged through EIT are potentially useful for the purpose of salivary monitoring.« less

Sports Participation, Functional Outcome, and Complications After Ankle Arthrodesis: Midterm Follow-up.

PubMed

Kerkhoff, Yvonne R A; Keijsers, Noël L W; Louwerens, Jan Willem K

2017-10-01

Ankle arthrodesis provides satisfactory functional outcome based on basic daily activities, but information regarding more demanding tasks is limited. Also, studies reporting longer term survival and complication rates are sparse and concern small study populations. This study reports functional outcome with more focus on demanding tasks and sports and reports the mid- to long-term union and complication rates in a large study population. Between 2005 and 2010, an ankle arthrodesis was performed on 185 ankles. Clinical results were retrospectively assessed with the Foot Function Index (FFI), visual analog scale (VAS) for pain, and the Foot and Ankle Ability Measure (FAAM). Information regarding sports pre- and postoperatively was obtained through a questionnaire. In addition, postoperative complications, reoperations, and failures (defined as nonunion of the ankle arthrodesis) were determined. Mean follow-up time was 8 years. FFI scores significantly improved, the FAAM ADL score was 70%, and the mean VAS for pain at the ankle/hindfoot at follow-up was 20. Sports participation slightly diminished from 79.5% prior to the onset of disabling complaints to 68.9% postoperatively. Of the patients, 73.1% were able to hike with a median hiking time of 40 minutes (range, 2-600 minutes). Kneeling could be performed on average 10 minutes (range, 2-60 minutes) in 39.8% and jumping down from steps by 23.5% of the patients. A small selection of patients was able to sprint (14%), and 16.8% of the patients were able to run a median distance of 60 meters (range, 3-1000 meters). Failure occurred in 9.2% and other postoperative complications were present in 21.6%, requiring reoperation in 8.6% of the cases. Ankle arthrodesis led to satisfactory functional outcome and pain reduction. Most patients remained active in sports, but a transition to less demanding sporting activities was seen. The complication and failure rates were similar with previous literature, and the incidence of nonrevision secondary surgery was relatively low. Level III, retrospective comparative study.

Regional Pediatric Acute Stroke Protocol: Initial Experience During 3 Years and 13 Recanalization Treatments in Children.

PubMed

Tabone, Laurence; Mediamolle, Nicolas; Bellesme, Celine; Lesage, Fabrice; Grevent, David; Ozanne, Augustin; Naggara, Olivier; Husson, Beatrice; Desguerre, Isabelle; Lamy, Catherine; Denier, Christian; Kossorotoff, Manoelle

2017-08-01

To evaluate hyperacute management of pediatric arterial ischemic stroke, setting up dedicated management pathways is the first recommended step to prove the feasibility and safety of such treatments. A regional pediatric stroke alert protocol including 2 centers in the Paris-Ile-de-France area, France, was established. Consecutive pediatric patients (28 days-18 years) with confirmed arterial ischemic stroke who had acute recanalization treatment (intravenous r-tPA [recombinant tissue-type plasminogen activator], endovascular procedure, or both) according to the regional pediatric stroke alert were retrospectively reviewed during a 40-month period. Thirteen children, aged 3.7 to 16.6 years, had recanalization treatment. Median time from onset to magnetic resonance imaging was 165 minutes (150-300); 9 out of 13 had large-vessel occlusion. Intravenous r-tPA was used in 11 out of 13 patients, with median time from onset to treatment of 240 minutes (178-270). Endovascular procedure was performed in patients time-out for intravenous r-tPA (n=2) or after intravenous r-tPA inefficiency (n=2). No intracranial or peripheral bleeding was reported. One patient died of malignant stroke; outcome was favorable in 11 out of 12 survivors (modified Rankin Scale score 0-2). Hyperacute recanalization treatment in pediatric stroke, relying on common protocols and adult/pediatric ward collaboration, is feasible. Larger systematic case collection is encouraged. © 2017 American Heart Association, Inc.

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 sensitive and selective Escherichia coli detection using immobilized optical fiber microprobe

NASA Astrophysics Data System (ADS)

Li, Yanpeng; Sun, Qizhen; Luo, Yiyang; Li, Yue; Gong, Andong; Zhang, Haibin; Liu, Deming

2017-04-01

We proposed and demonstrated a stable, label-free bacteriophage-based sensor of Escherichia coli using microfiber probe. T4 Bacteriophage was covalently immobilized on microfiber surface and E.coli concentration was investigated using the high accurate spectral interference mechanism. By immersing microfiber sensor into different concentration E.coli solution, the relationship between resonant wavelength shift and E.coli concentration was analyzed in the range of 103-107cfu/ml. The proposed method is capable of reliable detection of E.coli concentration as low as 103cfu/ml with a fast response time about 10minutes, which makes the real-time detection of E.coli move on a giant step. Additionally, the sensor has great potential to be applied in the fields like environment monitoring and food safety.

RF Microalgal lipid content characterization

PubMed Central

Ahmad, Mahmoud Al; Al-Zuhair, Sulaiman; Taher, Hanifa; Hilal-Alnaqbi, Ali

2014-01-01

Most conventional techniques for the determination of microalgae lipid content are time consuming and in most cases are indirect and require excessive sample preparations. This work presents a new technique that utilizes radio frequency (RF) for rapid lipid quantification, without the need for sample preparation. Tests showed that a shift in the resonance frequency of a RF open-ended coaxial resonator and a gradual increase in its resonance magnitude may occur as the lipids content of microalgae cells increases. These response parameters can be then calibrated against actual cellular lipid contents and used for rapid determination of the cellular lipids. The average duration of lipid quantification using the proposed technique was of about 1 minute, which is significantly less than all other conventional techniques, and was achieved without the need for any time consuming treatment steps. PMID:24870372

An Embedded Device for Real-Time Noninvasive Intracranial Pressure Estimation.

PubMed

Matthews, Jonathan M; Fanelli, Andrea; Heldt, Thomas

2018-01-01

The monitoring of intracranial pressure (ICP) is indicated for diagnosing and guiding therapy in many neurological conditions. Current monitoring methods, however, are highly invasive, limiting their use to the most critically ill patients only. Our goal is to develop and test an embedded device that performs all necessary mathematical operations in real-time for noninvasive ICP (nICP) estimation based on a previously developed model-based approach that uses cerebral blood flow velocity (CBFV) and arterial blood pressure (ABP) waveforms. The nICP estimation algorithm along with the required preprocessing steps were implemented on an NXP LPC4337 microcontroller unit (MCU). A prototype device using the MCU was also developed, complete with display, recording functionality, and peripheral interfaces for ABP and CBFV monitoring hardware. The device produces an estimate of mean ICP once per minute and performs the necessary computations in 410 ms, on average. Real-time nICP estimates differed from the original batch-mode MATLAB implementation of theestimation algorithm by 0.63 mmHg (root-mean-square error). We have demonstrated that real-time nICP estimation is possible on a microprocessor platform, which offers the advantages of low cost, small size, and product modularity over a general-purpose computer. These attributes take a step toward the goal of real-time nICP estimation at the patient's bedside in a variety of clinical settings.

Inpatient treatment time across disciplines in spinal cord injury rehabilitation

PubMed Central

Whiteneck, Gale; Gassaway, Julie; Dijkers, Marcel; Backus, Deborah; Charlifue, Susan; Chen, David; Hammond, Flora; Hsieh, Ching-Hui; Smout, Randall J.

2011-01-01

Background/objective Length of stay (LOS) for rehabilitation treatment after spinal cord injury (SCI) has been documented extensively. However, there is almost no published research on the nature, extent, or intensity of the various treatments patients receive during their stay. This study aims at providing such information on a large sample of patients treated by specialty rehabilitation inpatient programs. Methods Six hundred patients with traumatic SCI admitted to six rehabilitation centers were enrolled. Time spent on various therapeutic activities was documented by each rehabilitation clinician after each patient encounter. Patients were grouped by neurologic level and completeness of injury. Total time spent by each rehabilitation discipline over a patient's stay and total minutes of treatment per week were calculated. Ordinary least squares stepwise regression models were used to identify patient and injury characteristics associated with time spent in rehabilitation treatment overall and within each discipline. Results Average LOS was 55 days (standard deviation 37), during which 180 (106) hours of treatment were received, or 24 (5) hours per week. Extensive variation was found in the amount of treatment received, between and within neurologic groups. Total hours of treatment provided throughout a patient's stay were primarily determined by LOS, which in turn was primarily predicted by medical acuity. Variation in minutes per week of treatment delivered by individual disciplines was predicted poorly by patient and injury characteristics. Conclusions Variations between and within SCI rehabilitation patient groups in LOS, minutes of treatment per week overall, and for each rehabilitation discipline are large. Variation in treatment intensity was not well explained by patient and injury characteristics. In accordance with practice-based evidence methodology, the next step in the SCIRehab study will be to determine which treatment interventions are related with positive outcomes (at 1 year post injury), after controlling for patient and injury differences. PMID:21675353

Association of Accelerometry-Measured Physical Activity and Cardiovascular Events in Mobility-Limited Older Adults: The LIFE (Lifestyle Interventions and Independence for Elders) Study.

PubMed

Cochrane, Shannon K; Chen, Shyh-Huei; Fitzgerald, Jodi D; Dodson, John A; Fielding, Roger A; King, Abby C; McDermott, Mary M; Manini, Todd M; Marsh, Anthony P; Newman, Anne B; Pahor, Marco; Tudor-Locke, Catrine; Ambrosius, Walter T; Buford, Thomas W

2017-12-02

Data are sparse regarding the value of physical activity (PA) surveillance among older adults-particularly among those with mobility limitations. The objective of this study was to examine longitudinal associations between objectively measured daily PA and the incidence of cardiovascular events among older adults in the LIFE (Lifestyle Interventions and Independence for Elders) study. Cardiovascular events were adjudicated based on medical records review, and cardiovascular risk factors were controlled for in the analysis. Home-based activity data were collected by hip-worn accelerometers at baseline and at 6, 12, and 24 months postrandomization to either a physical activity or health education intervention. LIFE study participants (n=1590; age 78.9±5.2 [SD] years; 67.2% women) at baseline had an 11% lower incidence of experiencing a subsequent cardiovascular event per 500 steps taken per day based on activity data (hazard ratio, 0.89; 95% confidence interval, 0.84-0.96; P =0.001). At baseline, every 30 minutes spent performing activities ≥500 counts per minute (hazard ratio, 0.75; confidence interval, 0.65-0.89 [ P =0.001]) were also associated with a lower incidence of cardiovascular events. Throughout follow-up (6, 12, and 24 months), both the number of steps per day (per 500 steps; hazard ratio, 0.90, confidence interval, 0.85-0.96 [ P =0.001]) and duration of activity ≥500 counts per minute (per 30 minutes; hazard ratio, 0.76; confidence interval, 0.63-0.90 [ P =0.002]) were significantly associated with lower cardiovascular event rates. Objective measurements of physical activity via accelerometry were associated with cardiovascular events among older adults with limited mobility (summary score >10 on the Short Physical Performance Battery) both using baseline and longitudinal data. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01072500. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

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.

Immobilization Techniques to Avoid Enzyme Loss from Oxidase-Based Biosensors: A One-Year Study

PubMed Central

House, Jody L.; Anderson, Ellen M.; Ward, W. Kenneth

2007-01-01

Background Continuous amperometric sensors that measure glucose or lactate require a stable sensitivity, and glutaraldehyde crosslinking has been used widely to avoid enzyme loss. Nonetheless, little data is published on the effectiveness of enzyme immobilization with glutaraldehyde. Methods A combination of electrochemical testing and spectrophotometric assays was used to study the relationship between enzyme shedding and the fabrication procedure. In addition, we studied the relationship between the glutaraldehyde concentration and sensor performance over a period of one year. Results The enzyme immobilization process by glutaraldehyde crosslinking to glucose oxidase appears to require at least 24-hours at room temperature to reach completion. In addition, excess free glucose oxidase can be removed by soaking sensors in purified water for 20 minutes. Even with the addition of these steps, however, it appears that there is some free glucose oxidase entrapped within the enzyme layer which contributes to a decline in sensitivity over time. Although it reduces the ultimate sensitivity (probably via a change in the enzyme's natural conformation), glutaraldehyde concentration in the enzyme layer can be increased in order to minimize this instability. Conclusions After exposure of oxidase enzymes to glutaraldehyde, effective crosslinking requires a rinse step and a 24-hour incubation step. In order to minimize the loss of sensor sensitivity over time, the glutaraldehyde concentration can be increased. PMID:19888375

Expectation of an upcoming large postural perturbation influences the recovery stepping response and outcome.

PubMed

Pater, Mackenzie L; Rosenblatt, Noah J; Grabiner, Mark D

2015-01-01

Tripping during locomotion, the leading cause of falls in older adults, generally occurs without prior warning and often while performing a secondary task. Prior warning can alter the state of physiological preparedness and beneficially influence the response to the perturbation. Previous studies have examined how altering the initial "preparedness" for an upcoming perturbation can affect kinematic responses following small disturbances that did not require a stepping response to restore dynamic stability. The purpose of this study was to examine how expectation affected fall outcome and recovery response kinematics following a large, treadmill-delivered perturbation simulating a trip and requiring at least one recovery step to avoid a fall. Following the perturbation, 47% of subjects fell when they were not expecting the perturbation whereas 12% fell when they were aware that the perturbation would occur "sometime in the next minute". The between-group differences were accompanied by slower reaction times in the non-expecting group (p < 0.01). Slower reaction times were associated with kinematics that have previously been shown to increase the likelihood of falling following a laboratory-induced trip. The results demonstrate the importance of considering the context under which recovery responses are assessed, and further, gives insight to the context during which task-specific perturbation training is administered. Copyright © 2014 Elsevier B.V. All rights reserved.

MAMMALIAN DNA IN PCR REAGENTS

EPA Science Inventory

Ancient DNA analysis is becoming widespread. These studies use polymerase chain reaction (PCR) to amplify minute quantities of heavily damaged template. Unusual steps are taken to achieve the sensitivity necessary to detect ancient DNA, including high- cycle PCR amplification t...

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.

Sharp turning and corner turning: comparison of energy expenditure, gait parameters, and level of fatigue among community-dwelling elderly.

PubMed

Justine, Maria; Manaf, Haidzir; Sulaiman, Affeenddie; Razi, Shahir; Alias, Hani Asilah

2014-01-01

This study compares energy expenditure (EE), gait parameters (GP), and level of fatigue (LOF) between 5-minute walking with sharp turning (ST) and corner turning (CT). Data were obtained from 29 community-dwelling elderly (mean age, 62.7 ± 3.54 years). For 5 minutes, in ST task, participants walked on a 3-meter pathway with 2 cones placed at each end (180° turning), while in CT task, participants walked on a 6-meter pathway with 4 cones placed at 4 corners (90° turning). The physiological cost index, pedometer, and 10-point Modified Borg Dyspnoea Scale were used to measure EE (beats/min), GP (no of steps), and LOF, respectively. Data were analyzed by using independent t-tests. EE during ST (0.62 ± 0.21 beats/min) was significantly higher than CT (0.48 ± 0.17 beats/min) (P < 0.05). GP (434 ± 92.93 steps) and LOF (1.40 ± 1.11) in ST were found to be lower compared to GP (463 ± 92.18 steps) and LOF (1.54 ± 1.34) in CT (All, P > 0.05). Higher EE in ST could be due to the difficulty in changing to a 180° direction, which may involve agility and different turning strategies (step-turn or pivot-turn) to adjust the posture carefully. In CT, participants could choose a step-turn strategy to change to a 90° direction, which was less challenging to postural control.

Pretreatment of patients requiring oral contrast abdominal computed tomography with antiemetics: a randomized controlled trial of efficacy.

PubMed

Garra, Gregory; Singer, Adam J; Bamber, Danny; Chohan, Jasmine; Troxell, Regina; Thode, Henry C

2009-04-01

Ingestion of diatrizoate meglumine before abdominal computed tomography (CT) is time consuming. We hypothesized that pretreatment with metoclopramide or ondansetron would result in faster ingestion of diatrizoate meglumine than placebo. The study was a double-blind, randomized controlled trial on adults requiring oral contrast abdominal CT. Patients were randomized to placebo, metoclopramide 10 mg, or ondansetron 4 mg intravenously 15 minutes before ingesting 2 L of diatrizoate meglumine. The primary outcome was time to complete diatrizoate meglumine ingestion. Secondary outcome measures included volume of diatrizoate meglumine ingested, 100-mm visual analog scale for nausea at 15-minute intervals, time to CT, vomiting, and use of rescue antiemetics. The study was powered to detect a 60-minute difference in diatrizoate meglumine ingestion time between saline and medication groups. One hundred six patients were randomized; placebo (36), metoclopramide (35), and ondansetron (35). Groups were similar in baseline characteristics. Median (interquartile range) times for diatrizoate meglumine ingestion were placebo 109 minutes (82 to 135 minutes); metoclopramide 105 minutes (75 to 135 minutes); and ondansetron 110 minutes (79 to 140 minutes) (P=.67). Vomiting was less frequent with metoclopramide (3%) than placebo (18%) or ondansetron (9%) (P=.11). The visual analog scale for nausea at each point was not significantly different between groups (P=.11). The need for rescue antiemetics was lowest for metoclopramide (3%) compared with placebo (27%) and ondansetron (12%) (P=.02). Pretreatment with ondansetron or metoclopramide does not reduce oral contrast solution ingestion time.

Objective measurement of free-living physical activity (performance) in lumbar spinal stenosis: are physical activity guidelines being met?

PubMed

Norden, Justin; Smuck, Matthew; Sinha, Aman; Hu, Richard; Tomkins-Lane, Christy

2017-01-01

Research suggests that people with lumbar spinal stenosis (LSS) would benefit from increased physical activity. Yet, to date, we do not have disease-specific activity guidelines for LSS, and the nature of free-living physical activity (performance) in LSS remains unknown. LSS care providers could endorse the 2008 United States Physical Activity Guidelines; however, we do not know if this is realistic. The goal of the present study was to determine the proportion of individuals with LSS meeting the 2008 Guidelines. A secondary goal was to better understand the nature of physical performance in this population. Retrospective study. People from the Lumbar Spinal Stenosis Accelerometry Database, all of whom have both radiographic and clinical LSS and are seeking various treatments for their symptoms. Seven-day accelerometry (functional outcome) and demographics (self-reported). For the present study, we analyzed only baseline data that were obtained before any new treatments. Patients with at least 4 valid days of baseline accelerometry data were included. We determined the proportion of individuals with LSS meeting the 2008 US Physical Activity Guidelines of at least 150 minutes of moderate-vigorous (MV) physical activity per week in bouts of 10 minutes or more. We also used the novel Physical Performance analysis designed by our group to determine time spent in varying intensities of activity. There are no conflicts of interest to disclose. We analyzed data from 75 individuals with a mean age of 68 (SD 9), 37% of whom were male. Three people (4%) were considered Meeting Guidelines (at least 150 MV minutes/week), and 56 (75%) were considered Inactive with not even 1 MV minute/week. With the 10-minute bout requirement removed, 10 of 75 (13%) achieved the 150-minute threshold. The average time spent in sedentary activity was 82%, and of time spent in nonsedentary activity, 99.6% was in the light activity range. In conclusion, the present study confirms that people with symptomatic LSS, neurogenic claudication, walking limitations, and LSS-related disability are extremely sedentary and are not meeting guidelines for physical activity. There is an urgent need for interventions aimed at reducing sedentary behavior and increasing the overall level of physical activity in LSS, not only to improve function but also to prevent diseases of inactivity. The present study suggests that reducing sedentary time, increasing time spent in light intensity activity, and increasing time spent in higher intensities of light activity may be appropriate as initial goals for exercise interventions in people with symptomatic LSS and neurogenic claudication, transitioning to moderate activity when appropriate. Results of the present study also demonstrate the importance of employing disease-specific measures for assessment of performance in LSS, and highlight the potential value of these methods for developing targeted and realistic goals for physical activity. Physical activity goals could be personalized using objective assessment of performance with accelerometry. The present study is one step toward a personalized medicine approach for people with LSS, focusing on increasing physical function. Copyright © 2016 Elsevier Inc. All rights reserved.

Modified penoplasty for concealed penis in children.

PubMed

Yang, Tianyou; Zhang, Liyu; Su, Cheng; Li, Zhongmin; Wen, Yingquan

2013-09-01

To report a modified penoplasty technique for concealed penis in children. Between January 2006 and June 2012, 201 cases of concealed penis were surgically repaired with modified penoplasty. The modified penoplasty technique consisted of 3 major steps: (1) degloved the penile skin and excised the inner prepuce, (2) advanced penoscrotal skin to cover penile shaft, and (3) fixed the penis base and reconstructed the penoscrotal angle. Two hundred one cases of concealed penis were enrolled in this study over a period of 6 years. Mean age at the time of surgery was 5.3 years (range 1-13 years) and mean operative time was 40 minutes (range 30-65minutes). All patients were routinely followed up at 1, 3, and 6 months after surgery. Most patients developed postoperative edema and were resolved within 1 month, whereas 20 cases developed prolonged postoperative edema, especially at the site of frenulum, which took 3 months to be resolved. Ten cases had retraction after surgery. No erection difficulties were recorded. Patients/parents reported better hygiene and improved visualization and accessibility of penis after surgery and were satisfied with the cosmetic outcome. The result of this study shows that the modified penoplasty technique is a simple, safe, and effective procedure for concealed penis with satisfied cosmetic outcome. Copyright © 2013 Elsevier Inc. All rights reserved.

Is the Balanced School Day truly balanced? A review of the impacts on children, families, and school food environments.

PubMed

Wu, Theresa F; Macaskill, Lesley A; Salvadori, Marina I; Dworatzek, Paula D N

2015-06-01

The Balanced School Day (BSD) is a scheduling policy that has the potential to impact children's food behaviors because students are provided with two 20-minute eating opportunities versus the traditional 20-minute lunch. We aim to raise awareness of this grassroots academic policy and its potential consequences to inform future decision making and minimize potential unintended negative health consequences. While there is limited research on this schedule, it has been shown that there is less time lost in transition from classroom to recess. Perception surveys have shown that principals and custodians are the most satisfied, followed by parents, teachers, and secretaries, with students being the least satisfied. The BSD is also perceived to improve organization of instructional time, playground cleanliness, and student concentration. Despite these purported benefits, there is limited data on the impact of the BSD on children's eating habits, physical activity, and body mass index (BMI). While 1 study reported fewer pedometer-measured step counts during breaks in the BSD, more research is needed on the impact of this alternative schedule on children's food intake and BMI. School and public health professionals must advocate for "health impact assessments" to assess the health effects of this policy. © 2015, American School Health Association.

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.

Improving preanalytic processes using the principles of lean production (Toyota Production System).

PubMed

Persoon, Thomas J; Zaleski, Sue; Frerichs, Janice

2006-01-01

The basic technologies used in preanalytic processes for chemistry tests have been mature for a long time, and improvements in preanalytic processes have lagged behind improvements in analytic and postanalytic processes. We describe our successful efforts to improve chemistry test turnaround time from a central laboratory by improving preanalytic processes, using existing resources and the principles of lean production. Our goal is to report 80% of chemistry tests in less than 1 hour and to no longer recognize a distinction between expedited and routine testing. We used principles of lean production (the Toyota Production System) to redesign preanalytic processes. The redesigned preanalytic process has fewer steps and uses 1-piece flow to move blood samples through the accessioning, centrifugation, and aliquoting processes. Median preanalytic processing time was reduced from 29 to 19 minutes, and the laboratory met the goal of reporting 80% of chemistry results in less than 1 hour for 11 consecutive months.

Differences in Functional Fitness Among Older Adults With and Without Risk of Falling.

PubMed

Zhao, Yanan; Chung, Pak-Kwong

2016-03-01

This study aimed to identify the differences in functional fitness between older adults who were at risk of falling and those who were not. A total of 104 older adults aged 65-74 years were recruited from a local community senior center. They were independent older adults without a history of falls in the preceding 12 months. Falling risk status was assessed using the Fall Risk Test. Five dimensions of functional fitness with seven testing parameters (i.e., 30-second chair stand test, 30-second arm curl test, 2-minute step test, chair sit and reach test, back scratch test, 8-foot up and go test, and body mass index) were evaluated by the Senior Fitness Test. Only 78 participants completed all the tests, of which 48 participants were identified with risk of falling, and 30 participants were free from risk of falling. Results from multivariate analysis of variance found significant differences on the combined outcome variables, especially in the 8-foot up and go test, 2-minute step test, and 30-second arm curl test. Results from discriminant analysis found a significant discriminant function among all the seven testing parameters, where the 8-foot up and go test, and the 2-minute step test contributed most. Older adults who are at the early stage of risk of falling tend to have lower functional fitness capacities, especially in agility and dynamic balance, aerobic endurance as well as in a combined relationship among all the testing parameters. Copyright © 2016. Published by Elsevier B.V.

Residents as teachers: psychiatry and family medicine residents' self-assessment of teaching knowledge, skills, and attitudes.

PubMed

Brand, Michael W; Ekambaram, Vijayabharathi; Tucker, Phebe; Aggarwal, Ruchi

2013-09-01

Residents are one of the prime sources of information and education for medical students. As an initial step in supporting residents as teachers, a baseline self-assessment of residents' knowledge, skills, attitudes, and values related to teaching was conducted among psychiatry and family medicine residents to compare and improve their confidence and skills as teachers. Psychiatry residents (N=12) and family medicine residents (N=23) completed self-assessments of their knowledge, skills, attitudes, and values related to teaching. Residents also were asked to list steps used in the One-Minute Preceptor process and estimate the time each spent in teaching. Descriptive summary statistics were used for four main areas related to teaching; t-test and chi-square analyses were conducted to ascertain whether there was a significant difference in resident groups. In the current study, the perceived amount of time spent for teaching patients was significantly higher among family practice residents, whereas no group differences were found for time teaching medical students, peers, community members, non-physicians, or others. However, family medicine residents rated themselves higher than psychiatry residents in their understanding of their roles in teaching medical students and teaching patients. Also, family medicine residents' self-reported teaching skills were more advanced (82.4%) than psychiatry residents' (54.2%). They most likely applied at least two different teaching methods in inpatient and outpatient settings, as compared with psychiatry residents. No significant group differences were found in the other 15 items assessing teaching knowledge, skills, attitudes, and values. Results indicate that residents' knowledge, skills, attitudes, and values regarding teaching varies across institutions and training programs. The psychiatry residents in this study do not clearly understand their role as educators with patients and medical students; they have a less clear understanding of teaching techniques, and report spending less time educating patients than do family medicine residents. The differences might be due to different patient populations and treatment settings. The study suggests that psychiatry residents may have difficulty adapting the One-Minute Preceptor technique in psychiatric settings. Results serve as a benchmarking study in a performance-improvement program to enhance psychiatry residents' teaching skills.

Clinical usefulness of augmented reality using infrared camera based real-time feedback on gait function in cerebral palsy: a case study

PubMed Central

Lee, Byoung-Hee

2016-01-01

[Purpose] This study investigated the effects of real-time feedback using infrared camera recognition technology-based augmented reality in gait training for children with cerebral palsy. [Subjects] Two subjects with cerebral palsy were recruited. [Methods] In this study, augmented reality based real-time feedback training was conducted for the subjects in two 30-minute sessions per week for four weeks. Spatiotemporal gait parameters were used to measure the effect of augmented reality-based real-time feedback training. [Results] Velocity, cadence, bilateral step and stride length, and functional ambulation improved after the intervention in both cases. [Conclusion] Although additional follow-up studies of the augmented reality based real-time feedback training are required, the results of this study demonstrate that it improved the gait ability of two children with cerebral palsy. These findings suggest a variety of applications of conservative therapeutic methods which require future clinical trials. PMID:27190489

Semiautomated Segmentation of Polycystic Kidneys in T2-Weighted MR Images.

PubMed

Kline, Timothy L; Edwards, Marie E; Korfiatis, Panagiotis; Akkus, Zeynettin; Torres, Vicente E; Erickson, Bradley J

2016-09-01

The objective of the present study is to develop and validate a fast, accurate, and reproducible method that will increase and improve institutional measurement of total kidney volume and thereby avoid the higher costs, increased operator processing time, and inherent subjectivity associated with manual contour tracing. We developed a semiautomated segmentation approach, known as the minimal interaction rapid organ segmentation (MIROS) method, which results in human interaction during measurement of total kidney volume on MR images being reduced to a few minutes. This software tool automatically steps through slices and requires rough definition of kidney boundaries supplied by the user. The approach was verified on T2-weighted MR images of 40 patients with autosomal dominant polycystic kidney disease of varying degrees of severity. The MIROS approach required less than 5 minutes of user interaction in all cases. When compared with the ground-truth reference standard, MIROS showed no significant bias and had low variability (mean ± 2 SD, 0.19% ± 6.96%). The MIROS method will greatly facilitate future research studies in which accurate and reproducible measurements of cystic organ volumes are needed.

High-speed thermal cycling system and method of use

DOEpatents

Hansen, A.D.A.; Jaklevic, J.M.

1996-04-16

A thermal cycling system and method of use are described. The thermal cycling system is based on the circulation of temperature-controlled water directly to the underside of thin-walled polycarbonate plates. The water flow is selected from a manifold fed by pumps from heated reservoirs. The plate wells are loaded with typically 15-20 microliters of reagent mix for the PCR process. Heat transfer through the thin polycarbonate is sufficiently rapid that the contents reach thermal equilibrium with the water in less than 15 seconds. Complete PCR amplification runs of 40 three-step cycles have been performed in as little as 14.5 minutes, with the results showing substantially enhanced specificity compared to conventional technology requiring run times in excess of 100 minutes. The plate clamping station is designed to be amenable to robotic loading and unloading of the system. It includes a heated lid, thus eliminating the need for mineral oil overlay of the reactants. The present system includes three or more plate holder stations, fed from common reservoirs but operating with independent switching cycles. The system can be modularly expanded. 13 figs.

High-speed thermal cycling system and method of use

DOEpatents

Hansen, Anthony D. A.; Jaklevic, Joseph M.

1996-01-01

A thermal cycling system and method of use are described. The thermal cycling system is based on the-circulation of temperature-controlled water directly to the underside of thin-walled polycarbonate microtiter plates. The water flow is selected from a manifold fed by pumps from heated reservoirs. The plate wells are loaded with typically 15-20 .mu.l of reagent mix for the PCR process. Heat transfer through the thin polycarbonate is sufficiently rapid that the contents reach thermal equilibrium with the water in less than 15 seconds. Complete PCR amplification runs of 40 three-step cycles have been performed in as little as 14.5 minutes, with the results showing substantially enhanced specificity compared to conventional technology requiring run times in excess of 100 minutes. The plate clamping station is designed to be amenable to robotic loading and unloading of the system. It includes a heated lid, thus eliminating the need for mineral oil overlay of the reactants. The present system includes three or more plate holder stations, fed from common reservoirs but operating with independent switching cycles. The system can be modularly expanded.

Spirolit-2 instrument used to test pulmonary ventilation

NASA Astrophysics Data System (ADS)

Zhuravlev, V. V.

1985-02-01

At the present time, the Spirolit-2 automatic analyzer of main respiratory gases, of the Junkalor Dessau firm, is used to examine parameters of gas exchange, levels of energy expended by man and animals with different degrees of activity. However, the capabilities of this model of the instrument are limited. A method of determining pulmonary ventilation with use of the Spirolit-2 is described. An additional exhalation valve is built into a valve box to which an anesthesia machine rubber bag is attached. Samples are collected into another bag concurrently with the usual tests on the Spirolit-2 instrument. Four to five minutes are sufficient to obtain stable parameters at relative rest of oxygen uptake, determine carbon dioxide output per minute and collect samples in for analysis of exhaled air. The proposed method can furnish information about the dynamics of development of respiratory function of the lungs at virtually any moment with a constant physical load. For this, there must be spare bags to collect samples. Stage-by-stage data can be obtained analogously as to ventilation volume during a step test while determining maximum oxygen uptake.

Don't Talk, Teach: Breaking Bad Rehearsal Habits.

ERIC Educational Resources Information Center

Kruth, Edwin C.

1984-01-01

Tips to help conductors improve school music rehearsals are provided. For example, students should learn that the minute the conductor steps on the podium, they should stop playing and talking and direct their attention to the podium. (RM)

Developing a Performance Data Suite to Facilitate Lean Improvement in a Chemotherapy Day Unit

PubMed Central

Lingaratnam, Senthil; Murray, Danielle; Carle, Amber; Kirsa, Sue W.; Paterson, Rebecca; Rischin, Danny

2013-01-01

Purpose: A multidisciplinary team from the Peter MacCallum Cancer Centre in Melbourne, Australia, developed a performance data suite to support a service improvement project based on lean manufacturing principles in its 19-chair chemotherapy day unit (CDU) and cytosuite chemotherapy production facility. The aims of the project were to reduce patient wait time and improve equity of access to the CDU. Methods: A project team consisting of a pharmacist and CDU nurse supported the management team for 10 months in engaging staff and customers to identify waste in processes, analyze root causes, eliminate non–value-adding steps, reduce variation, and level workloads to improve quality and flow. Process mapping, staff and patient tracking and opinion surveys, medical record audits, and interrogation of electronic treatment records were undertaken. Results: This project delivered a 38% reduction in median wait time on the day (from 32 to 20 minutes; P < .01), 7-day reduction in time to commencement of treatment for patients receiving combined chemoradiotherapy regimens (from 25 to 18 days; P < .01), and 22% reduction in wastage associated with expired drug and pharmacy rework (from 29% to 7%; P < .01). Improvements in efficiency enabled the cytosuite to increase the percentage of product manufactured within 10 minutes of appointment times by 29% (from 47% to 76%; P < .01). Conclusion: A lean improvement methodology provided a robust framework for improved understanding and management of complex system constraints within a CDU, resulting in improved access to treatment and reduced waiting times on the day. PMID:23942927

Quality initiatives: improving patient flow for a bone densitometry practice: results from a Mayo Clinic radiology quality initiative.

PubMed

Aakre, Kenneth T; Valley, Timothy B; O'Connor, Michael K

2010-03-01

Lean Six Sigma process improvement methodologies have been used in manufacturing for some time. However, Lean Six Sigma process improvement methodologies also are applicable to radiology as a way to identify opportunities for improvement in patient care delivery settings. A multidisciplinary team of physicians and staff conducted a 100-day quality improvement project with the guidance of a quality advisor. By using the framework of DMAIC (define, measure, analyze, improve, and control), time studies were performed for all aspects of patient and technologist involvement. From these studies, value stream maps for the current state and for the future were developed, and tests of change were implemented. Comprehensive value stream maps showed that before implementation of process changes, an average time of 20.95 minutes was required for completion of a bone densitometry study. Two process changes (ie, tests of change) were undertaken. First, the location for completion of a patient assessment form was moved from inside the imaging room to the waiting area, enabling patients to complete the form while waiting for the technologist. Second, the patient was instructed to sit in a waiting area immediately outside the imaging rooms, rather than in the main reception area, which is far removed from the imaging area. Realignment of these process steps, with reduced technologist travel distances, resulted in a 3-minute average decrease in the patient cycle time. This represented a 15% reduction in the initial patient cycle time with no change in staff or costs. Radiology process improvement projects can yield positive results despite small incremental changes.

Integrating robotic partial nephrectomy to an existing robotic surgery program.

PubMed

Yuh, Bertram; Muldrew, Shantel; Menchaca, Anita; Yip, Wesley; Lau, Clayton; Wilson, Timothy; Josephson, David

2012-04-01

As more centers develop robotic proficiency, progressing to a successful robot-assisted partial nephrectomy (RAPN) program depends on a number of factors. We describe our technique, results, and analysis of program setup for RAPN. Between 2005 and 2011, 92 RAPNs were performed following maturation of a robotic prostatectomy program. Operating rooms and supply rooms were outfitted for efficient robotic throughput. Tilepro and intraoperative ultrasound were used for all cases. Training and experiential learning for surgeons, anesthesia and nursing staff was a high priority. An onsite robotic technician helped troubleshoot, prepare the room and staff prior to starting surgery, and provide assistance with different robotic models. Average operative time decreased over time from 235 min to 199 min (p = .03). Warm ischemia time decreased from 26 minutes to 23 minutes (p = .02) despite an increased complexity of tumors and operations on multiple tumors. Median estimated blood loss was 150 mL. Average length of hospital stay was 3 days (range 1-9). Average size of lesions was 2.7 cm (range 0.7-8.6). Final pathology demonstrated 71 (77%) malignant lesions and 21 (23%) benign lesions. The addition of a robot-assisted partial nephrectomy program to an institutional robotic program can be coordinated with several key steps. Outcomes from an operational, oncologic, and renal functional standpoint are acceptable. Despite increased complexity of tumors and treatment of multiple lesions, operative and warm ischemia times showed a decrease over time. An organizational model that involves the surgeons, anesthesia, nursing staff, and possibly a robotic technical specialist helps to overcome the learning curve.

System restricts nurses' overtime.

PubMed

2010-10-01

Noting concern over patient safety and staff well-being, Emory Healthcare in Atlanta has instituted a new policy that restricts overtime hours for nurses, including those in the ED. Here are some of the ways in which the system ensures their nurses get adequate rest: Nurses who want to work overtime cannot be on duty more than 60 hours a week. A central staffing center has been established to cover shifts. A number of the nurses have ED experience. Steps have been taken to ensure that nurses can take their 30-minute lunches and 15-minute breaks.

The Impact of Different Degrees of Feedback on Physical Activity Levels: A 4-Week Intervention Study

PubMed Central

Van Hoye, Karen; Boen, Filip; Lefevre, Johan

2015-01-01

Assessing levels of physical activity (PA) and providing feedback about these levels might have an effect on participant’s PA behavior. This study discusses the effect of different levels of feedback—from minimal to use of a feedback display and coach—on PA over a 4-week intervention period. PA was measured at baseline, during and immediately after the intervention. Participants (n = 227) were randomly assigned to a Minimal Intervention Group (MIG-no feedback), Pedometer Group (PG-feedback on steps taken), Display Group (DG-feedback on steps, minutes of moderate to vigorous physical activity and energy expenditure) or Coaching Group (CoachG-same as DG with need-supportive coaching). Two-way ANCOVA showed no significant Group × Time interaction effect for the different PA variables between the MIG and PG. Also no differences emerged between PG and DG. As hypothesized, CoachG had higher PA values throughout the intervention compared with DG. Self-monitoring using a pedometer resulted in more steps compared with a no-feedback condition at the start of the intervention. However, adding individualized coaching seems necessary to increase the PA level until the end of the intervention. PMID:26067990

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.

Teaching Science differently

NASA Astrophysics Data System (ADS)

Collery, Véronique

2014-05-01

Using different kind of activities is a good way to motivate students. Depending on the class i suggest them to carry out experiments and write a report of them, to prepare a video (about 3 minutes long) presenting some experiments on a theme they choose among selected topics (working in groups of 2 or 3), to do an oral presentation, to debate on a topic, to participate in scientific breakfast/tea-time. The scientific breakfast or tea-time is an opportunity for students to meet great researchers and to exchange with them friendly sharing a breakfast or a tea-time. For example, to prepare the video, the lesson consists of three steps for a total length of three or four hours.The first step is the selection of the theme and the selection of 2 or 3 impressive, funny, original, visual experiments. The second step is trying out the experiments and the writing of the script. The third step is the making of the video. During the last step the students are supposed to watch and to grade the video. For example, to impulse a debate in a class of 16-year-old students I use a part of the movie 'Appolo 13' (chapter 28). This activity is a new approach of the theme 'the gravitational force' the students learnt in their Physic's curriculum. It's a quite difficult phenomenon to visualize. The lesson consists of three steps for a total length of two hours. During the pre-task phase, students are supposed to do a matching activity to introduce scientific words and their definitions. In the task phase, an extract of the movie APOLLO 13 is shown in order to stimulate students' listening and comprehension. To help them exchange around gravity, and space flights, students are engaged in a CLIL game. In the post-task phase, the pairs join together to form 2 groups. These groups correspond the two options the controllers in Houston make to get the astronauts back home safely. A debate is requested to argue each point of view.

Optimum time for intravenous cannulation after induction with sevoflurane, oxygen, and nitrous oxide in children without any premedication.

PubMed

Hasan, Abm Kamrul; Sivasankar, Raman; Nair, Salil G; Hasan, Wamia U; Latif, Zulaidi

2018-02-01

Intravenous cannulation is usually done in children after inhalational induction with volatile anesthetic agents. The optimum time for safe intravenous cannulation after induction with sevoflurane, oxygen, and nitrous oxide has been studied in premedicated children, but there is no information for the optimum time for cannulation with inhalational induction in children without premedication. The aim of this study was to determine the optimum time for intravenous cannulation after the induction of anesthesia with sevoflurane, oxygen, and nitrous oxide in children without any premedication. This is a prospective, observer-blinded, up-and-down sequential allocation study in unpremedicated ASA grade 1 children aged 2-6 years undergoing elective dental surgery. Intravenous cannulation was attempted after inhalational induction with sevoflurane, oxygen, and nitrous oxide. The timing of cannulation was considered adequate if there was no movement, coughing, or laryngospasm. The cannulation attempt for the first child was set at 4 minutes after the loss of eyelash reflex and the time for intravenous cannulation was determined by the up-and-down method using 15 seconds as step size. Probit test was used to analyze the up-down sequences for the study. The adequate time for effective cannulation after induction with sevoflurane, oxygen, and nitrous oxide in 50% and 95% of patients was 53.02 seconds (95% confidence limits, 20.23-67.76 seconds) and 87.21 seconds (95% confidence limits, 70.77-248.03 seconds), respectively. We recommend waiting for 1 minute 45 seconds (105 seconds) after the loss of eyelash reflex before attempting intravenous cannulation in pediatric patients induced with sevoflurane, oxygen, and nitrous oxide without any premedication. © 2018 John Wiley & Sons Ltd.

Effectiveness and cost-effectiveness of a very brief physical activity intervention delivered in NHS Health Checks (VBI Trial): study protocol for a randomised controlled trial.

PubMed

Mitchell, Joanna; Hardeman, Wendy; Pears, Sally; Vasconcelos, Joana C; Prevost, A Toby; Wilson, Ed; Sutton, Stephen

2016-06-27

Physical activity interventions that are targeted at individuals can be effective in encouraging people to be more physically active. However, most such interventions are too long or complex and not scalable to the general population. This trial will test the effectiveness and cost-effectiveness of a very brief physical activity intervention when delivered as part of preventative health checks in primary care (National Health Service (NHS) Health Check). The Very Brief Intervention (VBI) Trial is a two parallel-group, randomised, controlled trial with 1:1 individual allocation and follow-up at 3 months. A total of 1,140 participants will be recruited from 23 primary care practices in the east of England. Participants eligible for an NHS Health Check and who are considered suitable to take part by their doctor and able to provide written informed consent are eligible for the trial. Participants are randomly assigned at the beginning of the NHS Health Check to either 1) the control arm, in which they receive only the NHS Health Check, or 2) the intervention arm, in which they receive the NHS Health Check plus 'Step It Up' (a very brief intervention that can be delivered in 5 minutes by nurses and/or healthcare assistants at the end of the Health Check). 'Step It Up' includes (1) a face-to-face discussion, including feedback on current activity level, recommendations for physical activity, and information on how to use a pedometer, set step goals, and monitor progress; (2) written material supporting the discussion and tips and links to further resources to help increase physical activity; and (3) a pedometer to wear and a step chart for monitoring progress. The primary outcome is accelerometer counts per minute at 3-month follow-up. Secondary outcomes include the time spent in the different levels of physical activity, self-reported physical activity and economic measures. Trial recruitment is underway. The VBI trial will provide evidence on the effectiveness and cost-effectiveness of the Step It Up intervention delivered during NHS Health Checks and will inform policy decisions about introducing very brief interventions into routine primary care practice. ISRCTN Registry, ISRCTN72691150 . Registered on 17 July 2014.

Prognostic value of serial six-minute walk tests using tele-accelerometry in patients with chronic heart failure: A pre-specified sub-study of the TIM-HF-Trial.

PubMed

Prescher, Sandra; Schoebel, Christoph; Koehler, Kerstin; Deckwart, Oliver; Wellge, Brunhilde; Honold, Marcus; Hartmann, Oliver; Winkler, Sebastian; Koehler, Friedrich

2016-10-01

The six-minute walk test (6MWT) is an established functional test assessing exercise capacity and is used to predict clinical prognosis in patients with chronic heart failure (HF). Tele-accelerometry is a novel approach to activity monitoring using telemedical data transfer and allows a Tele-6MWT to be performed in an outpatient setting. It offers patients the option of performing simple serial follow-up tests in their own home. The aim of this study was to investigate the prognostic value of serial Tele-6MWTs using tele-accelerometry in patients with HF. In this proof-of-concept study, 155 patients with HF completed the Tele-6MWT in an outdoor setting once per month over a period of 0.25-21 months. We analysed the differences in the number of steps over time to predict hospitalization as a result of HF or death. Patients with at least one event (n = 31) recorded a lower number of steps and a shorter distance in Tele-6MWT at baseline compared with patients who remained event-free (n = 124) (540.1 ± 78.4 steps vs. 601.8 ± 76.7 steps, P < 0.001 respectively; 353.2 ± 82.4 m vs. 418.8 ± 95.6 m, P < 0.001). Patients (n = 19) who performed more than one Tele-6MWT prior to a clinical event showed no significant difference in the number of steps, regardless of whether the baseline test was compared with the last Tele-6MWT before the event or with the last two tests before the event. Tele-6MWT has a high predictive value with respect to hospitalization as a result of HF or death from any cause and the results were comparable with the prognostic impact of a conventional 6MWT. Therefore Tele-6MWT may be used as alternative test method in the home environment. However, there is no added prognostic value of repeating Tele-6MWTs on a monthly basis. © The European Society of Cardiology 2016.

Two-step infiltration of aluminum melts into Al-Ti-B4C-CuO powder mixture pellets

NASA Astrophysics Data System (ADS)

Zhang, Jingjing; Lee, Jung-Moo; Cho, Young-Hee; Kim, Su-Hyeon; Yu, Huashun

2016-03-01

Aluminum matrix composites with a high volume fraction of B4C and TiB2 were fabricated by a novel processing technique - a quick spontaneous infiltration process. The process combines a pressureless infiltration with the combustion reaction of Al-Ti-B4C-CuO in molten aluminum. The process is realized in a simple and economical way in which the whole process is performed in air in a few minutes. To verify the rapidity of the process, the infiltration kinetics was calculated based on the Washburn equation in which melt flows into a porous skeleton. However, there was a noticeable deviation from the calculated results with the experimental results. Considering the cross-sections of the samples at different processing times, a new infiltration model (two step infiltration) consisting of macro-infiltration and micro-infiltration is suggested. The calculated kinetics results in light of the proposed model agree well with the experimental results.

Physical activity of Canadian children and youth: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey.

PubMed

Colley, Rachel C; Garriguet, Didier; Janssen, Ian; Craig, Cora L; Clarke, Janine; Tremblay, Mark S

2011-03-01

Physical activity is an important determinant of health and fitness. This study provides contemporary estimates of the physical activity levels of Canadians aged 6 to 19 years. Data are from the 2007 to 2009 Canadian Health Measures Survey. The physical activity of a nationally representative sample was measured using accelerometers. Data are presented as time spent in sedentary, light, moderate and vigorous intensity movement, and in steps accumulated per day. An estimated 9% of boys and 4% of girls accumulate 60 minutes of moderate-to-vigorous physical activity on at least 6 days a week. Regardless of age group, boys are more active than girls. Canadian children and youth spend 8.6 hours per day-62% of their waking hours-in sedentary pursuits. Daily step counts average 12,100 for boys and 10,300 for girls. Based on objective and robust measures, physical activity levels of Canadian children and youth are low.

The analysis and interpretation of very-long-period seismic signals on volcanoes

NASA Astrophysics Data System (ADS)

Sindija, Dinko; Neuberg, Jurgen; Smith, Patrick

2017-04-01

The study of very long period (VLP) seismic signals became possible with the widespread use of broadband instruments. VLP seismic signals are caused by transients of pressure in the volcanic edifice and have periods ranging from several seconds to several minutes. For the VLP events recorded in March 2012 and 2014 at Soufriere Hills Volcano, Montserrat, we model the ground displacement using several source time functions: a step function using Richards growth equation, Küpper wavelet, and a damped sine wave to which an instrument response is then applied. This way we get a synthetic velocity seismogram which is directly comparable to the data. After the full vector field of ground displacement is determined, we model the source mechanism to determine the relationship between the source mechanism and the observed VLP waveforms. Emphasis of the research is on how different VLP waveforms are related to the volcano environment and the instrumentation used and on the processing steps in this low frequency band to get most out of broadband instruments.

Fast quantification of bovine milk proteins employing external cavity-quantum cascade laser spectroscopy.

PubMed

Schwaighofer, Andreas; Kuligowski, Julia; Quintás, Guillermo; Mayer, Helmut K; Lendl, Bernhard

2018-06-30

Analysis of proteins in bovine milk is usually tackled by time-consuming analytical approaches involving wet-chemical, multi-step sample clean-up procedures. The use of external cavity-quantum cascade laser (EC-QCL) based IR spectroscopy was evaluated as an alternative screening tool for direct and simultaneous quantification of individual proteins (i.e. casein and β-lactoglobulin) and total protein content in commercial bovine milk samples. Mid-IR spectra of protein standard mixtures were used for building partial least squares (PLS) regression models. A sample set comprising different milk types (pasteurized; differently processed extended shelf life, ESL; ultra-high temperature, UHT) was analysed and results were compared to reference methods. Concentration values of the QCL-IR spectroscopy approach obtained within several minutes are in good agreement with reference methods involving multiple sample preparation steps. The potential application as a fast screening method for estimating the heat load applied to liquid milk is demonstrated. Copyright © 2018 Elsevier Ltd. All rights reserved.

Integration of advanced preparation with coal liquefaction. Second quarterly technical progress report, January 1-March 31, 1984

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

Steedman, W.G.; Longanbach, J.R.; Muralidhara, H.S.

Standard reaction conditions of 427 C, 5 minutes reaction time, 2:1 solvent/coal ratio and 1000 psig (r.t.) hydrogen overpressure result in good, but not maximum, conversions to THF soluble with both Illinois No. 6 and Wyodak (upper seam) coals. The cumulative effects of the pretreatment steps were also examined using feedstocks which were dried in a vacuum oven at room temperature under nitrogen before liquefaction to remove the effects of moisture. Chloride removal followed by drying had a positive effect on liquefaction. Oil agglomeration followed by drying also improved liquefaction reactivity significantly. Solvent drying also resulted in a small increasemore » in liquefaction reactivity. The overall reactivity of coal treated in sequence with each pretreatment step was slightly less than that of the dry ground coal. Liquefaction under a high partial pressure of hydrogen sulfide in hydrogen also results in a significant increase in conversion to THF solubles. 1 reference, 12 figures, 7 tables.« less

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.

Effects of surface wettability and contact time on protein adhesion to biomaterial surfaces

PubMed Central

Xu, Li-Chong; Siedlecki, Christopher A.

2013-01-01

Atomic force microscopy (AFM) was used to directly measure the adhesion forces between three test proteins and low density polyethylene (LDPE) surfaces treated by glow discharge plasma to yield various levels of water wettability. The adhesion of proteins to the LDPE substrates showed a step dependence on the wettability of surfaces as measured by the water contact angle (θ). For LDPE surfaces with θ > ∼60–65°, stronger adhesion forces were observed for bovine serum albumin, fibrinogen and human FXII than for the surfaces with θ < 60°. Smaller adhesion forces were observed for FXII than for the other two proteins on all surfaces although trends were identical. Increasing the contact time from 0 to 50 s for each protein–surface combination increased the adhesion force regardless of surface wettability. Time varying adhesion data was fit to an exponential model and free energies of protein unfolding were calculated. This data, viewed in light of previously published studies, suggests a 2-step model of protein denaturation, an early stage on the order of seconds to minutes where the outer surface of the protein interacts with the substrate and a second stage involving movement of hydrophobic amino acids from the protein core to the protein/surface interface. Impact statement The work described in this manuscript shows a stark transition between protein adherent and protein non-adherent materials in the range of water contact angles 60–65°, consistent with known changes in protein adsorption and activity. Time-dependent changes in adhesion force were used to calculate unfolding energies relating to protein–surface interactions. This analysis provides justification for a 2-step model of protein denaturation on surfaces. PMID:17466368

Emergency department usage by community step-down facilities--patterns and recommendations.

PubMed

Lee, S W; Goh, C; Chan, Y H

2003-09-01

This study examines the interface between institutional community step-down facilities (CSDFs) and acute hospital's Emergency Department (ED). It also provides a comprehensive description of the usage of an ED's services by CSDFs in its vicinity. This is a prospective 12-week observational study conducted in the Accident and Emergency Department of Changi General Hospital in Singapore. All patients from CSDFs transferred to the department were eligible for the study. Hospital records were used to extract relevant clinical data after admission for the length of stay and final discharge diagnosis. There was a total of 201 referrals to the ED over the 3-month period. The age of the patients ranged from 32 to 107 years, with a median of 83 years. Ninety-two patients (45.8%) were male residents. There were more referrals from CSDF on weekdays than on weekends. In particular, the number of referrals from CSDFs on Mondays were significantly higher (P < 0.05, Poisson regression) than other days of the week. Fifty-one per cent of the ED visits occurred during regular working hours. Eighty-two per cent of the transfers were admitted. The main complaint was shortness of breath with cough, followed by fever and falls. The most common investigation ordered was chest radiograph, followed by electrocardiogram and other radiographs. The most common treatment procedure in the ED was placement of an intravenous line. For those admitted residents, average length of hospital stay was 8.27 +/- 8.19 days (median, 5 days). Seventeen patients (10.3%) died within 3 days of admission, while 31 patients (18.8%) stayed less than 3 days. The admitted residents had an average turnaround time (from time of registration to time of leaving the ED and proceeding to ward) of 97.94 minutes. For patients discharged from the ED, the average turnaround time (time from registration to time of leaving the ED) was 177 minutes. Residents from CSDFs are transferred to the ED for a variety of medical reasons. The most appropriate role of the ED in evaluation of residents of CSDFs is not yet clearly defined. There is increasing need to streamline processes in acute hospitals to cope with an increasing ageing population and to ensure that quality care is delivered to the institutionalised sick.

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.

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.

ANIMAL DNA IN PCR REAGENTS PLAGUES ANCIENT DNA RESEARCH

EPA Science Inventory

Ancient DNA analysis is becoming widespread. These studies use polymerase chain reaction (PCR) to amplify minute quantities of heavily damaged template. Unusual steps are taken to achieve the sensitivity necessary to detect ancient DNA, including high-cycle PCR amplification targ...

Development of a microfluidics biosensor for agarose-bead immobilized Escherichia coli bioreporter cells for arsenite detection in aqueous samples.

PubMed

Buffi, Nina; Merulla, Davide; Beutier, Julien; Barbaud, Fanny; Beggah, Siham; van Lintel, Harald; Renaud, Philippe; van der Meer, Jan Roelof

2011-07-21

Contamination with arsenic is a recurring problem in both industrialized and developing countries. Drinking water supplies for large populations can have concentrations much higher than the permissible levels (for most European countries and the United States, 10 μg As per L; elsewhere, 50 μg As per L). Arsenic analysis requires high-end instruments, which are largely unavailable in developing countries. Bioassays based on genetically engineered bacteria have been proposed as suitable alternatives but such tests would profit from better standardization and direct incorporation into sensing devices. The goal of this work was to develop and test microfluidic devices in which bacterial bioreporters could be embedded, exposed and reporter signals detected, as a further step towards a complete miniaturized bacterial biosensor. The signal element in the biosensor is a nonpathogenic laboratory strain of Escherichia coli, which produces a variant of the green fluorescent protein after contact to arsenite and arsenate. E. coli bioreporter cells were encapsulated in agarose beads and incorporated into a microfluidic device where they were captured in 500 × 500 μm(2) cages and exposed to aqueous samples containing arsenic. Cell-beads frozen at -20 °C in the microfluidic chip retained inducibility for up to a month and arsenic samples with 10 or 50 μg L(-1) could be reproducibly discriminated from the blank. In the 0-50 μg L(-1) range and with an exposure time of 200 minutes, the rate of signal increase was linearly proportional to the arsenic concentration. The time needed to reliably and reproducibly detect a concentration of 50 μg L(-1) was 75-120 minutes, and 120-180 minutes for a concentration of 10 μg L(-1).

Influence of centrifugation conditions on the results of 77 routine clinical chemistry analytes using standard vacuum blood collection tubes and the new BD-Barricor tubes

PubMed Central

Cadamuro, Janne; Mrazek, Cornelia; Leichtle, Alexander B.; Kipman, Ulrike; Felder, Thomas K.; Wiedemann, Helmut; Oberkofler, Hannes; Fiedler, Georg M.; Haschke-Becher, Elisabeth

2017-01-01

Introduction Although centrifugation is performed in almost every blood sample, recommendations on duration and g-force are heterogeneous and mostly based on expert opinions. In order to unify this step in a fully automated laboratory, we aimed to evaluate different centrifugation settings and their influence on the results of routine clinical chemistry analytes. Materials and methods We collected blood from 41 healthy volunteers into BD Vacutainer PST II-heparin-gel- (LiHepGel), BD Vacutainer SST II-serum-, and BD Vacutainer Barricor heparin-tubes with a mechanical separator (LiHepBar). Tubes were centrifuged at 2000xg for 10 minutes and 3000xg for 7 and 5 minutes, respectively. Subsequently 60 and 21 clinical chemistry analytes were measured in plasma and serum samples, respectively, using a Roche COBAS instrument. Results High sensitive Troponin T, pregnancy-associated plasma protein A, ß human chorionic gonadotropin and rheumatoid factor had to be excluded from statistical evaluation as many of the respective results were below the measuring range. Except of free haemoglobin (fHb) measurements, no analyte result was altered by the use of shorter centrifugation times at higher g-forces. Comparing LiHepBar to LiHepGel tubes at different centrifugation setting, we found higher lactate-dehydrogenase (LD) (P = 0.003 to < 0.001) and lower bicarbonate values (P = 0.049 to 0.008) in the latter. Conclusions Serum and heparin samples may be centrifuged at higher speed (3000xg) for a shorter amount of time (5 minutes) without alteration of the analytes tested in this study. When using LiHepBar tubes for blood collection, a separate LD reference value might be needed. PMID:29187797

Influence of centrifugation conditions on the results of 77 routine clinical chemistry analytes using standard vacuum blood collection tubes and the new BD-Barricor tubes.

PubMed

Cadamuro, Janne; Mrazek, Cornelia; Leichtle, Alexander B; Kipman, Ulrike; Felder, Thomas K; Wiedemann, Helmut; Oberkofler, Hannes; Fiedler, Georg M; Haschke-Becher, Elisabeth

2018-02-15

Although centrifugation is performed in almost every blood sample, recommendations on duration and g-force are heterogeneous and mostly based on expert opinions. In order to unify this step in a fully automated laboratory, we aimed to evaluate different centrifugation settings and their influence on the results of routine clinical chemistry analytes. We collected blood from 41 healthy volunteers into BD Vacutainer PST II-heparin-gel- (LiHepGel), BD Vacutainer SST II-serum-, and BD Vacutainer Barricor heparin-tubes with a mechanical separator (LiHepBar). Tubes were centrifuged at 2000xg for 10 minutes and 3000xg for 7 and 5 minutes, respectively. Subsequently 60 and 21 clinical chemistry analytes were measured in plasma and serum samples, respectively, using a Roche COBAS instrument. High sensitive Troponin T, pregnancy-associated plasma protein A, ß human chorionic gonadotropin and rheumatoid factor had to be excluded from statistical evaluation as many of the respective results were below the measuring range. Except of free haemoglobin (fHb) measurements, no analyte result was altered by the use of shorter centrifugation times at higher g-forces. Comparing LiHepBar to LiHepGel tubes at different centrifugation setting, we found higher lactate-dehydrogenase (LD) (P = 0.003 to < 0.001) and lower bicarbonate values (P = 0.049 to 0.008) in the latter. Serum and heparin samples may be centrifuged at higher speed (3000xg) for a shorter amount of time (5 minutes) without alteration of the analytes tested in this study. When using LiHepBar tubes for blood collection, a separate LD reference value might be needed.

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.

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.

Effects of Gait Training With Body Weight Support on a Treadmill Versus Overground in Individuals With Stroke.

PubMed

Gama, Gabriela L; Celestino, Melissa L; Barela, José A; Forrester, Larry; Whitall, Jill; Barela, Ana M

2017-04-01

To investigate the effects of gait training with body weight support (BWS) on a treadmill versus overground in individuals with chronic stroke. Randomized controlled trial. University research laboratory. Individuals (N=28) with chronic stroke (>6mo from the stroke event). Participants were randomly assigned to receive gait training with BWS on a treadmill (n=14) or overground (n=14) 3 times a week for 6 weeks. Gait speed measured using the 10-meter walk test, endurance measured using the 6-minute walk test, functional independence measured using the motor domain of the FIM, lower limb recovery measured using the lower extremity domain of the Fugl-Meyer assessment, step length, step length symmetry ratio, and single-limb support duration. Measurements were obtained at baseline, immediately after the training session, and 6 weeks after the training session. At 1 week after the last training session, both groups improved in all outcome measures except paretic step length and step length symmetry ratio, which were improved only in the overground group (P=.01 and P=.01, respectively). At 6 weeks after the last training session, all improvements remained and the treadmill group also improved paretic step length (P<.001) but not step length symmetry ratio (P>.05). Individuals with chronic stroke equally improve gait speed and other gait parameters after 18 sessions of BWS gait training on either a treadmill or overground. Only the overground group improved step length symmetry ratio, suggesting a role of integrating overground walking into BWS interventions poststroke. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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.

Robotic single port cholecystectomy (R-LESS-C): experience in 36 patients.

PubMed

Uras, Cihan; Böler, Deniz Eren; Ergüner, Ilknur; Hamzaoğlu, Ismail

2014-07-01

Laparoendoscopic single-site surgery (LESS) has emerged as a result of a search for "pain-less" and "scar-less" surgery. Laparoendoscopic single-site cholecystectomy (LESS-C) is probably the most common application in general surgery, although it harbors certain limitations. It was proposed that the da Vinci Single-Site (Si) robotic system may overcome some of the difficulties experienced during LESS, providing three dimensional views and the ability to work in a right-handed fashion. Thirty-six robotic single port cholecystectomies (R-LESS-C) performed with the da Vinci Si robotic system are evaluated in this paper R-LESS-C performed in 36 patients were reviewed. The data related to the perioperative period (i.e., anesthesia time, operation time, docking time, and console time) was recorded prospectively, whereas the hospitalization period, postoperative visual analogue scale (VAS) pain scores were collected retrospectively. A total number of 36 patients, with a mean age of 40.1 years (21-64 years), underwent R-LESS-C. There were five men and 31 women. The mean anesthesia and operation times were 79.3 minutes (45-130 minutes) and 61.8 minutes (34-110 minutes), respectively. The mean docking time was 9.8 minutes (4-30 minutes) and the mean console time was 24.9 minutes (7-60 minutes). The mean hospital stay was 1.05 days (1-2 days) and the mean pain score (VAS) was 3.6 (2-8) in the first 24 hours. Incisional hernia was recorded in one patient. R-LESS-C can be performed reliably with acceptable operative times and safety. The da Vinci Si robotic system may ease LESS-C. Two issues should be considered for routine use: expensive resources are needed and the incidence of incisional hernia may increase. Copyright © 2013. Published by Elsevier B.V.

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.

Effect of Varying Acid Hydrolysis Condition in Gracilaria Sp. Fermentation Using Sasad

NASA Astrophysics Data System (ADS)

Mansuit, H.; Samsuri, M. D. C.; Sipaut, C. S.; Yee, C. F.; Yasir, S. M.; Mansa, R.

2015-04-01

Macroalgae or seaweed is being considered as promising feedstock for bioalcohol production due to high polysaccharides content. Polysaccharides can be converted into fermentable sugar through acid hydrolysis pre-treatment. In this study, the potential of using carbohydrate-rich macroalgae, Gracilaria sp. as feedstock for bioalcohol production via various acid hydrolysis conditions prior to the fermentation process was investigated and evaluated. The seaweed used in this research was from the red algae group, using species of Gracilaria sp. which was collected from Sg. Petani Kedah, Malaysia. Pre-treatment of substrate was done using H2SO4 and HCl with molarity ranging from 0.2M to 0.8M. The pretreatment time were varied in the range of 15 to 30 minutes. Fermentation was conducted using Sasad, a local Sabahan fermentation agent as a starter culture. Alcohol extraction was done using a distillation unit. Reducing sugar analysis was done by Benedict test method. Alcohol content analysis was done using specific gravity test. After hydrolysis, it was found out that acid hydrolysis at 0.2M H2SO4 and pre-treated for 20 minutes at 121°C has shown the highest reducing sugar content which has yield (10.06 mg/g) of reducing sugar. It was followed by other samples hydrolysis using 0.4M HCl with 30 minutes pre-treatment and 0.2M H2SO4, 15 minutes pre-treatment with yield of 8.06 mg/g and 5.75 mg/g reducing sugar content respectively. In conclusion, acid hydrolysis of Gracilaria sp. can produce higher reducing sugar yield and thus it can further enhance the bioalcohol production yield. Hence, acid hydrolysis of Gracilaria sp. should be studied more as it is an important step in the bioalcohol production and upscaling process.

Simultaneous bilateral stereotactic procedure for deep brain stimulation implants: a significant step for reducing operation time.

PubMed

Fonoff, Erich Talamoni; Azevedo, Angelo; Angelos, Jairo Silva Dos; Martinez, Raquel Chacon Ruiz; Navarro, Jessie; Reis, Paul Rodrigo; Sepulveda, Miguel Ernesto San Martin; Cury, Rubens Gisbert; Ghilardi, Maria Gabriela Dos Santos; Teixeira, Manoel Jacobsen; Lopez, William Omar Contreras

2016-07-01

OBJECT Currently, bilateral procedures involve 2 sequential implants in each of the hemispheres. The present report demonstrates the feasibility of simultaneous bilateral procedures during the implantation of deep brain stimulation (DBS) leads. METHODS Fifty-seven patients with movement disorders underwent bilateral DBS implantation in the same study period. The authors compared the time required for the surgical implantation of deep brain electrodes in 2 randomly assigned groups. One group of 28 patients underwent traditional sequential electrode implantation, and the other 29 patients underwent simultaneous bilateral implantation. Clinical outcomes of the patients with Parkinson's disease (PD) who had undergone DBS implantation of the subthalamic nucleus using either of the 2 techniques were compared. RESULTS Overall, a reduction of 38.51% in total operating time for the simultaneous bilateral group (136.4 ± 20.93 minutes) as compared with that for the traditional consecutive approach (220.3 ± 27.58 minutes) was observed. Regarding clinical outcomes in the PD patients who underwent subthalamic nucleus DBS implantation, comparing the preoperative off-medication condition with the off-medication/on-stimulation condition 1 year after the surgery in both procedure groups, there was a mean 47.8% ± 9.5% improvement in the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) score in the simultaneous group, while the sequential group experienced 47.5% ± 15.8% improvement (p = 0.96). Moreover, a marked reduction in the levodopa-equivalent dose from preoperatively to postoperatively was similar in these 2 groups. The simultaneous bilateral procedure presented major advantages over the traditional sequential approach, with a shorter total operating time. CONCLUSIONS A simultaneous stereotactic approach significantly reduces the operation time in bilateral DBS procedures, resulting in decreased microrecording time, contributing to the optimization of functional stereotactic procedures.

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

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.

Progressive Adaptive Physical Activity in Stroke Improves Balance, Gait, and Fitness: Preliminary Results

PubMed Central

Michael, Kathleen; Goldberg, Andrew P.; Treuth, Margarita S.; Beans, Jeffrey; Normandt, Peter; Macko, Richard F.

2010-01-01

Purpose We conducted a noncontrolled pilot intervention study in stroke survivors to examine the efficacy of low-intensity adaptive physical activity to increase balance, improve walking function, and increase cardiovascular fitness and to determine whether improvements were carried over into activity profiles in home and community. Method Adaptive physical activity sessions were conducted 3 times/week for 6 months. The main outcomes were Berg Balance Scale, Dynamic Gait Index, 6-Minute Walk Test, cardiovascular fitness (VO2 peak), Falls Efficacy Scale, and 5-day Step Activity Monitoring. Results Seven men and women with chronic ischemic stroke completed the 6-month intervention. The mean Berg Balance baseline score increased from 33.9 ± 8.5 to 46 ± 6.7 at 6 months (mean ± SD; p = .006). Dynamic Gait Index increased from 13.7 ± 3.0 to 19.0 ± 3.5 (p = .01). Six-minute walk distance increased from 840 ± 110 feet to 935 ± 101 feet (p = 0.02). VO2 peak increased from 15.3 ± 4.1 mL/kg/min to 17.5 ± 4.7 mL/kg/min (p = .03). There were no significant changes in falls efficacy or free-living ambulatory activity. Conclusion A structured adaptive physical activity produces improvements in balance, gait, fitness, and ambulatory performance but not in falls efficacy or free-living daily step activity. Randomized studies are needed to determine the cardiovascular health and functional benefits of structured group physical activity programs and to develop behavioral interventions that promote increased free-living physical activity patterns. PMID:19581199

Modified ECC ozone sonde for long-duration flights aboard isopicnic drifting balloons

NASA Astrophysics Data System (ADS)

Gheusi, Francois; Durand, Pierre; Verdier, Nicolas; Dulac, François; Attié, Jean-Luc; Commun, Philippe; Barret, Brice; Basdevant, Claude; Clénet, Antoine; Fontaine, Alain; Jambert, Corinne; Meyerfeld, Yves; Roblou, Laurent; Tocquer, Flore

2015-04-01

Since few years, the French space agency CNES has developed boundary-layer pressurized balloons (BLPB) with the capability to transport scientific payloads at isopicnic level over very long distances and durations (up to several weeks in absence of navigation limits). However, the autonomy of conventional electrochemical concentration cell (ECC) ozone sondes, that are widely used for tropospheric and stratospheric soundings, is limited to few hours due to power consumption and electrolyte evaporation (owing to air bubbling in the cathode solution). In collaboration with the French research community, CNES has developed a new ozone payload suited for long duration flights aboard BLPB. The mechanical elements (Teflon pump and motor) and the electrochemical cell of conventional ECC sondes have been kept but the electronic implementation is entirely new. The main feature is the possibility of programming periodic measurement sequences -- with possible remote control during the flight. To increase the ozone sonde autonomy, a strategy has been adopted of short measurement sequences (typically 2-3 min) regularly spaced in time (e.g. every 15 min, which is usually sufficient for air quality studies). The rest of the time, the sonde is at rest (pump motor off). The response time of an ECC sonde to an ozone concentration step is below one minute. Consequently, the measurement sequence is typically composed of a one-minute spin-up period after the pump has been turned on, followed by a one- to two-minute acquisition period. All time intervals can be adjusted before and during the flight. Results of a preliminary ground-based test in spring 2012 are first presented. The sonde provided correct ozone concentrations against a reference UV analyzer every 15 minutes during 4 days. Then we illustrate results from 16 BLBP flights launched in the low troposphere over the Mediterranean during summer field campaings in 2012 and 2013 (TRAQA and ChArMEx programmes). BLPB drifting altitudes were in the range 0.25-3.2 km. The longest flight lasted more than 32 hours and covered more than 1000 km between Minorca and the limit of the authorized flight area south of Malta. During some flights, satisfying comparisons were obtained relatively to independent measurements close in time and space. The obtained quasi-Lagrangian measurements allow an evaluation of the ozone production/destruction rate as a function of the solar radiation (also measured onboard, as well as standard weather variables) that will be helpful to test chemistry-transport models.

Oceanic signals in rapid polar motion: results from a barotropic forward model with explicit consideration of self-attraction and loading effects

NASA Astrophysics Data System (ADS)

Schindelegger, Michael; Quinn, Katherine J.; Ponte, Rui M.

2017-04-01

Numerical modeling of non-tidal variations in ocean currents and bottom pressure has played a key role in closing the excitation budget of Earth's polar motion for a wide range of periodicities. Non-negligible discrepancies between observations and model accounts of pole position changes prevail, however, on sub-monthly time scales and call for examination of hydrodynamic effects usually omitted in general circulation models. Specifically, complete hydrodynamic cores must incorporate self-attraction and loading (SAL) feedbacks on redistributed water masses, effects that produces ocean bottom pressure perturbations of typically about 10% relative to the computed mass variations. Here, we report on a benchmark simulation with a near-global, barotropic forward model forced by wind stress, atmospheric pressure, and a properly calculated SAL term. The latter is obtained by decomposing ocean mass anomalies on a 30-minute grid into spherical harmonics at each time step and applying Love numbers to account for seafloor deformation and changed gravitational attraction. The increase in computational time at each time step is on the order of 50%. Preliminary results indicate that the explicit consideration of SAL in the forward runs increases the fidelity of modeled polar motion excitations, in particular on time scales shorter than 5 days as evident from cross spectral comparisons with geodetic excitation. Definite conclusions regarding the relevance of SAL in simulating rapid polar motion are, however, still hampered by the model's incomplete domain representation that excludes parts of the highly energetic Arctic Ocean.

Smart Hydrogel Particles: Biomarker Harvesting: One-step affinity purification, size exclusion, and protection against degradation

PubMed Central

Luchini, Alessandra; Geho, David H.; Bishop, Barney; Tran, Duy; Xia, Cassandra; Dufour, Robert; Jones, Clint; Espina, Virginia; Patanarut, Alexis; Zhu, Weidong; Ross, Mark; Tessitore, Alessandra; Petricoin, Emanuel; Liotta, Lance A.

2010-01-01

Disease-associated blood biomarkers exist in exceedingly low concentrations within complex mixtures of high-abundance proteins such as albumin. We have introduced an affinity bait molecule into N-isopropylacrylamide to produce a particle that will perform three independent functions within minutes, in one step, in solution: a) molecular size sieving b) affinity capture of all solution phase target molecules, and c) complete protection of harvested proteins from enzymatic degradation. The captured analytes can be readily electroeluted for analysis. PMID:18076201

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.

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.

Reallocating bouted sedentary time to non-bouted sedentary time, light activity and moderate-vigorous physical activity in adults with prediabetes and type 2 diabetes

PubMed Central

Buman, Matthew P.; Johansson, Unn-Britt; Yngve, Agneta; Ainsworth, Barbara; Brismar, Kerstin; Hagströmer, Maria

2017-01-01

Aim The aim of this study was to investigate the potential associations of reallocating 30 minutes sedentary time in long bouts (>60 min) to sedentary time in non-bouts, light intensity physical activity (LPA) and moderate- to vigorous physical activity (MVPA) with cardiometabolic risk factors in a population diagnosed with prediabetes or type 2 diabetes. Methods Participants diagnosed with prediabetes and type 2 diabetes (n = 124, 50% men, mean [SD] age = 63.8 [7.5] years) were recruited to the physical activity intervention Sophia Step Study. For this study baseline data was used with a cross-sectional design. Time spent in sedentary behaviors in bouts (>60 min) and non-bouts (accrued in <60 min bouts) and physical activity was measured using the ActiGraph GT1M. Associations of reallocating bouted sedentary time to non-bouted sedentary time, LPA and MVPA with cardiometabolic risk factors were examined using an isotemporal substitution framework with linear regression models. Results Reallocating 30 minutes sedentary time in bouts to MVPA was associated with lower waist circumference (b = -4.30 95% CI:-7.23, -1.38 cm), lower BMI (b = -1.46 95% CI:-2.60, -0.33 kg/m2) and higher HDL cholesterol levels (b = 0.11 95% CI: 0.02, 0.21 kg/m2. Similar associations were seen for reallocation of sedentary time in non-bouts to MVPA. Reallocating sedentary time in bouts to LPA was associated only with lower waist circumference. Conclusion Reallocation of sedentary time in bouts as well as non-bouts to MVPA, but not to LPA, was beneficially associated with waist circumference, BMI and HDL cholesterol in individuals with prediabetes and type 2 diabetes. The results of this study confirm the importance of reallocation sedentary time to MVPA. PMID:28753626

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

Cathodic Potential Dependence of Electrochemical Reduction of SiO2 Granules in Molten CaCl2

NASA Astrophysics Data System (ADS)

Yang, Xiao; Yasuda, Kouji; Nohira, Toshiyuki; Hagiwara, Rika; Homma, Takayuki

2016-09-01

As part of an ongoing fundamental study to develop a new process for producing solar-grade silicon, this paper examines the effects of cathodic potential on reduction kinetics, current efficiency, morphology, and purity of Si product during electrolysis of SiO2 granules in molten CaCl2 at 1123 K (850 °C). SiO2 granules were electrolyzed potentiostatically at different cathodic potentials (0.6, 0.8, 1.0, and 1.2 V vs Ca2+/Ca). The reduction kinetics was evaluated based on the growth of the reduced Si layer and the current behavior during electrolysis. The results suggest that a more negative cathodic potential is favorable for faster reduction. Current efficiencies in 60 minutes are greater than 65 pct at all the potentials examined. Si wires with sub-micron diameters are formed, and their morphologies show little dependence on the cathodic potential. The impurities in the Si product can be controlled at low level. The rate-determining step for the electrochemical reduction of SiO2 granules in molten CaCl2 changes with time. At the initial stage of electrolysis, the electron transfer is the rate-determining step. At the later stage, the diffusion of O2- ions is the rate-determining step. The major cause of the decrease in reduction rate with increasing electrolysis time is the potential drop from the current collector to the reaction front due to the increased contact resistance among the reduced Si particles.

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

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.

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.

GWAS with longitudinal phenotypes: performance of approximate procedures

PubMed Central

Sikorska, Karolina; Montazeri, Nahid Mostafavi; Uitterlinden, André; Rivadeneira, Fernando; Eilers, Paul HC; Lesaffre, Emmanuel

2015-01-01

Analysis of genome-wide association studies with longitudinal data using standard procedures, such as linear mixed model (LMM) fitting, leads to discouragingly long computation times. There is a need to speed up the computations significantly. In our previous work (Sikorska et al: Fast linear mixed model computations for genome-wide association studies with longitudinal data. Stat Med 2012; 32.1: 165–180), we proposed the conditional two-step (CTS) approach as a fast method providing an approximation to the P-value for the longitudinal single-nucleotide polymorphism (SNP) effect. In the first step a reduced conditional LMM is fit, omitting all the SNP terms. In the second step, the estimated random slopes are regressed on SNPs. The CTS has been applied to the bone mineral density data from the Rotterdam Study and proved to work very well even in unbalanced situations. In another article (Sikorska et al: GWAS on your notebook: fast semi-parallel linear and logistic regression for genome-wide association studies. BMC Bioinformatics 2013; 14: 166), we suggested semi-parallel computations, greatly speeding up fitting many linear regressions. Combining CTS with fast linear regression reduces the computation time from several weeks to a few minutes on a single computer. Here, we explore further the properties of the CTS both analytically and by simulations. We investigate the performance of our proposal in comparison with a related but different approach, the two-step procedure. It is analytically shown that for the balanced case, under mild assumptions, the P-value provided by the CTS is the same as from the LMM. For unbalanced data and in realistic situations, simulations show that the CTS method does not inflate the type I error rate and implies only a minimal loss of power. PMID:25712081

Exploring the Feasibility of a Broad-Reach Physical Activity Behavior Change Intervention for Women Receiving Chemotherapy for Breast Cancer: A Randomized Trial.

PubMed

Vallance, Jeff K; Friedenreich, Christine M; Lavallee, Celeste M; Culos-Reed, Nicole; Mackey, John R; Walley, Barbara; Courneya, Kerry S

2016-02-01

Facilitating healthy levels of physical activity (PA) during chemotherapy is important for the psychosocial and physical health of breast cancer survivors. The primary objective of this feasibility study was to examine the effects of a broad-reach PA behavior change intervention among women with breast cancer receiving adjuvant chemotherapy. Breast cancer patients receiving adjuvant chemotherapy (N = 95) were randomly assigned to receive a PA resource kit consisting of tailored print materials and a step pedometer (intervention) or a standard public health PA recommendation (standard recommendation). The primary outcome was daily pedometer steps. Secondary outcomes were self-reported light, moderate, and vigorous intensity PA, total moderate-to-vigorous PA, and sedentary time. Assessments were conducted before and after adjuvant chemotherapy. Attrition was 19% (17 of 95). Intervention patients wore their step pedometer for 85 days (range, 35-144 days; SD = 26.4) for a 95% adherence rate. Analyses of covariance suggested that the intervention was not statistically superior to standard recommendation for daily average pedometer steps (-771; 95% CI = -2024 to 482; P = 0.22), total MVPA minutes (-4; 95% CI = -62 to 570; P = 0.90), or sedentary time (+160; 95% CI = -186 to 506; P = 0.42). This broach-reach and low intensive intervention was not more effective for promoting PA in breast cancer patients receiving chemotherapy than providing the standard public health guidelines for PA. Achieving physical activity behavior change during adjuvant breast cancer chemotherapy may require some level of supervised physical activity or more intensive (e.g., face-to-face, supervised) interventions. ©2015 American Association for Cancer Research.

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.

Neighbourhood environment correlates of physical activity: a study of eight Czech regional towns.

PubMed

Sigmundová, Dagmar; El Ansari, Walid; Sigmund, Erik

2011-02-01

An adequate amount of physical activity (PA) is a key factor that is associated with good health. This study assessed socio-environmental factors associated with meeting the health recommendations for PA (achieving 10,000 steps per day). In total, 1,653 respondents randomly selected from across eight regional towns (each >90,000 inhabitants) in the Czech Republic participated in the study. The ANEWS questionnaire assessed the environment in neighbourhoods, and participants' weekly PA was objectively monitored (Yamax Digiwalker SW-700 pedometer). About 24% of participants were sufficiently active, 27% were highly active; 28% participants were overweight and 5% were obese. Although BMI was significantly inversely associated with the daily step counts achieved only in females, for both genders, BMI was generally not significantly associated with the criterion of achieving 10,000 steps per day during the week. Increased BMI in both genders was accompanied with a decline in participation in organized PA and with increasing age. As regards to the demographic/lifestyle factors, for females, more participation in organized PA was significantly positively correlated with the achieved daily step counts. In contrast, older age and higher BMI (for females) and smoking (for males) were significantly negatively correlated with the achieved daily step counts. In terms of the environmental aspects, pleasant environments were significantly positively correlated to daily step counts for both genders. Additionally, for males, better residencies (more family homes rather than apartment blocks) in the neighbourhood were significantly positively correlated with their daily step counts. For females, less accessibility of shops and non-sport facilities (depending on walking distance in minutes) were significantly negatively correlated to the achieved daily step counts. Individuals who lived in pleasant neighbourhoods, with better access to shops and who participated in organized PA (≥ 2 times a week) tended to meet the recommendations for health-enhancing PA levels. The creation of physical activity-friendly environments could be associated with enhancing people's achieved daily step counts and meeting the health criteria for PA.

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.

Convective Weather Avoidance with Uncertain Weather Forecasts

NASA Technical Reports Server (NTRS)

Karahan, Sinan; Windhorst, Robert D.

2009-01-01

Convective weather events have a disruptive impact on air traffic both in terminal area and in en-route airspaces. In order to make sure that the national air transportation system is safe and efficient, it is essential to respond to convective weather events effectively. Traffic flow control initiatives in response to convective weather include ground delay, airborne delay, miles-in-trail restrictions as well as tactical and strategic rerouting. The rerouting initiatives can potentially increase traffic density and complexity in regions neighboring the convective weather activity. There is a need to perform rerouting in an intelligent and efficient way such that the disruptive effects of rerouting are minimized. An important area of research is to study the interaction of in-flight rerouting with traffic congestion or complexity and developing methods that quantitatively measure this interaction. Furthermore, it is necessary to find rerouting solutions that account for uncertainties in weather forecasts. These are important steps toward managing complexity during rerouting operations, and the paper is motivated by these research questions. An automated system is developed for rerouting air traffic in order to avoid convective weather regions during the 20- minute - 2-hour time horizon. Such a system is envisioned to work in concert with separation assurance (0 - 20-minute time horizon), and longer term air traffic management (2-hours and beyond) to provide a more comprehensive solution to complexity and safety management. In this study, weather is dynamic and uncertain; it is represented as regions of airspace that pilots are likely to avoid. Algorithms are implemented in an air traffic simulation environment to support the research study. The algorithms used are deterministic but periodically revise reroutes to account for weather forecast updates. In contrast to previous studies, in this study convective weather is represented as regions of airspace that pilots are likely to avoid. The automated system periodically updates forecasts and reassesses rerouting decisions in order to account for changing weather predictions. The main objectives are to reroute flights to avoid convective weather regions and determine the resulting complexity due to rerouting. The eventual goal is to control and reduce complexity while rerouting flights during the 20 minute - 2 hour planning period. A three-hour simulation is conducted using 4800 flights in the national airspace. The study compares several metrics against a baseline scenario using the same traffic and weather but with rerouting disabled. The results show that rerouting can have a negative impact on congestion in some sectors, as expected. The rerouting system provides accurate measurements of the resulting complexity in the congested sectors. Furthermore, although rerouting is performed only in the 20-minute - 2-hour range, it results in a 30% reduction in encounters with nowcast weather polygons (100% being the ideal for perfectly predictable and accurate weather). In the simulations, rerouting was performed for the 20-minute - 2-hour flight time horizon, and for the en-route segment of air traffic. The implementation uses CWAM, a set of polygons that represent probabilities of pilot deviation around weather. The algorithms were implemented in a software-based air traffic simulation system. Initial results of the system's performance and effectiveness were encouraging. Simulation results showed that when flights were rerouted in the 20-minute - 2-hour flight time horizon of air traffic, there were fewer weather encounters in the first 20 minutes than for flights that were not rerouted. Some preliminary results were also obtained that showed that rerouting will also increase complexity. More simulations will be conducted in order to report conclusive results on the effects of rerouting on complexity. Thus, the use of the 20-minute - 2-hour flight time horizon weather avoidance teniques performed in the simulation is expected to provide benefits for short-term weather avoidance.

The First Steps Series. [Videotapes].

ERIC Educational Resources Information Center

1998

This videotape series offers emotional support and self-confidence to parents reaching out for knowledge about how young children, grow, develop, and learn. The video "Common Concerns of Parents of Young" (30 minutes) features parents expressing some universal concerns regarding their young children. Child psychologists and pediatricians offer…

All about Your Risk for Prediabetes, Type 2 Diabetes, and Heart Disease

MedlinePlus

... to work up to 10,000 steps every day. J Buddy up with a friend or family member. ... Or do something else active that you enjoy. J Take a walk every day. Work up to 30 minutes of brisk walking, ...

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.

Determining the Cost-Savings Threshold and Alignment Accuracy of Patient-Specific Instrumentation in Total Ankle Replacements.

PubMed

Hamid, Kamran S; Matson, Andrew P; Nwachukwu, Benedict U; Scott, Daniel J; Mather, Richard C; DeOrio, James K

2017-01-01

Traditional intraoperative referencing for total ankle replacements (TARs) involves multiple steps and fluoroscopic guidance to determine mechanical alignment. Recent adoption of patient-specific instrumentation (PSI) allows for referencing to be determined preoperatively, resulting in less steps and potentially decreased operative time. We hypothesized that usage of PSI would result in decreased operating room time that would offset the additional cost of PSI compared with standard referencing (SR). In addition, we aimed to compare postoperative radiographic alignment between PSI and SR. Between August 2014 and September 2015, 87 patients undergoing TAR were enrolled in a prospectively collected TAR database. Patients were divided into cohorts based on PSI vs SR, and operative times were reviewed. Radiographic alignment parameters were retrospectively measured at 6 weeks postoperatively. Time-driven activity-based costing (TDABC) was used to derive direct costs. Cost vs operative time-savings were examined via 2-way sensitivity analysis to determine cost-saving thresholds for PSI applicable to a range of institution types. Cost-saving thresholds defined the price of PSI below which PSI would be cost-saving. A total of 35 PSI and 52 SR cases were evaluated with no significant differences identified in patient characteristics. Operative time from incision to completion of casting in cases without adjunct procedures was 127 minutes with PSI and 161 minutes with SR ( P < .05). PSI demonstrated similar postoperative accuracy to SR in coronal tibial-plafond alignment (1.1 vs 0.3 degrees varus, P = .06), tibial-plafond alignment (0.3 ± 2.1 vs 1.1 ± 2.1 degrees varus, P = .06), and tibial component sagittal alignment (0.7 vs 0.9 degrees plantarflexion, P = .14). The TDABC method estimated a PSI cost-savings threshold range at our institution of $863 below which PSI pricing would provide net cost-savings. Two-way sensitivity analysis generated a globally applicable cost-savings threshold model based on institution-specific costs and surgeon-specific time-savings. This study demonstrated equivalent postoperative TAR alignment with PSI and SR referencing systems but with a significant decrease in operative time with PSI. Based on TDABC and associated sensitivity analysis, a cost-savings threshold of $863 was identified for PSI pricing at our institution below which PSI was less costly than SR. Similar internal cost accounting may benefit health care systems for identifying cost drivers and obtaining leverage during price negotiations. Level III, therapeutic study.

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.

Time-Gated Orthogonal Scanning Automated Microscopy (OSAM) for High-speed Cell Detection and Analysis

NASA Astrophysics Data System (ADS)

Lu, Yiqing; Xi, Peng; Piper, James A.; Huo, Yujing; Jin, Dayong

2012-11-01

We report a new development of orthogonal scanning automated microscopy (OSAM) incorporating time-gated detection to locate rare-event organisms regardless of autofluorescent background. The necessity of using long-lifetime (hundreds of microseconds) luminescent biolabels for time-gated detection implies long integration (dwell) time, resulting in slow scan speed. However, here we achieve high scan speed using a new 2-step orthogonal scanning strategy to realise on-the-fly time-gated detection and precise location of 1-μm lanthanide-doped microspheres with signal-to-background ratio of 8.9. This enables analysis of a 15 mm × 15 mm slide area in only 3.3 minutes. We demonstrate that detection of only a few hundred photoelectrons within 100 μs is sufficient to distinguish a target event in a prototype system using ultraviolet LED excitation. Cytometric analysis of lanthanide labelled Giardia cysts achieved a signal-to-background ratio of two orders of magnitude. Results suggest that time-gated OSAM represents a new opportunity for high-throughput background-free biosensing applications.

WE-G-BRA-02: SafetyNet: Automating Radiotherapy QA with An Event Driven Framework

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

Hadley, S; Kessler, M; Litzenberg, D

2015-06-15

Purpose: Quality assurance is an essential task in radiotherapy that often requires many manual tasks. We investigate the use of an event driven framework in conjunction with software agents to automate QA and eliminate wait times. Methods: An in house developed subscription-publication service, EventNet, was added to the Aria OIS to be a message broker for critical events occurring in the OIS and software agents. Software agents operate without user intervention and perform critical QA steps. The results of the QA are documented and the resulting event is generated and passed back to EventNet. Users can subscribe to those eventsmore » and receive messages based on custom filters designed to send passing or failing results to physicists or dosimetrists. Agents were developed to expedite the following QA tasks: Plan Revision, Plan 2nd Check, SRS Winston-Lutz isocenter, Treatment History Audit, Treatment Machine Configuration. Results: Plan approval in the Aria OIS was used as the event trigger for plan revision QA and Plan 2nd check agents. The agents pulled the plan data, executed the prescribed QA, stored the results and updated EventNet for publication. The Winston Lutz agent reduced QA time from 20 minutes to 4 minutes and provided a more accurate quantitative estimate of radiation isocenter. The Treatment Machine Configuration agent automatically reports any changes to the Treatment machine or HDR unit configuration. The agents are reliable, act immediately, and execute each task identically every time. Conclusion: An event driven framework has inverted the data chase in our radiotherapy QA process. Rather than have dosimetrists and physicists push data to QA software and pull results back into the OIS, the software agents perform these steps immediately upon receiving the sentinel events from EventNet. Mr Keranen is an employee of Varian Medical Systems. Dr. Moran’s institution receives research support for her effort for a linear accelerator QA project from Varian Medical Systems. Other quality projects involving her effort are funded by Blue Cross Blue Shield of Michigan, Breast Cancer Research Foundation, and the NIH.« less

Purification of biodiesel by choline chloride based deep eutectic solvent

NASA Astrophysics Data System (ADS)

Niawanti, Helda; Zullaikah, Siti; Rachimoellah, M.

2017-05-01

Purification is a crucial step in biodiesel production to meet the biodiesel standard. This study purified biodiesel using choline chloride based deep eutectic solvent (DES). DES was used to reduce unreacted oil and unsaponifiable matter in rice bran oil based biodiesel. The objective of this work was to study the effect of extraction time using DES on the content and yield of fatty acid methyl ester (FAME). Rice bran used in this work contains 16.49 % of oil with initial free fatty acids (FFA) of 44.75 %. Acid catalyzed methanolysis was employed to convert rice bran oil (RBO) into biodiesel under following operation conditions: T = 60 °C, t = 8 h, molar ratio of oil to methanol = 1/10, H2SO4 = 1% w/w of oil. Rice bran oil based biodiesel obtained contain 89.05 % of FAME with very low FFA content (0.05 %). DES was made from a mixture of choline chloride and ethylene glycol with molar ratio of 1/2. Molar ratio of crude biodiesel to DES were 1/2 and 1/4. Extraction time was varied from 15 minutes to 240 minutes at 30 °C. The highest FAME content was obtained after purification for 240 min. at molar ratio crude biodiesel to DES 1/4 was 96.60 %. This work shows that DES has potential to purify biodiesel from non-edible raw material, such as RBO.

Modification of cassava starch using combination process lactic acid hydrolysis and micro wave heating to increase coated peanut expansion quality

NASA Astrophysics Data System (ADS)

Sumardiono, Siswo; Pudjihastuti, Isti; Jos, Bakti; Taufani, Muhammad; Yahya, Faad

2017-05-01

Modified cassava starch is very prospective products in the food industry. The main consideration of this study is the increasing volume of imported wheat and the demand for modified cassava starch industry. The purpose of this study is the assessing of lactic acid hydrolysis and microwave heating impact to the physicochemical and rheological properties of modified cassava starch, and test applications of modified cassava starch to coated peanut expansion quality. Experimental variables include the concentration of lactic acid (0.5% w/w, 1% w/w; 2% w/w), a time of hydrolysis (15, 30, 45 minutes), a time of microwave heating (1, 2, 3 hours). The research step is by dissolving lactic acid using aquadest in the stirred tank reactor, then added cassava starch. Hydrolysed cassava starch was then heated by microwave. Physicochemical properties and rheology of the modified cassava starch is determined by the solubility, swelling power, and test congestion. The optimum obtained results indicate that solubility, swelling power, congestion test, respectively for 19.75%; 24.25% and 826.10% in the hydrolysis treatment for 15 minutes, 1% w lactic acid and microwave heating 3 hours. The physicochemical and rheological properties of modified cassava starch have changed significantly when compared to the native cassava starch. Furthermore, these modified cassava starch are expected to be used for the substitution of food products.

[Temporal Analysis of Body Sway during Reciprocator Motion Movie Viewing].

PubMed

Sugiura, Akihiro; Tanaka, Kunihiko; Wakatabe, Shun; Matsumoto, Chika; Miyao, Masaru

2016-01-01

We aimed to investigate the effect of stereoscopic viewing and the degree of awareness of motion sickness on posture by measuring body sway during motion movie viewing. Nineteen students (12 men and 7 women; age range, 21-24 years) participated in this study. The movie, which showed several balls randomly positioned, was projected on a white wall 2 m in front of the subjects through a two-dimensional (2-D)/three-dimensional (3-D) convertible projector. To measure body sway during movie viewing, the subjects stood statically erect on a Wii balance board, with the toe opening at 18 degrees. The study protocol was as follows: The subjects watched (1) a nonmoving movie for 1 minute as the pretest and then (2) a round-trip sinusoidally moving-in-depth-direction movie for 3 minutes. (3) The initial static movie was shown again for 1 minute. Steps (2) and (3) were treated as one trial, after which two trials (2-D and 3-D movies) were performed in a random sequence. In this study, we found that posture changed according to the motion in the movie and that the longer the viewing time, the higher the synchronization accuracy. These tendencies depended on the level of awareness of motion sickness or the 3-D movie viewed. The mechanism of postural change in movie viewing was not vection but self-defense to resolve sensory conflict between visual information (spatial swing) and equilibrium sense (motionlessness).

A Classroom-Based Physical Activity Intervention for Urban Kindergarten and First-Grade Students: A Feasibility Study

PubMed Central

Wylie-Rosett, Judith; Kim, Mimi; Ozuah, Philip O.

2015-01-01

Abstract Background: Urban elementary schools in minority communities with high obesity prevalence may have limited resources for physical education (PE) to achieve daily activity recommendations. Little is known whether integrating physical activity (PA) into classrooms can increase activity levels of students attending such schools. Methods: We conducted a cluster randomized, controlled trial among kindergarten and first-grade students from four Bronx, New York, schools to determine feasibility and impact of a classroom-based intervention on students' PA levels. Students in two intervention schools received the Children's Hospital at Montefiore Joining Academics and Movement (CHAM JAM), an audio CD consisting of 10-minute, education-focused aerobic activities led by teachers three times a day. PA was objectively measured by pedometer. Each subject wore a sealed pedometer during the 6-hour school day for 5 consecutive days at baseline (Time 1) and 8 weeks postintervention (Time 2). Hierarchical linear models were fit to evaluate differences in mean number of steps between the two groups. Results: A total of 988 students participated (intervention group, n=500; control group, n=488). There was no significant difference at baseline between the two groups on mean number of steps (2581 [standard deviation (SD), 1284] vs. 2476 [SD, 1180]; P=0.71). Eight weeks post–CHAM JAM, intervention group students took significantly greater mean number of steps than controls (2839 [SD, 1262] vs. 2545 [SD, 1153]; P=0.0048) after adjusting for baseline number of steps and other covariates (grade, gender, recess, and PE class). CHAM JAM was equally effective in gender, grade level, and BMI subgroups. Conclusions: CHAM JAM significantly increased school-based PA among kindergarten and first-grade students in inner-city schools. This approach holds promise as a cost-effective means to integrate the physical and cognitive benefits of PA into high-risk schools. PMID:25747719

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

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.

Common Bolted Joint Analysis Tool

NASA Technical Reports Server (NTRS)

Imtiaz, Kauser

2011-01-01

Common Bolted Joint Analysis Tool (comBAT) is an Excel/VB-based bolted joint analysis/optimization program that lays out a systematic foundation for an inexperienced or seasoned analyst to determine fastener size, material, and assembly torque for a given design. Analysts are able to perform numerous what-if scenarios within minutes to arrive at an optimal solution. The program evaluates input design parameters, performs joint assembly checks, and steps through numerous calculations to arrive at several key margins of safety for each member in a joint. It also checks for joint gapping, provides fatigue calculations, and generates joint diagrams for a visual reference. Optimum fastener size and material, as well as correct torque, can then be provided. Analysis methodology, equations, and guidelines are provided throughout the solution sequence so that this program does not become a "black box:" for the analyst. There are built-in databases that reduce the legwork required by the analyst. Each step is clearly identified and results are provided in number format, as well as color-coded spelled-out words to draw user attention. The three key features of the software are robust technical content, innovative and user friendly I/O, and a large database. The program addresses every aspect of bolted joint analysis and proves to be an instructional tool at the same time. It saves analysis time, has intelligent messaging features, and catches operator errors in real time.

Gait characteristics after gait-oriented rehabilitation in chronic stroke.

PubMed

Peurala, Sinikka H; Titianova, Ekaterina B; Mateev, Plamen; Pitkänen, Kauko; Sivenius, Juhani; Tarkka, Ina M

2005-01-01

To assess the effects of rehabilitation in thirty-seven ambulatory patients with chronic stroke during three weeks in-patient rehabilitation period. In the intervention group, each patient received 75 min physiotherapy daily every workday including 20 minutes in the electromechanical gait trainer with body-weight support (BWS). In the control group, each patient participated in 45 min conventional physiotherapy daily. Motor ability was assessed with the first five items of the Modified Motor Assessment Scale (MMAS1-5) and ten meters walking speed. Spatio-temporal gait characteristics were recorded with an electrical walkway. The MMAS1-5 (p<0.0005 and p=0.005) and ten meters walking time (p<0.0005 and p=0.006) improved in both groups. The improvements in MMAS1-5 and ten meters walking time did not differ between the groups (p=0.217 and p=0.195). Specific gait characteristics improved only in the intervention group, as seen in increased Functional Ambulation Profile score (p=0.023), velocity (p=0.023), the step lengths (affected side, p=0.011, non-affected side p=0.040), the stride lengths (p=0.018, p=0.006) and decreased step-time differential (p=0.043). Furthermore, all gait characteristics and other motor abilities remained in the discharge level at the six months in the intervention group. It appears that BWS training gives a long-lasting benefit in gait qualities even in chronic stroke patients.

Efficiency of an automated reception and turnaround time management system for the phlebotomy room.

PubMed

Yun, Soon Gyu; Shin, Jeong Won; Park, Eun Su; Bang, Hae In; Kang, Jung Gu

2016-01-01

Recent advances in laboratory information systems have largely been focused on automation. However, the phlebotomy services have not been completely automated. To address this issue, we introduced an automated reception and turnaround time (TAT) management system, for the first time in Korea, whereby the patient's information is transmitted directly to the actual phlebotomy site and the TAT for each phlebotomy step can be monitored at a glance. The GNT5 system (Energium Co., Ltd., Korea) was installed in June 2013. The automated reception and TAT management system has been in operation since February 2014. Integration of the automated reception machine with the GNT5 allowed for direct transmission of laboratory order information to the GNT5 without involving any manual reception step. We used the mean TAT from reception to actual phlebotomy as the parameter for evaluating the efficiency of our system. Mean TAT decreased from 5:45 min to 2:42 min after operationalization of the system. The mean number of patients in queue decreased from 2.9 to 1.0. Further, the number of cases taking more than five minutes from reception to phlebotomy, defined as the defect rate, decreased from 20.1% to 9.7%. The use of automated reception and TAT management system was associated with a decrease of overall TAT and an improved workflow at the phlebotomy room.

Efficiency of an Automated Reception and Turnaround Time Management System for the Phlebotomy Room

PubMed Central

Yun, Soon Gyu; Park, Eun Su; Bang, Hae In; Kang, Jung Gu

2016-01-01

Background Recent advances in laboratory information systems have largely been focused on automation. However, the phlebotomy services have not been completely automated. To address this issue, we introduced an automated reception and turnaround time (TAT) management system, for the first time in Korea, whereby the patient's information is transmitted directly to the actual phlebotomy site and the TAT for each phlebotomy step can be monitored at a glance. Methods The GNT5 system (Energium Co., Ltd., Korea) was installed in June 2013. The automated reception and TAT management system has been in operation since February 2014. Integration of the automated reception machine with the GNT5 allowed for direct transmission of laboratory order information to the GNT5 without involving any manual reception step. We used the mean TAT from reception to actual phlebotomy as the parameter for evaluating the efficiency of our system. Results Mean TAT decreased from 5:45 min to 2:42 min after operationalization of the system. The mean number of patients in queue decreased from 2.9 to 1.0. Further, the number of cases taking more than five minutes from reception to phlebotomy, defined as the defect rate, decreased from 20.1% to 9.7%. Conclusions The use of automated reception and TAT management system was associated with a decrease of overall TAT and an improved workflow at the phlebotomy room. PMID:26522759

Fast Conceptual Cost Estimating of Aerospace Projects Using Historical Information

NASA Technical Reports Server (NTRS)

Butts, Glenn

2007-01-01

Accurate estimates can be created in less than a minute by applying powerful techniques and algorithms to create an Excel-based parametric cost model. In five easy steps you will learn how to normalize your company 's historical cost data to the new project parameters. This paper provides a complete, easy-to-understand, step by step how-to guide. Such a guide does not seem to currently exist. Over 2,000 hours of research, data collection, and trial and error, and thousands of lines of Excel Visual Basic Application (VBA) code were invested in developing these methods. While VBA is not required to use this information, it increases the power and aesthetics of the model. Implementing all of the steps described, while not required, will increase the accuracy of the results.

Toxin detection using a fiber-optic-based biosensor

NASA Astrophysics Data System (ADS)

Ogert, Robert A.; Shriver-Lake, Lisa C.; Ligler, Frances S.

1993-05-01

Using an evanescent wave fiber optic-based biosensor developed at Naval Research Laboratory, ricin toxin can be detected in the low ng/ml range. Sensitivity was established at 1 - 5 ng/ml using a two-step assay. The two-step assay showed enhanced signal levels in comparison to a one-step assay. A two-step assay utilizes a 10 minute incubation of an immobilized affinity purified anti-ricin antibody fiber optic probe in the ricin sample before placement in a solution of fluorophore-labeled goat anti-ricin antibodies. The specific fluorescent signal is obtained by the binding of the fluorophore-labeled antibodies to ricin which is bound by the immobilized antibodies on the fiber optic probe. The toxin can be detected directly from urine and river water using this fiber optic assay.

A resolution honoring the Minute Man National Historical Park on the occasion of its 50th anniversary.

THOMAS, 111th Congress

Sen. Kerry, John F. [D-MA

2009-09-21

Senate - 05/07/2010 Resolution agreed to in Senate without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

The 50-Minute Robot.

ERIC Educational Resources Information Center

Buckland, Miram R.

1985-01-01

Sixth graders built working "robots" (or grasping bars) for remote control use during a unit on simple mechanics. Steps for making a robot are presented, including: cutting the wood, drilling and nailing, assembling the jaws, and making them work. The "jaws," used to pick up objects, illustrate principles of levers. (DH)

Ethnic and gender differences in physical activity levels among 9–10-year-old children of white European, South Asian and African–Caribbean origin: the Child Heart Health Study in England (CHASE Study)

PubMed Central

Owen, Christopher G; Nightingale, Claire M; Rudnicka, Alicja R; Cook, Derek G; Ekelund, Ulf; Whincup, Peter H

2009-01-01

Background Ethnic differences in physical activity in children in the UK have not been accurately assessed. We made objective measurements of physical activity in 9–10-year-old British children of South Asian, black African–Caribbean and white European origin. Methods Cross-sectional study of urban primary school children (2006–07). Actigraph-GT1M activity monitors were worn by 2071 children during waking hours on at least 1 full day. Ethnic differences in mean daily activity [counts, counts per minute of registered time (CPM) and steps] were adjusted for age, gender, day of week and month. Multilevel modelling allowed for repeated days within individual and clustering within school. Results In white Europeans, mean daily counts, CPM and mean daily steps were 394 785, 498 and 10 220, respectively. South Asian and black Caribbean children recorded more registered time per day than white Europeans (34 and 36 min, respectively). Compared with white Europeans, South Asians recorded 18 789 fewer counts [95% confidence interval (CI) 6390–31 187], 41 fewer CPM 95% CI 26–57) and 905 fewer steps (95% CI 624–1187). Black African–Caribbeans recorded 25 359 more counts (95% CI 14 273–36 445), and similar CPM, but fewer steps than white Europeans. Girls recorded less activity than boys in all ethnic groups, with 74 782 fewer counts (95% CI 66 665–82 899), 84 fewer CPM (95% CI 74–95) and 1484 fewer steps (95% CI 1301–1668). Conclusion British South Asian children have lower objectively measured physical activity levels than European whites and black African–Caribbeans. PMID:19377098

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.

Determination of the rCBF in the Amygdala and Rhinal Cortex Using a FAIR-TrueFISP Sequence

PubMed Central

Martirosian, Petros; Klose, Uwe; Nägele, Thomas; Schick, Fritz; Ernemann, Ulrike

2011-01-01

Objective Brain perfusion can be assessed non-invasively by modern arterial spin labeling MRI. The FAIR (flow-sensitive alternating inversion recovery)-TrueFISP (true fast imaging in steady precession) technique was applied for regional assessment of cerebral blood flow in brain areas close to the skull base, since this approach provides low sensitivity to magnetic susceptibility effects. The investigation of the rhinal cortex and the amygdala is a potentially important feature for the diagnosis and research on dementia in its early stages. Materials and Methods Twenty-three subjects with no structural or psychological impairment were investigated. FAIR-True-FISP quantitative perfusion data were evaluated in the amygdala on both sides and in the pons. A preparation of the radiofrequency FOCI (frequency offset corrected inversion) pulse was used for slice selective inversion. After a time delay of 1.2 sec, data acquisition began. Imaging slice thickness was 5 mm and inversion slab thickness for slice selective inversion was 12.5 mm. Image matrix size for perfusion images was 64 × 64 with a field of view of 256 × 256 mm, resulting in a spatial resolution of 4 × 4 × 5 mm. Repetition time was 4.8 ms; echo time was 2.4 ms. Acquisition time for the 50 sets of FAIR images was 6:56 min. Data were compared with perfusion data from the literature. Results Perfusion values in the right amygdala, left amygdala and pons were 65.2 (± 18.2) mL/100 g/minute, 64.6 (± 21.0) mL/100 g/minute, and 74.4 (± 19.3) mL/100 g/minute, respectively. These values were higher than formerly published data using continuous arterial spin labeling but similar to 15O-PET (oxygen-15 positron emission tomography) data. Conclusion The FAIR-TrueFISP approach is feasible for the quantitative assessment of perfusion in the amygdala. Data are comparable with formerly published data from the literature. The applied technique provided excellent image quality, even for brain regions located at the skull base in the vicinity of marked susceptibility steps. PMID:21927556

[Technical recommendations and best practice guidelines for May-Grünwald-Giemsa staining: literature review and insights from the quality assurance].

PubMed

Piaton, Eric; Fabre, Monique; Goubin-Versini, Isabelle; Bretz-Grenier, Marie-Françoise; Courtade-Saïdi, Monique; Vincent, Serge; Belleannée, Geneviève; Thivolet, Françoise; Boutonnat, Jean; Debaque, Hervé; Fleury-Feith, Jocelyne; Vielh, Philippe; Cochand-Priollet, Béatrix; Egelé, Caroline; Bellocq, Jean-Pierre; Michiels, Jean-François

2015-08-01

May-Grünwald-Giemsa (MGG) stain is a Romanowsky-type, polychromatic stain as those of Giemsa, Leishman and Wright. Apart being the reference method of haematology, it has become a routine stain of diagnostic cytopathology for the study of air-dried preparations (lymph node imprints, centrifuged body fluids and fine needle aspirations). In the context of their actions of promoting the principles of quality assurance in cytopathology, the French Association for Quality Assurance in Anatomic and Cytologic Pathology (AFAQAP) and the French Society of Clinical Cytology (SFCC) conducted a proficiency test on MGG stain in 2013. Results from the test, together with the review of literature data allow pre-analytical and analytical steps of MGG stain to be updated. Recommendations include rapid air-drying of cell preparations/imprints, fixation using either methanol or May-Grünwald alone for 3-10minutes, two-step staining: 50% May-Grünwald in buffer pH 6.8 v/v for 3-5minutes, followed by 10% buffered Giemsa solution for 10-30minutes, and running water for 1-3minutes. Quality evaluation must be performed on red blood cells (RBCs) and leukocytes, not on tumour cells. Under correct pH conditions, RBCs must appear pink-orange (acidophilic) or buff-coloured, neither green nor blue. Leukocyte cytoplasm must be almost transparent, with clearly delineated granules. However, staining may vary somewhat and testing is recommended for automated methods (slide stainers) which remain the standard for reproducibility. Though MGG stain remains the reference stain, Diff-Quik(®) stain can be used for the rapid evaluation of cell samples. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

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.

Effects of a multicomponent exercise program in institutionalized elders with Alzheimer's disease.

PubMed

Sampaio, Arnaldina; Marques, Elisa A; Mota, Jorge; Carvalho, Joana

2016-10-18

This study examined the effect of a Multicomponent Training (MT) intervention on cognitive function, functional fitness and anthropometric variables in institutionalized patients with Alzheimer's disease (AD). Thirty-seven institutionalized elders (84.05 ± 5.58 years) clinically diagnosed with AD (mild and moderate stages) were divided into two groups: Experimental Group (EG, n = 19) and Control Group (CG, n = 18). The EG participated in a six-month supervised MT program (aerobic, muscular resistance, flexibility and postural exercises) of 45-55 minutes/session, twice/week. Cognitive function (MMSE), physical fitness (Senior Fitness Test) and anthropometric variables (Body Mass Index and Waist Circumference), were assessed before (M1), after three months (M2) and after six months (M3) of the experimental protocol. A two-way ANOVA, with repeated measures, revealed significant group and time interactions on cognitive function, chair stand, arm curl, 2-min step, 8-foot up-and-go (UG), chair sit-and-reach (CSR) and back scratch tests as well as waist circumference. Accordingly, for those variables a different response in each group was evident over the time, supported by a significantly better EG performance in chair stand, arm curl, 2-min step, UG, CSR and back scratch tests from M1 to M3, and a significant increase in MMSE from M1 to M2. The CG's performance decreased over time (M1 to M3) in chair stand, arm curl, 2-min step, UG, CSR, back scratch and MMSE. Results suggest that MT programs may be an important non-pharmacological strategy to improve physical and cognitive functions in institutionalized AD patients. © The Author(s) 2016.

The importance of daily physical activity for improved exercise tolerance in heart failure patients with limited access to centre-based cardiac rehabilitation.

PubMed

Sato, Noriaki; Origuchi, Hideki; Yamamoto, Umpei; Takanaga, Yasuhiro; Mohri, Masahiro

2012-09-01

Supervised cardiac rehabilitation provided at dedicated centres ameliorates exercise intolerance in patients with chronic heart failure. To correlate the amount of physical activity outside the hospital with improved exercise tolerance in patients with limited access to centre-based programs. Forty patients (median age 69 years) with stable heart failure due to systolic left ventricular dysfunction participated in cardiac rehabilitation once per week for five months. Using a validated single-axial accelerometer, the number of steps and physical activity-related energy expenditures on nonrehabilitation days were determined. Median (interquartile range) peak oxygen consumption was increased from 14.4 mL/kg/min (range 12.9 mL/kg/min to 17.8 mL/kg/min) to 16.4 mL/kg/min (range 13.9 mL/kg/min to 19.1 mL/kg/min); P<0.0001, in association with a decreased slope of the minute ventilation to carbon dioxide production plot (34.2 [range 31.3 to 38.1] versus 32.7 [range 30.3 to 36.5]; P<0.0001). Changes in peak oxygen consumption were correlated with the daily number of steps (P<0.01) and physical activity-related energy expenditures (P<0.05). Furthermore, these changes were significantly correlated with total exercise time per day and time spent for light (≤3 metabolic equivalents) exercise, but not with time spent for moderate/vigorous (>3 metabolic equivalents) exercise. The number of steps and energy expenditures outside the hospital were correlated with improved exercise capacity. An accelerometer may be useful for guiding home-based cardiac rehabilitation.

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.

Relationships between heart rate target determined in different exercise testing in COPD patients to prescribed with individualized exercise training.

PubMed

Fabre, Claudine; Chehere, Baptiste; Bart, Frédéric; Mucci, Patrick; Wallaert, Benoit; Grosbois, Jean Marie

2017-01-01

It has been scientifically proven that pulmonary rehabilitation improves exercise tolerance and facilitates the carrying out of daily physical activities. To optimize the physical and physiological benefits, it is necessary to individualize the training intensity for each patient. The aim of this study is to compare the heart rate (HR) responses to three exercise modalities measuring aerobic fitness in chronic obstructive pulmonary disease patients, in order to easily prescribe individual target HRs for endurance training. Fifty COPD patients (mean age: 60.1±8.5 years) were included in the study. Each patient carried out a cardiopulmonary exercise test, a 6-minute walk test (6MWT) and a 6-minute stepper test (6MST). During these tests, HR was recorded continuously. After the cardiopulmonary exercise test, the HR was noted at the ventilatory threshold (VT) and at the end of the two exercise field tests (6MWT peak and 6MST peak ). The values of the HR during the last 3 minutes of both field tests were averaged (6MWT 456 and 6MST 456 ). Finally, the HR at 60% of the HR reserve was calculated with the values of the HR measured during 6MWT and 6MST (HRr 60%walk , HRr 60%step ). The HRs measured during the 6MST were significantly higher than those measured during the 6MWT. The HRr 60%step was not significantly different from 6MWT 456 and 6MWT peak HR ( P =0.51; P =0.48). A significant correlation was observed between 6MWT 456 and 6MWT peak ( r =0.58). The 6MWT 456 and 6MWT peak HR were correlated with HRr 60%step ( r =0.68 and r =0.62). The VT could be determined in 28 patients. The HR VT was not different from 6MWT 456 , 6MWT peak , and HRr 60%step ( P =0.57, P =0.41 and P =0.88) and was correlated to 6MWT 456 , 6MWT peak , and HRr 60%step ( r =0.45, r =0.40, r =0.48). An individualized target HR for endurance training can be prescribed from the HR measured during routine tests, such as 6MWT or 6MST.

Relationships between heart rate target determined in different exercise testing in COPD patients to prescribed with individualized exercise training

PubMed Central

Fabre, Claudine; Chehere, Baptiste; Bart, Frédéric; Mucci, Patrick; Wallaert, Benoit; Grosbois, Jean Marie

2017-01-01

Background It has been scientifically proven that pulmonary rehabilitation improves exercise tolerance and facilitates the carrying out of daily physical activities. To optimize the physical and physiological benefits, it is necessary to individualize the training intensity for each patient. The aim of this study is to compare the heart rate (HR) responses to three exercise modalities measuring aerobic fitness in chronic obstructive pulmonary disease patients, in order to easily prescribe individual target HRs for endurance training. Patients and method Fifty COPD patients (mean age: 60.1±8.5 years) were included in the study. Each patient carried out a cardiopulmonary exercise test, a 6-minute walk test (6MWT) and a 6-minute stepper test (6MST). During these tests, HR was recorded continuously. After the cardiopulmonary exercise test, the HR was noted at the ventilatory threshold (VT) and at the end of the two exercise field tests (6MWTpeak and 6MSTpeak). The values of the HR during the last 3 minutes of both field tests were averaged (6MWT456 and 6MST456). Finally, the HR at 60% of the HR reserve was calculated with the values of the HR measured during 6MWT and 6MST (HRr60%walk, HRr60%step). Results The HRs measured during the 6MST were significantly higher than those measured during the 6MWT. The HRr60%step was not significantly different from 6MWT456 and 6MWTpeak HR (P=0.51; P=0.48). A significant correlation was observed between 6MWT456 and 6MWTpeak (r=0.58). The 6MWT456 and 6MWTpeak HR were correlated with HRr60%step (r=0.68 and r=0.62). The VT could be determined in 28 patients. The HRVT was not different from 6MWT456, 6MWTpeak, and HRr60%step (P=0.57, P=0.41 and P=0.88) and was correlated to 6MWT456, 6MWTpeak, and HRr60%step (r=0.45, r=0.40, r=0.48). Conclusion An individualized target HR for endurance training can be prescribed from the HR measured during routine tests, such as 6MWT or 6MST. PMID:28553100

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.

[Ladder step strategy for surgical repair of congenital concealed penis in children].

PubMed

Wang, Fu-Ran; Zhong, Hong-Ji; Chen, Yi; Zhao, Jun-Feng; Li, Yan

2016-11-01

To assess the feasibility of the ladder step strategy in surgical repair of congenital concealed penis in children. This study included 52 children with congenital concealed penis treated in the past two years by surgical repair using the ladder step strategy, which consists of five main steps: cutting the narrow ring of the foreskin, degloving the penile skin, fixing the penile skin at the base, covering the penile shaft, and reshaping the prepuce. The perioperative data of the patients were prospectively collected and statistically described. Of the 52 patients, 20 needed remodeling of the frenulum and 27 received longitudinal incision in the penoscrotal junction to expose and deglove the penile shaft. The advanced scrotal flap technique was applied in 8 children to cover the penile shaft without tension, the pedicled foreskin flap technique employed in 11 to repair the penile skin defect, and excision of the webbed skin of the ventral penis performed in another 44 to remodel the penoscrotal angle. The operation time, blood loss, and postoperative hospital stay were 40－100 minutes, 5－30 ml, and 3－6 days, respectively. Wound bleeding and infection occurred in 1 and 5 cases, respectively. Follow-up examinations at 3 and 6 months after surgery showed that all the children had a satisfactory penile appearance except for some minor complications (2 cases of penile retraction, 2 cases of redundant ventral skin, and 1 case of iatrogenic penile curvature). The ladder step strategy for surgical repair of congenital concealed penis in children is a simple procedure with minor injury and satisfactory appearance of the penis.

Number of Nanoparticles per Cell through a Spectrophotometric Method - A key parameter to Assess Nanoparticle-based Cellular Assays.

PubMed

Unciti-Broceta, Juan D; Cano-Cortés, Victoria; Altea-Manzano, Patricia; Pernagallo, Salvatore; Díaz-Mochón, Juan J; Sánchez-Martín, Rosario M

2015-05-15

Engineered nanoparticles (eNPs) for biological and biomedical applications are produced from functionalised nanoparticles (NPs) after undergoing multiple handling steps, giving rise to an inevitable loss of NPs. Herein we present a practical method to quantify nanoparticles (NPs) number per volume in an aqueous suspension using standard spectrophotometers and minute amounts of the suspensions (up to 1 μL). This method allows, for the first time, to analyse cellular uptake by reporting NPs number added per cell, as opposed to current methods which are related to solid content (w/V) of NPs. In analogy to the parameter used in viral infective assays (multiplicity of infection), we propose to name this novel parameter as multiplicity of nanofection.

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.

Physiotherapy, based on the Bobath concept, may influence the gait pattern in persons with limb-girdle muscle dystrophy: a multiple case series study.

PubMed

Oygard, Kjellaug; Haestad, Helge; Jørgensen, Lone

2011-03-01

 There are few studies on possible effects of physiotherapy for adults with muscular dystrophy. The aim of this study was to examine if treatment based on the Bobath concept may influence specific gait parameters in some of these patients.   A single-subject experimental design with A-B-A-A phases was used, and four patients, three with limb-girdle muscular dystrophy (LGMD) and one with fascioscapulohumeral muscular dystrophy (FSHD), were included. The patients had 1 hour of individually tailored physiotherapy at each working day for a period of 3 weeks. Step length, step width and gait velocity were measured during the A-B-A-A phases by use of an electronic walkway. Walking distance and endurance were measured by use of the '6 minute walk test'.  . The three LGMD patients, who initially walked with a wide base of support, had a narrower, velocity-adjusted step width after treatment, accompanied with the same or even longer step length. These changes lasted throughout follow-up. Moreover, two of the patients were able to walk a longer distance within 6 minutes after the treatment period. The fourth patient (with FSHD) had a normal step width at baseline, which did not change during the study.   The results indicate that physiotherapy treatment based on the Bobath concept may influence the gait pattern in patients with LGMD. However, in order to evaluate the effectiveness of physiotherapy to patients with muscular dystrophies, we call for larger studies and controlled trials. Copyright © 2010 John Wiley & Sons, Ltd.

Lubiprostone neither decreases gastric and small-bowel transit time nor improves visualization of small bowel for capsule endoscopy: a double-blind, placebo-controlled study.

PubMed

Hooks, S Bennett; Rutland, Travis J; Di Palma, Jack A

2009-11-01

Lubiprostone, a selective activator of type 2 chloride channels, is approved for treatment of chronic idiopathic constipation and recently constipation-predominant irritable bowel syndrome. It has been suggested that lubiprostone has a prokinetic effect. This investigation was designed to evaluate lubiprostone as a preparation and propulsive agent for small-bowel capsule endoscopy. The PillCam Small Bowel capsule endoscopy system with the PillCam SB1 capsule and Rapid 5 software platform were used. The study was designed as a double-blind, placebo-controlled trial. Forty healthy adults. Gastric transit time (GTT), small-bowel transit time (SBTT), and adequacy of small-bowel cleansing preparation. The study subjects received 24 mug lubiprostone or placebo 30 minutes before PillCam capsule ingestion. Capsule endoscopy studies were read by 2 independent investigators unaware of the study medication received, and differences in interpretation were resolved by consensus. Anatomical landmarks were identified, and GTT and SBTT were calculated. Overall preparation quality assessment of the proximal, mid, and distal small bowel was determined by using a 4-step scale. The percentage of visualized bowel was determined by review of 10-minute video segments at 1-hour intervals after the capsule passed through the pylorus. In the lubiprostone group (n = 20), 2 subjects did not pass the capsule through the pylorus in the 8-hour battery life of the capsule. An additional 3 capsules did not pass into the colon. In the placebo group (n = 20), all capsules passed into the small bowel, but 1 did not pass into the colon. The subjects in whom the capsule did not pass into the small bowel were excluded from the small-bowel analysis. In the subjects in whom the capsule did reach the colon, the SBTT could not be calculated and they were excluded from SBTT analysis. The mean GTT in the lubiprostone group was 126 minutes and 43 minutes in the placebo group (P = .0095). The mean SBTT in the lubiprostone group was 188 minutes and 219 minutes in the placebo group (P = .130). The overall preparation assessment of the small bowel was not statistically significant between the 2 groups in the proximal, mid, or distal small bowel (proximal, P = .119; mid, P = .118; distal, P = .121). There was no significant difference in lubiprostone compared with placebo in the percentage of visualized small bowel. Some capsules did not leave the stomach or reach the cecum. Lubiprostone produced a significant increase in GTT but did not result in a significant decrease in SBTT compared with placebo. The administration of lubiprostone before capsule ingestion did not result in improved overall preparation of the small bowel for capsule endoscopy or increase the percentage of visualized small bowel. (The trial was registered at www.clinicaltrials.gov, identifier NCT00746395.).

New NASA 3D Animation Shows Seven Days of Simulated Earth Weather

NASA Image and Video Library

2014-08-11

This visualization shows early test renderings of a global computational model of Earth's atmosphere based on data from NASA's Goddard Earth Observing System Model, Version 5 (GEOS-5). This particular run, called Nature Run 2, was run on a supercomputer, spanned 2 years of simulation time at 30 minute intervals, and produced Petabytes of output. The visualization spans a little more than 7 days of simulation time which is 354 time steps. The time period was chosen because a simulated category-4 typhoon developed off the coast of China. The 7 day period is repeated several times during the course of the visualization. Credit: NASA's Scientific Visualization Studio Read more or download here: svs.gsfc.nasa.gov/goto?4180 NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

Interventions to increase physical activity in middle-age women at the workplace: a randomized controlled trial.

PubMed

Ribeiro, Marcos Ausenka; Martins, Milton Arruda; Carvalho, Celso R F

2014-01-01

A four-group randomized controlled trial evaluated the impact of distinct workplace interventions to increase the physical activity (PA) and to reduce anthropometric parameters in middle-age women. One-hundred and ninety-five women age 40-50 yr who were employees from a university hospital and physically inactive at their leisure time were randomly assigned to one of four groups: minimal treatment comparator (MTC; n = 47), pedometer-based individual counseling (PedIC; n = 53), pedometer-based group counseling (PedGC; n = 48), and aerobic training (AT; n = 47). The outcomes were total number of steps (primary outcome), those performed at moderate intensity (≥ 110 steps per minute), and weight and waist circumference (secondary outcomes). Evaluations were performed at baseline, at the end of a 3-month intervention, and 3 months after that. Data were presented as delta [(after 3 months-baseline) or (after 6 months-baseline)] and 95% confidence interval. To detect the differences among the groups, a one-way ANOVA and a Holm-Sidak post hoc test was used (P < 0.05). The Cohen effect size was calculated, and an intention-to-treat approach was performed. Only groups using pedometers (PedIC and PedGC) increased the total number of steps after 3 months (P < 0.05); however, the increase observed in PedGC group (1475 steps per day) was even higher than that in PedIC (512 steps per day, P < 0.05) with larger effect size (1.4). The number of steps performed at moderate intensity also increased only in the PedGC group (845 steps per day, P < 0.05). No PA benefit was observed at 6 months. Women submitted to AT did not modify PA daily life activity but reduced anthropometric parameters after 3 and 6 months (P < 0.05). Our results show that in the workplace setting, pedometer-based PA intervention with counseling is effective increasing daily life number of steps, whereas AT is effective for weight loss.

Solar magnetic field studies using the 12 micron emission lines. I - Quiet sun time series and sunspot slices

NASA Technical Reports Server (NTRS)

Deming, Drake; Boyle, Robert J.; Jennings, Donald E.; Wiedemann, Gunter

1988-01-01

The use of the extremely Zeeman-sensitive IR emission line Mg I, at 12.32 microns, to study solar magnetic fields. Time series observations of the line in the quiet sun were obtained in order to determine the response time of the line to the five-minute oscillations. Based upon the velocity amplitude and average period measured in the line, it is concluded that it is formed in the temperature minimum region. The magnetic structure of sunspots is investigated by stepping a small field of view in linear 'slices' through the spots. The region of penumbral line formation does not show the Evershed outflow common in photospheric lines. The line intensity is a factor of two greater in sunspot penumbrae than in the photosphere, and at the limb the penumbral emission begins to depart from optical thinness, the line source function increasing with height. For a spot near disk center, the radial decrease in absolute magnetic field strength is steeper than the generally accepted dependence.

Single-Shot X-Ray Phase-Contrast Computed Tomography with Nonmicrofocal Laboratory Sources

NASA Astrophysics Data System (ADS)

Diemoz, P. C.; Hagen, C. K.; Endrizzi, M.; Minuti, M.; Bellazzini, R.; Urbani, L.; De Coppi, P.; Olivo, A.

2017-04-01

We present a method that enables performing x-ray phase-contrast imaging (XPCI) computed tomography with a laboratory setup using a single image per projection angle, eliminating the need to move optical elements during acquisition. Theoretical derivation of the method is presented, and its validity conditions are provided. The object is assumed to be quasihomogeneous, i.e., to feature a ratio between the refractive index and the linear attenuation coefficient that is approximately constant across the field of view. The method is experimentally demonstrated on a plastics phantom and on biological samples using a continuous rotation acquisition scheme achieving scan times of a few minutes. Moreover, we show that such acquisition times can be further reduced with the use of a high-efficiency photon-counting detector. Thanks to its ability to substantially simplify the image-acquisition procedure and greatly reduce collection times, we believe this method represents a very important step towards the application of XPCI to real-world problems.

The effects of core stabilization exercise on dynamic balance and gait function in stroke patients.

PubMed

Chung, Eun-Jung; Kim, Jung-Hee; Lee, Byoung-Hee

2013-07-01

[Purpose] The purpose of this study was to determine the effects of core stabilization exercise on dynamic balance and gait function in stroke patients. [Subjects] The subjects were 16 stroke patients, who were randomly divided into two groups: a core stabilization exercise group of eight subjects and control group of eight subjects. [Methods] Subjects in both groups received general training five times per week. Subjects in the core stabilization exercise group practiced an additional core stabilization exercise program, which was performed for 30 minutes, three times per week, during a period of four weeks. All subjects were evaluated for dynamic balance (Timed Up and Go test, TUG) and gait parameters (velocity, cadence, step length, and stride length). [Results] Following intervention, the core exercise group showed a significant change in TUG, velocity, and cadence. The only significant difference observed between the core group and control group was in velocity. [Conclusion] The results of this study suggest the feasibility and suitability of core stabilization exercise for stroke patients.

Rapidly Characterizing the Fast Dynamics of RNA Genetic Circuitry with Cell-Free Transcription–Translation (TX-TL) Systems

PubMed Central

2014-01-01

RNA regulators are emerging as powerful tools to engineer synthetic genetic networks or rewire existing ones. A potential strength of RNA networks is that they may be able to propagate signals on time scales that are set by the fast degradation rates of RNAs. However, a current bottleneck to verifying this potential is the slow design-build-test cycle of evaluating these networks in vivo. Here, we adapt an Escherichia coli-based cell-free transcription-translation (TX-TL) system for rapidly prototyping RNA networks. We used this system to measure the response time of an RNA transcription cascade to be approximately five minutes per step of the cascade. We also show that this response time can be adjusted with temperature and regulator threshold tuning. Finally, we use TX-TL to prototype a new RNA network, an RNA single input module, and show that this network temporally stages the expression of two genes in vivo. PMID:24621257

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.

The Misgav Ladach method: a step forward in the operative technique of caesarean section.

PubMed

Poonam; Banerjee, B; Singh, S N; Raina, A

2006-01-01

Caesarean delivery remains the most common intraperitoneal surgical procedure in obstetric and gynaecologic practice. Since time immemorial there have been countless efforts to improve the technique of caesarean section. One such innovative breakthrough technique is the Misgav Ladach method of caesarean of section. The objective of this trial was to compare the intraoperative and short-term postoperative outcomes between the conventional and the Misgav-Ladach technique for caesarean section. The randomized prospective comparative study was carried out in the department of Obstetrics and Gynaecology, B.P Koirala Institute of Health Sciences, Dharan Nepal. Four hundred patients were randomized to either Misgav Ladach or the Conventional method of caesarean section. Only term pregnancies with singleton foetuses' were included whereas pregnancies with previous caesarean section were excluded from the study. The study period was from September 2001 to September 2004. There was not much difference in the demographic variables between the two groups. The age of the patients ranged between 18-40 years. The mean age of patients in Misgav Ladach and conventional group was 24.5 and 23.6 years respectively. Foetal distress was the commonest indication for caesarean section followed by non progress of labour. The mean incision to delivery interval, operating time and blood loss in the Misgav Ladach group was 1 minute 30 seconds, 16 minutes and 35 0ml as compared to 3 minutes, 28 minutes and 600 ml in the conventional group respectively. 3.5%of patients in the Misgav Ladach group showed febrile morbidity as compared to 7% in the conventional group. 19% from conventional group and only 4%from Misgav Ladach group required added analgesia. Almost equal number of patients (10-12) in each group experienced significant headache.).0.1%in the Misgav group and 5% in the Conventional group required post operative blood transfusion. Four patients from the conventional group had their wound gaped. The number of neonates requiring intensive care was sixteen (8% ) in the conventional group and 3 (1.5%) in the Misgav group.6.5% from conventional group and 2% from Misgav Ladach group required maternal intensive care admissions. Misgav-Ladach technique has been be associated with shorter operative time, quicker recovery, and lesser need for postoperative medications, when compared with traditional caesarean section. It has also been shown to be more cost-effective. A further advantage of the technique may be the shorter time taken for the delivery of the child.

In vitro sterilization technique on embryo of black Toraja rice

NASA Astrophysics Data System (ADS)

Haring, F.; Riadi, M.; Rafiuddin; Sjahril, R.; Muchlis, A. R.

2018-05-01

Toraja black rice has a high anthocyanin content, a water-soluble pigments, with antioxidant activity. Toraja black rice has a variety of seeds colour in one panicles such as full black (the outside and inside the rice), medium black (the outside and slightly inside rice) and a little black (only the outside of rice). Embryo culture in vitro is one way to grow plants in sterile conditions. The presence of contamination and the death of the embryo require in vitro embryo culture. The sterilization technique is a very important first step to eliminate contamination and the death of embryos. This research aims to determine the right material composition for sterilization of black rice’s embryo. The experiment was done by growing black rice on half strength MS media with the treatment of three method of sterilization, i.e.: S1 (70% alcohol for 5 minutes, 3% and 2% Chlorox each for 10 minutes,), S2 (70% alcohol for 3 minutes, 2% Clorox for 10 minutes) and S3 (70% alcohol for 3 minutes and 1% Clorox for 15 minutes). The materials used are rice seedlings that have been cut in two and opened the pericarp of paddy grain, leaving a piece of rice that has a complete embryo. The best sterilization for Toraja black rice embryo culture was using the S3 composition. Best germination was seen on the seeds with full and medium black color.

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.

Laboratory Layered Latte

NASA Astrophysics Data System (ADS)

Xue, Nan; Khodaparast, Sepideh; Zhu, Lailai; Nunes, Janine; Kim, Hyoungsoo; Stone, Howard

2017-11-01

Layered composite fluids are sometimes observed in confined systems of rather chaotic initial states, for example, layered lattes formed by pouring espresso into a glass of warm milk. In such configurations, pouring forces a lower density liquid (espresso) into a higher density ambient, which is similar to the fountain effects that characterize a wide range of flows driven by injecting a fluid into a second miscible phase. Although the initial state of the mixture is complex and chaotic, there are conditions where the mixture cools at room temperature and exhibits an organized layered pattern. Here we report controlled experiments injecting a fluid into a miscible phase and show that, above a critical injection velocity, layering naturally emerges over the time scale of minutes. We perform experimental and numerical analyses of the time-dependent flows to observe and understand the convective circulation in the layers. We identify critical conditions to produce the layering and relate the results quantitatively to the critical Rayleigh number in double-diffusive convection, which indicates the competition between the horizontal thermal gradient and the vertical density gradient generated by the fluid injection. Based on this understanding, we show how to employ this single-step process to produce layered structures in soft materials, where the local elastic properties as well as the local material concentration vary step-wise along the length of the material.

Temporary Stabilization with External Fixator in 'Tripolar' Configuration in Two Steps Treatment of Tibial Pilon Fractures.

PubMed

Daghino, Walter; Messina, Marco; Filipponi, Marco; Alessandro, Massè

2016-01-01

The tibial pilon fractures represent a complex therapeutic problem for the orthopedic surgeon, given the frequent complications and outcomes disabling. The recent medical literature indicates that the best strategy to reduce amount of complications in tibial pilon fractures is two-stages procedure. We describe our experience in the primary stabilization of these fractures. We treated 36 cases with temporary external fixation in a simple configuration, called "tripolar": this is an essential structure (only three screws and three rods), that is possible to perform even without the availability of X-rays and with simple anesthesia or sedation. We found a sufficient mechanical stability for the nursing post-operative, in absence of intraoperative and postoperative problems. The time between trauma and temporary stabilization ranged between 3 and 144 hours; surgical average time was 8.4 minutes. Definitive treatment was carried out with a delay of a minimum of 4 and a maximum of 15 days from the temporary stabilization, always without problems, both in case of ORIF (open reduction, internal fixation) or circular external fixation. Temporary stabilization with external fixator in 'tripolar' configuration seems to be the most effective strategy in two steps treatment of tibial pilon fractures. These preliminary encouraging results must be confirmed by further studies with more cases.

Degradation of bromothymol blue by 'greener' nano-scale zero-valent iron synthesized using tea polyphenols

EPA Science Inventory

A green single-step synthesis of iron nanoparticles using tea (Camellia sinensis) polyphenols is described that uses no added surfactants/polymers as a capping or reducing agents. The expeditious reaction between polyphenols and ferric nitrate occurs within few minutes at room te...

Minute Man National Historical Park Boundary Revision Act

THOMAS, 111th Congress

Rep. Tsongas, Niki [D-MA-5

2009-01-08

House - 02/04/2009 Referred to the Subcommittee on National Parks, Forests and Public Lands. (All Actions) Notes: For further action, see H.R.146, which became Public Law 111-11 on 3/30/2009. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

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.

Adaptive goal setting and financial incentives: a 2 × 2 factorial randomized controlled trial to increase adults' physical activity.

PubMed

Adams, Marc A; Hurley, Jane C; Todd, Michael; Bhuiyan, Nishat; Jarrett, Catherine L; Tucker, Wesley J; Hollingshead, Kevin E; Angadi, Siddhartha S

2017-03-29

Emerging interventions that rely on and harness variability in behavior to adapt to individual performance over time may outperform interventions that prescribe static goals (e.g., 10,000 steps/day). The purpose of this factorial trial was to compare adaptive vs. static goal setting and immediate vs. delayed, non-contingent financial rewards for increasing free-living physical activity (PA). A 4-month 2 × 2 factorial randomized controlled trial tested main effects for goal setting (adaptive vs. static goals) and rewards (immediate vs. delayed) and interactions between factors to increase steps/day as measured by a Fitbit Zip. Moderate-to-vigorous PA (MVPA) minutes/day was examined as a secondary outcome. Participants (N = 96) were mainly female (77%), aged 41 ± 9.5 years, and all were insufficiently active and overweight/obese (mean BMI = 34.1 ± 6.2). Participants across all groups increased by 2389 steps/day on average from baseline to intervention phase (p < .001). Participants receiving static goals showed a stronger increase in steps per day from baseline phase to intervention phase (2630 steps/day) than those receiving adaptive goals (2149 steps/day; difference = 482 steps/day, p = .095). Participants receiving immediate rewards showed stronger improvement (2762 step/day increase) from baseline to intervention phase than those receiving delayed rewards (2016 steps/day increase; difference = 746 steps/day, p = .009). However, the adaptive goals group showed a slower decrease in steps/day from the beginning of the intervention phase to the end of the intervention phase (i.e. less than half the rate) compared to the static goals group (-7.7 steps vs. -18.3 steps each day; difference = 10.7 steps/day, p < .001) resulting in better improvements for the adaptive goals group by study end. Rate of change over the intervention phase did not differ between reward groups. Significant goal phase x goal setting x reward interactions were observed. Adaptive goals outperformed static goals (i.e., 10,000 steps) over a 4-month period. Small immediate rewards outperformed larger, delayed rewards. Adaptive goals with either immediate or delayed rewards should be preferred for promoting PA. ClinicalTrials.gov ID: NCT02053259 registered prospectively on January 31, 2014.

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

Morphological and chemical characteristics of different titanium surfaces treated by bicarbonate and glycine powder air abrasive systems.

PubMed

Menini, Maria; Piccardo, Paolo; Baldi, Domenico; Dellepiane, Elena; Pera, Paolo

2015-02-01

This in vitro study investigated possible morphological and chemical changes induced by glycine or sodium bicarbonate powder air polishing on machined and acid-etched titanium surfaces. The glycine powder (granulometry <65 μm) and sodium bicarbonate powder (granulometry <150 μm) were applied on 2 machined healing abutments and on 2 acid-etched healing abutments. The samples were characterized by scanning electron microscopy coupled with energy dispersive x-ray spectroscopy. The analyses were performed at different steps: (1) as received, right after opening the abutment packaging; (2) after 20 minutes air exposure; (3) after aging in artificial saliva; (4) after glycine or sodium bicarbonate powder air polishing for 5 seconds; (5) after repetition of steps 3 and 4 with longer time of polishing (20 seconds). Air polishing using glycine and sodium bicarbonate powder seemed to be safe for professional oral hygiene of titanium dental implants, although acid-etched abutments and abutments treated with bicarbonate harbored more salts. This might indicate a greater plaque accumulation in a clinical situation. However, this result has to be investigated in vivo to understand its clinical relevance.

The Effects of Augmented Reality-based Otago Exercise on Balance, Gait, and Falls Efficacy of Elderly Women.

PubMed

Yoo, Ha-Na; Chung, Eunjung; Lee, Byoung-Hee

2013-07-01

[Purpose] The purpose of this study was to determine the effects of augmented reality-based Otago exercise on balance, gait, and falls efficacy of elderly women. [Subjects] The subjects were 21 elderly women, who were randomly divided into two groups: an augmented reality-based Otago exercise group of 10 subjects and an Otago exercise group of 11 subjects. [Methods] All subjects were evaluated for balance (Berg Balance Scale, BBS), gait parameters (velocity, cadence, step length, and stride length), and falls efficacy. Within 12 weeks, Otago exercise for muscle strengthening and balance training was conducted three times, for a period of 60 minutes each, and subjects in the experimental group performed augmented reality-based Otago exercise. [Results] Following intervention, the augmented reality-based Otago exercise group showed significant increases in BBS, velocity, cadence, step length (right side), stride length (right side and left side) and falls efficacy. [Conclusion] The results of this study suggest the feasibility and suitability of this augmented reality-based Otago exercise for elderly women.

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 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

Performance-Based Measures Associate With Frailty in Patients With End-Stage Liver Disease.

PubMed

Lai, Jennifer C; Volk, Michael L; Strasburg, Debra; Alexander, Neil

2016-12-01

Physical frailty, as measured by the Fried Frailty Index, is increasingly recognized as a critical determinant of outcomes in patients with cirrhosis. However, its utility is limited by the inclusion of self-reported components. We aimed to identify performance-based measures associated with frailty in patients with cirrhosis. Patients with cirrhosis, aged 50 years or older, underwent: 6-minute walk test (cardiopulmonary endurance), chair stands in 30 seconds (muscle endurance), isometric knee extension (lower extremity strength), unipedal stance time (static balance), and maximal step length (dynamic balance/coordination). Linear regression associated each physical performance test with frailty. Principal components exploratory factor analysis evaluated the interrelatedness of frailty and the 5 physical performance tests. Of 40 patients with cirrhosis, with a median age of 64 years and Model for End-stage Liver Disease (MELD) MELD of 12.10 (25%) were frail by Fried Frailty Index ≥3. Frail patients with cirrhosis had poorer performance in 6-minute walk test distance (231 vs 338 m), 30-second chair stands (7 vs 10), isometric knee extension (86 vs 122 Newton meters), and maximal step length (22 vs 27 in. (P ≤ 0.02 for each). Each physical performance test was significantly associated with frailty (P < 0.01), even after adjustment for MELD or hepatic encephalopathy. Principal component factor analysis demonstrated substantial, but unique, clustering of each physical performance test to a single factor-frailty. Frailty in cirrhosis is a multidimensional construct that is distinct from liver dysfunction and incorporates endurance, strength, and balance. Our data provide specific targets for prehabilitation interventions aimed at reducing frailty in patients with cirrhosis in preparation for liver transplantation.

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

BIOBEHAVIORAL PROGNOSTIC FACTORS IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE: Results from the INSPIRE-II Trial

PubMed Central

Blumenthal, James A.; Smith, Patrick J.; Durheim, Michael; Mabe, Stephanie; Emery, Charles F.; Martinu, Tereza; Diaz, Philip T.; Babyak, Michael; Welty-Wolf, Karen; Palmer, Scott

2015-01-01

Objective To examine the prognostic value of select biobehavioral factors in patients with chronic obstructive pulmonary disease (COPD) in a secondary analysis of participants from the INSPIRE-II trial. Methods Three hundred twenty six outpatients with COPD underwent assessments of pulmonary function, physical activity, body mass index, inflammation, pulmonary symptoms, depression, and pulmonary quality of life, and were followed for up to 5.4 years for subsequent clinical events. The prognostic value of each biobehavioral factor, considered individually and combined, also was examined in the context of existing Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2011 risk stratification. Results Sixty-nine individuals experienced a hospitalization or died over a mean follow-up time period of 2.4 (interquartile range = 1.6) years. GOLD classification was associated with an increased risk of clinical events (HR = 2.72 [95% CI 1.63, 4.54], per stage); Six Minute Walk (HR = 0.50 [0.34, 0.73] per 500 feet), total steps (HR = 0.82 [0.71, 0.94] per 1,000 steps), hsC-reactive protein (HR = 1.44 [1.01, 2.06] per 4.5 mg/L), depression (HR = 1.12 [1.01, 1.25] per 4 points), and pulmonary quality of life (HR = 1.73 [1.14, 2.63] per 25 points) were each predictive over and above the GOLD assessment. However, only GOLD group and Six Minute Walk were predictive of all-cause mortality and COPD hospitalization when all biobehavioral variables were included together in a multivariable model. Conclusion Biobehavioral factors provide added prognostic information over and above measures of COPD severity in predicting adverse events in patients with COPD. PMID:26780299

Doppler ultrasound-guided percutaneous nephrolithotomy with two-step tract dilation for management of complex renal stones.

PubMed

Xu, Youming; Wu, Zhonghua; Yu, Jianhua; Wang, Shulong; Li, Fang; Chen, Jiushun; Liu, Jin; Chen, Kan

2012-06-01

To report our experience and assess the safety and efficacy of Doppler ultrasound-guided percutaneous nephrolithotomy (PCNL) with 2-step tract dilation for complex renal stones. From March 2009 to February 2011, 262 patients underwent PCNL. Eighty-three patients had a complete and 105 had partial staghorn calculus, and 74 had a renal pelvic stone of >2 cm in diameter. Thirty-five patients had renal surgical history. Doppler ultrasound-guided PCNL with 2-step tract dilation were performed. Stones were fragmented and cleared using a combination of ultrasonic and pneumatic lithotripters. All PCNL procedures were successful. Successful access to the collecting system was 100%. Although most of the cases (231/262) were managed satisfactorily by a single tract, a second tract was used in 31 cases. Mean operation time was 56 minutes (range 25-145). The primary stone-free rate of PCNL was 80.9%. There were 39 auxiliary procedures (13 second PCNL and 26 extracorporeal shock wave lithotripsy). One month after treatment, the overall stone-free rate was 92.7%. Five patients (1.9%) received blood transfusion. Eight patients (3.1%) with a postoperative fever of ≥38.5°C were cured by intravenous antibiotics. No other severe complications occurred. The mean postoperative stay was 3.8 days (range 2-12). Doppler ultrasound-guided PCNL with 2-step tract dilation for complex renal stones is safe, effective, and worthy of wider use in clinical practice. Copyright © 2012 Elsevier Inc. All rights reserved.

Toward a practical template-based approach to semiquantitative SPECT myocardial perfusion imaging.

PubMed

Hughes, Tyler; Celler, Anna

2012-03-01

Our template-based quantitative perfusion single photon emission computed tomography (SPECT) method (T-QPS) performs semiquantitative analysis for myocardial perfusion imaging (MPI) without the use of normal databases. However, in its current form, T-QPS requires extensive calculations, which limits its clinical application. In the interest of clinical feasibility, the authors examine the trade-off between accuracy and processing time as the method is simplified. The T-QPS method uses the reconstructed SPECT image of the patient to create a 3D digital template of his∕her healthy heart. This template is then projected, reconstructed, and sampled into the bulls-eye map domain. A ratio of the patient and template images produces a final corrected image in which a threshold is applied to identify perfusion defects. In principle, the template should be constructed with the heart and all extracardiac activity, and the projection step should include primary and scatter components; however, this leads to lengthy calculations. In an attempt to shorten the processing time, the authors analyzed the performance of four template (T) generation methods: T(P-HRT), T(PS-HRT), T(P-HRTBKG), and T(PS-HRTBKG), where P and S represent primary and scattered photons included in the projection step, respectively; and HRT and HRTBKG represent template constructed with the heart only and the heart with background activity, respectively. Forty-eight thorax phantoms and 21 randomly selected patient studies were analyzed using each approach. All studies used GE's Infinia Hawkeye SPECT∕CT system and followed a standard cardiac acquisition protocol. Approximate processing times for the T(P-HRT), T(PS-HRT), T(P-HRTBKG), and T(PS-HRTBKG) methods were less than a minute, 2-3 h, less than a minute and 3-4 h, respectively. In both the simulation and patient studies, a significant reduction in the quality of perfusion defect definition was exhibited by the T(P-HRT) method relative to the other three methods. The optimal method with respect to perfusion defect definition and processing time was T(P-HRTBKG) with a sensitivity, specificity, and accuracy in spatially defining the perfusion defects (simulation study) of 80%, 84%, and 83%, respectively. The T-QPS method using T(P-HRTBKG) leads to accurate and fast semiquantitative analysis of SPECT MPI, without the use of normal databases.

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...

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