Frame Transmission Efficiency-Based Cross-Layer Congestion Notification Scheme in Wireless Ad Hoc Networks.

PubMed

He, Huaguang; Li, Taoshen; Feng, Luting; Ye, Jin

2017-07-15

Different from the traditional wired network, the fundamental cause of transmission congestion in wireless ad hoc networks is medium contention. How to utilize the congestion state from the MAC (Media Access Control) layer to adjust the transmission rate is core work for transport protocol design. However, recent works have shown that the existing cross-layer congestion detection solutions are too complex to be deployed or not able to characterize the congestion accurately. We first propose a new congestion metric called frame transmission efficiency (i.e., the ratio of successful transmission delay to the frame service delay), which describes the medium contention in a fast and accurate manner. We further present the design and implementation of RECN (ECN and the ratio of successful transmission delay to the frame service delay in the MAC layer, namely, the frame transmission efficiency), a general supporting scheme that adjusts the transport sending rate through a standard ECN (Explicit Congestion Notification) signaling method. Our method can be deployed on commodity switches with small firmware updates, while making no modification on end hosts. We integrate RECN transparently (i.e., without modification) with TCP on NS2 simulation. The experimental results show that RECN remarkably improves network goodput across multiple concurrent TCP flows.

A Bayesian ridge regression analysis of congestion's impact on urban expressway safety.

PubMed

Shi, Qi; Abdel-Aty, Mohamed; Lee, Jaeyoung

2016-03-01

With the rapid growth of traffic in urban areas, concerns about congestion and traffic safety have been heightened. This study leveraged both Automatic Vehicle Identification (AVI) system and Microwave Vehicle Detection System (MVDS) installed on an expressway in Central Florida to explore how congestion impacts the crash occurrence in urban areas. Multiple congestion measures from the two systems were developed. To ensure more precise estimates of the congestion's effects, the traffic data were aggregated into peak and non-peak hours. Multicollinearity among traffic parameters was examined. The results showed the presence of multicollinearity especially during peak hours. As a response, ridge regression was introduced to cope with this issue. Poisson models with uncorrelated random effects, correlated random effects, and both correlated random effects and random parameters were constructed within the Bayesian framework. It was proven that correlated random effects could significantly enhance model performance. The random parameters model has similar goodness-of-fit compared with the model with only correlated random effects. However, by accounting for the unobserved heterogeneity, more variables were found to be significantly related to crash frequency. The models indicated that congestion increased crash frequency during peak hours while during non-peak hours it was not a major crash contributing factor. Using the random parameter model, the three congestion measures were compared. It was found that all congestion indicators had similar effects while Congestion Index (CI) derived from MVDS data was a better congestion indicator for safety analysis. Also, analyses showed that the segments with higher congestion intensity could not only increase property damage only (PDO) crashes, but also more severe crashes. In addition, the issues regarding the necessity to incorporate specific congestion indicator for congestion's effects on safety and to take care of the multicollinearity between explanatory variables were also discussed. By including a specific congestion indicator, the model performance significantly improved. When comparing models with and without ridge regression, the magnitude of the coefficients was altered in the existence of multicollinearity. These conclusions suggest that the use of appropriate congestion measure and consideration of multicolilnearity among the variables would improve the models and our understanding about the effects of congestion on traffic safety. Copyright © 2015 Elsevier Ltd. All rights reserved.

Congestion estimation technique in the optical network unit registration process.

PubMed

Kim, Geunyong; Yoo, Hark; Lee, Dongsoo; Kim, Youngsun; Lim, Hyuk

2016-07-01

We present a congestion estimation technique (CET) to estimate the optical network unit (ONU) registration success ratio for the ONU registration process in passive optical networks. An optical line terminal (OLT) estimates the number of collided ONUs via the proposed scheme during the serial number state. The OLT can obtain congestion level among ONUs to be registered such that this information may be exploited to change the size of a quiet window to decrease the collision probability. We verified the efficiency of the proposed method through simulation and experimental results.

Relationship Between Carbon Dioxide Levels and Reported Congestion and Headaches on the International Space Station

NASA Technical Reports Server (NTRS)

Cole, Robert; Wear, Mary; Young, Millennia; Cobel, Christopher; Mason, Sara

2017-01-01

Congestion is commonly reported during spaceflight, and most crewmembers have reported using medications for congestion during International Space Station (ISS) missions. Although congestion has been attributed to fluid shifts during spaceflight, fluid status reaches equilibrium during the first week after launch while congestion continues to be reported throughout long duration missions. Congestion complaints have anecdotally been reported in relation to ISS CO2 levels; this evaluation was undertaken to determine whether or not an association exists. METHODS: Reported headaches, congestion symptoms, and CO2 levels were obtained for ISS expeditions 2-31, and time-weighted means and single-point maxima were determined for 24-hour (24hr) and 7-day (7d) periods prior to each weekly private medical conference. Multiple imputation addressed missing data, and logistic regression modeled the relationship between probability of reported event of congestion or headache and CO2 levels, adjusted for possible confounding covariates. The first seven days of spaceflight were not included to control for fluid shifts. Data were evaluated to determine the concentration of CO2 required to maintain the risk of congestion below 1% to allow for direct comparison with a previously published evaluation of CO2 concentrations and headache. RESULTS: This study confirmed a previously identified significant association between CO2 and headache and also found a significant association between CO2 and congestion. For each 1-mm Hg increase in CO2, the odds of a crew member reporting congestion doubled. The average 7-day CO2 would need to be maintained below 1.5 mmHg to keep the risk of congestion below 1%. The predicted probability curves of ISS headache and congestion curves appear parallel when plotted against ppCO2 levels with congestion occurring at approximately 1mmHg lower than a headache would be reported. DISCUSSION: While the cause of congestion is multifactorial, this study showed congestion is associated with CO2 levels on ISS. Data from additional expeditions could be incorporated to further assess this finding. CO2 levels are also associated with reports of headaches on ISS. While it may be expected for astronauts with congestion to also complain of headaches, these two symptoms are commonly mutually exclusive. Furthermore, it is unknown if a temporal CO2 relationship exists between congestion and headache on ISS. CO2 levels were time-weighted for 24hr and 7d, and thus the time course of congestion leading to headache was not assessed; however, congestion could be an early CO2-related symptom when compared to headache. Future studies evaluating the association of CO2-related congestion leading to headache would be difficult due to the relatively stable daily CO2 levels on ISS currently, but a systematic study could be implemented on-orbit if desired.

Features of acute liver congestion on gadoxetate disodium-enhanced MRI in a rat model: Role of organic anion-transporting polypeptide 1A1.

PubMed

Shimizu, Akira; Kobayashi, Akira; Motoyama, Hiroaki; Sakai, Hiroshi; Yamada, Akira; Yoshizawa, Akihiko; Momose, Masanobu; Kadoya, Masumi; Miyagawa, Shin-ichi

2015-09-01

To evaluate the features of hepatic congestion on gadoxetate disodium (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and the mechanisms responsible for the radiological findings in a rat model of partial liver congestion. A conventional T1 -weighted spin-echo sequence of the liver was performed using a 1.5T magnetic resonance imager with an 80-mm magnetic aperture for animal studies. We induced regional congestion using partial left lateral hepatic vein ligation (n = 5) and evaluated the following in both congestive liver (CL) and noncongestive liver (non-CL): 1) chronological changes in the relative enhancement (RE) up to 60 minutes after Gd-EOB-DTPA administration, and 2) mRNA and protein expression of rat organic anion transporting protein 1a1 (Oatp1a1). The RE in the CL reached a small peak (18%) at 5 minutes, corresponding to approximately half of the value observed in the non-CL, then slowly decreased in a linear manner thereafter. The degree of RE in the CL was significantly lower than that in the non-CL for up to 30 minutes (P < 0.05). An immunohistological examination showed that Oatp1a1 protein expression was downregulated in the CL. The mRNA level of Oatp1a1 in the CL was significantly upregulated, compared with that in control rat liver (P = 0.046), whereas no significant difference was observed between the CL and the non-CL (P = 0.698). The reduced signal intensity in the CL on Gd-EOB-DTPA-enhanced MRI could be explained by the decreased uptake of Gd-EOB-DTPA via Oatp1a1 protein in the congestive area. © 2015 Wiley Periodicals, Inc.

Transport Protocols for Wireless Mesh Networks

NASA Astrophysics Data System (ADS)

Eddie Law, K. L.

Transmission control protocol (TCP) provides reliable connection-oriented services between any two end systems on the Internet. With TCP congestion control algorithm, multiple TCP connections can share network and link resources simultaneously. These TCP congestion control mechanisms have been operating effectively in wired networks. However, performance of TCP connections degrades rapidly in wireless and lossy networks. To sustain the throughput performance of TCP connections in wireless networks, design modifications may be required accordingly in the TCP flow control algorithm, and potentially, in association with other protocols in other layers for proper adaptations. In this chapter, we explain the limitations of the latest TCP congestion control algorithm, and then review some popular designs for TCP connections to operate effectively in wireless mesh network infrastructure.

Airport Pricing Strategies

NASA Technical Reports Server (NTRS)

Pels, Eric; Verhoef, Erik T.

2003-01-01

Conventional economic wisdom suggests that congestion pricing would be an appropriate response to cope with the growing congestion levels currently experienced at many airports. Several characteristics of aviation markets, however, may make naive congestion prices equal to the value of marginal travel delays a non-optimal response. This paper has developed a model of airport pricing that captures a number of these features. The model in particular reflects that airlines typically have market power and are engaged in oligopolistic competition at different sub-markets; that part of external travel delays that aircraft impose are internal to an operator and hence should not be accounted for in congestion tolls. We presented an analytical treatment for a simple bi-nodal symmetric network, which through the use of 'hyper-networks' would be readily applicable to dynamic problems (in discrete time) such as peak - off-peak differences, and some numerical exercises for the same symmetric network, which was only designed to illustrate the possible comparative static impacts of tolling, in addition to marginal equilibrium conditions as could be derived for the general model specification. Some main conclusions are that second-best optimal tolls are typically lower than what would be suggested by congestion costs alone and may even be negative, and that the toll as derived by Brueckner (2002) may not lead to an increase in total welfare. While Brueckner (2002) has made clear that congestion tolls on airports may be smaller than expected when congestion costs among aircraft are internal for a firm, our analysis adds to this that a further downward adjustment may be in order due to market power. The presence of market power (which causes prices to exceed marginal costs) may cause the pure congestion toll to be suboptimal, because the resulting decrease in demand is too high (the pure congestion tall does not take into account the decrease in consumer surplus). The various downward adjustments in welfare maximizing tolls may well cause the optimal values of these to be negative. Insofar as subsidization is considered unacceptable for whichever reason, our results warn that the most efficient among the non-negative tolls may actually be a zero toll; the pure congestion toll may actually decrease welfare compared to the base case. The model in this paper contains a few simplifying assumptions that may be relaxed in future work. Load factors and aircraft capacity are fixed in this model for simplicity. In a more advanced version of this model, load factors and aircraft capacity can be endogenized. This makes the derivation of the optimality conditions far more complicated, but it should be feasible in a numerical experiment. One can also add a fourth layer to the model, describing the airport's optimization problem. For example, the airport can maximize profits under a cost recovery constraint. The model then deals with interactions between four types of agents. No distinction is made between peak and off-peak traffic in this paper. Finally, the results of the numerical exercise in this paper need to be checked against an asymmetric equilibrium.

Iodine-123 metaiodobenzylguanidine imaging of the heart in idiopathic congestive cardiomyopathy and cardiac transplants

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

Glowniak, J.V.; Turner, F.E.; Gray, L.L.

1989-07-01

Iodine-123 metaiodobenzylguanidine ((/sup 123/I)MIBG) is a norepinephrine analog which can be used to image the sympathetic innervation of the heart. In this study, cardiac imaging with (/sup 123/I)MIBG was performed in patients with idiopathic congestive cardiomyopathy and compared to normal controls. Initial uptake, half-time of tracer within the heart, and heart to lung ratios were all significantly reduced in patients compared to normals. Uptake in lungs, liver, salivary glands, and spleen was similar in controls and patients with cardiomyopathy indicating that decreased MIBG uptake was not a generalized abnormality in these patients. Iodine-123 MIBG imaging was also performed in cardiacmore » transplant patients to determine cardiac nonneuronal uptake. Uptake in transplants was less than 10% of normals in the first 2 hr and nearly undetectable after 16 hr. The decreased uptake of MIBG suggests cardiac sympathetic nerve dysfunction while the rapid washout of MIBG from the heart suggests increased cardiac sympathetic nerve activity in idiopathic congestive cardiomyopathy.« less

Improving Emergency Department flow through optimized bed utilization

PubMed Central

Chartier, Lucas Brien; Simoes, Licinia; Kuipers, Meredith; McGovern, Barb

2016-01-01

Over the last decade, patient volumes in the emergency department (ED) have grown disproportionately compared to the increase in staffing and resources at the Toronto Western Hospital, an academic tertiary care centre in Toronto, Canada. The resultant congestion has spilled over to the ED waiting room, where medically undifferentiated and potentially unstable patients must wait until a bed becomes available. The aim of this quality improvement project was to decrease the 90th percentile of wait time between triage and bed assignment (time-to-bed) by half, from 120 to 60 minutes, for our highest acuity patients. We engaged key stakeholders to identify barriers and potential strategies to achieve optimal flow of patients into the ED. We first identified multiple flow-interrupting challenges, including operational bottlenecks and cultural issues. We then generated change ideas to address two main underlying causes of ED congestion: unnecessary patient utilization of ED beds and communication breakdown causing bed turnaround delays. We subsequently performed seven tests of change through sequential plan-do-study-act (PDSA) cycles. The most significant gains were made by improving communication strategies: small gains were achieved through the optimization of in-house digital information management systems, while significant improvements were achieved through the implementation of a low-tech direct contact mechanism (a two-way radio or walkie-talkie). In the post-intervention phase, time-to-bed for the 90th percentile of high-acuity patients decreased from 120 minutes to 66 minutes, with special cause variation showing a significant shift in the weekly measurements. PMID:27752312

Improving Emergency Department flow through optimized bed utilization.

PubMed

Chartier, Lucas Brien; Simoes, Licinia; Kuipers, Meredith; McGovern, Barb

2016-01-01

Over the last decade, patient volumes in the emergency department (ED) have grown disproportionately compared to the increase in staffing and resources at the Toronto Western Hospital, an academic tertiary care centre in Toronto, Canada. The resultant congestion has spilled over to the ED waiting room, where medically undifferentiated and potentially unstable patients must wait until a bed becomes available. The aim of this quality improvement project was to decrease the 90th percentile of wait time between triage and bed assignment (time-to-bed) by half, from 120 to 60 minutes, for our highest acuity patients. We engaged key stakeholders to identify barriers and potential strategies to achieve optimal flow of patients into the ED. We first identified multiple flow-interrupting challenges, including operational bottlenecks and cultural issues. We then generated change ideas to address two main underlying causes of ED congestion: unnecessary patient utilization of ED beds and communication breakdown causing bed turnaround delays. We subsequently performed seven tests of change through sequential plan-do-study-act (PDSA) cycles. The most significant gains were made by improving communication strategies: small gains were achieved through the optimization of in-house digital information management systems, while significant improvements were achieved through the implementation of a low-tech direct contact mechanism (a two-way radio or walkie-talkie). In the post-intervention phase, time-to-bed for the 90th percentile of high-acuity patients decreased from 120 minutes to 66 minutes, with special cause variation showing a significant shift in the weekly measurements.

Evaluation of the public health impacts of traffic congestion: a health risk assessment.

PubMed

Levy, Jonathan I; Buonocore, Jonathan J; von Stackelberg, Katherine

2010-10-27

Traffic congestion is a significant issue in urban areas in the United States and around the world. Previous analyses have estimated the economic costs of congestion, related to fuel and time wasted, but few have quantified the public health impacts or determined how these impacts compare in magnitude to the economic costs. Moreover, the relative magnitudes of economic and public health impacts of congestion would be expected to vary significantly across urban areas, as a function of road infrastructure, population density, and atmospheric conditions influencing pollutant formation, but this variability has not been explored. In this study, we evaluate the public health impacts of ambient exposures to fine particulate matter (PM2.5) concentrations associated with a business-as-usual scenario of predicted traffic congestion. We evaluate 83 individual urban areas using traffic demand models to estimate the degree of congestion in each area from 2000 to 2030. We link traffic volume and speed data with the MOBILE6 model to characterize emissions of PM2.5 and particle precursors attributable to congestion, and we use a source-receptor matrix to evaluate the impact of these emissions on ambient PM2.5 concentrations. Marginal concentration changes are related to a concentration-response function for mortality, with a value of statistical life approach used to monetize the impacts. We estimate that the monetized value of PM2.5-related mortality attributable to congestion in these 83 cities in 2000 was approximately $31 billion (2007 dollars), as compared with a value of time and fuel wasted of $60 billion. In future years, the economic impacts grow (to over $100 billion in 2030) while the public health impacts decrease to $13 billion in 2020 before increasing to $17 billion in 2030, given increasing population and congestion but lower emissions per vehicle. Across cities and years, the public health impacts range from more than an order of magnitude less to in excess of the economic impacts. Our analyses indicate that the public health impacts of congestion may be significant enough in magnitude, at least in some urban areas, to be considered in future evaluations of the benefits of policies to mitigate congestion.

Losartan corrects abnormal frequency response of renal vasculature in congestive heart failure.

PubMed

DiBona, Gerald F; Sawin, Linda L

2003-11-01

In congestive heart failure, renal blood flow is decreased and renal vascular resistance is increased in a setting of increased activity of both the sympathetic nervous and renin-angiotensin systems. The renal vasoconstrictor response to renal nerve stimulation is enhanced. This is associated with an abnormality in the low-pass filter function of the renal vasculature wherein higher frequencies (> or =0.01 Hz) within renal sympathetic nerve activity are not normally attenuated and are passed into the renal blood flow signal. This study tested the hypothesis that excess angiotensin II action mediates the abnormal frequency response characteristics of the renal vasculature in congestive heart failure. In anesthetized rats, the renal vasoconstrictor response to graded frequency renal nerve stimulation was significantly greater in congestive heart failure than in control rats. Losartan attenuated the renal vasoconstrictor response to a significantly greater degree in congestive heart failure than in control rats. In control rats, the frequency response of the renal vasculature was that of a first order (-20 dB/frequency decade) low-pass filter with a corner frequency (-3 dB, 30% attenuation) of 0.002 Hz and 97% attenuation (-30 dB) at > or =0.1 Hz. In congestive heart failure rats, attenuation did not exceed 45% (-5 dB) over the frequency range of 0.001-0.6 Hz. The frequency response of the renal vasculature was not affected by losartan treatment in control rats but was completely restored to normal by losartan treatment in congestive heart failure rats. The enhanced renal vasoconstrictor response to renal nerve stimulation and the associated abnormality in the frequency response characteristics of the renal vasculature seen in congestive heart failure are mediated by the action of angiotensin II on renal angiotensin II AT1 receptors.

Spotted black snake (Pseudechis guttatus) envenomation in a maned wolf (Chrysocyon brachyurus).

PubMed

Portas, Timothy J; Montali, Richard J

2007-09-01

Envenomation by a spotted black snake (Pseudechis guttatus), following multiple bites on the buccal mucosa of a captive maned wolf (Chrysocyon brachyurus), caused the animal's collapse, hemolysis, rhabdomyolysis, local tissue necrosis, hepatic and renal failure, and subsequent death. The wolf died despite intensive supportive care including antivenom administration, fluid support, and a blood transfusion. Gross necropsy findings included myocardial and intestinal hemorrhage, pulmonary congestion, hepatomegaly, and splenomegaly. Microscopic examination of formalin-fixed tissues demonstrated pulmonary and abdominal visceral hemorrhage, acute nephrosis with casts, multifocal hepatic necrosis, and splenic congestion.

Performance Analysis of TCP Enhancements in Satellite Data Networks

NASA Technical Reports Server (NTRS)

Broyles, Ren H.

1999-01-01

This research examines two proposed enhancements to the well-known Transport Control Protocol (TCP) in the presence of noisy communication links. The Multiple Pipes protocol is an application-level adaptation of the standard TCP protocol, where several TCP links cooperate to transfer data. The Space Communication Protocol Standard - Transport Protocol (SCPS-TP) modifies TCP to optimize performance in a satellite environment. While SCPS-TP has inherent advantages that allow it to deliver data more rapidly than Multiple Pipes, the protocol, when optimized for operation in a high-error environment, is not compatible with legacy TCP systems, and requires changes to the TCP specification. This investigation determines the level of improvement offered by SCPS-TP's Corruption Mode, which will help determine if migration to the protocol is appropriate in different environments. As the percentage of corrupted packets approaches 5 %, Multiple Pipes can take over five times longer than SCPS-TP to deliver data. At high error rates, SCPS-TP's advantage is primarily caused by Multiple Pipes' use of congestion control algorithms. The lack of congestion control, however, limits the systems in which SCPS-TP can be effectively used.

Carvedilol case history: the discovery and development of the first β-blocker for the treatment of congestive heart failure.

PubMed

Ruffolo, Robert R; Feuerstein, Giora Z

2006-06-01

Carvedilol is a multiple action drug that blocks β1-, β2- and α1- adrenoceptors, and has potent antioxidant properties. Carvedilol is the first drug of its kind to be approved for the treatment of congestive heart failure, and is now the standard of care for this devastating disease. The discovery and development of carvedilol encountered an adverse regulatory climate, skepticism by the cardiology community and hesitance by the company, and in the early 1990s, the fate of the drug was uncertain. Nonetheless, in the largest heart failure study conducted up until that point, carvedilol produced marked reductions in morbidity and mortality, and has given new hope to patients afflicted with congestive heart failure. The story behind carvedilol contains important observations and lessons for scientists, regulators and physicians.

Allergic rhinitis-induced nasal congestion: its impact on sleep quality.

PubMed

Storms, William

2008-03-01

Allergic rhinitis (AR) is an extremely common health problem affecting 20 to 40 million Americans and between 10-25% of the world's population. Patients with AR suffer from both nasal symptoms (congestion, rhinorrhea, itching, and sneezing) and ocular symptoms (itching, redness, and tearing). The negative impact on sleep quality and quantity, and consequently on various aspects of the patient's life, is an under-recognised and under-treated component of AR morbidity. Nasal congestion, which is one of the most bothersome and prevalent symptoms of AR, is thought to be the leading symptom responsible for rhinitis-related sleep problems. In addition to reducing clinical symptoms, pharmacologic therapies for AR that specifically reduce inflammatory cells and mediators - and therefore nasal congestion and other symptoms - should also improve sleep quality and overall quality of life (QOL). Intranasal corticosteroids (INS) are the current mainstay of therapy for AR. Results of a number of clinical trials demonstrate that INS effectively reduce nasal congestion and ocular symptoms, improve sleep quality, and decrease daytime somnolence. Intranasal corticosteroids have also proved to be effective in reducing symptoms of acute rhinosinusitis and nasal polyposis, both of which also negatively impact on sleep quality. Intranasal corticosteroids are considered safe due to their low systemic bioavailability.

Modeling and analyzing cascading dynamics of the Internet based on local congestion information

NASA Astrophysics Data System (ADS)

Zhu, Qian; Nie, Jianlong; Zhu, Zhiliang; Yu, Hai; Xue, Yang

2018-06-01

Cascading failure has already become one of the vital issues in network science. By considering realistic network operational settings, we propose the congestion function to represent the congested extent of node and construct a local congestion-aware routing strategy with a tunable parameter. We investigate the cascading failures on the Internet triggered by deliberate attacks. Simulation results show that the tunable parameter has an optimal value that makes the network achieve a maximum level of robustness. The robustness of the network has a positive correlation with tolerance parameter, but it has a negative correlation with the packets generation rate. In addition, there exists a threshold of the attacking proportion of nodes that makes the network achieve the lowest robustness. Moreover, by introducing the concept of time delay for information transmission on the Internet, we found that an increase of the time delay will decrease the robustness of the network rapidly. The findings of the paper will be useful for enhancing the robustness of the Internet in the future.

Traffic Congestion Detection System through Connected Vehicles and Big Data

PubMed Central

Cárdenas-Benítez, Néstor; Aquino-Santos, Raúl; Magaña-Espinoza, Pedro; Aguilar-Velazco, José; Edwards-Block, Arthur; Medina Cass, Aldo

2016-01-01

This article discusses the simulation and evaluation of a traffic congestion detection system which combines inter-vehicular communications, fixed roadside infrastructure and infrastructure-to-infrastructure connectivity and big data. The system discussed in this article permits drivers to identify traffic congestion and change their routes accordingly, thus reducing the total emissions of CO2 and decreasing travel time. This system monitors, processes and stores large amounts of data, which can detect traffic congestion in a precise way by means of a series of algorithms that reduces localized vehicular emission by rerouting vehicles. To simulate and evaluate the proposed system, a big data cluster was developed based on Cassandra, which was used in tandem with the OMNeT++ discreet event network simulator, coupled with the SUMO (Simulation of Urban MObility) traffic simulator and the Veins vehicular network framework. The results validate the efficiency of the traffic detection system and its positive impact in detecting, reporting and rerouting traffic when traffic events occur. PMID:27136548

Traffic Congestion Detection System through Connected Vehicles and Big Data.

PubMed

Cárdenas-Benítez, Néstor; Aquino-Santos, Raúl; Magaña-Espinoza, Pedro; Aguilar-Velazco, José; Edwards-Block, Arthur; Medina Cass, Aldo

2016-04-28

This article discusses the simulation and evaluation of a traffic congestion detection system which combines inter-vehicular communications, fixed roadside infrastructure and infrastructure-to-infrastructure connectivity and big data. The system discussed in this article permits drivers to identify traffic congestion and change their routes accordingly, thus reducing the total emissions of CO₂ and decreasing travel time. This system monitors, processes and stores large amounts of data, which can detect traffic congestion in a precise way by means of a series of algorithms that reduces localized vehicular emission by rerouting vehicles. To simulate and evaluate the proposed system, a big data cluster was developed based on Cassandra, which was used in tandem with the OMNeT++ discreet event network simulator, coupled with the SUMO (Simulation of Urban MObility) traffic simulator and the Veins vehicular network framework. The results validate the efficiency of the traffic detection system and its positive impact in detecting, reporting and rerouting traffic when traffic events occur.

Evaluation of the public health impacts of traffic congestion: a health risk assessment

PubMed Central

2010-01-01

Background Traffic congestion is a significant issue in urban areas in the United States and around the world. Previous analyses have estimated the economic costs of congestion, related to fuel and time wasted, but few have quantified the public health impacts or determined how these impacts compare in magnitude to the economic costs. Moreover, the relative magnitudes of economic and public health impacts of congestion would be expected to vary significantly across urban areas, as a function of road infrastructure, population density, and atmospheric conditions influencing pollutant formation, but this variability has not been explored. Methods In this study, we evaluate the public health impacts of ambient exposures to fine particulate matter (PM2.5) concentrations associated with a business-as-usual scenario of predicted traffic congestion. We evaluate 83 individual urban areas using traffic demand models to estimate the degree of congestion in each area from 2000 to 2030. We link traffic volume and speed data with the MOBILE6 model to characterize emissions of PM2.5 and particle precursors attributable to congestion, and we use a source-receptor matrix to evaluate the impact of these emissions on ambient PM2.5 concentrations. Marginal concentration changes are related to a concentration-response function for mortality, with a value of statistical life approach used to monetize the impacts. Results We estimate that the monetized value of PM2.5-related mortality attributable to congestion in these 83 cities in 2000 was approximately $31 billion (2007 dollars), as compared with a value of time and fuel wasted of $60 billion. In future years, the economic impacts grow (to over $100 billion in 2030) while the public health impacts decrease to $13 billion in 2020 before increasing to $17 billion in 2030, given increasing population and congestion but lower emissions per vehicle. Across cities and years, the public health impacts range from more than an order of magnitude less to in excess of the economic impacts. Conclusions Our analyses indicate that the public health impacts of congestion may be significant enough in magnitude, at least in some urban areas, to be considered in future evaluations of the benefits of policies to mitigate congestion. PMID:20979626

Congestive Heart Failure: A Case of Protein Misfolding

PubMed Central

Ha, Chung-Eun; Bhagavan, Nadhipuram V; Loscalzo, Miki; Chan, Stephen K; Nguyen, Huy V; Rios, Carlos N

2014-01-01

This article describes an interesting case of a patient presenting with congestive heart failure found to have restrictive cardiomyopathy with initial laboratory evaluation showing hypogammaglobuminemia without a monoclonal band on serum and urine electrophoresis. This case highlights the clinically significant cardiac manifestation caused by protein misfolding, a defect in protein homeostasis. In addition, the utility of a relatively newer laboratory test, serum free light chains as well as the importance of clinical and pathophysiologic correlation is also discussed. We present a relatively uncommon cause of heart disease, cardiac amyloidosis in a patient with a systemic plasma cell dyscrasia, and multiple myeloma. PMID:24959390

Can complexity decrease in congestive heart failure?

NASA Astrophysics Data System (ADS)

Mukherjee, Sayan; Palit, Sanjay Kumar; Banerjee, Santo; Ariffin, M. R. K.; Rondoni, Lamberto; Bhattacharya, D. K.

2015-12-01

The complexity of a signal can be measured by the Recurrence period density entropy (RPDE) from the reconstructed phase space. We have chosen a window based RPDE method for the classification of signals, as RPDE is an average entropic measure of the whole phase space. We have observed the changes in the complexity in cardiac signals of normal healthy person (NHP) and congestive heart failure patients (CHFP). The results show that the cardiac dynamics of a healthy subject is more complex and random compare to the same for a heart failure patient, whose dynamics is more deterministic. We have constructed a general threshold to distinguish the border line between a healthy and a congestive heart failure dynamics. The results may be useful for wide range for physiological and biomedical analysis.

Targeting congestion in allergic rhinitis: the importance of intranasal corticosteroids.

PubMed

Marple, Bradley F

2008-01-01

The cardinal nasal symptoms of allergic rhinitis (AR) are sustained by an underlying inflammatory process. Congestion is one of the most prominent and distressing symptoms for patients and is strongly associated with a broadly deteriorated quality of life and significant losses in productivity. The purpose of this study was to explore the role of intranasal corticosteroids (INSs) in down-regulating the inflammatory response to allergen and their clinical efficacy on AR symptoms, particularly congestion. AR is characterized by an influx of inflammatory cells and mediators into the nasal mucosa after antigen exposure. The response is biphasic, encompassing an early and a late phase. Antigen exposure has a priming effect, decreasing the threshold for subsequent allergic reaction on rechallenge and increasing the responsiveness of the nasal mucosa. INSs are a mainstay of therapy for AR and the most effective intervention for nasal congestion and other nasal symptoms, with established superiority to antihistamines, decongestants, and leukotriene antagonists. In addition to symptom relief, INSs suppress numerous stages of the inflammatory cascade, inhibiting the influx of inflammatory cells and mediators. Topical nasal corticosteroids have a low incidence of local adverse effects, negligible systemic absorption, and excellent safety. Congestion is one of the most bothersome symptoms of AR. INS therapy improves AR symptoms, with particular efficacy in relieving congestion, by attenuating nasal hyperresponsiveness. Pretreatment with INSs has been shown to relieve early and late-phase clinical symptoms of AR. Modification of the disease process results in significant relief of symptoms and leads to fewer disease exacerbations.

The kidney in congestive heart failure: 'are natriuresis, sodium, and diuretics really the good, the bad and the ugly?'.

PubMed

Verbrugge, Frederik H; Dupont, Matthias; Steels, Paul; Grieten, Lars; Swennen, Quirine; Tang, W H Wilson; Mullens, Wilfried

2014-02-01

This review discusses renal sodium handling in heart failure. Increased sodium avidity and tendency to extracellular volume overload, i.e. congestion, are hallmark features of the heart failure syndrome. Particularly in the case of concomitant renal dysfunction, the kidneys often fail to elicit potent natriuresis. Yet, assessment of renal function is generally performed by measuring serum creatinine, which has inherent limitations as a biomarker for the glomerular filtration rate (GFR). Moreover, glomerular filtration only represents part of the nephron's function. Alterations in the fractional reabsorptive rate of sodium are at least equally important in emerging therapy-refractory congestion. Indeed, renal blood flow decreases before the GFR is affected in congestive heart failure. The resulting increased filtration fraction changes Starling forces in peritubular capillaries, which drive sodium reabsorption in the proximal tubules. Congestion further stimulates this process by augmenting renal lymph flow. Consequently, fractional sodium reabsorption in the proximal tubules is significantly increased, limiting sodium delivery to the distal nephron. Orthosympathetic activation probably plays a pivotal role in those deranged intrarenal haemodynamics, which ultimately enhance diuretic resistance, stimulate neurohumoral activation with aldosterone breakthrough, and compromise the counter-regulatory function of natriuretic peptides. Recent evidence even suggests that intrinsic renal derangements might impair natriuresis early on, before clinical congestion or neurohumoral activation are evident. This represents a paradigm shift in heart failure pathophysiology, as it suggests that renal dysfunction-although not by conventional GFR measurements-is driving disease progression. In this respect, a better understanding of renal sodium handling in congestive heart failure is crucial to achieve more tailored decongestive therapy, while preserving renal function. © 2013 The Authors. European Journal of Heart Failure © 2013 European Society of Cardiology.

Factors associated with health-related quality of life in stable ambulatory congestive heart failure patients: Systematic review.

PubMed

Baert, Anneleen; De Smedt, Delphine; De Sutter, Johan; De Bacquer, Dirk; Puddu, Paolo Emilio; Clays, Els; Pardaens, Sofie

2018-03-01

Background Since improved treatment of congestive heart failure has resulted in decreased mortality and hospitalisation rates, increasing self-perceived health-related quality of life (HRQoL) has become a major goal of congestive heart failure treatment. However, an overview on predictieve factors of HRQoL is currently lacking in literature. Purpose The aim of this study was to identify key factors associated with HRQoL in stable ambulatory patients with congestive heart failure. Methods A systematic review was performed. MEDLINE, Web of Science and Embase were searched for the following combination of terms: heart failure, quality of life, health perception or functional status between the period 2000 and February 2017. Literature screening was done by two independent reviewers. Results Thirty-five studies out of 8374 titles were included for quality appraisal, of which 29 were selected for further data extraction. Four distinct categories grouping different types of variables were identified: socio-demographic characteristics, clinical characteristics, health and health behaviour, and care provider characteristics. Within the above-mentioned categories the presence of depressive symptoms was most consistently related to a worse HRQoL, followed by a higher New York Heart Association functional class, younger age and female gender. Conclusion Through a systematic literature search, factors associated with HRQoL among congestive heart failure patients were investigated. Age, gender, New York Heart Association functional class and depressive symptoms are the most consistent variables explaining the variance in HRQoL in patients with congestive heart failure. These findings are partly in line with previous research on predictors for hard endpoints in patients with congestive heart failure.

Time allocation shifts and pollutant exposure due to traffic congestion: an analysis using the national human activity pattern survey.

PubMed

Zhang, Kai; Batterman, Stuart A

2009-10-15

Traffic congestion increases air pollutant exposures of commuters and urban populations due to the increased time spent in traffic and the increased vehicular emissions that occur in congestion, especially "stop-and-go" traffic. Increased time in traffic also decreases time in other microenvironments, a trade-off that has not been considered in previous time activity pattern (TAP) analyses conducted for exposure assessment purposes. This research investigates changes in time allocations and exposures that result from traffic congestion. Time shifts were derived using data from the National Human Activity Pattern Survey (NHAPS), which was aggregated to nine microenvironments (six indoor locations, two outdoor locations and one transport location). After imputing missing values, handling outliers, and conducting other quality checks, these data were stratified by respondent age, employment status and period (weekday/weekend). Trade-offs or time-shift coefficients between time spent in vehicles and the eight other microenvironments were then estimated using robust regression. For children and retirees, congestion primarily reduced the time spent at home; for older children and working adults, congestion shifted the time spent at home as well as time in schools, public buildings, and other indoor environments. Changes in benzene and PM(2.5) exposure were estimated for the current average travel delay in the U.S. (9 min day(-1)) and other scenarios using the estimated time shifts coefficients, concentrations in key microenvironments derived from the literature, and a probabilistic analysis. Changes in exposures depended on the duration of the congestion and the pollutant. For example, a 30 min day(-1) travel delay was determined to account for 21+/-12% of current exposure to benzene and 14+/-8% of PM(2.5) exposure. The time allocation shifts and the dynamic approach to TAPs improve estimates of exposure impacts from congestion and other recurring events.

Briefing paper : toward a best practice model for managed lanes in Texas.

DOT National Transportation Integrated Search

2013-09-01

Over the past two decades, agencies : have increasingly implemented managed : lanes (MLs) to mitigate growing urban traffic : congestion in the United States. Multiple operating : projects : representing a combination : of HOV-to-HOT conversions a...

0-6803 : technology task force.

DOT National Transportation Integrated Search

2013-12-01

Texas 83rd Legislature charged the Texas Department : of Transportation (TxDOT) with examining and : evaluating innovative transportation technologies to : decrease costs, reduce traffic congestion, enhance : safety, and increase economic producti...

Total synthesis of (+/-)-taiwaniaquinol B via a domino intramolecular friedel-crafts acylation/carbonyl alpha-tert-alkylation reaction.

PubMed

Fillion, Eric; Fishlock, Dan

2005-09-28

The first synthesis of taiwaniaquinol B, a 6-nor-5(6-->7)abeoabietane-type diterpenoid exhibiting the uncommon fused 6-5-6 tricyclic carbon skeleton, was accomplished in 15 steps. A Lewis acid-promoted tandem intramolecular Friedel-Crafts/carbonyl alpha-tert-alkylation reaction was exploited as the core strategy for the synthesis of the sterically congested 1-indanone-containing tricyclic structure. This multiple carbon-carbon bond forming reaction exploits the unique reactivity of Meldrum's acid. The facile precursor synthesis makes this a useful methodology for the expedient modification and assembly of sterically congested 1-indanone-containing ring systems.

Hysteresis phenomena of the intelligent driver model for traffic flow

NASA Astrophysics Data System (ADS)

Dahui, Wang; Ziqiang, Wei; Ying, Fan

2007-07-01

We present hysteresis phenomena of the intelligent driver model for traffic flow in a circular one-lane roadway. We show that the microscopic structure of traffic flow is dependent on its initial state by plotting the fraction of congested vehicles over the density, which shows a typical hysteresis loop, and by investigating the trajectories of vehicles on the velocity-over-headway plane. We find that the trajectories of vehicles on the velocity-over-headway plane, which usually show a hysteresis loop, include multiple loops. We also point out the relations between these hysteresis loops and the congested jams or high-density clusters in traffic flow.

The impacts of freight mode splitting on congestion, risk, and delivery reliability.

DOT National Transportation Integrated Search

2012-09-01

Although splitting shipments across multiple delivery or transportation modes typically : increases total shipping costs as a result of diseconomies of scale, it may offer certain benefits : that can more than offset these costs. These benefits inclu...

Visceral Congestion in Heart Failure: Right Ventricular Dysfunction, Splanchnic Hemodynamics, and the Intestinal Microenvironment.

PubMed

Polsinelli, Vincenzo B; Sinha, Arjun; Shah, Sanjiv J

2017-12-01

Visceral venous congestion of the gut may play a key role in the pathogenesis of right-sided heart failure (HF) and cardiorenal syndromes. Here, we review the role of right ventricular (RV) dysfunction, visceral congestion, splanchnic hemodynamics, and the intestinal microenvironment in the setting of right-sided HF. We review recent literature on this topic, outline possible mechanisms of disease pathogenesis, and discuss potential therapeutics. There are several mechanisms linking RV-gut interactions via visceral venous congestion which could result in (1) hypoxia and acidosis in enterocytes, which may lead to enhanced sodium-hydrogen exchanger 3 (NHE3) expression with increased sodium and fluid retention; (2) decreased luminal pH in the intestines, which could lead to alteration of the gut microbiome which could increase gut permeability and inflammation; (3) alteration of renal hemodynamics with triggering of the cardiorenal syndrome; and (4) altered phosphate metabolism resulting in increased pulmonary artery stiffening, thereby increasing RV afterload. A wide variety of therapeutic interventions that act on the RV, pulmonary vasculature, intestinal microenvironment, and the kidney could alter these pathways and should be tested in patients with right-sided HF. The RV-gut axis is an important aspect of HF pathogenesis that deserves more attention. Modulation of the pathways interconnecting the right heart, visceral congestion, and the intestinal microenvironment could be a novel avenue of intervention for right-sided HF.

Inappropriate expression of hepcidin by liver congestion contributes to anemia and relative iron deficiency.

PubMed

Suzuki, Tomoyasu; Hanawa, Haruo; Jiao, Shuang; Ohno, Yukako; Hayashi, Yuka; Yoshida, Kaori; Kashimura, Takeshi; Obata, Hiroaki; Minamino, Tohru

2014-04-01

Anemia and relative iron deficiency (RID) are prevalent in patients with heart failure (HF). The etiology of anemia and RID in HF patients is unclear. Hepcidin expression may be closely related to anemia and RID in HF patients. Although hepcidin is produced mainly by the liver, and the most frequent histologic appearance of liver in HF patients is congestion, the influence of liver congestion (LC) on hepcidin production has not yet been investigated. We investigated whether hepcidin contributed to anemia and RID in rats with LC. LC was induced in rats by ligating the inferior vena cava and compared with bleeding anemia (BA) model induced by phlebotomy and hemolytic anemia (HA) model induced by injection of phenylhydrazine. BA and HA strongly suppressed expression of hepcidin in liver and so did not cause decrease in serum iron and transferrin saturation. However, hepcidin expression did not decrease in LC rats, which resulted in anemia and lower transferrin saturation. In addition, many cells with hemosiderin deposits were observed in the liver and spleen and not in the bone marrow, and this appeared to be related to suppression of hepcidin expression. Iron accumulated in hepatocytes, and bone morphogenetic protein 6, which induces hepcidin, increased. Inflammation was observed in the congestive liver, and there was an increase in interleukin-6, which also induced hepcidin and was induced by free heme and hemoglobin via Toll-like receptor 4. We conclude that LC contributes to RID and anemia, and it does so via inappropriate expression of hepcidin. Copyright © 2014 Elsevier Inc. All rights reserved.

Drivers' evaluation of the diverging diamond interchange

DOT National Transportation Integrated Search

2007-01-01

In recent years, the Federal Highway Administration (FHWA) has been advocating novel intersection designs as a way to promote intersection safety while meeting the often conflicting demands for increasing capacity, decreasing congestion, and minimizi...

Transmission congestion management in the electricity market

NASA Astrophysics Data System (ADS)

Chen, Yue

2018-04-01

In this paper we mainly discuss how to optimize the arrangement to decrease the loss of each line when the power generation side of the system transmission congestion occurs in a safe and economical manner. We respectively set the adjust model if the transmission can be eliminated which can calculate the best scheme and safety margin model when transmission cannot be eliminated which is a multi-objective planning problem. We solve the two models on the condition of the load power demands are 982.4MW and 1052.8 MW by Lingo and get the optimal management scheme.

Serial cardiac MRIs in adult Fontan patients detect progressive hepatic enlargement and congestion.

PubMed

Lewis, Matthew J; Hecht, Elizabeth; Ginns, Jonathan; Benton, Joshua; Prince, Martin; Rosenbaum, Marlon S

2017-03-01

The progression of hepatic disease in adult Fontan patients is not well understood. They reviewed the experience with serial cardiac MRIs (CMR) in adult Fontan patients to determine if hepatic anatomic markers of prolonged Fontan exposure were present and if clinical predictors of progressive hepatic congestion could be identified. A retrospective cohort study of all adult Fontan patients who had undergone at least two CMRs was performed. Hepatic dimensions, inferior vena cava (IVC) size, right hepatic vein (RHV) size and spleen diameter were determined from images acquired at the time of clinically guided CMR. Two radiologists with expertise in hepatic imaging graded congestion and liver size independently using post-gadolinium contrast sequences. Twenty-seven patients met inclusion criteria. Over a mean time of 5.1 years between CMRs, there was a significant increase in mean lateral-medial hepatic dimension (P = .005), mean RHV diameter (P = .004), and mean splenic diameter (P = .001). Serial post-gadolinium imaging was available in 25/27 (93%) patients of which 15/27 (55%) showed evidence of progressive hepatic congestion across serial studies. Progressive hepatic congestion was associated with single ventricle ejection fraction (SVEF) less than 50% (P = .008), and larger indexed end-diastolic (EDVI) and end-systolic volume (ESVI). RHV diameter was the only anatomic variable significantly correlated with time from Fontan completion (P = .004). Serial CMRs detected progressive liver and hepatic vein enlargement in our cohort of adult Fontan patients over a mean time of 5.2 years. Progressive hepatic congestion occurs in a significant number of adult Fontan patients and may be associated with ventricular enlargement and decreased ventricular function by CMR. © 2016 Wiley Periodicals, Inc.

An Automated Approach for Ranking Journals to Help in Clinician Decision Support

PubMed Central

Jonnalagadda, Siddhartha R.; Moosavinasab, Soheil; Nath, Chinmoy; Li, Dingcheng; Chute, Christopher G.; Liu, Hongfang

2014-01-01

Point of care access to knowledge from full text journal articles supports decision-making and decreases medical errors. However, it is an overwhelming task to search through full text journal articles and find quality information needed by clinicians. We developed a method to rate journals for a given clinical topic, Congestive Heart Failure (CHF). Our method enables filtering of journals and ranking of journal articles based on source journal in relation to CHF. We also obtained a journal priority score, which automatically rates any journal based on its importance to CHF. Comparing our ranking with data gathered by surveying 169 cardiologists, who publish on CHF, our best Multiple Linear Regression model showed a correlation of 0.880, based on five-fold cross validation. Our ranking system can be extended to other clinical topics. PMID:25954382

Bolus versus continuous low dose of enalaprilat in congestive heart failure with acute refractory decompensation.

PubMed

Podbregar, M; Voga, G; Horvat, M; Zuran, I; Krivec, B; Skale, R; Pareznik, R

1999-01-01

The first dose of angiotensin-converting enzyme (ACE) inhibitors may trigger a considerable fall of blood pressure in chronic heart failure. The response may be dose-related. To determine hemodynamic and systemic oxygenation effects of low-dose enalaprilat, we administered intravenous enalaprilat (0.004 mg/kg) as bolus (group B) or continuous 1-hour infusion (group C) in 20 patients with congestive heart failure due to ischemic heart disease with acute decompensation refractory to inotropic, vasodilator and diuretic therapy. Hemodynamic and systemic oxygenation variables were recorded at baseline (+0 min), +30, +60, +120, +180, and +360 min after the start of intervention. Mean arterial pressure (MAP) (p < 0. 001), mean pulmonary artery pressure (MPAP) (p < 0.001), pulmonary artery occlusion pressure (PAOP) (p < 0.001), oxygen extraction ratio (ER) (p < 0.026) decreased regardless of enalaprilat application. Compared to group B, there was in group C prolonged decrease of MAP, MPAP, PAOP, ER and increase of pulmonary artery oxyhemoglobin saturation in regard to baseline values. Cardiac index, heart rate, central venous pressure and oxygen consumption index did not change. A low dose of intravenous enalaprilat (0.004 mg/kg) can be used to safely improve hemodynamics and systemic oxygenation in congestive heart failure due to ischemic heart disease with acute refractory decompensation.

Position verification systems for an automated highway system.

DOT National Transportation Integrated Search

2015-03-01

Automated vehicles promote road safety, fuel efficiency, and reduced travel time by decreasing traffic : congestion and driver workload. In a vehicle platoon (grouping vehicles to increase road capacity by : managing distance between vehicles using e...

Oxymetazoline plus dexpanthenol in nasal congestion.

PubMed

Jagade, Mohan V; Langade, Deepak G; Pophale, Rupesh R; Prabhu, Arun

2008-12-01

To compare the efficacy and tolerability of Oxymetazoline 0.05 % plus Dexpanthanol 5% versus Xylometazoline 0.1 % nasal drops in patients with nasal congestion due to allergic rhinitis and following nasal surgery. An investigator-blind, randomized, controlled, phase IV clinical trial conducted in 100 patients with acute allergic rhinitis or patients post-nasal surgery. Patients received either Oxymetazoline 0.05% with Dexpanthanol 5% (OD) or Xylometazoline 0.1% (XO) nasal drops. Relief from nasal congestion was significantly better in the OD group then in the XO group (mean nasal scores 1.24 vs 1.86). Significantly more improvement in sneezing and decrease in nasal discharge was seen in the OD group than the XO group. Nasal irritation in the OD group was significantly less as compared to XO group (0.38 v/s 1.12 on second day and 0.10 vs 0.36 on the fourth day). The recovery time for OD group was 1.08 hours, which was significantly (46 min) lesser than that of the XO group. Rebound congestion was significantly less in OD as compared to XO group (6.25% vs 82.98%). 93.75% of the physicians in the OD group and 51.28% in XO group reported response to therapy as good to excellent. 95.83% patients in the OD group and only 52.91% patients in the XO group rated tolerability to therapy as good to excellent. Oxymetazoline and dexpanthenol combination has a better efficacy, shorter recovery time, causes lesser rebound congestion and has better tolerability than xylometazoline.

Acoustic rhinometry in the dog: a novel large animal model for studies of nasal congestion.

PubMed

Koss, Michael C; Yu, Yongxin; Hey, John A; McLeod, Robbie L

2002-01-01

The aim of this project was to develop and pharmacologically characterize an experimental dog model of nasal congestion in which nasal patency is measured using acoustic rhinometry. Solubilized compound 48/80 (0.3-3.0%) was administered intranasally to thiopental anesthetized beagle dogs to elicit nasal congestion via localized mast cell degranulation. Compound 48/80-induced effects on parameters of nasal patency were studied in vehicle-treated animals, as well as in the same animals pretreated 2 hours earlier with oral d-pseudoephedrine or chlorpheniramine. Local mast cell degranulation caused a close-related decrease in nasal cavity volume and minimal cross-sectional area (Amin) together with a highly variable increase in nasal secretions. Maximal responses were seen at 90-120 minutes after 48/80 administration. Oral administration of the adrenergic agonist, d-pseudoephedrine (3.0 mg/kg), significantly antagonized all of the nasal effects of compound 48/80 (3.0%). In contrast, oral administration of the histamine H1 receptor antagonist chlorpheniramine (10 mg/kg) appeared to reduce the increased nasal secretions but was without effect on the compound 48/ 80-induced nasal congestion (i.e., volume and Amin). These results show the effectiveness of using acoustic rhinometry in this anesthetized dog model. The observations that compound 48/80-induced nasal congestion was prevented by d-pseudoephedrine pretreatment, but not by chlorpheniramine, suggest that this noninvasive model system may provide an effective tool with which to study the actions of decongestant drugs in preclinical investigations.

Long-term administration of tolvaptan increases myocardial remodeling and mortality via exacerbation of congestion in mice heart failure model after myocardial infarction.

PubMed

Eguchi, Akiyo; Iwasaku, Toshihiro; Okuhara, Yoshitaka; Naito, Yoshiro; Mano, Toshiaki; Masuyama, Tohru; Hirotani, Shinichi

2016-10-15

In contrast to loop diuretics, tolvaptan does not cause neurohormonal activation in several animal heart failure models. However, it remains unknown whether chronic vasopressin type 2 receptor blockade exerts beneficial effects on mortality in murine heart failure after myocardial infarction (MI). In an experimental heart failure model, we tested the hypothesis that tolvaptan reduces myocardial remodeling and mortality. MI was induced in 9-week-old male C57Bl6/J by the left coronary artery ligation. In study 1, animals were randomly assigned to treatment with placebo or tolvaptan starting 14days post-MI. In study 2, animals were randomized to tolvaptan or furosemide+tolvaptan starting 14days post-MI. Interestingly, results showed lower survival rate in tolvaptan group compared to placebo. Tolvaptan group had higher serum osmolality, heavier body weight, more severe myocardial remodeling, and lung congestion at day 28 of drug administration compared to placebo. In study 2, addition of furosemide significantly reduced mortality rate seen with tolvaptan, and presented with decreased osmolality, myocardial remodeling, and lung congestion compared to tolvaptan-treated mice. Increase in proximal tubular expression of aquaporin 1, Angiotensin II, and vasopressin seen with tolvaptan treatments were normalized to basal levels, similar to levels in placebo-treated mice. Contrary to our hypothesis, tolvaptan was associated with increased mortality in murine heart failure after MI. This increase in lung congestion, myocardial remodeling, could be prevented by co-administration of furosemide, which resulted in normalized serum osmolality, neurohormonal activation, and renal aquaporin 1 expression, and hence decreased mortality post-MI. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Does nasal congestion have a role in decreased resistance to regular CPAP usage?

PubMed

İriz, Ayşe; Düzlü, Mehmet; Köktürk, Oğuz; Kemaloğlu, Yusuf Kemal; Eravcı, Fakih Cihat; Zorlu, Mehmet Ekrem; Karamert, Recep

2017-11-01

Nasal obstruction is known to cause resistance to continuous positive airway pressure (CPAP) therapy in obstructive sleep apnea syndrome (OSAS). In this paper, short- and long-term nasal congestion in OSAS patients receiving CPAP treatment were evaluated with acoustic rhinometry (AR). A total of 36 patients with moderate-to-severe OSAS, diagnosed with polysomnography were included in the study. Ten healthy subjects without OSAS constituted the control group. Pre-treatment nasal patency were measured with AR in all participants. 26 patients used the recommended CPAP treatment. Ten patients did not accept CPAP treatment. The AR test was repeated for all the subjects after 1 and 3 months except the 3rd month's measurements of the control group. There was no statistically significant difference between the initial minimum cross-sectional area (MCA) measurements of OSAS patients, using or not using CPAP, and the control group (P > 0.05). However, the first month MCA measurements of patients receiving CPAP were found to be significantly decreased compared with the initial values (P < 0.001). There was no significant change in the first and third months MCA values in the control group and patients who did not use CPAP (P > 0.05). No significant difference revealed in the 3rd month MCA measurements of the patients using CPAP compared with the initial values (P > 0.05). In this study, the increased nasal congestion, which is thought to be the cause of CPAP resistance, was objectively demonstrated in OSAS patients using CPAP. In addition, the nasal congestion developing at the first month was shown to disappear over time, supporting the opinion that patient compliance in CPAP treatment is expected to increase after regular device usage.

System-Level Integration of Mass Memory

NASA Technical Reports Server (NTRS)

Cox, Brian; Mellstrom, Jeffrey; Wysocky, Terry

2008-01-01

A report discusses integrating multiple memory modules on the high-speed serial interconnect (IEEE 1393) that is used by a spacecraft?s inter-module communications in order to ease data congestion and provide for a scalable, strong, flexible system that can meet new system-level mass memory requirements.

Integration of transportation for improved mobility.

DOT National Transportation Integrated Search

2017-07-04

Mobility management and improvement have become the focal point of the federal, state, and local transportation agencies over the last decade. Even with decreasing vehicle-miles-traveled (VMT) over the same time span, the congestion and delays have n...

Research, education, and outreach derived from campus transit laboratory.

DOT National Transportation Integrated Search

2014-04-01

Increased use of public transportation is an effective means of decreasing roadway congestion and : its associated externalities. To increase the use of public transportation under economic and resource : constraints, it is important to improve the u...

Research on three-phase traffic flow modeling based on interaction range

NASA Astrophysics Data System (ADS)

Zeng, Jun-Wei; Yang, Xu-Gang; Qian, Yong-Sheng; Wei, Xu-Ting

2017-12-01

On the basis of the multiple velocity difference effect (MVDE) model and under short-range interaction, a new three-phase traffic flow model (S-MVDE) is proposed through careful consideration of the influence of the relationship between the speeds of the two adjacent cars on the running state of the rear car. The random slowing rule in the MVDE model is modified in order to emphasize the influence of vehicle interaction between two vehicles on the probability of vehicles’ deceleration. A single-lane model which without bottleneck structure under periodic boundary conditions is simulated, and it is proved that the traffic flow simulated by S-MVDE model will generate the synchronous flow of three-phase traffic theory. Under the open boundary, the model is expanded by adding an on-ramp, the congestion pattern caused by the bottleneck is simulated at different main road flow rates and on-ramp flow rates, which is compared with the traffic congestion pattern observed by Kerner et al. and it is found that the results are consistent with the congestion characteristics in the three-phase traffic flow theory.

Improving UDP/IP Transmission Without Increasing Congestion

NASA Technical Reports Server (NTRS)

Burleigh, Scott

2006-01-01

Datagram Retransmission (DGR) is a computer program that, within certain limits, ensures the reception of each datagram transmitted under the User Datagram Protocol/Internet Protocol. [User Datagram Protocol (UDP) is considered unreliable because it does not involve a reliability-ensuring connection-initiation dialogue between sender and receiver. UDP is well suited to issuing of many small messages to many different receivers.] Unlike prior software for ensuring reception of UDP datagrams, DGR does not contribute to network congestion by retransmitting data more frequently as an ever-increasing number of messages and acknowledgements is lost. Instead, DGR does just the opposite: DGR includes an adaptive timeout-interval- computing component that provides maximum opportunity for reception of acknowledgements, minimizing retransmission. By monitoring changes in the rate at which message-transmission transactions are completed, DGR detects changes in the level of congestion and responds by imposing varying degrees of delay on the transmission of new messages. In addition, DGR maximizes throughput by not waiting for acknowledgement of a message before sending the next message. All DGR communication is asynchronous, to maximize efficient utilization of network connections. DGR manages multiple concurrent datagram transmission and acknowledgement conversations.

THE RAPID SHALLOW BREATHING RESULTING FROM PULMONARY CONGESTION AND EDEMA

PubMed Central

Churchill, Edward D.; Cope, Oliver

1929-01-01

These experiments record the effects of the experimental production of pulmonary congestion and edema in a lung completely isolated from the general circulation, but with an intact nerve supply. The resulting changes are: a slowing of the heart rate, a fall in systemic blood pressure and a temporary inhibition of respiration succeeded by rapid shallow breathing. The pulse rate and blood pressure show a rapid and spontaneous return to initial conditions. The respirations show a partial but not a complete return to their former rate and depth. The effects on respiration are similar to those described by Dunn and Binger and Moore which follow multiple embolism of the pulmonary circuit with starch granules. The alterations in the pulse rate and blood pressure are characteristic of the effects of vagal stimulation. A chemical effect on the respiratory center is excluded by the nature of the preparation. These results, therefore, add further evidence to support the hypothesis that the rapid shallow breathing attending congestion and edema of the lungs is due to the stimulation of nerve endings in the lungs. PMID:19869562

Venus' nighttime horizontal plasma flow, 'magnetic congestion', and ionospheric hole production

NASA Technical Reports Server (NTRS)

Grebowsky, J. M.; Mayr, H. G.; Curtis, S. A.; Taylor, H. A., Jr.

1983-01-01

A simple rectilinear, two-dimensional MHD model is used to investigate the effects of field-aligned plasma loss and cooling on a dense plasma convecting across a weak magnetic field, in order to illumine the Venus nighttime phenomena of horizontal plasma flow, magnetic congestion and ionospheric hole production. By parameterizing field-aligned variations and explicitly solving for cross magnetic field variations, it is shown that the abrupt horizontal enhancements of the vertical magnetic field, as well as sudden decreases of the plasma density to very low values (which are characteristic of ionospheric holes), can be produced in the presence of field-aligned losses.

Load balancing strategy and its lookup-table enhancement in deterministic space delay/disruption tolerant networks

NASA Astrophysics Data System (ADS)

Huang, Jinhui; Liu, Wenxiang; Su, Yingxue; Wang, Feixue

2018-02-01

Space networks, in which connectivity is deterministic and intermittent, can be modeled by delay/disruption tolerant networks. In space delay/disruption tolerant networks, a packet is usually transmitted from the source node to the destination node indirectly via a series of relay nodes. If anyone of the nodes in the path becomes congested, the packet will be dropped due to buffer overflow. One of the main reasons behind congestion is the unbalanced network traffic distribution. We propose a load balancing strategy which takes the congestion status of both the local node and relay nodes into account. The congestion status, together with the end-to-end delay, is used in the routing selection. A lookup-table enhancement is also proposed. The off-line computation and the on-line adjustment are combined together to make a more precise estimate of the end-to-end delay while at the same time reducing the onboard computation. Simulation results show that the proposed strategy helps to distribute network traffic more evenly and therefore reduces the packet drop ratio. In addition, the average delay is also decreased in most cases. The lookup-table enhancement provides a compromise between the need for better communication performance and the desire for less onboard computation.

Non-Gaussianity of Low Frequency Heart Rate Variability and Sympathetic Activation: Lack of Increases in Multiple System Atrophy and Parkinson Disease

PubMed Central

Kiyono, Ken; Hayano, Junichiro; Kwak, Shin; Watanabe, Eiichi; Yamamoto, Yoshiharu

2012-01-01

The correlates of indices of long-term ambulatory heart rate variability (HRV) of the autonomic nervous system have not been completely understood. In this study, we evaluated conventional HRV indices, obtained from the daytime (12:00–18:00) Holter recording, and a recently proposed non-Gaussianity index (λ; Kiyono et al., 2008) in 12 patients with multiple system atrophy (MSA) and 10 patients with Parkinson disease (PD), known to have varying degrees of cardiac vagal and sympathetic dysfunction. Compared with the age-matched healthy control group, the MSA patients showed significantly decreased HRV, most probably reflecting impaired vagal heart rate control, but the PD patients did not show such reduced variability. In both MSA and PD patients, the low-to-high frequency (LF/HF) ratio and the short-term fractal exponent α1, suggested to reflect the sympathovagal balance, were significantly decreased, as observed in congestive heart failure (CHF) patients with sympathetic overdrive. In contrast, the analysis of the non-Gaussianity index λ showed that a marked increase in intermittent and non-Gaussian HRV observed in the CHF patients was not observed in the MSA and PD patients with sympathetic dysfunction. These findings provide additional evidence for the relation between the non-Gaussian intermittency of HRV and increased sympathetic activity. PMID:22371705

Load index model: An advanced tool to support decision making during mass-casualty incidents.

PubMed

Adini, Bruria; Aharonson-Daniel, Limor; Israeli, Avi

2015-03-01

In mass-casualty events, accessing information concerning hospital congestion levels is crucial to improving patient distribution and optimizing care. The study aimed to develop a decision support tool for distributing casualties to hospitals in an emergency scenario involving multiple casualties. A comprehensive literature review and structured interviews with 20 content experts produced a shortlist of relevant criteria for inclusion in the model. A "load index model" was prepared, incorporating results of a modified Delphi survey of 100 emergency response experts. The model was tested in three simulation exercises in which an emergency scenario was presented to six groups of senior emergency managers. Information was provided regarding capacities of 11 simulated admitting hospitals in the region, and evacuation destinations were requested for 600 simulated casualties. Of the three simulation rounds, two were performed without the model and one after its presentation. Following simulation experiments and implementation during a real-life security threat, the efficacy of the model was assessed. Variability between experts concerning casualties' evacuation destinations decreased significantly following the model's introduction. Most responders (92%) supported the need for standardized data, and 85% found that the model improved policy setting regarding casualty evacuation in an emergency situation. These findings were reaffirmed in a real-life emergency scenario. The proposed model improved capacity to ensure evacuation of patients to less congested medical facilities in emergency situations, thereby enhancing lifesaving medical services. The model supported decision-making processes in both simulation exercises and an actual emergency situation.

Interpretation and use of natriuretic peptides in non-congestive heart failure settings.

PubMed

Tsai, Shih-Hung; Lin, Yen-Yue; Chu, Shi-Jye; Hsu, Ching-Wang; Cheng, Shu-Meng

2010-03-01

Natriuretic peptides (NPs) have been found to be useful markers in differentiating acute dyspneic patients presenting to the emergency department (ED) and emerged as potent prognostic markers for patients with congestive heart failure (CHF). The best-established and widely used clinical application of BNP and NT-proBNP testing is for the emergent diagnosis of CHF in patients presenting with acute dyspnea. Nevertheless, elevated NPs levels can be found in many circumstances involving left ventricular (LV) dysfunction or hypertrophy; right ventricular (RV) dysfunction secondary to pulmonary diseases; cardiac inflammatory or infectious diseases; endocrinology diseases and high output status without decreased LV ejection fraction. Even in the absence of significant clinical evidence of volume overload or LV dysfunction, markedly elevated NP levels can be found in patients with multiple comorbidities with a certain degree of prognostic value. Potential clinical applications of NPs are expanded accompanied by emerging reports regarding screening the presence of secondary cardiac dysfunction; monitoring the therapeutic responses, risk stratifications and providing prognostic values in many settings. Clinicians need to have expanded knowledge regarding the interpretation of elevated NPs levels and potential clinical applications of NPs. Clinicians should recognize that currently the only reasonable application for routine practice is limited to differentiation of acute dyspnea, rule-out-diagnostic-tests, monitoring of therapeutic responses and prognosis of acute or decompensated CHF. The rationales as well the potential applications of NPs in these settings are discussed in this review article.

Interpretation and Use of Natriuretic Peptides in Non-Congestive Heart Failure Settings

PubMed Central

Lin, Yen-Yue; Chu, Shi-Jye; Hsu, Ching-Wang; Cheng, Shu-Meng

2010-01-01

Natriuretic peptides (NPs) have been found to be useful markers in differentiating acute dyspneic patients presenting to the emergency department (ED) and emerged as potent prognostic markers for patients with congestive heart failure (CHF). The best-established and widely used clinical application of BNP and NT-proBNP testing is for the emergent diagnosis of CHF in patients presenting with acute dyspnea. Nevertheless, elevated NPs levels can be found in many circumstances involving left ventricular (LV) dysfunction or hypertrophy; right ventricular (RV) dysfunction secondary to pulmonary diseases; cardiac inflammatory or infectious diseases; endocrinology diseases and high output status without decreased LV ejection fraction. Even in the absence of significant clinical evidence of volume overload or LV dysfunction, markedly elevated NP levels can be found in patients with multiple comorbidities with a certain degree of prognostic value. Potential clinical applications of NPs are expanded accompanied by emerging reports regarding screening the presence of secondary cardiac dysfunction; monitoring the therapeutic responses, risk stratifications and providing prognostic values in many settings. Clinicians need to have expanded knowledge regarding the interpretation of elevated NPs levels and potential clinical applications of NPs. Clinicians should recognize that currently the only reasonable application for routine practice is limited to differentiation of acute dyspnea, rule-out-diagnostic-tests, monitoring of therapeutic responses and prognosis of acute or decompensated CHF. The rationales as well the potential applications of NPs in these settings are discussed in this review article. PMID:20191004

Effects of Multiple Cleaning and Disinfection Interventions on Infectious Diseases in Children: A Group Randomized Trial in China.

PubMed

Ban, Hai Qun; Li, Tao; Shen, Jin; Li, Jin; Peng, Pin Zhang; Ye, Heng Ping; Zhang, Liu Bo

2015-11-01

To assess the effectiveness of multiple cleaning and disinfection interventions in the homes and kindergartens, in reducing gastrointestinal and respiratory illnesses of children. From October 2010 to September 2011, we performed a prospective, controlled study in China. 408 children under 5 years old were recruited and group randomized into intervention and control groups. Families and kindergartens in the intervention group were provided with antibacterial products for hand hygiene and surface cleaning or disinfection for one year. Each child's illness symptoms and sick leave were recorded every day. A total of 393 children completed the study, with similar baseline demographics in each of the 2 groups. Except for abdominal pain, the odds of symptoms (fever, cough and expectoration, runny nose and nasal congestion, diarrhea), illness (acute respiratory illness and gastrointestinal illness), and sick leave per person each month were significantly reduced by interventions. The rates of fever, diarrhea, acute respiratory illness, gastrointestinal illness and sick leave per person per year were significantly decreased as well. Not only the acute respiratory and gastrointestinal illness but the sick leave rate in children were significantly reduced by multiple interventions. Copyright © 2015 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

Curbing gridlock: Peak-period fees to relieve traffic congestion. Volume 2. Commissioned papers. Special report

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

Not Available

1994-01-01

;Contents: Volume 2: Commissioned Papers: Congestion Trends in Metropolitan Areas; Alternative Methods for Measuring Congestion Levels; Potential of Congestion Pricing in the Metropolitan Washington Region; Transportation Pricing and Travel Behavior; Peak Pricing Strategies in Transportation, Utilities, and Telecommunications: Lessons for Road Pricing; Cashing Out Employer-Paid Parking: A Precedent for Congestion Pricing; The New York Region: First in Tolls, Last in Road Pricing; Pricing Urban Roadways: Administrative and Institutional Issues; Equity and Fairness Considerations of Congestion Pricing; The Politics of Congestion Pricing; Institutional and Political Challenges in Implementing Congestion Pricing: Case Study of the San Francisco Bay Area; How Congestion Pricingmore » Came to Be Proposed in the San Diego Region: A Case History; Urban Transportation Congestion Pricing: Effects on Urban Form; Congestion Pricing and Motor Vehicle Emissions: An Initial Review; Private Toll Roads: Acceptability of Congestion Pricing in Southern California; Potential of Next-Generation Technology; Electronic Toll Collection Systems; and Impacts of Congestion Pricing on Transit and Carpool Demand and Supply.« less

Traffic congestion and reliability : trends and advanced strategies for congestion mitigation.

DOT National Transportation Integrated Search

2005-09-01

The report Traffic Congestion and Reliability: Trends and Advanced Strategies for : Congestion Mitigation provides a snapshot of congestion in the United States by : summarizing recent trends in congestion, highlighting the role of travel time : reli...

Designing for Discovery Learning of Complexity Principles of Congestion by Driving Together in the TrafficJams Simulation

ERIC Educational Resources Information Center

Levy, Sharona T.; Peleg, Ran; Ofeck, Eyal; Tabor, Naamit; Dubovi, Ilana; Bluestein, Shiri; Ben-Zur, Hadar

2018-01-01

We propose and evaluate a framework supporting collaborative discovery learning of complex systems. The framework blends five design principles: (1) individual action: amidst (2) social interactions; challenged with (3) multiple tasks; set in (4) a constrained interactive learning environment that draws attention to (5) highlighted target…

The merits of a robot: a Dutch experience.

PubMed

Mobach, Mark P

2006-01-01

To determine the merits of a robot at the community pharmacy in a quasi-experiment. The applied methods for data-collection were barcode-time measurements, direct observations, time-interval studies, and tally at a Dutch community pharmacy. The topics consisted of workload, waiting times, congestion, slack, general work, counter work, and work at the consultation room. The topics were studied in pre-test and post-test stages, each stage during six weeks. By using these topics and some additional data from the pharmacy, the economics of the robot were also assessed. The workload decreased with 15 prescriptions per person per day. The waiting times decreased with one minute and 18 seconds per dispensing process, reducing the wait until counter contact. The day congestion decreased with one hour 27 minutes and 36 seconds, and the day slack increased with 28 minutes. The analysis of the general work showed no appreciable difference in the bulk of the care-related activities and the other activities. However, some work was re-shuffled: 7% increase at counter work and 7% decrease at logistics. Moreover, statistically significant increases were observed at counter work (5%) and robot work (4%), and significant decreases at telephone (3%) and filling work in presence of the patient (4%). The counter tally study showed a rise in care-related activities with 8%. Moreover, it also illuminated a statistically significant decrease at no information (11%) and an increase at only social (2%). The consultation room was never used during the study. The pharmacy economics of the robot showed that the robot had high estimated costs for purchase, depreciation, and maintenance: EUR 187,024 in the first year. Moreover, the robot had positive impact on waiting times, congestion, staffing, logistics, and care-related work, which was estimated on EUR 91,198 in the first year. The estimated payback time of the robot was three years. An introduction of the robot may indeed have the often supposed positive effects on pharmaceutical care. Even though the costs are high and the technical problems are present, the robot seems to be financial beneficial after three years. The robot can create space for pharmaceutical care, but it has a substantial cost.

A Beacon Transmission Power Control Algorithm Based on Wireless Channel Load Forecasting in VANETs.

PubMed

Mo, Yuanfu; Yu, Dexin; Song, Jun; Zheng, Kun; Guo, Yajuan

2015-01-01

In a vehicular ad hoc network (VANET), the periodic exchange of single-hop status information broadcasts (beacon frames) produces channel loading, which causes channel congestion and induces information conflict problems. To guarantee fairness in beacon transmissions from each node and maximum network connectivity, adjustment of the beacon transmission power is an effective method for reducing and preventing channel congestion. In this study, the primary factors that influence wireless channel loading are selected to construct the KF-BCLF, which is a channel load forecasting algorithm based on a recursive Kalman filter and employs multiple regression equation. By pre-adjusting the transmission power based on the forecasted channel load, the channel load was kept within a predefined range; therefore, channel congestion was prevented. Based on this method, the CLF-BTPC, which is a transmission power control algorithm, is proposed. To verify KF-BCLF algorithm, a traffic survey method that involved the collection of floating car data along a major traffic road in Changchun City is employed. By comparing this forecast with the measured channel loads, the proposed KF-BCLF algorithm was proven to be effective. In addition, the CLF-BTPC algorithm is verified by simulating a section of eight-lane highway and a signal-controlled urban intersection. The results of the two verification process indicate that this distributed CLF-BTPC algorithm can effectively control channel load, prevent channel congestion, and enhance the stability and robustness of wireless beacon transmission in a vehicular network.

A Beacon Transmission Power Control Algorithm Based on Wireless Channel Load Forecasting in VANETs

PubMed Central

Mo, Yuanfu; Yu, Dexin; Song, Jun; Zheng, Kun; Guo, Yajuan

2015-01-01

In a vehicular ad hoc network (VANET), the periodic exchange of single-hop status information broadcasts (beacon frames) produces channel loading, which causes channel congestion and induces information conflict problems. To guarantee fairness in beacon transmissions from each node and maximum network connectivity, adjustment of the beacon transmission power is an effective method for reducing and preventing channel congestion. In this study, the primary factors that influence wireless channel loading are selected to construct the KF-BCLF, which is a channel load forecasting algorithm based on a recursive Kalman filter and employs multiple regression equation. By pre-adjusting the transmission power based on the forecasted channel load, the channel load was kept within a predefined range; therefore, channel congestion was prevented. Based on this method, the CLF-BTPC, which is a transmission power control algorithm, is proposed. To verify KF-BCLF algorithm, a traffic survey method that involved the collection of floating car data along a major traffic road in Changchun City is employed. By comparing this forecast with the measured channel loads, the proposed KF-BCLF algorithm was proven to be effective. In addition, the CLF-BTPC algorithm is verified by simulating a section of eight-lane highway and a signal-controlled urban intersection. The results of the two verification process indicate that this distributed CLF-BTPC algorithm can effectively control channel load, prevent channel congestion, and enhance the stability and robustness of wireless beacon transmission in a vehicular network. PMID:26571042

Mount Baker - Snoqualmie National Forest alternative transportation feasibility study : phase I final report

DOT National Transportation Integrated Search

2012-05-31

Mount Baker-Snoqualmie National Forest (MBSNF) is located in close proximity to the Puget Sound metropolitan area in western Washington State. The Forest is facing a number of transportation issues, such as increasing congestion and decreasing availa...

Maximizing port and transportation system productivity by exploring alternative port operation strategies.

DOT National Transportation Integrated Search

2011-06-01

Seaports are a critical transportation component that supports the nations economy. Many U.S. : ports are now experiencing significant truck congestion at the gate, which decreases the productivity of : ports and truck fleets (e.g. truck wait time...

Optimizing End-to-End Big Data Transfers over Terabits Network Infrastructure

DOE PAGES

Kim, Youngjae; Atchley, Scott; Vallee, Geoffroy R.; ...

2016-04-05

While future terabit networks hold the promise of significantly improving big-data motion among geographically distributed data centers, significant challenges must be overcome even on today's 100 gigabit networks to realize end-to-end performance. Multiple bottlenecks exist along the end-to-end path from source to sink, for instance, the data storage infrastructure at both the source and sink and its interplay with the wide-area network are increasingly the bottleneck to achieving high performance. In this study, we identify the issues that lead to congestion on the path of an end-to-end data transfer in the terabit network environment, and we present a new bulkmore » data movement framework for terabit networks, called LADS. LADS exploits the underlying storage layout at each endpoint to maximize throughput without negatively impacting the performance of shared storage resources for other users. LADS also uses the Common Communication Interface (CCI) in lieu of the sockets interface to benefit from hardware-level zero-copy, and operating system bypass capabilities when available. It can further improve data transfer performance under congestion on the end systems using buffering at the source using flash storage. With our evaluations, we show that LADS can avoid congested storage elements within the shared storage resource, improving input/output bandwidth, and data transfer rates across the high speed networks. We also investigate the performance degradation problems of LADS due to I/O contention on the parallel file system (PFS), when multiple LADS tools share the PFS. We design and evaluate a meta-scheduler to coordinate multiple I/O streams while sharing the PFS, to minimize the I/O contention on the PFS. Finally, with our evaluations, we observe that LADS with meta-scheduling can further improve the performance by up to 14 percent relative to LADS without meta-scheduling.« less

Optimizing End-to-End Big Data Transfers over Terabits Network Infrastructure

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

Kim, Youngjae; Atchley, Scott; Vallee, Geoffroy R.

While future terabit networks hold the promise of significantly improving big-data motion among geographically distributed data centers, significant challenges must be overcome even on today's 100 gigabit networks to realize end-to-end performance. Multiple bottlenecks exist along the end-to-end path from source to sink, for instance, the data storage infrastructure at both the source and sink and its interplay with the wide-area network are increasingly the bottleneck to achieving high performance. In this study, we identify the issues that lead to congestion on the path of an end-to-end data transfer in the terabit network environment, and we present a new bulkmore » data movement framework for terabit networks, called LADS. LADS exploits the underlying storage layout at each endpoint to maximize throughput without negatively impacting the performance of shared storage resources for other users. LADS also uses the Common Communication Interface (CCI) in lieu of the sockets interface to benefit from hardware-level zero-copy, and operating system bypass capabilities when available. It can further improve data transfer performance under congestion on the end systems using buffering at the source using flash storage. With our evaluations, we show that LADS can avoid congested storage elements within the shared storage resource, improving input/output bandwidth, and data transfer rates across the high speed networks. We also investigate the performance degradation problems of LADS due to I/O contention on the parallel file system (PFS), when multiple LADS tools share the PFS. We design and evaluate a meta-scheduler to coordinate multiple I/O streams while sharing the PFS, to minimize the I/O contention on the PFS. Finally, with our evaluations, we observe that LADS with meta-scheduling can further improve the performance by up to 14 percent relative to LADS without meta-scheduling.« less

Multimodality Imaging of Myocardial Injury and Remodeling

PubMed Central

Kramer, Christopher M.; Sinusas, Albert J.; Sosnovik, David E.; French, Brent A.; Bengel, Frank M.

2011-01-01

Advances in cardiovascular molecular imaging have come at a rapid pace over the last several years. Multiple approaches have been taken to better understand the structural, molecular, and cellular events that underlie the progression from myocardial injury to myocardial infarction (MI) and, ultimately, to congestive heart failure. Multimodality molecular imaging including SPECT, PET, cardiac MRI, and optical approaches is offering new insights into the pathophysiology of MI and left ventricular remodeling in small-animal models. Targets that are being probed include, among others, angiotensin receptors, matrix metalloproteinases, integrins, apoptosis, macrophages, and sympathetic innervation. It is only a matter of time before these advances are applied in the clinical setting to improve post-MI prognostication and identify appropriate therapies in patients to prevent the onset of congestive heart failure. PMID:20395347

Analysis of Random Drop for Gateway Congestion Control

DTIC Science & Technology

1989-11-01

effective congest)on control policies. Currently No Gateway Policy is used to relieve and signal congestion, which leads to unfair service to the...early application of the policy removes the pressure of congestion relief and allows more accurate signaling of congestion. ’ To be used effectively ...prompted the need for more effective congestion control policies. Currently No Gateway Policy is used to relieve and signal congestion, which leads to

CAPILLARY NETWORK ANOMALIES IN BRANCH RETINAL VEIN OCCLUSION ON OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY.

PubMed

Rispoli, Marco; Savastano, Maria Cristina; Lumbroso, Bruno

2015-11-01

To analyze the foveal microvasculature features in eyes with branch retinal vein occlusion (BRVO) using optical coherence tomography angiography based on split spectrum amplitude decorrelation angiography technology. A total of 10 BRVO eyes (mean age 64.2 ± 8.02 range between 52 years and 76 years) were evaluated by optical coherence tomography angiography (XR-Avanti; Optovue). The macular angiography scan protocol covered a 3 mm × 3 mm area. The focus of angiography analysis were two retinal layers: superficial vascular network and deep vascular network. The following vascular morphological congestion parameters were assessed in the vein occlusion area in both the superficial and deep networks: foveal avascular zone enlargement, capillary non-perfusion occurrence, microvascular abnormalities appearance, and vascular congestion signs. Image analyses were performed by 2 masked observers and interobserver agreement of image analyses was 0.90 (κ = 0.225, P < 0.01). In both superficial and deep network of BRVO, a decrease in capillary density with foveal avascular zone enlargement, capillary non-perfusion occurrence, and microvascular abnormalities appearance was observed (P < 0.01). The deep network showed the main vascular congestion at the boundary between healthy and nonperfused retina. Optical coherence tomography angiography in BRVO allows to detect foveal avascular zone enlargement, capillary nonperfusion, microvascular abnormalities, and vascular congestion signs both in the superficial and deep capillary network in all eyes. Optical coherence tomography angiography technology is a potential clinical tool for BRVO diagnosis and follow-up, providing stratigraphic vascular details that have not been previously observed by standard fluorescein angiography. The normal retinal vascular nets and areas of nonperfusion and congestion can be identified at various retinal levels. Optical coherence tomography angiography provides noninvasive images of the retinal capillaries and vascular networks.

Comparing Perceptions and Measures of Congestion

DOT National Transportation Integrated Search

2012-10-01

Peoples perception of congestion and the actual measured congestion do not always agree. Measured : congestion relates to the delay resulting from field measurements of traffic volume, speed, and travel : time. Peoples perception of congestion ...

Pulmonary edema associated with upper airway obstruction in dogs.

PubMed

Algren, J T; Price, R D; Buchino, J J; Stremel, R W

1993-12-01

In order to evaluate the effect of acute upper airway obstruction upon pulmonary edema (PE) formation, we studied seven dogs that were subjected to inspiratory obstruction for three hours. Hypoxia was avoided by the administration of supplemental oxygen during the study period. Six dogs developed pulmonary vascular congestion, and four developed histologic findings of PE. Inspiratory intrapleural pressure decreased to -28 +/- 4 mmHg in dogs that developed PE and to -23 +/- 2 mmHg in dogs that did not. Transmural pulmonary artery pressure and pulmonary artery wedge pressure did not increase significantly. Central venous pressure during inspiration (CVPi) increased in all dogs, and CVP at end expiration (CVPe) was significantly higher in dogs with PE. Dogs that developed PE experienced a decrease in cardiac output and an increase in systemic vascular resistance. Furthermore, alveolar ventilation declined in dogs with PE, ultimately resulting in ventilatory failure. Pulmonary edema formation was not preceded by an increase in pulmonary vascular pressures but was associated with higher CVP, pulmonary vascular congestion, and hypercarbia.

Value of positive myocardial technetium-99m-pyrophosphate scintigraphy in the noninvasive diagnosis of cardiac amyloidosis

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

Wizenberg, T.A.; Muz, J.; Sohn, Y.H.

1982-04-01

Ten consecutive patients with tissue-proven amyloidosis, seven of whom presented with congestive heart failure, were found to exhibit intense diffuse uptake of technetium-99m-pyrophosphate (Tc-99m-PYP) on cardiac radionuclide imaging. The patients exhibited echocardiographic and systolic time interval abnormalities suggesting combined restrictive and congestive cardiomyopathic changes. On M-mode echocardiograms, there was symmetrically increased thickness of the interventricular septum and left ventricular (LV) posterior wall in diastole (10 of 10), decreased fractional shortening of the LV minor axis diameter in systole (eight of nine), and decreased percent thickening of the LV minor axis diameter in systole (eight of nine) and LV posterior wallmore » (10 of 10) in systole. Three patients demonstrated enlarged LV end-diastolic diameter. All 10 patients had abnormal PEP/LVET and eight had shortened LVETI. When combined with noninvasive tests of LV performance, positive myocardial pyrophosphate (PYP) scanning provides a new and useful adjunct in the diagnosis of amyloid heart disease.« less

Canine model of nasal congestion and allergic rhinitis.

PubMed

Tiniakov, Ruslan L; Tiniakova, Olga P; McLeod, Robbie L; Hey, John A; Yeates, Donovan B

2003-05-01

The ragweed- and histamine-induced decreases in nasal patency in cohorts of ragweed-sensitized and nonsensitized dogs were assessed. The volume of nasal airways (V(NA)) was assessed by acoustic rhinometry and resistance to airflow (R(NA)) by anterior rhinomanometry. Histamine delivered to the nasal passages of five dogs caused a rapid and prolonged increase in R(NA) (0.75 +/- 0.26 to 3.56 +/- 0.50 cmH(2)O. l(-1). min), an effect that was reversed by intranasal delivery of aerosolized phenylephrine. Ragweed challenge in five ragweed-sensitized dogs increased R(NA) from 0.16 +/- 0.02 to 0.53 +/- 0.07 cmH(2)O. l(-1). min and decreased V(NA) from 12.5 +/- 1.9 to 3.9 +/- 0.3 cm(3), whereas administration of saline aerosol neither increased R(NA) nor decreased V(NA). Prior administration of d-pseudoephedrine (30 mg po) attenuated the ragweed-induced increase in R(NA) and decrease in V(NA). Ragweed challenge changed neither R(NA) nor V(NA) in four nonsensitized dogs. Mediator-induced nasal congestion and allergen-induced allergic rhinitis in ragweed-sensitized dogs, which exhibit symptoms similar to human disease, can be used in the evaluation of safety and efficacy of antiallergic activity of potential drugs.

Delivering Faster Congestion Feedback with the Mark-Front Strategy

NASA Technical Reports Server (NTRS)

Liu, Chunlei; Jain, Raj

2001-01-01

Computer networks use congestion feedback from the routers and destinations to control the transmission load. Delivering timely congestion feedback is essential to the performance of networks. Reaction to the congestion can be more effective if faster feedback is provided. Current TCP/IP networks use timeout, duplicate Acknowledgement Packets (ACKs) and explicit congestion notification (ECN) to deliver the congestion feedback, each provides a faster feedback than the previous method. In this paper, we propose a markfront strategy that delivers an even faster congestion feedback. With analytical and simulation results, we show that mark-front strategy reduces buffer size requirement, improves link efficiency and provides better fairness among users. Keywords: Explicit Congestion Notification, mark-front, congestion control, buffer size requirement, fairness.

Using Cellular Automata for Parking Recommendations in Smart Environments

PubMed Central

Horng, Gwo-Jiun

2014-01-01

In this work, we propose an innovative adaptive recommendation mechanism for smart parking. The cognitive RF module will transmit the vehicle location information and the parking space requirements to the parking congestion computing center (PCCC) when the driver must find a parking space. Moreover, for the parking spaces, we use a cellular automata (CA) model mechanism that can adjust to full and not full parking lot situations. Here, the PCCC can compute the nearest parking lot, the parking lot status and the current or opposite driving direction with the vehicle location information. By considering the driving direction, we can determine when the vehicles must turn around and thus reduce road congestion and speed up finding a parking space. The recommendation will be sent to the drivers through a wireless communication cognitive radio (CR) model after the computation and analysis by the PCCC. The current study evaluates the performance of this approach by conducting computer simulations. The simulation results show the strengths of the proposed smart parking mechanism in terms of avoiding increased congestion and decreasing the time to find a parking space. PMID:25153671

Measurement of nasal patency in anesthetized and conscious dogs.

PubMed

Koss, Michael C; Yu, Yongxin; Hey, John A; McLeod, Robbie L

2002-02-01

Experiments were undertaken to characterize a noninvasive chronic, model of nasal congestion in which nasal patency is measured using acoustic rhinometry. Compound 48/80 was administered intranasally to elicit nasal congestion in five beagle dogs either by syringe (0.5 ml) in thiopental sodium-anesthetized animals or as a mist (0.25 ml) in the same animals in the conscious state. Effects of mast cell degranulation on nasal cavity volume as well as on minimal cross-sectional area (A(min)) and intranasal distance to A(min) (D(min)) were studied. Compound 48/80 caused a dose-related decrease in nasal cavity volume and A(min) together with a variable increase in D(min). Maximal responses were seen at 90-120 min. Compound 48/80 was less effective in producing nasal congestion in conscious animals, which also had significantly larger basal nasal cavity volumes. These results demonstrate the utility of using acoustic rhinometry to measure parameters of nasal patency in dogs and suggest that this model may prove useful in studies of the actions of decongestant drugs.

Investigating the effect of freeway congestion thresholds on decision-making inputs.

DOT National Transportation Integrated Search

2010-05-01

Congestion threshold is embedded in the congestion definition. Two basic approaches exist in : current practice for setting the congestion threshold. One common approach uses the free-flow or : unimpeded conditions as the congestion threshold. ...

[Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery--a literature review].

PubMed

Knobloch, K; Gohritz, A; Busch, K; Spies, M; Vogt, P M

2007-04-01

Medical leech therapy has enjoyed a renaissance in the world of reconstructive microsurgery during recent years. Especially venous congestion is decreased using hirudo medicinalis application such as following replantation of amputated fingers or congested flaps. They provide a temporary relief to venous engorgement whilst venous drainage is re-established. Living in symbiosis with Aeromonas hydrophila, who can digest the sixfold blood meal related to their body weight, and a broad number of anticoagulant agents such as the thrombin inhibitor hirudin, apyrase as well as collagenase, hyaluronidase, Factor Xa inhibitor and fibrinase I and II, leeches decrease venous congestion. Laser Doppler flowmetry could demonstrate a significant increase in superficial skin perfusion following leech application 16 mm around the biting zone. Following the initial blood meal accounting for about 2.5 ml, the anticoagulant effect of the various leeches enzymes follows within the next 5-6 hours, which both account for the beneficial effects. Infection associated with leech therapy is a documented complication of leech application, with reported incidences ranging from 2.4 to 20 % and a chinolone antibiotic is currently recommended to face the potential Aeromonas hydrophila infection. Anemia is a second adverse effect during medicinal leech application which has to be taken account with repetitive blood samples. Besides the successful applications of leeches in various applications in plastic and reconstructive microsurgery, randomized-controlled trials are pending to elucidate the value of hirudo medicinalis according to evidence-based criteria above from case series and case studies.

Reducing congestion : congestion pricing has promise for improving use of transportation infrastructure

DOT National Transportation Integrated Search

2003-05-06

Congestion pricing can potentially reduce congestion by providing incentives for drivers to shift trips to off-peak periods, use less congested routes, or use alternative modes, thereby spreading out demand for available transportation infrastructure...

Understanding the topological characteristics and flow complexity of urban traffic congestion

NASA Astrophysics Data System (ADS)

Wen, Tzai-Hung; Chin, Wei-Chien-Benny; Lai, Pei-Chun

2017-05-01

For a growing number of developing cities, the capacities of streets cannot meet the rapidly growing demand of cars, causing traffic congestion. Understanding the spatial-temporal process of traffic flow and detecting traffic congestion are important issues associated with developing sustainable urban policies to resolve congestion. Therefore, the objective of this study is to propose a flow-based ranking algorithm for investigating traffic demands in terms of the attractiveness of street segments and flow complexity of the street network based on turning probability. Our results show that, by analyzing the topological characteristics of streets and volume data for a small fraction of street segments in Taipei City, the most congested segments of the city were identified successfully. The identified congested segments are significantly close to the potential congestion zones, including the officially announced most congested streets, the segments with slow moving speeds at rush hours, and the areas near significant landmarks. The identified congested segments also captured congestion-prone areas concentrated in the business districts and industrial areas of the city. Identifying the topological characteristics and flow complexity of traffic congestion provides network topological insights for sustainable urban planning, and these characteristics can be used to further understand congestion propagation.

Treatment effects and mechanisms of Yujin Powder on rat model of large intestine dampness-heat syndrome.

PubMed

Yao, Wanling; Yang, Chaoxue; Wen, Yanqiao; Zhang, Wangdong; Zhang, Xiaosong; Ma, Qi; Ji, Peng; Hua, Yongli; Wei, Yanming

2017-04-18

Yujin Powder (YJP), an old prescription, is one of the most classical prescription for treating the large intestine dampness-heat syndrome (LIDHS). However, its potential modern pharmacological mechanisms remain unclear. The present study was designed to explore the essence of LIDHS and treatment mechanisms of the YJP on the LIDHS. The rat model of LIDHS was established by such complex factors as high-sugar and high-fat diet, improper diet, high temperature and humidity environment (HTHE), drinking and intraperitoneal injection of Escherichia coli., which imitated the inducing conditions of LIDHS. Then the clinical symptoms and signs, blood routine, blood biochemistry, whole blood viscosity (WBV), serum inflammatory cytokines levels and the histopathological changes of main organs were detected and observed, respectively. The results showed that the clinical symptoms and signs of the model rats were consistent with the diagnostic criteria of LIDHS, moreover, there were obvious systemic inflammatory response and extensive congestion. And after treatment with YJP in different dosages, the clinical symptoms and signs of the rats with LIDHS were improved; the indexes of blood routine and blood biochemistry and inflammatory cytokines levels tended to be normal; the WBV decreased and histopathological changes of major organs were alleviated or returned to normal. There was an obvious dose-effect relationship, and the high dose of YJP (HD-YJP) had the best treatment effects. These results suggested that in LIDHS, diarrhea was the major clinical manifestation; the large intestine was the main lesion area; mucosa injury, inflammation and congestion of the large intestine with systemic inflammatory response and congestion were the most typical pathological characteristics. Meanwhile, YJP exhibited the comprehensive effects of anti-diarrhea, anti-inflammation, lowering blood lipid, relieving blood stasis, repairing intestinal mucosa and regulation and protection of multiple organs on LIDHS. These findings provided not only important information for understanding the essence of LIDHS but also the theoretical basis for developing new-drugs for treating dampness-heat type of diarrheal diseases. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Network congestion control algorithm based on Actor-Critic reinforcement learning model

NASA Astrophysics Data System (ADS)

Xu, Tao; Gong, Lina; Zhang, Wei; Li, Xuhong; Wang, Xia; Pan, Wenwen

2018-04-01

Aiming at the network congestion control problem, a congestion control algorithm based on Actor-Critic reinforcement learning model is designed. Through the genetic algorithm in the congestion control strategy, the network congestion problems can be better found and prevented. According to Actor-Critic reinforcement learning, the simulation experiment of network congestion control algorithm is designed. The simulation experiments verify that the AQM controller can predict the dynamic characteristics of the network system. Moreover, the learning strategy is adopted to optimize the network performance, and the dropping probability of packets is adaptively adjusted so as to improve the network performance and avoid congestion. Based on the above finding, it is concluded that the network congestion control algorithm based on Actor-Critic reinforcement learning model can effectively avoid the occurrence of TCP network congestion.

Humans and intelligent vehicles : the hope, the help, and the harm.

DOT National Transportation Integrated Search

2016-03-01

Intelligent vehicles offer hope for a world in which crashes are rare, congestion is reduced, carbon emissions are decreased, and mobility is extended to a wider population. As long as humans are in the loop, over a half century of research in human ...

Forearm vasodilatation following release of venous congestion

PubMed Central

Caro, C. G.; Foley, T. H.; Sudlow, M. F.

1970-01-01

1. The volume rate of forearm blood flow was measured with a mercury-in-rubber strain gauge, or with a water-filled plethysmograph, from 1 sec after termination of a 2-3 min period of venous congestion. 2. When congesting pressure had been less than 18 mm Hg, average post-congestion flow (five subjects) was constant during approx. 10 sec and not significantly different from resting flow. 3. When congesting pressure had been 30 mm Hg, average post-congestion flow (eight subjects) was 26% higher than resting, during 3-4 sec after release of congestion, but rose to 273% of resting during 4-6 sec after release of congestion. 4. In other studies forearm vascular resistance had been found normal or increased during such venous congestion, and theoretical studies here indicated that passive mechanical factors could not account for the delayed occurrence of high post-congestion flow. 5. It appears, therefore, that the forearm vascular bed dilates actively shortly after release of substantial venous congestion. It would seem more likely that a myogenic mechanism, rather than a metabolic one, is responsible. PMID:5532541

Protective effect of Tribulus terrestris linn on liver and kidney in cadmium intoxicated rats.

PubMed

Lakshmi, G Dhana; Kumar, P Ravi; Bharavi, K; Annapurna, P; Rajendar, B; Patel, Pankaj T; Kumar, C S V Satish; Rao, G S

2012-02-01

Administration of cadmium (Cd) significantly increased the peroxidation markers such as malondialdehyde and protein carbonyls along with significant decrease in antioxidant markers such as super oxide dismutase and reduced glutathione in liver and kidney tissues. Cadmium also caused a significant alteration in hepatic and renal functional markers in serum viz. total protein, albumin, alanine transaminase, blood urea nitrogen and creatinine. Prominent pathological changes observed in liver were severe vascular and sinusoidal congestion with diffuse degenerative changes and mononuclear infiltration into peripheral areas, while the kidney showed vascular and glomerular congestion, cloudy swelling of tubular epithelium. Coadministration of ethonolic extract of T. terrestris or vitamin E along with Cd significantly reversed the Cd induced changes along with significant reduction in Cd load.

Research on Urban Road Traffic Congestion Charging Based on Sustainable Development

NASA Astrophysics Data System (ADS)

Ye, Sun

Traffic congestion is a major problem which bothers our urban traffic sustainable development at present. Congestion charging is an effective measure to alleviate urban traffic congestion. The paper first probes into several key issues such as the goal, the pricing, the scope, the method and the redistribution of congestion charging from theoretical angle. Then it introduces congestion charging practice in Singapore and London and draws conclusion and suggestion that traffic congestion charging should take scientific plan, support of public, public transportation development as the premise.

Return on Investment in Disease Management: A Review

PubMed Central

Goetzel, Ron Z.; Ozminkowski, Ronald J.; Villagra, Victor G.; Duffy, Jennifer

2005-01-01

The results of 44 studies investigating financial impact and return on investment (ROI) from disease management (DM) programs for asthma, congestive heart failure (CHF), diabetes, depression, and multiple illnesses were examined. A positive ROI was found for programs directed at CHF and multiple disease conditions. Some evidence suggests that diabetes programs may save more than they cost, but additional studies are needed. Results are mixed for asthma management programs. Depression management programs cost more than they save in medical expenses, but may save money when considering productivity outcomes. PMID:17288065

Return on investment in disease management: a review.

PubMed

Goetzel, Ron Z; Ozminkowski, Ronald J; Villagra, Victor G; Duffy, Jennifer

2005-01-01

The results of 44 studies investigating financial impact and return on investment (ROI) from disease management (DM) programs for asthma, congestive heart failure (CHF), diabetes, depression, and multiple illnesses were examined. A positive ROI was found for programs directed at CHF and multiple disease conditions. Some evidence suggests that diabetes programs may save more than they cost, but additional studies are needed. Results are mixed for asthma management programs. Depression management programs cost more than they save in medical expenses, but may save money when considering productivity outcomes.

Interaction between worsening renal function and persistent congestion in acute decompensated heart failure.

PubMed

Wattad, Malak; Darawsha, Wisam; Solomonica, Amir; Hijazi, Maher; Kaplan, Marielle; Makhoul, Badira F; Abassi, Zaid A; Azzam, Zaher S; Aronson, Doron

2015-04-01

Worsening renal function (WRF) and congestion are inextricably related pathophysiologically, suggesting that WRF occurring in conjunction with persistent congestion would be associated with worse clinical outcome. We studied the interdependence between WRF and persistent congestion in 762 patients with acute decompensated heart failure (HF). WRF was defined as ≥0.3 mg/dl increase in serum creatinine above baseline at any time during hospitalization and persistent congestion as ≥1 sign of congestion at discharge. The primary end point was all-cause mortality with mean follow-up of 15 ± 9 months. Readmission for HF was a secondary end point. Persistent congestion was more common in patients with WRF than in patients with stable renal function (51.0% vs 26.6%, p <0.0001). Both persistent congestion and persistent WRF were significantly associated with mortality (both p <0.0001). There was a strong interaction (p = 0.003) between persistent WRF and congestion, such that the increased risk for mortality occurred predominantly with both WRF and persistent congestion. The adjusted hazard ratio for mortality in patients with persistent congestion as compared with those without was 4.16 (95% confidence interval [CI] 2.20 to 7.86) in patients with WRF and 1.50 (95% CI 1.16 to 1.93) in patients without WRF. In conclusion, persisted congestion is frequently associated with WRF. We have identified a substantial interaction between persistent congestion and WRF such that congestion portends increased mortality particularly when associated with WRF. Copyright © 2015 Elsevier Inc. All rights reserved.

Delay-based virtual congestion control in multi-tenant datacenters

NASA Astrophysics Data System (ADS)

Liu, Yuxin; Zhu, Danhong; Zhang, Dong

2018-03-01

With the evolution of cloud computing and virtualization, the congestion control of virtual datacenters has become the basic issue for multi-tenant datacenters transmission. Regarding to the friendly conflict of heterogeneous congestion control among multi-tenant, this paper proposes a delay-based virtual congestion control, which translates the multi-tenant heterogeneous congestion control into delay-based feedback uniformly by setting the hypervisor translation layer, modifying three-way handshake of explicit feedback and packet loss feedback and throttling receive window. The simulation results show that the delay-based virtual congestion control can effectively solve the unfairness of heterogeneous feedback congestion control algorithms.

SDTCP: Towards Datacenter TCP Congestion Control with SDN for IoT Applications.

PubMed

Lu, Yifei; Ling, Zhen; Zhu, Shuhong; Tang, Ling

2017-01-08

The Internet of Things (IoT) has gained popularity in recent years. Today's IoT applications are now increasingly deployed in cloud platforms to perform Big Data analytics. In cloud data center networks (DCN), TCP incast usually happens when multiple senders simultaneously communicate with a single receiver. However, when TCP incast happens, DCN may suffer from both throughput collapse for TCP burst flows and temporary starvation for TCP background flows. In this paper, we propose a software defined network (SDN)-based TCP congestion control mechanism, referred to as SDTCP, to leverage the features, e.g., centralized control methods and the global view of the network, in order to solve the TCP incast problems. When we detect network congestion on an OpenFlow switch, our controller can select the background flows and reduce their bandwidth by adjusting the advertised window of TCP ACK packets of the corresponding background flows so as to reserve more bandwidth for burst flows. SDTCP is transparent to the end systems and can accurately decelerate the rate of background flows by leveraging the global view of the network gained via SDN. The experiments demonstrate that our SDTCP can provide high tolerance for burst flows and achieve better flow completion time for short flows. Therefore, SDTCP is an effective and scalable solution for the TCP incast problem.

Characterization of Visual Scanning Patterns in Air Traffic Control

PubMed Central

McClung, Sarah N.; Kang, Ziho

2016-01-01

Characterization of air traffic controllers' (ATCs') visual scanning strategies is a challenging issue due to the dynamic movement of multiple aircraft and increasing complexity of scanpaths (order of eye fixations and saccades) over time. Additionally, terminologies and methods are lacking to accurately characterize the eye tracking data into simplified visual scanning strategies linguistically expressed by ATCs. As an intermediate step to automate the characterization classification process, we (1) defined and developed new concepts to systematically filter complex visual scanpaths into simpler and more manageable forms and (2) developed procedures to map visual scanpaths with linguistic inputs to reduce the human judgement bias during interrater agreement. The developed concepts and procedures were applied to investigating the visual scanpaths of expert ATCs using scenarios with different aircraft congestion levels. Furthermore, oculomotor trends were analyzed to identify the influence of aircraft congestion on scan time and number of comparisons among aircraft. The findings show that (1) the scanpaths filtered at the highest intensity led to more consistent mapping with the ATCs' linguistic inputs, (2) the pattern classification occurrences differed between scenarios, and (3) increasing aircraft congestion caused increased scan times and aircraft pairwise comparisons. The results provide a foundation for better characterizing complex scanpaths in a dynamic task and automating the analysis process. PMID:27239190

Characterization of Visual Scanning Patterns in Air Traffic Control.

PubMed

McClung, Sarah N; Kang, Ziho

2016-01-01

Characterization of air traffic controllers' (ATCs') visual scanning strategies is a challenging issue due to the dynamic movement of multiple aircraft and increasing complexity of scanpaths (order of eye fixations and saccades) over time. Additionally, terminologies and methods are lacking to accurately characterize the eye tracking data into simplified visual scanning strategies linguistically expressed by ATCs. As an intermediate step to automate the characterization classification process, we (1) defined and developed new concepts to systematically filter complex visual scanpaths into simpler and more manageable forms and (2) developed procedures to map visual scanpaths with linguistic inputs to reduce the human judgement bias during interrater agreement. The developed concepts and procedures were applied to investigating the visual scanpaths of expert ATCs using scenarios with different aircraft congestion levels. Furthermore, oculomotor trends were analyzed to identify the influence of aircraft congestion on scan time and number of comparisons among aircraft. The findings show that (1) the scanpaths filtered at the highest intensity led to more consistent mapping with the ATCs' linguistic inputs, (2) the pattern classification occurrences differed between scenarios, and (3) increasing aircraft congestion caused increased scan times and aircraft pairwise comparisons. The results provide a foundation for better characterizing complex scanpaths in a dynamic task and automating the analysis process.

The effect of nitroglycerin on microvascular perfusion and oxygenation during gastric tube reconstruction.

PubMed

Buise, Marc P; Ince, Can; Tilanus, Hugo W; Klein, Jan; Gommers, Diederik; van Bommel, Jasper

2005-04-01

Esophagectomy followed by gastric tube reconstruction is the surgical treatment of choice for patients with esophageal cancer. Complications of the cervical anastomosis are associated with impaired microvascular blood flow (MBF) and ischemia in the gastric fundus. The aim of the present study was to differentiate whether the decrease in MBF is a result of arterial insufficiency or of venous congestion. To do this we assessed MBF, microvascular hemoglobin oxygen saturation (muHbSo(2)), and microvascular hemoglobin concentration (muHbcon) simultaneously during different stages of gastric tube reconstruction. In 14 patients, MBF was determined with laser Doppler flowmetry, and muHbSo(2) and muHbcon were determined with reflectance spectro- photometry. After completion of the anastomosis, nitroglycerin was applied at the fundus. Although MBF did not change significantly in the pylorus, MBF decreased progressively during surgery in the fundus from 210 +/- 18 Arbitrary Units at baseline (normal stomach) to 52 +/- 9 Arbitrary Units after completion of reconstruction (mean +/- sem; P < 0.05). There was no change in muHbSo(2) and muHbcon during the reconstruction. After application of nitroglycerin, MBF doubled. We conclude that MBF decreases during gastric tube reconstruction but that muHbSo(2) and muHbcon do not. This decrease might be the result of venous congestion, which can partly be counteracted by application of nitroglycerin.

Endovascular repair of a traumatic arteriovenous fistula 34 years after the injury: report of a case.

PubMed

Baril, Donald T; Denoya, Paula I; Ellozy, Sharif H; Carroccio, Alfio; Marin, Michael L

2007-01-01

Penetrating extremity injuries can result in the development of arteriovenous fistulas (AVFs), whereby normal blood flow through the capillary bed is bypassed. Late complications of untreated AVFs include proximal arterial dilatation, venous congestion, congestive heart failure, and distal ischemia. We report the case of a 57-year-old man who was referred to us for treatment of a traumatic AVF with multiple sequelae, 34 years after he sustained a shrapnel injury to his right lower leg. We performed successful endovascular repair of this AVF with the patient under spinal anesthesia. Computed tomographic angiography (CTA) done 1 month and 6 months later confirmed AVF exclusion. Patients may present with sequelae of traumatic AVFs many years after their initial injury. Endovascular repair of AVFs offers several advantages over conventional repair and can be performed successfully even in the presence of complex anatomic abnormalities.

Querying and Extracting Timeline Information from Road Traffic Sensor Data

PubMed Central

Imawan, Ardi; Indikawati, Fitri Indra; Kwon, Joonho; Rao, Praveen

2016-01-01

The escalation of traffic congestion in urban cities has urged many countries to use intelligent transportation system (ITS) centers to collect historical traffic sensor data from multiple heterogeneous sources. By analyzing historical traffic data, we can obtain valuable insights into traffic behavior. Many existing applications have been proposed with limited analysis results because of the inability to cope with several types of analytical queries. In this paper, we propose the QET (querying and extracting timeline information) system—a novel analytical query processing method based on a timeline model for road traffic sensor data. To address query performance, we build a TQ-index (timeline query-index) that exploits spatio-temporal features of timeline modeling. We also propose an intuitive timeline visualization method to display congestion events obtained from specified query parameters. In addition, we demonstrate the benefit of our system through a performance evaluation using a Busan ITS dataset and a Seattle freeway dataset. PMID:27563900

Dynamic, stochastic models for congestion pricing and congestion securities.

DOT National Transportation Integrated Search

2010-12-01

This research considers congestion pricing under demand uncertainty. In particular, a robust optimization (RO) approach is applied to optimal congestion pricing problems under user equilibrium. A mathematical model is developed and an analysis perfor...

Integrated Incident Management System (IIMS) web client application development, deployment and evaluation: an evaluation of a potential IIMS deployment in Western New York : final report.

DOT National Transportation Integrated Search

2015-09-30

Incident Management (IM) is an area of transportation management that can significantly decrease the congestion and increase the : efficiency of transportation networks in non-ideal conditions. In this study, the existing state of the Integrated Inci...

The Physics of Traffic

NASA Astrophysics Data System (ADS)

Davis, L. Craig

2006-03-01

Congestion in freeway traffic is an example of self-organization in the language of complexity theory. Nonequilibrium, first-order phase transitions from free flow cause complex spatiotemporal patterns. Two distinct phases of congestion are observed in empirical traffic data--wide moving jams and synchronous flow. Wide moving jams are characterized by stopped or slowly moving vehicles within the jammed region, which widens and moves upstream at 15-20 km/h. Above a critical density of vehicles, a sudden decrease in the velocity of a lead vehicle can initiate a transition from metastable states to this phase. Human behaviors, especially delayed reactions, are implicated in the formation of jams. The synchronous flow phase results from a bottleneck such as an on-ramp. Thus, in contrast to a jam, the downstream front is pinned at a fixed location. The name of the phase comes from the equilibration (or synchronization) of speed and flow rate across all lanes caused by frequent vehicle lane changes. Synchronous flow occurs when the mainline flow and the rate of merging from an on-ramp are sufficiently large. Large-scale simulations using car-following models reproduce the physical phenomena occurring in traffic and suggest methods to improve flow and mediate congestion.

Reducing transit bus emissions: Alternative fuels or traffic operations?

NASA Astrophysics Data System (ADS)

Alam, Ahsan; Hatzopoulou, Marianne

2014-06-01

In this study, we simulated the operations and greenhouse gas (GHG) emissions of transit buses along a busy corridor and quantified the effects of two different fuels (conventional diesel and compressed natural gas) as well as a set of driving conditions on emissions. Results indicate that compressed natural gas (CNG) reduces GHG emissions by 8-12% compared to conventional diesel, this reduction could increase to 16% with high levels of traffic congestion. However, the benefits of switching from conventional diesel to CNG are less apparent when the road network is uncongested. We also investigated the effects of bus operations on emissions by applying several strategies such as transit signal priority (TSP), queue jumper lanes, and relocation of bus stops. Results show that in congested conditions, TSP alone can reduce GHG emissions by 14% and when combined with improved technology; a reduction of 23% is achieved. The reduction benefits are even more apparent when other transit operational improvements are combined with TSP. Finally a sensitivity analysis was performed to investigate the effect of operational improvements on emissions under varying levels of network congestion. We observe that under “extreme congestion”, the benefits of TSP decrease.

Endoplasmic reticulum stress sensor protein kinase R-like endoplasmic reticulum kinase (PERK) protects against pressure overload-induced heart failure and lung remodeling.

PubMed

Liu, Xiaoyu; Kwak, Dongmin; Lu, Zhongbing; Xu, Xin; Fassett, John; Wang, Huan; Wei, Yidong; Cavener, Douglas R; Hu, Xinli; Hall, Jennifer; Bache, Robert J; Chen, Yingjie

2014-10-01

Studies have reported that development of congestive heart failure is associated with increased endoplasmic reticulum stress. Double stranded RNA-activated protein kinase R-like endoplasmic reticulum kinase (PERK) is a major transducer of the endoplasmic reticulum stress response and directly phosphorylates eukaryotic initiation factor 2α, resulting in translational attenuation. However, the physiological effect of PERK on congestive heart failure development is unknown. To study the effect of PERK on ventricular structure and function, we generated inducible cardiac-specific PERK knockout mice. Under unstressed conditions, cardiac PERK knockout had no effect on left ventricular mass, or its ratio to body weight, cardiomyocyte size, fibrosis, or left ventricular function. However, in response to chronic transverse aortic constriction, PERK knockout mice exhibited decreased ejection fraction, increased left ventricular fibrosis, enhanced cardiomyocyte apoptosis, and exacerbated lung remodeling in comparison with wild-type mice. PERK knockout also dramatically attenuated cardiac sarcoplasmic reticulum Ca(2+)-ATPase expression in response to aortic constriction. Our findings suggest that PERK is required to protect the heart from pressure overload-induced congestive heart failure. © 2014 American Heart Association, Inc.

Effect of renal denervation on dynamic autoregulation of renal blood flow.

PubMed

DiBona, Gerald F; Sawin, Linda L

2004-06-01

Vasoconstrictor intensities of renal sympathetic nerve stimulation elevate the renal arterial pressure threshold for steady-state stepwise autoregulation of renal blood flow. This study examined the tonic effect of basal renal sympathetic nerve activity on dynamic autoregulation of renal blood flow in rats with normal (Sprague-Dawley and Wistar-Kyoto) and increased levels of renal sympathetic nerve activity (congestive heart failure and spontaneously hypertensive rats). Steady-state values of arterial pressure and renal blood flow before and after acute renal denervation were subjected to transfer function analysis. Renal denervation increased basal renal blood flow in congestive heart failure (+35 +/- 3%) and spontaneously hypertensive rats (+21 +/- 3%) but not in Sprague-Dawley and Wistar-Kyoto rats. Renal denervation significantly decreased transfer function gain (i.e., improved autoregulation of renal blood flow) and increased coherence only in spontaneously hypertensive rats. Thus vasoconstrictor intensities of renal sympathetic nerve activity impaired the dynamic autoregulatory adjustments of the renal vasculature to oscillations in arterial pressure. Renal denervation increased renal blood flow variability in spontaneously hypertensive rats and congestive heart failure rats. The contribution of vasoconstrictor intensities of basal renal sympathetic nerve activity to limiting renal blood flow variability may be important in the stabilization of glomerular filtration rate.

The impact of neighboring infection on the computer virus spread in packets on scale-free networks

NASA Astrophysics Data System (ADS)

Lazfi, S.; Lamzabi, S.; Rachadi, A.; Ez-Zahraouy, H.

2017-12-01

In this paper, we introduce the effect of neighbors on the infection of packets by computer virus in the SI and SIR models using the minimal traffic routing protocol. We have applied this model to the Barabasi-Albert network to determine how intrasite and extrasite infection rates affect virus propagation through the traffic flow of information packets in both the free-flow and the congested phases. The numerical results show that when we change the intrasite infection rate λ1 while keeping constant the extrasite infection rate λ2, we get normal behavior in the congested phase: in the network, the proportion of infected packets increases to reach a peak and then decreases resulting in a simultaneous increase of the recovered packets. In contrast, when the intrasite infection rate λ1 is kept fixed, an increase of the extrasite infection rate results in two regimes: The first one is characterized by an increase of the proportion of infected packets until reaching some peak value and then decreases smoothly. The second regime is characterized by an increase of infected packets to some stationary value.

A high risk critical mitral valve stenosis with emergency management at Apollo Hospitals Dhaka.

PubMed

Zahangir, N M; Hoque, K Z; Khan, M H; Haque, M A; Haider, M Z

2013-10-01

Heart valve surgery in high-risk patients with severe jaundice, congestive hepatomegaly and renal impairment is associated with considerable morbidity and mortality. Without operation the consequences are invariably grave. A 35 years old gentleman with congestive cardiac failure was initially treated in coronary care unit (CCU). Mitral valve area was 0.5cm², pulmonary arterial systolic pressure (PASP) was 110mmHg, serum bilirubin was 20mg/dl, SGPT & SGOT were 1024iu/l and 1027iu/l respectively. Serum creatinine was 3.35mmol/l. Serum bilirubin gradually diminished to 3.1mg/dl after 12 days treatment in Coronary Care Unit but next day it increased to 3.6mg/dl. Mitral valve was replaced on an emergency basis. Echocardiogram on the 5th post operative day showed well functioning prosthetic mitral valve in situ. Serum bilirubin decreased to 2.2mg/dl, SGPT, SGOT and serum creatinine to 43iu/l, 40iu/l and 1.34mmol/l respectively. After 8 weeks of postoperative follow up his serum bilirubin decreased to 0.8mg/dl.

Isolation of Clostridium perfringens type A from wild bharals (Pseudois nayaur) following sudden death in Tibet, China.

PubMed

Zhu, Lingwei; Zhou, Wei; Wang, Tiecheng; Xiang, Haiyang; Ji, Xue; Han, Yixiao; Tian, Yuan; Sun, Yang; Liu, Jun; Guo, Xuejun

2017-04-01

Dozens of wild bharals died suddenly in Tibet. Necropsy showed severe congestion and hemorrhage in multiple organs, with large numbers of Gram-positive bacilli. Strains of Clostridium perfringens type A were isolated from the different organs and the intestinal contents. The other possible pathogens were ruled out by PCR. Copyright © 2017 Elsevier Ltd. All rights reserved.

Traffic congestion and reliability : linking solutions to problems.

DOT National Transportation Integrated Search

2004-07-19

The Traffic Congestion and Reliability: Linking Solutions to Problems Report provides : a snapshot of congestion in the United States by summarizing recent trends in : congestion, highlighting the role of unreliable travel times in the effects of con...

The natural history of community-acquired common colds symptoms assessed over 4-years.

PubMed

Witek, Theodore J; Ramsey, David L; Carr, Andrew N; Riker, Donald K

2015-03-01

The common cold is the most frequently experienced infection among humans, but limited data exist to characterize the onset, duration, severity and intersection of symptoms in community-acquired colds. A more complete understanding of the symptom frequency and burden in naturally occurring colds is needed. We characterized common cold symptoms from 226 cold episodes experienced by 104 male or female subjects. Subjects were enrolled in the work environment in an attempt to start symptom evaluation (frequency and severity) at the earliest sign of their cold. We also assessed the symptom that had the greatest impact on the subject by asking them to identify their single most bothersome symptom. Symptom reporting started within 24 hours of cold onset for most subjects. Sore throat was a harbinger of the illness but was accompanied by multiple symptoms, including nasal congestion, runny nose and headache. Cough was not usually the most frequent symptom, but was present throughout the cold, becoming most bothersome later in the cold. Nasal congestion, pain (eg, sore throat, headache, muscle pains) or feverishness and secretory symptoms (eg, runny nose, sneezing), and even cough, were simultaneously experienced with high incidence over the first 4 days of illness. The single most bothersome symptom was sore throat on day 1, followed by nasal congestion on days 2-5 and cough on days 6 and 7. There is substantial overlap in the appearance of common cold symptoms over the first several days of the common cold. Nasal congestion, secretory and pain symptoms frequently occur together, with cough being somewhat less prominent, but quite bothersome when present. These data establish the typical symptomatology of a common cold and provide a foundation for the rational treatment of cold symptoms typically experienced by cold sufferers.

The role of pseudoephedrine on daytime somnolence in patients suffering from perennial allergic rhinitis (PAR).

PubMed

Sherkat, Amir A; Sardana, Niti; Safaee, Sahar; Lehman, Erik B; Craig, Timothy J

2011-02-01

Allergic rhinitis is one of several inflammatory diseases affecting the nasal mucosa. Cellular inflammation of nasal mucosa is a hallmark of this disease and is characterized by the accumulation of eosinophils and the release of various chemical messengers such as chemokines, cytokines, and histamine. This inflammation of the nose leads to nasal congestion and a reduction in sleep quality, resulting in daytime somnolence. Drugs that significantly reduce the symptoms of nasal congestion also may help in alleviating sleep-related symptoms of allergic rhinitis. Pseudoephedrine is a sympathomimetic amine that is indicated for treatment of nasal congestion associated with allergic rhinitis. Despite relieving nasal congestion, we speculated that, because of pseudoephedrine's well-known stimulant profile, sleep would not be improved. Fourteen subjects who met the inclusion criteria were enrolled into a double-blind, placebo-controlled, randomized study to either pseudoephedrine or placebo once per day in the morning, using the traditional crossover design. Skin testing test was performed to ensure a positive response to a relevant perennial allergen and a negative response to a seasonal allergen. Several questionnaires were used to evaluate the patients' sleep-related symptoms, allergic rhinitis symptoms, and quality of life. Our results showed that pseudoephedrine did not have a positive or negative effect on quality of sleep, daytime sleepiness, or daytime fatigue as compared with placebo. Pseudoephedrine did show a statistical significance in improving stuffy nose (P = .0172). With respect to quality of life, pseudoephedrine led to a statistically significant decrease in intimate relationships and sexual activity as compared with the placebo group (P = .0310). Our research suggests that sleep quality is not significantly affected by pseudoephedrine. As expected, congestion is reduced, but side effects such as a decline of intimate relationships and sexual activity may interfere with quality of life. Copyright © 2011 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Effects on respiratory health of a reduction in air pollution from vehicle exhaust emissions

PubMed Central

Burr, M; Karani, G; Davies, B; Holmes, B; Williams, K

2004-01-01

Aims: To determine whether residents of congested streets have a higher prevalence of respiratory symptoms than residents of nearby uncongested streets, and whether their respiratory health improves following a reduction in exposure to traffic related air pollutants. Methods: An area was identified where certain streets were subject to air pollution from heavy road traffic, which was likely to improve following the construction of a by-pass. A respiratory survey was conducted among the residents, together with the residents of nearby uncongested streets, at baseline and again a year after the by-pass opened. Measurements were made of air pollutant concentrations in both areas on both occasions. Results: Initial concentrations of PM10 and PM2.5 were substantially higher in the congested than in the uncongested streets. When the by-pass opened, the volume of heavy goods traffic fell by nearly 50%. PM10 decreased by 23% (8.0 µg/m3) in the congested streets and by 29% (3.4 µg/m3) in the uncongested streets, with similar proportionate falls in PM2.5. There were no clear or consistent differences between the residents of the two areas initially in terms of symptoms or peak flow variability. Repeat questionnaires were obtained from 165 and 283 subjects in the congested and uncongested areas respectively, and showed a tendency for most symptoms to improve in both areas. For chest symptoms, the improvement tended to be greater in the uncongested area, although the difference between the areas was not statistically significant. Rhinitis and rhinoconjunctivitis tended to improve to a greater extent in the congested streets; the difference between the areas was significant for the degree to which rhinitis interfered with daily activities. Peak flow variability tended to improve in the uncongested area. Conclusions: The by-pass reduced pollutant levels to a degree that probably alleviates rhinitis and rhinoconjunctivitis but has little effect on lower respiratory symptoms. PMID:14985515

Prognostic value of decreased peripheral congestion detected by Bioelectrical Impedance Vector Analysis (BIVA) in patients hospitalized for acute heart failure: BIVA prognostic value in acute heart failure.

PubMed

Santarelli, Simona; Russo, Veronica; Lalle, Irene; De Berardinis, Benedetta; Vetrone, Francesco; Magrini, Laura; Di Stasio, Enrico; Piccoli, Antonio; Codognotto, Marta; Mion, Monica M; Castello, Luigi M; Avanzi, Gian Carlo; Di Somma, Salvatore

2017-06-01

The objective of this study was to investigate the prognostic role of quantitative reduction of congestion during hospitalization assessed by Bioelectrical Impedance Vector Analysis (BIVA) serial evaluations in patients admitted for acute heart failure (AHF). AHF is a frequent reason for patients to be admitted. Exacerbation of chronic heart failure is linked with a progressive worsening of the disease with increased incidence of death. Fluid overload is the main mechanism underlying acute decompensation in these patients. BIVA is a validated technique able to quantify fluid overload. a prospective, multicentre, observational study in AHF and no AHF patients in three Emergency Departments centres in Italy. Clinical data and BIVA evaluations were performed at admission (t0) and discharge (tdis). A follow-up phone call was carried out at 90 days. Three hundred and thirty-six patients were enrolled (221 AHF and 115 no AHF patients). We found that clinical signs showed the most powerful prognostic relevance. In particular the presence of rales and lower limb oedema at tdis were linked with events relapse at 90 days. At t0, congestion detected by BIVA was observed only in the AHF group, and significantly decreased at tdis. An increase of resistance variation (dR/H) >11 Ω/m during hospitalization was associated with survival. BIVA showed significant results in predicting total events, both at t0 (area under the curve (AUC) 0.56, p<0.04) and at tdis (AUC 0.57, p<0.03). When combined with clinical signs, BIVA showed a very good predictive value for cardiovascular events at 90 days (AUC 0.97, p<0.0001). In AHF patients, an accurate physical examination evaluating the presence of rales and lower limbs oedema remains the cornerstone in the management of patients with AHF. A congestion reduction, obtained as a consequence of therapies and detected through BIVA analysis, with an increase of dR/H >11 Ω/m during hospitalization seems to be associated with increased 90 day survival in patients admitted for AHF.

2012 urban congestion trends, operations : the key to reliable travel.

DOT National Transportation Integrated Search

2013-04-01

Congestion levels remained relatively unchanged : from 2011 to 2012 in the 19 urban areas in the United States monitored : in this report. : Congestion levels across all of the congestion measures are still generally : below the levels experienced in...

Desloratadine and pseudoephedrine combination therapy as a comprehensive treatment for allergic rhinitis and nasal congestion.

PubMed

Anolik, Robert

2009-06-01

Allergic rhinitis (AR) is rapidly increasing in global prevalence. Symptoms of AR, particularly nasal congestion, can cause quality of life (QoL) impairment. Second-generation antihistamines are a recommended first-line therapy for AR but are not viewed as very effective for the treatment of congestion. Therefore, an antihistamine plus a decongestant, such as the combination of desloratadine and pseudoephedrine, is a convenient and efficacious treatment. To review the clinical evidence on the efficacy and safety of combination desloratadine/pseudoephedrine for the treatment of AR symptoms, particularly nasal congestion. Four large studies found that improvement in nasal congestion is enhanced when patients are treated with combination desloratadine/pseudoephedrine. The combination drug significantly improved mean reflective nasal congestion scores in these studies compared with either component as monotherapy (p

Contemporary approaches to congestion pricing : lessons learned from the national evaluation of congestion pricing strategies at six sites.

DOT National Transportation Integrated Search

2015-08-01

This document represents the final report of the national evaluation of congestion reduction strategies at six sites that received federal funding under the Urban Partnership Agreement (UPA) and Congestion Reduction Demonstration (CRD) programs. The ...

Mobility and the costs of congestion in New Jersey : 2001 update

DOT National Transportation Integrated Search

2001-07-01

The objective of the Mobility and the Costs of Congestion study is to measure quantifiable and qualitative impacts of roadway congestion in New Jersey. The study addresses the impacts of congestion on an average traveler or affected person, as well a...

Diagnosis and management of nasal congestion: the role of intranasal corticosteroids.

PubMed

Benninger, Michael

2009-01-01

Nasal congestion is considered the most bothersome of allergic rhinitis (AR) symptoms and can significantly impair ability to function at work, home, and school. Effective management of AR-related nasal congestion depends on accurate diagnosis and appropriate treatment. Many individuals with AR and AR-related congestion remain undiagnosed and do not receive prescription medication. However, new tools intended to improve the diagnosis of nasal congestion have been developed and validated. Intranasal corticosteroids (INSs) are recommended as first-line therapy for patients with moderate-to-severe AR and also when nasal congestion is a prominent symptom. Double blind, randomized clinical trials have demonstrated greater efficacy of INSs versus placebo, antihistamines, or montelukast for relief of all nasal symptoms, especially congestion. Patient adherence to treatment also affects outcomes, and this may be influenced by patient preferences for the sensory attributes of an individual drug. Increased awareness of the effects of AR-related nasal congestion, the efficacy and safety of available pharmacotherapies, and barriers to adherence may improve clinical outcomes.

Signalling and obfuscation for congestion control

NASA Astrophysics Data System (ADS)

Mareček, Jakub; Shorten, Robert; Yu, Jia Yuan

2015-10-01

We aim to reduce the social cost of congestion in many smart city applications. In our model of congestion, agents interact over limited resources after receiving signals from a central agent that observes the state of congestion in real time. Under natural models of agent populations, we develop new signalling schemes and show that by introducing a non-trivial amount of uncertainty in the signals, we reduce the social cost of congestion, i.e., improve social welfare. The signalling schemes are efficient in terms of both communication and computation, and are consistent with past observations of the congestion. Moreover, the resulting population dynamics converge under reasonable assumptions.

Improving Explicit Congestion Notification with the Mark-Front Strategy

NASA Technical Reports Server (NTRS)

Liu, Chunlei; Jain, Raj

2001-01-01

Delivering congestion signals is essential to the performance of networks. Current TCP/IP networks use packet losses to signal congestion. Packet losses not only reduces TCP performance, but also adds large delay. Explicit Congestion Notification (ECN) delivers a faster indication of congestion and has better performance. However, current ECN implementations mark the packet from the tail of the queue. In this paper, we propose the mark-front strategy to send an even faster congestion signal. We show that mark-front strategy reduces buffer size requirement, improves link efficiency and provides better fairness among users. Simulation results that verify our analysis are also presented.

The Heavy Brigade Combat Team in COIN: An Assessment Capabilities to Clear-Hold-Build-and Sustain Success

DTIC Science & Technology

2009-12-11

Abrams tanks and M2A3 Bradley fighting vehicles. The cities and villages had many obstacles such as narrow congested roads with single and multiple story...M1A2 tanks and M2A3 Bradley Fighting Vehicles were ―worth their weight in gold-when they rolled, the bad guys took notice and when they fired, the

23 CFR 971.214 - Federal lands congestion management system (CMS).

Code of Federal Regulations, 2011 CFR

2011-04-01

... congestion management strategies; (v) Determine methods to monitor and evaluate the performance of the multi... Federal lands congestion management system (CMS). (a) For purposes of this section, congestion means the... for the transportation systems providing access to and within National Forests, as appropriate, that...

23 CFR 970.214 - Federal lands congestion management system (CMS).

Code of Federal Regulations, 2014 CFR

2014-04-01

... 23 Highways 1 2014-04-01 2014-04-01 false Federal lands congestion management system (CMS). 970... LANDS HIGHWAYS NATIONAL PARK SERVICE MANAGEMENT SYSTEMS National Park Service Management Systems § 970.214 Federal lands congestion management system (CMS). (a) For purposes of this section, congestion...

23 CFR 450.320 - Congestion management process in transportation management areas.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 23 Highways 1 2014-04-01 2014-04-01 false Congestion management process in transportation... Programming § 450.320 Congestion management process in transportation management areas. (a) The transportation planning process in a TMA shall address congestion management through a process that provides for safe and...

23 CFR 450.320 - Congestion management process in transportation management areas.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 23 Highways 1 2011-04-01 2011-04-01 false Congestion management process in transportation... Programming § 450.320 Congestion management process in transportation management areas. (a) The transportation planning process in a TMA shall address congestion management through a process that provides for safe and...

23 CFR 450.320 - Congestion management process in transportation management areas.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 23 Highways 1 2013-04-01 2013-04-01 false Congestion management process in transportation... Programming § 450.320 Congestion management process in transportation management areas. (a) The transportation planning process in a TMA shall address congestion management through a process that provides for safe and...

76 FR 75875 - Plan for Conduct of 2012 Electric Transmission Congestion Study

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-05

... DEPARTMENT OF ENERGY Plan for Conduct of 2012 Electric Transmission Congestion Study AGENCY... preparation of a study of electric transmission congestion pursuant to section 216(a)(1) of the Federal Power...-register at this Web site: http://energy.gov/oe/congestion-study-2012 . [[Page 75876

Intravenous Milrinone in Treatment of Advanced Congestive Heart Failure

PubMed Central

Zewail, Aly M.; Nawar, Mohammad; Vrtovec, Bojan; Eastwood, Cathy; Kar, Biswajit; Delgado, Reynolds M.

2003-01-01

Phosphodiesterase inhibitors such as milrinone can relieve symptoms and improve hemodynamics in patients with advanced congestive heart failure. We retrospectively evaluated the hemodynamic and clinical outcomes of long-term combination therapy with intravenous milrinone and oral β-blockers in 65 patients with severe congestive heart failure (New York Heart Association class IV function and ejection fraction <25%) refractory to oral medical therapy. Fifty-one patients successfully began β-blocker therapy while on intravenous milrinone. Oral medical therapy was maximized when possible. The mean duration of milrinone treatment in this combination-treatment group was 269 days (range, 14–1,026 days). Functional class improved from IV to II–III with milrinone therapy. Twenty-four such patients tolerated β-blocker up-titration and were successfully weaned from milrinone. Sixteen patients (31%) died while receiving combination therapy; one died of sudden cardiac death (on treatment day 116); the other 15 died of progressive heart failure or other complications. Hospital admissions during the previous 6 months and admissions within 6 months after milrinone initiation stayed the same. Meanwhile, the total number of hospital days decreased from 450 to 380 (a 15.6% reduction), and the mean length of stay decreased by 1.4 days (a 14.7% reduction). We conclude that 1) milrinone plus β-blocker combination therapy is an effective treatment for heart failure even with β-blocker up-titration, 2) weaning from milrinone may be possible once medications are maximized, 3) patients' functional status improves on the combination regimen, and 4) treatment-related sudden death is relatively infrequent during the combination regimen. (Tex Heart Inst J 2003;30:109–13) PMID:12809251

Smoothing inpatient discharges decreases emergency department congestion: a system dynamics simulation model.

PubMed

Wong, Hannah J; Wu, Robert C; Caesar, Michael; Abrams, Howard; Morra, Dante

2010-08-01

Timely access to emergency patient care is an important quality and efficiency issue. Reduced discharges of inpatients at weekends are a reality to many hospitals and may reduce hospital efficiency and contribute to emergency department (ED) congestion. To evaluate the daily number of ED beds occupied by inpatients after evenly distributing inpatient discharges over the course of the week using a computer simulation model. Simulation modelling study from an academic care hospital in Toronto, Canada. Daily historical data from the general internal medicine (GIM) department between 15 January and 15 December for two years, 2005 and 2006, were used for model building and validation, respectively. There was good agreement between model simulations and historical data for both ED and ward censuses and their respective lengths of stay (LOS), with the greatest difference being +7.8% for GIM ward LOS (model: 9.3 days vs historical: 8.7 days). When discharges were smoothed across the 7 days, the number of ED beds occupied by GIM patients decreased by approximately 27-57% while ED LOS decreased 7-14 hours. The model also demonstrated that patients occupying hospital beds who no longer require acute care have a considerable impact on ED and ward beds. Smoothing out inpatient discharges over the course of a week had a positive effect on decreasing the number of ED beds occupied by inpatients. Despite the particular challenges associated with weekend discharges, simulation experiments suggest that discharges evenly spread across the week may significantly reduce bed requirements and ED LOS.

SDTCP: Towards Datacenter TCP Congestion Control with SDN for IoT Applications

PubMed Central

Lu, Yifei; Ling, Zhen; Zhu, Shuhong; Tang, Ling

2017-01-01

The Internet of Things (IoT) has gained popularity in recent years. Today’s IoT applications are now increasingly deployed in cloud platforms to perform Big Data analytics. In cloud data center networks (DCN), TCP incast usually happens when multiple senders simultaneously communicate with a single receiver. However, when TCP incast happens, DCN may suffer from both throughput collapse for TCP burst flows and temporary starvation for TCP background flows. In this paper, we propose a software defined network (SDN)-based TCP congestion control mechanism, referred to as SDTCP, to leverage the features, e.g., centralized control methods and the global view of the network, in order to solve the TCP incast problems. When we detect network congestion on an OpenFlow switch, our controller can select the background flows and reduce their bandwidth by adjusting the advertised window of TCP ACK packets of the corresponding background flows so as to reserve more bandwidth for burst flows. SDTCP is transparent to the end systems and can accurately decelerate the rate of background flows by leveraging the global view of the network gained via SDN. The experiments demonstrate that our SDTCP can provide high tolerance for burst flows and achieve better flow completion time for short flows. Therefore, SDTCP is an effective and scalable solution for the TCP incast problem. PMID:28075347

LADS: Optimizing Data Transfers using Layout-Aware Data Scheduling

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

Kim, Youngjae; Atchley, Scott; Vallee, Geoffroy R

While future terabit networks hold the promise of signifi- cantly improving big-data motion among geographically distributed data centers, significant challenges must be overcome even on today s 100 gigabit networks to real- ize end-to-end performance. Multiple bottlenecks exist along the end-to-end path from source to sink. Data stor- age infrastructure at both the source and sink and its in- terplay with the wide-area network are increasingly the bottleneck to achieving high performance. In this paper, we identify the issues that lead to congestion on the path of an end-to-end data transfer in the terabit network en- vironment, and we presentmore » a new bulk data movement framework called LADS for terabit networks. LADS ex- ploits the underlying storage layout at each endpoint to maximize throughput without negatively impacting the performance of shared storage resources for other users. LADS also uses the Common Communication Interface (CCI) in lieu of the sockets interface to use zero-copy, OS-bypass hardware when available. It can further im- prove data transfer performance under congestion on the end systems using buffering at the source using flash storage. With our evaluations, we show that LADS can avoid congested storage elements within the shared stor- age resource, improving I/O bandwidth, and data transfer rates across the high speed networks.« less

Autonomous Congestion Control in Delay-Tolerant Networks

NASA Technical Reports Server (NTRS)

Burleigh, Scott; Jennings, Esther; Schoolcraft, Joshua

2006-01-01

Congestion control is an important feature that directly affects network performance. Network congestion may cause loss of data or long delays. Although this problem has been studied extensively in the Internet, the solutions for Internet congestion control do not apply readily to challenged network environments such as Delay Tolerant Networks (DTN) where end-to-end connectivity may not exist continuously and latency can be high. In DTN, end-to-end rate control is not feasible. This calls for congestion control mechanisms where the decisions can be made autonomously with local information only. We use an economic pricing model and propose a rule-based congestion control mechanism where each router can autonomously decide on whether to accept a bundle (data) based on local information such as available storage and the value and risk of accepting the bundle (derived from historical statistics). Preliminary experimental results show that this congestion control mechanism can protect routers from resource depletion without loss of data.

A research of the community’s opening to the outside world

NASA Astrophysics Data System (ADS)

Xu, Lan; Liu, Xiangzhuo

2017-03-01

Closed residential areas, called community, the traffic network and result in various degrees of traffic congestion such as amputating, dead ends and T-shaped roads. In order to reveal the mechanism of the congestion, establish an effective evaluation index system and finally provide theoretical basis for the study of traffic congestion, we have done researches on factors for traffic congestion and have established a scientific evaluation index system combining experiences home and abroad, based on domestic congestion status. Firstly, we analyse the traffic network as the entry point, and then establish the evaluation model of road capacity with the method of AHP index system. Secondly, we divide the condition of urban congestion into 5 levels from congestion to smoothness. Besides, with VISSIM software, simulations about traffic capacity before and after community opening are carried out. Finally, we provide forward reasonable suggestions upon the combination of models and reality.

Pulmonary edema

MedlinePlus

... congestion; Lung water; Pulmonary congestion; Heart failure - pulmonary edema ... Pulmonary edema is often caused by congestive heart failure . When the heart is not able to pump efficiently, blood ...

A resilience-oriented approach for quantitatively assessing recurrent spatial-temporal congestion on urban roads.

PubMed

Tang, Junqing; Heinimann, Hans Rudolf

2018-01-01

Traffic congestion brings not only delay and inconvenience, but other associated national concerns, such as greenhouse gases, air pollutants, road safety issues and risks. Identification, measurement, tracking, and control of urban recurrent congestion are vital for building a livable and smart community. A considerable amount of works has made contributions to tackle the problem. Several methods, such as time-based approaches and level of service, can be effective for characterizing congestion on urban streets. However, studies with systemic perspectives have been minor in congestion quantification. Resilience, on the other hand, is an emerging concept that focuses on comprehensive systemic performance and characterizes the ability of a system to cope with disturbance and to recover its functionality. In this paper, we symbolized recurrent congestion as internal disturbance and proposed a modified metric inspired by the well-applied "R4" resilience-triangle framework. We constructed the metric with generic dimensions from both resilience engineering and transport science to quantify recurrent congestion based on spatial-temporal traffic patterns and made the comparison with other two approaches in freeway and signal-controlled arterial cases. Results showed that the metric can effectively capture congestion patterns in the study area and provides a quantitative benchmark for comparison. Also, it suggested not only a good comparative performance in measuring strength of proposed metric, but also its capability of considering the discharging process in congestion. The sensitivity tests showed that proposed metric possesses robustness against parameter perturbation in Robustness Range (RR), but the number of identified congestion patterns can be influenced by the existence of ϵ. In addition, the Elasticity Threshold (ET) and the spatial dimension of cell-based platform differ the congestion results significantly on both the detected number and intensity. By tackling this conventional problem with emerging concept, our metric provides a systemic alternative approach and enriches the toolbox for congestion assessment. Future work will be conducted on a larger scale with multiplex scenarios in various traffic conditions.

Analysis of random drop for gateway congestion control. M.S. Thesis

NASA Technical Reports Server (NTRS)

Hashem, Emam Salaheddin

1989-01-01

Lately, the growing demand on the Internet has prompted the need for more effective congestion control policies. Currently No Gateway Policy is used to relieve and signal congestion, which leads to unfair service to the individual users and a degradation of overall network performance. Network simulation was used to illustrate the character of Internet congestion and its causes. A newly proposed gateway congestion control policy, called Random Drop, was considered as a promising solution to the pressing problem. Random Drop relieves resource congestion upon buffer overflow by choosing a random packet from the service queue to be dropped. The random choice should result in a drop distribution proportional to the bandwidth distribution among all contending TCP connections, thus applying the necessary fairness. Nonetheless, the simulation experiments demonstrate several shortcomings with this policy. Because Random Drop is a congestion control policy, which is not applied until congestion has already occurred, it usually results in a high drop rate that hurts too many connections including well-behaved ones. Even though the number of packets dropped is different from one connection to another depending on the buffer utilization upon overflow, the TCP recovery overhead is high enough to neutralize these differences, causing unfair congestion penalties. Besides, the drop distribution itself is an inaccurate representation of the average bandwidth distribution, missing much important information about the bandwidth utilization between buffer overflow events. A modification of Random Drop to do congestion avoidance by applying the policy early was also proposed. Early Random Drop has the advantage of avoiding the high drop rate of buffer overflow. The early application of the policy removes the pressure of congestion relief and allows more accurate signaling of congestion. To be used effectively, algorithms for the dynamic adjustment of the parameters of Early Random Drop to suite the current network load must still be developed.

Making the Traffic Operations Case for Congestion Pricing: Operational Impacts of Congestion Pricing

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

Chin, Shih-Miao; Hu, Patricia S; Davidson, Diane

2011-02-01

Congestion begins when an excess of vehicles on a segment of roadway at a given time, resulting in speeds that are significantly slower than normal or 'free flow' speeds. Congestion often means stop-and-go traffic. The transition occurs when vehicle density (the number of vehicles per mile in a lane) exceeds a critical level. Once traffic enters a state of congestion, recovery or time to return to a free-flow state is lengthy; and during the recovery process, delay continues to accumulate. The breakdown in speed and flow greatly impedes the efficient operation of the freeway system, resulting in economic, mobility, environmentalmore » and safety problems. Freeways are designed to function as access-controlled highways characterized by uninterrupted traffic flow so references to freeway performance relate primarily to the quality of traffic flow or traffic conditions as experienced by users of the freeway. The maximum flow or capacity of a freeway segment is reached while traffic is moving freely. As a result, freeways are most productive when they carry capacity flows at 60 mph, whereas lower speeds impose freeway delay, resulting in bottlenecks. Bottlenecks may be caused by physical disruptions, such as a reduced number of lanes, a change in grade, or an on-ramp with a short merge lane. This type of bottleneck occurs on a predictable or 'recurrent' basis at the same time of day and same day of week. Recurrent congestion totals 45% of congestion and is primarily from bottlenecks (40%) as well as inadequate signal timing (5%). Nonrecurring bottlenecks result from crashes, work zone disruptions, adverse weather conditions, and special events that create surges in demand and that account for over 55% of experienced congestion. Figure 1.1 shows that nonrecurring congestion is composed of traffic incidents (25%), severe weather (15%), work zones, (10%), and special events (5%). Between 1995 and 2005, the average percentage change in increased peak traveler delay, based on hours spent in traffic in a year, grew by 22% as the national average of hours spent in delay grew from 36 hours to 44 hours. Peak delay per traveler grew one-third in medium-size urban areas over the 10 year period. The traffic engineering community has developed an arsenal of integrated tools to mitigate the impacts of congestion on freeway throughput and performance, including pricing of capacity to manage demand for travel. Congestion pricing is a strategy which dynamically matches demand with available capacity. A congestion price is a user fee equal to the added cost imposed on other travelers as a result of the last traveler's entry into the highway network. The concept is based on the idea that motorists should pay for the additional congestion they create when entering a congested road. The concept calls for fees to vary according to the level of congestion with the price mechanism applied to make travelers more fully aware of the congestion externality they impose on other travelers and the system itself. The operational rationales for the institution of pricing strategies are to improve the efficiency of operations in a corridor and/or to better manage congestion. To this end, the objectives of this project were to: (1) Better understand and quantify the impacts of congestion pricing strategies on traffic operations through the study of actual projects, and (2) Better understand and quantify the impacts of congestion pricing strategies on traffic operations through the use of modeling and other analytical methods. Specifically, the project was to identify credible analytical procedures that FHWA can use to quantify the impacts of various congestion pricing strategies on traffic flow (throughput) and congestion.« less

Decrease of cardiac chaos in congestive heart failure

NASA Astrophysics Data System (ADS)

Poon, Chi-Sang; Merrill, Christopher K.

1997-10-01

The electrical properties of the mammalian heart undergo many complex transitions in normal and diseased states. It has been proposed that the normal heartbeat may display complex nonlinear dynamics, including deterministic chaos,, and that such cardiac chaos may be a useful physiological marker for the diagnosis and management, of certain heart trouble. However, it is not clear whether the heartbeat series of healthy and diseased hearts are chaotic or stochastic, or whether cardiac chaos represents normal or abnormal behaviour. Here we have used a highly sensitive technique, which is robust to random noise, to detect chaos. We analysed the electrocardiograms from a group of healthy subjects and those with severe congestive heart failure (CHF), a clinical condition associated with a high risk of sudden death. The short-term variations of beat-to-beat interval exhibited strongly and consistently chaotic behaviour in all healthy subjects, but were frequently interrupted by periods of seemingly non-chaotic fluctuations in patients with CHF. Chaotic dynamics in the CHF data, even when discernible, exhibited a high degree of random variability over time, suggesting a weaker form of chaos. These findings suggest that cardiac chaos is prevalent in healthy heart, and a decrease in such chaos may be indicative of CHF.

Neuroprotective effect of grape seed extract against cadmium toxicity in male albino rats

PubMed Central

El-Tarras, Adel El-Sayed; Attia, Hossam Fouad; Soliman, Mohammed Mohamed; El Awady, Mohammed Abdelhamid; Amin, Adnan Abelghani

2016-01-01

Cadmium toxicity can disturb brain chemistry leading to depression, anxiety, and weakened immunity. Cadmium disturbs the neurotransmitter dopamine, resulting in low energy, lack of motivation, and depression, which are predisposing factors for violence. The purpose of this study was to evaluate the ameliorative effect of grape seed extract (GSE) on the brain of 40 male albino rats after exposure to cadmium chloride (Cd) toxicity. The rats were separated into either the control group, the Cd group, the GSE group, or the GSE and Cd mixture (treated) group. The cerebrum showed evidence of degeneration of some nerve fibers and cells. Fibrosis, vacuolations, and congestion in the blood vessels were demonstrated. Satelletosis was located in the capsular cells. Immunohistochemical expression of Bax was strongly positive in the Cd group and decreased in the treated group. These histopathological changes were decreased in the brain tissue of the treated group, but a few blood vessels still had evidence of congestion. Cadmium administration increased the level of MDA and decreased MAO-A, acetylcholinesterase, and glutathione reductase (GR), while the treatment with GSE affected the alterations in these parameters. In addition, cadmium downregulated the mRNA expression levels of GST and GPx, while GSE treatment normalized the transcript levels. The expression of both dopamine and 5-hydroxytryptamine transporter was downregulated in the rats administered cadmium and the addition of GSE normalized the expression of these aggression associated genes. PMID:27271977

Tissue PAH, blood cell and tissue changes following exposure to water accommodated fractions of crude oil in alligator gar, Atractosteus spatula.

PubMed

Omar-Ali, Ahmad; Hohn, Claudia; Allen, Peter J; Rodriguez, Jose; Petrie-Hanson, Lora

2015-07-01

Alligator gar Atractosteus spatula acclimated to brackish water (9 ppt) were exposed to water accommodated fraction oil loadings (surrogate to Macondo Deepwater Horizon, northern Gulf of Mexico) of 0.5 and 4.0 gm oil/L tank water for 48 h. The surrogate oil was approximately 98% alkanes and alkynes and 2% petroleum aromatic hydrocarbons. The 2% petroleum aromatic hydrocarbons were predominately naphthalene. After 48 h, naphthalene levels in fish liver exposed to 0.5 or 4 gm oil/L were 547.79 and 910.68 ppb, while muscle levels were 214.11 and 253.84 ppb. There was a significant decrease in peripheral blood lymphocyte numbers and a significant reduction of granulocytes in the kidney marrow of the same fish. Tissue changes included hepatocellular vacuolization and necrosis, necrotizing pancreatitis, renal eosinophilia, and splenic congestion. After 7 days recovery, liver naphthalene levels decreased to 43.59 and 43.20 ppb, while muscle levels decreased to 9.74, and 16.78 ppb for oil exposures of 0, 0.5 or 4 g/L. In peripheral blood and kidney marrow, blood cell counts returned to normal. The severity of liver and kidney lesions lessened after 7 days recovery in non-oiled water, but splenic congestion remained in all gar. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Rate of change of heart size before congestive heart failure in dogs with mitral regurgitation.

PubMed

Lord, P; Hansson, K; Kvart, C; Häggström, J

2010-04-01

The objective of the study was to examine the changes in vertebral heart scale, and left atrial and ventricular dimensions before and at onset of congestive heart failure in cavalier King Charles spaniels with mitral regurgitation. Records and radiographs from 24 cavalier King Charles spaniels with mitral regurgitation were used. Vertebral heart scale (24 dogs), and left atrial dimension and left ventricular end diastolic and end systolic diameters (18 dogs) and their rate of increase were measured at intervals over years to the onset of congestive heart failure. They were plotted against time to onset of congestive heart failure. Dimensions and rates of change of all parameters were highest at onset of congestive heart failure, the difference between observed and chance outcome being highly significant using a two-tailed chi-square test (P<0.001). The left heart chambers increase in size rapidly only in the last year before the onset of congestive heart failure. Increasing left ventricular end systolic dimension is suggestive of myocardial failure before the onset of congestive heart failure. Rate of increase of heart dimensions may be a useful indicator of impending congestive heart failure.

Morphological biomarkers in Prochilodus lineatus (pisces, prochilodontidae) for environmental impact assessment in the region of the Baixada Maranhense, Brazil

NASA Astrophysics Data System (ADS)

Dantas, Janaína Gomes; Andrade, Ticianne de Sousa de Oliveira Mota; Sodré, Camilla Fernanda Lima; Castro, Jonatas da Silva; Carvalho-Neta, Raimunda Nonata Fortes; Junior, Audálio Rebelo Torres

2015-12-01

This study aimed to identify the types of histopathological lesions found in gills of Prochilodus lineatus of the Environmental Protection Area of the Baixada Maranhense region (Brazil). Fish were collected in Mearim river. Sampling took place in October, November and December 2014. We have purchased 30 samples of fish from local fishermen. In the laboratory fish gills were removed, and then fixed in 10% formalin solution and kept into alcohol 70% to the usual histological processing. The tissue was performed by light microscopy and findings were photomicrographed in light microscope - ZEIS. The following lesions were identified: epithelial displacement, the marginal channel shift a start vascular congestion, hyperplasia and merging multiple slides; epithelial disruption, edema, vascular congestion, total fusion of lamellae and disorganization of secondary lamellae. These changes express a response of the body to some xenobiontes. Morphological changes in the gills may represent adaptive strategies for conservation of some biological functions when animals are facing changes in the water quality.

Death from Barotrauma Due to Compressed Air: A Medico-legal Analysis.

PubMed

Giugliano, Pasquale; Massoni, Francesco; Crisci, Antonello; Ricci, Serafino

2016-11-01

Lesions of the digestive tract due to barotrauma resulting from compressed air application are not common, are rarely lethal, and largely affect the sigmoid and descending colon. Moreover, their pathogenic mechanism is a topic of discussion because these lesions have multiple characteristics. Here, the authors describe an autoptic case of death from lesions of the ascending and transverse segments, with perforations and bleeding suffusions as well as ischemic areas covered the colonic wall that was extremely thinned, congested, and hemorrhagic, with considerable flattening leading to disappearance of the mucosal folds and with numerous petechial hemorrhages. The pathological framework of lung congestion made it possible to identify the mechanism responsible for this death as depletion of the heart's pumping function, which contributed significantly to the acute respiratory failure due to respiratory distress as well as to reduced mobility of the diaphragm due to intestinal distension. Acute heart failure played an important role in this death. © 2016 American Academy of Forensic Sciences.

The first report of pyrrolizidine alkaloid poisoning in a gazelle (Gazella Subgutturosa) - histopathologic diagnosis.

PubMed

Khordadmehr, Monireh; Rezazadeh, Fereydoon; Ashrafi-Helan, Javad; Hosseini-Ghomi, Mir Mohsen

2016-03-01

Pyrrolizidine alkaloids (PAs) are natural phytotoxins found in thousands of plant species around the world. They are probably the most common poisonous plants affecting livestock, wildlife and humans. The disease occurs almost entirely as a consequence of chronic poisoning and in general ends fatally. In the present study, PAs poisoning was investigated in a gazelle with hepatic encephalopathy associated with severe neurologic signs. The main clinical signs included head pressing, progressive depression and weakness, ataxia and reluctance to move, turn the head to the left and to paddle, hyperesthesia and decreased food intake. Histopathological examination revealed major lesions in the liver consisting of severe hepatocyte megalocytosis and hypertrophy with nuclei enlargement, mild bile duct hyperplasia, centriacinar fatty change and hepatocellular necrosis. Moreover, pulmonary congestion and edema with endothelium necrosis and alveolar septa thickening, severe congestion in vessels of the brain and meninges, and myocardial necrosis were observed.

Survival Analysis of Patients with End Stage Renal Disease

NASA Astrophysics Data System (ADS)

Urrutia, J. D.; Gayo, W. S.; Bautista, L. A.; Baccay, E. B.

2015-06-01

This paper provides a survival analysis of End Stage Renal Disease (ESRD) under Kaplan-Meier Estimates and Weibull Distribution. The data were obtained from the records of V. L. MakabaliMemorial Hospital with respect to time t (patient's age), covariates such as developed secondary disease (Pulmonary Congestion and Cardiovascular Disease), gender, and the event of interest: the death of ESRD patients. Survival and hazard rates were estimated using NCSS for Weibull Distribution and SPSS for Kaplan-Meier Estimates. These lead to the same conclusion that hazard rate increases and survival rate decreases of ESRD patient diagnosed with Pulmonary Congestion, Cardiovascular Disease and both diseases with respect to time. It also shows that female patients have a greater risk of death compared to males. The probability risk was given the equation R = 1 — e-H(t) where e-H(t) is the survival function, H(t) the cumulative hazard function which was created using Cox-Regression.

Intelligent traffic lights based on MATLAB

NASA Astrophysics Data System (ADS)

Nie, Ying

2018-04-01

In this paper, I describes the traffic lights system and it has some. Through analysis, I used MATLAB technology, transformed the camera photographs into digital signals. Than divided the road vehicle is into three methods: very congestion, congestion, a little congestion. Through the MCU programming, solved the different roads have different delay time, and Used this method, saving time and resources, so as to reduce road congestion.

A new casemix adjustment index for hospital mortality among patients with congestive heart failure.

PubMed

Polanczyk, C A; Rohde, L E; Philbin, E A; Di Salvo, T G

1998-10-01

Comparative analysis of hospital outcomes requires reliable adjustment for casemix. Although congestive heart failure is one of the most common indications for hospitalization, congestive heart failure casemix adjustment has not been widely studied. The purposes of this study were (1) to describe and validate a new congestive heart failure-specific casemix adjustment index to predict in-hospital mortality and (2) to compare its performance to the Charlson comorbidity index. Data from all 4,608 admissions to the Massachusetts General Hospital from January 1990 to July 1996 with a principal ICD-9-CM discharge diagnosis of congestive heart failure were evaluated. Massachusetts General Hospital patients were randomly divided in a derivation and a validation set. By logistic regression, odds ratios for in-hospital death were computed and weights were assigned to construct a new predictive index in the derivation set. The performance of the index was tested in an internal Massachusetts General Hospital validation set and in a non-Massachusetts General Hospital external validation set incorporating data from all 1995 New York state hospital discharges with a primary discharge diagnosis of congestive heart failure. Overall in-hospital mortality was 6.4%. Based on the new index, patients were assigned to six categories with incrementally increasing hospital mortality rates ranging from 0.5% to 31%. By logistic regression, "c" statistics of the congestive heart failure-specific index (0.83 and 0.78, derivation and validation set) were significantly superior to the Charlson index (0.66). Similar incrementally increasing hospital mortality rates were observed in the New York database with the congestive heart failure-specific index ("c" statistics 0.75). In an administrative database, this congestive heart failure-specific index may be a more adequate casemix adjustment tool to predict hospital mortality in patients hospitalized for congestive heart failure.

Rhode Island congestion management plan : executive summary

DOT National Transportation Integrated Search

1997-09-01

This document provides an overview of the Rhode Island Congestion Management System (CMS) program consisting of the following: Congestion Management System Plan; Incident Management Plan; and Intelligent Transportation System (ITS) Early Deployment P...

Technologies that enable congestion pricing : a primer

DOT National Transportation Integrated Search

2008-10-01

This volume explores transportation technologies that enable congestion pricing. This document considers the following: the functional processes for tolling and congestion pricing; what technologies there are to consider; how the technologies are app...

Better road congestion measures are needed

DOT National Transportation Integrated Search

2003-05-01

Road congestion is growing worse as demand : outstrips new roadway construction and other : efforts to increase traffic flows. : Better ways to measure congestion are needed to : effectively address the problem. : Actual measures of speeds an...

Income-based equity impacts of congestion pricing

DOT National Transportation Integrated Search

2008-12-01

This equity primer was produced to examine the impacts of congestion pricing on low-income groups, public opinion as expressed by various income groups, and ways to mitigate the equity impacts of congestion pricing

Income-based equity impacts of congestion pricing.

DOT National Transportation Integrated Search

2008-12-01

This equity primer was produced to examine the impacts of congestion pricing on low-income groups, public opinion as expressed by various income groups, and ways to mitigate the equity impacts of congestion pricing.

Autonomous Congestion Control in Delay-Tolerant Networks

NASA Technical Reports Server (NTRS)

Burleigh, Scott C.; Jennings, Esther H.

2005-01-01

Congestion control is an important feature that directly affects network performance. Network congestion may cause loss of data or long delays. Although this problem has been studied extensively in the Internet, the solutions for Internet congestion control do not apply readily to challenged network environments such as Delay Tolerant Networks (DTN) where end-to-end connectivity may not exist continuously and latency can be high. In DTN, end-to-end rate control is not feasible. This calls for congestion control mechanisms where the decisions can be made autonomously with local information only. We use an economic pricing model and propose a rule-based congestion control mechanism where each router can autonomously decide on whether to accept a bundle (data) based on local information such as available storage and the value and risk of accepting the bundle (derived from historical statistics).

Liver congestion in heart failure contributes to inappropriately increased serum hepcidin despite anemia.

PubMed

Ohno, Yukako; Hanawa, Haruo; Jiao, Shuang; Hayashi, Yuka; Yoshida, Kaori; Suzuki, Tomoyasu; Kashimura, Takeshi; Obata, Hiroaki; Tanaka, Komei; Watanabe, Tohru; Minamino, Tohru

2015-01-01

Hepcidin is a key regulator of mammalian iron metabolism and mainly produced by the liver. Hepcidin excess causes iron deficiency and anemia by inhibiting iron absorption from the intestine and iron release from macrophage stores. Anemia is frequently complicated with heart failure. In heart failure patients, the most frequent histologic appearance of liver is congestion. However, it remains unclear whether liver congestion associated with heart failure influences hepcidin production, thereby contributing to anemia and functional iron deficiency. In this study, we investigated this relationship in clinical and basic studies. In clinical studies of consecutive heart failure patients (n = 320), anemia was a common comorbidity (41%). In heart failure patients without active infection and ongoing cancer (n = 30), log-serum hepcidin concentration of patients with liver congestion was higher than those without liver congestion (p = 0.0316). Moreover, in heart failure patients with liver congestion (n = 19), the anemia was associated with the higher serum hepcidin concentrations, which is a type of anemia characterized by induction of hepcidin. Subsequently, we produced a rat model of heart failure with liver congestion by injecting monocrotaline that causes pulmonary hypertension. The monocrotaline-treated rats displayed liver congestion with increase of hepcidin expression at 4 weeks after monocrotaline injection, followed by anemia and functional iron deficiency observed at 5 weeks. We conclude that liver congestion induces hepcidin production, which may result in anemia and functional iron deficiency in some patients with heart failure.

Cardiovascular Disease in Acromegaly.

PubMed

Sharma, Morali D; Nguyen, Anh V; Brown, Spandana; Robbins, Richard J

2017-01-01

In patients with acromegaly, chronic excess of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) leads to the development of acromegalic cardiomyopathy. Its main features are biventricular hypertrophy, diastolic dysfunction, and in later stages, systolic dysfunction and congestive heart failure. Surgical and/or pharmacological treatment of acromegaly and control of cardiovascular risk factors help reverse some of these pathophysiologic changes and decrease the high risk of cardiovascular complications.

AMPKα2 regulates expression of estrogen-related receptor alpha, a metabolic transcription factor related to heart failure development

PubMed Central

Hu, Xinli; Xu, Xin; Lu, Zhongbing; Zhang, Ping; Fassett, John; Zhang, Ying; Xin, Yi; Hall, Jennifer L.; Viollet, Benoit; Bache, Robert J.; Huang, Yimin; Chen, Yingjie

2011-01-01

The normal expression of myocardial mitochondrial enzymes is essential to maintain the cardiac energy reserve and facilitate responses to stress, but the molecular mechanisms to maintain myocardial mitochondrial enzyme expression have been elusive. Here we report that congestive heart failure is associated with a significant decrease of myocardial Estrogen-Related Receptor alpha (ERRα), but not PPAR gamma coactivator-1 alpha (PGC1α), in human heart failure samples. In addition, chronic pressure overload in mice caused a decrease of ERRα expression that was significantly correlated to the degree of LV dysfunction, pulmonary congestion and decreases of a group of myocardial energy metabolism related genes. We found that the metabolic sensor AMP activated protein kinase (AMPK) regulates ERRα expression in vivo and in vitro. AMPKα2 KO decreased myocardial ERRα (both mRNA and protein) and its downstream targets under basal conditions, with no change in myocardial PGC1α expression. Using cultured rat neonatal cardiac myocytes, we found that overexpression of constitutively active AMPKα significantly induced ERRα mRNA, protein and promoter activity. Conversely, selective gene silencing of AMPKα2 repressed ERRα and its target gene levels, indicating that AMPKα2 is involved in the regulation of ERRα expression. In addition, over-expression of ERRα in AMPKα2 KO neonatal cardiac myocytes partially rescued the repressed expression of some energy metabolism related genes. These data support an important role for AMPKα2 in regulating the expression of myocardial ERRα and its downstream mitochondrial enzymes. PMID:21825219

Urban emissions hotspots: Quantifying vehicle congestion and air pollution using mobile phone GPS data.

PubMed

Gately, Conor K; Hutyra, Lucy R; Peterson, Scott; Sue Wing, Ian

2017-10-01

On-road emissions vary widely on time scales as short as minutes and length scales as short as tens of meters. Detailed data on emissions at these scales are a prerequisite to accurately quantifying ambient pollution concentrations and identifying hotspots of human exposure within urban areas. We construct a highly resolved inventory of hourly fluxes of CO, NO 2 , NO x , PM 2.5 and CO 2 from road vehicles on 280,000 road segments in eastern Massachusetts for the year 2012. Our inventory integrates a large database of hourly vehicle speeds derived from mobile phone and vehicle GPS data with multiple regional datasets of vehicle flows, fleet characteristics, and local meteorology. We quantify the 'excess' emissions from traffic congestion, finding modest congestion enhancement (3-6%) at regional scales, but hundreds of local hotspots with highly elevated annual emissions (up to 75% for individual roadways in key corridors). Congestion-driven reductions in vehicle fuel economy necessitated 'excess' consumption of 113 million gallons of motor fuel, worth ∼ $415M, but this accounted for only 3.5% of the total fuel consumed in Massachusetts, as over 80% of vehicle travel occurs in uncongested conditions. Across our study domain, emissions are highly spatially concentrated, with 70% of pollution originating from only 10% of the roads. The 2011 EPA National Emissions Inventory (NEI) understates our aggregate emissions of NO x , PM 2.5 , and CO 2 by 46%, 38%, and 18%, respectively. However, CO emissions agree within 5% for the two inventories, suggesting that the large biases in NO x and PM 2.5 emissions arise from differences in estimates of diesel vehicle activity. By providing fine-scale information on local emission hotspots and regional emissions patterns, our inventory framework supports targeted traffic interventions, transparent benchmarking, and improvements in overall urban air quality. Copyright © 2017 Elsevier Ltd. All rights reserved.

Alternative performance measures for evaluating congestion.

DOT National Transportation Integrated Search

2004-04-01

This report summarizes the results of the work performed under the project Alternative Performance Measures for Evaluating : Congestion. The study first outlines existing approaches to looking at congestion. It then builds on the previous work in the...

Technologies that complement congestion pricing : a primer.

DOT National Transportation Integrated Search

2008-10-01

The purpose of this volume is to consider the technology options that are available to complement congestion-pricing approaches. This primer explores how technology broadens the success for congestion pricing by supporting the traveler's decision to ...

Multimodal and corridor applications of travel time reliability.

DOT National Transportation Integrated Search

2012-03-30

Congestion is all too familiar in Floridas cities. Traditionally, agencies have tried to mitigate recurring congestion by comparing demand and capacity during peak periods and alleviating bottlenecks. However, congestion is often due to nonrecurri...

Multimodal and corridor applications of travel time reliability : [summary].

DOT National Transportation Integrated Search

2012-01-01

Congestion is all too familiar in Floridas cities. Traditionally, agencies have tried to mitigate recurring congestion by comparing demand and capacity during peak periods and alleviating bottlenecks. However, congestion is often due to nonrecurri...

Statewide GIS mapping of recurring congestion corridors : final report.

DOT National Transportation Integrated Search

2009-07-01

Recurring congestion occurs when travel demand reaches or exceeds the available roadway : capacity. This project developed an interactive geographic information system (GIS) map of the : recurring congestion corridors (labeled herein as hotspots) in ...

Congestion pricing : a primer : overview

DOT National Transportation Integrated Search

2008-10-01

This Overview primer was produced to explain the concept of congestion pricing and its benefits, to present examples of congestion-pricing approaches implemented in the United States and abroad, and to briefly discuss federal-aid policy and programs ...

Local empathy provides global minimization of congestion in communication networks

NASA Astrophysics Data System (ADS)

Meloni, Sandro; Gómez-Gardeñes, Jesús

2010-11-01

We present a mechanism to avoid congestion in complex networks based on a local knowledge of traffic conditions and the ability of routers to self-coordinate their dynamical behavior. In particular, routers make use of local information about traffic conditions to either reject or accept information packets from their neighbors. We show that when nodes are only aware of their own congestion state they self-organize into a hierarchical configuration that delays remarkably the onset of congestion although leading to a sharp first-order-like congestion transition. We also consider the case when nodes are aware of the congestion state of their neighbors. In this case, we show that empathy between nodes is strongly beneficial to the overall performance of the system and it is possible to achieve larger values for the critical load together with a smooth, second-order-like, transition. Finally, we show how local empathy minimize the impact of congestion as much as global minimization. Therefore, here we present an outstanding example of how local dynamical rules can optimize the system’s functioning up to the levels reached using global knowledge.

Fixture congestion modulates post-match recovery kinetics in professional soccer players.

PubMed

Lundberg, Tommy R; Weckström, Kristoffer

2017-01-01

This study examined the influence of fixture congestion on physical performance and biochemical variables in professional male footballers. After 3 competitive matches within a week (3M cycle), 16 players underwent blood sampling and field testing 72 h after the last match. The same tests were performed after a regular 1 match-week cycle (1M cycle). The 1M vs. 3M change scores were compared between Congested (high match exposure) and non-selected Control players. The change score in muscle soreness was greater (effect size 1.0; CI 0.0-1.9) in the Congested players than Controls, indicating a possible negative effect of fixture congestion. There were no effects on sprint and jump performance. The change in plasma (P)-Urea was greater in Congested players than controls (effect size 1.3; CI 0.3-2.2). The effects on other blood variables were either non-existing/trivial, or unclear. Altogether, physical fitness and immune function were not compromised by match congestion, yet some indices of physiological stress and muscle damage were still evident.

Infrared laser spectroscopy of the n-propyl and i-propyl radicals: Stretch-bend Fermi coupling in the alkyl CH stretch region

DOE PAGES

Franke, Peter R.; Tabor, Daniel P.; Moradi, Christopher P.; ...

2016-12-13

The n-propyl and i-propyl radicals were generated in the gas phase via pyrolysis of n-butyl nitrite [CH 3(CH 2) 3ONO] and i-butyl nitrite [(CH 3) 2CHCH 2ONO], respectively. Nascent radicals were promptly solvated by a beam of He nanodroplets, and the infrared spectra of the radicals were recorded in the CH stretching region. Several previously unreported bands are observed between 2800 and 3150 cm –1. The CH stretching modes observed above 3000 cm –1 are in excellent agreement with CCSD(T) anharmonic frequencies computed using second-order vibrational perturbation theory. However, between 2800 and 3000 cm –1, the spectra of n- andmore » i-propyl radicals become congested and difficult to assign due to the presence of multiple anharmonic resonance polyads. To model the spectrally congested region, Fermi and Darling-Dennison resonances are treated explicitly using “dressed” Hamiltonians and CCSD(T) quartic force fields in the normal mode representation, and the agreement with experiment is less than satisfactory. Computations employing local mode effective Hamiltonians reveal the origin of the spectral congestion to be strong coupling between the high frequency CH stretching modes and the lower frequency CH n bending/scissoring motions. The most significant coupling is between stretches and bends localized on the same CH 2/CH 3 group. As a result, spectral simulations using the local mode approach are in excellent agreement with experiment.« less

Infrared laser spectroscopy of the n-propyl and i-propyl radicals: Stretch-bend Fermi coupling in the alkyl CH stretch region

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

Franke, Peter R.; Tabor, Daniel P.; Moradi, Christopher P.

The n-propyl and i-propyl radicals were generated in the gas phase via pyrolysis of n-butyl nitrite [CH 3(CH 2) 3ONO] and i-butyl nitrite [(CH 3) 2CHCH 2ONO], respectively. Nascent radicals were promptly solvated by a beam of He nanodroplets, and the infrared spectra of the radicals were recorded in the CH stretching region. Several previously unreported bands are observed between 2800 and 3150 cm –1. The CH stretching modes observed above 3000 cm –1 are in excellent agreement with CCSD(T) anharmonic frequencies computed using second-order vibrational perturbation theory. However, between 2800 and 3000 cm –1, the spectra of n- andmore » i-propyl radicals become congested and difficult to assign due to the presence of multiple anharmonic resonance polyads. To model the spectrally congested region, Fermi and Darling-Dennison resonances are treated explicitly using “dressed” Hamiltonians and CCSD(T) quartic force fields in the normal mode representation, and the agreement with experiment is less than satisfactory. Computations employing local mode effective Hamiltonians reveal the origin of the spectral congestion to be strong coupling between the high frequency CH stretching modes and the lower frequency CH n bending/scissoring motions. The most significant coupling is between stretches and bends localized on the same CH 2/CH 3 group. As a result, spectral simulations using the local mode approach are in excellent agreement with experiment.« less

Atlanta congestion reduction demonstration : national evaluation report.

DOT National Transportation Integrated Search

2014-03-01

This document presents the final report on the national evaluation of the Atlanta Congestion Reduction Demonstration (CRD) under the United States Department of Transportation (U.S. DOT) CRD Program. The Atlanta CRD projects focus on reducing congest...

Modeling the effect of accessibility and congestion in location choice.

DOT National Transportation Integrated Search

2012-12-01

This study explores the relationship between accessibility and congestion, and their impacts on property values. Three research questions are addressed: (1) What is the relation between accessibility and congestion both regional and neighborhood leve...

Speed harmonization and peak-period shoulder use to manage urban freeway congestion.

DOT National Transportation Integrated Search

2009-10-01

Traffic congestion is an increasing problem in the nations urban areas, leading to personal inconvenience, : increased pollution, hampered economic productivity, and reduced quality of life. While traffic congestion tends : to continuously increas...

A toolbox for alleviating traffic congestion and enhancing mobility

DOT National Transportation Integrated Search

2012-06-01

This report presents the Tolling Data Test Plan for the national evaluation of the Los Angeles (LA) Congestion Reduction Demonstration (Metro ExpressLanes) under the United States Department of Transportation (U.S. DOT) Congestion Reduction Demonstra...

Determining queue and congestion in highway work zone bottlenecks.

DOT National Transportation Integrated Search

2011-03-11

Construction zones, though required for infrastructure maintenance, have become congestion choke points on most highway systems in the US. The congestion may create potentially unsafe driving conditions for approaching motorists that do not expect qu...

Determining Queue and Congestion in Highway Work Zone Bottlenecks

DOT National Transportation Integrated Search

2011-03-11

Construction zones, though required for infrastructure maintenance, have become congestion choke points on most highway systems in the US. The congestion may create potentially unsafe driving conditions for approaching motorists that do not expect qu...

Diagnosis and Treatment of Depression in Patients With Congestive Heart Failure: A Review of the Literature

PubMed Central

Stern, Theodore A.; Hebert, Kathy A.; Musselman, Dominique L.

2013-01-01

Context: Major depressive disorder (MDD) can be challenging to diagnose in patients with congestive heart failure, who often suffer from fatigue, insomnia, weight changes, and other neurovegetative symptoms that overlap with those of depression. Pathophysiologic mechanisms (eg, inflammation, autonomic nervous system dysfunction, cardiac arrhythmias, and altered platelet function) connect depression and congestive heart failure. Objective: We sought to review the prevalence, diagnosis, neurobiology, and treatment of depression associated with congestive heart failure. Data Sources: A search of all English-language articles between January 2003 and January 2013 was conducted using the search terms congestive heart failure and depression. Study Selection: We found 1,498 article abstracts and 19 articles (meta-analyses, systematic reviews, and original research articles) that were selected for inclusion, as they contained information about our focus on diagnosis, treatment, and pathophysiology of depression associated with congestive heart failure. The search was augmented with manual review of reference lists of articles from the initial search. Articles selected for review were determined by author consensus. Data Extraction: The prevalence, diagnosis, neurobiology, and treatment of depression associated with congestive heart failure were reviewed. Particular attention was paid to the safety, efficacy, and tolerability of antidepressant medications commonly used to treat depression and how their side-effect profiles impact the pathophysiology of congestive heart failure. Drug-drug interactions between antidepressant medications and medications used to treat congestive heart failure were examined. Results: MDD is highly prevalent in patients with congestive heart failure. Moreover, the prevalence and severity of depression correlate with the degree of cardiac dysfunction and development of congestive heart failure. Depression increases the risk of congestive heart failure, particularly in those patients with coronary artery disease , and is associated with a poorer quality of life, increased use of health care resources, more frequent adverse clinical events and hospitalizations, and twice the risk of mortality. Conclusions: At present, limited empirical data exist with regard to treatment of depression in the increasingly large population of patients with congestive heart failure. Evidence reveals that both psychotherapeutic treatment (eg, cognitive-behavioral therapy) and pharmacologic treatment (eg, use of the selective serotonin reuptake inhibitor sertraline) are safe and effective in reducing depression severity in patients with cardiovascular disease. Collaborative care programs featuring interventions that work to improve adherence to medical and psychiatric treatments improve both cardiovascular disease and depression outcomes. Depression rating scales such as the 9-item Patient Health Questionnaire should be used to monitor therapeutic efficacy. PMID:24392265

Clinical efficacy of crataegus extract WS 1442 in congestive heart failure NYHA class II.

PubMed

Zapfe jun, G

2001-07-01

In a randomised, placebo-controlled, double-blind clinical study the clinical efficacy and safety of Crataegus extract WS 1442, standardised to 18.75% oligomeric procyanidines, were investigated in 40 female and male outpatients suffering from congestive heart failure NYHA class II. Following a wash-out period of up to seven days, the patients were randomised to be treated for 12 weeks with either WS 1442 (3 x 1 capsule) or placebo. The primary outcome variable was exercise tolerance determined with bicycle exercise testing; as a secondary outcome variable the difference of the double product was calculated. On average, the exercise tolerance increased by 66.3 W x min (10.8%) in the WS 1442 group while in the placebo group a reduction of 105.3 W x min (16.9%) was measured. This difference between the groups was borderline statistically significant (p = 0.06). During the three month therapy the difference of the double product (heart rate x systolic blood pressure x 10(-2)) decreased by 14.4 mmHg s(-1) (26.8%) in the WS 1442 group and by 1.3 mmHg s(-1) (2.7%) in the placebo group, respectively. Recording of laboratory parameters and adverse events showed that WS 1442 was safe and well tolerated. The data show that Crataegus extract WS 1442 is clinically effective in patients with congestive heart failure corresponding to NYHA class II.

Forecasting the clearance time of freeway accidents

DOT National Transportation Integrated Search

2002-01-01

Freeway congestion is a major and costly problem in many U.S. metropolitan areas. From a traveler's perspective, congestion has costs in terms of longer travel times and lost productivity. From the traffic manager's perspective, congestion causes a f...

The economic cost of traffic congestion in Florida.

DOT National Transportation Integrated Search

2010-08-01

Traffic congestion in the U.S. is bad and getting worse, and it is expensive. Appropriate solutions to this problem require appropriate information. A comprehensive and accurate analysis of congestion costs is a critical tool for planning and impleme...

Air quality assessment at a congested urban intersection

DOT National Transportation Integrated Search

2000-09-01

The deficient transportation system of Beirut results in significant economic losses for the city and causes severe traffic congestion in the urban areas. Proposals have been made for grade separations at some of the worst congested intersections. Th...

Impact of congestion on bus operations and costs.

DOT National Transportation Integrated Search

2003-10-01

Traffic congestion in Northern New Jersey imposes substantial operational and monetary penalty on bus service. The purpose of this project was to quantify the additional time and costs due to traffic congestion. A regression model was developed that ...

Mobility and the Costs of Congestion in New Jersey

DOT National Transportation Integrated Search

2000-02-01

This study measured quantifiable and qualitative impacts of congestion in New Jersey on mobility, the cost of transportation, and economic productivity. It addressed the impacts of congestion on both an individual level (impacts on an average travele...

Measuring non-recurrent congestion in small to medium sized urban areas.

DOT National Transportation Integrated Search

2013-05-01

Understanding the relative magnitudes of recurrent vs. non-recurrent congestion in an urban area is critical to the selection of proper countermeasures and the appropriate allocation of resources to address congestion problems. Small to medium sized ...

Medicinal Leech Therapy for Glans Penis Congestion After Primary Bladder Exstrophy-Epispadias Repair in an Infant: A Case Report.

PubMed

Wagenheim, Gavin N; Au, Jason; Gargollo, Patricio C

2016-01-01

Many postoperative complications have been reported after repair of classic bladder exstrophy. We present a case of medicinal leech therapy for glans penis congestion following exstrophy repair in an infant. A 2-week-old male with classic bladder exstrophy underwent complete primary repair. On postoperative day 1, he developed rapidly worsening glans penis venous congestion. Medicinal leech therapy was instituted with antibiotics and blood transfusions to maintain a hematocrit >30%. After 24 hours, venous congestion improved and therapy was discontinued. The patient's remaining hospital course was uncomplicated. Medicinal leeches are an effective therapy to relieve glans penis venous congestion. Copyright © 2015 Elsevier Inc. All rights reserved.

Phase diagram of congested traffic flow: An empirical study

PubMed

Lee; Lee; Kim

2000-10-01

We analyze traffic data from a highway section containing one effective on-ramp. Based on two criteria, local velocity variation patterns and expansion (or nonexpansion) of congested regions, three distinct congested traffic states are identified. These states appear at different levels of the upstream flux and the on-ramp flux, thereby generating a phase digram of the congested traffic flow. Observed traffic states are compared with recent theoretical analyses and both agreeing and disagreeing features are found.

[Use of antihypertensive drug therapy and risk of development of congestive heart failure].

PubMed

Sobrino, Javier; Plana, Jaume; Felip, Angela; Doménech, Mónica; Reth, Peter; Adrián, María Jesús; de la Sierra, Alejandro

2004-09-18

It has been suggested that the use of some antihypertensive agents may favour the development of congestive heart failure. The aim of the present study was to evaluate such a possible association in patients who had a new diagnosis of congestive heart failure. This was a retrospective case-control study of 81 patients who had a first hospital admission with a new diagnosis of congestive heart failure (cases) and 162 patients admitted for other hypertensive complications (controls). Previous antihypertensive drug use was registered and the possible association with congestive heart failure was evaluated. The presence of congestive heart failure was not associated with the use of any antihypertensive drug class. When treatments were grouped in classic (diuretics and betablockers) or modern (calcium channel blockers, angiotensin-converting-enzyme inhibitors, alphablockers or angiotensin receptor blockers), a negative association was observed with the latter group, which was observed in 48.1% of cases and 63.6% of controls (odds ratio: 0.532; 95% confidence interval, 0.310-0.913). This association was lost after adjustment for other cardiovascular risk factors or previous hypertensive complications. The development of congestive heart failure was not associated with the use of any specific antihypertensive drug class. From the present evidence, it is not possible to recommend a specific antihypertensive agent in patients at risk of developing congestive heart failure but without evidence of such disease.

Development of congestion performance measures using ITS information.

DOT National Transportation Integrated Search

2003-01-01

The objectives of this study were to define a performance measure(s) that could be used to show congestion levels on critical corridors throughout Virginia and to develop a method to select and calculate performance measures to quantify congestion in...

Urban roadway congestion : annual report

DOT National Transportation Integrated Search

1998-01-01

The annual traffic congestion study is an effort to monitor roadway congestion in major urban areas in the United States. The comparisons to other areas and to previous experiences in each area are facilitated by a database that begins in 1982 and in...

A simulation-optimization-based decision support tool for mitigating traffic congestion.

DOT National Transportation Integrated Search

2009-12-01

"Traffic congestion has grown considerably in the United States over the past twenty years. In this paper, we develop : a robust decision support tool based on simulation optimization to evaluate and recommend congestion-mitigation : strategies to tr...

Cumulative dose of hydroxychloroquine is associated with a decrease of resting heart rate in patients with systemic lupus erythematosus: a pilot study.

PubMed

Cairoli, E; Danese, N; Teliz, M; Bruzzone, M J; Ferreira, J; Rebella, M; Cayota, A

2015-10-01

The use of hydroxychloroquine (HCQ) in patients with systemic lupus erythematosus (SLE) offers a wide range of benefits. However, there are evidence in favour of cardiotoxicity, including heart conduction disturbances and congestive heart failure. To determine the effects of HCQ in the resting heart rate (RHR) of SLE patients. Included were patients with non active SLE, with a sedentary lifestyle and treated with HCQ. Excluded were patients on beta blocker treatment, trained patients, pacemaker's users and patients with clinical or analytical evidence of anemia, renal disease, obstructive pulmonary disease, obesity, uncontrolled thyroid disease, fever or current infection. Standard 12-lead electrocardiogram was performed in the resting condition (supine decubitus and orthostatic position). Comparison between groups was performed using Mann-Whitney U test. A multiple linear regression was performed. A p value <0.05 was considered statistically significant. 42 patients were included. Patients were divided in two groups based on the cumulative dose of HCQ (CD-HCQ), considering 365 g as cut-off. There were 24 patients with low-HCQ (<365 g) and 18 patients with high-HCQ (>365 g). Non significant differences were found in age, sex, prednisone dose or SLEDAI. The mean RHR was 73 ± 6 beats/min in the low-HCQ and 65 ± 7 beats/min in the high-HCQ, with a significant decrease of 11% (p = 0.003). In multiple linear regressions, there were non significant association between the decrease of RHR and prednisone dose, age, SLEDAI or TSH, but there was significant association between RHR and CD-HCQ (p = 0.024) and RHR and time of exposure to HCQ (p = 0.029). CD-HCQ higher than 365 g was associated with a significant decrease (11%) in RHR in non-active SLE patients, although a larger prospective study is required to allow more definitive conclusions. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

[Effects of trimetazidine on serum oxygen free radicals in congestive heart failure].

PubMed

Ma, Qi-lin; Xie, Yong; Zhang, Sai-dan

2002-12-28

To investigate the level of serum superoxide dismutase (SOD) and maiondialdehyde (MDA) and left ventricular systolic function in congestive heart failure (CHF) and to evaluate the influence of trimetazidine on them. Serum SOD and MDA were measured in 50 patients with heart function from grade two to four and 15 normal subjects. All the persons underwent echocardiography to determine the left ventricular end-systolic volume index (LVESVI) and the left ventricular ejection fraction (EF). The patients with CHF were randomly treated with trimetazidine plus routine therapy (n = 25) or routine therapy only (n = 25) for 8 weeks with evaluations made before and after the treatment. The SOD level and EF in the patients with CHF significantly decreased and the MDA level and LVESVI in those patients significantly increased compared with the normal subjects (P < 0.05); the severer the CHF, the greater the changes. After the treatment, the SOD level and EF increased significantly and MDA and LVESVI decreased significantly (P < 0.01) in both the trimetazidine and the conventional groups. And these changes were more obvious in the trimetazidine group than in the conventional group(P < 0.01). Oxygen free radicals play an important role in the pathophysiologic changes of CHF. The level of serum SOD and MDA can indicate the degree of CHF. Trimetazidine not only increases the level of SOD and decreases the level of MDA, but also improves the left ventricular systolic function.

The diagnostic accuracy of physical examination compared to lung ultrasound for determining lung congestion in hemodialysis patients who have reached their dry weight

NASA Astrophysics Data System (ADS)

Rahardjo, K. D.; Dharmaeizar; Nainggolan, G.; Harimurti, K.

2017-08-01

Research has shown that hemodialysis patients with lung congestion have high morbidity and mortality. Patients were assumed to be free of lung congestion if they had reached their post-dialysis dry weight. Most often, to determine if the patient was free of lung congestion, physical examination was used. However, the accuracy of physical examination in detecting lung congestion has not been established. To compare the capabilities of physical examination and lung ultrasound in detection of lung congestion, cross-sectional data collection was conducted on hemodialysis patients. Analysis was done to obtain proportion, sensitivity, specificity, positive predictive value, negative predictive value, and positive likelihood ratio. Sixty patients participated in this study. The inter observer variation of 20 patients revealed a kappa value of 0.828. When all 60 patients were taken into account, we found that 36 patients (57.1%) had lung congestion. Mild lung congestion was found in 24 (38.1%), and 12 (19%) had a moderate degree of congestion. In the analysis comparing jugular venous pressure to lung ultrasound, we found that sensitivity was 0.47 (0.31-0.63), specificity was 0.73 (0.54-0.86), positive predictive value (PPV) was 0.51 (0.36-0.67), negative predictive value (NPV) was 0.70 (0.49-0.84), positive likelihood ratio (PLR) was 1.75 (0.88-3.47), and the negative likelihood ratio (NLR) was 0.72 (0.47-1.12). In terms of lung auscultation, we found that sensitivity was 0.56 (0.39-0.71), specificity was 0.54 (0.35-0.71), PPV was 0.61 (0.44-0.76), NPV was 0.48 (0.31-0.66), PLR was 1.21 (0.73-2.0), and NLR was 0.82 (0.49-1.38). The results of our study showed that jugular venous distention and lung auscultation examination are not reliable means of detecting lung congestion.

Distributed multiple path routing in complex networks

NASA Astrophysics Data System (ADS)

Chen, Guang; Wang, San-Xiu; Wu, Ling-Wei; Mei, Pan; Yang, Xu-Hua; Wen, Guang-Hui

2016-12-01

Routing in complex transmission networks is an important problem that has garnered extensive research interest in the recent years. In this paper, we propose a novel routing strategy called the distributed multiple path (DMP) routing strategy. For each of the O-D node pairs in a given network, the DMP routing strategy computes and stores multiple short-length paths that overlap less with each other in advance. And during the transmission stage, it rapidly selects an actual routing path which provides low transmission cost from the pre-computed paths for each transmission task, according to the real-time network transmission status information. Computer simulation results obtained for the lattice, ER random, and scale-free networks indicate that the strategy can significantly improve the anti-congestion ability of transmission networks, as well as provide favorable routing robustness against partial network failures.

Efficient quantum transmission in multiple-source networks.

PubMed

Luo, Ming-Xing; Xu, Gang; Chen, Xiu-Bo; Yang, Yi-Xian; Wang, Xiaojun

2014-04-02

A difficult problem in quantum network communications is how to efficiently transmit quantum information over large-scale networks with common channels. We propose a solution by developing a quantum encoding approach. Different quantum states are encoded into a coherent superposition state using quantum linear optics. The transmission congestion in the common channel may be avoided by transmitting the superposition state. For further decoding and continued transmission, special phase transformations are applied to incoming quantum states using phase shifters such that decoders can distinguish outgoing quantum states. These phase shifters may be precisely controlled using classical chaos synchronization via additional classical channels. Based on this design and the reduction of multiple-source network under the assumption of restricted maximum-flow, the optimal scheme is proposed for specially quantized multiple-source network. In comparison with previous schemes, our scheme can greatly increase the transmission efficiency.

The Improvement on the Xinjiekou Subway Transfer Channel of Nanjing

NASA Astrophysics Data System (ADS)

Xu, X. D.; Zheng, C. J.

The subway, which is an effective way to alleviate the traffic congestion, has gradually been constructed in many cities. With the completion of the construction, the transfer station will become the factor that affects the efficiency of the whole transport network. Based on investigation and analysis of the present situation of the passenger flow, the essay will make a prediction with the multiple linear regression and put forward two kinds of transfer channel improvement schemes for xinjiekou transfer station.

The congestion control algorithm based on queue management of each node in mobile ad hoc networks

NASA Astrophysics Data System (ADS)

Wei, Yifei; Chang, Lin; Wang, Yali; Wang, Gaoping

2016-12-01

This paper proposes an active queue management mechanism, considering the node's own ability and its importance in the network to set the queue threshold. As the network load increases, local congestion of mobile ad hoc network may lead to network performance degradation, hot node's energy consumption increase even failure. If small energy nodes congested because of forwarding data packets, then when it is used as the source node will cause a lot of packet loss. This paper proposes an active queue management mechanism, considering the node's own ability and its importance in the network to set the queue threshold. Controlling nodes buffer queue in different levels of congestion area probability by adjusting the upper limits and lower limits, thus nodes can adjust responsibility of forwarding data packets according to their own situation. The proposed algorithm will slow down the send rate hop by hop along the data package transmission direction from congestion node to source node so that to prevent further congestion from the source node. The simulation results show that, the algorithm can better play the data forwarding ability of strong nodes, protect the weak nodes, can effectively alleviate the network congestion situation.

A New Procedure for Wrapped-Negative Pressure Wound Therapy for Congestion After Arterialized Venous Flap Surgery

PubMed Central

Niimi, Yosuke; Mori, Satoko; Takeuchi, Masaki

2017-01-01

Negative pressure wound therapy (NPWT) is a method for treating wound. However, there are no case reports using NPWT for treating congestion after arterialized venous flap. Therefore, this study reported favorable outcomes after using a single-use NPWT system for managing congestion. A 39-year-old man had his index finger caught by a press machine. The finger had a soft tissue defect at the ventral part. An arterialized venous flap taken from the right forearm was transplanted. Perfusion of the flap was favorable, but on postoperative day 5, congestion and the edema of the flap were found. Then, NPWT was initiated. The congestion and edema in the flap were improved without complications such as flap necrosis and wound infection. At 4 months postoperatively, the morphology of the finger was favorable. In this study, NPWT was speculated to force the deeper blood vessels within the flap to dilate with inducing drainage and the simultaneous reduction in excess blood flow to the cortical layer, resulting in the improvement of congestion. Negative pressure wound therapy was used for treating congestion after the transplantation of arterialized venous flap, and the wound was favorably managed. PMID:29270041

How Travel Demand Affects Detection of Non-Recurrent Traffic Congestion on Urban Road Networks

NASA Astrophysics Data System (ADS)

Anbaroglu, B.; Heydecker, B.; Cheng, T.

2016-06-01

Occurrence of non-recurrent traffic congestion hinders the economic activity of a city, as travellers could miss appointments or be late for work or important meetings. Similarly, for shippers, unexpected delays may disrupt just-in-time delivery and manufacturing processes, which could lose them payment. Consequently, research on non-recurrent congestion detection on urban road networks has recently gained attention. By analysing large amounts of traffic data collected on a daily basis, traffic operation centres can improve their methods to detect non-recurrent congestion rapidly and then revise their existing plans to mitigate its effects. Space-time clusters of high link journey time estimates correspond to non-recurrent congestion events. Existing research, however, has not considered the effect of travel demand on the effectiveness of non-recurrent congestion detection methods. Therefore, this paper investigates how travel demand affects detection of non-recurrent traffic congestion detection on urban road networks. Travel demand has been classified into three categories as low, normal and high. The experiments are carried out on London's urban road network, and the results demonstrate the necessity to adjust the relative importance of the component evaluation criteria depending on the travel demand level.

Impact of tocilizumab on N-terminal pro-brain natriuretic peptide levels in patients with active rheumatoid arthritis without cardiac symptoms.

PubMed

Yokoe, I; Kobayashi, H; Kobayashi, Y; Giles, J T; Yoneyama, K; Kitamura, N; Takei, M

2018-05-28

To prospectively investigate the effect of tocilizumab (TCZ) on the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), as a predictor of congestive heart failure (CHF) in patients with active rheumatoid arthritis (RA). Seventy patients with RA (median age 59 years, 86% female) free of cardiovascular disease were treated with TCZ and followed for 24 weeks. The NT-proBNP levels were measured at baseline and week 24. Thirty healthy controls were included for comparison of normal NT-proBNP levels with those of RA patients. The NT-proBNP level was significantly higher in patients with RA than in controls (median 42.5 pg/mL vs 109.0 pg/mL, p < 0.001). NT-proBNP levels decreased by 63% over the 24 weeks of TCZ treatment. Multiple linear regression analysis indicated that the percentage change in the NT-proBNP level was significantly associated with that of the Simplified Disease Activity Index (β = 0.356, p = 0.014), even after adjusting for the levels of rheumatoid factor, duration of RA, age, and anti-cyclic citrullinated peptide antibody. TCZ decreased the NT-proBNP level in patients with RA without preceding cardiovascular disease and CHF. TCZ may have a cardioprotective effect in those with active RA.

Role of cardiac output and the autonomic nervous system in the antinatriuretic response to acute constriction of the thoracic superior vena cava.

NASA Technical Reports Server (NTRS)

Schrier, R. W.; Humphreys, M. H.; Ufferman, R. C.

1971-01-01

Study of the differential characteristics of hepatic congestion and decreased cardiac output in terms of potential afferent stimuli in the antinatriuretic effect of acute thoracic inferior vena cava (TIVC) constriction. An attempt is made to see if the autonomic nervous system is involved in the antinatriuretic effect of acute TIVC or thoracic superior vena cava constriction.

TVP1022 attenuates cardiac remodeling and kidney dysfunction in experimental volume overload-induced congestive heart failure.

PubMed

Abassi, Zaid A; Barac, Yaron D; Kostin, Sawa; Roguin, Ariel; Ovcharenko, Elena; Awad, Hoda; Blank, Ayelet; Bar-Am, Orit; Amit, Tamar; Schaper, Jutta; Youdim, Moussa; Binah, Ofer

2011-07-01

Despite the availability of many pharmacological and mechanical therapies, the mortality rate among patients with congestive heart failure (CHF) remains high. We tested the hypothesis that TVP1022 (the S-isomer of rasagiline; Azilect), a neuroprotective and cytoprotective molecule, is also cardioprotective in the settings of experimental CHF in rats. In rats with volume overload-induced CHF, we investigated the therapeutic efficacy of TVP1022 (7.5 mg/kg) on cardiac function, structure, biomarkers, and kidney function. Treatment with TVP1022 for 7 days before CHF induction prevented the increase in left ventricular end-diastolic area and end-systolic area, and the decrease in fractional shortening measured 14 days after CHF induction. Additionally, TVP1022 pretreatment attenuated CHF-induced cardiomyocyte hypertrophy, fibrosis, plasma and ventricular B-type natriuretic peptide levels, and reactive oxygen species expression. Further, in CHF rats, TVP1022 decreased cytochrome c and caspase 3 expression, thereby contributing to the cardioprotective efficacy of the drug. TVP1022 also enhanced the urinary Na(+) excretion and improved the glomerular filtration rate. Similar cardioprotective effects were obtained when TVP1022 was given to rats after CHF induction. TVP1022 attenuated the adverse functional, structural, and molecular alterations in CHF, rendering this drug a promising candidate for improving cardiac and renal function in this disease state.

Desloratadine therapy improves allergic rhinitis symptoms in latin american children aged 6 to 12 years.

PubMed

Tassinari, Paolo; Suárez, Nelson R; Centeno, Jorge; Velásquez, Janina Vergara; Aguirre-Mariscal, Héctor; Gonzálezdíaz, Sandra N; Jerves, Alfredo Fernández de Córdova

2009-04-01

: To determine the effectiveness of desloratadine syrup in relieving symptoms of allergic rhinitis (AR) among children in Latin America. : In an open-label trial conducted in 5 Latin American countries, 455 children aged 6 to 12 years with seasonal or perennial AR were treated with desloratadine syrup 2.5 mg/d for 6 weeks. Thirty percent of subjects were concomitantly taking corticosteroids, and 21.3% had a history of asthma. Efficacy was measured by improvement in the Total Symptom Severity 4 questionnaire and decrease in severity of individual nasal symptoms of congestion, rhinorrhea, pruritus, and sneezing. Physicians and subjects' caregivers rated symptom improvement in a separate assessment at final visit. : Treatment with desloratadine led to a significant decrease in mean Total Symptom Severity 4 score, from 7.54 at baseline to 1.96 at study end (P < 0.0001), and in individual symptom scores, including congestion (P < 0.0001 for all). Similar improvements were found in groups receiving desloratadine monotherapy and desloratadine plus corticosteroids. Allergic rhinitis symptoms were rated "better" or "much better" by 94% of caregivers. Incidence of adverse events was 6%. : Desloratadine, with or without concomitant corticosteroids, was efficacious and safe in the treatment of AR in this group of Latin American children.

An evaluation of congestion-reducing measures used in Virginia.

DOT National Transportation Integrated Search

1992-01-01

Congestion on our nation's highways, especially in urban areas, is a serious problem that is growing steadily worse. In Virginia, it is estimated that 28 percent of the daily vehicle miles of travel (VMT) occurring during peak hour traffic is congest...

Seasonal variation in traffic congestion : a study of three U.S. cities

DOT National Transportation Integrated Search

2008-08-01

Drivers may notice seasonal : changes in patterns of highway : congestion in many urban : areas of the country. These : patterns, however, can be very different for individual cities. : This report looks at congestion patterns over a 3-year period : ...

Projecting future landside congestion delays at the BWI Airport : final report.

DOT National Transportation Integrated Search

2003-10-01

This study examines the access to the BWI Airport in detail. Complex density functions are utilized to determine the : congestion curves faced by passengers arriving at the airport. It is found that all lots have congestion during peak : periods and ...

Long Island Transportation Plan to Manage Congestion: Framework for Developing and Evaluating Improvement Strategies

DOT National Transportation Integrated Search

2002-04-20

The Long Island Transportation Plan to Manage Congestion (LITP 2000) will establish an integrated, multi-modal transportation program of cost-effective strategies to manage congestion and improve the movement of people and goods in Nassau and Suffolk...

Quick Vegas: Improving Performance of TCP Vegas for High Bandwidth-Delay Product Networks

NASA Astrophysics Data System (ADS)

Chan, Yi-Cheng; Lin, Chia-Liang; Ho, Cheng-Yuan

An important issue in designing a TCP congestion control algorithm is that it should allow the protocol to quickly adjust the end-to-end communication rate to the bandwidth on the bottleneck link. However, the TCP congestion control may function poorly in high bandwidth-delay product networks because of its slow response with large congestion windows. In this paper, we propose an enhanced version of TCP Vegas called Quick Vegas, in which we present an efficient congestion window control algorithm for a TCP source. Our algorithm improves the slow-start and congestion avoidance techniques of original Vegas. Simulation results show that Quick Vegas significantly improves the performance of connections as well as remaining fair when the bandwidth-delay product increases.

Fair and efficient network congestion control based on minority game

NASA Astrophysics Data System (ADS)

Wang, Zuxi; Wang, Wen; Hu, Hanping; Deng, Zhaozhang

2011-12-01

Low link utility, RTT unfairness and unfairness of Multi-Bottleneck network are the existing problems in the present network congestion control algorithms at large. Through the analogy of network congestion control with the "El Farol Bar" problem, we establish a congestion control model based on minority game(MG), and then present a novel network congestion control algorithm based on the model. The result of simulations indicates that the proposed algorithm can make the achievements of link utility closing to 100%, zero packet lose rate, and small of queue size. Besides, the RTT unfairness and the unfairness of Multi-Bottleneck network can be solved, to achieve the max-min fairness in Multi-Bottleneck network, while efficiently weaken the "ping-pong" oscillation caused by the overall synchronization.

Traffic jams induced by fluctuation of a leading car.

PubMed

Nagatani, T

2000-04-01

We present a phase diagram of the different kinds of congested traffic triggered by fluctuation of a leading car in an open system without sources and sinks. Traffic states and density waves are investigated numerically by varying the amplitude of fluctuation using a car following model. The phase transitions among the free traffic, oscillatory congested traffic, and homogeneous congested traffic occur by fluctuation of a leading car. With increasing the amplitude of fluctuation, the transition between the free traffic and oscillatory traffic occurs at lower density and the transition between the homogeneous congested traffic and the oscillatory traffic occurs at higher density. The oscillatory congested traffic corresponds to the coexisting phase. Also, the moving localized clusters appear just above the transition lines.

An evaluation of the use of new Doppler methods for detecting longitudinal function abnormalities in a pacing-induced heart failure model

NASA Technical Reports Server (NTRS)

Tabata, Tomotsugu; Cardon, Lisa A.; Armstrong, Guy P.; Fukamach, Kiyotaka; Takagaki, Masami; Ochiai, Yoshie; McCarthy, Patrick M.; Thomas, James D.

2003-01-01

BACKGROUND: Doppler tissue echocardiography and color M-mode Doppler flow propagation velocity have proven useful in evaluating cross-sections of patients with left ventricular (LV) dysfunction, but experience with serial changes is limited. Purpose and methods: We tested their use by evaluating the temporal changes of LV function in a pacing-induced congestive heart failure model. Rapid ventricular pacing was initiated and maintained in 20 dogs for 4 weeks. Echocardiography was performed at baseline and weekly during brief pacing cessation. RESULTS: With rapid pacing, LV volume significantly increased and ejection fraction (57%-28%), stroke volume (37-18 mL), and mitral annulus systolic velocity (16.1-6.6 cm/s) by Doppler tissue echocardiography significantly decreased, with ejection fraction and mitral annulus systolic velocity closely correlated (r = 0.706, P <.0001). In contrast to the mitral inflow velocities, mitral annulus early diastolic velocity decreased steadily (12.3-7.3 cm/s) resulting in a dramatic decrease in mitral annulus early/late (1.22-0.57) diastolic velocity with no tendency toward pseudonormalization. The color M-mode Doppler flow propagation velocity also showed significant steady decrease (57-24 cm/s) throughout the pacing period. Multiple regression analysis chose mitral annulus systolic velocity (r = 0.895, P <.0001) and propagation velocity (r = 0.782, P <.0001) for the most important factor predicting LV systolic and diastolic function, respectively. CONCLUSIONS: Doppler tissue echocardiography and color M-mode Doppler flow could evaluate the serial deterioration in LV dysfunction throughout the pacing period. These were more useful in quantifying progressive LV dysfunction than conventional ehocardiographic techniques, and were probably relatively independent of preload. These techniques could be suitable for longitudinal evaluation in addition to the cross-sectional study.

Enhancing CORSIM for simulating high occupancy/toll lane operations.

DOT National Transportation Integrated Search

2012-03-15

Congestion pricing has been advocated as an efficient way to mitigate traffic congestion : since 1920s. A prevalent form of congestion pricing in the U.S. is high occupancy/toll (HOT) : lanes. The operating objective of HOT lanes is to improve the th...

23 CFR 500.109 - CMS.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... Congestion management means the application of strategies to improve system performance and reliability by... SYSTEMS Management Systems § 500.109 CMS. (a) For purposes of this part, congestion means the level at... management system or process is a systematic and regionally accepted approach for managing congestion that...

23 CFR 500.109 - CMS.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... Congestion management means the application of strategies to improve system performance and reliability by... SYSTEMS Management Systems § 500.109 CMS. (a) For purposes of this part, congestion means the level at... management system or process is a systematic and regionally accepted approach for managing congestion that...

23 CFR 500.109 - CMS.

Code of Federal Regulations, 2013 CFR

2013-04-01

... SYSTEMS Management Systems § 500.109 CMS. (a) For purposes of this part, congestion means the level at.... Congestion management means the application of strategies to improve system performance and reliability by... management system or process is a systematic and regionally accepted approach for managing congestion that...

23 CFR 500.109 - CMS.

Code of Federal Regulations, 2014 CFR

2014-04-01

... SYSTEMS Management Systems § 500.109 CMS. (a) For purposes of this part, congestion means the level at.... Congestion management means the application of strategies to improve system performance and reliability by... management system or process is a systematic and regionally accepted approach for managing congestion that...

23 CFR 500.109 - CMS.

Code of Federal Regulations, 2012 CFR

2012-04-01

... SYSTEMS Management Systems § 500.109 CMS. (a) For purposes of this part, congestion means the level at.... Congestion management means the application of strategies to improve system performance and reliability by... management system or process is a systematic and regionally accepted approach for managing congestion that...

Value of travel-time reliability, part II : a study of tradeoffs between travel reliability, congestion-mitigation strategies and emissions.

DOT National Transportation Integrated Search

2012-09-01

Capacity, demand, and vehicle based emissions reduction strategies are compared for several pollutants employing aggregate US : congestion and vehicle fleet condition data. We find that congestion mitigation does not inevitably lead to reduced emissi...

Statewide planning scenario synthesis : transportation congestion measurement and management.

DOT National Transportation Integrated Search

2005-09-01

This study is a review of current practices in 13 states to: (1) measure traffic congestion and its costs; and (2) manage congestion with programs and techniques that do not involve the building of new highway capacity. In regard to the measures of c...

Voiding dysfunction in patients with nasal congestion treated with pseudoephedrine: a prospective study.

PubMed

Shao, I-Hung; Wu, Chia-Chen; Tseng, Hsiao-Jung; Lee, Ta-Jen; Lin, Yu-Hsiang; Tam, Yuan-Yun

2016-01-01

Pseudoephedrine is a sympathomimetic drug widely used as a nasal decongestant. However, it can cause adverse effects, such as voiding dysfunction. The risk of voiding dysfunction remains uncertain in patients without subjective voiding problems. We prospectively enrolled patients with nasal congestion who required treatment with pseudoephedrine from May to August 2015. All patients denied concomitant subjective voiding problem. The International Prostate Symptom Score (IPSS) questionnaire was used to evaluate voiding function before and 1 week after the pseudoephedrine treatment. The results of the IPSS questionnaire were analyzed as the total (IPSS-T), voiding (IPSS-V), storage (IPSS-S), and quality of life due to urinary symptom scores. We enrolled 131 males with a mean age of 42.0±14.3 years. The IPSS-T, IPSS-V, and IPSS-S scores slightly increased after the medication (IPSS-T increased from 6.49 to 6.77, IPSS-V from 3.33 to 3.53, and IPSS-S from 3.17 to 3.24). The quality of life due to urinary symptom score nonsignificantly decreased from 2.02 to 1.87. We observed that older age and a higher premedication IPSS-V score yielded significant differences (P<0.05) for subclinical voiding dysfunction and unchanged voiding function. In patients aged ≥50 years, the IPSS-T, IPSS-V, and IPSS-S scores significantly increased after the pseudoephedrine treatment (IPSS-T increased from 9.95 to 11.45, IPSS-V from 5.38 to 6.07, and IPSS-S 4.57 to 5.38), whereas the quality of life due to urinary symptom score nonsignificantly decreased from 2.71 to 2.48 (P=0.057). In patients aged <50 years, all scores did not significantly differ. Pseudoephedrine treatment for nasal congestion requires extra precautions in males >50 years, even without subjective voiding symptoms.

Voiding dysfunction in patients with nasal congestion treated with pseudoephedrine: a prospective study

PubMed Central

Shao, I-Hung; Wu, Chia-Chen; Tseng, Hsiao-Jung; Lee, Ta-Jen; Lin, Yu-Hsiang; Tam, Yuan-Yun

2016-01-01

Background Pseudoephedrine is a sympathomimetic drug widely used as a nasal decongestant. However, it can cause adverse effects, such as voiding dysfunction. The risk of voiding dysfunction remains uncertain in patients without subjective voiding problems. Methodology We prospectively enrolled patients with nasal congestion who required treatment with pseudoephedrine from May to August 2015. All patients denied concomitant subjective voiding problem. The International Prostate Symptom Score (IPSS) questionnaire was used to evaluate voiding function before and 1 week after the pseudoephedrine treatment. The results of the IPSS questionnaire were analyzed as the total (IPSS-T), voiding (IPSS-V), storage (IPSS-S), and quality of life due to urinary symptom scores. Results We enrolled 131 males with a mean age of 42.0±14.3 years. The IPSS-T, IPSS-V, and IPSS-S scores slightly increased after the medication (IPSS-T increased from 6.49 to 6.77, IPSS-V from 3.33 to 3.53, and IPSS-S from 3.17 to 3.24). The quality of life due to urinary symptom score nonsignificantly decreased from 2.02 to 1.87. We observed that older age and a higher premedication IPSS-V score yielded significant differences (P<0.05) for subclinical voiding dysfunction and unchanged voiding function. In patients aged ≥50 years, the IPSS-T, IPSS-V, and IPSS-S scores significantly increased after the pseudoephedrine treatment (IPSS-T increased from 9.95 to 11.45, IPSS-V from 5.38 to 6.07, and IPSS-S 4.57 to 5.38), whereas the quality of life due to urinary symptom score nonsignificantly decreased from 2.71 to 2.48 (P=0.057). In patients aged <50 years, all scores did not significantly differ. Conclusion Pseudoephedrine treatment for nasal congestion requires extra precautions in males >50 years, even without subjective voiding symptoms. PMID:27486310

Impact of traffic congestion on road accidents: a spatial analysis of the M25 motorway in England.

PubMed

Wang, Chao; Quddus, Mohammed A; Ison, Stephen G

2009-07-01

Traffic congestion and road accidents are two external costs of transport and the reduction of their impacts is often one of the primary objectives for transport policy makers. The relationship between traffic congestion and road accidents however is not apparent and less studied. It is speculated that there may be an inverse relationship between traffic congestion and road accidents, and as such this poses a potential dilemma for transport policy makers. This study aims to explore the impact of traffic congestion on the frequency of road accidents using a spatial analysis approach, while controlling for other relevant factors that may affect road accidents. The M25 London orbital motorway, divided into 70 segments, was chosen to conduct this study and relevant data on road accidents, traffic and road characteristics were collected. A robust technique has been developed to map M25 accidents onto its segments. Since existing studies have often used a proxy to measure the level of congestion, this study has employed a precise congestion measurement. A series of Poisson based non-spatial (such as Poisson-lognormal and Poisson-gamma) and spatial (Poisson-lognormal with conditional autoregressive priors) models have been used to account for the effects of both heterogeneity and spatial correlation. The results suggest that traffic congestion has little or no impact on the frequency of road accidents on the M25 motorway. All other relevant factors have provided results consistent with existing studies.

Substance P contributes to rapidly adapting receptor responses to pulmonary venous congestion in rabbits.

PubMed

Bonham, A C; Kott, K S; Ravi, K; Kappagoda, C T; Joad, J P

1996-05-15

1. This study tested the hypothesis that substance P stimulates rapidly adapting receptors (RARs), contributes to the increase in RAR activity produced by mild pulmonary congestion, and evokes an augmented response from RARs when combined with near-threshold levels of pulmonary congestion. 2. RAR activity, peak tracheal pressure, arterial blood pressure and left atrial pressure were measured in paralysed, anaesthetized and ventilated rabbits. Substance P was given i.v. in one-half log incremental doses to a maximum of 3 micrograms kg-1. Mild pulmonary congestion was produced by inflating a balloon in the left atrium to increase left atrial pressure by 5 mmHg. Near-threshold levels of pulmonary congestion were produced by increasing left atrial pressure by 2 mmHg. 3. Substance P produced dose-dependent increases in RAR activity. The highest dose given increased the activity from 1.3 +/- 0.5 to 11.0 +/- 3.1 impulses bin-1. Increases in left atrial pressure of 5 mmHg increased RAR activity from 3.8 +/- 1.4 to 14.7 +/- 3.9 impulses bin-1. Blockade of NK1 receptors with CP 96345 significantly attenuated RAR responses to substance P and to mild pulmonary congestion. 4. Doses of substance P, which alone had no effect, stimulated the RARs when delivered during near-threshold levels of pulmonary congestion. 5. The findings suggest that substance P augments the stimulatory effect of mild pulmonary congestion on RAR activity, most probably by enhancing hydraulically induced microvascular leak.

76 FR 34848 - Drawbridge Operation Regulation; Atlantic Intracoastal Waterway (AIWW), Elizabeth River, Southern...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-15

... until December 20, 2013, relieving vehicular traffic congestion during the weekday and weekend daytime... final temporary could result in additional vehicular traffic congestion without providing any additional... anticipates continued vehicular traffic congestion over the Gilmerton Highway Bridge due to the reduction of...

Alternative Fuels Data Center: Deploying Alternative Fuel Vehicles and

Science.gov Websites

Infrastructure in Chicago, Illinois, Through the Congestion Mitigation and Air Quality Improvement Program and Infrastructure in Chicago, Illinois, Through the Congestion Mitigation and Air Quality Vehicles and Infrastructure in Chicago, Illinois, Through the Congestion Mitigation and Air Quality

Effect of reductions in biomass fuel exposure on symptoms of sleep apnea in children living in the peruvian andes: a preliminary field study.

PubMed

Castañeda, Jacqueline L; Kheirandish-Gozal, Leila; Gozal, David; Accinelli, Roberto A

2013-10-01

Multiple studies have evaluated the prevalence of sleep apnea in pediatric populations. Although environmental exposures to cigarette smoke (ECS) increase the risk of habitual snoring, no studies have thus far examined the potential contribution of indoor pollution in children. To determine the frequency of symptoms associated with sleep apnea in children exposed to traditional wood-burning stoves to open fire, and assess whether symptoms subside following implementation of improved less environmentally contaminating stoves. Residents of the communities of Chucllapampa, Sayhuapata, and Alparcuna in Cangallo province, department of Ayacucho, Peru were surveyed on two occasions within 12 months before and after the installation of an improved Inkawasi wood stove. The frequency of symptoms associated with sleep apnea was assessed in all children <15 years of age using a previously validated questionnaire. Parents of 59 children (62.7% males; mean age 7.76 ± 4.2 years) were interviewed representing >97% of the children in those small villages. The most common symptoms included nighttime awakenings, habitual snoring, repetitive movements during sleep, nasal congestion, and sore throat. After implementation of improved stoves in the homes, snoring (52.5% vs. 18.2%, P < 0.0001) nasal congestion (33.9% vs. 1.8%, P < 0.0001), behavioral hyperactivity (28.8% vs. 3.8%, P < 0.002), nighttime awakenings (42.4% vs. 1.7%, P < 0.0001), sore throat (38.2% vs. 5.5% P < 0.0001), breathing through the mouth during the day (33.9% vs. 1.8%, P < 0.001), daytime sleepiness (21.1% vs. 1.8%, P < 0.003), and falling asleep at school (14.6% vs. 0%, P < 0.03) were all significantly improved. Children exposed to traditional biomass fuel stoves had a higher frequency of symptoms related to sleep apnea, which decrease with improvements in biomass pollution. © 2012 Wiley Periodicals, Inc.

On the history of lacunes, etat criblé, and the white matter lesions of vascular dementia.

PubMed

Román, Gustavo C

2002-01-01

The history of lesions associated with vascular dementia (17th to 19th century) is reviewed. Recognition of ischemic and hemorrhagic stroke types dates back to the 17th century; however, at that time a third type ('cerebral congestion') emerged as the most common form of apoplexy. This entity vanished as arterial hypertension became established with the introduction of the sphygmomanometer (1905). Before the 19th century, apoplexy was considered a uniformly fatal disease, although Willis first recognized post-stroke dementia in 1672. Dechambre (1838) first reported 'lacunes' in stroke survivors with small cerebral softenings. Durand-Fardel (1842) described interstitial atrophy of the brain (leukoaraiosis) and état criblé (cribriform state) reflecting chronic cerebral congestion. In 1894, Alzheimer and Binswanger identified 'arteriosclerotic brain atrophy,' a form of vascular dementia characterized by 'miliary apoplexies' (lacunes). Also in 1894, Binswanger described the disease that now bears his name. In 1901, Pierre Marie coined the name état lacunaire (lacunar state) for the clinical syndrome of elderly patients with multiple lacunes. Copyright 2002 S. Karger AG, Basel

Morphological biomarkers in Prochilodus lineatus (pisces, prochilodontidae) for environmental impact assessment in the region of the Baixada Maranhense, Brazil

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

Dantas, Janaína Gomes; Superintendency of Biodiversity and Protected Areas of the Secretariat of Environment and Natural Resources of Maranhão; Andrade, Ticianne de Sousa de Oliveira Mota

2015-12-31

This study aimed to identify the types of histopathological lesions found in gills of Prochilodus lineatus of the Environmental Protection Area of the Baixada Maranhense region (Brazil). Fish were collected in Mearim river. Sampling took place in October, November and December 2014. We have purchased 30 samples of fish from local fishermen. In the laboratory fish gills were removed, and then fixed in 10% formalin solution and kept into alcohol 70% to the usual histological processing. The tissue was performed by light microscopy and findings were photomicrographed in light microscope - ZEIS. The following lesions were identified: epithelial displacement, themore » marginal channel shift a start vascular congestion, hyperplasia and merging multiple slides; epithelial disruption, edema, vascular congestion, total fusion of lamellae and disorganization of secondary lamellae. These changes express a response of the body to some xenobiontes. Morphological changes in the gills may represent adaptive strategies for conservation of some biological functions when animals are facing changes in the water quality.« less

Survival and echocardiographic data in dogs with congestive heart failure caused by mitral valve disease and treated by multiple drugs: a retrospective study of 21 cases.

PubMed

de Madron, Eric; King, Jonathan N; Strehlau, Günther; White, Regina Valle

2011-11-01

This retrospective study reports the survival time [onset of congestive heart failure (CHF) to death from any cause] of 21 dogs with mitral regurgitation (MR) and CHF treated with a combination of furosemide, angiotensin-converting enzyme inhibitor (ACEI, benazepril, or enalapril), pimobendan, spironolactone, and amlodipine. Baseline echocardiographic data: end-systolic and end-diastolic volume indices (ESVI and EDVI), left atrium to aorta ratio (LA/Ao), and regurgitant fraction (RF) are reported. Median survival time (MST) was 430 d. Initial dosage of furosemide (P = 0.0081) and LA/Ao (P = 0.042) were negatively associated with survival. Baseline echocardiographic indices (mean ± standard deviation) were 40.24 ± 16.76 for ESVI, 161.48 ± 44.49 mL/m(2) for EDVI, 2.11 ± 0.75 for LA/Ao, and 64.71 ± 16.85% for RF. Combining furosemide, ACEI, pimobendan, spironolactone, and amlodipine may result in long survival times in dogs with MR and CHF. Severity of MR at onset of CHF is at least moderate.

Survival and echocardiographic data in dogs with congestive heart failure caused by mitral valve disease and treated by multiple drugs: A retrospective study of 21 cases

PubMed Central

de Madron, Eric; King, Jonathan N.; Strehlau, Günther; White, Regina Valle

2011-01-01

This retrospective study reports the survival time [onset of congestive heart failure (CHF) to death from any cause] of 21 dogs with mitral regurgitation (MR) and CHF treated with a combination of furosemide, angiotensin-converting enzyme inhibitor (ACEI, benazepril, or enalapril), pimobendan, spironolactone, and amlodipine. Baseline echocardiographic data: end-systolic and end-diastolic volume indices (ESVI and EDVI), left atrium to aorta ratio (LA/Ao), and regurgitant fraction (RF) are reported. Median survival time (MST) was 430 d. Initial dosage of furosemide (P = 0.0081) and LA/Ao (P = 0.042) were negatively associated with survival. Baseline echocardiographic indices (mean ± standard deviation) were 40.24 ± 16.76 for ESVI, 161.48 ± 44.49 mL/m2 for EDVI, 2.11 ± 0.75 for LA/Ao, and 64.71 ± 16.85% for RF. Combining furosemide, ACEI, pimobendan, spironolactone, and amlodipine may result in long survival times in dogs with MR and CHF. Severity of MR at onset of CHF is at least moderate. PMID:22547843

Pelvic congestion syndrome and left renal compression syndrome - clinical features and therapeutic approaches.

PubMed

Jeanneret, Christina; Beier, Konstantin; von Weymarn, Alexander; Traber, Jürg

2016-01-01

Knowledge of the anatomy of the pelvic, gonadal and renal veins is important to understand pelvic congestion syndrome (PCS) and left renal vein compression syndrome (LRCS), which is also known as the nutcracker syndrome. LRCS is related to PCS and to the presence of vulvar, vaginal and pudendal varicose veins. The diagnosis of the two syndromes is difficult, and usually achieved with CT- or phlebography. The gold standard is the intravenous pressure measurement using conventional phlebography. The definition of PCS is described as pelvic pain, aggravated in the standing position and lasting for more than 6 months. Pain in the left flank and microhaematuria is seen in patients with LRCS. Women with multiple pregnancies are at increased risk of developing varicose vein recurrences with pelvic drainage and ovarian vein reflux after crossectomy and stripping of the great saphenous vein. The therapeutic options are: conservative treatment (medroxyprogesteron) or interventional (coiling of the ovarian vein) or operative treatment (clipping of the ovarian vein). Controlled prospective trials are needed to find the best treatment.

Ephedrine QoS: An Antidote to Slow, Congested, Bufferless NoCs

PubMed Central

Fang, Juan; Yao, Zhicheng; Sui, Xiufeng; Bao, Yungang

2014-01-01

Datacenters consolidate diverse applications to improve utilization. However when multiple applications are colocated on such platforms, contention for shared resources like networks-on-chip (NoCs) can degrade the performance of latency-critical online services (high-priority applications). Recently proposed bufferless NoCs (Nychis et al.) have the advantages of requiring less area and power, but they pose challenges in quality-of-service (QoS) support, which usually relies on buffer-based virtual channels (VCs). We propose QBLESS, a QoS-aware bufferless NoC scheme for datacenters. QBLESS consists of two components: a routing mechanism (QBLESS-R) that can substantially reduce flit deflection for high-priority applications and a congestion-control mechanism (QBLESS-CC) that guarantees performance for high-priority applications and improves overall system throughput. We use trace-driven simulation to model a 64-core system, finding that, when compared to BLESS, a previous state-of-the-art bufferless NoC design, QBLESS, improves performance of high-priority applications by an average of 33.2% and reduces network-hops by an average of 42.8%. PMID:25250386

THE RENIN-ANGIOTENSIN SYSTEM AND THE BIOLOGY OF SKELETAL MUSCLE: MECHANISMS OF MUSCLE WASTING IN CHRONIC DISEASE STATES.

PubMed

Delafontaine, Patrice; Yoshida, Tadashi

2016-01-01

Sarcopenia and cachexia are muscle-wasting syndromes associated with aging and with many chronic diseases such as congestive heart failure, diabetes, cancer, chronic obstructive pulmonary disease, and renal failure. While mechanisms are complex, these conditions are often accompanied by elevated angiotensin II (Ang II). We found that Ang II infusion in rodents leads to skeletal muscle wasting via alterations in insulin-like growth factor-1 signaling, increased apoptosis, enhanced muscle protein breakdown via the ubiquitin-proteasome system, and decreased appetite resulting from downregulation of hypothalamic orexigenic neuropeptides orexin and neuropeptide Y. Furthermore, Ang II inhibits skeletal muscle stem cell proliferation, leading to lowered muscle regenerative capacity. Distinct stem cell Ang II receptor subtypes are critical for regulation of muscle regeneration. In ischemic mouse congestive heart failure model skeletal muscle wasting and attenuated muscle regeneration are Ang II dependent. These data suggest that the renin-angiotensin system plays a critical role in mechanisms underlying cachexia in chronic disease states.

Effects of burstiness on the air transportation system

NASA Astrophysics Data System (ADS)

Ito, Hidetaka; Nishinari, Katsuhiro

2017-01-01

The effects of burstiness in complex networks have received considerable attention. In particular, the effects on temporal distance and delays in the air transportation system are significant owing to their huge impact on our society. Therefore, in this paper, the temporal distance of empirical U.S. flight schedule data is compared with that of regularized data without burstiness to analyze the effects of burstiness. The temporal distance is calculated by a graph analysis method considering flight delays, missed connections, flight cancellations, and congestion. In addition, we propose two temporal distance indexes based on passengers' behavior to quantify the effects. As a result, we find that burstiness reduces both the scheduled and the actual temporal distances for business travelers, while delays caused by missed connections and congestion are increased. We also find that the decrease of the scheduled temporal distance by burstiness is offset by an increase of the delays for leisure passengers. Moreover, we discover that the positive effect of burstiness is lost when flight schedules are overcrowded.

Impact of Considering 110 kV Grid Structures on the Congestion Management in the German Transmission Grid

NASA Astrophysics Data System (ADS)

Hoffrichter, André; Barrios, Hans; Massmann, Janek; Venkataramanachar, Bhavasagar; Schnettler, Armin

2018-02-01

The structural changes in the European energy system lead to an increase of renewable energy sources that are primarily connected to the distribution grid. Hence the stationary analysis of the transmission grid and the regionalization of generation capacities are strongly influenced by subordinate grid structures. To quantify the impact on the congestion management in the German transmission grid, a 110 kV grid model is derived using publicly available data delivered by Open Street Map and integrated into an existing model of the European transmission grid. Power flow and redispatch simulations are performed for three different regionalization methods and grid configurations. The results show a significant impact of the 110 kV system and prove an overestimation of power flows in the transmission grid when neglecting subordinate grids. Thus, the redispatch volume in Germany to dissolve bottlenecks in case of N-1 contingencies decreases by 38 % when considering the 110 kV grid.

High altitude simulation, substance P and airway rapidly adapting receptor activity in rabbits.

PubMed

Bhagat, R; Yasir, A; Vashisht, A; Kulshreshtha, R; Singh, S B; Ravi, K

2011-09-15

To investigate whether there is a change in airway rapidly adapting receptor (RAR) activity during high altitude exposure, rabbits were placed in a high altitude simulation chamber (barometric pressure, 429 mm Hg). With 12 h exposure, when there was pulmonary congestion, an increase in basal RAR activity was observed. With 36 h exposure, when there was alveolar edema, there was a further increase in basal RAR activity. In these backgrounds, there was an increase in the sensitivity of the RARs to substance P (SP). To assess whether there was an increase in lung SP level, neutral endopeptidase activity was determined which showed a decrease in low barometric pressure exposed groups. It is concluded that along with the SP released, pulmonary congestion and edema produced, respectively by different durations of low barometric pressure exposure cause a progressive increase in RAR activity which may account for the respiratory symptoms reported in climbers who are unacclimatized. Copyright © 2011 Elsevier B.V. All rights reserved.

Neurohormonal Imbalance: A Neglected Problem-And Potential Therapeutic Target-In Acute Heart Failure.

PubMed

Goldsmith, Steven R; Bart, Bradley A; Pin A, Ileana L

2017-12-16

Decompensated or acute heart failure (AHF) is characterized by increased ventricular and atrial pressures which may lead to and be caused by circulatory congestion. Unless due to a primary decrease in cardiac function, congestion arises from volume expansion or vasoconstriction. In turn, volume expansion and vasoconstriction are due to neurohormonal imbalance since both result from activation of the sympathetic nervous system, the renin-angiotensin-aldosterone axis and excess secretion of arginine vasopressin. Outcomes in AHF remain dismal. Loop diuretics are the mainstay of therapy for AHF and may themselves aggravate neurohormonal imbalance. No adjunctive pharmacotherapy has yielded improvement in outcomes in AHF despite many attempts with various vasodilators and inotropes. We, therefore, propose that insufficient attention has been paid to neurohormonal imbalance in AHF. As in chronic HF, rectifying the effects of neurohormonal imbalance may lead to better outcomes. The use of alternative decongestive strategies or adjunctive pharmacotherapy directed at neurohormonal activation could yield benefit. Copyright © 2017 Elsevier B.V. All rights reserved.

Effects of burstiness on the air transportation system.

PubMed

Ito, Hidetaka; Nishinari, Katsuhiro

2017-01-01

The effects of burstiness in complex networks have received considerable attention. In particular, the effects on temporal distance and delays in the air transportation system are significant owing to their huge impact on our society. Therefore, in this paper, the temporal distance of empirical U.S. flight schedule data is compared with that of regularized data without burstiness to analyze the effects of burstiness. The temporal distance is calculated by a graph analysis method considering flight delays, missed connections, flight cancellations, and congestion. In addition, we propose two temporal distance indexes based on passengers' behavior to quantify the effects. As a result, we find that burstiness reduces both the scheduled and the actual temporal distances for business travelers, while delays caused by missed connections and congestion are increased. We also find that the decrease of the scheduled temporal distance by burstiness is offset by an increase of the delays for leisure passengers. Moreover, we discover that the positive effect of burstiness is lost when flight schedules are overcrowded.

Urban partnership agreement and congestion reduction demonstration programs : lessons learned on congestion pricing from the Seattle and Atlanta household travel behavior surveys.

DOT National Transportation Integrated Search

2014-04-01

This paper presents lessons learned from household traveler surveys administered in Seattle and Atlanta as part of the evaluation of the Urban Partnership Agreement and Congestion Reduction Demonstration Programs. The surveys use a two-stage panel su...

23 CFR 970.214 - Federal lands congestion management system (CMS).

Code of Federal Regulations, 2011 CFR

2011-04-01

... experiencing congestion, the NPS shall develop a separate CMS to cover those facilities. Approaches may include... congestion management strategies; (v) Determine methods to monitor and evaluate the performance of the multi... means the level at which transportation system performance is no longer acceptable due to traffic...

23 CFR 970.214 - Federal lands congestion management system (CMS).

Code of Federal Regulations, 2010 CFR

2010-04-01

... experiencing congestion, the NPS shall develop a separate CMS to cover those facilities. Approaches may include... congestion management strategies; (v) Determine methods to monitor and evaluate the performance of the multi... means the level at which transportation system performance is no longer acceptable due to traffic...

23 CFR 973.214 - Indian lands congestion management system (CMS).

Code of Federal Regulations, 2014 CFR

2014-04-01

... 23 Highways 1 2014-04-01 2014-04-01 false Indian lands congestion management system (CMS). 973.214... HIGHWAYS MANAGEMENT SYSTEMS PERTAINING TO THE BUREAU OF INDIAN AFFAIRS AND THE INDIAN RESERVATION ROADS PROGRAM Bureau of Indian Affairs Management Systems § 973.214 Indian lands congestion management system...

Feasibility of incorporating crash risk in developing congestion mitigation measures for interstate highways : a case study of the Hampton Roads area.

DOT National Transportation Integrated Search

2002-01-01

A relationship between traffic flow variables and crash characteristics can greatly help the traffic engineer in the field to arrive at appropriate congestion mitigation measures that not only alleviate congestion and save time but also reduce the pr...

14 CFR 137.49 - Operations over other than congested areas.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Operations over other than congested areas. 137.49 Section 137.49 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... congested areas below 500 feet above the surface and closer than 500 feet to persons, vessels, vehicles, and...

76 FR 70122 - Plan for Conduct of 2012 Electric Transmission Congestion Study

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-10

... preparations for the 2012 Congestion Study, and seeks comments on what publicly-available data and information...), and Microsoft PowerPoint (.ppt). The Department intends to use only data that is publicly available... Study, the Department gathered historical congestion data obtained from existing studies prepared by...

Quantum random walks on congested lattices and the effect of dephasing.

PubMed

Motes, Keith R; Gilchrist, Alexei; Rohde, Peter P

2016-01-27

We consider quantum random walks on congested lattices and contrast them to classical random walks. Congestion is modelled on lattices that contain static defects which reverse the walker's direction. We implement a dephasing process after each step which allows us to smoothly interpolate between classical and quantum random walks as well as study the effect of dephasing on the quantum walk. Our key results show that a quantum walker escapes a finite boundary dramatically faster than a classical walker and that this advantage remains in the presence of heavily congested lattices.

Integrative Assessment of Congestion in Heart Failure Throughout the Patient Journey.

PubMed

Girerd, Nicolas; Seronde, Marie-France; Coiro, Stefano; Chouihed, Tahar; Bilbault, Pascal; Braun, François; Kenizou, David; Maillier, Bruno; Nazeyrollas, Pierre; Roul, Gérard; Fillieux, Ludivine; Abraham, William T; Januzzi, James; Sebbag, Laurent; Zannad, Faiez; Mebazaa, Alexandre; Rossignol, Patrick

2018-04-01

Congestion is one of the main predictors of poor patient outcome in patients with heart failure. However, congestion is difficult to assess, especially when symptoms are mild. Although numerous clinical scores, imaging tools, and biological tests are available to assist physicians in ascertaining and quantifying congestion, not all are appropriate for use in all stages of patient management. In recent years, multidisciplinary management in the community has become increasingly important to prevent heart failure hospitalizations. Electronic alert systems and communication platforms are emerging that could be used to facilitate patient home monitoring that identifies congestion from heart failure decompensation at an earlier stage. This paper describes the role of congestion detection methods at key stages of patient care: pre-admission, admission to the emergency department, in-hospital management, and lastly, discharge and continued monitoring in the community. The multidisciplinary working group, which consisted of cardiologists, emergency physicians, and a nephrologist with both clinical and research backgrounds, reviewed the current literature regarding the various scores, tools, and tests to detect and quantify congestion. This paper describes the role of each tool at key stages of patient care and discusses the advantages of telemedicine as a means of providing true integrated patient care. Copyright © 2018. Published by Elsevier Inc.

Does rush hour see a rush of emotions? Driver mood in conditions likely to exhibit congestion

PubMed Central

Morris, Eric A; Hirsch, Jana A.

2016-01-01

Polls show that a large portion of the public considers traffic congestion to be a problem and believes a number of policy interventions would ameliorate it. However, most of the public rejects new taxes and fees to fund these improvements. This may be because of a disconnect between the public's stated antipathy towards congestion and the recalled emotional costs congestion imposes. To explore this, we use a large and representative sample drawn from the American Time Use Survey to examine how drivers experience four emotions (happiness, sadness, stress, and fatigue), plus a constructed composite mood variable, when they travel in peak periods, in large cities, in city centers, and in combinations of these. We also explore the interactions between these indicators and trip duration. We find evidence that drivers in the largest cities at the very peak of rush hour (5:00pm-6:00pm) are in a less positive mood, presumably because of congestion. However, this effect, though significant, is small, and we find no significant results using broader definitions of the peak period. In all, our findings suggest that congestion's impact on drivers as a group is quite limited. This may help explain why the public's attitude toward painful financial trade-offs to address congestion is lukewarm. PMID:27231669

Erythrocyte deformation in ischemic acute tubular necrosis and amelioration by splenectomy in the dog.

PubMed

Mandal, A K; Taylor, C A; Bell, R D; Hillman, N M; Jarnot, M D; Cunningham, J D; Phillips, L G

1991-11-01

Bilateral renal artery occlusion (RAO) for 120 minutes in dogs results in acute tubular necrosis (ATN) and peritubular capillary (PTC) congestion with rapidly deteriorating renal function. We have shown that prior splenectomy minimizes RAO-induced renal functional and histopathologic changes. The purpose of this study was to examine whether this renal protection is due to prevention of red blood cell echinocyte formation and resultant renal PTC congestion. Echinocytes (burr cells) are poorly deformable, impart high viscosity to the blood, and may hinder reperfusion by increasing resistance to renal capillary blood flow. Splenectomized (SPLX) or sham-SPLX dogs were treated with bilateral RAO for 120 minutes. After RAO, renal function and renal blood flow were monitored, and peripheral blood red blood cells were examined at 1 hour and at 24-hour intervals for 96 hours. Renal biopsies were taken 1 hour after RAO and the kidneys removed 96 hours after RAO. The RBCs and renal tissues were studied using scanning electron microscopy. Renal function was assessed by endogenous creatinine clearance. Sham-SPLX animals showed a marked and sustained decrease in creatinine clearance, consistently elevated serum creatinine levels and fractional excretion of sodium, and diffuse ATN and PTC congestion with echinocytes. These animals had a peak in circulating echinocytes 1 hour after RAO (p less than 0.05), which showed an excellent negative correlation with creatinine clearance (r = -0.999; p less than 0.001). On the contrary, SPLX animals had essentially no change in serum creatinine or fractional excretion of sodium, minimal tubular changes, no PTC congestion, and no rise in circulating echinocytes during the 96-hour observation. In vitro treatment of the postischemic red blood cells from sham animals with adenosine-inosine or fresh postischemic plasma from the SPLX animals showed almost complete reversal to discocytes (normal red blood cells), whereas in vitro treatment of postischemic red blood cells from the SPLX animals with fresh postischemic plasma from the sham animals resulted in a marked echinocytic response. We conclude that 1) a marked echinocyte response in the immediate postischemic period is an important mechanism in initiating ischemic ATN, 2) an echinocyte inducing factor may reside in the plasma of spleen-intact animals, and 3) mitigation of ATN and PTC congestion by splenectomy is, at least in part, consequential to attenuated echinocytic response in the immediate postischemic period.

Solving the negative impact of congestion in the postanesthesia care unit: a cost of opportunity analysis.

PubMed

Ruiz-Patiño, Alejandro; Acosta-Ospina, Laura Elena; Rueda, Juan-David

2017-04-01

Congestion in the postanesthesia care unit (PACU) leads to the formation of waiting queues for patients being transferred after surgery, negatively affecting hospital resources. As patients recover in the operating room, incoming surgeries are delayed. The purpose of this study was to establish the impact of this phenomenon in multiple settings. An operational mathematical study based on the queuing theory was performed. Average queue length, average queue waiting time, and daily queue waiting time were evaluated. Calculations were based on the mean patient daily flow, PACU length of stay, occupation, and current number of beds. Data was prospectively collected during a period of 2 months, and the entry and exit time was recorded for each patient taken to the PACU. Data was imputed in a computational model made with MS Excel. To account for data uncertainty, deterministic and probabilistic sensitivity analyses for all dependent variables were performed. With a mean patient daily flow of 40.3 and an average PACU length of stay of 4 hours, average total lost surgical opportunity time was estimated at 2.36 hours (95% CI: 0.36-4.74 hours). Cost of opportunity was calculated at $1592 per lost hour. Sensitivity analysis showed that an increase of two beds is required to solve the queue formation. When congestion has a negative impact on cost of opportunity in the surgical setting, queuing analysis grants definitive actions to solve the problem, improving quality of service and resource utilization. Copyright © 2016 Elsevier Inc. All rights reserved.

Abnormalities of capillary microarchitecture in a rat model of coronary ischemic congestive heart failure

PubMed Central

Chen, Jiqiu; Yaniz-Galende, Elisa; Kagan, Heather J.; Liang, Lifan; Hekmaty, Saboor; Giannarelli, Chiara

2015-01-01

The aim of the present study is to explore the role of capillary disorder in coronary ischemic congestive heart failure (CHF). CHF was induced in rats by aortic banding plus ischemia-reperfusion followed by aortic debanding. Coronary arteries were perfused with plastic polymer containing fluorescent dye. Multiple fluorescent images of casted heart sections and scanning electric microscope of coronary vessels were obtained to characterize changes in the heart. Cardiac function was assessed by echocardiography and in vivo hemodynamics. Stenosis was found in all levels of the coronary arteries in CHF. Coronary vasculature volume and capillary density in remote myocardium were significantly increased in CHF compared with control. This occurred largely in microvessels with a diameter of ≤3 μm. Capillaries in CHF had a tortuous structure, while normal capillaries were linear. Capillaries in CHF had inconsistent diameters, with assortments of narrowed and bulged segments. Their surfaces appeared rough, potentially indicating endothelial dysfunction in CHF. Segments of main capillaries between bifurcations were significantly shorter in length in CHF than in control. Transiently increasing preload by injecting 50 μl of 30% NaCl demonstrated that the CHF heart had lower functional reserve; this may be associated with congestion in coronary microcirculation. Ischemic coronary vascular disorder is not limited to the main coronary arteries, as it occurs in arterioles and capillaries. Capillary disorder in CHF included stenosis, deformed structure, proliferation, and roughened surfaces. This disorder in the coronary artery architecture may contribute to the reduction in myocyte contractility in the setting of heart failure. PMID:25659485

PULMONARY ARTERIAL DISEASE ASSOCIATED WITH RIGHT-SIDED CARDIAC HYPERTROPHY AND CONGESTIVE HEART FAILURE IN ZOO MAMMALS HOUSED AT 2,100 M ABOVE SEA LEVEL.

PubMed

Juan-Sallés, Carles; Martínez, Liliana Sofía; Rosas-Rosas, Arely G; Parás, Alberto; Martínez, Osvaldo; Hernández, Alejandra; Garner, Michael M

2015-12-01

Subacute and chronic mountain sickness of humans and the related brisket disease of cattle are characterized by right-sided congestive heart failure in individuals living at high altitudes as a result of sustained hypoxic pulmonary hypertension. Adaptations to high altitude and disease resistance vary among species, breeds, and individuals. The authors conducted a retrospective survey of right-sided cardiac hypertrophy associated with pulmonary arterial hypertrophy or arteriosclerosis in zoo mammals housed at Africam Safari (Puebla, México), which is located at 2,100 m above sea level. Seventeen animals with detailed pathology records matched the study criterion. Included were 10 maras (Dolichotis patagonum), 2 cotton-top tamarins (Saguinus oedipus oedipus), 2 capybaras (Hydrochaeris hydrochaeris), and 1 case each of Bennet's wallaby (Macropus rufogriseus), nilgai antelope (Boselaphus tragocamelus), and scimitar-horned oryx (Oryx dammah). All had right-sided cardiac hypertrophy and a variety of arterial lesions restricted to the pulmonary circulation and causing arterial thickening with narrowing of the arterial lumen. Arterial lesions most often consisted of medial hypertrophy or hyperplasia of small and medium-sized pulmonary arteries. All maras also had single or multiple elevated plaques in the pulmonary arterial trunk consisting of fibrosis, accompanied by chondroid metaplasia in some cases. Both antelopes were juvenile and died with right-sided congestive heart failure associated with severe pulmonary arterial lesions. To the authors' knowledge, this is the first description of cardiac and pulmonary arterial disease in zoo mammals housed at high altitudes.

Diagnostic accuracy of an ultrasonic multiple transducer cardiac imaging system

NASA Technical Reports Server (NTRS)

Popp, R. L.; Brown, O. R.; Harrison, D. C.

1975-01-01

An ultrasonic multiple-transducer imaging system for intracardiac structure visualization is developed in order to simplify visualization of the human heart in vivo without radiation hazard or invasion of the body. Results of the evaluation of the diagnostic accuracy of the devised system in a clinical setting for adult patients are presented and discussed. Criteria are presented for recognition of mitral valva prolapse, mitral stenosis, pericardial effusion, atrial septal defect, and left ventricular dyssynergy. The probable cause for false-positive and false-negative diagnoses is discussed. However, hypertrophic myopathy and congestive myopathy were unable to be detected. Since only qualitative criteria were used, it was not possible to differentiate patients with left ventricular volume overload from patients without cardiac pathology.

Feasibility of a special-purpose computer to solve the Navier-Stokes equations

NASA Technical Reports Server (NTRS)

Gritton, E. C.; King, W. S.; Sutherland, I.; Gaines, R. S.; Gazley, C., Jr.; Grosch, C.; Juncosa, M.; Petersen, H.

1978-01-01

Orders-of-magnitude improvements in computer performance can be realized with a parallel array of thousands of fast microprocessors. In this architecture, wiring congestion is minimized by limiting processor communication to nearest neighbors. When certain standard algorithms are applied to a viscous flow problem and existing LSI technology is used, performance estimates of this conceptual design show a dramatic decrease in computational time when compared to the CDC 7600.

Substance P contributes to rapidly adapting receptor responses to pulmonary venous congestion in rabbits.

PubMed Central

Bonham, A C; Kott, K S; Ravi, K; Kappagoda, C T; Joad, J P

1996-01-01

1. This study tested the hypothesis that substance P stimulates rapidly adapting receptors (RARs), contributes to the increase in RAR activity produced by mild pulmonary congestion, and evokes an augmented response from RARs when combined with near-threshold levels of pulmonary congestion. 2. RAR activity, peak tracheal pressure, arterial blood pressure and left atrial pressure were measured in paralysed, anaesthetized and ventilated rabbits. Substance P was given i.v. in one-half log incremental doses to a maximum of 3 micrograms kg-1. Mild pulmonary congestion was produced by inflating a balloon in the left atrium to increase left atrial pressure by 5 mmHg. Near-threshold levels of pulmonary congestion were produced by increasing left atrial pressure by 2 mmHg. 3. Substance P produced dose-dependent increases in RAR activity. The highest dose given increased the activity from 1.3 +/- 0.5 to 11.0 +/- 3.1 impulses bin-1. Increases in left atrial pressure of 5 mmHg increased RAR activity from 3.8 +/- 1.4 to 14.7 +/- 3.9 impulses bin-1. Blockade of NK1 receptors with CP 96345 significantly attenuated RAR responses to substance P and to mild pulmonary congestion. 4. Doses of substance P, which alone had no effect, stimulated the RARs when delivered during near-threshold levels of pulmonary congestion. 5. The findings suggest that substance P augments the stimulatory effect of mild pulmonary congestion on RAR activity, most probably by enhancing hydraulically induced microvascular leak. Images Figure 6 PMID:8735708

Financial and technical feasibility of dynamic congestion pricing as a revenue generation source in Indiana : exploiting the availability of real-time information and dynamic pricing technologies.

DOT National Transportation Integrated Search

2011-10-19

"Highway stakeholders continue to support research studies that address critical issues of the current era, including congestion mitigation and revenue generation. A mechanism that addresses both concerns is congestion pricing which establishes a dir...

Distributive routing and congestion control in wireless multihop ad hoc communication networks

NASA Astrophysics Data System (ADS)

Glauche, Ingmar; Krause, Wolfram; Sollacher, Rudolf; Greiner, Martin

2004-10-01

Due to their inherent complexity, engineered wireless multihop ad hoc communication networks represent a technological challenge. Having no mastering infrastructure the nodes have to selforganize themselves in such a way that for example network connectivity, good data traffic performance and robustness are guaranteed. In this contribution the focus is on routing and congestion control. First, random data traffic along shortest path routes is studied by simulations as well as theoretical modeling. Measures of congestion like end-to-end time delay and relaxation times are given. A scaling law of the average time delay with respect to network size is revealed and found to depend on the underlying network topology. In the second step, a distributive routing and congestion control is proposed. Each node locally propagates its routing cost estimates and information about its congestion state to its neighbors, which then update their respective cost estimates. This allows for a flexible adaptation of end-to-end routes to the overall congestion state of the network. Compared to shortest-path routing, the critical network load is significantly increased.

Congestion and flow control in signaling system no. 7: Impacts of intelligent networks and new services

NASA Astrophysics Data System (ADS)

Zepf, Joachim; Rufa, Gerhard

1994-04-01

This paper focuses on the transient performance analysis of the congestion and flow control mechanisms in CCITT Signaling System No. 7 (SS7). Special attention is directed to the impacts of the introduction of intelligent services and new applications, e.g., Freephone, credit card services, user-to-user signaling, etc. In particular, we show that signaling traffic characteristics like signaling scenarios or signaling message length as well as end-to-end signaling capabilities have a significant influence on the congestion and flow control and, therefore, on the real-time signaling performance. One important result of our performance studies is that if, e.g., intelligent services are introduced, the SS7 congestion and flow control does not work correctly. To solve this problem, some reinvestigations into these mechanisms would be necessary. Therefore, some approaches, e.g., modification of the Signaling Connection Control Part (SCCP) congestion control, usage of the SCCP relay function, or a redesign of the MTP flow control procedures are discussed in order to guarantee the efficacy of the congestion and flow control mechanisms also in the future.

Efficient Quantum Transmission in Multiple-Source Networks

PubMed Central

Luo, Ming-Xing; Xu, Gang; Chen, Xiu-Bo; Yang, Yi-Xian; Wang, Xiaojun

2014-01-01

A difficult problem in quantum network communications is how to efficiently transmit quantum information over large-scale networks with common channels. We propose a solution by developing a quantum encoding approach. Different quantum states are encoded into a coherent superposition state using quantum linear optics. The transmission congestion in the common channel may be avoided by transmitting the superposition state. For further decoding and continued transmission, special phase transformations are applied to incoming quantum states using phase shifters such that decoders can distinguish outgoing quantum states. These phase shifters may be precisely controlled using classical chaos synchronization via additional classical channels. Based on this design and the reduction of multiple-source network under the assumption of restricted maximum-flow, the optimal scheme is proposed for specially quantized multiple-source network. In comparison with previous schemes, our scheme can greatly increase the transmission efficiency. PMID:24691590

Integrated Traffic Flow Management Decision Making

NASA Technical Reports Server (NTRS)

Grabbe, Shon R.; Sridhar, Banavar; Mukherjee, Avijit

2009-01-01

A generalized approach is proposed to support integrated traffic flow management decision making studies at both the U.S. national and regional levels. It can consider tradeoffs between alternative optimization and heuristic based models, strategic versus tactical flight controls, and system versus fleet preferences. Preliminary testing was accomplished by implementing thirteen unique traffic flow management models, which included all of the key components of the system and conducting 85, six-hour fast-time simulation experiments. These experiments considered variations in the strategic planning look-ahead times, the replanning intervals, and the types of traffic flow management control strategies. Initial testing indicates that longer strategic planning look-ahead times and re-planning intervals result in steadily decreasing levels of sector congestion for a fixed delay level. This applies when accurate estimates of the air traffic demand, airport capacities and airspace capacities are available. In general, the distribution of the delays amongst the users was found to be most equitable when scheduling flights using a heuristic scheduling algorithm, such as ration-by-distance. On the other hand, equity was the worst when using scheduling algorithms that took into account the number of seats aboard each flight. Though the scheduling algorithms were effective at alleviating sector congestion, the tactical rerouting algorithm was the primary control for avoiding en route weather hazards. Finally, the modeled levels of sector congestion, the number of weather incursions, and the total system delays, were found to be in fair agreement with the values that were operationally observed on both good and bad weather days.

Alternative Path Communication in Wide-Scale Cluster-Tree Wireless Sensor Networks Using Inactive Periods

PubMed Central

Leão, Erico; Montez, Carlos; Moraes, Ricardo; Portugal, Paulo; Vasques, Francisco

2017-01-01

The IEEE 802.15.4/ZigBee cluster-tree topology is a suitable technology to deploy wide-scale Wireless Sensor Networks (WSNs). These networks are usually designed to support convergecast traffic, where all communication paths go through the PAN (Personal Area Network) coordinator. Nevertheless, peer-to-peer communication relationships may be also required for different types of WSN applications. That is the typical case of sensor and actuator networks, where local control loops must be closed using a reduced number of communication hops. The use of communication schemes optimised just for the support of convergecast traffic may result in higher network congestion and in a potentially higher number of communication hops. Within this context, this paper proposes an Alternative-Route Definition (ARounD) communication scheme for WSNs. The underlying idea of ARounD is to setup alternative communication paths between specific source and destination nodes, avoiding congested cluster-tree paths. These alternative paths consider shorter inter-cluster paths, using a set of intermediate nodes to relay messages during their inactive periods in the cluster-tree network. Simulation results show that the ARounD communication scheme can significantly decrease the end-to-end communication delay, when compared to the use of standard cluster-tree communication schemes. Moreover, the ARounD communication scheme is able to reduce the network congestion around the PAN coordinator, enabling the reduction of the number of message drops due to queue overflows in the cluster-tree network. PMID:28481245

Alternative Path Communication in Wide-Scale Cluster-Tree Wireless Sensor Networks Using Inactive Periods.

PubMed

Leão, Erico; Montez, Carlos; Moraes, Ricardo; Portugal, Paulo; Vasques, Francisco

2017-05-06

The IEEE 802.15.4/ZigBee cluster-tree topology is a suitable technology to deploy wide-scale Wireless Sensor Networks (WSNs). These networks are usually designed to support convergecast traffic, where all communication paths go through the PAN (Personal Area Network) coordinator. Nevertheless, peer-to-peer communication relationships may be also required for different types of WSN applications. That is the typical case of sensor and actuator networks, where local control loops must be closed using a reduced number of communication hops. The use of communication schemes optimised just for the support of convergecast traffic may result in higher network congestion and in a potentially higher number of communication hops. Within this context, this paper proposes an Alternative-Route Definition (ARounD) communication scheme for WSNs. The underlying idea of ARounD is to setup alternative communication paths between specific source and destination nodes, avoiding congested cluster-tree paths. These alternative paths consider shorter inter-cluster paths, using a set of intermediate nodes to relay messages during their inactive periods in the cluster-tree network. Simulation results show that the ARounD communication scheme can significantly decrease the end-to-end communication delay, when compared to the use of standard cluster-tree communication schemes. Moreover, the ARounD communication scheme is able to reduce the network congestion around the PAN coordinator, enabling the reduction of the number of message drops due to queue overflows in the cluster-tree network.

Understanding congested travel in urban areas

PubMed Central

Çolak, Serdar; Lima, Antonio; González, Marta C.

2016-01-01

Rapid urbanization and increasing demand for transportation burdens urban road infrastructures. The interplay of number of vehicles and available road capacity on their routes determines the level of congestion. Although approaches to modify demand and capacity exist, the possible limits of congestion alleviation by only modifying route choices have not been systematically studied. Here we couple the road networks of five diverse cities with the travel demand profiles in the morning peak hour obtained from billions of mobile phone traces to comprehensively analyse urban traffic. We present that a dimensionless ratio of the road supply to the travel demand explains the percentage of time lost in congestion. Finally, we examine congestion relief under a centralized routing scheme with varying levels of awareness of social good and quantify the benefits to show that moderate levels are enough to achieve significant collective travel time savings. PMID:26978719

Understanding congested travel in urban areas

NASA Astrophysics Data System (ADS)

Çolak, Serdar; Lima, Antonio; González, Marta C.

2016-03-01

Rapid urbanization and increasing demand for transportation burdens urban road infrastructures. The interplay of number of vehicles and available road capacity on their routes determines the level of congestion. Although approaches to modify demand and capacity exist, the possible limits of congestion alleviation by only modifying route choices have not been systematically studied. Here we couple the road networks of five diverse cities with the travel demand profiles in the morning peak hour obtained from billions of mobile phone traces to comprehensively analyse urban traffic. We present that a dimensionless ratio of the road supply to the travel demand explains the percentage of time lost in congestion. Finally, we examine congestion relief under a centralized routing scheme with varying levels of awareness of social good and quantify the benefits to show that moderate levels are enough to achieve significant collective travel time savings.

Effect of venous and lymphatic congestion on lymph capillary pressure of the skin in healthy volunteers and patients with lymph edema.

PubMed

Gretener, S B; Läuchli, S; Leu, A J; Koppensteiner, R; Franzeck, U K

2000-01-01

The aim of the present study was to assess the influence of venous and lymphatic congestion on lymph capillary pressure (LCP) in the skin of the foot dorsum of healthy volunteers and of patients with lymph edema. LCP was measured at the foot dorsum of 12 patients with lymph edema and 18 healthy volunteers using the servo-nulling technique. Glass micropipettes (7-9 microm) were inserted under microscopic control into lymphatic microvessels visualized by fluorescence microlymphography before and during venous congestion. Venous and lymphatic congestion was attained by cuff compression (50 mm Hg) at the thigh level. Simultaneously, the capillary filtration rate was measured using strain gauge plethysmography. The mean LCP in patients with lymph edema increased significantly (p < 0.05) during congestion (15.7 +/- 8.8 mm Hg) compared to the control value (12.2 +/- 8.9 mm Hg). The corresponding values of LCP in healthy volunteers were 4.3 +/- 2.6 mm Hg during congestion and 2.6 +/- 2.8 mm Hg during control conditions (p < 0.01). The mean increase in LCP in patients with lymph edema was 3.4 +/- 4.1 mm Hg, and 1.7 +/- 2.0 mm Hg in healthy volunteers (NS). The maximum spread of the lymph capillary network in patients increased from 13.9 +/- 6.8 mm before congestion to 18.8 +/- 8.2 mm during thigh compression (p < 0.05). No increase could be observed in healthy subjects. In summary, venous and lymphatic congestion by cuff compression at the thigh level results in a significant increase in LCP in healthy volunteers as well as in patients with lymph edema. The increased spread of the contrast medium in the superficial microlymphatics in lymph edema patients indicates a compensatory mechanism for lymphatic drainage during congestion of the veins and lymph collectors of the leg. Copyright 2000 S. Karger AG, Basel

Quantum random walks on congested lattices and the effect of dephasing

PubMed Central

Motes, Keith R.; Gilchrist, Alexei; Rohde, Peter P.

2016-01-01

We consider quantum random walks on congested lattices and contrast them to classical random walks. Congestion is modelled on lattices that contain static defects which reverse the walker’s direction. We implement a dephasing process after each step which allows us to smoothly interpolate between classical and quantum random walks as well as study the effect of dephasing on the quantum walk. Our key results show that a quantum walker escapes a finite boundary dramatically faster than a classical walker and that this advantage remains in the presence of heavily congested lattices. PMID:26812924

An improved global dynamic routing strategy for scale-free network with tunable clustering

NASA Astrophysics Data System (ADS)

Sun, Lina; Huang, Ning; Zhang, Yue; Bai, Yannan

2016-08-01

An efficient routing strategy can deliver packets quickly to improve the network capacity. Node congestion and transmission path length are inevitable real-time factors for a good routing strategy. Existing dynamic global routing strategies only consider the congestion of neighbor nodes and the shortest path, which ignores other key nodes’ congestion on the path. With the development of detection methods and techniques, global traffic information is readily available and important for the routing choice. Reasonable use of this information can effectively improve the network routing. So, an improved global dynamic routing strategy is proposed, which considers the congestion of all nodes on the shortest path and incorporates the waiting time of the most congested node into the path. We investigate the effectiveness of the proposed routing for scale-free network with different clustering coefficients. The shortest path routing strategy and the traffic awareness routing strategy only considering the waiting time of neighbor node are analyzed comparatively. Simulation results show that network capacity is greatly enhanced compared with the shortest path; congestion state increase is relatively slow compared with the traffic awareness routing strategy. Clustering coefficient increase will not only reduce the network throughput, but also result in transmission average path length increase for scale-free network with tunable clustering. The proposed routing is favorable to ease network congestion and network routing strategy design.

Tolvaptan in Patients Hospitalized With Acute Heart Failure: Rationale and Design of the TACTICS and the SECRET of CHF Trials.

PubMed

Felker, G Michael; Mentz, Robert J; Adams, Kirkwood F; Cole, Robert T; Egnaczyk, Gregory F; Patel, Chetan B; Fiuzat, Mona; Gregory, Douglas; Wedge, Patricia; O'Connor, Christopher M; Udelson, James E; Konstam, Marvin A

2015-09-01

Congestion is a primary reason for hospitalization in patients with acute heart failure (AHF). Despite inpatient diuretics and vasodilators targeting decongestion, persistent congestion is present in many AHF patients at discharge and more severe congestion is associated with increased morbidity and mortality. Moreover, hospitalized AHF patients may have renal insufficiency, hyponatremia, or an inadequate response to traditional diuretic therapy despite dose escalation. Current alternative treatment strategies to relieve congestion, such as ultrafiltration, may also result in renal dysfunction to a greater extent than medical therapy in certain AHF populations. Truly novel approaches to volume management would be advantageous to improve dyspnea and clinical outcomes while minimizing the risks of worsening renal function and electrolyte abnormalities. One effective new strategy may be utilization of aquaretic vasopressin antagonists. A member of this class, the oral vasopressin-2 receptor antagonist tolvaptan, provides benefits related to decongestion and symptom relief in AHF patients. Tolvaptan may allow for less intensification of loop diuretic therapy and a lower incidence of worsening renal function during decongestion. In this article, we summarize evidence for decongestion benefits with tolvaptan in AHF and describe the design of the Targeting Acute Congestion With Tolvaptan in Congestive Heart Failure Study (TACTICS) and Study to Evaluate Challenging Responses to Therapy in Congestive Heart Failure (SECRET of CHF) trials. © 2015 American Heart Association, Inc.

Congestion based mechanism for route discovery in a V2I-V2V system applying smart devices and IoT.

PubMed

Parrado, Natalia; Donoso, Yezid

2015-03-31

The Internet of Things is a new paradigm in which objects in a specific context can be integrated into traditional communication networks to actively participate in solving a determined problem. The Vehicle-to-Vehicle (V2V) and Vehicle-to-Infrastructure (V2I) technologies are specific cases of IoT and key enablers for Intelligent Transportation Systems (ITS). V2V and V2I have been widely used to solve different problems associated with transportation in cities, in which the most important is traffic congestion. A high percentage of congestion is usually presented by the inappropriate use of resources in vehicular infrastructure. In addition, the integration of traffic congestion in decision making for vehicular traffic is a challenge due to its high dynamic behavior. In this paper, an optimization model over the load balancing in the congestion percentage of the streets is formulated. Later, we explore a fully congestion-oriented route discovery mechanism and we make a proposal on the communication infrastructure that should support it based on V2I and V2V communication. The mechanism is also compared with a modified Dijkstra's approach that reacts at congestion states. Finally, we compare the results of the efficiency of the vehicle's trip with the efficiency in the use of the capacity of the vehicular network.

Limb congestion enhances the synchronization of sympathetic outflow with muscle contraction

NASA Technical Reports Server (NTRS)

Mostoufi-Moab, S.; Herr, M. D.; Silber, D. H.; Gray, K. S.; Leuenberger, U. A.; Sinoway, L. I.

2000-01-01

In this report, we examined if the synchronization of muscle sympathetic nerve activity (MSNA) with muscle contraction is enhanced by limb congestion. To explore this relationship, we applied signal-averaging techniques to the MSNA signal obtained during short bouts of forearm contraction (2-s contraction/3-s rest cycle) at 40% maximal voluntary contraction for 5 min. We performed this analysis before and after forearm venous congestion; an intervention that augments the autonomic response to sustained static muscle contractions via a local effect on muscle afferents. There was an increased percentage of the MSNA noted during second 2 of the 5-s contraction/rest cycles. The percentage of total MSNA seen during this particular second increased from minute 1 to 5 of contraction and was increased further by limb congestion (control minute 1 = 25.6 +/- 2.0%, minute 5 = 32.8 +/- 2.2%; limb congestion minute 1 = 29.3 +/- 2.1%, minute 5 = 37.8 +/- 3.9%; exercise main effect <0.005; limb congestion main effect P = 0.054). These changes in the distribution of signal-averaged MSNA were seen despite the fact that the mean number of sympathetic discharges did not increase over baseline. We conclude that synchronization of contraction and MSNA is seen during short repetitive bouts of handgrip. The sensitizing effect of contraction time and limb congestion are apparently due to feedback from muscle afferents within the exercising muscle.

Congestion Based Mechanism for Route Discovery in a V2I-V2V System Applying Smart Devices and IoT

PubMed Central

Parrado, Natalia; Donoso, Yezid

2015-01-01

The Internet of Things is a new paradigm in which objects in a specific context can be integrated into traditional communication networks to actively participate in solving a determined problem. The Vehicle-to-Vehicle (V2V) and Vehicle-to-Infrastructure (V2I) technologies are specific cases of IoT and key enablers for Intelligent Transportation Systems (ITS). V2V and V2I have been widely used to solve different problems associated with transportation in cities, in which the most important is traffic congestion. A high percentage of congestion is usually presented by the inappropriate use of resources in vehicular infrastructure. In addition, the integration of traffic congestion in decision making for vehicular traffic is a challenge due to its high dynamic behavior. In this paper, an optimization model over the load balancing in the congestion percentage of the streets is formulated. Later, we explore a fully congestion-oriented route discovery mechanism and we make a proposal on the communication infrastructure that should support it based on V2I and V2V communication. The mechanism is also compared with a modified Dijkstra’s approach that reacts at congestion states. Finally, we compare the results of the efficiency of the vehicle’s trip with the efficiency in the use of the capacity of the vehicular network. PMID:25835185

Large-scale transportation network congestion evolution prediction using deep learning theory.

PubMed

Ma, Xiaolei; Yu, Haiyang; Wang, Yunpeng; Wang, Yinhai

2015-01-01

Understanding how congestion at one location can cause ripples throughout large-scale transportation network is vital for transportation researchers and practitioners to pinpoint traffic bottlenecks for congestion mitigation. Traditional studies rely on either mathematical equations or simulation techniques to model traffic congestion dynamics. However, most of the approaches have limitations, largely due to unrealistic assumptions and cumbersome parameter calibration process. With the development of Intelligent Transportation Systems (ITS) and Internet of Things (IoT), transportation data become more and more ubiquitous. This triggers a series of data-driven research to investigate transportation phenomena. Among them, deep learning theory is considered one of the most promising techniques to tackle tremendous high-dimensional data. This study attempts to extend deep learning theory into large-scale transportation network analysis. A deep Restricted Boltzmann Machine and Recurrent Neural Network architecture is utilized to model and predict traffic congestion evolution based on Global Positioning System (GPS) data from taxi. A numerical study in Ningbo, China is conducted to validate the effectiveness and efficiency of the proposed method. Results show that the prediction accuracy can achieve as high as 88% within less than 6 minutes when the model is implemented in a Graphic Processing Unit (GPU)-based parallel computing environment. The predicted congestion evolution patterns can be visualized temporally and spatially through a map-based platform to identify the vulnerable links for proactive congestion mitigation.

Large-Scale Transportation Network Congestion Evolution Prediction Using Deep Learning Theory

PubMed Central

Ma, Xiaolei; Yu, Haiyang; Wang, Yunpeng; Wang, Yinhai

2015-01-01

Understanding how congestion at one location can cause ripples throughout large-scale transportation network is vital for transportation researchers and practitioners to pinpoint traffic bottlenecks for congestion mitigation. Traditional studies rely on either mathematical equations or simulation techniques to model traffic congestion dynamics. However, most of the approaches have limitations, largely due to unrealistic assumptions and cumbersome parameter calibration process. With the development of Intelligent Transportation Systems (ITS) and Internet of Things (IoT), transportation data become more and more ubiquitous. This triggers a series of data-driven research to investigate transportation phenomena. Among them, deep learning theory is considered one of the most promising techniques to tackle tremendous high-dimensional data. This study attempts to extend deep learning theory into large-scale transportation network analysis. A deep Restricted Boltzmann Machine and Recurrent Neural Network architecture is utilized to model and predict traffic congestion evolution based on Global Positioning System (GPS) data from taxi. A numerical study in Ningbo, China is conducted to validate the effectiveness and efficiency of the proposed method. Results show that the prediction accuracy can achieve as high as 88% within less than 6 minutes when the model is implemented in a Graphic Processing Unit (GPU)-based parallel computing environment. The predicted congestion evolution patterns can be visualized temporally and spatially through a map-based platform to identify the vulnerable links for proactive congestion mitigation. PMID:25780910

Multi-Scale Visualization Analysis of Bus Flow Average Travel Speed in Qingdao

NASA Astrophysics Data System (ADS)

Yong, HAN; Man, GAO; Xiao-Lei, ZHANG; Jie, LI; Ge, CHEN

2016-11-01

Public transportation is a kind of complex spatiotemporal behaviour. The traffic congestion and environmental pollution caused by the increase in private cars is becoming more and more serious in our city. Spatiotemporal data visualization is an effective tool for studying traffic, transforming non-visual data into recognizable images, which can reveal where/when congestion is formed, developed and disappeared in space and time simultaneously. This paper develops a multi-scale visualization of average travel speed derived from floating bus data, to enable congestion on urban bus networks to be shown and analyzed. The techniques of R language, Echarts, WebGL are used to draw statistical pictures and 3D wall map, which show the congestion in Qingdao from the view of space and time. The results are as follows:(1) There is a more severely delay in Shibei and Shinan areas than Licun and Laoshan areas; (2) The high congestion usually occurs on Hong Kong Middle Road, Shandong Road, Nanjing Road, Liaoyang West Road and Taiping Road;(3) There is a similar law from Monday to Sunday that the congestion is severer in the morning and evening rush hours than other hours; (4) On Monday morning the severity of congestion is higher than on Friday morning, and on Friday evening the severity is higher than on Monday evening. The research results will help to improve the public transportation of Qingdao.

Traffic Congestion on a University Campus: A Consideration of Unconventional Remedies to Nontraditional Transportation Patterns

ERIC Educational Resources Information Center

Kaplan, Dave; Clapper, Thomas

2007-01-01

U.S. transportation data suggest that the number of vehicle miles traveled has far surpassed new capacity, resulting in increased traffic congestion in many communities throughout the country. This article reports on traffic congestion around a university campus located within a small town. The mix of trip purposes varies considerably in this…

Examining the speed-flow-delay paradox in the Washington, DC region : potential impacts of reduced traffic on congestion delay and potential for reductions in discretionary travel during peak periods.

DOT National Transportation Integrated Search

2008-12-01

Traffic congestion in the Washington, DC area, especially congestion on our freeways, costs our residents every day : in terms of wasted time, fuel, and increased air pollution. Highway studies have determined that once traffic volumes : exceed the c...

Can home care for homebound patients with chronic heart failure reduce hospitalizations and costs?

PubMed

Punchik, Boris; Komarov, Roman; Gavrikov, Dmitry; Semenov, Anna; Freud, Tamar; Kagan, Ella; Goldberg, Yury; Press, Yan

2017-01-01

Congestive heart failure (CHF), a common problem in adults, is associated with multiple hospitalizations, high mortality rates and high costs. To evaluate whether home care for homebound patients with CHF reduces healthcare service utilization and overall costs. A retrospective study of healthcare utilization among homebound patients who received home care for CHF from 2012-1015. The outcome measures were number of hospital admissions per month, total number of hospitalization days and days for CHF only, emergency room visits, and overall costs. A comparison was conducted between the 6-month period prior to entry into home care and the time in home care. Over the study period 196 patients were treated by home care for CHF with a mean age of 79.4±9.5 years. 113 (57.7%) were women. Compared to the six months prior to home care, there were statistically significant decreases in hospitalizations (46.3%), in the number of total in-hospital days (28.7%), in the number of in-hospital days for CHF (66.7%), in emergency room visits (47%), and in overall costs (23.9%). Home care for homebound adults with CHF can reduce healthcare utilization and healthcare costs.

Toxins in Botanical Dietary Supplements: Blue Cohosh Components Disrupt Cellular Respiration and Mitochondrial Membrane Potential

PubMed Central

Datta, Sandipan; Mahdi, Fakhri; Ali, Zulfiqar; Jekabsons, Mika B.; Khan, Ikhlas A.; Nagle, Dale G.; Zhou, Yu-Dong

2014-01-01

Certain botanical dietary supplements have been associated with idiosyncratic organ-specific toxicity. Similar toxicological events, caused by drug-induced mitochondrial dysfunction, have forced the withdrawal or U.S. FDA “Black Box” warnings of major pharmaceuticals. To assess the potential mitochondrial liability of botanical dietary supplements, extracts from 352 authenticated plant samples used in traditional Chinese, Ayurvedic, and Western herbal medicine were evaluated for the ability to disrupt cellular respiration. Blue cohosh (Caulophyllum thalictroides) methanol extract exhibited mitochondriotoxic activity. Used by some U.S. midwives to help induce labor, blue cohosh has been associated with perinatal stroke, acute myocardial infarction, congestive heart failure, multiple organ injury, and neonatal shock. The potential link between mitochondrial disruption and idiosyncratic herbal intoxication prompted further examination. The C. thalictroides methanol extract and three saponins, cauloside A (1), saponin PE (2), and cauloside C (3) exhibited concentration- and time-dependent mitochondriotoxic activities. Upon treatment, cell respiration rate rapidly increased and then dramatically decreased within minutes. Mechanistic studies revealed that C. thalictroides constituents impair mitochondrial function by disrupting membrane integrity. These studies provide a potential etiological link between this mitochondria-sensitive form of cytotoxicity and idiosyncratic organ damage. PMID:24328138

On-board congestion control for satellite packet switching networks

NASA Technical Reports Server (NTRS)

Chu, Pong P.

1991-01-01

It is desirable to incorporate packet switching capability on-board for future communication satellites. Because of the statistical nature of packet communication, incoming traffic fluctuates and may cause congestion. Thus, it is necessary to incorporate a congestion control mechanism as part of the on-board processing to smooth and regulate the bursty traffic. Although there are extensive studies on congestion control for both baseband and broadband terrestrial networks, these schemes are not feasible for space based switching networks because of the unique characteristics of satellite link. Here, we propose a new congestion control method for on-board satellite packet switching. This scheme takes into consideration the long propagation delay in satellite link and takes advantage of the the satellite's broadcasting capability. It divides the control between the ground terminals and satellite, but distributes the primary responsibility to ground terminals and only requires minimal hardware resource on-board satellite.

Traffic congestion and blood pressure elevation: A comparative cross-sectional study in Lebanon.

PubMed

Bou Samra, Patrick; El Tomb, Paul; Hosni, Mohammad; Kassem, Ahmad; Rizk, Robin; Shayya, Sami; Assaad, Sarah

2017-12-01

This comparative cross-sectional study examines the association between traffic congestion and elevation of systolic and/or diastolic blood pressure levels among a convenience sample of 310 drivers. Data collection took place during a gas station pause at a fixed time of day. Higher average systolic (142 vs 123 mm Hg) and diastolic (87 vs 78 mm Hg) blood pressures were detected among drivers exposed to traffic congestion compared with those who were not exposed (P<.001), while controlling for body mass index, age, sex, pack-year smoking, driving hours per week, and occupational driving. Moreover, among persons exposed to traffic congestion, longer exposure time was associated with higher systolic and diastolic blood pressures. Further studies are needed to better understand the mechanisms of the significant association between elevated blood pressure and traffic congestion. ©2017 Wiley Periodicals, Inc.

A Rate-Based Congestion Control Algorithm for the SURAP 4 Packet Radio Architecture (SRNTN-72)

DTIC Science & Technology

1990-01-01

factor, one packet. as at connection initialization. However. these TCP enhancements do not solve the fairness problem. The slow start algorithm ma...and signal interference (including lamming) and by the delavs demanded b% the hink -layer protocols in the absence of contention for resources at the...values. This role would be redundant if bits-per-second rations used measurements of packet duration to determine how fast to decrease, at the expense of

The toxic mechanism of high lethality of herbicide butachlor in marine flatfish flounder, Paralichthys olivaceus

NASA Astrophysics Data System (ADS)

Guo, Huarong; Yin, Licheng; Zhang, Shicui; Feng, Wenrong

2010-09-01

The toxic mechanism of herbicide butachlor to induce extremely high lethality in marine flatfish flounder, Paralichthys Olivaceus, was analyzed by histopathological examination, antioxidant enzymes activities and ATP content assay. Histopathological examination of gill, liver and kidney of exposed fishes showed that gill was a target organ of butachlor. The butachlor seriously impaired the respiration of gills by a series of lesions such as edema, lifting and detachment of lamellar epithelium, breakdown of pillar cells, and blood congestion. The dysfunction of gill respiration caused suffocation to the exposed flounder with extremely high acute lethality. Antioxidant enzyme activity assay of the in vitro cultured flounder gill (FG) cells exposed to butachlor indicated that butachlor markedly inhibited the antioxidant enzyme activities of Superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX). Furthermore, along with the decline of antioxidant enzyme activities, ATP content in the exposed FG cells decreased, too. This infers that the oxidative stress induced by butachlor can inhibit the production of cellular ATP. Similar decrease of ATP content was also observed in the exposed flounder gill tissues. Taken together, as in FG cells, butachlor possibly induced a short supply of ATP in pillar cells by inhibiting the antioxidant enzyme activities and then affecting the contractibility of the pillar cells, which in turn resulted in the blood congestion and suffocation of exposed flounder.

Congestion and flow control in signaling system No. 7: Impacts of intelligent networks and new services

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

Zepf, J.; Rufa, G.

1994-04-01

This paper focuses on the transient performance analysis of the congestion and flow control mechanisms in CCITT Signaling System No. 7 (SS7). Special attention is directed to the impacts of the introduction of intelligent services and new applications, e.g., Freephone, credit card services, user-to-user signaling, etc. In particular, we show that signaling traffic characteristics like signaling scenarios or signaling message length as well as end-to-end signaling capabilities have a significant influence on the congestion and flow control and, therefore, on the real-time signaling performance. One important result of our performance studies is that if, e.g., intelligent services are introduced, themore » SS7 congestion and flow control does not work correctly. To solve this problem, some reinvestigations into these mechanisms would be necessary. Therefore, some approaches, e.g., modification of the Signaling Connection Control Part (SCCP) congestion control, usage of the SCCP relay function, or a redesign of the MTP flow control procedures are discussed in order to guarantee the efficacy of the congestion and flow control mechanisms also in the future. 16 refs.« less

Congestive heart failure in subjects with thyrotoxicosis in a black community

PubMed Central

Anakwue, R C; Onwubere, B J C; Anisiuba, B C; Ikeh, V O; Mbah, A; Ike, S O

2010-01-01

Introduction: Thyroid hormone has profound effects on a number of metabolic processes in virtually all tissues but the cardiovascular manifestations are prominent usually creating a hyperdynamic circulatory state. Thyrotoxicosis is not a common cause of congestive heart failure among black communities. Objectives: To determine the hospital prevalence, clinical characteristics and echocardiographic findings in patients with thyrotoxicosis who present with congestive heart failure (CCF) in the eastern part of Nigeria. Subjects and methods: A total of 50 subjects aged 15 years and above who were diagnosed as thyrotoxic following clinical and thyroid function tests were consecutively recruited. Fifty age- and sex-matched controls with no clinical or biochemical evidence of thyrotoxicosis and no comorbidities were used as controls. Two-dimensional echocardiography was carried out on all the subjects. CCF was determined clinically and echocardiographically. Results: Eight patients (5 females and 3 males) out of a total of 50 thyrotoxic patients presented with congestive heart failure. Conclusion: The study revealed that congestive heart failure can occur in thyrotoxicosis in spite of the associated hyperdynamic condition. The underlying mechanism may include direct damage by autoimmune myocarditis, congestive circulation secondary to excess sodium, and fluid retention. PMID:20730063

Leech Therapy For The Treatment Of Venous Congestion In Flaps, Digital Re-Plants And Revascularizations - A Two-Year Review From A Regional Centre.

PubMed

Butt, Ahsan Masood; Ismail, Amir; Lawson-Smith, Matthew; Shahid, Muhammad; Webb, Jill; Chester, Darren L

2016-01-01

Leeches are a well-recognized treatment for congested tissue. This study reviewed the efficacy of leech therapy for salvage of venous congested flaps and congested replanted or revascularized hand digits over a 2-year period. All patients treated with leeches between 1 Oct 2010 and 30 Sep 2012 (two years) at Queen Elizabeth Hospital, Birmingham, UK were included in the study. Details regarding mode of injury requiring reconstruction, surgical procedure, leech therapy duration, subsequent surgery requirement and tissue salvage rates were recorded. Twenty tissues in 18 patients required leeches for tissue congestion over 2 years: 13 men and 5 women. The mean patient age was 41 years (range 17-79). The defect requiring reconstruction was trauma in 16 cases, following tumour resection in two, and two miscellaneous causes. Thirteen cases had flap reconstruction and seven digits in six patients had hand digit replantations or revascularisation. Thirteen of 20 cases (65%) had successful tissue salvage following leech therapy for congestion (77% in 10 out of 13 flaps, and 43% in 3 of 7 digits). The rate of tissue salvage in pedicled flaps was good 6/6 (100%) and so was in digital revascularizations 2/3 (67%), but poor in digital re-plants 1/4 (25%) and free flaps 0/2 (0%). Leeches are a helpful tool for congested tissue salvage and in this study, showed a greater survival benefit for pedicled flaps than for free flaps or digital replantations.

Plasmapheresis affects responses of slowly and rapidly adapting airway receptors to pulmonary venous congestion in dogs.

PubMed Central

Kappagoda, C T; Ravi, K

1989-01-01

1. The effects of plasmapheresis on the responses of rapidly adapting receptors (RARs) and slowly adapting receptors (SARs) of the airways to pulmonary venous congestion were examined in dogs anaesthetized with alpha-chloralose. Pulmonary venous congestion was produced in a graded manner by partial obstruction of the mitral valve sufficient to raise the mean left atrial pressure by 5, 10 and 15 mmHg. Plasmapheresis was performed by withdrawing 10% of blood volume twice. 2. Both RARs (n = 11) and SARs (n = 5) responded to pulmonary venous congestion by increasing their activities. The responses of the former were proportionately greater. 3. After plasmapheresis which reduced the concentration of plasma proteins by 12.3 +/- 1.0%, the responses of the RARs to pulmonary venous congestion were enhanced significantly. There was no significant change in the responses of SARs. 4. In another set of six RARs, the effects of graded pulmonary venous congestion were investigated twice with an interval of 45 min between the two observations. No significant differences were noted between the two responses. 5. Collection of lymph from the tracheobronchial lymph duct (n = 6) showed that after plasmapheresis, there was an increase in the control lymph flow. In addition, the lymph flow was enhanced during pulmonary venous congestion (mean left atrial pressure increased by 10 mmHg). 6. It is suggested that a natural stimulus for the excitation of the RAR is a function of the fluid fluxes in the pulmonary extravascular space. PMID:2607464

Optimization study on multiple train formation scheme of urban rail transit

NASA Astrophysics Data System (ADS)

Xia, Xiaomei; Ding, Yong; Wen, Xin

2018-05-01

The new organization method, represented by the mixed operation of multi-marshalling trains, can adapt to the characteristics of the uneven distribution of passenger flow, but the research on this aspect is still not perfect enough. This paper introduced the passenger sharing rate and congestion penalty coefficient with different train formations. On this basis, this paper established an optimization model with the minimum passenger cost and operation cost as objective, and operation frequency and passenger demand as constraint. The ideal point method is used to solve this model. Compared with the fixed marshalling operation model, the overall cost of this scheme saves 9.24% and 4.43% respectively. This result not only validates the validity of the model, but also illustrate the advantages of the multiple train formations scheme.

Distribution and observed associations of orthostatic blood pressure changes in elderly general medicine outpatients

NASA Technical Reports Server (NTRS)

Robertson, D.; DesJardin, J. A.; Lichtenstein, M. J.

1998-01-01

Factors associated with orthostatic blood pressure change in elderly outpatients were determined by surveying 398 medical clinical outpatients aged 65 years and older. Blood pressure was measured with random-zero sphygmomanometers after patients were 5 minutes in a supine and 5 minutes in a standing position. Orthostatic blood pressure changes were at normally distributed levels with systolic and diastolic pressures dropping an average of 4 mm Hg (standard deviation [SD]=15 mm Hg) and 2 mm Hg (SD=11 mm Hg), respectively. Orthostatic blood pressure changes were unassociated with age, race, sex, body mass, time since eating, symptoms, or other factors. According to multiple linear regression analysis, supine systolic pressure, chronic obstructive pulmonary disease (COPD), and diabetes mellitus were associated with a decrease in systolic pressure on standing. Hypertension, antiarthritic drugs, and abnormal heartbeat were associated with an increase in systolic pressure on standing. For orthostatic diastolic pressure changes, supine diastolic pressure and COPD were associated with a decrease in diastolic pressure on standing. Congestive heart failure was associated with an increase in standing diastolic pressure. Using logistic regression analysis, only supine systolic pressure was associated with a greater than 20-mm Hg drop in systolic pressure (n=53, prevalence=13%). Supine diastolic pressure and COPD were the only variables associated with a greater than 20-mm Hg drop in diastolic pressure (n=16, prevalence=4%). These factors may help physicians in identifying older persons at risk for having orthostatic hypotension.

14 CFR 105.21 - Parachute operations over or into a congested area or an open-air assembly of persons.

Code of Federal Regulations, 2010 CFR

2010-01-01

... congested area or an open-air assembly of persons. 105.21 Section 105.21 Aeronautics and Space FEDERAL...-air assembly of persons. (a) No person may conduct a parachute operation, and no pilot in command of... congested area of a city, town, or settlement, or an open-air assembly of persons unless a certificate of...

Airport Characterization for the Adaptation of Surface Congestion Management Approaches

DTIC Science & Technology

2013-02-01

Surface Congestion Management Program at New York JFK airport [6,7], the human-in-the-loop simulations of the Spot and Runway Departure Advisor...a surface congestion management technique at New York JFK airport ,” AIAA Aviation Technology, Integration and Operations (ATIO) Conference...Virginia Beach, VA, September 2011. [7] S. Stroiney, H. Khadilkar and H. Balakrishnan, “Ground Management Program at JFK Airport : Implementation and

A multiple drug fatality involving MK-801 (dizocilpine), a mimic of phencyclidine.

PubMed

Mozayani, Ashraf; Schrode, Paul; Carter, Joye; Danielson, Terry J

2003-04-23

MK-801 (dizocilpine) is a non-competitive antagonist at the N-methyl-D-aspartate (NMDA) family of glutamate receptors in the central nervous system. It is an anticonvulsant and also shares several pharmacological properties with phencyclidine and ketamine. It is not observed routinely as a substance of abuse. The deceased, a 45-year-old white male, obtained MK-801 surreptitiously in an attempt to treat a self-diagnosed depression. He was discovered the next morning, unresponsive on the bathroom floor. An empty bottle, labeled to contain 25mg of MK-801, was found near the body. The autopsy was performed at the Joseph A Jachimczyk Forensic Center, Houston, TX. Body weight at autopsy was 88kg. Lungs were edematous and congested (right: 775g; left 700g). The heart had proportionate chambers and was otherwise unremarkable. The kidneys (right: 220g; left 225g) were smooth surfaced. The brain (1550g) was congested and without trauma. Microscopic evaluation of the heart, kidneys and lungs showed normal histology and confirmed pulmonary congestion and edema. Samples of heart blood, liver, bile, vitreous humor, stomach contents and urine were collected at autopsy. There were 550ml of stomach contents. Drugs in blood were screened by EMIT II Plus immunoassay procedures and by gas chromatography/mass spectrometry (GC/MS) of an organic solvent extract of basified blood. Alcohol was determined by gas chromatography with headspace injection. MK-801, benzodiazepines and alcohol were detected in blood. Amounts of MK-801 present in blood, bile, liver, vitreous humor and urine were 0.15, 0.29, 0.92, less than 0.1 and 0.36 mg/l (kg), respectively. The cause of death was benzodiazepine, dizocilpine and ethanol toxicity and the manner accidental.

Medicare capitation model, functional status, and multiple comorbidities: model accuracy

PubMed Central

Noyes, Katia; Liu, Hangsheng; Temkin-Greener, Helena

2012-01-01

Objective This study examined financial implications of CMS-Hierarchical Condition Categories (HCC) risk-adjustment model on Medicare payments for individuals with comorbid chronic conditions. Study Design The study used 1992-2000 data from the Medicare Current Beneficiary Survey and corresponding Medicare claims. The pairs of comorbidities were formed based on the prior evidence about possible synergy between these conditions and activities of daily living (ADL) deficiencies and included heart disease and cancer, lung disease and cancer, stroke and hypertension, stroke and arthritis, congestive heart failure (CHF) and osteoporosis, diabetes and coronary artery disease, CHF and dementia. Methods For each beneficiary, we calculated the actual Medicare cost ratio as the ratio of the individual’s annualized costs to the mean annual Medicare cost of all people in the study. The actual Medicare cost ratios, by ADLs, were compared to the HCC ratios under the CMS-HCC payment model. Using multivariate regression models, we tested whether having the identified pairs of comorbidities affects the accuracy of CMS-HCC model predictions. Results The CMS-HCC model underpredicted Medicare capitation payments for patients with hypertension, lung disease, congestive heart failure and dementia. The difference between the actual costs and predicted payments was partially explained by beneficiary functional status and less than optimal adjustment for these chronic conditions. Conclusions Information about beneficiary functional status should be incorporated in reimbursement models since underpaying providers for caring for population with multiple comorbidities may provide severe disincentives for managed care plans to enroll such individuals and to appropriately manage their complex and costly conditions. PMID:18837646

The rainfall plot: its motivation, characteristics and pitfalls.

PubMed

Domanska, Diana; Vodák, Daniel; Lund-Andersen, Christin; Salvatore, Stefania; Hovig, Eivind; Sandve, Geir Kjetil

2017-05-18

A visualization referred to as rainfall plot has recently gained popularity in genome data analysis. The plot is mostly used for illustrating the distribution of somatic cancer mutations along a reference genome, typically aiming to identify mutation hotspots. In general terms, the rainfall plot can be seen as a scatter plot showing the location of events on the x-axis versus the distance between consecutive events on the y-axis. Despite its frequent use, the motivation for applying this particular visualization and the appropriateness of its usage have never been critically addressed in detail. We show that the rainfall plot allows visual detection even for events occurring at high frequency over very short distances. In addition, event clustering at multiple scales may be detected as distinct horizontal bands in rainfall plots. At the same time, due to the limited size of standard figures, rainfall plots might suffer from inability to distinguish overlapping events, especially when multiple datasets are plotted in the same figure. We demonstrate the consequences of plot congestion, which results in obscured visual data interpretations. This work provides the first comprehensive survey of the characteristics and proper usage of rainfall plots. We find that the rainfall plot is able to convey a large amount of information without any need for parameterization or tuning. However, we also demonstrate how plot congestion and the use of a logarithmic y-axis may result in obscured visual data interpretations. To aid the productive utilization of rainfall plots, we demonstrate their characteristics and potential pitfalls using both simulated and real data, and provide a set of practical guidelines for their proper interpretation and usage.

Performance analysis of SS7 congestion controls under sustained overload

NASA Astrophysics Data System (ADS)

Manfield, David R.; Millsteed, Gregory K.; Zukerman, Moshe

1994-04-01

Congestion controls are a key factor in achieving the robust performance required of common channel signaling (CCS) networks in the face of partial network failures and extreme traffic loads, especially as networks become large and carry high traffic volume. The CCITT recommendations define a number of types of congestion control, and the parameters of the controls must be well set in order to ensure their efficacy under transient and sustained signalling network overload. The objective of this paper is to present a modeling approach to the determination of the network parameters that govern the performance of the SS7 congestion controls under sustained overload. Results of the investigation by simulation are presented and discussed.

[Renal cirsoid aneurysm (congenital arteriovenous fistula): a rare cause of severe hematuria].

PubMed

Pereira Arias, José Gregorio; Ullate Jaime, Vicente; Pereda Martínez, Esther; Gutiérrez Díez, José María; Ateca Díaz-Obregón, Ricardo; Ramírez Rodríguez, Maria Mar; Berreteaga Gallastegui, José Ramón

2007-06-01

Congenital arteriovenous fistulas are an exceptional clinical feature. Although they are frequently asymptomatic, their presentation as severe hematuria pose an excellent diagnostic exercise and often immediate therapeutic action. We report the case of a 75-year-old female patient presenting with severe hematuria producing anaemia, high blood pressure and congestive heart failure. Image tests revealed right ureteral-hydronephrosis with bladder blockage by blood clots. The endoscopic study (cystoscopy and ureterorenoscopy) alerted about the origin of the hematuria from the right kidney, finally requiring nephrectomy as definitive treatment. Pathology revealed the presence of a round formation with multiple vascular channels, arterial and venous, in the pyelocalicial submucosa, with focal epithelial erosion, compatible with congenital arteriovenous fistula. We review the diagnostic and therapeutic features in the literature. Renal congenital arteriovenous fistulas represent a diagnostic dilemma. They may present asymptomatic or condition clinical features derived from the shunt and high cardiac output (hypertensive cardiopathy and congestive heart failure) or from the erosion and acute hemorrhage into the urinary tract (severe renal hematuria). Treatment should be conservative with embolization or supraselective sclerosis. Nevertheless, in cases of big fistulas, post embolization revascularization, or hemodynamic instability nephrectomy is an excellent option.

Scalable Heuristics for Planning, Placement and Sizing of Flexible AC Transmission System Devices

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

Frolov, Vladmir; Backhaus, Scott N.; Chertkov, Michael

Aiming to relieve transmission grid congestion and improve or extend feasibility domain of the operations, we build optimization heuristics, generalizing standard AC Optimal Power Flow (OPF), for placement and sizing of Flexible Alternating Current Transmission System (FACTS) devices of the Series Compensation (SC) and Static VAR Compensation (SVC) type. One use of these devices is in resolving the case when the AC OPF solution does not exist because of congestion. Another application is developing a long-term investment strategy for placement and sizing of the SC and SVC devices to reduce operational cost and improve power system operation. SC and SVCmore » devices are represented by modification of the transmission line inductances and reactive power nodal corrections respectively. We find one placement and sizing of FACTs devices for multiple scenarios and optimal settings for each scenario simultaneously. Our solution of the nonlinear and nonconvex generalized AC-OPF consists of building a convergent sequence of convex optimizations containing only linear constraints and shows good computational scaling to larger systems. The approach is illustrated on single- and multi-scenario examples of the Matpower case-30 model.« less

An Airway Network Flow Assignment Approach Based on an Efficient Multiobjective Optimization Framework

PubMed Central

Zhang, Xuejun; Lei, Jiaxing

2015-01-01

Considering reducing the airspace congestion and the flight delay simultaneously, this paper formulates the airway network flow assignment (ANFA) problem as a multiobjective optimization model and presents a new multiobjective optimization framework to solve it. Firstly, an effective multi-island parallel evolution algorithm with multiple evolution populations is employed to improve the optimization capability. Secondly, the nondominated sorting genetic algorithm II is applied for each population. In addition, a cooperative coevolution algorithm is adapted to divide the ANFA problem into several low-dimensional biobjective optimization problems which are easier to deal with. Finally, in order to maintain the diversity of solutions and to avoid prematurity, a dynamic adjustment operator based on solution congestion degree is specifically designed for the ANFA problem. Simulation results using the real traffic data from China air route network and daily flight plans demonstrate that the proposed approach can improve the solution quality effectively, showing superiority to the existing approaches such as the multiobjective genetic algorithm, the well-known multiobjective evolutionary algorithm based on decomposition, and a cooperative coevolution multiobjective algorithm as well as other parallel evolution algorithms with different migration topology. PMID:26180840

Efficient algorithm for locating and sizing series compensation devices in large power transmission grids: II. Solutions and applications

DOE PAGES

Frolov, Vladimir; Backhaus, Scott; Chertkov, Misha

2014-10-01

In a companion manuscript, we developed a novel optimization method for placement, sizing, and operation of Flexible Alternating Current Transmission System (FACTS) devices to relieve transmission network congestion. Specifically, we addressed FACTS that provide Series Compensation (SC) via modification of line inductance. In this manuscript, this heuristic algorithm and its solutions are explored on a number of test cases: a 30-bus test network and a realistically-sized model of the Polish grid (~ 2700 nodes and ~ 3300 lines). The results on the 30-bus network are used to study the general properties of the solutions including non-locality and sparsity. The Polishmore » grid is used as a demonstration of the computational efficiency of the heuristics that leverages sequential linearization of power flow constraints and cutting plane methods that take advantage of the sparse nature of the SC placement solutions. Using these approaches, the algorithm is able to solve an instance of Polish grid in tens of seconds. We explore the utility of the algorithm by analyzing transmission networks congested by (a) uniform load growth, (b) multiple overloaded configurations, and (c) sequential generator retirements.« less

Costs of Chronic Diseases at the State Level: The Chronic Disease Cost Calculator

PubMed Central

Murphy, Louise B.; Khavjou, Olga A.; Li, Rui; Maylahn, Christopher M.; Tangka, Florence K.; Nurmagambetov, Tursynbek A.; Ekwueme, Donatus U.; Nwaise, Isaac; Chapman, Daniel P.; Orenstein, Diane

2015-01-01

Introduction Many studies have estimated national chronic disease costs, but state-level estimates are limited. The Centers for Disease Control and Prevention developed the Chronic Disease Cost Calculator (CDCC), which estimates state-level costs for arthritis, asthma, cancer, congestive heart failure, coronary heart disease, hypertension, stroke, other heart diseases, depression, and diabetes. Methods Using publicly available and restricted secondary data from multiple national data sets from 2004 through 2008, disease-attributable annual per-person medical and absenteeism costs were estimated. Total state medical and absenteeism costs were derived by multiplying per person costs from regressions by the number of people in the state treated for each disease. Medical costs were estimated for all payers and separately for Medicaid, Medicare, and private insurers. Projected medical costs for all payers (2010 through 2020) were calculated using medical costs and projected state population counts. Results Median state-specific medical costs ranged from $410 million (asthma) to $1.8 billion (diabetes); median absenteeism costs ranged from $5 million (congestive heart failure) to $217 million (arthritis). Conclusion CDCC provides methodologically rigorous chronic disease cost estimates. These estimates highlight possible areas of cost savings achievable through targeted prevention efforts or research into new interventions and treatments. PMID:26334712

Efficient Algorithm for Locating and Sizing Series Compensation Devices in Large Transmission Grids: Solutions and Applications (PART II)

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

Frolov, Vladimir; Backhaus, Scott N.; Chertkov, Michael

2014-01-14

In a companion manuscript, we developed a novel optimization method for placement, sizing, and operation of Flexible Alternating Current Transmission System (FACTS) devices to relieve transmission network congestion. Specifically, we addressed FACTS that provide Series Compensation (SC) via modification of line inductance. In this manuscript, this heuristic algorithm and its solutions are explored on a number of test cases: a 30-bus test network and a realistically-sized model of the Polish grid (~2700 nodes and ~3300 lines). The results on the 30-bus network are used to study the general properties of the solutions including non-locality and sparsity. The Polish grid ismore » used as a demonstration of the computational efficiency of the heuristics that leverages sequential linearization of power flow constraints and cutting plane methods that take advantage of the sparse nature of the SC placement solutions. Using these approaches, the algorithm is able to solve an instance of Polish grid in tens of seconds. We explore the utility of the algorithm by analyzing transmission networks congested by (a) uniform load growth, (b) multiple overloaded configurations, and (c) sequential generator retirements« less

Data on the key performance indicators for quality of service of GSM networks in Nigeria.

PubMed

Popoola, Segun I; Atayero, Aderemi A; Faruk, Nasir; Badejo, Joke A

2018-02-01

In this data article, the Key Performance Indicators (KPIs) for Quality of Service (QoS) of Global System for Mobile Communications (GSM) networks in Nigeria are provided and analyzed. The data provided in this paper contain the Call Setup Success Rate (CSSR), Drop Call Rate (DCR), Stand-alone Dedicated Channel (SDCCH) congestion, and Traffic Channel (TCH) congestion for the four GSM network operators in Nigeria (Airtel, Etisalat, Glo, and MTN). These comprehensive data were obtained from the Nigerian Communications Commission (NCC). Significant differences in each of the KPIs for the four quarters of each year were presented based on Analysis of Variance (ANOVA). The values of the KPIs were plotted against the months of the year for better visualization and understanding of data trends across the four quarters. Multiple comparisons of the mean-quarterly differences of the KPIs were also presented using Tukey's Post Hoc test. Public availability and further interpretation and discussion of these useful information will assist the network providers, Nigerian government, local and international regulatory bodies, policy makers, and other stakeholders in ensuring access of people, machines, and things to high quality telecommunications services.

Transport solutions for cleaner air.

PubMed

Kelly, Frank J; Zhu, Tong

2016-05-20

In cities across the globe, road transport remains an important source of air pollutants that are linked with acute and chronic health effects. Decreasing vehicle emissions--while maintaining or increasing commuter journeys--remains a major challenge for city administrators. In London, congestion-charging and a citywide low-emission zone failed to bring nitrogen dioxide concentrations under control. In Beijing, controls on the purchase and use of cars have not decreased transport emissions to a sufficient extent. As cities continue to grow, not even zero-emission vehicles are the solution. Moving increasingly large numbers of people efficiently around a city can only be achieved by expanding mass transit systems. Copyright © 2016, American Association for the Advancement of Science.

Liver Function in Areas of Hepatic Venous Congestion After Hepatectomy for Liver Cancer: 99mTc-GSA SPECT/CT Fused Imaging Study.

PubMed

Yoshida, Morikatsu; Beppu, Toru; Shiraishi, Shinya; Tsuda, Noriko; Sakamoto, Fumi; Kuramoto, Kunitaka; Okabe, Hirohisa; Nitta, Hidetoshi; Imai, Katsunori; Tomiguchi, Seiji; Baba, Hideo; Yamashita, Yasuyuki

2018-05-01

Background/Aim: The sacrifice of a major hepatic vein can cause hepatic venous congestion (HVC). We evaluated the effects of HVC on regional liver function using the liver uptake value (LUV), that was calculated from 99m Tc-labeled-galactosyl-human-serum-albumin ( 99m Tc-GSA) single-photon emission computed tomography (SPECT) /contrast-enhanced computed tomography (CE-CT) fused images. Patients and Methods: Sixty-two patients underwent 99m Tc-GSA SPECT/CE-CT prior to hepatectomy for liver cancer and at 7 days after surgery were divided into groups with (n=8) and without HVC (n=54). In the HVC group, CT volume (CTv) and LUV were separately calculated in both congested and non-congested areas. Results: The remnant LUV/CTv of the HVC group was significantly smaller than that of the non-HVC group (p<0.01). The mean functional ratio was 0.47±0.05, and all ratios were ≥0.39. Conclusion: After hepatectomy with sacrifice of major hepatic vein, liver function per unit volume in the congested areas was approximately 40% of that in the non-congested areas. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Patent ductus arteriosus in an adult cat with pulmonary hypertension and right-sided congestive heart failure: hemodynamic evaluation and clinical outcome following ductal closure.

PubMed

Novo-Matos, José; Hurter, Karin; Bektas, Rima; Grest, Paula; Glaus, Tony

2014-09-01

Right-sided congestive heart failure (CHF) developed secondary to severe pulmonary hypertension (PH) in an 8-year-old cat with a left-to-right shunting patent ductus arteriosus (PDA). Vascular reactivity was tested prior to shunt ligation by treatment with oxygen and sildenafil. This treatment was associated with a significant decrease in pulmonary artery pressure as assessed by echocardiography. Subsequently surgical shunt ligation was planned. During thoracotomy, digital occlusion of the PDA was performed for 10 min with simultaneous catheter measurement of right ventricular pressure, which did not increase. Permanent shunt ligation resulted in a complete and sustained clinical recovery. A lung biopsy sample obtained during thoracotomy demonstrated histopathological arterial changes typical of PH. Cats can develop clinically severe PH and right-sided CHF secondary to a left-to-right PDA even at an advanced age. Assuming there is evidence of pulmonary reactivity, PDA occlusion might be tolerated and can potentially produce long-term clinical benefits. Copyright © 2014 Elsevier B.V. All rights reserved.

Topical nasal decongestant oxymetazoline (0.05%) provides relief of nasal symptoms for 12 hours.

PubMed

Druce, H M; Ramsey, D L; Karnati, S; Carr, A N

2018-05-22

Nasal congestion, often referred to as stuffy nose or blocked nose is one of the most prevalent and bothersome symptoms of an upper respiratory tract infection. Oxymetazoline, a widely used intranasal decongestant, offers fast symptom relief, but little is known about the duration of effect. The results of 2 randomized, double-blind, vehicle-controlled, single-dose, parallel, clinical studies (Study 1, n=67; Study 2, n=61) in which the efficacy of an oxymetazoline (0.05% Oxy) nasal spray in patients with acute coryzal rhinitis was assessed over a 12-hour time-period. Data were collected on both subjective relief of nasal congestion (6-point nasal congestion scale) and objective measures of nasal patency (anterior rhinomanometry) in both studies. A pooled study analysis showed statistically significant changes from baseline in subjective nasal congestion for 0.05% oxymetazoline and vehicle at each hourly time-point from Hour 1 through Hour 12 (marginally significant at Hour 11). An objective measure of nasal flow was statistically significant at each time-point up to 12 hours. Adverse events on either treatment were infrequent. The number of subjects who achieved an improvement in subjective nasal congestion scores of at least 1.0 was significantly higher in the Oxy group vs. vehicle at all hourly time-points on a 6-point nasal congestion scale. This study shows for the first time, that oxymetazoline provides both statistically significant and clinically meaningful relief of nasal congestion and improves nasal airflow for up to 12 hours following a single dose.

Analysis of Aircraft Clusters to Measure Sector-Independent Airspace Congestion

NASA Technical Reports Server (NTRS)

Bilimoria, Karl D.; Lee, Hilda Q.

2005-01-01

The Distributed Air/Ground Traffic Management (DAG-TM) concept of operations* permits appropriately equipped aircraft to conduct Free Maneuvering operations. These independent aircraft have the freedom to optimize their trajectories in real time according to user preferences; however, they also take on the responsibility to separate themselves from other aircraft while conforming to any local Traffic Flow Management (TFM) constraints imposed by the air traffic service provider (ATSP). Examples of local-TFM constraints include temporal constraints such as a required time of arrival (RTA), as well as spatial constraints such as regions of convective weather, special use airspace, and congested airspace. Under current operations, congested airspace typically refers to a sector(s) that cannot accept additional aircraft due to controller workload limitations; hence Dynamic Density (a metric that is indicative of controller workload) can be used to quantify airspace congestion. However, for Free Maneuvering operations under DAG-TM, an additional metric is needed to quantify the airspace congestion problem from the perspective of independent aircraft. Such a metric would enable the ATSP to prevent independent aircraft from entering any local areas of congestion in which the flight deck based systems and procedures may not be able to ensure separation. This new metric, called Gaggle Density, offers the ATSP a mode of control to regulate normal operations and to ensure safety and stability during rare-normal or off-normal situations (e.g., system failures). It may be difficult to certify Free Maneuvering systems for unrestricted operations, but it may be easier to certify systems and procedures for specified levels of Gaggle Density that could be monitored by the ATSP, and maintained through relatively minor flow-rate (RTA type) restrictions. Since flight deck based separation assurance is airspace independent, the challenge is to measure congestion independent of sector boundaries. Figure 1 , reproduced from Ref. 1, depicts an example traffic situation. When the situation is analyzed by sector boundaries (left side of figure), a Dynamic Density metric would identify excessive congestion in the central sector. When the same traffic situation is analyzed independent of sector boundaries (right side of figure), a Gaggle Density metric would identify congestion in two dynamically defined areas covering portions of several sectors. The first step towards measuring airspace-independent congestion is to identify aircraft clusters, i.e., groups of closely spaced aircraft. The objective of this work is to develop techniques to detect and classify clusters of aircraft.

Risk of venous congestion in live donors of extended right liver graft

PubMed Central

Radtke, Arnold; Sgourakis, George; Molmenti, Ernesto P; Beckebaum, Susanne; Cicinnati, Vito R; Schmidt, Hartmut; Peitgen, Heinz-Otto; Broelsch, Christoph E; Malagó, Massimo; Schroeder, Tobias

2015-01-01

AIM: To investigate middle hepatic vein (MHV) management in adult living donor liver transplantation and safer remnant volumes (RV). METHODS: There were 59 grafts with and 12 grafts without MHV (including 4 with MHV-5/8 reconstructions). All donors underwent our five-step protocol evaluation containing a preoperative protocol liver biopsy Congestive vs non-congestive RV, remnant-volume-body-weight ratios (RVBWR) and postoperative outcomes were evaluated in 71 right graft living donors. Dominant vs non-dominant MHV anatomy in total liver volume (d-MHV/TLV vs nd-MHV/TLV) was constellated with large/small congestion volumes (CV-index). Small for size (SFS) and non-SFS remnant considerations were based on standard cut-off- RVBWR and RV/TLV. Non-congestive RVBWR was based on non-congestive RV. RESULTS: MHV and non-MHV remnants showed no significant differences in RV, RV/TLV, RVBWR, total bilirubin, or INR. SFS-remnants with RV/TLV < 30% and non-SFS-remnants with RV/TLV ≥ 30% showed no significant differences either. RV and RVBWR for non-MHV (n = 59) and MHV-containing (n = 12) remnants were 550 ± 95 mL and 0.79 ± 0.1 mL vs 568 ± 97 mL and 0.79 ± 0.13, respectively (P = 0.423 and P = 0.919. Mean left RV/TLV was 35.8% ± 3.9%. Non-MHV (n = 59) and MHV-containing (n = 12) remnants (34.1% ± 3% vs 36% ± 4% respectively, P = 0.148. Eight SFS-remnants with RVBWR < 0.65 had a significantly smaller RV/TLV than 63 non-SFS-remnants with RVBWR ≥ 0.65 [SFS: RV/TLV 32.4% (range: 28%-35.7%) vs non-SFS: RV/TLV 36.2% (range: 26.1%-45.5%), P < 0.009. Six SFS-remnants with RV/TLV < 30% had significantly smaller RVBWR than 65 non-SFS-remnants with RV/TLV ≥ 30% (0.65 (range: 0.6-0.7) vs 0.8 (range: 0.6-1.27), P < 0.01. Two (2.8%) donors developed reversible liver failure. RVBWR and RV/TLV were concordant in 25%-33% of SFS and in 92%-94% of non-SFS remnants. MHV management options including complete MHV vs MHV-4A selective retention were necessary in n = 12 vs n = 2 remnants based on particularly risky congestive and non-congestive volume constellations. CONCLUSION: MHV procurement should consider individual remnant congestive- and non-congestive volume components and anatomy characteristics, RVBWR-RV/TLV constellation enables the identification of marginally small remnants. PMID:26019467

Effect of K+ATP channel and adenosine receptor blockade during rest and exercise in congestive heart failure.

PubMed

Traverse, Jay H; Chen, YingJie; Hou, MingXiao; Li, Yunfang; Bache, Robert J

2007-06-08

K(+)(ATP) channels are important metabolic regulators of coronary blood flow (CBF) that are activated in the setting of reduced levels of ATP or perfusion pressure. In the normal heart, blockade of K(+)(ATP) channels results in a approximately 20% reduction in resting CBF but does not impair the increase in CBF that occurs during exercise. In contrast, adenosine receptor blockade fails to alter CBF or myocardial oxygen consumption (MVO(2)) in the normal heart but contributes to the increase in CBF during exercise when vascular K(+)(ATP) channels are blocked. Congestive heart failure (CHF) is associated with a decrease in CBF that is matched to a decrease in MVO(2) suggesting downregulation of myocardial energy utilization. Because myocardial ATP levels and coronary perfusion pressure are reduced in CHF, this study was undertaken to examine the role of K(+)(ATP) channels and adenosine in dogs with pacing-induced CHF. Myocardial blood flow (MBF) and MVO(2) were measured during rest and treadmill exercise before and after K(+)(ATP) channel blockade with glibenclamide (50 microg/kg/min ic) or adenosine receptor blockade with 8-phenyltheophylline (8-PT; 5 mg/kg iv). Inhibition of K(+)(ATP) channels resulted in a decrease in CBF and MVO(2) at rest and during exercise without a change in the relationship between CBF and MVO(2). In contrast, adenosine receptor blockade caused a significant increase in CBF that occurred secondary to an increase of MVO(2). These findings demonstrate that coronary K(+)(ATP) channel activity contribute to the regulation of resting MBF in CHF, and that endogenous adenosine may act to inhibit MVO(2) in the failing heart.

Evaluation of Effectiveness of Embolization in Pelvic Congestion Syndrome with the New Vascular Occlusion Device (ArtVentive EOS™): Preliminary Results

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

Pyra, Krzysztof, E-mail: k.pyra@poczta.fm; Woźniak, Sławomir, E-mail: slavwo7572@gmail.com; Drelich-Zbroja, Anna, E-mail: zbroanna@interia.pl

PurposeThis study aimed to collect confirmatory data in support of the safety and efficiency of the ArtVentive EOS™ for the treatment of the pelvic congestion syndrome (PCS). This study was based on the OCCLUDE 1 Study Protocol approved by the Local Ethics Committee.Materials and MethodsA prospective study carried out in June and July 2014 included 12 women aged 21–48 years (mean 31 years) scheduled for PCS embolization using the ArtVentive EOS™. The inclusion criteria were clinical symptoms of PCS documented by transvaginal Doppler ultrasound and pelvic MRI. The pelvic pain was assessed by VAS score from 0 to 10 (0 represents lackmore » of pain and 10 unbearable pain). A decrease in pelvic pain intensity based on the VAS was considered a clinical success.ResultsSuccessful embolization procedures with ArtVentive EOS™ were performed in 11 out of 12 patients. Nine patients underwent unilateral embolization of the left ovarian vein, and two had bilateral embolization of the ovarian veins. Complete ovarian vein occlusion confirmed by post deployment venography was achieved in all 11 patients. Procedures lasted from 19 to 45 min (average 28 min). Pain intensity decrease was observed in all 11 patients—a decrease of 5.6 points—from 7.3 pre-procedure to 1.6 post-embolization (standard deviation: 0.67). In one case, the left ovarian vein was injured by guide wire manipulation with contrast extravasation—not clinically significant.ConclusionsThe use of ArtVentive EOS™ for occlusion of the ovarian veins in PCS patients is safe and effective.« less

Effects of treatment on respiratory rate, serum natriuretic peptide concentration, and Doppler echocardiographic indices of left ventricular filling pressure in dogs with congestive heart failure secondary to degenerative mitral valve disease and dilated cardiomyopathy.

PubMed

Schober, Karsten E; Hart, Taye M; Stern, Joshua A; Li, Xiaobai; Samii, Valerie F; Zekas, Lisa J; Scansen, Brian A; Bonagura, John D

2011-08-15

To evaluate the effects of treatment on respiratory rate, serum natriuretic peptide concentrations, and Doppler echocardiographic indices of left ventricular filling pressure in dogs with congestive heart failure (CHF) secondary to degenerative mitral valve disease (MVD) and dilated cardiomyopathy (DCM). Prospective cohort study. 63 client-owned dogs. Physical examination, thoracic radiography, analysis of natriuretic peptide concentrations, and Doppler echocardiography were performed twice, at baseline (examination 1) and 5 to 14 days later (examination 2). Home monitoring of respiratory rate was performed by the owners between examinations. In dogs with MVD, resolution of CHF was associated with a decrease in respiratory rate, serum N-terminal probrain natriuretic peptide (NT-proBNP) concentration, and diastolic functional class and an increase of the ratio of peak velocity of early diastolic transmitral flow to peak velocity of early diastolic lateral mitral annulus motion (E:Ea Lat). In dogs with DCM, resolution of CHF was associated with a decrease in respiratory rate and serum NT-proBNP concentration and significant changes in 7 Doppler echocardiographic variables, including a decrease of E:Ea Lat and the ratio of peak velocity of early diastolic transmitral flow to isovolumic relaxation time. Only respiratory rate predicted the presence of CHF at examination 2 with high accuracy. Resolution of CHF was associated with predictable changes in respiratory rate, serum NT-proBNP concentration, and selected Doppler echocardiographic variables in dogs with DCM and MVD. Home monitoring of respiratory rate was simple and was the most useful in the assessment of successful treatment of CHF.

Implementation of an emergency department atrial fibrillation and flutter pathway improves rates of appropriate anticoagulation, reduces length of stay and thirty-day revisit rates for congestive heart failure.

PubMed

Barbic, David; DeWitt, Chris; Harris, Devin; Stenstrom, Robert; Grafstein, Eric; Wu, Crane; Vadeanu, Cristian; Heilbron, Brett; Haaf, Jenelle; Tung, Stanley; Kalla, Dan; Marsden, Julian; Christenson, Jim; Scheuermeyer, Frank

2018-05-01

An evidence-based emergency department (ED) atrial fibrillation and flutter (AFF) pathway was developed to improve care. The primary objective was to measure rates of new anticoagulation (AC) on ED discharge for AFF patients who were not AC correctly upon presentation. This is a pre-post evaluation from April to December 2013 measuring the impact of our pathway on rates of new AC and other performance measures in patients with uncomplicated AFF solely managed by emergency physicians. A standardized chart review identified demographics, comorbidities, and ED treatments. The primary outcome was the rate of new AC. Secondary outcomes were ED length of stay (LOS), referrals to AFF clinic, ED revisit rates, and 30-day rates of return visits for congestive heart failure (CHF), stroke, major bleeding, and death. ED AFF patients totalling 301 (129 pre-pathway [PRE]; 172 post-pathway [POST]) were included; baseline demographics were similar between groups. The rates of AC at ED presentation were 18.6% (PRE) and 19.7% (POST). The rates of new AC on ED discharge were 48.6 % PRE (95% confidence interval [CI] 42.1%-55.1%) and 70.2% POST (62.1%-78.3%) (20.6% [p<0.01; 15.1-26.3]). Median ED LOS decreased from 262 to 218 minutes (44 minutes [p<0.03; 36.2-51.8]). Thirty-day rates of ED revisits for CHF decreased from 13.2% to 2.3% (10.9%; p<0.01; 8.1%-13.7%), and rates of other measures were similar. The evidence-based pathway led to an improvement in the rate of patients with new AC upon discharge, a reduction in ED LOS, and decreased revisit rates for CHF.

Home-based primary care and the risk of ambulatory care-sensitive condition hospitalization among older veterans with diabetes mellitus.

PubMed

Edwards, Samuel T; Prentice, Julia C; Simon, Steven R; Pizer, Steven D

2014-11-01

Primary care services based at home have the potential to reduce the likelihood of hospitalization among older adults with multiple chronic diseases. To characterize the association between enrollment in Home-Based Primary Care (HBPC), a national home care program operated by the US Department of Veterans Affairs (VA), and hospitalizations owing to an ambulatory care-sensitive condition among older veterans with diabetes mellitus. Retrospective cohort study. Patients admitted to VA and non-VA hospitals were followed up from January 1, 2006, through December 31, 2010. Veterans 67 years or older who were fee-for-service Medicare beneficiaries, were diagnosed as having diabetes mellitus and at least 1 other chronic disease, and had at least 1 admission to a VA or non-VA hospital in 2005 or 2006. Enrollment in HBPC, defined as a minimum of 2 HBPC encounters during the study period. Admission to VA and non-VA hospitals owing to an ambulatory care-sensitive condition, as measured by the Agency for Healthcare Research and Quality's Prevention Quality Indicators in VA medical records and Medicare claims. Outcomes were analyzed using distance from the veteran's residence to a VA facility that provides HBPC as an instrumental variable. Among 56 608 veterans, 1978 enrolled in HBPC. These patients were older (mean age, 79.1 vs 77.1 years) and had more chronic diseases (eg, 59.2% vs 53.5% had congestive heart failure). Multivariable predictors for HBPC enrollment included paralysis (odds ratio [OR], 2.11; 95% CI, 1.63-2.74), depression (OR, 1.99; 95% CI, 1.70-2.34), congestive heart failure (OR, 1.36; 95% CI, 1.17-1.58), and distance from the nearest HBPC-providing VA facility (OR, 0.59; 95% CI, 0.50-0.70 for >10-30 vs <5 miles). After controlling for selection using an instrumental variable analysis, HBPC was associated with a significant reduction in the probability of experiencing a hospitalization owing to an ambulatory care-sensitive condition (hazard ratio, 0.71; 95% CI, 0.57-0.89), with an absolute reduction in the probability of hospitalization of 5.8% in 1 year. Home-Based Primary Care is associated with a decreased probability of ambulatory care-sensitive condition hospitalization among elderly veterans with diabetes mellitus. In accountable care models, HBPC may have an important role in the management of older adults with multiple chronic diseases.

Involvement of systemic venous congestion in heart failure.

PubMed

Rubio Gracia, J; Sánchez Marteles, M; Pérez Calvo, J I

2017-04-01

Systemic venous congestion has gained significant importance in the interpretation of the pathophysiology of acute heart failure, especially in the development of renal function impairment during exacerbations. In this study, we review the concept, clinical characterisation and identification of venous congestion. We update current knowledge on its importance in the pathophysiology of acute heart failure and its involvement in the prognosis. We pay special attention to the relationship between abdominal congestion, the pulmonary interstitium as filtering membrane, inflammatory phenomena and renal function impairment in acute heart failure. Lastly, we review decongestion as a new therapeutic objective and the measures available for its assessment. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

A hierarchical framework for air traffic control

NASA Astrophysics Data System (ADS)

Roy, Kaushik

Air travel in recent years has been plagued by record delays, with over $8 billion in direct operating costs being attributed to 100 million flight delay minutes in 2007. Major contributing factors to delay include weather, congestion, and aging infrastructure; the Next Generation Air Transportation System (NextGen) aims to alleviate these delays through an upgrade of the air traffic control system. Changes to large-scale networked systems such as air traffic control are complicated by the need for coordinated solutions over disparate temporal and spatial scales. Individual air traffic controllers must ensure aircraft maintain safe separation locally with a time horizon of seconds to minutes, whereas regional plans are formulated to efficiently route flows of aircraft around weather and congestion on the order of every hour. More efficient control algorithms that provide a coordinated solution are required to safely handle a larger number of aircraft in a fixed amount of airspace. Improved estimation algorithms are also needed to provide accurate aircraft state information and situational awareness for human controllers. A hierarchical framework is developed to simultaneously solve the sometimes conflicting goals of regional efficiency and local safety. Careful attention is given in defining the interactions between the layers of this hierarchy. In this way, solutions to individual air traffic problems can be targeted and implemented as needed. First, the regional traffic flow management problem is posed as an optimization problem and shown to be NP-Hard. Approximation methods based on aggregate flow models are developed to enable real-time implementation of algorithms that reduce the impact of congestion and adverse weather. Second, the local trajectory design problem is solved using a novel slot-based sector model. This model is used to analyze sector capacity under varying traffic patterns, providing a more comprehensive understanding of how increased automation in NextGen will affect the overall performance of air traffic control. The dissertation also provides solutions to several key estimation problems that support corresponding control tasks. Throughout the development of these estimation algorithms, aircraft motion is modeled using hybrid systems, which encapsulate both the discrete flight mode of an aircraft and the evolution of continuous states such as position and velocity. The target-tracking problem is posed as one of hybrid state estimation, and two new algorithms are developed to exploit structure specific to aircraft motion, especially near airports. First, discrete mode evolution is modeled using state-dependent transitions, in which the likelihood of changing flight modes is dependent on aircraft state. Second, an estimator is designed for systems with limited mode changes, including arrival aircraft. Improved target tracking facilitates increased safety in collision avoidance and trajectory design problems. A multiple-target tracking and identity management algorithm is developed to improve situational awareness for controllers about multiple maneuvering targets in a congested region. Finally, tracking algorithms are extended to predict aircraft landing times; estimated time of arrival prediction is one example of important decision support information for air traffic control.

Extraskeletal multiple myeloma presenting with an atrial mass: a case report and a review of the literature.

PubMed

Vigo, Federica; Ciammella, Patrizia; Valli, Riccardo; Cagni, Elisabetta; Iotti, Cinzia

2012-08-10

Extraskeletal presentation at diagnosis or during the course of multiple myeloma is a rare event. The prognosis is usually very poor. At the moment there is no agreed gold standard for the treatment of this presentation. A 79-year-old Caucasian woman was treated at our hospital for right atrial myeloma localization. Our patient showed the following signs and symptoms of congestive heart failure: dyspnea, hypotension, cyanosis and facial edema. Surgery was not considered feasible due to the extent of the disease. Our patient underwent external-beam radiation therapy using an intensity modulated technique, thus obtaining a persistent complete remission. Our patient has been in continuous complete local remission for 25 months since the end of radiotherapy. The role of radiotherapy is not defined in multiple myeloma with extraskeletal presentation. Our regimen seems to be effective in controlling the disease in this patient.This case report adds to the existing literature as it describes an unusual presentation of the disease and a new therapeutic approach to this rare presentation of multiple myeloma.

Evaluation of Swift Start TCP in Long-Delay Environment

NASA Technical Reports Server (NTRS)

Lawas-Grodek, Frances J.; Tran, Diepchi T.

2004-01-01

This report presents the test results of the Swift Start algorithm in single-flow and multiple-flow testbeds under the effects of high propagation delays, various slow bottlenecks, and small queue sizes. Although this algorithm estimates capacity and implements packet pacing, the findings were that in a heavily congested link, the Swift Start algorithm will not be applicable. The reason is that the bottleneck estimation is falsely influenced by timeouts induced by retransmissions and the expiration of delayed acknowledgment (ACK) timers, thus causing the modified Swift Start code to fall back to regular transmission control protocol (TCP).

High Resolution Far-Infrared Spectra of Thiophosgene with a Synchrotron Source: The ν2 and ν4 Bands Near 500 cm-1

NASA Astrophysics Data System (ADS)

McKellar, A. R. W.; Billinghurst, B. E.

2010-02-01

Thiophosgene (Cl2CS) is a favorite model system for studies of vibrational dynamics. But there are no previous rotationally-resolved infrared studies because the spectra are very congested due to its (relatively) large mass and multiple isotopic species. Here we report a detailed gas-phase study of the ν2 (˜504 cm-1) and ν4 (˜471 cm-1) fundamental bands, based on spectra obtained at the Canadian Light Source far-infrared beamline using synchrotron radiation and a Bruker IFS125 FT spectrometer.

Impact of moderate functional mitral insufficiency in patients undergoing surgical revascularization.

PubMed

Grossi, Eugene A; Crooke, Gregory A; DiGiorgi, Paul L; Schwartz, Charles F; Jorde, Ulrich; Applebaum, Robert M; Ribakove, Greg H; Galloway, Aubrey C; Grau, Juan B; Colvin, Stephen B

2006-07-04

Mild and moderate functional ischemic mitral insufficiency present at the time of surgical revascularization present clinical uncertainty. It is unclear whether the relatively poor outcomes in this cohort are dependent on valvular function or related to left ventricular dysfunction. The purpose of this study was to examine the early and late outcomes in patients with less-than-severe functional ischemic mitral insufficiency at the time of isolated coronary artery bypass grafting (CABG). From 1996 through 2004, 2242 consecutive patients undergoing isolated CABG were identified as having none to moderate mitral regurgitation (MR) and no valve leaflet pathology. All of the patients at this single institution routinely had an intraoperative transesophageal echocardiography, prospectively quantified MR, and ejection fraction (EF). The New York State Cardiac Surgery Reporting System infrastructure was used to prospectively collect in-hospital patient variables and outcomes. Social Security Death Benefit Index was used to determine long-term survival. Odds ratio and significance (P value) are presented for each determined risk factor. There were 841 patients (37.5%) with no MR, 1137 (50.7%) with mild MR, and 264 (11.8%) with moderate MR. The patients with moderate MR were more likely to be older, female, and have more renal disease, previous MI, congestive heart failure, previous cardiac surgery, and lower EFs. Hospital mortality was independently and significantly associated with renal disease, decreasing EF, increasing age, previous cardiac operation, and cerebral vascular disease. Multivariable analysis revealed decreased survival with increasing age, previous operation, congestive heart failure, diabetes, nonelective operation, decreasing EF, and the presence of moderate MR (expbeta = 1.49; P=0.007) and mild MR (expbeta = 1.34; P=0.033). Independent of ventricular function, mild and moderate functional mitral insufficiency are associated with significantly decreased survival in patients undergoing CABG. Whether correction of moderate functional MR at the time of CABG improves outcome still needs to be determined.

Accuracy of tissue Doppler echocardiography in the diagnosis of new-onset congestive heart failure in patients with levels of B-type natriuretic peptide in the midrange and normal left ventricular ejection fraction.

PubMed

Arques, Stephane; Roux, Emmanuel; Sbragia, Pascal; Pieri, Bertrand; Gelisse, Richard; Ambrosi, Pierre; Luccioni, Roger

2006-09-01

Based on the hypothesis that it reflects left ventricular (LV) diastolic pressures, B-type natriuretic peptide (BNP) is largely utilized as first-line diagnostic complement in the emergency diagnosis of congestive heart failure (HF). The incremental diagnostic value of tissue Doppler echocardiography, a reliable noninvasive estimate of LV filling pressures, has been reported in patients with preserved LV ejection fraction and discrepancy between BNP levels and the clinical judgment, however, its clinical validity in such patients in the presence of BNP concentrations in the midrange, which may reflect intermediate, nondiagnostic levels of LV filling pressures, is unknown. 34 patients without history of HF, presenting with acute dyspnea at rest, BNP levels of 100-400 pg/ml and normal LV ejection fraction were prospectively enrolled (17 with congestive HF and 17 with noncardiac cause). Tissue Doppler echocardiography was performed within 3 hours after admission. Unlike BNP (P = 0.78), Boston criteria (P = 0.0129), radiographic pulmonary edema (P = 0.0036) and average E/Ea ratio (P = 0.0032) were predictive of congestive HF by logistic regression analysis. In this clinical setting, radiographic pulmonary edema had a positive predictive value of 80% in the diagnosis of congestive HF. In patients without evidence of radiographic pulmonary edema, average E/Ea > 10 was a powerful predictor of congestive HF (area under the ROC curve of 0.886, P < 0.001, sensitivity 100% and specificity 78.6%). By better reflecting LV filling pressures, bedside tissue Doppler echocardiography accurately differentiates congestive HF from noncardiac cause in dyspneic patients with intermediate, nondiagnostic BNP levels and normal LV ejection fraction.

Cardiac Dysfunction, Congestion and Loop Diuretics: their Relationship to Prognosis in Heart Failure.

PubMed

Pellicori, Pierpaolo; Cleland, John G F; Zhang, Jufen; Kallvikbacka-Bennett, Anna; Urbinati, Alessia; Shah, Parin; Kazmi, Syed; Clark, Andrew L

2016-12-01

Diuretics are the mainstay of treatment for congestion but concerns exist that they adversely affect prognosis. We explored whether the relationship between loop diuretic use and outcome is explained by the underlying severity of congestion amongst patients referred with suspected heart failure. Of 1190 patients, 712 had a left ventricular ejection fraction (LVEF) ≤50 %, 267 had LVEF >50 % with raised plasma NTproBNP (>400 ng/L) and 211 had LVEF >50 % with NTproBNP ≤400 ng/L; respectively, 72 %, 68 % and 37 % of these groups were treated with loop diuretics including 28 %, 29 % and 10 % in doses ≥80 mg furosemide equivalent/day. Compared to patients with cardiac dysfunction (either LVEF ≤50 % or NT-proBNP >400 ng/L) but not taking a loop diuretic, those taking a loop diuretic were older and had more clinical evidence of congestion, renal dysfunction, anaemia and hyponatraemia. During a median follow-up of 934 (IQR: 513-1425) days, 450 patients were hospitalized for HF or died. Patients prescribed loop diuretics had a worse outcome. However, in multi-variable models, clinical, echocardiographic (inferior vena cava diameter), and biochemical (NTproBNP) measures of congestion were strongly associated with an adverse outcome but not the use, or dose, of loop diuretics. Prescription of loop diuretics identifies patients with more advanced features of heart failure and congestion, which may account for their worse prognosis. Further research is needed to clarify the relationship between loop diuretic agents and outcome; imaging and biochemical measures of congestion might be better guides to diuretic dose than symptoms or clinical signs.

Effect of metoprolol administration on renal sodium handling in experimental congestive heart failure.

PubMed

DiBona, G F; Sawin, L L

1999-07-06

Long-term metoprolol therapy improves cardiac performance and decreases mortality in patients with chronic congestive heart failure (CHF). This study examined the effect of long-term metoprolol therapy on renal sodium handling in an experimental rat model of CHF. Rats with left coronary ligation and myocardial infarction-induced CHF were treated with metoprolol (1.5 mg. kg-1. h-1) or vehicle for 3 weeks by osmotic minipump. They were then evaluated for their ability to excrete a short-term sodium load (5% body weight isotonic saline infusion over 30 minutes) and a long-term sodium load (change from low- to high-sodium diet over 8 days). All CHF rats had left ventricular end-diastolic pressure >10 mm Hg, and heart weight/body weight ratios averaged 0.68+/-0.02% (versus control of approximately 0.40%). Compared with vehicle CHF rats (n=19), metoprolol CHF rats (n=18) had lower basal values of mean arterial pressure (122+/-3 versus 112+/-3 mm Hg) and heart rate (373+/-14 versus 315+/-9 bpm) and decreased heart rate responses to intravenous doses of isoproterenol. During short-term isotonic saline volume loading, metoprolol CHF rats excreted 54+/-4% more of the sodium load than vehicle CHF rats. During long-term dietary sodium loading, metoprolol CHF rats retained 28+/-3% less sodium than vehicle CHF rats. Metoprolol treatment of rats with CHF results in an improved ability to excrete both short- and long-term sodium loads.

Evidence Report: The efficacy and safety of mitoxantrone (Novantrone) in the treatment of multiple sclerosis: Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology.

PubMed

Marriott, James J; Miyasaki, Janis M; Gronseth, Gary; O'Connor, Paul W

2010-05-04

The chemotherapeutic agent mitoxantrone was approved for use in multiple sclerosis (MS) in 2000. After a review of all the available evidence, the original report of the Therapeutics and Technology Assessment Subcommittee in 2003 concluded that mitoxantrone probably reduced clinical attack rates, MRI activity, and disease progression. Subsequent reports of decreased systolic function, heart failure, and leukemia prompted the US Food and Drug Administration to institute a "black box" warning in 2005. This review was undertaken to examine the available literature on the efficacy and safety of mitoxantrone use in patients with MS since the initial report. Relevant articles were obtained through a review of the medical literature and the strength of the available evidence was graded according to the American Academy of Neurology evidence classification scheme. The accumulated Class III and IV evidence suggests an increased incidence of systolic dysfunction and therapy-related acute leukemia (TRAL) with mitoxantrone therapy. Systolic dysfunction occurs in approximately 12% of patients with MS treated with mitoxantrone, congestive heart failure occurs in approximately 0.4%, and leukemia occurs in approximately 0.8%. The number needed to harm is 8 for systolic dysfunction and 123 for TRAL. There is no new efficacy evidence that would change the recommendation from the previous report. The risk of systolic dysfunction and leukemia in patients treated with mitoxantrone is higher than suggested at the time of the previous report, although comprehensive postmarketing surveillance data are lacking.

Gross umbilical cord complications are associated with placental lesions of circulatory stasis and fetal hypoxia.

PubMed

Chan, Joanna S Y; Baergen, Rebecca N

2012-01-01

Umbilical cord complications (UCC), such as true knots (TK), velamentous (VEL) insertion, marginal umbilical cord (MUC) insertion, umbilical cord entanglement (UCE) (both nuchal and non-nuchal), excessively long umbilical cord (ELUC), and excessively twisted umbilical cord (ETUC), can lead to decreased UC blood flow and have been associated with adverse fetal outcome and intrauterine fetal demise (IUFD). Few large series exist that correlate UCC with specific pathologic findings of the placenta. We present the largest series of UCC at this time. Eight hundred forty-one 3rd-trimester placentas with UCC were identified, as well as 858 randomly selected gestational age-matched placentas with grossly unremarkable UC. Lesions associated with circulatory stasis and thrombosis, including villous capillary congestion (VC), umbilical vessel distension (UVD), chorionic plate vessel distension (CPD), umbilical vessel thrombosis (UVT), fetal vascular thrombosis (FVT), intimal fibrin cushions (IFC), and avascular villi (AV), were noted, as well as other pathologic lesions. Data were analyzed by analysis of variance and Fisher exact tests, with P < 0.05 statistically significant. Umbilical cord complications as a group was associated with a significant increase in placental circulatory stasis lesions. Lesions associated with hypoxia, namely nucleated red blood cells and chorangiosis, were also increased. Finally, the presence of any UCC was significantly associated with IUFD. We also found that multiple UCC are associated with nonreassuring fetal heart rate and chorangiosis but that the presence of a single UCC was not. This indicates that UCC may lead to intrauterine hypoxia and subsequent adverse fetal outcome and that multiple UCC may be cumulative in effect.

Increasing Intelligence in Inter-Vehicle Communications to Reduce Traffic Congestions: Experiments in Urban and Highway Environments.

PubMed

Meneguette, Rodolfo I; Filho, Geraldo P R; Guidoni, Daniel L; Pessin, Gustavo; Villas, Leandro A; Ueyama, Jó

2016-01-01

Intelligent Transportation Systems (ITS) rely on Inter-Vehicle Communication (IVC) to streamline the operation of vehicles by managing vehicle traffic, assisting drivers with safety and sharing information, as well as providing appropriate services for passengers. Traffic congestion is an urban mobility problem, which causes stress to drivers and economic losses. In this context, this work proposes a solution for the detection, dissemination and control of congested roads based on inter-vehicle communication, called INCIDEnT. The main goal of the proposed solution is to reduce the average trip time, CO emissions and fuel consumption by allowing motorists to avoid congested roads. The simulation results show that our proposed solution leads to short delays and a low overhead. Moreover, it is efficient with regard to the coverage of the event and the distance to which the information can be propagated. The findings of the investigation show that the proposed solution leads to (i) high hit rate in the classification of the level of congestion, (ii) a reduction in average trip time, (iii) a reduction in fuel consumption, and (iv) reduced CO emissions.

Increasing Intelligence in Inter-Vehicle Communications to Reduce Traffic Congestions: Experiments in Urban and Highway Environments

PubMed Central

Filho, Geraldo P. R.; Guidoni, Daniel L.; Pessin, Gustavo; Villas, Leandro A.; Ueyama, Jó

2016-01-01

Intelligent Transportation Systems (ITS) rely on Inter-Vehicle Communication (IVC) to streamline the operation of vehicles by managing vehicle traffic, assisting drivers with safety and sharing information, as well as providing appropriate services for passengers. Traffic congestion is an urban mobility problem, which causes stress to drivers and economic losses. In this context, this work proposes a solution for the detection, dissemination and control of congested roads based on inter-vehicle communication, called INCIDEnT. The main goal of the proposed solution is to reduce the average trip time, CO emissions and fuel consumption by allowing motorists to avoid congested roads. The simulation results show that our proposed solution leads to short delays and a low overhead. Moreover, it is efficient with regard to the coverage of the event and the distance to which the information can be propagated. The findings of the investigation show that the proposed solution leads to (i) high hit rate in the classification of the level of congestion, (ii) a reduction in average trip time, (iii) a reduction in fuel consumption, and (iv) reduced CO emissions PMID:27526048

Insomnia Self-Management in Heart Failure

ClinicalTrials.gov

2018-01-05

Cardiac Failure; Heart Failure; Congestive Heart Failure; Heart Failure, Congestive; Sleep Initiation and Maintenance Disorders; Chronic Insomnia; Disorders of Initiating and Maintaining Sleep; Fatigue; Pain; Depressive Symptoms; Sleep Disorders; Anxiety

On the Inefficiency of Equilibria in Linear Bottleneck Congestion Games

NASA Astrophysics Data System (ADS)

de Keijzer, Bart; Schäfer, Guido; Telelis, Orestis A.

We study the inefficiency of equilibrium outcomes in bottleneck congestion games. These games model situations in which strategic players compete for a limited number of facilities. Each player allocates his weight to a (feasible) subset of the facilities with the goal to minimize the maximum (weight-dependent) latency that he experiences on any of these facilities. We derive upper and (asymptotically) matching lower bounds on the (strong) price of anarchy of linear bottleneck congestion games for a natural load balancing social cost objective (i.e., minimize the maximum latency of a facility). We restrict our studies to linear latency functions. Linear bottleneck congestion games still constitute a rich class of games and generalize, for example, load balancing games with identical or uniformly related machines with or without restricted assignments.

Continuum modeling of cooperative traffic flow dynamics

NASA Astrophysics Data System (ADS)

Ngoduy, D.; Hoogendoorn, S. P.; Liu, R.

2009-07-01

This paper presents a continuum approach to model the dynamics of cooperative traffic flow. The cooperation is defined in our model in a way that the equipped vehicle can issue and receive a warning massage when there is downstream congestion. Upon receiving the warning massage, the (up-stream) equipped vehicle will adapt the current desired speed to the speed at the congested area in order to avoid sharp deceleration when approaching the congestion. To model the dynamics of such cooperative systems, a multi-class gas-kinetic theory is extended to capture the adaptation of the desired speed of the equipped vehicle to the speed at the downstream congested traffic. Numerical simulations are carried out to show the influence of the penetration rate of the equipped vehicles on traffic flow stability and capacity in a freeway.

Cogestion and recreation site demand: a model of demand-induced quality effects

USGS Publications Warehouse

Douglas, Aaron J.; Johnson, Richard L.

1993-01-01

This analysis focuses on problems of estimating site-specific dollar benefits conferred by outdoor recreation sites in the face of congestion costs. Encounters, crowding effects and congestion costs have often been treated by natural resource economists in a piecemeal fashion. In the current paper, encounters and crowding effects are treated systematically. We emphasize the quantitative impact of congestion costs on site-specific estimates of benefits conferred by improvements in outdoor recreation sites. The principal analytic conclusion is that techniques that streamline on data requirements produce biased estimates of benefits conferred by site improvements at facilities with significant crowding effects. The principal policy recommendation is that the Federal and state agencies should collect and store information on visitation rates, encounter levels and congestion costs at various outdoor recreation sites.

Congestion of mastoid mucosa and influence on middle ear pressure - Effect of retroauricular injection of adrenaline.

PubMed

Fooken Jensen, Pernille Vita; Gaihede, Michael

2016-10-01

Micro-CT scanning of temporal bones has revealed numerous retroauricular microchannels, which connect the outer bone surface directly to the underlying mastoid air cells. Their structure and dimensions have suggested a separate vascular supply to the mastoid mucosa, which may play a role in middle ear (ME) pressure regulation. This role may be accomplished by changes in the mucosa congestion resulting in volumetric changes, which ultimately affect the pressure of the enclosed ME gas pocket (Boyle's law). Further, such mucosa congestion may be susceptible to α-adrenergic stimulation similar to the mucosa of the nose. The purpose of our study was to investigate these hypotheses by recording the ME pressure in response to adrenergic stimulation administered by retroauricular injections at the surface of the microchannels. In a group of 20 healthy adults we measured the ME pressure by tympanometry initially in the sitting position, and then in the supine position over a 5 min period with 30 s intervals. In each subject, the study included 1) a control reference experiment with no intervention, 2) a control experiment with subcutaneously retroauricular injection of 1 ml isotonic NaCl solution, and 3) a test experiment with subcutaneously retroauricular injection of 1 ml NaCl-adrenaline solution. In both control experiments the ME pressure displayed an immediate increase in response to changing body position; this pressure increase remained stable for the entire period up to five minutes. In the test experiments the ME pressure also showed an initial pressure increase, but it was followed by a distinct significant pressure decrease with a maximum after 90 s. The test group was injected with both a 5 and 10% adrenaline solution, but the responses appeared similar for the two concentrations. Subcutaneous retroauricular injection of adrenaline caused a significant pressure decrease in ME pressure compared with control ears. This may be explained by the microchannels conveying the adrenaline to the underlying mastoid mucosa, where it may result in a vascular constriction and decongestion, ultimately resulting in a ME pressure decrease. These findings suggest that the microchannels contain vascular connections to the mastoid mucosa, and that the mastoid mucosa is susceptible to vasoactive mediators, which may play a role in ME pressure regulation. Further anatomical and physiological experiments should be carried out to confirm these suggestions including pharmacological interactions with the mastoid mucosa. Copyright © 2016 Elsevier B.V. All rights reserved.

Primary Care Physician Panel Size and Quality of Care: A Population-Based Study in Ontario, Canada.

PubMed

Dahrouge, Simone; Hogg, William; Younger, Jaime; Muggah, Elizabeth; Russell, Grant; Glazier, Richard H

2016-01-01

The purpose of this study was to determine the relationship between the number of patients under a primary care physician's care (panel size) and primary care quality indicators. We conducted a cross-sectional, population-based study of fee-for-service and capitated interprofessional and non-interprofessional primary health care practices in Ontario, Canada between April 2008 and March 2010, encompassing 4,195 physicians with panel sizes ≥1,200 serving 8.3 million patients. Data was extracted from multiple linked, health-related administrative databases and covered 16 quality indicators spanning 5 dimensions of care: access, continuity, comprehensiveness, and evidence-based indicators of cancer screening and chronic disease management. The likelihood of being up-to-date on cervical, colorectal, and breast cancer screening showed relative decreases of 7.9% (P <.001), 5.9% (P = .01), and 4.6% (P <.001), respectively, with increasing panel size (from 1,200 to 3,900). Eight chronic care indicators (4 medication-based and 4 screening-based) showed no significant association with panel size. The likelihood of individuals with a new diagnosis of congestive heart failure having an echocardiogram, however, increased by a relative 8.1% (P <.001) with higher panel size. Increasing panel size was also associated with a 10.8% relative increase in hospitalization rates for ambulatory-care-sensitive conditions (P = .04) and a 10.8% decrease in non-urgent emergency department visits (P = .004). Continuity was highest with medium panel sizes (P <.001), and comprehensiveness had a small decrease (P = .03) with increasing panel size. Increasing panel size was associated with small decreases in cancer screening, continuity, and comprehensiveness, but showed no consistent relationships with chronic disease management or access indicators. We found no panel size threshold above which quality of care suffered. © 2016 Annals of Family Medicine, Inc.

Auctionable fixed transmission rights for congestion management

NASA Astrophysics Data System (ADS)

Alomoush, Muwaffaq Irsheid

Electric power deregulation has proposed a major change to the regulated utility monopoly. The change manifests the main part of engineers' efforts to reshape three components of today's regulated monopoly: generation, distribution and transmission. In this open access deregulated power market, transmission network plays a major role, and transmission congestion is a major problem that requires further consideration especially when inter-zonal/intra-zonal scheme is implemented. Declaring that engineering studies and experience are the criteria to define zonal boundaries or defining a zone based on the fact that a zone is a densely interconnected area (lake) and paths connecting these densely interconnected areas are inter-zonal lines will render insufficient and fuzzy definitions. Moreover, a congestion problem formulation should take into consideration interactions between intra-zonal and inter-zonal flows and their effects on power systems. In this thesis, we introduce a procedure for minimizing the number of adjustments of preferred schedules to alleviate congestion and apply control schemes to minimize interactions between zones. In addition, we give the zone definition a certain criterion based on the Locational Marginal Price (LMP). This concept will be used to define congestion zonal boundaries and to decide whether any zone should be merged with another zone or split into new zones. The thesis presents a unified scheme that combines zonal and FTR schemes to manage congestion. This combined scheme is utilized with LMPs to define zonal boundaries more appropriately. The presented scheme gains the best features of the FTR scheme, which are providing financial certainty, maximizing the efficient use of the system and making users pay for the actual use of congested paths. LMPs may give an indication of the impact of wheeling transactions, and calculations of and comparisons of LMPs with and without wheeling transactions should be adequate criteria to approve the transaction by the ISO, take a decision to expand the existing system, or retain the original structure of the system. Also, the thesis investigates the impact of wheeling transactions on congestion management, where we present a generalized mathematical model for the Fixed Transmission Right (FTR) auction. The auction guarantees FTR availability to all participants on a non-discriminatory basis, in which system users are permitted to buy, sell and trade FTRs through an auction. When FTRs are utilized with LMPs, they increase the efficient use of the transmission system and let a transmission customer gain advantageous features such as acquiring a mechanism to offset the extra cost due to congestion charges, providing financial and operational certainty and making system users pay for the actual use of the congested paths. The thesis also highlighted FTR trading in secondary markets to self-arrange access across different paths, create long-term transmission rights and provide more commercial certainty.

Transportation network policy modeling for congestion and pollution control: A variational inequality approach

NASA Astrophysics Data System (ADS)

Ramanujam, Padma

1999-08-01

Public concern over the state of the environment has grown over the past decade. All indications are that this concern will continue to influence policy making into the foreseeable future. Road transport is seen as the major contributor to environmental degradation. Transportation planners around the world face the question: cleaner air and/or faster commutes? While individual vehicles can be made more environmentally friendly, the sheer scale of growth in world-wide vehicle numbers is projected to cause significant environmental degradation in the longer run, and in the absence of newer and stricter polices. It is a challenge for governments to find policies that ensure congestion-free metropolitan areas while guaranteeing both critical environmental quality levels and a sufficient infrastructure access to all groups involved. The objective of the dissertation is to provide a mathematical framework to study transportation policy models for the purpose of controlling congestion and pollution. Towards this objective. a series of transportation policy models are developed to study travel behavior and to quantity the reductions in congestion and automobile emissions. The dissertation begins with a brief historical overview of some of the pioneering works in urban transportation economics and later presents the theoretical foundation for the transportation policy models developed. The dissertation introduces single modal and multimodal transportation network policy models that accomplish road pricing with the imposition of goal targets on link loads. as well as, integrated traffic equilibrium models with marketable mobile emission permits. Furthermore, equilibrium conditions are derived for each model, and both qualitative analysis and computational procedures are studied. Finally, the dissertation concludes with a comparative study of the relationship between regulatory pricing models and marketable emission permit transportation models and a discussion on key factors that influence implementation of the proposed policy models. The framework of variational inequalities has been utilized in our dissertation, because it is ideal for equilibrium systems. With the addition of pricing policy interventions and the integration of marketable mobile emission permits, traffic equilibrium models become extremely complex. Consequently, the computation of the equilibrium is made more difficult. However, it is shown in the dissertation that in addition to pricing interventions and the integration of a marketable emission permit system that it is possible to incorporate multiple modes of transport and even to handle the issue of noncompliance, using the framework of variational inequalities.

A case of sudden onset of thyroid storm just before cesarean section manifesting congestive heart failure and pulmonary edema.

PubMed

Sugiyama, Yuki; Tanaka, Ryusuke; Yoshiyama, Yuki; Ichino, Takashi; Hishinuma, Norimasa; Shimizu, Sari; Imai, Noriko; Mitsuzawa, Kunihiro; Kawamata, Mikito

2017-01-01

Since acute respiratory failure (ARF) is a life-threatening complication, particularly in the gestational period, differential diagnosis and rapid treatment are required. Among the various causes of sudden onset of ARF, thyroid storm is a rare cause in a parturient complicated with well-controlled hyperthyroidism. In this case report, we describe a parturient with hyperthyroidism in whom a thyroid storm manifesting congestive heart failure and pulmonary edema developed just before an emergency ceasarean section, even though hyperthyroidism was well-controlled with antithyroid drugs. A 36-year-old pregnant woman was diagnosed as having clinical chorioamnionitis, and an emergency cesarean section was performed at 25 weeks of pregnancy. She had a complication of hyperthyroidism accompanied by mild mitral regurgitation, and she had been treated with methimazole. She was treated with ritodrine and MgSO 4 for the threat of premature delivery. At the preoperative consultation, her percutaneous oxygen saturation (SpO 2 ) was 98% on room air. When she was admitted to the operating room, her heart rate and blood pressure were 130 beats/min and 196/78 mmHg, respectively. SpO 2 was 88% on room air without any symptoms; however, just after starting oxygen administration via a facemask, she complained of severe respiratory distress and became agitated. Partial pressure of arterial oxygen was 108 mmHg with an inspiratory oxygen fraction of 1.0. Chest radiography revealed pulmonary congestion, and transesophageal echocardiography revealed normal right ventricular function without an embolus and severe mitral regurgitation with preserved left ventricular function. Contrast-enhanced computed tomography after the operation revealed no pulmonary embolus but revealed a pulmonary effusion, and free triiodothyronine level was increased at the onset of dyspnea. Therefore, we diagnosed the causes of sudden onset of dyspnea as pulmonary edema and congestive heart failure induced by a thyroid storm. Sudden onset of a thyroid storm just before a cesarean section occurred in a patient with several risk factors of thyroid storm and pulmonary edema, including pregnancy, treatment with tocolytic agents, and infection. The involvement of these multiple factors was considered to be the cause of the sudden onset of the thyroid storm and the cause of rapidly progressive pulmonary edema.

The importance of antipersistence for traffic jams

NASA Astrophysics Data System (ADS)

Krause, Sebastian M.; Habel, Lars; Guhr, Thomas; Schreckenberg, Michael

2017-05-01

Universal characteristics of road networks and traffic patterns can help to forecast and control traffic congestion. The antipersistence of traffic flow time series has been found for many data sets, but its relevance for congestion has been overseen. Based on empirical data from motorways in Germany, we study how antipersistence of traffic flow time-series impacts the duration of traffic congestion on a wide range of time scales. We find a large number of short-lasting traffic jams, which implies a large risk for rear-end collisions.

Congestive cardiomyopathy and endobronchial granulomas as manifestations of Churg-Strauss syndrome.

PubMed Central

Alvarez-Sala, R.; Prados, C.; Armada, E.; Del Arco, A.; Villamor, J.

1995-01-01

Churg-Strauss syndrome is a systemic vasculitis. Its most frequent complications are heart diseases and asthma. Usually, cardiological manifestations are pericarditis, cardiac failure and myocardial infarction. Endobronchial granulomas identified by bronchoscopy are unusual. We present the case of a man with congestive cardiomyopathy and endobronchial granulomas macroscopically visible at bronchoscopy. After a review of medical literature, we found one case of congestive cardiomyopathy and no cases of endobronchial granulomas observed by bronchoscopy associated with Churg-Strauss syndrome. Images Figure PMID:7644400

Algorithm and data support of traffic congestion forecasting in the controlled transport

NASA Astrophysics Data System (ADS)

Dmitriev, S. V.

2015-06-01

The topicality of problem of the traffic congestion forecasting in the logistic systems of product movement highways is considered. The concepts: the controlled territory, the highway occupancy by vehicles, the parking and the controlled territory are introduced. Technical realizabilityof organizing the necessary flow of information on the state of the transport system for its regulation has been marked. Sequence of practical implementation of the solution is given. An algorithm for predicting traffic congestion in the controlled transport system is suggested.

Connected vehicle freeway speed harmonization systems.

DOT National Transportation Integrated Search

2016-03-15

The capacity drop phenomenon, which reduces the maximum bottleneck discharge rate following the onset of congestion, is a critical restriction in transportation networks that causes additional traffic congestion. Consequently, preventing or reducing ...

Speed harmonization

DOT National Transportation Integrated Search

2015-01-01

Speed harmonization is a method to reduce congestion and improve traffic performance. This method is applied at points where lanes merge and form bottlenecks, the greatest cause of congestion nationwide. The strategy involves gradually lowering speed...

Prognostic Significance of Creatinine Increases During an Acute Heart Failure Admission in Patients With and Without Residual Congestion: A Post Hoc Analysis of the PROTECT Data.

PubMed

Metra, Marco; Cotter, Gad; Senger, Stefanie; Edwards, Christopher; Cleland, John G; Ponikowski, Piotr; Cursack, Guillermo C; Milo, Olga; Teerlink, John R; Givertz, Michael M; O'Connor, Christopher M; Dittrich, Howard C; Bloomfield, Daniel M; Voors, Adriaan A; Davison, Beth A

2018-05-01

The importance of a serum creatinine increase, traditionally considered worsening renal function (WRF), during admission for acute heart failure has been recently debated, with data suggesting an interaction between congestion and creatinine changes. In post hoc analyses, we analyzed the association of WRF with length of hospital stay, 30-day death or cardiovascular/renal readmission and 90-day mortality in the PROTECT study (Placebo-Controlled Randomized Study of the Selective A1 Adenosine Receptor Antagonist Rolofylline for Patients Hospitalized With Acute Decompensated Heart Failure and Volume Overload to Assess Treatment Effect on Congestion and Renal Function). Daily creatinine changes from baseline were categorized as WRF (an increase of 0.3 mg/dL or more) or not. Daily congestion scores were computed by summing scores for orthopnea, edema, and jugular venous pressure. Of the 2033 total patients randomized, 1537 patients had both available at study day 14. Length of hospital stay was longer and 30-day cardiovascular/renal readmission or death more common in patients with WRF. However, these were driven by significant associations in patients with concomitant congestion at the time of assessment of renal function. The mean difference in length of hospital stay because of WRF was 3.51 (95% confidence interval, 1.29-5.73) more days ( P =0.0019), and the hazard ratio for WRF on 30-day death or heart failure hospitalization was 1.49 (95% confidence interval, 1.06-2.09) times higher ( P =0.0205), in significantly congested than nonsignificantly congested patients. A similar trend was observed with 90-day mortality although not statistically significant. In patients admitted for acute heart failure, WRF defined as a creatinine increase of ≥0.3 mg/dL was associated with longer length of hospital stay, and worse 30- and 90-day outcomes. However, effects were largely driven by patients who had residual congestion at the time of renal function assessment. URL: https://www.clinicaltrials.gov. Unique identifiers: NCT00328692 and NCT00354458. © 2018 American Heart Association, Inc.

Biomedical study on combined effects of simulated weightlessness and emergent depressurization of spacecraft

NASA Astrophysics Data System (ADS)

Yang, T. D.; Zhang, R. G.; Wang, C. M.; Fu, H. W.; Zhang, B. L.; Zhang, J. X.

1999-01-01

Cabin emergent depressurization (CED) may occur in spacecraft during manned space flight. The purpose of this paper was to study the combined effects of simulated weightlessness (SW) and CED factors on humans and animals. It was found that the amplitude of T wave of human electrocardiograms (ECG) significantly decreased in bed rest and hypoxia compared with the control condition (P<0.05), and that suspension with pure O2 induced severer edema in the lungs of rats than that in only a pure O2 environment. SW and pure O2 caused middle ear congestion and decreased the barofunction during pressure changes. These results indicate that human response to CED factors become more serious under SW because of the blood redistribution.

Monitoring the effect of football match congestion on hamstring strength and lower limb flexibility: Potential for secondary injury prevention?

PubMed

Wollin, Martin; Thorborg, Kristian; Pizzari, Tania

2018-01-01

To investigate the effect of competitive football match congestion on hamstring strength and lower limb flexibility. Repeated measures. Elite male youth football. Fifteen male elite youth football players from the national football association centre of excellence were included (age = 15.81 ±0.65 years, height = 171.95 ±6.89 cm, weight = 65.93 ±7.53 kg). Hamstring strength and pain, ankle dorsiflexion, hip extension, knee extension and flexion range of motion. Hamstring strength was highest at baseline and significantly reduced at 24 (p = 0.001, mean difference -0.19 Nm/Kg, CI 95  -0.28, -0.1) and 48 h post-match 1 (p = 0.002, mean difference -0.16 Nm/Kg, CI 95  -0.25, -0.07). Strength recovered by match day 2 before significantly reducing again 24 h post-match 2 (p = 0.012, mean difference -0.17 Nm/Kg, CI 95  -0.29, -0.04). Pain was lowest at baseline and increased in the post-match periods (p < 0.05) with standardised effect sizes ranging from 0.07 to 0.42. Passive knee flexion range decreased post-match (p < 0.01) with mean differences of 1.5°-2.7°. The other flexibility measures remained unaffected by match play. Isometric hamstring strength and pain can be considered for inclusion in-season to monitor player's post-match hamstring recovery characteristics during congested match fixtures. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

A New TCP Congestion Control Supporting RTT-Fairness

NASA Astrophysics Data System (ADS)

Ogura, Kazumine; Nemoto, Yohei; Su, Zhou; Katto, Jiro

This paper focuses on RTT-fairness of multiple TCP flows over the Internet, and proposes a new TCP congestion control named “HRF (Hybrid RTT-Fair)-TCP”. Today, it is a serious problem that the flows having smaller RTT utilize more bandwidth than others when multiple flows having different RTT values compete in the same network. This means that a user with longer RTT may not be able to obtain sufficient bandwidth by the current methods. This RTT fairness issue has been discussed in many TCP papers. An example is CR (Constant Rate) algorithm, which achieves RTT-fairness by multiplying the square of RTT value in its window increment phase against TCP-Reno. However, the method halves its windows size same as TCP-Reno when a packet loss is detected. This makes worse its efficiency in certain network cases. On the other hand, recent proposed TCP versions essentially require throughput efficiency and TCP-friendliness with TCP-Reno. Therefore, we try to keep these advantages in our TCP design in addition to RTT-fairness. In this paper, we make intuitive analytical models in which we separate resource utilization processes into two cases: utilization of bottleneck link capacity and that of buffer space at the bottleneck link router. These models take into account three characteristic algorithms (Reno, Constant Rate, Constant Increase) in window increment phase where a sender receives an acknowledgement successfully. Their validity is proved by both simulations and implementations. From these analyses, we propose HRF-TCP which switches two modes according to observed RTT values and achieves RTT fairness. Experiments are carried out to validate the proposed method. Finally, HRF-TCP outperforms conventional methods in RTT-fairness, efficiency and friendliness with TCP-Reno.

Factors associated with efficacy of an ibuprofen/pseudoephedrine combination drug in pharmacy customers with common cold symptoms.

PubMed

Klimek, Ludger; Schumacher, Helmut; Schütt, Tanja; Gräter, Heidemarie; Mueck, Tobias; Michel, Martin C

2017-02-01

The aim of this study was to explore factors affecting efficacy of treatment of common cold symptoms with an over-the-counter ibuprofen/pseudoephedrine combination product. Data from an anonymous survey among 1770 pharmacy customers purchasing the combination product for treatment of own common cold symptoms underwent post-hoc descriptive analysis. Scores of symptoms typically responsive to ibuprofen (headache, pharyngeal pain, joint pain and fever), typically responsive to pseudoephedrine (congested nose, congested sinus and runny nose), considered non-specific (sneezing, fatigue, dry cough, cough with expectoration) and comprising all 11 symptoms were analysed. Multiple regression analysis was applied to explore factors associated with greater reduction in symptom intensity or greater probability of experiencing a symptom reduction of at least 50%. After intake of first dose of medication, typically ibuprofen-sensitive, pseudoephedrine-responsive, non-specific and total symptoms were reduced by 60.0%, 46.3%, 45.4% and 52.8%, respectively. A symptom reduction of at least 50% was reported by 73.6%, 55.1%, 50.9% and 61.6% of participants, respectively. A high baseline score was associated with greater reductions in symptom scores but smaller probability of achieving an improvement of at least 50%. Across both multiple regression approaches, two tablets at first dosing were more effective than one and (except for ibuprofen-sensitive symptoms) starting treatment later than day 2 of the cold was generally less effective. Efficacy of an ibuprofen/pseudoephedrine combination in the treatment of common cold symptoms was dose-dependent and greatest when treatment started within the first 2 days after onset of symptoms. © 2016 The Authors. International Journal of Clinical Practice Published by John Wiley & Sons Ltd.

Clinical, double-blind, placebo-controlled study investigating the combination of acetylsalicylic acid and pseudoephedrine for the symptomatic treatment of nasal congestion associated with common cold.

PubMed

Loose, Irene; Winkel, Matthias

2004-01-01

It was the aim of this clinical study to demonstrate the efficacy of 1000 mg acetylsalicylic acid (ASA, CAS 50-78-2) in combination with 60 mg pseudoephedrine (PSE, CAS 90-82-4), compared with placebo, in the symptomatic treatment of nasal congestion associated with the common cold. A further aim was to demonstrate the efficacy of 500 mg ASA + 30 mg PSE and of 1000 mg paracetamol (CAS 103-90-2) + 60 mg PSE (active control) in the symptomatic treatment of nasal congestion. The study was designed as a randomized, two-center, double-blind, double-dummy, placebo-controlled, parallel-group, single-dose efficacy and safety trial over 6 h and was carried out in the USA. In total, at two centers, 643 patients who had a history and diagnosis of acute upper respiratory tract infection (URTI), were included; they showed symptoms such as nasal congestion, scratchy/sore throat, headache, generalized muscle ache, earache, runny nose, fever, sneezing etc. The investigational drugs ASA and PSE were both provided as granules in sachets and the granules were dissolved in water before administration; the combined preparation of paracetamol + PSE was administered as commercially available tablets encapsulated for blinding. For all preparations, matching placebos were provided. The primary efficacy variable was the area under the curve for differences from baseline on a nasal congestion scale in the first 2 h after treatment. To be eligible for the study, otherwise healthy volunteers were to present with nasal stuffiness of recent onset that reached a score of at least 6 on the 11-point scale for nasal congestion (0 = not stuffy, 10 = very stuffy). The primary analysis of the primary efficacy variable was calculated by analysis of variance including treatment group, severity (moderate/severe) and center as main strata. The analysis was performed using the intent-to-treat population. All active treatments proved to be statistically significantly superior to placebo with regard to the primary efficacy variable. Significant superiority of active treatment compared with placebo could also be demonstrated for an interval of up to 6 h after intake of the drug and for the relief of nasal congestion. The lower dose did not reveal significant different results compared with placebo for relief of nasal congestion in patients with a severe nasal congestion score at baseline. As well in patients with moderate nasal congestion score (NCS) at start of the study the difference from baseline in the NCS compared with placebo was not statistically significant. Thus a trend towards better efficacy in the higher dose could be assumed. No difference was found between 1000 mg ASA + 60 mg PSE and the active control. There were no differences between the two centers. The treatment proved to be safe and well tolerated, without relevant differences between the four treatment groups. Main adverse events were found to be related to the upper respiratory tract infection or were of gastrointestinal nature. In conclusion, the combination of ASA with PSE can be considered as an effective and safe remedial for the symptomatic treatment of the nasal congestion during URTI.

Can home care for homebound patients with chronic heart failure reduce hospitalizations and costs?

PubMed Central

Punchik, Boris; Komarov, Roman; Gavrikov, Dmitry; Semenov, Anna; Freud, Tamar; Kagan, Ella; Goldberg, Yury

2017-01-01

Background Congestive heart failure (CHF), a common problem in adults, is associated with multiple hospitalizations, high mortality rates and high costs. Purpose To evaluate whether home care for homebound patients with CHF reduces healthcare service utilization and overall costs. Methods A retrospective study of healthcare utilization among homebound patients who received home care for CHF from 2012–1015. The outcome measures were number of hospital admissions per month, total number of hospitalization days and days for CHF only, emergency room visits, and overall costs. A comparison was conducted between the 6-month period prior to entry into home care and the time in home care. Results Over the study period 196 patients were treated by home care for CHF with a mean age of 79.4±9.5 years. 113 (57.7%) were women. Compared to the six months prior to home care, there were statistically significant decreases in hospitalizations (46.3%), in the number of total in-hospital days (28.7%), in the number of in-hospital days for CHF (66.7%), in emergency room visits (47%), and in overall costs (23.9%). Conclusion Home care for homebound adults with CHF can reduce healthcare utilization and healthcare costs. PMID:28753675

Green tea catechins: defensive role in cardiovascular disorders.

PubMed

Bhardwaj, Pooja; Khanna, Deepa

2013-07-01

Green tea, Camellia sinensis (Theaceae), a major source of flavonoids such as catechins, has recently shown multiple cardiovascular health benefits through various experimental and clinical studies. These studies suggest that green tea catechins prevent the incidence of detrimental cardiovascular events, and also lower the cardiovascular mortality rate. Catechins present in green tea have the ability to prevent atherosclerosis, hypertension, endothelial dysfunction, ischemic heart diseases, cardiomyopathy, cardiac hypertrophy and congestive heart failure by decreasing oxidative stress, preventing inflammatory events, reducing platelet aggregation and halting the proliferation of vascular smooth muscle cells. Catechins afford an anti-oxidant effect by inducing anti-oxidant enzymes, inhibiting pro-oxidant enzymes and scavenging free radicals. Catechins present anti-inflammatory activity through the inhibition of transcriptional factor NF-κB-mediated production of cytokines and adhesion molecules. Green tea catechins interfere with vascular growth factors and thus inhibit vascular smooth muscle cell proliferation, and also inhibit thrombogenesis by suppressing platelet adhesion. Additionally, catechins could protect vascular endothelial cells and enhance vascular integrity and regulate blood pressure. In this review various experimental and clinical studies suggesting the role of green tea catechins against the markers of cardiovascular disorders and the underlying mechanisms for these actions are discussed. Copyright © 2013 China Pharmaceutical University. Published by Elsevier B.V. All rights reserved.

Influence of food kiosk attraction on the road’s level of service

NASA Astrophysics Data System (ADS)

Agustin, I. W.

2018-01-01

The main purpose of the research is to analyze the influence of food kiosk attraction on the road’s level service and to find a solution to decrease congestion at Mayjen Sungkono Road in Surabaya City. The development of commercial sector has profoundly contributed to the land use change into business and residential areas. There is an increase in the number of vehicles passing through Mayjen Sungkono Road per year based on the data from Department of Transportation in Surabaya. In 2014, the number of light vehicles (LV) passing through Mayjen Sungkono Road was as many as 131,620 units, heavy vehicles (HV) reached 248 units, while motorcycles (MC) recorded at 187,371 units. The research uses the road’s level of service analysis, multiple linear regression analysis, and do-something analysis. The results show that the influential variables comprise of the number of visitors (X32), parking area (X30), and building area (X29). The food kiosk attraction model is Yfood kiosk = 51.827+ 0.723(X32) + 5.859(X30) + 0.072(X29), and the result of attraction movement derived from food kiosk is 7,670.71 pcu/day. Widening the road can raise the average ofthe road’s level of service (LOS) at Mayjen Sungkono of formerly F value increased to D.

Green Urbanism for the Greener Future of Metropolitan Areas

NASA Astrophysics Data System (ADS)

Zaręba, Anna; Krzemińska, Alicja; Widawski, Krzysztof

2016-10-01

Intensive urbanization is swallowing municipal green areas which causes intensification of erosion, decrease in biodiversity and permanent fragmentation of habitats. In the face of these changes, a risk of irreversible damages to urban ecosystems is growing. That is why planning of solutions within the framework of Green Urbanism in metropolitan areas inhabited by over 55% of the global population is of extraordinary importance. The task of the paper is to present patterns of the Green Urbanism using selected examples of metropolitan areas as case studies. The main goal of the research is to make comparison between GU practices in different countries, in various spatial settings. The principles of triple zero framework: zero fossil-fuel energy use, zero waste, zero emissions (from low-to-no-carbon emissions) introduce not only the contemporary trends in theoretical urban planning but are dictated by practical considerations to create a healthy environment for a healthy society with a minimized environmental footprint. The research results help to identify Green Urbanism techniques used for multiple functions, including ecological, recreational, cultural, aesthetic and other uses and present opportunities for implementation of Green Urbanism solutions in metropolitan areas. To achieve healthier society and environment, highly congested and polluted cities have to be recreated through working with the existing landscape, topography and natural resources particular to the site.

Land use and traffic congestion.

DOT National Transportation Integrated Search

2012-03-01

"The study investigated the link between land use, travel behavior, and traffic congestion. Popular wisdom : suggests that higher-density development patterns may be beneficial in reducing private vehicle dependency : and use, which if true, could ho...

Guidelines for operating congested traffic signals.

DOT National Transportation Integrated Search

2010-08-01

The objective of this project was to develop guidelines for mitigating congestion in traffic signal systems. As : part of the project, researchers conducted a thorough review of literature and developed preliminary : guidelines for combating congesti...

I-55 integrated diversion traffic management benefit study.

DOT National Transportation Integrated Search

2014-11-01

Traffic congestion, recurrent and non-recurrent, creates significant economic losses and environmental impacts. : Integrated Corridor Management (ICM) is a U.S.DOT research initiative that has been proven to effectively relieve : recurrent congestion...

New entrant safety research

DOT National Transportation Integrated Search

1994-07-22

This study pursued five objectives. The first objective was the development of a study data base. Second, the study provided a general understanding of congestion. This understanding should include techniques for defining and measuring congestion as ...

Congestion information surveillance system

DOT National Transportation Integrated Search

1992-10-14

This document advances a proposal to implement a Congestion Information Surveillance System (CISS)for the Albuquerque metropolitan area. The CISS will offer agencies in the region responsible for transportation and air quality management a new capabi...

Modeling truck traffic volume growth congestion.

DOT National Transportation Integrated Search

2009-05-01

Modeling of the statewide transportation system is an important element in understanding issues and programming of funds to thwart potential congestion. As Alabama grows its manufacturing economy, the number of heavy vehicles traversing its highways ...

Measuring and improving performance in incident management.

DOT National Transportation Integrated Search

2010-03-01

Traffic incidents account for about 25 percent of traffic congestion and delay. Clearing incidents rapidly is crucial in : minimizing congestion, reducing secondary crashes and improving safety for both emergency responders and : travelers. Especiall...

Congestion Management System Process Report

DOT National Transportation Integrated Search

1996-03-01

In January 1995, the Indianapolis Metropolitan Planning Organization with the help of an interagency Study Review Committee began the process of developing a Congestion Management System (CMS) Plan resulting in this report. This report documents the ...

Developing a congestion mitigation toolbox.

DOT National Transportation Integrated Search

2011-09-30

Researchers created A Michigan Toolbox for Mitigating Traffic Congestion to be a useful desk reference for practitioners and an educational tool for elected officials acting through public policy boards to better understand the development, planning,...

Random early detection for congestion avoidance in wired networks: a discretized pursuit learning-automata-like solution.

PubMed

Misra, Sudip; Oommen, B John; Yanamandra, Sreekeerthy; Obaidat, Mohammad S

2010-02-01

In this paper, we present a learning-automata-like The reason why the mechanism is not a pure LA, but rather why it yet mimics one, will be clarified in the body of this paper. (LAL) mechanism for congestion avoidance in wired networks. Our algorithm, named as LAL Random Early Detection (LALRED), is founded on the principles of the operations of existing RED congestion-avoidance mechanisms, augmented with a LAL philosophy. The primary objective of LALRED is to optimize the value of the average size of the queue used for congestion avoidance and to consequently reduce the total loss of packets at the queue. We attempt to achieve this by stationing a LAL algorithm at the gateways and by discretizing the probabilities of the corresponding actions of the congestion-avoidance algorithm. At every time instant, the LAL scheme, in turn, chooses the action that possesses the maximal ratio between the number of times the chosen action is rewarded and the number of times that it has been chosen. In LALRED, we simultaneously increase the likelihood of the scheme converging to the action, which minimizes the number of packet drops at the gateway. Our approach helps to improve the performance of congestion avoidance by adaptively minimizing the queue-loss rate and the average queue size. Simulation results obtained using NS2 establish the improved performance of LALRED over the traditional RED methods which were chosen as the benchmarks for performance comparison purposes.

Case report: Unilateral conduction hearing loss due to central venous occlusion.

PubMed

Ribeiro, Phillip; Patel, Swetal; Qazi, Rizwan A

2016-05-07

Central venous stenosis is a well-known complication in patients with vascular access for hemodialysis. We report two cases involving patients on hemodialysis with arteriovenous fistulas who developed reversible unilateral conductive hearing loss secondary to critical stenosis of central veins draining the arteriovenous dialysis access. A proposed mechanism for the patients' reversible unilateral hearing loss is pterygoid venous plexus congestion leading to decreased Eustachian tube patency. Endovascular therapy was conducted to treat the stenosis and the hearing loss of both patients was returned to near normal after successful central venous angioplasty.

A longitudinal, collaborative, practice-based learning and improvement model to improve post-discharge heart failure outcomes.

PubMed

Anagnostou, Valsamo K; Bailey, Grant; Sze, Edward; Hay, Seonaid; Hyson, Anne; Federman, Daniel G

2014-01-01

Practice-based learning and improvement is one of the Accreditation Council of Graduate Medical Education's core competencies fortrainees. Residencyprograms have grappled with how to accomplish this goal. We describe our institution's unique, longitudinal post-graduate year process and project. West Haven, VA Medical Center. Yale University School of Medicine junior residents on ambulatory electives and faculty preceptor. Longitudinal program aimed to decrease re-admissions for hospitalized patients with congestive heart failure. We feel that our longitudinal project is a novel innovation worthy of further study.

Circadian body temperature variability is an indicator of poor prognosis in cardiomyopathic hamsters.

PubMed

Ahmed, Amany; Gondi, Sreedevi; Cox, Casey; Wang, Suwei; Stupin, Igor V; Shankar, K J; Munir, Shahzeb M; Sobash, Ed; Brewer, Alan; Ferguson, James J; Elayda, Macarthur A; Casscells, S Ward; Wilson, James M

2010-03-01

Low body temperature is an independent predictor of poor prognosis in patients with congestive heart failure. The cardiomyopathic hamster develops progressive biventricular dysfunction, resulting in heart failure death at 9 months to 1 year of life. Our goal was to use cardiomyopathic hamsters to examine the relationship between body temperature and heart failure decompensation and death. To this end, we implanted temperature and activity transducers with telemetry into the peritoneal space of 46 male Bio-TO-2 Syrian cardiomyopathic hamsters. Multiple techniques, including computing mean temperature, frequency domain analysis, and nonlinear analysis, were used to determine the most useful method for predicting poor prognosis. Data from 44 hamsters were included in our final analysis. We detected a decline in core body temperature in 98% of the hamsters 8+/-4 days before death (P < .001). We examined the dominant frequency of temperature variation (ie, the circadian rhythm) by using cosinor analysis, which revealed a significant decrease in the amplitude of the body temperature circadian rhythm 8 weeks before death (0.28 degrees C; 95% CI, 0.26-0.31) compared to baseline (0.36 degrees C; 95% CI, 0.34-0.39; P=.005). The decline in the circadian temperature variation preceded all other evidence of decompensation. We conclude that a decrease in the amplitude of the body temperature circadian rhythm precedes fatal decompensation in cardiomyopathic hamsters. Continuous temperature monitoring may be useful in predicting preclinical decompensation in patients with heart failure and in identifying opportunities for therapeutic intervention. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Containing air pollution and traffic congestion: Transport policy and the environment in Singapore

NASA Astrophysics Data System (ADS)

Chin, Anthony T. H.

Land transportation remains one of the main contributors of noise and air pollution in urban areas. This is in addition to traffic congestion and accidents which result in the loss of productive activity. While there is a close relationship between traffic volumes and levels of noise and air pollution, transport authorities often assume that solving traffic congestion would reduce noise and air pollutant levels. Tight control over automobile ownership and use in Singapore has contributed in improving traffic flows, travel speeds and air quality. The adoption of internationally accepted standards on automobile emissions and gasoline have been effective in reducing air pollution from motor vehicles. Demand management measures have largely focused on controlling the source of traffic congestion, i.e. private automobile ownership and its use especially within the Central Business District during the day. This paper reviews and analyzes the effectiveness of two measures which are instrumental in controlling congestion and automobile ownership, i.e. road pricing and the vehicle quota scheme (VQS). While these measures have been successful in achieving desired objectives, it has also led to the spreading of traffic externalities to other roads in the network, loss in consumer welfare and rent seeking by automobile traders.

Automated Flight Routing Using Stochastic Dynamic Programming

NASA Technical Reports Server (NTRS)

Ng, Hok K.; Morando, Alex; Grabbe, Shon

2010-01-01

Airspace capacity reduction due to convective weather impedes air traffic flows and causes traffic congestion. This study presents an algorithm that reroutes flights in the presence of winds, enroute convective weather, and congested airspace based on stochastic dynamic programming. A stochastic disturbance model incorporates into the reroute design process the capacity uncertainty. A trajectory-based airspace demand model is employed for calculating current and future airspace demand. The optimal routes minimize the total expected traveling time, weather incursion, and induced congestion costs. They are compared to weather-avoidance routes calculated using deterministic dynamic programming. The stochastic reroutes have smaller deviation probability than the deterministic counterpart when both reroutes have similar total flight distance. The stochastic rerouting algorithm takes into account all convective weather fields with all severity levels while the deterministic algorithm only accounts for convective weather systems exceeding a specified level of severity. When the stochastic reroutes are compared to the actual flight routes, they have similar total flight time, and both have about 1% of travel time crossing congested enroute sectors on average. The actual flight routes induce slightly less traffic congestion than the stochastic reroutes but intercept more severe convective weather.

Congestion control strategy on complex network with privilege traffic

NASA Astrophysics Data System (ADS)

Li, Shi-Bao; He, Ya; Liu, Jian-Hang; Zhang, Zhi-Gang; Huang, Jun-Wei

The congestion control of traffic is one of the most important studies in complex networks. In the previous congestion algorithms, all the network traffic is assumed to have the same priority, and the privilege of traffic is ignored. In this paper, a privilege and common traffic congestion control routing strategy (PCR) based on the different priority of traffic is proposed, which can be devised to cope with the different traffic congestion situations. We introduce the concept of privilege traffic in traffic dynamics for the first time and construct a new traffic model which taking into account requirements with different priorities. Besides, a new factor Ui is introduced by the theoretical derivation to characterize the interaction between different traffic routing selection, furthermore, Ui is related to the network throughput. Since the joint optimization among different kinds of traffic is accomplished by PCR, the maximum value of Ui can be significantly reduced and the network performance can be improved observably. The simulation results indicate that the network throughput with PCR has a better performance than the other strategies. Moreover, the network capacity is improved by 25% at least. Additionally, the network throughput is also influenced by privilege traffic number and traffic priority.

Understanding congestion in China's medical market: an incentive structure perspective.

PubMed

Sun, Zesheng; Wang, Shuhong; Barnes, Stephen R

2016-04-01

Congestion has become one of the most important factors leading to patient dissatisfaction and doctor-patient conflicts in the medical market of China. In this study, we explore the causes and effects of structural congestion in the Chinese medical market from an incentive structure perspective. Our analysis reveals that prior medical system reforms with price regulation in China have induced hospitals to establish incentives for capital-intensive investments, while ignoring human capital, and have driven medical staff and patients to higher-level hospitals, reinforcing an incentive structure in which congestion in higher-level hospitals and idle resources in lower-level hospitals coexist. The existing incentive structure has led to cost increases and degradation of human capital and specific factor effects. Recent reforms to reduce congestion in the Chinese medical market were not effective. Most of them had no impact on and did not involve the existing distorted incentive structure. Future reforms should consider rebalancing expectations for medical quality, free flow of human capital and price regulation reforms to rebuild a new incentive structure. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Impact of distracted driving on congestion.

DOT National Transportation Integrated Search

2011-03-01

Studies have documented a link between distracted driving and diminished safety; however, an association : between distracted driving and traffic congestion has not been investigated in depth. The present study : examined the behavior of teens and yo...

Innovative contracting methods and construction traffic congestion.

DOT National Transportation Integrated Search

2012-01-01

Increasing travel demand and lack of sufficient highway capacity are serious problems in most : major metropolitan areas in the United States. Large metropolitan cities have been experiencing : increased traffic congestion problems over the past seve...

Atlanta congestion reduction demonstration national evaluation plan.

DOT National Transportation Integrated Search

2011-04-01

This report provides an analytic framework for evaluating the Atlanta Congestion Reduction Demonstration (CRD) under the United States Department of Transportation (U.S. DOT) Urban Partnership Agreement (UPA) and CRD Programs. The Atlanta CRD project...

A Michigan toolbox for mitigating traffic congestion.

DOT National Transportation Integrated Search

2011-09-30

"Researchers created A Michigan Toolbox for Mitigating Traffic Congestion to be a useful desk reference : for practitioners and an educational tool for elected officials acting through public policy boards to better : understand the development, plan...

Improving intermodal connectivity in rural areas to enhance transportation efficiency : a case study.

DOT National Transportation Integrated Search

2011-05-01

Congested roadways in Texas metropolitan centers are important arteries for transporting : agricultural commodities into domestic and international markets. Truck transportation of these : commodities contributes to the observed congestion and del...

Congestion-based emergency vehicle preemption.

DOT National Transportation Integrated Search

2010-08-01

This research analyzed and evaluated a new strategy for preemption of emergency vehicles along a corridor, which is : route-based and adaptive to real-time traffic conditions. The method uses dynamic offsets which are adjusted using : congestion-leve...

Lessons learned from international experience in congestion pricing.

DOT National Transportation Integrated Search

2008-08-01

Large road pricing projects have been implemented in U.K., France, Norway, Sweden, : Germany, Switzerland, Singapore and Australia over the past three decades. Additionally, : congestion pricing has been analyzed and evaluated through numerous studie...

Implementing active traffic management strategies in the U.S.

DOT National Transportation Integrated Search

2010-10-01

Limited public funding for roadway expansion and improvement projects, coupled with continued growth in travel along congested urban freeway corridors, creates a pressing need for innovative congestion management approaches. Strategies to address con...

A new chest pain strategy in Thunder Bay.

PubMed

Mutrie, D

1999-04-01

Thunder Bay Regional Hospital (TBRH) developed a chest pain strategy (CPS) to support its emergency physicians in making the difficult clinical decisions required to properly evaluate and manage ED "chest pain" patients. This strategy was developed to ensure excellent patient care in a setting of diminished inpatient bed availability and increasing ED congestion. It focuses on rapid risk stratification, using history, electrocardiogram, physical examination and 3 new point-of-care cardiac markers: myoglobin, CK-MB mass, and cardiac troponin I. Following the introduction of the CPS in 1997, TBRH realized significant ($500 000/yr) institutional resource savings through a 60% decrease in the admission rate of non-myocardial infarction, non-unstable angina chest pain patients, a 30% decrease in ED chest pain evaluation time, and improved ED availability of monitored stretchers. The CPS has allowed TBRH to simultaneously decrease costs and improve patient care.

Highly survivable bed pressure mat remote patient monitoring system for mHealth.

PubMed

Joshi, Vilas; Holtzman, Megan; Arcelus, Amaya; Goubran, Rafik; Knoefel, Frank

2012-01-01

The high speed mobile networks like 4G and beyond are making a ubiquitous remote patient monitoring (RPM) system using multiple sensors and wireless sensor networks a realistic possibility. The high speed wireless RPM system will be an integral part of the mobile health (mHealth) paradigm reducing cost and providing better service to the patients. While the high speed wireless RPM system will allow clinicians to monitor various chronic and acute medical conditions, the reliability of such system will depend on the network Quality of Service (QoS). The RPM system needs to be resilient to temporary reduced network QoS. This paper presents a highly survivable bed pressure mat RPM system design using an adaptive information content management methodology for the monitored sensor data. The proposed design improves the resiliency of the RPM system under adverse network conditions like congestion and/or temporary loss of connectivity. It also shows how the proposed RPM system can reduce the information rate and correspondingly reduce the data transfer rate by a factor of 5.5 and 144 to address temporary network congestion. The RPM system data rate reduction results in a lower specificity and sensitivity for the features being monitored but increases the survivability of the system from 1 second to 2.4 minutes making it highly robust.

Road Environments: Impact of Metals on Human Health in Heavily Congested Cities of Poland

PubMed Central

Adamiec, Ewa

2017-01-01

Road dust as a by-product of exhaust and non-exhaust emissions can be a major cause of systemic oxidative stress and multiple disorders. Substantial amounts of road dust are repeatedly resuspended, in particular at traffic lights and junctions where more braking is involved, causing potential threat to pedestrians, especially children. In order to determine the degree of contamination in the heavily traffic-congested cities of Poland, a total of 148 samples of road dust (RD), sludge from storm drains (SL) and roadside soil (RS) were collected. Sixteen metals were analysed using inductively coupled plasma mass spectrometry (ICP-MS), inductively coupled plasma atomic emission spectroscopy (ICP-OES) and atomic absorption spectroscopy (AAS) in all samples. Chemical evaluation followed by Principal Component Analysis (PCA) revealed that road environments have been severely contaminated with traffic-related elements. Concentration of copper in all road-environment samples is even higher, exceeding even up to 15 times its average concentrations established for the surrounding soils. Non-carcinogenic health risk assessment revealed that the hazard index (HI) for children in all road-environment samples exceeds the safe level of 1. Therefore, greater attention should be paid to potential health risks caused by the ingestion of traffic-related particles during outdoor activities. PMID:28661464

Road Environments: Impact of Metals on Human Health in Heavily Congested Cities of Poland.

PubMed

Adamiec, Ewa

2017-06-29

Road dust as a by-product of exhaust and non-exhaust emissions can be a major cause of systemic oxidative stress and multiple disorders. Substantial amounts of road dust are repeatedly resuspended, in particular at traffic lights and junctions where more braking is involved, causing potential threat to pedestrians, especially children. In order to determine the degree of contamination in the heavily traffic-congested cities of Poland, a total of 148 samples of road dust (RD), sludge from storm drains (SL) and roadside soil (RS) were collected. Sixteen metals were analysed using inductively coupled plasma mass spectrometry (ICP-MS), inductively coupled plasma atomic emission spectroscopy (ICP-OES) and atomic absorption spectroscopy (AAS) in all samples. Chemical evaluation followed by Principal Component Analysis (PCA) revealed that road environments have been severely contaminated with traffic-related elements. Concentration of copper in all road-environment samples is even higher, exceeding even up to 15 times its average concentrations established for the surrounding soils. Non-carcinogenic health risk assessment revealed that the hazard index (HI) for children in all road-environment samples exceeds the safe level of 1. Therefore, greater attention should be paid to potential health risks caused by the ingestion of traffic-related particles during outdoor activities.

Variability in Light-Duty Gasoline Vehicle Emission Factors from Trip-Based Real-World Measurements.

PubMed

Liu, Bin; Frey, H Christopher

2015-10-20

Using data obtained with portable emissions measurements systems (PEMS) on multiple routes for 100 gasoline vehicles, including passenger cars (PCs), passenger trucks (PTs), and hybrid electric vehicles (HEVs), variability in tailpipe emission rates was evaluated. Tier 2 emission standards are shown to be effective in lowering NOx, CO, and HC emission rates. Although PTs are larger, heavier vehicles that consume more fuel and produce more CO2 emissions, they do not necessarily produce more emissions of regulated pollutants compared to PCs. HEVs have very low emission rates compared to tier 2 vehicles under real-world driving. Emission factors vary with cycle average speed and road type, reflecting the combined impact of traffic control and traffic congestion. Compared to the slowest average speed and most congested cycles, optimal emission rates could be 50% lower for CO2, as much as 70% lower for NOx, 40% lower for CO, and 50% lower for HC. There is very high correlation among vehicles when comparing driving cycles. This has implications for how many cycles are needed to conduct comparisons between vehicles, such as when comparing fuels or technologies. Concordance between empirical and predicted emission rates using the U.S. Environmental Protection Agency's MOVES model was also assessed.

Infrared Laser Spectroscopy of the n-PROPYL and i-PROPYL Radicals in Helium Droplets: Significant Bend-Stretch Coupling Revealed in the CH Stretch Region

NASA Astrophysics Data System (ADS)

Moradi, Christopher P.; Douberly, Gary E.; Tabor, Daniel P.; Sibert, Edwin

2016-06-01

The n-propyl and i-propyl radicals were generated in the gas phase via pyrolysis of n-butyl nitrite (CH3(CH2)3ONO) and i-butyl nitrite (CH3CH(CH3)CH2ONO) precursors, respectively. Nascent radicals were promptly solvated by a beam of He nanodroplets, and the infrared spectra of the radicals were recorded in the C-H stretching region. In addition to three vibrations of n-propyl previously measured in an Ar matrix, we observe many unreported bands between 2800 and 3150 wn, which we attribute to propyl radicals. The C-H stretching modes observed above 2960 wn for both radicals are in excellent agreement with anharmonic frequencies computed using VPT2. Between 2800 and 2960 wn, however, the spectra of n-propyl and i-propyl radicals become quite congested and difficult to assign due to the presence of multiple anharmonic resonances. Computations employing a local mode Hamiltonian reveal the origin of the spectral congestion to be strong coupling between the high frequency C-H stretching modes and the lower frequency bending/scissoring motions. The only significant local coupling is between stretches and bends on the same CH2/CH3 group.

The economics of time shared computing: Congestion, user costs and capacity

NASA Technical Reports Server (NTRS)

Agnew, C. E.

1982-01-01

Time shared systems permit the fixed costs of computing resources to be spread over large numbers of users. However, bottleneck results in the theory of closed queueing networks can be used to show that this economy of scale will be offset by the increased congestion that results as more users are added to the system. If one considers the total costs, including the congestion cost, there is an optimal number of users for a system which equals the saturation value usually used to define system capacity.

A new transport phenomenon in nanostructures: a mesoscopic analog of the Braess paradox encountered in road networks

PubMed Central

2012-01-01

The Braess paradox, known for traffic and other classical networks, lies in the fact that adding a new route to a congested network in an attempt to relieve congestion can degrade counterintuitively the overall network performance. Recently, we have extended the concept of the Braess paradox to semiconductor mesoscopic networks, whose transport properties are governed by quantum physics. In this paper, we demonstrate theoretically that, alike in classical systems, congestion plays a key role in the occurrence of a Braess paradox in mesoscopic networks. PMID:22913510

Ventilatory support in critically ill hematology patients with respiratory failure

PubMed Central

2012-01-01

Introduction Hematology patients admitted to the ICU frequently experience respiratory failure and require mechanical ventilation. Noninvasive mechanical ventilation (NIMV) may decrease the risk of intubation, but NIMV failure poses its own risks. Methods To establish the impact of ventilatory management and NIMV failure on outcome, data from a prospective, multicenter, observational study were analyzed. All hematology patients admitted to one of the 34 participating ICUs in a 17-month period were followed up. Data on demographics, diagnosis, severity, organ failure, and supportive therapies were recorded. A logistic regression analysis was done to evaluate the risk factors associated with death and NIVM failure. Results Of 450 patients, 300 required ventilatory support. A diagnosis of congestive heart failure and the initial use of NIMV significantly improved survival, whereas APACHE II score, allogeneic transplantation, and NIMV failure increased the risk of death. The risk factors associated with NIMV success were age, congestive heart failure, and bacteremia. Patients with NIMV failure experienced a more severe respiratory impairment than did those electively intubated. Conclusions NIMV improves the outcome of hematology patients with respiratory insufficiency, but NIMV failure may have the opposite effect. A careful selection of patients with rapidly reversible causes of respiratory failure may increase NIMV success. PMID:22827955

Analysis Of Inland Waterway Transport For Container Shipping: Cikarang To Port Of TanjungPriok

NASA Astrophysics Data System (ADS)

Achmadi, T.; Nur, H. I.; Rahmadhon, L. R.

2018-03-01

Industry's development which is in the center of Cikarang's industrial estate causes a considerable increase from 7% to 13% of container's flow from and to Port of Tanjung Priok per year. Therefore, those obstacles rise the number of traffic congestion and transport cost. This research aims to analyze the potential alternative of transportation in order to transport containers at the route of Tanjung Priok to Cikarang utilizing Inland Waterways Transport through Cikarang Bekasi Laut (CBL) river. This research will be conducted by comparing component of total logistic cost that emerging caused by container trucks and vessels. Self Propelled Container Barge (SPCB) is a pointed alternative transportation in which it is used to transport containers through the waterways. The result of analysis obtained that the capacity of Cikarang Bekasi Laut river is 18,558 roundtrip per year. Furthermore, the collaboration of 3 SPCB operations, as well payload 32 TEUS can decrease the amount of road traffic congestion/density of Cikarang-Port of Tanjung Priok as much as 18.6%. The cost of containers shipping per unit transported by truck is IDR 2.2 Million per TEUs, whereas containers shipping transported by Inland Waterways cost only IDR 1.8 Million per TEUs.

Smoking, environmental tobacco smoke and occupational irritants increase the risk of chronic rhinitis.

PubMed

Hisinger-Mölkänen, Hanna; Piirilä, Päivi; Haahtela, Tari; Sovijärvi, Anssi; Pallasaho, Paula

2018-01-01

Allergic and non-allergic rhinitis cause a lot of symptoms in everyday life. To decrease the burden more information of the preventable risk factors is needed. We assessed prevalence and risk factors for chronic nasal symptoms, exploring the effects of smoking, environmental tobacco smoke, exposure to occupational irritants, and their combinations. In 2016, a postal survey was conducted among a random population sample of 8000 adults in Helsinki, Finland with a 50.5% response rate. Smoking was associated with a significant increase in occurrence of chronic rhinitis (longstanding nasal congestion or runny nose), but not with self-reported or physician diagnosed allergic rhinitis. The highest prevalence estimates of nasal symptoms, 55.1% for chronic rhinitis, 49.1% for nasal congestion, and 40.7% for runny nose, were found among smokers with occupational exposure to gases, fumes or dusts.Besides active smoking, also exposure to environmental tobacco smoke combined with occupational exposure increased the risk of nasal symptoms. Smoking, environmental tobacco smoke, and occupational irritants are significant risk factors for nasal symptoms with an additive pattern. The findings suggest that these factors should be systematically inquired in patients with nasal symptoms for appropriate preventive measures. (192 words).

On the impact of fiber-delay-lines (FDL) in an all-optical network (AON) bottleneck without wavelength conversion

NASA Astrophysics Data System (ADS)

Argibay-Losada, Pablo Jesus; Sahin, Gokhan

2014-08-01

Random access memories (RAM) are fundamental in conventional electronic switches and routers to manage short-term congestion and to decrease data loss probabilities. Switches in all-optical networks (AONs), however, do not have access to optical RAM, and therefore are prone to much higher loss levels than their electronic counterparts. Fiber-delay-lines (FDLs), able to delay an optical data packet a fixed amount of time, have been proposed in the literature as a means to alleviate those high loss levels. However, they are extremely bulky to manage, so their usage introduces a trade-off between practicality and performance in the design and operation of the AON. In this paper we study the influence that FDLs have in the performance of flows crossing an all-optical switch that acts as their bottleneck. We show how extremely low numbers of FDLs (e.g., 1 or 2) can help in reducing losses by several orders of magnitude in several illustrative scenarios with high aggregation levels. Our results therefore suggest that FDLs can be a practical means of dealing with congestion in AONs in the absence of optical RAM buffers or of suitable data interchange protocols specifically designed for AONs.

Optimization of BEV Charging Strategy

NASA Astrophysics Data System (ADS)

Ji, Wei

This paper presents different approaches to optimize fast charging and workplace charging strategy of battery electric vehicle (BEV) drivers. For the fast charging analysis, a rule-based model was built to simulate BEV charging behavior. Monte Carlo analysis was performed to explore to the potential range of congestion at fast charging stations which could be more than four hours at the most crowded stations. Genetic algorithm was performed to explore the theoretical minimum waiting time at fast charging stations, and it can decrease the waiting time at the most crowded stations to be shorter than one hour. A deterministic approach was proposed as a feasible suggestion that people should consider to take fast charging when the state of charge is approaching 40 miles. This suggestion is hoped to help to minimize potential congestion at fast charging stations. For the workplace charging analysis, scenario analysis was performed to simulate temporal distribution of charging demand under different workplace charging strategies. It was found that if BEV drivers charge as much as possible and as late as possible at workplace, it could increase the utility of solar-generated electricity while relieve grid stress of extra intensive electricity demand at night caused by charging electric vehicles at home.

Minoxidil accelerates heart failure development in rats with ascending aortic constriction.

PubMed

Turcani, M; Jacob, R

1998-06-01

To test the ability of the heart to express characteristic geometric features of concentric and eccentric hypertrophy concurrently, constriction of the ascending aorta was performed in 4-week-old rats. Simultaneously, these rats were treated with an arteriolar dilator minoxidil. An examination 6 weeks after induction of the hemodynamic overload revealed no signs of congestion in systemic or pulmonary circulation in rats with aortic constriction or minoxidil-treated sham-operated rats. The magnitude of hemodynamic overload caused by aortic constriction or minoxidil treatment could be considered as equivalent, because the same enlargement of left ventricular pressure-volume area was necessary to compensate for either pressure or volume overload. Myocardial contractility decreased in rats with aortic constriction, and the compensation was achieved wholly by the marked concentric hypertrophy. Volume overload in minoxidil-treated rats was compensated partially by the eccentric hypertrophy and partially by the increased myocardial contractility. In contrast, increased lung weight and pleural effusion were found in all minoxidil-treated rats with aortic constriction. Unfavorable changes in left ventricular mass and geometry, relatively high chamber stiffness, and depressed ventricular and myocardial function were responsible for the massive pulmonary congestion.

Relief and Recurrence of Congestion During and After Hospitalization for Acute Heart Failure: Insights From Diuretic Optimization Strategy Evaluation in Acute Decompensated Heart Failure (DOSE-AHF) and Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARESS-HF).

PubMed

Lala, Anuradha; McNulty, Steven E; Mentz, Robert J; Dunlay, Shannon M; Vader, Justin M; AbouEzzeddine, Omar F; DeVore, Adam D; Khazanie, Prateeti; Redfield, Margaret M; Goldsmith, Steven R; Bart, Bradley A; Anstrom, Kevin J; Felker, G Michael; Hernandez, Adrian F; Stevenson, Lynne W

2015-07-01

Congestion is the most frequent cause for hospitalization in acute decompensated heart failure. Although decongestion is a major goal of acute therapy, it is unclear how the clinical components of congestion (eg, peripheral edema, orthopnea) contribute to outcomes after discharge or how well decongestion is maintained. A post hoc analysis was performed of 496 patients enrolled in the Diuretic Optimization Strategy Evaluation in Acute Decompensated Heart Failure (DOSE-AHF) and Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARRESS-HF) trials during hospitalization with acute decompensated heart failure and clinical congestion. A simple orthodema congestion score was generated based on symptoms of orthopnea (≥2 pillows=2 points, <2 pillows=0 points) and peripheral edema (trace=0 points, moderate=1 point, severe=2 points) at baseline, discharge, and 60-day follow-up. Orthodema scores were classified as absent (score of 0), low-grade (score of 1-2), and high-grade (score of 3-4), and the association with death, rehospitalization, or unscheduled medical visits through 60 days was assessed. At baseline, 65% of patients had high-grade orthodema and 35% had low-grade orthodema. At discharge, 52% patients were free from orthodema at discharge (score=0) and these patients had lower 60-day rates of death, rehospitalization, or unscheduled visits (50%) compared with those with low-grade or high-grade orthodema (52% and 68%, respectively; P=0.038). Of the patients without orthodema at discharge, 27% relapsed to low-grade orthodema and 38% to high-grade orthodema at 60-day follow-up. Increased severity of congestion by a simple orthodema assessment is associated with increased morbidity and mortality. Despite intent to relieve congestion, current therapy often fails to relieve orthodema during hospitalization or to prevent recurrence after discharge. URL: http://www.clinicaltrials.gov. Unique identifiers: NCT00608491, NCT00577135. © 2015 American Heart Association, Inc.

Improving traffic flow at a 2-to-1 lane reduction with wirelessly connected, adaptive cruise control vehicles

NASA Astrophysics Data System (ADS)

Davis, L. C.

2016-06-01

Wirelessly connected vehicles that exchange information about traffic conditions can reduce delays caused by congestion. At a 2-to-1 lane reduction, the improvement in flow past a bottleneck due to traffic with a random mixture of 40% connected vehicles is found to be 52%. Control is based on connected-vehicle-reported velocities near the bottleneck. In response to indications of congestion the connected vehicles, which are also adaptive cruise control vehicles, reduce their speed in slowdown regions. Early lane changes of manually driven vehicles from the terminated lane to the continuous lane are induced by the slowing connected vehicles. Self-organized congestion at the bottleneck is thus delayed or eliminated, depending upon the incoming flow magnitude. For the large majority of vehicles, travel times past the bottleneck are substantially reduced. Control is responsible for delaying the onset of congestion as the incoming flow increases. Adaptive cruise control increases the flow out of the congested state at the bottleneck. The nature of the congested state, when it occurs, appears to be similar under a variety of conditions. Typically 80-100 vehicles are approximately equally distributed between the lanes in the 500 m region prior to the end of the terminated lane. Without the adaptive cruise control capability, connected vehicles can delay the onset of congestion but do not increase the asymptotic flow past the bottleneck. Calculations are done using the Kerner-Klenov three-phase theory, stochastic discrete-time model for manual vehicles. The dynamics of the connected vehicles is given by a conventional adaptive cruise control algorithm plus commanded deceleration. Because time in the model for manual vehicles is discrete (one-second intervals), it is assumed that the acceleration of any vehicle immediately in front of a connected vehicle is constant during the time interval, thereby preserving the computational simplicity and speed of a discrete-time model.

In Vivo Evaluation of Active and Passive Physiological Control Systems for Rotary Left and Right Ventricular Assist Devices.

PubMed

Gregory, Shaun D; Stevens, Michael C; Pauls, Jo P; Schummy, Emma; Diab, Sara; Thomson, Bruce; Anderson, Ben; Tansley, Geoff; Salamonsen, Robert; Fraser, John F; Timms, Daniel

2016-09-01

Preventing ventricular suction and venous congestion through balancing flow rates and circulatory volumes with dual rotary ventricular assist devices (VADs) configured for biventricular support is clinically challenging due to their low preload and high afterload sensitivities relative to the natural heart. This study presents the in vivo evaluation of several physiological control systems, which aim to prevent ventricular suction and venous congestion. The control systems included a sensor-based, master/slave (MS) controller that altered left and right VAD speed based on pressure and flow; a sensor-less compliant inflow cannula (IC), which altered inlet resistance and, therefore, pump flow based on preload; a sensor-less compliant outflow cannula (OC) on the right VAD, which altered outlet resistance and thus pump flow based on afterload; and a combined controller, which incorporated the MS controller, compliant IC, and compliant OC. Each control system was evaluated in vivo under step increases in systemic (SVR ∼1400-2400 dyne/s/cm(5) ) and pulmonary (PVR ∼200-1000 dyne/s/cm(5) ) vascular resistances in four sheep supported by dual rotary VADs in a biventricular assist configuration. Constant speed support was also evaluated for comparison and resulted in suction events during all resistance increases and pulmonary congestion during SVR increases. The MS controller reduced suction events and prevented congestion through an initial sharp reduction in pump flow followed by a gradual return to baseline (5.0 L/min). The compliant IC prevented suction events; however, reduced pump flows and pulmonary congestion were noted during the SVR increase. The compliant OC maintained pump flow close to baseline (5.0 L/min) and prevented suction and congestion during PVR increases. The combined controller responded similarly to the MS controller to prevent suction and congestion events in all cases while providing a backup system in the event of single controller failure. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Characterizing the tradeoffs and costs associated with transportation congestion in supply chains.

DOT National Transportation Integrated Search

2010-01-21

We consider distribution and location-planning models for supply chains that explicitly : account for traffic congestion effects. The majority of facility location and transportation : planning models in the operations research literature consider fa...

Department of Transportation's intelligent transportation systems (ITS) projects book

DOT National Transportation Integrated Search

2001-01-01

Surface transportation systems in the United States today face a number of significant challenges. Congestion and safety continue to present serious problems in spite of the nations superb roadway systems. Congestion imposes an exorbitant cost on ...

Department of Transportation's intelligent transportation systems (ITS) projects book

DOT National Transportation Integrated Search

2002-01-01

Surface transportation systems in the United States today face a number of significant challenges. Congestion and safety continue to present serious problems in spite of the nations superb roadway systems. Congestion imposes an exorbitant cost on ...

Investigation of freeway operations in metro Detroit.

DOT National Transportation Integrated Search

2011-10-01

Traffic incidents are the primary cause of non-recurrent congestion in urban areas, resulting in : reductions in roadway capacity due to crashes, vehicle breakdowns, and other events. In addition to : contributing to congestion and delay, incidents c...

Congestion management system/IVHS program study Birmingham, Alabama : phase 1, report

DOT National Transportation Integrated Search

1995-04-01

The Inter-modal Surface Transportation Efficiency Act of 1991 (ISTEA) required states and : metropolitan areas designated as transportation management areas develop congestion : management systems. The Birmingham Planning Area is designated as a non-...

Congestion Management System/IVHS Program Study for Birmingham, Alabama. Phase 1 Report

DOT National Transportation Integrated Search

1995-04-01

The Inter-modal Surface Transportation Efficiency Act of 1991 (ISTEA) required states and : metropolitan areas designated as transportation management areas develop congestion : management systems. The Birmingham Planning Area is designated as a non-...

Real-timing the 2010 urban mobility report.

DOT National Transportation Integrated Search

2011-02-01

The Texas Transportation Institute is a national leader in providing congestion and mobility : information. The Urban Mobility Report (UMR) is the most widely quoted report on urban : congestion and its associated costs in the nation. The report meas...

Economics : pricing, demand, and economic efficiency : a primer.

DOT National Transportation Integrated Search

2008-11-01

The Congestion Pricing Primer Series is part of : FHWAs outreach efforts to introduce the various : aspects of congestion pricing to decision-makers and : transportation professionals in the United States. The : primers are intended to lay out the...

Refining the real-timed urban mobility report.

DOT National Transportation Integrated Search

2012-03-01

The Texas Transportation Institute (TTI) is considered a national leader in providing congestion and : mobility information. The Urban Mobility Report (UMR) is the most widely quoted report on urban : congestion and the associated costs in the nation...

Delaware Valley Regional Planning Commission Philadelphia Metropolitan Region : planning for congestion

DOT National Transportation Integrated Search

2009-04-01

The Delaware Valley Regional Planning Commission uses a systematic process for managing traffic congestion and monitoring transportation system performance in the Philadelphia metropolitan region. Guided by an advisory team of stakeholders, the agenc...

Interactive transportation information stations

DOT National Transportation Integrated Search

1997-12-01

Dade County (Florida) experiences severe congestion on its roadways, and has been classified as the fourth most congested urban area in the United States. Due to scarcity of funding to build new highways and widen the existing roadways to meet demand...

Urban Partnership Agreement and Congestion Reduction Demonstration : National Evaluation Framework

DOT National Transportation Integrated Search

2008-11-21

This report provides an analytical framework for evaluating six deployments under the United States Department of Transportation (U.S. DOT) Urban Partnership Agreement (UPA) and Congestion Reduction Demonstration (CRD) Programs. The six UPA/CRD sites...

Reducing congestion and funding transportation using road pricing in Europe and Singapore

DOT National Transportation Integrated Search

2010-12-01

Congestion pricing use has been limited in the United States because of political, institutional, and public acceptance concerns. The Federal Highway Administration, American Association of State Highway and Transportation Officials, and National Coo...

Traffic control strategies for congested freeways and work zones.

DOT National Transportation Integrated Search

2008-10-01

The primary objective of the research was to identify and evaluate effective ways of improving traffic operations and : safety on congested freeways. There was particular interest in finding condition-responsive traffic control solutions : for the fo...

Minnesota : innovative choices for congestion relief.

DOT National Transportation Integrated Search

2011-01-01

Minnesota UPA projects focus on reducing traffic congestion in the I-35W corridor and in downtown Minneapolis. ITS technologies underlie many of the Minnesota UPA projects, including those centered on tolling, real-time traffic and transit informatio...

Share the road campaign research study : final report

DOT National Transportation Integrated Search

2012-07-01

This report presents the Environmental Data Test Plan for the national evaluation of the Los Angeles (LA) Congestion Reduction Demonstration (Metro ExpressLanes) under the United States Department of Transportation (U.S. DOT) Congestion Reduction Dem...

The Influence of Individual Driver Characteristics on Congestion Formation

NASA Astrophysics Data System (ADS)

Wang, Lanjun; Zhang, Hao; Meng, Huadong; Wang, Xiqin

Previous works have pointed out that one of the reasons for the formation of traffic congestion is instability in traffic flow. In this study, we investigate theoretically how the characteristics of individual drivers influence the instability of traffic flow. The discussions are based on the optimal velocity model, which has three parameters related to individual driver characteristics. We specify the mappings between the model parameters and driver characteristics in this study. With linear stability analysis, we obtain a condition for when instability occurs and a constraint about how the model parameters influence the unstable traffic flow. Meanwhile, we also determine how the region of unstable flow densities depends on these parameters. Additionally, the Langevin approach theoretically validates that under the constraint, the macroscopic characteristics of the unstable traffic flow becomes a mixture of free flows and congestions. All of these results imply that both overly aggressive and overly conservative drivers are capable of triggering traffic congestion.

Extracorporeal Ultrafiltration for Fluid Overload in Heart Failure

PubMed Central

Costanzo, Maria Rosa; Ronco, Claudio; Abraham, William T.; Agostoni, Piergiuseppe; Barasch, Jonathan; Fonarow, Gregg C.; Gottlieb, Stephen S.; Jaski, Brian E.; Kazory, Amir; Levin, Allison P.; Levin, Howard R.; Marenzi, Giancarlo; Mullens, Wilfried; Negoianu, Dan; Redfield, Margaret M.; Tang, W.H. Wilson; Testani, Jeffrey M.; Voors, Adriaan A.

2017-01-01

More than 1 million heart failure hospitalizations occur annually, and congestion is the predominant cause. Rehospitalizations for recurrent congestion portend poor outcomes independently of age and renal function. Persistent congestion trumps serum creatinine increases in predicting adverse heart failure outcomes. No decongestive pharmacological therapy has reduced these harmful consequences. Simplified ultrafiltration devices permit fluid removal in lower-acuity hospital settings, but with conflicting results regarding safety and efficacy. Ultrafiltration performed at fixed rates after onset of therapy-induced increased serum creatinine was not superior to standard care and resulted in more complications. In contrast, compared with diuretic agents, some data suggest that adjustment of ultrafiltration rates to patients’ vital signs and renal function may be associated with more effective decongestion and fewer heart failure events. Essential aspects of ultrafiltration remain poorly defined. Further research is urgently needed, given the burden of congestion and data suggesting sustained benefits of early and adjustable ultrafiltration. PMID:28494980

Launching automated rotary parking system: Towards traffic congestion free Dhaka city

NASA Astrophysics Data System (ADS)

Islam, Mohummad Shariful; Tithi, Afshana Morshed; Hossain, Farzad; Shetu, Rifat Sultana; Amin, S. M. Abdullah Al; Chowdhury, Shakia Zannatul Ferdous

2017-12-01

Bangladesh is the most densely populated city in the whole world, which is visible more in the capital city Dhaka. People have to suffer and valuable times are being wasted for this chronic quandary. Lack of proper planning of the city, different speed vehicles on the same road, over population, inadequate road space, unplanned stoppage or parking etc. are responsible for causing the traffic congestion in Dhaka City. Among those insufficient/unplanned parking system is one of the main reasons for causing traffic congestion. The automated rotary car parking system is the best and suitable because of its less utilization of space compared to other systems. It is a friendly parking system due to the non-utilization of noise/pollution related mechanism. The aim of this paper is to develop an automated car parking system with a minimum cost for reducing congestion in Dhaka city.

Surveying traffic congestion based on the concept of community structure of complex networks

NASA Astrophysics Data System (ADS)

Ma, Lili; Zhang, Zhanli; Li, Meng

2016-07-01

In this paper, taking the traffic of Beijing city as an instance, we study city traffic states, especially traffic congestion, based on the concept of network community structure. Concretely, using the floating car data (FCD) information of vehicles gained from the intelligent transport system (ITS) of the city, we construct a new traffic network model which is with floating cars as network nodes and time-varying. It shows that this traffic network has Gaussian degree distributions at different time points. Furthermore, compared with free traffic situations, our simulations show that the traffic network generally has more obvious community structures with larger values of network fitness for congested traffic situations, and through the GPSspg web page, we show that all of our results are consistent with the reality. Then, it indicates that network community structure should be an available way for investigating city traffic congestion problems.

Reducing Traffic Congestions by Introducing CACC-Vehicles on a Multi-Lane Highway Using Agent-Based Approach

NASA Technical Reports Server (NTRS)

Arnaout, Georges M.; Bowling, Shannon R.

2011-01-01

Traffic congestion is an ongoing problem of great interest to researchers from different areas in academia. With the emerging technology for inter-vehicle communication, vehicles have the ability to exchange information with predecessors by wireless communication. In this paper, we present an agent-based model of traffic congestion and examine the impact of having CACC (Cooperative Adaptive Cruise Control) embedded vehicle(s) on a highway system consisting of 4 traffic lanes without overtaking. In our model, CACC vehicles adapt their acceleration/deceleration according to vehicle-to-vehicle inter-communication. We analyze the average speed of the cars, the shockwaves, and the evolution of traffic congestion throughout the lifecycle of the model. The study identifies how CACC vehicles affect the dynamics of traffic flow on a complex network and reduce the oscillatory behavior (stop and go) resulting from the acceleration/deceleration of the vehicles.

Fixed-rate layered multicast congestion control

NASA Astrophysics Data System (ADS)

Bing, Zhang; Bing, Yuan; Zengji, Liu

2006-10-01

A new fixed-rate layered multicast congestion control algorithm called FLMCC is proposed. The sender of a multicast session transmits data packets at a fixed rate on each layer, while receivers each obtain different throughput by cumulatively subscribing to deferent number of layers based on their expected rates. In order to provide TCP-friendliness and estimate the expected rate accurately, a window-based mechanism implemented at receivers is presented. To achieve this, each receiver maintains a congestion window, adjusts it based on the GAIMD algorithm, and from the congestion window an expected rate is calculated. To measure RTT, a new method is presented which combines an accurate measurement with a rough estimation. A feedback suppression based on a random timer mechanism is given to avoid feedback implosion in the accurate measurement. The protocol is simple in its implementation. Simulations indicate that FLMCC shows good TCP-friendliness, responsiveness as well as intra-protocol fairness, and provides high link utilization.

Preliminary studies on nasal decongestant activity from the seed of the shea butter tree, Butyrospermum parkii.

PubMed

Tella, A

1979-05-01

1 The seed of Butyrospermum parkii yields shea butter which according to local traditional healers relieves inflammation of the nostrils. 2 Since there is as yet no absolutely satisfactory nasal decongestant in clinical use, it was decided to investigate the effects of shea butter in nasal congestion. The substance was prepared in the laboratory. 3 The human subjects used were those suffering from rhinitis with moderate to severe nasal congestion. They were divided into the test group which received shea butter, the control group which was treated with xylometazoline and the 'placebo' group which received white petroleum jelly B.P. 4 The results showed that nasal congestion was relieved more satisfactorily in the test group than in the other two groups. 5 It is concluded that shea butter may prove more efficacious in nasal congestion than conventional nasal drops.

Preliminary studies on nasal decongestant activity from the seed of the shea butter tree, Butyrospermum parkii.

PubMed Central

Tella, A

1979-01-01

1 The seed of Butyrospermum parkii yields shea butter which according to local traditional healers relieves inflammation of the nostrils. 2 Since there is as yet no absolutely satisfactory nasal decongestant in clinical use, it was decided to investigate the effects of shea butter in nasal congestion. The substance was prepared in the laboratory. 3 The human subjects used were those suffering from rhinitis with moderate to severe nasal congestion. They were divided into the test group which received shea butter, the control group which was treated with xylometazoline and the 'placebo' group which received white petroleum jelly B.P. 4 The results showed that nasal congestion was relieved more satisfactorily in the test group than in the other two groups. 5 It is concluded that shea butter may prove more efficacious in nasal congestion than conventional nasal drops. PMID:89854

Influence of TCSC Devices on Congestion Management in a Deregulated Power System Using Evolutionary Programming Technique

NASA Astrophysics Data System (ADS)

Ananthichristy, A., Dr.; Elanthirayan, R.; Brindha, R., Dr.; Siddhiq, M. S.; Venkatesh, N.; Harshit, M. V.; Nikhilreddy, M.

2018-04-01

Congestion management is one of the technical challenges in power system deregulation. In deregulated electricity market it may always not be possible to dispatch all of the contracted power transactions due to congestion of the transmission corridors. Transmission congestion occurs when there is insufficient transmission capacity to simultaneously accommodate all constraints for transmission of a line. Flexible Alternative Current Transmission System (FACTS) devices can be an alternative to reduce the flows in the heavily loaded lines, resulting in an increased loadability, low system loss, improved stability of the network, reduced cost of production and fulfilled contractual requirement by controlling the power flow in the network. A method to determine the optimal location of FACTS has been suggested based on reduction of total system VAR power losses. The simulation was done on IEEE 14 bus system and results were obtained.

Role of interventional procedures in obstetrics/gynecology.

PubMed

Lopera, Jorge; Suri, Rajeev; Kroma, Ghazwan M; Garza-Berlanga, Andres; Thomas, John

2013-11-01

In uterine fibroid embolization (UFE), knowledge of the potential ovarian-uterine anastomoses is important because they provide collateral blood flow that may result in the failure of the UFE or ovarian nontarget embolization. Uterine artery embolization is an alternative treatment of postpartum hemorrhage with 80% to 90% bleeding control and in which fertility can be preserved. Diagnosis of pelvic congestion syndrome on routine sonographic or computed tomography/magnetic resonance imaging is often missed. Fallopian tube recanalization allows couples to have unlimited attempts to conceive naturally and avoids the risks (multiple pregnancies, ovarian hyperstimulation syndrome), and high cost of in vitro fertilization. Copyright © 2013 Elsevier Inc. All rights reserved.

Telehealth Protocol to Prevent Readmission Among High-Risk Patients With Congestive Heart Failure.

PubMed

Rosen, Daniel; McCall, Janice D; Primack, Brian A

2017-11-01

Congestive heart failure is the leading cause of hospital readmissions. We aimed to assess adherence to and effectiveness of a telehealth protocol designed to prevent hospital admissions for congestive heart failure. We recruited a random sample of 50 patients with congestive heart failure (mean age 61 years) from a managed care organization. We developed a telehealth platform allowing for daily, real-time reporting of health status and video conferencing. We defined adherence as the percentage of days on which the patient completed the daily check-in protocol. To assess efficacy, we compared admission and readmission rates between the 6-month intervention period and the prior 6 months. Primary outcomes were admissions and readmissions due to congestive heart failure, and secondary outcomes were admissions and readmissions due to any cause. Forty-eight patients (96%) completed the protocol. Approximately half (46%) were at high risk for readmission according to standardized measures. Median 120-day adherence was 96% (interquartile range, 92%-98%), and adherence did not significantly differ across sex, race, age, living situation, depression, cognitive ability, or risk for readmission. Approximately equal proportions of patients were admitted for all causes during the 6-month intervention period versus the comparison period (37% vs 43%; P = .32). Half as many patients were admitted for congestive heart failure during the 6-month intervention period compared with the comparison period (12% vs 25%; P = .11). Adherence to this telehealth protocol was excellent and consistent, even among high-risk patients. Future research should test the protocol using a more rigorous randomized design. Copyright © 2017 Elsevier Inc. All rights reserved.

Heterogeneity Index for the Assessment of Relationship Between Land Use Pattern and Road Traffic Congestion in Apapa-Oworoshoki Express way, Lagos Metropolis

NASA Astrophysics Data System (ADS)

Alaigba, D. B.; Soumah, M.; Banjo, M. O.

2017-05-01

The problem of urban mobility is complicated by traffic delay, resulting from poor planning, high population density and poor condition of roads within urban spaces. This study assessed traffic congestion resulting from differential contribution made by various land-uses along Apapa-Oworoshoki expressway in Lagos metropolis. The data for this study was from both primary and secondary sources; GPS point data was collected at selected points for traffic volume count; observation of the nature of vehicular traffic congestion, and land use types along the corridor. Existing data on traffic count along the corridor, connectivity map and land use map sourced from relevant authorities were acquired. Traffic congestion within the area was estimated using volume capacity ratio (V/C). Heterogeneity Index was developed and used to quantify the percentage contribution to traffic volume from various land-use categories. Analytical Hierarchical Processing (AHP) and knowledge-based weighting were used to rank the importance of different heterogeneity indices. Results showed significant relationship between the degree of heterogeneity of the land use pattern and road traffic congestion. Volume Capacity Ratio computed revealed that the route corridor exceeds its designed capacity in the southward direction between the hours of 8am and 12pm on working days. Five major nodes were analyzed along the corridor, and were all above the expected Passenger Car Unit (PCU), these are "Oshodi" 15 %, "Airport junction" 10 %, "Cele bus stop" 21 %, "Mile 2" 14 %, "Berger" 15 % and "Tincan bus stop" 33 % indicating heavy traffic congestion.

Efficacy and safety of desloratadine/pseudoephedrine combination vs its components in seasonal allergic rhinitis.

PubMed

Grubbe, R E; Lumry, W R; Anolik, R

2009-01-01

Antihistamines are first-line therapy for the treatment of seasonal allergic rhinitis (AR); however, an oral decongestant is often added to improve control of nasal congestion. To examine whether a tablet combining the nonsedating antihistamine desloratadine and the decongestant pseudoephedrine was more effective than either drug administered alone in reducing the symptoms of seasonal AR, including nasal congestion. In this multicenter, double-blind study, participants (N = 598) with symptomatic seasonal AR were administered either a combination tablet of desloratadine 2.5 mg/pseudoephedrine 120 mg (DL/PSE) bid, a desloratadine 5.0 mg qd and a placebo tablet, or pseudoephedrine 120 mg bid. Participants assessed their symptom severity twice daily over the 2-week treatment period. The primary variable to assess the effects of the antihistamine component--mean change from baseline in average AM/PM reflective total symptom score (TSS), excluding nasal congestion--was significantly greater (-6.54) for DL/PSE than for desloratadine (-5.09) or pseudoephedrine (-5.07) monotherapy (P < .001 for both). The primary variable to assess the effects of the decongestant component--mean change from baseline in average AM/PM reflective nasal congestion score--was also significantly greater (-0.93) for DL/PSE than for desloratadine (-0.66) or pseudoephedrine (-0.75) (P < .001 vs desloratadine; P = .006 vs pseudoephedrine). This study demonstrated that DL/PSE therapy was more effective in reducing symptoms of seasonal AR, including nasal congestion, than the individual components when administered alone, thus supporting use of this combination in participants with symptomatic seasonal AR and prominent nasal congestion.

Analysis of local bus markets : volume II – rider characteristics : final report.

DOT National Transportation Integrated Search

2017-07-04

Despite having an extensive network of public transit, traffic congestion and transportation-related greenhouse gas (GHG) emissions are significant concerns in New Jersey. This research hypothesizes that traffic congestion and air quality concerns in...

Analysis of local bus markets : volume I – methodology and findings : final report.

DOT National Transportation Integrated Search

2017-07-04

Despite having an extensive network of public transit, traffic congestion and transportation-related greenhouse gas (GHG) emissions are significant concerns in New Jersey. This research hypothesizes that traffic congestion and air quality concerns in...

Analysis of local bus markets : volume III – travel characteristics : final report.

DOT National Transportation Integrated Search

2017-07-04

Despite having an extensive network of public transit, traffic congestion and transportation-related greenhouse gas (GHG) emissions are significant concerns in New Jersey. This research hypothesizes that traffic congestion and air quality concerns in...

Applications of variable speed control for contending with recurrent highway congestion.

DOT National Transportation Integrated Search

2014-07-01

This research project developed vital operational guidelines for design of a variable speed limit (VSL) system and its integrated operations with ramp metering control in contending with recurrent highway congestion. The developed guidelines can serv...

Assessing the value of delay to truckers and carriers.

DOT National Transportation Integrated Search

2011-07-01

This project evaluates the value of delay (VOD) to commercial vehicle operators due to highway congestion. : The VOD for congestion is a fundamental parameter driving the private sectors response to public freight : projects and policies such as c...

Mendenhall Glacier Visitor Center vehicular and pedestrian traffic congestion study

DOT National Transportation Integrated Search

2007-05-01

The Mendenhall Glacier Visitor Center of Tongass National Forest in Juneau, Alaska is experiencing vehicular and pedestrian congestion. This study was initiated by the United States Forest Service, Alaska Region, in cooperation with Western Federal L...

Analysis of local bus markets – volumes I - III: technical brief.

DOT National Transportation Integrated Search

2017-07-04

Despite having an extensive network of public transit, traffic congestion and transportation-related greenhouse gas (GHG) emissions are significant concerns in New Jersey. This research examines the congestion and GHG impacts of transit by exclusivel...

Assessing the value of delay to truckers and carriers.

DOT National Transportation Integrated Search

2011-07-01

This project evaluates the value of delay (VOD) to commercial vehicle operators due to highway congestion. The VOD for : congestion is a fundamental parameter driving the private sectors response to public freight projects and policies such as cor...

Investigation of solutions to recurring congestion on freeways.

DOT National Transportation Integrated Search

2009-01-01

Persistent daily congestion, which has been increasing in recent years, is commonly experienced for several hours or more during the morning and evening on Virginia's urban freeways. Many of these roadways are at or near capacity, which causes severe...

Congestion-Responsive On-Ramp Metering : Before and After Studies - Phase 1

DOT National Transportation Integrated Search

2016-07-06

The objective of this project was to develop recommendations toward a statewide policy of congestion responsive freeway ramp metering operation. The research is performed in two phases. In phase 1, alternative ramp metering activation strategies were...

Computing moving and intermittent queue propagation in highway work zones.

DOT National Transportation Integrated Search

2012-07-01

Drivers may experience intermittent congestion and moving queue conditions in work zones due to several reasons such as presence of lane closure, roadway geometric changes, higher demand, lower speed, and reduced capacity. The congestion and queue ha...

21 CFR 520.1010 - Furosemide.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... For treatment of physiological parturient edema of the mammary gland and associated structures. (iii...) Indications for use—(A) For treatment of edema (pulmonary congestion, ascites) associated with cardiac insufficiency and acute noninflammatory tissue edema. (B) For treatment of edema (pulmonary congestion, ascites...

21 CFR 520.1010 - Furosemide.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... For treatment of physiological parturient edema of the mammary gland and associated structures. (iii...) Indications for use—(A) For treatment of edema (pulmonary congestion, ascites) associated with cardiac insufficiency and acute noninflammatory tissue edema. (B) For treatment of edema (pulmonary congestion, ascites...

Left atrial volume and function in dogs with naturally occurring myxomatous mitral valve disease.

PubMed

Höllmer, M; Willesen, J L; Tolver, A; Koch, J

2017-02-01

Myxomatous mitral valve disease (MMVD) induces progressive left atrial (LA) enlargement. The LA modulates left ventricular filling and performance through its reservoir, conduit, and contractile function. Assessment of LA size and function may provide valuable information on the level of cardiac compensation. Left atrial function in dogs with naturally occurring MMVD remains largely unexplored. The objective of this study was to evaluate LA volume and function in dogs with naturally occurring MMVD. This prospective study included 205 client-owned dogs of different breeds, 114 healthy dogs, and 91 dogs with MMVD of different disease severities. Using two-dimensional echocardiography, the biplane area-length method was applied to assess LA volume and calculate volumetric indices of LA reservoir, conduit, and contractile function. Left atrial volume and LA stroke volume increased, whereas LA reservoir and contractile function decreased with increasing disease severity. A maximal LA volume <2.25mL/kg was the optimal cut off identified for excluding congestive heart failure in dogs with chronic MMVD with a sensitivity of 96% and a specificity of 100%. An active LA emptying fraction <24% and/or a LA expansion index <126% were suggestive of congestive heart failure in dogs with chronic MMVD with a sensitivity of 77% and a specificity of 89% and a sensitivity of 82% and a specificity of 82%, respectively. Dogs with MMVD appear to have larger LA volumes with poorer LA function. Deteriorating LA function, characterized by a decreasing reservoir and active contractile function, was evident in dogs with MMVD with increasing disease severity. Copyright © 2016 Elsevier B.V. All rights reserved.

Diagnosis of Fibrosis and Activity by a Combined Use of Strain and Shear Wave Imaging in Patients with Liver Disease.

PubMed

Yada, Norihisa; Tamaki, Nobuhura; Koizumi, Yohei; Hirooka, Masashi; Nakashima, Osamu; Hiasa, Yoichi; Izumi, Namiki; Kudo, Masatoshi

2017-01-01

Performing shear wave imaging is simple, but can be difficult when inflammation, jaundice, and congestion are present. Therefore, the correct diagnosis of liver fibrosis using shear wave imaging alone might be difficult in mild-to-moderate fibrosis cases. Strain imaging can diagnose liver fibrosis without the influence of inflammation. Therefore, the combined use of strain and shear wave imaging (combinational elastography) for cases without jaundice and congestion might be useful for evaluating fibrosis and inflammation. We enrolled consecutive patients with liver disease, without jaundice or liver congestion. Strain and shear wave imaging, blood tests, and liver biopsy were performed on the same day. The liver fibrosis index (LF index) was calculated by strain imaging; real-time tissue elastography, and the shear wave velocity (Vs) was calculated by shear wave imaging. Fibrosis index (F index) and activity index (A index) were calculated as a multiple regression equation for determining hepatic fibrosis and inflammation using histopathological diagnosis as the gold standard. The diagnostic ability of F index for fibrosis and A index for inflammation were compared using LF index and Vs. The total number of enrolled cases was 388. The area under the receiver operating characteristic (AUROC) was 0.87, 0.80, 0.83, and 0.80, at diagnosis of fibrosis stage with an F index of F1 or higher, F2 or higher, F3 or higher, and F4, respectively. The AUROC was 0.94, 0.74, and 0.76 at diagnosis of activity grade with an A index of A1 or higher, A2 or higher, and A3, respectively. The diagnostic ability of F index for liver fibrosis and A index for inflammation was higher than for other conventional diagnostic values. The combined use of strain and shear wave imaging (combinational elastography) might increase the positive diagnosis of liver fibrosis and inflammation. © 2017 S. Karger AG, Basel.

Reducing Traffic Congestion: Using Market Prices to Enhance Mobility

DOT National Transportation Integrated Search

1998-01-01

This is the Department of Transportation's 1997 biennial report on the Congestion Pricing Pilot Program, as required by Section 1012(b) of the Intermodal Surface Transportation Efficiency Act of 1991, P.L. 102-240. The report highlights the significa...

Using detector data to identify and examine crashes and incidents on freeways.

DOT National Transportation Integrated Search

2010-09-01

Traffic incidents, such as crashes and vehicular breakdowns, result in reductions in roadway capacity and : are the primary cause of non-recurrent congestion in urban areas. In addition to contributing to : congestion and delay, incidents adversely a...

Using detector data to identify and examine crashes and incidents on freeways

DOT National Transportation Integrated Search

2010-09-01

Traffic incidents, such as crashes and vehicular breakdowns, result in reductions in roadway capacity and are the primary cause of non-recurrent congestion in urban areas. In addition to contributing to congestion and delay, incidents adversely affec...

Emission Reduction Potential of the Congestion Mitigation and Air Quality Program

DOT National Transportation Integrated Search

1997-05-19

The Congestion Mitigation and Air Quality Improvement Program (CMAQ) provides : funds to states for projects designed to help attain and maintain the national : ambient air quality standards (NAAQS) set under the Clean Air Act (CAA). CMAQ : was creat...

Atlanta congestion reduction demonstration. National evaluation : travel demand management (TDM) data test plan.

DOT National Transportation Integrated Search

2001-01-01

Internet-based Advanced Traveler Information Services (ATIS) provide the urban traveler with estimated travel times based on current roadway congestion. Survey research indicates that the vast majority of current ATIS users are satisfied consumers wh...

Real time driver information for congestion management.

DOT National Transportation Integrated Search

2015-07-01

Traffic demand in the U.S. has grown substantially over the past few years because of the increase in population and : urbanization in large cities. This causes traffic congestion to spread out over U.S. highways and arterials, and subsequently : lea...

Quantifying incident-induced travel delays on freeways using traffic sensor data

DOT National Transportation Integrated Search

2008-02-01

Traffic congestion is a major operational problem for freeways in Washington State. Recent studies have estimated that more than 50% of freeway congestion is caused by traffic incidents. To help the Washington State Department of Transportation (WSDO...

Quantifying incident-induced travel delays on freeways using traffic sensor data

DOT National Transportation Integrated Search

2008-05-01

Traffic congestion is a major operational problem for freeways in Washington State. Recent studies have estimated that more than 50 percent of freeway congestion is caused by traffic incidents. To help the Washington State Department of Transportatio...

Incorporating travel-time reliability into the congestion management process : a primer.

DOT National Transportation Integrated Search

2015-02-01

This primer explains the value of incorporating travel-time reliability into the Congestion Management Process (CMP) : and identifies the most current tools available to assist with this effort. It draws from applied research and best practices : fro...

Acadia National Park ITS field operational test : parking report

DOT National Transportation Integrated Search

2003-04-01

An important goal of the Field Operational Test of ITS at Acadia National Park is to reduce vehicle congestion in the Park. Reduced congestion will have the added benefits of increased mobility of visitors and residents, aesthetic and environmental b...

Exploring a new congestion pricing concept : focus group findings from Northern Virginia and Philadelphia

DOT National Transportation Integrated Search

2007-12-01

In support of the U.S Department of Transportations (DOT) National Strategy to Reduce Congestion on Americas Transportation Network, the Federal Highway Administrations (FHWA) Office of Natural and Human Environment (HEPN) and Office of Tran...

Evaluating Environmental Impact of Traffic Congestion in Real Time Based on Sparse Mobile Crowd-sourced Data

DOT National Transportation Integrated Search

2018-02-02

Traffic congestion at arterial intersections and freeway bottlenecks degrades the air quality and threatens the public health. Conventionally, air pollutants are monitored by sparsely-distributed Quality Assurance Air Monitoring Sites. Sparse mobile ...

Agent-based real-time signal coordination in congested networks.

DOT National Transportation Integrated Search

2014-01-01

This study is the continuation of a previous NEXTRANS study on agent-based reinforcement : learning methods for signal coordination in congested networks. In the previous study, the : formulation of a real-time agent-based traffic signal control in o...

21 CFR 522.1010 - Furosemide.

Code of Federal Regulations, 2011 CFR

2011-04-01

... treatment of edema (pulmonary congestion, ascites) associated with cardiac insufficiency and acute noninflammatory tissue edema. (2) Horses—(i) Amount. 250 to 500 mg per animal once or twice daily, intramuscularly or intravenously. (A) Indications for use. For the treatment of edema (pulmonary congestion, ascites...

21 CFR 522.1010 - Furosemide.

Code of Federal Regulations, 2010 CFR

2010-04-01

... treatment of edema (pulmonary congestion, ascites) associated with cardiac insufficiency and acute noninflammatory tissue edema. (2) Horses—(i) Amount. 250 to 500 mg per animal once or twice daily, intramuscularly or intravenously. (A) Indications for use. For the treatment of edema (pulmonary congestion, ascites...

Commuting, congestion, and pollution : the employer-paid parking connection

DOT National Transportation Integrated Search

1992-09-01

Urban areas increasingly face problems associated with traffic congestion and vehicle air emissions. Employer-paid parking--a form of matching grant whereby an employer offers to pay the cost of parking if employees are willing to pay all other costs...

Using pricing to reduce traffic congestion.

DOT National Transportation Integrated Search

2009-03-01

Highway congestion occurs when a vehicle causes delay to other vehicles on the road, resulting in longer and less reliable travel times, the use of additional fuel, and other costs to the economy. According to one widely cited study, in 2005 highway ...

23 CFR 450.320 - Congestion management process in transportation management areas.

Code of Federal Regulations, 2010 CFR

2010-04-01

... travel demand reduction and operational management strategies. (b) The development of a congestion... appropriate analysis of reasonable (including multimodal) travel demand reduction and operational management... the analysis demonstrates that travel demand reduction and operational management strategies cannot...

Effects of inter-packet spacing on the delivery of multimedia content

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

Kapadia, A. C.; Feng, A. C.; Feng, W. C.

2001-01-01

Streaming multimedia content with UDP has become increasingly popular over distributed systems such as the Internet. However, because UDP does not possess any congestion-control mechanism and most best-effort trafic is served by the congestion-controlled TCP, UDP flows steal bandwidth from TCP to the point that TCP flows can starve for network resources. Furthermore, such applications may cause the Internet infrastructure to eventually suffer from congestion collapse because UDP trafic does not self-regulate itself. To address this problem, next-generation Internet routers will implement active queue-management schemes to punish malicious traffic, e.g., non-adaptive UDP flows, and to the improve the performance ofmore » congestion-controlled traffic, e.g., TCP flows. The arrival of such routers will cripple the performance of today's UDP-based multimedia applications. So, in this paper, we introduce the notion of inter-packet spacing with control feedback to enable these UDP-based applications to perform well in the next-generation Internet while being adaptive and self-regulating. When compared with traditional UDP-based multimedia streaming, we illustrate that our counterintuitive, interpacket-spacing scheme with control feedback can reduce packet loss by 90% without adversely affecting delivered throughput. Keywords: network protocol, multimedia, packet spacing, rate-adjusting congestion control.« less

Cooperative vehicles for robust traffic congestion reduction: An analysis based on algorithmic, environmental and agent behavioral factors

PubMed Central

Desai, Prajakta; Desai, Aniruddha

2017-01-01

Traffic congestion continues to be a persistent problem throughout the world. As vehicle-to-vehicle communication develops, there is an opportunity of using cooperation among close proximity vehicles to tackle the congestion problem. The intuition is that if vehicles could cooperate opportunistically when they come close enough to each other, they could, in effect, spread themselves out among alternative routes so that vehicles do not all jam up on the same roads. Our previous work proposed a decentralized multiagent based vehicular congestion management algorithm entitled Congestion Avoidance and Route Allocation using Virtual Agent Negotiation (CARAVAN), wherein the vehicles acting as intelligent agents perform cooperative route allocation using inter-vehicular communication. This paper focuses on evaluating the practical applicability of this approach by testing its robustness and performance (in terms of travel time reduction), across variations in: (a) environmental parameters such as road network topology and configuration; (b) algorithmic parameters such as vehicle agent preferences and route cost/preference multipliers; and (c) agent-related parameters such as equipped/non-equipped vehicles and compliant/non-compliant agents. Overall, the results demonstrate the adaptability and robustness of the decentralized cooperative vehicles approach to providing global travel time reduction using simple local coordination strategies. PMID:28792513

Cooperative vehicles for robust traffic congestion reduction: An analysis based on algorithmic, environmental and agent behavioral factors.

PubMed

Desai, Prajakta; Loke, Seng W; Desai, Aniruddha

2017-01-01

Traffic congestion continues to be a persistent problem throughout the world. As vehicle-to-vehicle communication develops, there is an opportunity of using cooperation among close proximity vehicles to tackle the congestion problem. The intuition is that if vehicles could cooperate opportunistically when they come close enough to each other, they could, in effect, spread themselves out among alternative routes so that vehicles do not all jam up on the same roads. Our previous work proposed a decentralized multiagent based vehicular congestion management algorithm entitled Congestion Avoidance and Route Allocation using Virtual Agent Negotiation (CARAVAN), wherein the vehicles acting as intelligent agents perform cooperative route allocation using inter-vehicular communication. This paper focuses on evaluating the practical applicability of this approach by testing its robustness and performance (in terms of travel time reduction), across variations in: (a) environmental parameters such as road network topology and configuration; (b) algorithmic parameters such as vehicle agent preferences and route cost/preference multipliers; and (c) agent-related parameters such as equipped/non-equipped vehicles and compliant/non-compliant agents. Overall, the results demonstrate the adaptability and robustness of the decentralized cooperative vehicles approach to providing global travel time reduction using simple local coordination strategies.

Analysis of vehicular traffic flow in the major areas of Kuala Lumpur utilizing open-traffic

NASA Astrophysics Data System (ADS)

Manogaran, Saargunawathy; Ali, Muhammad; Yusof, Kamaludin Mohamad; Suhaili, Ramdhan

2017-09-01

Vehicular traffic congestion occurs when a large number of drivers are overcrowded on the road and the traffic flow does not run smoothly. Traffic congestion causes chaos on the road and interruption to daily activities of users. Time consumed on road give lots of negative effects on productivity, social behavior, environmental and cost to economy. Congestion is worsens and leads to havoc during the emergency such as flood, accidents, road maintenance and etc., where behavior of traffic flow is always unpredictable and uncontrollable. Real-time and historical traffic data are critical inputs for most traffic flow analysis applications. Researcher attempt to predict traffic using simulations as there is no exact model of traffic flow exists due to its high complexity. Open Traffic is an open source platform available for traffic data analysis linked to Open Street Map (OSM). This research is aimed to study and understand the Open Traffic platform. The real-time traffic flow pattern in Kuala Lumpur area was successfully been extracted and analyzed using Open Traffic. It was observed that the congestion occurs on every major road in Kuala Lumpur and most of it owes to the offices and the economic and commercial centers during rush hours. At some roads the congestion occurs at night due to the tourism activities.

Acute Spinal Subdural Hematoma after Vertebroplasty: A Case Report Emphasizing the Possible Etiologic Role of Venous Congestion.

PubMed

Mattei, Tobias A; Rehman, Azeem A; Dinh, Dzung H

2015-10-01

Study Design Case report and literature review. Objective Spinal subdural hematomas are rare events that often progress with severe neurologic deficits. Although there have been several case reports in the literature of spontaneous spinal subdural hematomas in the setting of anticoagulation, antiplatelet therapy, or coagulation disorders, the exact pathophysiology of such phenomena remains obscure. Methods We present the first report of a subdural hematoma after a percutaneous vertebroplasty and provide a comprehensive review on the anatomy of venous drainage of the vertebral bodies with emphasis on the possible effects of venous congestion caused by cement obstruction. Results Because the subdural hematoma occurred in the absence of major cement extravasation to the spinal canal and two levels above the site of the vertebroplasty, we discuss the possible role of venous congestion as the main etiologic factor leading to rupture of the fragile, valveless radiculomedullary veins into the subdural space. Conclusions The reported case supports a possible new pathophysiological scheme for the development of spinal subdural hematoma in which venous congestion plays a pivotal etiologic role. The reported findings suggests that future anatomical and histologic studies investigating the response of the radiculomedullary veins to congestive venous hypertension may shed new light into the pathophysiology of spinal subdural hematomas.

Acute Spinal Subdural Hematoma after Vertebroplasty: A Case Report Emphasizing the Possible Etiologic Role of Venous Congestion

PubMed Central

Mattei, Tobias A.; Rehman, Azeem A.; Dinh, Dzung H.

2015-01-01

Study Design Case report and literature review. Objective Spinal subdural hematomas are rare events that often progress with severe neurologic deficits. Although there have been several case reports in the literature of spontaneous spinal subdural hematomas in the setting of anticoagulation, antiplatelet therapy, or coagulation disorders, the exact pathophysiology of such phenomena remains obscure. Methods We present the first report of a subdural hematoma after a percutaneous vertebroplasty and provide a comprehensive review on the anatomy of venous drainage of the vertebral bodies with emphasis on the possible effects of venous congestion caused by cement obstruction. Results Because the subdural hematoma occurred in the absence of major cement extravasation to the spinal canal and two levels above the site of the vertebroplasty, we discuss the possible role of venous congestion as the main etiologic factor leading to rupture of the fragile, valveless radiculomedullary veins into the subdural space. Conclusions The reported case supports a possible new pathophysiological scheme for the development of spinal subdural hematoma in which venous congestion plays a pivotal etiologic role. The reported findings suggests that future anatomical and histologic studies investigating the response of the radiculomedullary veins to congestive venous hypertension may shed new light into the pathophysiology of spinal subdural hematomas. PMID:26430602

CCS_WHMS: A Congestion Control Scheme for Wearable Health Management System.

PubMed

Kafi, Mohamed Amine; Ben Othman, Jalel; Bagaa, Miloud; Badache, Nadjib

2015-12-01

Wearable computing is becoming a more and more attracting field in the last years thanks to the miniaturisation of electronic devices. Wearable healthcare monitoring systems (WHMS) as an important client of wearable computing technology has gained a lot. Indeed, the wearable sensors and their surrounding healthcare applications bring a lot of benefits to patients, elderly people and medical staff, so facilitating their daily life quality. But from a research point of view, there is still work to accomplish in order to overcome the gap between hardware and software parts. In this paper, we target the problem of congestion control when all these healthcare sensed data have to reach the destination in a reliable manner that avoids repetitive transmission which wastes precious energy or leads to loss of important information in emergency cases, too. We propose a congestion control scheme CCS_WHMS that ensures efficient and fair data delivery while used in the body wearable system part or in the multi-hop inter bodies wearable ones to get the destination. As the congestion detection paradigm is very important in the control process, we do experimental tests to compare between state of the art congestion detection methods, using MICAz motes, in order to choose the appropriate one for our scheme.

Nasal decongestants in monotherapy for the common cold.

PubMed

Deckx, Laura; De Sutter, An Im; Guo, Linda; Mir, Nabiel A; van Driel, Mieke L

2016-10-17

Many treatments for the common cold exist and are sold over-the-counter. Nevertheless, evidence on the effectiveness and safety of nasal decongestants is limited. To assess the efficacy, and short- and long-term safety, of nasal decongestants used in monotherapy to alleviate symptoms of the common cold in adults and children. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 6, June 2016), which contains the Cochrane Acute Respiratory Infections (ARI) Specialised Register, MEDLINE (1946 to July 2016), Embase (2010 to 15 July 2016), CINAHL (1981 to 15 July 2016), LILACS (1982 to July 2016), Web of Science (1955 to July 2016) and clinical trials registers. Randomised controlled trials (RCTs) and cluster-RCTs investigating the effectiveness and adverse effects of nasal decongestants compared with placebo for treating the common cold in adults and children. We excluded quasi-RCTs. Three review authors independently extracted and summarised data on subjective measures of nasal congestion, overall patient well-being score, objective measures of nasal airway resistance, adverse effects and general recovery. One review author acted as arbiter in cases of disagreement. We categorised trials as single and multi-dose and analysed data both separately and together. We also analysed studies using an oral or topical nasal decongestant separately and together. We included 15 trials with 1838 participants. Fourteen studies included adult participants only (aged 18 years and over). In six studies the intervention was a single dose and in nine studies multiple doses were used. Nine studies used pseudoephedrine and three studies used oxymetazoline. Other decongestants included phenylpropanolamine, norephedrine and xylometazoline. Phenylpropanolamine (or norephedrine) is no longer available on the market therefore we did not include the results of these studies in the meta-analyses. Eleven studies used oral decongestants; four studies used topical decongestants.Participants were included after contracting the common cold. The duration of symptoms differed among studies; in 10 studies participants had symptoms for less than three days, in three studies symptoms were present for less than five days, one study counted the number of colds over one year, and one study experimentally induced the common cold. In the single-dose studies, the effectiveness of a nasal decongestant was measured on the same day, whereas the follow-up in multi-dose studies ranged between one and 10 days.Most studies were conducted in university settings (N = eight), six at a specific university common cold centre. Three studies were conducted at a university in collaboration with a hospital and two in a hospital only setting. In two studies the setting was unclear.There were large differences in the reporting of outcomes and the reporting of methods in most studies was limited. Therefore, we judged most studies to be at low or unclear risk of bias. Pooling was possible for a limited number of studies only; measures of effect are expressed as standardised mean differences (SMDs). A positive SMD represents an improvement in congestion. There is no defined minimal clinically important difference for measures of subjective improvement in nasal congestion, therefore we used the SMDs as a guide to assess whether an effect was small (0.2 to 0.49), moderate (0.5 to 0.79) or large (≥ 0.8).Single-dose decongestant versus placebo: 10 studies compared a single dose of nasal decongestant with placebo and their effectiveness was tested between 15 minutes and 10 hours after dosing. Seven of 10 studies reported subjective symptom scores for nasal congestion; none reported overall patient well-being. However, pooling was not possible due to the large diversity in the measurement and reporting of symptoms of congestion. Two studies recorded adverse events. Both studies used an oral decongestant and each of them showed that there was no statistical difference between the number of adverse events in the treatment group versus the placebo group.Multi-dose decongestant versus placebo: nine studies compared multiple doses of nasal decongestants with placebo, but only five reported on the primary outcome, subjective symptom scores for nasal congestion. Only one study used a topical decongestant; none reported overall patient well-being. Subjective measures of congestion were significantly better for the treatment group compared with placebo approximately three hours after the last dose (SMD 0.49, 95% confidence interval (CI) 0.07 to 0.92; P = 0.02; GRADE: low-quality evidence). However, the SMD of 0.49 only indicates a small clinical effect. Pooling was based on two studies, one oral and one topical, therefore we were unable to assess the effects of oral and topical decongestants separately. Seven studies reported adverse events (six oral and one topical decongestant); meta-analysis showed that there was no statistical difference between the number of adverse events in the treatment group (125 per 1000) compared to the placebo group (126 per 1000). The odds ratio (OR) for adverse events in the treatment group was 0.98 (95% CI 0.68 to 1.40; P = 0.90; GRADE: low-quality evidence). The results remained the same when we only considered studies using an oral decongestant (OR 0.95, 95% CI 0.65 to 1.39; P = 0.80; GRADE: low-quality evidence). We were unable to draw conclusions on the effectiveness of single-dose nasal decongestants due to the limited evidence available. For multiple doses of nasal decongestants, the current evidence suggests that these may have a small positive effect on subjective measures of nasal congestion in adults with the common cold. However, the clinical relevance of this small effect is unknown and there is insufficient good-quality evidence to draw any firm conclusions. Due to the small number of studies that used a topical nasal decongestant, we were also unable to draw conclusions on the effectiveness of oral versus topical decongestants. Nasal decongestants do not seem to increase the risk of adverse events in adults in the short term. The effectiveness and safety of nasal decongestants in children and the clinical relevance of their small effect in adults is yet to be determined.

Effect of hawthorn (Crataegus oxycantha) crude extract and chromatographic fractions on multiple activities in a cultured cardiomyocyte assay.

PubMed

Long, S R; Carey, R A; Crofoot, K M; Proteau, P J; Filtz, T M

2006-11-01

Extracts of hawthorn (Crataegus oxycantha) have become popular herbal supplements for their well-recognized cardiotonic effects. Many commercial preparations have been used successfully in the treatment of congestive heart failure, although the active principles within these extracts have yet to be conclusively identified. Several hawthorn preparations were studied and found to have negative chronotropic effects in a cultured neonatal murine cardiomyocyte assay using unpaced cells. As compared to conventional cardiac drugs (i.e., epinephrine, milrinone, ouabain, or propranolol), hawthorn extract has a unique activity profile. Hawthorn extract appears to be anti-arrhythmic and capable of inducing rhythmicity in quiescent cardiomyocytes. Hawthorn extract does not cause beta-adrenergic receptor blockade at concentrations which cause negative chronotropic effects. Commercial hawthorn preparations, extracts prepared from dried leaves and those made from dried berries have similar chronotropic activities. When crude extracts are separated using size-exclusion chromatography, several fractions retain multiple cardiac activities. Assays with chromatographic fractions reveal that multiple dissimilar cardioactive components may exist within the extract, making the identification of individual active constituents more challenging.

City-level variations in NOx emissions derived from hourly monitoring data in Chicago

NASA Astrophysics Data System (ADS)

de Foy, Benjamin

2018-03-01

Control on emissions of nitrogen oxides (NOx) in the United States of America have led to reductions in concentrations in urban areas by up to a factor of two in the last decade. The Air Quality System monitoring network provides surface measurements of concentrations at hourly resolution over multiple years, revealing variations at the annual, seasonal, day of week and diurnal time scales. A multiple linear regression model was used to estimate the temporal profiles in the NOx concentrations as well as the impact of meteorology, ozone concentrations, and boundary layer heights. The model is applied to data from 2005 to 2016 available at 6 sites in Chicago, Illinois. Results confirm the 50% decrease in NOx over the length of the time series. The weekend effect is found to be stronger in more commercial areas, with 32% reductions on Saturdays and 45% on Sundays and holidays; and weaker in more residential areas with 20% reductions on Saturdays and 30% reductions on Sundays. Weekday diurnal profiles follow a double hump with emission peaks during the morning and afternoon rush hours, but only a shallow drop during the middle day. Difference in profiles from the 6 sites suggest that there are different emission profiles within the urban area. Diurnal profiles on Saturdays have less variation throughout the day and more emissions in the evening. Sundays are very different from both weekdays and Saturdays with a gradual increase until the early evening. The results suggest that in addition to vehicle type and vehicle miles traveled, vehicle speed and congestion must be taken into account to correctly quantify morning rush hour emissions and the weekend effect.

Disease management programs for CKD patients: the potential and pitfalls.

PubMed

Rocco, Michael V

2009-03-01

Disease management describes the use of a number of approaches to identify and treat patients with chronic health conditions, especially those that are expensive to treat. Disease management programs have grown rapidly in the United States in the past several years. These programs have been established for patients with chronic kidney disease (CKD), but some have been discontinued because of the high cost of the program. Disease management programs for CKD face unique challenges. Identification of patients with CKD is hampered by incomplete use of the International Classification of Diseases, Ninth Revision (ICD-9) codes for CKD by physicians and the less than universal use of estimated glomerular filtration rate from serum creatinine measurements to identify patients with an estimated glomerular filtration rate less than 60 mL/min/1.73 m(2). CKD affects multiple organ systems. Thus, a comprehensive disease management program will need to manage each of these aspects of CKD. These multiple interventions likely will make a CKD disease management program more costly than similar disease management programs designed for patients with diabetes mellitus, congestive heart failure, or other chronic diseases. The lack of data that can be used to develop effective disease management programs in CKD makes it difficult to determine goals for the management of each organ system affected by CKD. Finally, long periods of observation will be needed to determine whether a particular disease management program is effective in not only improving patient outcomes, but also decreasing both resource use and health care dollars. This long-term observation period is contrary to how most disease management contracts are written, which usually are based on meeting goals during a 1- to 3-year period. Until these challenges are resolved, it likely will be difficult to maintain effective disease management programs for CKD.

Determining the cost of implementing and operating a remote patient monitoring programme for the elderly with chronic conditions: A systematic review of economic evaluations.

PubMed

Peretz, Daniel; Arnaert, Antonia; Ponzoni, Norma N

2018-01-01

Introduction Remote patient monitoring (RPM) in conjunction with home nursing visits is becoming increasingly popular for the follow-up of patients with chronic conditions and evidence exists that it improves patients' health outcomes. Current cost data is reported inconsistently and often gathered from studies of poor methodological quality, making it difficult for decision-makers who consider implementing this service in their organizations. This study reviewed the cost of RPM programmes targeting elderly patients with chronic conditions. Methods After evaluation against the inclusion and exclusion criteria and appraisal against two criteria which are important for economic evaluations, data from selected studies were extracted and grouped into meaningful cost categories, then adjusted to reflect November 2015 US dollars. Results In the 13 selected studies, the newly-created cost category 'Combined intervention cost' (reflecting equipment purchasing, servicing and monitoring cost) for the various RPM programmes ranged from US$275-US$7963 per patient per year. The three main findings are: (a) RPM programme costs have decreased since 2004 due to cheaper technology; (b) monitoring a single vital sign is likely to be less costly than monitoring multiple vital signs; and (c) programmes targeting hypertension or congestive heart failure are less costly than those targeting respiratory diseases or multiple conditions. Conclusions This review recommends that future studies present their cost data with more granularity, that grouping of costs should be minimized and that any assumptions, such as amortization, should be made explicit. In addition, studies should compare programmes with similar characteristics in terms of type of conditions, number of vital signs monitored, etc. for more generalizable results.

Estimating Congestion Benefits of Transportation Projects with FIXiT 2.0: Updating and Improving the Sketch Planning Tool

DOT National Transportation Integrated Search

2017-11-01

Transportation agencies face continual pressure to ensure the proper allocation of transportation investments and financial resources. Choosing the right set of congestion mitigation and mobility strategies is critical to ensuring the wise applicatio...

Improving Goods Movement in a Metropolitan Area Adjacent to a Port

DOT National Transportation Integrated Search

2009-01-01

Southern California and specifically Los Angeles faces enormous congestion associated with increase in cargo movement from/to the regional Ports. The region has started to drown in a sea of trucks and trains. This growing congestion has elevated the ...

46 CFR 393.3 - Marine Highway Corridors.

Code of Federal Regulations, 2013 CFR

2013-10-01

... offer the maximum potential public benefit in congestion-related emissions reduction, energy efficiency... Strategy to Reduce Congestion that have commercial waterways that parallel or can otherwise benefit them... and passengers. (3) Obtain public benefit by shifting freight and passengers in measurable terms from...

46 CFR 393.3 - Marine Highway Corridors.

Code of Federal Regulations, 2010 CFR

2010-10-01

... offer the maximum potential public benefit in congestion-related emissions reduction, energy efficiency... Strategy to Reduce Congestion that have commercial waterways that parallel or can otherwise benefit them... and passengers. (3) Obtain public benefit by shifting freight and passengers in measurable terms from...

46 CFR 393.3 - Marine Highway Corridors.

Code of Federal Regulations, 2012 CFR

2012-10-01

... offer the maximum potential public benefit in congestion-related emissions reduction, energy efficiency... Strategy to Reduce Congestion that have commercial waterways that parallel or can otherwise benefit them... and passengers. (3) Obtain public benefit by shifting freight and passengers in measurable terms from...

46 CFR 393.3 - Marine Highway Corridors.

Code of Federal Regulations, 2011 CFR

2011-10-01

... offer the maximum potential public benefit in congestion-related emissions reduction, energy efficiency... Strategy to Reduce Congestion that have commercial waterways that parallel or can otherwise benefit them... and passengers. (3) Obtain public benefit by shifting freight and passengers in measurable terms from...

46 CFR 393.3 - Marine Highway Corridors.

Code of Federal Regulations, 2014 CFR

2014-10-01

... offer the maximum potential public benefit in congestion-related emissions reduction, energy efficiency... Strategy to Reduce Congestion that have commercial waterways that parallel or can otherwise benefit them... and passengers. (3) Obtain public benefit by shifting freight and passengers in measurable terms from...

2009 urban mobility report.

DOT National Transportation Integrated Search

2009-07-01

Congestion is a problem in Americas 439 urban areas, and it has gotten worse in regions of all : sizes. In 2007, congestion caused urban Americans to travel 4.2 billion hours more and to : purchase an extra 2.8 billion gallons of fuel for a conges...

Los Angeles congestion reduction demonstration express lanes program : national evaluation report.

DOT National Transportation Integrated Search

2015-08-01

This document presents the final report on the national evaluation of the Los Angeles Congestion Reduction Demonstration (LA CRD) ExpressLanes Program under the United States Department of Transportation (U.S. DOT) CRD Program. The LA CRD projects fo...

Relief of reinforcing congestion in beams and bent caps of concrete bridges.

DOT National Transportation Integrated Search

2012-06-01

In order to determine how to resolve the issues involving steel congestion in reinforced concrete (RC) structures, three potential solutions to this problem were researched. In the first method, reinforced concrete (RC) was mixed with steel fibers. T...

Incidence and Risk of Cardiac Events in Patients With Previously Treated Multiple Myeloma Versus Matched Patients Without Multiple Myeloma: An Observational, Retrospective, Cohort Study.

PubMed

Kistler, Kristin D; Kalman, Jill; Sahni, Gagan; Murphy, Brian; Werther, Winifred; Rajangam, Kanya; Chari, Ajai

2017-02-01

Multiple myeloma (MM) patients have age-, disease-, and treatment-related risk factors for cardiac events. We analyzed the 2006 to 2011 MarketScan database to determine whether the risk of cardiac events is greater in MM patients than in non-MM patients. Included were 1723 MM patients treated with corticosteroids and ≥ 3 drugs (bortezomib, immunomodulatory derivatives, and alkylating agents or anthracyclines). The index date (ID) was the date on which the 3-drug exposure criterion was met. Also included were 8615 age- and gender-matched non-MM patients (5:1). The distribution of non-MM patients' IDs matched that of the MM patients' IDs. Baseline was 6 months before the ID. The follow-up duration was from the ID to study end (ie, 2011 or end of enrollment or prescription drug coverage). Hazard ratios (HRs) and 95% confidence intervals (CIs) were adjusted for baseline variables when the univariate analyses showed a 10% difference. The median duration of observation was 9 months (range, 0-60 months) for MM patients and 19 months (range, 0-66 months) for non-MM patients. The risk of any cardiac event (HR, 2.2; 95% CI, 1.9-2.5), dysrhythmia (HR, 4.1; 95% CI, 3.5-4.8), congestive heart failure (HR, 2.9; 95% CI, 2.2-3.7), cardiomyopathy (HR, 2.6; 95% CI, 1.8-3.8), and conduction disorders (HR, 1.7; 95% CI, 1.2-2.5) was significantly greater for MM than for non-MM patients. The incidence of hypertensive or arterial events and ischemic heart disease was similar between the 2 groups. The present study provides the first known comparison of cardiac event risk in patients with MM versus age- and gender-matched patients without MM. The cardiac event risk was greater in MM patients with ≥ 3 previous drugs for any cardiac event, dysrhythmias, congestive heart failure, cardiomyopathy, and conduction disorders compared with patients without MM. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Detection and prognostic value of pulmonary congestion by lung ultrasound in ambulatory heart failure patients.

PubMed

Platz, Elke; Lewis, Eldrin F; Uno, Hajime; Peck, Julie; Pivetta, Emanuele; Merz, Allison A; Hempel, Dorothea; Wilson, Christina; Frasure, Sarah E; Jhund, Pardeep S; Cheng, Susan; Solomon, Scott D

2016-04-14

Pulmonary congestion is a common and important finding in heart failure (HF). While clinical examination and chest radiography are insensitive, lung ultrasound (LUS) is a novel technique that may detect and quantify subclinical pulmonary congestion. We sought to independently relate LUS and clinical findings to 6-month HF hospitalizations and all-cause mortality (composite primary outcome). We used LUS to examine 195 NYHA class II-IV HF patients (median age 66, 61% men, 74% white, ejection fraction 34%) during routine cardiology outpatient visits. Lung ultrasound was performed in eight chest zones with a pocket ultrasound device (median exam duration 2 min) and analysed offline. In 185 patients with adequate LUS images in all zones, the sum of B-lines (vertical lines on LUS) ranged from 0 to 13. B-lines, analysed by tertiles, were associated with clinical and laboratory markers of congestion. Thirty-two per cent of patients demonstrated ≥3 B-lines on LUS, yet 81% of these patients had no findings on auscultation. During the follow-up period, 50 patients (27%) were hospitalized for HF or died. Patients in the third tertile (≥3 B-lines) had a four-fold higher risk of the primary outcome (adjusted HR 4.08, 95% confidence interval, CI 1.95, 8.54; P < 0.001) compared with those in the first tertile and spent a significantly lower number of days alive and out of the hospital (125 days vs. 165 days; adjusted P < 0.001). Pulmonary congestion assessed by ultrasound is prevalent in ambulatory patients with chronic HF, is associated with other features of clinical congestion, and identifies those who have worse prognosis. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Congestion road tax and physical activity.

PubMed

Bergman, Patrick; Grjibovski, Andrej M; Hagströmer, Maria; Patterson, Emma; Sjöström, Michael

2010-02-01

Large-scale policy and environmental changes, such as congestion road taxes, may be a way to promote active transportation. This study aimed to examine the potential effect of a congestion road tax on physical activity. Baseline data were collected during October-November 2003, follow-up data in May 2006, and analysis was performed in September 2008. The short self-administered version of the International Physical Activity Questionnaire was used to assess physical activity. Data from those with access to motorized vehicles in the Stockholm region (n=165), where the tax was in place, were compared with those from the Göteborg/Malmö regions (n=138). Within each region before and during the road tax implementation, the data were analyzed for differences in time spent at different intensity levels of physical activity, in addition to sitting, as well as for changes in reported time in overall (weighted) physical activity. There were no significant differences in the magnitude of the changes of the intensity levels of physical activity, weighted overall physical activity, or sitting, between Stockholm and Göteborg/Malmö. Among those exposed to the congestion road tax and with access to motorized vehicles, an increase in moderate physical activity (p=0.036); overall physical activity (p=0.015); and a reduction in time spent sitting (p=0.009) was observed. No differences were observed among those unexposed. The results from this study on the influence of a congestion road tax on levels of physical activity, though inconclusive, suggest that policy changes such as a congestion road tax might promote improvements in physical activity levels in individuals with motorized vehicles. Copyright 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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).

[Clinical examination and the Valsalva maneuver in heart failure].

PubMed

Liniado, Guillermo E; Beck, Martín A; Gimeno, Graciela M; González, Ana L; Cianciulli, Tomás F; Castiello, Gustavo G; Gagliardi, Juan A

2018-01-01

Congestion in heart failure patients with reduced ejection fraction (HFrEF) is relevant and closely linked to the clinical course. Bedside blood pressure measurement during the Valsalva maneuver (Val) added to clinical examination may improve the assessment of congestion when compared to NT-proBNP levels and left atrial pressure (LAP) estimation by Doppler echocardiography, as surrogate markers of congestion in HFrEF. A clinical examination, LAP and blood tests were performed in 69 HFrEF ambulatory patients with left ventricular ejection fraction ≤ 40% and sinus rhythm. Framingham Heart Failure Score (HFS) was used to evaluate clinical congestion; Val was classified as normal or abnormal, NT-proBNP was classified as low (< 1000 pg/ml) or high (≥ 1000 pg/ml) and the ratio between Doppler early mitral inflow and tissue diastolic velocity was used to estimate LAP and was classified as low (E/e'< 15) or high (E/e' ≥ 15). A total of 69 patients with HFrEF were included; 27 had a HFS ≥ 2 and 13 of them had high NT-proBNP. HFS ≥ 2 had a 62% sensitivity, 70% specificity and a positive likelihood ratio of 2.08 (p=0.01) to detect congestion. When Val was added to clinical examination, the presence of a HFS ≥ 2 and abnormal Val showed a 100% sensitivity, 64% specificity and a positive likelihood ratio of 2.8 (p = 0.0004). Compared with LAP, the presence of HFS = 2 and abnormal Val had 86% sensitivity, 54% specificity and a positive likelihood ratio of 1.86 (p = 0.03). In conclusion, an integrated clinical examination with the addition Valsalva maneuver may improve the assessment of congestion in patients with HFrEF.

Heavy truck restrictions and air quality implications in São Paulo, Brazil.

PubMed

Pérez-Martínez, Pedro José; de Fátima Andrade, María; de Miranda, Regina Maura

2017-11-01

This study quantified the effects of traffic restrictions on diesel fuel heavy vehicles (HVs) on the air quality of the Bandeirantes corridor using hourly data obtained by continuous monitoring of traffic and air quality at sites located on this avenue. The study addressed the air quality of a city impacted by vehicular emissions and that PM 10 and NO X concentrations are mainly due to diesel burning. Data collection was split into two time periods, a period of no traffic constraint on HVs (Nov 2008 and 2009) and a period of constraint (Nov 2010, 2011 and 2012). We found that pollutants on this corridor, mainly PM 10 and NO X , decreased significantly during the period from 2008 to 2012 (28 and 43%, 15.8 and 86.9 ppb) as a direct consequence of HV traffic restrictions (a 72% reduction). Rebound effects in the form of increased traffic of light vehicles (LVs) during this time had impacts on the concentration levels, explaining the differences between rates of reduction in HV traffic and pollutants. Reductions in the number of trucks resulted in longer travel times and increased traffic congestion as a consequence of the modal shift towards LVs. We found that a 51% decrease in PM 10 (28.8 μg m -3 ) was due to a reduction in HV traffic (vehicle emissions were estimated to be 71% of total sources, 40.1 μg m -3 ). This percentage was partially offset by 10% more PM 10 emissions related to an increase in LV traffic, while other causes, such as climatic conditions, contributed to a 13% increase in PM 10 concentrations. The relationships analyzed in this research served to highlight the need to apply urban transport policies aimed at decreasing pollutant concentrations in São Paulo, especially in heavily congested urban corridors on working days. Copyright © 2017 Elsevier Ltd. All rights reserved.

Anti-rheumatic drug use and risk of hospitalization for congestive heart failure in rheumatoid arthritis.

PubMed

Bernatsky, S; Hudson, M; Suissa, S

2005-05-01

To assess the risk of hospitalization for congestive heart failure (CHF) associated with the use of disease-modifying anti-rheumatic drugs (DMARDs) and other medications used in RA. We used a case-control design nested within an administrative database cohort of patients with rheumatoid arthritis (RA) who were dispensed a DMARD between September 1998 and December 2001. Subjects identified with a prior history of CHF were excluded. For each hospitalized case of CHF identified during follow-up, 10 controls matched on age and time were randomly selected from the cohort. Conditional logistic regression was used to estimate the rate ratio (RR) of hospitalizations for CHF associated with the current use of specific drugs, adjusted for sex and co-morbidity. The cohort included 41 885 patients; 75% were women, with an average age at cohort entry of 51 yr. During follow-up, 520 hospitalizations for CHF occurred, for a rate of 10.1 per 1000 per year. The adjusted RR of CHF for current use of any DMARD was 0.7 (95% CI 0.6-0.9) relative to no current use. By DMARD category, there was evidence of a beneficial effect for both tumour necrosis factor-alpha antagonists (RR 0.5, 95% CI 0.2-0.9) and methotrexate monotherapy (RR 0.8, 95% CI 0.6-1.0). For non-DMARD medications, the rate of CHF was not clearly increased or decreased, except for COX-2 inhibitors. The data suggested an increased risk of CHF with rofecoxib (RR 1.3, 95% CI 1.0-3.1) and a decreased risk of CHF with celecoxib (RR 0.6, 95% CI 0.4, 1.0). The use of DMARDs was associated with a reduction in the risk of hospitalizations for CHF in this RA cohort. The increased risk with rofecoxib alongside a decreased risk with celecoxib suggests the absence of a class effect with respect to COX-II inhibitors for some types of cardiovascular morbidity.

Lean intervention improves patient discharge times, improves emergency department throughput and reduces congestion.

PubMed

Beck, Michael J; Okerblom, Davin; Kumar, Anika; Bandyopadhyay, Subhankar; Scalzi, Lisabeth V

2016-12-01

To determine if a lean intervention improved emergency department (ED) throughput and reduced ED boarding by improving patient discharge efficiency from a tertiary care children's hospital. The study was conducted at a tertiary care children's hospital to study the impact lean that changes made to an inpatient pediatric service line had on ED efficiency. Discharge times from the general pediatrics' service were compared to patients discharged from all other pediatric subspecialty services. The intervention was multifaceted. First, team staffing reconfiguration permitted all discharge work to be done at the patient's bedside using a new discharge checklist. The intervention also incorporated an afternoon interdisciplinary huddle to work on the following day's discharges. Retrospectively, we determined the impact this had on median times of discharge order entry, patient discharge, and percent of patients discharged before noon. As a marker of ED throughput, we determined median hour of day that admitted patients left the ED to move to their hospital bed. As marker of ED congestion we determined median boarding times. For the general pediatrics service line, the median discharge order entry time decreased from 1:43pm to 11:28am (p < 0.0001) and the median time of discharge decreased from 3:25pm to 2:25pm (p < 0.0001). The percent of patients discharged before noon increased from 14.0% to 26.0% (p < 0.0001). The discharge metrics remained unchanged for the pediatric subspecialty services group. Median ED boarding time decreased by 49 minutes (p < 0.0001). As a result, the median time of day admitted patients were discharged from the ED was advanced from 5 PM to 4 PM. Lean principles implemented by one hospital service line improved patient discharge times enhanced patient ED throughput, and reduced ED boarding times.

Inter-Vehicle Communication System Utilizing Autonomous Distributed Transmit Power Control

NASA Astrophysics Data System (ADS)

Hamada, Yuji; Sawa, Yoshitsugu; Goto, Yukio; Kumazawa, Hiroyuki

In ad-hoc network such as inter-vehicle communication (IVC) system, safety applications that vehicles broadcast the information such as car velocity, position and so on periodically are considered. In these applications, if there are many vehicles broadcast data in a communication area, congestion incurs a problem decreasing communication reliability. We propose autonomous distributed transmit power control method to keep high communication reliability. In this method, each vehicle controls its transmit power using feed back control. Furthermore, we design a communication protocol to realize the proposed method, and we evaluate the effectiveness of proposed method using computer simulation.

Evaluation of an Impedance Threshold Device as a VIIP Countermeasure

NASA Technical Reports Server (NTRS)

Ebert, D.; Macias, B.; Garcia, K.; Stenger, M.; Hargens, A.; Johnston, S.

2016-01-01

Visual Impairment /Intracranial Pressure (VIIP) is a top human spaceflight risk for which NASA does not currently have a proven mitigation strategy. Thigh cuffs (Braslets) and lower body negative pressure (LBNP; Chibis) devices have been or are currently being evaluated as a means to reduce VIIP signs and symptoms, but these methods alone may not provide sufficient relief of cephalic venous congestion and VIIP symptoms. Additionally, current LBNP devices are too large and cumbersome for their systematic use as a countermeasure. Therefore, a novel approach is needed that is easy to implement and provides specific relief of symptoms. This investigation will evaluate an impedance threshold device (ITD) as a VIIP countermeasure. The ITD works by providing up to 7 cm H2O (approximately 5 mmHg) resistance to inspiratory air flow, effectively turning the thorax into a vacuum pump upon each inhalation which lowers the intrathoracic pressure (ITP) and facilitates venous return to the heart. The ITD is FDA-approved and was developed to augment venous return to the central circulation and increase cardiac output during cardiopulmonary resuscitation (CPR) and in patients with hypotension. While the effect of ITD on CPR survival outcomes is controversial, the ITD's ability to lower ITP with a concomitant decrease in intracranial pressure (ICP) is well documented. A similar concept that creates negative ITP during exhalation (intrathoracic pressure regulator; ITPR) decreased ICP in 16 of 20 patients with elevated ICP in a hospital pilot study. ITP and central venous pressure (CVP) have been shown to decrease in microgravity however ITP drops more than CVP, indicating an increased transmural CVP. This could explain the paradoxical distention of jugular veins (JV) in microgravity despite lower absolute CVP and also suggests that JV transmural pressure is not dramatically elevated. Use of an ITD may lower JV pressure enough to remove or relieve cephalic venous congestion. During spaceflight experiments with Braslet thigh cuffs and modified (open-glottis) Mueller maneuvers, Braslets alone reduced cardiac preload but only reduced the internal JV (IJV) cross sectional area by 23%. The addition of Mueller maneuvers resulted in an IJV area reduction of 48%. This project will test if ITD essentially applies a Mueller maneuver with added negative ITP in every respiratory cycle, acting to: 1) reduce venous congestion in the neck and 2) potentially lower ICP. The expected mechanism of action is that in microgravity (or an analog) blood is relocated toward the heart from vasculature in the head and neck. Once validated, the ITD would be an exceptionally easy countermeasure to deploy and test on the ISS. Dosage could be altered though 1) duration of application and 2) inspiratory resistance set point. Effects could be additionally enhanced through co-application with other countermeasures such as thigh cuffs or LBNP.

Evaluation of an Impedance Threshold Device as a VIIP Countermeasure

NASA Technical Reports Server (NTRS)

Ebert, Douglas; Macias, Brandon; Sargsyan, Ashot; Garcia, Kathleen; Stenger, Michael; Hargens, Alan; Johnston, Smith; Kemp, David; Danielson, Richard

2016-01-01

Visual Impairment/Intracranial Pressure (VIIP) is a top human spaceflight risk for which NASA does not currently have a proven mitigation strategy. Thigh cuffs (Braslets) and lower body negative pressure (LBNP; Chibis) devices have been or are currently being evaluated as a means to reduce VIIP signs and symptoms, but these methods alone may not provide sufficient relief of cephalic venous congestion and VIIP symptoms. Additionally, current LBNP devices are too large and cumbersome for their systematic use as a countermeasure. Therefore, a novel approach is needed that is easy to implement and provides specific relief of symptoms. This investigation will evaluate an impedance threshold device (ITD) as a VIIP countermeasure. The ITD works by providing up to 7 cm H2O (approximately 5 mmHg) resistance to inspiratory air flow, effectively turning the thorax into a vacuum pump upon each inhalation which lowers the intrathoracic pressure (ITP) and facilitates venous return to the heart. The ITD is FDA-approved and was developed to augment venous return to the central circulation and increase cardiac output during cardiopulmonary resuscitation (CPR) and in patients with hypotension. While the effect of ITD on CPR survival outcomes is controversial, the ITD's ability to lower ITP with a concomitant decrease in intracranial pressure (ICP) is well documented. A similar concept that creates negative ITP during exhalation (intrathoracic pressure regulator; ITPR) decreased ICP in 16 of 20 patients with elevated ICP in a hospital pilot study. ITP and central venous pressure (CVP) have been shown to decrease in microgravity however ITP drops more than CVP, indicating an increased transmural CVP. This could explain the paradoxical distention of jugular veins (JV) in microgravity despite lower absolute CVP and also suggests that JV transmural pressure is not dramatically elevated. Use of an ITD may lower JV pressure enough to remove or relieve cephalic venous congestion. During spaceflight experiments with Braslet thigh cuffs and modified (open-glottis) Mueller maneuvers, Braslets alone reduced cardiac preload but only reduced the internal JV (IJV) cross sectional area by 23%. The addition of Mueller maneuvers resulted in an IJV area reduction of 48%. This project will test if ITD essentially applies a Mueller maneuver with added negative ITP in every respiratory cycle, acting to: 1) reduce venous congestion in the neck and 2) potentially lower ICP. The expected mechanism of action is that in microgravity (or an analog) blood is relocated toward the heart from vasculature in the head and neck. Once validated, the ITD would be an exceptionally easy countermeasure to deploy and test on the ISS. Dosage could be altered though 1) duration of application and 2) inspiratory resistance set point. Effects could be additionally enhanced through co-application with other countermeasures such as thigh cuffs or LBNP.