Sample records for oscillometric method influenced

  1. Comparison of Doppler and oscillometric ankle blood pressure measurement in patients with angiographically documented lower extremity arterial occlusive disease.

    PubMed

    Nukumizu, Yoshihito; Matsushita, Masahiro; Sakurai, Tsunehisa; Kobayashi, Masayoshi; Nishikimi, Naomichi; Komori, Kimihiro

    2007-01-01

    To assess the reliability of the oscillometric method in patients with peripheral vascular disease, ankle blood pressure measurement by Doppler and oscillometry was compared. This study represents a prospective, non-blinded examination of pressure measurements in 168 patients. Twenty-two patients were included who had abdominal aortic aneurysms (AAA) and 146 had peripheral arterial occlusive disease (PAOD). Patients with PAOD were divided into 2 groups according to angiography results: a crural artery occlusion group (CAO, n = 32), and a no crural artery occlusion group (NCAO, n = 114). All subjects underwent pressure measurement by both Doppler and oscillometry. The correlation coefficient was 0.928 in AAA patients and 0.922 in PAOD patients. In CAO patients, there were significantly fewer patients whose oscillometric pressure was equivalent to the Doppler pressure (DP), as compared to NCAO patients, because the oscillometric pressure (OP) was 10% higher than DP in 44% of CAO patients. A high correlation exists between Doppler and oscillometric ankle pressure measurements irrespective of the type of vascular disease. However, the oscillometric method could not be substituted for the Doppler method completely, because there were several patients whose OP was greater than DP especially in those with crural artery occlusive disease.

  2. Non-invasive determination of instantaneous brachial blood flow using the oscillometric method.

    PubMed

    Liu, Shing-Hong; Wang, Jia-Jung; Cheng, Da-Chuan

    2009-08-01

    The oscillometric method has been widely used to measure arterial systolic and diastolic blood pressures, but its potential for arterial blood flow measurements still remains to be explored. The aim of this study was to non-invasively determine arterial blood flow using an oscillometric blood flow measurement system. The system consists of a pneumatic elastic cuff, an air-pumping motor, a releaser valve, a pressure transducer, and an airflow meter. To build a non-linear cuff model, we measured airflow pumped into the pneumatic cuff and cuff pressure using an airflow meter and pressure transducer during the inflation period, respectively. During the deflation period, only the pressure transducer was used to record cuff pressure. Based on the cuff model, the oscillometric blood flow waveform was obtained by integrating the oscillometric pressure waveform. We compared arterial blood flow derived from the maximum amplitude of the oscillometric blood flow waveform with Doppler-measured blood flow calculated with the diameters and blood velocities of the brachial arteries in 32 subjects who underwent diagnostic evaluations for peripheral arterial embolism. A linear correlation coefficient of r = 0.716 was found between the oscillometry- and Doppler-based blood flow measurements in the 32 subjects. These results suggest that blood flow passing through the brachial artery can be quantified non-invasively using the oscillometric approach after appropriate calibration.

  3. Comparison of invasive and oscillometric blood pressure measurement techniques in anesthetized camelids.

    PubMed

    Aarnes, Turi K; Hubbell, John A E; Lerche, Phillip; Bednarski, Richard M

    2012-08-01

    This study assessed the accuracy of the oscillometric method for arterial blood pressure (ABP) monitoring in anesthetized camelids. Twenty camelids were anesthetized and systolic ABP (SABP), mean ABP (MABP), and diastolic ABP (DABP) were measured directly and using the oscillometric method. The mean difference between SABP measurements was -9.9 ± 21.9 mmHg with a range of -76 to 54 mmHg, and the 95% limits of agreement (LOA) were -33 to 53 mmHg. The difference between DABP measurements was -1.8 ± 15.6 mmHg with a range of -81 to 36 mmHg, and the 95% LOA were -32 to 29 mmHg. The difference between MABP measurements was -2.9 ± 17.0 mmHg with a range of -81 to 36 mmHg, and the 95% LOA were -30 to 36 mmHg. Accurate ABP monitoring in anesthetized camelids cannot be accomplished using the oscillometric method.

  4. Comparison of invasive and oscillometric blood pressure measurement techniques in anesthetized camelids

    PubMed Central

    Aarnes, Turi K.; Hubbell, John A.E.; Lerche, Phillip; Bednarski, Richard M.

    2012-01-01

    This study assessed the accuracy of the oscillometric method for arterial blood pressure (ABP) monitoring in anesthetized camelids. Twenty camelids were anesthetized and systolic ABP (SABP), mean ABP (MABP), and diastolic ABP (DABP) were measured directly and using the oscillometric method. The mean difference between SABP measurements was −9.9 ± 21.9 mmHg with a range of −76 to 54 mmHg, and the 95% limits of agreement (LOA) were −33 to 53 mmHg. The difference between DABP measurements was −1.8 ± 15.6 mmHg with a range of −81 to 36 mmHg, and the 95% LOA were −32 to 29 mmHg. The difference between MABP measurements was −2.9 ± 17.0 mmHg with a range of −81 to 36 mmHg, and the 95% LOA were −30 to 36 mmHg. Accurate ABP monitoring in anesthetized camelids cannot be accomplished using the oscillometric method. PMID:23372197

  5. Prospective clinical study to evaluate an oscillometric blood pressure monitor in pet rabbits.

    PubMed

    Bellini, Luca; Veladiano, Irene A; Schrank, Magdalena; Candaten, Matteo; Mollo, Antonio

    2018-02-27

    Rabbits are particularly sensitive to develop hypotension during sedation or anaesthesia. Values of systolic or mean non-invasive arterial blood pressure below 80 or 60 mmHg respectively are common under anaesthesia despite an ongoing surgery. A reliable method of monitoring arterial blood pressure is extremely important, although invasive technique is not always possible due to the anatomy and dimension of the artery. The aim of this study was to evaluate the agreement between a new oscillometric device for non-invasive arterial blood pressure measurement and the invasive method. Moreover the trending ability of the device, ability to identify changes in the same direction with the invasive methods, was evaluated as well as the sensibility of the device in identifying hypotension arbitrarily defined as invasive arterial blood pressure below 80 or 60 mmHg. Bland-Altman analysis for repeated measurements showed a poor agreement between the two methods; the oscillometric device overestimated the invasive arterial blood pressure, particularly at high arterial pressure values. The same analysis repeated considering oscillometric measurement that match invasive mean pressure lower or equal to 60 mmHg showed a decrease in biases and limits of agreement between methods. The trending ability of the device, evaluated with both the 4-quadrant plot and the polar plot was poor. Concordance rate of mean arterial blood pressure was higher than systolic and diastolic pressure although inferior to 90%. The sensibility of the device in detecting hypotension defined as systolic or mean invasive arterial blood pressure lower than 80 or 60 mmHg was superior for mean oscillometric pressure rather than systolic. A sensitivity of 92% was achieved with an oscillometric measurement for mean pressure below 65 mmHg instead of 60 mmHg. Non-invasive systolic blood pressure is less sensitive as indicator of hypotension regardless of the cutoff limit considered. Although mean invasive arterial blood pressure is overestimated by the device, the sensitivity of this non-invasive oscillometric monitor in detecting invasive mean pressure below 60 mmHg is acceptable but a cutoff value of 65 mmHg needs to be used.

  6. Comparison of an oscillometric method with cardiac magnetic resonance for the analysis of aortic pulse wave velocity.

    PubMed

    Feistritzer, Hans-Josef; Reinstadler, Sebastian J; Klug, Gert; Kremser, Christian; Seidner, Benjamin; Esterhammer, Regina; Schocke, Michael F; Franz, Wolfgang-Michael; Metzler, Bernhard

    2015-01-01

    Pulse wave velocity (PWV) is the proposed gold-standard for the assessment of aortic elastic properties. The aim of this study was to compare aortic PWV determined by a recently developed oscillometric device with cardiac magnetic resonance imaging (CMR). PWV was assessed in 40 volunteers with two different methods. The oscillometric method (PWVOSC) is based on a transfer function from the brachial pressure waves determined by oscillometric blood pressure measurements with a common cuff (Mobil-O-Graph, I.E.M. Stolberg, Germany). CMR was used to determine aortic PWVCMR with the use of the transit time method based on phase-contrast imaging at the level of the ascending and abdominal aorta on a clinical 1.5 Tesla scanner (Siemens, Erlangen, Germany). The median age of the study population was 34 years (IQR: 24-55 years, 11 females). A very strong correlation was found between PWVOSC and PWVCMR (r = 0.859, p < 0.001). Mean PWVOSC was 6.7 ± 1.8 m/s and mean PWVCMR was 6.1 ± 1.8 m/s (p < 0.001). Analysis of agreement between the two measurements using Bland-Altman method showed a bias of 0.57 m/s (upper and lower limit of agreement: 2.49 m/s and -1.34 m/s). The corresponding coefficient of variation between both measurements was 15%. Aortic pulse wave velocity assessed by transformation of the brachial pressure waveform showed an acceptable agreement with the CMR-derived transit time method.

  7. Comparison of an Oscillometric Method with Cardiac Magnetic Resonance for the Analysis of Aortic Pulse Wave Velocity

    PubMed Central

    Feistritzer, Hans-Josef; Reinstadler, Sebastian J.; Klug, Gert; Kremser, Christian; Seidner, Benjamin; Esterhammer, Regina; Schocke, Michael F.; Franz, Wolfgang-Michael; Metzler, Bernhard

    2015-01-01

    Objectives Pulse wave velocity (PWV) is the proposed gold-standard for the assessment of aortic elastic properties. The aim of this study was to compare aortic PWV determined by a recently developed oscillometric device with cardiac magnetic resonance imaging (CMR). Methods PWV was assessed in 40 volunteers with two different methods. The oscillometric method (PWVOSC) is based on a transfer function from the brachial pressure waves determined by oscillometric blood pressure measurements with a common cuff (Mobil-O-Graph, I.E.M. Stolberg, Germany). CMR was used to determine aortic PWVCMR with the use of the transit time method based on phase-contrast imaging at the level of the ascending and abdominal aorta on a clinical 1.5 Tesla scanner (Siemens, Erlangen, Germany). Results The median age of the study population was 34 years (IQR: 24–55 years, 11 females). A very strong correlation was found between PWVOSC and PWVCMR (r = 0.859, p < 0.001). Mean PWVOSC was 6.7 ± 1.8 m/s and mean PWVCMR was 6.1 ± 1.8 m/s (p < 0.001). Analysis of agreement between the two measurements using Bland-Altman method showed a bias of 0.57 m/s (upper and lower limit of agreement: 2.49 m/s and -1.34 m/s). The corresponding coefficient of variation between both measurements was 15%. Conclusion Aortic pulse wave velocity assessed by transformation of the brachial pressure waveform showed an acceptable agreement with the CMR-derived transit time method. PMID:25612307

  8. Oscillometric analysis compared with cardiac magnetic resonance for the assessment of aortic pulse wave velocity in patients with myocardial infarction.

    PubMed

    Feistritzer, Hans-Josef; Klug, Gert; Reinstadler, Sebastian J; Reindl, Martin; Mayr, Agnes; Schocke, Michael; Metzler, Bernhard

    2016-09-01

    Measurement of aortic pulse wave velocity (PWV) is the gold standard for assessment of aortic stiffness. In patients with ST-segment elevation myocardial infarction (STEMI), high aortic PWV has deleterious effects on the myocardium. In the present study, we compared a novel oscillometric device with cardiac magnetic resonance (CMR) imaging for the assessment of aortic PWV in STEMI patients. We measured aortic PWV in 60 reperfused STEMI patients using two different methods. The oscillometric method (PWVOSC) is based on mathematical transformation of brachial pressure waveforms, oscillometrically determined using a common cuff (Mobil-O-Graph, I.E.M., Stolberg, North Rhine-Westphalia, Germany). Phase-contrast CMR imaging (1.5 T scanner, Siemens, Erlangen, Bavaria, Germany) at the level of the ascending and abdominal aorta was performed to determine CMR-derived pulse wave velocity with the use of the transit time method. The mean age of the study population was 57 ± 11 years; 11 (18%) were women. Median PWVOSC was 7.4 m/s (interquartile range 6.8-8.9 m/s), and median CMR-derived pulse wave velocity was 6.3 m/s (interquartile range 5.7-8.2 m/s) (P < 0.001). A strong correlation was detected between both methods (r = 0.724, P < 0.001). Bland-Altman analysis revealed a bias of 0.62 m/s (upper and lower limit of agreement: 3.84 and -2.61 m/s). The coefficient of variation between both methods was 21%. In reperfused STEMI patients, aortic PWV assessed noninvasively by transformation of brachial pressure waveforms showed an acceptable agreement with the CMR-derived transit time method.

  9. Oscillometric Blood Pressure Estimation: Past, Present, and Future.

    PubMed

    Forouzanfar, Mohamad; Dajani, Hilmi R; Groza, Voicu Z; Bolic, Miodrag; Rajan, Sreeraman; Batkin, Izmail

    2015-01-01

    The use of automated blood pressure (BP) monitoring is growing as it does not require much expertise and can be performed by patients several times a day at home. Oscillometry is one of the most common measurement methods used in automated BP monitors. A review of the literature shows that a large variety of oscillometric algorithms have been developed for accurate estimation of BP but these algorithms are scattered in many different publications or patents. Moreover, considering that oscillometric devices dominate the home BP monitoring market, little effort has been made to survey the underlying algorithms that are used to estimate BP. In this review, a comprehensive survey of the existing oscillometric BP estimation algorithms is presented. The survey covers a broad spectrum of algorithms including the conventional maximum amplitude and derivative oscillometry as well as the recently proposed learning algorithms, model-based algorithms, and algorithms that are based on analysis of pulse morphology and pulse transit time. The aim is to classify the diverse underlying algorithms, describe each algorithm briefly, and discuss their advantages and disadvantages. This paper will also review the artifact removal techniques in oscillometry and the current standards for the automated BP monitors.

  10. The impact of arm circumference on noninvasive oscillometric blood pressure referenced with intra-aortic blood pressure.

    PubMed

    Shangguan, Qing; Wu, Yanqing; Xu, Jinsong; Su, Hai; Li, Juxiang; Hong, Kui; Cheng, Xiaoshu

    2015-12-01

    To investigate the influence of arm circumference (AC) on the brachial blood pressure (BP) measured with an adult cuff. This study included 208 patients (150 men, 61.0±8.0 years) for coronary angiography. Intra-aortic BP and noninvasive right brachial oscillometric BP (noninvasive BP) were measured simultaneously before coronary angiography. The noninvasive BP was measured using an electronic oscillometric device with an adult cuff (12×22 cm). The mid-ACs were measured. Thus, proper cuff-arm (≤26 cm) and small cuff (>26 cm) groups were created. The difference in intra-aortic and noninvasive BP was calculated as BPi-n. The correlation coefficients (r) between noninvasive and invasive systolic blood pressure (SBP), mean artery pressure, and diastolic blood pressure (DBP) were 0.88, 0.76, and 0.58, respectively. The SBPi-n was higher (7.9±1.6 vs. 5.2±1.1 mmHg), but the DBPi-n (3.9±1.4 vs. 6.1±1.0 mmHg, P<0.05) was lower in the group ≤26 cm than in the group >26 cm. Among the four subgroups divided by 20-23, 24-26, 27-30, and 31-37 cm of AC, as the AC increased, the SBPi-n increased, but DBP decreased, resulting in noninvasive SBP 4.6 mmHg higher and noninvasive DBP 4.6 mmHg lower in the 31-37 cm group in comparison with the 20-23 cm group. When an adult cuff was used, the noninvasive oscillometric SBP was overestimated, but DBP was underestimated in the individuals with large arms against the intra-aortic BP.

  11. A computational model of the cardiovascular system coupled with an upper-arm oscillometric cuff and its application to studying the suprasystolic cuff oscillation wave, concerning its value in assessing arterial stiffness.

    PubMed

    Liang, Fuyou; Takagi, Shu; Himeno, Ryutaro; Liu, Hao

    2013-01-01

    A variety of methods have been proposed to noninvasively assess arterial stiffness using single or multiple oscillometric cuffs. A common pitfall of most of such methods is that the individual-specific accuracy of assessment is not clearly known due to an insufficient understanding of the relationships between the characteristics of cuff oscillometry and cardiovascular properties. To provide a tool for quantitatively investigating such relationships, we developed a computational model of the cardiovascular system coupled with an oscillometric cuff wrapped around the left upper arm. The model was first examined by simulating the inflation-deflation process of the cuff. The simulated results reasonably reproduced the well-established characteristics of cuff oscillometry. The model was then applied to study the oscillation wave generated by a suprasystolic cuff that is currently under considerable debate regarding its validity for assessing aortic stiffness. The simulated results confirmed the experimental observations that the suprasystolic cuff oscillation wave resembles the blood pressure wave in the proximal brachial artery and is characterised by the presence of two systolic peaks. A systemic analysis on the simulation results for various cardiovascular/physiological conditions revealed that neither the time lag nor the height difference between the two peaks is a direct indicator of aortic stiffness. These findings provided useful evidence for explaining the conflicts among previous studies. Finally, it was stressed that although the emphasis of this study has been placed on a suprasystolic upper-arm cuff, the model could be employed to address more issues related to oscillometric cuffs.

  12. Assessment of sequential same arm agreement of blood pressure measurements by a CVProfilor DO-2020 versus a Baumanometer mercury sphygmomanometer.

    PubMed

    Prisant, L M; Resnick, L M; Hollenberg, S M

    2001-06-01

    The aim of this study was to assess the accuracy of sequential same arm blood pressure measurement by the mercury sphygmomanometer with the oscillometric blood pressure measurements from a device that also determines arterial elasticity. A prospective, multicentre, clinical study evaluated sequential same arm blood pressure measurements, using a mercury sphygmomanometer (Baumanometer, W. A. Baum Co., Inc., Copiague, New York, USA) and an oscillometric non-invasive device that calculates arterial elasticity (CVProfilor DO-2020 Cardiovascular Profiling System, Hypertension Diagnostics, Inc., Eagan, Minnesota, USA). Blood pressure was measured supine in triplicate, 3 min apart in a randomized sequence after a period of rest. The study population of 230 normotensive and hypertensive subjects included 57% females, 51% Caucasians, and 33% African Americans. The mean difference between test methods of systolic blood pressure, diastolic blood pressure, and heart rate was -3.2 +/- 6.9 mmHg, +0.8 +/- 5.9 mmHg, and +1.0 +/- 5.7 beats/minute. For systolic and diastolic blood pressure, 60.9 and 70.4% of sequential measurements by each method were within +/- 5 mmHg. Few or no points fell beyond the mean +/- 2 standard deviations lines for each cuff bladder size. Sequential same arm measurements of the CVProfilor DO-2020 Cardiovascular Profiling System measures blood pressure by an oscillometric method (dynamic linear deflation) with reasonable agreement with a mercury sphygmomanometer.

  13. Improved Measurement of Blood Pressure by Extraction of Characteristic Features from the Cuff Oscillometric Waveform

    PubMed Central

    Lim, Pooi Khoon; Ng, Siew-Cheok; Jassim, Wissam A.; Redmond, Stephen J.; Zilany, Mohammad; Avolio, Alberto; Lim, Einly; Tan, Maw Pin; Lovell, Nigel H.

    2015-01-01

    We present a novel approach to improve the estimation of systolic (SBP) and diastolic blood pressure (DBP) from oscillometric waveform data using variable characteristic ratios between SBP and DBP with mean arterial pressure (MAP). This was verified in 25 healthy subjects, aged 28 ± 5 years. The multiple linear regression (MLR) and support vector regression (SVR) models were used to examine the relationship between the SBP and the DBP ratio with ten features extracted from the oscillometric waveform envelope (OWE). An automatic algorithm based on relative changes in the cuff pressure and neighbouring oscillometric pulses was proposed to remove outlier points caused by movement artifacts. Substantial reduction in the mean and standard deviation of the blood pressure estimation errors were obtained upon artifact removal. Using the sequential forward floating selection (SFFS) approach, we were able to achieve a significant reduction in the mean and standard deviation of differences between the estimated SBP values and the reference scoring (MLR: mean ± SD = −0.3 ± 5.8 mmHg; SVR and −0.6 ± 5.4 mmHg) with only two features, i.e., Ratio2 and Area3, as compared to the conventional maximum amplitude algorithm (MAA) method (mean ± SD = −1.6 ± 8.6 mmHg). Comparing the performance of both MLR and SVR models, our results showed that the MLR model was able to achieve comparable performance to that of the SVR model despite its simplicity. PMID:26087370

  14. Deep learning ensemble with asymptotic techniques for oscillometric blood pressure estimation.

    PubMed

    Lee, Soojeong; Chang, Joon-Hyuk

    2017-11-01

    This paper proposes a deep learning based ensemble regression estimator with asymptotic techniques, and offers a method that can decrease uncertainty for oscillometric blood pressure (BP) measurements using the bootstrap and Monte-Carlo approach. While the former is used to estimate SBP and DBP, the latter attempts to determine confidence intervals (CIs) for SBP and DBP based on oscillometric BP measurements. This work originally employs deep belief networks (DBN)-deep neural networks (DNN) to effectively estimate BPs based on oscillometric measurements. However, there are some inherent problems with these methods. First, it is not easy to determine the best DBN-DNN estimator, and worthy information might be omitted when selecting one DBN-DNN estimator and discarding the others. Additionally, our input feature vectors, obtained from only five measurements per subject, represent a very small sample size; this is a critical weakness when using the DBN-DNN technique and can cause overfitting or underfitting, depending on the structure of the algorithm. To address these problems, an ensemble with an asymptotic approach (based on combining the bootstrap with the DBN-DNN technique) is utilized to generate the pseudo features needed to estimate the SBP and DBP. In the first stage, the bootstrap-aggregation technique is used to create ensemble parameters. Afterward, the AdaBoost approach is employed for the second-stage SBP and DBP estimation. We then use the bootstrap and Monte-Carlo techniques in order to determine the CIs based on the target BP estimated using the DBN-DNN ensemble regression estimator with the asymptotic technique in the third stage. The proposed method can mitigate the estimation uncertainty such as large the standard deviation of error (SDE) on comparing the proposed DBN-DNN ensemble regression estimator with the DBN-DNN single regression estimator, we identify that the SDEs of the SBP and DBP are reduced by 0.58 and 0.57  mmHg, respectively. These indicate that the proposed method actually enhances the performance by 9.18% and 10.88% compared with the DBN-DNN single estimator. The proposed methodology improves the accuracy of BP estimation and reduces the uncertainty for BP estimation. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Respiratory modulation of oscillometric cuff pressure pulses and Korotkoff sounds during clinical blood pressure measurement in healthy adults.

    PubMed

    Chen, Diliang; Chen, Fei; Murray, Alan; Zheng, Dingchang

    2016-05-10

    Accurate blood pressure (BP) measurement depends on the reliability of oscillometric cuff pressure pulses (OscP) and Korotkoff sounds (KorS) for automated oscillometric and manual techniques. It has been widely accepted that respiration is one of the main factors affecting BP measurement. However, little is known about how respiration affects the signals from which BP measurement is obtained. The aim was to quantify the modulation effect of respiration on oscillometric pulses and KorS during clinical BP measurement. Systolic and diastolic BPs were measured manually from 40 healthy subjects (from 23 to 65 years old) under normal and regular deep breathing. The following signals were digitally recorded during linear cuff deflation: chest motion from a magnetometer to obtain reference respiration, cuff pressure from an electronic pressure sensor to derive OscP, and KorS from a digital stethoscope. The effects of respiration on both OscP and KorS were determined from changes in their amplitude associated with respiration between systole and diastole. These changes were normalized to the mean signal amplitude of OscP and KorS to derive the respiratory modulation depth. Reference respiration frequency, and the frequencies derived from the amplitude modulation of OscP and KorS were also calculated and compared. Respiratory modulation depth was 14 and 40 % for OscP and KorS respectively under normal breathing condition, with significant increases (both p < 0.05) to 16 and 49 % with deeper breathing. There was no statistically significant difference between the reference respiration frequency and those derived from the oscillometric and Korotkoff signals (both p > 0.05) during deep breathing, and for the oscillometric signal during normal breathing (p > 0.05). Our study confirmed and quantified the respiratory modulation effect on the oscillometric pulses and KorS during clinical BP measurement, with increased modulation depth under regular deeper breathing.

  16. Arterial Stiffness Measured with the Cuff Oscillometric Method Is Predictive of Exercise Capacity in Patients with Cardiac Diseases.

    PubMed

    Tazawa, Yasushi; Mori, Nobuyoshi; Ogawa, Yoshiko; Ito, Osamu; Kohzuki, Masahiro

    2016-06-01

    Arterial stiffness is widely used in assessing arteriosclerosis in the background of increased cardiovascular events. Arteriosclerosis also causes reduction in exercise capacity, which is a most important prognostic factor in patients with cardiovascular disease; however, data on the association between arterial stiffness and exercise capacity are limited. Therefore, a simple and noninvasive measurement of arterial stiffness that reflects the central circulation and exercise capacity is needed. The arterial velocity pulse index (AVI) is a parameter of arterial stiffness measurable with the cuff oscillometric method; however, the clinical utility of this method is unclear. We aimed to evaluate the trend of AVI in patients with coronary artery disease (CAD), and the association between AVI and exercise capacity. A cross-sectional study of 116 patients with cardiac disease (34 CAD and 82 non-CAD patients) was performed. Non-CAD patients were those with any cardiac diseases who did not have proven CAD. The results showed that the AVI was significantly higher in CAD patients than non-CAD patients (P < 0.05, analysis of covariance). The AVI was inversely correlated with peakVO2 (r = -0.239, P < 0.05) and was a significant explanatory variable for peakVO2 in stepwise regression analysis (β = -14.62, t = -2.5, P < 0.05). These results indicate that the AVI is strongly associated with CAD and predictive of the exercise capacity in patients with cardiac diseases. We, therefore, propose that the cuff oscillometric method is clinically useful in evaluating arterial stiffness in patients with cardiac diseases, especially CAD.

  17. A Microcontroller-Based Device for Monitoring Blood Pressure in the Field

    DTIC Science & Technology

    1993-12-01

    Service de sant6 des Forces armies canadiennes. On a mis au point un appareil de mesure des signes vitaux, qui peut mesurer la fr~quence cardiaque et...methods for taking systolic and diastolic pressure readings include the auscultation method, the oscillometric method, and the ultrasonic method...pressures are determined from its output, are the best ways of distinguishing between the three main methods previously listed. The auscultation method

  18. Forearm and upper-arm oscillometric blood pressure comparison in acutely ill adults.

    PubMed

    Schell, Kathleen; Morse, Kate; Waterhouse, Julie K

    2010-04-01

    When patients' upper arms are not accessible and/or when cuffs do not fit large upper arms, the forearm site is often used for blood pressure (BP) measurement. The purpose of this study is to compare forearm and upper-arm BPs in 70 acutely ill adults, admitted to a community hospital's 14-bed ICU. Using Philips oscillometric monitors, three repeated measures of forearm and upper-arm BPs are obtained with head of bed flat and with head of bed elevated at 30 degrees. Arms are resting on the bed. Paired t tests show statistically significant differences in systolic BPs, diastolic BPs, and mean arterial pressures in the supine and head-elevated positions. Bland-Altman analyses indicate that forearm and upper-arm oscillometric BPs are not interchangeable in acutely ill adults.

  19. ACCURACY OF NONINVASIVE ANESTHETIC MONITORING IN THE ANESTHETIZED GIRAFFE (GIRAFFA CAMELOPARDALIS).

    PubMed

    Bertelsen, Mads F; Grøndahl, Carsten; Stegmann, George F; Sauer, Cathrine; Secher, Niels H; Hasenkam, J Michael; Damkjær, Mads; Aalkjær, Christian; Wang, Tobias

    2017-09-01

    This study evaluated the accuracy of pulse oximetry, capnography, and oscillometric blood pressure during general anesthesia in giraffes (Giraffa camelopardalis). Thirty-two giraffes anesthetized for physiologic experiments were instrumented with a pulse oximeter transmittance probe positioned on the tongue and a capnograph sampling line placed at the oral end of the endotracheal tube. A human size 10 blood pressure cuff was placed around the base of the tail, and an indwelling arterial catheter in the auricular artery continuously measured blood pressure. Giraffes were intermittently ventilated using a Hudson demand valve throughout the procedures. Arterial blood for blood gas analysis was collected at multiple time points. Relationships between oxygen saturation as determined by pulse oximetry and arterial oxygen saturation, between arterial carbon dioxide partial pressure and end-tidal carbon dioxide, and between oscillometric pressure and invasive arterial blood pressure were assessed, and the accuracy of pulse oximetry, capnography, and oscillometric blood pressure monitoring evaluated using Bland-Altman analysis. All three noninvasive methods provided relatively poor estimates of the reference values. Receiver operating characteristic curve fitting was used to determine cut-off values for hypoxia, hypocapnia, hypercapnia, and hypotension for dichotomous decision-making. Applying these cut-off values, there was reasonable sensitivity for detection of hypocapnia, hypercapnia, and hypotension, but not for hypoxemia. Noninvasive anesthetic monitoring should be interpreted with caution in giraffes and, ideally, invasive monitoring should be employed.

  20. Reliability of oscillometric central hemodynamic responses to an orthostatic challenge.

    PubMed

    Stoner, Lee; Bonner, Chantel; Credeur, Daniel; Lambrick, Danielle; Faulkner, James; Wadsworth, Daniel; Williams, Michelle A

    2015-08-01

    Monitoring central hemodynamic responses to an orthostatic challenge may provide important insight into autonomic nervous system function. Oscillometric pulse wave analysis devices have recently emerged, presenting clinically viable options for investigating central hemodynamic properties. The purpose of the current study was to determine whether oscillometric pulse wave analysis can be used to reliably (between-day) assess central blood pressure and central pressure augmentation (augmentation index) responses to a 5 min orthostatic challenge (modified tilt-table). Twenty healthy adults (26.4 y (SD 5.2), 55% F, 24.7 kg/m(2) (SD 3.8)) were tested on 3 different mornings in the fasted state, separated by a maximum of 7 days. Central hemodynamic variables were assessed on the left arm using an oscillometric device. Repeated measures analysis of variance indicated a significant main effect of the modified tilt-table for all central hemodynamic variables (P < 0.001). In response to the tilt, central diastolic pressure increased by 4.5 mmHg (CI: 2.6, 6.4), central systolic blood pressure increased by 2.3 (CI: 4.4, 0.16) mmHg, and augmentation index decreased by an absolute - 5.3%, (CI: -2.7, -7.9%). The intra-class correlation coefficient values for central diastolic pressure (0.83-0.86), central systolic blood pressure (0.80-0.87) and AIx (0.79-0.82) were above the 0.75 criterion in both the supine and tilted positions, indicating excellent between-day reliability. Central hemodynamic responses to an orthostatic challenge can be assessed with acceptable between-day reliability using oscillometric pulse wave analysis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Comparison of auscultatory and oscillometric BP measurements in children with obesity and their effect on the diagnosis of arterial hypertension.

    PubMed

    Fonseca-Reyes, Salvador; Romero-Velarde, Enrique; Torres-Gudiño, Edith; Illescas-Zarate, Daniel; Forsyth-MacQuarrie, Avril M

    The level of agreement between two blood pressure (BP) reading methods, auscultatory vs oscillometric, was examined using a mercury sphygmomanometer and an electronic device in children and adolescents with different levels of obesity. The readings were compared to determine their impact on the diagnosis of pre-hypertension/hypertension. Blood pressure readings were taken in children with obesity (body mass index ≥ 95th percentile) and severe obesity (≥120% 95th percentile). Bland-Altman analysis and Intraclass Correlation Coefficient were used to determine the agreement between measurements. The mercury sphygmomanometer readings were lower than those obtained with the electronic device for both systolic and diastolic BP (P=.01 and P=.001, respectively). The mean systolic and diastolic BP differences between the oscillometric vs first mercury reading were 4.2/10.2mmHg, respectively. A large difference was observed between the BP measurement methods. The ICC showed regular to moderate reliability for the systolic BP (.595), but poor for the diastolic BP (.330). Screening using the first of three mercury measurements showed that 10.4% of the children and adolescents had BPs within the pre-hypertension/hypertension range. This was reduced to 5.2% when the mean of three mercury readings was used. Large discrepancies were observed in both the systolic and diastolic BP. These differences are not clinically acceptable as to consider the two instruments interchangeable. The electronic device readings were higher, and they overestimated the diagnosis of hypertension. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  2. Oscillometric blood pressure devices and simulators: measurements of repeatability and differences between models.

    PubMed

    Sims, A J; Reay, C A; Bousfield, D R; Menes, J A; Murray, A

    2005-01-01

    To measure the repeatability and pressure pulse envelope of simulators used for testing oscillometric non-invasive blood pressure (NIBP) devices; to study the effect of different envelopes on NIBP devices, and to measure the difference between NIBP devices due to different oscillometric algorithms. Three different models of NIBP simulator and 18 different patient monitors with NIBP function were studied. We developed a pressure measurement system (accuracy 0.048?mmHg) to measure the repeatability of simulators. The effect of changing the envelope was measured by using three simulators with one NIBP device. Differences between 18 NIBP devices were measured using one simulator at seven blood pressure settings. Simulators generate repeatable pressure pulse envelopes (< 0.2 mmHg) but the magnitude and shape depends on the model of simulator. Oscillometric NIBP devices are highly repeatable (< 2 mmHg) when presented with a repeatable pressure pulse envelope, but different devices employ different algorithms and give different results. For a simulated standard blood pressure setting of 120/80 mmHg, estimates of systolic pressure ranged from 112.6 to 126.6 mmHg (sd of 3.0 mmHg), and diastolic pressure ranged from 74.8 to 86.9 mmHg (sd of 3.5 mmHg). Simulators and NIBP devices are sufficiently repeatable for clinical use, but further systematic clinical studies are required to better characterize the pressure pulse envelope for different patient groups.

  3. Validation of a new algorithm for the BPM-100 electronic oscillometric office blood pressure monitor.

    PubMed

    Wright, J M; Mattu, G S; Perry, T L; Gelferc, M E; Strange, K D; Zorn, A; Chen, Y

    2001-06-01

    To test the accuracy of a new algorithm for the BPM-100, an automated oscillometric blood pressure (BP) monitor, using stored data from an independently conducted validation trial comparing the BPM-100(Beta) with a mercury sphygmomanometer. Raw pulse wave and cuff pressure data were stored electronically using embedded software in the BPM-100(Beta), during the validation trial. The 391 sets of measurements were separated objectively into two subsets. A subset of 136 measurements was used to develop a new algorithm to enhance the accuracy of the device when reading higher systolic pressures. The larger subset of 255 measurements (three readings for 85 subjects) was used as test data to validate the accuracy of the new algorithm. Differences between the new algorithm BPM-100 and the reference (mean of two observers) were determined and expressed as the mean difference +/- SD, plus the percentage of measurements within 5, 10, and 15 mmHg. The mean difference between the BPM-100 and reference systolic BP was -0.16 +/- 5.13 mmHg, with 73.7% < or = 5 mmHg, 94.9% < or = 10 mmHg and 98.8% < or = 15 mmHg. The mean difference between the BPM-100 and reference diastolic BP was -1.41 +/- 4.67 mmHg, with 78.4% < or = 5 mmHg, 92.5% < or = 10 mmHg, and 99.2% < or = 15 mmHg. These data improve upon that of the BPM-100(Beta) and pass the AAMI standard, and 'A' grade BHS protocol. This study illustrates a new method for developing and testing a change in an algorithm for an oscillometric BP monitor utilizing collected and stored electronic data and demonstrates that the new algorithm meets the AAMI standard and BHS protocol.

  4. Arterial blood pressure estimation using ultrasound: Clinical results on healthy volunteers and a medicated hypertensive volunteer.

    PubMed

    Zakrzewski, Aaron M; Anthony, Brian W

    2017-07-01

    This study presents a non-occlusive and non-invasive ultrasound-based technique to measure blood pressure. Most popular clinically-used arterial blood pressure measurement techniques suffer from important weaknesses including being inaccurate, invasive, or occlusive. In the proposed technique, an ultrasound probe is placed on the patient's carotid artery and the contact force between the probe and the tissue is slowly increased while ultrasound images and contact force data are recorded. From this data, the artery is segmented and the segmentation data is sent into an optimization procedure; after post-processing, blood pressure is displayed to the user. This technique was applied to 24 healthy single-visit volunteers, one multi-visit healthy volunteer, and one multi-visit medicated hypertensive volunteer. Compared to the oscillometric cuff, the accuracy and precision of the algorithm-reported systolic pressure is -2.4 ± 10.2 mmHg, and for diastolic pressure is -0.3 ± 8.2 mmHg. This method has the potential to occupy a clinical middle-ground between the arterial catheter and the oscillometric cuff.

  5. Simultaneous inter-arm and inter-leg systolic blood pressure differences to diagnose peripheral artery disease: a diagnostic accuracy study.

    PubMed

    Herráiz-Adillo, Ángel; Soriano-Cano, Alba; Martínez-Hortelano, José Alberto; Garrido-Miguel, Miriam; Mariana-Herráiz, Julián Ángel; Martínez-Vizcaíno, Vicente; Notario-Pacheco, Blanca

    2018-04-01

    Inter-arm systolic blood pressure differences (IASBPD) and inter-leg systolic blood pressure differences (ILSBPD) have arisen as potential tools to detect peripheral artery disease (PAD) and individuals at high cardiovascular risk. This study aims to evaluate the diagnostic accuracy of IASBPD and ILSBPD to detect PAD, and whether IASBPD or ILSBPD improves diagnostic accuracy of the oscillometric ankle-brachial index (ABI). In this prospective study, eligible for inclusion were consecutive adults, with at least one of the following cardiovascular risk factors: diabetes, dyslipidemia, hypertension, smoking habit or age ≥65. IASBPD, ILSBPD and ankle-brachial index (ABI) were measured in all participants through four-limb simultaneous oscillometric measurements and compared with Doppler ABI (reference test, positive cut-off: ≤ 0.9). Of 171 subjects included, PAD was confirmed in 23 and excluded in 148. Thirteen and 38 subjects had IASBPD and ILSBPD ≥10 mmHg, respectively. Pearson correlation with Doppler ABI of IASBPD and ILSBPD was 0.073 (P = .343) and -0.628 (P < .001), respectively. Diagnostic accuracy of an ILSBPD ≥10 mmHg to detect PAD was: sensitivity = 69.6% (95%CI = 48.6-90.5), specificity = 85.1% (79.1-91.2), diagnostic odds ratio (dOR) = 13.1 (4.8-35.5) and area under ROC curve (AUC) = 0.765 (0.616-0.915). IASBPD had an AUC = 0.532 (0.394-0.669), and oscillometric ABI had an AUC = 0.977 (0.950-1.000). The addition of ILSBPD to oscillometric ABI reduced dOR from 174.0 (38.3-789.9) to 34.4 (9.5-125.1). Similarly, the addition of IASBPD reduced dOR to 49.3 (14.6-167.0). In a Primary Care population with ≥1 cardiovascular risk factors, ILSBPD showed acceptable diagnostic accuracy for PAD, whilst IASBPD accuracy was negligible. However, the combination of ILSBPD (or IASBPD) with oscillometric ABI did not improve the ability to detect PAD. Thus, oscillometer ABI seems to be preferable to detect PAD and individuals at high cardiovascular risk. ILSBPD could be uniquely recommended for the diagnosis of PAD when blood pressure measurements in upper limbs are not possible.

  6. Ankle-Brachial index by oscillometry: A very useful method to assess peripheral arterial disease in diabetes

    PubMed Central

    Premanath, M.; Raghunath, M.

    2010-01-01

    Background: Peripheral Arterial Disease (PAD) remains the least recognized form of atherosclerosis. The Ankle-Brachial Index (ABI) has emerged as one of the potent markers of diffuse atherosclerosis, cardiovascular (CV) risk, and overall survival in general public, especially in diabetics. The important reason for the lack of early diagnosis is the non-availability of a test that is easy to perform and less expensive, with no training required. Objectives: To evaluate the osillometric method of performing ABI with regard to its usefulness in detecting PAD cases and to correlate the signs and symptoms with ABI. Materials and Methods: Two hundred diabetics of varying duration attending the clinic for a period of eight months, from August 2006 to April 2007, were evaluated for signs, symptoms, and risk factors. ABI was performed using the oscillometric method. The positives were confirmed by Doppler evaluation. An equal number of age- and sex-matched controls, which were ABI negative, were also assessed by Doppler. Sensitivity and Specificity were determined. Results: There were 120 males and 80 females. Twelve males (10%) and six females (7.5%) were ABI positive. On Doppler, eleven males (91.5%) and three females (50%) were true positives. There were six false negatives from the controls (three each). The Sensitivity was 70% and Specificity was 75%. Symptoms and signs correlated well with ABI positives. Hypertension was the most important risk factor. Conclusions: In spite of the limitations, the oscillometric method of performing ABI is a simple procedure, easy to perform, does not require training and can be performed as an outpatient procedure not only by doctors, but also by the paramedical staff to detect more PAD cases. PMID:20535314

  7. Assessment of central haemomodynamics from a brachial cuff in a community setting

    PubMed Central

    2012-01-01

    Background Large artery stiffening and wave reflections are independent predictors of adverse events. To date, their assessment has been limited to specialised techniques and settings. A new, more practical method allowing assessment of central blood pressure from waveforms recorded using a conventional automated oscillometric monitor has recently been validated in laboratory settings. However, the feasibility of this method in a community based setting has not been assessed. Methods One-off peripheral and central haemodynamic (systolic and diastolic blood pressure (BP) and pulse pressure) and wave reflection parameters (augmentation pressure (AP) and index, AIx) were obtained from 1,903 volunteers in an Austrian community setting using a transfer-function like method (ARCSolver algorithm) and from waveforms recorded with a regular oscillometric cuff. We assessed these parameters for known differences and associations according to gender and age deciles from <30 years to >80 years in the whole population and a subset with a systolic BP < 140 mmHg. Results We obtained 1,793 measures of peripheral and central BP, PP and augmentation parameters. Age and gender associations with central haemodynamic and augmentation parameters reflected those previously established from reference standard non-invasive techniques under specialised settings. Findings were the same for patients with a systolic BP below 140 mmHg (i.e. normotensive). Lower values for AIx in the current study are possibly due to differences in sampling rates, detection frequency and/or averaging procedures and to lower numbers of volunteers in younger age groups. Conclusion A novel transfer-function like algorithm, using brachial cuff-based waveform recordings, provides robust and feasible estimates of central systolic pressure and augmentation in community-based settings. PMID:22734820

  8. Validation of the Omron M3 Intellisense (HEM-7051-E) upper arm blood pressure monitor, for self-measurement, according to the European Society of Hypertension International Protocol revision 2010 in a stage 3-5 chronic kidney disease population.

    PubMed

    Akpolat, Tekin; Erdem, Emre; Aydogdu, Türkan

    2012-01-01

    Encouragement of home blood pressure (BP) monitoring has a great potential to improve hypertension control rates. The purpose of this study was to test validation of the Omron M3 Intellisense (HEM-7051-E) upper arm BP measuring monitor for self-measurement according to the European Society of Hypertension International Protocol revision 2010 (ESH-IP2) in stage 3-5 chronic kidney disease (CKD) patients. 66 patients having CKD stage 3-5 were included in the study. Nine consecutive measurements were made according to the ESH-IP2 protocol. The Omron M3 Intellisense device fulfills the validation criteria of the ESH-IP2 for stage 3-5 CKD patients. Although arterial stiffness can affect accurate BP measurement, there are limited data regarding the use of automated oscillometric devices in CKD. To our knowledge, this is the first study investigating validation of an oscillometric device in stage 3-5 predialysis CKD patients. This study validates the Omron M3 Intellisense upper arm device for stage 3-5 CKD patients. New validation studies investigating other oscillometric sphygmomanometers for CKD patients and involvement of nephrologists in these studies have great potential to increase patient care in CKD. Copyright © 2011 S. Karger AG, Basel.

  9. The effect of back and feet support on oscillometric blood pressure measurements.

    PubMed

    Ringrose, Jennifer S; Wong, Jonathan; Yousefi, Farahnaz; Padwal, Raj

    2017-08-01

    Recommendations to support the back and feet during blood pressure (BP) measurement are not always followed in clinical practice. Our objective was to determine to what extent back and feet support affects mean oscillometric BP measurements. Eighty-five consecutive, consenting participants 18 years or older with systolic BP readings 80-220 mmHg and diastolic BP readings 50-120 mmHg and arm circumferences of 25-43 cm were recruited. BP was measured using an Omron HEM 907 oscillometric device. Back and feet support were examined independently. First, while the feet were supported, two sets of three BP readings were taken in random order: one with the back supported and one with the back unsupported. Next, with the back supported, two sets of three BP readings were taken in random order: one with the feet dangling and one with feet supported. The mean age of the participants was 52.0±20.7 years and the mean arm circumference was 31.0±3.2 cm; 62% were women and 49% had hypertension. The mean BP levels with the back unsupported were slightly higher than those with the back supported (119.8±15.5/69.9±8.9 vs. 119.2±16.4/68.2±8.8 mmHg; difference of 0.7±4.9/1.8±3.0; P=0.21 for systolic and <0.0001 for diastolic comparisons). The mean BP levels with feet dangling were slightly lower than with feet supported (120.3±16.3/72.6±8.9 vs. 121.2±16.1/72.9±8.6 mmHg; difference of -0.9±4.1/-0.3±2.8; P=0.04 for systolic and <0.36 for diastolic comparisons). Systolic BP differences were greater than or equal to 5 mmHg in 34% (back phase) and 23% (feet phase) of the participants. Provision of back and feet support has a small effect on the mean oscillometric BP. The magnitude of effect is greatest on diastolic BP when the back is unsupported.

  10. Significantly Reduced Blood Pressure Measurement Variability for Both Normotensive and Hypertensive Subjects: Effect of Polynomial Curve Fitting of Oscillometric Pulses

    PubMed Central

    Zhu, Mingping; Chen, Aiqing

    2017-01-01

    This study aimed to compare within-subject blood pressure (BP) variabilities from different measurement techniques. Cuff pressures from three repeated BP measurements were obtained from 30 normotensive and 30 hypertensive subjects. Automatic BPs were determined from the pulses with normalised peak amplitude larger than a threshold (0.5 for SBP, 0.7 for DBP, and 1.0 for MAP). They were also determined from cuff pressures associated with the above thresholds on a fitted curve polynomial curve of the oscillometric pulse peaks. Finally, the standard deviation (SD) of three repeats and its coefficient of variability (CV) were compared between the two automatic techniques. For the normotensive group, polynomial curve fitting significantly reduced SD of repeats from 3.6 to 2.5 mmHg for SBP and from 3.7 to 2.1 mmHg for MAP and reduced CV from 3.0% to 2.2% for SBP and from 4.3% to 2.4% for MAP (all P < 0.01). For the hypertensive group, SD of repeats decreased from 6.5 to 5.5 mmHg for SBP and from 6.7 to 4.2 mmHg for MAP, and CV decreased from 4.2% to 3.6% for SBP and from 5.8% to 3.8% for MAP (all P < 0.05). In conclusion, polynomial curve fitting of oscillometric pulses had the ability to reduce automatic BP measurement variability. PMID:28785580

  11. Precision Medicine for Hypertension Management in Chronic Kidney Disease: Relevance of SPRINT for Therapeutic Targets in Nondiabetic Renal Disease.

    PubMed

    Ruzicka, Marcel; Burns, Kevin D; Hiremath, Swapnil

    2017-05-01

    In this review we evaluate the literature to determine if lower blood pressure (BP) targets are beneficial for patients with nondiabetic chronic kidney disease (CKD). Modification of Diet in Renal Disease (MDRD), African American Study of Kidney Disease and Hypertension (AASK), and Ramipril Efficacy in Nephropathy-2 (REIN-2), designed to assess the benefit of lower BP on progression of nondiabetic CKD, generally came to the same negative conclusion. They were not designed and powered to assess an effect of lower BP on cardiovascular outcomes. The Systolic Blood Pressure Intervention Trial (SPRINT) was the first trial designed and powered to address this issue, and showed a clear benefit of a lower targeted and achieved BP. SPRINT did not show any renal benefits from lower BP, and it was not designed to assess this outcome, and it enrolled patients with less "renal risk" per se. A distinguishing feature of SPRINT compared with other large trials is that it highlighted the importance of precise BP measurement methods in defining targets in hypertension treatment. Accordingly, we propose that SPRINT is truly a "game-changing" clinical trial that sets the bar for management of hypertension in select patients with nondiabetic CKD. In these patients, systolic BP target depends critically on the BP measurement method: < 140 mm Hg when derived from 3 readings using a mercury sphygmomanometer after 5 minutes of rest, < 130 mm Hg when calculated from at a minimum of 3 readings using an automated oscillometric device, and < 120 mm Hg when taken using an automated oscillometric device after 5 minutes of unattended rest. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  12. Oscillometric estimation of central blood pressure: validation of the Mobil-O-Graph in comparison with the SphygmoCor device.

    PubMed

    Weiss, Wolfgang; Gohlisch, Christopher; Harsch-Gladisch, Christl; Tölle, Markus; Zidek, Walter; van der Giet, Markus

    2012-06-01

    Hypertension is a major risk factor for a wide range of cardiovascular diseases and is typically identified by measuring blood pressure (BP) at the brachial artery. Although such a measurement may accurately determine diastolic BP, systolic BP is not reflected accurately. Current noninvasive techniques for assessing central aortic BP require additional recording of an arterial pressure wave using a high-fidelity applanation tonometer. Within one measurement cycle, the Mobil-O-Graph BP device uses brachial oscillometric BP waves for a noninvasive estimation of central BP. We therefore validated the Mobil-O-Graph against the SphygmoCor device, which is widely known as the commonly used approach for a noninvasive estimation of central BP. For each individual, we compared three readings of the central BP values obtained by the Mobil-O-Graph and SphygmoCor device consecutively. One hundred individuals (mean age 56.1 ± 15.4 years) were recruited for measurement.Differences between the central BP values of the test device and the SphygmoCor device were calculated for each measurement. The mean difference (95% confidence interval) for the estimated central systolic BP between both devices was -0.6 ± 3.7 mmHg. Comparison of the central BP values measured by the two devices showed a statistically significant linear correlation (R=0.91, P<0.0001). The mean between-method difference was 0.50 mmHg for central systolic BP estimation. The intrarater reproducibility between both the devices was also comparable. Bland and Altman analyses showed that the mean differences (95% confidence interval) between repeated measurements were 1.89 (0.42-3.36) mmHg and 1.36 (-0.16 to 2.83) mmHg for the SphygmoCor and the Mobil-O-Graph device, respectively. Thus, neither of these differences was statistically significantly different from 0. The limits of agreement were -16.34 to 19.73 and -15.23 to 17.17 mmHg for the SphygmoCor and the Mobil-O-Graph device, respectively. Oscillometric noninvasive estimation of central BP with the Mobil-O-Graph BP device is as effective as using the well-established SphygmoCor applanation tonometry device. In comparison, the Mobil-O-Graph combines the widespread benefits of brachial BP measurement and also provides central BP within one measurement.

  13. A Comparison of the Diagnostic Accuracy of Common Office Blood Pressure Monitoring Protocols.

    PubMed

    Kronish, I M; Edmondson, D; Shimbo, D; Shaffer, J A; Krakoff, L R; Schwartz, J E

    2018-04-20

    The optimal approach to measuring office blood pressure (BP) is uncertain. We aimed to compare BP measurement protocols that differed based on numbers of readings within and between visits and by assessment method. We enrolled a sample of 707 employees without known hypertension or cardiovascular disease, and obtained 6 standardized BP readings during each of 3 office visits at least 1 week apart, using mercury sphygmomanometer and BpTRU oscillometric devices (18 readings per participant) for a total of 12,645 readings. We used confirmatory factor analysis to develop a model estimating "true" office BP that could be used to compare the probability of correctly classifying participants' office BP status using differing numbers and types of office BP readings. Averaging two systolic BP readings across two visits correctly classified participants as having BP below or above the 140 mmHg threshold at least 95% of the time if the averaged reading was <134 mmHg or >149 mmHg, respectively. Our model demonstrated that more confidence was gained by increasing the number of visits with readings than by increasing the number of readings within a visit. No clinically significant confidence was gained by dropping the first reading versus averaging all readings, nor by measuring with a manual mercury device versus with an automated oscillometric device. Averaging two BP readings across two office visits appeared to best balance increased confidence in office BP status with efficiency of BP measurement, though the preferred measurement strategy may vary with the clinical context.

  14. Impact of applying the more stringent validation criteria of the revised European Society of Hypertension International Protocol 2010 on earlier validation studies.

    PubMed

    Stergiou, George S; Karpettas, Nikos; Atkins, Neil; O'Brien, Eoin

    2011-04-01

    Since 2002 when the European Society of Hypertension International Protocol (ESH-IP) was published it has become the preferred protocol for validating blood pressure monitors worldwide. In 2010, a revised version of the ESH-IP with more stringent criteria was published. This study assesses the impact of applying the revised ESH-IP criteria. A systematic literature review of ESH-IP studies reported between 2002 and 2010 was conducted. The impact of applying the ESH-IP 2010 criteria retrospectively on the data reported in these studies was investigated. The performance of the oscillometric devices in the last decade was also investigated on the basis of the ESH-IP criteria. Among 119 published studies, 112 with sufficient data were analyzed. According to ESH-IP 2002, the test device failed in 19 studies, whereas by applying the ESH-IP 2010 criteria in 28 additional studies increased the failure rate from 17 to 42%. Of these 28 studies, in 20 (71%) the test device failed at part 1 (accuracy per measurement) and in 22 (79%) at part 2 (accuracy per subject). Most of the failures involved the '5 mmHg or less' criterion. In the last decade there has been a consistent trend toward improved performance of oscillometric devices assessed on the basis of the ESH-IP criteria. This retrospective analysis shows that the stricter revised ESH-IP 2010 criteria will noticeably increase the failure rate of devices being validated. Oscillometric devices are becoming more accurate, and the revised ESH-IP by acknowledging this trend will allow more accurate devices to enter the market.

  15. Cuff-Based Oscillometric Central and Brachial Blood Pressures Obtained Through ABPM are Similarly Associated with Renal Organ Damage in Arterial Hypertension.

    PubMed

    Fernández-Llama, Patricia; Pareja, Júlia; Yun, Sergi; Vázquez, Susana; Oliveras, Anna; Armario, Pedro; Blanch, Pedro; Calero, Francesca; Sierra, Cristina; de la Sierra, Alejandro

    2017-01-01

    Central blood pressure (BP) has been suggested to be a better estimator of hypertension-associated risks. We aimed to evaluate the association of 24-hour central BP, in comparison with 24-hour peripheral BP, with the presence of renal organ damage in hypertensive patients. Brachial and central (calculated by an oscillometric system through brachial pulse wave analysis) office BP and ambulatory BP monitoring (ABPM) data and aortic pulse wave velocity (PWV) were measured in 208 hypertensive patients. Renal organ damage was evaluated by means of the albumin to creatinine ratio and the estimated glomerular filtration rate. Fifty-four patients (25.9%) were affected by renal organ damage, displaying either microalbuminuria (urinary albumin excretion ≥30 mg/g creatinine) or an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2. Compared to those without renal abnormalities, hypertensive patients with kidney damage had higher values of office brachial systolic BP (SBP) and pulse pressure (PP), and 24-h, daytime, and nighttime central and brachial SBP and PP. They also had a blunted nocturnal decrease in both central and brachial BP, and higher values of aortic PWV. After adjustment for age, gender, and antihypertensive treatment, only ABPM-derived BP estimates (both central and brachial) showed significant associations with the presence of renal damage. Odds ratios for central BP estimates were not significantly higher than those obtained for brachial BP. Compared with peripheral ABPM, cuff-based oscillometric central ABPM does not show a closer association with presence of renal organ damage in hypertensive patients. More studies, however, need to be done to better identify the role of central BP in clinical practice. © 2017 The Author(s). Published by S. Karger AG, Basel.

  16. [Metformin and changes in blood pressure and heart rate in lean patients with polycystic ovary syndrome (PCOS)--preliminary study].

    PubMed

    Tomczyk, Rita; Ociepka, Agnieszka; Kiałka, Marta; Milewicz, Tomasz; Migacz, Kamila; Kowalczuk, Aleksandra; Klocek, Marek

    2015-01-01

    The aim of our study was to assess the value of blood pressure and heart rate using the 24-hour blood pressure monitoring (ABPM) before and after treatment with metformin to patients with polycystic ovary syndrome (PCOS) and normal lean. 5 patients received metformin 1500 mg per day in three divided doses. ABPM was performed to each patient with PCOS twice: before and after 6 months of treatment with metformin. In patients with PCOS and normal lean after treatment with metformin we observed: statistically significant lower systolic blood pressure (120.2 ± 22.33 mmHg vs 113.22 ± 21.43 mm Hg, p = 0.0248); lower systolic blood pressure of daily measurements (127.1 ± 32.13 mmHg vs 116.1 ± 22.08 mmHg, p = 0.0062); reduction in average arterial pressure MAP in the measurement of the day (95.52 ± 22.76 mmHg vs 88.36 ± 16.41 mmHg, p = 0.048); oscillometric pressure reduction (96.27 ± 27.93 mmHg vs 87.82 ± 21.61, p = 0.0004 mmHg); oscillometric pressure reduction of daily measurements (102.1 ± 27.93 mmHg vs 91.85 ± 21.61 mmHg, p = 0.0032); oscillometric pressure reduction in the measure- ment of the night (88.81 ± 24.85 mmHg vs 82.22 ± 20.54 mmHg, p = 0.0089). In women after treatment with metformin has also been observed higher average heart rate (65.82 ± 13.48 / min vs. 70.71 ± 16.04 min; p < 0.01). The calculations included 500 measurements. Treatment with metformin in patients with PCOS and normal lean leads to lower blood pressure and increases the frequency of heart rate.

  17. Advanced instrumentation for research in diving and hyperbaric medicine.

    PubMed

    Sieber, Arne; L'Abbate, Antonio; Kuch, Benjamin; Wagner, Matthias; Benassi, Antonio; Passera, Mirko; Bedini, Remo

    2010-01-01

    Improving the safety of diving and increasing knowledge about the adaptation of the human body to underwater and hyperbaric environment require specifically developed underwater instrumentation for physiological measurements. In fact, none of the routine clinical devices for health control is suitable for in-water and/or under-pressure operation. The present paper addresses novel technological acquisitions and the development of three dedicated devices: * an underwater data logger for recording O2 saturation (reflective pulsoxymetry), two-channel ECG, depth and temperature; * an underwater blood pressure meter based on the oscillometric method; and * an underwater echography system. Moreover, examples of recordings are presented and discussed.

  18. Importance of Calibration Method in Central Blood Pressure for Cardiac Structural Abnormalities.

    PubMed

    Negishi, Kazuaki; Yang, Hong; Wang, Ying; Nolan, Mark T; Negishi, Tomoko; Pathan, Faraz; Marwick, Thomas H; Sharman, James E

    2016-09-01

    Central blood pressure (CBP) independently predicts cardiovascular risk, but calibration methods may affect accuracy of central systolic blood pressure (CSBP). Standard central systolic blood pressure (Stan-CSBP) from peripheral waveforms is usually derived with calibration using brachial SBP and diastolic BP (DBP). However, calibration using oscillometric mean arterial pressure (MAP) and DBP (MAP-CSBP) is purported to provide more accurate representation of true invasive CSBP. This study sought to determine which derived CSBP could more accurately discriminate cardiac structural abnormalities. A total of 349 community-based patients with risk factors (71±5years, 161 males) had CSBP measured by brachial oscillometry (Mobil-O-Graph, IEM GmbH, Stolberg, Germany) using 2 calibration methods: MAP-CSBP and Stan-CSBP. Left ventricular hypertrophy (LVH) and left atrial dilatation (LAD) were measured based on standard guidelines. MAP-CSBP was higher than Stan-CSBP (149±20 vs. 128±15mm Hg, P < 0.0001). Although they were modestly correlated (rho = 0.74, P < 0.001), the Bland-Altman plot demonstrated a large bias (21mm Hg) and limits of agreement (24mm Hg). In receiver operating characteristic (ROC) curve analyses, MAP-CSBP significantly better discriminated LVH compared with Stan-CSBP (area under the curve (AUC) 0.66 vs. 0.59, P = 0.0063) and brachial SBP (0.62, P = 0.027). Continuous net reclassification improvement (NRI) (P < 0.001) and integrated discrimination improvement (IDI) (P < 0.001) corroborated superior discrimination of LVH by MAP-CSBP. Similarly, MAP-CSBP better distinguished LAD than Stan-CSBP (AUC 0.63 vs. 0.56, P = 0.005) and conventional brachial SBP (0.58, P = 0.006), whereas Stan-CSBP provided no better discrimination than conventional brachial BP (P = 0.09). CSBP is calibration dependent and when oscillometric MAP and DBP are used, the derived CSBP is a better discriminator for cardiac structural abnormalities. © American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Validity and reliability of central blood pressure estimated by upper arm oscillometric cuff pressure.

    PubMed

    Climie, Rachel E D; Schultz, Martin G; Nikolic, Sonja B; Ahuja, Kiran D K; Fell, James W; Sharman, James E

    2012-04-01

    Noninvasive central blood pressure (BP) independently predicts mortality, but current methods are operator-dependent, requiring skill to obtain quality recordings. The aims of this study were first, to determine the validity of an automatic, upper arm oscillometric cuff method for estimating central BP (O(CBP)) by comparison with the noninvasive reference standard of radial tonometry (T(CBP)). Second, we determined the intratest and intertest reliability of O(CBP). To assess validity, central BP was estimated by O(CBP) (Pulsecor R6.5B monitor) and compared with T(CBP) (SphygmoCor) in 47 participants free from cardiovascular disease (aged 57 ± 9 years) in supine, seated, and standing positions. Brachial mean arterial pressure (MAP) and diastolic BP (DBP) from the O(CBP) device were used to calibrate in both devices. Duplicate measures were recorded in each position on the same day to assess intratest reliability, and participants returned within 10 ± 7 days for repeat measurements to assess intertest reliability. There was a strong intraclass correlation (ICC = 0.987, P < 0.001) and small mean difference (1.2 ± 2.2 mm Hg) for central systolic BP (SBP) determined by O(CBP) compared with T(CBP). Ninety-six percent of all comparisons (n = 495 acceptable recordings) were within 5 mm Hg. With respect to reliability, there were strong correlations but higher limits of agreement for the intratest (ICC = 0.975, P < 0.001, mean difference 0.6 ± 4.5 mm Hg) and intertest (ICC = 0.895, P < 0.001, mean difference 4.3 ± 8.0 mm Hg) comparisons. Estimation of central SBP using cuff oscillometry is comparable to radial tonometry and has good reproducibility. As a noninvasive, relatively operator-independent method, O(CBP) may be as useful as T(CBP) for estimating central BP in clinical practice.

  20. [Comparison of invasive blood pressure measurement in the aorta with indirect oscillometric blood pressure measurement at the wrist and forearm].

    PubMed

    Saul, F; Aristidou, Y; Klaus, D; Wiemeyer, A; Lösse, B

    1995-09-01

    Indirectly measured blood pressure at the wrist or upper arm was compared with directly measured values in the aortic arch during routinely performed diagnostic cardiac catheterization in 100 patients (31-80 years, mean 59.3 years, 60% males). The noninvasive measurements were carried out by oscillometric devices, NAiS Blood Pressure Watch for measurements at the wrist, and Hestia OZ80 at the upper arm. Systolic blood pressure measured at the wrist was 4.3 +/- 14.1 mm Hg, and the diastolic value 6.0 +/- 8.9 mm Hg higher than when measured at the aortic arch; the difference was significant in both cases. Correlation coefficients were 0.85 for systolic and 0.71 for diastolic blood pressure. In 16% of the patients the systolic blood pressure at the wrist differed more than +/- 20 mm Hg. The diastolic blood pressure at the wrist measured more than +/- 20 mm Hg higher than in the aorta in 5% of the patients. At the upper arm mean systolic values were not different to the aorta. The diastolic pressure was 9.3 +/- 9.8 mm Hg higher in the aorta than at the upper arm. To verify the accuracy of values measured with the NAiS Blood Pressure Watch compared with the standard technique at the upper arm, sequential measurements were made at wrist and ipsilateral upper arm in the same group of 100 patients. The systolic blood pressure at the left wrist was 3.4 +/- 13.3 mm Hg higher and the diastolic pressure 3.8 +/- 9.5 mm Hg lower than at the upper arm. Only 53% of systolic values lay within a range of +/- 10 mm Hg. The correspondence between wrist and upper arm values was better for diastolic blood pressure, the values differing by less than +/- 10 mm Hg in two-thirds of patients. Self-measurement of arterial blood pressure with an oscillometric device at the wrist can be recommended only in individual cases with a difference of simultaneously measured values at the upper arm of less than +/- 10 mm Hg for systolic and diastolic blood pressures. The standard method for indirectly measuring arterial blood pressure remains the measurement at the upper arm site, which nevertheless showed a systolic pseudohypertension (deviation of more than 10 mm Hg) in comparison to the invasively measured values in 15% of our selected patients and a diastolic pseudohypertension (deviation of more than 15 mm Hg) in 23% of the patients.

  1. Athermal laser treatment of the diabetic leg

    NASA Astrophysics Data System (ADS)

    Ignat, P.; Suteanu, S.; Brojbeanu, Gabriela; Vasiliu, Virgil V.

    1995-03-01

    This work shows the result obtained in the medical clinic of the `Dr. I. Cantacuzino Hospital' on a lot of 43 diabetic patients using the `LASSIS' devices composed of a He-Ne laser and 4 semiconductor lasers. The 43 patients showed various clinic pictures of a diabetic leg (diabetic arteriopathy and neuropathy) 16 of the lot showed an arteriopathy with claudication and a decrease of pulses oscillometrically measurements, 15 had ulceration and a beginning of gangrene and the other 12 showed a plantary boring ill. There has been achieved an amelioration of the oscillometric index of the claudication while walking the amelioration of local circulation, together with the limitation of the necrosis. For the boring ill, there has been achieved the acceleration of the granulating and epithelization process avoiding surgeries, suppuration and cutaneous plasties. The response to the laser treatment was compared to the response to the classic treatment (vasodilatation surgery unstrapping, antibiotherapy) on a proving lot. We appreciated that the cicatrization and local vasodilatation with athermal laser treatment should be a hope for the treatment of patients suffering of diabetic arteriopathy and neuropathy.

  2. Genetic influence on the relation between exhaled nitric oxide and pulse wave reflection.

    PubMed

    Tarnoki, David Laszlo; Tarnoki, Adam Domonkos; Medda, Emanuela; Littvay, Levente; Lazar, Zsofia; Toccaceli, Virgilia; Fagnani, Corrado; Stazi, Maria Antonietta; Nisticó, Lorenza; Brescianini, Sonia; Penna, Luana; Lucatelli, Pierleone; Boatta, Emanuele; Zini, Chiara; Fanelli, Fabrizio; Baracchini, Claudio; Meneghetti, Giorgio; Koller, Akos; Osztovits, Janos; Jermendy, Gyorgy; Preda, Istvan; Kiss, Robert Gabor; Karlinger, Kinga; Lannert, Agnes; Horvath, Tamas; Schillaci, Giuseppe; Molnar, Andrea Agnes; Garami, Zsolt; Berczi, Viktor; Horvath, Ildiko

    2013-06-01

    Nitric oxide has an important role in the development of the structure and function of the airways and vessel walls. Fractional exhaled nitric oxide (FE(NO)) is inversely related to the markers and risk factors of atherosclerosis. We aimed to estimate the relative contribution of genes and shared and non-shared environmental influences to variations and covariation of FE(NO) levels and the marker of elasticity function of arteries. Adult Caucasian twin pairs (n = 117) were recruited in Hungary, Italy and in the United States (83 monozygotic and 34 dizygotic pairs; age: 48 ± 16 SD years). FE(NO) was measured by an electrochemical sensor-based device. Pulse wave reflection (aortic augmentation index, Aix(ao)) was determined by an oscillometric method (Arteriograph). A bivariate Cholesky decomposition model was applied to investigate whether the heritabilities of FE(NO) and Aix(ao) were linked. Genetic effects accounted for 58% (95% confidence interval (CI): 42%, 71%) of the variation in FE(NO) with the remaining 42% (95%CI: 29%, 58%) due to non-shared environmental influences. A modest negative correlation was observed between FE(NO) and Aix(ao) (r = -0.17; 95%CI:-0.32,-0.02). FE(NO) showed a significant negative genetic correlation with Aix(ao) (r(g) = -0.25; 95%CI:-0.46,-0.02). Thus in humans, variations in FE(NO) are explained both by genetic and non-shared environmental effects. Covariance between FE(NO) and Aix(ao) is explained entirely by shared genetic factors. This is consistent with an overlap among the sets of genes involved in the expression of these phenotypes and provides a basis for further genetic studies on cardiovascular and respiratory diseases.

  3. Tissue-Informative Mechanism for Wearable Non-invasive Continuous Blood Pressure Monitoring

    NASA Astrophysics Data System (ADS)

    Woo, Sung Hun; Choi, Yun Young; Kim, Dae Jung; Bien, Franklin; Kim, Jae Joon

    2014-10-01

    Accurate continuous direct measurement of the blood pressure is currently available thru direct invasive methods via intravascular needles, and is mostly limited to use during surgical procedures or in the intensive care unit (ICU). Non-invasive methods that are mostly based on auscultation or cuff oscillometric principles do provide relatively accurate measurement of blood pressure. However, they mostly involve physical inconveniences such as pressure or stress on the human body. Here, we introduce a new non-invasive mechanism of tissue-informative measurement, where an experimental phenomenon called subcutaneous tissue pressure equilibrium is revealed and related for application in detection of absolute blood pressure. A prototype was experimentally verified to provide an absolute blood pressure measurement by wearing a watch-type measurement module that does not cause any discomfort. This work is supposed to contribute remarkably to the advancement of continuous non-invasive mobile devices for 24-7 daily-life ambulatory blood-pressure monitoring.

  4. Arterial stiffness in people with Type 2 diabetes and obstructive sleep apnoea.

    PubMed

    Hvelplund Kristiansen, M; Banghøj, A M; Laugesen, E; Tarnow, L

    2018-05-15

    To examine whether people with Type 2 diabetes with concurrent obstructive sleep apnoea have increased arterial stiffness as compared with people with Type 2 diabetes without obstructive sleep apnoea. In a study with a case-control design, 40 people with Type 2 diabetes and treatment-naïve moderate to severe obstructive sleep apnoea (Apnoea-Hypopnoea Index ≥15) and a control group of 31 people with Type 2 diabetes without obstructive sleep apnoea (Apnoea-Hypopnoea Index <5) were examined. Obstructive sleep apnoea status was evaluated using the ApneaLink ® + home-monitoring device (Resmed Inc., San Diego, CA, USA), providing the Apnoea-Hypopnoea Index scores. Arterial stiffness was assessed according to carotid-femoral pulse wave velocity using the Sphygmocor device and the oscillometric Mobil-O-Graph ® (I.E.M. GmbH, Stolberg, Germany). Carotid-femoral pulse wave velocity was not significantly different between participants with Type 2 diabetes with obstructive sleep apnoea and those without obstructive sleep apnoea (10.7±2.2 m/s vs 10.3±2.1 m/s; P=0.513), whereas oscillometric pulse wave velocity was significantly higher in participants with Type 2 diabetes with obstructive sleep apnoea than in those without obstructive sleep apnoea (9.5±1.0 m/s vs 8.6±1.4 m/s; P=0.002). In multiple regression analysis, age (P=0.002), gender (men; P=0.018) and HbA 1c (P=0.027) were associated with carotid-femoral pulse wave velocity, and systolic blood pressure (P=0.004) and age (P<0.001) were associated with oscillometric pulse wave velocity. After adjustment, presence of obstructive sleep apnoea was not independently associated with pulse wave velocity whether assessed by tonometry or oscillometry. In conclusion, the present study did not find an age- and blood pressure-independent association between moderate to severe obstructive sleep apnoea and arterial stiffness in non-sleepy people with Type 2 diabetes. (Clinical trial registration number: NCT02482584). © 2018 Diabetes UK.

  5. Validation of four devices: Omron M6 Comfort, Omron HEM-7420, Withings BP-800, and Polygreen KP-7670 for home blood pressure measurement according to the European Society of Hypertension International Protocol

    PubMed Central

    Topouchian, Jirar; Agnoletti, Davide; Blacher¹, Jacques; Youssef, Ahmed; Chahine, Mirna N; Ibanez, Isabel; Assemani, Nathalie; Asmar, Roland

    2014-01-01

    Background Four oscillometric devices, including the Omron M6 Comfort, Omron HEM-7420, Withings BP-800, and Polygreen KP-7670, designed for self-blood pressure measurement (SBPM) were evaluated according to the European Society of Hypertension (ESH) International Protocol Revision 2010 in four separate studies. Methods The four devices measure brachial blood pressure (BP) using the oscillometric method. The Withings BP-800 has to be connected to an Apple® iOS device such as an iPhone®, iPad®, or iPod®. The ESH International Protocol Revision 2010 includes a total number of 33 subjects. The difference between observer and device BP values was calculated for each measure. Ninety-nine pairs of BP differences were classified into three categories (≤5 mmHg, ≤10 mmHg, ≤15 mmHg). The protocol procedures were followed precisely in each of the four studies. Results All four tested devices passed the validation process. The mean differences between the device and mercury readings were: −1.8±5.1 mmHg and −0.4±2.8 mmHg for systolic and diastolic BP, respectively, using the Omron M6 Comfort device; 2.5±4.6 mmHg and −1.2±4.3 mmHg for the Omron HEM-7420 device; −0.2±5.0 mmHg and 0.4±4.2 mmHg for the Withings BP-800 device; and 3.0±5.3 mmHg and 0.3±5.2 mmHg for the Polygreen KP-7670 device. Conclusion Omron M6 Comfort, Omron HEM-7420, Withings BP-800, and Polygreen KP-7670 readings differing by less than 5 mmHg, 10 mmHg, and 15 mmHg fulfill the ESH International Protocol Revision 2010 requirements, and therefore are suitable for use by patients for SBPM, if used correctly. PMID:24476688

  6. Evaluation of vascular wall elasticity of human digital arteries using alternating current-signal photoplethysmography

    PubMed Central

    Uangpairoj, Pichitra; Shibata, Masahiro

    2013-01-01

    Purpose A simple method of estimating arterial elasticity in the human finger using a volume-oscillometric technique with photoplethysmography was principally studied under the various effects of age, sex, and cold-stress stimulation for testing the capability of using this technique in arterial elasticity analysis. Methods Amplitude variations in the alternating current signal of the photoplethysmograph during a continuous change in transmural pressure were analyzed to obtain the blood pressure and the transmural pressure–relative volume difference relationship of the arteries. We first tested the effect of the occluding cuff size on the arterial elasticity analysis in eight subjects (ages 20–45 years) to obtain a suitable cuff size, resulting in the selection of a middle cuff with a 22 mm diameter. Blood pressure and arterial elasticity were measured in six groups of subjects separated into three age-groups of women and men (ages 20–25, 32–45, and over 50 years) for testing the effect of age and sex. Twelve subjects (ages 20–25 years) also had their blood pressure and arterial elasticity measured in three conditions under the influence of the cold-stress stimulation. Results Age, sex, and cold-stress stimulation had an impact on mean blood pressure (P < 0.0005, 0.025), whereas pulse pressure and heart rate were statistically unchanged by those factors. Furthermore, an advanced age (over 50 years) was found to induce an increase in relative volume difference values (P < 0.025) and upward shifting of the transmural pressure–relative volume difference relationships, whereas sex, level of mean blood pressure, and cold-stress stimulation had no influence on these forms of the index. Conclusion This study showed the usefulness of the relative volume difference as being a mean blood pressure-independent indicator for changes in arterial elasticity. PMID:23766653

  7. Prevalence, Awareness, Treatment and Influence of Socioeconomic Variables on Control of High Blood Pressure: Results of the ELSA-Brasil Study

    PubMed Central

    Chor, Dóra; Pinho Ribeiro, Antonio Luiz; Sá Carvalho, Marilia; Duncan, Bruce Bartholow; Andrade Lotufo, Paulo; Araújo Nobre, Aline; de Aquino, Estela Mota Lima Leão; Schmidt, Maria Inês; Griep, Rosane Härter; Molina, Maria Del Carmen Bisi; Barreto, Sandhi Maria; Passos, Valéria Maria de Azeredo; Benseñor, Isabela Judith Martins; Matos, Sheila Maria Alvim; Mill, José Geraldo

    2015-01-01

    High blood pressure (HBP) is the leading risk factor for years of life lost in Brazil. Factors associated with HBP awareness, treatment and control need to be understood better. Our aim is to estimate prevalence, awareness, and types of anti-hypertensive treatment and to investigate the association of HBP control with social position. Data of 15,103 (54% female) civil servants in six Brazilian state capitals collected at the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline (2008-2010) were used to estimate prevalence and cross-sectional association of HBP control with education, per capita family income and self-reported race, using multiple logistic regression. Blood pressure was measured by the oscillometric method. 35.8% were classified as presenting HBP; 76.8% of these used anti-hypertensive medication. Women were more aware than men (84.8% v. 75.8%) and more often using medication (83.1% v. 70.7%). Adjusted HBP prevalence was, in ascending order, Whites (30.3%), Browns (38.2%) and Blacks (49.3%). The therapeutic schemes most used were angiotensin-converting enzyme inhibitors, in isolation (12.4%) or combined with diuretics (13.3%). Among those in drug treatment, controlled blood pressure was more likely in the (postgraduate) higher education group than among participants with less than secondary school education (PR = 1.21; 95% CI: 1.14–1.28), and among Asian (PR = 1.21; 95% CI: 1.12–1.32) and ‘Whites (PR = 1.19; 95% CI: 1.12–1.26) compared to Blacks. Socioeconomic and racial inequality—as measured by different indicators—are strongly associated with HBP control, beyond the expected influence of health services access. PMID:26102079

  8. Comparison of Direct and Indirect Methods of Measuring Arterial Blood Pressure in Healthy Male Rhesus Macaques (Macaca mulatta).

    PubMed

    France, Logan K; Vermillion, Meghan S; Garrett, Caroline M

    2018-01-01

    Blood pressure is a critical parameter for evaluating cardiovascular health, assessing effects of drugs and procedures, monitoring physiologic status during anesthesia, and making clinical decisions. The placement of an arterial catheter is the most direct and accurate method for measuring blood pressure; however, this approach is invasive and of limited use during brief sedated examinations. The objective of this study was to determine which method of indirect blood pressure monitoring was most accurate compared with measurement by direct arterial catheterization. In addition, we sought to determine the relative accuracy of each indirect method (compared with direct arterial measurement) at a given body location and to assess whether the accuracy of each indirect method was dependent on body location. We compared direct blood pressure measurements by means of catheterization of the saphenous artery with oscillometric and ultrasonic Doppler flow detection measurements at 3 body locations (forearm, distal leg, and tail base) in 16 anesthetized, male rhesus macaques. The results indicate that oscillometry at the forearm is the best indirect method and location for accurately and consistently measuring blood pressure in healthy male rhesus macaques.

  9. Validation of four devices: Omron M6 Comfort, Omron HEM-7420, Withings BP-800, and Polygreen KP-7670 for home blood pressure measurement according to the European Society of Hypertension International Protocol.

    PubMed

    Topouchian, Jirar; Agnoletti, Davide; Blacher, Jacques; Youssef, Ahmed; Chahine, Mirna N; Ibanez, Isabel; Assemani, Nathalie; Asmar, Roland

    2014-01-01

    Four oscillometric devices, including the Omron M6 Comfort, Omron HEM-7420, Withings BP-800, and Polygreen KP-7670, designed for self-blood pressure measurement (SBPM) were evaluated according to the European Society of Hypertension (ESH) International Protocol Revision 2010 in four separate studies. The four devices measure brachial blood pressure (BP) using the oscillometric method. The Withings BP-800 has to be connected to an Apple® iOS device such as an iPhone®, iPad®, or iPod®. The ESH International Protocol Revision 2010 includes a total number of 33 subjects. The difference between observer and device BP values was calculated for each measure. Ninety-nine pairs of BP differences were classified into three categories (≤5 mmHg, ≤10 mmHg, ≤15 mmHg). The protocol procedures were followed precisely in each of the four studies. All four tested devices passed the validation process. The mean differences between the device and mercury readings were: -1.8±5.1 mmHg and -0.4±2.8 mmHg for systolic and diastolic BP, respectively, using the Omron M6 Comfort device; 2.5±4.6 mmHg and -1.2±4.3 mmHg for the Omron HEM-7420 device; -0.2±5.0 mmHg and 0.4±4.2 mmHg for the Withings BP-800 device; and 3.0±5.3 mmHg and 0.3±5.2 mmHg for the Polygreen KP-7670 device. Omron M6 Comfort, Omron HEM-7420, Withings BP-800, and Polygreen KP-7670 readings differing by less than 5 mmHg, 10 mmHg, and 15 mmHg fulfill the ESH International Protocol Revision 2010 requirements, and therefore are suitable for use by patients for SBPM, if used correctly.

  10. Evaluation of indirect blood pressure monitoring in awake and anesthetized red-tailed hawks (Buteo jamaicensis): effects of cuff size, cuff placement, and monitoring equipment.

    PubMed

    Zehnder, Ashley M; Hawkins, Michelle G; Pascoe, Peter J; Kass, Philip H

    2009-09-01

    To compare Doppler and oscillometric methods of indirect arterial blood pressure (IBP) with direct arterial measurements in anesthetized and awake red-tailed hawks. Prospective, randomized, blinded study. Six, sex unknown, adult red-tailed hawks. Birds were anesthetized and IBP measurements were obtained by oscillometry (IBP-O) and Doppler (IBP-D) on the pectoral and pelvic limbs using three cuffs of different width based on limb circumference: cuff 1 (20-30% of circumference), cuff 2 (30-40%), and cuff 3 (40-50%). Direct arterial pressure measurements were obtained from the contralateral superficial ulnar artery. Indirect blood pressure measurements were compared to direct systolic arterial pressure (SAP) and mean arterial pressure (MAP) during normotension and induced states of hypotension and hypertension. Measurements were also obtained in awake, restrained birds. Three-way anova, linear regression and Bland-Altman analyses were used to evaluate the IBP-D data. Results are reported as mean bias (95% confidence intervals). The IBP-O monitor reported errors during 54% of the measurements. Indirect blood pressure Doppler measurements were most accurate with cuff 3 and were comparable to MAP with a bias of 2 (-9, 13 mmHg). However, this cuff consistently underestimated SAP with a bias of 33 (19, 48 mmHg). Variability in the readings within and among birds was high. There was no significant difference between sites of cuff placement. Awake birds had SAP, MAP and diastolic arterial pressure that were 56, 43, and 38 mmHg higher than anesthetized birds. Indirect blood pressure (oscillometric) measurements were unreliable in red-tailed hawks. Indirect blood pressure (Doppler) measurements were closer to MAP measurements than SAP measurements. There was slightly better agreement with the use of cuff 3 on either the pectoral or pelvic limbs. Awake, restrained birds have significantly higher arterial pressures than those under sevoflurane anesthesia.

  11. Automated Versus Manual Blood Pressure Measurement: A Randomized Crossover Trial in the Emergency Department of a Tertiary Care Hospital in Karachi, Pakistan: Are Third World Countries Ready for the Change?

    PubMed

    Mansoor, Kanaan; Shahnawaz, Saba; Rasool, Mariam; Chaudhry, Huwad; Ahuja, Gul; Shahnawaz, Sara

    2016-09-15

    Hypertension has proven to be a strong liability with 13.5% of all mortality worldwide being attributed to elevated blood pressures in 2001. An accurate blood pressure measurement lies at the crux of an appropriate diagnosis. Despite the mercury sphygmomanometer being the gold standard, the ongoing deliberation as to whether mercury sphygmomanometers should be replaced with the automated oscillometric devices stems from the risk mercury poses to the environment. This study was performed to check the validity of automated oscillometric blood pressure measurements as compared to the manual blood pressure measurements in Karachi, Pakistan. Blood pressure was recorded in 200 individuals aged 15 and above using both, an automated oscillometric blood pressure device (Dinamap Procare 100) and a manual mercury sphygmomanometer concomitantly. Two nurses were assigned to each patient and the device, arm for taking the reading and nurses were randomly determined. SPSS version 20 was used for analysis. Mean and standard deviation of the systolic and diastolic measurements from each modality were compared to each other and P values of 0.05 or less were considered to be significant. Validation criteria of British Hypertension Society (BHS) and the US Association for the Advancement of Medical Instrumentation (AAMI) were used. Two hundred patients were included. The mean of the difference of systolic was 8.54 ± 9.38 while the mean of the difference of diastolic was 4.21 ± 7.88. Patients were further divided into three groups of different systolic blood pressure <= 120, > 120 to = 150 and > 150, their means were 6.27 ± 8.39 (p-value 0.175), 8.91 ± 8.96 (p-value 0.004) and 10.98 ± 10.49 (p-value 0.001) respectively. In our study 89 patients were previously diagnosed with hypertension; their difference of mean systolic was 9.43 ± 9.89 (p-value 0.000) and difference of mean diastolic was 4.26 ± 7.35 (p-value 0.000). Systolic readings from a previously validated device are not reliable when used in the ER and they show a higher degree of incongruency and inaccuracy when they are used outside validation settings. Also, readings from the right arm tend to be more precise.

  12. Automated Office Blood Pressure Measurement

    PubMed Central

    2018-01-01

    Manual blood pressure (BP) recorded in routine clinical practice is relatively inaccurate and associated with higher readings compared to BP measured in research studies in accordance with standardized measurement guidelines. The increase in routine office BP is the result of several factors, especially the presence of office staff, which tends to make patients nervous and also allows for conversation to occur. With the disappearance of the mercury sphygmomanometer because of environmental concerns, there is greater use of oscillometric BP recorders, both in the office setting and elsewhere. Although oscillometric devices may reduce some aspects of observer BP measurement error in the clinical setting, they are still associated with higher BP readings, known as white coat hypertension (for diagnosis) or white coat effect (with treated hypertension). Now that fully automated sphygmomanometers are available which are capable of recording several readings with the patient resting quietly, there is no longer any need to have office staff present when BP is being recorded. Such readings are called automated office blood pressure (AOBP) and they are both more accurate than conventional manual office BP and not associated with the white coat phenomena. AOBP readings are also similar to the awake ambulatory BP and home BP, both of which are relatively good predictors of cardiovascular risk. The available evidence suggests that AOBP should now replace manual or electronic office BP readings when screening patients for hypertension and also after antihypertensive drug therapy is initiated. PMID:29625508

  13. Towards development of a mobile RF Doppler sensor for continuous heart rate variability and blood pressure monitoring.

    PubMed

    Insoo Kim; Bhagat, Yusuf A

    2016-08-01

    The standard in noninvasive blood pressure (BP) measurement is an inflatable cuff device based on the oscillometric method, which poses several practical challenges for continuous BP monitoring. Here, we present a novel ultra-wide band RF Doppler radar sensor for next-generation mobile interface for the purpose of characterizing fluid flow speeds, and for ultimately measuring cuffless blood flow in the human wrist. The system takes advantage of the 7.1~10.5 GHz ultra-wide band signals which can reduce transceiver complexity and power consumption overhead. Moreover, results obtained from hardware development, antenna design and human wrist modeling, and subsequent phantom development are reported. Our comprehensive lab bench system setup with a peristaltic pump was capable of characterizing various speed flow components during a linear velocity sweep of 5~62 cm/s. The sensor holds potential for providing estimates of heart rate and blood pressure.

  14. Automated measurement of office, home and ambulatory blood pressure in atrial fibrillation.

    PubMed

    Kollias, Anastasios; Stergiou, George S

    2014-01-01

    1. Hypertension and atrial fibrillation (AF) often coexist and are strong risk factors for stroke. Current guidelines for blood pressure (BP) measurement in AF recommend repeated measurements using the auscultatory method, whereas the accuracy of the automated devices is regarded as questionable. This review presents the current evidence on the feasibility and accuracy of automated BP measurement in the presence of AF and the potential for automated detection of undiagnosed AF during such measurements. 2. Studies evaluating the use of automated BP monitors in AF are limited and have significant heterogeneity in methodology and protocols. Overall, the oscillometric method is feasible for static (office or home) and ambulatory use and appears to be more accurate for systolic than diastolic BP measurement. 3. Given that systolic hypertension is particularly common and important in the elderly, the automated BP measurement method may be acceptable for self-home and ambulatory monitoring, but not for professional office or clinic measurement. 4. An embedded algorithm for the detection of asymptomatic AF during routine automated BP measurement with high diagnostic accuracy has been developed and appears to be a useful screening tool for elderly hypertensives. © 2013 Wiley Publishing Asia Pty Ltd.

  15. Automated Office Blood Pressure Measurement.

    PubMed

    Myers, Martin G

    2018-04-01

    Manual blood pressure (BP) recorded in routine clinical practice is relatively inaccurate and associated with higher readings compared to BP measured in research studies in accordance with standardized measurement guidelines. The increase in routine office BP is the result of several factors, especially the presence of office staff, which tends to make patients nervous and also allows for conversation to occur. With the disappearance of the mercury sphygmomanometer because of environmental concerns, there is greater use of oscillometric BP recorders, both in the office setting and elsewhere. Although oscillometric devices may reduce some aspects of observer BP measurement error in the clinical setting, they are still associated with higher BP readings, known as white coat hypertension (for diagnosis) or white coat effect (with treated hypertension). Now that fully automated sphygmomanometers are available which are capable of recording several readings with the patient resting quietly, there is no longer any need to have office staff present when BP is being recorded. Such readings are called automated office blood pressure (AOBP) and they are both more accurate than conventional manual office BP and not associated with the white coat phenomena. AOBP readings are also similar to the awake ambulatory BP and home BP, both of which are relatively good predictors of cardiovascular risk. The available evidence suggests that AOBP should now replace manual or electronic office BP readings when screening patients for hypertension and also after antihypertensive drug therapy is initiated. Copyright © 2018. The Korean Society of Cardiology.

  16. Evaluation of a novel brachial cuff-based oscillometric method for estimating central systolic pressure in hemodialysis patients.

    PubMed

    Sarafidis, Pantelis A; Georgianos, Panagiotis I; Karpetas, Antonios; Bikos, Athanasios; Korelidou, Linda; Tersi, Maria; Divanis, Dimitrios; Tzanis, Georgios; Mavromatidis, Konstantinos; Liakopoulos, Vassilios; Zebekakis, Pantelis E; Lasaridis, Anastasios; Protogerou, Athanase D

    2014-01-01

    Elevated wave reflections and arterial stiffness, as well as ambulatory blood pressure (BP) are independent predictors of cardiovascular risk in end-stage-renal-disease. This study is the first to evaluate in hemodialysis patients the validity of a new ambulatory oscillometric device (Mobil-O-Graph, IEM, Germany), which estimates aortic BP, augmentation index (AIx) and pulse wave velocity (PWV). Aortic SBP (aSBP), heart rate-adjusted AIx (AIx(75)) and PWV measured with Mobil-O-Graph were compared with the values from the most widely used tonometric device (Sphygmocor, ArtCor, Australia) in 73 hemodialysis patients. Measurements were made in a randomized order after 10 min of rest in the supine position at least 30 min before a dialysis session. Brachial BP (mercury sphygmomanometer) was used for the calibration of Sphygmocor's waveform. Sphygmocor-derived aSBP and AIx(75) did not differ from the relevant Mobil-O-Graph measurements (aSBP: 136.3 ± 19.6 vs. 133.5 ± 19.3 mm Hg, p = 0.068; AIx(75): 28.4 ± 9.3 vs. 30.0 ± 11.8%, p = 0.229). The small difference in aSBP is perhaps explained by a relevant difference in brachial SBP used for calibration (146.9 ± 20.4 vs. 145.2 ± 19.9 mm Hg, p = 0.341). Sphygmocor PWV was higher than Mobil-O-Graph PWV (10.3 ± 3.4 vs. 9.5 ± 2.1 m/s, p < 0.01). All 3 parameters estimated by Mobil-O-Graph showed highly significant (p < 0.001) correlations with the relevant measurements of Sphygmocor (aSBP, r = 0.770; AIx(75), r = 0.400; PWV, r = 0.739). The Bland-Altman Plots for aSBP and AIx(75) showed acceptable agreement between the two devices and no evidence of systemic bias for PWV. As in other populations, acceptable agreement between Mobil-O-Graph and Sphygmocor was evident for aSBP and AIx(75) in hemodialysis patients; PWV was slightly underestimated by Mobil-O-Graph. © 2014 S. Karger AG, Basel.

  17. Arterial stiffness estimation in healthy subjects: a validation of oscillometric (Arteriograph) and tonometric (SphygmoCor) techniques.

    PubMed

    Ring, Margareta; Eriksson, Maria Jolanta; Zierath, Juleen Rae; Caidahl, Kenneth

    2014-11-01

    Arterial stiffness is an important cardiovascular risk marker, which can be measured noninvasively with different techniques. To validate such techniques in healthy subjects, we compared the recently introduced oscillometric Arteriograph (AG) technique with the tonometric SphygmoCor (SC) method and their associations with carotid ultrasound measures and traditional risk indicators. Sixty-three healthy subjects aged 20-69 (mean 48 ± 15) years were included. We measured aortic pulse wave velocity (PWVao) and augmentation index (AIx) by AG and SC, and with SC also the PWVao standardized to 80% of the direct distance between carotid and femoral sites (St-PWVaoSC). The carotid strain, stiffness index and intima-media thickness (cIMTmean) were evaluated by ultrasound. PWVaoAG (8.00 ± 2.16 m s(-1)) was higher (P<0.001) than PWVaoSC (6.87 ± 1.47 m s(-1)), but did not differ from St-PWVaoSC (7.68 ± 1.58 m s(-1)), and correlated (P<0.001) with both (r = 0.54 and 0.59). St-PWVaoSC was significantly (P < 0.01) higher than PWVaoAG for values below median (7.4 m s(-1)). PWVao by SC and AG differed significantly in females (P<0.001), but not in males (P=0.40). AIxaoAG (27.5 ± 14.5%) was higher (P < 0.001) than AIxaoSC (20.5 ± 17.4%), but related closely (r=0.97, P<0.001). St-PWVaoSC, PWVao and AIxao by SC, and PWVao and AIxao by AG were all related to serum cholesterol and to cIMTmean (P<0.001). Arterial stiffness indices by AG and SC correlate with vascular risk markers in healthy subjects. AIxao results by AG and SC are closely interrelated, but higher values are obtained by AG. In the lower range, PWVao values by AG and SC are similar, but differ for higher values. Our results imply the necessity to apply one and the same technique for repeated studies.

  18. Reliability of pulse waveform separation analysis: effects of posture and fasting.

    PubMed

    Stoner, Lee; Credeur, Daniel; Fryer, Simon; Faulkner, James; Lambrick, Danielle; Gibbs, Bethany Barone

    2017-03-01

    Oscillometric pulse wave analysis devices enable, with relative simplicity and objectivity, the measurement of central hemodynamic parameters. The important parameters are central blood pressures and indices of arterial wave reflection, including wave separation analysis (backward pressure component Pb and reflection magnitude). This study sought to determine whether the measurement precision (between-day reliability) of Pb and reflection magnitude: exceeds the criterion for acceptable reliability; and is affected by posture (supine, seated) and fasting state. Twenty healthy adults (50% female, 27.9 years, 24.2 kg/m) were tested on six different mornings: 3 days fasted, 3 days nonfasted condition. On each occasion, participants were tested in supine and seated postures. Oscillometric pressure waveforms were recorded on the left upper arm. The criterion intra-class correlation coefficient value of 0.75 was exceeded for Pb (0.76) and reflection magnitude (0.77) when participants were assessed under the combined supine-fasted condition. The intra-class correlation coefficient was lowest for Pb in seated-nonfasted condition (0.57), and lowest for reflection magnitude in the seated-fasted condition (0.56). For Pb, the smallest detectible change that must be exceeded in order for a significant change to occur in an individual was 2.5 mmHg, and for reflection magnitude, the smallest detectable change was 8.5%. Assessments of Pb and reflection magnitude are as follows: exceed the criterion for acceptable reliability; and are most reliable when participants are fasted in a supine position. The demonstrated reliability suggests sufficient precision to detect clinically meaningful changes in reflection magnitude and Pb.

  19. Associations of Novel and Traditional Vascular Biomarkers of Arterial Stiffness: Results of the SAPALDIA 3 Cohort Study.

    PubMed

    Endes, Simon; Caviezel, Seraina; Schaffner, Emmanuel; Dratva, Julia; Schindler, Christian; Künzli, Nino; Bachler, Martin; Wassertheurer, Siegfried; Probst-Hensch, Nicole; Schmidt-Trucksäss, Arno

    There is a lack of evidence concerning associations between novel parameters of arterial stiffness as cardiovascular risk markers and traditional structural and functional vascular biomarkers in a population-based Caucasian cohort. We examined these associations in the second follow-up of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA 3). Arterial stiffness was measured oscillometrically by pulse wave analysis to derive the cardio-ankle vascular index (CAVI), brachial-ankle (baPWV) and aortic pulse wave velocity (aPWV), and amplitude of the forward and backward wave. Carotid ultrasonography was used to measure carotid intima-media thickness (cIMT) and carotid lumen diameter (LD), and to derive a distensibility coefficient (DC). We used multivariable linear regression models adjusted for several potential confounders for 2,733 people aged 50-81 years. CAVI, aPWV and the amplitude of the forward and backward wave were significant predictors of cIMT (p < 0.001). All parameters were significantly associated with LD (p < 0.001), with aPWV and the amplitude of the forward wave explaining the highest proportion of variance (2%). Only CAVI and baPWV were significant predictors of DC (p < 0.001), explaining more than 0.3% of the DC variance. We demonstrated that novel non-invasive oscillometric arterial stiffness parameters are differentially associated with specific established structural and functional local stiffness parameters. Longitudinal studies are needed to follow-up on these cross-sectional findings and to evaluate their relevance for clinical phenotypes.

  20. Non-Contact Heart Rate and Blood Pressure Estimations from Video Analysis and Machine Learning Modelling Applied to Food Sensory Responses: A Case Study for Chocolate.

    PubMed

    Gonzalez Viejo, Claudia; Fuentes, Sigfredo; Torrico, Damir D; Dunshea, Frank R

    2018-06-03

    Traditional methods to assess heart rate (HR) and blood pressure (BP) are intrusive and can affect results in sensory analysis of food as participants are aware of the sensors. This paper aims to validate a non-contact method to measure HR using the photoplethysmography (PPG) technique and to develop models to predict the real HR and BP based on raw video analysis (RVA) with an example application in chocolate consumption using machine learning (ML). The RVA used a computer vision algorithm based on luminosity changes on the different RGB color channels using three face-regions (forehead and both cheeks). To validate the proposed method and ML models, a home oscillometric monitor and a finger sensor were used. Results showed high correlations with the G color channel (R² = 0.83). Two ML models were developed using three face-regions: (i) Model 1 to predict HR and BP using the RVA outputs with R = 0.85 and (ii) Model 2 based on time-series prediction with HR, magnitude and luminosity from RVA inputs to HR values every second with R = 0.97. An application for the sensory analysis of chocolate showed significant correlations between changes in HR and BP with chocolate hardness and purchase intention.

  1. Relationships between 24-h blood pressure variability and 24-h central arterial pressure, pulse wave velocity and augmentation index in hypertensive patients.

    PubMed

    Omboni, Stefano; Posokhov, Igor N; Rogoza, Anatoly N

    2017-04-01

    Twenty-four-h blood pressure variability (BPV) predicts cardiovascular complications in hypertension, but its association with pulse wave indices (central arterial pressure, pulse wave velocity (PWV) and augmentation index (AIx)) is poorly understood. In the present study, we assessed the degree of the effect of 24-h BPV on 24-h pulse wave indices. Brachial blood pressure was measured non-invasively over the 24 h with an electronic, oscillometric, automated device (BPLab) in 661 uncomplicated treated or untreated hypertensive patients. Digitalized oscillometric waveforms were analyzed with a validated algorithm to obtain pulse wave indices. Twenty-four-h BPV was calculated as the unweighted (SDu) or weighted s.d. (SDw) of the mean blood pressure or as the average real variability (ARV). Twenty-four-h systolic BPV showed a direct and significant relationship with the central arterial systolic pressure (r=0.28 SDu, r=0.40 SDw, r=0.34 ARV), PWV (r=0.10 SDu, r=0.21 SDw, r=0.19 ARV) and AIx (r=0.17 SDu, r=0.27 SDw, r=0.23 ARV). After adjustment for age, sex, body mass index, antihypertensive treatment and 24-h systolic blood pressure, the relationship lost some power but was still significant for all measures, except for the AIx. Pulse wave indices were higher in patients with high BPV than in those with low BPV: after adjustment, these differences were abolished for the AIx. The diastolic BPV showed a weak association with the pulse wave indices. In conclusion, in hypertensive patients, 24-h systolic BPV is moderately and independently associated with 24-h central arterial pressure and stiffness.

  2. Relationship Between 24-Hour Ambulatory Central Systolic Blood Pressure and Left Ventricular Mass: A Prospective Multicenter Study.

    PubMed

    Weber, Thomas; Wassertheurer, Siegfried; Schmidt-Trucksäss, Arno; Rodilla, Enrique; Ablasser, Cornelia; Jankowski, Piotr; Lorenza Muiesan, Maria; Giannattasio, Cristina; Mang, Claudia; Wilkinson, Ian; Kellermair, Jörg; Hametner, Bernhard; Pascual, Jose Maria; Zweiker, Robert; Czarnecka, Danuta; Paini, Anna; Salvetti, Massimo; Maloberti, Alessandro; McEniery, Carmel

    2017-12-01

    We investigated the relationship between left ventricular mass and brachial office as well as brachial and central ambulatory systolic blood pressure in 7 European centers. Central systolic pressure was measured with a validated oscillometric device, using a transfer function, and mean/diastolic pressure calibration. M-mode images were obtained by echocardiography, and left ventricular mass was determined by one single reader blinded to blood pressure. We studied 289 participants (137 women) free from antihypertensive drugs (mean age: 50.8 years). Mean office blood pressure was 145/88 mm Hg and mean brachial and central ambulatory systolic pressures were 127 and 128 mm Hg, respectively. Mean left ventricular mass was 93.3 kg/m 2 , and 25.6% had left ventricular hypertrophy. The correlation coefficient between left ventricular mass and brachial office, brachial ambulatory, and central ambulatory systolic pressure was 0.29, 0.41, and 0.47, respectively ( P =0.003 for comparison between brachial office and central ambulatory systolic pressure and 0.32 for comparison between brachial and central ambulatory systolic pressure). The results were consistent for men and women, and young and old participants. The areas under the curve for prediction of left ventricular hypertrophy were 0.618, 0.635, and 0.666 for brachial office, brachial, and central ambulatory systolic pressure, respectively ( P =0.03 for comparison between brachial and central ambulatory systolic pressure). In younger participants, central ambulatory systolic pressure was superior to both other measurements. Central ambulatory systolic pressure, measured with an oscillometric cuff, shows a strong trend toward a closer association with left ventricular mass and hypertrophy than brachial office/ambulatory systolic pressure. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01278732. © 2017 American Heart Association, Inc.

  3. Comparison of the oscillometric blood pressure monitor (BPM-100(Beta) ) with the auscultatory mercury sphygmomanometer.

    PubMed

    Mattu, G S; Perry, T L; Wright, J M

    2001-06-01

    To compare directly the accuracy of the BPM-100(Beta) monitor (an automated oscillometric blood pressure device) with standard auscultatory mercury sphygmomanometry. The BPM-100(Beta) was connected in parallel via a T-tube to a mercury sphygmomanometer. The BPM-100(Beta) and two trained observers (blinded from each other and from the BPM-100(Beta)) measured the sitting blood pressure simultaneously. Means, standard deviations and ranges were calculated for all the demographic data: age, arm size, heart rate and blood pressure. The agreement between the BPM-100(Beta) and the mean of two observers (the reference) was determined and expressed as the mean +/- SD, as well as the percentage of differences falling within 5, 10 and 15 mmHg. Of the 92 subjects recruited, 85 (92.4%) met the inclusion criteria, and 391 sets of sitting blood pressure and heart rate measurements were available for analysis. The mean difference between the BPM-100(Beta) monitor and the reference was -0.62 +/- 6.96 mmHg for systolic blood pressure, -1.48 +/- 4.80 mmHg for diastolic blood pressure and 0.14 +/- 1.86 beats/min for heart rate. The only limitation of the device was its tendency to underestimate higher systolic blood pressures. This problem has been addressed by a minor change in the algorithm (see the companion publication, Blood Press Monit, 6, 161-165, 2001). The BPM-100(Beta) is an accurate blood pressure monitor for the office setting, meeting all requirements of the Association for the Advancement of Medical Instrumentation and achieving an 'A' grade according to the British Hypertension Society protocol.

  4. Lack of validation of the Dixtal (DX 2020) upper arm blood pressure monitor, in oscillometric mode, for clinical use in an intensive care unit, according to the European Society of Hypertension-International Protocol revision 2010.

    PubMed

    Gothardo, Ana C L O; Savioli, Amanda F; Santos, Dayanna S; Lamas, José L T

    2013-08-01

    The aim of the study was to evaluate the accuracy of the oscillometric blood pressure section in the DX 2020 Dixtal multiparametric monitor in adults according to the European Society of Hypertension-International Protocol as revised in 2010 (ESH-IP 2010). The blood pressure was sequentially verified in 33 individuals admitted to an adult ICU (18 men, mean age 44 years) with a mercury column sphygmomanometer (two observers) and the DX 2020 test device (one supervisor). Ninety-nine pairs of differences were obtained. Data analysis followed the ESH-IP 2010 requirements. In the first requirement, the DX 2020 device failed in the validation study in the 5, 10, and 15 mmHg ranges. From the 99 pairs of differences, only 43/73, 69/87, and 81/96 were obtained for systolic blood pressure and 29/65, 56/81, and 71/93 were obtained for diastolic blood pressure. In the second requirement, at least 24 individuals should have, from their comparisons, two under 0-5 mmHg ranges, which was observed only with 16 individuals in the systolic and nine in the diastolic range. Moreover, at maximum, only three readings could have differences of more than 5 mmHg, and this was observed in 10 individuals in the systolic range and 17 individuals in the diastolic range. The DX 2020 automatic multiparametric monitor for blood pressure measurement has not been recommended for clinical use according to the ESH-IP 2010. It is important to highlight that this work refers only to a blood pressure measurement module and that the same conclusion cannot be drawn for its other functions.

  5. [Blood pressure values in adolescents in the Community of Madrid: Tables based on the MEPAFAC Study].

    PubMed

    Molinero, A; Cervero, M; Magro, M C; Partearroyo, T; Zuluaga, P; Martín, A

    High blood pressure (HBP) is a modifiable cardiovascular risk factor and its detection at early ages may allow strategies to be designed to reduce cardiovascular risk in adulthood. To provide blood pressure (BP) values in a sample of adolescents using an electronic oscillometric device. BP was measured according the European Society of Hypertension guidelines using an oscillometric device. Height and weight were also measured. Four height groups were used in order to associate the 90, 95, and 99 percentiles with systolic BP (pSBP) and diastolic BP percentiles (pDBP) for sex and age: H150 (≤ 150cm), H160(151-160cm), H170(161-170cm), and H180(≥171cm). Data from 2,758 students aged 12-17 years were included in the analysis. BP increases with age, with differences of up to 11mmHg in boys vs. 3mmHg in girls for SBP and 3mmHg vs. 1mmHg for DBP. In high SBP, for the younger adolescents, the difference related to height was 15mmHg in boys vs. 8mmHg in girls, with no significant increase in the older ones in either gender. The high BDP varied depending on the height, 10mmHg in younger boys and 3mmHg in older ones, while in girls the variation was 3mmHg for all ages. SBP/DBP in adolescents increases with age and also with height, giving similar figures in the taller ones, regardless of age. Copyright © 2017 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. What is the optimal interval between successive home blood pressure readings using an automated oscillometric device?

    PubMed

    Eguchi, Kazuo; Kuruvilla, Sujith; Ogedegbe, Gbenga; Gerin, William; Schwartz, Joseph E; Pickering, Thomas G

    2009-06-01

    To clarify whether a shorter interval between three successive home blood pressure (HBP) readings (10 s vs. 1 min) taken twice a day gives a better prediction of the average 24-h BP and better patient compliance. We enrolled 56 patients from a hypertension clinic (mean age: 60 +/- 14 years; 54% female patients). The study consisted of three clinic visits, with two 4-week periods of self-monitoring of HBP between them, and a 24-h ambulatory BP monitoring at the second visit. Using a crossover design, with order randomized, the oscillometric HBP device (HEM-5001) could be programmed to take three consecutive readings at either 10-s or 1-min intervals, each of which was done for 4 weeks. Patients were asked to measure three HBP readings in the morning and evening. All the readings were stored in the memory of the monitors. The analyses were performed using the second-third HBP readings. The average systolic BP/diastolic BP for the 10-s and 1-min intervals at home were 136.1 +/- 15.8/77.5 +/- 9.5 and 133.2 +/- 15.5/76.9 +/- 9.3 mmHg (P = 0.001/0.19 for the differences in systolic BP and diastolic BP), respectively. The 1-min BP readings were significantly closer to the average of awake ambulatory BP (131 +/- 14/79 +/- 10 mmHg) than the 10-s interval readings. There was no significant difference in patients' compliance in taking adequate numbers of readings at the different time intervals. The 1-min interval between HBP readings gave a closer agreement with the daytime average BP than the 10-s interval.

  7. What is the optimal interval between successive home blood pressure readings using an automated oscillometric device?

    PubMed Central

    Eguchi, Kazuo; Kuruvilla, Sujith; Ogedegbe, Gbenga; Gerin, William; Schwartz, Joseph E.; Pickering, Thomas G.

    2010-01-01

    Objectives To clarify whether a shorter interval between three successive home blood pressure (HBP) readings (10 s vs. 1 min) taken twice a day gives a better prediction of the average 24-h BP and better patient compliance. Design We enrolled 56 patients from a hypertension clinic (mean age: 60 ±14 years; 54% female patients). The study consisted of three clinic visits, with two 4-week periods of self-monitoring of HBP between them, and a 24-h ambulatory BP monitoring at the second visit. Using a crossover design, with order randomized, the oscillometric HBP device (HEM-5001) could be programmed to take three consecutive readings at either 10-s or 1-min intervals, each of which was done for 4 weeks. Patients were asked to measure three HBP readings in the morning and evening. All the readings were stored in the memory of the monitors. Results The analyses were performed using the second–third HBP readings. The average systolic BP/diastolic BP for the 10-s and 1-min intervals at home were 136.1 ±15.8/77.5 ±9.5 and 133.2 ±15.5/76.9 ±9.3 mmHg (P = 0.001/0.19 for the differences in systolic BP and diastolic BP), respectively. The 1-min BP readings were significantly closer to the average of awake ambulatory BP (131 ±14/79 ±10 mmHg) than the 10-s interval readings. There was no significant difference in patients’ compliance in taking adequate numbers of readings at the different time intervals. Conclusion The 1-min interval between HBP readings gave a closer agreement with the daytime average BP than the 10-s interval. PMID:19462492

  8. Letter to editor: Blood pressure, hypertension and lead exposure.

    PubMed

    Yang, Wen-Yi; Staessen, Jan A

    2018-02-19

    A significant association of office diastolic blood pressure with low-level blood lead exposure was reported in a Brazilian adult population. However, caution should be taken to interpret these results. The multivariable-adjusted association with blood pressure was positive for diastolic blood pressure, but inverse for systolic blood pressure. The association sizes were infinitesimal without clinical relevance. The outcome measures, i.e. blood pressure and the prevalence of hypertension were analysed across categories of the blood lead distribution - not in relation to blood lead as continuous variable. Blood pressure was the average of two oscillometric office readings, whereas ambulatory monitoring is the state-of-the-art.

  9. Noninvasive monitoring of blood pressure using optical Ballistocardiography and Photoplethysmograph approaches.

    PubMed

    Chen, Zhihao; Yang, Xiufeng; Teo, Ju Teng; Ng, Soon Huat

    2013-01-01

    A new all optical method for long term and continuous blood pressure measurement and monitoring without using cuffs is proposed by using Ballistocardiography (BCG) and Photoplethysmograph (PPG). Based on BCG signal and PPG signal, a time delay between these two signals is obtained to calculate both systolic blood pressure and diastolic blood pressure via linear regression analysis. The fabricated noninvasive blood pressure monitoring device consists of a fiber sensor mat to measure BCG signal and a SpO2 sensor to measure PPG signal. A commercial digital oscillometric blood pressure meter is used to obtain reference values and for calibration. It has been found that by comparing with the reference device, our prototype has typical means and standard deviations of 9+/-5.6 mmHg for systolic blood pressure, 1.8+/-1.3 mmHg for diastolic blood pressure and 0.6+/-0.9 bpm for pulse rate, respectively. If the fiber optic SpO2 probe is used, this new all fiber cuffless noninvasive blood pressure monitoring device will truly be a MRI safe blood pressure measurement and monitoring device.

  10. Neurovascular control during exercise in acute coronary syndrome patients with Gln27Glu polymorphism of β2-adrenergic receptor

    PubMed Central

    Ferreira-Santos, Larissa; Martinez, Daniel G.; Nicolau, José Carlos; Moreira, Humberto G.; Alves, Maria Janieire; Pereira, Alexandre C.; Trombetta, Ivani C.; Negrão, Carlos Eduardo

    2017-01-01

    Background Gln27Glu (rs1042714) polymorphism of the β2-adrenergic receptor (ADRB2) has been association with cardiovascular functionality in healthy subjects. However, it is unknown whether the presence of the ADRB2 Gln27Glu polymorphism influences neurovascular responses during exercise in patients with acute coronary syndromes (ACS). We tested the hypothesis that patients with ACS homozygous for the Gln allele would have increased muscle sympathetic nerve activity (MSNA) responses and decreased forearm vascular conductance (FVC) responses during exercise compared with patients carrying the Glu allele (Gln27Glu and Glu27Glu). In addition, exercise training would restore these responses in Gln27Gln patients. Methods and results Thirty-days after an ischemic event, 61 patients with ACS without ventricular dysfunction were divided into 2 groups: (1) Gln27Gln (n = 35, 53±1years) and (2) Gln27Glu+Glu27Glu (n = 26, 52±2years). MSNA was directly measured using the microneurography technique, blood pressure (BP) was measured with an automatic oscillometric device, and blood flow was measured using venous occlusion plethysmography. MSNA, mean BP, and FVC were evaluated at rest and during a 3-min handgrip exercise. The MSNA (P = 0.02) and mean BP (P = 0.04) responses during exercise were higher in the Gln27Gln patients compared with that in the Gln27Glu+Glu27Glu patients. No differences were found in FVC. Two months of exercise training significantly decreased the MSNA levels at baseline (P = 0.001) and in their response during exercise (P = 0.02) in Gln27Gln patients, but caused no changes in Gln27Glu+Glu27Glu patients. Exercise training increased FVC responses in Gln27Glu+Glu27Glu patients (P = 0.03), but not in Gln27Gln patients. Conclusion The exaggerated MSNA and mean BP responses during exercise suggest an increased cardiovascular risk in patients with ACS and Gln27Gln polymorphism. Exercise training emerges as an important strategy for restoring this reflex control. Gln27Glu polymorphism of ADRB2 influences exercise-induced vascular adaptation in patients with ACS. PMID:28235084

  11. Toe pressure determination by audiophotoplethysmography.

    PubMed

    Fronek, A; Blazek, V; Curran, B

    1994-08-01

    The purpose of this study was to evaluate the performance of audiophotoplethysmography as a modality to measure toe pressure without the requirement of a recorder. A portable photoplethysmograph with an audio output was used to determine toe pressures, and the results were compared with those obtained by a commercial photoplethysmograph with a recorder. Thirty-one measurements in control subjects and 62 measurements in patients with arterial occlusive disease were performed. The average toe pressure recorded with oscillography with standard photoplethysmography was 103.5 mm Hg +/- 14.7 SD and 95.9 mm Hg +/- 13.4 SD with audio-photoplethysmography. In the patient group the pressure recorded with a commercial photoplethysmograph was 65.3 mm Hg +/- 34.9 SD compared with 61.6 mm Hg +/- 34.8 SD obtained with audio-photoplethysmography. The difference in both groups was insignificant, and the correlation between both methods was very good. A portable hand-held photoplethysmograph equipped with an audio output was used to measure toe pressure in control subjects and in patients with arterial occlusive disease. The results have been compared with the oscillometric method by a standard commercial photoplethysmograph connected to a recorder. The correlation was very good in the control and patient groups, and the difference between both methods was below the level of statistical significance. The fact that no recorder is needed may help in introducing toe pressure measurement into everyday office diagnostic practice.

  12. Accuracy and Precision of Noninvasive Blood Pressure in Normo-, Hyper-, and Hypotensive Standing and Anesthetized Adult Horses.

    PubMed

    Heliczer, N; Lorello, O; Casoni, D; Navas de Solis, C

    2016-05-01

    Blood pressure is relevant to the diagnosis and management of many medical, cardiovascular and critical diseases. The accuracy of many commonly used noninvasive blood pressure (NIBP) monitors and the accuracy of NIBP measurements in hypo- and hypertensive standing horses has not been determined. The objective of this study was to investigate the accuracy of an oscillometric BP monitor in standing horses before and during pharmacologically induced hyper- and hypotension and to compare results in standing and anesthetized horses. Eight standing mares from a research herd (SG) and eight anesthetized horses from a hospital population (AG). Prospective experimental and observational studies. Invasive blood pressure (IBP) and NIBP, corrected to heart level, were measured simultaneously. In the SG hyper- and hypotension were induced by administration of phenylephrine (3 μg/kg/min IV for 15 minutes) and acepromazine (0.05 mg/kg IV), respectively. In the AG NIBP and IBP were recorded during regular hospital procedures. There was a significant correlation between mean NIBP and IBP in standing (R = 0.88, P < .001) and anesthetized horses (R = 0.81, P < .001). The mean bias (lower, upper limit of agreement) was 16.4(-16.1, 48.9) mmHg for mean BP in the SG and 0.5(-22.3, 23.2) mmHg in the AG. The NIBP device was capable of identifying the increase and decrease in BP in all horses, but in the SG significant correlation between NIBP and IBP was only detected for the normotensive phase. While the evaluated oscillometric BP device allowed estimation of BP and adequately differentiated marked trends, the accuracy and precision were low in standing horses. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  13. New clinical validation method for automated sphygmomanometer: a proposal by Japan ISO-WG for sphygmomanometer standard.

    PubMed

    Shirasaki, Osamu; Asou, Yosuke; Takahashi, Yukio

    2007-12-01

    Owing to fast or stepwise cuff deflation, or measuring at places other than the upper arm, the clinical accuracy of most recent automated sphygmomanometers (auto-BPMs) cannot be validated by one-arm simultaneous comparison, which would be the only accurate validation method based on auscultation. Two main alternative methods are provided by current standards, that is, two-arm simultaneous comparison (method 1) and one-arm sequential comparison (method 2); however, the accuracy of these validation methods might not be sufficient to compensate for the suspicious accuracy in lateral blood pressure (BP) differences (LD) and/or BP variations (BPV) between the device and reference readings. Thus, the Japan ISO-WG for sphygmomanometer standards has been studying a new method that might improve validation accuracy (method 3). The purpose of this study is to determine the appropriateness of method 3 by comparing immunity to LD and BPV with those of the current validation methods (methods 1 and 2). The validation accuracy of the above three methods was assessed in human participants [N=120, 45+/-15.3 years (mean+/-SD)]. An oscillometric automated monitor, Omron HEM-762, was used as the tested device. When compared with the others, methods 1 and 3 showed a smaller intra-individual standard deviation of device error (SD1), suggesting their higher reproducibility of validation. The SD1 by method 2 (P=0.004) significantly correlated with the participant's BP, supporting our hypothesis that the increased SD of device error by method 2 is at least partially caused by essential BPV. Method 3 showed a significantly (P=0.0044) smaller interparticipant SD of device error (SD2), suggesting its higher interparticipant consistency of validation. Among the methods of validation of the clinical accuracy of auto-BPMs, method 3, which showed the highest reproducibility and highest interparticipant consistency, can be proposed as being the most appropriate.

  14. Asymptomatic tracheal MALT lymphoma discovered on spirometric findings presenting with elevated respiratory resistance.

    PubMed

    Kadota, Naoki; Shinohara, Tsutomu; Machida, Hisanori; Nakanishi, Hirofumi; Suehiro, Fumie; Toda, Hiroko; Yoshino, Tadashi; Ogushi, Fumitaka

    2015-06-06

    Central airway obstruction (CAO) may be caused by various etiologies. However, conventional chest X-rays are rarely diagnostic for patients with CAO. We here described a 64-year-old asymptomatic female with tracheal mucosa-associated lymphoid tissue lymphoma discovered on spirometric findings during a complete physical examination. The plateau of forced expiratory flow was consistent with CAO. A decreased peak expiratory flow rate was noted at least 3 years before the diagnosis, and was attributed to an insufficient effort by the patient. Impulse oscillometric measurements, which were taken during quiet breathing and were effort-independent, suggested elevated respiratory resistance. These abnormalities completely disappeared after radiation therapy. The addition of impulse oscillometry to spirometry may be useful for screening CAO in routine health examinations.

  15. Different methods of calculating ankle-brachial index in mid-elderly men and women: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    PubMed

    Miname, M; Bensenor, I M; Lotufo, P A

    2016-01-01

    The ankle-brachial index (ABI) is a marker of subclinical atherosclerosis related to health-adverse outcomes. ABI is inexpensive compared to other indexes, such as coronary calcium score and determination of carotid artery intima-media thickness (IMT). Our objective was to identify how the ABI can be applied to primary care. Three different methods of calculating the ABI were compared among 13,921 men and women aged 35 to 74 years who were free of cardiovascular diseases and enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The ABI ratio had the same denominator for the three categories created (the highest value for arm systolic blood pressure), and the numerator was based on the four readings for leg systolic blood pressure: the highest (ABI-HIGH), the mean (ABI-MEAN), and the lowest (ABI-LOW). The cut-off for analysis was ABI<1.0. All determinations of blood pressure were done with an oscillometric device. The prevalence of ABI<1% was 0.5, 0.9, and 2.7 for the categories HIGH, MEAN and LOW, respectively. All methods were associated with a high burden of cardiovascular risk factors. The association with IMT was stronger for ABI-HIGH than for the other categories. The proportion of participants with a 10-year Framingham Risk Score of coronary heart disease >20% without the inclusion of ABI<1.0 was 4.9%. For ABI-HIGH, ABI-MEAN and ABI-LOW, the increase in percentage points was 0.3, 0.7, and 2.3%, respectively, and the relative increment was 6.1, 14.3, and 46.9%. In conclusion, all methods were acceptable, but ABI-LOW was more suitable for prevention purposes.

  16. Association Between Aerobic Fitness And High Blood Pressure in Adolescents in Brazil: Evidence for Criterion-Referenced Cut-Points.

    PubMed

    Silva, Diego Augusto; Tremblay, Mark; Pelegrini, Andreia; Dos Santos Silva, Roberto Jeronimo; Cabral de Oliveira, Antonio Cesar; Petroski, Edio Luiz

    2016-05-01

    Criterion-referenced cut-points for health-related fitness measures are lacking. This study aimed to determine the associations between aerobic fitness and high blood pressure levels (HBP) to determine the cut-points that best predict HBP among adolescents. This cross-sectional school-based study with sample of 875 adolescents aged 14-19 years was conducted in southern Brazil. Aerobic fitness was assessed using the modified Canadian Aerobic Fitness Test (mCAFT). Systolic and diastolic blood pressure were measured by the oscillometric method with a digital sphygmomanometer. Analyses controlled for sociodemographic variables, physical activity, body mass and biological maturation. Receiver Operating Characteristic (ROC) curves demonstrated that mCAFT measures could discriminate HBP in both sexes (female: AUC = 0.70; male: AUC = 0.63). The cut-points with the best discriminatory power for HBP were 32 mL·kg-1·min-1 for females and 40 mL·kg-1·min-1 for males. Females (OR = 8.4; 95% CI: 2.1, 33.7) and males (OR: 2.5; CI 95%: 1.2, 5.2) with low aerobic fitness levels were more likely to have HBP. mCAFT measures are inversely associated with BP and cut-points from ROC analyses have good discriminatory power for HBP.

  17. Ankle-Brachial Index, Toe-Brachial Index, and Pulse Volume Recording in Healthy Young Adults

    PubMed Central

    Masaki, Hisao; Yunoki, Yasuhiro; Tabuchi, Atushi; Morita, Ichiro; Mohri, Satoshi; Tanemoto, Kazuo

    2015-01-01

    Objective: To clarify the characteristics of ankle-brachial index (ABI), toe-brachial index (TBI), and pulse volume recording (PVR) of the ankle with brachial-ankle pulse wave velocity (baPWV) in healthy young adults. Material and Methods: We analyzed ABI, TBI, baPWV, and PVR in the ankle of healthy adults aged 20 to 25 years (median, 20 years) using an automatic oscillometric device between 2002 and 2013. The ABI, baPWV, and PVR in 1282 legs of 641 subjects (301 men and 340 women) and the TBI in 474 toes of 237 subjects (117 men and 120 women) were evaluated. Results: The measured values showed no bilateral differences. ABI and baPWV were higher in men than in women, but TBI was similar in both sexes. ABI <1.0 was observed in 18.1% of the legs in men and in 25.6% in women. TBI <0.7 was observed in 16.2% of the toes in men and 19.1% in women. For ankle PVR, the % mean arterial pressure was higher in women than in men. The upstroke time was <180 ms in most subjects. Conclusions: For young people, ABI <1.0 or TBI <0.7 may not always indicate vascular abnormalities. When evaluating circulatory indexes, age and sex should be considered. PMID:26421072

  18. An underwater blood pressure measuring device.

    PubMed

    Sieber, Arne; Kuch, Benjamin; L'abbate, Antonio; Wagner, Matthias; Dario, Paolo; Bedini, Remo

    2008-09-01

    Measurement of arterial blood pressure is an important vital sign for monitoring the circulation. However, up to now no instrument has been available that enables the measurement of blood pressure underwater. The present paper details a novel, oscillometric, automatic digital blood pressure (BP) measurement device especially designed for this purpose. It consists mainly of analogue and digital electronics in a lexan housing that is rated to a depth of up to 200 metres' sea water, a cuff and a solenoid for inflation of the cuff with air supplied from a scuba tank. An integrated differential pressure sensor, exposed to the same ambient pressure as the cuff, allows accurate BP measurement. Calculation of systolic and diastolic pressures is based on the analysis of pressure oscillations recorded during the deflation. In hyperbaric chamber tests to pressures up to 405 kPa, BP measurements taken with the prototype were comparable to those obtained with established manual and automated methods. Swimming pool tests confirmed the correct functioning of the system underwater. The quality of the recorded pressure oscillations was very good even at 10 metres' fresh water, and allowed determination of diastolic and systolic pressure values. Based on these results we envisage that this device will lead to a better understanding of human cardiovascular physiology in underwater and hyperbaric environments.

  19. Attended and Unattended Automated Office Blood Pressure Measurements Have Better Agreement With Ambulatory Monitoring Than Conventional Office Readings.

    PubMed

    Andreadis, Emmanuel A; Geladari, Charalampia V; Angelopoulos, Epameinondas T; Savva, Florentia S; Georgantoni, Anna I; Papademetriou, Vasilios

    2018-04-07

    Automated office blood pressure (AOBP) measurement is superior to conventional office blood pressure (OBP) because it eliminates the "white coat effect" and shows a strong association with ambulatory blood pressure. We conducted a cross-sectional study in 146 participants with office hypertension, and we compared AOBP readings, taken with or without the presence of study personnel, before and after the conventional office readings to determine whether their variation in blood pressure showed a difference in blood pressure values. We also compared AOBP measurements with daytime ambulatory blood pressure monitoring and conventional office readings. The mean age of the studied population was 56±12 years, and 53.4% of participants were male. Bland-Altman analysis revealed a bias (ie, mean of the differences) of 0.6±6 mm Hg systolic for attended AOBP compared with unattended and 1.4±6 and 0.1±6 mm Hg bias for attended compared with unattended systolic AOBP when measurements were performed before and after conventional readings, respectively. A small bias was observed when unattended and attended systolic AOBP measurements were compared with daytime ambulatory blood pressure monitoring (1.3±13 and 0.6±13 mm Hg, respectively). Biases were higher for conventional OBP readings compared with unattended AOBP (-5.6±15 mm Hg for unattended AOBP and oscillometric OBP measured by a physician, -6.8±14 mm Hg for unattended AOBP and oscillometric OBP measured by a nurse, and -2.1±12 mm Hg for unattended AOBP and auscultatory OBP measured by a second physician). Our findings showed that independent of the presence or absence of medical staff, AOBP readings revealed similar values that were closer to daytime ambulatory blood pressure monitoring than conventional office readings, further supporting the use of AOBP in the clinical setting. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  20. Thirty-minute compared to standardised office blood pressure measurement in general practice

    PubMed Central

    Scherpbier-de Haan, Nynke; van der Wel, Mark; Schoenmakers, Gijs; Boudewijns, Steve; Peer, Petronella; van Weel, Chris; Thien, Theo; Bakx, Carel

    2011-01-01

    Background Although blood pressure measurement is one of the most frequently performed measurements in clinical practice, there are concerns about its reliability. Serial, automated oscillometric blood pressure measurement has the potential to reduce measurement bias and white-coat effect' Aim To study agreement of 30-minute office blood pressure measurement (OBPM) with standardised OBPM, and to compare repeatability Design and setting Method comparison study in two general practices in the Netherlands Method Thirty-minute and standardised OBPM was carried out with the same, validated device in 83 adult patients, and the procedure was repeated after 2 weeks. During 30-minute OBPM, blood pressure was measured automatically every 3 minutes, with the patient in a sitting position, alone in a quiet room. Agreement between 30-minute and standardised OBPM was assessed by Bland–Altman analysis. Repeatability of the blood pressure measurement methods after 2 weeks was expressed as the mean difference in combination with the standard deviation of difference (SDD) Results Mean 30-minute OBPM readings were 7.6/2.5 mmHg (95% confidence interval [CI] = 6.1 to 9.1/1.5 to 3.4 mmHg) lower than standardised OBPM readings. The mean difference and SDD between repeated 30-minute OBPMs (mean difference = 3/1 mmHg, 95% CI = 1 to 5/0 to 2 mmHg; SDD 9.5/5.3 mmHg) were lower than those of standardised OBPMs (mean difference = 6/2 mmHg, 95% CI = 4 to 8/1 to 4 mmHg; SDD 10.9/6.3 mmHg). Conclusion Thirty-minute OBPM resulted in lower readings than standardised OBPM and had a better repeatability. These results suggest that 30-minute OBPM better reflects the patient's true blood pressure than standardised OBPM does. PMID:22152748

  1. Ankle brachial index for the diagnosis of lower limb peripheral arterial disease.

    PubMed

    Crawford, Fay; Welch, Karen; Andras, Alina; Chappell, Francesca M

    2016-09-14

    Peripheral arterial disease (PAD) of the lower limb is common, with prevalence of both symptomatic and asymptomatic disease estimated at 13% in the over 50 age group. Symptomatic PAD affects about 5% of individuals in Western populations between the ages of 55 and 74 years. The most common initial symptom of PAD is muscle pain on exercise that is relieved by rest and is attributed to reduced lower limb blood flow due to atherosclerotic disease (intermittent claudication). The ankle brachial index (ABI) is widely used by a variety of healthcare professionals, including specialist nurses, physicians, surgeons and podiatrists working in primary and secondary care settings, to assess signs and symptoms of PAD. As the ABI test is non-invasive and inexpensive and is in widespread clinical use, a systematic review of its diagnostic accuracy in people presenting with leg pain suggestive of PAD is highly relevant to routine clinical practice. To estimate the diagnostic accuracy of the ankle brachial index (ABI) - also known as the ankle brachial pressure index (ABPI) - for the diagnosis of peripheral arterial disease in people who experience leg pain on walking that is alleviated by rest. We carried out searches of the following databases in August 2013: MEDLINE (Ovid SP),Embase (Ovid SP), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCO), Latin American and Caribbean Health Sciences (LILACS) (Bireme), Database of Abstracts of Reviews of Effects and the Health Technology Assessment Database in The Cochrane Library, the Institute for Scientific Information (ISI) Conference Proceedings Citation Index - Science, the British Library Zetoc Conference search and Medion. We included cross-sectional studies of ABI in which duplex ultrasonography or angiography was used as the reference standard. We also included cross-sectional or diagnostic test accuracy (DTA) cohort studies consisting of both prospective and retrospective studies.Participants were adults presenting with leg pain on walking that was relieved by rest, who were tested in primary care settings or secondary care settings (hospital outpatients only) and who did not have signs or symptoms of critical limb ischaemia (rest pain, ischaemic ulcers or gangrene).The index test was ABI, also called the ankle brachial pressure index (ABPI) or the Ankle Arm Index (AAI), which was performed with a hand-held doppler or oscillometry device to detect ankle vessels. We included data collected via sphygmomanometers (both manual and aneroid) and digital equipment. Two review authors independently replicated data extraction by using a standard form, which included an assessment of study quality, and resolved disagreements by discussion. Two review authors extracted participant-level data when available to populate 2×2 contingency tables (true positives, true negatives, false positives and false negatives).After a pilot phase involving two review authors working independently, we used the methodological quality assessment tool the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2), which incorporated our review question - along with a flow diagram to aid reviewers' understanding of the conduct of the study when necessary and an assessment of risk of bias and applicability judgements. We screened 17,055 records identified through searches of databases. We obtained 746 full-text articles and assessed them for relevance. We scrutinised 49 studies to establish their eligibility for inclusion in the review and excluded 48, primarily because participants were not patients presenting solely with exertional leg pain, investigators used no reference standard or investigators used neither angiography nor duplex ultrasonography as the reference standard. We excluded most studies for more than one reason.Only one study met the eligibility criteria and provided limb-level accuracy data from just 85 participants (158 legs). This prospective study compared the manual doppler method of obtaining an ABI (performed by untrained personnel) with the automated oscillometric method. Limb-level data, as reported by the study, indicated that the accuracy of the ABI in detecting significant arterial disease on angiography is superior when stenosis is present in the femoropopliteal vessels, with sensitivity of 97% (95% confidence interval (CI) 93% to 99%) and specificity of 89% (95% CI 67% to 95%) for oscillometric ABI, and sensitivity of 95% (95% CI 89% to 97%) and specificity of 56% (95% CI 33% to 70%) for doppler ABI. The ABI threshold was not reported. Investigators attributed the lower specificity for doppler to the fact that a tibial or dorsalis pedis pulse could not be detected by doppler in 12 of 27 legs with normal vessels or non-significant lesions. The superiority of the oscillometric (automated) method for obtaining an ABI reading over the manual method with a doppler probe used by inexperienced operators may be a clinically important finding. Evidence about the accuracy of the ankle brachial index for the diagnosis of PAD in people with leg pain on exercise that is alleviated by rest is sparse. The single study included in our review provided only limb-level data from a few participants. Well-designed cross-sectional studies are required to evaluate the accuracy of ABI in patients presenting with early symptoms of peripheral arterial disease in all healthcare settings. Another systematic review of existing studies assessing the use of ABI in alternative patient groups, including asymptomatic, high-risk patients, is required.

  2. Comparison of pulse wave velocity assessed by three different techniques: Arteriograph, Complior, and Echo-tracking.

    PubMed

    Mihalcea, Diana J; Florescu, Maria; Suran, Berenice M C; Enescu, Oana A; Mincu, Raluca I; Magda, Stefania; Patrascu, Natalia; Vinereanu, Dragos

    2016-04-01

    Arterial stiffness estimated by pulse wave velocity (PWV) is an independent predictor of cardiovascular morbidity and mortality. Although recommended by the current guidelines, clinical applicability of this parameter is difficult, due to differences between the various techniques used to measure it and to biological variability. Our aim was to compare PWV assessed by 3 different commercially available systems. 100 subjects (51 ± 16 years, 45 men) were evaluated using the 3 methods: an oscillometric technique (Arteriograph, PWV-A); a piezo-electric method (Complior, PWV-C); and an high-resolution ultrasound technique implemented with an Echo-tracking system (Aloka, PWV-E). Conventional biological markers were measured. Correlations of PWV measured by the 3 methods were poor (r = 0.39, r = 0.39, and r = 0.31 for PWV-A vs. PWV-C, PWV-A vs. PWV-E, and PWV-C vs. PWV-E, respectively, all p < 0.05). By Bland-Altman analysis, mean difference (±SD) of PWV-A vs. PWV-C was -1.9 ± 2.0 m/s, of PWV-A vs. PWV-E -3.6 ± 1.9 m/s, and of PWV-C vs. PWV-E -2.7 ± 1.9 m/s, with a wide coefficient of variation (22.3, 25.7, and 25.7 %, respectively). As expected, PWV-A, PWV-C, and PWV-E correlated with other arterial stiffness parameters, such as intima-media thickness (r = 0.22, r = 0.22, and r = 0.36, respectively), E p (r = 0.37, r = 0.26, and r = 0.94, respectively), and augmentation index measured by Arteriograph method (r = 0.66, r = 0.35, and r = 0.26, respectively); all p < 0.05. Assessment of PWV is markedly dependent on the technique used to measure it, related to various methods for measuring traveled distance of the arterial wave. Our results suggest the urgent need to establish reference values of PWV for each of these techniques, separately, to be used in routine clinical practice.

  3. Accuracy of the Omron HEM-705 CP for blood pressure measurement in large epidemiologic studies.

    PubMed

    Vera-Cala, Lina M; Orostegui, Myriam; Valencia-Angel, Laura I; López, Nahyr; Bautista, Leonelo E

    2011-05-01

    Accurate measurement of blood pressure is of utmost importance in hypertension research. In the context of epidemiologic and clinical studies, oscillometric devices offer important advantages to overcome some of the limitations of the auscultatory method. Even though their accuracy has been evaluated in multiple studies in the clinical setting, there is little evidence of their performance in large epidemiologic studies. We evaluated the accuracy of the Omron HEM-705-CP, an automatic device for blood pressure (BP) measurement, as compared to the standard auscultatory method with a mercury sphygmomanometer in a large cohort study. We made three auscultatory measurements, followed by two measurements with the Omron device in 1,084 subjects. Bias was estimated as the average of the two Omron minus the average of the last two auscultatory measurements, with its corresponding 95% limits of agreement (LA). The Omron overestimated systolic blood pressure (SBP) by 1.8 mmHg (LA:-10.1, 13.7) and underestimated diastolic blood pressure (DBP) by 1.6 mmHg (LA:-12.3, 9.2). Bias was significantly larger in men. Bias in SBP increased with age and decreased with BP level, while bias in DBP decreased with age and increased with BP level. The sensitivity and specificity of the Omron to detect hypertension were 88.2% and 98.6%, respectively. Minimum bias in the estimates of the effects of several factors resulted from the use of Omron measurements. Our results showed that the Omron HEM-705-CP could be used for measuring BP in large epidemiology studies without compromising study validity or precision.

  4. Wearable and low-stress ambulatory blood pressure monitoring technology for hypertension diagnosis.

    PubMed

    Altintas, Ersin; Takoh, Kimiyasu; Ohno, Yuji; Abe, Katsumi; Akagawa, Takeshi; Ariyama, Tetsuri; Kubo, Masahiro; Tsuda, Kenichiro; Tochikubo, Osamu

    2015-01-01

    We propose a highly wearable, upper-arm type, oscillometric-based blood pressure monitoring technology with low-stress. The low-stress is realized by new developments in the hardware and software design. In the hardware design, conventional armband; cuff, is almost halved in volume thanks to a flexible plastic core and a liquid bag which enhances the fitness and pressure uniformity over the arm. Reduced air bag volume enables smaller motor pump size and battery leading to a thinner, more compact and more wearable unified device. In the software design, a new prediction algorithm enabled to apply less stress (and less pain) on arm of the patient. Proof-of-concept experiments on volunteers show a high accuracy on both technologies. This paper mainly introduces hardware developments. The system is promising for less-painful and less-stressful 24-hour blood pressure monitoring in hypertension managements and related healthcare solutions.

  5. Increased blood pressures in veterans with post traumatic stress disorder.

    PubMed

    Moazen-Zadeh, Ehsan; Khoshdel, Alireza; Avakh, Farhad; Rahmani, Arash

    2016-08-01

    Objective Veterans of war affected by posttraumatic stress disorder (PTSD) are at increased risk for cardiovascular diseases. We aimed to compare brachial and central blood pressures between veterans with PTSD and controls. Method In this case-control study on veterans of Iran-Iraq war, 50 veterans with PTSD and 50 veterans as controls were selected from an outpatient clinic and matched for age ±3 years. Exclusion criteria were malignancies, severe anatomical defects such as amputated extremities, history of PTSD before serving in war, comorbid psychiatric disorders other than anxiety or depressive disorders. Detailed history was taken concerning medical and social aspects. Beck Depression Inventory was used for depressive symptoms. Brachial blood pressures were measured using both auscultatory and oscillometric devices. Measures of central hemodynamics were estimated accordingly. Data on lipid profile were collected either through medical records or newly required lab tests. Results Brachial systolic, diastolic, and pulse pressures as well as estimated central systolic and diastolic pressures were significantly higher in the PTSD group. Beck Depression Inventory scores, frequency of diabetes mellitus, and hypertension were significantly higher in the PTSD group. PTSD status was an independent predictor of both brachial and central systolic and diastolic pressures. Conclusions We demonstrated increased measures of blood pressure in veterans with PTSD independent of depression and other risk factors. Further research is warranted to confirm our results.

  6. Blood pressure measurement in obese patients: comparison between upper arm and forearm measurements.

    PubMed

    Pierin, Angela M G; Alavarce, Débora C; Gusmão, Josiane L; Halpern, Alfredo; Mion, Décio

    2004-06-01

    It is well known that blood pressure measurement with a standard 12-13 cm wide cuff is erroneous for large arms. To compare arm blood pressure measurements with an appropriate cuff and forearm blood pressure measurements (BPM) with a standard cuff, and both measurements by the Photopletismography (Finapres) method. One hundred and twenty-nine obese patients were studied (body mass index=40+/-7 kg/m2). The patients had three arm BPM taken by an automatic oscillometric device using an appropriate cuff and three forearm BPM with a standard cuff in the sitting position after a five-minute rest. Data were analysed by the analysis of variance. The correction values were obtained by the linear regression test. Systolic and diastolic arm BPM with an appropriate cuff were significantly lower (p<0.05) than forearm BPM with a standard cuff. The measurements obtained by Finapres were significantly lower (p<0.05) than those found for forearm systolic and diastolic blood pressures and upper arm diastolic blood pressure. The equation to correct BPM in forearm in obese patients with arm circumference between 32-44 cm was: systolic BPM=33.2+/-0.68 x systolic forearm BPM, and diastolic BPM=25.2+0.59 x forearm diastolic BPM. This study showed that forearm blood pressure measurement overestimates the values of arm blood pressure measurement. In addition, it is possible to correct forearm BPM with an equation.

  7. Ghrelin and its promoter variant associated with cardiac hypertrophy.

    PubMed

    Ukkola, O; Pääkkö, T; Kesäniemi, Y A

    2012-07-01

    The roles of ghrelin, a peptide hormone that has a role in regulating food intake and energy homeostasis, in the cardiovascular system have not yet been unambiguously established. We evaluated the association between plasma ghrelin concentrations and -501A>C single-nucleotide polymorphism (SNP) in the ghrelin gene 5' flanking area and echocardiographic measurements in 1037 middle-aged subjects. Left ventricular mass index (LVMI) was calculated according to Devereux's method. The ambulatory blood pressure (BP) was recorded using the fully automatic SpaceLabs 90207 oscillometric unit. Results suggested that plasma ghrelin was not related to mean ambulatory BP values. However, the highest plasma ghrelin tertile was associated with increased intraventricular septum (P=0.043) and posterior ventricular wall (P=0.002) thicknesses as well as left ventricular mass (P=0.05). After adjustment for age, sex, body mass index and systolic BP, the association persisted between ghrelin tertiles and intraventricular septum (P=0.05) and posterior ventricular wall (P=0.001) thicknesses. The SNP -501A>C polymorphism was associated with LVMI after adjustments for age, sex and systolic BP. In conclusion, ghrelin and its promoter variant are associated with cardiac hypertrophy indexes independent of BP. Positive correlation between ghrelin levels and increased wall thickness parameters may reflect compensatory up-regulation of ghrelin concentrations or direct effects of ghrelin on myocardium. The effects of the SNP seem not to be mediated through its effects on ghrelin plasma levels.

  8. Hypertension Canada's 2018 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults and Children.

    PubMed

    Nerenberg, Kara A; Zarnke, Kelly B; Leung, Alexander A; Dasgupta, Kaberi; Butalia, Sonia; McBrien, Kerry; Harris, Kevin C; Nakhla, Meranda; Cloutier, Lyne; Gelfer, Mark; Lamarre-Cliche, Maxime; Milot, Alain; Bolli, Peter; Tremblay, Guy; McLean, Donna; Padwal, Raj S; Tran, Karen C; Grover, Steven; Rabkin, Simon W; Moe, Gordon W; Howlett, Jonathan G; Lindsay, Patrice; Hill, Michael D; Sharma, Mike; Field, Thalia; Wein, Theodore H; Shoamanesh, Ashkan; Dresser, George K; Hamet, Pavel; Herman, Robert J; Burgess, Ellen; Gryn, Steven E; Grégoire, Jean C; Lewanczuk, Richard; Poirier, Luc; Campbell, Tavis S; Feldman, Ross D; Lavoie, Kim L; Tsuyuki, Ross T; Honos, George; Prebtani, Ally P H; Kline, Gregory; Schiffrin, Ernesto L; Don-Wauchope, Andrew; Tobe, Sheldon W; Gilbert, Richard E; Leiter, Lawrence A; Jones, Charlotte; Woo, Vincent; Hegele, Robert A; Selby, Peter; Pipe, Andrew; McFarlane, Philip A; Oh, Paul; Gupta, Milan; Bacon, Simon L; Kaczorowski, Janusz; Trudeau, Luc; Campbell, Norman R C; Hiremath, Swapnil; Roerecke, Michael; Arcand, Joanne; Ruzicka, Marcel; Prasad, G V Ramesh; Vallée, Michel; Edwards, Cedric; Sivapalan, Praveena; Penner, S Brian; Fournier, Anne; Benoit, Geneviève; Feber, Janusz; Dionne, Janis; Magee, Laura A; Logan, Alexander G; Côté, Anne-Marie; Rey, Evelyne; Firoz, Tabassum; Kuyper, Laura M; Gabor, Jonathan Y; Townsend, Raymond R; Rabi, Doreen M; Daskalopoulou, Stella S

    2018-05-01

    Hypertension Canada provides annually updated, evidence-based guidelines for the diagnosis, assessment, prevention, and treatment of hypertension in adults and children. This year, the adult and pediatric guidelines are combined in one document. The new 2018 pregnancy-specific hypertension guidelines are published separately. For 2018, 5 new guidelines are introduced, and 1 existing guideline on the blood pressure thresholds and targets in the setting of thrombolysis for acute ischemic stroke is revised. The use of validated wrist devices for the estimation of blood pressure in individuals with large arm circumference is now included. Guidance is provided for the follow-up measurements of blood pressure, with the use of standardized methods and electronic (oscillometric) upper arm devices in individuals with hypertension, and either ambulatory blood pressure monitoring or home blood pressure monitoring in individuals with white coat effect. We specify that all individuals with hypertension should have an assessment of global cardiovascular risk to promote health behaviours that lower blood pressure. Finally, an angiotensin receptor-neprilysin inhibitor combination should be used in place of either an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in individuals with heart failure (with ejection fraction < 40%) who are symptomatic despite appropriate doses of guideline-directed heart failure therapies. The specific evidence and rationale underlying each of these guidelines are discussed. Copyright © 2018 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  9. Comparison of noninvasive blood pressure measurement techniques via the coccygeal artery in anesthetized cheetahs (Acinonyx jubatus).

    PubMed

    Sadler, Ryan A; Hall, Natalie H; Kass, Philip H; Citino, Scott B

    2013-12-01

    Two indirect blood pressure measurement techniques, Doppler (DOP) sphygmomanometry and oscillometry, applied at the ventral coccygeal artery were compared with simultaneous direct blood pressure measurements at the dorsal pedal artery in 10 anesthetized, captive cheetahs (Acinonyx jubatus). The DOP method was moderately accurate, with relatively little bias (mean difference 3.8 mmHg) and 88.6% of the DOP systolic arterial pressure measurements being within 10 mmHg of the direct systolic arterial measurement. With the oscillometric (OM) method, 89.2% of the mean arterial pressure measurements were within 10 mmHg of the direct measurement and had the least bias (mean difference 2.3 mmHg), 80.7% of the systolic measurements were within 10 mmHg of the direct measurement and had the second least bias (mean difference 2.3 mmHg), and 59% of the diastolic measurements were within 10 mmHg of the direct measurement and had significant bias (mean difference 7.3 mmHg). However, DOP showed relatively poor precision (SD 11.2 mmHg) compared with OM systolic (SD 8.0 mmHg), diastolic (SD 8.6 mmHg), and mean (SD 5.7 mmHg). Both techniques showed a linear relationship with the direct technique measurements over a wide range of blood pressures. The DOP method tended to underestimate systolic measurements below 160 mmHg and overestimate systolic measurements above 160 mmHg. The OM method tended to underestimate mean pressures below 160 mm Hg, overestimate mean pressures above 160 mmHg, underestimate systolic pressures below 170 mmHg, overestimate systolic pressures above 170 mmHg, and underestimate diastolic pressures throughout the measured blood pressure range. Indirect blood pressure measurement using the ventral coccygeal artery, particularly when using an OM device for mean and systolic arterial pressure, may be useful in the clinical assessment of cheetahs when monitoring trends over time, but caution should be taken when interpreting individual values.

  10. Exercise training improves muscle vasodilatation in individuals with T786C polymorphism of endothelial nitric oxide synthase gene.

    PubMed

    Negrao, Marcelo V; Alves, Cleber R; Alves, Guilherme B; Pereira, Alexandre C; Dias, Rodrigo G; Laterza, Mateus C; Mota, Gloria F; Oliveira, Edilamar M; Bassaneze, Vinícius; Krieger, Jose E; Negrao, Carlos E; Rondon, Maria Urbana P B

    2010-09-01

    Allele T at promoter region of the eNOS gene has been associated with an increase in coronary disease mortality, suggesting that this allele increases susceptibility for endothelial dysfunction. In contrast, exercise training improves endothelial function. Thus, we hypothesized that: 1) Muscle vasodilatation during exercise is attenuated in individuals homozygous for allele T, and 2) Exercise training improves muscle vasodilatation in response to exercise for TT genotype individuals. From 133 preselected healthy individuals genotyped for the T786C polymorphism, 72 participated in the study: TT (n = 37; age 27 ± 1 yr) and CT+CC (n = 35; age 26 ± 1 yr). Forearm blood flow (venous occlusion plethysmography) and blood pressure (oscillometric automatic cuff) were evaluated at rest and during 30% handgrip exercise. Exercise training consisted of three sessions per week for 18 wk, with intensity between anaerobic threshold and respiratory compensation point. Resting forearm vascular conductance (FVC, P = 0.17) and mean blood pressure (P = 0.70) were similar between groups. However, FVC responses during handgrip exercise were significantly lower in TT individuals compared with CT+CC individuals (0.39 ± 0.12 vs. 1.08 ± 0.27 units, P = 0.01). Exercise training significantly increased peak VO(2) in both groups, but resting FVC remained unchanged. This intervention significantly increased FVC response to handgrip exercise in TT individuals (P = 0.03), but not in CT+CC individuals (P = 0.49), leading to an equivalent FVC response between TT and CT+CC individuals (1.05 ± 0.18 vs. 1.59 ± 0.27 units, P = 0.27). In conclusion, exercise training improves muscle vasodilatation in response to exercise in TT genotype individuals, demonstrating that genetic variants influence the effects of interventions such as exercise training.

  11. Gender-specific association of the plasminogen activator inhibitor-1 4G/5G polymorphism with central arterial blood pressure.

    PubMed

    Björck, Hanna M; Eriksson, Per; Alehagen, Urban; De Basso, Rachel; Ljungberg, Liza U; Persson, Karin; Dahlström, Ulf; Länne, Toste

    2011-07-01

    The functional plasminogen activator inhibitor-1 (PAI-1) 4G/5G polymorphism has previously been associated with hypertension. In recent years, central blood pressure, rather than brachial has been argued a better measure of cardiovascular damage and clinical outcome. The aim of this study was to investigate the possible influence of the 4G/5G polymorphism on central arterial blood pressure in a cohort of elderly individuals. We studied 410 individuals, 216 men and 194 women, aged 70-88. Central pressures and pulse waveforms were calculated from the radial artery pressure waveform by the use of the SphygmoCor system and a generalized transfer function. Brachial pressure was recorded using oscillometric technique (Dinamap, Critikon, Tampa, FL). PAI-1 antigen was determined in plasma. The results showed that central pressures were higher in women carrying the PAI-1 4G/4G genotype compared to female carriers of the 5G/5G genotype, (P = 0.025, P = 0.002, and P = 0.002 for central systolic-, diastolic-, and mean arterial pressure, respectively). The association remained after adjustment for potentially confounding factors related to hypertension. No association of the PAI-1 genotype with blood pressure was found in men. Multiple regression analysis revealed an association between PAI-1 genotype and plasma PAI-1 levels (P = 0.048). Our findings show a gender-specific association of the PAI-1 4G/5G polymorphism with central arterial blood pressure. The genotype effect was independent of other risk factors related to hypertension, suggesting that impaired fibrinolytic potential may play an important role in the development of central hypertension in women.

  12. Improving the accuracy of blood pressure measurement: the influence of the European Society of Hypertension International Protocol (ESH-IP) for the validation of blood pressure measuring devices and future perspectives.

    PubMed

    Stergiou, George S; Asmar, Roland; Myers, Martin; Palatini, Paolo; Parati, Gianfranco; Shennan, Andrew; Wang, Jiguang; O'Brien, Eoin

    2018-03-01

    The European Society of Hypertension (ESH) International Protocol (ESH-IP) for the validation of blood pressure (BP) measuring devices was published in 2002, with the main objective of simplifying the validation procedures, so that more BP monitors would be subjected to independent validation. This article provides an overview of the international impact of the ESH-IP and of the lessons learned from its use, to be able to justify further developments in validation protocols. A review of published (PubMed) validation studies from 2002 to 2017 was performed. One hundred and seventy-seven validation studies using the ESH-IP, 59 using the British Hypertension Society protocol, 46 using the Association for the Advancement of Medical Instrumentation (AAMI) standard and 23 using the International Organization for Standardization (ISO) standard were identified. Lists of validated office-clinic, home and ambulatory BP monitors are provided. Of the ESH-IP studies, 93% tested oscillometric devices, 80% upper arm, 71% home, 25% office and 7% ambulatory monitors (some had more than one function). The original goal of the ESH-IP has been fulfilled in that in the last decade the number of published validation studies has more than doubled. It is now recognized that the provision of accurate devices would be best served by having a universal protocol. An international initiative has been put in place by AAMI, ESH and ISO experts aiming to reach consensus for a universal validation protocol to be accepted worldwide, which will allow a more thorough evaluation of the accuracy and performance of future BP monitors.

  13. Short-term blood pressure variability - variation between arm side, body position and successive measurements: a population-based cohort study.

    PubMed

    Lacruz, Maria Elena; Kluttig, Alexander; Kuss, Oliver; Tiller, Daniel; Medenwald, Daniel; Nuding, Sebastian; Greiser, Karin Halina; Frantz, Stefan; Haerting, Johannes

    2017-01-18

    Precise blood pressure (BP) measurements are central for the diagnosis of hypertension in clinical and epidemiological studies. The purpose of this study was to quantify the variability in BP associated with arm side, body position, and successive measurements in the setting of a population-based observational study. Additionally, we aimed to evaluate the influence of different measurement conditions on prevalence of hypertension. The sample included 967 men and 812 women aged 45 to 83 years at baseline. BP was measured according to a standardized protocol with oscillometric devices including three sitting measurements at left arm, one simultaneous supine measurement at both arms, and four supine measurements at the arm with the higher BP. Hypertension was defined as systolic BP (SBP) ≥140 mmHg and/or diastolic BP (DBP) ≥90 mmHg. Variability in SBP and DBP were analysed with sex-stratified linear covariance pattern models. We found that overall, no mean BP differences were measured according to arm-side, but substantial higher DBP and for men also higher SBP was observed in sitting than in supine position and there was a clear BP decline by consecutive measurement. Accordingly, the prevalence of hypertension depends strongly on the number and scheme of BP measurements taken to calculate the index values. Thus, BP measurements should only be compared between studies applying equal measurement conditions and index calculation. Moreover, the first BP measurement should not be used to define hypertension since it overestimates BP. The mean of second and third measurement offers the advantage of better reproducibility over single measurements.

  14. Recommendations for blood pressure measurement in humans and experimental animals: Part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research.

    PubMed

    Pickering, Thomas G; Hall, John E; Appel, Lawrence J; Falkner, Bonita E; Graves, John; Hill, Martha N; Jones, Daniel W; Kurtz, Theodore; Sheps, Sheldon G; Roccella, Edward J

    2005-01-01

    Accurate measurement of blood pressure is essential to classify individuals, to ascertain blood pressure-related risk, and to guide management. The auscultatory technique with a trained observer and mercury sphygmomanometer continues to be the method of choice for measurement in the office, using the first and fifth phases of the Korotkoff sounds, including in pregnant women. The use of mercury is declining, and alternatives are needed. Aneroid devices are suitable, but they require frequent calibration. Hybrid devices that use electronic transducers instead of mercury have promise. The oscillometric method can be used for office measurement, but only devices independently validated according to standard protocols should be used, and individual calibration is recommended. They have the advantage of being able to take multiple measurements. Proper training of observers, positioning of the patient, and selection of cuff size are all essential. It is increasingly recognized that office measurements correlate poorly with blood pressure measured in other settings, and that they can be supplemented by self-measured readings taken with validated devices at home. There is increasing evidence that home readings predict cardiovascular events and are particularly useful for monitoring the effects of treatment. Twenty-four-hour ambulatory monitoring gives a better prediction of risk than office measurements and is useful for diagnosing white-coat hypertension. There is increasing evidence that a failure of blood pressure to fall during the night may be associated with increased risk. In obese patients and children, the use of an appropriate cuff size is of paramount importance.

  15. Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research.

    PubMed

    Pickering, Thomas G; Hall, John E; Appel, Lawrence J; Falkner, Bonita E; Graves, John; Hill, Martha N; Jones, Daniel W; Kurtz, Theodore; Sheps, Sheldon G; Roccella, Edward J

    2005-02-08

    Accurate measurement of blood pressure is essential to classify individuals, to ascertain blood pressure-related risk, and to guide management. The auscultatory technique with a trained observer and mercury sphygmomanometer continues to be the method of choice for measurement in the office, using the first and fifth phases of the Korotkoff sounds, including in pregnant women. The use of mercury is declining, and alternatives are needed. Aneroid devices are suitable, but they require frequent calibration. Hybrid devices that use electronic transducers instead of mercury have promise. The oscillometric method can be used for office measurement, but only devices independently validated according to standard protocols should be used, and individual calibration is recommended. They have the advantage of being able to take multiple measurements. Proper training of observers, positioning of the patient, and selection of cuff size are all essential. It is increasingly recognized that office measurements correlate poorly with blood pressure measured in other settings, and that they can be supplemented by self-measured readings taken with validated devices at home. There is increasing evidence that home readings predict cardiovascular events and are particularly useful for monitoring the effects of treatment. Twenty-four-hour ambulatory monitoring gives a better prediction of risk than office measurements and is useful for diagnosing white-coat hypertension. There is increasing evidence that a failure of blood pressure to fall during the night may be associated with increased risk. In obese patients and children, the use of an appropriate cuff size is of paramount importance.

  16. Seaweed intake and blood pressure levels in healthy pre-school Japanese children

    PubMed Central

    2011-01-01

    Background Few studies have examined whether dietary factors might affect blood pressure in children. We purposed to investigate whether seaweed intake is associated with blood pressure level among Japanese preschool children. Methods The design of the study was cross-sectional and it was conducted in autumn 2006. Subjects were healthy preschoolers aged 3-6 years in Aichi, Japan. Blood pressure and pulse were measured once by an automated sphygmomanometer, which uses oscillometric methods. Dietary data, including seaweed intake, were assessed using 3-day dietary records covering 2 consecutive weekdays and 1 weekend day. Of a total of 533 children, 459 (86.1 percent) agreed to be enrolled in our study. Finally, blood pressure measurement, complete dietary records and parent-reported height and weight were obtained for 223 boys and 194 girls. Results When we examined Spearman's correlation coefficients, seaweed intake was significantly negatively related to systolic blood pressure in girls (P = 0.008). In the one-way analysis of covariance for blood pressure and pulse after adjustments for age and BMI, the boys with the lowest, middle and highest tertiles of seaweed intake had diastolic blood pressure readings of 62.8, 59.3 and 59.6 mmHg, respectively (P = 0.11, trend P = 0.038). Girls with higher seaweed intake had significantly lower systolic blood pressure readings (102.4, 99.2 and 96.9 mmHg for girls with the lowest, middle and highest tertiles of seaweed intake, respectively; P = 0.037, trend P = 0.030). Conclusion Our study showed that seaweed intake was negatively related to diastolic blood pressure in boys and to systolic blood pressure in girls. This suggests that seaweed might have beneficial effects on blood pressure among children. PMID:21827710

  17. Increased arterial stiffness in children with congenital heart disease.

    PubMed

    Häcker, Anna-Luisa; Reiner, Barbara; Oberhoffer, Renate; Hager, Alfred; Ewert, Peter; Müller, Jan

    2018-01-01

    Objective Central systolic blood pressure (SBP) is a measure of arterial stiffness and strongly associated with atherosclerosis and end-organ damage. It is a stronger predictor of cardiovascular events and all-cause mortality than peripheral SBP. In particular, for children with congenital heart disease, a higher central SBP might impose a greater threat of cardiac damage. The aim of the study was to analyse and compare central SBP in children with congenital heart disease and in healthy counterparts. Patients and methods Central SBP was measured using an oscillometric method in 417 children (38.9% girls, 13.0 ± 3.2 years) with various congenital heart diseases between July 2014 and February 2017. The test results were compared with a recent healthy reference cohort of 1466 children (49.5% girls, 12.9 ± 2.5 years). Results After correction for several covariates in a general linear model, central SBP of children with congenital heart disease was significantly increased (congenital heart disease: 102.1 ± 10.2 vs. healthy reference cohort: 100.4 ± 8.6, p < .001). The analysis of congenital heart disease subgroups revealed higher central SBP in children with left heart obstructions (mean difference: 3.6 mmHg, p < .001), transpositions of the great arteries after arterial switch (mean difference: 2.2 mmHg, p = .017) and univentricular hearts after total cavopulmonary connection (mean difference: 2.1 mmHg, p = .015) compared with the reference. Conclusion Children with congenital heart disease have significantly higher central SBP compared with healthy peers, predisposing them to premature heart failure. Screening and long-term observations of central SBP in children with congenital heart disease seems warranted in order to evaluate the need for treatment.

  18. Neurovascular control during exercise in acute coronary syndrome patients with Gln27Glu polymorphism of β2-adrenergic receptor.

    PubMed

    Ferreira-Santos, Larissa; Martinez, Daniel G; Nicolau, José Carlos; Moreira, Humberto G; Alves, Maria Janieire; Pereira, Alexandre C; Trombetta, Ivani C; Negrão, Carlos Eduardo; Rondon, Maria Urbana P B

    2017-01-01

    Gln27Glu (rs1042714) polymorphism of the β2-adrenergic receptor (ADRB2) has been association with cardiovascular functionality in healthy subjects. However, it is unknown whether the presence of the ADRB2 Gln27Glu polymorphism influences neurovascular responses during exercise in patients with acute coronary syndromes (ACS). We tested the hypothesis that patients with ACS homozygous for the Gln allele would have increased muscle sympathetic nerve activity (MSNA) responses and decreased forearm vascular conductance (FVC) responses during exercise compared with patients carrying the Glu allele (Gln27Glu and Glu27Glu). In addition, exercise training would restore these responses in Gln27Gln patients. Thirty-days after an ischemic event, 61 patients with ACS without ventricular dysfunction were divided into 2 groups: (1) Gln27Gln (n = 35, 53±1years) and (2) Gln27Glu+Glu27Glu (n = 26, 52±2years). MSNA was directly measured using the microneurography technique, blood pressure (BP) was measured with an automatic oscillometric device, and blood flow was measured using venous occlusion plethysmography. MSNA, mean BP, and FVC were evaluated at rest and during a 3-min handgrip exercise. The MSNA (P = 0.02) and mean BP (P = 0.04) responses during exercise were higher in the Gln27Gln patients compared with that in the Gln27Glu+Glu27Glu patients. No differences were found in FVC. Two months of exercise training significantly decreased the MSNA levels at baseline (P = 0.001) and in their response during exercise (P = 0.02) in Gln27Gln patients, but caused no changes in Gln27Glu+Glu27Glu patients. Exercise training increased FVC responses in Gln27Glu+Glu27Glu patients (P = 0.03), but not in Gln27Gln patients. The exaggerated MSNA and mean BP responses during exercise suggest an increased cardiovascular risk in patients with ACS and Gln27Gln polymorphism. Exercise training emerges as an important strategy for restoring this reflex control. Gln27Glu polymorphism of ADRB2 influences exercise-induced vascular adaptation in patients with ACS.

  19. Validation of the Pangao PG-800B26 upper arm blood pressure monitor in the general population according to the European Society of Hypertension and the British Hypertension Society protocols.

    PubMed

    Chen, Liang; Li, Jiyu; Wen, Jing; Guo, Changfeng; Zhang, Jingying; Yu, Zhen

    2018-02-01

    This study aimed to evaluate the accuracy of the automated oscillometric upper arm blood pressure monitor Pangao PG-800B26 for home blood pressure monitoring according to the European Society of Hypertension International Protocol (ESH-IP) revision 2010 and the British Hypertension Society (BHS) protocols. Systolic and diastolic blood pressures were measured sequentially in 33 and 85 adults, respectively, on the basis of the ESH-IP and BHS protocols using a mercury sphygmomanometer (two observers) and the device (one supervisor). The procedures and analysis methods of the protocols were followed precisely. The device fulfilled the criteria of the ESH-IP, with device-observer differences of 1.01±5.16 and -0.58±4.17 mmHg for systolic and diastolic blood pressure, respectively. Furthermore, the A/A grade of the BHS protocol was also achieved for overall grading and for the three pressure levels, with average differences of 0.85±6.35 and -0.15±5.65 mmHg for systolic and diastolic blood pressure, respectively, which also fulfilled the requirements of the Association for the Advancement of Medical Instrumentation. The Pangao PG-800B26 fulfilled the criteria of the ESH-IP 2010 and achieved the A/A grade of the BHS protocol, and hence can be recommended for home use in adults.

  20. Oscillometric and spirometric bronchodilator response in preschool children with and without asthma

    PubMed Central

    Shin, Youn Ho; Jang, Sun Jung; Yoon, Jung Won; Jee, Hye Mi; Choi, Sun Hee; Yum, Hye Yung; Warburton, David; Han, Man Yong

    2012-01-01

    BACKGROUND: Bronchodilator responses (BDR) are routinely used in the diagnosis and management of asthma; however, their acceptability and repeatability have not been evaluated using quality control criteria for preschool children. OBJECTIVES: To compare conventional spirometry with an impulse oscillometry system (IOS) in healthy and asthmatic preschool children. METHODS: Data from 30 asthmatic children and 29 controls (two to six years of age) who underwent IOS and spirometry before and after salbutamol administration were analyzed. RESULTS: Stable asthmatic subjects significantly differed versus controls in their spirometry-assessed BDR (forced expiratory volume in 1 s [FEV1], forced vital capacity and forced expiratory flow at 25% to 75% of forced vital capacity) as well as their IOS-assessed BDR (respiratory resistance at 5 Hz [Rrs5], respiratory reactance at 5 Hz and area under the reactance curve). However, comparisons based on the area under the ROC curve for ΔFEV1 % initial versus ΔRrs5 % initial were 0.82 (95% CI 0.71 to 0.93) and 0.75 (95% CI 0.62 to 0.87), respectively. Moreover, the sensitivity and specificity for ΔFEV1 ≥9% were 0.53 and 0.93, respectively. Importantly, sensitivity increased to 0.63 when either ΔFEV1 ≥9% or ΔRrs5 ≥29% was considered as an additional criterion for the diagnosis of asthma. CONCLUSION: The accuracy of asthma diagnosis in preschool children may be increased by combining spirometry with IOS when measuring BDR. PMID:22891189

  1. Call to action on use and reimbursement for home blood pressure monitoring: executive summary: a joint scientific statement from the American Heart Association, American Society Of Hypertension, and Preventive Cardiovascular Nurses Association.

    PubMed

    Pickering, Thomas G; Miller, Nancy Houston; Ogedegbe, Gbenga; Krakoff, Lawrence R; Artinian, Nancy T; Goff, David

    2008-07-01

    Home blood pressure monitoring (HBPM) overcomes many of the limitations of traditional office blood pressure (BP) measurement and is both cheaper and easier to perform than ambulatory BP monitoring. Monitors that use the oscillometric method are currently available that are accurate, reliable, easy to use, and relatively inexpensive. An increasing number of patients are using them regularly to check their BP at home, but although this has been endorsed by national and international guidelines, detailed recommendations for their use have been lacking. There is a rapidly growing literature showing that measurements taken by patients at home are often lower than readings taken in the office and closer to the average BP recorded by 24-hour ambulatory monitors, which is the BP that best predicts cardiovascular risk. Because of the larger numbers of readings that can be taken by HBPM than in the office and the elimination of the white-coat effect (the increase of BP during an office visit), home readings are more reproducible than office readings and show better correlations with measures of target organ damage. In addition, prospective studies that have used multiple home readings to express the true BP have found that home BP predicts risk better than office BP (class IIa; level of evidence A). This call-to-action article makes the following recommendations: (1) It is recommended that HBPM should become a routine component of BP measurement in the majority of patients with known or suspected hypertension; (2) Patients should be advised to purchase oscillometric monitors that measure BP on the upper arm with an appropriate cuff size and that have been shown to be accurate according to standard international protocols. They should be shown how to use them by their healthcare providers; (3) Two to 3 readings should be taken while the subject is resting in the seated position, both in the morning and at night, over a period of 1 week. A total of >or=12 readings are recommended for making clinical decisions; (4) HBPM is indicated in patients with newly diagnosed or suspected hypertension, in whom it may distinguish between white-coat and sustained hypertension. If the results are equivocal, ambulatory BP monitoring may help to establish the diagnosis; (5) In patients with prehypertension, HBPM may be useful for detecting masked hypertension; (6) HBPM is recommended for evaluating the response to any type of antihypertensive treatment and may improve adherence; (7) The target HBPM goal for treatment is <135/85 mm Hg or <130/80 mm Hg in high-risk patients; (8) HBPM is useful in the elderly, in whom both BP variability and the white-coat effect are increased; (9) HBPM is of value in patients with diabetes, in whom tight BP control is of paramount importance; (10) Other populations in whom HBPM may be beneficial include pregnant women, children, and patients with kidney disease; and (11) HBPM has the potential to improve the quality of care while reducing costs and should be reimbursed.

  2. Call to action on use and reimbursement for home blood pressure monitoring: executive summary a joint scientific statement from the american heart association, american society of hypertension, and preventive cardiovascular nurses association.

    PubMed

    Pickering, Thomas G; Miller, Nancy Houston; Ogedegbe, Gbenga; Krakoff, Lawrence R; Artinian, Nancy T; Goff, David

    2008-01-01

    Home blood pressure monitoring (HBPM) overcomes many of the limitations of traditional office blood pressure (BP) measurement and is both cheaper and easier to perform than ambulatory BP monitoring. Monitors that use the oscillometric method are currently available that are accurate, reliable, easy to use, and relatively inexpensive. An increasing number of patients are using them regularly to check their BP at home, but although this has been endorsed by national and international guidelines, detailed recommendations for their use have been lacking. There is a rapidly growing literature showing that measurements taken by patients at home are often lower than readings taken in the office and closer to the average BP recorded by 24-hour ambulatory monitors, which is the BP that best predicts cardiovascular risk. Because of the larger numbers of readings that can be taken by HBPM than in the office and the elimination of the white-coat effect (the increase of BP during an office visit), home readings are more reproducible than office readings and show better correlations with measures of target organ damage. In addition, prospective studies that have used multiple home readings to express the true BP have found that home BP predicts risk better than office BP (class IIa; level of evidence A). This call-to-action article makes the following recommendations: 1) It is recommended that HBPM should become a routine component of BP measurement in the majority of patients with known or suspected hypertension; 2) Patients should be advised to purchase oscillometric monitors that measure BP on the upper arm with an appropriate cuff size and that have been shown to be accurate according to standard international protocols. They should be shown how to use them by their healthcare providers; 3) Two to three readings should be taken while the subject is resting in the seated position, both in the morning and at night, over a period of 1 week. A total of >/=12 readings are recommended for making clinical decisions; 4) HBPM is indicated in patients with newly diagnosed or suspected hypertension, in whom it may distinguish between white-coat and sustained hypertension. If the results are equivocal, ambulatory BP monitoring may help to establish the diagnosis; 5) In patients with prehypertension, HBPM may be useful for detecting masked hypertension; 6) HBPM is recommended for evaluating the response to any type of antihypertensive treatment and may improve adherence; 7) The target HBPM goal for treatment is <135/85 mm Hg or <130/80 mm Hg in high-risk patients; 8) HBPM is useful in the elderly, in whom both BP variability and the white-coat effect are increased; 9) HBPM is of value in patients with diabetes, in whom tight BP control is of paramount importance; 10) Other populations in whom HBPM may be beneficial include pregnant women, children, and patients with kidney disease; and 11) HBPM has the potential to improve the quality of care while reducing costs and should be reimbursed.

  3. Call to action on use and reimbursement for home blood pressure monitoring: a joint scientific statement from the American Heart Association, American Society Of Hypertension, and Preventive Cardiovascular Nurses Association.

    PubMed

    Pickering, Thomas G; Miller, Nancy Houston; Ogedegbe, Gbenga; Krakoff, Lawrence R; Artinian, Nancy T; Goff, David

    2008-07-01

    Home blood pressure monitoring (HBPM) overcomes many of the limitations of traditional office blood pressure (BP) measurement and is both cheaper and easier to perform than ambulatory BP monitoring. Monitors that use the oscillometric method are currently available that are accurate, reliable, easy to use, and relatively inexpensive. An increasing number of patients are using them regularly to check their BP at home, but although this has been endorsed by national and international guidelines, detailed recommendations for their use have been lacking. There is a rapidly growing literature showing that measurements taken by patients at home are often lower than readings taken in the office and closer to the average BP recorded by 24-hour ambulatory monitors, which is the BP that best predicts cardiovascular risk. Because of the larger numbers of readings that can be taken by HBPM than in the office and the elimination of the white-coat effect (the increase of BP during an office visit), home readings are more reproducible than office readings and show better correlations with measures of target organ damage. In addition, prospective studies that have used multiple home readings to express the true BP have found that home BP predicts risk better than office BP (Class IIa; Level of Evidence A). This call-to-action article makes the following recommendations: (1) It is recommended that HBPM should become a routine component of BP measurement in the majority of patients with known or suspected hypertension; (2) Patients should be advised to purchase oscillometric monitors that measure BP on the upper arm with an appropriate cuff size and that have been shown to be accurate according to standard international protocols. They should be shown how to use them by their healthcare providers; (3) Two to 3 readings should be taken while the subject is resting in the seated position, both in the morning and at night, over a period of 1 week. A total of >or=12 readings are recommended for making clinical decisions; (4) HBPM is indicated in patients with newly diagnosed or suspected hypertension, in whom it may distinguish between white-coat and sustained hypertension. If the results are equivocal, ambulatory BP monitoring may help to establish the diagnosis; (5) In patients with prehypertension, HBPM may be useful for detecting masked hypertension; (6) HBPM is recommended for evaluating the response to any type of antihypertensive treatment and may improve adherence; (7) The target HBPM goal for treatment is <135/85 mm Hg or <130/80 mm Hg in high-risk patients; (8) HBPM is useful in the elderly, in whom both BP variability and the white-coat effect are increased; (9) HBPM is of value in patients with diabetes, in whom tight BP control is of paramount importance; (10) Other populations in whom HBPM may be beneficial include pregnant women, children, and patients with kidney disease; and (11) HBPM has the potential to improve the quality of care while reducing costs and should be reimbursed.

  4. Call to action on use and reimbursement for home blood pressure monitoring: a joint scientific statement from the American Heart Association, American Society of Hypertension, and Preventive Cardiovascular Nurses Association.

    PubMed

    Pickering, Thomas G; Miller, Nancy Houston; Ogedegbe, Gbenga; Krakoff, Lawrence R; Artinian, Nancy T; Goff, David

    2008-01-01

    Home blood pressure monitoring (HBPM) overcomes many of the limitations of traditional office blood pressure (BP) measurement and is both cheaper and easier to perform than ambulatory BP monitoring. Monitors that use the oscillometric method are currently available that are accurate, reliable, easy to use, and relatively inexpensive. An increasing number of patients are using them regularly to check their BP at home, but although this has been endorsed by national and international guidelines, detailed recommendations for their use have been lacking. There is a rapidly growing literature showing that measurements taken by patients at home are often lower than readings taken in the office and closer to the average BP recorded by 24-hour ambulatory monitors, which is the BP that best predicts cardiovascular risk. Because of the larger numbers of readings that can be taken by HBPM than in the office and the elimination of the white-coat effect (the increase of BP during an office visit), home readings are more reproducible than office readings and show better correlations with measures of target organ damage. In addition, prospective studies that have used multiple home readings to express the true BP have found that home BP predicts risk better than office BP (Class IIa; Level of Evidence A). This call-to-action article makes the following recommendations: (1) It is recommended that HBPM should become a routine component of BP measurement in the majority of patients with known or suspected hypertension; (2) Patients should be advised to purchase oscillometric monitors that measure BP on the upper arm with an appropriate cuff size and that have been shown to be accurate according to standard international protocols. They should be shown how to use them by their healthcare providers; (3) Two to 3 readings should be taken while the subject is resting in the seated position, both in the morning and at night, over a period of 1 week. A total of >/=12 readings are recommended for making clinical decisions; (4) HBPM is indicated in patients with newly diagnosed or suspected hypertension, in whom it may distinguish between white-coat and sustained hypertension. If the results are equivocal, ambulatory BP monitoring may help to establish the diagnosis; (5) In patients with prehypertension, HBPM may be useful for detecting masked hypertension; (6) HBPM is recommended for evaluating the response to any type of antihypertensive treatment and may improve adherence; (7) The target HBPM goal for treatment is <135/85 mm Hg or <130/80 mm Hg in high-risk patients; (8) HBPM is useful in the elderly, in whom both BP variability and the white-coat effect are increased; (9) HBPM is of value in patients with diabetes, in whom tight BP control is of paramount importance; (10) Other populations in whom HBPM may be beneficial include pregnant women, children, and patients with kidney disease; and (11) HBPM has the potential to improve the quality of care while reducing costs and should be reimbursed.

  5. Call to action on use and reimbursement for home blood pressure monitoring: Executive Summary. A joint scientific statement from the American Heart Association, American Society of Hypertension, and Preventive Cardiovascular Nurses Association.

    PubMed

    Pickering, Thomas G; Miller, Nancy Houston; Ogedegbe, Gbenga; Krakoff, Lawrence R; Artinian, Nancy T; Goff, David

    2008-06-01

    Home blood pressure monitoring (HBPM) overcomes many of the limitations of traditional office blood pressure (BP) measurement and is both cheaper and easier to perform than ambulatory BP monitoring. Monitors that use the oscillometric method are currently available that are accurate, reliable, easy to use, and relatively inexpensive. An increasing number of patients are using them regularly to check their BP at home, but although this has been endorsed by national and international guidelines, detailed recommendations for their use have been lacking. There is a rapidly growing literature showing that measurements taken by patients at home are often lower than readings taken in the office and closer to the average BP recorded by 24-hour ambulatory monitors, which is the BP that best predicts cardiovascular risk. Because of the larger numbers of readings that can be taken by HBPM than in the office and the elimination of the white-coat effect (the increase of BP during an office visit), home readings are more reproducible than office readings and show better correlations with measures of target organ damage. In addition, prospective studies that have used multiple home readings to express the true BP have found that home BP predicts risk better than office BP (class IIa; level of evidence A). This call-to-action article makes the following recommendations: (1) It is recommended that HBPM should become a routine component of BP measurement in the majority of patients with known or suspected hypertension; (2) Patients should be advised to purchase oscillometric monitors that measure BP on the upper arm with an appropriate cuff size and that have been shown to be accurate according to standard international protocols. They should be shown how to use them by their healthcare providers; (3) Two to 3 readings should be taken while the subject is resting in the seated position, both in the morning and at night, over a period of 1 week. A total of > or =12 readings are recommended for making clinical decisions; (4) HBPM is indicated in patients with newly diagnosed or suspected hypertension, in whom it may distinguish between white-coat and sustained hypertension. If the results are equivocal, ambulatory BP monitoring may help to establish the diagnosis; (5) In patients with prehypertension, HBPM may be useful for detecting masked hypertension; (6) HBPM is recommended for evaluating the response to any type of antihypertensive treatment and may improve adherence; (7) The target HBPM goal for treatment is <135/85 mm Hg or <130/80 mm Hg in high-risk patients; (8) HBPM is useful in the elderly, in whom both BP variability and the white-coat effect are increased; (9) HBPM is of value in patients with diabetes, in whom tight BP control is of paramount importance; (10) Other populations in whom HBPM may be beneficial include pregnant women, children, and patients with kidney disease; and (11) HBPM has the potential to improve the quality of care while reducing costs and should be reimbursed.

  6. Omnibus experiment: CPT and CP violation with sterile neutrinos

    NASA Astrophysics Data System (ADS)

    Loo, K. K.; Novikov, Yu N.; Smirnov, M. V.; Trzaska, W. H.; Wurm, M.

    2017-09-01

    The verification of the sterile neutrino hypothesis and, if confirmed, the determination of the relevant oscillation parameters is one of the goals of the neutrino physics in near future. We propose to search for the sterile neutrinos with a high statistics measurement utilizing the radioactive sources and oscillometric approach with large liquid scintillator detector like LENA, JUNO, or RENO-50. Our calculations indicate that such an experiment is realistic and could be performed in parallel to the main research plan for JUNO, LENA, or RENO-50. Assuming as the starting point the values of the oscillation parameters indicated by the current global fit (in 3 + 1 scenario) and requiring at least 5σ confidence level, we estimate that we would be able to detect differences in the mass squared differences Δ m41^2 of electron neutrinos and electron antineutrinos of the order of 1% or larger. That would allow to probe the CPT symmetry with neutrinos with an unprecedented accuracy.

  7. [Validation of the Omron HEM-650 wrist blood pressure device using the British Hypertension Society protocol in emergency patients in Hong Kong].

    PubMed

    Hung, Kevin KC; Lai, W Y; Cocks, Robert A; Rainer, Timothy H; Graham, Colin A

    2015-10-01

    Automated wrist cuff blood pressure (BP) devices are more compact and easier to use, particularly when access to the upper arm is restricted, for example in emergencies. We tested the Omron HEM-650 wrist device using the validation criteria of the British Hypertension Society (BHS) protocol in a major emergency department (ED) in Hong Kong. 85 patients had three measurements each by both the Omron HEM-650 wrist device and the mercury sphygmomanometer. The conventional automated BP with arm cuff was also measured using an oscillometric (Colin BP-88S NXT) device for comparison. The Omron HEM-650 achieved a grade B for both systolic and diastolic BP and demonstrated acceptable accuracy and reliability in Chinese patients in the emergency setting. The Omron HEM 650 wrist device can be recommended for use in adult emergency patients. Further research is warranted for its use in pregnant women and critically ill patients.

  8. ANESTHETIC MANAGEMENT OF AN INDO-PACIFIC BOTTLENOSE DOLPHIN (TURSIOPS ADUNCUS) REQUIRING SURGICAL DEBRIDEMENT OF A TAIL ABSCESS.

    PubMed

    Tamura, Jun; Yanagisawa, Makio; Endo, Yusuke; Ueda, Keiichi; Koga, Haruka; Izumisawa, Yasuharu; Yamashita, Kazuto

    2017-03-01

    This report describes the anesthetic management of a 14-yr-old, 160-kg, female Indo-Pacific bottlenose dolphin ( Tursiops aduncus ) that underwent surgical debridement for a refractory subcutaneous abscess twice within a 6-mo interval. The animal was otherwise in good physical condition at each anesthetic procedure. Following premedication with intramuscular midazolam and butorphanol, anesthesia was induced with propofol and maintained with sevoflurane by intubation. During surgery ventilation was controlled. Blood pressure was indirectly estimated using either oscillometric or pulse oximetry. Presumed hypotension was managed by adjusting the sevoflurane concentration and infusion of dopamine. During recovery, the dolphin regained adequate spontaneous respiration following intravenous administration of flumazenil and doxapram. The dolphin was extubated at 85 min and 53 min after the first and second surgeries, respectively. Successful weaning from the ventilator and initiation of spontaneous respiration was the most important complication encountered. Establishment of a reliable blood pressure measurement technique is critical to success for anesthesia in this species.

  9. A New Cuffless Device for Measuring Blood Pressure: A Real-Life Validation Study

    PubMed Central

    Schoot, Tessa S; Weenk, Mariska; van de Belt, Tom H; Engelen, Lucien JLPG; van Goor, Harry

    2016-01-01

    Background Cuffless blood pressure (BP) monitoring devices, based on pulse transit time, are being developed as an easy-to-use, more convenient, fast, and relatively cheap alternative to conventional BP measuring devices based on cuff occlusion. Thereby they may provide a great alternative to BP self-measurement. Objective The objective of our study was to evaluate the performance of the first release of the Checkme Health Monitor (Viatom Technology), a cuffless BP monitor, in a real-life setting. Furthermore, we wanted to investigate whether the posture of the volunteer and the position of the device relative to the heart level would influence its outcomes. Methods Study volunteers fell into 3 BP ranges: high (>160 mmHg), normal (130–160 mmHg), and low (<130 mmHg). All requirements for test environment, observer qualification, volunteer recruitment, and BP measurements were met according to the European Society of Hypertension International Protocol (ESH-IP) for the validation of BP measurement devices. After calibrating the Checkme device, we measured systolic BP with Checkme and a validated, oscillometric reference BP monitor (RM). Measurements were performed in randomized order both in supine and in sitting position, and with Checkme at and above heart level. Results We recruited 52 volunteers, of whom we excluded 15 (12 due to calibration failure with Checkme, 3 due to a variety of reasons). The remaining 37 volunteers were divided into low (n=14), medium (n=13), and high (n=10) BP ranges. There were 18 men and 19 women, with a mean age of 54.1 (SD 14.5) years, and mean recruitment systolic BP of 141.7 (SD 24.7) mmHg. BP results obtained by RM and Checkme correlated well. In the supine position, the difference between the RM and Checkme was >5 mmHg in 17 of 37 volunteers (46%), of whom 9 of 37 (24%) had a difference >10 mmHg and 5 of 37 (14%) had a difference >15 mmHg. Conclusions BP obtained with Checkme correlated well with RM BP, particularly in the position (supine) in which the device was calibrated. These preliminary results are promising for conducting further research on cuffless BP measurement in the clinical and outpatient settings. PMID:27150527

  10. Correlations of high-sensitivity C-reactive protein and atherosclerosis in Japanese type 2 diabetic patients.

    PubMed

    Anan, Futoshi; Masaki, Takayuki; Umeno, Yoshikazu; Iwao, Tetsu; Yonemochi, Hidetoshi; Eshima, Nobuoki; Saikawa, Tetsunori; Yoshimatsu, Hironobu

    2007-09-01

    The elevated level of high-sensitivity C-reactive protein (HSCRP) and aortic stiffness are associated with high mortality in type 2 diabetic patients. We tested the hypothesis that the HSCRP correlates with aortic stiffness and insulin resistance in type 2 diabetic patients. The study consisted of 46 Japanese patients with type 2 diabetes and high HSCRP group (0.3-1.0 mg/dl, age: 57+/-5 years, mean+/-s.d.) and a control group of 55 age-matched patients with low HSCRP group (<0.3 mg/dl, 57+/-6 years). Brachial-ankle pulse wave velocity (BaPWV) was measured by automatic oscillometric method and was used as an index of atherosclerosis. The body mass index (BMI) values (P<0.05) and waist circumferences (P<0.0005) and the waist-to-hip ratios (P<0.05) were higher in the high HSCRP group than in the low HSCRP group. The BaPWV was higher in the high HSCRP group than in the low HSCRP group (P<0.0001). Fasting plasma glucose (FPG; P<0.005) and insulin concentrations (P<0.0001), and the homeostasis model assessment (HOMA) index (P<0.0001), were higher in the high HSCRP group than in the low HSCRP group. Multiple regression analysis showed that HSCRP levels were independently predicted by BaPWV and HOMA index. Our results indicate that the elevated level of HSCRP in Japanese patients with type 2 diabetes is characterized by increased aortic stiffness and insulin resistance, and that the BaPWV and HOMA index are independent predictors of HSCRP.

  11. The relationship between weight, height and body mass index with hemodynamic parameters is not same in patients with and without chronic kidney disease.

    PubMed

    Afsar, Baris; Elsurer, Rengin; Soypacaci, Zeki; Kanbay, Mehmet

    2016-02-01

    Although anthropometric measurements are related with clinical outcomes; these relationships are not universal and differ in some disease states such as in chronic kidney disease (CKD). The current study was aimed to analyze the relationship between height, weight and BMI with hemodynamic and arterial stiffness parameters both in normal and CKD patients separately. This cross-sectional study included 381 patients with (N 226) and without CKD (N 155) with hypertension. Routine laboratory and 24-h urine collection were performed. Augmentation index (Aix) which is the ratio of augmentation pressure to pulse pressure was calculated from the blood pressure waveform after adjusted heart rate at 75 [Aix@75 (%)]. Pulse wave velocity (PWV) is a simple measure of the time taken by the pressure wave to travel over a specific distance. Both [Aix@75 (%)] and PWV which are measures of arterial stiffness were measured by validated oscillometric methods using mobil-O-Graph device. In patients without CKD, height is inversely correlated with [Aix@75 (%)]. Additionally, weight and BMI were positively associated with PWV in multivariate analysis. However, in patients with CKD, weight and BMI were inversely and independently related with PWV. In CKD patients, as weight and BMI increased stiffness parameters such as Aix@75 (%) and PWV decreased. While BMI and weight are positively associated with arterial stiffness in normal patients, this association is negative in patients with CKD. In conclusion, height, weight and BMI relationship with hemodynamic and arterial stiffness parameters differs in patients with and without CKD.

  12. The Diurnal Profile of Central Hemodynamics in a General Uruguayan Population.

    PubMed

    Boggia, José; Luzardo, Leonella; Lujambio, Inés; Sottolano, Mariana; Robaina, Sebastián; Thijs, Lutgarde; Olascoaga, Alicia; Noboa, Oscar; Struijker-Boudier, Harry A; Safar, Michel E; Staessen, Jan A

    2016-06-01

    No previous population study assessed the diurnal profile of central arterial properties. In 167 participants (mean age, 56.1 years; 63.5% women), randomly recruited in Montevideo, Uruguay, we used the oscillometric Mobil-O-Graph 24-h PWA monitor to measure peripheral and central systolic (SBP), diastolic (DBP), and pulse (PP) pressures and central hemodynamics standardized to a heart rate of 75 bpm, including aortic pulse wave velocity, systolic augmentation (first/second peak × 100), and pressure amplification (peripheral PP/central PP). Over 24 hours, day and night, peripheral minus central differences in SBP/DBP and in PP averaged 12.2/-1.1, 14.0/-0.7, and 9.7/0.2mm Hg and 12.6, 14.7, and 9.5mm Hg, respectively (P < 0.001 except for nighttime DBP (P = 0.38)). The central-to-peripheral ratios of SBP, DBP, and PP were 0.89, 1.00, and 0.70 unadjusted, but after accounting for anthropometric characteristics decreased to 0.74, 0.97, and 0.63, respectively, with strong influence of height for SBP and DBP and of sex for PP. From day (10-20h) to nighttime (0-6h), peripheral (-10.4/-10.5 mm Hg) and central (-6.0/-11.3mm Hg) SBP/DBP, pulse wave velocity (-0.7 m/s) and pressure amplification (-0.05) decreased (P < 0.001), whereas central PP (+5.3mm Hg) and systolic augmentation (+2.3%) increased (P < 0.001). The diurnal rhythm of central pressure runs in parallel with that of peripheral pressure, but the nocturnal fall in SBP is smaller centrally than peripherally. pulse wave velocity, systolic augmentation, and pressure amplification loop through the day with high pulse wave velocity and pressure amplification but low systolic augmentation in the evening and opposite trends in the morning. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. COMPARISON OF HIGH-DEFINITION OSCILLOMETRIC AND DIRECT ARTERIAL BLOOD PRESSURE MEASUREMENT IN ANESTHETIZED CHEETAHS (ACINONYX JUBATUS).

    PubMed

    Sant Cassia, Emma V; Boswood, Adrian; Tordiffe, Adrian S W

    2015-09-01

    Blood pressure measurement reveals important insights into the health of conscious and anesthetized individuals. This is of particular interest in cheetahs (Acinonyx jubatus), which in captivity are known to suffer from chronic diseases that may be associated with hypertension and which often require immobilization for transport or veterinary treatment. Invasive testing methods are considered the gold standard but are not practical in many settings. Consequently, it is important to evaluate the use of noninvasive methods in this species. Measurements for systolic, diastolic, and mean arterial pressure obtained using high-definition oscillometry (HDO) at the coccygeal artery were compared to simultaneous direct measurements obtained via catheterization of the femoral or dorsal pedal artery in eight anesthetized captive cheetahs during nine anesthetic events. Overall, HDO and direct measurements agreed most closely for mean arterial pressure, and the poorest agreement was observed for systolic pressure. There was a tendency for low diastolic pressures to be underestimated and for high diastolic pressures to be overestimated. Across all three parameters, HDO measurements from the tail overestimated directly measured pressures in the femoral artery and underestimated those in the dorsal pedal artery. HDO agreed most closely with directly measured dorsal pedal pressures. Mean arterial pressure showed the greatest precision (standard deviation of 10.2 mm Hg) and lowest bias (-1.2 mm Hg), with 75.9% of readings within 10 mm Hg of the direct dorsal pedal pressure. Agreement with systolic pressure was hindered by a high bias (-10.4 mm Hg), but if a correction factor of +10 mm Hg was applied to all systolic measurements, agreement was improved and 65.7% of readings were within 10 mm Hg of the direct pressure. When compared to criteria defined by the American College of Veterinary Internal Medicine for validation of blood pressure devices, results were favorable, but a limited sample size prevented formal validation.

  14. Variation of the Korotkoff Stethoscope Sounds During Blood Pressure Measurement: Analysis Using a Convolutional Neural Network.

    PubMed

    Pan, Fan; He, Peiyu; Liu, Chengyu; Li, Taiyong; Murray, Alan; Zheng, Dingchang

    2017-11-01

    Korotkoff sounds are known to change their characteristics during blood pressure (BP) measurement, resulting in some uncertainties for systolic and diastolic pressure (SBP and DBP) determinations. The aim of this study was to assess the variation of Korotkoff sounds during BP measurement by examining all stethoscope sounds associated with each heartbeat from above systole to below diastole during linear cuff deflation. Three repeat BP measurements were taken from 140 healthy subjects (age 21 to 73 years; 62 female and 78 male) by a trained observer, giving 420 measurements. During the BP measurements, the cuff pressure and stethoscope signals were simultaneously recorded digitally to a computer for subsequent analysis. Heartbeats were identified from the oscillometric cuff pressure pulses. The presence of each beat was used to create a time window (1 s, 2000 samples) centered on the oscillometric pulse peak for extracting beat-by-beat stethoscope sounds. A time-frequency two-dimensional matrix was obtained for the stethoscope sounds associated with each beat, and all beats between the manually determined SBPs and DBPs were labeled as "Korotkoff." A convolutional neural network was then used to analyze consistency in sound patterns that were associated with Korotkoff sounds. A 10-fold cross-validation strategy was applied to the stethoscope sounds from all 140 subjects, with the data from ten groups of 14 subjects being analyzed separately, allowing consistency to be evaluated between groups. Next, within-subject variation of the Korotkoff sounds analyzed from the three repeats was quantified, separately for each stethoscope sound beat. There was consistency between folds with no significant differences between groups of 14 subjects (P = 0.09 to P = 0.62). Our results showed that 80.7% beats at SBP and 69.5% at DBP were analyzed as Korotkoff sounds, with significant differences between adjacent beats at systole (13.1%, P = 0.001) and diastole (17.4%, P < 0.001). Results reached stability for SBP (97.8%, at sixth beat below SBP) and DBP (98.1%, at sixth beat above DBP) with no significant differences between adjacent beats (SBP P = 0.74; DBP P = 0.88). There were no significant differences at high-cuff pressures, but at low pressures close to diastole there was a small difference (3.3%, P = 0.02). In addition, greater within subject variability was observed at SBP (21.4%) and DBP (28.9%), with a significant difference between both (P < 0.02). In conclusion, this study has demonstrated that Korotkoff sounds can be consistently identified during the period below SBP and above DBP, but that at systole and diastole there can be substantial variations that are associated with high variation in the three repeat measurements in each subject.

  15. Relationship between psychosocial stress and hypertension among Ghanaians in Amsterdam, the Netherlands – the GHAIA study

    PubMed Central

    2014-01-01

    Background Hypertension is highly prevalent among recent sub-Saharan African (SSA) migrants in western countries and some tend to associate their hypertension to psychosocial stress. However data on the relationship between hypertension and psychosocial stress among SSA migrants are rare. We assessed the relationship between psychosocial stress and hypertension among the largest SSA migrant population (Ghanaians) in Amsterdam, the Netherlands. Methods Data were obtained from structured interviews along with medical examination among 212 participants from a cross-sectional study: the GHAIA study in 2010 in Amsterdam. Blood pressure was measured with a validated Oscillometric automated digital blood pressure device. Psychosocial stress was assessed by questionnaires on perceived discrimination, depressive symptoms and financial problems. Binary logistic regression was used to study associations between psychosocial stress and hypertension. Results The overall prevalence of hypertension was 54.7%. About two thirds of the study population experienced a moderate (31%) or high (36%) level of discrimination. 20.0% of the participants had mild depressive symptoms, whilst 9% had moderate depressive symptoms. The prevalence of financial stress was 34.8%. The psychosocial stresses we assessed were not significantly associated with hypertension: adjusted odds ratios comparing those with low levels and those with high levels were 0.99 (95% CI, 0.47–2.08) for perceived discrimination, 0.81 (95% CI, 0.26–2.49) for depressive symptoms and 0.71 (95% CI, 0.37–1.36) for financial stress, respectively. Conclusion We did not find evidence for the association between psychosocial stress and hypertension among recent SSA migrants. More efforts are needed to unravel other potential factors that may underlie the high prevalence of hypertension among these populations. PMID:25001592

  16. Central and peripheral blood pressures in relation to plasma advanced glycation end products in a Chinese population.

    PubMed

    Huang, Q-F; Sheng, C-S; Kang, Y-Y; Zhang, L; Wang, S; Li, F-K; Cheng, Y-B; Guo, Q-H; Li, Y; Wang, J-G

    2016-07-01

    We investigated the association of plasma AGE (advanced glycation end product) concentration with central and peripheral blood pressures and central-to-brachial blood pressure amplification in a Chinese population. The study subjects were from a newly established residential area in the suburb of Shanghai. Using the SphygmoCor system, we recorded radial arterial waveforms and derived aortic waveforms by a generalized transfer function and central systolic and pulse pressure by calibration for brachial blood pressure measured with an oscillometric device. The central-to-brachial pressure amplification was expressed as the central-to-brachial systolic blood pressure difference and pulse pressure difference and ratio. Plasma AGE concentration was measured by the enzyme-linked immunosorbent assay method and logarithmically transformed for statistical analysis. The 1051 participants (age, 55.1±13.1 years) included 663 women. After adjustment for sex, age and other confounding factors, plasma AGE concentration was associated with central but not peripheral blood pressures and with some of the pressure amplification indexes. Indeed, each 10-fold increase in plasma AGE concentration was associated with 2.94 mm Hg (P=0.04) higher central systolic blood pressure and 2.39% lower central-to-brachial pulse pressure ratio (P=0.03). In further subgroup analyses, the association was more prominent in the presence of hypercholesterolemia (+8.11 mm Hg, P=0.008) for central systolic blood pressure and in the presence of overweight and obesity (-4.89%, P=0.009), diabetes and prediabetes (-6.26%, P=0.10) or current smoking (-6.68%, P=0.045) for central-to-brachial pulse pressure ratio. In conclusion, plasma AGE concentration is independently associated with central systolic blood pressure and pulse pressure amplification, especially in the presence of several modifiable cardiovascular risk factors.

  17. A new automatic blood pressure kit auscultates for accurate reading with a smartphone: A diagnostic accuracy study.

    PubMed

    Wu, Hongjun; Wang, Bingjian; Zhu, Xinpu; Chu, Guang; Zhang, Zhi

    2016-08-01

    The widely used oscillometric automated blood pressure (BP) monitor was continuously questioned on its accuracy. A novel BP kit named Accutension which adopted Korotkoff auscultation method was then devised. Accutension worked with a miniature microphone, a pressure sensor, and a smartphone. The BP values were automatically displayed on the smartphone screen through the installed App. Data recorded in the phone could be played back and reconfirmed after measurement. They could also be uploaded and saved to the iCloud. The accuracy and consistency of this novel electronic auscultatory sphygmomanometer was preliminarily verified here. Thirty-two subjects were included and 82 qualified readings were obtained. The mean differences ± SD for systolic and diastolic BP readings between Accutension and mercury sphygmomanometer were 0.87 ± 2.86 and -0.94 ± 2.93 mm Hg. Agreements between Accutension and mercury sphygmomanometer were highly significant for systolic (ICC = 0.993, 95% confidence interval (CI): 0.989-0.995) and diastolic (ICC = 0.987, 95% CI: 0.979-0.991). In conclusion, Accutension worked accurately based on our pilot study data. The difference was acceptable. ICC and Bland-Altman plot charts showed good agreements with manual measurements. Systolic readings of Accutension were slightly higher than those of manual measurement, while diastolic readings were slightly lower. One possible reason was that Accutension captured the first and the last korotkoff sound more sensitively than human ear during manual measurement and avoided sound missing, so that it might be more accurate than traditional mercury sphygmomanometer. By documenting and analyzing of variant tendency of BP values, Accutension helps management of hypertension and therefore contributes to the mobile heath service.

  18. The evaluation of arterial stiffness of essential hypertension and white coat hypertension in children: a case-control study.

    PubMed

    Tokgöz, Semiha Terlemez; Yılmaz, Dilek; Tokgöz, Yavuz; Çelik, Bülent; Bulut, Yasin

    2018-03-01

    The aim of this study was to determine and compare cardiovascular risks by assessing arterial stiffness in children with essential hypertension and white coat hypertension. Paediatric patients followed up with essential hypertension and white coat hypertension diagnoses and with no established end organ damage were involved in the study. Arterial stiffness in children included in the study was evaluated and compared by using the oscillometric device (Mobil-O-Graph) method. A total of 62 essential hypertension (34 male, 28 female), 38 white coat hypertension (21 male, 17 female), and 60 healthy controls (33 male, 27 female) were assessed in the present study. Pulse wave velocity of the essential hypertension, white coat hypertension, and control group was, respectively, as follows: 5.3±0.6 (m/s), 5.1±0.4 (m/s), 4.3±0.4 (m/s) (p<0.001); augmentation index outcomes were, respectively, determined as follows: 21.3±6.5, 19.3±6.4, 16.0±0.3 (p<0.001). Pulse wave velocity and augmentation index values of children with essential hypertension and white coat hypertension were found to be higher compared with the control group. This level was identified as correlated with the duration of hypertension in both patient groups (p<0.01). Arterial stiffness in children with essential hypertension and white coat hypertension was impaired compared with healthy children. This finding has made us think that white coat hypertension is not an innocent clinical situation. This information should be taken into consideration in the follow-up and treatment approaches of the patients.

  19. Considerations for SphygmoCor radial artery pulse wave analysis: side selection and peripheral arterial blood pressure calibration.

    PubMed

    Martin, Jeffrey S; Borges, Alexandra R; Christy, John B; Beck, Darren T

    2015-10-01

    Methods employed for pulse wave analysis (PWA) and peripheral blood pressure (PBP) calibration vary. The purpose of this study was to evaluate the agreement of SphygmoCor PWA parameters derived from radial artery tonometry when considering (1) timing (before vs. after tonometry) and side selection (ipsilateral vs. contralateral limb) for PBP calibration and (2) side selection for tonometry (left vs. right arm). In 34 subjects (aged 21.9 ± 2.3 years), bilateral radial artery tonometry was performed simultaneously on three instances. PBP assessment via oscillometric sphygmomanometry in the left arm only and both arms simultaneously occurred following the first and second instances of tonometry, respectively. Significant within arm differences in PWA parameters derived before and after PBP measurement were observed in the right arm only (for example, aortic systolic blood pressure, Δ=0.38 ± 0.64 mm Hg). Simultaneously captured bilateral PWA variables demonstrated significant between arm differences in 88% (14/16) and 56% (9/16) of outcome variables when calibrated to within arm and equivalent PBP, respectively. Moreover, the right arm consistently demonstrated lower values for clinical PWA variables (for example, augmentation index, bias=-2.79%). However, 26% (n=9) of participants presented with clinically significant differences (>10 mm Hg) in bilateral PBP and their exclusion from analysis abolished most between arm differences observed. SphygmoCor PWA in the right radial artery results in greater variability independent of the timing of PBP measurement and magnitude of calibration pressures in young subjects. Moreover, bilateral PBP measurement is imperative to identify subjects in whom a significant difference in bilateral PWA outcomes may exist.

  20. Inter-Arm Difference in Brachial Blood Pressure in the General Population of Koreans

    PubMed Central

    Song, Bo Mi; Shim, Jee-Seon; Lee, Myung Ha; Choi, Dong Phil

    2016-01-01

    Background and Objectives We investigated the inter-arm difference in blood pressure of the general Korean population to identify associated factors. Subjects and Methods A total of 806 participants aged 30 to 64 years without history of major cardiovascular disease were analyzed in this cross-sectional study. They participated in the Cardiovascular and Metabolic Disease Etiology Research Center cohort study that began in 2013. Brachial blood pressure was measured simultaneously for both arms using an automated oscillometric device equipped with two cuffs in seated position. After five minutes of rest, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured three times. The average of the three measurements was used for analysis. Multivariate logistic regression models were used to identify factors associated with inter-arm differences in blood pressure. Results The mean inter-arm difference was 3.3 mmHg for SBP and 2.0 mmHg for DBP. Large inter-arm differences (≥10 mmHg) in SBP and in DBP were found in 3.7% and 0.9% of subjects, respectively. A large inter-arm difference in SBP was associated with mean SBP (p=0.002) and C-reactive protein (p=0.014) while a large inter-arm different in DBP was only associated with body mass index (p=0.015). Sex, age, and anti-hypertensive medication use were not associated with differences in inter-arm blood pressure. Conclusion Large inter-arm difference in blood pressure is only present in a small portion of healthy Korean adults. Our findings suggest that high SBP, chronic inflammation, and obesity may be associated with larger difference in inter-arm blood pressure. PMID:27275174

  1. Effects of long-term exercise training on autonomic control in myocardial infarction patients.

    PubMed

    Martinez, Daniel G; Nicolau, José C; Lage, Rony L; Toschi-Dias, Edgar; de Matos, Luciana D N J; Alves, Maria Janieire N N; Trombetta, Ivani C; Dias da Silva, Valdo J; Middlekauff, Holly R; Negrão, Carlos E; Rondon, Maria U P B

    2011-12-01

    Autonomic dysfunction, including baroreceptor attenuation and sympathetic activation, has been reported in patients with myocardial infarction (MI) and has been associated with increased mortality. We tested the hypotheses that exercise training (ET) in post-MI patients would normalize arterial baroreflex sensitivity (BRS) and muscle sympathetic nerve activity (MSNA), and long-term ET would maintain the benefits in BRS and MSNA. Twenty-eight patients after 1 month of uncomplicated MI were randomly assigned to 2 groups, ET (MI-ET) and untrained. A normal control group was also studied. ET consisted of three 60-minute exercise sessions per week for 6 months. We evaluated MSNA (microneurography), blood pressure (automatic oscillometric method), heart rate (ECG), and spectral analysis of RR interval, systolic arterial pressure (SAP), and MSNA. Baroreflex gain of SAP-RR interval and SAP-MSNA were calculated using the α-index. At 3 to 5 days and 1 month after MI, MSNA and low-frequency SAP were significantly higher and BRS significantly lower in MI patients when compared with the normal control group. ET significantly decreased MSNA (bursts per 100 heartbeats) and the low-frequency component of SAP and significantly increased the low-frequency component of MSNA and BRS of the RR interval and MSNA. These changes were so marked that the differences between patients with MI and the normal control group were no longer observed after ET. MSNA and BRS in the MI-untrained group did not change from baseline over the same time period. ET normalizes BRS, low-frequency SAP, and MSNA in patients with MI. These improvements in autonomic control are maintained by long-term ET. These findings highlight the clinical importance of this nonpharmacological therapy based on ET in the long-term treatment of patients with MI.

  2. Prevalence of arterial stiffness and the risk of myocardial diastolic dysfunction in women.

    PubMed

    Seeland, Ute; Brecht, Anna; Nauman, Ahmad T; Oertelt-Prigione, Sabine; Ruecke, Mirjam; Knebel, Fabian; Stangl, Verena; Regitz-Zagrosek, Vera

    2016-10-01

    The present study determines the prevalence of vascular dysfunction and arterial stiffness (ASt) in a female urban population by measuring the brachial augmentation index (AIx) and aortic pulse wave velocity (PWV). The study tests the hypothesis that the measurement of AIx and PWV is useful in addition to that of traditional cardiovascular risk factors when assessing the risk for left ventricular diastolic dysfunction (LVDD). This cross-sectional study recruited 965 women aged 25-75 years from 12 districts of Berlin. The ASt indices, brachial AIx, aortic PWV and the central blood pressure were measured by an oscillometric method. A randomly selected subgroup (n=343) was examined by echocardiography. Trans-mitral inflow E/A ratio and diastolic mitral annulus velocity (é) were assessed. Questionnaires, medical history and blood sampling were used for the evaluation of individual risk factors. Normal vascular function was found in 55% of the women included. The prevalence of women with pathological AIx only (AIx ⩾ -10%, PWV normal) was 21.5%, whereas 17.9% were affected by increased AIx and PWV (AIx ⩾ -10%, PWV ⩾9.7 m/s), and 6% with only pathological PWV values. The prevalence of LVDD was 31.7%. LVDD was significantly associated with pathological PWV ⩾ 9.7 m/s [OR: 1.27, 95%CI: 1.02-1.57], age [OR: 4.17, 95%CI: 2.87-6.07] and a waist circumference >80 cm [OR: 3.61, 95%CI: 1.85-7.04] in multiple regression analysis. The high prevalence of markers for vascular dysfunction and ASt in a general female population and their importance as a mediator of diastolic dysfunction should encourage implementation of aortic PWV measurement to improve cardiovascular-risk assessment in particular to identify subclinical myocardial diastolic dysfunction. © 2016 The Author(s).

  3. Real Alerts and Artifact Classification in Archived Multi-signal Vital Sign Monitoring Data—Implications for Mining Big Data — Implications for Mining Big Data

    PubMed Central

    Hravnak, Marilyn; Chen, Lujie; Dubrawski, Artur; Bose, Eliezer; Clermont, Gilles; Pinsky, Michael R.

    2015-01-01

    PURPOSE Huge hospital information system databases can be mined for knowledge discovery and decision support, but artifact in stored non-invasive vital sign (VS) high-frequency data streams limits its use. We used machine-learning (ML) algorithms trained on expert-labeled VS data streams to automatically classify VS alerts as real or artifact, thereby “cleaning” such data for future modeling. METHODS 634 admissions to a step-down unit had recorded continuous noninvasive VS monitoring data (heart rate [HR], respiratory rate [RR], peripheral arterial oxygen saturation [SpO2] at 1/20Hz., and noninvasive oscillometric blood pressure [BP]) Time data were across stability thresholds defined VS event epochs. Data were divided Block 1 as the ML training/cross-validation set and Block 2 the test set. Expert clinicians annotated Block 1 events as perceived real or artifact. After feature extraction, ML algorithms were trained to create and validate models automatically classifying events as real or artifact. The models were then tested on Block 2. RESULTS Block 1 yielded 812 VS events, with 214 (26%) judged by experts as artifact (RR 43%, SpO2 40%, BP 15%, HR 2%). ML algorithms applied to the Block 1 training/cross-validation set (10-fold cross-validation) gave area under the curve (AUC) scores of 0.97 RR, 0.91 BP and 0.76 SpO2. Performance when applied to Block 2 test data was AUC 0.94 RR, 0.84 BP and 0.72 SpO2). CONCLUSIONS ML-defined algorithms applied to archived multi-signal continuous VS monitoring data allowed accurate automated classification of VS alerts as real or artifact, and could support data mining for future model building. PMID:26438655

  4. A new automatic blood pressure kit auscultates for accurate reading with a smartphone

    PubMed Central

    Wu, Hongjun; Wang, Bingjian; Zhu, Xinpu; Chu, Guang; Zhang, Zhi

    2016-01-01

    Abstract The widely used oscillometric automated blood pressure (BP) monitor was continuously questioned on its accuracy. A novel BP kit named Accutension which adopted Korotkoff auscultation method was then devised. Accutension worked with a miniature microphone, a pressure sensor, and a smartphone. The BP values were automatically displayed on the smartphone screen through the installed App. Data recorded in the phone could be played back and reconfirmed after measurement. They could also be uploaded and saved to the iCloud. The accuracy and consistency of this novel electronic auscultatory sphygmomanometer was preliminarily verified here. Thirty-two subjects were included and 82 qualified readings were obtained. The mean differences ± SD for systolic and diastolic BP readings between Accutension and mercury sphygmomanometer were 0.87 ± 2.86 and −0.94 ± 2.93 mm Hg. Agreements between Accutension and mercury sphygmomanometer were highly significant for systolic (ICC = 0.993, 95% confidence interval (CI): 0.989–0.995) and diastolic (ICC = 0.987, 95% CI: 0.979–0.991). In conclusion, Accutension worked accurately based on our pilot study data. The difference was acceptable. ICC and Bland–Altman plot charts showed good agreements with manual measurements. Systolic readings of Accutension were slightly higher than those of manual measurement, while diastolic readings were slightly lower. One possible reason was that Accutension captured the first and the last korotkoff sound more sensitively than human ear during manual measurement and avoided sound missing, so that it might be more accurate than traditional mercury sphygmomanometer. By documenting and analyzing of variant tendency of BP values, Accutension helps management of hypertension and therefore contributes to the mobile heath service. PMID:27512876

  5. Seaweed intake and blood pressure levels in healthy pre-school Japanese children.

    PubMed

    Wada, Keiko; Nakamura, Kozue; Tamai, Yuya; Tsuji, Michiko; Sahashi, Yukari; Watanabe, Kaori; Ohtsuchi, Sakiko; Yamamoto, Keiko; Ando, Kyoko; Nagata, Chisato

    2011-08-10

    Few studies have examined whether dietary factors might affect blood pressure in children. We purposed to investigate whether seaweed intake is associated with blood pressure level among Japanese preschool children. The design of the study was cross-sectional and it was conducted in autumn 2006. Subjects were healthy preschoolers aged 3-6 years in Aichi, Japan. Blood pressure and pulse were measured once by an automated sphygmomanometer, which uses oscillometric methods. Dietary data, including seaweed intake, were assessed using 3-day dietary records covering 2 consecutive weekdays and 1 weekend day. Of a total of 533 children, 459 (86.1 percent) agreed to be enrolled in our study. Finally, blood pressure measurement, complete dietary records and parent-reported height and weight were obtained for 223 boys and 194 girls. When we examined Spearman's correlation coefficients, seaweed intake was significantly negatively related to systolic blood pressure in girls (P = 0.008). In the one-way analysis of covariance for blood pressure and pulse after adjustments for age and BMI, the boys with the lowest, middle and highest tertiles of seaweed intake had diastolic blood pressure readings of 62.8, 59.3 and 59.6 mmHg, respectively (P = 0.11, trend P = 0.038). Girls with higher seaweed intake had significantly lower systolic blood pressure readings (102.4, 99.2 and 96.9 mmHg for girls with the lowest, middle and highest tertiles of seaweed intake, respectively; P = 0.037, trend P = 0.030). Our study showed that seaweed intake was negatively related to diastolic blood pressure in boys and to systolic blood pressure in girls. This suggests that seaweed might have beneficial effects on blood pressure among children.

  6. Development of a Blood Pressure Measurement Instrument with Active Cuff Pressure Control Schemes.

    PubMed

    Kuo, Chung-Hsien; Wu, Chun-Ju; Chou, Hung-Chyun; Chen, Guan-Ting; Kuo, Yu-Cheng

    2017-01-01

    This paper presents an oscillometric blood pressure (BP) measurement approach based on the active control schemes of cuff pressure. Compared with conventional electronic BP instruments, the novelty of the proposed BP measurement approach is to utilize a variable volume chamber which actively and stably alters the cuff pressure during inflating or deflating cycles. The variable volume chamber is operated with a closed-loop pressure control scheme, and it is activated by controlling the piston position of a single-acting cylinder driven by a screw motor. Therefore, the variable volume chamber could significantly eliminate the air turbulence disturbance during the air injection stage when compared to an air pump mechanism. Furthermore, the proposed active BP measurement approach is capable of measuring BP characteristics, including systolic blood pressure (SBP) and diastolic blood pressure (DBP), during the inflating cycle. Two modes of air injection measurement (AIM) and accurate dual-way measurement (ADM) were proposed. According to the healthy subject experiment results, AIM reduced 34.21% and ADM reduced 15.78% of the measurement time when compared to a commercial BP monitor. Furthermore, the ADM performed much consistently (i.e., less standard deviation) in the measurements when compared to a commercial BP monitor.

  7. Validation of the Medisana MTP Plus upper arm blood pressure monitor, for self-measurement, according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Erdem, Emre; Aydogdu, Türkan; Akpolat, Tekin

    2011-02-01

    Standard validation protocols are objective guides for healthcare providers, physicians, and patients. The purpose of this study was to test validation of the Medisana MTP Plus upper arm blood pressure (BP) measuring monitor for self-measurement according to the European Society of Hypertension International Protocol (ESH-IP2) in adults. The Medisana MTP Plus monitor is an automated and oscillometric upper arm device for home BP monitoring. Nine consecutive measurements were made according to the ESH-IP2. Overseen by an independent supervisor, measurements were recorded by two observers blinded from both each other's readings and from the device readings. The Medisana MTP Plus device fulfills the validation criteria of the ESH-IP2 for the general population. The mean (standard deviation) of the difference between the observers and the device measurements was 0.6 mmHg (5.1 mmHg) for systolic and 2.7 mmHg (3.4 mmHg) for diastolic pressures, respectively. As the Medisana MTP Plus device has achieved the required standards, it is recommended for home BP monitoring in an adult population.

  8. Validation of the SEJOY BP-1307 upper-arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Lei, Lei; Chen, Yi; Chen, Qi; Li, Yan; Wang, Ji-Guang

    2017-12-01

    The present study aimed to evaluate the accuracy of the automated oscillometric upper-arm blood pressure monitor SEJOY BP-1307 (also called JOYTECH DBP-1307) for home blood pressure monitoring according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic blood pressures were sequentially measured in 33 adult Chinese individuals (13 women, 45.1 years of mean age) using a mercury sphygmomanometer (two observers) and the SEJOY BP-1307 device (one supervisor). Ninety-nine pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. The average±SD of the device-observer differences was 0.2±4.1 and -1.7±4.7 mmHg for systolic and diastolic blood pressure, respectively. The SEJOY BP-1307 device achieved the criteria in both part 1 and part 2 of the validation study. The SEJOY upper-arm blood pressure monitor BP-1307 has passed the requirements of the International Protocol revision 2010, and hence can be recommended for home use in adults.

  9. Validation of the fully automated A&D TM-2656 blood pressure monitor according to the British Hypertension Society Protocol.

    PubMed

    Zeng, Wei-Fang; Liu, Ming; Kang, Yuan-Yuan; Li, Yan; Wang, Ji-Guang

    2013-08-01

    The present study aimed to evaluate the accuracy of the fully automated oscillometric upper-arm blood pressure monitor TM-2656 according to the British Hypertension Society (BHS) Protocol 1993. We recruited individuals until there were 85 eligible participants and their blood pressure could meet the blood pressure distribution requirements specified by the BHS Protocol. For each individual, we sequentially measured the systolic and diastolic blood pressures using a mercury sphygmomanometer (two observers) and the TM-2656 device (one supervisor). Data analysis was carried out according to the BHS Protocol. The device achieved grade A. The percentage of blood pressure differences within 5, 10, and 15 mmHg was 62, 85, and 96%, respectively, for systolic blood pressure, and 71, 93, and 99%, respectively, for diastolic blood pressure. The average (±SD) of the device-observer differences was -2.1±7.8 mmHg (P<0.0001) and -1.1±5.8 mmHg (P<0.0001) for systolic and diastolic blood pressures, respectively. The A&D upper-arm blood pressure monitor TM-2656 has passed the requirements of the BHS Protocol, and can thus be recommended for blood pressure measurement.

  10. Brachial-ankle pulse wave velocity is associated with coronary calcium in young and middle-aged asymptomatic adults: The Kangbuk Samsung Health Study.

    PubMed

    Cainzos-Achirica, Miguel; Rampal, Sanjay; Chang, Yoosoo; Ryu, Seungho; Zhang, Yiyi; Zhao, Di; Cho, Juhee; Choi, Yuni; Pastor-Barriuso, Roberto; Lim, So Yeon; Bruguera, Jordi; Elosua, Roberto; Lima, Joao A C; Shin, Hocheol; Guallar, Eliseo

    2015-08-01

    To evaluate the association between brachial-ankle pulse wave velocity (baPWV), a convenient, non-radiating, readily available measurement of arterial stiffness, and coronary artery calcium (CAC), a reliable marker of coronary atherosclerosis, in a large sample of young and middle-aged asymptomatic adults; and to assess the incremental value of baPWV for detecting prevalent CAC beyond traditional risk factors. Cross-sectional study of 15,185 asymptomatic Korean adults who voluntarily underwent a comprehensive health screening program including measurement of baPWV and CAC. BaPWV was measured using an oscillometric method with cuffs placed on both arms and ankles. CAC burden was assessed using a multi-detector CT scan and scored following Agatston's method. The prevalence of CAC > 0 and CAC > 100 increased across baPWV quintiles. The multivariable-adjusted odds ratios (95% CI) for CAC > 0 comparing baPWV quintiles 2-5 versus quintile 1 were 1.06 (0.87-1.30), 1.24 (1.02-1.50), 1.39 (1.15-1.69) and 1.60 (1.31-1.96), respectively (P trend < 0.001). Similarly, the relative prevalence ratios for CAC > 100 were 1.30 (0.74-2.26), 1.59 (0.93-2.71), 1.74 (1.03-2.94) and 2.59 (1.54-4.36), respectively (P trend < 0.001). For CAC > 100, the area under the ROC curve for baPWV alone was 0.71 (0.68-0.74), and the addition of baPWV to traditional risk factors significantly improved the discrimination and calibration of models for detecting prevalent CAC > 0 and CAC > 100. BaPWV was independently associated with the presence and severity of CAC in a large sample of young and middle-aged asymptomatic adults. BaPWV may be a valuable tool for identifying apparently low-risk individuals with increased burden of coronary atherosclerosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. A New Cuffless Device for Measuring Blood Pressure: A Real-Life Validation Study.

    PubMed

    Schoot, Tessa S; Weenk, Mariska; van de Belt, Tom H; Engelen, Lucien J L P G; van Goor, Harry; Bredie, Sebastian J H

    2016-05-05

    Cuffless blood pressure (BP) monitoring devices, based on pulse transit time, are being developed as an easy-to-use, more convenient, fast, and relatively cheap alternative to conventional BP measuring devices based on cuff occlusion. Thereby they may provide a great alternative to BP self-measurement. The objective of our study was to evaluate the performance of the first release of the Checkme Health Monitor (Viatom Technology), a cuffless BP monitor, in a real-life setting. Furthermore, we wanted to investigate whether the posture of the volunteer and the position of the device relative to the heart level would influence its outcomes. Study volunteers fell into 3 BP ranges: high (>160 mmHg), normal (130-160 mmHg), and low (<130 mmHg). All requirements for test environment, observer qualification, volunteer recruitment, and BP measurements were met according to the European Society of Hypertension International Protocol (ESH-IP) for the validation of BP measurement devices. After calibrating the Checkme device, we measured systolic BP with Checkme and a validated, oscillometric reference BP monitor (RM). Measurements were performed in randomized order both in supine and in sitting position, and with Checkme at and above heart level. We recruited 52 volunteers, of whom we excluded 15 (12 due to calibration failure with Checkme, 3 due to a variety of reasons). The remaining 37 volunteers were divided into low (n=14), medium (n=13), and high (n=10) BP ranges. There were 18 men and 19 women, with a mean age of 54.1 (SD 14.5) years, and mean recruitment systolic BP of 141.7 (SD 24.7) mmHg. BP results obtained by RM and Checkme correlated well. In the supine position, the difference between the RM and Checkme was >5 mmHg in 17 of 37 volunteers (46%), of whom 9 of 37 (24%) had a difference >10 mmHg and 5 of 37 (14%) had a difference >15 mmHg. BP obtained with Checkme correlated well with RM BP, particularly in the position (supine) in which the device was calibrated. These preliminary results are promising for conducting further research on cuffless BP measurement in the clinical and outpatient settings.

  12. Evaluation of the overall efficacy of the Omron office digital blood pressure HEM-907 monitor in adults.

    PubMed

    White, W B; Anwar, Y A

    2001-04-01

    Non-invasive self blood pressure monitoring has become increasingly popular. To assure the accuracy of devices used for this purpose, all need to be validated independently prior to marketing. The objective of this study was to assess the accuracy of the HEM-907, a new semi-automatic, non-invasive, oscillometric blood pressure monitoring device specifically designed to be used in the clinic or physician's office setting. Blood pressure measurements taken employing this device were compared with the results obtained by two experienced observers using a mercury sphygmomanometer on 100 subjects and patients (384 measurements). The limits of agreement were calculated for the device compared with the results of the two observers according to the standards of the Association for the Advancement of Medical Instrumentation (AAMI). The agreement between the two observers was -0.36+/-2.32mmHg for systolic blood pressure and 0.02+/-2.42mmHg for diastolic blood pressure. The agreement between the device and the observers was 1.56+/-4.42mmHg and 3.49+/-4.61mmHg for systolic and diastolic blood pressure respectively. The Omron HEM-907 satisfied the AAMI criteria for accuracy for a non-invasive blood pressure monitoring device.

  13. A comparison of two ambulatory blood pressure monitors worn at the same time.

    PubMed

    Kallem, Radhakrishna R; Meyers, Kevin E C; Sawinski, Deirdre L; Townsend, Raymond R

    2013-05-01

    There are limited data in the literature comparing two simultaneously worn ambulatory blood pressure (BP) monitoring (ABPM) devices. The authors compared BPs from two monitors (Mobil-O-Graph [I.E.M., Stolberg, Germany] and Spacelabs 90207 [Spacelabs Medical, Issequah, WA]). In the nonrandomized component of the study, simultaneous 8-hour BP and heart rate data were measured by Mobil-O-Graph, consistently applied to the nondominant arm, and Spacelabs to the dominant arm on 12 untreated adults. Simultaneous 8-hour BP and heart data were obtained by the same monitors randomly assigned to a dominant or nondominant arm on 12 other untreated adults. Oscillometric BP profiles were obtained in the dominant and nondominant arms of the above 24 patients using an Accutorr (Datascope, Mahwah, NJ) device. The Spacelabs monitor recorded a 10.2-mm Hg higher systolic pressure in the nonrandomized (P=.0016) and a 7.9-mm Hg higher systolic pressure in the randomized studies (P=.00008) compared with the Mobil-O-Graph. The mean arterial pressures were 1 mm Hg to 2 mm Hg different between monitors in the two studies, and heart rates were nearly identical. Our observations, if confirmed in larger cohorts, support the concern that ABPM device manufacturers consider developing normative databases for their devices. ©2013 Wiley Periodicals, Inc.

  14. Pulse wave velocity is associated with cognitive impairment in hemodialysis patients.

    PubMed

    Angermann, Susanne; Baumann, Marcus; Wassertheurer, Siegfried; Mayer, Christopher Clemens; Steubl, Dominik; Hauser, Christine; Suttmann, Yana; Reichelt, Anna-Lena; Satanovskij, Robin; Lorenz, Georg; Lukas, Moritz; Haller, Bernhard; Heemann, Uwe; Grimmer, Timo; Schmaderer, Christoph

    2017-07-01

    Cognitive impairment in hemodialysis patients is common and associated with adverse outcomes. So far, the underlying pathogenesis remains unclear. Therefore, we examined the potential relationship between cognitive impairment and three different categories of risk factors with particular focus on arterial stiffness measured by pulse wave velocity (PWV). A total of 201 chronic hemodialysis patients underwent cognitive testing under standardized conditions using the Montreal Cognitive Assessment (MoCA). Demographic data including cardiovascular risk factors, dialysis-associated factors as well as factors related to chronic kidney disease (CKD) were analyzed. To account for arterial stiffness, PWV was measured by ambulatory blood pressure monitoried with an oscillometric device that records brachial blood pressure along with pulse waves. In our cohort, 60.2% of patients showed pathological MoCA test results indicating cognitive impairment. PWV was significantly associated with cognitive impairment apart from age, educational level, diabetes, and hypercholesterolemia. High prevalence of cognitive impairment in hemodialysis patients was confirmed. For the first time, an association between cognitive impairment and arterial stiffness was detected in a larger cohort of hemodialysis patients. Concerning the underlying pathogenesis of cognitive impairment, current results revealed a potential involvement of arterial stiffness, which has to be further evaluated in future studies. © 2017 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.

  15. Subclinical arterial and cardiac damage in white-coat and masked hypertension.

    PubMed

    Wojciechowska, Wiktoria; Stolarz-Skrzypek, Katarzyna; Olszanecka, Agnieszka; Klima, Łukasz; Gąsowski, Jerzy; Grodzicki, Tomasz; Kawecka-Jaszcz, Kalina; Czarnecka, Danuta

    2016-08-01

    The study aimed to compare arterial and echocardiographic parameters in subjects with newly diagnosed masked (MH) or white-coat hypertension (WCH) to subjects with sustained normotension or sustained hypertension, defined according to the 2014 European Society of Hypertension practice guidelines for ambulatory blood pressure (BP) monitoring. We recruited 303 participants (mean age 46.9 years) in a family-based population study. SpaceLabs monitors and oscillometric sphygmomanometers were used to evaluate ambulatory and office BP, respectively. Central pulse pressure (PP) and aortic pulse-wave velocity (PWV) were measured with pulse-wave analysis (SphygmoCor software). Carotid intima-media thickness (IMT) and cardiac evaluation were assessed by ultrasonography. Analysing participants without antihypertensive treatment (115 sustained normotensives, 41 sustained hypertensives, 20 with WCH, 25 with MH), we detected significantly higher peripheral and central PP, PWV, IMT and left ventricular mass index in hypertensive subgroups than in those with sustained normotension. The differences between categories remained significant for peripheral PP and PWV after adjustment for confounding factors, including 24 h systolic and diastolic BP. Participants with WCH and MH, defined according to strict criteria, had more pronounced arterial and heart involvement than normotensive participants. The study demonstrates a high prevalence of these conditions in the general population that deserves special attention from physicians.

  16. Traffic noise and blood pressure in low-socioeconomic status, African-American urban schoolchildren.

    PubMed

    Belojevic, Goran; Evans, Gary W

    2012-09-01

    The primary aim of this field study was to investigate the relationships among residential noise exposure at home and at school and blood pressure in low-socioeconomic status African-American children. Children were recruited from Boys and Girls Clubs in a mid-sized, Northeastern city. The sample consisted of 250 schoolchildren (128 boys and 122 girls) aged 6-14 years. Each child was interviewed prior to anthropometric and blood pressure measurement. An oscillometric monitor was used for measurement of resting blood pressure. Correlation analysis in the overall sample showed no significant relationship between noise exposure and children's blood pressure. No interactions were found between noise at home and at schools as well as orientation of bedroom and/or living room and noise at home with blood pressure. A sub-sample of children was also examined by adding the orientation of bedroom and living room as inclusion criteria (n = 128), and there was an interaction between noise exposure and age on systolic blood pressure. In younger children aged 6-10 years, a significant positive relation was found between noise levels at homes and systolic blood pressure, controlling for body mass index (B = 0.48, 95% C.I. = 0.07 -0.88, p = 0.02).

  17. Using Supervised Machine Learning to Classify Real Alerts and Artifact in Online Multi-signal Vital Sign Monitoring Data

    PubMed Central

    Chen, Lujie; Dubrawski, Artur; Wang, Donghan; Fiterau, Madalina; Guillame-Bert, Mathieu; Bose, Eliezer; Kaynar, Ata M.; Wallace, David J.; Guttendorf, Jane; Clermont, Gilles; Pinsky, Michael R.; Hravnak, Marilyn

    2015-01-01

    OBJECTIVE Use machine-learning (ML) algorithms to classify alerts as real or artifacts in online noninvasive vital sign (VS) data streams to reduce alarm fatigue and missed true instability. METHODS Using a 24-bed trauma step-down unit’s non-invasive VS monitoring data (heart rate [HR], respiratory rate [RR], peripheral oximetry [SpO2]) recorded at 1/20Hz, and noninvasive oscillometric blood pressure [BP] less frequently, we partitioned data into training/validation (294 admissions; 22,980 monitoring hours) and test sets (2,057 admissions; 156,177 monitoring hours). Alerts were VS deviations beyond stability thresholds. A four-member expert committee annotated a subset of alerts (576 in training/validation set, 397 in test set) as real or artifact selected by active learning, upon which we trained ML algorithms. The best model was evaluated on alerts in the test set to enact online alert classification as signals evolve over time. MAIN RESULTS The Random Forest model discriminated between real and artifact as the alerts evolved online in the test set with area under the curve (AUC) performance of 0.79 (95% CI 0.67-0.93) for SpO2 at the instant the VS first crossed threshold and increased to 0.87 (95% CI 0.71-0.95) at 3 minutes into the alerting period. BP AUC started at 0.77 (95%CI 0.64-0.95) and increased to 0.87 (95% CI 0.71-0.98), while RR AUC started at 0.85 (95%CI 0.77-0.95) and increased to 0.97 (95% CI 0.94–1.00). HR alerts were too few for model development. CONCLUSIONS ML models can discern clinically relevant SpO2, BP and RR alerts from artifacts in an online monitoring dataset (AUC>0.87). PMID:26992068

  18. Ambulatory aortic blood pressure, wave reflections and pulse wave velocity are elevated during the third in comparison to the second interdialytic day of the long interval in chronic haemodialysis patients

    PubMed Central

    Koutroumbas, Georgios; Georgianos, Panagiotis I.; Sarafidis, Pantelis A.; Protogerou, Athanase; Karpetas, Antonios; Vakianis, Pantelis; Raptis, Vassilios; Liakopoulos, Vassilios; Panagoutsos, Stylianos; Syrganis, Christos; Passadakis, Ploumis

    2015-01-01

    Background Increased arterial stiffness and aortic blood pressure (BP) are independent predictors of cardiovascular outcomes in end-stage renal disease. The 3-day interdialytic interval is associated with elevated risk of cardiovascular morbidity and mortality in haemodialysis. This study investigated differences in ambulatory aortic BP and arterial stiffness between the second and third day of the long interdialytic interval. Methods Ambulatory BP monitoring with Mobil-O-Graph monitor (IEM, Stolberg, Germany) was performed in 55 haemodialysis patients during a 3-day interval. Mobil-O-Graph records oscillometric brachial BP and pulse waves and calculates aortic BP and augmentation index (AIx) as measure of wave reflections, and pulse wave velocity (PWV) as measure of arterial stiffness. Results Ambulatory aortic systolic blood pressure (SBP) and diastolic blood pressure (DBP) were higher during the third versus second interdialytic day (123.6 ± 17.0 versus 118.5 ± 17.1 mmHg, P < 0.001; 81.5 ± 11.8 versus 78 ± 11.9 mmHg, P < 0.001, respectively). Similar differences were noted for brachial BP. Ambulatory AIx and PWV were also significantly increased during the third versus second day (30.5 ± 9.9 versus 28.8 ± 9.9%, P < 0.05; 9.6 ± 2.3 versus 9.4 ± 2.3 m/s, P < 0.001, respectively). Differences between Days 2 and 3 remained significant when day-time and night-time periods were compared separately. Aortic SBP and DBP, AIx and PWV showed gradual increases from the end of dialysis session onwards. Interdialytic weight gain was a strong determinant of the increase in the above parameters. Conclusions This study showed significantly higher ambulatory aortic BP, AIx and PWV levels during the third compared with the second interdialytic day. These findings support a novel pathway for increased cardiovascular risk during the third interdialytic day in haemodialysis. PMID:25920919

  19. The associations of cardiorespiratory fitness, adiposity and sports participation with arterial stiffness in youth with chronic diseases or physical disabilities

    PubMed Central

    Haapala, Eero A; Lankhorst, Kristel; de Groot, Janke; Zwinkels, Maremka; Verschuren, Olaf; Wittink, Harriet; Backx, Frank JG; Visser-Meily, Anne

    2017-01-01

    Background The evidence on the associations of cardiorespiratory fitness, body adiposity and sports participation with arterial stiffness in children and adolescents with chronic diseases or physical disabilities is limited. Methods Altogether 140 children and adolescents with chronic diseases or physical disabilities participated in this cross-sectional study. Cardiorespiratory fitness was assessed using maximal exercise test with respiratory gas analyses either using shuttle run, shuttle ride, or cycle ergometer test. Cardiorespiratory fitness was defined as peak oxygen uptake by body weight or fat-free mass. Body adiposity was assessed using waist circumference, body mass index standard deviation score and body fat percentage. Sports participation was assessed by a questionnaire. Aortic pulse wave velocity and augmentation index were assessed by a non-invasive oscillometric tonometry device. Results Peak oxygen uptake/body weight (standardised regression coefficient β −0.222, 95% confidence interval (CI) −0.386 to −0.059, P = 0.002) and peak oxygen uptake/fat-free mass (β −0.173, 95% CI −0.329 to −0.017, P = 0.030) were inversely and waist circumference directly (β 0.245, 95% CI 0.093 to 0.414, P = 0.002) associated with aortic pulse wave velocity. However, the associations of the measures of cardiorespiratory fitness with aortic pulse wave velocity were attenuated after further adjustment for waist circumference. A higher waist circumference (β −0.215, 95% CI −0.381 to −0.049, P = 0.012) and a higher body mass index standard deviation score (β 0.218, 95% CI −0.382 to −0.054, P = 0.010) were related to lower augmentation index. Conclusions Poor cardiorespiratory fitness and higher waist circumference were associated with increased arterial stiffness in children and adolescents with chronic diseases and physical disabilities. The association between cardiorespiratory fitness and arterial stiffness was partly explained by waist circumference. PMID:28374647

  20. The associations of cardiorespiratory fitness, adiposity and sports participation with arterial stiffness in youth with chronic diseases or physical disabilities.

    PubMed

    Haapala, Eero A; Lankhorst, Kristel; de Groot, Janke; Zwinkels, Maremka; Verschuren, Olaf; Wittink, Harriet; Backx, Frank Jg; Visser-Meily, Anne; Takken, Tim

    2017-07-01

    Background The evidence on the associations of cardiorespiratory fitness, body adiposity and sports participation with arterial stiffness in children and adolescents with chronic diseases or physical disabilities is limited. Methods Altogether 140 children and adolescents with chronic diseases or physical disabilities participated in this cross-sectional study. Cardiorespiratory fitness was assessed using maximal exercise test with respiratory gas analyses either using shuttle run, shuttle ride, or cycle ergometer test. Cardiorespiratory fitness was defined as peak oxygen uptake by body weight or fat-free mass. Body adiposity was assessed using waist circumference, body mass index standard deviation score and body fat percentage. Sports participation was assessed by a questionnaire. Aortic pulse wave velocity and augmentation index were assessed by a non-invasive oscillometric tonometry device. Results Peak oxygen uptake/body weight (standardised regression coefficient β -0.222, 95% confidence interval (CI) -0.386 to -0.059, P = 0.002) and peak oxygen uptake/fat-free mass (β -0.173, 95% CI -0.329 to -0.017, P = 0.030) were inversely and waist circumference directly (β 0.245, 95% CI 0.093 to 0.414, P = 0.002) associated with aortic pulse wave velocity. However, the associations of the measures of cardiorespiratory fitness with aortic pulse wave velocity were attenuated after further adjustment for waist circumference. A higher waist circumference (β -0.215, 95% CI -0.381 to -0.049, P = 0.012) and a higher body mass index standard deviation score (β 0.218, 95% CI -0.382 to -0.054, P = 0.010) were related to lower augmentation index. Conclusions Poor cardiorespiratory fitness and higher waist circumference were associated with increased arterial stiffness in children and adolescents with chronic diseases and physical disabilities. The association between cardiorespiratory fitness and arterial stiffness was partly explained by waist circumference.

  1. ECG Voltage in Relation to Peripheral and Central Ambulatory Blood Pressure

    PubMed Central

    Yang, Wen-Yi; Mujaj, Blerim; Efremov, Ljupcho; Zhang, Zhen-Yu; Thijs, Lutgarde; Wei, Fang-Fei; Huang, Qi-Fang; Luttun, Aernout; Verhamme, Peter; Nawrot, Tim S; Boggia, José; Staessen, Jan A

    2018-01-01

    Abstract BACKGROUND The heart ejects in the central elastic arteries. No previous study in workers described the diurnal profile of central blood pressure (BP) or addressed the question whether electrocardiogram (ECG) indexes are more closely associated with central than peripheral BP. METHODS In 177 men (mean age, 29.1 years), we compared the associations of ECG indexes with brachial and central ambulatory BP, measured over 24 hours by the validated oscillometric Mobil-O-Graph 24h PWA monitor. RESULTS From wakefulness to sleep, as documented by diaries, systolic/diastolic BP decreased by 11.7/13.1 mm Hg peripherally and 9.3/13.6 mm Hg centrally, whereas central pulse pressure (PP) increased by 4.3 mm Hg (P < 0.0001). Over 24 hours and the awake and asleep periods, the peripheral-minus-central differences in systolic/diastolic BPs averaged 11.8/–1.6, 12.7/–1.8, and 10.3/–1.2 mm Hg, respectively (P < 0.0001). Cornell voltage and index averaged 1.18 mV and 114.8 mV·ms. Per 1-SD increment in systolic/diastolic BP, the Cornell voltages were 0.104/0.086 mV and 0.082/0.105 mV higher in relation to brachial 24-hour and asleep BP and 0.088/0.90 mV and 0.087/0.107 mV higher in relation to central BP. The corresponding estimates for the Cornell indexes were 9.6/8.6 and 8.2/10.5 mV·ms peripherally and 8.6/8.9 and 8.8/10.7 mV·ms centrally. The regression slopes (P ≥ 0.067) and correlation coefficients (P ≥ 0.088) were similar for brachial and central BP. Associations of ECG measurements with awake BP and PP were not significant. CONCLUSIONS Peripheral and central BPs run in parallel throughout the day and are similarly associated with the Cornell voltage and index. PMID:28985271

  2. Reference Intervals of Central Aortic Blood Pressure and Augmentation Index Assessed with an Oscillometric Device in Healthy Children, Adolescents, and Young Adults from Argentina

    PubMed Central

    Bia, Daniel

    2018-01-01

    Age-related reference intervals (RIs) of central (aortic) systolic blood pressure (cSBP) and augmentation index (cAIx) obtained from large healthy population are lacking in Argentina (South America). Aims. To analyze the existence of associations among cSBP and cAIx with demographic, anthropometric, and hemodynamic parameters and to generate percentile curves and RIs adjusted to each level of age and gender and/or body height. cSBP and cAIx were measured in 1038 healthy children, adolescents, and young adults. First, we evaluated if RIs for males and females were necessary using correlation and covariate analysis. Second, mean (M) and standard deviation (SD) age-related equations were obtained for cSBP and cAIx, using parametric regression methods based on fractional polynomials. Third, age specific percentiles curves were generated. Fourth, body height specific percentiles curves were generated using a similar procedure. The obtained equations (considering age as independent variable) for all subjects (cSBP0.26 and (cAIx + 12.001)0.5) were as follows: cSBP Mean = 3.0581 + 0.2189 log(Age) − 0.001044Age; cSBP SD = −0.03919 + 0.1535 log(Age) − 0.004564Age; cAIx mean = 9.5226 − 6.1599 log(Age) + 0.1450Age; cAIx SD = 1.3880 − 0.8468 log(Age) + 0.03212Age. This study, performed in Argentinean healthy children, adolescents, and young adults with ages of 5 to 22 years, provides the first RIs and percentile curves of cSBP and cAIx. Additionally, specific body height-related cAIx percentiles are reported for the analyzed population. The RIs and percentiles contribute to the knowledge of arterial dynamic evolution along the normal aging process and the interpretation of data obtained in clinical research and daily clinical practice. PMID:29850222

  3. Hypertension and correlates among Montenegrin schoolchildren-a cross-sectional study.

    PubMed

    Martinovic, M; Belojevic, G; Evans, G W; Kavaric, N; Asanin, B; Pantovic, S; Jaksic, M; Boljevic, J

    2017-06-01

    In one of the few national studies of children in a former Eastern bloc country emerging as a Western democracy and the first such study ever in Montenegro, this study establishes the prevalence and correlates of childhood hypertension (CH). A cross-sectional national study. The study was conducted with 3254 children aged 7-13 years (50.3% male) from 39 elementary schools. We used a structured questionnaire to gather sociodemographic information as well as data on factors potentially related to CH. Children's nutritional status was assessed using the criteria of the International Obesity Task Force. Waist circumference was also measured. Blood pressure was measured in schools using an oscillometric monitor. CH was defined as an average systolic blood pressure and/or diastolic blood pressure greater than or equal to the 95th percentile for sex, age, and height. The prevalence of CH was 10.4% with no differences between boys and girls. Multiple regression revealed that the odds for child hypertension were lowered by 10% for each year of age. On the other hand, rural environment and child obesity raised the odds of hypertension by 38% and 68%, respectively. We found hypertension in one out of ten Montenegrin schoolchildren, with no gender differences. Obesity and rural areas may be unfriendly to children's blood pressure. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  4. Prognostic significance of between-arm blood pressure differences.

    PubMed

    Agarwal, Rajiv; Bunaye, Zerihun; Bekele, Dagim M

    2008-03-01

    Blood pressure (BP) recordings often differ between arms, but the extent to which these differences are reproducible and whether the differences have prognostic importance is unknown. We enrolled 421 consecutive patients from a medicine and a renal clinic at a veterans' hospital. Three BP recordings were obtained in each arm using an oscillometric device in a sequential manner and repeated in 1 week. Patients were followed for all-cause mortality

  5. Validation of the Andon KD5031 for clinical use and self-measurement according to the European Society of Hypertension International Protocol.

    PubMed

    Wu, Ning; Zhang, Xuezhong; Wang, Wen; Zhang, Hongye

    2016-10-01

    This study aimed to evaluate the accuracy of the automated oscillometric upper arm blood pressure (BP) monitor Andon KD5031 for home BP monitoring according to the European Society of Hypertension International Protocol revision 2010. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were sequentially measured in 33 participants using the standard mercury sphygmomanometer and the Andon KD5031 device. Ninety-nine pairs of comparisons were obtained from 33 participants for analysis. The KD5031 device achieved the targets in part 1 of the validation study. The number of absolute differences between the device and the observers within a range of 5, 10, and 15 mmHg was 66/99, 93/99, and 98/99, respectively, for SBP and 72/99, 94/99, and 99/99, respectively, for DBP. The device also achieved the targets in part 2 of the validation study. Twenty-six participants for both SBP and DBP had at least two of the three device-observer differences within 5 mmHg (required ≥24). The number of participants without a device-observer difference within 5 mmHg was one for SBP and three for DBP (required ≤3). The Andon upper arm BP monitor KD5031 has passed the International Protocol requirements, and it can be recommended for clinical use and self-measurement in adults.

  6. Validation of A&D TM-2430 upper-arm blood pressure monitor for ambulatory blood pressure monitoring in children and adolescents, according to the British Hypertension Society protocol.

    PubMed

    Yip, Gabriel Wai-Kwok; So, Hung-Kwan; Li, Albert Martin; Tomlinson, Brian; Wong, Sik-Nin; Sung, Rita Yn-Tz

    2012-04-01

    The A&D TM-2430 ambulatory blood pressure (BP) monitor has been validated in adults but not in a young population. We sought to validate the device monitoring in children and adolescents, according to the British Hypertension Society (BHS) protocol. The A&D TM-2430 is an automated oscillometric upper-arm device for ambulatory BP monitoring. Nine consecutive measurements were taken in 61 children (mean age, 9.8 years; range, 5-15 years) according to the BHS criteria. Overseen by an independent supervisor, measurements were recorded by two observers blinded from each other's readings and from the device readings. The mean difference ± SD between the observers and device measurements was 0.73 ± 1.64 mmHg for systolic blood pressure (SBP) and -1.23 ± 1.65 mmHg for diastolic blood pressure (DBP), respectively, with an interobserver difference of 4 mmHg. The cumulative percentages of differences within 5, 10, and 15 mmHg were 89, 95, and 98% for SBP and 67, 88, and 98% for DBP. The device achieved a grade A rating for SBP and a B grade for DBP. The A&D TM-2430 upper-arm BP monitor has fulfilled the required BHS standards and can be recommended for measuring ambulatory BP in children and adolescent populations.

  7. Validation of the Andon KD595 for clinical use and self-measurement according to the European Society of Hypertension International Protocol.

    PubMed

    Wu, Ning; Zhang, Xuezhong; Wang, Wen; Zhang, Hongye

    2016-04-01

    This study aimed to evaluate the accuracy of the automated oscillometric upper arm blood pressure monitor Andon KD595 for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were sequentially measured in 33 participants using the standard mercury sphygmomanometer and the Andon KD595 device. Ninety-nine pairs of comparisons were obtained from 33 participants for analysis. The KD595 device achieved the targets in part 1 of the validation study. The number of absolute differences between the device and the observers within a range of 5, 10, and 15 mmHg was 72/99, 93/99, and 96/99, respectively, for SBP and 72/99, 96/99, and 99/99, respectively, for DBP. The device also achieved the targets in part 2 of the validation study. A total of 28 and 25 participants had at least two of the three device-observer differences within 5 mmHg (required≥24) for SBP and DBP, respectively. The number of participants without device-observer difference within 5 mmHg was two for SBP and two for DBP (required≤3). The Andon upper arm blood pressure monitor KD595 has passed the International Protocol requirements and it can be recommended for clinical use and self-measurement in adults.

  8. Role of home blood pressure monitoring in hemodialysis patients.

    PubMed

    Agarwal, R

    1999-04-01

    To investigate the use of manual home blood pressure (BP) monitoring in chronic hemodialysis patients, daily home BPs in 20 patients undergoing chronic hemodialysis were compared with the 44-hour interdialytic ambulatory BPs (ABPs). Each patient recorded home BPs for 2 consecutive weeks with a digital BP monitor three times daily. Prehemodialysis and posthemodialysis BPs were recorded by an oscillometric device in the hemodialysis unit during the same 2 weeks. ABPs were recorded either after the first or second hemodialysis session of the second week during a 44-hour interdialytic period using a Spacelab 90207 ABP monitor. ABP monitoring showed that BP decreased progressively after dialysis, decreased during the first night, and rapidly reached predialysis levels by the next morning. There was no decrease in BP during the second night. There was an excellent correlation between average systolic and diastolic ABP and respective home BPs. Prehemodialysis diastolic BPs were a good reflection of diastolic ABP, but there was more variability in predialysis systolic BP. Posthemodialysis BPs did not correlate with ABP. In patients undergoing chronic hemodialysis, home BPs more reliably reflected the overall BP than incenter BP readings. Predialysis, but not postdialysis, BP should be used as a screening tool to detect hypertension in the hemodialysis unit. Home BP monitoring should be used as a cost-effective means to diagnose occult hypertension in chronic hemodialysis patients.

  9. [Clinical utility of home blood pressure monitoring in patients under treatment].

    PubMed

    Bauk, L; Costa, H A; Caligiuri, S I

    2015-01-01

    A low number of patients who are treated with antihypertensive drugs achieve therapeutic goals. Home blood pressure monitoring is an excellent tool for studying this population. To determine the prevalence of patients with controlled and uncontrolled hypertension, as well as white-coat-effect and masked hypertension, and to evaluate the relationship with target organ damage in different groups. Blood pressure readings were performed simultaneously in the clinic and in the home using the same validated oscillometric equipment on 83 hypertensive patients on treatment with 2 or more antihypertensive drugs. They were then classified into 4 groups according to the cut-off values of the clinic and home blood pressure measurements. Left ventricular mass index, carotid intima media thickness, and microalbuminuria as markers of target organ damage, were also evaluated. Controlled blood pressure was present in 32.5%, 30.2% had sustained hypertension. The white coat effect was seen in 26.5%, while 10.8% were masked uncontrolled hypertension. Left ventricular mass index was higher in patients with no ambulatory control compared to controlled patients, and carotid IMT was also higher too in uncontrolled and white coat effect groups than controlled patients. More than one third of our patients who were treated with 2 or more drugs were not properly controlled, and they had significantly greater target organ damage than controlled patients. Copyright © 2014 SEHLELHA. Published by Elsevier Espana. All rights reserved.

  10. Acute Effect of Interval Walking on Arterial Stiffness in Healthy Young Adults.

    PubMed

    Okamoto, Takanobu; Min, Seok-Ki; Sakamaki-Sunaga, Mikako

    2018-05-18

    The purpose of this study was to determine the acute effects of interval walking (IW) on arterial stiffness. The participants in this study were 14 healthy men and women (age 27.5±3.8 y). Carotid-femoral pulse wave velocity (cfPWV) was measured using an automatic oscillometric device at 30 min before (baseline) and at 30 and 60 min after walking. Participants repeated five sets of 3-min walks at 30% and 70% of maximum aerobic capacity for a total of 6 min per set in the IW trial. The participants also walked for 30 min at 50% (moderate intensity) of maximum aerobic capacity in a continuous walking (CW) trial. cfPWV was significantly decreased from baseline at 30 min (P=0.02) after the IW trial, and this reduction in cfPWV persisted for 60 min (P=0.01). In contrast, cfPWV was significantly decreased from baseline at 30 min (P=0.03) after the CW trial, but the reduction did not persist for 60 min. Moreover, changes in cfPWV in the IW trial after 30 and 60 min were significantly lower than in the CW trial (P<0.05). These results suggest that IW acutely reduces central arterial stiffness more than CW in healthy young adults. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Reference Values of Impulse Oscillometric Lung Function Indices in Adults of Advanced Age

    PubMed Central

    Schulz, Holger; Flexeder, Claudia; Behr, Jürgen; Heier, Margit; Holle, Rolf; Huber, Rudolf M.; Jörres, Rudolf A.; Nowak, Dennis; Peters, Annette; Wichmann, H.-Erich; Heinrich, Joachim; Karrasch, Stefan

    2013-01-01

    Background Impulse oscillometry (IOS) is a non-demanding lung function test. Its diagnostic use may be particularly useful in patients of advanced age with physical or mental limitations unable to perform spirometry. Only few reference equations are available for Caucasians, none of them covering the old age. Here, we provide reference equations up to advanced age and compare them with currently available equations. Methods IOS was performed in a population-based sample of 1990 subjects, aged 45–91 years, from KORA cohorts (Augsburg, Germany). From those, 397 never-smoking, lung healthy subjects with normal spirometry were identified and sex-specific quantile regression models with age, height and body weight as predictors for respiratory system impedance, resistance, reactance, and other parameters of IOS applied. Results Women (n = 243) showed higher resistance values than men (n = 154), while reactance at low frequencies (up to 20 Hz) was lower (p<0.05). A significant age dependency was observed for the difference between resistance values at 5 Hz and 20 Hz (R5–R20), the integrated area of low-frequency reactance (AX), and resonant frequency (Fres) in both sexes whereas reactance at 5 Hz (X5) was age dependent only in females. In the healthy subjects (n = 397), mean differences between observed values and predictions for resistance (5 Hz and 20 Hz) and reactance (5 Hz) ranged between −1% and 5% when using the present model. In contrast, differences based on the currently applied equations (Vogel & Smidt 1994) ranged between −34% and 76%. Regarding our equations the indices were beyond the limits of normal in 8.1% to 18.6% of the entire KORA cohort (n = 1990), and in 0.7% to 9.4% with the currently applied equations. Conclusions Our study provides up-to-date reference equations for IOS in Caucasians aged 45 to 85 years. We suggest the use of the present equations particularly in advanced age in order to detect airway dysfunction. PMID:23691036

  12. Reference intervals of aortic pulse wave velocity assessed with an oscillometric device in healthy children and adolescents from Argentina.

    PubMed

    Alejandro, Díaz; Yanina, Zócalo; Daniel, Bia; Franco, Sabino; Victoria, Rodríguez; Edmundo, Cabrera FIscher

    2018-03-09

    Age-related reference intervals (RIs) of aortic pulse wave velocity (Ao-PWV) obtained from a large healthy population are lacking in South America. The aims of this study were to determine Ao-PWV RIs in a cohort of healthy children and adolescents from Argentina and to generate year-to-year percentile curves. Ao-PWV was measured in 1000 healthy subjects non-exposed to traditional cardiovascular risk factors (Age: 10-22 y. o., 56% males). First, we evaluated if RIs for males and females were necessaries (correlation and covariate analysis). Second, mean (M) and standard deviation (SD) age-related equations were obtained for cf-PWV, using parametric regression methods based on fractional polynomials. Third, age-specific (year to year) percentiles curves (for all, males and females children and adolescents) were generated using the standard normal distribution. They were, age-specific 1st, 2.5th, 5th, 10th, 25th, 50th, 75th, 90th, 95th, 97.5th and 99th percentile curves and values. After covariate analysis (i.e., adjusting by age, jugulum-symphysis distance, body weight and height), specific RIs for males and females of children and adolescents were evidenced as necessaries. The equations were For all subjects: Ao-PWV_Mean = 4.98 + 12.86x10 -5 Age 3 . Ao-PWV_SD = 0.47 + 21.00x10 -6 Age 3 . For girls: Ao-PWV_Mean = 5.07 + 10.23x10 -5 Age 3 . Ao-PWV_SD = 0.50 + 10.00x10 -6 Age 3 . For boys: Ao-PWV_Mean = 4.87 + 15.81x10 -5 Age 3 . Ao-PWV_SD = 0.46 + 22.34x10 -6 Age 3 . Our study provides the largest database to-date concerning Ao-PWV in healthy children and adolescents in Argentina. Age-related equations (M and SD values) for Ao-PWV are reported by the first time. Specific RIs and percentiles of Ao-PWV are now available according to age and sex for an Argentinian population.

  13. Interarm blood pressure difference and target organ damage in the general population.

    PubMed

    Johansson, Jouni K; Puukka, Pauli J; Jula, Antti M

    2014-02-01

    The objective of the study was to investigate interarm differences of blood pressure (BP) and its determinants, and to clarify whether both arms are equally good in assessing BP and target organ damage in the general population. We studied a representative sample of Finnish adult population with 484 study participants, ages 25-74 years. BP was measured twice by an oscillometric monitor simultaneously on both arms. Study participants underwent a clinical examination including measurements of serum lipids, glucose and indicators of target organ damage. BP was 2.3/0.2 mmHg higher on right than on left arm (P < 0.001/P = 0.15 for SBP/DBP differences). SBP and DBP measured on right and left arms correlated equally with left ventricular mass index (LVMI), interventricular septal thickness (IVST), posterior wall thickness (PWT), pulse wave velocity (PWV) and albuminuria. Higher SBP level was an independent determinant of both greater systolic and diastolic interarm BP difference. Exaggerated absolute diastolic interarm BP difference (>5 mmHg) was associated with higher BMI, arm circumference, LVMI, IVST and PWT, whereas exaggerated absolute systolic interarm BP difference (>10 mmHg) was not associated with any clinical variables. There was only a small difference in BP between arms in a healthy general population. Both arms are equally good determinants of target organ damage. BP should be measured at least once on both arms and prefer the arm with higher BP readings in the future BP measurements.

  14. Validation of the AVITA BPM64 upper-arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Kang, Yuan-Yuan; Chen, Qi; Liu, Chang-Yuan; Li, Yan; Wang, Ji-Guang

    2018-02-01

    The aim of this study was to evaluate the accuracy of the automated oscillometric upper arm blood pressure (BP) monitor AVITA BPM64 for home BP monitoring according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic BPs were measured sequentially in 33 adult Chinese (14 women, mean age 47.0 years) using a mercury sphygmomanometer (two observers) and the AVITA BPM64 device (one supervisor). A total of 99 pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. The AVITA BPM64 device achieved the targets in part 1 of the validation study. The number of absolute differences between device and observers within 5, 10, and 15 mmHg was 91/99, 98/99, and 98/99, respectively, for systolic BP and 92/99, 99/99, and 99/99, respectively, for diastolic BP. The device also fulfilled the criteria in part 2 of the validation study. Thirty-two participants for both systolic and diastolic BP had at least two of the three device-observer differences within 5 mmHg (required ≥24). Only one participant for systolic BP had all three device-observer comparisons greater than 5 mmHg. The AVITA upper arm BP monitor BPM64 has passed the requirements of the International Protocol revision 2010, and hence can be recommended for home use in adults.

  15. Acute effects of particulate matter on respiratory diseases, symptoms and functions:. epidemiological results of the Austrian Project on Health Effects of Particulate Matter (AUPHEP)

    NASA Astrophysics Data System (ADS)

    Neuberger, Manfred; Schimek, Michael G.; Horak, Friedrich; Moshammer, Hanns; Kundi, Michael; Frischer, Thomas; Gomiscek, Bostjan; Puxbaum, Hans; Hauck, Helger; Auphep-Team

    To examine hypotheses regarding health effects of particulate matter, we conducted time series studies in Austrian urban and rural areas. Of the pollutants measured, ambient PM 2.5 was most consistently associated with parameters of respiratory health. Time series studies applying semiparametric generalized additive models showed significant increases of respiratory hospital admissions (ICD 490-496) at age 65 and older. The early increase of 5.5% in Vienna at a lag of 2 days in males and of 5.6% per 10 μg/m 3 at a lag of 3 days in females was not observed in a nearby rural area. Another increase of respiratory admissions (mainly COPD) was observed after a lag of 10-11 days. A time series on a panel of 56 healthy preschool children showed a significant impact of the carbonaceous fraction of PM 2.5 on tidal breathing pattern assessed by inductive plethysmography. In repeated oscillometric measurements of respiratory resistance in 164 healthy elementary school children not only immediate responses to fine particulates were found but also latent ones, possibly indicating inflammatory changes in airways. It may be speculated that the improvements of urban air quality prevented measurable effects on respiratory mortality. More sensitive indicators, however, still show acute impairments of respiratory function and health in elderly and children which are associated with fine particulates and subfractions related to motor traffic.

  16. Relationship between indirect blood pressure and various stages of chronic kidney disease in cats.

    PubMed

    Hori, Yasutomo; Heishima, Yasuhiro; Yamashita, Yohei; Isayama, Noriko; Kanno, Nobuyuki; Nakamura, Kensuke; Iguchi, Masayuki; Ibaragi, Toshiki; Onodera, Hideyuki; Aramaki, Yoshitaka; Hirakawa, Atsushi; Yamano, Shigeki; Katagi, Michio; Kitade, Akihito; Sawada, Tamotsu

    2018-03-24

    Chronic kidney disease (CKD) is a common cause of secondary systemic hypertension in cats. We investigated the relationship between indirect blood pressure and the prevalence of systemic hypertension in various CKD stages in cats. Client-owned cats (24 control cats and 77 cats with CKD) were included. Biochemical examinations of plasma were conducted by a commercial laboratory. Diseased cats were divided into two groups based on the International Renal Interest Society (IRIS) guidelines (II and III-IV). Indirect blood pressure was measured using an oscillometric technique. Severe hypertension was diagnosed if systolic blood pressure (SBP) was ≥180 mmHg. Indirect blood pressures were significantly higher in IRIS stage III-IV than in the control cats. Of 77 cats with CKD, 25 (32.5%) had severe hypertension. The frequency of severe hypertension increased with an increase in IRIS stage; 0% in the controls, 27.6% in the IRIS stage II, and 47.4% in the IRIS stage III-IV, respectively. The indirect SBP was weakly correlated with urea nitrogen (r=0.27) and creatinine (r=0.23) concentrations in plasma. Binary logistic regression analysis showed that if plasma creatinine concentration is >3.7 mg/dl, cats with CKD had an increased risk for developing severe hypertension (P<0.001). Our results suggest that indirect blood pressure was correlated with the severity of CKD, and the prevalence of severe hypertension increased in cats with severe CKD. The risk of severe hypertension may be high in cats with severe CKD.

  17. Improving Blood Pressure Control Using Smart Technology.

    PubMed

    Ciemins, Elizabeth L; Arora, Anupama; Coombs, Nicholas C; Holloway, Barbara; Mullette, Elizabeth J; Garland, Robin; Walsh Bishop-Green, Shannon; Penso, Jerry; Coon, Patricia J

    2018-03-01

    The authors sought to determine if wireless oscillometric home blood pressure monitoring (HBPM) that integrates with smartphone technology improves blood pressure (BP) control among patients with new or existing uncontrolled hypertension (HTN). A prospective observational cohort study monitored BP control before and after an educational intervention and introduction to HBPM. Patients in the intervention group were instructed to track their BP using a smartphone device three to seven times per week. Cases were matched to controls at a 1:3 allocation ratio on several clinical characteristics over the same period and received usual care. The proportion of patients with controlled BP was compared between groups at pre- and postintervention, ∼9 months later. Results and Materials: The total study population included 484 patients with mean age 60 years (range 23-102 years), 47.7% female, and 84.6% Caucasian. Mean preintervention BP was 137.8 mm Hg systolic and 81.4 mm Hg diastolic. Mean BP control rates improved for patients who received HBPM from 42% to 67% compared with matched control patients who improved from 59% to 67% (p < 0.01). HBPM with smartphone technology has the potential to improve HTN management among patients with uncontrolled or newly diagnosed HTN. Technology needs to be easy to use and operate and would work best when integrated into local electronic health record systems. In systems without this capability, medical assistants or other personnel may be trained to facilitate the process. Nurse navigator involvement was instrumental in bridging communication between the patients and provider.

  18. Influence analysis in quantitative trait loci detection.

    PubMed

    Dou, Xiaoling; Kuriki, Satoshi; Maeno, Akiteru; Takada, Toyoyuki; Shiroishi, Toshihiko

    2014-07-01

    This paper presents systematic methods for the detection of influential individuals that affect the log odds (LOD) score curve. We derive general formulas of influence functions for profile likelihoods and introduce them into two standard quantitative trait locus detection methods-the interval mapping method and single marker analysis. Besides influence analysis on specific LOD scores, we also develop influence analysis methods on the shape of the LOD score curves. A simulation-based method is proposed to assess the significance of the influence of the individuals. These methods are shown useful in the influence analysis of a real dataset of an experimental population from an F2 mouse cross. By receiver operating characteristic analysis, we confirm that the proposed methods show better performance than existing diagnostics. © 2014 The Author. Biometrical Journal published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Acute effect of ivabradine on heart rate and myocardial oxygen consumption in dogs with asymptomatic mitral valve degeneration.

    PubMed

    Pirintr, Prapawadee; Limprasutr, Vudhiporn; Saengklub, Nakkawee; Pavinadol, Parnpradub; Yapao, Napat; Limvanicharat, Natthakarn; Kuecharoen, Hathaisiri; Kijtawornrat, Anusak

    2018-05-14

    Degenerative mitral valve disease (DMVD) is a common cardiac disease in geriatric dogs characterized by the degeneration of the mitral valve, leading to decreased cardiac output and activation of the sympathetic and renin-angiotensin-aldosterone system. This disease results in an increased resting heart rate (HR) and myocardial oxygen consumption (MVO 2 ). A recent publication demonstrated that dogs with asymptomatic DMVD had a significantly higher HR and systemic blood pressure (BP) than age-matched control dogs. This higher HR will eventually contribute to increased MVO 2 . This study aimed to determine the effects of a single oral dose of ivabradine on the HR, MVO 2 as assessed by the rate-pressure product, and BP in dogs with asymptomatic DMVD. Seven beagles with naturally occurring DMVD were instrumented by the Holter recorder and an oscillometric device to measure electrocardiogram and BP for 24 and 12 h, respectively. Each dog was randomly subjected to receive either placebo or ivabradine (0.5, 1.0 and 2.0 mg/kg). The results revealed that oral administration of ivabradine significantly decreased the HR and rate-pressure product in a dose-dependent manner without adverse effects. The highest dose of 2.0 mg/kg significantly reduced systolic and mean BP. Therefore, the findings imply that a single oral ivabradine administration at a dose of 1.0 mg/kg is suitable for dogs with asymptomatic DMVD to reduce the HR and MVO 2 without marked effects on BP. This may potentially make ivabradine promising for management of an elevated HR in DMVD dogs.

  20. Mechanisms of pulse pressure amplification dipping pattern during sleep time: the SAFAR study.

    PubMed

    Argyris, Antonios A; Nasothimiou, Efthimia; Aissopou, Evaggelia; Papaioannou, Theodoros G; Zhang, Yi; Blacher, Jacques; Safar, Michel E; Sfikakis, Petros P; Protogerou, Athanase D

    2018-02-01

    The difference in pulse pressure (PP) between peripheral arteries and the aorta, called pulse pressure amplification (PPamp), is a well-described physiological phenomenon independently associated with cardiovascular events. Recent studies suggest that it exhibits circadian variability. Our aim was to detect the factors associated with the circadian variability of PPamp. In 497 consecutive subjects (aged 54 years, 56.7% male, 79.7% hypertensives), we assessed the circadian pattern of peripheral and central arterial hemodynamics by 24-hour evaluation of brachial and aortic blood pressure (BP), augmentation index (AI), and pulse wave velocity (PWV) using a validated oscillometric device (Mobil-O-Graph). All parameters exhibited a circadian variation. Sleep dipping (decrease) pattern was observed for PPamp, brachial and aortic systolic BP, mean BP, and PWV, whereas a rising pattern (higher sleep than wake values) was observed for brachial PP, aortic PP, and AI. The factors independently associated with the less sleep dipping in PPamp were older age, lower height, the use of antihypertensive medication, and sleep decrease in arterial stiffness (PWV), whereas female gender, the presence of hypertension, sleep increase of pressure wave reflections (AI), sleep decrease in heart rate, and mean BP were associated with a greater sleep-dipping in PPamp. These data provide further pathophysiological understanding of the mechanisms leading to PPamp dipping. Several implications regarding the clinical use of the aortic and brachial BP, especially during sleep time, are raised that should be addressed in future research. Copyright © 2017 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  1. Controversies in the association of cardiorespiratory fitness and arterial stiffness in children and adolescents.

    PubMed

    Meyer, Joanna; Elmenhorst, Julia; Giegerich, Tobias; Oberhoffer, Renate; Müller, Jan

    2017-07-01

    The relationship between cardiorespiratory fitness and arterial compliance in children and adolescents remains controversial. The aim of this study was to assess this association with a quantitative approach. A total of 646 healthy children and adolescents (316 females, age 13.9±2.1 years) were cross-sectionally investigated in seven school settings in and around Munich for their cardiorespiratory fitness and demographic, anthropometric and hemodynamic parameters. Surrogates of arterial stiffness, such as pulse wave velocity (PWV), Augmentation Index normalized to a heart rate of 75 (AI@75), and peripheral and central systolic blood pressures were measured in a supine position using the oscillometric Mobil-O-Graph. Cardiopulmonary fitness was measured by 6-min indoor run tests. After correction for age, sex, body weight, body height, heart rate and mean arterial pressure, controversial findings were produced. PWV increased with higher cardiorespiratory fitness (Beta=0.173; P<0.001), which represented an unfavorable relationship, whereas AI@75 declined with higher cardiorespiratory fitness (Beta=-0.106; P=0.025). Therefore, in contrast to PWV, higher cardiorespiratory fitness seems beneficial for AI@75. The third surrogate of arterial stiffness, central systolic blood pressure, showed no association with cardiorespiratory fitness (Beta=0.066; P=0.052). These controversial outcomes remain almost unchanged when the boys and girls were analyzed separately. Different surrogates of arterial stiffness have different relationships with cardiorespiratory fitness in children and adolescents after correcting for multiple confounders. More research is needed in this field to understand the functioning of the juvenile vessels, and measurements and methodological approaches should be reconsidered.

  2. Challenges in standardization of blood pressure measurement at the population level.

    PubMed

    Tolonen, Hanna; Koponen, Päivikki; Naska, Androniki; Männistö, Satu; Broda, Grazyna; Palosaari, Tarja; Kuulasmaa, Kari

    2015-04-10

    Accurate blood pressure measurements are needed in clinical practice, intervention studies and health examination surveys. Blood pressure measurements are sensitive: their accuracy can be affected by measurement environment, behaviour of the subject, measurement procedures, devices used for the measurement and the observer. To minimize errors in blood pressure measurement, a standardized measurement protocol is needed. The European Health Examination Survey (EHES) Pilot project was conducted in 2009-2012. A pilot health examination survey was conducted in 12 countries using a standardized protocol. The measurement protocols used in each survey, training provided for the measurers, measurement data, and observations during site visits were collected and evaluated to assess the level of standardization. The EHES measurement protocol for blood pressure was followed accurately in all 12 pilot surveys. Most of the surveys succeeded in organizing a quiet and comfortable measurement environment, and staff instructed survey participants appropriately before examination visits. In all surveys, blood pressure was measured three times, from the right arm in a sitting posture. The biggest variation was in the device used for the blood pressure measurement. It is possible to reach a high level of standardization for blood pressure measurements across countries and over time. A detailed, standardized measurement protocol, and adequate training and monitoring during the fieldwork and centrally organized quality assessment of the data are needed. The recent EU regulation banning the sale of mercury sphygmomanometer in European Union Member States has set new challenges for the standardization of measurement devices since the validity of oscillometric measurements is device-specific and performance of aneroid devices depends very much on calibration.

  3. Inter-Arm Difference in Brachial Blood Pressure in the General Population of Koreans.

    PubMed

    Song, Bo Mi; Kim, Hyeon Chang; Shim, Jee-Seon; Lee, Myung Ha; Choi, Dong Phil

    2016-05-01

    We investigated the inter-arm difference in blood pressure of the general Korean population to identify associated factors. A total of 806 participants aged 30 to 64 years without history of major cardiovascular disease were analyzed in this cross-sectional study. They participated in the Cardiovascular and Metabolic Disease Etiology Research Center cohort study that began in 2013. Brachial blood pressure was measured simultaneously for both arms using an automated oscillometric device equipped with two cuffs in seated position. After five minutes of rest, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured three times. The average of the three measurements was used for analysis. Multivariate logistic regression models were used to identify factors associated with inter-arm differences in blood pressure. The mean inter-arm difference was 3.3 mmHg for SBP and 2.0 mmHg for DBP. Large inter-arm differences (≥10 mmHg) in SBP and in DBP were found in 3.7% and 0.9% of subjects, respectively. A large inter-arm difference in SBP was associated with mean SBP (p=0.002) and C-reactive protein (p=0.014) while a large inter-arm different in DBP was only associated with body mass index (p=0.015). Sex, age, and anti-hypertensive medication use were not associated with differences in inter-arm blood pressure. Large inter-arm difference in blood pressure is only present in a small portion of healthy Korean adults. Our findings suggest that high SBP, chronic inflammation, and obesity may be associated with larger difference in inter-arm blood pressure.

  4. Consistency of blood pressure differences between the left and right arms.

    PubMed

    Eguchi, Kazuo; Yacoub, Mona; Jhalani, Juhee; Gerin, William; Schwartz, Joseph E; Pickering, Thomas G

    2007-02-26

    It is unclear to what extent interarm blood pressure (BP) differences are reproducible vs the result of random error. The present study was designed to resolve this issue. We enrolled 147 consecutive patients from a hypertension clinic. Three sets of 3 BP readings were recorded, first using 2 oscillometric devices simultaneously in the 2 arms (set 1); next, 3 readings were taken sequentially for each arm using a standard mercury sphygmomanometer (set 2); finally, the readings as performed for set 1 were repeated (set 3). The protocol was repeated at a second visit for 91 patients. Large interarm systolic BP differences were consistently seen in 2 patients with obstructive arterial disease. In the remaining patients, the systolic BP and the diastolic BP, respectively, were slightly higher in the right arm than in the left arm by 2 to 3 mm Hg and by 1 mm Hg for all 3 sets (P<.01 for all). For the systolic BP and the diastolic BP, respectively, the numbers of patients who had a mean interarm difference of more than 5 mm Hg were 11 (7.5%) and 4 (2.7%) across all 3 sets of readings. Among patients who repeated the test, none had a consistent interarm BP difference of more than 5 mm Hg across the 2 visits. The interarm BP difference was consistent only when obstructive arterial disease was present. Although BP in the right arm tended to be higher than in the left arm, clinically meaningful interarm differences were not reproducible in the absence of obstructive arterial disease and are attributable to random variation.

  5. Validation of the Kingyield BP210 wrist blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension-International Protocol.

    PubMed

    Zeng, Wei-Fang; Huang, Qi-Fang; Sheng, Chang-Sheng; Li, Yan; Wang, Ji-Guang

    2012-02-01

    The present study aimed to evaluate the accuracy of the automated oscillometric wrist blood pressure monitor BP210 for home blood pressure monitoring according to the International Protocol of the European Society of Hypertension. Systolic and diastolic blood pressures were sequentially measured in 33 adult Chinese participants (21 women, 51 years of mean age) using a mercury sphygmomanometer (two observers) and the BP210 device (one supervisor). Ninety-nine pairs of comparisons were obtained from 15 participants in phase 1 and a further 18 participants in phase 2 of the validation study. Data analysis was conducted using the ESHIP analyzer. The BP210 device successfully passed phase 1 of the validation study with a number of absolute differences between device and observers within 5, 10, and 15 mmHg for at least 33/45, 44/45, and 44/45 measurements, respectively. The device also achieved the targets for phase 2.1, with 77/99, 95/99, and 97/99 differences within 5, 10, and 15 mmHg, respectively for systolic blood pressure, and with 78/99, 97/99, and 99/99 within 5, 10, and 15 mmHg, respectively for diastolic blood pressure. In phase 2.2, 29 and 25 participants had at least two of the three device-observers differences within 5 mmHg (required≥22) for systolic blood pressure and diastolic blood pressure, respectively. The Kingyield wrist blood pressure monitor BP210 has passed the International Protocol requirements, and hence can be recommended for home use in adults.

  6. Validation of the Rossmax CF175 upper-arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Zhang, Lu; Kang, Yuan-Yuan; Zeng, Wei-Fang; Li, Yan; Wang, Ji-Guang

    2015-04-01

    The present study aimed to evaluate the accuracy of the Rossmax CF175 upper-arm blood pressure monitor for home blood pressure monitoring according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic blood pressures were sequentially measured in 33 adult Chinese (17 women, mean age 46 years) using a mercury sphygmomanometer (two observers) and the Rossmax CF175 device (one supervisor). A total of 99 pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. All the blood pressure requirements were fulfilled. The Rossmax CF175 device achieved the targets in part 1 of the validation study. The number of absolute differences between the device and observers within 5, 10, and 15 mmHg was 78/99, 94/99, and 98/99, respectively, for systolic blood pressure, and 81/99, 96/99, and 97/99, respectively, for diastolic blood pressure. The device also achieved the criteria in part 2 of the validation study. Twenty-nine participants, for both of systolic and diastolic blood pressure, had at least two of the three device-observers differences within 5 mmHg (required ≥24). Only one participant for diastolic blood pressure had all three device-observers comparisons greater than 5 mmHg. The Rossmax automated oscillometric upper-arm blood pressure monitor CF175 fulfilled the requirements of the International Protocol revision 2010, and hence can be recommended for blood pressure measurement in adults.

  7. Validation of the AVITA BPM15S wrist blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Kang, Yuan-Yuan; Zeng, Wei-Fang; Zhang, Lu; Li, Yan; Wang, Ji-Guang

    2014-06-01

    The present study aimed to evaluate the accuracy of the automated oscillometric wrist blood pressure monitor AVITA BPM15S for home blood pressure monitoring according to the International Protocol revision 2010 of the European Society of Hypertension. Systolic and diastolic blood pressures were sequentially measured in 33 Chinese adults (15 women, mean age 51 years) using a mercury sphygmomanometer (two observers) and the AVITA BPM15S device (one supervisor). Ninety-nine pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. The AVITA BPM15S device achieved the targets in part 1 of the validation study. The number of absolute differences between the device and observers within 5, 10, and 15 mmHg were 85/99, 94/99, and 98/99, respectively, for systolic blood pressure, and 82/99, 96/99, and 98/99, respectively, for diastolic blood pressure. The device also achieved the criteria in part 2 of the validation study. Thirty-two and 28 participants for systolic and diastolic blood pressure, respectively, had at least two of the three device-observer differences within 5 mmHg (required ≥ 24). No participant had all of the three device-observer comparisons greater than 5 mmHg for systolic or diastolic blood pressure. The AVITA wrist blood pressure monitor BPM15S fulfilled the requirements of the International Protocol revision 2010 and hence can be recommended for home use in an adult population.

  8. Validation of the HONSUN LD-578 blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol.

    PubMed

    Zhang, Yi; Wang, Jie; Huang, Qi-Fang; Sheng, Chang-Sheng; Li, Yan; Wang, Ji-Guang

    2009-06-01

    This study aimed to evaluate the accuracy of the automated oscillometric upper arm blood pressure monitor LD-578 (HONSUN Group, Shanghai, China) for home blood pressure monitoring according to the International Protocol. Systolic and diastolic blood pressures were sequentially measured in 33 adult Chinese using a mercury sphygmomanometer (two observers) and the LD-578 device (one supervisor). Ninety-nine pairs of comparisons were obtained from 15 participants in phase 1 and a further 18 participants in phase 2 of the validation study. Data analysis was performed using the ESHIP Analyzer. The LD-578 device successfully passed phase 1 of the validation study with a number of absolute differences between device and observers within 5, 10, and 15 mmHg for at least 32 of 45, 41 of 45, and 45 of 45 measurements (required 25, 35, and 40), respectively. The device also achieved the targets for phase 2.1, with 67 of 99, 90 of 99, and 98 of 99 differences within 5, 10, and 15 mmHg, respectively, for systolic blood pressure, and with 69 of 99, 95 of 99, and 98 of 99 within 5, 10, and 15 mmHg, respectively, for diastolic blood pressure. In phase 2.2, 24 participants had at least two of the three device-observers differences within 5 mmHg (required >or=22) for systolic and diastolic blood pressure. The HONSUN upper arm blood pressure monitor LD-578 can be recommended for home use in adults.

  9. Validation of the Pangao PG-800B11 blood pressure monitor according to the European Society of Hypertension and the British Hypertension Society protocols.

    PubMed

    Bing, Sen; Zhang, Cunhai; Wang, Liping; Li, Linyi; Wan, Yi

    2014-12-01

    The study aimed to determine the accuracy of the fully automated oscillometric upper-arm blood pressure (BP) monitor Pangao PG-800B11 according to the European Society of Hypertension-International Protocol (ESH-IP) revision 2010 and the British Hypertension Society (BHS) protocol 1993. Data from 33 participants were initially examined according to the ESH-IP revision 2010. Furthermore, 52 participants were then enrolled to fulfill the BHS protocol requirements. In all participants, sequential left arm measurements were performed by two trained observers using a mercury sphygmomanometer and one supervisor using the device. The protocols' requirements were followed precisely. The device passed all parts of the ESH protocol for systolic blood pressure (SBP) and diastolic blood pressure (DBP) and was graded A according to the criteria of the BHS protocol for both SBP and DBP. The A/A grade was achieved in low (<130/80 mmHg), medium (130-160/80-100 mmHg), and high (>160/100 mmHg) BP categories. The mean BP difference between PG-800B11 and observers in the 85 participants was -0.6±5.0 mmHg for SBP and -0.6±4.5 mmHg for DBP; thus, the device also fulfilled the requirements of the Association for the Advancement of Medical Instrumentation (AAMI). The Pangao PG-800B11 passed all requirements of the ESH-IP revision 2010 and achieved A/A grade of the BHS protocol across a wide range of BPs.

  10. Validation of the Andon KD-5965 upper-arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Huang, Jinhua; Li, Zhijie; Li, Guimei; Liu, Zhaoying

    2015-10-01

    This study aimed to evaluate the accuracy of the Andon KD-5965 upper-arm blood pressure monitor according to the European Society of Hypertension International Protocol revision 2010. Systolic and diastolic blood pressures were sequentially measured in 33 adults, with 20 women using a mercury sphygmomanometer (two observers) and the Andon KD-5965 device (one supervisor). A total of 99 pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. The device achieved the targets in part 1 of the validation study. The number of absolute differences between the device and observers within 5, 10, and 15 mmHg was 70/99, 91/99, and 98/99, respectively, for systolic blood pressure and 81/99, 99/99, and 99/99, respectively, for diastolic blood pressure. The device also fulfilled the criteria in part 2 of the validation study. Twenty-five and 29 participants, for systolic and diastolic blood pressure, respectively, had at least two of the three device-observers differences within 5 mmHg (required≥24). Two and one participants for systolic and diastolic blood pressure, respectively, had all three device-observers comparisons greater than 5 mmHg. According to the validation results, with better performance for diastolic blood pressure than that for systolic blood pressure, the Andon automated oscillometric upper-arm blood pressure monitor KD-5965 fulfilled the requirements of the European Society of Hypertension International Protocol revision 2010, and hence can be recommended for blood pressure measurement in adults.

  11. Blood pressure among rural Montenegrin children in relation to poverty and gender.

    PubMed

    Martinovic, Milica; Belojevic, Goran; Evans, Gary W; Asanin, Bogdan; Lausevic, Dragan; Kovacevic, Natasa Duborija; Samardzic, Mira; Jaksic, Marina; Pantovic, Snezana

    2014-06-01

    Health inequalities may begin during childhood. The aim of this study was to investigate the main effect of poverty and its interactive effect with gender on children's blood pressure. The study was performed in two elementary schools from a rural region near Podgorica, the capital of Montenegro. A questionnaire including questions on family monthly income, children's physical activity and the consumption of junk food was self-administered by parents of 434 children (223 boys and 211 girls) aged 6-13 years. Children's poverty level was assessed using the recommendations from the National Study on Poverty in Montenegro. Children's body weight and height were measured and body mass index-for-gender-and-age percentile was calculated. An oscillometric monitor was used for measurement of children's resting blood pressure in school. A two-factorial analysis of variance with body mass index percentile, physical activity and junk food as covariates showed an interaction of gender and poverty on children's blood pressure, pointing to synergy between poverty and female gender, with statistical significance for raised diastolic pressure (F = 5.462; P = 0.021). Neither physical activity nor the consumption of junk food explained the interactive effect of poverty and gender on blood pressure. We show that poverty is linked to elevated blood pressure for girls but not boys, and this effect is statistically significant for diastolic pressure. The results are discussed in the light of gender differences in stress and coping that are endemic to poverty. © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  12. Validation of the SCIAN LD-735 wrist blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Kang, Yuan-Yuan; Chen, Qi; Li, Yan; Wang, Ji-Guang

    2016-08-01

    This study aimed to evaluate the accuracy of the automated oscillometric wrist blood pressure monitor SCIAN LD-735 for home blood pressure monitoring according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic blood pressures were measured sequentially in 33 adult Chinese participants (10 women, mean age 44.8 years) using a mercury sphygmomanometer (two observers) and the SCIAN LD-735 device (one supervisor). A total of 99 pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. The SCIAN LD-735 device achieved the targets in part 1 of the validation study. The number of absolute differences between device and observers within 5, 10, and 15 mmHg was 86/99, 97/99, and 98/99, respectively, for systolic blood pressure and 85/99, 98/99, and 99/99, respectively, for diastolic blood pressure. The device also fulfilled the criteria in part 2 of the validation study. In total, 30 and 33 participants for systolic and diastolic blood pressure, respectively, had at least two of the three device-observer differences within 5 mmHg (required ≥24). No participant had all of the three device-observer comparisons greater than 5 mmHg for systolic or diastolic blood pressure. The SCIAN wrist blood pressure monitor LD-735 has passed the requirements of the International Protocol revision 2010, and hence can be recommended for home use in adults.

  13. Validation of the Tensoval Duo Control II blood pressure monitor for clinic use and self-measurement according to the British Hypertension Society protocol and the European Society of Hypertension International Protocol Revision 2010.

    PubMed

    de Greeff, Annemarie; Shennan, Andrew H

    2013-06-01

    The Tensoval Duo Control II is an automated upper arm device that uses a combination of oscillometric and auscultatory technology to determine blood pressure noninvasively. The accuracy of this device was assessed according to the British Hypertension Society (BHS) protocol and the European Society of Hypertension International Protocol revision 2010 (ESH-IP2) in an adult population. Ethical approval was obtained. Eighty-five and 33 adult individuals, respectively, were recruited to fulfil the requirements of each protocol. Trained observers took nine sequential same-arm measurements alternating between a mercury sphygmomanometer and the device. The device had to achieve at least a B grade for both systolic and diastolic pressures to pass the BHS protocol and had to fulfil the criteria of all three phases of the ESH-IP2 protocol to receive recommendation. The device achieved an A/A grading for the BHS protocol and passed all three phases of the ESH-IP2 protocol. The mean difference±SD for the BHS/ESH protocols, respectively, was -1.8±6.5/-0.7±5.7 mmHg for systolic pressure and 1.9±5.1/2.4±4.5 mmHg for diastolic pressure. The device maintained its A/A grading throughout the low-pressure, medium-pressure and high-pressure ranges. The Tensoval Duo Control II device is recommended for clinical and home use according to both the BHS and the ESH-IP2 standard.

  14. Validation of the BPUMP BF1112 upper-arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Chen, Qi; Kang, Yuan-Yuan; Li, Yan; Wang, Ji-Guang

    2017-04-01

    The present study aimed to evaluate the accuracy of the automated oscillometric upper-arm blood pressure (BP) monitor BPUMP BF1112 for home BP monitoring according to the International Protocol of the European Society of Hypertension revision 2010 (ESH-IP2010). Systolic and diastolic BPs were sequentially measured in 33 adult Chinese (13 women, mean age 46.7 years) using a mercury sphygmomanometer (two observers) and the BF1112 device (one supervisor). A total of 99 pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. The BPUMP BF1112 device achieved the targets in part 1 of the validation study. The number of absolute differences between device and observers within 5, 10, and 15 mmHg was 85/99, 96/99, and 97/99, respectively, for systolic BP, and 83/99, 97/99, and 99/99, respectively, for diastolic BP. The device also fulfilled the criteria in part 2 of the validation study. A total of 31 and 30 participants for systolic and diastolic BP, respectively, had at least two of the three device-observer differences within 5 mmHg (required≥24mmHg). No participant for systolic or diastolic BP had all the three device-observer comparisons greater than 5 mmHg. The BPUMP BP monitor BF1112 has passed the requirements of the ESH-IP2010, and hence can be recommended for home use in adults.

  15. Validation of the Artsana CSI 610 automated blood pressure monitor in adults according to the International Protocol of the European Society of Hypertension.

    PubMed

    Pini, Claudio; Pastori, Marco; Baccheschi, Jordan; Omboni, Stefano; Parati, Gianfranco

    2007-06-01

    There is evidence that blood pressure measurement outside the doctor's office can provide valuable information for the diagnostic evaluation of hypertensive patients and for monitoring their response to treatment. Home blood pressure monitoring devices have a major role in this setting, provided that their accuracy in measuring blood pressure is demonstrated by validation studies. This study aimed at verifying whether the automatic electronic oscillometric blood pressure measuring device Artsana CSI 610 complied with the standard of accuracy indicated by the ESH International Protocol. Sequential measurements of systolic and diastolic blood pressure were obtained in 33 participants using the mercury sphygmomanometer (two observers) and the test device (one supervisor). A standard adult cuff was always employed during the study. According to the ESH validation protocol, 99 couples of test device and reference blood pressure measurements were obtained during the two phases of the study (three pairs for each of the 33 participants). The Artsana CSI 610 device successfully passed phase 1 of study validation with the number of absolute differences between test and reference device never <35 within 5 mmHg and never <40 within 10 and 15 mmHg. The test device also passed phase 2 of the validation study with a mean (+/-SD) device-observer difference of -1.4+/-4.8 mmHg for systolic and -0.9+/-3.5 mmHg for diastolic blood pressure. According to the results of the validation study on the basis of the ESH International Protocol, the Artsana CSI 610 can be recommended for clinical use in adults.

  16. Validation of the AVITA BPM17 wrist blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Kang, Yuan-Yuan; Chen, Qi; Liu, Chang-Yuan; Li, Yan; Wang, Ji-Guang

    2017-08-01

    The aim of the present study was to evaluate the accuracy of the automated oscillometric wrist blood pressure monitor AVITA BPM17 for home blood pressure monitoring according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic blood pressures were sequentially measured in 33 adult Chinese (19 men, 45.7 years of mean age) using a mercury sphygmomanometer (two observers) and the AVITA BPM17 device (one supervisor). Ninety-nine pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. The AVITA BPM17 device achieved the targets in part 1 of the validation study. The number of absolute differences between device and observers within 5, 10, and 15 mmHg was 94/99, 98/99, and 98/99, respectively, for systolic blood pressure and 92/99, 99/99, and 99/99, respectively, for diastolic blood pressure. The device also fulfilled the criteria in part 2 of the validation study. Overall, 32 participants for both systolic and diastolic blood pressure, respectively, had at least two of the three device-observerss differences within 5 mmHg (required ≥24). None had all the three device-observers comparisons greater than 5 mmHg for systolic and diastolic blood pressure. The AVITA wrist blood pressure monitor BPM17 has passed the requirements of the International Protocol revision 2010, and hence can be recommended for home use in adults.

  17. Symptoms of anxiety and mood disturbance alter cardiac and peripheral autonomic control in patients with metabolic syndrome.

    PubMed

    Toschi-Dias, Edgar; Trombetta, Ivani C; da Silva, Valdo José Dias; Maki-Nunes, Cristiane; Alves, Maria Janieire N N; Angelo, Luciana F; Cepeda, Felipe X; Martinez, Daniel G; Negrão, Carlos Eduardo; Rondon, Maria Urbana P B

    2013-03-01

    Previous investigations show that metabolic syndrome (MetSyn) causes sympathetic hyperactivation. Symptoms of anxiety and mood disturbance (AMd) provoke sympatho-vagal imbalance. We hypothesized that AMd would alter even further the autonomic function in patients with MetSyn. Twenty-six never-treated patients with MetSyn (ATP-III) were allocated to two groups, according to the levels of anxiety and mood disturbance: (1) with AMd (MetSyn + AMd, n = 15), and (2) without AMd (MetSyn, n = 11). Ten healthy control subjects were also studied (C, n = 10). AMd was determined using quantitative questionnaires. Muscle sympathetic nerve activity (MSNA, microneurography), blood pressure (oscillometric beat-to-beat basis), and heart rate (ECG) were measured during a baseline 10-min period. Spectral analysis of RR interval and systolic arterial pressure were analyzed, and the power of low (LF) and high (HF) frequency bands were determined. Sympatho-vagal balance was obtained by LF/HF ratio. Spontaneous baroreflex sensitivity (BRS) was evaluated by calculation of α-index. MSNA was greater in patients with MetSyn + AMd compared with MetSyn and C. Patients with MetSyn + AMd showed higher LF and lower HF power compared with MetSyn and C. In addition, LF/HF balance was higher in MetSyn + AMd than in MetSyn and C groups. BRS was decreased in MetSyn + AMd compared with MetSyn and C groups. Anxiety and mood disturbance alter autonomic function in patients with MetSyn. This autonomic dysfunction may contribute to the increased cardiovascular risk observed in patients with mood alterations.

  18. Blood Pressure Estimation Using Pulse Transit Time From Bioimpedance and Continuous Wave Radar.

    PubMed

    Buxi, Dilpreet; Redout, Jean-Michel; Yuce, Mehmet Rasit

    2017-04-01

    We have developed and tested a new architecture for pulse transit time (PTT) estimation at the central arteries using electrical bioimpedance, electrocardiogram, and continuous wave radar to estimate cuffless blood pressure. A transmitter and receiver antenna are placed at the sternum to acquire the arterial pulsation at the aortic arch. A four-electrode arrangement across the shoulders acquires arterial pulse across the carotid and subclavian arteries from bioimpedance as well as a bipolar lead I electrocardiogram. The PTT and pulse arrival times (PATs) are measured on six healthy male subjects during exercise on a bicycle ergometer. Using linear regression, the estimated PAT and PTT values are calibrated to the systolic and mean as well as diastolic blood pressure from an oscillometric device. For all subjects, the Pearson correlation coefficients for PAT-SBP and PTT-SBP are -0.66 (p = 0.001) and -0.48 (p = 0.0029), respectively. Correlation coefficients for individual subjects ranged from -0.54 to -0.9 and -0.37 to -0.95, respectively. The proposed system architecture is promising in estimating cuffless arterial blood pressure at the central, proximal arteries, which obey the Moens-Korteweg equation more closely when compared to peripheral arteries. An important advantage of PTT from the carotid and subclavian arteries is that the PTT over the central elastic arteries is measured instead of the peripheral arteries, which potentially reduces the changes in PTT due to vasomotion. Furthermore, the sensors can be completely hidden under a patients clothes, making them more acceptable by the patient for ambulatory monitoring.

  19. The association between cardiovascular risk factors and high blood pressure in adolescents: a school-based study.

    PubMed

    Christofaro, Diego G D; Fernandes, Rômulo A; Oliveira, Arli R; Freitas Júnior, Ismael Forte; Barros, Mauro V G; Ritti-Dias, Raphael M

    2014-01-01

    Although previous studies have analyzed the association between cardiovascular risk factors and blood pressure in adolescents, few studies conducted in developing countries analyzed whether the aggregation of risk factors contributes to an increased risk of high blood pressure in adolescents. The objective of this study was to assess the association between cardiovascular risk factors (including general overweight, abdominal obesity, high consumption of foods rich in fats, and insufficient physical activity levels) and high blood pressure in adolescents. This study was carried out from 2007 to 2008 with 1021 adolescents (528 girls) from primary schools located in the city of Londrina- Brazil. Blood pressure was assessed using an oscillometric device. General overweight was obtained through body mass index, abdominal obesity was assessed using waist circumference, and the consumption of foods rich in fat and physical activity were assessed using a questionnaire. The sum of these risk factors was determined. Adolescents with three or four aggregated risk factors were more likely to have higher values of systolic and diastolic blood pressure when compared with adolescents who did not have any cardiovascular risk factors (P = 0.001 for both). Logistic regression indicated that groups of adolescents with 2 (OR= 2.46 [1.11-5.42]; P = 0.026), 3 (OR= 4.97 [2.07-11.92]; P = 0.001) or 4 risk factors (OR= 6.79 [2.24-19.9]; P = 0.001) presented an increased likelihood of high blood pressure. The number of cardiovascular risk factors was found to be related to high blood pressure in adolescents. Copyright © 2014 Wiley Periodicals, Inc.

  20. An Influence Function Method for Predicting Store Aerodynamic Characteristics during Weapon Separation,

    DTIC Science & Technology

    1981-05-14

    8217 AO-Ail 777 GRUMMAN AEROSPACE CORP BETHPAGE NY F/G 20/4 AN INFLUENCE FUNCTION METHOD FOR PREDICTING STORE AERODYNAMIC C--ETCCU) MAY 8 1 R MEYER, A...CENKO, S YARDS UNCLASSIFIED N ’.**~~N**n I EHEEKI j~j .25 Q~4 111110 111_L 5. AN INFLUENCE FUNCTION METHOD FOR PREDICTING STORE AERODYNAMIC...extended to their logical conclusion one is led quite naturally to consideration of an " Influence Function Method" for I predicting store aerodynamic

  1. Superior Effects of High-Intensity Interval Training vs. Moderate Continuous Training on Arterial Stiffness in Episodic Migraine: A Randomized Controlled Trial.

    PubMed

    Hanssen, Henner; Minghetti, Alice; Magon, Stefano; Rossmeissl, Anja; Papadopoulou, Athina; Klenk, Christopher; Schmidt-Trucksäss, Arno; Faude, Oliver; Zahner, Lukas; Sprenger, Till; Donath, Lars

    2017-01-01

    Background: Migraine is associated with increased cardiovascular risk and vascular dysfunction. Since aerobic exercise can reduce cardiovascular risk, the present randomized controlled trail aimed at investigating the effects of high-intensity interval training (HIT) vs. moderate continuous exercise training (MCT) on arterial stiffness in migraine patients. Methods: Forty-eight episodic migraineurs were initially enrolled in the study. 37 patients [female: 30; age: 37 ( SD : 10); BMI: 23.1 (5.2); Migraine days per month: 3.7 (2.5)] completed the intervention. Central blood pressure, pulse wave reflection, and aortic pulse wave velocity (PWV) were obtained by an oscillometric monitor. Incremental treadmill exercise testing yielded maximal and submaximal fitness parameters. Participants were randomly assigned to either HIT, MCT, or a control group (CON). The intervention groups trained twice a week over a 12-week intervention period. Results: After adjustment for between-group baseline differences, a moderate meaningful overall reduction of the augmentation index at 75 min -1 heart rate (AIx@75) was observed [partial eta squared ([Formula: see text]) = 0.16; p = 0.06]. With 91% likely beneficial effects, HIT was more effective in reducing AIx@75 than MCT [HIT: pre 22.0 (9.7), post 14.9 (13.0), standardized mean difference (SMD) = 0.62; MCT: pre 16.6 (8.5), post 21.3 (10.4), SMD -0.49]. HIT induced a relevant reduction in central systolic blood pressure [cSBP: pre 118 (23) mmHg, post 110 (16) mmHg, SMD = 0.42] with a 59% possibly beneficial effect compared to CON, while MCT showed larger effects in lowering central diastolic blood pressure [pre 78 (7) mmHg, post 74 (7) mmHg, SMD = 0.61], presenting 60% possibly beneficial effects compared to CON. Central aortic PWV showed no changes in any of the three groups. Migraine days were reduced more successfully by HIT than MCT (HIT: SMD = 1.05; MCT: SMD = 0.43). Conclusion: HIT but not MCT reduces AIx@75 as a measure of pulse wave reflection and indirect marker of systemic arterial stiffness. Both exercise modalities beneficially affect central blood pressure. HIT proved to be an effective complementary treatment option to reduce vascular dysfunction and blood pressure in migraineurs.

  2. Correlation of Noninvasive Blood Pressure and Invasive Intra-arterial Blood Pressure in Patients Treated with Vasoactive Medications in a Neurocritical Care Unit.

    PubMed

    Saherwala, Ali A; Stutzman, Sonja E; Osman, Mohamed; Kalia, Junaid; Figueroa, Stephen A; Olson, DaiWai M; Aiyagari, Venkatesh

    2018-03-22

    The correlation between noninvasive (oscillometric) blood pressure (NBP) and intra-arterial blood pressure (IAP) in critically ill patients receiving vasoactive medications in a Neurocritical Care Unit has not been systematically studied. The purpose of this study is to examine the relationship between simultaneously measured NBP and IAP recordings in these patients. Prospective observational study of patients (N = 70) admitted to a neurocritical care unit receiving continuous vasopressor or antihypertensive infusions. Paired NBP/IAP observations along with covariate and demographic data were abstracted via chart audit. Analysis was performed using SAS v9.4. A total of 2177 paired NBP/IAP observations from 70 subjects (49% male, 63% white, mean age 59 years) receiving vasopressors (n = 21) or antihypertensive agents (n = 49) were collected. Paired t test analysis showed significant differences between NBP versus IAP readings: ([systolic blood pressure (SBP): mean = 136 vs. 140 mmHg; p < 0.0001], [diastolic blood pressure (DBP): mean = 70 vs. 68 mmHg, p < 0.0001], [mean arterial blood pressure (MAP): mean = 86 vs. 90 mmHg, p < 0.0001]). Bland-Altman plots for MAP, SBP, and DBP demonstrate good inter-method agreement between paired measures (excluding outliers) and demonstrate NBP-IAP SBP differences at extremes of blood pressures. Pearson correlation coefficients show strong positive correlations for paired MAP (r = 0.82), SBP (r = 0.84), and DBP (r = 0.73) recordings. An absolute NBP-IAP SBP difference of > 20 mmHg was seen in ~ 20% of observations of nicardipine, ~ 25% of observations of norepinephrine, and ~ 35% of observations of phenylephrine. For MAP, the corresponding numbers were ~ 10, 15, and 25% for nicardipine, norepinephrine, and phenylephrine, respectively. Despite overall strong positive correlations between paired NBP and IAP readings of MAP and SBP, clinically relevant differences in blood pressure are frequent. When treating with vasoactive infusions targeted to a specific BP goal, it is important to keep in mind that NBP and IAP values are not interchangeable.

  3. Comparison study of upper arm and forearm non-invasive blood pressures in adult Emergency Department patients.

    PubMed

    Schimanski, Karen; Jull, Andrew; Mitchell, Nancy; McLay, Jessica

    2014-12-01

    Forearm blood pressures have been suggested as an alternative site to measure blood pressures when the upper arm is unavailable. However there is little evidence utilising clinical populations to support this substitution. To determine agreement between blood pressures measured in the left upper arm and forearm using a singular oscillometric non-invasive device in adult Emergency Department patients. The secondary objective was to explore the relationship of blood pressure differences with age, sex, ethnicity, smoking history and obesity. Single centre comparison study. Adult Emergency Department, Tertiary Trauma Centre. Forty-four participants who met inclusion/exclusion criteria selected sequentially from the Emergency Department arrival board. A random assignment of order of measurement for left upper arm and forearm blood pressures was utilised. Participants were eligible if they were aged 18 years or older, had been assigned an Australasian Triage Scale code of 2, 3, 4, or 5, were able to consent, and able to have blood pressures measured on their left arm whilst lying at a 45° angle. The Bland-Altman method of statistical analysis was used, with the level of agreement for clinical acceptability for the systolic, diastolic and mean arterial pressure defined as ±10 mmHg. The forearm measure overestimated systolic (mean difference 2.2 mmHg, 95% limits of agreement ±19 mmHg), diastolic (mean difference 3.4 mmHg, 95% limits of agreement ±14.4 mmHg), and mean arterial pressures (mean difference 4.1 mmHg, 95% limits of agreement ±13.7 mmHg). The systolic measure was not significantly different from zero. Evidence of better agreement was found with upper arm/forearm systolic measures below 140 mmHg compared to systolic measures above 140 mmHg using the Levene's test (p=0.002, F-statistic=11.09). Blood pressure disparity was not associated with participant characteristics. Forearm measures cannot routinely replace upper arm measures for blood pressure measurement. If the clinical picture requires use of forearm blood pressure, the potential variance from an upper arm measure is ±19 mmHg for systolic pressure, although the variability may be close to ±10 mmHg if the systolic blood pressure is below 140 mmHg. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Sampling Based Influence Maximization on Linear Threshold Model

    NASA Astrophysics Data System (ADS)

    Jia, Su; Chen, Ling

    2018-04-01

    A sampling based influence maximization on linear threshold (LT) model method is presented. The method samples the routes in the possible worlds in the social networks, and uses Chernoff bound to estimate the number of samples so that the error can be constrained within a given bound. Then the active possibilities of the routes in the possible worlds are calculated, and are used to compute the influence spread of each node in the network. Our experimental results show that our method can effectively select appropriate seed nodes set that spreads larger influence than other similar methods.

  5. Relaxed Fidelity CFD Methods Applied to Store Separation Problems

    DTIC Science & Technology

    2004-06-01

    accuracy-productivity characteristics of influence function methods and time-accurate CFD methods. Two methods are presented in this paper, both of...which provide significant accuracy improvements over influence function methods while providing rapid enough turn around times to support parameter and

  6. Regional aortic distensibility and its relationship with age and aortic stenosis: a computed tomography study.

    PubMed

    Wong, Dennis T L; Narayan, Om; Leong, Darryl P; Bertaso, Angela G; Maia, Murilo G; Ko, Brian S H; Baillie, Timothy; Seneviratne, Sujith K; Worthley, Matthew I; Meredith, Ian T; Cameron, James D

    2015-06-01

    Aortic distensibility (AD) decreases with age and increased aortic stiffness is independently associated with adverse cardiovascular outcomes. The association of severe aortic stenosis (AS) with AD in different aortic regions has not been evaluated. Elderly subjects with severe AS and a cohort of patients without AS of similar age were studied. Proximal aortic cross-sectional-area changes during the cardiac cycle were determined using retrospective-ECG-gating on 128-detector row computed-tomography. Using oscillometric-brachial-blood-pressure measurements, the AD at the ascending-aorta (AA), proximal-descending-aorta (PDA) and distal-descending-aorta (DDA) was determined. Linear mixed effects modelling was used to determine the association of age and aortic stenosis on regional AD. 102 patients were evaluated: 36 AS patients (70-85 years), 24 AS patients (>85 years) and 42 patients without AS (9 patients <50 years, 20 patients between 51-70 years and 13 patients 70-85 years). When comparing patients 70-85 years, AA distensibility was significantly lower in those with AS compared to those without AS (0.9 ± 0.9 vs. 1.4 ± 1.1, P = 0.03) while there was no difference in the PDA (1.0 ± 1.1 vs. 1.0 ± 1.2, P = 0.26) and DDA (1.1 ± 1.2 vs. 1.2 ± 0.8, P = 0.97). In patients without AS, AD decreased with age in all aortic regions (P < 0.001). The AA in patients <50 years were the most distensible compared to other aortic regions. There is regional variation in aortic distensibility with aging. Patients with aortic stenosis demonstrated regional differences in aortic distensibility with lower distensibility demonstrated in the proximal ascending aorta compared to an age-matched cohort.

  7. Spectral analysis of femoral artery blood flow waveforms of conscious domestic cats.

    PubMed

    dos Reis, Gisele F M; Nogueira, Rodrigo B; Silva, Adriana C; Oberlender, Guilherme; Muzzi, Ruthnéa A L; Mantovani, Matheus M

    2014-12-01

    The qualitative and quantitative aspects of femoral artery blood flow waveform spectra were evaluated in 15 male and 15 female Persian and mixed breed domestic cats (Felis catus), which were healthy and not sedated, using duplex Doppler ultrasonography (DDU). Spectral Doppler demonstrated a biphasic characteristic in 16 (53.34%) of the animals evaluated, and a triphasic characteristic in the 14 (46.66%) remaining animals. The systolic blood pressure and heart rate values were within the normal range for the species. The quantitative parameters evaluated, based on the spectral Doppler, were as follows: systolic velocity peak (SVP), recent diastolic velocity peak (RDVP), end diastolic velocity peak (EDVP), mean velocity (MV), integral velocity time (ITV), artery diameter (AD), femoral flow volume (FFV), pulsatility index (PI), resistive index (RI), systolic peak acceleration time (AT) and deceleration time (DT). The respective mean values were: 36.41 ± 7.33 cm/s, 4.69 ± 0.90 cm/s, 10.74 ± 2.74 cm/s, 23.06 ± 4.86 cm/s, 3.91 ± 1.05 cm, 0.17 ± 0.04 cm, 0.11 ± 0.08 cm(3), 3.85 ± 0.19, 1.40 ± 0.20, 39.84 ± 7.38 ms, and 114.0 ± 22.15 ms. No significant differences were found between males and females. The analyses carried out on the femoral artery flow spectrum obtained by DDU showed that it is easy to use and highly tolerated in non-sedated, healthy cats. It appears that DDU may be a useful diagnostic technique, but further studies are needed to evaluate how it compares with invasive telemetric methodology or high-definition oscillometric waveform analytic techniques. © ISFM and AAFP 2014.

  8. Relationship between psychosocial stress and hypertension among Ghanaians in Amsterdam, the Netherlands--the GHAIA study.

    PubMed

    Agyei, Bernard; Nicolaou, Mary; Boateng, Linda; Dijkshoorn, Henriette; van den Born, Bert-Jan; Agyemang, Charles

    2014-07-07

    Hypertension is highly prevalent among recent sub-Saharan African (SSA) migrants in western countries and some tend to associate their hypertension to psychosocial stress. However data on the relationship between hypertension and psychosocial stress among SSA migrants are rare. We assessed the relationship between psychosocial stress and hypertension among the largest SSA migrant population (Ghanaians) in Amsterdam, the Netherlands. Data were obtained from structured interviews along with medical examination among 212 participants from a cross-sectional study: the GHAIA study in 2010 in Amsterdam. Blood pressure was measured with a validated Oscillometric automated digital blood pressure device. Psychosocial stress was assessed by questionnaires on perceived discrimination, depressive symptoms and financial problems. Binary logistic regression was used to study associations between psychosocial stress and hypertension. The overall prevalence of hypertension was 54.7%. About two thirds of the study population experienced a moderate (31%) or high (36%) level of discrimination. 20.0% of the participants had mild depressive symptoms, whilst 9% had moderate depressive symptoms. The prevalence of financial stress was 34.8%. The psychosocial stresses we assessed were not significantly associated with hypertension: adjusted odds ratios comparing those with low levels and those with high levels were 0.99 (95% CI, 0.47-2.08) for perceived discrimination, 0.81 (95% CI, 0.26-2.49) for depressive symptoms and 0.71 (95% CI, 0.37-1.36) for financial stress, respectively. We did not find evidence for the association between psychosocial stress and hypertension among recent SSA migrants. More efforts are needed to unravel other potential factors that may underlie the high prevalence of hypertension among these populations.

  9. Effect of acute high-intensity resistance exercise on optic nerve sheath diameter and ophthalmic artery blood flow pulsatility.

    PubMed

    Lefferts, W K; Hughes, W E; Heffernan, K S

    2015-12-01

    Exertional hypertension associated with acute high-intensity resistance exercise (RE) increases both intravascular and intracranial pressure (ICP), maintaining cerebrovascular transmural pressure. Carotid intravascular pressure pulsatility remains elevated after RE. Whether ICP also remains elevated after acute RE in an attempt to maintain the vessel wall transmural pressure is unknown. Optic nerve sheath diameter (ONSD), a valid proxy of ICP, was measured in 20 participants (6 female; 24 ± 4 yr, 24.2 ± 3.9 kg m(-)(2)) at rest (baseline), following a time-control condition, and following RE (5 sets, 5 repetition maximum bench press, 5 sets 10 repetition maximum biceps curls) using ultrasound. Additionally, intracranial hemodynamic pulsatility index (PI) was assessed in the ophthalmic artery (OA) by using Doppler. Aortic pulse wave velocity (PWV) was obtained from synthesized aortic pressure waveforms obtained via a brachial oscillometric cuff and carotid pulse pressure was measured by using applanation tonometry. Aortic PWV (5.2 ± 0.5-6.0 ± 0.7 m s(-1), P < 0.05) and carotid pulse pressure (45 ± 17-59 ± 19 mm Hg, P < 0.05) were significantly elevated post RE compared with baseline. There were no significant changes in ONSD (5.09 ± 0.7-5.09 ± 0.7 mm, P > 0.05) or OA flow PI (1.35 ± 0.2-1.38 ± 0.3, P > 0.05) following acute RE. In conclusion, during recovery from acute high-intensity RE, there are increases in aortic stiffness and extracranial pressure pulsatility in the absence of changes in ICP and flow pulsatility. These findings may have implications for alterations in cerebral transmural pressure and cerebral aneurysmal wall stress following RE.

  10. Neurovascular Response during Exercise and Mental Stress in Anabolic Steroid Users.

    PubMed

    Porello, Rafael Armani; Dos Santos, Marcelo Rodrigues; DE Souza, Francis Ribeiro; DA Fonseca, Guilherme Wesley Peixoto; Sayegh, Ana Luiza Carrari; DE Oliveira, Tiago Franco; Akiho, César Abreu; Yonamine, Maurício; Pereira, Rosa Maria Rodrigues; Negrão, Carlos Eduardo; Alves, Maria-Janieire DE Nazaré Nunes

    2018-03-01

    Increased resting muscle sympathetic nerve activity (MSNA) and lower forearm blood flow (FBF) were observed in young men who use anabolic androgenic steroids (AAS). However, the response of MSNA and FBF in AAS users triggered by muscle mechanoreflex and central command has never been tested. In addition, we evaluated the blood pressure (BP) and heart rate (HR) responses during these maneuvers. Nineteen AAS users (AASU) 31 ± 6 yr of age and 18 AAS nonusers (AASNU) 29 ± 4 yr of age were recruited. All participants were involved in strength training. AAS use was determined using a urine test (liquid chromatography with tandem mass spectrometry). MSNA was measured using the microneurography technique. FBF was measured by using venous occlusion plethysmography. BP was measured using an automatic oscillometric device. HR was recorded continuously through ECG. Isometric handgrip exercise was performed at 30% of the maximal voluntary contraction for 3 min, and mental stress was elicited by the Stroop color-word test for 4 min. The MSNA and FBF responses during exercise were similar between AASU and AASNU, with a trend toward higher MSNA (bursts per minute; P = 0.084) and lower forearm vascular conductance (FVC; units; P = 0.084) in AASU than in AASNU. During mental stress, AASU showed a significantly higher MSNA (P < 0.05) and lower FBF (P < 0.05) compared with AASNU. During both maneuvers, HR and BP increased linearly in both groups; however, AASU showed a significantly higher HR compared with AASNU. During muscle mechanoreflex activation (isometric exercise), AASU have normal MSNA and FBF responses, whereas during central command (mental stress) stimulation, AASU have exacerbated MSNA and blunted vasodilation. Therefore, mental stress seems to exacerbate neurovascular control throughout stress reaction situations in AASU.

  11. The Effect of Revascularization on the Hemodynamic Profile of Patients with Infrarenal Aortic Occlusion.

    PubMed

    Argyriou, Christos; Georgakarakos, Efstratios; Georgiadis, George S; Schoretsanitis, Nikolaos; Lazarides, Miltos K

    2017-08-01

    Patients undergoing revascularization for infrarenal aortic occlusion (IAO) have been reported to present improved survival rates compared to those treated conservatively. Aim of this study was to investigate the hemodynamic changes induced after revascularization for IAO, as expressed with pulse wave velocity (PWV), augmentation index (Aix), augmentation pressure (AP), and pulse wave reflection coefficient (RC). Twelve patients underwent revascularization (9 aortobifemoral/aortobiiliac bypasses, 2 primary iliac stenting, and 1 hybrid procedure of unilateral aortoiliac stenting and crossover bypass). Calculation of hemodynamic parameters was performed in all patients preoperatively, at 1 month, and 1 year postoperatively. Pulse wave analysis was performed noninvasively with a novel validated brachial cuff-based automatic oscillometric device (Mobil-O-Graph; IEM, Stolberg, Germany). The estimated hemodynamic parameters were AIx, AP, RC, and PWV. Data were analyzed with the Friedman analysis of variance test. Aix decreased significantly at 1 month and further at 1 year postoperatively compared to preoperative values (24 ± 11 and 17 ± 13 vs. 34 ± 13.5, respectively, P = 0.0006). AP decreased at 1 month and 1 year postoperatively compared to preoperative values (6.5 ± 4 mm Hg and 8 ± 6.5 mm Hg vs. 13 ± 12 mm Hg, respectively, P = 0.045). RC decreased also at 1-month and 1-year postoperatively compared to preoperative values (62 ± 5.5, 64 ± 4.3 vs. 73 ± 5.1, respectively, P = 0.002). However, changes in PWV were less prominent in this short-term postoperative period. Improved hemodynamic profile may theoretically contribute to the enhanced survival rates of these patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. [Pulse wave velocity as an early marker of diastolic heart failure in patients with hypertension].

    PubMed

    Moczulska, Beata; Kubiak, Monika; Bryczkowska, Anna; Malinowska, Ewa

    2017-04-21

    According to the WHO, hypertension is one of the major causes of death worldwide. It leads to a number of severe complications. Diastolic heart failure, that is heart failure with preserved ejection fraction (HFPEF), is especially common. New, but simple, indices for the early detection of patients who have not yet developed complications or are in their early developmental stages are still searched for. The aim of this study is to examine the correlation between pulse wave velocity (PWV) and markers of diastolic heart failure (DHF) assessed in echocardiography in patients with hypertension and no symptoms of heart failure. The study was comprised of 65 patients with treated hypertension. Patients with symptoms of heart failure, those with diabetes and smokers were excluded. Arterial stiffness was measured with the Mobil-O-Graph NG PWA. Pulse wave velocity (PWV) was estimated. The following markers of diastolic heart failure were assessed in the echocardiographic examination: E/A ratio - the ratio of the early (E) to late (A) ventricular filling velocities, DT - decceleration time, E/E' - the ratio of mitral peak velocity of early filling (E) to early diastolic mitral annular velocity E' in tissue Doppler echocardiography. PWV was statistically significantly higher in the DHF group. In the group of patients with heart failure, the average E/A ratio was significantly lower as compared to the group with no heart failure. Oscillometric measurement of pulse wave velocity is non-invasive, lasts a few minutes and does not require the presence of a specialist. It allows for an early detection of patients at risk of diastolic heart failure even within the conditions of primary health care.

  13. Frequency of early vascular aging and associated risk factors among an adult population in Latin America: the OPTIMO study.

    PubMed

    Botto, Fernando; Obregon, Sebastian; Rubinstein, Fernando; Scuteri, Angelo; Nilsson, Peter M; Kotliar, Carol

    2018-03-01

    The main objective was to estimate the frequency of early vascular aging (EVA) in a sample of subjects from Latin America, with emphasis in young adults. We included 1416 subjects from 12 countries in Latin America who provided information about lifestyle, cardiovascular risk factors (CVRF), and anthropometrics. We measured pulse wave velocity (PWV) as a marker of arterial stiffness, and blood pressure (BP) using an oscillometric device (Mobil-O-Graph). To determine the frequency of EVA, we used multiple linear regression to estimate each subject's PWV expected for his/her age and systolic BP, and compared with observed values to obtain standardized residuals (z-scores). We defined EVA when z-score was ≥1.96. Finally, a multivariable logistic regression analysis was performed to determine baseline characteristics associated with EVA. Mean age was 49.9 ± 15.5 years, male gender was 50.3%. Mean PWV was 7.52 m/s (SD 1.97), mean systolic BP was 125.3 mmHg (SD 16.7) and mean diastolic BP was 78.9 mmHg (SD 12.2). The frequency of EVA was 5.7% in the total population, 9.8% in adults of 40 years or less and 18.7% in those 30 years or less. In these young adults, multiple logistic regression analyses demonstrated that dyslipidemia and hypertension showed an independent association with EVA, and smoking a borderline association (p  =  0.07). In conclusion, the frequency of EVA in a sample from Latin America was around 6%, with higher rates in young adults. These results would support the search of CVRF and EVA during early adulthood.

  14. Differences in blood pressure by body position (supine, Fowler's, and sitting) in hypertensive subjects.

    PubMed

    Cicolini, Giancarlo; Pizzi, Carmine; Palma, Elisabetta; Bucci, Marco; Schioppa, Francesco; Mezzetti, Andrea; Manzoli, Lamberto

    2011-10-01

    Although blood pressure (BP) differences from supine to sitting position have long been recognized, limited data are available on other commonly used body positions. We performed a cross-sectional study to compare BP values obtained in supine, sitting, and Fowler's positions in essential hypertensive subjects. Systolic BP (SBP) and diastolic BP (DBP) were recorded using an automatic oscillometric device. Nine measurements were taken: three measurements, in random order, in supine, Fowler's, and sitting position. Two generalized estimating equations models were used to evaluate potential predictors of SBP and DBP adjusting for heart rate and measurement order. The sample consisted of 250 subjects (mean age 66.3 ± 13.4 years; 44.4% males). Measured in supine, Fowler's, and sitting position, mean SBPs were 139.3 ± 14.0; 138.1 ± 13.8; 137.2 ± 13.7 mm Hg, respectively, and mean DBPs 80.1 ± 9.1; 81.9 ± 9.4; 83.0 ± 9.6 mm Hg, respectively. At multivariate analysis, mean SBP significantly decreased if measured in Fowler's and sitting positions, as compared to supine. In contrast, DBP significantly increased. A relevant proportion of subjects showed large differences (≤ or ≥10 mm Hg) in mean SBP across positions: i.e., 30.0% comparing supine vs. sitting SBP. An even higher prevalence of large differences was observed according to the measurement order within the same positions, with no univocal direction (random variation). Fowler's position may represent a valid alternative to sitting and supine positions for BP measurement in clinical practice. BP random variability was found to be large regardless of body position, reinforcing the need for operators to closely follow current guidelines that recommend ≥2 recordings at each measurement.

  15. Reference values and associated factors for Japanese newborns' blood pressure and pulse rate: the babies' and their parents' longitudinal observation in Suzuki Memorial Hospital on intrauterine period (BOSHI) study.

    PubMed

    Satoh, Michihiro; Inoue, Ryusuke; Tada, Hideko; Hosaka, Miki; Metoki, Hirohito; Asayama, Kei; Murakami, Takahisa; Mano, Nariyasu; Ohkubo, Takayoshi; Yagihashi, Katsuyo; Hoshi, Kazuhiko; Suzuki, Masakuni; Imai, Yutaka

    2016-08-01

    Currently, normative means and ranges of blood pressure (BP) and pulse rates in Japanese newborns are not available. The objective of the present study was to estimate BP, pulse rate, and their distribution among Japanese newborns. Using oscillometric devices, arm or calf BP and pulse rate levels were obtained from 3148 infants born between 2007 and 2014, consecutively at Suzuki Memorial Hospital, Iwanuma, Japan. Of those, data from 2628 full-term, singleton newborns with BP measured on day 3 after birth were analyzed. Arm SBP/DBP and pulse rate in the reference group (n = 2628) were 70.5 ± 7.4/44.3 ± 6.7 mmHg and 117.3 ± 16.6 bpm, respectively. The 5-95th percentiles were 58-83 mmHg for SBP, 35-57 mmHg for DBP, and 91-145 bpm for pulse rate. Similar values were obtained from calf measurements. In multiple regression analysis, birth weight and spontaneous cephalic delivery were positively and light/deep sleep was inversely associated with higher arm SBP/DBP (P ≤ 0.04), whereas sex, Apgar score, gestational age, and mother's age did not significantly affect BP levels (P ≥ 0.06). Male sex, gestational age, spontaneous cephalic delivery, and light/deep sleep were inversely associated with higher pulse rate (P ≤ 0.02). The present study is the first to show the distributions of Asian newborns' BP levels and pulse rate. The assessment of newborns' BP levels and pulse rate should consider birth weight, gestational age after birth, and actual condition at BP measurement.

  16. Cardiovascular System during the Post Partum State in Women with a History of Preeclampsia

    PubMed Central

    Evans, Caroline S.; Gooch, Linda; Flotta, Deborah; Lykins, David; Powers, Robert W.; Landsittel, Douglas; Roberts, James M.; Shroff, Sanjeev G.

    2011-01-01

    Hypothesis In subjects with previous preeclampsia, differences in cardiovascular and/or blood biochemical parameters are present in the non-pregnant state and that a simultaneous assessment of multiple derived indices better differentiates between women with or without prior preeclampsia. We examined 18 prior preeclamptic and 50 prior uncomplicated pregnancies, ~16 months post partum. Cardiovascular assessment included: (1) systemic hemodynamics and mechanics (Doppler echocardiography, tonometry, oscillometric sphygmomanometry) (2) endothelial function (plethysmography) (3) left ventricular properties (echocardiography), and (4) blood biochemical analyses. Compared to women with prior uncomplicated pregnancies, prior preeclamptics had higher mean (80±1 vs. 86±3 mmHg, P=0.04) and diastolic (64±1 vs. 68±2 mmHg; P=0.04) pressures and total vascular resistance (1562±37 vs. 1784±114 dyne•s/cm5; P=0.03). Systolic blood pressure, arterial compliance, and left ventricular properties were not different. While heart-to-femoral pulse wave velocity was not different, heart-to-brachial pulse wave velocity tended to be faster in prior preeclamptics (374±8 vs. 404±20 cm/s; P=0.06). Stress-induced increase in forearm blood flow was less in prior preeclamptics (245±21% vs. 136±22%; P=0.01), indicating impaired endothelial function. No significant differences were observed in markers of endothelial activation, dyslipidemia, or oxidative stress; prior preeclamptics tended to have higher glucose level (58.7±1.9 vs. 95±5.2 mg/dl; P=0.06). Logistic regression analysis indicated that a simultaneous evaluation of multiple derived indices better discriminated between the two groups. The differences in the prior preeclamptic group are in directions known to be associated with greater cardiovascular disease risk later in life. PMID:21606389

  17. A Western dietary pattern is associated with higher blood pressure in Iranian adolescents.

    PubMed

    Hojhabrimanesh, Abdollah; Akhlaghi, Masoumeh; Rahmani, Elham; Amanat, Sasan; Atefi, Masoumeh; Najafi, Maryam; Hashemzadeh, Maral; Salehi, Saedeh; Faghih, Shiva

    2017-02-01

    The dietary determinants of adolescent blood pressure (BP) are not well understood. We determined the association between major dietary patterns and BP in a sample of Iranian adolescents. This cross-sectional study was conducted among a representative sample (n = 557) of Shirazi adolescents aged 12-19 years. Participants' systolic and diastolic BP was measured using a validated oscillometric BP monitor. Usual dietary intakes during the past 12 months were assessed using a valid and reproducible 168-item semiquantitative food frequency questionnaire through face-to-face interviews. Principal component factor analysis was used to identify major dietary patterns based on a set of 25 predefined food groups. Overall, three major dietary patterns were identified, among which only the Western pattern (abundant in soft drinks, sweets and desserts, salt, mayonnaise, tea and coffee, salty snacks, high-fat dairy products, French fries, and red or processed meats) had a significant association with BP. After adjusting for potential confounders in the analysis of covariance models, multivariable adjusted means of the systolic and mean BP of subjects in the highest tertile of the Western pattern score were significantly higher than those in the lowest tertile (for systolic BP: mean difference 6.9 mmHg, P = 0.001; and for mean BP: mean difference 4.2 mmHg, P = 0.003). A similar but statistically insignificant difference was observed in terms of diastolic BP. The findings suggest that a Western dietary pattern is associated with higher BP in Iranian adolescents. However, additional large-scale prospective studies with adequate methodological quality are required to confirm these findings.

  18. Between-visit reproducibility of inter-arm systolic blood pressure differences in treated hypertensive patients: the coconet study.

    PubMed

    Kim, Jang Young; Kim, Eung Ju; Namgung, June; Cho, Byung-Ryul; Nam, Chang-Wook; Kim, Young-Kwon; Park, Jeong Bae

    2017-05-01

    Inter-arm systolic blood pressure (BP) differences (sIADs) have recently been recognized as a risk factor for cardiovascular mortality. However, sIAD reproducibility remains unresolved from a controlled trial perspective. We evaluated the between-visit reproducibility of sIADs in hypertensive patients. We examined 1875 hypertensive participants aged 20 years and older (mean age: 62.3 years, 45.4% female) from nine primary clinics and 27 secondary and tertiary hospitals. The BPs in both arms were automatically and simultaneously measured in triplicate with a cuff-oscillometric BP device. BP measurements were obtained at baseline and at 3-month follow-up time points. Increased sIAD was defined as an absolute difference of ⩾10 mm Hg in the average systolic BPs between the left and right arms. The overall mean sIAD was 4.33±4.17 mm Hg. The prevalences of increased sIAD at baseline and at the 3-month measurements were 7.6% and 7.1%, respectively. The intraclass correlation coefficient for the between-visit sIADs was 0.304 (95% confidence interval (CI) 0.262-0.344). The κ-value between the baseline and follow-up increased sIADs was 0.165 (95% CI 0.096-0.234). The percentage of patients who exhibited an increased sIAD at 3 months compared with the initially increased sIAD at baseline was 21.8%. The reproducibility of sIAD determination between baseline and the 3-month follow-up measurements lacked agreement in the hypertensive patients. Further studies should identify the relevant variables and characteristics of this poor reproducibility (CRIS number; KCT0001235).

  19. Significant interarm blood pressure difference predicts cardiovascular risk in hypertensive patients: CoCoNet study.

    PubMed

    Kim, Su-A; Kim, Jang Young; Park, Jeong Bae

    2016-06-01

    There has been a rising interest in interarm blood pressure difference (IAD), due to its relationship with peripheral arterial disease and its possible relationship with cardiovascular disease. This study aimed to characterize hypertensive patients with a significant IAD in relation to cardiovascular risk. A total of 3699 patients (mean age, 61 ± 11 years) were prospectively enrolled in the study. Blood pressure (BP) was measured simultaneously in both arms 3 times using an automated cuff-oscillometric device. IAD was defined as the absolute difference in averaged BPs between the left and right arm, and an IAD ≥ 10 mm Hg was considered to be significant. The Framingham risk score was used to calculate the 10-year cardiovascular risk. The mean systolic IAD (sIAD) was 4.3 ± 4.1 mm Hg, and 285 (7.7%) patients showed significant sIAD. Patients with significant sIAD showed larger body mass index (P < 0.001), greater systolic BP (P = 0.050), more coronary artery disease (relative risk = 1.356, P = 0.034), and more cerebrovascular disease (relative risk = 1.521, P = 0.072). The mean 10-year cardiovascular risk was 9.3 ± 7.7%. By multiple regression, sIAD was significantly but weakly correlated with the 10-year cardiovascular risk (β = 0.135, P = 0.008). Patients with significant sIAD showed a higher prevalence of coronary artery disease, as well as an increase in 10-year cardiovascular risk. Therefore, accurate measurements of sIAD may serve as a simple and cost-effective tool for predicting cardiovascular risk in clinical settings.

  20. Significant interarm blood pressure difference predicts cardiovascular risk in hypertensive patients

    PubMed Central

    Kim, Su-A; Kim, Jang Young; Park, Jeong Bae

    2016-01-01

    Abstract There has been a rising interest in interarm blood pressure difference (IAD), due to its relationship with peripheral arterial disease and its possible relationship with cardiovascular disease. This study aimed to characterize hypertensive patients with a significant IAD in relation to cardiovascular risk. A total of 3699 patients (mean age, 61 ± 11 years) were prospectively enrolled in the study. Blood pressure (BP) was measured simultaneously in both arms 3 times using an automated cuff-oscillometric device. IAD was defined as the absolute difference in averaged BPs between the left and right arm, and an IAD ≥ 10 mm Hg was considered to be significant. The Framingham risk score was used to calculate the 10-year cardiovascular risk. The mean systolic IAD (sIAD) was 4.3 ± 4.1 mm Hg, and 285 (7.7%) patients showed significant sIAD. Patients with significant sIAD showed larger body mass index (P < 0.001), greater systolic BP (P = 0.050), more coronary artery disease (relative risk = 1.356, P = 0.034), and more cerebrovascular disease (relative risk = 1.521, P = 0.072). The mean 10-year cardiovascular risk was 9.3 ± 7.7%. By multiple regression, sIAD was significantly but weakly correlated with the 10-year cardiovascular risk (β = 0.135, P = 0.008). Patients with significant sIAD showed a higher prevalence of coronary artery disease, as well as an increase in 10-year cardiovascular risk. Therefore, accurate measurements of sIAD may serve as a simple and cost-effective tool for predicting cardiovascular risk in clinical settings. PMID:27310982

  1. Validation of the A&D UM-211 device for office blood pressure measurement according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Fania, Claudio; Albertini, Federica; Palatini, Paolo

    2017-10-01

    The aim of this study was to define the accuracy of UM-211, an automated oscillometric device for office use coupled to several cuffs for different arm sizes, according to the International Protocol of the European Society of Hypertension. The validation was performed in 33 individuals. Their mean age was 59.6±12.9 years, systolic blood pressure (BP) was 144.3±21.5 mmHg (range: 96-184 mmHg), diastolic BP was 86.8±18.5 mmHg (range: 48-124 mmHg), and arm circumference was 30.2±4.3 cm (range: 23-39 cm). Four sequential readings were taken by observers 1 and 2 using a double-headed stethoscope and a mercury sphygmomanometer, whereas three BP readings were taken by the supervisor using the test instrument. The differences between the readings provided by the device and the mean observer measurements were calculated. Therefore, each device measurement was compared with the previous and the next mean observer measurement. The validation results fulfilled all the 2010 European Society of Hypertension revision Protocol criteria for the general population and passed all validation grades. On average, the device overestimated systolic BP by 1.7±2.4 mmHg and diastolic BP by 1.7±2.5 mmHg. These data show that the UM-211 device coupled to several cuffs for different ranges of arm circumference met the requirements for validation according to the International Protocol and can be recommended for clinical use in the adult population. However, these results mainly apply to the use of the 22-32 and the 31-45 cm cuffs.

  2. Validation of the AVITA BPM63S upper arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Kang, Yuan-Yuan; Zeng, Wei-Fang; Liu, Ming; Li, Yan; Wang, Ji-Guang

    2014-02-01

    The present study aimed to evaluate the accuracy of the AVITA BPM63S upper arm blood pressure monitor for home blood pressure monitoring according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic blood pressures were sequentially measured in 33 adult Chinese (14 women, mean age of 47 years) using a mercury sphygmomanometer (two observers) and the AVITA BPM63S device (one supervisor). Ninety-nine pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. All the blood pressure requirements were fulfilled. The AVITA BPM63S device achieved the targets in part 1 of the validation study. The number of absolute differences between device and observers within 5, 10, and 15 mmHg was 68/99, 89/99, and 96/99, respectively, for systolic blood pressure, and 75/99, 95/99, and 97/99, respectively, for diastolic blood pressure. The device also achieved the criteria in part 2 of the validation study. Twenty-four and 25 participants for systolic and diastolic blood pressure, respectively, had at least two of the three device-observers differences within 5 mmHg (required ≥24). One and two participants for systolic and diastolic blood pressure, respectively, had all three device-observers differences greater than 5 mmHg. The AVITA BPM63S automated oscillometric upper arm blood pressure monitor has passed the requirements of the International Protocol revision 2010, and hence can be recommended for blood pressure measurement at home in adults.

  3. An ultrasound look at Korotkoff sounds: the role of pulse wave velocity and flow turbulence.

    PubMed

    Benmira, Amir; Perez-Martin, Antonia; Schuster, Iris; Veye, Florent; Triboulet, Jean; Berron, Nicolas; Aichoun, Isabelle; Coudray, Sarah; Laurent, Jérémy; Bereksi-Reguig, Fethi; Dauzat, Michel

    2017-04-01

    The aim of this study was to analyze the temporal relationships between pressure, flow, and Korotkoff sounds, providing clues for their comprehensive interpretation. When measuring blood pressure in a group of 23 volunteers, we used duplex Doppler ultrasonography to assess, under the arm-cuff, the brachial artery flow, diameter changes, and local pulse wave velocity (PWV), while recording Korotkoff sounds 10 cm downstream together with cuff pressure and ECG. The systolic (SBP) and diastolic (DBP) blood pressures were 118.8±17.7 and 65.4±10.4 mmHg, respectively (n=23). The brachial artery lumen started opening when cuff pressure decreased below the SBP and opened for an increasing length of time until cuff pressure reached the DBP, and then remained open but pulsatile. A high-energy low-frequency Doppler signal, starting a few milliseconds before flow, appeared and disappeared together with Korotkoff sounds at the SBP and DBP, respectively. Its median duration was 42.7 versus 41.1 ms for Korotkoff sounds (P=0.54; n=17). There was a 2.20±1.54 ms/mmHg decrement in the time delay between the ECG R-wave and the Korotkoff sounds during cuff deflation (n=18). The PWV was 10±4.48 m/s at null cuff pressure and showed a 0.62% decrement per mmHg when cuff pressure increased (n=13). Korotkoff sounds are associated with a high-energy low-frequency Doppler signal of identical duration, typically resulting from wall vibrations, followed by flow turbulence. Local arterial PWV decreases when cuff pressure increases. Exploiting these changes may help improve SBP assessment, which remains a challenge for oscillometric techniques.

  4. Single-dose pharmacokinetics and cardiovascular effects of oral pimobendan in healthy cats.

    PubMed

    Yata, M; McLachlan, A J; Foster, D J R; Hanzlicek, A S; Beijerink, N J

    2016-12-01

    To investigate the pharmacokinetics and pharmacodynamics of oral pimobendan in conscious, healthy cats. Eight healthy adult cats. A randomised, single-blinded, crossover design was used. Two oral doses of pimobendan (0.625-mg [LD], 1.25-mg [HD]) and a control substance (3-mL water) were administered to each cat. Blood collection, echocardiography, and oscillometric blood pressure measurements were performed repeatedly for 12 h following each dose. Plasma concentrations of pimobendan and the active metabolite, O-desmethylpimobendan (ODMP), were quantified using ultra-high-performance liquid chromatography tandem mass spectrometry. Cardiovascular parameters were evaluated for between- and within-treatment effects over time using linear mixed modelling. Pimobendan was rapidly absorbed and converted to ODMP with the pimobendan AUC 0-∞ greater than ODMP AUC 0-∞ (ODMP:pimobendan AUC 0-∞ ratio 0.6 [LD] and 0.5 [HD]) despite a longer elimination half-life of ODMP (pimobendan t 1/2 0.8 h vs. ODMP t 1/2 1.6 h [LD]; pimobendan t 1/2 0.7 h vs. ODMP t 1/2 1.3 h [HD]). Averaged across all time points, pimobendan increased several measures of systolic function; however, its effect could not be further characterised. Although treatment was well-tolerated, two cats vomited following HD and another had a ventricular premature beat recorded following LD. The lower ODMP:pimobendan AUC 0-∞ ratio compared to that observed previously in dogs suggests reduced metabolism in cats. Treatment effects were observed in measures of systolic function; however, the duration of action and differences in effects between the two pimobendan doses could not be characterised. Further studies are required to evaluate pimobendan in feline cardiovascular medicine. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Effect of mechanical behaviour of the brachial artery on blood pressure measurement during both cuff inflation and cuff deflation.

    PubMed

    Zheng, Dingchang; Pan, Fan; Murray, Alan

    2013-10-01

    The aim of this study was to investigate the effect of different mechanical behaviour of the brachial artery on blood pressure (BP) measurements during cuff inflation and deflation. BP measurements were taken from each of 40 participants, with three repeat sessions under three randomized cuff deflation/inflation conditions. Cuff pressure was linearly deflated and inflated at a standard rate of 2-3 mmHg/s and also linearly inflated at a fast rate of 5-6 mmHg/s. Manual auscultatory systolic and diastolic BPs, and pulse pressure (SBP, DBP, PP) were measured. Automated BPs were determined from digitally recorded cuff pressures by fitting a polynomial model to the oscillometric pulse amplitudes. The BPs from cuff deflation and inflation were then compared. Repeatable measurements between sessions and between the sequential order of inflation/deflation conditions (all P > 0.1) indicated stability of arterial mechanical behaviour with repeat measurements. Comparing BPs obtained by standard inflation with those from standard deflation, manual SBP was 2.6 mmHg lower (P < 0.01), manual DBP was 1.5 mmHg higher (P < 0.01), manual PP was 4.2 mmHg lower (P < 0.001), automated DBP was 6.7 mmHg higher (P < 0.001) and automatic PP was 7.5 mmHg lower (P < 0.001). There was no statistically significant difference for any automated BPs between fast and standard cuff inflation. The statistically significant BP differences between inflation and deflation suggest different arterial mechanical behaviour between arterial opening and closing during BP measurement. We have shown that the mechanical behaviour of the brachial artery during BP measurement differs between cuff deflation and cuff inflation.

  6. Validation of the A&D UA-1020 upper-arm blood pressure monitor for home blood pressure monitoring according to the British Hypertension Society Protocol.

    PubMed

    Zeng, Wei-Fang; Kang, Yuan-Yuan; Liu, Ming; Li, Yan; Wang, Ji-Guang

    2013-06-01

    The present study aimed to evaluate the accuracy of the automated oscillometric upper-arm blood pressure (BP) monitor A&D UA-1020 with two different-shaped cuffs for home BP monitoring according to the British Hypertension Society (BHS) Protocol. We recruited individuals for each of the two cuffs (D-ring and cylindrical) until there were 85 eligible participants (255 pairs of comparisons) and their BP could meet the BP distribution requirements specified by the BHS Protocol. For each participant, we sequentially measured the systolic and diastolic BP using a mercury sphygmomanometer (two observers) and the UA-1020 device (one supervisor). For the D-ring cuff, the device achieved grade A. The percentage of BP differences within 5, 10, and 15 mmHg was 67, 87, and 96%, respectively, for systolic BP, and 70, 90, and 99%, respectively, for diastolic BP. The average (±SD) of the device-observer differences was -0.2±7.3 mmHg (P=0.64) and 1.7±5.8 mmHg (P<0.0001) for systolic and diastolic BP, respectively. For the cylindrical cuff, the device also achieved grade A. The percentage of BP differences within 5, 10, and 15 mmHg was 67, 88, and 97%, respectively, for systolic BP and 64, 89, and 98%, respectively, for diastolic BP. The average of the device-observer differences was -0.1±7.0 mmHg (P=0.89) and 2.0±6.3 mmHg (P<0.0001) for systolic and diastolic BP, respectively. The UA-1020 device has passed the requirements of the BHS Protocol with both the D-ring and the cylindrical cuffs, and hence can be recommended for home use in adults.

  7. Validation of the Konsung QD217A for clinical use and self-measurement according to the European Society of Hypertension International Protocol.

    PubMed

    Wu, Ning; Zhang, Xuezhong; Wang, Wen; Zhang, Hongye

    2015-08-01

    This study aimed to evaluate the accuracy of the automated oscillometric upper arm blood pressure (BP) monitor Konsung QD217A for home BP monitoring according to the European Society of Hypertension International Protocol revision 2010. Three trained observers validated the performance of these devices by comparing the measurements obtained from these devices with those taken using a standard mercury sphygmomanometer. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were sequentially measured in 33 participants using a standard mercury sphygmomanometer and the Konsung QD217A device. A total of 99 pairs of comparisons were obtained from 33 participants. The QD217A device achieved the targets in part 1 of the validation study. The number of absolute differences between the device and the observers within a range of 5, 10 and 15 mmHg was 70/99, 92/99 and 96/99, respectively, for SBP and 80/99, 94/99 and 99/99, respectively, for DBP. The device also achieved the targets in part 2 of the validation study. A total of 27 and 31 participants for SBP and DBP, respectively, showed at least two of the three device-observers differences within 5 mmHg (required≥24). The number of participants without device-observer difference within 5 mmHg was one for SBP and one for DBP (required≤3). The Konsung upper arm BP monitor QD217A has passed the International Protocol requirements and it can be recommended for clinical use and self-measurement in adults. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

  8. Validation of the YuWell YE690A upper-arm blood pressure monitor, for clinic use and self-measurement, according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Chen, Qi; Lei, Lei; Li, Yan; Wang, Ji-Guang

    2017-10-01

    The present study aimed to evaluate the accuracy of the automated oscillometric upper-arm blood pressure monitor YuWell YE690A for blood pressure measurement according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic blood pressures were measured sequentially in 33 adult Chinese (12 women, 44.2 years of mean age) using a mercury sphygmomanometer (two observers) and the YE690A device (one supervisor). A total of 99 pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. All the blood pressure requirements were fulfilled. The YuWell YE690A device achieved the targets in part 1 of the validation study. The number of absolute differences between device and observers within 5, 10, and 15 mmHg was 79/99, 96/99, and 97/99, respectively, for systolic blood pressure and 72/99, 95/99, and 98/99, respectively, for diastolic blood pressure. The device also fulfilled the criteria in part 2 of the validation study. Thirty-one and 25 participants for systolic and diastolic blood pressure, respectively, had at least two of the three device-observer differences within 5 mmHg (required ≥24). No participant for systolic and two participants for diastolic blood pressure had all the three device-observer comparisons greater than 5 mmHg. The YuWell blood pressure monitor YE690A has passed the requirements of the International Protocol revision 2010 and hence can be recommended for blood pressure measurement in adults.

  9. Questionable accuracy of home blood pressure measurements in the obese population - Validation of the Microlife WatchBP O3® and Omron RS6® devices according to the European Society of Hypertension-International Protocol.

    PubMed

    Azaki, Alaa; Diab, Reem; Harb, Aya; Asmar, Roland; Chahine, Mirna N

    2017-01-01

    Two oscillometric devices, the Microlife WatchBP O3 ® and the Omron RS6 ® , designed for self-blood pressure measurement were evaluated according to the European Society of Hypertension (ESH)-International Protocol (IP) Revision 2010 in the obese population. The Microlife WatchBP O3 measures blood pressure (BP) at the brachial level and the Omron RS6 measures BP at the wrist level. The ESH-IP revision 2010 includes a total of 33 subjects. The difference between observers' and device BP values was calculated for each measure. A total of 99 pairs of BP differences were classified into three categories (≤5, ≤10, and ≤15 mmHg). The protocol procedures were followed precisely in each of the two studies. Microlife WatchBP O3 and Omron RS6 failed to fulfill the criteria of the ESH-IP. The mean differences between the device and the mercury readings were: 0.3±7.8 mmHg and -1.9±6.4 mmHg for systolic BP and diastolic BP, respectively, for Microlife WatchBP O3, and 2.7±9.9 mmHg for SBP and 3.5±11.1 mmHg for diastolic BP for Omron RS6. Microlife WatchBP O3 and Omron RS6 readings differing from the mercury standard by more than 5, 10, and 15 mmHg failed to fulfill the ESH-IP revision 2010 requirements in obese subjects. Therefore, the two devices cannot be recommended for use in obese subjects.

  10. Effects of magnesium supplements on blood pressure, endothelial function and metabolic parameters in healthy young men with a family history of metabolic syndrome.

    PubMed

    Cosaro, E; Bonafini, S; Montagnana, M; Danese, E; Trettene, M S; Minuz, P; Delva, P; Fava, C

    2014-11-01

    Magnesium plays an important role in the modulation of vascular tone and endothelial function and can regulate glucose and lipid metabolism. Patients with hypertension, metabolic syndrome (MetS) and diabetes mellitus (T2DM) have low body magnesium content; indeed, magnesium supplementation has been shown to have a positive effect on blood pressure (BP) and gluco-metabolic parameters. The aim of our study was to evaluate the effect of magnesium supplements on hemodynamic and metabolic parameters in healthy men with a positive family history of MetS or T2DM. In a randomized, double-blind, placebo-controlled 8-week crossover trial with a 4 week wash-out period, oral supplements of 8.1 mmol of magnesium-pidolate or placebo were administered twice a day to 14 healthy normomagnesemic participants, aged 23-33 years. The primary endpoint was office BP, measured with a semiautomatic oscillometric device. Secondary endpoints included characteristics of the MetS, namely endothelial function, arterial stiffness and inflammation. Plasma and urinary magnesium were measured in all participants while free intracellular magnesium was measured only in a subsample. There was no significant difference in either systolic and diastolic BP in participants post-magnesium supplementation and post-placebo treatment when compared to baseline BP measurements. Further, the metabolic, inflammatory and hemodynamic parameters did not vary significantly during the study. Our study showed no beneficial effect of magnesium supplements on BP, vascular function and glycolipid profile in young men with a family history of MetS/T2DM (trial registration at clinicaltrial.gov ID: NCT01181830; 12th of Aug 2010). Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Twenty-four-hour central blood pressure is not better associated with hypertensive target organ damage than 24-h peripheral blood pressure.

    PubMed

    de la Sierra, Alejandro; Pareja, Julia; Fernández-Llama, Patricia; Armario, Pedro; Yun, Sergi; Acosta, Eva; Calero, Francesca; Vázquez, Susana; Blanch, Pedro; Sierra, Cristina; Oliveras, Anna

    2017-10-01

    Central blood pressure (BP) is increasingly considered as a better estimator of hypertension associated risks. We aimed to evaluate the association of 24-h central BP, in comparison with 24-h peripheral BP, with the presence of target organ damage (TOD). Cross-sectional study of 208 hypertensive patients, aged 57 ± 12 years, 34% women. Office (mean of 4 measurements) and 24-h central and peripheral BP were measured by the oscillometric Mobil-O-Graph device. TOD was assessed at cardiac (left ventricular hypertrophy by echocardiography), renal (reduction of glomerular filtration rate and/or microalbuminuria), and arterial (increased aortic pulse wave velocity) levels. A total of 107 patients (51.4%) had TOD (77, 35% patients left ventricular hypertrophy; 54, 25.9% renal abnormalities; and 40, 19.2% arterial stiffness). All SBP and pulse BP estimates (office, 24-h, daytime, and night-time) were associated with the presence of TOD, after adjustment for age, sex, and antihypertensive treatment, with higher odds ratios for ambulatory-derived values. Odds ratios for central and peripheral BP were similar for all office, 24-h, daytime, and night-time BP. After simultaneous adjustment, peripheral, but not central, 24-h and night-time SBP and pulse pressures were associated with the presence of TOD. TOD in hypertension is associated with BP elevation, independently of the type of measurement (office or ambulatory, central or peripheral). Central BP, even monitored during 24 h, is not better associated with TOD than peripheral BP. These results do not support a routine measurement of 24-h central BP.

  12. Validation of the SunTech Medical Advantage Model 2 Series Automated Blood Pressure Module in Pregnancy.

    PubMed

    Kuper, Spencer G; Dotson, Kristin N; Anderson, Sarah B; Harris, Stacy L; Harper, Lorie M; Tita, Alan T

    2018-06-15

     We sought to validate the SunTech Medical Advantage Model 2 Series with firmware LX 3.40.8 algorithm noninvasive blood pressure module in a pregnant population, including those with preeclampsia.  Validation study of an oscillometric noninvasive blood pressure module using the ANSI/AAMI ISO 81060-2:2013 standard guidelines. Pregnant women were enrolled into three subgroups: normotensive, hypertensive without proteinuria, and preeclampsia (hypertensive with random protein-to-creatinine ratio ≥ 0.3 or a 24-hour urine protein > 300 mg). Two trained research nurses, blinded to each other's measurements, used a mercury sphygmomanometer to validate the module by following the protocol set forth in the ANSI/AAMI ISO 81060-2:2013 standard guidelines.  A total of 45 patients, 15 in each subgroup, were included. The mean systolic and diastolic differences with standard deviations between the module and the mean observers' measurements for all participants were -2.3 ± 7.3 and 0.2 ± 6.5 mm Hg, respectively. The systolic and diastolic standard deviations of the mean of the individual patient's paired module and observers' measurements were 6.27 and 5.98 mm Hg, respectively. The test device, relative to a mercury sphygmomanometer, underestimated the systolic blood pressure in patients with preeclampsia by at least 10 mm Hg in 24% (11/45) of paired measurements.  The SunTech Medical Advantage Model 2 Series with firmware LX 3.40.8 algorithm noninvasive blood pressure module is validated in pregnancy, including patients with preeclampsia; however, it may underestimate systolic blood pressure measurements in patients with preeclampsia. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  13. Comparisons of automated blood pressures in a primary health care setting with self-measurements at the office and at home using the Omron i-C10 device.

    PubMed

    Al-Karkhi, Isam; Al-Rubaiy, Raad; Rosenqvist, Ulf; Falk, Magnus; Nystrom, Fredrik H

    2015-04-01

    We aimed to compare blood pressure (BP) levels recorded using the semiautomatic oscillometric Omron i-C10 BP device in patients with or without hypertension in three different settings: (a) when used by a doctor or a nurse at the office (OBP); (b) when used for self-measurement by the patient at the office (SMOBP); and (c) when used for 7 consecutive days at home (HBP). A total of 247 individuals were invited to participate, but 78 of these individuals declined and a further seven were excluded, leaving a final cohort of 162 participants. The mean OBP was higher than HBP (difference 8.1±14/3.1±8.8 mmHg, P<0.0001) and so was SMOBP compared with HBP (difference 7.0±13/4.2±7.3 mmHg, P<0.0001). Sixteen participants (9.9%) had at least 10 mmHg higher systolic SMOBP than OBP and 28 (17%) participants had at least 10 mmHg lower systolic SMOBP than OBP. Participants who were current smokers had a larger mean difference between systolic OBP and SMOBP than nonsmokers (OBP-SMOBP in smokers: 6.6±9.4 mmHg, OBP-SMOBP in nonsmokers: 0.5±9.2 mmHg, P=0.011 between groups). Self-measurement of BP in the office does not preclude an increase in BP when levels in the individual patients are compared with HBP using the same equipment. Thus, SMOBP with a semiautomatic device does not lead to a reduction in the white-coat effect in the same manner as fully automatic devices.

  14. Increased pulse wave velocity in patients with acute lacunar infarction doubled the risk of future ischemic stroke.

    PubMed

    Saji, Naoki; Murotani, Kenta; Shimizu, Hirotaka; Uehara, Toshiyuki; Kita, Yasushi; Toba, Kenji; Sakurai, Takashi

    2017-04-01

    The aim of this study was to determine whether pulse wave velocity (PWV), a marker of vascular endothelial impairment and arteriosclerosis, predicts future ischemic stroke in patients who developed acute lacunar infarction. Patients with a first-ever ischemic stroke due to acute lacunar infarction were enrolled in this study. An oscillometric device (Form PWV/ABI; Omron Colin, Tokyo, Japan) was used to measure brachial-ankle PWV 1 week after stroke onset. Patients were followed for at least 5 years. The main end point of the study was recurrent ischemic stroke. Event-free survival was analyzed using Kaplan-Meier plots and log-rank tests. The risk of recurrent ischemic stroke was estimated using the Cox proportional-hazards model. Of the 156 patients (61% male, mean age: 69.2±11.3 years) assessed in this study, 29 developed recurrent ischemic stroke. The median brachial-ankle PWV value was 20.4 m s -1 . Patients with high PWV values had a greater risk of recurrent ischemic stroke than patients with low PWV values (28% vs. 15%, P=0.08). Kaplan-Meier curve analysis showed that patients with high PWV values had a less favorable (that is, free of recurrent ischemic stroke) survival time (P=0.015). A multivariate Cox proportional-hazards model identified high PWV as an independent predictor of recurrent ischemic stroke after adjusting for age, sex and blood pressure (hazard ratio 2.35, 95% confidence interval, 1.02-5.70, P=0.044). In patients with acute lacunar infarction, a high PWV predicts a twofold greater risk of future ischemic stroke, independent of patient age, sex and blood pressure levels.

  15. Real alerts and artifact classification in archived multi-signal vital sign monitoring data: implications for mining big data.

    PubMed

    Hravnak, Marilyn; Chen, Lujie; Dubrawski, Artur; Bose, Eliezer; Clermont, Gilles; Pinsky, Michael R

    2016-12-01

    Huge hospital information system databases can be mined for knowledge discovery and decision support, but artifact in stored non-invasive vital sign (VS) high-frequency data streams limits its use. We used machine-learning (ML) algorithms trained on expert-labeled VS data streams to automatically classify VS alerts as real or artifact, thereby "cleaning" such data for future modeling. 634 admissions to a step-down unit had recorded continuous noninvasive VS monitoring data [heart rate (HR), respiratory rate (RR), peripheral arterial oxygen saturation (SpO 2 ) at 1/20 Hz, and noninvasive oscillometric blood pressure (BP)]. Time data were across stability thresholds defined VS event epochs. Data were divided Block 1 as the ML training/cross-validation set and Block 2 the test set. Expert clinicians annotated Block 1 events as perceived real or artifact. After feature extraction, ML algorithms were trained to create and validate models automatically classifying events as real or artifact. The models were then tested on Block 2. Block 1 yielded 812 VS events, with 214 (26 %) judged by experts as artifact (RR 43 %, SpO 2 40 %, BP 15 %, HR 2 %). ML algorithms applied to the Block 1 training/cross-validation set (tenfold cross-validation) gave area under the curve (AUC) scores of 0.97 RR, 0.91 BP and 0.76 SpO 2 . Performance when applied to Block 2 test data was AUC 0.94 RR, 0.84 BP and 0.72 SpO 2 . ML-defined algorithms applied to archived multi-signal continuous VS monitoring data allowed accurate automated classification of VS alerts as real or artifact, and could support data mining for future model building.

  16. Acute effects of interval versus continuous endurance training on pulse wave reflection in healthy young men.

    PubMed

    Hanssen, Henner; Nussbaumer, Monique; Moor, Christoph; Cordes, Mareike; Schindler, Christian; Schmidt-Trucksäss, Arno

    2015-02-01

    Our aim was to investigate the acute and 24-hour (h) effects of high-intensity interval training (HIIT) and moderate continuous training (MCT) on arterial pulse wave reflection, an established marker of arterial stiffness and cardiovascular risk. In a randomized cross-over design, 21 young healthy male participants performed a HIIT or a MCT on separate visits. Before and 5 (t5), 20 (t20), 35 (t35), and 50 (t50) minutes after the acute exercise bouts, the crude augmentation index (AIx) and the AIx at a set heart rate (AIx@75) were analysed by applanation tonometry. Starting 1 h post-exercise, both indices were captured over 24-h with an oscillometric monitoring device. AIx did not change significantly after MCT but declined progressively after HIIT, reaching significantly lower values compared to MCT at t35 (P = 0.045) and t50 (P = 0.008). AIx@75 increased after both acute exercise types but was higher after HIIT at t5 (P < 0.001), t20 (P < 0.001) and t35 (P = 0.009) compared to MCT. The 24-h follow-up revealed a significant decline in AIx@75 after HIIT (P = 0.007) but not after MCT (P = 0.813). Exercise intensity affects pulse wave reflection, with different time courses for AIx and AIx@75 post-exercise. Although initially higher after HIIT, AIx@75 declines in the 24-h recovery period indicating more favourable effects on pulse wave reflection compared to MCT. This may result in substantial positive chronic training effects on arterial stiffness in health and cardiovascular disease. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Older Women with Controlled Isolated Systolic Hypertension: Exercise and Blood Pressure.

    PubMed

    Ubolsakka-Jones, Chulee; Sangthong, Benjarat; Aueyingsak, Sahachat; Jones, David A

    2016-06-01

    Exercise is generally regarded as beneficial for health, but the consequent increases in blood pressure might pose a risk for hypertensive subjects. The purpose of this study was to determine blood pressure responses to dynamic exercise and sustained handgrip in patients with isolated systolic hypertension (ISH) who were stable on medication. Nineteen female ISH patients (66 ± 5 yr) and 19 age-matched normotensive (NT) female controls undertook a 5-min cycle exercise (60% heart rate reserve [HRR]) and a 2-min handgrip exercise (30% maximum voluntary contraction). Blood pressure responses were measured using an oscillometric cuff, together with heart rate and resting brachial pulse transit times. Systolic blood pressure (SBP) levels after cycle exercise were 194 ± 18 and 153 ± 19 mm Hg for ISH and NT, respectively, with the increase above resting being greater for ISH (P < 0.001), and only small changes were found in diastolic blood pressure (DBP). During handgrip exercise, SBP rose to 168 ± 19 and 140 ± 8 mm Hg for ISH and NT, respectively. The increases above baseline were greater for ISH both during the exercise and postexercise circulatory occlusion (P = 0.017). The increase in DBP levels during exercise and postexercise occlusion were similar in ISH and NT, suggesting little difference in metaboreflex sensitivity. Pulse transit time was shorter for ISH compared with NT (166 ± 6 ms and 242 ± 24 ms, respectively, P < 0.001), indicating stiffer arteries, which would increase SBP but not DBP. Despite being well controlled and normotensive control subjects at rest, ISH patients had high SBP responses to both dynamic and static exercises, which may constitute a risk for cardiovascular incidents.

  18. Validation of four automatic devices for self-measurement of blood pressure according to the international protocol of the European Society of Hypertension.

    PubMed

    Topouchian, Jirar; Agnoletti, Davide; Blacher, Jacques; Youssef, Ahmed; Ibanez, Isabel; Khabouth, Jose; Khawaja, Salwa; Beaino, Layale; Asmar, Roland

    2011-01-01

    Four oscillometric devices for self-measurement of blood pressure (SBPM) were evaluated according to the European Society of Hypertension (ESH) international protocol and its 2010 revision in four separate studies. The Omron® M2, Omron M3, and Omron M6 measure blood pressure (BP) at the brachial level, while the Omron R2 measures BP at the wrist level. The international protocol requires a total number of 33 subjects in which the validation is performed. The Omron M2 and Omron R2 were validated in 2009 according to the ESH international protocol, while the Omron M3 and Omron M6 were validated in 2010-2011 according to the 2010 ESH international protocol revision. The protocol procedures were followed precisely. All four tested devices passed the validation process. The mean differences between the device and mercury readings were 2.7 ± 5.0 and -1.4 ± 3.2 mmHg for systolic and diastolic BP, respectively, using the Omron M2 device, and 1.7 ± 3.2 and -0.9 ± 2.6 mmHg using the Omron M3, 1.6 ± 2.9 and -0.9 ± 2.5 mmHg using the Omron M6, and -1.1 ± 4.8 and -0.9 ± 4.3 mmHg using the Omron R2. Readings from the Omron M2, Omron M3, Omron M6, and Omron R2, differing by less than 5, 10, and 15 mmHg, fulfill the ESH international protocol and its 2010 revision requirements. Therefore, each of these four devices can be used by patients for SBPM.

  19. Validation of the Beneware model ABP-021 ambulatory blood pressure monitor according to the revised 2010 European Society of hypertension international protocol.

    PubMed

    Pereira, Telmo; Guimarães, João

    2018-06-11

    This study aimed to evaluate the accuracy of the Beneware model ABP-021 oscillometric blood pressure monitor in the general population according to the European Society of Hypertension International Protocol (ESH-IP). The accuracy of the device was assessed in relation to various clinical variables, including age, sex, BMI, and arm circumference. Thirty-three individuals (18 men and 15 women), with a mean age of 36±14 years (age range: 20-68 years), were studied according to the recommendations of the ESH-IP. Sequential same-arm blood pressure measurements were performed, alternating between a mercury standard and the automatic device. The differences among the test-control measurements were assessed and divided into categorization zones of 5, 10, and 15 mmHg discrepancy. The device complied with the quality requirements of the ESH-IP. The device-observer disagreement was -1.2±4.7 mmHg for systolic blood pressure (SBP) and -1.7±4.3 mmHg for diastolic blood pressure (DBP). The device produced 77, 93, and 98 measurements, respectively, within the 5, 10, and 15 mmHg discrepancy limits for SBP. For DBP, 80, 97, and 99 measurements were observed within the 5, 10, and 15 mmHg discrepancy limits. The number of participants with two or three of the device-observer differences within 5 mmHg was 26 for SBP and 29 for DBP, whereas there were only two participants with no device-observer differences within 5 mmHg for DBP. These data show that the Beneware model ABP-021 monitor meets the requirements of the ESH-IP, in static conditions, indicating its suitability for measuring blood pressure in the general adult population.

  20. Nondipping pattern and carotid atherosclerosis in a middle-aged population: OPERA Study.

    PubMed

    Vasunta, Riitta-Liisa; Kesäniemi, Y Antero; Ylitalo, Antti; Ukkola, Olavi

    2012-01-01

    BACKGROUND The lack of dropping in night-time blood pressure of 10% or more (nondipping) seems to associate with cardiovascular risk factors. The relationship between the dipping pattern and atherosclerosis is not clear. The night-time systolic blood pressure (SBP) determines the dipping status. We investigated the connection between intima-media thickness (IMT) and dipping status (dipper, nondipper) taking into account covariates known to associate with hypertension and early atherosclerosis. 900 middle-aged (446 men, 454 women) were studied, 51% of them using blood pressure lowering medication. IMT was measured by a duplex ultrasound from the common carotid artery (CCA), the internal carotid artery (ICA) and the bifurcation enlargement (BIF). The mean IMT was defined as the mean of ICA, BIF, and the 3 highest CCA measurements. Ambulatory blood pressure (ABP) was recorded using the fully automatic SpaceLabs90207 oscillometric unit. Nondippers had lower high-density lipoprotein cholesterol (P = 0.02), higher triglycerides (P < 0.01), body mass index (P < 0.0001) and higher night-time blood pressure (P < 0.0001) than dippers and they were more often nonsmokers (P = 0.01). Increased mean IMT in carotid artery was associated with ABP nondipping pattern (P < 0.01) regardless of conventional cardiovascular risk factors, antihypertensive or lipid lowering medications. Nocturnal blood pressure elevation was independently associated with IMT (P < 0.01). When sexes were analysed separately, the association was seen in men but was only a trend among women. Nondipping status in ABP monitoring is independently associated with early atherosclerosis. Whether nondipping pattern is a predictor of atherosclerosis remains to be explored in a future prospective follow-up of this cohort.

  1. A Comparison and Calibration of a Wrist-Worn Blood Pressure Monitor for Patient Management: Assessing the Reliability of Innovative Blood Pressure Devices

    PubMed Central

    Melville, Sarah; Teskey, Robert; Philip, Shona; Simpson, Jeremy A; Lutchmedial, Sohrab

    2018-01-01

    Background Clinical guidelines recommend monitoring of blood pressure at home using an automatic blood pressure device for the management of hypertension. Devices are not often calibrated against direct blood pressure measures, leaving health care providers and patients with less reliable information than is possible with current technology. Rigorous assessments of medical devices are necessary for establishing clinical utility. Objective The purpose of our study was 2-fold: (1) to assess the validity and perform iterative calibration of indirect blood pressure measurements by a noninvasive wrist cuff blood pressure device in direct comparison with simultaneously recorded peripheral and central intra-arterial blood pressure measurements and (2) to assess the validity of the measurements thereafter of the noninvasive wrist cuff blood pressure device in comparison with measurements by a noninvasive upper arm blood pressure device to the Canadian hypertension guidelines. Methods The cloud-based blood pressure algorithms for an oscillometric wrist cuff device were iteratively calibrated to direct pressure measures in 20 consented patient participants. We then assessed measurement validity of the device, using Bland-Altman analysis during routine cardiovascular catheterization. Results The precalibrated absolute mean difference between direct intra-arterial to wrist cuff pressure measurements were 10.8 (SD 9.7) for systolic and 16.1 (SD 6.3) for diastolic. The postcalibrated absolute mean difference was 7.2 (SD 5.1) for systolic and 4.3 (SD 3.3) for diastolic pressures. This is an improvement in accuracy of 33% systolic and 73% diastolic with a 48% reduction in the variability for both measures. Furthermore, the wrist cuff device demonstrated similar sensitivity in measuring high blood pressure compared with the direct intra-arterial method. The device, when calibrated to direct aortic pressures, demonstrated the potential to reduce a treatment gap in high blood pressure measurements. Conclusions The systolic pressure measurements of the wrist cuff have been iteratively calibrated using gold standard central (ascending aortic) pressure. This improves the accuracy of the indirect measures and potentially reduces the treatment gap. Devices that undergo auscultatory (indirect) calibration for licensing can be greatly improved by additional iterative calibration via intra-arterial (direct) measures of blood pressure. Further clinical trials with repeated use of the device over time are needed to assess the reliability of the device in accordance with current and evolving guidelines for informed decision making in the management of hypertension. Trial Registration ClinicalTrials.gov NCT03015363; https://clinicaltrials.gov/ct2/show/NCT03015363 (Archived by WebCite at http://www.webcitation.org/6xPZgseYS) PMID:29695375

  2. Teacher Responses to Classroom Misbehavior: Influence Methods in a Perilous Equilibrium.

    ERIC Educational Resources Information Center

    DeFlaminis, John A.

    This paper describes a study which had a twofold purpose. The first was to determine which methods of influence were used by teachers to control pupils who exhibited various types of disruptive misbehavior. The second purpose of this study was to determine why teachers chose those specific methods of control. Influence was considered from the…

  3. Store Separation Lessons Learned During the Last 30 Years

    DTIC Science & Technology

    2010-01-01

    the same time period the Influence Function Method (IFM) was also developed5. This method allowed for a straight STORE SEPARATION LESSONS LEARNED...developed at Grumman under an Air Force contract. The Influence Function Method (IFM)5,6,7 was used to determine the effect of the aircraft flowfield on...A Chimera Grid Scheme,” Advances in Grid Generation, ASME, June 1983. 5. Meyer, R., Cenko, A., and Yaros, S., “An Influence Function Method for

  4. A Network Method of Measuring Affiliation-Based Peer Influence: Assessing the Influences of Teammates' Smoking on Adolescent Smoking

    ERIC Educational Resources Information Center

    Fujimoto, Kayo; Unger, Jennifer B.; Valente, Thomas W.

    2012-01-01

    Using a network analytic framework, this study introduces a new method to measure peer influence based on adolescents' affiliations or 2-mode social network data. Exposure based on affiliations is referred to as the "affiliation exposure model." This study demonstrates the methodology using data on young adolescent smoking being influenced by…

  5. The Nonlinear Dynamic Response of an Elastic-Plastic Thin Plate under Impulsive Loading,

    DTIC Science & Technology

    1987-06-11

    Among those numerical methods, the finite element method is the most effective one. The method presented in this paper is an " influence function " numerical...computational time is much less than the finite element method. Its precision is higher also. II. Basic Assumption and the Influence Function of a Simple...calculation. Fig. 1 3 2. The Influence function of a Simple Supported Plate The motion differential equation of a thin plate can be written as DV’w+ _.eluq() (1

  6. The Earth Education Program Sunship™ Earth: A Mixed Methods Study of the Long-Term Influence on Environmental Attitudes and Actions

    ERIC Educational Resources Information Center

    Bires, Nancy K.

    2013-01-01

    There have been a limited number of studies on the short-term influence of environmental and earth education programs, however, not much information is available about the long-term influence of these programs on participants' environmental attitudes and actions. This mixed methods study explores the long-term influence of the earth education…

  7. Methods and systems for carrying out a pH-influenced chemical and/or biological reaction

    DOEpatents

    Stern, Michael C.; Simeon, Fritz; Hatton, Trevor Alan

    2016-04-05

    The present invention generally relates to methods and systems for carrying out a pH-influenced chemical and/or biological reaction. In some embodiments, the pH-influenced reaction involves the conversion of CO.sub.2 to a dissolved species.

  8. Influence of the quality of intraoperative fluoroscopic images on the spatial positioning accuracy of a CAOS system.

    PubMed

    Wang, Junqiang; Wang, Yu; Zhu, Gang; Chen, Xiangqian; Zhao, Xiangrui; Qiao, Huiting; Fan, Yubo

    2018-06-01

    Spatial positioning accuracy is a key issue in a computer-assisted orthopaedic surgery (CAOS) system. Since intraoperative fluoroscopic images are one of the most important input data to the CAOS system, the quality of these images should have a significant influence on the accuracy of the CAOS system. But the regularities and mechanism of the influence of the quality of intraoperative images on the accuracy of a CAOS system have yet to be studied. Two typical spatial positioning methods - a C-arm calibration-based method and a bi-planar positioning method - are used to study the influence of different image quality parameters, such as resolution, distortion, contrast and signal-to-noise ratio, on positioning accuracy. The error propagation rules of image error in different spatial positioning methods are analyzed by the Monte Carlo method. Correlation analysis showed that resolution and distortion had a significant influence on spatial positioning accuracy. In addition the C-arm calibration-based method was more sensitive to image distortion, while the bi-planar positioning method was more susceptible to image resolution. The image contrast and signal-to-noise ratio have no significant influence on the spatial positioning accuracy. The result of Monte Carlo analysis proved that generally the bi-planar positioning method was more sensitive to image quality than the C-arm calibration-based method. The quality of intraoperative fluoroscopic images is a key issue in the spatial positioning accuracy of a CAOS system. Although the 2 typical positioning methods have very similar mathematical principles, they showed different sensitivities to different image quality parameters. The result of this research may help to create a realistic standard for intraoperative fluoroscopic images for CAOS systems. Copyright © 2018 John Wiley & Sons, Ltd.

  9. Results of the Investigation of Psychological Influence on Development of Students' Motivation

    ERIC Educational Resources Information Center

    Lekerova, G. Zh.; Karbozova, G. K.; Isabayeva, A. S.; Dlimbetova, B. S.; Mamykova, R. U.; Omarova, G. A.; Aymenov, A. Zh.

    2016-01-01

    The article considers peculiar problems of motivation formation in pedagogical activity, motivational sphere of the personality by means of purposeful influence of psychological factors, influence in the form of active methods of study (special psychological course, practicum, and training), problems of realization of active methods in teaching…

  10. Iranian Tentacles into Iraq: The Basis and Extent of Iranian Influence into Southern Iraq

    DTIC Science & Technology

    2009-01-01

    cultural values, based on their historical development. Tehran uses methods along the spectrum of psychological persuasion to influence and subvert the ...49 pages. Most of those who comment on Iran’s attempt to influence Iraqi Shia, do so without considering the historical and cultural connection...varied cultural values, based on their historical development. Tehran uses methods along the spectrum of psychological persuasion to influence and

  11. Screening for Multiple Genes Influencing Dyslexia.

    ERIC Educational Resources Information Center

    Smith, Shelley D.; And Others

    1991-01-01

    Examines the "sib pair" method of linkage analysis designed to locate genes influencing dyslexia, which has several advantages over the "LOD" score method. Notes that the sib pair analysis was able to detect the same linkages as the LOD method, plus a possible third region. Confirms that the sib pair method is an effective means of screening. (RS)

  12. Influence of parameter changes to stability behavior of rotors

    NASA Technical Reports Server (NTRS)

    Fritzen, C. P.; Nordmann, R.

    1982-01-01

    The occurrence of unstable vibrations in rotating machinery requires corrective measures for improvement of the stability behavior. A simple approximate method is represented to find out the influence of parameter changes to the stability behavior. The method is based on an expansion of the eigenvalues in terms of system parameters. Influence coefficients show the effect of structural modifications. The method first of all was applied to simple nonconservative rotor models. It was approved for an unsymmetric rotor of a test rig.

  13. Identifying potential engaging leaders within medical education: The role of positive influence on peers.

    PubMed

    Michalec, Barret; Veloski, J Jon; Hojat, Mohammadreza; Tykocinski, Mark L

    2014-08-26

    Abstract Background: Previous research has paid little to no attention towards exploring methods of identifying existing medical student leaders. Aim: Focusing on the role of influence and employing the tenets of the engaging leadership model, this study examines demographic and academic performance-related differences of positive influencers and if students who have been peer-identified as positive influencers also demonstrate high levels of genuine concern for others. Methods: Three separate fourth-year classes were asked to designate classmates that had significant positive influences on their professional and personal development. The top 10% of those students receiving positive influence nominations were compared with the other students on demographics, academic performance, and genuine concern for others. Results: Besides age, no demographic differences were found between positive influencers and other students. High positive influencers were not found to have higher standardized exam scores but did receive significantly higher clinical clerkship ratings. High positive influencers were found to possess a higher degree of genuine concern for others. Conclusion: The findings lend support to (a) utilizing the engaging model to explore leaders and leadership within medical education, (b) this particular method of identifying existing medical student leaders, and (c) return the focus of leadership research to the power of influence.

  14. Perturbation Selection and Local Influence Analysis for Nonlinear Structural Equation Model

    ERIC Educational Resources Information Center

    Chen, Fei; Zhu, Hong-Tu; Lee, Sik-Yum

    2009-01-01

    Local influence analysis is an important statistical method for studying the sensitivity of a proposed model to model inputs. One of its important issues is related to the appropriate choice of a perturbation vector. In this paper, we develop a general method to select an appropriate perturbation vector and a second-order local influence measure…

  15. Using Citation Analysis Methods to Assess the Influence of Science, Technology, Engineering, and Mathematics Education Evaluations

    ERIC Educational Resources Information Center

    Greenseid, Lija O.; Lawrenz, Frances

    2011-01-01

    This study explores the use of citation analysis methods to assess the influence of program evaluations conducted within the area of science, technology, engineering, and mathematics (STEM) education. Citation analysis is widely used within scientific research communities to measure the relative influence of scientific research enterprises and/or…

  16. ITPI: Initial Transcription Process-Based Identification Method of Bioactive Components in Traditional Chinese Medicine Formula

    PubMed Central

    Zhang, Baixia; Li, Yanwen; Zhang, Yanling; Li, Zhiyong; Bi, Tian; He, Yusu; Song, Kuokui; Wang, Yun

    2016-01-01

    Identification of bioactive components is an important area of research in traditional Chinese medicine (TCM) formula. The reported identification methods only consider the interaction between the components and the target proteins, which is not sufficient to explain the influence of TCM on the gene expression. Here, we propose the Initial Transcription Process-based Identification (ITPI) method for the discovery of bioactive components that influence transcription factors (TFs). In this method, genome-wide chip detection technology was used to identify differentially expressed genes (DEGs). The TFs of DEGs were derived from GeneCards. The components influencing the TFs were derived from STITCH. The bioactive components in the formula were identified by evaluating the molecular similarity between the components in formula and the components that influence the TF of DEGs. Using the formula of Tian-Zhu-San (TZS) as an example, the reliability and limitation of ITPI were examined and 16 bioactive components that influence TFs were identified. PMID:27034696

  17. Influence of the Simulation Method on 7th Grade Students' Achievements in Science and Technology Lessons

    ERIC Educational Resources Information Center

    Teke, Huseyin; Dogan, Bekir; Duran, Ahmet

    2015-01-01

    This study aimed to make a comparative analysis of seventh-grade (the second level of the primary education) students' achievement in "Systems of The Human Body" unit in Science and Technology lesson which was taught using both the simulation method and the traditional method along with the influence of these methods on students'…

  18. Validation of BP devices QardioArm® in the general population and Omron M6 Comfort® in type II diabetic patients according to the European Society of Hypertension International Protocol (ESH-IP)

    PubMed Central

    Chahine, Mirna N; Topouchian, Jirar; Zelveian, Parounak; Hakobyan, Zoya; Melkonyan, Arevik; Azaki, Alaa; Diab, Reem; Harb, Aya; Asmar, Roland

    2018-01-01

    Background Following the European Society of Hypertension International Protocol (ESH-IP) Revision 2010, QardioArm® and Omron M6 Comfort IT® oscillometric devices were evaluated in the general population and in patients with type II diabetes, respectively, for self-blood pressure (BP) measurement. Methods Both devices, QardioArm® and Omron M6 Comfort®, measure BP at the brachial level. The ESH-IP Revision 2010 includes a total number of 33 subjects. For each measure, the difference between observer and device BP values was calculated. In all, 99 pairs of BP differences are classified into three categories (≤5, ≤10, and ≤15 mmHg). The protocol procedures were followed precisely. Results: QardioArm® and Omron M6 Comfort® fulfilled the requirements of the ESH-IP and passed the validation process successfully. For QardioArm®, a total of 69 out of 99 comparisons for systolic blood pressure (SBP) showed an absolute difference within 5 mmHg and 82 out of 99 for diastolic blood pressure (DBP). As for Omron M6 Comfort®, a total of 83 out of 99 comparisons for SBP showed an absolute difference within 5 mmHg and 77 out of 99 for DBP. The mean differences between the device and mercury readings were 0.7±5.9 mmHg for SBP and 0.3±4.1 mmHg for DBP for QardioArm® and −1.4±4.7 mmHg for SBP and −2.1±4.3 mmHg for DBP for Omron M6 Comfort®. With regard to part 2 of ESH-IP 2010, 27 out of 33 subjects had a minimum of two out of three measurements within 5 mmHg difference for SBP and 31 out of 33 subjects for DBP for the QardioArm®, and 29 out of 33 patients had a minimum of two out of three measurements within 5 mmHg difference for SBP and 26 out of 33 patients for DBP for Omron M6 Comfort®. Conclusion: QardioArm® and Omron M6 Comfort® readings differing from the mercury standard by <5, 10, and 15 mmHg fulfill the ESH-IP Revision 2010 requirements. Consequently, these two devices are suitable for use in the general population and non-insulin-dependent type II diabetic patients, respectively. PMID:29343992

  19. The Influence of Fees on Supervision of Licensed Professional Counselor Interns in Texas: A Mixed-Methods Study

    ERIC Educational Resources Information Center

    Stark, Marcella Dortch

    2010-01-01

    Purpose. The purpose of this study was to explore the influence of payment status on perceptions of Licensed Professional Counselor (LPC) Interns regarding aspects of the supervisory relationship. Method. Survey responses from 230 LPC Interns in Texas were collected using SurveyMonkey[TM] (2009) to examine how supervision fees influence: (a)…

  20. Differences between Cheddar cheese manufactured by the milled-curd and stirred-curd methods using different commercial starters.

    PubMed

    Shakeel-ur-Rehman; Drake, M A; Farkye, N Y

    2008-01-01

    Traditionally, Cheddar cheese is made by the milled-curd method. However, because of the mechanization of cheese making and time constraints, the stirred-curd method is more commonly used by many large-scale commercial manufacturers. This study was undertaken to evaluate quality differences during ripening (at 2 and 8 degrees C) of Cheddar cheese made by the milled-curd and stirred-curd methods, using 4 different commercial starters. Twenty-four vats (4 starters x 2 methods x 3 replicates) were made, with approximately 625 kg of pasteurized (72 degrees C x 16 s) whole milk in each vat. Fat, protein, and salt contents of the cheeses were not affected by the starter. Starter cell densities in cheese were not affected by the method of manufacture. Nonstarter lactic acid bacteria counts at 90, 180, and 270 d were influenced by the manufacturing method, with a higher trend in milled-curd cheeses. Proteolysis in cheese (percentage of water-soluble N) was influenced by the starter and manufacturing method (270 d). Sensory analysis by a trained descriptive panel (n = 8) revealed differences in cooked, whey, sulfur, brothy, milk fat, umami, and bitter attributes caused by the starter, whereas only brothy flavor was influenced by storage temperature. The method of manufacture influenced diacetyl, sour, and salty flavors.

  1. Influence of postnatal glucocorticoids on hippocampal-dependent learning varies with elevation patterns and administration methods

    DTIC Science & Technology

    2017-05-22

    Influence of postnatal glucocorticoids on hippocampal-dependent learning varies with elevation patterns and administration methods 5b. GRANT NUMBER...of these effects varies with the elevation patterns (level, duration, temporal fluctuation) achieved by different administration methods . In general...learning varies with elevation patterns and administration methods Dragana I. Claflin a, Kevin D. Schmidt a, Zachary D. Vallandingham b, Michal

  2. College Institutional Characteristics and the Use of Barrier Methods among Undergraduate Students

    ERIC Educational Resources Information Center

    Griner, Stacey B.; Thompson, Erika L.; Vamos, Cheryl A.; Logan, Rachel; Vázquez-Otero, Coralia; Daley, Ellen M.

    2017-01-01

    Sexually transmitted infections (STIs) may be prevented through the use of barrier methods, but rates of use among US college students are low. Previous research focuses on individual-level factors influencing barrier method use, but few studies consider community-level influences. This study examined consistency of barrier use by college…

  3. Finding the Right Mix: Teaching Methods as Predictors for Student Progress on Learning Objectives

    ERIC Educational Resources Information Center

    Glover, Jacob I.

    2012-01-01

    This study extends existing student ratings research by exploring how teaching methods, individually and collectively, influence a minimum standard of student achievement on learning objectives and how class size impacts this influence. Twenty teaching methods were used to predict substantial or exceptional progress on each of 12 learning…

  4. Influence of Ultrasonic Nonlinear Propagation on Hydrophone Calibration Using Two-Transducer Reciprocity Method

    NASA Astrophysics Data System (ADS)

    Yoshioka, Masahiro; Sato, Sojun; Kikuchi, Tsuneo; Matsuda, Yoichi

    2006-05-01

    In this study, the influence of ultrasonic nonlinear propagation on hydrophone calibration by the two-transducer reciprocity method is investigated quantitatively using the Khokhlov-Zabolotskaya-Kuznetsov (KZK) equation. It is proposed that the correction for the diffraction and attenuation of ultrasonic waves used in two-transducer reciprocity calibration can be derived using the KZK equation to remove the influence of nonlinear propagation. The validity of the correction is confirmed by comparing the sensitivities calibrated by the two-transducer reciprocity method and laser interferometry.

  5. Noise covariance incorporated MEG-MUSIC algorithm: a method for multiple-dipole estimation tolerant of the influence of background brain activity.

    PubMed

    Sekihara, K; Poeppel, D; Marantz, A; Koizumi, H; Miyashita, Y

    1997-09-01

    This paper proposes a method of localizing multiple current dipoles from spatio-temporal biomagnetic data. The method is based on the multiple signal classification (MUSIC) algorithm and is tolerant of the influence of background brain activity. In this method, the noise covariance matrix is estimated using a portion of the data that contains noise, but does not contain any signal information. Then, a modified noise subspace projector is formed using the generalized eigenvectors of the noise and measured-data covariance matrices. The MUSIC localizer is calculated using this noise subspace projector and the noise covariance matrix. The results from a computer simulation have verified the effectiveness of the method. The method was then applied to source estimation for auditory-evoked fields elicited by syllable speech sounds. The results strongly suggest the method's effectiveness in removing the influence of background activity.

  6. A method to eliminate the influence of incident light variations in spectral analysis

    NASA Astrophysics Data System (ADS)

    Luo, Yongshun; Li, Gang; Fu, Zhigang; Guan, Yang; Zhang, Shengzhao; Lin, Ling

    2018-06-01

    The intensity of the light source and consistency of the spectrum are the most important factors influencing the accuracy in quantitative spectrometric analysis. An efficient "measuring in layer" method was proposed in this paper to limit the influence of inconsistencies in the intensity and spectrum of the light source. In order to verify the effectiveness of this method, a light source with a variable intensity and spectrum was designed according to Planck's law and Wien's displacement law. Intra-lipid samples with 12 different concentrations were prepared and divided into modeling sets and prediction sets according to different incident lights and solution concentrations. The spectra of each sample were measured with five different light intensities. The experimental results showed that the proposed method was effective in eliminating the influence caused by incident light changes and was more effective than normalized processing.

  7. Measurement of influence function using swing arm profilometer and laser tracker.

    PubMed

    Jing, Hongwei; King, Christopher; Walker, David

    2010-03-01

    We present a novel method to accurately measure 3D polishing influence functions by using a swing arm profilometer (SAP) and a laser tracker. The laser tracker is used to align the SAP and measure the parameters of the SAP setup before measuring the influence function. The instruments and the measurement method are described, together with measurement uncertainty analysis. An influence function deliberately produced with asymmetric form in order to create a challenging test is measured, and compared with that of a commercial 3D profilometer. The SAP result is 48.2 microm in PV, 7.271 mm(3) in volume. The 3D profilometer result is 48.4 microm in PV, 7.289 mm(3) in volume. The forms of the two results show excellent correlation. This gives confidence of the viability of the SAP method for larger influence functions out of range of the commercial instrument.

  8. The relation between periods’ identification and noises in hydrologic series data

    NASA Astrophysics Data System (ADS)

    Sang, Yan-Fang; Wang, Dong; Wu, Ji-Chun; Zhu, Qing-Ping; Wang, Ling

    2009-04-01

    SummaryIdentification of dominant periods is a typical and important issue in hydrologic series data analysis, since it is the basis of building effective stochastic models, understanding complex hydrologic processes, etc. However it is still a difficult task due to the influence of many interrelated factors, such as noises in hydrologic series data. In this paper, firstly the great influence of noises on periods' identification has been analyzed. Then, based on two conventional methods of hydrologic series analysis: wavelet analysis (WA) and maximum entropy spectral analysis (MESA), a new method of periods' identification of hydrologic series data, main series spectral analysis (MSSA), has been put forward, whose main idea is to identify periods of the main series on the basis of reducing hydrologic noises. Various methods (include fast Fourier transform (FFT), MESA and MSSA) have been applied to both synthetic series and observed hydrologic series. Results show that conventional methods (FFT and MESA) are not as good as expected due to the great influence of noises. However, this influence is not so strong while using the new method MSSA. In addition, by using the new de-noising method proposed in this paper, which is suitable for both normal noises and skew noises, the results are more reasonable, since noises separated from hydrologic series data generally follow skew probability distributions. In conclusion, based on comprehensive analyses, it can be stated that the proposed method MSSA could improve periods' identification by effectively reducing the influence of hydrologic noises.

  9. Influence diagnostics in meta-regression model.

    PubMed

    Shi, Lei; Zuo, ShanShan; Yu, Dalei; Zhou, Xiaohua

    2017-09-01

    This paper studies the influence diagnostics in meta-regression model including case deletion diagnostic and local influence analysis. We derive the subset deletion formulae for the estimation of regression coefficient and heterogeneity variance and obtain the corresponding influence measures. The DerSimonian and Laird estimation and maximum likelihood estimation methods in meta-regression are considered, respectively, to derive the results. Internal and external residual and leverage measure are defined. The local influence analysis based on case-weights perturbation scheme, responses perturbation scheme, covariate perturbation scheme, and within-variance perturbation scheme are explored. We introduce a method by simultaneous perturbing responses, covariate, and within-variance to obtain the local influence measure, which has an advantage of capable to compare the influence magnitude of influential studies from different perturbations. An example is used to illustrate the proposed methodology. Copyright © 2017 John Wiley & Sons, Ltd.

  10. Digital image color analysis compared to direct dental CIE colorimeter assessment under different ambient conditions.

    PubMed

    Knösel, Michael; Attin, Rengin; Jung, Klaus; Brunner, Edgar; Kubein-Meesenburg, Dietmar; Attin, Thomas

    2009-04-01

    To evaluate the concordance and repeatability of two in vivo methods for dental color assessment and to clarify the influence of different ambient light conditions and subject's head position on the assessed color variables. Color assessments were performed by two examiners on 16 arbitrarily selected subjects under two different, standardized conditions of illumination and at two different standardized head angulations. CIE (L*a*b*) data for upper and lower central incisors were recorded in two different ways: (1) by an intra-oral contact dental colorimeter and (2) by processing digital images for performing color calculation using Adobe Photoshop software. The influence of the different ambient conditions on both methods, as well as the concordance of measurements was analyzed statistically using several mixed linear models. Ambient light as a single factor had no significant influence on maxillary L*, a* and b* values, but it did have an effect on mandible assessments. Head angulation variation resulted in significant L* value differences using the photo method. The operator had a significant influence on values a* and b* for the photo method and on a* values for the colorimeter method. In fully lit ambient condition, the operator had a significant influence on the segregated L*, a*, and b* values. With dimmed lights, head angulation became significant, but not the operator. Evaluation of segregated L* values was error prone in both methods. Comparing both methods, deltaE values did not exceed 2.85 units, indicating that color differences between methods and recorded under varying ambient conditions were well below the sensitivity of the naked eye.

  11. Statistical technique for analysing functional connectivity of multiple spike trains.

    PubMed

    Masud, Mohammad Shahed; Borisyuk, Roman

    2011-03-15

    A new statistical technique, the Cox method, used for analysing functional connectivity of simultaneously recorded multiple spike trains is presented. This method is based on the theory of modulated renewal processes and it estimates a vector of influence strengths from multiple spike trains (called reference trains) to the selected (target) spike train. Selecting another target spike train and repeating the calculation of the influence strengths from the reference spike trains enables researchers to find all functional connections among multiple spike trains. In order to study functional connectivity an "influence function" is identified. This function recognises the specificity of neuronal interactions and reflects the dynamics of postsynaptic potential. In comparison to existing techniques, the Cox method has the following advantages: it does not use bins (binless method); it is applicable to cases where the sample size is small; it is sufficiently sensitive such that it estimates weak influences; it supports the simultaneous analysis of multiple influences; it is able to identify a correct connectivity scheme in difficult cases of "common source" or "indirect" connectivity. The Cox method has been thoroughly tested using multiple sets of data generated by the neural network model of the leaky integrate and fire neurons with a prescribed architecture of connections. The results suggest that this method is highly successful for analysing functional connectivity of simultaneously recorded multiple spike trains. Copyright © 2011 Elsevier B.V. All rights reserved.

  12. The influence of non-ionisable excipients on precipitation parameters measured using the CheqSol method.

    PubMed

    Etherson, Kelly; Halbert, Gavin; Elliott, Moira

    2016-09-01

    The aim of this study was to determine the influence of non-ionisable excipients hydroxypropyl-β-cyclodextrin (HPβCD) and poloxamers 407 and 188 on the supersaturation and precipitation kinetics of ibuprofen, gliclazide, propranolol and atenolol induced through solution pH shifts using the CheqSol method. The drug's kinetic and intrinsic aqueous solubilities were measured in the presence of increasing excipient concentrations using the CheqSol method. Experimental data rate of change of pH with time was also examined to determine excipient-induced parachute effects and influence on precipitation rates. The measured kinetic and intrinsic solubilities provide a determination of the influence of each excipient on supersaturation index, and the area under the CheqSol curve can measure the parachute capability of excipients. The excipients influence on precipitation kinetics can be measured with novel parameters; for example, the precipitation pH or percentage ionised drug at the precipitation point, which provide further information on the excipient-induced changes in precipitation performance. This method can therefore be employed to measure the influence of non-ionisable excipients on the kinetic solubility behaviour of supersaturated solutions of ionisable drugs and to provide data, which discriminates between excipient systems during precipitation. © 2016 Royal Pharmaceutical Society.

  13. A mathematical model of microbial enhanced oil recovery (MEOR) method for mixed type rock

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

    Sitnikov, A.A.; Eremin, N.A.; Ibattulin, R.R.

    1994-12-31

    This paper deals with the microbial enhanced oil recovery method. It covers: (1) Mechanism of microbial influence on the reservoir was analyzed; (2) The main groups of metabolites affected by the hydrodynamic characteristics of the reservoir were determined; (3) The criterions of use of microbial influence method on the reservoir are defined. The mathematical model of microbial influence on the reservoir was made on this basis. The injection of molasse water solution with Clostridium bacterias into the mixed type of rock was used in this model. And the results of calculations were compared with experimental data.

  14. An Exploration of the Examination Script Features that Most Influence Expert Judgements in Three Methods of Evaluating Script Quality

    ERIC Educational Resources Information Center

    Suto, Irenka; Novakovic, Nadezda

    2012-01-01

    Some methods of determining grade boundaries within examinations, such as awarding, paired comparisons, and rank ordering, entail expert judgements of script quality. We aimed to identify the features of examinees' scripts that most influence judgements in the three methods. For contrasting examinations in biology and English, a Latin square…

  15. The Influence of Alternative Pedagogical Methods in Postsecondary Biology Education: How Do Students Experience a Multimedia Case-Study Environment?

    ERIC Educational Resources Information Center

    Wolter, Bjorn Hugo Karl

    2010-01-01

    The purpose of this study was to better understand how an online, multimedia case study method influenced students' motivation, performance, and perceptions of science in collegiate level biology classes. It utilized a mix-methods design including data from pre- and post-test, student surveys, and focus group interviews to answer one primary…

  16. Teaching Methods Influencing the Sustainability of the Teaching Process in Technology Education in General Education Schools

    ERIC Educational Resources Information Center

    Soobik, Mart

    2014-01-01

    The sustainability of technology education is related to a traditional understanding of craft and the methods used to teach it; however, the methods used in the teaching process have been influenced by the innovative changes accompanying the development of technology. In respect to social and economic development, it is important to prepare young…

  17. Implications of Blood Pressure Measurement Technique for Implementation of Systolic Blood Pressure Intervention Trial (SPRINT).

    PubMed

    Agarwal, Rajiv

    2017-02-03

    Cardiovascular morbidity and mortality was reduced by 25% when blood pressure (BP) was targeted to 120 mm Hg systolic compared with 140 mm Hg systolic in Systolic Blood Pressure Intervention Trial (SPRINT); however, BP was measured using a research technique. SPRINT specified 5 minutes of seated rest in a quiet room followed by 3 oscillometric measurements without an observer in the room. The relationship of this research-grade methodology to routine BP measurements is not known. Among 275 people with chronic kidney disease who had BP <140/90 mm Hg when they came to the clinic, we measured BP as in SPRINT and recorded BP on the same day without specification of seated rest. Compared with routine measurement, the research-grade systolic BP was 12.7 mm Hg lower with wide limits of agreement (-46.1 to 20.7 mm Hg). Research grade systolic BP was 7.9 mm Hg lower than daytime ambulatory systolic BP and had wide agreement limits (-33.2 to 17.4 mm Hg). Whereas the routine, research-grade, and daytime ambulatory systolic BP were all related to echocardiographic left ventricular hypertrophy, the strength of the relationship between research-grade and daytime ambulatory systolic BP to left ventricular hypertrophy was similar and stronger than the strength of the relationship between routine systolic BP and left ventricular hypertrophy. Taken together, these results suggest that translation of the SPRINT results will require measurement of BP as performed in that trial. Instead of an algebraic manipulation of routine clinic measurements, the SPRINT methodology of BP measurement would be needed at minimum if implementation of the SPRINT results were to be deployed in the population at large. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  18. A preliminary study on multi-wavelength PPG based pulse transit time detection for cuffless blood pressure measurement.

    PubMed

    Jing Liu; Yuan-Ting Zhang; Xiao-Rong Ding; Wen-Xuan Dai; Ni Zhao

    2016-08-01

    Pulse transit time (PTT) has been widely studied as an index of blood pressure (BP) changes. In recent years, some prototypes of PTT-based wearable BP measurement devices have been developed, which can relieve users from the discomfort caused by the inflating cuff used in auscultatory and oscillometric BP measurement techniques. However, in the common practice for PTT detection, multi-site sensor implementation on human body is required, making it difficult for the integration of wearable devices. Since multi-wavelength (MW) photoplethysmogram (PPG) signals carry blood pulsation information of different blood vessels embedded in different skin depths, the time difference between different wavelength PPG signals collected at the same body site can be treated as a special PTT on a short length of blood vessels beneath the skin. In this work, the time difference between MW PPG, denoted as PTT_MW, was explored to track BP changes as a substitute of infrared (IR) PTT_EP. (PTT_EP is the time interval between electrocardiogram (ECG) and IR PPG.) Ten healthy adult subjects participated in the experiment, and their continuous BP, ECG and fingertip MW PPG signals generated from blue, green, yellow and IR light were recorded after 2-minute static handgrip exercise at 33% maximal voluntary contraction. The results showed that the correlation between Systolic BP (SBP) and IR-Blue PTT_MW (|r|= 0.52) was comparable to the correlation between SBP and IR PTT_EP (|r|= 0.59). Moreover, we optimized the wavelength combination of PTT_MWs for each subject and found the average value of optimal correlation between SBP and PTT_MW reached 0.76, which was significantly (p<;0.01) higher than the correlation between IR PTT_EP and SBP. This study reveals that the time difference between MW PPG can be potentially used as PTT for cuffless BP measurement with its unique advantage in simple sensor implementation at only one body site.

  19. Late outcomes of a randomized trial of high-frequency oscillation in neonates.

    PubMed

    Zivanovic, Sanja; Peacock, Janet; Alcazar-Paris, Mireia; Lo, Jessica W; Lunt, Alan; Marlow, Neil; Calvert, Sandy; Greenough, Anne

    2014-03-20

    Results from an observational study involving neonates suggested that high-frequency oscillatory ventilation (HFOV), as compared with conventional ventilation, was associated with superior small-airway function at follow-up. Data from randomized trials are needed to confirm this finding. We studied 319 adolescents who had been born before 29 weeks of gestation and had been enrolled in a multicenter, randomized trial that compared HFOV with conventional ventilation immediately after birth. The trial involved 797 neonates, of whom 592 survived to hospital discharge. We compared follow-up data from adolescents who had been randomly assigned to HFOV with follow-up data from those who had been randomly assigned to conventional ventilation, with respect to lung function and respiratory health, health-related quality of life, and functional status, as assessed with the use of questionnaires completed when the participants were 11 to 14 years of age. The primary outcome was forced expiratory flow at 75% of the expired vital capacity (FEF75). The HFOV group had superior results on a test of small-airway function (z score for FEF75, -0.97 with HFOV vs. -1.19 with conventional therapy; adjusted difference, 0.23 [95% confidence interval, 0.02 to 0.45]). There were significant differences in favor of HFOV in several other measures of respiratory function, including forced expiratory volume in 1 second, forced vital capacity, peak expiratory flow, diffusing capacity, and impulse-oscillometric findings. As compared with the conventional-therapy group, the HFOV group had significantly higher ratings from teachers in three of eight school subjects assessed, but there were no other significant differences in functional outcomes. In a randomized trial involving children who had been born extremely prematurely, those who had undergone HFOV, as compared with those who had received conventional ventilation, had superior lung function at 11 to 14 years of age, with no evidence of poorer functional outcomes. (Funded by the National Institute for Health Research Health Technology Assessment Programme and others.).

  20. ECG Voltage in Relation to Peripheral and Central Ambulatory Blood Pressure.

    PubMed

    Yang, Wen-Yi; Mujaj, Blerim; Efremov, Ljupcho; Zhang, Zhen-Yu; Thijs, Lutgarde; Wei, Fang-Fei; Huang, Qi-Fang; Luttun, Aernout; Verhamme, Peter; Nawrot, Tim S; Boggia, José; Staessen, Jan A

    2018-01-12

    The heart ejects in the central elastic arteries. No previous study in workers described the diurnal profile of central blood pressure (BP) or addressed the question whether electrocardiogram (ECG) indexes are more closely associated with central than peripheral BP. In 177 men (mean age, 29.1 years), we compared the associations of ECG indexes with brachial and central ambulatory BP, measured over 24 hours by the validated oscillometric Mobil-O-Graph 24h PWA monitor. From wakefulness to sleep, as documented by diaries, systolic/diastolic BP decreased by 11.7/13.1 mm Hg peripherally and 9.3/13.6 mm Hg centrally, whereas central pulse pressure (PP) increased by 4.3 mm Hg (P < 0.0001). Over 24 hours and the awake and asleep periods, the peripheral-minus-central differences in systolic/diastolic BPs averaged 11.8/-1.6, 12.7/-1.8, and 10.3/-1.2 mm Hg, respectively (P < 0.0001). Cornell voltage and index averaged 1.18 mV and 114.8 mV·ms. Per 1-SD increment in systolic/diastolic BP, the Cornell voltages were 0.104/0.086 mV and 0.082/0.105 mV higher in relation to brachial 24-hour and asleep BP and 0.088/0.90 mV and 0.087/0.107 mV higher in relation to central BP. The corresponding estimates for the Cornell indexes were 9.6/8.6 and 8.2/10.5 mV·ms peripherally and 8.6/8.9 and 8.8/10.7 mV·ms centrally. The regression slopes (P ≥ 0.067) and correlation coefficients (P ≥ 0.088) were similar for brachial and central BP. Associations of ECG measurements with awake BP and PP were not significant. Peripheral and central BPs run in parallel throughout the day and are similarly associated with the Cornell voltage and index. © The Author 2017. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd.

  1. Brachial cuff measurements of blood pressure during passive leg raising for fluid responsiveness prediction.

    PubMed

    Lakhal, K; Ehrmann, S; Benzekri-Lefèvre, D; Runge, I; Legras, A; Dequin, P-F; Mercier, E; Wolff, M; Régnier, B; Boulain, T

    2012-05-01

    The passive leg raising maneuver (PLR) for fluid responsiveness testing relies on cardiac output (CO) measurements or invasive measurements of arterial pressure (AP) whereas the initial hemodynamic management during shock is often based solely on brachial cuff measurements. We assessed PLR-induced changes in noninvasive oscillometric readings to predict fluid responsiveness. Multicentre interventional study. In ICU sedated patients with circulatory failure, AP (invasive and noninvasive readings) and CO measurements were performed before, during PLR (trunk supine, not modified) and after 500-mL volume expansion. Areas under the ROC curves (AUC) were determined for fluid responsiveness (>10% volume expansion-induced increase in CO) prediction. In 112 patients (19% with arrhythmia), changes in noninvasive systolic AP during PLR (noninvasiveΔ(PLR)SAP) only predicted fluid responsiveness (cutoff 17%, n=21, positive likelihood ratio [LR] of 26 [18-38]), not unresponsiveness. If PLR-induced change in central venous pressure (CVP) was at least of 2 mm Hg (n=60), suggesting that PLR succeeded in altering cardiac preload, noninvasiveΔ(PLR)SAP performance was good: AUC of 0.94 [0.85-0.98], positive and negative LRs of 5.7 [4.6-6.8] and 0.07 [0.009-0.5], respectively, for a cutoff of 9%. Of note, invasive AP-derived indices did not outperform noninvasiveΔ(PLR)SAP. Regardless of CVP (i.e., during "blind PLR"), noninvasiveΔ(PLR)SAP more than 17% reliably identified fluid responders. During "CVP-guided PLR", in case of sufficient change in CVP, noninvasiveΔ(PLR)SAP performed better (cutoff of 9%). These findings, in sedated patients who had already undergone volume expansion and/or catecholamines, have to be verified during the early phase of circulatory failure (before an arterial line and/or a CO measuring device is placed). Copyright © 2012 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  2. Fluid challenge: tracking changes in cardiac output with blood pressure monitoring (invasive or non-invasive).

    PubMed

    Lakhal, Karim; Ehrmann, Stephan; Perrotin, Dominique; Wolff, Michel; Boulain, Thierry

    2013-11-01

    To assess whether invasive and non-invasive blood pressure (BP) monitoring allows the identification of patients who have responded to a fluid challenge, i.e., who have increased their cardiac output (CO). Patients with signs of circulatory failure were prospectively included. Before and after a fluid challenge, CO and the mean of four intra-arterial and oscillometric brachial cuff BP measurements were collected. Fluid responsiveness was defined by an increase in CO ≥10 or ≥15% in case of regular rhythm or arrhythmia, respectively. In 130 patients, the correlation between a fluid-induced increase in pulse pressure (Δ500mlPP) and fluid-induced increase in CO was weak and was similar for invasive and non-invasive measurements of BP: r² = 0.31 and r² = 0.29, respectively (both p < 0.001). For the identification of responders, invasive Δ500mlPP was associated with an area under the receiver-operating curve (AUC) of 0.82 (0.74-0.88), similar (p = 0.80) to that of non-invasive Δ500mlPP [AUC of 0.81 (0.73-0.87)]. Outside large gray zones of inconclusive values (5-23% for invasive Δ500mlPP and 4-35% for non-invasive Δ500mlPP, involving 35 and 48% of patients, respectively), the detection of responsiveness or unresponsiveness to fluid was reliable. Cardiac arrhythmia did not impair the performance of invasive or non-invasive Δ500mlPP. Other BP-derived indices did not outperform Δ500mlPP. As evidenced by large gray zones, BP-derived indices poorly reflected fluid responsiveness. However, in our deeply sedated population, a high increase in invasive pulse pressure (>23%) or even in non-invasive pulse pressure (>35%) reliably detected a response to fluid. In the absence of a marked increase in pulse pressure (<4-5%), a response to fluid was unlikely.

  3. Opposing effects of particle pollution, ozone, and ambient temperature on arterial blood pressure.

    PubMed

    Hoffmann, Barbara; Luttmann-Gibson, Heike; Cohen, Allison; Zanobetti, Antonella; de Souza, Celine; Foley, Christopher; Suh, Helen H; Coull, Brent A; Schwartz, Joel; Mittleman, Murray; Stone, Peter; Horton, Edward; Gold, Diane R

    2012-02-01

    Diabetes increases the risk of hypertension and orthostatic hypotension and raises the risk of cardiovascular death during heat waves and high pollution episodes. We examined whether short-term exposures to air pollution (fine particles, ozone) and heat resulted in perturbation of arterial blood pressure (BP) in persons with type 2 diabetes mellitus (T2DM). We conducted a panel study in 70 subjects with T2DM, measuring BP by automated oscillometric sphygmomanometer and pulse wave analysis every 2 weeks on up to five occasions (355 repeated measures). Hourly central site measurements of fine particles, ozone, and meteorology were conducted. We applied linear mixed models with random participant intercepts to investigate the association of fine particles, ozone, and ambient temperature with systolic, diastolic, and mean arterial BP in a multipollutant model, controlling for season, meteorological variables, and subject characteristics. An interquartile increase in ambient fine particle mass [particulate matter (PM) with an aerodynamic diameter of ≤ 2.5 μm (PM2.5)] and in the traffic component black carbon in the previous 5 days (3.54 and 0.25 μg/m3, respectively) predicted increases of 1.4 mmHg [95% confidence interval (CI): 0.0, 2.9 mmHg] and 2.2 mmHg (95% CI: 0.4, 4.0 mmHg) in systolic BP (SBP) at the population geometric mean, respectively. In contrast, an interquartile increase in the 5-day mean of ozone (13.3 ppb) was associated with a 5.2 mmHg (95% CI: -8.6, -1.8 mmHg) decrease in SBP. Higher temperatures were associated with a marginal decrease in BP. In subjects with T2DM, PM was associated with increased BP, and ozone was associated with decreased BP. These effects may be clinically important in patients with already compromised autoregulatory function.

  4. Assessment of the biological effects of welding fumes emitted from metal inert gas welding processes of aluminium and zinc-plated materials in humans.

    PubMed

    Hartmann, L; Bauer, M; Bertram, J; Gube, M; Lenz, K; Reisgen, U; Schettgen, T; Kraus, T; Brand, P

    2014-03-01

    The aim of this study was to investigate biological effects and potential health risks due to two different metal-inert-gas (MIG) welding fumes (MIG welding of aluminium and MIG soldering of zinc coated steel) in healthy humans. In a threefold cross-over design study 12 male subjects were exposed to three different exposure scenarios. Exposures were performed under controlled conditions in the Aachener Workplace Simulation Laboratory (AWSL). On three different days the subjects were either exposed to filtered ambient air, to welding fumes from MIG welding of aluminium, or to fumes from MIG soldering of zinc coated materials. Exposure was performed for 6 h and the average fume concentration was 2.5 mg m(-3). Before, directly after, 1 day after, and 7 days after exposure spirometric and impulse oscillometric measurements were performed, exhaled breath condensate (EBC) was collected and blood samples were taken and analyzed for inflammatory markers. During MIG welding of aluminium high ozone concentrations (up to 250 μg m(-3)) were observed, whereas ozone was negligible for MIG soldering. For MIG soldering, concentrations of high-sensitivity CRP (hsCRP) and factor VIII were significantly increased but remained mostly within the normal range. The concentration of neutrophils increased in tendency. For MIG welding of aluminium, the lung function showed significant decreases in Peak Expiratory Flow (PEF) and Mean Expiratory Flow at 75% vital capacity (MEF 75) 7 days after exposure. The concentration of ristocetin cofactor was increased. The observed increase of hsCRP during MIG-soldering can be understood as an indicator for asymptomatic systemic inflammation probably due to zinc (zinc concentration 1.5 mg m(-3)). The change in lung function observed after MIG welding of aluminium may be attributed to ozone inhalation, although the late response (7 days after exposure) is surprising. Copyright © 2013 Elsevier GmbH. All rights reserved.

  5. Automated office and home phone-transmitted blood pressure recordings in uncontrolled hypertension treated with valsartan and hydrochlorothiazide.

    PubMed

    Girerd, Xavier; Denolle, Thierry; Yau, Caroline; Fiquet, Béatrice; Brunel, Patrick; Moulin, Bruno; Herpin, Daniel

    2004-12-01

    The study objective was to evaluate, by means of automated office and phone-transmitted home blood pressure (OBP and HBP) recordings, the effects of a fixed combination of valsartan 160 mg and hydrochlorothiazide (HCTZ) 25 mg in hypertensive patients previously uncontrolled with the combination of an angiotensin receptor antagonist and HCTZ. From 241 selected patients, 171 (71%) had uncontrolled hypertension OBP and HBP [mean baseline OBP and HBP systolic and diastolic (SBP/DBP): 157/91 and 152/87 mmHg]. In this open-design study, patients were directly switched from other angiotensin receptor blocker combination products to valsartan/HCTZ for 6 weeks. The same validated automated device was used for OBP and HBP recordings. At baseline, mean HBP was 152 +/- 15/87 +/- 10 mmHg and mean OBP was 157 +/- 12/91 +/- 9 mmHg. After 6 weeks of treatment with valsartan 160 mg and HCTZ 25 mg, a significant decrease in BP was observed both at home (146 +/- 17/83 +/- 12 mmHg) and at the office (151 +/- 18/87 +/- 11 mmHg), with a difference from baseline of -4 mmHg, p < 0.001 for DBP and of -6 mmHg for SBP, p < 0.001. The percentage of patients with office and home control was 24% and 23% respectively, with a kappa index at 0.459. Elevated OBP only (office hypertension) was observed in 3.6% and elevated HBP only (masked hypertension) in 10% of patients. In conclusion, treatment with valsartan and HCTZ 25 mg in patients with confirmed uncontrolled hypertension induced a clinically relevant decrease in BP with approximately 23% of additional patients strictly controlled with a single tablet. The use of an automated oscillometric device at the office and at home allowed the detection of controlled subjects with good agreement.

  6. Dietary sodium and potassium intakes: Data from urban and rural areas.

    PubMed

    Mizéhoun-Adissoda, Carmelle; Houinato, Dismand; Houehanou, Corine; Chianea, Thierry; Dalmay, François; Bigot, André; Aboyans, Victor; Preux, Pierre-Marie; Bovet, Pascal; Desport, Jean-Claude

    2017-01-01

    Hypertension is highly prevalent in West African populations, but little data is available on salt and potassium intake in these populations. We assumed in this study that sodium and potassium intake might be high and low, respectively, in the Beninese population in view of the emerging nutritional transition. The aim of this study was to estimate dietary sodium and potassium intakes based on 24-h urine collections. We selected 420 individuals (ages 25-64 y), representative of the population, from urban and rural areas in Benin. Urine was collected over 24 h, and sodium, potassium, and creatinine were quantified. Blood pressure was measured on the left arm using a validated electronic oscillometric monitor. Adequate data were available for 354 participants. Mean dietary intake of sodium and potassium were 4.4 ± 2.1 and 1.8 ± 0.9 g/24 h, respectively. High intake of sodium was associated with urban area, age <44 y, administrative occupation, higher income, body mass index (BMI) ≥25 kg/m 2 , and a large waist circumference. High potassium intake was associated with male sex, administrative occupation, BMI ≥25 kg/m 2 , and large waist circumference. Sodium intake was associated with high systolic and diastolic blood pressures. In multivariate analysis, only age <44 y and, marginally, BMI ≥25 kg/m 2 were associated with high sodium intake, whereas male sex and a BMI ≥25 kg/m 2 were associated with high potassium intake. Large proportions of the population had sodium intake higher, and potassium intake lower, than dietary recommendations. These results suggest that interventions to reduce salt consumption and promote potassium-rich foods, including fruits and vegetables, are needed in Benin. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Regression of left ventricular hypertrophy provides an additive physiological benefit following treatment of aortic stenosis: insights from serial coronary wave-intensity analysis.

    PubMed

    Broyd, Christopher J; Rigo, Fausto; Nijjer, Sukhjinder; Sen, Sayan; Petraco, Ricardo; Al-Lamee, Rasha; Foin, Nicolas; Chukwuemeka, Andrew; Anderson, Jon; Parker, Jessica; Malik, Iqbal S; Mikhail, Ghada W; Francis, Darrel P; Parker, Kim; Hughes, Alun D; Mayet, Jamil; Davies, Justin E

    2018-06-23

    Severe aortic stenosis frequently involves the development of left ventricular hypertrophy (LVH) creating a dichotomous hemodynamic state within the coronary circulation. Whilst the increased force of ventricular contraction enhances its resultant relaxation and thus increases the distal diastolic coronary 'suction' force, the presence of LVH has a potentially opposing effect on ventricular-coronary interplay. The aim of this study was to use non-invasive coronary wave-intensity analysis (WIA) to separate and measure the sequential effects of outflow-tract obstruction relief and then left ventricular hypertrophy (LVH) regression following intervention for aortic stenosis. 15 patients with unobstructed coronary arteries undergoing aortic valve intervention (11 SAVR, 4 TAVI) were successfully assessed before and after intervention, and at 6- and 12-months post-procedure. Coronary WIA was constructed from simultaneously acquired coronary flow from transthoracic echo and pressure from an oscillometric brachial-cuff system. Immediately following intervention, a decline in the BDW was noted (9.7±5.7 vs 5.1±3.6 x10 3 Wm -2 s -1 , p<0.01). Over 12 months, LV mass-index fell from 114±19 to 82±17 kg/m 2 . Accompanying this, the BDW fraction increased to 32.8±7.2% (p=0.01 vs post-procedure) and to 34.7±6.7% at 12 months (p<0.001 vs post-procedure). In aortic stenosis, both the outflow-tract gradient and the presence of LVH impact significantly on coronary haemodynamics that cannot be appreciated by examining resting coronary flow rates alone. An immediate change in coronary wave-intensity occurs following intervention with further effects appreciable with hypertrophy regression. The improvement in prognosis with treatment is likely to be attributable to both features. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  8. Bringing Creativity into Being: Underlying Assumptions That Influence Methods of Studying Organizational Creativity

    ERIC Educational Resources Information Center

    Taylor, Mark; Callahan, Jamie L.

    2005-01-01

    We compare different epistemological frameworks for the effective collection of creativity data. We suggest that researchers' epistemological approaches can significantly influence collection methods and subsequent outcomes. Classic sociological epistemological approaches--functionalism, interpretivism, radical humanism, and radical structuralism…

  9. A Study of Upward Influence in Organizations.

    ERIC Educational Resources Information Center

    Schilit, Warren K.; Locke, Edwin A.

    1982-01-01

    Researchers interviewed 83 subordinate employees and 70 supervisory employees to investigate the ways subordinates try to influence their supervisors. Supervisors and subordinates reported similar agents and methods of influence, causes of success, and outcomes of attempts at upward influence, but different causes of failure. (Author/RW)

  10. Influence maximization in social networks under an independent cascade-based model

    NASA Astrophysics Data System (ADS)

    Wang, Qiyao; Jin, Yuehui; Lin, Zhen; Cheng, Shiduan; Yang, Tan

    2016-02-01

    The rapid growth of online social networks is important for viral marketing. Influence maximization refers to the process of finding influential users who make the most of information or product adoption. An independent cascade-based model for influence maximization, called IMIC-OC, was proposed to calculate positive influence. We assumed that influential users spread positive opinions. At the beginning, users held positive or negative opinions as their initial opinions. When more users became involved in the discussions, users balanced their own opinions and those of their neighbors. The number of users who did not change positive opinions was used to determine positive influence. Corresponding influential users who had maximum positive influence were then obtained. Experiments were conducted on three real networks, namely, Facebook, HEP-PH and Epinions, to calculate maximum positive influence based on the IMIC-OC model and two other baseline methods. The proposed model resulted in larger positive influence, thus indicating better performance compared with the baseline methods.

  11. Vocal Ergonomics in the Workplace: Heating, Ventilation, and Air-Conditioning Method Influences on Vocal Comfort and Function

    ERIC Educational Resources Information Center

    Sandage, Mary J.; Rahn, Keith A.; Smith, Audrey G.

    2017-01-01

    Purpose: The purpose of this study was to examine the influence of the heating, ventilation, and air-conditioning method on voice function following a voicing task using ecologically valid offices, one with radiant HVAC and one with forced air. Method: A total of 12 consented participants (6 women, 6 men) narrated a video in each of 4…

  12. Collective Leadership: Principals' Decision Influence and the Supportive or Inhibiting Decision Influence of Other Stakeholders

    ERIC Educational Resources Information Center

    Ni, Yongmei; Yan, Rui; Pounder, Diana

    2018-01-01

    Purpose: Using the collective leadership framework, this study examines (a) how principals perceive their own influence and that of other key stakeholders in various school decisions and (b) how principals' perceived influences of other stakeholders are associated with their own influence. Research Method/Approach: This study uses the nationally…

  13. Scaffolds with a standardized macro-architecture fabricated from several calcium phosphate ceramics using an indirect rapid prototyping technique

    PubMed Central

    Wilson, C. E.; van Blitterswijk, C. A.; Verbout, A. J.; de Bruijn, J. D.

    2010-01-01

    Calcium phosphate ceramics, commonly applied as bone graft substitutes, are a natural choice of scaffolding material for bone tissue engineering. Evidence shows that the chemical composition, macroporosity and microporosity of these ceramics influences their behavior as bone graft substitutes and bone tissue engineering scaffolds but little has been done to optimize these parameters. One method of optimization is to place focus on a particular parameter by normalizing the influence, as much as possible, of confounding parameters. This is difficult to accomplish with traditional fabrication techniques. In this study we describe a design based rapid prototyping method of manufacturing scaffolds with virtually identical macroporous architectures from different calcium phosphate ceramic compositions. Beta-tricalcium phosphate, hydroxyapatite (at two sintering temperatures) and biphasic calcium phosphate scaffolds were manufactured. The macro- and micro-architectures of the scaffolds were characterized as well as the influence of the manufacturing method on the chemistries of the calcium phosphate compositions. The structural characteristics of the resulting scaffolds were remarkably similar. The manufacturing process had little influence on the composition of the materials except for the consistent but small addition of, or increase in, a beta-tricalcium phosphate phase. Among other applications, scaffolds produced by the method described provide a means of examining the influence of different calcium phosphate compositions while confidently excluding the influence of the macroporous structure of the scaffolds. PMID:21069558

  14. Dosimetric evaluation of intrafractional tumor motion by means of a robot driven phantom

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

    Richter, Anne; Wilbert, Juergen; Flentje, Michael

    2011-10-15

    Purpose: The aim of the work was to investigate the influence of intrafractional tumor motion to the accumulated (absorbed) dose. The accumulated dose was determined by means of calculations and measurements with a robot driven motion phantom. Methods: Different motion scenarios and compensation techniques were realized in a phantom study to investigate the influence of motion on image acquisition, dose calculation, and dose measurement. The influence of motion on the accumulated dose was calculated by employing two methods (a model based and a voxel based method). Results: Tumor motion resulted in a blurring of steep dose gradients and a reductionmore » of dose at the periphery of the target. A systematic variation of motion parameters allowed the determination of the main influence parameters on the accumulated dose. The key parameters with the greatest influence on dose were the mean amplitude and the pattern of motion. Investigations on necessary safety margins to compensate for dose reduction have shown that smaller safety margins are sufficient, if the developed concept with optimized margins (OPT concept) was used instead of the standard internal target volume (ITV) concept. Both calculation methods were a reasonable approximation of the measured dose with the voxel based method being in better agreement with the measurements. Conclusions: Further evaluation of available systems and algorithms for dose accumulation are needed to create guidelines for the verification of the accumulated dose.« less

  15. Environmental influences on methods used to collect dietary data from children.

    PubMed

    Frank, G C

    1994-01-01

    When collecting dietary data on children, confidence about responses is required. Children exist in multienvironments in their everyday lives, eg, the personal, school, home, peer, medical care, media, food industry, and fast-food facility environments. These macroenvironments influence the format and type of data-collection methods used to interview today's youth. Researchers should identify the influence of each environment on the child's eating pattern and nutrient intake, explore the pros and cons of various data-collection methods amid these environments, and determine unresolved methodological issues to stimulate future research. Standardized protocols for interviewing children, exclusion criteria for surrogate responses, and currency of nutrient data for new food products available to children are needed. Redefining our methods by understanding the macroenvironments of youth can create a dietary methodology for the 21st century--an evolutionary method that builds on past research and incorporates current technology and societal changes.

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

    Ji, Changyoon, E-mail: changyoon@yonsei.ac.kr; Hong, Taehoon, E-mail: hong7@yonsei.ac.kr

    Previous studies have proposed several methods for integrating characterized environmental impacts as a single index in life cycle assessment. Each of them, however, may lead to different results. This study presents internal and external normalization methods, weighting factors proposed by panel methods, and a monetary valuation based on an endpoint life cycle impact assessment method as the integration methods. Furthermore, this study investigates the differences among the integration methods and identifies the causes of the differences through a case study in which five elementary school buildings were used. As a result, when using internal normalization with weighting factors, the weightingmore » factors had a significant influence on the total environmental impacts whereas the normalization had little influence on the total environmental impacts. When using external normalization with weighting factors, the normalization had more significant influence on the total environmental impacts than weighing factors. Due to such differences, the ranking of the five buildings varied depending on the integration methods. The ranking calculated by the monetary valuation method was significantly different from that calculated by the normalization and weighting process. The results aid decision makers in understanding the differences among these integration methods, and, finally, help them select the method most appropriate for the goal at hand.« less

  17. [Nursing research and positivism].

    PubMed

    de Almeida, A M; de Oliveira, E R; Garcia, T R

    1996-04-01

    The authors discuss positivism foundations; the most remarkable influences to comtian's philosophy structuration; how Comte's ideas, as doctrine in so far as method, dominate society's thoughts, passing beyond XIX century and reaching XX century; and how the positivist doctrine and empirical method influenced Nursing conceptions about science and about human being/environment/disease.

  18. Collective Influence of Multiple Spreaders Evaluated by Tracing Real Information Flow in Large-Scale Social Networks.

    PubMed

    Teng, Xian; Pei, Sen; Morone, Flaviano; Makse, Hernán A

    2016-10-26

    Identifying the most influential spreaders that maximize information flow is a central question in network theory. Recently, a scalable method called "Collective Influence (CI)" has been put forward through collective influence maximization. In contrast to heuristic methods evaluating nodes' significance separately, CI method inspects the collective influence of multiple spreaders. Despite that CI applies to the influence maximization problem in percolation model, it is still important to examine its efficacy in realistic information spreading. Here, we examine real-world information flow in various social and scientific platforms including American Physical Society, Facebook, Twitter and LiveJournal. Since empirical data cannot be directly mapped to ideal multi-source spreading, we leverage the behavioral patterns of users extracted from data to construct "virtual" information spreading processes. Our results demonstrate that the set of spreaders selected by CI can induce larger scale of information propagation. Moreover, local measures as the number of connections or citations are not necessarily the deterministic factors of nodes' importance in realistic information spreading. This result has significance for rankings scientists in scientific networks like the APS, where the commonly used number of citations can be a poor indicator of the collective influence of authors in the community.

  19. On the Interpretation of the Influence of Substituents on the UV-Spectroscopic Properties of Benzimidazole and Indazole Derivatives (In German)

    NASA Astrophysics Data System (ADS)

    Fabian, Walter

    1983-12-01

    On the interpretation of the influence of substituents on the UV-spectroscopic properties of benzimidazole and indazole derivatives. The UV spectra of a series of substituted benzimidazoles and indazoles were calculated by means of semiempirical quantum chemical methods (PPP, CNDO/S-CI). The results of the PPP calculations were subjected to a configuration analysis. Using this method, the influence of the nature and position of substituents on the absorption characteristics could be rationalized.

  20. Mutual influence of molecular diffusion in gas and surface phases

    NASA Astrophysics Data System (ADS)

    Hori, Takuma; Kamino, Takafumi; Yoshimoto, Yuta; Takagi, Shu; Kinefuchi, Ikuya

    2018-01-01

    We develop molecular transport simulation methods that simultaneously deal with gas- and surface-phase diffusions to determine the effect of surface diffusion on the overall diffusion coefficients. The phenomenon of surface diffusion is incorporated into the test particle method and the mean square displacement method, which are typically employed only for gas-phase transport. It is found that for a simple cylindrical pore, the diffusion coefficients in the presence of surface diffusion calculated by these two methods show good agreement. We also confirm that both methods reproduce the analytical solution. Then, the diffusion coefficients for ink-bottle-shaped pores are calculated using the developed method. Our results show that surface diffusion assists molecular transport in the gas phase. Moreover, the surface tortuosity factor, which is known to be uniquely determined by physical structure, is influenced by the presence of gas-phase diffusion. This mutual influence of gas-phase diffusion and surface diffusion indicates that their simultaneous calculation is necessary for an accurate evaluation of the diffusion coefficients.

  1. Influence of outliers on accuracy estimation in genomic prediction in plant breeding.

    PubMed

    Estaghvirou, Sidi Boubacar Ould; Ogutu, Joseph O; Piepho, Hans-Peter

    2014-10-01

    Outliers often pose problems in analyses of data in plant breeding, but their influence on the performance of methods for estimating predictive accuracy in genomic prediction studies has not yet been evaluated. Here, we evaluate the influence of outliers on the performance of methods for accuracy estimation in genomic prediction studies using simulation. We simulated 1000 datasets for each of 10 scenarios to evaluate the influence of outliers on the performance of seven methods for estimating accuracy. These scenarios are defined by the number of genotypes, marker effect variance, and magnitude of outliers. To mimic outliers, we added to one observation in each simulated dataset, in turn, 5-, 8-, and 10-times the error SD used to simulate small and large phenotypic datasets. The effect of outliers on accuracy estimation was evaluated by comparing deviations in the estimated and true accuracies for datasets with and without outliers. Outliers adversely influenced accuracy estimation, more so at small values of genetic variance or number of genotypes. A method for estimating heritability and predictive accuracy in plant breeding and another used to estimate accuracy in animal breeding were the most accurate and resistant to outliers across all scenarios and are therefore preferable for accuracy estimation in genomic prediction studies. The performances of the other five methods that use cross-validation were less consistent and varied widely across scenarios. The computing time for the methods increased as the size of outliers and sample size increased and the genetic variance decreased. Copyright © 2014 Ould Estaghvirou et al.

  2. Factors that influence utilisation of HIV/AIDS prevention methods among university students residing at a selected university campus.

    PubMed

    Ndabarora, Eléazar; Mchunu, Gugu

    2014-01-01

    Various studies have reported that university students, who are mostly young people, rarely use existing HIV/AIDS preventive methods. Although studies have shown that young university students have a high degree of knowledge about HIV/AIDS and HIV modes of transmission, they are still not utilising the existing HIV prevention methods and still engage in risky sexual practices favourable to HIV. Some variables, such as awareness of existing HIV/AIDS prevention methods, have been associated with utilisation of such methods. The study aimed to explore factors that influence use of existing HIV/AIDS prevention methods among university students residing in a selected campus, using the Health Belief Model (HBM) as a theoretical framework. A quantitative research approach and an exploratory-descriptive design were used to describe perceived factors that influence utilisation by university students of HIV/AIDS prevention methods. A total of 335 students completed online and manual questionnaires. Study findings showed that the factors which influenced utilisation of HIV/AIDS prevention methods were mainly determined by awareness of the existing university-based HIV/AIDS prevention strategies. Most utilised prevention methods were voluntary counselling and testing services and free condoms. Perceived susceptibility and perceived threat of HIV/AIDS score was also found to correlate with HIV risk index score. Perceived susceptibility and perceived threat of HIV/AIDS showed correlation with self-efficacy on condoms and their utilisation. Most HBM variables were not predictors of utilisation of HIV/AIDS prevention methods among students. Intervention aiming to improve the utilisation of HIV/AIDS prevention methods among students at the selected university should focus on removing identified barriers, promoting HIV/AIDS prevention services and providing appropriate resources to implement such programmes.

  3. A Network Method of Measuring Affiliation-based Peer Influence: Assessing the Influences of Teammates’ Smoking on Adolescent Smoking

    PubMed Central

    Fujimoto, Kayo; Unger, Jennifer B.; Valente, Thomas W.

    2011-01-01

    Using a network analytic framework, this study introduces a new method to measure peer influence based on adolescents’ affiliations or two-mode social network data. Exposure based on affiliations is referred to as the “affiliation exposure model.” This study demonstrates the methodology using data on young adolescent smoking being influenced by joint participation in school-based organized sports activities with smokers. The analytic sample consisted of 1260 American adolescents from age 10 to 13 in middle schools, and the results of the longitudinal regression analyses showed that adolescents were more likely to smoke as they were increasingly exposed to teammates who smoke. This study illustrates the importance of peer influence via affiliation through team sports. PMID:22313152

  4. Common method biases in behavioral research: a critical review of the literature and recommended remedies.

    PubMed

    Podsakoff, Philip M; MacKenzie, Scott B; Lee, Jeong-Yeon; Podsakoff, Nathan P

    2003-10-01

    Interest in the problem of method biases has a long history in the behavioral sciences. Despite this, a comprehensive summary of the potential sources of method biases and how to control for them does not exist. Therefore, the purpose of this article is to examine the extent to which method biases influence behavioral research results, identify potential sources of method biases, discuss the cognitive processes through which method biases influence responses to measures, evaluate the many different procedural and statistical techniques that can be used to control method biases, and provide recommendations for how to select appropriate procedural and statistical remedies for different types of research settings.

  5. An optimized method to calculate error correction capability of tool influence function in frequency domain

    NASA Astrophysics Data System (ADS)

    Wang, Jia; Hou, Xi; Wan, Yongjian; Shi, Chunyan

    2017-10-01

    An optimized method to calculate error correction capability of tool influence function (TIF) in certain polishing conditions will be proposed based on smoothing spectral function. The basic mathematical model for this method will be established in theory. A set of polishing experimental data with rigid conformal tool is used to validate the optimized method. The calculated results can quantitatively indicate error correction capability of TIF for different spatial frequency errors in certain polishing conditions. The comparative analysis with previous method shows that the optimized method is simpler in form and can get the same accuracy results with less calculating time in contrast to previous method.

  6. Preliminary Results on the Influence of Engineered Artificial Mucus Layer on Phonation

    ERIC Educational Resources Information Center

    Döllinger, Michael; Gröhn, Franziska; Berry, David A.; Eysholdt, Ulrich; Luegmair, Georg

    2014-01-01

    Purpose: Previous studies have confirmed the influence of dehydration and an altered mucus (e.g., due to pathologies) on phonation. However, the underlying reasons for these influences are not fully understood. This study was a preliminary inquiry into the influences of mucus architecture and concentration on vocal fold oscillation. Method: Two…

  7. Validation of the Cultural Influence on Helping Scale among Chinese Adolescents

    ERIC Educational Resources Information Center

    Law, Ben M. F.; Shek, Daniel T. L.

    2011-01-01

    The influence of culture on adolescent prosocial behavior is a neglected aspect in existing studies. Objectives: This study evaluates the psychometric properties of the Cultural Influence on Helping Scale (CIHS) among Chinese adolescents. CIHS is an instrument that assesses Chinese cultural influence on helping other people. Method: The CIHS was…

  8. The influence of wives' and husbands' education levels on contraceptive method choice in Nepal, 1996-2006.

    PubMed

    Gubhaju, Bina

    2009-12-01

    The association between education level and fertility, contraceptive behavior and method choice has been extensively researched, but little is known about how the education differential between husbands and wives in Nepal may influence the choice of specific methods. Data collected from currently married, nonpregnant women aged 15-49 in the Nepal Demographic and Health Surveys of 1996, 2001 and 2006 were analyzed to identify shifts in the education levels of husbands and wives and the influence of those shifts on couples' current contraceptive method use over the past decade. Multinomial logistic regression models assessed associations between method choice and each partner's education level, the education differential between partners and a combined education measure. Although the wife's education level was associated with the type of method used by the couple, the husband's education level had more influence on the use of male sterilization and condoms. For example, men with any secondary or higher education were more likely than those with none to rely on either of these methods (relative risk ratios, 1.6-2.1). Furthermore, couples in which the husband had at least six more years of education than the wife also showed increased reliance on male sterilization or condoms (1.6-1.8). Differences in the use of any method of family planning by education level have narrowed considerably in the past decade, although differentials remain in the use of some methods. A better understanding of how wives' and husbands' relative educational attainment affects decisions on their contraceptive choices is needed, particularly when both education levels and contraceptive use are increasing.

  9. Molecular Alterations that Reduce Cortical Containment of Tubulin Microtentacles and their Impact on Breast Tumor Metastasis

    DTIC Science & Technology

    2010-04-01

    This technique provides a reliable method of determining cellular plasticity and metastatic potential [5, 6]. These studies are nearing completion and...directed chemotherapies could influence CTCs and high- lights the need to investigate these effects. Current methods for detecting CTCs in metastatic...understanding of how these compounds influence detached and circulating tumor cells. Materials and methods Cell culture MCF-10A human MECs were

  10. The analysis of waste treatment methods and managerial skills towards the effectiveness of CO2 emmissions (an ex post facto study at TPA Bantar Gebang Bekasi)

    NASA Astrophysics Data System (ADS)

    Ria Rajagukguk, Jenni; Siagian, Lestina

    2017-09-01

    In the last three years, Java Island produces 29.413.336 m3/year of waste, coming from settlement (house hold) and non-settlement waste. Recently, this waste is managed with conventional technology, composting and recycling. Based on law No. 18 of 2008 on Waste Management, Chapter III Article 5, it is firmly stated that the government and regional governments are responsible for ensuring proper and environmentally sound waste management in accordance with the objectives. The observation of managerial skills is highly needed to investigate the operation of waste management at TPA Bantar Gebang towards the effectiveness of CO2 emissions.The problems are (1)Whether there is any influence between the method of waste management through Biogas Technology to the effectiveness of CO2 emissions. (2) Whether there is any influence between managerial skills to effectiveness of CO2 emission. (3) Whether there is any simultaneous influence between waste management method and managerial skill to CO2 emission effectiveness and (4) how is the method of waste management. Quantitative and egineering method were used to process the data.Biogas Technology variables and Managerial Skill are simultaneously and significantly influenced to CO2 Emission Effectiveness, this is based on Fh > Ft value of 168,453 > 3.072467) and its significance is 0.000 < 0,05. Then Ho was rejected and Ha was accepted which means that variable of Managerial Skill have influence or very big influence to Effeciveness of CO2 Emission, Correlation coefficient value 94,1% which means there is very strong relation between variable of Biogas Technology, Managerial Skill to Effectiveness of CO2 emission. Then Technology management through Biogas Technology is anaerobic biology.

  11. Experimental and numerical investigation into the influence of loading conditions in biomechanical testing of locking plate fracture fixation devices

    PubMed Central

    MacLeod, A.; Simpson, A. H. R. W.

    2018-01-01

    Objectives Secondary fracture healing is strongly influenced by the stiffness of the bone-fixator system. Biomechanical tests are extensively used to investigate stiffness and strength of fixation devices. The stiffness values reported in the literature for locked plating, however, vary by three orders of magnitude. The aim of this study was to examine the influence that the method of restraint and load application has on the stiffness produced, the strain distribution within the bone, and the stresses in the implant for locking plate constructs. Methods Synthetic composite bones were used to evaluate experimentally the influence of four different methods of loading and restraining specimens, all used in recent previous studies. Two plate types and three screw arrangements were also evaluated for each loading scenario. Computational models were also developed and validated using the experimental tests. Results The method of loading was found to affect the gap stiffness strongly (by up to six times) but also the magnitude of the plate stress and the location and magnitude of strains at the bone-screw interface. Conclusions This study demonstrates that the method of loading is responsible for much of the difference in reported stiffness values in the literature. It also shows that previous contradictory findings, such as the influence of working length and very large differences in failure loads, can be readily explained by the choice of loading condition. Cite this article: A. MacLeod, A. H. R. W. Simpson, P. Pankaj. Experimental and numerical investigation into the influence of loading conditions in biomechanical testing of locking plate fracture fixation devices. Bone Joint Res 2018;7:111–120. DOI: 10.1302/2046-3758.71.BJR-2017-0074.R2. PMID:29363522

  12. Factors, Practices, and Policies Influencing Students' Upward Transfer to Baccalaureate-Degree Programs and Institutions: A Mixed Methods Analysis

    ERIC Educational Resources Information Center

    LaSota, Robin Rae

    2013-01-01

    My dissertation utilizes an explanatory, sequential mixed-methods research design to assess factors influencing community college students' transfer probability to baccalaureate-granting institutions and to present promising practices in colleges and states directed at improving upward transfer, particularly for low-income and first-generation…

  13. A method of selecting forest sites for air pollution study

    Treesearch

    Sreedevi K. Bringi; Thomas A. Seliga; Leon S. Dochinger

    1981-01-01

    Presents a method of selecting suitable forested areas for meaningful assessments of air pollution effects. The approach is based on the premise that environmental influences can significantly affect the forest-air pollution relationship, and that it is, therefore, desirable to equalize such influences at different sites. From existing data on environmental factors and...

  14. [Islet isolation outcome is influenced by pancreas preparation method].

    PubMed

    Pokrywczyńska, Marta; Drewa, Tomasz; Cieślak, Zaneta

    2008-09-01

    Pancreatic islet transplantation is a treatment method for type I diabetes. Its outcome is influenced by numerous factors, islet quantity and function being important ones of them. was to estimate the influence of pancreas preparation method on the outcome of islet isolation in rat. 6 pancreata harvested from Lewis rats were used in this research. Pancreatic duct was cannulated and pancreas was injected with 1 mg/ml collagenase P solution (Sigma) and then excised. After cutting into smaller fragments, it was digested in collagenase P solution for 15-20 min. Enzyme activity was then stopped by adding dilution medium. Heterogenous cell suspension was centrifuged in density gradient (Gradisol) to isolate islets. Pancreatic islets were collected and islet equivalent was calculated. Islet purity degree was estimated as islet cells to all cells, including exocrine, ratio. Islet viability was estimated using propidium iodide and fluorescein diacetate staining. Photographic documentation was made. Proper islet morphology, highest number and viability was obtained when pancreas was excised properly (isolation 3 and 4). Pancreas preparation method is one of which influences on islet isolation outcome.

  15. Hierarchical and coupling model of factors influencing vessel traffic flow.

    PubMed

    Liu, Zhao; Liu, Jingxian; Li, Huanhuan; Li, Zongzhi; Tan, Zhirong; Liu, Ryan Wen; Liu, Yi

    2017-01-01

    Understanding the characteristics of vessel traffic flow is crucial in maintaining navigation safety, efficiency, and overall waterway transportation management. Factors influencing vessel traffic flow possess diverse features such as hierarchy, uncertainty, nonlinearity, complexity, and interdependency. To reveal the impact mechanism of the factors influencing vessel traffic flow, a hierarchical model and a coupling model are proposed in this study based on the interpretative structural modeling method. The hierarchical model explains the hierarchies and relationships of the factors using a graph. The coupling model provides a quantitative method that explores interaction effects of factors using a coupling coefficient. The coupling coefficient is obtained by determining the quantitative indicators of the factors and their weights. Thereafter, the data obtained from Port of Tianjin is used to verify the proposed coupling model. The results show that the hierarchical model of the factors influencing vessel traffic flow can explain the level, structure, and interaction effect of the factors; the coupling model is efficient in analyzing factors influencing traffic volumes. The proposed method can be used for analyzing increases in vessel traffic flow in waterway transportation system.

  16. Hierarchical and coupling model of factors influencing vessel traffic flow

    PubMed Central

    Liu, Jingxian; Li, Huanhuan; Li, Zongzhi; Tan, Zhirong; Liu, Ryan Wen; Liu, Yi

    2017-01-01

    Understanding the characteristics of vessel traffic flow is crucial in maintaining navigation safety, efficiency, and overall waterway transportation management. Factors influencing vessel traffic flow possess diverse features such as hierarchy, uncertainty, nonlinearity, complexity, and interdependency. To reveal the impact mechanism of the factors influencing vessel traffic flow, a hierarchical model and a coupling model are proposed in this study based on the interpretative structural modeling method. The hierarchical model explains the hierarchies and relationships of the factors using a graph. The coupling model provides a quantitative method that explores interaction effects of factors using a coupling coefficient. The coupling coefficient is obtained by determining the quantitative indicators of the factors and their weights. Thereafter, the data obtained from Port of Tianjin is used to verify the proposed coupling model. The results show that the hierarchical model of the factors influencing vessel traffic flow can explain the level, structure, and interaction effect of the factors; the coupling model is efficient in analyzing factors influencing traffic volumes. The proposed method can be used for analyzing increases in vessel traffic flow in waterway transportation system. PMID:28414747

  17. [The significance of the Montessori method and phenomenon with a particular view to the therapy of the aphasics (author's transl)].

    PubMed

    Birchmeier-Nussbaumer, A K

    1980-05-01

    The methods of the Italian physician Maria Montessori influenced the development of modern learning practices. There is general agreement that the Montessori phenomenon is personality forming. Aspects of this method, which are relevant for the rehabilitation of the brain-damaged and, in particular, the aphasics are presented. Possible shifts of emphasis within the relationship therapist - method - patient are analysed. Examples are used to outline in how far an increasingly patient-oriented therapy can influence the development of the aphasic patient.

  18. Influence of model order reduction methods on dynamical-optical simulations

    NASA Astrophysics Data System (ADS)

    Störkle, Johannes; Eberhard, Peter

    2017-04-01

    In this work, the influence of model order reduction (MOR) methods on optical aberrations is analyzed within a dynamical-optical simulation of a high precision optomechanical system. Therefore, an integrated modeling process and new methods have to be introduced for the computation and investigation of the overall dynamical-optical behavior. For instance, this optical system can be a telescope optic or a lithographic objective. In order to derive a simplified mechanical model for transient time simulations with low computational cost, the method of elastic multibody systems in combination with MOR methods can be used. For this, software tools and interfaces are defined and created. Furthermore, mechanical and optical simulation models are derived and implemented. With these, on the one hand, the mechanical sensitivity can be investigated for arbitrary external excitations and on the other hand, the related optical behavior can be predicted. In order to clarify these methods, academic examples are chosen and the influences of the MOR methods and simulation strategies are analyzed. Finally, the systems are investigated with respect to the mechanical-optical frequency responses, and in conclusion, some recommendations for the application of reduction methods are given.

  19. Influence of the Extractive Method on the Recovery of Phenolic Compounds in Different Parts of Hymenaea martiana Hayne

    PubMed Central

    Oliveira, Fernanda Granja da Silva; de Lima-Saraiva, Sarah Raquel Gomes; Oliveira, Ana Paula; Rabêlo, Suzana Vieira; Rolim, Larissa Araújo; Almeida, Jackson Roberto Guedes da Silva

    2016-01-01

    Background: Popularly known as “jatobá,” Hymenaea martiana Hayne is a medicinal plant widely used in the Brazilian Northeast for the treatment of various diseases. Objective: The aim of this study was to evaluate the influence of different extractive methods in the production of phenolic compounds from different parts of H. martiana. Materials and Methods: The leaves, bark, fruits, and seeds were dried, pulverized, and submitted to maceration, ultrasound, and percolation extractive methods, which were evaluated for yield, visual aspects, qualitative phytochemical screening, phenolic compound content, and total flavonoids. Results: The highest results of yield were obtained from the maceration of the leaves, which may be related to the contact time between the plant drug and solvent. The visual aspects of the extracts presented some differences between the extractive methods. The phytochemical screening showed consistent data with other studies of the genus. Both the vegetal part as the different extractive methods influenced significantly the levels of phenolic compounds, and the highest content was found in the maceration of the barks, even more than the content found previously. No differences between the levels of total flavonoids were significant. The highest concentration of total flavonoids was found in the ultrasound of the barks, followed by maceration on this drug. According to the results, the barks of H. martiana presented the highest total flavonoid contents. Conclusion: The results demonstrate that both the vegetable and the different extractive methods influenced significantly various parameters obtained in the various extracts, demonstrating the importance of systematic comparative studies for the development of pharmaceuticals and cosmetics. SUMMARY The phytochemical screening showed consistent data with other studies of the genus HymenaeaBoth the vegetable part and the different extractive methods influenced significantly various parameters obtained in the various extracts, including the levels of phenolic compoundsThe barks of H. martiana presented the highest total phenolic and flavonoid contents. PMID:27695267

  20. Coatings influencing thermal stress in photonic crystal fiber laser

    NASA Astrophysics Data System (ADS)

    Pang, Dongqing; Li, Yan; Li, Yao; Hu, Minglie

    2018-06-01

    We studied how coating materials influence the thermal stress in the fiber core for three holding methods by simulating the temperature distribution and the thermal stress distribution in the photonic-crystal fiber laser. The results show that coating materials strongly influence both the thermal stress in the fiber core and the stress differences caused by holding methods. On the basis of the results, a two-coating PCF was designed. This design reduces the stress differences caused by variant holding conditions to zero, then the stability of laser operations can be improved.

  1. Design of power-transmitting shifts

    NASA Technical Reports Server (NTRS)

    Loewenthal, S. H.

    1984-01-01

    Power transmission shafting which is a vital element of all rotating machinery is discussed. Design methods, based on strength considerations for sizing shafts and axles to withstand both steady and fluctuating loads are summarized. The effects of combined bending, torsional, and axial loads are considered along with many application factors that are known to influence the fatigue strength of shafting materials. Methods are presented to account for variable amplitude loading histories and their influence on limited life designs. The influences of shaft rigidity, materials, and vibration on the design are discussed.

  2. Simulating the influence of scatter and beam hardening in dimensional computed tomography

    NASA Astrophysics Data System (ADS)

    Lifton, J. J.; Carmignato, S.

    2017-10-01

    Cone-beam x-ray computed tomography (XCT) is a radiographic scanning technique that allows the non-destructive dimensional measurement of an object’s internal and external features. XCT measurements are influenced by a number of different factors that are poorly understood. This work investigates how non-linear x-ray attenuation caused by beam hardening and scatter influences XCT-based dimensional measurements through the use of simulated data. For the measurement task considered, both scatter and beam hardening are found to influence dimensional measurements when evaluated using the ISO50 surface determination method. On the other hand, only beam hardening is found to influence dimensional measurements when evaluated using an advanced surface determination method. Based on the results presented, recommendations on the use of beam hardening and scatter correction for dimensional XCT are given.

  3. Validity of Teacher Ratings in Selecting Influential Aggressive Adolescents for a Targeted Preventive Intervention

    PubMed Central

    Henry, David B.; Miller-Johnson, Shari; Simon, Thomas R.; Schoeny, Michael E.

    2009-01-01

    This study describes a method for using teacher nominations and ratings to identify socially influential, aggressive middle school students for participation in a targeted violence prevention intervention. The teacher nomination method is compared with peer nominations of aggression and influence to obtain validity evidence. Participants were urban, predominantly African American and Latino sixth-grade students who were involved in a pilot study for a large multi-site violence prevention project. Convergent validity was suggested by the high correlation of teacher ratings of peer influence and peer nominations of social influence. The teacher ratings of influence demonstrated acceptable sensitivity and specificity when predicting peer nominations of influence among the most aggressive children. Results are discussed m terms of the application of teacher nominations and ratings in large trials and full implementation of targeted prevention programs. PMID:16378226

  4. Collective Influence of Multiple Spreaders Evaluated by Tracing Real Information Flow in Large-Scale Social Networks

    NASA Astrophysics Data System (ADS)

    Teng, Xian; Pei, Sen; Morone, Flaviano; Makse, Hernán A.

    2016-10-01

    Identifying the most influential spreaders that maximize information flow is a central question in network theory. Recently, a scalable method called “Collective Influence (CI)” has been put forward through collective influence maximization. In contrast to heuristic methods evaluating nodes’ significance separately, CI method inspects the collective influence of multiple spreaders. Despite that CI applies to the influence maximization problem in percolation model, it is still important to examine its efficacy in realistic information spreading. Here, we examine real-world information flow in various social and scientific platforms including American Physical Society, Facebook, Twitter and LiveJournal. Since empirical data cannot be directly mapped to ideal multi-source spreading, we leverage the behavioral patterns of users extracted from data to construct “virtual” information spreading processes. Our results demonstrate that the set of spreaders selected by CI can induce larger scale of information propagation. Moreover, local measures as the number of connections or citations are not necessarily the deterministic factors of nodes’ importance in realistic information spreading. This result has significance for rankings scientists in scientific networks like the APS, where the commonly used number of citations can be a poor indicator of the collective influence of authors in the community.

  5. Collective Influence of Multiple Spreaders Evaluated by Tracing Real Information Flow in Large-Scale Social Networks

    PubMed Central

    Teng, Xian; Pei, Sen; Morone, Flaviano; Makse, Hernán A.

    2016-01-01

    Identifying the most influential spreaders that maximize information flow is a central question in network theory. Recently, a scalable method called “Collective Influence (CI)” has been put forward through collective influence maximization. In contrast to heuristic methods evaluating nodes’ significance separately, CI method inspects the collective influence of multiple spreaders. Despite that CI applies to the influence maximization problem in percolation model, it is still important to examine its efficacy in realistic information spreading. Here, we examine real-world information flow in various social and scientific platforms including American Physical Society, Facebook, Twitter and LiveJournal. Since empirical data cannot be directly mapped to ideal multi-source spreading, we leverage the behavioral patterns of users extracted from data to construct “virtual” information spreading processes. Our results demonstrate that the set of spreaders selected by CI can induce larger scale of information propagation. Moreover, local measures as the number of connections or citations are not necessarily the deterministic factors of nodes’ importance in realistic information spreading. This result has significance for rankings scientists in scientific networks like the APS, where the commonly used number of citations can be a poor indicator of the collective influence of authors in the community. PMID:27782207

  6. Flood-frequency prediction methods for unregulated streams of Tennessee, 2000

    USGS Publications Warehouse

    Law, George S.; Tasker, Gary D.

    2003-01-01

    Up-to-date flood-frequency prediction methods for unregulated, ungaged rivers and streams of Tennessee have been developed. Prediction methods include the regional-regression method and the newer region-of-influence method. The prediction methods were developed using stream-gage records from unregulated streams draining basins having from 1 percent to about 30 percent total impervious area. These methods, however, should not be used in heavily developed or storm-sewered basins with impervious areas greater than 10 percent. The methods can be used to estimate 2-, 5-, 10-, 25-, 50-, 100-, and 500-year recurrence-interval floods of most unregulated rural streams in Tennessee. A computer application was developed that automates the calculation of flood frequency for unregulated, ungaged rivers and streams of Tennessee. Regional-regression equations were derived by using both single-variable and multivariable regional-regression analysis. Contributing drainage area is the explanatory variable used in the single-variable equations. Contributing drainage area, main-channel slope, and a climate factor are the explanatory variables used in the multivariable equations. Deleted-residual standard error for the single-variable equations ranged from 32 to 65 percent. Deleted-residual standard error for the multivariable equations ranged from 31 to 63 percent. These equations are included in the computer application to allow easy comparison of results produced by the different methods. The region-of-influence method calculates multivariable regression equations for each ungaged site and recurrence interval using basin characteristics from 60 similar sites selected from the study area. Explanatory variables that may be used in regression equations computed by the region-of-influence method include contributing drainage area, main-channel slope, a climate factor, and a physiographic-region factor. Deleted-residual standard error for the region-of-influence method tended to be only slightly smaller than those for the regional-regression method and ranged from 27 to 62 percent.

  7. A Mixed Methods Examination of the Influence of Dimensions of Support on Training Transfer

    ERIC Educational Resources Information Center

    Schindler, Laura A.; Burkholder, Gary J.

    2016-01-01

    The purpose of this mixed methods sequential explanatory study was to explore how specific dimensions of supervisor support (mentoring, coaching, social support, and task support) influence the transfer of learned knowledge and skills to the job. Quantitative data were collected from employees (N = 48) who develop curriculum at an educational…

  8. A Mixed-Method Exploration of School Organizational and Social Relationship Factors That Influence Dropout-Decision Making in a Rural High School

    ERIC Educational Resources Information Center

    Farina, Andrea J.

    2013-01-01

    This explanatory mixed-method study explored the dropout phenomenon from an ecological perspective identifying the school organizational (academics, activities, structure) and social relationship (teachers, peers) factors that most significantly influence students' decisions to leave school prior to graduation at a rural high school in south…

  9. Perception of Teachers and Administrators on the Teaching Methods That Influence the Acquisition of Generic Skills

    ERIC Educational Resources Information Center

    Audu, R.; Bin Kamin, Yusri; Bin Musta'amal, Aede Hatib; Bin Saud, Muhammad Sukri; Hamid, Mohd. Zolkifli Abd.

    2014-01-01

    This study is designed to identify the most significant teaching methods that influence the acquisition of generic skills of mechanical engineering trades students at technical college level. Descriptive survey research design was utilized in carrying out the study. One hundred and ninety (190) respondents comprised of mechanical engineering…

  10. Parametric study on single shot peening by dimensional analysis method incorporated with finite element method

    NASA Astrophysics Data System (ADS)

    Wu, Xian-Qian; Wang, Xi; Wei, Yan-Peng; Song, Hong-Wei; Huang, Chen-Guang

    2012-06-01

    Shot peening is a widely used surface treatment method by generating compressive residual stress near the surface of metallic materials to increase fatigue life and resistance to corrosion fatigue, cracking, etc. Compressive residual stress and dent profile are important factors to evaluate the effectiveness of shot peening process. In this paper, the influence of dimensionless parameters on maximum compressive residual stress and maximum depth of the dent were investigated. Firstly, dimensionless relations of processing parameters that affect the maximum compressive residual stress and the maximum depth of the dent were deduced by dimensional analysis method. Secondly, the influence of each dimensionless parameter on dimensionless variables was investigated by the finite element method. Furthermore, related empirical formulas were given for each dimensionless parameter based on the simulation results. Finally, comparison was made and good agreement was found between the simulation results and the empirical formula, which shows that a useful approach is provided in this paper for analyzing the influence of each individual parameter.

  11. A method for studying decision-making by guideline development groups.

    PubMed

    Gardner, Benjamin; Davidson, Rosemary; McAteer, John; Michie, Susan

    2009-08-05

    Multidisciplinary guideline development groups (GDGs) have considerable influence on UK healthcare policy and practice, but previous research suggests that research evidence is a variable influence on GDG recommendations. The Evidence into Recommendations (EiR) study has been set up to document social-psychological influences on GDG decision-making. In this paper we aim to evaluate the relevance of existing qualitative methodologies to the EiR study, and to develop a method best-suited to capturing influences on GDG decision-making. A research team comprised of three postdoctoral research fellows and a multidisciplinary steering group assessed the utility of extant qualitative methodologies for coding verbatim GDG meeting transcripts and semi-structured interviews with GDG members. A unique configuration of techniques was developed to permit data reduction and analysis. Our method incorporates techniques from thematic analysis, grounded theory analysis, content analysis, and framework analysis. Thematic analysis of individual interviews conducted with group members at the start and end of the GDG process defines discrete problem areas to guide data extraction from GDG meeting transcripts. Data excerpts are coded both inductively and deductively, using concepts taken from theories of decision-making, social influence and group processes. These codes inform a framework analysis to describe and explain incidents within GDG meetings. We illustrate the application of the method by discussing some preliminary findings of a study of a National Institute for Health and Clinical Excellence (NICE) acute physical health GDG. This method is currently being applied to study the meetings of three of NICE GDGs. These cover topics in acute physical health, mental health and public health, and comprise a total of 45 full-day meetings. The method offers potential for application to other health care and decision-making groups.

  12. Determinants of modern family planning use among women of reproductive age in the Nkwanta district of Ghana: a case–control study

    PubMed Central

    2014-01-01

    Background Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. While several efforts had been made to improve family planning in the country, the district still had very low use of modern family planning methods. This study sought to determine the factors that influenced modern family planning use in general and specifically, the factors that determined the consistently low use of modern family planning methods in the district. Methods A case–control study was conducted in the Nkwanta district of Ghana to determine socio-economic, socio-cultural and service delivery factors influencing family planning usage. One hundred and thirty cases and 260 controls made up of women aged 15–49 years were interviewed using structured questionnaires. A logistic regression was fitted. Results Awareness and knowledge of modern family planning methods were high among cases and controls (over 90%). Lack of formal education among women, socio-cultural beliefs and spousal communication were found to influence modern family planning use. Furthermore, favourable opening hours of the facilities and distance to health facilities influenced the use of modern contraceptives. Conclusion While modern family planning seemed to be common knowledge among these women, actual use of such contraceptives was limited. There is need to improve use of modern family planning methods in the district. In addition to providing health facilities and consolidating close-to-client service initiatives in the district, policies directed towards improving modern family planning method use need to consider the influence of formal education. Promoting basic education, especially among females, will be a crucial step as the district is faced with high levels of school dropout and illiteracy rates. PMID:25117887

  13. A study of numerical methods of solution of the equations of motion of a controlled satellite under the influence of gravity gradient torque

    NASA Technical Reports Server (NTRS)

    Thompson, J. F.; Mcwhorter, J. C.; Siddiqi, S. A.; Shanks, S. P.

    1973-01-01

    Numerical methods of integration of the equations of motion of a controlled satellite under the influence of gravity-gradient torque are considered. The results of computer experimentation using a number of Runge-Kutta, multi-step, and extrapolation methods for the numerical integration of this differential system are presented, and particularly efficient methods are noted. A large bibliography of numerical methods for initial value problems for ordinary differential equations is presented, and a compilation of Runge-Kutta and multistep formulas is given. Less common numerical integration techniques from the literature are noted for further consideration.

  14. A systematic study on the influencing parameters and improvement of quantitative analysis of multi-component with single marker method using notoginseng as research subject.

    PubMed

    Wang, Chao-Qun; Jia, Xiu-Hong; Zhu, Shu; Komatsu, Katsuko; Wang, Xuan; Cai, Shao-Qing

    2015-03-01

    A new quantitative analysis of multi-component with single marker (QAMS) method for 11 saponins (ginsenosides Rg1, Rb1, Rg2, Rh1, Rf, Re and Rd; notoginsenosides R1, R4, Fa and K) in notoginseng was established, when 6 of these saponins were individually used as internal referring substances to investigate the influences of chemical structure, concentrations of quantitative components, and purities of the standard substances on the accuracy of the QAMS method. The results showed that the concentration of the analyte in sample solution was the major influencing parameter, whereas the other parameters had minimal influence on the accuracy of the QAMS method. A new method for calculating the relative correction factors by linear regression was established (linear regression method), which demonstrated to decrease standard method differences of the QAMS method from 1.20%±0.02% - 23.29%±3.23% to 0.10%±0.09% - 8.84%±2.85% in comparison with the previous method. And the differences between external standard method and the QAMS method using relative correction factors calculated by linear regression method were below 5% in the quantitative determination of Rg1, Re, R1, Rd and Fa in 24 notoginseng samples and Rb1 in 21 notoginseng samples. And the differences were mostly below 10% in the quantitative determination of Rf, Rg2, R4 and N-K (the differences of these 4 constituents bigger because their contents lower) in all the 24 notoginseng samples. The results indicated that the contents assayed by the new QAMS method could be considered as accurate as those assayed by external standard method. In addition, a method for determining applicable concentration ranges of the quantitative components assayed by QAMS method was established for the first time, which could ensure its high accuracy and could be applied to QAMS methods of other TCMs. The present study demonstrated the practicability of the application of the QAMS method for the quantitative analysis of multi-component and the quality control of TCMs and TCM prescriptions. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Region of influence regression for estimating the 50-year flood at ungaged sites

    USGS Publications Warehouse

    Tasker, Gary D.; Hodge, S.A.; Barks, C.S.

    1996-01-01

    Five methods of developing regional regression models to estimate flood characteristics at ungaged sites in Arkansas are examined. The methods differ in the manner in which the State is divided into subrogions. Each successive method (A to E) is computationally more complex than the previous method. Method A makes no subdivision. Methods B and C define two and four geographic subrogions, respectively. Method D uses cluster/discriminant analysis to define subrogions on the basis of similarities in watershed characteristics. Method E, the new region of influence method, defines a unique subregion for each ungaged site. Split-sample results indicate that, in terms of root-mean-square error, method E (38 percent error) is best. Methods C and D (42 and 41 percent error) were in a virtual tie for second, and methods B (44 percent error) and A (49 percent error) were fourth and fifth best.

  16. A Method of Determining Aerodynamic-Influence Coefficients from Wind-Tunnel Data for Wings at Supersonic Speeds

    NASA Technical Reports Server (NTRS)

    Gainer, Patrick A.

    1961-01-01

    A method is described for determining aerodynamic-influence coefficients from wind-tunnel data for calculating the steady-state load distribution on a wing with arbitrary angle-of-attack distribution at supersonic speeds. The method combines linearized theory with empirical adjustments in order to give accurate results over a wide range of angles of attack. The experimented data required are pressure distributions measured on a flat wing of the desired planform at the desired Mach number and over the desired range of angles of attack. The method has been tested by applying it to wind-tunnel data measured at Mach numbers of 1.61 and 2.01 on wings of the same planform but of different surface shapes. Influence coefficients adjusted to fit the flat wing gave good predictions of the spanwise and chord-wise distributions of loadings measured on twisted and cambered wings.

  17. Twin studies in psychiatry and psychology: science or pseudoscience?

    PubMed

    Joseph, Jay

    2002-01-01

    Twin studies are frequently cited in support of the influence of genetic factors for a wide range of psychiatric conditions and psychological trait differences. The most common method, known as the classical twin method, compares the concordance rates or correlations of reared-together identical (MZ) vs. reared-together same-sex fraternal (DZ) twins. However, drawing genetic inferences from MZ-DZ comparisons is problematic due to methodological problems and questionable assumptions. It is argued that the main theoretical assumption of the twin method--known as the "equal environment assumption"--is not tenable. The twin method is therefore of doubtful value as an indicator of genetic influences. Studies of reared-apart twins are discussed, and it is noted that these studies are also vulnerable to methodological problems and environmental confounds. It is concluded that there is little reason to believe that twin studies provide evidence in favor of genetic influences on psychiatric disorders and human behavioral differences.

  18. Detecting the Influence of Spreading in Social Networks with Excitable Sensor Networks

    PubMed Central

    Pei, Sen; Tang, Shaoting; Zheng, Zhiming

    2015-01-01

    Detecting spreading outbreaks in social networks with sensors is of great significance in applications. Inspired by the formation mechanism of humans’ physical sensations to external stimuli, we propose a new method to detect the influence of spreading by constructing excitable sensor networks. Exploiting the amplifying effect of excitable sensor networks, our method can better detect small-scale spreading processes. At the same time, it can also distinguish large-scale diffusion instances due to the self-inhibition effect of excitable elements. Through simulations of diverse spreading dynamics on typical real-world social networks (Facebook, coauthor, and email social networks), we find that the excitable sensor networks are capable of detecting and ranking spreading processes in a much wider range of influence than other commonly used sensor placement methods, such as random, targeted, acquaintance and distance strategies. In addition, we validate the efficacy of our method with diffusion data from a real-world online social system, Twitter. We find that our method can detect more spreading topics in practice. Our approach provides a new direction in spreading detection and should be useful for designing effective detection methods. PMID:25950181

  19. Cross-study differences in the etiology of reading comprehension: A meta-analytical review of twin studies

    PubMed Central

    Little, Callie W; Haughbrook, Rasheda; Hart, Sara A

    2016-01-01

    Numerous twin studies have been published examining the genetic and environmental etiology of reading comprehension, though the etiological estimates may be influenced currently unidentified sample conditions (e.g., Tucker-Drob & Bates, 2015). The purpose of the current meta-analysis was to average the etiological influences of reading comprehension and to explore the potential moderators that may be influencing these estimates. Results revealed an average heritability estimate of h2 = .59, with significant variation in estimates across studies, suggesting potential moderation. Heritability was moderated by publication year, grade level, project, zygosity determination method, and response type. The average shared environmental estimate was c2 = .16, with publication year, grade and zygosity determination method acting as significant moderators. These findings support the large role of genetic influences on reading comprehension, and a small but significant role of shared environmental influences. The significant moderators of etiological influences within the current synthesis suggest our interpretation of how genes and environment influence reading comprehension should reflect aspects of study and sample. PMID:27630039

  20. Influence of Structural Flexibility on the Dynamic Precision of a Vehicle-Mounted Equipment System

    DTIC Science & Technology

    2015-05-12

    Paramsothy Jayakumar , Dave Mechergui, Ronald Renke U.S.Army RDECOM TARDEC INFLUENCE OF STRUCTURAL FLEXIBILITY ON THE DYNAMIC PRECISION OF A...COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE INFLUENCE OF STRUCTURAL FLEXIBILITY ON THE DYNAMIC PRECISION OF A VEHICLE-MOUNTED EQUIPMENT...Equipment Enclosure CMS Results 23 12. Influence of CMS Method on the Vehicle Dynamics 24 13. Influence of Flexibility on the Vehicle

  1. Influence of material uncertainties on the RLC parameters of wound inductors modeled using the finite element method

    NASA Astrophysics Data System (ADS)

    Lossa, Geoffrey; Deblecker, Olivier; Grève, Zacharie De

    2018-05-01

    In this work, we highlight the influence of the material uncertainties (magnetic permeability, electric conductivity of a Mn-Zn ferrite core, and electric permittivity of wire insulation) on the RLC parameters of a wound inductor extracted from the finite element method. To that end, the finite element method is embedded in a Monte Carlo simulation. We show that considering mentioned different material properties as real random variables, leads to significant variations in the distributions of the RLC parameters.

  2. Optimal Treatment of Malignant Long Bone Fracture: Influence of Method of Repair and External Beam Irradiation on the Pathway and Efficacy of Fracture Healing

    DTIC Science & Technology

    2014-10-01

    Long Bone Fracture: Influence of Method of Repair and External Beam Irradiation on the Pathway and Efficacy of Fracture Healing 5a. CONTRACT NUMBER...in the fifth quarter of the award. 15. SUBJECT TERMS Fracture healing , bone healing , endochondral ossification, intramembranous ossification...of radiation on the two pathways of bone healing and propose an optimal method of surgical fracture repair for managing malignant osteoporotic

  3. Effect of Different Cooking Methods on Histamine Levels in Selected Foods

    PubMed Central

    Chung, Bo Young; Park, Sook Young; Byun, Yun Sun; Son, Jee Hee; Choi, Yong Won; Cho, Yong Se

    2017-01-01

    Background Histamine in food is known to cause food poisoning and allergic reactions. We usually ingest histamine in cooked food, but there are few studies about the influence of cooking method on the histamine level. Objective The purpose of this study was to determine the influence of cooking methods on the concentration of histamine in foods. Methods The foods chosen were those kinds consumed frequently and cooked by grilling, boiling, and frying. The histamine level of the food was measured using enzyme-linked immunosorbent assay. Results Grilled seafood had higher histamine levels than raw or boiled seafood. For meat, grilling increased the histamine level, whereas boiling decreased it. For eggs, there was not much difference in histamine level according to cooking method. Fried vegetables had higher histamine levels than raw vegetables. And fermented foods didn't show much difference in histamine level after being boiled. Conclusion The histamine level in food has changed according to the cooking method used to prepare it. Frying and grilling increased histamine level in foods, whereas boiling had little influence or even decreased it. The boiling method might be helpful to control the effect of histamine in histamine-sensitive or susceptible patients, compared with frying and grilling. PMID:29200758

  4. Maximizing the Spread of Influence via Generalized Degree Discount.

    PubMed

    Wang, Xiaojie; Zhang, Xue; Zhao, Chengli; Yi, Dongyun

    2016-01-01

    It is a crucial and fundamental issue to identify a small subset of influential spreaders that can control the spreading process in networks. In previous studies, a degree-based heuristic called DegreeDiscount has been shown to effectively identify multiple influential spreaders and has severed as a benchmark method. However, the basic assumption of DegreeDiscount is not adequate, because it treats all the nodes equally without any differences. To consider a general situation in real world networks, a novel heuristic method named GeneralizedDegreeDiscount is proposed in this paper as an effective extension of original method. In our method, the status of a node is defined as a probability of not being influenced by any of its neighbors, and an index generalized discounted degree of one node is presented to measure the expected number of nodes it can influence. Then the spreaders are selected sequentially upon its generalized discounted degree in current network. Empirical experiments are conducted on four real networks, and the results show that the spreaders identified by our approach are more influential than several benchmark methods. Finally, we analyze the relationship between our method and three common degree-based methods.

  5. Maximizing the Spread of Influence via Generalized Degree Discount

    PubMed Central

    Wang, Xiaojie; Zhang, Xue; Zhao, Chengli; Yi, Dongyun

    2016-01-01

    It is a crucial and fundamental issue to identify a small subset of influential spreaders that can control the spreading process in networks. In previous studies, a degree-based heuristic called DegreeDiscount has been shown to effectively identify multiple influential spreaders and has severed as a benchmark method. However, the basic assumption of DegreeDiscount is not adequate, because it treats all the nodes equally without any differences. To consider a general situation in real world networks, a novel heuristic method named GeneralizedDegreeDiscount is proposed in this paper as an effective extension of original method. In our method, the status of a node is defined as a probability of not being influenced by any of its neighbors, and an index generalized discounted degree of one node is presented to measure the expected number of nodes it can influence. Then the spreaders are selected sequentially upon its generalized discounted degree in current network. Empirical experiments are conducted on four real networks, and the results show that the spreaders identified by our approach are more influential than several benchmark methods. Finally, we analyze the relationship between our method and three common degree-based methods. PMID:27732681

  6. Improvements to the kernel function method of steady, subsonic lifting surface theory

    NASA Technical Reports Server (NTRS)

    Medan, R. T.

    1974-01-01

    The application of a kernel function lifting surface method to three dimensional, thin wing theory is discussed. A technique for determining the influence functions is presented. The technique is shown to require fewer quadrature points, while still calculating the influence functions accurately enough to guarantee convergence with an increasing number of spanwise quadrature points. The method also treats control points on the wing leading and trailing edges. The report introduces and employs an aspect of the kernel function method which apparently has never been used before and which significantly enhances the efficiency of the kernel function approach.

  7. Calculated spanwise lift distributions, influence functions, and influence coefficients for unswept wings in subsonic flow

    NASA Technical Reports Server (NTRS)

    Diederich, Franklin W; Zlotnick, Martin

    1955-01-01

    Spanwise lift distributions have been calculated for nineteen unswept wings with various aspect ratios and taper ratios and with a variety of angle-of-attack or twist distributions, including flap and aileron deflections, by means of the Weissinger method with eight control points on the semispan. Also calculated were aerodynamic influence coefficients which pertain to a certain definite set of stations along the span, and several methods are presented for calculating aerodynamic influence functions and coefficients for stations other than those stipulated. The information presented in this report can be used in the analysis of untwisted wings or wings with known twist distributions, as well as in aeroelastic calculations involving initially unknown twist distributions.

  8. [Study on depressive disorder and related factors in surgical inpatients].

    PubMed

    Ge, Hong-min; Liu, Lan-fen; Han, Jian-bo

    2008-03-01

    To investigate the prevalence and possible influencing factors of depressive disorder in surgical inpatients. Two hundred and sixty-six surgical inpatients meeting the inclusion criteria were first screened with the self rating depression scale (SDS), and then the subjects screened positive and 20% of those screened negative were evaluated with Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) as a gold standard for diagnosis of depressive disorder. Possible influencing factors were also analyzed by experienced psychiatrists. The standard score of SDS in the surgical inpatients were significantly higher than those in the Chinese norm, and the incidence of depressive disorder in the surgical inpatients was 37.2%. Unvaried analysis showed that depressive disorder were associated with gender, education, economic condition, variety of diseases, hospitalization duration, and treatment methods. Logistic regression analysis revealed that gender, economic condition, treatment methods and previous history were the main influencing factors. The incidence of depressive disorder in the surgical inpatients is high, and it is mainly influenced by gender, economic condition, treatment methods and previous history.

  9. Identifying influential directors in the United States corporate governance network

    NASA Astrophysics Data System (ADS)

    Huang, Xuqing; Vodenska, Irena; Wang, Fengzhong; Havlin, Shlomo; Stanley, H. Eugene

    2011-10-01

    The influence of directors has been one of the most engaging topics recently, but surprisingly little research has been done to quantitatively evaluate the influence and power of directors. We analyze the structure of the US corporate governance network for the 11-year period 1996-2006 based on director data from the Investor Responsibility Research Center director database, and we develop a centrality measure named the influence factor to estimate the influence of directors quantitatively. The US corporate governance network is a network of directors with nodes representing directors and links between two directors representing their service on common company boards. We assume that information flows in the network through information-sharing processes among linked directors. The influence factor assigned to a director is based on the level of information that a director obtains from the entire network. We find that, contrary to commonly accepted belief that directors of large companies, measured by market capitalization, are the most powerful, in some instances, the directors who are influential do not necessarily serve on boards of large companies. By applying our influence factor method to identify the influential people contained in the lists created by popular magazines such as Fortune, Networking World, and Treasury and Risk Management, we find that the influence factor method is consistently either the best or one of the two best methods in identifying powerful people compared to other general centrality measures that are used to denote the significance of a node in complex network theory.

  10. Identifying influential directors in the United States corporate governance network.

    PubMed

    Huang, Xuqing; Vodenska, Irena; Wang, Fengzhong; Havlin, Shlomo; Stanley, H Eugene

    2011-10-01

    The influence of directors has been one of the most engaging topics recently, but surprisingly little research has been done to quantitatively evaluate the influence and power of directors. We analyze the structure of the US corporate governance network for the 11-year period 1996-2006 based on director data from the Investor Responsibility Research Center director database, and we develop a centrality measure named the influence factor to estimate the influence of directors quantitatively. The US corporate governance network is a network of directors with nodes representing directors and links between two directors representing their service on common company boards. We assume that information flows in the network through information-sharing processes among linked directors. The influence factor assigned to a director is based on the level of information that a director obtains from the entire network. We find that, contrary to commonly accepted belief that directors of large companies, measured by market capitalization, are the most powerful, in some instances, the directors who are influential do not necessarily serve on boards of large companies. By applying our influence factor method to identify the influential people contained in the lists created by popular magazines such as Fortune, Networking World, and Treasury and Risk Management, we find that the influence factor method is consistently either the best or one of the two best methods in identifying powerful people compared to other general centrality measures that are used to denote the significance of a node in complex network theory.

  11. Hotel Housekeeping Work Influences on Hypertension Management

    PubMed Central

    Sanon, Marie-Anne

    2013-01-01

    Background Characteristics of hotel housekeeping work increase the risk for hypertension development. Little is known about the influences of such work on hypertension management. Methods For this qualitative study, 27 Haitian immigrant hotel housekeepers from Miami-Dade County, FL were interviewed. Interview transcripts were analyzed with the assistance of the Atlas. ti software for code and theme identification. Results Influences of hotel housekeeping work on hypertension management arose both at the individual and system levels. Factors at the individual level included co-worker dynamics and maintenance of transmigrant life. Factors at the system level included supervisory support, workload, work pace, and work hiring practices. No positive influences were reported for workload and hiring practices. Conclusions Workplace interventions may be beneficial for effective hypertension management among hotel housekeepers. These work influences must be considered when determining effective methods for hypertension management among hotel housekeepers. PMID:23775918

  12. De retibus socialibus et legibus momenti

    NASA Astrophysics Data System (ADS)

    Gayo-Avello, D.; Brenes, D. J.; Fernández-Fernández, D.; Fernández-Menéndez, M. E.; García-Suárez, R.

    2011-05-01

    Online Social Networks (OSNs) are a cutting edge topic. Almost everybody —users, marketers, brands, companies, and researchers— is approaching OSNs to better understand them and take advantage of their benefits. Maybe one of the key concepts underlying OSNs is that of influence which is highly related, although not entirely identical, to those of popularity and centrality. Influence is, according to Merriam-Webster, "the capacity of causing an effect in indirect or intangible ways". Hence, in the context of OSNs, it has been proposed to analyze the clicks received by promoted URLs in order to check for any positive correlation between the number of visits and different "influence" scores. That evaluation methodology is used in this letter to compare a number of those techniques with a new method firstly described here. That new method is a simple and rather elegant solution which tackles with influence in OSNs by applying a physical metaphor. On social networks and the laws of influence.

  13. Logging methods and peeling of Aspen

    Treesearch

    T. Schantz-Hansen

    1948-01-01

    The logging of forest products is influenced by many factors, including the size of the trees, density of the stand, the soundness of the trees, size of the area logged, topography and soil, weather conditions, the degree of utilization, the skill of the logger and the equipment used, the distance from market, etc. Each of these factors influences not only the method...

  14. Social Influences on Fertility: A Comparative Mixed Methods Study in Eastern and Western Germany

    ERIC Educational Resources Information Center

    Bernardi, Laura; Keim, Sylvia; von der Lippe, Holger

    2007-01-01

    This article uses a mixed methods design to investigate the effects of social influence on family formation in a sample of eastern and western German young adults at an early stage of their family formation. Theoretical propositions on the importance of informal interaction for fertility and family behavior are still rarely supported by systematic…

  15. Scoring Method of a Situational Judgment Test: Influence on Internal Consistency Reliability, Adverse Impact and Correlation with Personality?

    ERIC Educational Resources Information Center

    De Leng, W. E.; Stegers-Jager, K. M.; Husbands, A.; Dowell, J. S.; Born, M. Ph.; Themmen, A. P.

    2017-01-01

    Situational Judgment Tests (SJTs) are increasingly used for medical school selection. Scoring an SJT is more complicated than scoring a knowledge test, because there are no objectively correct answers. The scoring method of an SJT may influence the construct and concurrent validity and the adverse impact with respect to non-traditional students.…

  16. The Knowing-Doing Gap: The Influence of Teacher Feedback in Changing Principal Behavior--A Mixed Methods Study

    ERIC Educational Resources Information Center

    St. Martin, Kimberly

    2010-01-01

    This mixed methods study attempted to determine how a system of regular feedback from teachers on principal's work influenced the way in which two principals incorporated the 21 Leadership Responsibilities into their daily practice. Since Principals are the front line of school reform, even when a school commits to an improvement effort that is…

  17. Northwest Manufacturing Initiative

    DTIC Science & Technology

    2013-03-26

    Testing of Metallic Materials] specifications. For high temperature tests, a heated water bath was use while for low temperature testing down to...Weld metal and heat affected zones were evaluated using Charpy and E399 fracture toughness methods. The influence of temperature , loading rate, CVN...determine the influence of fracture test methods and welding procedures on toughness. Room temperature E399 tests, (CTS) were carried out under

  18. Influence of host seed on metabolic activity by Enterobacter cloacae in the spermosphere

    USDA-ARS?s Scientific Manuscript database

    Little is known regarding the influences of nutrients released from plants on the metabolic activity of colonizing microbes. To gain a better understanding of these influences, we used bioluminescence- and oxygen consumption-based methods to compare bacterial metabolic activity expressed during col...

  19. Moral communities.

    PubMed

    Chambers, David W

    2006-11-01

    This article explores the twin issues of whether organizations can act as ethical agents and what it means to exert moral influence over others. A discursive perspective is advanced that characterizes ethics as the action of communities based on promises. The received view of ethics as either the universal principles or individual responsibility is criticized as inadequate. Moral influence within community is considered under the various headings of democracy, office, brotherhood, agency, witness, and promise making. Moral influence among communities can include the damaging methods of "the superior position," coercion and misrepresentation, and appeal to third parties and the sound methods of rhetoric and promise making.

  20. Influence analysis of fluctuation parameters on flow stability based on uncertainty method

    NASA Astrophysics Data System (ADS)

    Meng, Tao; Fan, Shangchun; Wang, Chi; Shi, Huichao

    2018-05-01

    The relationship between flow fluctuation and pressure in a flow facility is studied theoretically and experimentally in this paper, and a method for measuring the flow fluctuation is proposed. According to the synchronicity of pressure and flow fluctuation, the amplitude of the flow fluctuation is calculated using the pressure measured in the flow facility and measurement of the flow fluctuation in a wide range of frequency is realized. Based on the method proposed, uncertainty analysis is used to evaluate the influences of different parameters on the flow fluctuation by the help of a sample-based stochastic model established and the parameters that have great influence are found, which can be a reference for the optimization design and the stability improvement of the flow facility.

  1. Modified Gaussian influence function of deformable mirror actuators.

    PubMed

    Huang, Linhai; Rao, Changhui; Jiang, Wenhan

    2008-01-07

    A new deformable mirror influence function based on a Gaussian function is introduced to analyze the fitting capability of a deformable mirror. The modified expressions for both azimuthal and radial directions are presented based on the analysis of the residual error between a measured influence function and a Gaussian influence function. With a simplex search method, we further compare the fitting capability of our proposed influence function to fit the data produced by a Zygo interferometer with that of a Gaussian influence function. The result indicates that the modified Gaussian influence function provides much better performance in data fitting.

  2. Multiple approaches to detect outliers in a genome scan for selection in ocellated lizards (Lacerta lepida) along an environmental gradient.

    PubMed

    Nunes, Vera L; Beaumont, Mark A; Butlin, Roger K; Paulo, Octávio S

    2011-01-01

    Identification of loci with adaptive importance is a key step to understand the speciation process in natural populations, because those loci are responsible for phenotypic variation that affects fitness in different environments. We conducted an AFLP genome scan in populations of ocellated lizards (Lacerta lepida) to search for candidate loci influenced by selection along an environmental gradient in the Iberian Peninsula. This gradient is strongly influenced by climatic variables, and two subspecies can be recognized at the opposite extremes: L. lepida iberica in the northwest and L. lepida nevadensis in the southeast. Both subspecies show substantial morphological differences that may be involved in their local adaptation to the climatic extremes. To investigate how the use of a particular outlier detection method can influence the results, a frequentist method, DFDIST, and a Bayesian method, BayeScan, were used to search for outliers influenced by selection. Additionally, the spatial analysis method was used to test for associations of AFLP marker band frequencies with 54 climatic variables by logistic regression. Results obtained with each method highlight differences in their sensitivity. DFDIST and BayeScan detected a similar proportion of outliers (3-4%), but only a few loci were simultaneously detected by both methods. Several loci detected as outliers were also associated with temperature, insolation or precipitation according to spatial analysis method. These results are in accordance with reported data in the literature about morphological and life-history variation of L. lepida subspecies along the environmental gradient. © 2010 Blackwell Publishing Ltd.

  3. Comparison of 3 in vivo methods for assessment of alcohol-based hand rubs.

    PubMed

    Edmonds-Wilson, Sarah; Campbell, Esther; Fox, Kyle; Macinga, David

    2015-05-01

    Alcohol-based hand rubs (ABHRs) are the primary method of hand hygiene in health-care settings. ICPs increasingly are assessing ABHR product efficacy data as improved products and test methods are developed. As a result, ICPs need better tools and recommendations for how to assess and compare ABHRs. Two ABHRs (70% ethanol) were tested according to 3 in vivo methods approved by ASTM International: E1174, E2755, and E2784. Log10 reductions were measured after a single test product use and after 10 consecutive uses at an application volume of 2 mL. The test method used had a significant influence on ABHR efficacy; however, in this study the test product (gel or foam) did not significantly influence efficacy. In addition, for all test methods, log10 reductions obtained after a single application were not predictive of results after 10 applications. Choice of test method can significantly influence efficacy results. Therefore, when assessing antimicrobial efficacy data of hand hygiene products, ICPs should pay close attention to the test method used, and ensure that product comparisons are made head to head in the same study using the same test methodology. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  4. Influence of stem temperature changes on heat pulse sap flux density measurements.

    PubMed

    Vandegehuchte, Maurits W; Burgess, Stephen S O; Downey, Alec; Steppe, Kathy

    2015-04-01

    While natural spatial temperature gradients between measurement needles have been thoroughly investigated for continuous heat-based sap flow methods, little attention has been given to how natural changes in stem temperature impact heat pulse-based methods through temporal rather than spatial effects. By modelling the theoretical equation for both an ideal instantaneous pulse and a step pulse and applying a finite element model which included actual needle dimensions and wound effects, the influence of a varying stem temperature on heat pulse-based methods was investigated. It was shown that the heat ratio (HR) method was influenced, while for the compensation heat pulse and Tmax methods changes in stem temperatures of up to 0.002 °C s(-1) did not lead to significantly different results. For the HR method, rising stem temperatures during measurements led to lower heat pulse velocity values, while decreasing stem temperatures led to both higher and lower heat pulse velocities, and to imaginary results for high flows. These errors of up to 40% can easily be prevented by including a temperature correction in the data analysis procedure, calculating the slope of the natural temperature change based on the measured temperatures before application of the heat pulse. Results of a greenhouse and outdoor experiment on Pinus pinea L. show the influence of this correction on low and average sap flux densities. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Influence relevance voting: an accurate and interpretable virtual high throughput screening method.

    PubMed

    Swamidass, S Joshua; Azencott, Chloé-Agathe; Lin, Ting-Wan; Gramajo, Hugo; Tsai, Shiou-Chuan; Baldi, Pierre

    2009-04-01

    Given activity training data from high-throughput screening (HTS) experiments, virtual high-throughput screening (vHTS) methods aim to predict in silico the activity of untested chemicals. We present a novel method, the Influence Relevance Voter (IRV), specifically tailored for the vHTS task. The IRV is a low-parameter neural network which refines a k-nearest neighbor classifier by nonlinearly combining the influences of a chemical's neighbors in the training set. Influences are decomposed, also nonlinearly, into a relevance component and a vote component. The IRV is benchmarked using the data and rules of two large, open, competitions, and its performance compared to the performance of other participating methods, as well as of an in-house support vector machine (SVM) method. On these benchmark data sets, IRV achieves state-of-the-art results, comparable to the SVM in one case, and significantly better than the SVM in the other, retrieving three times as many actives in the top 1% of its prediction-sorted list. The IRV presents several other important advantages over SVMs and other methods: (1) the output predictions have a probabilistic semantic; (2) the underlying inferences are interpretable; (3) the training time is very short, on the order of minutes even for very large data sets; (4) the risk of overfitting is minimal, due to the small number of free parameters; and (5) additional information can easily be incorporated into the IRV architecture. Combined with its performance, these qualities make the IRV particularly well suited for vHTS.

  6. The influence of digital filter type, amplitude normalisation method, and co-contraction algorithm on clinically relevant surface electromyography data during clinical movement assessments.

    PubMed

    Devaprakash, Daniel; Weir, Gillian J; Dunne, James J; Alderson, Jacqueline A; Donnelly, Cyril J

    2016-12-01

    There is a large and growing body of surface electromyography (sEMG) research using laboratory-specific signal processing procedures (i.e., digital filter type and amplitude normalisation protocols) and data analyses methods (i.e., co-contraction algorithms) to acquire practically meaningful information from these data. As a result, the ability to compare sEMG results between studies is, and continues to be challenging. The aim of this study was to determine if digital filter type, amplitude normalisation method, and co-contraction algorithm could influence the practical or clinical interpretation of processed sEMG data. Sixteen elite female athletes were recruited. During data collection, sEMG data was recorded from nine lower limb muscles while completing a series of calibration and clinical movement assessment trials (running and sidestepping). Three analyses were conducted: (1) signal processing with two different digital filter types (Butterworth or critically damped), (2) three amplitude normalisation methods, and (3) three co-contraction ratio algorithms. Results showed the choice of digital filter did not influence the clinical interpretation of sEMG; however, choice of amplitude normalisation method and co-contraction algorithm did influence the clinical interpretation of the running and sidestepping task. Care is recommended when choosing amplitude normalisation method and co-contraction algorithms if researchers/clinicians are interested in comparing sEMG data between studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. An efficient screening method for the isolation of heterotrophic bacteria influencing growth of diatoms under photoautotrophic conditions.

    PubMed

    Zecher, Karsten; Jagmann, Nina; Seemann, Philipp; Philipp, Bodo

    2015-12-01

    Interactions between photoautotrophic diatoms and heterotrophic bacteria are important for the biogeochemical C-cycle in the oceans. Additionally, biofilms formed by diatoms and bacteria are the initiating step of biofouling processes, which causes high costs in shipping. Despite this ecological and economical importance, the knowledge about biochemical and molecular mechanisms underlying these interkingdom interactions is relatively small. For analyzing these mechanisms, laboratory model systems are required. In this study, an efficient screening method for isolating bacteria influencing photoautotrophic diatom growth was established. First, diatom cultures of Phaeodactylum tricornutum and Thalassiosira pseudonana were made axenic by applying β-lactam antibiotics. Second, a non-invasive method for measuring growth of multiple parallel diatom cultures by chlorophyll fluorescence was established. This method allowed semi-quantitative chlorophyll determination of cultures with up to 3 μg (chlorophyll) ml(-1). Axenic diatom cultures were then used for enriching bacteria and led to the isolation of 24 strains influencing growth of both diatom strains in various ways. For example, Rheinheimera sp. strain Tn16 inhibited growth of T. pseudonana, while it stimulated growth and cell aggregation of P. tricornutum. Thus, this screening method is appropriate for isolating heterotrophic bacteria showing different interactions with different diatom species ranging from synergistic to antagonistic. In consecutive applications, this method will be useful to screen for bacterial mutants with altered phenotypes regarding the influence on diatom growth. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. [Influence of different processing methods and mature stages on 3,29-dibenzoyl rarounitriol of Trichosanthes kirilowii seeds].

    PubMed

    Liu, Jin-Na; Xie, Xiao-Liang; Yang, Tai-Xin; Zhang, Cun-Li; Jia, Dong-Sheng; Liu, Ming; Wen, Chun-Xiu

    2014-04-01

    To study the different mature stages and the best processing methods on the quality of Trichosanthes kirilowii seeds. The content of 3,29-dibenzoyl rarounitriol in Trichosanthes kirilowii seeds was determined by HPLC. The sample of different mature stages such as immature, near mature and fully mature and processed by different methods were studied. Fully mature Trichosanthes kirilowii seeds were better than the immatured, and the best processing method was dried under 60degrees C, the content of 3,29-dibenzoyl rarounitriol reached up to 131.63microlg/mL. Different processing methods and different mature stages had a significant influence on the quality of Trichosanthes kirilowii seeds.

  9. The Influence of Cartoon Character Advertising on Fruit and Vegetable Preferences of 9- to 11-Year-Old Children

    ERIC Educational Resources Information Center

    Bezbaruah, Nandita; Brunt, Ardith

    2012-01-01

    Objective: The aim of the present study is to determine the influence of cartoon characters in preferences of fruit and vegetables among children. Methods: A 10-item survey was used in this cross-sectional study to determine the factors that influence a child's likelihood of eating fruits and vegetables. Seven factors influencing consumption of…

  10. International Influences on Private Education in Russia: The Case of St. Petersburg, 1991-1998.

    ERIC Educational Resources Information Center

    Lisovskaya, Elena

    1999-01-01

    Explores international influences on emerging private schools in St. Petersburg, Russia, based on interviews with principals and top administrators. Key channels of international influences include foreign funding sources, foreign-student services, interschool partnerships, pedagogical methods, curricula, and school goals and outcomes. Survival…

  11. Influencing Teaching: An Inside View of an Outside Interest Group.

    ERIC Educational Resources Information Center

    Rowland, Paul

    The New Mexico Solar Energy Institute (NMSEI) education program has attempted to influence teachers to increase the quantity and quality of teaching about renewable energy sources and their uses. Since 1982, the program has used the following methods for influencing energy education: a newsletter for educators; conference and classroom…

  12. A Mixed Methods Approach for Identifying Influence on Public Policy

    ERIC Educational Resources Information Center

    Weaver-Hightower, Marcus B.

    2014-01-01

    Fields from political science to critical education policy studies have long explored power relations in policy processes, showing who influences policy agendas, policy creation, and policy implementation. Yet showing particular actors' influence on specific points in a policy text remains a methodological challenge. This article presents a…

  13. Spatial cluster for clustering the influence factor of birth and death child in Bogor Regency, West Java

    NASA Astrophysics Data System (ADS)

    Bekti, Rokhana Dwi; Rachmawati, Ro'fah

    2014-03-01

    The number of birth and death child is the benchmarks to determine and monitor the health and welfare in Indonesia. It can be used to identify groups of people who have a high mortality risk. Identifying group is important to compare the characteristics of human that have high and low risk. These characteristics can be seen from the factors that influenced it. Furthermore, there are factors which influence of birth and death child, such us economic, health facility, education, and others. The influence factors of every individual are different, but there are similarities some individuals which live close together or in the close locations. It means there was spatial effect. To identify group in this research, clustering is done by spatial cluster method, which is view to considering the influence of the location or the relationship between locations. One of spatial cluster method is Spatial 'K'luster Analysis by Tree Edge Removal (SKATER). The research was conducted in Bogor Regency, West Java. The goal was to get a cluster of districts based on the factors that influence birth and death child. SKATER build four number of cluster respectively consists of 26, 7, 2, and 5 districts. SKATER has good performance for clustering which include spatial effect. If it compare by other cluster method, Kmeans has good performance by MANOVA test.

  14. A cross sectional study investigating weight management motivations, methods and perceived healthy eating and physical activity influences in women up to five years following childbirth.

    PubMed

    Vincze, Lisa; Rollo, Megan E; Hutchesson, Melinda J; Burrows, Tracy L; MacDonald-Wicks, Lesley; Blumfield, Michelle; Collins, Clare E

    2017-06-01

    to explore motivations for weight change, weight loss methods used and factors perceived to influence healthy eating and physical activity for weight management following childbirth, and to evaluate differences by socio-demographic, weight status and pregnancy characteristics. cross-sectional online survey completed from May to August 2013. Australian women (n=874, aged 32.8±4.5 years, pre-pregnancy Body Mass Index 25.6±5.7kg/m 2 ) aged 18-40 years who had given birth in the previous 5 years MEASUREMENTS: women self-reported socio-demographic, weight status and pregnancy characteristics. Those who reported being unhappy at their current weight ranked their most to least important reasons for wanting to change their weight from a list of nine options. Weight control methods used in the previous two years were reported from a list of 12 options. Perceived healthy eating and physical activity factors influencing weight management were assessed across 20 items using a five-point Likert scale. the most prevalent motivators reported for weight change were to improve health (26.1%) and lift mood (20.3%). Three-quarters (75.7%) of women reported having used at least one weight loss method in the previous two years. Time constraints due to family commitments, enjoyment of physical activity and healthy eating, motivation and cost were factors most commonly reported to influence weight management. Body mass index, parity, education, household income and time since last birth were related to motivations for weight change, weight loss methods used and/or factors perceived to influence weight management. weight management support provided by health professionals should consider women's expressed motivators and factors influencing weight management, along with differences in sociodemographic, pregnancy and weight status characteristics, in order to engage women at this life-stage and facilitate adoption of healthy lifestyle behaviours. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Understanding the Influence Career Paths Have on Community and Technical College Chief Business Officers' Satisfaction with Their Position: A Mixed Method Investigation

    ERIC Educational Resources Information Center

    File, Carter L.

    2013-01-01

    This study was undertaken to understand whether a community or technical college chief business officer's career line influenced the lived experience of job satisfaction. This mixed method study was conducted in a two-phase approach using the Explanatory Design: Participant Selection Model variant. An initial quantitative survey was conducted from…

  16. Influence of Strategy of Learning and Achievement Motivation of Learning Achievement Class VIII Students of State Junior High School in District Blitar

    ERIC Educational Resources Information Center

    Ayundawati, Dyah; Setyosari, Punaji; Susilo, Herawati; Sihkabuden

    2016-01-01

    This study aims for know influence of problem-based learning strategies and achievement motivation on learning achievement. The method used in this research is quantitative method. The instrument used in this study is two fold instruments to measure moderator variable (achievement motivation) and instruments to measure the dependent variable (the…

  17. The Influence of Student-Centered Methods in Turkish Language Instruction on Academic Success: A Meta-Analysis Study

    ERIC Educational Resources Information Center

    Biçer, Nursat

    2017-01-01

    The aim of the present study is to determine the influence of student-centered methods employed in Turkish language instruction on the academic success of students through meta-analysis. To this end, a literature review was conducted on the relevant studies conducted between 2000 and 2016 in order to determine the studies were suitable for the…

  18. An Exploration into the Potential Career Effects from Middle and High School Mathematics Experiences: A Mixed Methods Investigation into STEM Career Choice

    ERIC Educational Resources Information Center

    DeThomas, Elizabeth M.

    2017-01-01

    This mixed methods research study examined the effects of middle and high school mathematics experiences on students' choice of college major, particularly whether students decided to major in a STEM field. Social cognitive career theory was used to examine potential influences of mathematics self-efficacy and how those influences and mathematics…

  19. Visual cluster analysis and pattern recognition methods

    DOEpatents

    Osbourn, Gordon Cecil; Martinez, Rubel Francisco

    2001-01-01

    A method of clustering using a novel template to define a region of influence. Using neighboring approximation methods, computation times can be significantly reduced. The template and method are applicable and improve pattern recognition techniques.

  20. Study on the influence of X-ray tube spectral distribution on the analysis of bulk samples and thin films: Fundamental parameters method and theoretical coefficient algorithms

    NASA Astrophysics Data System (ADS)

    Sitko, Rafał

    2008-11-01

    Knowledge of X-ray tube spectral distribution is necessary in theoretical methods of matrix correction, i.e. in both fundamental parameter (FP) methods and theoretical influence coefficient algorithms. Thus, the influence of X-ray tube distribution on the accuracy of the analysis of thin films and bulk samples is presented. The calculations are performed using experimental X-ray tube spectra taken from the literature and theoretical X-ray tube spectra evaluated by three different algorithms proposed by Pella et al. (X-Ray Spectrom. 14 (1985) 125-135), Ebel (X-Ray Spectrom. 28 (1999) 255-266), and Finkelshtein and Pavlova (X-Ray Spectrom. 28 (1999) 27-32). In this study, Fe-Cr-Ni system is selected as an example and the calculations are performed for X-ray tubes commonly applied in X-ray fluorescence analysis (XRF), i.e., Cr, Mo, Rh and W. The influence of X-ray tube spectra on FP analysis is evaluated when quantification is performed using various types of calibration samples. FP analysis of bulk samples is performed using pure-element bulk standards and multielement bulk standards similar to the analyzed material, whereas for FP analysis of thin films, the bulk and thin pure-element standards are used. For the evaluation of the influence of X-ray tube spectra on XRF analysis performed by theoretical influence coefficient methods, two algorithms for bulk samples are selected, i.e. Claisse-Quintin (Can. Spectrosc. 12 (1967) 129-134) and COLA algorithms (G.R. Lachance, Paper Presented at the International Conference on Industrial Inorganic Elemental Analysis, Metz, France, June 3, 1981) and two algorithms (constant and linear coefficients) for thin films recently proposed by Sitko (X-Ray Spectrom. 37 (2008) 265-272).

  1. Reducing preference reversals: The role of preference imprecision and nontransparent methods.

    PubMed

    Pinto-Prades, José Luis; Sánchez-Martínez, Fernando Ignacio; Abellán-Perpiñán, José María; Martínez-Pérez, Jorge E

    2018-05-16

    Preferences elicited with matching and choice usually diverge (as characterised by preference reversals), violating a basic rationality requirement, namely, procedure invariance. We report the results of an experiment that shows that preference reversals between matching (Standard Gamble in our case) and choice are reduced when the matching task is conducted using nontransparent methods. Our results suggest that techniques based on nontransparent methods are less influenced by biases (i.e., compatibility effects) than transparent methods. We also observe that imprecision of preferences influences the degree of preference reversals. The preference reversal phenomenon is less strong in subjects with more precise preferences. Copyright © 2018 John Wiley & Sons, Ltd.

  2. Influences of Normalization Method on Biomarker Discovery in Gas Chromatography-Mass Spectrometry-Based Untargeted Metabolomics: What Should Be Considered?

    PubMed

    Chen, Jiaqing; Zhang, Pei; Lv, Mengying; Guo, Huimin; Huang, Yin; Zhang, Zunjian; Xu, Fengguo

    2017-05-16

    Data reduction techniques in gas chromatography-mass spectrometry-based untargeted metabolomics has made the following workflow of data analysis more lucid. However, the normalization process still perplexes researchers, and its effects are always ignored. In order to reveal the influences of normalization method, five representative normalization methods (mass spectrometry total useful signal, median, probabilistic quotient normalization, remove unwanted variation-random, and systematic ratio normalization) were compared in three real data sets with different types. First, data reduction techniques were used to refine the original data. Then, quality control samples and relative log abundance plots were utilized to evaluate the unwanted variations and the efficiencies of normalization process. Furthermore, the potential biomarkers which were screened out by the Mann-Whitney U test, receiver operating characteristic curve analysis, random forest, and feature selection algorithm Boruta in different normalized data sets were compared. The results indicated the determination of the normalization method was difficult because the commonly accepted rules were easy to fulfill but different normalization methods had unforeseen influences on both the kind and number of potential biomarkers. Lastly, an integrated strategy for normalization method selection was recommended.

  3. Modularity-like objective function in annotated networks

    NASA Astrophysics Data System (ADS)

    Xie, Jia-Rong; Wang, Bing-Hong

    2017-12-01

    We ascertain the modularity-like objective function whose optimization is equivalent to the maximum likelihood in annotated networks. We demonstrate that the modularity-like objective function is a linear combination of modularity and conditional entropy. In contrast with statistical inference methods, in our method, the influence of the metadata is adjustable; when its influence is strong enough, the metadata can be recovered. Conversely, when it is weak, the detection may correspond to another partition. Between the two, there is a transition. This paper provides a concept for expanding the scope of modularity methods.

  4. Determinants of modern family planning use among women of reproductive age in the Nkwanta district of Ghana: a case-control study.

    PubMed

    Eliason, Sebastian; Awoonor-Williams, John K; Eliason, Cecilia; Novignon, Jacob; Nonvignon, Justice; Aikins, Moses

    2014-08-13

    Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. While several efforts had been made to improve family planning in the country, the district still had very low use of modern family planning methods. This study sought to determine the factors that influenced modern family planning use in general and specifically, the factors that determined the consistently low use of modern family planning methods in the district. A case-control study was conducted in the Nkwanta district of Ghana to determine socio-economic, socio-cultural and service delivery factors influencing family planning usage. One hundred and thirty cases and 260 controls made up of women aged 15-49 years were interviewed using structured questionnaires. A logistic regression was fitted. Awareness and knowledge of modern family planning methods were high among cases and controls (over 90%). Lack of formal education among women, socio-cultural beliefs and spousal communication were found to influence modern family planning use. Furthermore, favourable opening hours of the facilities and distance to health facilities influenced the use of modern contraceptives. While modern family planning seemed to be common knowledge among these women, actual use of such contraceptives was limited. There is need to improve use of modern family planning methods in the district. In addition to providing health facilities and consolidating close-to-client service initiatives in the district, policies directed towards improving modern family planning method use need to consider the influence of formal education. Promoting basic education, especially among females, will be a crucial step as the district is faced with high levels of school dropout and illiteracy rates.

  5. Factors Which Influence The Fish Purchasing Decision: A study on Traditional Market in Riau Mainland

    NASA Astrophysics Data System (ADS)

    Siswati, Latifa; Putri, Asgami

    2018-05-01

    The purposes of the research are to analyze and assess the factors which influence fish purchasing by the community at Tenayan Raya district Pekanbaru.Research methodology which used is survey method, especially interview and observation technique or direct supervision on the market which located at Tenayan Raya district. Determination technique of sampling location/region is done by purposive sampling. The sampling method is done by accidental sampling. Technique analysis of factors which used using the data that derived from the respondent opinion to various fish variable. The result of this research are the factors which influence fish purchasing decision done in a traditional market which located at Tenayan Raya district are product factor, price factors, social factor and individual factor. Product factor which influences fish purchasing decision as follows: the eyelets condition, the nutrition of fresh fish, the diversity of sold fish. Price factors influence the fish purchasing decision, such as: the price of fresh fish, the convincing price and the suitability price and benefits of the fresh fish. Individual factors which influence a fish purchasing decision, such as education and income levels. Social factors which influence a fish purchasing decision, such as family, colleagues and feeding habits of fish.

  6. Influences on the use of observational methods by practitioners when identifying risk factors in physical work.

    PubMed

    Diego-Mas, Jose-Antonio; Poveda-Bautista, Rocio; Garzon-Leal, Diana-Carolina

    2015-01-01

    Most observational methods for musculoskeletal disorder risk assessment have been developed by researchers to be applied in specific situations, and practitioners could find difficulties in their use in real-work conditions. The main objective of this study was to identify the factors which have an influence on how useful the observational techniques are perceived to be by practitioners and to what extent these factors influence their perception. A survey was conducted on practitioners regarding the problems normally encountered when implementing these methods, as well as the perceived overall utility of these techniques. The results show that practitioners place particular importance on the support the methods provide in making decisions regarding changes in work systems and how applicable they are to different types of jobs. The results of this study can serve as guide to researchers for the development of new assessment techniques that are more useful and applicable in real-work situations.

  7. The Influence of Stimulus Taste and Chemesthesis on Tongue Movement Timing in Swallowing

    ERIC Educational Resources Information Center

    Steele, Catriona M.; van Lieshout, Pascal H. H. M.; Pelletier, Cathy A.

    2012-01-01

    Purpose: To explore the influence of taste and trigeminal irritation (chemesthesis) on durational aspects of tongue movement in liquid swallowing, controlling for the influence of perceived taste intensity. Method: Electromagnetic midsagittal articulography was used to trace tongue movements during discrete liquid swallowing with 5 liquids: water,…

  8. Association of Active Play-Related Parenting Behaviors, Orientations, and Practices with Preschool Sedentary Behavior

    ERIC Educational Resources Information Center

    Loprinzi, Paul D.; Cardinal, Bradley J.; Kane, Christy; Lee, Hyo; Beets, Michael W.

    2014-01-01

    Background: Parents' behaviors, practices, beliefs, and attitudes greatly influence children's active play behavior; however, little research has examined these parental influences on preschool children's sedentary behavior (SB). Purpose: The purpose of this study was to examine the association between parental influences on preschool SB. Methods:…

  9. The Persuade Package Hypothesis: Further Evidence for an Influence Tactics Schema.

    ERIC Educational Resources Information Center

    Aguinis, Herman; And Others

    Researchers interested in social power in organizational contexts have focused on investigating whether situational factors affect people's preferences for types of influence tactics. The persuade package is defined as a small standard set of methods (influence tactics) that leads to a particular goal (persuade the target to do something). The…

  10. Orthography and Modality Influence Speech Production in Adults and Children

    ERIC Educational Resources Information Center

    Saletta, Meredith; Goffman, Lisa; Hogan, Tiffany P.

    2016-01-01

    Purpose: The acquisition of literacy skills influences the perception and production of spoken language. We examined if orthography influences implicit processing in speech production in child readers and in adult readers with low and high reading proficiency. Method: Children (n = 17), adults with typical reading skills (n = 17), and adults…

  11. The Influence of Teaching Style on Instructor Satisfaction with Teaching Fully Online Courses

    ERIC Educational Resources Information Center

    Franker, Karen A.

    2016-01-01

    This mixed methods study examined the role that teaching style plays in influencing instructors' perceptions of satisfaction with online teaching at the postsecondary level. Two questions guided the study: (1) To what extent does preferred teaching style influence satisfaction with online teaching for instructors who teach fully online courses?…

  12. Influence of Subjectivity in Geological Mapping on the Net Penetration Rate Prediction for a Hard Rock TBM

    NASA Astrophysics Data System (ADS)

    Seo, Yongbeom; Macias, Francisco Javier; Jakobsen, Pål Drevland; Bruland, Amund

    2018-05-01

    The net penetration rate of hard rock tunnel boring machines (TBM) is influenced by rock mass degree of fracturing. This influence is taken into account in the NTNU prediction model by the rock mass fracturing factor ( k s). k s is evaluated by geological mapping, the measurement of the orientation of fractures and the spacing of fractures and fracture type. Geological mapping is a subjective procedure. Mapping results can therefore contain considerable uncertainty. The mapping data of a tunnel mapped by three researchers were compared, and the influence of the variation in geological mapping was estimated to assess the influence of subjectivity in geological mapping. This study compares predicted net penetration rates and actual net penetration rates for TBM tunneling (from field data) and suggests mapping methods that can reduce the error related to subjectivity. The main findings of this paper are as follows: (1) variation of mapping data between individuals; (2) effect of observed variation on uncertainty in predicted net penetration rates; (3) influence of mapping methods on the difference between predicted and actual net penetration rate.

  13. Laser-based optoelectronic system for therapy by medical treatment of cardiovascular diseases

    NASA Astrophysics Data System (ADS)

    Chtchoupak, Oleg S.; Spilevoi, Boris N.; Zapaeva, Natlia L.

    1996-04-01

    The method and system's design for the laser treatment of the heart ischemia is presented. Our conceptual approach to the development of the system is based on the theoretical and experimental works about positive influence of low intensity near infrared laser irradiation by treatment of cardiovascular diseases. The method and system allow it to influence the subepicardial collateral blood circulation with near infrared (NIR) laser irradiation in wavelength ranges of 0.86 - 1.06 mkm. The presented techniques make it possible to achieve a higher effectiveness of treatment. First, due to individual choice of radiation parameters on the basis of analysis of the patient's conditions before and after laser therapy. Second, due to simultaneous influence at several points of the human body. Finally, results of the clinical tests are presented, which confirm the discussed methods.

  14. Vulnerabilities, Influences and Interaction Paths: Failure Data for Integrated System Risk Analysis

    NASA Technical Reports Server (NTRS)

    Malin, Jane T.; Fleming, Land

    2006-01-01

    We describe graph-based analysis methods for identifying and analyzing cross-subsystem interaction risks from subsystem connectivity information. By discovering external and remote influences that would be otherwise unexpected, these methods can support better communication among subsystem designers at points of potential conflict and to support design of more dependable and diagnosable systems. These methods identify hazard causes that can impact vulnerable functions or entities if propagated across interaction paths from the hazard source to the vulnerable target. The analysis can also assess combined impacts of And-Or trees of disabling influences. The analysis can use ratings of hazards and vulnerabilities to calculate cumulative measures of the severity and importance. Identification of cross-subsystem hazard-vulnerability pairs and propagation paths across subsystems will increase coverage of hazard and risk analysis and can indicate risk control and protection strategies.

  15. Visual cluster analysis and pattern recognition template and methods

    DOEpatents

    Osbourn, Gordon Cecil; Martinez, Rubel Francisco

    1999-01-01

    A method of clustering using a novel template to define a region of influence. Using neighboring approximation methods, computation times can be significantly reduced. The template and method are applicable and improve pattern recognition techniques.

  16. Inferring influence and leadership in moving animal groups.

    PubMed

    Strandburg-Peshkin, Ariana; Papageorgiou, Danai; Crofoot, Margaret C; Farine, Damien R

    2018-05-19

    Collective decision-making is a daily occurrence in the lives of many group-living animals, and can have critical consequences for the fitness of individuals. Understanding how decisions are reached, including who has influence and the mechanisms by which information and preferences are integrated, has posed a fundamental challenge. Here, we provide a methodological framework for studying influence and leadership in groups. We propose that individuals have influence if their actions result in some behavioural change among their group-mates, and are leaders if they consistently influence others. We highlight three components of influence (influence instances, total influence and consistency of influence), which can be assessed at two levels (individual-to-individual and individual-to-group). We then review different methods, ranging from individual positioning within groups to information-theoretic approaches, by which influence has been operationally defined in empirical studies, as well as how such observations can be aggregated to give insight into the underlying decision-making process. We focus on the domain of collective movement, with a particular emphasis on methods that have recently been, or are being, developed to take advantage of simultaneous tracking data. We aim to provide a resource bringing together methodological tools currently available for studying leadership in moving animal groups, as well as to discuss the limitations of current methodologies and suggest productive avenues for future research.This article is part of the theme issue 'Collective movement ecology'. © 2018 The Author(s).

  17. What influences the choice of assessment methods in health technology assessments? Statistical analysis of international health technology assessments from 1989 to 2002.

    PubMed

    Draborg, Eva; Andersen, Christian Kronborg

    2006-01-01

    Health technology assessment (HTA) has been used as input in decision making worldwide for more than 25 years. However, no uniform definition of HTA or agreement on assessment methods exists, leaving open the question of what influences the choice of assessment methods in HTAs. The objective of this study is to analyze statistically a possible relationship between methods of assessment used in practical HTAs, type of assessed technology, type of assessors, and year of publication. A sample of 433 HTAs published by eleven leading institutions or agencies in nine countries was reviewed and analyzed by multiple logistic regression. The study shows that outsourcing of HTA reports to external partners is associated with a higher likelihood of using assessment methods, such as meta-analysis, surveys, economic evaluations, and randomized controlled trials; and with a lower likelihood of using assessment methods, such as literature reviews and "other methods". The year of publication was statistically related to the inclusion of economic evaluations and shows a decreasing likelihood during the year span. The type of assessed technology was related to economic evaluations with a decreasing likelihood, to surveys, and to "other methods" with a decreasing likelihood when pharmaceuticals were the assessed type of technology. During the period from 1989 to 2002, no major developments in assessment methods used in practical HTAs were shown statistically in a sample of 433 HTAs worldwide. Outsourcing to external assessors has a statistically significant influence on choice of assessment methods.

  18. Social network- and community-level influences on contraceptive use: evidence from rural Poland.

    PubMed

    Colleran, Heidi; Mace, Ruth

    2015-05-22

    The diffusion of 'modern' contraceptives-as a proxy for the spread of low-fertility norms-has long interested researchers wishing to understand global fertility decline. A fundamental question is how local cultural norms and other people's behaviour influence the probability of contraceptive use, independent of women's socioeconomic and life-history characteristics. However, few studies have combined data at individual, social network and community levels to simultaneously capture multiple levels of influence. Fewer still have tested if the same predictors matter for different contraceptive types. Here, we use new data from 22 high-fertility communities in Poland to compare predictors of the use of (i) any contraceptives-a proxy for the decision to control fertility-with those of (ii) 'artificial' contraceptives-a subset of more culturally taboo methods. We find that the contraceptive behaviour of friends and family is more influential than are women's own characteristics and that community level characteristics additionally influence contraceptive use. Highly educated neighbours accelerate women's contraceptive use overall, but not their artificial method use. Highly religious neighbours slow women's artificial method use, but not their contraceptive use overall. Our results highlight different dimensions of sociocultural influence on contraceptive diffusion and suggest that these may be more influential than are individual characteristics. A comparative multilevel framework is needed to understand these dynamics.

  19. Influence of engine coolant composition on the electrochemical degradation behavior of EPDM radiator hoses

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

    Vroomen, G.L.M.; Lievens, S.S.; Maes, J.P.

    1999-08-01

    EPDM (ethylene-propylene rubber) has been used for more than 25 years as the main elastomer in radiator hoses because it offers a well-balanced price/performance ratio in this field of application. Some years ago the automotive and rubber industry became aware of a problem called electrochemical degradation and cracking. Cooling systems broke down due to a typical cracking failure of some radiator hoses. Different test methods were developed to simulate and solve the problem on laboratory scale. The influence of different variables with respect to the electrochemical degradation and cracking. Cooling systems broke down due to a typical cracking failure ofmore » some radiator hoses. Different test methods were developed to simulate and solve the problem on laboratory scale. The influence of different variables with respect to the electrochemical degradation process has been investigated, but until recently the influence of the engine coolant was ignored. Using a test method developed by DSM elastomers, the influence of the composition of the engine coolant as well as of the EPDM composition has now been evaluated. This paper gives an overview of test results with different coolant technologies and offers a plausible explanation of the degradation mechanisms as a function of the elastomer composition.« less

  20. The influence of the radial pressure gradient on the blade root loss in an annular subsonic nozzle cascade

    NASA Astrophysics Data System (ADS)

    Meng, D.; Weng, Z.; Xiang, Y.

    1985-09-01

    This paper presents a method for predicting the blade root loss in an annular nozzle cascade in which consideration is given to the influence of the radial pressure gradient (RPG) on it. The variation of blade root losses under different RPG is obtained experimentally, and finite element method is used to calculate the pressure distribution in the blade passage.

  1. If We Build It, They Will Come! Exploring the Role of ICTs in Curriculum Design and Development: The Myths, Miracles and Affordances

    ERIC Educational Resources Information Center

    Naidu, S.

    2007-01-01

    Central to the argument about the influence of media on learning is how this influence is measured or ascertained. Conventional methods which comprise the use of true and quasi-experimental designs are inadequate. Several lessons can be learned from this observation on the media debate. The first is that, conventional methods of ascertaining the…

  2. A Mixed Methods Mapping of Church versus Secular School Messages to Influence Sexual Decision Making as Perceived by Zimbabwean Orphan Girl Students

    ERIC Educational Resources Information Center

    Mpofu, Elias; Hallfors, Denise Dion; Mutepfa, Magen Mhaka; Dune, Tinashe Moira

    2014-01-01

    This study examined the messages perceived by adolescent girls with orphanhood to influence their sexual decision making. Participants were 125 students (mean age = 14.7 years), 54% of whom attended church schools in a rural district of eastern Zimbabwe. We collected and analyzed data using concept mapping, a mixed method approach that enabled the…

  3. The Influence of Teaching Methods and Learning Environment to the Student's Learning Achievement of Craft and Entrepreneurship Subjects at Vocational High School

    ERIC Educational Resources Information Center

    Munawaroh

    2017-01-01

    This research aims to explain the influence of teacher's teaching methods and learning environment to the learning achievement in class XI with the competency of accounting expertise to the subjects of craft and entrepreneurship, according to the students, the subject was very heavy and dull. The population in this research are students in class…

  4. A study of marketing and its effect on infant feeding practices.

    PubMed

    Suleiman, A

    2001-09-01

    A baby milk market was created in the late nineteenth and early twentieth centuries and was conceived through the mutual attraction of the manufacturers and doctors. This has partly attributed to the change from breast to artificial feeding. This study was conducted to determine whether marketing had any effect on infant feeding practices. Fifty Malay mothers whose last child was aged less than five years were asked, by questionnaire and by interview, to identify whether several marketing methods influenced their decision on the selection of infant feeding practice. It was found that these mothers felt milk advertisements on television were attractive (72%), were influenced by others to buy a particular brand of formula (38.4%), were influenced by free milk samples to buy a particular brand of milk formula (65.2%) and were not influenced by their doctors on the chosen method of feeding (68%). More studies should be conducted on a bigger sample in other settings and targeting other methods of marketing to substantiate the above results. Further, similar studies among Chinese and Indian mothers are also required.

  5. Attitude toward, acceptance of and knowledge about female sterilization as a method of contraception.

    PubMed

    Erlenwein, J; Kundu, S; Schippert, C; Soergel, P; Hillemanns, P; Staboulidou, I

    2015-02-01

    Surgical sterilization via tubal ligation or the disconnection of the tubes is a method of permanent contraception. The aim of this study was to evaluate the attitude, acceptance and knowledge of women about female sterilization as a method of contraception in terms of the social and cultural backgrounds of those women. Prospective study based on an anonymous questionnaire that analyzed background knowledge, attitude, influence factors and motivation regarding sterilization, as well as the reasons for declining. The questionnaire also attempted to evaluate the effects on the self-esteem of the women, as well as the impact of religious dogma and the related beliefs. One thousand, eight hundred questionnaires were distributed, and 1247 women completed the questionnaire—a response rate of 69.3%. There were mainly positive attitudes toward sterilization as a contraceptive method. Cultural background, including religion and faith; the mother's experiences and point of view; knowledge; family planning and the actual life situation have an influence on the attitudes toward and acceptance of sterilization as a contraceptive method and on the final choice of a contraceptive method. Cultural background and present life situation have a great impact on the attitude toward and acceptance of sterilization as a method of contraception, thus influencing the final choice of a contraceptive method. Detailed counselling about this topic is essential and should be improved. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Review: Quantifying animal feeding behaviour with a focus on pigs.

    PubMed

    Maselyne, Jarissa; Saeys, Wouter; Van Nuffel, Annelies

    2015-01-01

    The study of animal feeding behaviour is of interest to understand feeding, to investigate the effect of treatments and conditions or to predict illness. This paper reviews the different steps to undertake when studying animal feeding behaviour, with illustrations for group-housed pigs. First, one must be aware of the mechanisms that control feeding and the various influences that can change feeding behaviour. Satiety is shown to largely influence free feeding (ad libitum and without an operant condition) in animals, but 'free' feeding seems a very fragile process, given the many factors that can influence feeding behaviour. Second, a measurement method must be chosen that is compatible with the goal of the research. Several measurement methods exist, which lead to different experimental set-ups and measurement data. Sensors are available for lab conditions, for research on group-housed pigs and also for on-farm use. Most of these methods result in a record of feeding visits. However, these feeding visits are often found to be clustered into meals. Thus, the third step is to choose which unit of feeding behaviour to use for analysis. Depending on the situation, either meals, feeding visits, other raw data, or a combination thereof can be suitable. Meals are more appropriate for analysing short-term feeding behaviour, but this may not be true for disease detection. Further research is therefore needed. To cluster visits into meals, an appropriate analysis method has to be selected. The last part of this paper provides a review and discussion of the existing methods for meal determination. A variety of methods exist, with the most recent methods based on the influence of satiety on feeding. More thorough validation of the recent methods, including validation from a behavioural point of view and uniformity in the applied methods is therefore necessary. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. A Method for Formulizing Disaster Evacuation Demand Curves Based on SI Model

    PubMed Central

    Song, Yulei; Yan, Xuedong

    2016-01-01

    The prediction of evacuation demand curves is a crucial step in the disaster evacuation plan making, which directly affects the performance of the disaster evacuation. In this paper, we discuss the factors influencing individual evacuation decision making (whether and when to leave) and summarize them into four kinds: individual characteristics, social influence, geographic location, and warning degree. In the view of social contagion of decision making, a method based on Susceptible-Infective (SI) model is proposed to formulize the disaster evacuation demand curves to address both social influence and other factors’ effects. The disaster event of the “Tianjin Explosions” is used as a case study to illustrate the modeling results influenced by the four factors and perform the sensitivity analyses of the key parameters of the model. Some interesting phenomena are found and discussed, which is meaningful for authorities to make specific evacuation plans. For example, due to the lower social influence in isolated communities, extra actions might be taken to accelerate evacuation process in those communities. PMID:27735875

  8. Cross-Study Differences in the Etiology of Reading Comprehension: a Meta-Analytical Review of Twin Studies.

    PubMed

    Little, Callie W; Haughbrook, Rasheda; Hart, Sara A

    2017-01-01

    Numerous twin studies have examined the genetic and environmental etiology of reading comprehension, though it is likely that etiological estimates are influenced by unidentified sample conditions (e.g. Tucker-Drob and Bates, Psychol Sci:0956797615612727, 2015). The purpose of this meta-analysis was to average the etiological influences of reading comprehension and to explore the potential moderators influencing these estimates. Results revealed an average heritability estimate of h 2  = 0.59, with significant variation in estimates across studies, suggesting potential moderation. Moderation results indicated publication year, grade level, project, zygosity methods, and response type moderated heritability estimates. The average shared environmental estimate was c 2  = 0.16, with publication year, grade and zygosity methods acting as significant moderators. These findings support the role of genetics on reading comprehension, and a small significant role of shared environmental influences. The results suggest that our interpretation of how genes and environments influence reading comprehension should reflect aspects of study and sample.

  9. Influence of culture on contraceptive utilization among HIV-positive women in Brazil, Kenya, and South Africa.

    PubMed

    Todd, Catherine S; Stibich, Mark A; Laher, Fatima; Malta, Monica S; Bastos, Francisco I; Imbuki, Kennedy; Shaffer, Douglas N; Sinei, Samuel K; Gray, Glenda E

    2011-02-01

    Contraceptive choice and discontinuation are poorly understood among HIV-positive women, and HIV disease and culture may influence decisions. We assessed factors influencing contraceptive decision-making among HIV-positive women in three countries. This qualitative assessment of 108 HIV-positive women (36/site, selected by age and parity strata) was conducted in Rio de Janeiro, Brazil; Kericho, Kenya; and Soweto, South Africa. Freelist interviews assessed knowledge and attitudes towards contraception and were analyzed enumerating frequency and saliency of mentions. There was intersite consensus around list items but priority and themes varied. Site-specific factors influencing contraceptive choice were male partner wishes and fertility desire (Brazil), side-effects (South Africa), and impact on health and HIV progression (Kenya). Age, parity, and taking antiretroviral therapy (ART) impacted some themes. Contraceptive use among HIV-positive women is substantially influenced by culture and other factors. Counseling efforts should consider individual factors in method selection and offer method variety to accommodate changing needs.

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

    Eltayeb, Aly Eldeen O.; Stern, Michael C.; Hatton, Trevor Alan

    The present invention generally relates to methods and systems for carrying out a pH-influenced chemical and/or biological reaction. In some embodiments, the pH-influenced reaction involves the conversion of CO.sub.2 to a dissolved species.

  11. Local influence for generalized linear models with missing covariates.

    PubMed

    Shi, Xiaoyan; Zhu, Hongtu; Ibrahim, Joseph G

    2009-12-01

    In the analysis of missing data, sensitivity analyses are commonly used to check the sensitivity of the parameters of interest with respect to the missing data mechanism and other distributional and modeling assumptions. In this article, we formally develop a general local influence method to carry out sensitivity analyses of minor perturbations to generalized linear models in the presence of missing covariate data. We examine two types of perturbation schemes (the single-case and global perturbation schemes) for perturbing various assumptions in this setting. We show that the metric tensor of a perturbation manifold provides useful information for selecting an appropriate perturbation. We also develop several local influence measures to identify influential points and test model misspecification. Simulation studies are conducted to evaluate our methods, and real datasets are analyzed to illustrate the use of our local influence measures.

  12. Social Influences on Young People's Sexual Health in Uganda

    ERIC Educational Resources Information Center

    Bell, Stephen; Aggleton, Peter

    2013-01-01

    Purpose: The purpose of this paper is to examine the influence of social context on young people's sexual lives and sexual health, and to highlight the need for HIV prevention and sexual health programmes which better take into account these contextual influences. Design/methodology/approach: The paper draws on findings from a multi-method,…

  13. The Influence of Body Mass Index on Long-Term Fitness from Physical Education in Adolescent Girls

    ERIC Educational Resources Information Center

    Camhi, Sarah M.; Phillips, Jennie; Young, Deborah R.

    2011-01-01

    Background: Physical education (PE) can improve physical fitness; however, little research has evaluated PE's long-term influence. The purpose is to determine PE's longitudinal effects on fitness in a group of adolescent girls and to determine whether body mass index (BMI) status influenced any potential effects. Methods: Participants were…

  14. Disentangling Child and Family Influences on Maternal Expressed Emotion toward Children with Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Cartwright, Kim L.; Bitsakou, Paraskevi; Daley, David; Gramzow, Richard H.; Psychogiou, Lamprini; Simonoff, Emily; Thompson, Margaret J.; Sonuga-Barke, Edmund J. S.

    2011-01-01

    Objective: We used multi-level modelling of sibling-pair data to disentangle the influence of proband-specific and more general family influences on maternal expressed emotion (MEE) toward children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Method: MEE was measured using the Five Minute Speech Sample (FMSS) for 60…

  15. How Social Networks Influence Female Students' Choices to Major in Engineering

    ERIC Educational Resources Information Center

    Weinland, Kathryn Ann

    2012-01-01

    Scope and Method of Study: This study examined how social influence plays a part in female students' choices of college major, specifically engineering instead of science, technology, and math. Social influence may show itself through peers, family members, and teachers and may encompass resources under the umbrella of social capital. The…

  16. An influence coefficient method for the application of the modal technique to wing flutter suppression of the DAST ARW-1 wing

    NASA Technical Reports Server (NTRS)

    Pines, S.

    1981-01-01

    The methods used to compute the mass, structural stiffness, and aerodynamic forces in the form of influence coefficient matrices as applied to a flutter analysis of the Drones for Aerodynamic and Structural Testing (DAST) Aeroelastic Research Wing. The DAST wing was chosen because wind tunnel flutter test data and zero speed vibration data of the modes and frequencies exist and are available for comparison. A derivation of the equations of motion that can be used to apply the modal method for flutter suppression is included. A comparison of the open loop flutter predictions with both wind tunnel data and other analytical methods is presented.

  17. Ambulatory aortic blood pressure, wave reflections and pulse wave velocity are elevated during the third in comparison to the second interdialytic day of the long interval in chronic haemodialysis patients.

    PubMed

    Koutroumbas, Georgios; Georgianos, Panagiotis I; Sarafidis, Pantelis A; Protogerou, Athanase; Karpetas, Antonios; Vakianis, Pantelis; Raptis, Vassilios; Liakopoulos, Vassilios; Panagoutsos, Stylianos; Syrganis, Christos; Passadakis, Ploumis

    2015-12-01

    Increased arterial stiffness and aortic blood pressure (BP) are independent predictors of cardiovascular outcomes in end-stage renal disease. The 3-day interdialytic interval is associated with elevated risk of cardiovascular morbidity and mortality in haemodialysis. This study investigated differences in ambulatory aortic BP and arterial stiffness between the second and third day of the long interdialytic interval. Ambulatory BP monitoring with Mobil-O-Graph monitor (IEM, Stolberg, Germany) was performed in 55 haemodialysis patients during a 3-day interval. Mobil-O-Graph records oscillometric brachial BP and pulse waves and calculates aortic BP and augmentation index (AIx) as measure of wave reflections, and pulse wave velocity (PWV) as measure of arterial stiffness. Ambulatory aortic systolic blood pressure (SBP) and diastolic blood pressure (DBP) were higher during the third versus second interdialytic day (123.6 ± 17.0 versus 118.5 ± 17.1 mmHg, P < 0.001; 81.5 ± 11.8 versus 78 ± 11.9 mmHg, P < 0.001, respectively). Similar differences were noted for brachial BP. Ambulatory AIx and PWV were also significantly increased during the third versus second day (30.5 ± 9.9 versus 28.8 ± 9.9%, P < 0.05; 9.6 ± 2.3 versus 9.4 ± 2.3 m/s, P < 0.001, respectively). Differences between Days 2 and 3 remained significant when day-time and night-time periods were compared separately. Aortic SBP and DBP, AIx and PWV showed gradual increases from the end of dialysis session onwards. Interdialytic weight gain was a strong determinant of the increase in the above parameters. This study showed significantly higher ambulatory aortic BP, AIx and PWV levels during the third compared with the second interdialytic day. These findings support a novel pathway for increased cardiovascular risk during the third interdialytic day in haemodialysis. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  18. Ambulatory blood pressure and arterial stiffness in individuals with type 1 diabetes.

    PubMed

    Lithovius, Raija; Gordin, Daniel; Forsblom, Carol; Saraheimo, Markku; Harjutsalo, Valma; Groop, Per-Henrik

    2018-05-24

    This study aimed to assess the use of ambulatory BP monitoring (ABPM) to identify the presence of masked, nocturnal and white-coat hypertension in individuals with type 1 diabetes, patterns that could not be detected by regular office-based BP monitoring alone. We also analysed associations between BP patterns and arterial stiffness in order to identify individuals at cardiovascular risk. This substudy included 140 individuals with type 1 diabetes from the Helsinki metropolitan area, who attended the Finnish Diabetic Nephropathy Study (FinnDiane) Centre in Helsinki between January 2013 and August 2017. Twenty-four hour ABPM and pulse wave analysis were performed simultaneously using a validated non-invasive brachial oscillometric device (Mobil-O-Graph). Definitions of hypertension were based on the European Society of Hypertension guidelines. Masked hypertension was defined as normal office BP (BP obtained using a standardised automated BP device) but elevated 24 h ABPM, and white-coat hypertension as elevated office BP but normal 24 h ABPM. A total of 38% of individuals were normotensive and 33% had sustained hypertension, while 23% had masked and 6% had white-coat hypertension. About half of the cohort had increased absolute levels of night-time BP, half of whom were untreated. In the ambulatory setting, central BP and pulse wave velocity (PWV) were higher in participants with masked hypertension than in those with normotension (p ≤ 0.001). In a multivariable linear regression model adjusted for age, sex, BMI, antihypertensive treatment and eGFR, masked hypertension was independently associated with higher 24 h PWV (β 0.50 [95% CI 0.34, 0.66]), but not with PWV obtained during resting conditions (adjusted β 0.28 [95% CI -0.53, 1.10]), using normotension as the reference group. ABPM analysis revealed that one-quarter of the participants with type 1 diabetes had masked hypertension; these individuals would not have been detected by office BP alone. Moreover, arterial stiffness was increased in individuals with masked hypertension. These findings support the use of ABPM to identify individuals at risk of cardiovascular disease.

  19. Systolic blood pressure in babies of less than 32 weeks gestation in the first year of life

    PubMed Central

    Initiative, N. N.

    1999-01-01

    AIM—To define the normal range of systolic blood pressure in a non-selective population based sample of babies of low gestation throughout early infancy.
METHODS—Daily measurements of systolic blood pressure were made in all the babies of less than 32 weeks gestation born in the North of England in 1990 and 1991 during the first 10 days of life. Additional measurements were obtained from 135 of these babies throughout the first year of life. Systolic pressure was measured by sensing arterial flow with a Doppler ultrasound probe. It was assumed that blood pressure had never been pathologically abnormal in the neonatal period if the child was alive and free from severe disability two years later. Data of adequate quality were available from 398 such children. Additional data were collected, for comparative purposes, from 123 babies of 32, 36, or 40 weeks of gestation.
RESULTS—Systolic pressure correlated with weight and gestation at birth, and rose progressively during the first 10 days of life. The coefficient of variation did not vary with gestational or postnatal age (mean value 17%), the relation with gestation being closer than with birthweight. Systolic pressure rose 20% during the first 10 days from an initial mean of 42 mm Hg in babies of 24 weeks gestation, and by 42% from an initial mean of 48 mm Hg in babies of 31 weeks gestation. These findings were not altered by the exclusion of data from 14 babies who had inotropic support during this time. Simultaneous measurements in three centres using an oscillometric technique revealed that this technique tended to overestimate systolic pressure when this was below average. Systolic pressure finally stabilised at a mean of 92 (95% CI 72-112) mm Hg at a postconceptional age of 44-48 weeks irrespective of gestation at birth.
CONCLUSION—Systolic blood pressure 4-24 hours after birth was less than gestational age (in weeks) in only 3% of non-disabled long term survivors. Systolic pressure rose with increasing gestation and increasing postnatal age, but stabilised some six weeks after term, regardless of gestation at birth.

 PMID:10325810

  20. Opportunistic screening of atrial fibrillation by automatic blood pressure measurement in the community.

    PubMed

    Omboni, Stefano; Verberk, Willem J

    2016-04-12

    Timely detection of atrial fibrillation (AF) may effectively prevent cardiovascular consequences. However, traditional diagnostic tools are either poorly reliable (pulse palpation) or not readily accessible (ECG) in general practice. We tested whether an automatic oscillometric blood pressure (BP) monitor embedded with an algorithm for AF detection might be effective for opportunistic screening of asymptomatic AF in the community. A community-based screening campaign in an unselected population to verify the feasibility of AF screening with a Microlife WatchBP Office BP monitor with a patented AFIB algorithm. When possible AF was detected (≥2 of 3 BP measurements reporting AF), a doctor immediately performed a single-lead ECG in order to confirm or exclude the presence of the arrhythmia. The main demographic and clinical data were also collected. 220 consecutive participants from an unselected sample of individuals in a small Italian community. Number of patients detected with AF and diagnosed risk factors for AF. In 12 of 220 participants, the device detected possible AF during the BP measurement: in 4 of them (1.8%), the arrhythmia was confirmed by the ECG. Patients with AF were more likely to be older (77.0±1.2 vs 57.2±15.2 years, p=0.010), obese (50.0 vs 14.4%, p=0.048) and to suffer from a cardiovascular disease (50.0 vs 10.6%, p=0.014) than patients without AF. Participants with a positive BP AF reading and non-AF arrhythmias (n=8) did not differ in their general characteristics from participants with a negative BP AF reading and were younger than patients with AF (mean age 56.4±14.8, p=0.027; 5 of 8 participants aged <65 years). Opportunistic screening of AF by BP measurement is feasible to diagnose this arrhythmia in unaware participants, particularly in those older than 65 years, who are the target patient group recommended by current AF screening guidelines. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Reactive rise in blood pressure upon cuff inflation: cuff inflation at the arm causes a greater rise in pressure than at the wrist in hypertensive patients.

    PubMed

    Charmoy, Alexia; Würzner, Grégoire; Ruffieux, Christiane; Hasler, Christopher; Cachat, François; Waeber, Bernard; Burnier, Michel

    2007-10-01

    Cuff inflation at the arm is known to cause an instantaneous rise in blood pressure, which might be due to the discomfort of the procedure and might interfere with the precision of the blood pressure measurement. In this study, we compared the reactive rise in blood pressure induced by cuff inflation when the cuff was placed at the upper arm level and at the wrist. The reactive rise in systolic and diastolic blood pressure to cuff inflation was measured in 34 normotensive participants and 34 hypertensive patients. Each participant was equipped with two cuffs, one around the right upper arm (OMRON HEM-CR19, 22-32 cm) and one around the right wrist (OMRON HEM-CS 19, 17-22 cm; Omron Health Care Europe BV, Hoofddorp, The Netherlands). The cuffs were inflated in a double random order (maximal cuff pressure and position of the cuff) with two maximal cuff pressures: 180 and 240 mmHg. The cuffs were linked to an oscillometric device (OMRON HEM 907; Omron Health Care). Simultaneously, blood pressure was measured continuously at the middle finger of the left hand using photoplethysmography. Three measurements were made at each level of blood pressure at the arm and at the wrist, and the sequence of measurements was randomized. In normotensive participants, no significant difference was observed in the reactive rise in blood pressure when the cuff was inflated either at the arm or at the wrist irrespective of the level of cuff inflation. Inflating a cuff at the arm, however, induced a significantly greater rise in blood pressure than inflating it at the wrist in hypertensive participants for both systolic and diastolic pressures (P<0.01), and at both levels of cuff inflation. The blood pressure response to cuff inflation was independent of baseline blood pressure. The results show that in hypertensive patients, cuff inflation at the wrist produces a smaller reactive rise in blood pressure. The difference between the arm and the wrist is independent of the patient's level of blood pressure.

  2. Simultaneous validation of the SunTech CT40 automated blood pressure measurement device by the 1993 British Hypertension Society protocol and the Association for the Advancement of Medical Instrumentation/International Organization for Standardization 81060-2: 2013 standard.

    PubMed

    Polo Friz, Hernan; Punzi, Veronica; Petri, Francesco; Orlandi, Riccardo; Maggiolini, Daniele; Polo Friz, Melisa; Primitz, Laura; Vighi, Giuseppe

    2017-10-01

    This study aimed to perform a simultaneous, third-party, independent validation of the oscillometric SunTech CT40 device for blood pressure (BP) measurement, according to the 1993 protocol of the British Hypertension Society and the standard of the Association for the Advancement of Medical Instrumentation (AAMI)/the International Organization for Standardization (ISO) 81060-2:2013. Patient recruitment, study procedures, and data analysis followed the recommendations stated by the protocols. The study was approved by the institutional review board. A total of 94 participants were included, 52 (55.3%) women, mean±SD age: 63.1±18.0 years, mean±SD arm circumference: 35.0±9.0 cm. The average of observers' entry BPs was 146.9±37.2 mmHg for systolic blood pressure (SBP) and 82.2±22.1 mmHg for diastolic blood pressure (DBP). Differences between the standard measurement and the test device within 5, 10, and 15 mmHg, for the better observer, were 79.4, 96.5, and 100.0% for SBP and 82.6, 97.5, and 100.0% for DBP, respectively. The mean±SD differences between the readings obtained using the test device and those obtained by the observers (AAMI/ISO 81060-2:2013 standard criterion 1) were 0.3±5.0 mmHg (SBP) and -0.8±4.3 mmHg (DBP), and the mean±SD differences between average of reference readings and average of test device readings in each patient (criterion 2) were 0.3±3.9 and -0.8±3.5 mmHg for SBP and DBP, respectively. The CT40 BP device achieved A/A grade of the British Hypertension Society protocol and fulfilled the requirements (criteria 1 and 2) of the AAMI/ISO standard. CT40 can be recommended for BP measurement in adults.

  3. Characteristics of self-measured home blood pressure in a Nigerian urban community: the NIPREGH study.

    PubMed

    Odili, Augustine N; Abdullahi, Bolaji; Nwankwo, Adaku M; Asayama, Kei; Staessen, Jan A

    2015-10-01

    We investigated the characteristics of self-measured home blood pressure (HBP) in a randomly selected population of Nigerians living in Abuja, Nigeria. HBP was the average of 28 measurements comprising duplicate morning and evening readings obtained over a 7-day period by the participants using a semiautomated oscillometric device. Blood pressure measured five consecutive times by trained observers using mercury sphygmomanometer was averaged as the office blood pressure (OBP). Among the 337 participants included in the analysis, 46.6% were women and their mean age (SD) 40.3 (11.3). The mean, mean+2 SD and 95th percentile of HBP and OBP were 117/76, 147/96 and 145/93 mmHg and 114/73, 147/97 and 142/73 mmHg, respectively. The corresponding values in normotensive individuals were 113/73, 137/89 and 132/88 mmHg and 108/70, 130/88 and 128/84 mmHg. Morning HBPs were significantly higher than that of the evening, with a mean difference (confidence interval) of 1.8 mmHg (1.1-2.5 mmHg) and 1.9 mmHg (1.4-2.3 mmHg) for systolic and diastolic pressures, respectively (P<0.0001). There is a strong correlation between the office and home systolic (r=0.8, P<0.0001) and diastolic (r=0.7, P<0.0001) pressures. Overall, the HBP values were significantly higher than OBP, with a mean difference (confidence interval) of systolic/diastolic of 3.6 mmHg (2.5-4.6 mmHg)/2.3 mmHg (1.4-3.1 mmHg) (P<0.0001). The HBP/OBP difference was maintained in men and normotensive individuals, but in women and hypertensive participants, there was no significant difference between HBP and OBP. Our findings have shown that self-measured blood pressure is feasible and can be used to evaluate blood pressure outside the clinic environment among Nigerians.

  4. Seasonal variation in home blood pressure: findings from nationwide web-based monitoring in Japan

    PubMed Central

    Miura, Katsuyuki; Obayashi, Keiichi; Ohkubo, Takayoshi; Nakajima, Hiroshi; Shiga, Toshikazu; Ueshima, Hirotsugu

    2018-01-01

    Objectives Our aim was to assess seasonal variation in home blood pressure (BP) among free-living nationwide participants using home BP values accumulated from a web-based healthcare platform established in Japan. Settings An observational study. OMRON Healthcare Co., Ltd. has been developing web-based personal healthcare record systems in Japan since November 2010; over two million voluntary participants had joined this platform in September 2015. Nationwide home BP measurements made by oscillometric-type electronic sphygmomanometers from over 110 000 voluntary participants have been transmitted to the system from devices. Participants Seasonal variation in home BP was evaluated among 64 536 (51 335 men, 13 201 women; mean age 52.9 years) free-living nationwide users for whom data were automatically and simultaneously transmitted to the system from devices. Primary outcome measures Mean monthly and weekly home BP. Results In multiple regression analysis, the relationship between BP and temperature was a significant inverse association, independent of age, gender and geological locations. Highest and lowest BP was observed in December and July, respectively. Substantial seasonal differences in the mean values of morning and evening home systolic BP between summer and winter were 6.2 mmHg and 5.5 mmHg in men, and 7.3 mmHg and 6.5 mmHg in women. Seasonal variation was a little greater in older (7.3 mmHg in men, 8.7 mmHg in women) than in younger individuals (5.8 mmHg in men, 6.5 mmHg in women). BP from February to July was approximately 1.5 mmHg lower than the value from August to December. Conclusions A web-based healthcare platform has enabled easier monitoring of population-wide BP. Tighter BP control is necessary in winter than in summer, and especially in a colder climate toward winter than toward summer. New technologies using web-based self-monitoring systems for health-related indexes are expected to initiate a new phase of cardiovascular disease prevention and public health promotion. PMID:29306878

  5. Effect of alternating standing and sitting on blood pressure and pulse wave velocity during a simulated workday in adults with overweight/obesity.

    PubMed

    Barone Gibbs, Bethany; Kowalsky, Robert J; Perdomo, Sophy J; Taormina, John M; Balzer, Jeffrey R; Jakicic, John M

    2017-12-01

    Reducing prolonged sitting at work has been recommended by an expert panel, but whether intermittent standing improves vascular health is unclear. We aimed to test whether using a sit-stand desk could reduce blood pressure (BP) and pulse wave velocity (PWV) during a simulated workday. Overweight/obese adults with pre-to-Stage 1 hypertension completed a randomized crossover study with two simulated workday conditions: STAND-SIT (alternating standing and sitting condition every 30 min) and SIT (continuous sitting condition). Oscillometric BP was measured hourly. Carotid-femoral, carotid-radial, and carotid-ankle PWV were measured in the morning, mid-day, and late afternoon using tonometry. Participants [n = 25, 64% male, 84% white, mean (SD) age: 42 (12) years] had average resting SBP of 132 (9) mmHg and DBP of 83 (8) mmHg. In linear mixed models, STAND-SIT resulted in a significantly lower DBP (mean ± SE: -1.0 ± 0.4 mmHg, P = 0.020) and mean arterial pressure (MAP) (-1.0 ± 0.4 mmHg, P = 0.029) compared with SIT. SBP (-0.9 ± 0.7 mmHg, P = 0.176) was not different across conditions. Carotid-ankle PWV was significantly lower during the STAND-SIT vs. SIT condition (-0.27 ± 0.13 m/s, P = 0.047), whereas carotid-femoral PWV (-0.03 ± 0.13 m/s, P = 0.831) and carotid-radial PWV (-0.30 ± 0.18 m/s, P = 0.098) were not. Changes in MAP partially explained changes in PWV. Interrupting prolonged sitting during deskwork with intermittent standing was a sufficient stimulus to slightly, but statistically significantly, decrease DBP, MAP, and carotid-ankle PWV. Though the clinical significance of the observed effects is modest, regular use of a sit-stand desk may be a practical way to lower BP and PWV while performing deskwork.

  6. [Characteristics and cardiovascular events in a general population included in the RICARTO (RIesgo CARdiovascular TOledo) study: Data from the first 1,500 individuals included in the study].

    PubMed

    Rodríguez-Roca, G C; Segura-Fragoso, A; Villarín-Castro, A; Alonso-Moreno, F J; Rodríguez-Padial, L; Rodríguez-García, M L; Fernández-Conde, J A; Rojas-Martelo, G A; Menchén-Herreros, A; Escobar-Cervantes, C; Fernández-Martín, J; Artigao-Rodenas, L M; Carbayo-Herencia, J A; Hernández-Moreno, J

    2018-04-01

    The aim of this study was to assess cardiovascular risk (CVR) by investigating the prevalence of CVR factors (CVRF), target organ damage (TOD), and cardiovascular disease (CVD) in general population of the health area of Toledo, Spain. Epidemiological and observational study that analysed a sample from the general population aged 18years or older, randomly selected from a database of health cards stratified by age and gender. Clinical history, physical examination, and complementary tests were performed. Total blood and serum samples were frozen at -85°C to evaluate genetic studies in the future. Standard statistical analysis was performed. CVR was assessed by the SCORE scale calibrated for the Spanish population, and the Framingham Heart Study scale. A total of 1,500 individuals (mean age 49.1±15.8years, 55.6% women) were included. Prevalences: dyslipidaemia 56.9% (95% confidence interval [95% CI]: 54.3-59.4), hypertension 33.0% (95%CI: 30.6-35.4), diabetes mellitus 8.6% (95%CI: 7.17-10.1), smoking 24.2% (95%CI; 122.0-26.4), obesity 25.3% (95%CI; 23.1-27.5), and sedentary life-style 39.4% (95%CI; 36.9-41.8). No CVRF was reported in 21.1% of cases, and 18.6% had 3-5 CVRF. TOD: electrocardiographic left ventricular hypertrophy, 4.3%, peripheral artery disease, 10.1% (Doppler ultrasound), and 15.3% (oscillometric device), microalbuminuria, 4.3%, sub-clinical renal disease, 3.2%, and nephropathy in 3.8% (CKD-EPI). At least one CVD was reported in 9.2% of cases. A low CVR (SCORE) was present in 44.6% of individuals. Dyslipidaemia was found in 60% of individuals, 40% had a sedentary life-style, 30% with hypertension, 20% smoked, 20% obesity, and almost 10% with diabetes. More than a half of individuals have a moderate-high-very high risk. The prevalence of TOD and CVD are significant. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Performance of the Colson MAM BP 3AA1-2 automatic blood pressure monitor according to the European Society of Hypertension validation protocol.

    PubMed

    Pereira, Telmo; Maldonado, João

    2005-11-01

    To evaluate the performance of the Colson MAM BP 3AA1-2 oscillometric automatic blood pressure monitor according to the validation protocol of the European Society of Hypertension, testing its suitability for self-measurement of blood pressure. The performance of the device was assessed in relation to various clinical variables, including age, gender, body mass index, arm circumference and arterial stiffness. 33 subjects (15 men and 18 women), with a mean age of 47 +/- 10 years, were studied according to the procedures laid down in the European Society of Hypertension validation protocol. Sequential same-arm blood pressure measurements were made, alternating between a mercury standard and the automatic device. The differences among the test-control measurements were assessed and divided into categorization zones of 5, 10 and 15 mmHg discrepancy. Aortic pulse wave velocity was assessed in all subjects with a Complior device (Colson, Paris). The Colson MAM BP 3AA1-2 passed all three phases of the protocol for both systolic and diastolic blood pressure. The mean differences between the test and control measurements were -1.0 +/- 5.0 mmHg for systolic blood pressure and -1.1 +/- 4.1 mmHg for diastolic blood pressure. Both standard deviations are well below the 8 mmHg limit proposed by the Association for the Advancement of Medical Instrumentation. The predictive value of various clinical variables for the discrepancies was assessed by a regression model analysis, with no variable being found that independently undermined the performance of the monitor. In another regression analysis, we found a similar relation between test and control blood pressures and aortic pulse wave velocity, a widely recognized and validated index of target organ damage. These data show that the Colson MAM BP 3AA1-2 satisfies the quality requirements proposed by the European Society of Hypertension, demonstrating its suitability for inclusion in integrated programs of clinical surveillance based on self-measurement of blood pressure. The uniformity of its performance over a wide spectrum of clinical characteristics and the relation found with pulse wave velocity further reinforce its clinical validity.

  8. Finite Element Analysis of Increasing Column Section and CFRP Reinforcement Method under Different Axial Compression Ratio

    NASA Astrophysics Data System (ADS)

    Jinghai, Zhou; Tianbei, Kang; Fengchi, Wang; Xindong, Wang

    2017-11-01

    Eight less stirrups in the core area frame joints are simulated by ABAQUS finite element numerical software. The composite reinforcement method is strengthened with carbon fiber and increasing column section, the axial compression ratio of reinforced specimens is 0.3, 0.45 and 0.6 respectively. The results of the load-displacement curve, ductility and stiffness are analyzed, and it is found that the different axial compression ratio has great influence on the bearing capacity of increasing column section strengthening method, and has little influence on carbon fiber reinforcement method. The different strengthening schemes improve the ultimate bearing capacity and ductility of frame joints in a certain extent, composite reinforcement joints strengthening method to improve the most significant, followed by increasing column section, reinforcement method of carbon fiber reinforced joints to increase the minimum.

  9. Visual cluster analysis and pattern recognition template and methods

    DOEpatents

    Osbourn, G.C.; Martinez, R.F.

    1999-05-04

    A method of clustering using a novel template to define a region of influence is disclosed. Using neighboring approximation methods, computation times can be significantly reduced. The template and method are applicable and improve pattern recognition techniques. 30 figs.

  10. Social network analysis using k-Path centrality method

    NASA Astrophysics Data System (ADS)

    Taniarza, Natya; Adiwijaya; Maharani, Warih

    2018-03-01

    k-Path centrality is deemed as one of the effective methods to be applied in centrality measurement in which the influential node is estimated as the node that is being passed by information path frequently. Regarding this, k-Path centrality has been employed in the analysis of this paper specifically by adapting random-algorithm approach in order to: (1) determine the influential user’s ranking in a social media Twitter; and (2) ascertain the influence of parameter α in the numeration of k-Path centrality. According to the analysis, the findings showed that the method of k-Path centrality with random-algorithm approach can be used to determine user’s ranking which influences in the dissemination of information in Twitter. Furthermore, the findings also showed that parameter α influenced the duration and the ranking results: the less the α value, the longer the duration, yet the ranking results were more stable.

  11. Research on Operation Assessment Method for Energy Meter

    NASA Astrophysics Data System (ADS)

    Chen, Xiangqun; Huang, Rui; Shen, Liman; chen, Hao; Xiong, Dezhi; Xiao, Xiangqi; Liu, Mouhai; Xu, Renheng

    2018-03-01

    The existing electric energy meter rotation maintenance strategy regularly checks the electric energy meter and evaluates the state. It only considers the influence of time factors, neglects the influence of other factors, leads to the inaccuracy of the evaluation, and causes the waste of resources. In order to evaluate the running state of the electric energy meter in time, a method of the operation evaluation of the electric energy meter is proposed. The method is based on extracting the existing data acquisition system, marketing business system and metrology production scheduling platform that affect the state of energy meters, and classified into error stability, operational reliability, potential risks and other factors according to the influencing factors, based on the above basic test score, inspecting score, monitoring score, score of family defect detection. Then, according to the evaluation model according to the scoring, we evaluate electric energy meter operating state, and finally put forward the corresponding maintenance strategy of rotation.

  12. A Method of Evaluating Operation of Electric Energy Meter

    NASA Astrophysics Data System (ADS)

    Chen, Xiangqun; Li, Tianyang; Cao, Fei; Chu, Pengfei; Zhao, Xinwang; Huang, Rui; Liu, Liping; Zhang, Chenglin

    2018-05-01

    The existing electric energy meter rotation maintenance strategy regularly checks the electric energy meter and evaluates the state. It only considers the influence of time factors, neglects the influence of other factors, leads to the inaccuracy of the evaluation, and causes the waste of resources. In order to evaluate the running state of the electric energy meter in time, a method of the operation evaluation of the electric energy meter is proposed. The method is based on extracting the existing data acquisition system, marketing business system and metrology production scheduling platform that affect the state of energy meters, and classified into error stability, operational reliability, potential risks and other factors according to the influencing factors, based on the above basic test score, inspecting score, monitoring score, score of family defect detection. Then, according to the evaluation model according to the scoring, we evaluate electric energy meter operating state, and finally put forward the corresponding maintenance strategy of rotation.

  13. [Research on UPLC-PDA fingerprint of andrographis paniculata and quantitative determination of 4 major constituents].

    PubMed

    Huang, Jing-Yi; Liu, Xiao-Lin; Zhou, Shui-Ping; Tong, Ling; Ding, Li

    2014-11-01

    Andrographis paniculata from different parts and origins were analyzed by UPLC-PDA fingerprint to provide refererice for related preparation technology. Using the peak of andrographolide as reference, 27 common peaks were identified, and digitized UPLC-PDA fingerprints for 23 batches of andrographis paniculata were established in this research. Principal component analysis (PCA) was carried out after feature extraction. The contents of andrographolide, neoandrographolide, deoxyandrographolide, dehydroandrographolide were determined by external standard method. The Plackett-Burman design combined with pareto chart was used to analyze the factors influencing the robustness of the method. It was found that the medicinal part has a more remarkable influence on the quality of andrographis paniculata than the origin. The contents of the 4 lactones the differ greatly in the different parts of andrographis paniculata, and the pH of the mobile phase is an important factor that influenced the robustness of the method.

  14. A model of methods for influencing prescribing: Part I. A review of prescribing models, persuasion theories, and administrative and educational methods.

    PubMed

    Raisch, D W

    1990-04-01

    The purpose of this literature review is to develop a model of methods to be used to influence prescribing. Four bodies of literature were identified as being important for developing the model: (1) Theoretical prescribing models furnish information concerning factors that affect prescribing and how prescribing decisions are made. (2) Theories of persuasion provide insight into important components of educational communications. (3) Research articles of programs to improve prescribing identify types of programs that have been found to be successful. (4) Theories of human inference describe how judgments are formulated and identify errors in judgment that can play a role in prescribing. This review is presented in two parts. This article reviews prescribing models, theories of persuasion, studies of administrative programs to control prescribing, and sub-optimally designed studies of educational efforts to influence drug prescribing.

  15. [Descartes' influence on the development of the anatomoclinical method].

    PubMed

    González Hernández, A; Domínguez Rodríguez, M V; Fabre Pi, O; Cubero González, A

    2010-01-01

    The development of the anatomical-clinical method was a huge advance for modern medicine since it revealed a new approach to understanding diagnostic procedures. This change in medical thinking towards a more scientific basis has gradually evolved over several centuries, reaching its brilliant zenith with the contributions of the French school. There are certain similarities between the guidelines of the anatomical-clinical method and René Descartes' philosophical principles, so it is fair to consider him as one of the major precursors in this new line of thinking that definitely influenced the historical course of medicine.

  16. Influence of the extraction method on the yield of flavonoids and phenolics from Sideritis spp. (Pirin Mountain tea).

    PubMed

    Alipieva, Kalina; Petreska, Jasmina; Gil-Izquierdo, Angel; Stefova, Marina; Evstatieva, Ljuba; Bankova, Vassya

    2010-01-01

    The influence of the extraction method on the yield and composition of extracts of Sideritis (Pirin mountain tea) has been studied. Maceration, ultrasound-assisted (USAE) and microwave assisted extraction (MAE) were applied. Total phenolics and total flavonoids were quantified spectrophotometrically, and individual compounds were analyzed by HPLC-DAD-MS(n). This preliminary study reveals that the traditional way of tea preparation from Sideritis is the most appropriate in order to extract the maximum of total flavonoids and total phenolics. In the case of methanol extraction, the optimal method is USAE.

  17. Determinants of contraceptive use among women of reproductive age in Great Britain and Germany. II: Psychological factors.

    PubMed

    Oddens, B J

    1997-10-01

    Psychological determinants of contraceptive use were investigated in Great Britain and Germany, using national data obtained in 1992. It was hypothesised that current contraceptive use among sexually active, fertile women aged 15-45 was related to their attitude towards the various contraceptive methods, social influences, perceptions of being able to use a method correctly and consistently, a correct estimation of fertility, and communication with their partner. Effects of age and country were also taken into account. The attitude of respondents towards the various contraceptive methods was ambivalent and no method was seen as ideal. On medical methods (OCs, IUDs and sterilisation) many respondents expressed doubts as to their safety for health. Social influences most frequently concerned the use of OCs. Respondents considered themselves able to use oral contraceptives correctly, but expressed general fear about intrauterine devices and sterilisation, and many women believed they were not able to use condoms and periodic abstinence consistently. Multifactorial analyses revealed that current contraceptive use was principally determined by social influences, attitude and self-efficacy with respect to medical methods. Age and country, and, for use of unreliable methods, fertility awareness also played a role. Communication with the partner was less relevant. Contraceptive choice (and the use of non-medical methods) depended greatly on encouragement to use and being in favour of medical methods. A lack of social support for use of medical methods and a negative attitude towards them was related to higher use rates of condoms, periodic abstinence, withdrawal and reliance on 'luck'. In the case of withdrawal and/or no method, underestimation of fertility played an additional role. Contraceptive choice appears to be determined more by a general like or dislike of medical methods rather than on a weighing of the merits of individual available methods.

  18. Effect of Pesticide Inoculation, Duration of Composting, and Degradation Time on the Content of Compost Fatty Acids, Quantified Using Two Methods ▿ †

    PubMed Central

    Cardinali, Alessandra; Otto, Stefan; Vischetti, Costantino; Brown, Colin; Zanin, Giuseppe

    2010-01-01

    Compost biobeds can promote biodegradation of pesticides. The microbial community structure changes during the composting process, and simple methods can potentially be used to follow these changes. In this study the microbial identification (MIDI) and ester-linked (EL) procedures were used to determine the composition of fatty acid methyl esters (FAMEs) in composts aged 3 and 12 months, inoculated with 3 recalcitrant pesticides (azoxystrobin, chlorotoluron, and epoxyconazole and a coapplication of all three) after 0, 56, and 125 days of degradation. Pesticide persistence was high, and after 125 days the residue was 22 to 70% of the applied amount depending mostly on the composting age. Seventy-one FAMEs belonging to nine groups were detected. The EL method provided three times as many detections as did the MIDI method and was more sensitive for all FAME groups except alcohol. Thirty-six and five FAMEs were unique to the EL and MIDI methods, respectively. The extraction method was of importance. The EL method provided a higher number of detections for 57 FAMEs, and the MIDI method provided a higher number for 9 FAMEs, while the two methods were equal for 5 FAMEs; thus, the EL method provided a more uniform overall FAME profile. Effects of the other factors were not always clear. Inoculation with pesticide did not influence the FAME profile with the MIDI method, while it influenced cyclopropane and monounsaturated content with the EL method. Composting age and degradation time had an effect on some groups of FAMEs, and this effect was greater with the EL method. The use of some FAMEs as biomarkers to follow microbial community succession was likely influenced by the type of compost and other factors. PMID:20693445

  19. Identifying influential spreaders in complex networks through local effective spreading paths

    NASA Astrophysics Data System (ADS)

    Wang, Xiaojie; Zhang, Xue; Yi, Dongyun; Zhao, Chengli

    2017-05-01

    How to effectively identify a set of influential spreaders in complex networks is of great theoretical and practical value, which can help to inhibit the rapid spread of epidemics, promote the sales of products by word-of-mouth advertising, and so on. A naive strategy is to select the top ranked nodes as identified by some centrality indices, and other strategies are mainly based on greedy methods and heuristic methods. However, most of those approaches did not concern the connections between nodes. Usually, the distances between the selected spreaders are very close, leading to a serious overlapping of their influence. As a consequence, the global influence of the spreaders in networks will be greatly reduced, which largely restricts the performance of those methods. In this paper, a simple and efficient method is proposed to identify a set of discrete yet influential spreaders. By analyzing the spreading paths in the network, we present the concept of effective spreading paths and measure the influence of nodes via expectation calculation. The numerical analysis in undirected and directed networks all show that our proposed method outperforms many other centrality-based and heuristic benchmarks, especially in large-scale networks. Besides, experimental results on different spreading models and parameters demonstrates the stability and wide applicability of our method.

  20. The Influence of Sintering Method on Kaolin-Based Geopolymer Ceramics with Addition of Ultra High Molecular Weight Polyethylene as Binder

    NASA Astrophysics Data System (ADS)

    Romisuhani, A.; AlBakri, M. M.; Kamarudin, H.; Andrei, S. V.

    2017-11-01

    The influence of sintering method on kaolin-based geopolymer ceramics with addition of Ultra High Molecular Weight Polyethylene as binder were studied. Geopolymer were formed at room temperature from kaolin and sodium silicate in a highly alkaline medium, followed by curing and drying at 80 °C. 12 M of sodium hydroxide solution were mixed with sodium silicate at a ratio of 0.24 to form alkaline activator. Powder metallurgy technique were used in order to produce kaolin geopolymer ceramics with addition of Ultra High Molecular Weight Polyethylene. The samples were heated at temperature of 1200 °C with two different sintering method which are conventional method and two-step sintering method. The strength and density were tested.

  1. Systems of Career Influences: A Conceptual Model for Evaluating the Professional Development of Women in Academic Medicine

    PubMed Central

    Helitzer, Deborah; Morahan, Page; Chang, Shine; Gleason, Katharine; Cardinali, Gina; Wu, Chih-Chieh

    2012-01-01

    Abstract Background Surprisingly little research is available to explain the well-documented organizational and societal influences on persistent inequities in advancement of women faculty. Methods The Systems of Career Influences Model is a framework for exploring factors influencing women's progression to advanced academic rank, executive positions, and informal leadership roles in academic medicine. The model situates faculty as agents within a complex adaptive system consisting of a trajectory of career advancement with opportunities for formal professional development programming; a dynamic system of influences of organizational policies, practices, and culture; and a dynamic system of individual choices and decisions. These systems of influence may promote or inhibit career advancement. Within this system, women weigh competing influences to make career advancement decisions, and leaders of academic health centers prioritize limited resources to support the school's mission. Results and Conclusions The Systems of Career Influences Model proved useful to identify key research questions. We used the model to probe how research in academic career development might be applied to content and methods of formal professional development programs. We generated a series of questions and hypotheses about how professional development programs might influence professional development of health science faculty members. Using the model as a guide, we developed a study using a quantitative and qualitative design. These analyses should provide insight into what works in recruiting and supporting productive men and women faculty in academic medical centers. PMID:23101486

  2. Counteracting estimation bias and social influence to improve the wisdom of crowds.

    PubMed

    Kao, Albert B; Berdahl, Andrew M; Hartnett, Andrew T; Lutz, Matthew J; Bak-Coleman, Joseph B; Ioannou, Christos C; Giam, Xingli; Couzin, Iain D

    2018-04-01

    Aggregating multiple non-expert opinions into a collective estimate can improve accuracy across many contexts. However, two sources of error can diminish collective wisdom: individual estimation biases and information sharing between individuals. Here, we measure individual biases and social influence rules in multiple experiments involving hundreds of individuals performing a classic numerosity estimation task. We first investigate how existing aggregation methods, such as calculating the arithmetic mean or the median, are influenced by these sources of error. We show that the mean tends to overestimate, and the median underestimate, the true value for a wide range of numerosities. Quantifying estimation bias, and mapping individual bias to collective bias, allows us to develop and validate three new aggregation measures that effectively counter sources of collective estimation error. In addition, we present results from a further experiment that quantifies the social influence rules that individuals employ when incorporating personal estimates with social information. We show that the corrected mean is remarkably robust to social influence, retaining high accuracy in the presence or absence of social influence, across numerosities and across different methods for averaging social information. Using knowledge of estimation biases and social influence rules may therefore be an inexpensive and general strategy to improve the wisdom of crowds. © 2018 The Author(s).

  3. Detecting the causality influence of individual meteorological factors on local PM2.5 concentration in the Jing-Jin-Ji region

    NASA Astrophysics Data System (ADS)

    Chen, Ziyue; Cai, Jun; Gao, Bingbo; Xu, Bing; Dai, Shuang; He, Bin; Xie, Xiaoming

    2017-01-01

    Due to complicated interactions in the atmospheric environment, quantifying the influence of individual meteorological factors on local PM2.5 concentration remains challenging. The Beijing-Tianjin-Hebei (short for Jing-Jin-Ji) region is infamous for its serious air pollution. To improve regional air quality, characteristics and meteorological driving forces for PM2.5 concentration should be better understood. This research examined seasonal variations of PM2.5 concentration within the Jing-Jin-Ji region and extracted meteorological factors strongly correlated with local PM2.5 concentration. Following this, a convergent cross mapping (CCM) method was employed to quantify the causality influence of individual meteorological factors on PM2.5 concentration. The results proved that the CCM method was more likely to detect mirage correlations and reveal quantitative influences of individual meteorological factors on PM2.5 concentration. For the Jing-Jin-Ji region, the higher PM2.5 concentration, the stronger influences meteorological factors exert on PM2.5 concentration. Furthermore, this research suggests that individual meteorological factors can influence local PM2.5 concentration indirectly by interacting with other meteorological factors. Due to the significant influence of local meteorology on PM2.5 concentration, more emphasis should be given on employing meteorological means for improving local air quality.

  4. Influence of productivity and processing method on physicochemical characteristics of white button mushrooms in Brazil.

    PubMed

    Zied, Diego Cunha; Penachio, Sara Maciel; Dias, Eustáquio Souza; de Almeida Minhoni, Marli Teixeira; Ferraz, Rafael Augusto; Vieites, Rogério Lopes

    2014-11-01

    The white button mushroom is the edible fungus most commonly cultivated and commercialized in Brazil and worldwide. This work assesses the productivity of the different strains ABI 07/06 and ABI 06/05 of Agaricus bisporus grown under the conditions normally employed by growers in the southeast of Brazil, and the influence of four different chemical conservation methods on the physicochemical characteristics and storage properties of the fruit bodies. The productivities of strains ABI 07/06 and ABI 06/05 of white button mushrooms were found to be comparable. The colorimetric characteristics and chemical compositions (fat, fiber and protein contents) of the mushroom strains were similar, and these parameters were not influenced significantly by the conservation processes. Texture was negatively affected by all processing methods employed. It was concluded that chemical methods of processing mushrooms were not fully effective and novel alternative technologies should be considered by mushroom processors in Brazil. Some methods of mushroom storage using chemicals such as sodium metabisulfite are harmful to the human organism, so processing using autoclaving may be the best form of conservation of canned mushrooms. © 2014 Society of Chemical Industry.

  5. Influence of fundamental mode fill factor on disk laser output power and laser beam quality

    NASA Astrophysics Data System (ADS)

    Cheng, Zhiyong; Yang, Zhuo; Shao, Xichun; Li, Wei; Zhu, Mengzhen

    2017-11-01

    An three-dimensional numerical model based on finite element method and Fox-Li method with angular spectrum diffraction theoy is developed to calculate the output power and power density distribution of Yb:YAG disk laser. We invest the influence of fundamental mode fill factor(the ratio of fundamental mode size and pump spot size) on the output power and laser beam quality. Due to aspherical aberration and soft aperture effect in laser disk, high beam quality can be achieve with relative lower efficiency. The highest output power of fundamental laser mode is influenced by the fundamental mode fill factor. Besides we find that optimal mode fill factor increase with pump spot size.

  6. [Music therapy as a part of complex healing].

    PubMed

    Sliwka, Agnieszka; Jarosz, Anna; Nowobilski, Roman

    2006-10-01

    Music therapy is a method which takes the adventage of therapeutic influence of musie on psychological and somatic sphere of the human body. Its therapeutic properties are more and more used. Current scientific research have proved its modifying influence on vegetative, circulatory, respiratory and endocrine systems. Works devoted to the effects of musie on the patients' psychological sphere have also confirmed that it reduces psychopathologic symptoms (anxiety and depression), improves self-rating, influences quality and disorders of sleep, reduces pain, improves moral immunity and patients' openness, readiness, co-operation in treatment process. Music therapy is treated as a method which complements conventional treatment and makes up part of an integral whole together with physiotherapy, kinesitherapy and recuperation.

  7. Analysis of the influencing factors of global energy interconnection development

    NASA Astrophysics Data System (ADS)

    Zhang, Yi; He, Yongxiu; Ge, Sifan; Liu, Lin

    2018-04-01

    Under the background of building global energy interconnection and achieving green and low-carbon development, this paper grasps a new round of energy restructuring and the trend of energy technology change, based on the present situation of global and China's global energy interconnection development, established the index system of the impact of global energy interconnection development factors. A subjective and objective weight analysis of the factors affecting the development of the global energy interconnection was conducted separately by network level analysis and entropy method, and the weights are summed up by the method of additive integration, which gives the comprehensive weight of the influencing factors and the ranking of their influence.

  8. Evaluative Indices Assigned to Contraceptive Methods by University Undergraduates

    ERIC Educational Resources Information Center

    McDermott, Robert J.; Malo, Teri L.; Dodd, Virginia J.; Daley, Ellen M.; Mayer, Alyssa B.

    2011-01-01

    Background: Preordinate attitudes and beliefs about contraception may influence acceptance or rejection of a particular method. Purpose: We examined the attitudes about contraception methods held by undergraduate students (N=792) at two large southeastern universities in the United States. Methods: Twelve methods were rated on 40 semantic…

  9. Influential Observations in Principal Factor Analysis.

    ERIC Educational Resources Information Center

    Tanaka, Yutaka; Odaka, Yoshimasa

    1989-01-01

    A method is proposed for detecting influential observations in iterative principal factor analysis. Theoretical influence functions are derived for two components of the common variance decomposition. The major mathematical tool is the influence function derived by Tanaka (1988). (SLD)

  10. "Clickers" and Metacognition: A Quasi-Experimental Comparative Study about Metacognitive Self-Regulation and Use of Electronic Feedback Devices

    ERIC Educational Resources Information Center

    Brady, Melanie; Seli, Helena; Rosenthal, Jane

    2013-01-01

    The purpose of this study was to establish whether electronic response systems (clickers) influence student metacognition in large lecture settings more than low-technology polling devices. In this first part of a two part mixed methods study inquiry was made into whether student metacognition was influenced and how metacognition was influenced.…

  11. Evaluation of the Cross-Cultural Traits Influence on the Behavior of Russian and Chinese Students on the Higher Education Products Market

    ERIC Educational Resources Information Center

    Romanova, Irina M.; Noskova, Elena V.; Trotsenko, Anastasiya N.

    2016-01-01

    Development of academic mobility of students from different countries requires evaluating the influence of their cultural traits on the behavior on the educational products market. The subject of present study is the development of methodic approach towards evaluating the cross-cultural traits influence on students' behavior on the higher…

  12. Social network- and community-level influences on contraceptive use: evidence from rural Poland

    PubMed Central

    Colleran, Heidi; Mace, Ruth

    2015-01-01

    The diffusion of ‘modern’ contraceptives—as a proxy for the spread of low-fertility norms—has long interested researchers wishing to understand global fertility decline. A fundamental question is how local cultural norms and other people's behaviour influence the probability of contraceptive use, independent of women's socioeconomic and life-history characteristics. However, few studies have combined data at individual, social network and community levels to simultaneously capture multiple levels of influence. Fewer still have tested if the same predictors matter for different contraceptive types. Here, we use new data from 22 high-fertility communities in Poland to compare predictors of the use of (i) any contraceptives—a proxy for the decision to control fertility—with those of (ii) ‘artificial’ contraceptives—a subset of more culturally taboo methods. We find that the contraceptive behaviour of friends and family is more influential than are women's own characteristics and that community level characteristics additionally influence contraceptive use. Highly educated neighbours accelerate women's contraceptive use overall, but not their artificial method use. Highly religious neighbours slow women's artificial method use, but not their contraceptive use overall. Our results highlight different dimensions of sociocultural influence on contraceptive diffusion and suggest that these may be more influential than are individual characteristics. A comparative multilevel framework is needed to understand these dynamics. PMID:25904669

  13. Assessing the influence of component processing and donor characteristics on quality of red cell concentrates using quality control data.

    PubMed

    Jordan, A; Chen, D; Yi, Q-L; Kanias, T; Gladwin, M T; Acker, J P

    2016-07-01

    Quality control (QC) data collected by blood services are used to monitor production and to ensure compliance with regulatory standards. We demonstrate how analysis of quality control data can be used to highlight the sources of variability within red cell concentrates (RCCs). We merged Canadian Blood Services QC data with manufacturing and donor records for 28 227 RCC between June 2011 and October 2014. Units were categorized based on processing method, bag manufacturer, donor age and donor sex, then assessed based on product characteristics: haemolysis and haemoglobin levels, unit volume, leucocyte count and haematocrit. Buffy-coat method (top/bottom)-processed units exhibited lower haemolysis than units processed using the whole-blood filtration method (top/top). Units from female donors exhibited lower haemolysis than male donations. Processing method influenced unit volume and the ratio of additive solution to residual plasma. Stored red blood cell characteristics are influenced by prestorage processing and donor factors. Understanding the relationship between processing, donors and RCC quality will help blood services to ensure the safety of transfused products. © 2016 International Society of Blood Transfusion.

  14. Study on Commercialization of Biogasification Systems in Ishikari Bay New Port Area - Proposal of Estimation Method of Collectable Amount of Food Waste by using Binary Logit Model -

    NASA Astrophysics Data System (ADS)

    Watanabe, Sho; Furuichi, Toru; Ishii, Kazuei

    This study proposed an estimation method for collectable amount of food waste considering the food waste generator's cooperation ratio ant the amount of food waste generation, and clarified the factors influencing the collectable amount of food waste. In our method, the cooperation ratio was calculated by using the binary logit model which is often used for the traffic multiple choice question. In order to develop a more precise binary logit model, the factors influencing on the cooperation ratio were extracted by a questionnaire survey asking food waste generator's intention, and the preference investigation was then conducted at the second step. As a result, the collectable amount of food waste was estimated to be 72 [t/day] in the Ishikari bay new port area under a condition of current collection system by using our method. In addition, the most critical factor influencing on the collectable amount of food waste was the treatment fee for households, and was the permitted mixture degree of improper materials for retail trade and restaurant businesses

  15. Oral bioaccessibility of semi-volatile organic compounds (SVOCs) in settled dust: A review of measurement methods, data and influencing factors.

    PubMed

    Raffy, Gaëlle; Mercier, Fabien; Glorennec, Philippe; Mandin, Corinne; Le Bot, Barbara

    2018-06-15

    Many semi-volatile organic compounds (SVOCs), suspected of reprotoxic, neurotoxic or carcinogenic effects, were measured in indoor settled dust. Dust ingestion is a non-negligible pathway of exposure to some of these SVOCs, and an accurate knowledge of the real exposure is necessary for a better evaluation of health risks. To this end, the bioaccessibility of SVOCs in dust needs to be considered. In the present work, bioaccessibility measurement methods, SVOCs' oral bioaccessibility data and influencing factors were reviewed. SVOC bioaccessibilities (%) ranged from 11 to 94, 8 to 100, 3 to 92, 1 to 81, 6 to 52, and 2 to 17, for brominated flame retardants, organophosphorus flame retardants, polychlorobiphenyls, phthalates, pesticides and polycyclic aromatic hydrocarbons, respectively. Measurements method produced varying results depending on the inclusion of food and/or sink in the model. Characteristics of dust, e.g., organic matter content and particle size, also influenced bioaccessibility data. Last, results were influenced by SVOC properties, such as octanol/water partition coefficient and migration pathway into dust. Factors related to dust and SVOCs could be used in prediction models. To this end, more bioaccessibility studies covering more substances should be performed, using methods that are harmonized and validated by comparison to in-vivo studies. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Microwave-assisted rapid synthesis and characterization of CaF₂ particles-filled cellulose nanocomposites in ionic liquid.

    PubMed

    Deng, Fu; Fu, Lian-Hua; Ma, Ming-Guo

    2015-05-05

    In this article, we try to compound cellulose/alkali earth metal fluorides (MF2, M=Ca, Mg, Sr, Ba) nanocomposites via microwave-assisted ionic liquid method, wherein cellulose/CaF2 and cellulose/MgF2 were successfully synthesized through this method while cellulose/SrF2 and cellulose/BaF2 could not be synthesized. We focused on the synthesis of cellulose/CaF2 and investigated the influences of the different time and different temperature for the synthesis of cellulose/CaF2 nanocomposites. The influence of different heating methods such as oil-bath heating method was also studied. Ionic liquid ([Bmim][BF4]) was used for dissolving microcrystalline cellulose and providing the source of fluoride ionic and the alkali earth metal nitrate (Ca(NO3)2, Mg(NO3)2, Sr(NO3)2, and Ba(NO3)2) was used as the reaction initiator. They were investigated by X-ray powder diffraction (XRD), Fourier transform infrared spectrometry (FTIR), scanning electron microscopy (SEM), thermogravimetric analysis (TG), derivative thermogravimetric (DTG), and energy-dispersive X-ray spectra (EDS). The different heating modes have influence on the morphology and property. The different temperature and heating time also have a certain influence on the morphology and crystallinity of calcium fluoride. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Sample preparation method influences direct identification of anaerobic bacteria from positive blood culture bottles using MALDI-TOF MS.

    PubMed

    Jeverica, Samo; Nagy, Elisabeth; Mueller-Premru, Manica; Papst, Lea

    2018-05-15

    Rapid detection and identification of anaerobic bacteria from blood is important to adjust antimicrobial therapy by including antibiotics with activity against anaerobic bacteria. Limited data is available about direct identification of anaerobes from positive blood culture bottles using MALDI-TOF mass spectrometry (MS). In this study, we evaluated the performance of two sample preparation protocols for direct identification of anaerobes from positive blood culture bottles, the MALDI Sepsityper kit (Sepsityper) and the in-house saponin (saponin) method. Additionally, we compared two blood culture bottle types designed to support the growth of anaerobic bacteria, the BacT/ALERT-FN Plus (FN Plus) and the BACTEC-Lytic (Lytic), and their influence on direct identification. A selection of 30 anaerobe strains belonging to 22 different anaerobic species (11 reference strains and 19 clinical isolates) were inoculated to 2 blood culture bottle types in duplicate. In total, 120 bottles were inoculated and 99.2% (n = 119) signalled growth within 5 days of incubation. The Sepsityper method correctly identified 56.3% (n = 67) of anaerobes, while the saponin method correctly identified 84.9% (n = 101) of anaerobes with at least log(score) ≥1.6 (low confidence correct identification), (p < 0.001). Gram negative anaerobes were better identified with the saponin method (100% vs. 46.5%; p < 0.001), while Gram positive anaerobes were better identified with the Sepsityper method (70.8% vs. 62.5%; p = 0.454). Average log(score) values among only those isolates that were correctly identified simultaneously by both sample preparation methods were 2.119 and 2.029 in favour of the Sepsityper method, (p = 0.019). The inoculated bottle type didn't influence the performance of the two sample preparation methods. We confirmed that direct identification from positive blood culture bottles with MALDI-TOF MS is reliable for anaerobic bacteria. However, the results are influenced by the sample preparation method used. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Flood regionalization: A hybrid geographic and predictor-variable region-of-influence regression method

    USGS Publications Warehouse

    Eng, K.; Milly, P.C.D.; Tasker, Gary D.

    2007-01-01

    To facilitate estimation of streamflow characteristics at an ungauged site, hydrologists often define a region of influence containing gauged sites hydrologically similar to the estimation site. This region can be defined either in geographic space or in the space of the variables that are used to predict streamflow (predictor variables). These approaches are complementary, and a combination of the two may be superior to either. Here we propose a hybrid region-of-influence (HRoI) regression method that combines the two approaches. The new method was applied with streamflow records from 1,091 gauges in the southeastern United States to estimate the 50-year peak flow (Q50). The HRoI approach yielded lower root-mean-square estimation errors and produced fewer extreme errors than either the predictor-variable or geographic region-of-influence approaches. It is concluded, for Q50 in the study region, that similarity with respect to the basin characteristics considered (area, slope, and annual precipitation) is important, but incomplete, and that the consideration of geographic proximity of stations provides a useful surrogate for characteristics that are not included in the analysis. ?? 2007 ASCE.

  19. A full potential flow analysis with realistic wake influence for helicopter rotor airload prediction

    NASA Technical Reports Server (NTRS)

    Egolf, T. Alan; Sparks, S. Patrick

    1987-01-01

    A 3-D, quasi-steady, full potential flow solver was adapted to include realistic wake influence for the aerodynamic analysis of helicopter rotors. The method is based on a finite difference solution of the full potential equation, using an inner and outer domain procedure for the blade flowfield to accommodate wake effects. The nonlinear flow is computed in the inner domain region using a finite difference solution method. The wake is modeled by a vortex lattice using prescribed geometry techniques to allow for the inclusion of realistic rotor wakes. The key feature of the analysis is that vortices contained within the finite difference mesh (inner domain) were treated with a vortex embedding technique while the influence of the remaining portion of the wake (in the outer domain) is impressed as a boundary condition on the outer surface of the finite difference mesh. The solution procedure couples the wake influence with the inner domain solution in a consistent and efficient solution process. The method has been applied to both hover and forward flight conditions. Correlation with subsonic and transonic hover airload data is shown which demonstrates the merits of the approach.

  20. Quantitative influence of risk factors on blood glucose level.

    PubMed

    Chen, Songjing; Luo, Senlin; Pan, Limin; Zhang, Tiemei; Han, Longfei; Zhao, Haixiu

    2014-01-01

    The aim of this study is to quantitatively analyze the influence of risk factors on the blood glucose level, and to provide theory basis for understanding the characteristics of blood glucose change and confirming the intervention index for type 2 diabetes. The quantitative method is proposed to analyze the influence of risk factors on blood glucose using back propagation (BP) neural network. Ten risk factors are screened first. Then the cohort is divided into nine groups by gender and age. According to the minimum error principle, nine BP models are trained respectively. The quantitative values of the influence of different risk factors on the blood glucose change can be obtained by sensitivity calculation. The experiment results indicate that weight is the leading cause of blood glucose change (0.2449). The second factors are cholesterol, age and triglyceride. The total ratio of these four factors reaches to 77% of the nine screened risk factors. And the sensitivity sequences can provide judgment method for individual intervention. This method can be applied to risk factors quantitative analysis of other diseases and potentially used for clinical practitioners to identify high risk populations for type 2 diabetes as well as other disease.

  1. Influences of optical-spectrum errors on excess relative intensity noise in a fiber-optic gyroscope

    NASA Astrophysics Data System (ADS)

    Zheng, Yue; Zhang, Chunxi; Li, Lijing

    2018-03-01

    The excess relative intensity noise (RIN) generated from broadband sources degrades the angular-random-walk performance of a fiber-optic gyroscope dramatically. Many methods have been proposed and managed to suppress the excess RIN. However, the properties of the excess RIN under the influences of different optical errors in the fiber-optic gyroscope have not been systematically investigated. Therefore, it is difficult for the existing RIN-suppression methods to achieve the optimal results in practice. In this work, the influences of different optical-spectrum errors on the power spectral density of the excess RIN are theoretically analyzed. In particular, the properties of the excess RIN affected by the raised-cosine-type ripples in the optical spectrum are elaborately investigated. Experimental measurements of the excess RIN corresponding to different optical-spectrum errors are in good agreement with our theoretical analysis, demonstrating its validity. This work provides a comprehensive understanding of the properties of the excess RIN under the influences of different optical-spectrum errors. Potentially, it can be utilized to optimize the configurations of the existing RIN-suppression methods by accurately evaluating the power spectral density of the excess RIN.

  2. The Role of Protected Areas in the Avoidance of Anthropogenic Conversion in a High Pressure Region: A Matching Method Analysis in the Core Region of the Brazilian Cerrado

    PubMed Central

    Paiva, Rodrigo José Oliveira; Brites, Ricardo Seixas; Machado, Ricardo Bomfim

    2015-01-01

    Global efforts to avoid anthropogenic conversion of natural habitat rely heavily on the establishment of protected areas. Studies that evaluate the effectiveness of these areas with a focus on preserving the natural habitat define effectiveness as a measure of the influence of protected areas on total avoided conversion. Changes in the estimated effectiveness are related to local and regional differences, evaluation methods, restriction categories that include the protected areas, and other characteristics. The overall objective of this study was to evaluate the effectiveness of protected areas to prevent the advance of the conversion of natural areas in the core region of the Brazil’s Cerrado Biome, taking into account the influence of the restriction degree, governmental sphere, time since the establishment of the protected area units, and the size of the area on the performance of protected areas. The evaluation was conducted using matching methods and took into account the following two fundamental issues: control of statistical biases caused by the influence of covariates on the likelihood of anthropogenic conversion and the non-randomness of the allocation of protected areas throughout the territory (spatial correlation effect) and the control of statistical bias caused by the influence of auto-correlation and leakage effect. Using a sample design that is not based on ways to control these biases may result in outcomes that underestimate or overestimate the effectiveness of those units. The matching method accounted for a bias reduction in 94–99% of the estimation of the average effect of protected areas on anthropogenic conversion and allowed us to obtain results with a reduced influence of the auto-correlation and leakage effects. Most protected areas had a positive influence on the maintenance of natural habitats, although wide variation in this effectiveness was dependent on the type, restriction, governmental sphere, size and age group of the unit. PMID:26222140

  3. A general panel method for the analysis and design of arbitrary configurations in incompressible flows. [boundary value problem

    NASA Technical Reports Server (NTRS)

    Johnson, F. T.

    1980-01-01

    A method for solving the linear integral equations of incompressible potential flow in three dimensions is presented. Both analysis (Neumann) and design (Dirichlet) boundary conditions are treated in a unified approach to the general flow problem. The method is an influence coefficient scheme which employs source and doublet panels as boundary surfaces. Curved panels possessing singularity strengths, which vary as polynomials are used, and all influence coefficients are derived in closed form. These and other features combine to produce an efficient scheme which is not only versatile but eminently suited to the practical realities of a user-oriented environment. A wide variety of numerical results demonstrating the method is presented.

  4. Ranking the spreading ability of nodes in network core

    NASA Astrophysics Data System (ADS)

    Tong, Xiao-Lei; Liu, Jian-Guo; Wang, Jiang-Pan; Guo, Qiang; Ni, Jing

    2015-11-01

    Ranking nodes by their spreading ability in complex networks is of vital significance to better understand the network structure and more efficiently spread information. The k-shell decomposition method could identify the most influential nodes, namely network core, with the same ks values regardless to their different spreading influence. In this paper, we present an improved method based on the k-shell decomposition method and closeness centrality (CC) to rank the node spreading influence of the network core. Experiment results on the data from the scientific collaboration network and U.S. aviation network show that the accuracy of the presented method could be increased by 31% and 45% than the one obtained by the degree k, 32% and 31% than the one by the betweenness.

  5. Cambered Jet-Flapped Airfoil Theory with Tables and Computer Programs for Application.

    DTIC Science & Technology

    1977-09-01

    influence function which is a parametric function of the jet-momentum coefficient. In general, the integrals involved must be evaluated by numerical methods. Tables of the necessary influence functions are given in the report.

  6. Rolling resistance forces in pneumatic tires

    DOT National Transportation Integrated Search

    1976-01-31

    An analysis is presented for the influence of test drum curvature on stress levels and resulting rolling resistance forces in pneumatic tires. The influence of test method on the measurement of rolling loss is also considered, and expressions are der...

  7. A normalisation framework for (hyper-)spectral imagery

    NASA Astrophysics Data System (ADS)

    Grumpe, Arne; Zirin, Vladimir; Wöhler, Christian

    2015-06-01

    It is well known that the topography has an influence on the observed reflectance spectra. This influence is not compensated by spectral ratios, i.e. the effect is wavelength dependent. In this work, we present a complete normalisation framework. The surface temperature is estimated based on the measured surface reflectance. To normalise the spectral reflectance with respect to a standard illumination geometry, spatially varying reflectance parameters are estimated based on a non-linear reflectance model. The reflectance parameter estimation has one free parameter, i.e. a low-pass function, which sets the scale of the spatial-variance, i.e. the lateral resolution of the reflectance parameter maps. Since the local surface topography has a major influence on the measured reflectance, often neglected shading information is extracted from the spectral imagery and an existing topography model is refined to image resolution. All methods are demonstrated on the Moon Mineralogy Mapper dataset. Additionally, two empirical methods are introduced that deal with observed systematic reflectance changes in co-registered images acquired at different phase angles. These effects, however, may also be caused by the sensor temperature, due to its correlation with the phase angle. Surface temperatures above 300 K are detected and are very similar to a reference method. The proposed method, however, seems more robust in case of absorptions visible in the reflectance spectrum near 2000 nm. By introducing a low-pass into the computation of the reflectance parameters, the reflectance behaviour of the surfaces may be derived at different scales. This allows for an iterative refinement of the local surface topography using shape from shading and the computation reflectance parameters. The inferred parameters are derived from all available co-registered images and do not show significant influence of the local surface topography. The results of the empirical correction show that both proposed methods greatly reduce the influence of different phase angles or sensor temperatures.

  8. The Influence of Training Strategy and Physical Condition toward Forehand Drive Ability in Table Tennis

    NASA Astrophysics Data System (ADS)

    Langitan, F. W.

    2018-02-01

    The objective of this research is to find out the influence of training strategy and physical condition toward forehand drive ability in table tennis of student in faculty of sport in university of Manado, department of health and recreation education. The method used in this research was factorial 2x2 design method. The population was taken from the student of Faculty of Sport at Manado State University, Indonesia, in 2017 of 76 students for sample research. The result of this research shows that: In general, this training strategy of wall bounce gives better influence toward forehand drive ability compare with the strategy of pair training in table tennis. For the students who have strong forehand muscle, the wall bounce training strategy give better influence to their ability of forehand drive in table tennis. For the student who have weak forehand muscle, pair training strategy give better influence than wall bound training toward forehand drive ability in table tennis. There is an interaction between training using hand muscle strength to the training result in table tennis using forehand drive.

  9. Effects of Enrichment Presentation and Other Factors on Behavioral Welfare of Pantropical Spotted Dolphin (Stenella attenuata).

    PubMed

    Perez, Barbara C; Mehrkam, Lindsay R; Foltz, Amanda R; Dorey, Nicole R

    2018-01-01

    Environmental enrichment is a crucial element of promoting welfare for animals in captivity. However, enrichment programs are not always formally evaluated for their efficacy. Furthermore, there is little empirical evidence of enrichment evaluation for species of small cetaceans in zoological settings. A wide range of variables may potentially influence enrichment efficacy and how it in turn affects behavior. The purpose of this study was to determine the most preferred environmental enrichment, and method of presentation, for a species that has not been well studied in captivity, the pantropical spotted dolphin (Stenella attenuata). In order to determine which enrichment items and method of presentation were most effective at eliciting enrichment interaction, we systematically examined how several variables of enrichment influenced enrichment interaction. The results suggested that presenting enrichment after training sessions influenced interaction with the enrichment. The results also indicated preference for enrichment type and a specific enrichment device. Finally, factors that influenced interaction were also found to influence aberrant behavior. The results support the premise that enrichment be "redefined" for each species and each individual.

  10. E-commerce Review System to Detect False Reviews.

    PubMed

    Kolhar, Manjur

    2017-08-15

    E-commerce sites have been doing profitable business since their induction in high-speed and secured networks. Moreover, they continue to influence consumers through various methods. One of the most effective methods is the e-commerce review rating system, in which consumers provide review ratings for the products used. However, almost all e-commerce review rating systems are unable to provide cumulative review ratings. Furthermore, review ratings are influenced by positive and negative malicious feedback ratings, collectively called false reviews. In this paper, we proposed an e-commerce review system framework developed using the cumulative sum method to detect and remove malicious review ratings.

  11. Supervised chaos genetic algorithm based state of charge determination for LiFePO4 batteries in electric vehicles

    NASA Astrophysics Data System (ADS)

    Shen, Yanqing

    2018-04-01

    LiFePO4 battery is developed rapidly in electric vehicle, whose safety and functional capabilities are influenced greatly by the evaluation of available cell capacity. Added with adaptive switch mechanism, this paper advances a supervised chaos genetic algorithm based state of charge determination method, where a combined state space model is employed to simulate battery dynamics. The method is validated by the experiment data collected from battery test system. Results indicate that the supervised chaos genetic algorithm based state of charge determination method shows great performance with less computation complexity and is little influenced by the unknown initial cell state.

  12. Multi-spectral temperature measurement method for gas turbine blade

    NASA Astrophysics Data System (ADS)

    Gao, Shan; Feng, Chi; Wang, Lixin; Li, Dong

    2016-02-01

    One of the basic methods to improve both the thermal efficiency and power output of a gas turbine is to increase the firing temperature. However, gas turbine blades are easily damaged in harsh high-temperature and high-pressure environments. Therefore, ensuring that the blade temperature remains within the design limits is very important. There are unsolved problems in blade temperature measurement, relating to the emissivity of the blade surface, influences of the combustion gases, and reflections of radiant energy from the surroundings. In this study, the emissivity of blade surfaces has been measured, with errors reduced by a fitting method, influences of the combustion gases have been calculated for different operational conditions, and a reflection model has been built. An iterative computing method is proposed for calculating blade temperatures, and the experimental results show that this method has high precision.

  13. Regarding the influence of heating and the Soret effect on a magnetic fluid seal

    NASA Astrophysics Data System (ADS)

    Krakov, M. S.; Nikiforov, I. V.

    2017-06-01

    The influence of a temperature gradient and the Soret effect on the distribution of particles in a magnetic fluid seal (MFS) is studied. The heating of the MFS is found to be an effective method of homogenizing the magnetic fluid in the seal; in addition, the influence of the Soret effect on this process is found to be essential.

  14. Identifying Domains of Ideas to Influence Early Childhood Teachers' Beliefs in Globalisation: A Mixed-Method Study

    ERIC Educational Resources Information Center

    Tzuo, Pei-Wen; Tan, Liang See; Yang, Chien-Hui

    2013-01-01

    In the age of globalisation, it has been understood that teachers' beliefs revolve between old--new and local--foreign ideas of teaching and learning. The purpose of this study is to identify the domains of the various ideas that influence teachers' beliefs in globalisation, compare them to the strengths of influence, and explore the meanings of…

  15. [An experimental study of effects of active-heating-system for extravehicular spacesuit gloves on working performance].

    PubMed

    Ding, Li; Han, Long-zhu; Yang, Chun-xin; Yang, Feng; Yuan, Xiu-gan

    2005-02-01

    To observe the effects of active heating system for spacesuit gloves on extravehicular working performance. After analyzing the factors with gloves influence on the working performance, the effects of active heating system for gloves were studied experimentally with aspects to fatigue, hand strength, dexterity and tactile sensing. 1) Heating-system had not influence to grip; 2) Heating-system had 17% influence to fatigue except specific person; 3) Nut assembly and nipping pin showed that heating-system had little influence to dexterity; 4) Apperceiving shape of object and two-point distance showed heating-system had little influence to tactility. The active heating method is rational and has little influence on working performance.

  16. Influence of PVP in magnetic properties of NiSn nanoparticles prepared by polyol method

    NASA Astrophysics Data System (ADS)

    Bobadilla, L. F.; García, C.; Delgado, J. J.; Sanz, O.; Romero-Sarria, F.; Centeno, M. A.; Odriozola, J. A.

    2012-11-01

    The influence of PVP on the magnetic properties of NiSn nanoparticles prepared by polyol method has been studied. NiSn nanoparticles exhibit superparamagnetic behavior although there is a ferromagnetic contribution due to particles agglomerated below the blocking temperature. The particle size is controlled by the addiction of PVP in varying amounts. The addition of PVP also favours the particles isolation, narrow the particle size distribution and decrease the interparticle interaction strength increasing the superparamagnetic contribution.

  17. Simulation of scenario earthquake influenced field by using GIS

    USGS Publications Warehouse

    Zuo, H.-Q.; Xie, L.-L.; Borcherdt, R.D.

    1999-01-01

    The method for estimating the site effect on ground motion specified by Borcherdt (1994a, 1994b) is briefly introduced in the paper. This method and the detail geological data and site classification data in San Francisco bay area of California, the United States, are applied to simulate the influenced field of scenario earthquake by GIS technology, and the software for simulating has been drawn up. The paper is a partial result of cooperative research project between China Seismological Bureau and US Geological Survey.

  18. Using Self-Efficacy as a Construct for Evaluating Science and Mathematics Methods Courses

    NASA Astrophysics Data System (ADS)

    Brand, Brenda R.; Wilkins, Jesse L. M.

    2007-04-01

    The focus of this study was elementary preservice teachers’ development as effective teachers of science and mathematics as influenced by their participation in elementary science and mathematics methods courses. Preservice teachers’ reports of factors that influenced their perception of their teaching abilities were analyzed according to Bandura’s (1994) 4 sources of efficacy: mastery experiences, vicarious experiences, social persuasion, and stress reduction. This investigation allowed the researchers to evaluate the courses based on these sources. The analysis indicated all 4 sources influenced preservice teachers’ teaching self-efficacy beliefs, with mastery experiences considered the most influential. Embedded within discussions of mastery experiences were references to the other sources of efficacy, which suggest an interrelationship between mastery experiences and the other sources.

  19. Irradiation influence on the detection of genetic-modified soybeans

    NASA Astrophysics Data System (ADS)

    Villavicencio, A. L. C. H.; Araújo, M. M.; Baldasso, J. G.; Aquino, S.; Konietzny, U.; Greiner, R.

    2004-09-01

    Three soybean varieties were analyzed to evaluate the irradiation influence on the detection of genetic modification. Samples were treated in a 60Co facility at dose levels of 0, 500, 800, and 1000Gy. The seeds were at first analyzed by Comet Assay as a rapid screening irradiation detection method. Secondly, germination test was performed to detect the viability of irradiated soybeans. Finally, because of its high sensitivity, its specificity and rapidity the polimerase chain reaction was the method applied for genetic modified organism detection. The analysis of DNA by the single technique of microgel electrophoresis of single cells (DNA Comet Assay) showed that DNA damage increased with increasing radiation doses. No negative influence of irradiation on the genetic modification detection was found.

  20. Influences to ADHD Problem Recognition: Mixed-Method Investigation and Recommendations to Reduce Disparities for Latino Youth.

    PubMed

    Haack, Lauren M; Meza, Jocelyn; Jiang, Yuanyuan; Araujo, Eva Jimenez; Pfiffner, Linda

    2018-05-16

    ADHD problem recognition serves as the first step of help seeking for ethnic minority families, such as Latinos, who underutilize ADHD services. The current mixed-method study explores underlying factors influencing recognition of ADHD problems in a sample of 159 school-aged youth. Parent-teacher informant discrepancy results suggest that parent ethnicity, problem domain, and child age influence ADHD problem recognition. Emerging themes from semi-structured qualitative interviews/focus groups conducted with eighteen Spanish-speaking Latino parents receiving school-based services for attention and behavior concerns support a range of recognized ADHD problems, beliefs about causes, and reactions to ADHD identification. Findings provide recommendations for reducing disparities in ADHD problem recognition and subsequent help seeking.

  1. Does the liquid method of electret forming influence the adhesion of blood platelets?

    PubMed

    Lowkis, B; Szymanowicz, M

    1995-01-01

    This work presents the results of the effect of the electric charge on the adhesion of blood platelets. All experiments were carried out on polyethylene foil. The liquid method was used to form electrets. The evaluation of the electret effect influence on the adhesion of blood platelets was made on the basis of the observation of the electret surface after the contact with fresh citrate human blood group O Rh+ in an electron scanning microscope. Experimental results confirmed the essential influence of the electric charge on the process of adhesion of blood platelets. It was noticed that the preliminary aging of electrets decreases the density of the surface charge and improves the athrombogenic characteristics of polyethylene foil.

  2. A novel method to scale up fungal endophyte isolations

    USDA-ARS?s Scientific Manuscript database

    Estimations of species diversity are influenced by sampling intensity which in turn is influenced by methodology. For fungal endophyte diversity studies, the methodology includes surface-sterilization prior to isolation of endophytes. Surface-sterilization is an essential component of fungal endophy...

  3. Influence Diagrams as Decision-Making Tools for Pesticide Risk Management

    EPA Science Inventory

    The pesticide policy arena is filled with discussion of probabilistic approaches to assess ecological risk, however, similar discussions about implementing formal probabilistic methods in pesticide risk decision making are less common. An influence diagram approach is proposed f...

  4. Real-time topic-aware influence maximization using preprocessing.

    PubMed

    Chen, Wei; Lin, Tian; Yang, Cheng

    2016-01-01

    Influence maximization is the task of finding a set of seed nodes in a social network such that the influence spread of these seed nodes based on certain influence diffusion model is maximized. Topic-aware influence diffusion models have been recently proposed to address the issue that influence between a pair of users are often topic-dependent and information, ideas, innovations etc. being propagated in networks are typically mixtures of topics. In this paper, we focus on the topic-aware influence maximization task. In particular, we study preprocessing methods to avoid redoing influence maximization for each mixture from scratch. We explore two preprocessing algorithms with theoretical justifications. Our empirical results on data obtained in a couple of existing studies demonstrate that one of our algorithms stands out as a strong candidate providing microsecond online response time and competitive influence spread, with reasonable preprocessing effort.

  5. Effect of shot peening on the microstructure of laser hardened 17-4PH

    NASA Astrophysics Data System (ADS)

    Wang, Zhou; Jiang, Chuanhai; Gan, Xiaoyan; Chen, Yanhua

    2010-12-01

    In order to investigate the influence of shot peening on microstructure of laser hardened steel and clarify how much influence of initial microstructure induced by laser hardening treatment on final microstructure of laser hardened steel after shot peening treatment, measurements of retained austenite, measurements of microhardness and microstructural analysis were carried out on three typical areas including laser hardened area, transitional area and matrix area of laser hardened 17-4PH steel. The results showed that shot peening was an efficient cold working method to eliminate the retained austenite on the surface of laser hardened samples. The surface hardness increased dramatically when shot peening treatments were carried out. The analyses of microstructure of laser hardened 17-4PH after shot peening treatment were carried out in matrix area and laser hardened area via Voigt method. With the increasing peening intensity, the influence depth of shot peening on hardness and microstructure increased but the surface hardness and microstructure did not change when certain peening intensity was reached. Influence depth of shot peening on hardness was larger than influence depth of shot peening on microstructure due to the kinetic energy loss along the depth during shot peening treatment. From the microstructural result, it can be shown that the shot peening treatment can influence the domain size and microstrain of treated samples but laser hardening treatment can only influence the microstrain of treated samples.

  6. Extraction of GBH Film Medicine and Influence on Quality Evaluation of The Film

    NASA Astrophysics Data System (ADS)

    Ji, Y. B.; Lu, L.; Ru, X.; Guo, S. Z.; Qiao, A. N.; Wang, S. W.

    2017-12-01

    To know the extraction effects of GBH film medicine and the influence on film quality evaluation. Ultrasonic extraction and reflux extraction were used to extract the two methods with the traditional water decocting method to contrast. They were used to determining the content of total flavonoids. The same method was used to separate the root of the main medicinal herbs and the decoction of the water decoction of the other drug powder. They were used to determine the content of total flavonoids. The effect of extraction method on the preparation of membrane was investigated. The membrane preparation, evaluation and flexibility, respectively, film-forming property, smoothness and disintegration time are used to evaluating separately the effect of extraction method. The results showed that the extraction effect of 70% ethanol concentration of total flavonoids. The best extraction method had no effect on the film quality initial evaluation. This experiment provides a method for membrane extraction agent, has a certain practical significance.

  7. [Effect of two-step sintering method on properties of zirconia ceramic].

    PubMed

    Huang, Hui; Wei, Bin; Zhang, Fu-Qiang; Sun, Jing; Gao, Lian

    2008-04-01

    To study the influence of two-step sintering method on the sintering property, mechanical properties and microstructure of zirconia ceramic. The nano-size zirconia powder were compacted and divided into two groups, one group for one-step sintering method, another group for two-step sintering method. All samples sintered at different temperature. The relative density, three-bend strength, HV hardness, fracture toughness and microstructure of sintered block were investigated. Two-step sintering method influenced the sintering property and mechanical properties of zirconia ceramic. The maximal relative density was 98.49% at 900 degrees C/1,450 degrees C sintering temperature. There were significant difference of mechanical properties between one-step sintering and two-step sintering, the three-bend strength and fracture toughness declined, hardness increased at two-step sintering. The three-bend strength, HV hardness and fracture toughness reached to maximum value as 1,059.08 MPa +/- 75.24 MPa, 1,377.00 MPa +/- 16.37 MPa and 5.92 MPa x m1/2 +/- 0.37 MPa x m1/2 at 900 degrees C/1,450 degrees C sintering temperature respectively. Microscopy revealed the relationship between the porosity and shapes of grains was correlated to strength of the zirconia ceramics. Despite of the two-step sintering method influences the properties of zirconia, it also is a promising esthetic all-ceramic dental material.

  8. [Influence of different original processing methods on quality of Salvia Miltiorrhizae Radix et Rhizoma from Shandong].

    PubMed

    Zhao, Zhi-Gang; Gao, Shu-Rui; Hou, Jun-Ling; Wang, Wen-Quan; Xu, Zhen-Guang; Song, Yan; Zhang, Xian-Ming; Li, Jun

    2014-04-01

    In this paper the contents of rosmarinic acid, salvianolic acid B, crytotanshinone, tanshinone II(A) in samples of different original processed Salvia Miltiorrhizae Radix et Rhizoma were determined by HPLC. Different processing methods have varied influences on four active ingredients in Salvia Miltiorrhizae Radix et Rhizoma. Sun-drying reduced the content of crytotanshinone, tanshi-none II(A) and rosmarinic acid, integralsamples were better than those cut into segments. Oven dry method had great influence on water--soluble ingredients, high temperature (80-100 degrees C) could easily cause big loss of rosmarinic acid and salvianolic acid B. The role of traditional processing method "fahan: was complicated, the content of rosmarinic acid decreased, crytotanshinone and tanshinone II(A) increased, and salvianolic acid B showed no difference after "fahan". Drying in the shade and oven dry under low temperatrure (40-60 degrees C) were all effective to keep active ingredients of Salvia Miltiorrhizae Radix et Rhizoma, and, there was no difference between integral samples and samples cut into segments. Therefore, considering comprehensively the content of active ingredients in Salvia Miltiorrhizae Radix et Rhizoma, and processing costing etc., shade-drying or oven dry underlow temperature (40-60 degrees C) should be the most suitable original processing method.

  9. Influence of preconsolidation on consolidation quality after stamp forming of C/PEEK composites

    NASA Astrophysics Data System (ADS)

    Slange, T. K.; Warnet, L.; Grouve, W. J. B.; Akkerman, R.

    2016-10-01

    Stamp forming is a rapid manufacturing technology used to shape flat blanks of thermoplastic composite material into three-dimensional components. Currently, expensive autoclave and press consolidation are used to preconsolidate blanks. This study investigates the influence of preconsolidation on final consolidation quality after stamp forming and explores the potential of alternative blank manufacturing methods that could reduce part costs. Blanks were manufactured using various blank manufacturing methods and subsequently were stamp formed. The consolidation quality both before and after stamp forming was compared, where the focus was on void content as the main measure for consolidation quality. The void content was characterized through thickness and density measurements, as well as by microscopy analysis. Results indicate that preconsolidation quality does have an influence on the final consolidation quality. This is due to the severe deconsolidation and limited reconsolidation during stamp forming. Nevertheless, the potential of automated fiber placement and ultrasonic spot welding as alternative blank manufacturing methods was demonstrated.

  10. Cage Change Influences Serum Corticosterone and Anxiety-Like Behaviors in the Mouse

    PubMed Central

    Rasmussen, Skye; Miller, Melinda M.; Filipski, Sarah B.; Tolwani, Ravi J.

    2011-01-01

    Environmental variables and husbandry practices can influence physiology and alter behavior in mice. Our study evaluated the effects of cage change on serum corticosterone levels and anxiety-like behaviors in C57BL/6 male mice. We examined the effects of 3 different methods of performing cage transfer and of transferring mice to a clean or a dirty familiar cage microenvironment. The 3 different handling methods were forceps transfer, gentle transfer with gloved hands, and a passive transfer technique that did not involve active handling. Active handling methods and transfer to both clean and dirty cage microenvironments significantly increased serum corticosterone 15 min after cage change; however, at 60 min after cage change, levels were comparable to those of unmanipulated mice. Although the effects were transient, cage change altered anxiety-like behaviors in the open field when behavioral testing was performed on the same day. These results demonstrate that the timing of cage change can influence behavioral results, an effect that is an important consideration for rodent behavioral studies. PMID:21838975

  11. Subjective quality of video sequences rendered on LCD with local backlight dimming at different lighting conditions

    NASA Astrophysics Data System (ADS)

    Mantel, Claire; Korhonen, Jari; Pedersen, Jesper M.; Bech, Søren; Andersen, Jakob Dahl; Forchhammer, Søren

    2015-01-01

    This paper focuses on the influence of ambient light on the perceived quality of videos displayed on Liquid Crystal Display (LCD) with local backlight dimming. A subjective test assessing the quality of videos with two backlight dimming methods and three lighting conditions, i.e. no light, low light level (5 lux) and higher light level (60 lux) was organized to collect subjective data. Results show that participants prefer the method exploiting local dimming possibilities to the conventional full backlight but that this preference varies depending on the ambient light level. The clear preference for one method at the low light conditions decreases at the high ambient light, confirming that the ambient light significantly attenuates the perception of the leakage defect (light leaking through dark pixels). Results are also highly dependent on the content of the sequence, which can modulate the effect of the ambient light from having an important influence on the quality grades to no influence at all.

  12. Evaluating Point of Sale Tobacco Marketing Using Behavioral Laboratory Methods

    PubMed Central

    Robinson, Jason D.; Drobes, David J.; Brandon, Thomas H.; Wetter, David W.; Cinciripini, Paul M.

    2018-01-01

    With passage of the 2009 Family Smoking Prevention and Tobacco Control Act, the FDA has authority to regulate tobacco advertising. As bans on traditional advertising venues and promotion of tobacco products have grown, a greater emphasis has been placed on brand exposure and price promotion in displays of products at the point-of-sale (POS). POS marketing seeks to influence attitudes and behavior towards tobacco products using a variety of explicit and implicit messaging approaches. Behavioral laboratory methods have the potential to provide the FDA with a strong scientific base for regulatory actions and a model for testing future manipulations of POS advertisements. We review aspects of POS marketing that potentially influence smoking behavior, including branding, price promotions, health claims, the marketing of emerging tobacco products, and tobacco counter-advertising. We conceptualize how POS marketing potentially influence individual attention, memory, implicit attitudes, and smoking behavior. Finally, we describe specific behavioral laboratory methods that can be adapted to measure the impact of POS marketing on these domains.

  13. Influence of the yeast strain on the changes of the amino acids, peptides and proteins during sparkling wine production by the traditional method.

    PubMed

    Martínez-Rodríguez, A J; Carrascosa, A V; Martín-Alvarez, P J; Moreno-Arribas, V; Polo, M C

    2002-12-01

    The influence of five yeast strains on the nitrogen fractions, amino acids, peptides and proteins, during 12 months of aging of sparkling wines produced by the traditional or Champenoise method, was studied. High-performance liquid chromatography (HPLC) techniques were used for analysis of the amino acid and peptide fractions. Proteins plus polypeptides were determined by the colorimetric Bradford method. Four main stages were detected in the aging of wines with yeast. In the first stage, a second fermentation took place; amino acids and proteins plus polypeptides diminished, and peptides were liberated. In the second stage, there was a release of amino acids and proteins, and peptides were degraded. In the third stage, the release of proteins and peptides predominated. In the fourth stage, the amino acid concentration diminished. The yeast strain used influenced the content of free amino acids and peptides and the aging time in all the nitrogen fractions.

  14. The influence of averaging procedure on the accuracy of IVIVC predictions: immediate release dosage form case study.

    PubMed

    Ostrowski, Michalł; Wilkowska, Ewa; Baczek, Tomasz

    2010-12-01

    In vivo-in vitro correlation (IVIVC) is an effective tool to predict absorption behavior of active substances from pharmaceutical dosage forms. The model for immediate release dosage form containing amoxicillin was used in the presented study to check if the calculation method of absorption profiles can influence final results achieved. The comparison showed that an averaging of individual absorption profiles performed by Wagner-Nelson (WN) conversion method can lead to lose the discrimination properties of the model. The approach considering individual plasma concentration versus time profiles enabled to average absorption profiles prior WN conversion. In turn, that enabled to find differences between dispersible tablets and capsules. It was concluded that in the case of immediate release dosage form, the decision to use averaging method should be based on an individual situation; however, it seems that the influence of such a procedure on the discrimination properties of the model is then more significant. © 2010 Wiley-Liss, Inc. and the American Pharmacists Association

  15. Features of determining the nonmanufacturing premises comfort level by the integrated microclimate quality criteria

    NASA Astrophysics Data System (ADS)

    Buhmirov, V. V.; Prorokova, M. V.

    2015-01-01

    The method of determining a microclimate comfort level have been developed, taking into account the main parameters influencing the microclimate in residential, public and administration buildings, their mutual influence on the comfort level, and air quality.

  16. Biosocial Models of Deviant Behavior.

    ERIC Educational Resources Information Center

    Rowe, David C.

    1995-01-01

    Describes biological influences on criminality. Illustrative data suggest a biological sex difference in criminality and heritable differences in this trait among individuals. Methods of isolating environmental influences are described. Author notes that using environment-friendly behavior genetic research designs is not only proper but would…

  17. Flexible rotor balancing by the influence coefficient method: Multiple critical speeds with rigid or flexible supports

    NASA Technical Reports Server (NTRS)

    Tessarzik, J. M.

    1975-01-01

    Experimental tests were conducted to demonstrate the ability of the influence coefficient method to achieve precise balance of flexible rotors of virtually any design for operation through virtually any speed range. Various practical aspects of flexible-rotor balancing were investigated. Tests were made on a laboratory quality machine having a 122 cm (48 in.) long rotor weighing 50 kg (110 lb) and covering a speed range up to 18000 rpm. The balancing method was in every instance effective, practical, and economical and permitted safe rotor operation over the full speed range covering four rotor bending critical speeds. Improved correction weight removal methods for rotor balancing were investigated. Material removal from a rotating disk was demonstrated through application of a commercially available laser.

  18. Fuzzy Regression Prediction and Application Based on Multi-Dimensional Factors of Freight Volume

    NASA Astrophysics Data System (ADS)

    Xiao, Mengting; Li, Cheng

    2018-01-01

    Based on the reality of the development of air cargo, the multi-dimensional fuzzy regression method is used to determine the influencing factors, and the three most important influencing factors of GDP, total fixed assets investment and regular flight route mileage are determined. The system’s viewpoints and analogy methods, the use of fuzzy numbers and multiple regression methods to predict the civil aviation cargo volume. In comparison with the 13th Five-Year Plan for China’s Civil Aviation Development (2016-2020), it is proved that this method can effectively improve the accuracy of forecasting and reduce the risk of forecasting. It is proved that this model predicts civil aviation freight volume of the feasibility, has a high practical significance and practical operation.

  19. Pharmaceutical Company Influence on Non-Steroidal Anti-inflammatory Drug Prescribing Behaviors

    PubMed Central

    Naik, Aanand D.; Woofter, Aaron L.; Skinner, Jessica M.; Abraham, Neena S.

    2010-01-01

    Objectives Adherence to safer nonsteroidal anti-inflammatory drug (NSAID) prescribing strategies remains low, despite their acceptance as markers of high-quality care and their aggressive dissemination. This study describes the taxonomy of methods used by pharmaceutical companies to influence physicians’ NSAID prescribing behaviors and elicits physicians’ perceptions of and counter-balances to these influences. Study Design In-depth interviews analyzed using the constant comparative method of qualitative data analysis. Methods Qualitative interviews were conducted with physicians representing various clinical specialties. Interviews were transcribed and coded inductively using grounded theory. Recruitment was stopped at 25 participants after the attainment of thematic saturation, when no new concepts emerged from ongoing analysis of consecutive interviews. Results Physicians described a variety of influences that shaped their NSAID prescribing behaviors, including detailing and direct contact with pharmaceutical representatives, requests from patients inspired by direct-to-consumer advertisements, and marketing during medical school and residency training. Physicians described practice guidelines, peer-reviewed evidence and opinions of local physician experts as important counterweights to pharmaceutical company influence. Local physician experts interpreted and provided context for new clinical evidence, practice guidelines and NSAID related marketing. Conclusions The social and communicative strategies used by pharmaceutical companies can be adapted to improve physicians’ adoption of guidelines for safer NSAID prescribing. The communicative interactions between local experts and other physicians who prescribe NSAIDs may be the critical target for future interventions to promote safer NSAID prescribing. PMID:19341315

  20. Evaluation of the impact of observations on blended sea surface winds in a two-dimensional variational scheme using degrees of freedom

    NASA Astrophysics Data System (ADS)

    Wang, Ting; Xiang, Jie; Fei, Jianfang; Wang, Yi; Liu, Chunxia; Li, Yuanxiang

    2017-12-01

    This paper presents an evaluation of the observational impacts on blended sea surface winds from a two-dimensional variational data assimilation (2D-Var) scheme. We begin by briefly introducing the analysis sensitivity with respect to observations in variational data assimilation systems and its relationship with the degrees of freedom for signal (DFS), and then the DFS concept is applied to the 2D-Var sea surface wind blending scheme. Two methods, a priori and a posteriori, are used to estimate the DFS of the zonal ( u) and meridional ( v) components of winds in the 2D-Var blending scheme. The a posteriori method can obtain almost the same results as the a priori method. Because only by-products of the blending scheme are used for the a posteriori method, the computation time is reduced significantly. The magnitude of the DFS is critically related to the observational and background error statistics. Changing the observational and background error variances can affect the DFS value. Because the observation error variances are assumed to be uniform, the observational influence at each observational location is related to the background error variance, and the observations located at the place where there are larger background error variances have larger influences. The average observational influence of u and v with respect to the analysis is about 40%, implying that the background influence with respect to the analysis is about 60%.

  1. Analysis of feature selection with Probabilistic Neural Network (PNN) to classify sources influencing indoor air quality

    NASA Astrophysics Data System (ADS)

    Saad, S. M.; Shakaff, A. Y. M.; Saad, A. R. M.; Yusof, A. M.; Andrew, A. M.; Zakaria, A.; Adom, A. H.

    2017-03-01

    There are various sources influencing indoor air quality (IAQ) which could emit dangerous gases such as carbon monoxide (CO), carbon dioxide (CO2), ozone (O3) and particulate matter. These gases are usually safe for us to breathe in if they are emitted in safe quantity but if the amount of these gases exceeded the safe level, they might be hazardous to human being especially children and people with asthmatic problem. Therefore, a smart indoor air quality monitoring system (IAQMS) is needed that able to tell the occupants about which sources that trigger the indoor air pollution. In this project, an IAQMS that able to classify sources influencing IAQ has been developed. This IAQMS applies a classification method based on Probabilistic Neural Network (PNN). It is used to classify the sources of indoor air pollution based on five conditions: ambient air, human activity, presence of chemical products, presence of food and beverage, and presence of fragrance. In order to get good and best classification accuracy, an analysis of several feature selection based on data pre-processing method is done to discriminate among the sources. The output from each data pre-processing method has been used as the input for the neural network. The result shows that PNN analysis with the data pre-processing method give good classification accuracy of 99.89% and able to classify the sources influencing IAQ high classification rate.

  2. Investigating Forest Soil Disturbance with Different Timber Harvesting Operations in South Korea

    NASA Astrophysics Data System (ADS)

    Im, Sangjun; Lee, Eunjai; Eu, Song; Han, Sang-Kyun

    2017-04-01

    Forest operation such as timber harvesting can influence to forest environment by displacing soil particles, compacting surface layers, and destroying soil structures. This results in increased surface runoff and associated soil erosion during rainy season, due to soil disturbance. The extent of soil disturbance depends on the skidding/yarding method, types of machine used, and soil types. In South Korea, cut-to-length (CTL) operation is traditionally used by excavator with grapple in most areas. Recently, whole-tree (WT) harvesting system by swing yarder has gained considerable attention as an alternative traditional extraction method. The objectives of this study were to describe the effects of two different harvesting methods (CTL and WT) on soil disturbance and soil physical properties. After the CTL observation, we found that severe disturbed soils and compacted area were more than WT. Rutting was influenced more than 50% of the deep disturbance classes by the uphill climbing and downhill extraction method, while exposing bare soil was most disturbance in WT operation. Soil physical properties were influenced considerably by the number of excavator passes and slash residual classes in both units. The results from the study would be useful for understanding soil disturbance influence by timber harvesting in Korea. But, more detailed observations are needed to accurately estimate erosion rates and sediment delivery associated with forest management and operation. Acknowledgements. This study was carried out with the support of 'R&D Program for Forestry Technology (Project No. S211316L020110)' provided by Korea Forest Service.

  3. Postgraduation retention of medical students from Otago and Auckland medical programmes.

    PubMed

    Shelker, William; Poole, Phillippa; Bagg, Warwick; Wood, Ian; Glue, Paul

    2014-01-24

    Auckland and Otago medical programmes have different methods for selecting students. This study compared postgraduate retention in New Zealand (NZ) of medical graduates from the two medical programmes, to assess whether different selection methods influenced retention. Other variables assessed included entrance category and age at graduation. Anonymised databases were created of all graduates from the Otago Faculty of Medicine (1999-2011) and the Auckland medical programme (2000-2012). Demographic and entry category data were recorded. Retention was defined as presence on the NZ Medical Register in December 2012. Risk differences (RD) were calculated to compare retention between the two medical programmes using the Mantel-Haenszel method. The influence of medical programme entrance category on retention was also tested. The influence of covariates on retaining graduates on the register was evaluated using a multiple logistic regression model. The postgraduate retention of graduates of the two medical programmes over 13 years was identical (Auckland 74.9%, Otago 73.6%, P=0.48). Retention of graduate and non-graduate entry students from both medical programmes was similar by 6 years after graduation. Age during medical school did not affect retention. University of attendance had no effect on postgraduation retention of students on the NZ Medical Register, suggesting that retention is not influenced by the different student selection methods at each programme. The data presented shows that New Zealand graduates regardless of programme completed show a similar profile in terms of retention.

  4. Real-Time and High-Resolution 3D Face Measurement via a Smart Active Optical Sensor.

    PubMed

    You, Yong; Shen, Yang; Zhang, Guocai; Xing, Xiuwen

    2017-03-31

    The 3D measuring range and accuracy in traditional active optical sensing, such as Fourier transform profilometry, are influenced by the zero frequency of the captured patterns. The phase-shifting technique is commonly applied to remove the zero component. However, this phase-shifting method must capture several fringe patterns with phase difference, thereby influencing the real-time performance. This study introduces a smart active optical sensor, in which a composite pattern is utilized. The composite pattern efficiently combines several phase-shifting fringes and carrier frequencies. The method can remove zero frequency by using only one pattern. Model face reconstruction and human face measurement were employed to study the validity and feasibility of this method. Results show no distinct decrease in the precision of the novel method unlike the traditional phase-shifting method. The texture mapping technique was utilized to reconstruct a nature-appearance 3D digital face.

  5. Real-Time and High-Resolution 3D Face Measurement via a Smart Active Optical Sensor

    PubMed Central

    You, Yong; Shen, Yang; Zhang, Guocai; Xing, Xiuwen

    2017-01-01

    The 3D measuring range and accuracy in traditional active optical sensing, such as Fourier transform profilometry, are influenced by the zero frequency of the captured patterns. The phase-shifting technique is commonly applied to remove the zero component. However, this phase-shifting method must capture several fringe patterns with phase difference, thereby influencing the real-time performance. This study introduces a smart active optical sensor, in which a composite pattern is utilized. The composite pattern efficiently combines several phase-shifting fringes and carrier frequencies. The method can remove zero frequency by using only one pattern. Model face reconstruction and human face measurement were employed to study the validity and feasibility of this method. Results show no distinct decrease in the precision of the novel method unlike the traditional phase-shifting method. The texture mapping technique was utilized to reconstruct a nature-appearance 3D digital face. PMID:28362349

  6. A Methodology for Anatomic Ultrasound Image Diagnostic Quality Assessment.

    PubMed

    Hemmsen, Martin Christian; Lange, Theis; Brandt, Andreas Hjelm; Nielsen, Michael Bachmann; Jensen, Jorgen Arendt

    2017-01-01

    This paper discusses the methods for the assessment of ultrasound image quality based on our experiences with evaluating new methods for anatomic imaging. It presents a methodology to ensure a fair assessment between competing imaging methods using clinically relevant evaluations. The methodology is valuable in the continuing process of method optimization and guided development of new imaging methods. It includes a three phased study plan covering from initial prototype development to clinical assessment. Recommendations to the clinical assessment protocol, software, and statistical analysis are presented. Earlier uses of the methodology has shown that it ensures validity of the assessment, as it separates the influences between developer, investigator, and assessor once a research protocol has been established. This separation reduces confounding influences on the result from the developer to properly reveal the clinical value. This paper exemplifies the methodology using recent studies of synthetic aperture sequential beamforming tissue harmonic imaging.

  7. Using spatial mark-recapture for conservation monitoring of grizzly bear populations in Alberta.

    PubMed

    Boulanger, John; Nielsen, Scott E; Stenhouse, Gordon B

    2018-03-26

    One of the challenges in conservation is determining patterns and responses in population density and distribution as it relates to habitat and changes in anthropogenic activities. We applied spatially explicit capture recapture (SECR) methods, combined with density surface modelling from five grizzly bear (Ursus arctos) management areas (BMAs) in Alberta, Canada, to assess SECR methods and to explore factors influencing bear distribution. Here we used models of grizzly bear habitat and mortality risk to test local density associations using density surface modelling. Results demonstrated BMA-specific factors influenced density, as well as the effects of habitat and topography on detections and movements of bears. Estimates from SECR were similar to those from closed population models and telemetry data, but with similar or higher levels of precision. Habitat was most associated with areas of higher bear density in the north, whereas mortality risk was most associated (negatively) with density of bears in the south. Comparisons of the distribution of mortality risk and habitat revealed differences by BMA that in turn influenced local abundance of bears. Combining SECR methods with density surface modelling increases the resolution of mark-recapture methods by directly inferring the effect of spatial factors on regulating local densities of animals.

  8. Reliability Evaluation of Machine Center Components Based on Cascading Failure Analysis

    NASA Astrophysics Data System (ADS)

    Zhang, Ying-Zhi; Liu, Jin-Tong; Shen, Gui-Xiang; Long, Zhe; Sun, Shu-Guang

    2017-07-01

    In order to rectify the problems that the component reliability model exhibits deviation, and the evaluation result is low due to the overlook of failure propagation in traditional reliability evaluation of machine center components, a new reliability evaluation method based on cascading failure analysis and the failure influenced degree assessment is proposed. A direct graph model of cascading failure among components is established according to cascading failure mechanism analysis and graph theory. The failure influenced degrees of the system components are assessed by the adjacency matrix and its transposition, combined with the Pagerank algorithm. Based on the comprehensive failure probability function and total probability formula, the inherent failure probability function is determined to realize the reliability evaluation of the system components. Finally, the method is applied to a machine center, it shows the following: 1) The reliability evaluation values of the proposed method are at least 2.5% higher than those of the traditional method; 2) The difference between the comprehensive and inherent reliability of the system component presents a positive correlation with the failure influenced degree of the system component, which provides a theoretical basis for reliability allocation of machine center system.

  9. Experimental and environmental factors affect spurious detection of ecological thresholds

    USGS Publications Warehouse

    Daily, Jonathan P.; Hitt, Nathaniel P.; Smith, David; Snyder, Craig D.

    2012-01-01

    Threshold detection methods are increasingly popular for assessing nonlinear responses to environmental change, but their statistical performance remains poorly understood. We simulated linear change in stream benthic macroinvertebrate communities and evaluated the performance of commonly used threshold detection methods based on model fitting (piecewise quantile regression [PQR]), data partitioning (nonparametric change point analysis [NCPA]), and a hybrid approach (significant zero crossings [SiZer]). We demonstrated that false detection of ecological thresholds (type I errors) and inferences on threshold locations are influenced by sample size, rate of linear change, and frequency of observations across the environmental gradient (i.e., sample-environment distribution, SED). However, the relative importance of these factors varied among statistical methods and between inference types. False detection rates were influenced primarily by user-selected parameters for PQR (τ) and SiZer (bandwidth) and secondarily by sample size (for PQR) and SED (for SiZer). In contrast, the location of reported thresholds was influenced primarily by SED. Bootstrapped confidence intervals for NCPA threshold locations revealed strong correspondence to SED. We conclude that the choice of statistical methods for threshold detection should be matched to experimental and environmental constraints to minimize false detection rates and avoid spurious inferences regarding threshold location.

  10. Psychosocial Benefits of Cooking Interventions: A Systematic Review

    ERIC Educational Resources Information Center

    Farmer, Nicole; Touchton-Leonard, Katherine; Ross, Alyson

    2018-01-01

    Objectives: Cooking interventions are used in therapeutic and rehabilitative settings; however, little is known about the influence of these interventions on psychosocial outcomes. This systematic review examines the research evidence regarding the influence of cooking interventions on psychosocial outcomes. Methods: A systematic review of the…

  11. Practitioner Review: Early Adversity and Developmental Disorders

    ERIC Educational Resources Information Center

    Taylor, Eric; Rogers, Jody Warner

    2005-01-01

    Background: Knowledge of genetic influences, on developmental disorders such as autism spectrum, attention deficit/hyperactivity disorder and learning disabilities, has increased the opportunities for understanding the influences of the early environment. Methods: This paper provides a selective, narrative review for clinicians of the effects of…

  12. Integrated modeling and analysis of the multiple electromechanical couplings for the direct driven feed system in machine tools

    NASA Astrophysics Data System (ADS)

    Yang, Xiaojun; Lu, Dun; Liu, Hui; Zhao, Wanhua

    2018-06-01

    The complicated electromechanical coupling phenomena due to different kinds of causes have significant influences on the dynamic precision of the direct driven feed system in machine tools. In this paper, a novel integrated modeling and analysis method of the multiple electromechanical couplings for the direct driven feed system in machine tools is presented. At first, four different kinds of electromechanical coupling phenomena in the direct driven feed system are analyzed systematically. Then a novel integrated modeling and analysis method of the electromechanical coupling which is influenced by multiple factors is put forward. In addition, the effects of multiple electromechanical couplings on the dynamic precision of the feed system and their main influencing factors are compared and discussed, respectively. Finally, the results of modeling and analysis are verified by the experiments. It finds out that multiple electromechanical coupling loops, which are overlapped and influenced by each other, are the main reasons of the displacement fluctuations in the direct driven feed system.

  13. Aerodynamics of a linear oscillating cascade

    NASA Technical Reports Server (NTRS)

    Buffum, Daniel H.; Fleeter, Sanford

    1990-01-01

    The steady and unsteady aerodynamics of a linear oscillating cascade are investigated using experimental and computational methods. Experiments are performed to quantify the torsion mode oscillating cascade aerodynamics of the NASA Lewis Transonic Oscillating Cascade for subsonic inlet flowfields using two methods: simultaneous oscillation of all the cascaded airfoils at various values of interblade phase angle, and the unsteady aerodynamic influence coefficient technique. Analysis of these data and correlation with classical linearized unsteady aerodynamic analysis predictions indicate that the wind tunnel walls enclosing the cascade have, in some cases, a detrimental effect on the cascade unsteady aerodynamics. An Euler code for oscillating cascade aerodynamics is modified to incorporate improved upstream and downstream boundary conditions and also the unsteady aerodynamic influence coefficient technique. The new boundary conditions are shown to improve the unsteady aerodynamic influence coefficient technique. The new boundary conditions are shown to improve the unsteady aerodynamic predictions of the code, and the computational unsteady aerodynamic influence coefficient technique is shown to be a viable alternative for calculation of oscillating cascade aerodynamics.

  14. On thermal conditions and properties of thallium bromide single crystals grown by the Electro Dynamic Gradient method

    NASA Astrophysics Data System (ADS)

    Zheng, Zhiping; Yu, Yongtao; Gong, Shuping; Fu, Qiuyun; Zhou, Dongxiang

    2013-05-01

    The Electro Dynamic Gradient (EDG) method has been proved to be a feasible way to grow TlBr crystals in our previous work. In this research, the influence of thermal conditions such as cooling rate during growth process on the crystal performance was investigated. Crystals of approximately 12 mm diameter were obtained by the EDG method at different cooling rates during the growth process, and the quality of the crystals was routinely evaluated by X-ray diffraction (XRD), infrared (IR) and ultraviolet (UV) transmission, I-V measurement and energy response spectrum. The results proved that thermal conditions during growth had a profound influence on the characteristics of the crystals.

  15. Optics of the human cornea influence the accuracy of stereo eye-tracking methods: a simulation study.

    PubMed

    Barsingerhorn, A D; Boonstra, F N; Goossens, H H L M

    2017-02-01

    Current stereo eye-tracking methods model the cornea as a sphere with one refractive surface. However, the human cornea is slightly aspheric and has two refractive surfaces. Here we used ray-tracing and the Navarro eye-model to study how these optical properties affect the accuracy of different stereo eye-tracking methods. We found that pupil size, gaze direction and head position all influence the reconstruction of gaze. Resulting errors range between ± 1.0 degrees at best. This shows that stereo eye-tracking may be an option if reliable calibration is not possible, but the applied eye-model should account for the actual optics of the cornea.

  16. EPA (Environmental Protection Agency) programs and the regulation of carcinogens: Methods and philosophies. Technical report

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

    Jackson, M.; Johnson, L.; Kelly, J.

    1988-01-01

    This paper discusses the manner in which the EPA identifies, assesses risk for, and regulates substances determined to cause cancer in humans. The report provides an overall perspective of the carcinogen standard-setting process as it is affected by scientific, legal, and political influences. Discussed are: history and methods of carcinogen regulation; toxicological methods for determining carcinogenicity; the use of human-exposure data to regulate carcinogens; an overview of the agency's system for classifying chemical agents suspected or known to cause cancer; significant Federal court cases and decisions that have influenced attempts by Federal agencies to regulate carcinogens; and factors affecting EPAsmore » regulation of carcinogens.« less

  17. Thermal comfort of aeroplane seats: influence of different seat materials and the use of laboratory test methods.

    PubMed

    Bartels, Volkmar T

    2003-07-01

    This study determined the influence of different cover and cushion materials on the thermal comfort of aeroplane seats. Different materials as well as ready made seats were investigated by the physiological laboratory test methods Skin Model and seat comfort tester. Additionally, seat trials with human test subjects were performed in a climatic chamber. Results show that a fabric cover produces a considerably higher sweat transport than leather. A three-dimensional knitted spacer fabric turns out to be the better cushion alternative in comparison to a moulded foam pad. Results from the physiological laboratory test methods nicely correspond to the seat trials with human test subjects.

  18. Characterizing lentic freshwater fish assemblages using multiple sampling methods

    USGS Publications Warehouse

    Fischer, Jesse R.; Quist, Michael C.

    2014-01-01

    Characterizing fish assemblages in lentic ecosystems is difficult, and multiple sampling methods are almost always necessary to gain reliable estimates of indices such as species richness. However, most research focused on lentic fish sampling methodology has targeted recreationally important species, and little to no information is available regarding the influence of multiple methods and timing (i.e., temporal variation) on characterizing entire fish assemblages. Therefore, six lakes and impoundments (48–1,557 ha surface area) were sampled seasonally with seven gear types to evaluate the combined influence of sampling methods and timing on the number of species and individuals sampled. Probabilities of detection for species indicated strong selectivities and seasonal trends that provide guidance on optimal seasons to use gears when targeting multiple species. The evaluation of species richness and number of individuals sampled using multiple gear combinations demonstrated that appreciable benefits over relatively few gears (e.g., to four) used in optimal seasons were not present. Specifically, over 90 % of the species encountered with all gear types and season combinations (N = 19) from six lakes and reservoirs were sampled with nighttime boat electrofishing in the fall and benthic trawling, modified-fyke, and mini-fyke netting during the summer. Our results indicated that the characterization of lentic fish assemblages was highly influenced by the selection of sampling gears and seasons, but did not appear to be influenced by waterbody type (i.e., natural lake, impoundment). The standardization of data collected with multiple methods and seasons to account for bias is imperative to monitoring of lentic ecosystems and will provide researchers with increased reliability in their interpretations and decisions made using information on lentic fish assemblages.

  19. Factors Influencing Achievement in Undergraduate Social Science Research Methods Courses: A Mixed Methods Analysis

    ERIC Educational Resources Information Center

    Markle, Gail

    2017-01-01

    Undergraduate social science research methods courses tend to have higher than average rates of failure and withdrawal. Lack of success in these courses impedes students' progression through their degree programs and negatively impacts institutional retention and graduation rates. Grounded in adult learning theory, this mixed methods study…

  20. Influence of experimental parameters on the microencapsulation of a photopolymerizable phase.

    PubMed

    Pernot, J M; Brun, H; Pouyet, B; Sergent, M; Phan-Tan-Luu, R

    1993-01-01

    Conditions of microencapsulation by in situ polycondensation, using melamine-formaldehyde as wall material, are influenced by the chemical nature of the core to encapsulate. In our study concerning the encapsulation of a photopolymerizable phase containing an electrically charged compound, it was necessary to modify the experimental process to obtain capsules of good quality. We used the factorial design method of screening by utilization of an asymmetric matrix, according to the collapsing principle of Addleman. The advantage of this method is that it allows determination of the simultaneous influences of the 11 experimental parameters involved in this preparation. The calculation method can be applied to more than two levels for some of the factors. The continuously varying parameters were altered between two extreme levels, chosen to allow encapsulation. For discontinuous factors, such as the molecular weight of the modifying system or nature of the aminoplast, we used the commercially available compounds, respectively three and four kinds. The results of the obtained capsules were determined by comparing microphotographic pictures. With 16 experiments we found four more factors influencing quality of capsules. We also determined the most favourable levels for the other seven parameters. The results allowed us to find optimal conditions in the experimental field. We obtained capsules of a satisfactory quality for this purpose, using only minimum experimentation.

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