Micromachined silicon acoustic delay line with improved structural stability and acoustic directivity for real-time photoacoustic tomography

NASA Astrophysics Data System (ADS)

Cho, Young; Kumar, Akhil; Xu, Song; Zou, Jun

2017-03-01

Recent studies have shown that micromachined silicon acoustic delay lines can provide a promising solution to achieve real-time photoacoustic tomography without the need for complex transducer arrays and data acquisition electronics. However, as its length increases to provide longer delay time, the delay line becomes more vulnerable to structural instability due to reduced mechanical stiffness. In addition, the small cross-section area of the delay line results in a large acoustic acceptance angle and therefore poor directivity. To address these two issues, this paper reports the design, fabrication, and testing of a new silicon acoustic delay line enhanced with 3D printed polymer micro linker structures. First, mechanical deformation of the silicon acoustic delay line (with and without linker structures) under gravity was simulated by using finite element method. Second, the acoustic crosstalk and acoustic attenuation caused by the polymer micro linker structures were evaluated with both numerical simulation and ultrasound transmission testing. The result shows that the use of the polymer micro linker structures significantly improves the structural stability of the silicon acoustic delay lines without creating additional acoustic attenuation and crosstalk. In addition, a new tapered design for the input terminal of the delay line was also investigate to improve its acoustic directivity by reducing the acoustic acceptance angle. These two improvements are expected to provide an effective solution to eliminate current limitations on the achievable acoustic delay time and out-of-plane imaging resolution of micromachined silicon acoustic delay line arrays.

Truck transportation through border ports of entry : analysis of coordination systems.

DOT National Transportation Integrated Search

2002-11-01

This report identifies shortcomings in coordination at U.S. Mexico border ports-of-entry and recommends alternatives that would improve operations and reduce congestion and delay. Based on the review of numerous previous reports and more than 100...

Computer laboratory notification system via short message service to reduce health care delays in management of tuberculosis in Taiwan.

PubMed

Chen, Tun-Chieh; Lin, Wei-Ru; Lu, Po-Liang; Lin, Chun-Yu; Lin, Shu-Hui; Lin, Chuen-Ju; Feng, Ming-Chu; Chiang, Horn-Che; Chen, Yen-Hsu; Huang, Ming-Shyan

2011-06-01

We investigated the impacts of introducing an expedited acid-fast bacilli (AFB) smear laboratory procedure and an automatic, real-time laboratory notification system by short message with mobile phones on delays in prompt isolation of patients with pulmonary tuberculosis (TB). We analyzed the data for all patients with active pulmonary tuberculosis at a hospital in Kaohsiung, Taiwan, a 1,600-bed medical center, during baseline (January 2004 to February 2005) and intervention (July 2005 to August 2006) phases. A total of 96 and 127 patients with AFB-positive TB was reported during the baseline and intervention phases, respectively. There were significant decreases in health care system delays (ie, laboratory delays: reception of sputum to reporting, P < .001; response delays: reporting to patient isolation, P = .045; and interval from admission to patient isolation, P < .001) during the intervention phase. Significantly fewer nurses were exposed to each patient with active pulmonary TB during the intervention phase (P = .039). Implementation of expedited AFB smear laboratory procedures and an automatic, real-time laboratory mobile notification system significantly decreased delays in the diagnosis and isolation of patients with active TB. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Impact of geographic distance on appraisal delay for active TB treatment seeking in Uganda: a network analysis of the Kawempe Community Health Cohort Study.

PubMed

Fluegge, Kyle; Malone, LaShaunda L; Nsereko, Mary; Okware, Brenda; Wejse, Christian; Kisingo, Hussein; Mupere, Ezekiel; Boom, W Henry; Stein, Catherine M

2018-06-26

Appraisal delay is the time a patient takes to consider a symptom as not only noticeable, but a sign of illness. The study's objective was to determine the association between appraisal delay in seeking tuberculosis (TB) treatment and geographic distance measured by network travel (driving and pedestrian) time (in minutes) and distance (Euclidean and self-reported) (in kilometers) and to identify other risk factors from selected covariates and how they modify the core association between delay and distance. This was part of a longitudinal cohort study known as the Kawempe Community Health Study based in Kampala, Uganda. The study enrolled households from April 2002 to July 2012. Multivariable interval regression with multiplicative heteroscedasticity was used to assess the impact of time and distance on delay. The delay interval outcome was defined using a comprehensive set of 28 possible self-reported symptoms. The main independent variables were network travel time (in minutes) and Euclidean distance (in kilometers). Other covariates were organized according to the Andersen utilization conceptual framework. A total of 838 patients with both distance and delay data were included in the network analysis. Bivariate analyses did not reveal a significant association of any distance metric with the delay outcome. However, adjusting for patient characteristics and cavitary disease status, the multivariable model indicated that each minute of driving time to the clinic significantly (p = 0.02) and positively predicted 0.25 days' delay. At the median distance value of 47 min, this represented an additional delay of about 12 (95% CI: [3, 21]) days to the mean of 40 days (95% CI: [25, 56]). Increasing Euclidean distance significantly predicted (p = 0.02) reduced variance in the delay outcome, thereby increasing precision of the mean delay estimate. At the median Euclidean distance of 2.8 km, the variance in the delay was reduced by more than 25%. Of the four geographic distance measures, network travel driving time was a better and more robust predictor of mean delay in this setting. Including network travel driving time with other risk factors may be important in identifying populations especially vulnerable to delay.

Delay of T cell senescence by caloric restriction in aged long-lived nonhuman primates

PubMed Central

Messaoudi, Ilhem; Warner, Jessica; Fischer, Miranda; Park, Buyng; Hill, Brenna; Mattison, Julie; Lane, Mark A.; Roth, George S.; Ingram, Donald K.; Picker, Louis J.; Douek, Daniel C.; Mori, Motomi; Nikolich-Žugich, Janko

2006-01-01

Caloric restriction (CR) has long been known to increase median and maximal lifespans and to decreases mortality and morbidity in short-lived animal models, likely by altering fundamental biological processes that regulate aging and longevity. In rodents, CR was reported to delay the aging of the immune system (immune senescence), which is believed to be largely responsible for a dramatic increase in age-related susceptibility to infectious diseases. However, it is unclear whether CR can exert similar effects in long-lived organisms. Previous studies involving 2- to 4-year CR treatment of long-lived primates failed to find a CR effect or reported effects on the immune system opposite to those seen in CR-treated rodents. Here we show that long-term CR delays the adverse effects of aging on nonhuman primate T cells. CR effected a marked improvement in the maintenance and/or production of naïve T cells and the consequent preservation of T cell receptor repertoire diversity. Furthermore, CR also improved T cell function and reduced production of inflammatory cytokines by memory T cells. Our results provide evidence that CR can delay immune senescence in nonhuman primates, potentially contributing to an extended lifespan by reducing susceptibility to infectious disease. PMID:17159149

Do Work Beliefs Moderate the Relationship Between Work Interruptions, Wellbeing and Psychosomatic Symptoms?

PubMed Central

Zoupanou, Zoi(e); Rydstedt, Leif W.

2017-01-01

The purpose of this study was to explore the moderating effects of work beliefs in the relationship between work interruptions and general health, wellbeing and reports of psychosomatic symptoms. Self-report data were gathered from 310 employees from different occupational sectors. Results revealed that beliefs in hard work and morality ethic moderated the positive appraisal of work interruptions and acted as protective factors on impaired general health and wellbeing. The relationship was stronger among employees who endorsed strong beliefs in hard work and did not have regard for morality/ethics as a value. Likewise, beliefs in delay of gratification and morality/ethics moderated positive appraisal of work interruptions and reduced psychosomatic complaints. More specifically, the relationship was stronger among employees who had strong belief in the values of delayed gratification and weaker morality/ethics. These findings indicate that organisations should adopt work ideology or practices focused on work values particularly of hard work, delay of gratification and conformity to morality as protective factors that reduce the impact of work interruptions on employees’ general health and wellbeing. PMID:28580023

Delayed and reduced carbon uptake in a subarctic peatland following an extreme winter event

NASA Astrophysics Data System (ADS)

Parmentier, F. J. W.; Rasse, D. P.; Lund, M.; Bjerke, J. W.; Drake, B. G.; Weldon, S.; Tømmervik, H. A.; Hansen, G.

2017-12-01

An increase in the frequency of extreme winter events in the Arctic may lead to more widespread damage to shrub-dominated ecosystems, including peatlands. In principle, such damage should reduce carbon uptake in the following summer, but the resilience of northern ecosystems to extreme winter events remains unclear due to a dearth of flux measurements from affected areas. In this talk, therefore, we report CO2 fluxes measured with eddy covariance from a peatland in northern Norway and show that vegetation productivity was delayed and reduced during the summer of 2014, following an extreme winter event. Strong frost and the absence of a protective snow cover in January of that year - its combined intensity unprecedented in the local climate record - led to severe dieback of the shrub species Calluna vulgaris and Empetrum nigrum. Similar vegetation damage was reported at the time along 1000 km of coastal Norway, indicating the widespread impact of this frost drought event. Consequently, gross primary production (GPP) showed a strong delayed response to temperature, from snowmelt up to the peak of summer, potentially reducing carbon uptake by 15 (0-24) g C m-2 ( 13% of GPP in that period). The delayed response of the vegetation was also exhibited in remotely-sensed NDVI values, with a maximum two weeks later than normal and at the lowest level in more than a decade. Photosynthesis was eventually stimulated by the warm and sunny summer, but ecosystem respiration increased as well - which limited net carbon uptake. This study shows that damage from a single extreme winter event can have a profound impact on ecosystem CO2 uptake, and it highlights the importance of including winter-induced shrub damage in terrestrial ecosystem models to accurately predict vegetation and carbon sequestration trends in the arctic and boreal region.

Reduction of Weather-Related Terminal Area Delays in the Free-Flight Era

NASA Technical Reports Server (NTRS)

Johnson, Sally C.; Chin, David K.; Rovinsky, Robert B.; Kostiuk, Peter F.; Lee, David A.; Hemm, Robert V.; Wingrove, Earl R., III

1996-01-01

While much of the emphasis of the free-flight movement has been concentrated on reducing en-route delays, airport capacity is a major bottleneck in the current airspace system, particularly during bad weather. According to the Air Transport Association (ATA) Air Carrier Delay Reports, ground delays (gate-hold, taxi-in, and taxi-out) comprise 75 percent of total delays. It is likely that the projected steady growth in traffic will only exacerbate these losses. Preliminary analyses show that implementation of the terminal area technologies and procedures under development in NASA s Terminal Area Productivity program can potentially save the airlines at least $350M annually in weather-related delays by the year 2005 at Boston Logan and Detroit airports alone. This paper briefly describes the Terminal Area Productivity program, outlines the costhenefit analyses that are being conducted in support of the program, and presents some preliminary analysis results.

Disentangling the impact of multiple innovations to reduce delayed hospital discharges.

PubMed

Manzano-Santaella, Ana

2010-01-01

Delayed hospital discharges are often blamed for interrupting the smooth operation of hospitals. In England, the Community Care Act in 2003 introduced fines to social services departments to resolve this issue. Evaluations of this policy reported success in the reduction of delays. However, this policy was an amalgam of several innovations, not just the introduction of fines. This simultaneity makes attribution of impact of fines a difficult task because of the potential impact of those other measures. All the other designed organizational changes contain as much mechanisms of change as the more advertised fines. The exploration of how all these elements are connected unravels the inner workings of the programme as a whole, and by default, of the fines. This theoretical analysis also demonstrates how the reduction of some delays is based on the re-definition of key concepts for delayed discharges such as 'safe to transfer', team decision-making and causes for delays.

Use of postoperative steroids to reduce pain and inflammation.

PubMed

Fleischli, J W; Adams, W R

1999-01-01

Postoperative injection of a steroid is used by many podiatric surgeons to reduce pain and inflammation after foot surgery. The authors present a review of the literature on postoperative steroid use from many medical specialties as well as a review of wound and bone healing. The literature indicates that using a steroid is a safe and effective means to reduce postoperative pain and edema. Studies have shown steroids to delay healing, inhibit collagen synthesis, and increase the risk of postoperative infection. No author reported a delay in wound or bone healing or increased infection rate in patients in which a steroid was used. Although there is literature to support this practice, many questions remain and further investigation is needed.

Sleep deprivation accelerates delay-related loss of visual short-term memories without affecting precision.

PubMed

Wee, Natalie; Asplund, Christopher L; Chee, Michael W L

2013-06-01

Visual short-term memory (VSTM) is an important measure of information processing capacity and supports many higher-order cognitive processes. We examined how sleep deprivation (SD) and maintenance duration interact to influence the number and precision of items in VSTM using an experimental design that limits the contribution of lapses at encoding. For each trial, participants attempted to maintain the location and color of three stimuli over a delay. After a retention interval of either 1 or 10 seconds, participants reported the color of the item at the cued location by selecting it on a color wheel. The probability of reporting the probed item, the precision of report, and the probability of reporting a nonprobed item were determined using a mixture-modeling analysis. Participants were studied twice in counterbalanced order, once after a night of normal sleep and once following a night of sleep deprivation. Sleep laboratory. Nineteen healthy college age volunteers (seven females) with regular sleep patterns. Approximately 24 hours of total SD. SD selectively reduced the number of integrated representations that can be retrieved after a delay, while leaving the precision of object information in the stored representations intact. Delay interacted with SD to lower the rate of successful recall. Visual short-term memory is compromised during sleep deprivation, an effect compounded by delay. However, when memories are retrieved, they tend to be intact.

San Antonio's medical center corridor : lessons learned from the Metropolitan Model Deployment Initiative : reducing delay through integrated freeway and arterial management

DOT National Transportation Integrated Search

1997-04-01

This report presents the results of research on procurement-related legal and non-technical issues which may be constraining the deployment of Intelligent Transportation Systems (ITS). The reports focus is on State and local procurement practices ...

Ionizing radiation and cell cycle progression in ataxia telangiectasia

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

Beamish, H.; Khanna, K.K.; Lavin, M.F.

1994-04-01

Exposure of mammalian cells to ionizing radiation causes delay in normal progress through the cell cycle at a number of different checkpoints. Abnormalities in these checkpoints have been described for ataxia telangiectasia cells after irradiation. In this report we show that these abnormalities occur at different phases in the cell cycle in several ataxia telangiectasia lymphoblastoid cells. Ataxia telangiectasia cells, synchronized in late G{sub 1} phase with either mimosine or aphidicolin and exposed to radiation, showed a reduced delay in entering S phase compared to irradiated control cells. Failure to exhibit G{sub 1}-phase delay in ataxia telangiectasia cells is accompaniedmore » by a reduced ability of radiation to activate the product of the tumor suppressor gene p53, a protein involved in G{sub 1}/S-phase delay. When the progress of irradiated G{sub 1}-phase cells was followed into the subsequent G{sub 2} and G{sub 1} phases ataxia telangiectasia cells showed a more pronounced accumulation in G{sub 2} phase than control cells. When cells were irradiated in S phase and extent of delay was more evident in G{sub 2} phase and ataxia telangiectasia cells were delayed to a greater extent. These results suggest that the lack of initial delay in both G{sub 1} and S phases to the radiosensitivity observed in this syndrome. 26 refs., 3 figs., 2 tabs.« less

Minimizing delays in the Jordanian construction industry by adopting BIM technology

NASA Astrophysics Data System (ADS)

Btoush, M.; Harun, A. T.

2017-11-01

The Jordanian construction industry plays a significant role and contributes immensely to the gross domestic product (GDP) of the economy. However, the Jordanian public work and housing ministry and most industry players including engineers and contractors have reported that most of the projects experience delays which lead time and cost overruns, and extra efforts. The main causes of delays identified by researchers include poor scheduling and planning, change orders, site conditions, weather, late deliveries, incompetent technical staff. To address these challenges, the implementation of building information modelling (BIM) is paramount. This paper presents BIM as a powerful tool for reducing delays in Jordan construction projects. The paper focuses on two main parts; the first part involves the identification of the major causes of delays, and the second part is to accurately outline the roles and responsibilities of BIM specialist in construction projects. Finally, the paper matches the roles and responsibilities of BIM specialist and the causes of delays, and how the delays are addressed through BIM specialist.

Are we able to reduce the mortality and morbidity of oral cancer; Some considerations

PubMed Central

2013-01-01

Oral cancer makes up 1%-2% of all cancers that may arise in the body. The majority of oral cancers consists of squamous cell carcinomas. Oral cancer carries a considerable mortality rate, being mainly dependent on the stage of the disease at admission. Worldwide some 50% of the patients with oral cancer present with advanced disease. There are several ways of trying to diagnose oral cancer in a lower tumor stage, being 1) mass screening or screening in selected patients, 2) reduction of patients’ delay, and 3) reduction of doctors’ delay. Oral cancer population-based screening (“mass screening”) programs do not meet the guidelines for a successful outcome. There may be some benefit when focusing on high-risk groups, such as heavy smokers and heavy drinkers. Reported reasons for patients’ delay range from fear of a diagnosis of cancer, limited accessibility of primary health care, to unawareness of the possibility of malignant oral diseases. Apparently, information campaigns in news programs and TV have little effect on patients’ delay. Mouth self-examination may have some value in reducing patients’ delay. Doctors’ delay includes dentists’ delay and diagnostic delay caused by other medical and dental health care professionals. Doctors’ delay may vary from almost zero days up to more than six months. Usually, morbidity of cancer treatment is measured by quality of life (QoL) questionnaires. In the past decades this topic has drawn a lot of attention worldwide. It is a challenge to decrease the morbidity that is associated with the various treatment modalities that are used in oral cancer without substantially compromising the survival rate. Smoking cessation contributes to reducing the risk of oral cancers, with a 50% reduction in risk within five years. Indeed, risk factor reduction seems to be the most effective tool in an attempt to decrease the morbidity and mortality of oral cancer. Key words:Oral cancer, early diagnosis, quality of life. PMID:23229266

Estimating the Effects of the Terminal Area Productivity Program

NASA Technical Reports Server (NTRS)

Lee, David A.; Kostiuk, Peter F.; Hemm, Robert V., Jr.; Wingrove, Earl R., III; Shapiro, Gerald

1997-01-01

The report describes methods and results of an analysis of the technical and economic benefits of the systems to be developed in the NASA Terminal Area Productivity (TAP) program. A runway capacity model using parameters that reflect the potential impact of the TAP technologies is described. The runway capacity model feeds airport specific models which are also described. The capacity estimates are used with a queuing model to calculate aircraft delays, and TAP benefits are determined by calculating the savings due to reduced delays. The report includes benefit estimates for Boston Logan and Detroit Wayne County airports. An appendix includes a description and listing of the runway capacity model.

Analysis of delay reducing and fuel saving sequencing and spacing algorithms for arrival traffic

NASA Technical Reports Server (NTRS)

Neuman, Frank; Erzberger, Heinz

1991-01-01

The air traffic control subsystem that performs sequencing and spacing is discussed. The function of the sequencing and spacing algorithms is to automatically plan the most efficient landing order and to assign optimally spaced landing times to all arrivals. Several algorithms are described and their statistical performance is examined. Sequencing brings order to an arrival sequence for aircraft. First-come-first-served sequencing (FCFS) establishes a fair order, based on estimated times of arrival, and determines proper separations. Because of the randomness of the arriving traffic, gaps will remain in the sequence of aircraft. Delays are reduced by time-advancing the leading aircraft of each group while still preserving the FCFS order. Tightly spaced groups of aircraft remain with a mix of heavy and large aircraft. Spacing requirements differ for different types of aircraft trailing each other. Traffic is reordered slightly to take advantage of this spacing criterion, thus shortening the groups and reducing average delays. For heavy traffic, delays for different traffic samples vary widely, even when the same set of statistical parameters is used to produce each sample. This report supersedes NASA TM-102795 on the same subject. It includes a new method of time-advance as well as an efficient method of sequencing and spacing for two dependent runways.

Hemovigilance monitoring of platelet septic reactions with effective bacterial protection systems.

PubMed

Benjamin, Richard J; Braschler, Thomas; Weingand, Tina; Corash, Laurence M

2017-12-01

Delayed, large-volume bacterial culture and amotosalen/ultraviolet-A light pathogen reduction are effective at reducing the risk of bacterial proliferation in platelet concentrates (PCs). Hemovigilance programs continue to receive reports of suspected septic transfusion reactions, most with low imputability. Here, we compile national hemovigilance data to determine the relative efficacy of these interventions. Annual reports from the United Kingdom, France, Switzerland, and Belgium were reviewed between 2005 and 2016 to assess the risk of bacterial contamination and septic reactions. Approximately 1.65 million delayed, large-volume bacterial culture-screened PCs in the United Kingdom and 2.3 million amotosalen/ultraviolet-A-treated PCs worldwide were issued with no reported septic fatalities. One definite, one possible, and 12 undetermined/indeterminate septic reactions and eight contaminated "near misses" were reported with delayed, large-volume bacterial cultures between 2011 and 2016, for a lower false-negative culture rate than that in the previous 5 years (5.4 vs. 16.3 per million: odds ratio, 3.0; 95% confidence interval, 1.4-6.5). Together, the Belgian, Swiss, and French hemovigilance programs documented zero probable or definite/certain septic reactions with 609,290 amotosalen/ultraviolet-A-treated PCs (<1.6 per million). The rates were significantly lower than those reported with concurrently transfused, nonpathogen-reduced PCs in Belgium (<4.4 vs. 35.6 per million: odds ratio, 8.1; 95% confidence interval,1.1-353.3) and with historic septic reaction rates in Switzerland (<6.0 vs. 82.9 per million: odds ratio, 13.9; 95% confidence interval, 2.1-589.2), and the rates tended to be lower than those from concurrently transfused, nonpathogen-reduced PCs in France (<4.7 vs. 19.0 per million: odds ratio, 4.1; 95% confidence interval, 0.7-164.3). Pathogen reduction and bacterial culture both reduced the incidence of septic reactions, although under-reporting and strict imputability criteria resulted in an underestimation of risk. © 2017 The Authors Transfusion published by Wiley Periodicals, Inc. on behalf of AABB.

A Method for Forecasting the Commercial Air Traffic Schedule in the Future

NASA Technical Reports Server (NTRS)

Long, Dou; Lee, David; Gaier, Eric; Johnson, Jesse; Kostiuk, Peter

1999-01-01

This report presents an integrated set of models that forecasts air carriers' future operations when delays due to limited terminal-area capacity are considered. This report models the industry as a whole, avoiding unnecessary details of competition among the carriers. To develop the schedule outputs, we first present a model to forecast the unconstrained flight schedules in the future, based on the assumption of rational behavior of the carriers. Then we develop a method to modify the unconstrained schedules, accounting for effects of congestion due to limited NAS capacities. Our underlying assumption is that carriers will modify their operations to keep mean delays within certain limits. We estimate values for those limits from changes in planned block times reflected in the OAG. Our method for modifying schedules takes many means of reducing the delays into considerations, albeit some of them indirectly. The direct actions include depeaking, operating in off-hours, and reducing hub airports'operations. Indirect actions include using secondary airports, using larger aircraft, and selecting new hub airports, which, we assume, have already been modeled in the FAA's TAF. Users of our suite of models can substitute an alternative forecast for the TAF.

Factors Associated with Delayed Ejection in Mishaps Between 1993 and 2013.

PubMed

Miles, John E

2015-09-01

The purpose of this investigation was to identify factors associated with Air Force aviators delaying ejection during in-flight emergencies. The investigator reviewed all reports within the Air Force Safety Automated System describing mishaps that resulted in the destruction of Air Force ejection-seat equipped aircraft between 1993 and 2013. Crewmembers were classified as either timely or delayed ejectors based on altitude at onset of emergency, altitude at ejection, and a determination regarding whether or not the aircraft was controlled during the mishap sequence. Univariate analysis and multivariate logistic regression were used to explore the association between delayed ejection and multiple potential risk factors. In total, 366 crewmembers were involved in in-flight emergencies in ejection-seat-equipped aircraft that resulted in the loss of the aircraft; 201 (54.9%) of these crewmembers delayed ejection until their aircraft had descended below recommended minimum ejection altitudes. Multivariate analysis indicated that independent risk factors for delayed ejection included increased crewmember flight hours and a mechanical or human-factors related cause of the emergency versus bird strike or midair collision. This investigation provided quantitative assessments of factors associated with aviators delaying ejection during in-flight emergencies. Increased odds of delay among crewmembers with greater than 1500 total flight hours suggests that complacency and overconfidence may adversely influence the ejection decision to at least as great a degree as inexperience. Increased odds of delay during mechanical and human factors mishaps confirms previously reported hypotheses and reaffirms the importance of targeting these areas to reduce aviator injuries and fatalities.

Connected commercial vehicles-integrated truck project : vehicle build test report.

DOT National Transportation Integrated Search

2000-12-01

This paper examines the ways ITS is changing the way federal and state motor carrier agencies conduct business with the motor carrier industry. New technologies are streamlining credentialing operations, reducing delays for safe carriers, and improvi...

Break-before-make CMOS inverter for power-efficient delay implementation.

PubMed

Puhan, Janez; Raič, Dušan; Tuma, Tadej; Bűrmen, Árpád

2014-01-01

A modified static CMOS inverter with two inputs and two outputs is proposed to reduce short-circuit current in order to increment delay and reduce power overhead where slow operation is required. The circuit is based on bidirectional delay element connected in series with the PMOS and NMOS switching transistors. It provides differences in the dynamic response so that the direct-path current in the next stage is reduced. The switching transistors are never ON at the same time. Characteristics of various delay element implementations are presented and verified by circuit simulations. Global optimization procedure is used to obtain the most power-efficient transistor sizing. The performance of the modified CMOS inverter chain is compared to standard implementation for various delays. The energy (charge) per delay is reduced up to 40%. The use of the proposed delay element is demonstrated by implementing a low-power delay line and a leading-edge detector cell.

Break-before-Make CMOS Inverter for Power-Efficient Delay Implementation

PubMed Central

Raič, Dušan

2014-01-01

A modified static CMOS inverter with two inputs and two outputs is proposed to reduce short-circuit current in order to increment delay and reduce power overhead where slow operation is required. The circuit is based on bidirectional delay element connected in series with the PMOS and NMOS switching transistors. It provides differences in the dynamic response so that the direct-path current in the next stage is reduced. The switching transistors are never ON at the same time. Characteristics of various delay element implementations are presented and verified by circuit simulations. Global optimization procedure is used to obtain the most power-efficient transistor sizing. The performance of the modified CMOS inverter chain is compared to standard implementation for various delays. The energy (charge) per delay is reduced up to 40%. The use of the proposed delay element is demonstrated by implementing a low-power delay line and a leading-edge detector cell. PMID:25538951

Beneficial Effects of Adjuvant Melatonin in Minimizing Oral Mucositis Complications in Head and Neck Cancer Patients Receiving Concurrent Chemoradiation.

PubMed

Onseng, Kittipong; Johns, Nutjaree Pratheepawanit; Khuayjarernpanishk, Thanut; Subongkot, Suphat; Priprem, Aroonsri; Hurst, Cameron; Johns, Jeffrey

2017-12-01

Oral mucositis is a major cause of pain and delayed cancer treatment leading to poor survival in head and neck cancer patients receiving concurrent chemoradiation. The study evaluated the effect of adjuvant melatonin on minimizing oral mucositis complications to reduce these treatment delays and interruptions. A randomized, double-blind, double dummy, placebo-controlled clinical trial. Ubon Ratchathani Cancer Hospital, Thailand. Thirty-nine head and neck cancer patients receiving concurrent chemoradiation (5 days/week of radiation plus chemotherapy three or six cycles). Patients were randomized to receive 20 mg melatonin gargle (or matched placebo) before each irradiation, and 20 mg melatonin capsules (or matched placebo) taken nightly during 7 weeks of concurrent chemoradiation. Endpoints were oral mucositis events (incidence and time to grade 3 mucositis or grade 2 xerostomia), pain medication consumption and quality of life (QOL). Melatonin group reported lower incidence of grade 3 oral mucositis (42% vs. 55%) and grade 2 xerostomia (20% vs. 21%); no statistical significance was detected. Melatonin regimen delayed onset of grade 3 mucositis (median 34 days vs. 50 days; p = 0.0318), allowing median time of 16 more patient visits before its onset and fewer interrupted treatments due to oral mucositis were reported (n = 1 vs. n = 5). There was no difference of grade 2 xerostomia (median 32 days vs. 50 days; p = 0.624). Morphine consumption was also reduced (median 57 mg vs. 0 mg; p = 0.0342), while QOL was comparable during the study period. Adjuvant melatonin delayed the onset of oral mucositis, which enables uninterrupted cancer treatment and reduced the amount of morphine used for pain treatment.

Incident management under SCAT adaptive control system : FAST-TRAC phase III deliverable. #11, Final report on incident management under SCATS adaptive control system

DOT National Transportation Integrated Search

1998-04-01

The report documents the results of a study designed to test the effectiveness of ATMS and ATIS strategies to reduce delay resulting from an incident. The study had two main sections: a simulation study to test the effectiveness of several control st...

Reducing CO2 and other emissions from shipping : fourth report of session 2008-09 : report, together with formal minutes, oral and written evidence

DOT National Transportation Integrated Search

2009-06-01

The emission of greenhouse gases from shipping is a serious problem for international climate change policy. They are growing and there is a risk of considerable delay before they are brought under control. The advent of carbon budgets means it is no...

Prospective associations between measures of gross and fine motor coordination in infants and objectively measured physical activity and sedentary behavior in childhood

PubMed Central

Sánchez, Guillermo F López; Williams, Genevieve; Aggio, Daniel; Vicinanza, Domenico; Stubbs, Brendon; Kerr, Catherine; Johnstone, James; Roberts, Justine; Smith, Lee

2017-01-01

Abstract One important determinant of childhood physical activity and sedentary behavior may be that of motor development in infancy. The present analyses aimed to investigate whether gross and fine motor delays in infants were associated with objective and self-reported activity in childhood. Data were from the UK Millennium Cohort Study, a prospective cohort study, involving UK children born on or around the millennium (September 2000 and January 2002). When children were 9 months old, parents reported children's fine and gross motor-coordination, and at 7 years, sports club attendance and daily TV viewing time. Children's physical activity was measured using accelerometers at 7 years. Adjusted regression models were used to examine associations between delayed motor development and accelerometry measured moderate-to-vigorous physical activity and sedentary behavior, and parent-reported sport club attendance and TV viewing time. In this sample (n = 13,021), gross motor delay in infancy was associated with less time in moderate-to-vigorous physical activity (B −5.0 95% confidence interval [CI] −6.8, −3.2) and more time sedentary (B 13.5 95% CI 9.3, 17.8) in childhood. Gross and fine motor delays during infancy were associated with a reduced risk of having high attendance at sports clubs in childhood (both relative risk [RR] 0.7, 95% CI 0.6, 0.9). Fine motor delays, but not gross delays, were also associated with an increased risk of having high TV viewing time (RR 1.3 95% CI 1.0, 1.6). Findings from the present study suggest that delays in motor development in infancy are associated with physical activity and sedentary time in childhood. PMID:29145249

Prospective associations between measures of gross and fine motor coordination in infants and objectively measured physical activity and sedentary behavior in childhood.

PubMed

Sánchez, Guillermo F López; Williams, Genevieve; Aggio, Daniel; Vicinanza, Domenico; Stubbs, Brendon; Kerr, Catherine; Johnstone, James; Roberts, Justin; Smith, Lee

2017-11-01

One important determinant of childhood physical activity and sedentary behavior may be that of motor development in infancy. The present analyses aimed to investigate whether gross and fine motor delays in infants were associated with objective and self-reported activity in childhood. Data were from the UK Millennium Cohort Study, a prospective cohort study, involving UK children born on or around the millennium (September 2000 and January 2002). When children were 9 months old, parents reported children's fine and gross motor-coordination, and at 7 years, sports club attendance and daily TV viewing time. Children's physical activity was measured using accelerometers at 7 years. Adjusted regression models were used to examine associations between delayed motor development and accelerometry measured moderate-to-vigorous physical activity and sedentary behavior, and parent-reported sport club attendance and TV viewing time. In this sample (n = 13,021), gross motor delay in infancy was associated with less time in moderate-to-vigorous physical activity (B -5.0 95% confidence interval [CI] -6.8, -3.2) and more time sedentary (B 13.5 95% CI 9.3, 17.8) in childhood. Gross and fine motor delays during infancy were associated with a reduced risk of having high attendance at sports clubs in childhood (both relative risk [RR] 0.7, 95% CI 0.6, 0.9). Fine motor delays, but not gross delays, were also associated with an increased risk of having high TV viewing time (RR 1.3 95% CI 1.0, 1.6). Findings from the present study suggest that delays in motor development in infancy are associated with physical activity and sedentary time in childhood.

Benefit Estimates of Terminal Area Productivity Program Technologies

NASA Technical Reports Server (NTRS)

Hemm, Robert; Shapiro, Gerald; Lee, David; Gribko, Joana; Glaser, Bonnie

1999-01-01

This report documents benefit analyses for the NASA Terminal Area Technology (TAP) technology programs. Benefits are based on reductions in arrival delays at ten major airports over the 10 years from 2006 through 2015. Detailed analytic airport capacity and delay models were constructed to produce the estimates. The goal of TAP is enable good weather operations tempos in all weather conditions. The TAP program includes technologies to measure and predict runway occupancy times, reduce runway occupancy times in bad weather, accurately predict wake vortex hazards, and couple controller automation with aircraft flight management systems. The report presents and discusses the estimate results and describes the models. Three appendixes document the model algorithms and discuss the input parameters selected for the TAP technologies. The fourth appendix is the user's guide for the models. The results indicate that the combined benefits for all TAP technologies at all 10 airports range from $550 to $650 million per year (in constant 1997 dollars). Additional benefits will accrue from reductions in departure delays. Departure delay benefits are calculated by the current models.

Impact of communication delays to and from the International Space Station on self-reported individual and team behavior and performance: A mixed-methods study

NASA Astrophysics Data System (ADS)

Kintz, Natalie M.; Chou, Chih-Ping; Vessey, William B.; Leveton, Lauren B.; Palinkas, Lawrence A.

2016-12-01

Deep space explorations will involve significant delays in communication to and from Earth that will likely impact individual and team outcomes. However, the extent of these impacts and the appropriate countermeasures for their mitigation remain largely unknown. This study utilized the International Space Station (ISS), a high-fidelity analog for deep space, as a research platform to assess the impact of communication delays on individual and team performance, mood, and behavior. Three astronauts on the ISS and 18 mission support personnel performed tasks with and without communication delays (50-s one-way) during a mission lasting 166 days. Self-reported assessments of individual and team performance and mood were obtained after each task. Secondary outcomes included communication quality and task autonomy. Qualitative data from post-mission interviews with astronauts were used to validate and expand on quantitative data, and to elicit recommendations for countermeasures. Crew well-being and communication quality were significantly reduced in communication delay tasks compared to control. Communication delays were also significantly associated with increased individual stress/frustration. Qualitative data suggest communication delays impacted operational outcomes (i.e. task efficiency), teamwork processes (i.e. team/task coordination) and mood (i.e. stress/frustration), particularly when tasks involved high task-related communication demands, either because of poor communication strategies or low crew autonomy. Training, teamwork, and technology-focused countermeasures were identified to mitigate or prevent adverse impacts.

Three Positive Parenting Practices and Their Correlation with Risk of Childhood Developmental, Social, or Behavioral Delays: An Analysis of the National Survey of Children's Health.

PubMed

Cprek, Sarah E; Williams, Corrine M; Asaolu, Ibitola; Alexander, Linda A; Vanderpool, Robin C

2015-11-01

(1) Investigate the relationship between three specific positive parenting practices (PPP)-reading to children, engaging in storytelling or singing, and eating meals together as a family-and parent-reported risk of developmental, behavioral, or social delays among children between the ages of 1-5 years in the US. (2) Determine if a combination of these parenting practices has an effect on the outcome. Chi square and multiple logistic regression analyses were used to analyze cross-sectional data from the National Survey of Children's Health 2011/2012 in regards to the relationship between each of the three individual PPP as well as a total PPP score and the child's risk of being developmentally, socially, or behaviorally delayed (N = 21,527). Risk of delay was calculated using the Parents' Evaluation of Developmental Status Questionnaire, which is a parental self-report measure that has been correlated with diagnosed child delays. These analyses controlled for poverty and parental education. All analyses were completed using SAS Version 9.3. A strong correlation was found between each of the three PPP as well as the total PPP score and the child's risk of developmental, social, or behavioral delays (p < 0.05 for each test). These associations were found to have a dose-response relationship (p < 0.05 in all but one analysis). Daily engagement in PPP could possibly reduce children's risk of delay, and specifically engaging in all three PPP may have greater benefit.

Behavioral and psychosocial effects of two middle school sexual health education programs at tenth-grade follow-up.

PubMed

Markham, Christine M; Peskin, Melissa F; Shegog, Ross; Baumler, Elizabeth R; Addy, Robert C; Thiel, Melanie; Escobar-Chaves, Soledad Liliana; Robin, Leah; Tortolero, Susan R

2014-02-01

An earlier randomized controlled trial found that two middle school sexual education programs-a risk avoidance (RA) program and a risk reduction (RR) program-delayed initiation of sexual intercourse (oral, vaginal, or anal sex) and reduced other sexual risk behaviors in ninth grade. We examined whether these effects extended into 10th grade. Fifteen middle schools were randomly assigned to RA, RR, or control conditions. Follow-up surveys were conducted with participating students in 10th grade (n = 1,187; 29.2% attrition). Participants were 60% female, 50% Hispanic, and 39% black; seventh grade mean age was 12.6 years. In 10th grade, compared with the control condition, both programs significantly delayed anal sex initiation in the total sample (RA: adjusted odds ratio [AOR], .64, 95% confidence interval [CI], .42-.99; RR: AOR, .65, 95% CI, .50-.84) and among Hispanics (RA: AOR, .53, 95% CI, .31-.91; RR: AOR, .82, 95% CI, .74-.93). Risk avoidance students were less likely to report unprotected vaginal sex, either by using a condom or by abstaining from sex (AOR: .61, 95% CI, .45-.85); RR students were less likely to report recent unprotected anal sex (AOR: .34, 95% CI, .20-.56). Both programs sustained positive impact on some psychosocial outcomes. Although both programs delayed anal sex initiation into 10th grade, effects on the delayed initiation of oral and vaginal sex were not sustained. Additional high school sexual education may help to further delay sexual initiation and reduce other sexual risk behaviors in later high school years. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Delay Discounting as an Index of Sustainable Behavior: Devaluation of Future Air Quality and Implications for Public Health.

PubMed

Berry, Meredith S; Nickerson, Norma P; Odum, Amy L

2017-09-01

Poor air quality and resulting annual deaths represent significant public health concerns. Recently, rapid delay discounting (the devaluation of future outcomes) of air quality has been considered a potential barrier for engaging in long term, sustainable behaviors that might help to reduce emissions (e.g., reducing private car use, societal support for clean air initiatives). Delay discounting has been shown to be predictive of real world behavior outside of laboratory settings, and therefore may offer an important framework beyond traditional variables thought to measure sustainable behavior such as importance of an environmental issue, or environmental attitudes/values, although more research is needed in this area. We examined relations between discounting of air quality, respiratory health, and monetary gains and losses. We also examined, relations between discounting and self-reported importance of air quality and respiratory health, and nature relatedness. Results showed rapid delay discounting of all outcomes across the time frames assessed, and significant positive correlations between delay discounting of air quality, respiratory health, and monetary outcomes. Steeper discounting of monetary outcomes relative to air quality and respiratory health outcomes was observed in the context of gains; however, no differences in discounting were observed across losses of monetary, air quality, and respiratory health. Replicating the sign effect, monetary outcomes were discounted more steeply than monetary losses. Importance of air quality, respiratory health and nature relatedness were significantly and positively correlated with one another, but not with degree of delay discounting of any outcome, demonstrating the need for more comprehensive measures that predict pro-environmental behaviors that might benefit individuals and public health over time. These results add to our understanding of decision-making, and demonstrate alarming rates of delay discounting of air quality and health. These results implicate a major public health concern and potential barriers to individual and societal behavior that reduce pollution and emissions for conservation of clean air.

Delay Discounting as an Index of Sustainable Behavior: Devaluation of Future Air Quality and Implications for Public Health

PubMed Central

Berry, Meredith S.; Nickerson, Norma P.; Odum, Amy L.

2017-01-01

Poor air quality and resulting annual deaths represent significant public health concerns. Recently, rapid delay discounting (the devaluation of future outcomes) of air quality has been considered a potential barrier for engaging in long term, sustainable behaviors that might help to reduce emissions (e.g., reducing private car use, societal support for clean air initiatives). Delay discounting has been shown to be predictive of real world behavior outside of laboratory settings, and therefore may offer an important framework beyond traditional variables thought to measure sustainable behavior such as importance of an environmental issue, or environmental attitudes/values, although more research is needed in this area. We examined relations between discounting of air quality, respiratory health, and monetary gains and losses. We also examined, relations between discounting and self-reported importance of air quality and respiratory health, and nature relatedness. Results showed rapid delay discounting of all outcomes across the time frames assessed, and significant positive correlations between delay discounting of air quality, respiratory health, and monetary outcomes. Steeper discounting of monetary outcomes relative to air quality and respiratory health outcomes was observed in the context of gains; however, no differences in discounting were observed across losses of monetary, air quality, and respiratory health. Replicating the sign effect, monetary outcomes were discounted more steeply than monetary losses. Importance of air quality, respiratory health and nature relatedness were significantly and positively correlated with one another, but not with degree of delay discounting of any outcome, demonstrating the need for more comprehensive measures that predict pro-environmental behaviors that might benefit individuals and public health over time. These results add to our understanding of decision-making, and demonstrate alarming rates of delay discounting of air quality and health. These results implicate a major public health concern and potential barriers to individual and societal behavior that reduce pollution and emissions for conservation of clean air. PMID:28862671

Z-path SAW RFID tag.

PubMed

Härmä, Sanna; Plessky, Victor P; Hartmann, Clinton S; Steichen, William

2008-01-01

Surface acoustic wave (SAW) radio-frequency identification (RFID) tags are soon expected to be produced in very high volumes. The size and cost of a SAW RFID tag will be key parameters for many applications. Therefore, it is of primary importance to reduce the chip size. In this work, we describe the design principles of a 2.4-GHz SAW RFID tag that is significantly smaller than earlier reported tags. We also present simulated and experimental results. The coded signal should arrive at the reader with a certain delay (typically about 1 micros), i.e., after the reception of environmental echoes. If the tag uses a bidirectional interdigital transducer (IDT), space for the initial delay is needed on both sides of the IDT. In this work, we replace the bidirectional IDT by a unidirectional one. This halves the space required by the initial delay because all the code reflectors must now be placed on the same side of the IDT. We reduce tag size even further by using a Z-path geometry in which the same space in x-direction is used for both the initial delay and the code reflectors. Chip length is thus determined only by the space required by the code reflectors.

Reducing Ageism: Education About Aging and Extended Contact With Older Adults.

PubMed

Lytle, Ashley; Levy, Sheri R

2017-11-19

Ageism is of increasing concern due to the growing older population worldwide and youth-centered focus of many societies. The current investigation tested the PEACE (Positive Education about Aging and Contact Experiences) model for the first time. Two online experimental studies examined 2 key factors for reducing ageism: education about aging (providing accurate information about aging) and extended contact (knowledge of positive intergenerational contact) as well as their potential combined effect (education plus extended contact). In Study 1, 354 undergraduates in all 3 experimental conditions (vs. control participants) reported less negative attitudes toward older adults (delayed post-test) and greater aging knowledge (immediate and delayed post-tests), when controlling for pre-study attitudes. In Study 2, 505 national community participants (ages 18-59) in all experimental conditions (vs. control participants) reported less negative attitudes toward older adults (immediate post-test) and greater aging knowledge (immediate and delayed post-tests). In summary, across 2 online studies, education about aging and knowledge of intergenerational extended contact improved attitudes toward older adults and aging knowledge. Thus, brief, online ageism-reduction strategies can be an effective way to combat ageism. These strategies hold promise to be tested in other settings, with other samples, and to be elaborated into more in-depth interventions that aim to reduce ageism in everyday culture. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Implementation of uniform information on fetal movement in a Norwegian population reduced delayed reporting of decreased fetal movement and stillbirths in primiparous women - a clinical quality improvement

PubMed Central

2010-01-01

Background Delayed maternal reporting of decreased fetal movement (DFM) is associated with adverse pregnancy outcomes. Inconsistent information on fetal activity to women during the antenatal period may result in delayed reporting of DFM. We aimed to evaluate an intervention of implementation of uniform information on fetal activity to women during the antenatal period. Methods In a prospective before-and-after study, singleton women presenting DFM in the third trimester across 14 hospitals in Norway were registered. Outcome measures were maternal behavior regarding reporting of DFM, concerns and stillbirth. In addition, cross-sectional studies of all women giving birth were undertaken to assess maternal concerns about fetal activity, and population-based data were obtained from the Medical Birth Registry Norway. Results Pre- and post-intervention cohorts included 19 407 and 46 143 births with 1 215 and 3 038 women with DFM respectively. Among primiparous women with DFM, a reduction in delayed reporting of DFM (≥48 hrs) OR 0.61 (95% CI 0.47-0.81) and stillbirths OR 0.36 (95% CI 0.19-0.69) was shown in the post-intervention period. No difference was shown in rates of consultations for DFM or maternal concerns. Stillbirth rates and maternal behavior among women who were of non-Western origin, smokers, overweight or >34 years old were unchanged. Conclusions Uniform information on fetal activity provided to pregnant women was associated with a reduction in the number of primiparous women who delayed reporting of DFM and a reduction of the stillbirth rates for primiparous women reporting DFM. The information did not appear to increase maternal concerns or rate of consultation. Due to different imperfections in different clinical settings, further studies in other populations replicating these findings are required. PMID:20044943

Reducing the Deficit: Spending and Revenue Options. A Report to the Senate and House Committees on the Budget. Part 2

DTIC Science & Technology

1987-01-01

Loan Program 132 NDD-03 Reduce Funding for Research Supported by the National Institutes of Health 134 NDD-04 Reduce Subsidies Provided by the...faster pace under Strategy II but more slowly than under the Administra- tion’s plan. Both strategies would slow production and research and...develop- ment of many programs, but Strategy I probably would result in the cancel- lation or delay of a greater number of procurement and research

Damping Resonant Current in a Spark-Gap Trigger Circuit to Reduce Noise

DTIC Science & Technology

2009-06-01

DAMPING RESONANT CURRENT IN A SPARK- GAP TRIGGER CIRCUIT TO REDUCE NOISE E. L. Ruden Air Force Research Laboratory, Directed Energy Directorate, AFRL...REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE Damping Resonant Current In A Spark- Gap Trigger Circuit To Reduce Noise 5a...thereby triggering 2 after delay 0, is 1. Each of the two rail- gaps (represented by 2) is trig- gered to close after the spark- gap (1) in the

Prehospital delay, contributing aspects and responses to symptoms among Norwegian women and men with first time acute myocardial infarction.

PubMed

Løvlien, M; Schei, B; Hole, T

2007-12-01

In patients with acute myocardial infarction (AMI), the delay between the onset of symptoms and hospital admission is a critical factor in reducing morbidity and mortality. To assess gender differences in prehospital delay among women and men with first time AMI, generate more knowledge about aspects influencing this delay and investigate responses to acute symptoms. Of 738 eligible patients, 149 women and 384 men responded to a questionnaire (72%). Over half of both women and men waited over one hour before they called for medical assistance and more than half the patients had a total prehospital delay exceeding two hours. Rapid development of symptoms and symptoms matching expectations reduced, self medication and consulting the spouse increased patient delay in both genders. Calling the Emergency Medical Service (EMS) reduced and calling a general practitioner increased total prehospital delay in both genders. ST-ELEVATION: (STEMI), symptoms experienced as unbearable and attributed as cardiac reduced patient delay, and symptoms from the back, shoulders or between scapulae increased prehospital delay, only in men. How patients responded to symptoms had vital impact on prehospital delay among both genders, but the experience and interpretation of symptoms had more influence in men than in women.

Three Positive Parenting Practices and Their Correlation with Risk of Childhood Developmental, Social, or Behavioral Delays: An Analysis of the National Survey of Children's Health

PubMed Central

Cprek, Sarah E.; Williams, Corrine M.; Asaolu, Ibitola; Alexander, Linda A.; Vanderpool, Robin C.

2016-01-01

Objectives (1) Investigate the relationship between three specific positive parenting practices (PPP)—reading to children, engaging in storytelling or singing, and eating meals together as a family—and parent-reported risk of developmental, behavioral, or social delays among children between the ages of 1–5 years in the US. (2) Determine if a combination of these parenting practices has an effect on the outcome. Methods Chi square and multiple logistic regression analyses were used to analyze cross-sectional data from the National Survey of Children's Health 2011/2012 in regards to the relationship between each of the three individual PPP as well as a total PPP score and the child's risk of being developmentally, socially, or behaviorally delayed (N = 21,527). Risk of delay was calculated using the Parents’ Evaluation of Developmental Status Questionnaire, which is a parental self-report measure that has been correlated with diagnosed child delays. These analyses controlled for poverty and parental education. All analyses were completed using SAS Version 9.3. Results A strong correlation was found between each of the three PPP as well as the total PPP score and the child's risk of developmental, social, or behavioral delays (p < 0.05 for each test). These associations were found to have a dose–response relationship (p < 0.05 in all but one analysis). Conclusions Daily engagement in PPP could possibly reduce children's risk of delay, and specifically engaging in all three PPP may have greater benefit. PMID:26100132

Preschoolers’ Delay of Gratification Predicts Their Body Mass 30 Years Later

PubMed Central

Schlam, Tanya R.; Wilson, Nicole L.; Shoda, Yuichi; Mischel, Walter; Ayduk, Ozlem

2012-01-01

Objective To assess whether preschoolers’ performance on a delay of gratification task would predict their body mass index (BMI) 30 years later. Study design In the late 1960s/early 1970s, 4-year-olds from a university-affiliated preschool completed the classic delay of gratification task. As part of a longitudinal study, a subset (N = 164, 57% women) completed a follow-up approximately 30 years later and self-reported their height and weight. Data were analyzed using hierarchical regression. Results Performance on the delay of gratification task accounted for a significant portion of variance in BMI (4%, p < .01), over and above the variance accounted for by sex alone (13%). Each additional minute a preschooler delayed gratification predicted a .2 point reduction in BMI in adulthood. Conclusions Delaying gratification longer at 4 years of age was associated with having a lower BMI three decades later. The study is, however, correlational, and it is therefore not possible to make causal inferences regarding the relation between delay duration and BMI. Identifying children with greater difficulty delaying gratification could help detect children at risk of becoming overweight or obese. Interventions that improve self-control in young children have been developed and might reduce children’s risk of becoming overweight while having positive effects on other outcomes important to society. PMID:22906511

San Antonio's Medical Center Corridor: Lessons Learned From The Metropolitan Model Deployment Initiative: Reducing Delay Through Integrated Freeway & Arterial Management

DOT National Transportation Integrated Search

2000-10-01

This report demonstrates the benefits and potential pitfalls of deploying and operating an integrated freeway and arterial management system. In particular, it discusses the lessons learned about the Medical Center Corridor (MCC) Project deployed in ...

State and Federal project development procedures for bus rapid transit : managing differences and reducing implementation delays

DOT National Transportation Integrated Search

2011-08-01

This report documents an investigation into the transportation project development process in the : context of the implementation of bus rapid transit systems on the State Highway System as well as such : systems being part of the Federal New Starts ...

Delays in seeking and receiving health care services for pneumonia in children under five in the Peruvian Amazon: a mixed-methods study on caregivers' perceptions.

PubMed

Pajuelo, Mónica J; Anticona Huaynate, Cynthia; Correa, Malena; Mayta Malpartida, Holger; Ramal Asayag, Cesar; Seminario, Juan R; Gilman, Robert H; Murphy, Laura; Oberhelman, Richard A; Paz-Soldan, Valerie A

2018-03-01

Delays in receiving adequate care for children suffering from pneumonia can be life threatening and have been described associated with parents' limited education and their difficulties in recognizing the severity of the illness. The "three delays" was a model originally proposed to describe the most common determinants of maternal mortality, but has been adapted to describe delays in the health seeking process for caregivers of children under five. This study aims to explore the caregivers' perceived barriers for seeking and receiving health care services in children under five years old admitted to a referral hospital for community-acquired pneumonia in the Peruvian Amazon Region using the three-delays model framework. There were two parts to this mixed-method, cross-sectional, hospital-based study. First, medical charts of 61 children (1 to 60 months old) admitted for pneumonia were reviewed, and clinical characteristics were noted. Second, to examine health care-seeking decisions and actions, as well as associated delays in the process of obtaining health care services, we interviewed 10 of the children's caregivers. Half of the children in our study were 9 months old or less. Main reasons for seeking care at the hospital were cough (93%) and fever (92%). Difficulty breathing and fast breathing were also reported in more than 60% of cases. In the interviews, caregivers reported delays of 1 to 14 days to go to the closest health facility. Factors perceived as causes for delays in deciding to seek care were apparent lack of skills to recognize signs and symptoms and of confidence in the health system, and practicing self-medication. No delays in reaching a health facility were reported. Once the caregivers reached a health facility, they perceived lack of competence of medical staff and inadequate treatment provided by the primary care physicians. According to caregivers, the main delays to get health care services for pneumonia among young children were identified in the initial decision of caregivers to seek healthcare and in the health system to provide it. Specific interventions targeted to main barriers may be useful for reducing delays in providing appropriate health care for children with pneumonia.

Early onset marijuana use is associated with learning inefficiencies.

PubMed

Schuster, Randi Melissa; Hoeppner, Susanne S; Evins, A Eden; Gilman, Jodi M

2016-05-01

Verbal memory difficulties are the most widely reported and persistent cognitive deficit associated with early onset marijuana use. Yet, it is not known what memory stages are most impaired in those with early marijuana use. Forty-eight young adults, aged 18-25, who used marijuana at least once per week and 48 matched nonusing controls (CON) completed the California Verbal Learning Test, Second Edition (CVLT-II). Marijuana users were stratified by age of initial use: early onset users (EMJ), who started using marijuana at or before age 16 (n = 27), and late onset marijuana user group (LMJ), who started using marijuana after age 16 (n = 21). Outcome variables included trial immediate recall, total learning, clustering strategies (semantic clustering, serial clustering, ratio of semantic to serial clustering, and total number of strategies used), delayed recall, and percent retention. Learning improved with repetition, with no group effect on the learning slope. EMJ learned fewer words overall than LMJ or CON. There was no difference between LMJ and CON in total number of words learned. Reduced overall learning mediated the effect on reduced delayed recall among EMJ, but not CON or LMJ. Learning improved with greater use of semantic versus serial encoding, but this did not vary between groups. EMJ was not related to delayed recall after adjusting for encoding. Young adults reporting early onset marijuana use had learning weaknesses, which accounted for the association between early onset marijuana use and delayed recall. No amnestic effect of marijuana use was observed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Early Onset Marijuana Use Is Associated with Learning Inefficiencies

PubMed Central

Schuster, Randi Melissa; Hoeppner, Susanne S.; Evins, A. Eden; Gilman, Jodi M.

2016-01-01

Objective Verbal memory difficulties are the most widely reported and persistent cognitive deficit associated with early-onset marijuana use. Yet, it is not known what memory stages are most impaired in those with early marijuana use. Method Forty-eight young adults, aged 18–25, who used marijuana at least once per week and 48 matched non-using controls (CON) completed the California Verbal Learning Test, Second Edition (CVLT-II). Marijuana users were stratified by age of initial use: ‘early onset’ users (EMJ), who started using marijuana at or before age 16 (n = 27), and ‘late onset’ marijuana user group (LMJ), who started using marijuana after age 16 (n = 21). Outcome variables included trial immediate recall, total learning, clustering strategies (semantic clustering, serial clustering, ratio of semantic to serial clustering, and total number of strategies used), delayed recall, and percent retention. Results Learning improved with repetition, with no group effect on the learning slope. EMJ learned fewer words overall than LMJ or CON. There was no difference between LMJ and CON in total number of words learned. Reduced overall learning mediated the effect on reduced delayed recall among EMJ, but not CON or LMJ. Learning improved with greater use of semantic versus serial encoding, but this did not vary between groups. EMJ was not related to delayed recall after adjusting for encoding. Conclusions Young adults reporting early onset marijuana use had learning weaknesses, which accounted for the association between early onset marijuana use and delayed recall. No amnestic effect of marijuana use was observed. PMID:26986749

Micromachined silicon acoustic delay line with 3D-printed micro linkers and tapered input for improved structural stability and acoustic directivity

NASA Astrophysics Data System (ADS)

Cho, Y.; Kumar, A.; Xu, S.; Zou, J.

2016-10-01

Recent studies have shown that micromachined silicon acoustic delay lines can provide a promising solution to achieve real-time photoacoustic tomography without the need for complex transducer arrays and data acquisition electronics. To achieve deeper imaging depth and wider field of view, a longer delay time and therefore delay length are required. However, as the length of the delay line increases, it becomes more vulnerable to structural instability due to reduced mechanical stiffness. In this paper, we report the design, fabrication, and testing of a new silicon acoustic delay line enhanced with 3D printed polymer micro linker structures. First, mechanical deformation of the silicon acoustic delay line (with and without linker structures) under gravity was simulated by using finite element method. Second, the acoustic crosstalk and acoustic attenuation caused by the polymer micro linker structures were evaluated with both numerical simulation and ultrasound transmission testing. The result shows that the use of the polymer micro linker structures significantly improves the structural stability of the silicon acoustic delay lines without creating additional acoustic attenuation and crosstalk. In addition, the improvement of the acoustic acceptance angle of the silicon acoustic delay lines was also investigated to better suppress the reception of unwanted ultrasound signals outside of the imaging plane. These two improvements are expected to provide an effective solution to eliminate current limitations on the achievable acoustic delay time and out-of-plane imaging resolution of micromachined silicon acoustic delay line arrays.

Immediate versus delayed self-reporting of symptoms and side effects during chemotherapy: does timing matter?

PubMed

Coolbrandt, Annemarie; Van den Heede, Koen; Vanhove, Ellen; De Bom, Ann; Milisen, Koen; Wildiers, Hans

2011-04-01

The aim of this study was to examine how patients recall symptoms at a delayed self-report. Accurate insight into toxicity symptoms during chemotherapy is essential so that nurses and doctors can assess therapeutic tolerance and adjust supportive care accordingly. A non-experimental, longitudinal design was employed. Using the Therapy-Related Symptoms Checklist (TRSC), respondents (n = 142) reported their initial symptoms during the first 7 days of the chemotherapy cycle at two different times: (1) each day of the first seven days after the chemotherapy administration (immediate self-report), and (2) at their next hospital visit for chemotherapy (delayed self-report). We compared the number and severity of symptoms and side effects reported in the immediate and delayed self-reports. Respondents reported significantly fewer symptoms and fewer severe symptoms in the delayed self-report. For 22 out of 25 symptoms the delayed-reported grade was significantly lower than the immediate-reported maximum grade. Compared to the immediate-reported median grade, significant differences occurred in only 10 out of the 25 symptoms. In all cases, except fatigue, the delayed-reported grade was significantly higher than the immediate-reported median grade. This study indicates that delayed self-report of chemotherapy side effects is not an appropriate measure of actual symptoms and side effects experienced by patients. Delayed self-report gives a weaker insight into actual symptom burden. Fatigue is at particular risk to be minimized at the delayed self-report. Therefore it is recommended to assess chemotherapy-related symptoms and side effects by means of immediate self-report. Copyright © 2010 Elsevier Ltd. All rights reserved.

Short- and long-term clinical outcomes of use of beta-interferon or glatiramer acetate for people with clinically isolated syndrome: a systematic review of randomised controlled trials and network meta-analysis.

PubMed

Armoiry, X; Kan, A; Melendez-Torres, G J; Court, R; Sutcliffe, P; Auguste, P; Madan, J; Counsell, C; Clarke, A

2018-05-01

Beta-interferon (IFN-β) and glatiramer acetate (GA) have been evaluated in people with clinically isolated syndrome (CIS) with the aim to delay a second clinical attack and a diagnosis of clinically definite multiple sclerosis (CDMS). We systematically reviewed trials evaluating the short- and long-term clinical effectiveness of these drugs in CIS. We searched multiple electronic databases. We selected randomised controlled studies (RCTs) conducted in CIS patients and where the interventions were IFN-β and GA. Main outcomes were time to CDMS, and discontinuation due to adverse events (AE). We compared interventions using random-effect network meta-analyses (NMA). We also reported outcomes from long-term open-label extension (OLE) studies. We identified five primary studies. Four had open-label extensions following double-blind periods comparing outcomes between early vs delayed DMT. Short-term clinical results (double-blind period) showed that all drugs delayed CDMS compared to placebo. Indirect comparisons did not suggest superiority of any one active drug over another. We could not undertake a NMA for discontinuation due to AE. Long-term clinical results (OLE studies) showed that the risk of developing CDMS was consistently reduced across studies after early DMT treatment compared to delayed DMT (HR = 0.64, 95% CI 0.55, 0.74). No data supported the benefit of DMTs in reducing the time to, and magnitude of, disability progression. Meta-analyses confirmed that IFN-β and GA delay time to CDMS compared to placebo. In the absence of evidence that early DMTs can reduce disability progression, future research is needed to better identify patients most likely to benefit from long-term DMTs.

Determinants of delay in malaria care-seeking behaviour for children 15 years and under in Bata district, Equatorial Guinea.

PubMed

Romay-Barja, Maria; Cano, Jorge; Ncogo, Policarpo; Nseng, Gloria; Santana-Morales, Maria A; Valladares, Basilio; Riloha, Matilde; Benito, Agustin

2016-03-31

Malaria remains a major cause of morbidity and mortality in children under 5 years of age in Equatorial Guinea. Early appropriate treatment can reduce progression of the illness to severe stages, thus reducing of mortality, morbidity and onward transmission. The factors that contribute to malaria treatment delay have not been studied previously in Equatorial Guinea. The objective of this study was to assess the determinants of delay in seeking malaria treatment for children in the Bata district, in mainland Equatorial Guinea. A cross-sectional study was conducted in Bata district, in 2013, which involved 428 houses in 18 rural villages and 26 urban neighbourhoods. Household caregivers were identified in each house and asked about their knowledge of malaria and about the management of the last reported malaria episode in a child 15 years and younger under their care. Bivariate and multivariate statistical analyses were conducted to determine the relevance of socio-economic, geographical and behavioural factors on delays in care-seeking behaviour. Nearly half of the children sought treatment at least 24 h after the onset of the symptoms. The median delay in seeking care was 2.8 days. Children from households with the highest socio-economic status were less likely to be delayed in seeking care than those from households with the lowest socio-economic status (OR 0.37, 95% CI 0.19-0.72). Children that first received treatment at home, mainly paracetamol, were more than twice more likely to be delayed for seeking care, than children who did not first receive treatment at home (OR 2.36, 95% CI 1.45-3.83). Children living in a distance >3 km from the nearest health facility were almost two times more likely to be delayed in seeking care than those living closer to a facility but with non significant association once adjusted for other variables (OR 1.75, 95% CI 0.88-3.47). To decrease malaria morbidity and mortality in Bata district, efforts should be addressed to reduce household delays in seeking care. It is necessary to provide free access to effective malaria diagnosis and treatment, to reinforce malaria management at community level through community health workers and drug sellers and to increase awareness on the severity of malaria, the importance of early diagnosis and appropriate treatment.

Factors associated with long diagnostic delay in celiac disease.

PubMed

Fuchs, Valma; Kurppa, Kalle; Huhtala, Heini; Collin, Pekka; Mäki, Markku; Kaukinen, Katri

2014-11-01

Here, we investigated the factors associated with long diagnostic delay in celiac disease and the impact of the national Current Care Guidelines in reducing the delay. This population-based study involved 825 adult celiac disease patients. The diagnosis was considered delayed when the interval between first symptoms and diagnosis was >10 years. The patients were asked about the duration and type of symptoms before diagnosis, time and site (tertiary, secondary, or primary care) of the diagnosis, family history of the disease, and presence of significant comorbidities. Analysis was performed by binary logistic regression. Altogether, 261 (32%) out of 825 participants reported a diagnostic delay of >10 years. Female gender, neurological or musculoskeletal disorders and presence of diarrhea, abdominal pain, and malabsorption were associated with prolonged delay. Male gender, diagnosis after the introduction of the first Current Care Guidelines in 1997, and being detected by serological screening, and family history of celiac disease were associated with a lower risk of delayed diagnosis. Factors not associated with the delay were site of diagnosis, age, and presence of dermatitis herpetiformis, type 1 diabetes, or thyroidal disease. The number of long diagnostic delays in celiac disease has decreased over the past decades. The shift of diagnostics from secondary and tertiary care to primary care has not been detrimental. National guidelines together with increased awareness and active screening in at-risk groups of celiac disease are important in these circumstances.

Mandating green: on the design of renewable fuel policies and cost containment mechanisms : a national center for sustainable transportation research report.

DOT National Transportation Integrated Search

2015-10-01

Policymakers typically favor renewable fuel mandates over taxes and cap and trade programs to : reduce greenhouse gas emissions from the transportation sector. Because of delays in the development : of commercially viable renewable fuels and importan...

Facilitating tolerance of delayed reinforcement during functional communication training.

PubMed

Fisher, W W; Thompson, R H; Hagopian, L P; Bowman, L G; Krug, A

2000-01-01

Few clinical investigations have addressed the problem of delayed reinforcement. In this investigation, three individuals whose destructive behavior was maintained by positive reinforcement were treated using functional communication training (FCT) with extinction (EXT). Next, procedures used in the basic literature on delayed reinforcement and self-control (reinforcer delay fading, punishment of impulsive responding, and provision of an alternative activity during reinforcer delay) were used to teach participants to tolerate delayed reinforcement. With the first case, reinforcer delay fading alone was effective at maintaining low rates of destructive behavior while introducing delayed reinforcement. In the second case, the addition of a punishment component reduced destructive behavior to near-zero levels and facilitated reinforcer delay fading. With the third case, reinforcer delay fading was associated with increases in masturbation and head rolling, but prompting and praising the individual for completing work during the delay interval reduced all problem behaviors and facilitated reinforcer delay fading.

Impact of delaying school start time on adolescent sleep, mood, and behavior.

PubMed

Owens, Judith A; Belon, Katherine; Moss, Patricia

2010-07-01

To examine the impact of a 30-minute delay in school start time on adolescents' sleep, mood, and behavior. Participants completed the online retrospective Sleep Habits Survey before and after a change in school start time. An independent high school in Rhode Island. Students (n = 201) in grades 9 through 12. Intervention Institution of a delay in school start time from 8 to 8:30 am. Sleep patterns and behavior, daytime sleepiness, mood, data from the Health Center, and absences/tardies. After the start time delay, mean school night sleep duration increased by 45 minutes, and average bedtime advanced by 18 minutes (95% confidence interval, 7-29 minutes [t(423) = 3.36; P < .001]); the percentage of students getting less than 7 hours of sleep decreased by 79.4%, and those reporting at least 8 hours of sleep increased from 16.4% to 54.7%. Students reported significantly more satisfaction with sleep and experienced improved motivation. Daytime sleepiness, fatigue, and depressed mood were all reduced. Most health-related variables, including Health Center visits for fatigue-related complaints, and class attendance also improved. A modest delay in school start time was associated with significant improvements in measures of adolescent alertness, mood, and health. The results of this study support the potential benefits of adjusting school schedules to adolescents' sleep needs, circadian rhythm, and developmental stage.

Predictive Models of Duration of Ground Delay Programs in New York Area Airports

NASA Technical Reports Server (NTRS)

Kulkarni, Deepak

2011-01-01

Initially planned GDP duration often turns out to be an underestimate or an overestimate of the actual GDP duration. This, in turn, results in avoidable airborne or ground delays in the system. Therefore, better models of actual duration have the potential of reducing delays in the system. The overall objective of this study is to develop such models based on logs of GDPs. In a previous report, we described descriptive models of Ground Delay Programs. These models were defined in terms of initial planned duration and in terms of categorical variables. These descriptive models are good at characterizing the historical errors in planned GDP durations. This paper focuses on developing predictive models of GDP duration. Traffic Management Initiatives (TMI) are logged by Air Traffic Control facilities with The National Traffic Management Log (NTML) which is a single system for automated recoding, coordination, and distribution of relevant information about TMIs throughout the National Airspace System. (Brickman, 2004 Yuditsky, 2007) We use 2008-2009 GDP data from the NTML database for the study reported in this paper. NTML information about a GDP includes the initial specification, possibly one or more revisions, and the cancellation. In the next section, we describe general characteristics of Ground Delay Programs. In the third section, we develop models of actual duration. In the fourth section, we compare predictive performance of these models. The final section is a conclusion.

Stabilization of self-mode-locked quantum dash lasers by symmetric dual-loop optical feedback

NASA Astrophysics Data System (ADS)

Asghar, Haroon; Wei, Wei; Kumar, Pramod; Sooudi, Ehsan; McInerney, John. G.

2018-02-01

We report experimental studies of the influence of symmetric dual-loop optical feedback on the RF linewidth and timing jitter of self-mode-locked two-section quantum dash lasers emitting at 1550 nm. Various feedback schemes were investigated and optimum levels determined for narrowest RF linewidth and low timing jitter, for single-loop and symmetric dual-loop feedback. Two symmetric dual-loop configurations, with balanced and unbalanced feedback ratios, were studied. We demonstrate that unbalanced symmetric dual loop feedback, with the inner cavity resonant and fine delay tuning of the outer loop, gives narrowest RF linewidth and reduced timing jitter over a wide range of delay, unlike single and balanced symmetric dual-loop configurations. This configuration with feedback lengths 80 and 140 m narrows the RF linewidth by 4-67x and 10-100x, respectively, across the widest delay range, compared to free-running. For symmetric dual-loop feedback, the influence of different power split ratios through the feedback loops was determined. Our results show that symmetric dual-loop feedback is markedly more effective than single-loop feedback in reducing RF linewidth and timing jitter, and is much less sensitive to delay phase, making this technique ideal for applications where robustness and alignment tolerance are essential.

LPA3-mediated lysophosphatidic acid signalling in implantation and embryo spacing

PubMed Central

Ye, Xiaoqin; Hama, Kotaro; Contos, James J.A.; Anliker, Brigitte; Inoue, Aska; Skinner, Michael K.; Suzuki, Hiroshi; Amano, Tomokazu; Kennedy, Grace; Arai, Hiroyuki; Aoki, Junken; Chun, Jerold

2005-01-01

Every successful pregnancy requires proper embryo implantation. Low implantation rate is a major problem during infertility treatments using assisted reproductive technologies (ART) 1. Here we report a new molecular influence on implantation through the lysophosphatidic acid (LPA) receptor LPA3 2–4. Targeted deletion of LPA3 in mice resulted in significantly reduced litter size, which could be attributed to delayed implantation and altered embryo spacing. These two events led to delayed embryonic development, hypertrophic placentas shared by multiple embryos, and embryonic death. An enzyme demonstrated to influence implantation, cyclooxygenase-2 (COX-2) 5, was down-regulated in LPA3-deficient uteri during preimplantation. Down regulation of COX-2 led to reduced levels of prostaglandins that are critical for implantation 1. Exogenous administration of the prostaglandins PGE2 and cPGI into LPA3-deficient females rescued delayed implantation but did not rescue defects in embryo spacing. These data identify LPA3 receptor-mediated signalling as a new influence on implantation and further indicate linkage between LPA signalling and prostaglandin biosynthesis. PMID:15875025

Delay in reviewing test results prolongs hospital length of stay: a retrospective cohort study.

PubMed

Ong, Mei-Sing; Magrabi, Farah; Coiera, Enrico

2018-05-16

Failure in the timely follow-up of test results has been widely documented, contributing to delayed medical care. Yet, the impact of delay in reviewing test results on hospital length of stay (LOS) has not been studied. We examine the relationship between laboratory tests review time and hospital LOS. A retrospective cohort study of inpatients admitted to a metropolitan teaching hospital in Sydney, Australia, between 2011 and 2012 (n = 5804). Generalized linear models were developed to examine the relationship between hospital LOS and cumulative clinician read time (CRT), defined as the time taken by clinicians to review laboratory test results performed during an inpatient stay after they were reported in the computerized test reporting system. The models were adjusted for patients' age, sex, and disease severity (measured by the Charlson Comorbidity index), the number of test panels performed, the number of unreviewed tests pre-discharge, and the cumulative laboratory turnaround time (LTAT) of tests performed during an inpatient stay. Cumulative CRT is significantly associated with prolonged LOS, with each day of delay in reviewing test results increasing the likelihood of prolonged LOS by 13.2% (p < 0.0001). Restricting the analysis to tests with abnormal results strengthened the relationship between cumulative CRT and prolonged LOS, with each day of delay in reviewing test results increasing the likelihood of delayed discharge by 33.6% (p < 0.0001). Increasing age, disease severity and total number of tests were also significantly associated with prolonged LOS. Increasing number of unreviewed tests was negatively associated with prolonged LOS. Reducing unnecessary hospital LOS has become a critical health policy goal as healthcare costs escalate. Preventing delay in reviewing test results represents an important opportunity to address potentially avoidable hospital stays and unnecessary resource utilization.

Delayed clamping of the umbilical cord after delivery and implications for public cord blood banking.

PubMed

Allan, David S; Scrivens, Nicholas; Lawless, Tiffany; Mostert, Karen; Oppenheimer, Lawrence; Walker, Mark; Petraszko, Tanya; Elmoazzen, Heidi

2016-03-01

Public banking of umbilical cord blood units (CBUs) containing higher numbers of cells ensures timely engraftment after transplantation for increasing numbers of patients. Delayed clamping of the umbilical cord after birth may benefit some infants by preventing iron deficiency. Implications of delayed cord clamping for public cord blood banking remains unclear. CBUs collected by Canadian Blood Services at one collection site between November 1, 2014, and March 17, 2015, were analyzed. The delay in cord clamping after birth was timed and classified as "no delay," 20 to 60 seconds, more than 60 seconds, or more than 120 seconds. Of 367 collections, 100 reported no delay in clamping while clamping was delayed by 20 to 60 seconds (n = 69), more than 60 seconds (n = 98), or more than 120 seconds (n = 100) in the remaining cases. The mean volume and total nucleated cells (TNCs) in units with no delay in clamping were significantly greater than mean volumes for all categories of delayed clamping (Tukey's test, p < 0.05 for each comparison). The proportion of units with more than 1.5 × 10(9) TNCs was significantly reduced when clamping was delayed (p = 5.5 × 10(-8) ). The difference was most marked for cords that were clamped more than 120 seconds after delivery (6.2% compared with 39%). Delayed cord clamping greatly diminishes the volume and TNC count of units collected for a public cord blood bank. Creating an inventory of CBUs with high TNC content may take more time than expected. © 2015 AABB.

[Delays in diagnosing and treating tuberculosis in Croatia].

PubMed

Jurčev-Savičević, Anamarija; Popović-Grle, Sanja; Mulić, Rosanda; Smoljanović, Mladen; Miše, Kornelija

2012-09-01

The aim of this study was to determine factors causing delay in tuberculosis diagnosis and treatment in Croatia. It included 240 adults with pulmonary tuberculosis, who were interviewed for demographics, socioeconomic, lifestyle, and personal health data. Total delay was defined as a number of days from the onset of symptoms to the initiation of therapy. The median and the 75th percentile of the total delay were 68 and 120 days, respectively: 16.7 % of the patients initiated treatment within the first month, 23.8 % within the second month, 23.3 % within the third month, 12.9 % within the fourth month, and 23.3 % more than four months after the symptoms appeared. Long delay (exceeding median delay) was strongly associated with drug abuse (p=0.021). Extreme delay (75th percentile of delay) was significantly associated with the lowest level of education (p=0.021), below minimal income (p=0.039), minimal to average income (p=0.020), current smoking (p=0.050), and co-morbidity (p=0.048). In the multivariate model, long delay remained associated with drug abuse, while extreme delay was associated with the lowest level of education (p=0.033) and current (p=0.017) and ex-smoking (p=0.045).In a setting with decreasing TB incidence, the reported delay can be reduced by increasing health education, not only about tuberculosis per se, but about health in general and attitudes towards prevention and early care. It is also important to increase tuberculosis knowledge among healthcare workers as well as their diagnostic skills.

Improving Procedure Start Times and Decreasing Delays in Interventional Radiology: A Department's Quality Improvement Initiative.

PubMed

Villarreal, Monica C; Rostad, Bradley S; Wright, Richard; Applegate, Kimberly E

2015-12-01

To identify and reduce reasons for delays in procedure start times, particularly the first cases of the day, within the interventional radiology (IR) divisions of the Department of Radiology using principles of continuous quality improvement. An interdisciplinary team representative of the IR and preprocedure/postprocedure care area (PPCA) health care personnel, managers, and data analysts was formed. A standardized form was used to document both inpatient and outpatient progress through the PPCA and IR workflow in six rooms and to document reasons for delays. Data generated were used to identify key problems areas, implement improvement interventions, and monitor their effects. Project duration was 6 months. The average number of on-time starts for the first case of the day increased from 23% to 56% (P value < .01). The average number of on-time, scheduled outpatients increased from 30% to 45% (P value < .01). Patient wait time to arrive at treatment room once they were ready for their procedure was reduced on average by 10 minutes (P value < .01). Patient care delay duration per 100 patients was reduced from 30.3 to 21.6 hours (29% reduction). Number of patient care delays per 100 patients was reduced from 46.6 to 40.1 (17% reduction). Top reasons for delay included waiting for consent (26% of delays duration) and laboratory tests (12%). Many complex factors contribute to procedure start time delays within an IR practice. A data-driven and patient-centered, interdisciplinary team approach was effective in reducing delays in IR. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

Differentiation of Speech Delay and Global Developmental Delay in Children Using DTI Tractography-Based Connectome.

PubMed

Jeong, J-W; Sundaram, S; Behen, M E; Chugani, H T

2016-06-01

Pure speech delay is a common developmental disorder which, according to some estimates, affects 5%-8% of the population. Speech delay may not only be an isolated condition but also can be part of a broader condition such as global developmental delay. The present study investigated whether diffusion tensor imaging tractography-based connectome can differentiate global developmental delay from speech delay in young children. Twelve children with pure speech delay (39.1 ± 20.9 months of age, 9 boys), 14 children with global developmental delay (39.3 ± 18.2 months of age, 12 boys), and 10 children with typical development (38.5 ± 20.5 months of age, 7 boys) underwent 3T DTI. For each subject, whole-brain connectome analysis was performed by using 116 cortical ROIs. The following network metrics were measured at individual regions: strength (number of the shortest paths), efficiency (measures of global and local integration), cluster coefficient (a measure of local aggregation), and betweeness (a measure of centrality). Compared with typical development, global and local efficiency were significantly reduced in both global developmental delay and speech delay (P < .0001). The nodal strength of the cognitive network is reduced in global developmental delay, whereas the nodal strength of the language network is reduced in speech delay. This finding resulted in a high accuracy of >83% ± 4% to discriminate global developmental delay from speech delay. The network abnormalities identified in the present study may underlie the neurocognitive and behavioral consequences commonly identified in children with global developmental delay and speech delay. Further validation studies in larger samples are required. © 2016 by American Journal of Neuroradiology.

Departmental of Clinical Investigation: Annual Research Progress Report for Fiscal Year 1992. Volume 1

DTIC Science & Technology

1993-01-01

effect of cisapride on the symptoms of unexplained upper abdominal pain, nausea, vomiting, anorexia, early satiety, bloating/ distension in patients with...for 30 minutes following eccentric exercise will less the 3 indices of delayed-onset muscle soreness (DOMS): perceived muscular soreness, reduced...post-exercise and the Talag Pain Rating Scale will be used to assess muscular soreness. Progress: No progress report was furnished by the principal

An analysis of source structure effects in radio interferometry measurements

NASA Technical Reports Server (NTRS)

Thomas, J. B.

1980-01-01

To begin a study of structure effects, this report presents a theoretical framework, proposes an effective position approach to structure corrections based on brightness distribution measurements, and analyzes examples of analytical and measured brightness distributions. Other topics include the effect of the frequency dependence of a brightness distribution on bandwidth synthesis (BWS) delay, the determination of the absolute location of a measured brightness distribution, and structure effects in dual frequency calibration of charged particle delays. For the 10 measured distributions analyzed, it was found that the structure effect in BWS delay at X-band (3.6 cm) can reach 30 cm, but typically falls in the range of 0 to 5 cm. A trial limit equation that is dependent on visibility was successfully tested against the 10 measured brightness distributions (seven sources). If the validity of this particular equation for an upper limit can be established for nearly all sources, the structure effect in BWS delay could be greatly reduced without supplementary measurements of brightness distributions.

A Control Allocation System for Automatic Detection and Compensation of Phase Shift Due to Actuator Rate Limiting

NASA Technical Reports Server (NTRS)

Yildiz, Yidiray; Kolmanovsky, Ilya V.; Acosta, Diana

2011-01-01

This paper proposes a control allocation system that can detect and compensate the phase shift between the desired and the actual total control effort due to rate limiting of the actuators. Phase shifting is an important problem in control system applications since it effectively introduces a time delay which may destabilize the closed loop dynamics. A relevant example comes from flight control where aggressive pilot commands, high gain of the flight control system or some anomaly in the system may cause actuator rate limiting and effective time delay introduction. This time delay can instigate Pilot Induced Oscillations (PIO), which is an abnormal coupling between the pilot and the aircraft resulting in unintentional and undesired oscillations. The proposed control allocation system reduces the effective time delay by first detecting the phase shift and then minimizing it using constrained optimization techniques. Flight control simulation results for an unstable aircraft with inertial cross coupling are reported, which demonstrate phase shift minimization and recovery from a PIO event.

Delayed School Start Times and Adolescent Sleep: A Systematic Review of the Experimental Evidence

PubMed Central

Minges, Karl E.; Redeker, Nancy S.

2016-01-01

Summary Many schools have instituted later morning start times to improve sleep, academic, and other outcomes in response to the mismatch between youth circadian rhythms and early morning start times. However, there has been no systematic synthesis of the evidence on the effects of this practice. To examine the impact of delayed school start time on students’ sleep, health, and academic outcomes, electronic databases were systematically searched and data were extracted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six studies satisfied selection criteria and used pre-post, no control (n=3), randomized controlled trial (n=2), and quasi-experimental (n=1) designs. School start times were delayed 25 to 60 minutes, and correspondingly, total sleep time increased from 25 to 77 minutes per weeknight. Some studies revealed reduced daytime sleepiness, depression, caffeine use, tardiness to class, and trouble staying awake. Overall, the evidence supports recent non-experimental study findings and calls for policy that advocates for delayed school start time to improve sleep. This presents a potential long-term solution to chronic sleep restriction during adolescence. However, there is a need for rigorous randomized study designs and reporting of consistent outcomes, including objective sleep measures and consistent measures of health and academic performance. PMID:26545246

Health Disparities and Delayed Health care among Older Adults in California: A Perspective from Race, Ethnicity, and Immigration.

PubMed

Du, Yan; Xu, Qingwen

2016-09-01

To examine racial/ethnic/immigration disparities in health and to investigate the relationships among race/ethnic/immigration status, delayed health care, and health of the elderly. Responses from 13,508 people aged 65 and above were analyzed based on the California Health Interview Survey (CHIS) 2011-2012. Key variables include race/ethnicity/immigration status, health outcome, and delayed health care. Age, gender, education, work status, and annual family income are used as covariates. The findings indicate that Whites (regardless of country of birth) and U.S.-born Asians enjoy better health than Latinos, African-Americans, and Foreign-born Asians. Foreign-born Asians and foreign-born Latinos have the poorest self-reported health and mental health, respectively. Delayed use of health care is negatively associated with both self-reported health and mental health status. Health disparities exist among older adult populations; the combined effects of minority and immigrant status can be approximated from the results in this study. Health care accessibility and the quality of care should be promoted in minority/immigrant populations. Public health nurses have a strong potential to aide in reducing health disparities among an aging American population that continues to exhibit increasing racial/ethnic diversity. © 2016 Wiley Periodicals, Inc.

The Effects of Methylphenidate on Discounting of Delayed Rewards in ADHD

PubMed Central

Shiels, Keri; Hawk, Larry W.; Reynolds, Brady; Mazzullo, Rebecca; Rhodes, Jessica; Pelham, William E.; Waxmonsky, James G.; Gangloff, Brian P.

2010-01-01

Impulsivity is a central component of attention-deficit/hyperactivity disorder (ADHD). Delay discounting, or a preference for smaller, immediate rewards over larger, delayed rewards is considered an important aspect of impulsivity, and delay-related impulsivity has been emphasized in etiological models of ADHD. The current study examined whether stimulant medication, an effective treatment for ADHD, reduces discounting of delayed experiential and hypothetical rewards among 49 children (age 9–12 years) with ADHD. Following a practice day, participants completed a 3-day double-blind placebo-controlled acute medication assessment. Active doses were long-acting methylphenidate (Concerta), with the nearest equivalents of 0.3 and 0.6 mg/kg TID immediate-release methylphenidate. On each testing day, participants completed experiential (real-world money in real time) and hypothetical discounting tasks. Relative to placebo, methylphenidate reduced discounting of delayed experiential rewards, but not hypothetical rewards. Broadly consistent with etiological models that emphasize delay-related impulsivity among children with ADHD, these findings provide initial evidence that stimulant medication reduces delay discounting among those with the disorder. The present results also draw attention to task parameters that may influence the sensitivity of various delay discounting measures to medication effects. PMID:19803628

A Control Allocation Technique to Recover From Pilot-Induced Oscillations (CAPIO) Due to Actuator Rate Limiting

NASA Technical Reports Server (NTRS)

Yildiz, Yildiray; Kolmanovsky, Ilya V.

2010-01-01

This paper proposes a control allocation technique that can help pilots recover from pilot induced oscillations (PIO). When actuators are rate-saturated due to aggressive pilot commands, high gain flight control systems or some anomaly in the system, the effective delay in the control loop may increase depending on the nature of the cause. This effective delay increase manifests itself as a phase shift between the commanded and actual system signals and can instigate PIOs. The proposed control allocator reduces the effective time delay by minimizing the phase shift between the commanded and the actual attitude accelerations. Simulation results are reported, which demonstrate phase shift minimization and recovery from PIOs. Conversion of the objective function to be minimized and constraints to a form that is suitable for implementation is given.

High-speed optical coherence tomography using fiberoptic acousto-optic phase modulation

NASA Astrophysics Data System (ADS)

Xie, Tuqiang; Wang, Zhenguo; Pan, Yingtian

2003-12-01

We report a new rapid-scanning optical delay device suitable for high-speed optical coherence tomography (OCT) in which an acousto-optic modulator (AOM) is used to independently modulate the Doppler frequency shift of the reference light beam for optical heterodyne detection. Experimental results show that the fluctuation of the measured Doppler frequency shift is less than +/-0.2% over 95% duty cycle of OCT imaging, thus allowing for enhanced signal-to-noise ratio of optical heterodyne detection. The increased Doppler frequency shift by AOM also permits complete envelop demodulation without the compromise of reducing axial resolution; if used with a resonant rapid-scanning optical delay, it will permit high-performance real-time OCT imaging. Potentially, this new rapid-scanning optical delay device will improve the performance of high-speed Doppler OCT techniques.

Subfertility in relation to welding. A case referent study among male welders.

PubMed

Bonde, J P

1990-02-01

A recent report indicates that welding work is associated with increased risk of reduced semen quality. The purpose of this study was to investigate a possible association between welding exposure and male subfertility. A cross-sectional population of 673 metal workers and electricians employed at six major Danish work places in the same geographic area constituted the study population. Data on reproductive and occupational experience was obtained by means of a self-administered postal questionnaire. The response rate was 79 percent among welders and 83 percent among the other workers. A significantly increased rate of delayed conception in relation to welding work at the time of this event was observed when self-reported welding exposure among cases of delayed conception was compared to welding exposure both among age-matched referents and among referents with a child born without delay in conception. However, in the first approach the risk dropped to insignificant levels when adjustments were made for potential confounding factors. This preliminary study has methodological drawbacks, and the association between welding exposure and male fertility should be investigated further.

National Practice Patterns of Obtaining Informed Consent for Stroke Thrombolysis.

PubMed

Mendelson, Scott J; Courtney, D Mark; Gordon, Elisa J; Thomas, Leena F; Holl, Jane L; Prabhakaran, Shyam

2018-03-01

No standard approach to obtaining informed consent for stroke thrombolysis with tPA (tissue-type plasminogen activator) currently exists. We aimed to assess current nationwide practice patterns of obtaining informed consent for tPA. An online survey was developed and distributed by e-mail to clinicians involved in acute stroke care. Multivariable logistic regression analyses were performed to determine independent factors contributing to always obtaining informed consent for tPA. Among 268 respondents, 36.7% reported always obtaining informed consent and 51.8% reported the informed consent process caused treatment delays. Being an emergency medicine physician (odds ratio, 5.8; 95% confidence interval, 2.9-11.5) and practicing at a nonacademic medical center (odds ratio, 2.1; 95% confidence interval, 1.0-4.3) were independently associated with always requiring informed consent. The most commonly cited cause of delay was waiting for a patient's family to reach consensus about treatment. Most clinicians always or often require informed consent for stroke thrombolysis. Future research should focus on standardizing content and delivery of tPA information to reduce delays. © 2018 American Heart Association, Inc.

The Power of the Virtual Ideal Self in Weight Control: Weight-Reduced Avatars Can Enhance the Tendency to Delay Gratification and Regulate Dietary Practices.

PubMed

Kuo, Hsu-Chan; Lee, Chun-Chia; Chiou, Wen-Bin

2016-02-01

The tendency to discount larger future benefits in favor of smaller immediate gains (i.e., temporal discounting) is relevant to the issue of obesity. Successful weight loss requires individuals to sacrifice immediate culinary pleasures in favor of future health gains. Based on the notion that increasing the vividness of one's future self may mitigate temporal discounting and promote the ability to delay gratification, we examined whether viewing one's weight-reduced self (i.e., the ideal self) in a virtual environment can decrease temporal discounting and lead to better regulation of dietary practices. Seventy-six undergraduates who had reported an intention to lose weight were recruited to participate in a laboratory experiment and were randomly assigned to interact with either the weight-reduced self (experimental condition) or the present self (control condition) by looking into a dressing mirror in a virtual fitting room. A temporal-discounting task and a taste test were subsequently administered. Results showed that, compared with control participants, participants who viewed their weight-reduced avatars ate less ice cream in a taste test and were more likely to choose a sugar-free drink as a reward. The discounting rate mediated the association between the avatar manipulation and the amount of ice cream eaten in the subsequent taste test. Overall, our findings suggest that a computer-generated image of one's weight-reduced self may assist in resisting impulses that promote immediate gratification over delayed benefits. This research provides a new approach for controlling impulsive behavior such as dietary regulation and weight control.

Folic Acid Supplements in Pregnancy and Severe Language Delay in Children

PubMed Central

Roth, Christine; Magnus, Per; Schjølberg, Synnve; Stoltenberg, Camilla; Surén, Pål; McKeague, Ian W.; Smith, George Davey; Reichborn-Kjennerud, Ted; Susser, Ezra

2013-01-01

Context Prenatal folic acid supplements reduce the risk of neural tube defects and may have beneficial effects on other aspects of neurodevelopment. Objective To examine associations between mothers' use of prenatal folic acid supplements and risk of severe language delay in their children at age 3 years. Design, Setting, and Patients The prospective observational Norwegian Mother and Child Cohort Study recruited pregnant women between 1999 and December 2008. Data on children born before 2008 whose mothers returned the 3-year follow-up questionnaire by June 16, 2010, were used. Maternal use of folic acid supplements within the interval from 4 weeks before to 8 weeks after conception was the exposure. Relative risks were approximated by estimating odds ratios (ORs) with 95% CIs in a logistic regression analysis. Main Outcome Measure Children's language competency at age 3 years measured by maternal report on a 6-point ordinal language grammar scale. Children with minimal expressive language (only 1-word or unintelligible utterances) were rated as having severe language delay. Results Among 38 954 children, 204 (0.5%) had severe language delay. Children whose mothers took no dietary supplements in the specified exposure interval were the reference group (n=9052 [24.0%], with severe language delay in 81 children [0.9%]). Adjusted ORs for 3 patterns of exposure to maternal dietary supplements were (1) other supplements, but no folic acid (n=2480 [6.6%], with severe language delay in 22 children [0.9%]; OR, 1.04; 95% CI, 0.62-1.74); (2) folic acid only (n=7127 [18.9%], with severe language delay in 28 children [0.4%]; OR, 0.55; 95% CI, 0.35-0.86); and (3) folic acid in combination with other supplements (n=19005 [50.5%], with severe language delay in 73 children [0.4%]; OR, 0.55; 95% CI, 0.39-0.78). Conclusion Among this Norwegian cohort of mothers and children, maternal use of folic acid supplements in early pregnancy was associated with a reduced risk of severe language delay in children at age 3 years. PMID:21990300

Masculinity, medical mistrust, and preventive health services delays among community-dwelling African-American men.

PubMed

Hammond, Wizdom Powell; Matthews, Derrick; Mohottige, Dinushika; Agyemang, Amma; Corbie-Smith, Giselle

2010-12-01

The contribution of masculinity to men's healthcare use has gained increased public health interest; however, few studies have examined this association among African-American men, who delay healthcare more often, define masculinity differently, and report higher levels of medical mistrust than non-Hispanic White men. To examine associations between traditional masculinity norms, medical mistrust, and preventive health services delays. A cross-sectional analysis using data from 610 African-American men age 20 and older recruited primarily from barbershops in the North, South, Midwest, and West regions of the U.S. (2003-2009). Independent variables were endorsement of traditional masculinity norms around self-reliance, salience of traditional masculinity norms, and medical mistrust. Dependent variables were self-reported delays in three preventive health services: routine check-ups, blood pressure screenings, and cholesterol screenings. We controlled for socio-demography, healthcare access, and health status. After final adjustment, men with a greater endorsement of traditional masculinity norms around self-reliance (OR: 0.77; 95% CI: 0.60-0.98) were significantly less likely to delay blood pressure screening. This relationship became non-significant when a longer BP screening delay interval was used. Higher levels of traditional masculinity identity salience were associated with a decreased likelihood of delaying cholesterol screening (OR: 0.62; 95% CI: 0.45-0.86). African-American men with higher medical mistrust were significantly more likely to delay routine check-ups (OR: 2.64; 95% CI: 1.34-5.20), blood pressure (OR: 3.03; 95% CI: 1.45-6.32), and cholesterol screenings (OR: 2.09; 95% CI: 1.03-4.23). Contrary to previous research, higher traditional masculinity is associated with decreased delays in African-American men's blood pressure and cholesterol screening. Routine check-up delays are more attributable to medical mistrust. Building on African-American men's potential to frame preventive services utilization as a demonstration, as opposed to, denial of masculinity and implementing policies to reduce biases in healthcare delivery that increase mistrust, may be viable strategies to eliminate disparities in African-American male healthcare utilization.

Masculinity, Medical Mistrust, and Preventive Health Services Delays Among Community-Dwelling African-American Men

PubMed Central

Matthews, Derrick; Mohottige, Dinushika; Agyemang, Amma; Corbie-Smith, Giselle

2010-01-01

BACKGROUND The contribution of masculinity to men’s healthcare use has gained increased public health interest; however, few studies have examined this association among African-American men, who delay healthcare more often, define masculinity differently, and report higher levels of medical mistrust than non-Hispanic White men. OBJECTIVE To examine associations between traditional masculinity norms, medical mistrust, and preventive health services delays. DESIGN AND PARTICIPANTS A cross-sectional analysis using data from 610 African-American men age 20 and older recruited primarily from barbershops in the North, South, Midwest, and West regions of the U.S. (2003-2009). MEASUREMENTS Independent variables were endorsement of traditional masculinity norms around self-reliance, salience of traditional masculinity norms, and medical mistrust. Dependent variables were self-reported delays in three preventive health services: routine check-ups, blood pressure screenings, and cholesterol screenings. We controlled for socio-demography, healthcare access, and health status. RESULTS After final adjustment, men with a greater endorsement of traditional masculinity norms around self-reliance (OR: 0.77; 95% CI: 0.60–0.98) were significantly less likely to delay blood pressure screening. This relationship became non-significant when a longer BP screening delay interval was used. Higher levels of traditional masculinity identity salience were associated with a decreased likelihood of delaying cholesterol screening (OR: 0.62; 95% CI: 0.45–0.86). African-American men with higher medical mistrust were significantly more likely to delay routine check-ups (OR: 2.64; 95% CI: 1.34–5.20), blood pressure (OR: 3.03; 95% CI: 1.45–6.32), and cholesterol screenings (OR: 2.09; 95% CI: 1.03–4.23). CONCLUSIONS Contrary to previous research, higher traditional masculinity is associated with decreased delays in African-American men’s blood pressure and cholesterol screening. Routine check-up delays are more attributable to medical mistrust. Building on African-American men’s potential to frame preventive services utilization as a demonstration, as opposed to, denial of masculinity and implementing policies to reduce biases in healthcare delivery that increase mistrust, may be viable strategies to eliminate disparities in African-American male healthcare utilization. PMID:20714819

Are pertussis cases reported too late for public health interventions? Retrospective analysis of cases in London and South East England, 2010 to 2015

PubMed Central

Crabbe, Helen; Saavedra-Campos, María; Verlander, Neville Q; Leonard, Anusha; Morris, Jill; Wright, Amanda; Balasegaram, Sooria

2017-01-01

In the United Kingdom, pertussis guidance recommends prophylaxis for household contacts within 21 days of case symptom onset if the household includes a vulnerable contact. The aim of our study was to identify characteristics associated with cases reported late for public health action. We reviewed the epidemiology of cases reported in London and South East England for the period 2010 to 2015. We characterised risk factors associated with late reporting of cases and described public health actions taken on timely reported cases. From 2010 to 2015, 9,163 cases of pertussis were reported to health protection teams. Only 11% of cases were reported within 21 days of onset, limiting opportunities for secondary prevention. Timely reporting was associated with younger age groups, pregnancy, being a healthcare worker and being reported by schools or hospital clinicians. Late reporting was associated with older age groups and general practitioner or laboratory reporting. Delays, such as those due to insidious onset and late presentation to healthcare, may be unavoidable; however, delay in reporting once a patient presents can be reduced since cases can be reported before laboratory confirmation. Thus we recommend working with clinicians and laboratories to determine causes and improve early reporting to public health. PMID:28749334

Delayed interval delivery in multiple gestations.

PubMed

Platt, J S; Rosa, C

1999-05-01

The incidence of higher-order gestations is increasing primarily as a result of menstrual cycle manipulation, with concomitant increased risk in maternal and fetal complications. Perinatal mortality rates range between 47 and 120 per 1000 births for twins and 93 to 203 per 1000 births for triplets. The critical period of perinatal mortality and morbidity is between weeks 23 and 28 of gestation. Attention has recently turned to methods of delaying the birth of second and higher order fetuses to improve newborn survival and decrease neonatal morbidity in these high-risk pregnancies. We report two cases of delayed interval delivery. Neither pregnancy involved a monochorionic/monoamniotic gestation. The first case was a twin gestation delivered at 21 weeks with an interval of 5 days and extreme prematurity of both twins. The second case was a triplet gestation delivered at 21 weeks with an interval of 5 days. Triplet A was stillborn; triplets B and C succumbed in extreme prematurity. Preterm labor in multiple gestations usually results in delivery of all fetuses. On occasion, the uterus will spontaneously cease to contract after the birth of one or more premature infants. Review of the literature now reports 48 twin pregnancies exposed to delayed interval delivery with 40 surviving infants of 96 fetuses. Whereas delaying the delivery of remaining fetuses improves their prognosis, there is currently no consensus regarding technique nor is there statistical significance in techniques currently used. Furthermore, study is indicated to reduce preterm birth and associated costs.

The influence of performance on action-effect integration in sense of agency.

PubMed

Wen, Wen; Yamashita, Atsushi; Asama, Hajime

2017-08-01

Sense of agency refers to the subjective feeling of being able to control an outcome through one's own actions or will. Prior studies have shown that both sensory processing (e.g., comparisons between sensory feedbacks and predictions basing on one's motor intentions) and high-level cognitive/constructive processes (e.g., inferences based on one's performance or the consequences of one's actions) contribute to judgments of sense of agency. However, it remains unclear how these two types of processes interact, which is important for clarifying the mechanisms underlying sense of agency. Thus, we examined whether performance-based inferences influence action-effect integration in sense of agency using a delay detection paradigm in two experiments. In both experiments, participants pressed left and right arrow keys to control the direction in which a moving dot was travelling. The dot's response delay was manipulated randomly on 7 levels (0-480ms) between the trials; for each trial, participants were asked to judge whether the dot response was delayed and to rate their level of agency over the dot. In Experiment 1, participants tried to direct the dot to reach a destination on the screen as quickly as possible. Furthermore, the computer assisted participants by ignoring erroneous commands for half of the trials (assisted condition), while in the other half, all of the participants' commands were executed (self-control condition). In Experiment 2, participants directed the dot as they pleased (without a specific goal), but, in half of the trials, the computer randomly ignored 32% of their commands (disturbed condition) rather than assisted them. The results from the two experiments showed that performance enhanced action-effect integration. Specifically, when task performance was improved through the computer's assistance in Experiment 1, delay detection was reduced in the 480-ms delay condition, despite the fact that 32% of participants' commands were ignored. Conversely, when no feedback on task performance was given (as in Experiment 2), the participants reported greater delay when some of their commands were randomly ignored. Furthermore, the results of a logistic regression analysis showed that the threshold of delay detection was greater in the assisted condition than in the self-control condition in Experiment 1, which suggests a wider time window for action-effect integration. A multivariate analysis also revealed that assistance was related to reduced delay detection via task performance, while reduced delay detection was directly correlated with a better sense of agency. These results indicate an association between the implicit and explicit aspects of sense of agency. Copyright © 2017 Elsevier Inc. All rights reserved.

Study of Relationship Between Illness Perception and Delay in Seeking Help for Breast Cancer Patients Based on Leventhal's Self-Regulation Model.

PubMed

Attari, Seyedeh Maryam; Ozgoli, Giti; Solhi, Mahnaz; Alavi Majd, Hamid

2016-01-01

One of the major causes of morbidity and mortality in breast cancer patients is delay in seeking help. Leventhal's self-regulation model provides an appropriate framework to assess delay in seeking help. The aim of this study was to investigate the relationship between "illness perception" and "help seeking delay" in breast cancer patients based on Leventhal's self-regulation model. In this correlational descriptive study with convenience sampling conducted in 2013, participants were 120 women with breast cancer who were diagnosed in the last year and referred to chemotherapy and radiotherapy centers in Rasht, Iran. Data collection scales included demographic data, Revised Illness Perception Questionnaire (IPQ-R)and a researcher made questionnaire to measure the delay in seeking help. Pre-hospital delay (help seeking delay) was evaluated in 3 phases (assessment, disease, behavior). The data were analyzed using SPSS-19. The mean (SD) age calculated for the patients was 47.3±10.2. Some 43% of the patients had a high school or higher education level and 82% were married. The "pre-hospital delay" was reported ≥3 months. Logistic regression analysis showed that none of the illness perception components were correlated with appraisal and behavioral delay phases. In the illness delay phase, "time line" (p-value =0.04) and "risk factors"(p-value=0.03) had significant effects on reducing and "psychological attributions" had significant effects on increasing the delay (p-value =0.01). "Illness coherence" was correlated with decreased pre-hospital patient delay (p-value<0.01). Women's perceptions of breast cancer influences delay in seeking help. In addition to verifying the validity of Leventhal's self-regulation model in explaining delay in seeking help, the results signify the importance of the "illness delay phase" (decision to seek help) and educational interventions-counseling for women in the community.

The delaying effect of stigma on mental health help-seeking in Sri Lanka.

PubMed

Fernando, Sunera M; Deane, Frank P; McLeod, Hamish J

2017-03-01

Mental health stigma has been associated with delays in seeking treatment. To describe perceived stigma experienced by patients and carers in Sri Lanka and to determine the effects of stigma on help-seeking delay. Survey of outpatients and family carers (n = 118 dyads) attending two psychiatric hospitals in Sri Lanka, using the Disclosure and Discrimination subscales of the Stigma Scale. Stigma was positively related to help-seeking delay for carers but not patients. Public stigma experienced by carers accounted for 23% of the variance in help-seeking delay. Reducing stigma may reduce help-seeking delays during the course of treatment. © 2016 John Wiley & Sons Australia, Ltd.

Reduced size liver transplantation from a donor supported by a Berlin Heart.

PubMed

Misra, M V; Smithers, C J; Krawczuk, L E; Jenkins, R L; Linden, B C; Weldon, C B; Kim, H B

2009-11-01

Patients on cardiac assist devices are often considered to be high-risk solid organ donors. We report the first case of a reduced size liver transplant performed using the left lateral segment of a pediatric donor whose cardiac function was supported by a Berlin Heart. The recipient was a 22-day-old boy with neonatal hemochromatosis who developed fulminant liver failure shortly after birth. The transplant was complicated by mild delayed graft function, which required delayed biliary reconstruction and abdominal wall closure, as well as a bile leak. However, the graft function improved quickly over the first week and the patient was discharged home with normal liver function 8 weeks after transplant. The presence of a cardiac assist device should not be considered an absolute contraindication for abdominal organ donation. Normal organ procurement procedures may require alteration due to the unusual technical obstacles that are encountered when the donor has a cardiac assist device.

Network coding based joint signaling and dynamic bandwidth allocation scheme for inter optical network unit communication in passive optical networks

NASA Astrophysics Data System (ADS)

Wei, Pei; Gu, Rentao; Ji, Yuefeng

2014-06-01

As an innovative and promising technology, network coding has been introduced to passive optical networks (PON) in recent years to support inter optical network unit (ONU) communication, yet the signaling process and dynamic bandwidth allocation (DBA) in PON with network coding (NC-PON) still need further study. Thus, we propose a joint signaling and DBA scheme for efficiently supporting differentiated services of inter ONU communication in NC-PON. In the proposed joint scheme, the signaling process lays the foundation to fulfill network coding in PON, and it can not only avoid the potential threat to downstream security in previous schemes but also be suitable for the proposed hybrid dynamic bandwidth allocation (HDBA) scheme. In HDBA, a DBA cycle is divided into two sub-cycles for applying different coding, scheduling and bandwidth allocation strategies to differentiated classes of services. Besides, as network traffic load varies, the entire upstream transmission window for all REPORT messages slides accordingly, leaving the transmission time of one or two sub-cycles to overlap with the bandwidth allocation calculation time at the optical line terminal (the OLT), so that the upstream idle time can be efficiently eliminated. Performance evaluation results validate that compared with the existing two DBA algorithms deployed in NC-PON, HDBA demonstrates the best quality of service (QoS) support in terms of delay for all classes of services, especially guarantees the end-to-end delay bound of high class services. Specifically, HDBA can eliminate queuing delay and scheduling delay of high class services, reduce those of lower class services by at least 20%, and reduce the average end-to-end delay of all services over 50%. Moreover, HDBA also achieves the maximum delay fairness between coded and uncoded lower class services, and medium delay fairness for high class services.

Delays and Uncertain Energy Savings in Program to Promote State Energy Conservation. Report to the Congress by the Comptroller General of the United States.

ERIC Educational Resources Information Center

Comptroller General of the U.S., Washington, DC.

Presented is a study and assessment of the United States Department of Energy State Energy Conservation Program (SECP). The goal of the SECP is to reduce energy consumption in each state by 5% by 1980. However, it is unlikely that this goal will be attained or that the savings reported for 1978 are a valid measure of the program's impact on energy…

Military Training Time and Cost Should Be Reduced Through Improved Management.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC.

The report on the management of recruit and initial skill training identifies delays in training cycles, their causes, and resultant costs. In visits to four recruit training centers, eight initial skill training schools, and various headquarters offices, the General Accounting Office (GAO) identified 1,979,000 man-days per year that new members…

Refractive eye surgery in treating functional amblyopia in children.

PubMed

Levenger, Samuel; Nemet, Pinhas; Hirsh, Ami; Kremer, Israel; Nemet, Arie

2006-01-01

While excimer laser refractive surgery is recommended and highly successful for correcting refractive errors in adults, its use in children has not been extensively exercised or studied. We report our experience treating children with amblyopia due to high anisometropia, high astigmatism, high myopia and with associated developmental delay. Review of patient records of our refractive clinic. A retrospective review was made of all 11 children with stable refractive errors who were unsuccessfully treated non-surgically and then underwent corneal refractive surgery and in one case, lenticular surgery. Seven had high myopic anisometropia, 2 had high astigmatism, and two had high myopia--one with Down's Syndrome and one with agenesis of the corpus callosum. The surgical refractive treatment eliminated or reduced the anisometropia, reduced the astigmatic error, improved vision and improved the daily function of the children with developmental delay. There were no complications or untoward results. Refractive surgery is safe and effective in treating children with high myopic anisometropia, high astigmatism, high myopia and developmental delay due to the resulting poor vision. Surgery can improve visual acuity in amblyopia not responding to routine treatment by correcting the refractive error and refractive aberrations.

A statistical study of radio-source structure effects on astrometric very long baseline interferometry observations

NASA Technical Reports Server (NTRS)

Ulvestad, J. S.

1989-01-01

Errors from a number of sources in astrometric very long baseline interferometry (VLBI) have been reduced in recent years through a variety of methods of calibration and modeling. Such reductions have led to a situation in which the extended structure of the natural radio sources used in VLBI is a significant error source in the effort to improve the accuracy of the radio reference frame. In the past, work has been done on individual radio sources to establish the magnitude of the errors caused by their particular structures. The results of calculations on 26 radio sources are reported in which an effort is made to determine the typical delay and delay-rate errors for a number of sources having different types of structure. It is found that for single observations of the types of radio sources present in astrometric catalogs, group-delay and phase-delay scatter in the 50 to 100 psec range due to source structure can be expected at 8.4 GHz on the intercontinental baselines available in the Deep Space Network (DSN). Delay-rate scatter of approx. 5 x 10(exp -15) sec sec(exp -1) (or approx. 0.002 mm sec (exp -1) is also expected. If such errors mapped directly into source position errors, they would correspond to position uncertainties of approx. 2 to 5 nrad, similar to the best position determinations in the current JPL VLBI catalog. With the advent of wider bandwidth VLBI systems on the large DSN antennas, the system noise will be low enough so that the structure-induced errors will be a significant part of the error budget. Several possibilities for reducing the structure errors are discussed briefly, although it is likely that considerable effort will have to be devoted to the structure problem in order to reduce the typical error by a factor of two or more.

40 CFR 1500.5 - Reducing delay.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Reducing delay. 1500.5 Section 1500.5 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY PURPOSE, POLICY, AND MANDATE § 1500.5 Reducing...). (b) Emphasizing interagency cooperation before the environmental impact statement is prepared, rather...

40 CFR 1500.5 - Reducing delay.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Reducing delay. 1500.5 Section 1500.5 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY PURPOSE, POLICY, AND MANDATE § 1500.5 Reducing...). (b) Emphasizing interagency cooperation before the environmental impact statement is prepared, rather...

Perceived Discrimination and Reported Delay of Pharmacy Prescriptions and Medical Tests

PubMed Central

Van Houtven, Courtney Harold; Voils, Corrine I; Oddone, Eugene Z; Weinfurt, Kevin P; Friedman, Joëlle Y; Schulman, Kevin A; Bosworth, Hayden B

2005-01-01

BACKGROUND Access to health care varies according to a person's race and ethnicity. Delaying treatment is one measure of access with important health consequences. OBJECTIVE Determine whether perceptions of unfair treatment because of race or ethnicity are associated with reported treatment delays, controlling for economic constraints, self-reported health, depression, and demographics. DESIGN Cross-sectional, observational study. PARTICIPANTS A randomly selected community sample of 181 blacks, 148 Latinos, and 193 whites in Durham County, NC. MEASUREMENTS A phone survey conducted in 2002 to assess discrimination, trust in medical care, quality of care, and access to care. Treatment delays were measured by whether or not a person reported delaying or forgoing filling a prescription and delaying or forgoing having a medical test/treatment in the past 12 months. Perceived discrimination was measured as unfair treatment in health care and as racism in local health care institutions. RESULTS The odds of delaying filling prescriptions were significantly higher (odds ratio (OR)=2.02) for persons who perceived unfair treatment, whereas the odds of delaying tests or treatments were significantly higher (OR=2.42) for persons who thought racism was a problem in health care locally. People with self-reported depression and people who reported not working had greater odds of delaying both types of care. CONCLUSIONS A prospective cohort study with both personal and macro measures of discrimination, as well as more refined measures of treatment delays, would help us better understand the relationship between perceived discrimination and treatment delays. PMID:16050850

Delayed Complications After Transsphenoidal Surgery for Pituitary Adenomas.

PubMed

Alzhrani, Gmaan; Sivakumar, Walavan; Park, Min S; Taussky, Philipp; Couldwell, William T

2018-01-01

Perioperative complications after transsphenoidal surgery for pituitary adenomas have been well documented in the literature; however, some complications can occur in a delayed fashion postoperatively, and reports are sparse about their occurrence, management, and outcome. Here, we describe delayed complications after transsphenoidal surgery and discuss the incidence, temporality from the surgery, and management of these complications based on the findings of studies that reported delayed postoperative epistaxis, delayed postoperative cavernous carotid pseudoaneurysm formation and rupture, vasospasm, delayed symptomatic hyponatremia, hypopituitarism, hydrocephalus, and sinonasal complications. Our findings from this review revealed an incidence of 0.6%-3.3% for delayed postoperative epistaxis at 1-3 weeks postoperatively, 18 reported cases of delayed carotid artery pseudoaneurysm formation at 2 days to 10 years postoperatively, 30 reported cases of postoperative vasospasm occurring 8 days postoperatively, a 3.6%-19.8% rate of delayed symptomatic hyponatremia at 4-7 days postoperatively, a 3.1% rate of new-onset hypopituitarism at 2 months postoperatively, and a 0.4%-5.8% rate of hydrocephalus within 2.2 months postoperatively. Sinonasal complications are commonly reported after transsphenoidal surgery, but spontaneous resolutions within 3-12 months have been reported. Although the incidence of some of these complications is low, providing preoperative counseling to patients with pituitary tumors regarding these delayed complications and proper postoperative follow-up planning is an important part of treatment planning. Copyright © 2017 Elsevier Inc. All rights reserved.

Microdeletion/microduplication of proximal 15q11.2 between BP1 and BP2: a susceptibility region for neurological dysfunction including developmental and language delay.

PubMed

Burnside, Rachel D; Pasion, Romela; Mikhail, Fady M; Carroll, Andrew J; Robin, Nathaniel H; Youngs, Erin L; Gadi, Inder K; Keitges, Elizabeth; Jaswaney, Vikram L; Papenhausen, Peter R; Potluri, Venkateswara R; Risheg, Hiba; Rush, Brooke; Smith, Janice L; Schwartz, Stuart; Tepperberg, James H; Butler, Merlin G

2011-10-01

The proximal long arm of chromosome 15 has segmental duplications located at breakpoints BP1-BP5 that mediate the generation of NAHR-related microdeletions and microduplications. The classical Prader-Willi/Angelman syndrome deletion is flanked by either of the proximal BP1 or BP2 breakpoints and the distal BP3 breakpoint. The larger Type I deletions are flanked by BP1 and BP3 in both Prader-Willi and Angelman syndrome subjects. Those with this deletion are reported to have a more severe phenotype than individuals with either Type II deletions (BP2-BP3) or uniparental disomy 15. The BP1-BP2 region spans approximately 500 kb and contains four evolutionarily conserved genes that are not imprinted. Reports of mutations or disturbed expression of these genes appear to impact behavioral and neurological function in affected individuals. Recently, reports of deletions and duplications flanked by BP1 and BP2 suggest an association with speech and motor delays, behavioral problems, seizures, and autism. We present a large cohort of subjects with copy number alteration of BP1 to BP2 with common phenotypic features. These include autism, developmental delay, motor and language delays, and behavioral problems, which were present in both cytogenetic groups. Parental studies demonstrated phenotypically normal carriers in several instances, and mildly affected carriers in others, complicating phenotypic association and/or causality. Possible explanations for these results include reduced penetrance, altered gene dosage on a particular genetic background, or a susceptibility region as reported for other areas of the genome implicated in autism and behavior disturbances.

Dental Care for Survivors of Adolescent and Young Adult Cancer: Special Considerations

PubMed Central

Fair, Douglas; Wright, Jennifer; Kirchhoff, Anne C.

2016-01-01

Purpose: Oral health is important for quality of life, but may be undermanaged for survivors of cancer. We examine dental care use and barriers among long-term survivors of adolescent and young adult (AYA) cancer in comparison to individuals without a history of cancer. Methods: The 2008–2012 Medical Expenditure Panel Survey (MEPS) identified 1216 individuals diagnosed with cancer at AYA ages (15–39 years), who were at least 5 years from diagnosis. A comparison group was matched using age, sex, and other factors. We evaluated self-reported dental visits in the previous 12 months, and inability and delay in receiving necessary dental care among survivors and the comparison group. Furthermore, individual factors associated with dental care use were identified using multivariable logistic regressions. Results: Of survivors, 60.86% reported no dental visits in the previous year compared to 51.96% of the comparison individuals (p < 0.001). Survivors were more likely to report inability (10.71% vs. 6.29%, p = 0.001) and delay (8.12% vs. 4.45%, p = 0.001) in getting necessary dental care than the comparison group. Notably, survivors without dental insurance were more likely to report inability and delay. Female survivors were more likely to use dental care than males (odds ratio = 1.76, 95% confidence interval 1.15–2.71, p = 0.01). Hispanic survivors, those diagnosed at younger ages, and uninsured survivors were less likely to have at least one dental visit. Conclusion: Survivors of AYA cancer need timely surveillance to manage late effects, including dental complications. Yet, these survivors, particularly those who are uninsured, delay dental care more often than individuals from the general population. Survivor-specific interventions are needed to reduce dental care barriers. PMID:27028878

Delayed posthypoxic demyelination. Association with arylsulfatase A deficiency and lactic acidosis on proton MR spectroscopy.

PubMed

Gottfried, J A; Mayer, S A; Shungu, D C; Chang, Y; Duyn, J H

1997-11-01

Delayed demyelination is a rare and poorly understood complication of hypoxic brain injury. A previous case report has suggested an association with mild-to-moderate deficiency of arylsulfatase A. We describe a 36-year-old man who recovered completely from an episode of hypoxia related to drug overdose, and 2 weeks later progressed from a confusional state to deep coma. MRI showed diffuse white matter signal changes, and brain biopsy demonstrated a noninflammatory demyelinating process. Proton magnetic resonance spectroscopy revealed elevated choline and lactate and reduced N-acetyl aspartate signal in the affected white matter, consistent with demyelination and a shift to anaerobic metabolism. Arylsulfatase A activity from peripheral leukocytes was approximately 50% of normal, consistent with a "pseudodeficiency" phenotype. These findings confirm the hypothesis that relative arylsulfatase A deficiency predisposes susceptible individuals to delayed posthypoxic leukoencephalopathy and implicates lactic acidosis in the pathogenesis of this disorder.

Revisiting the Marshmallow Test: A Conceptual Replication Investigating Links Between Early Delay of Gratification and Later Outcomes.

PubMed

Watts, Tyler W; Duncan, Greg J; Quan, Haonan

2018-05-01

We replicated and extended Shoda, Mischel, and Peake's (1990) famous marshmallow study, which showed strong bivariate correlations between a child's ability to delay gratification just before entering school and both adolescent achievement and socioemotional behaviors. Concentrating on children whose mothers had not completed college, we found that an additional minute waited at age 4 predicted a gain of approximately one tenth of a standard deviation in achievement at age 15. But this bivariate correlation was only half the size of those reported in the original studies and was reduced by two thirds in the presence of controls for family background, early cognitive ability, and the home environment. Most of the variation in adolescent achievement came from being able to wait at least 20 s. Associations between delay time and measures of behavioral outcomes at age 15 were much smaller and rarely statistically significant.

Pupillometric and saccadic measures of affective and executive processing in anxiety.

PubMed

Hepsomali, Piril; Hadwin, Julie A; Liversedge, Simon P; Garner, Matthew

2017-07-01

Anxious individuals report hyper-arousal and sensitivity to environmental stimuli, difficulties concentrating, performing tasks efficiently and inhibiting unwanted thoughts and distraction. We used pupillometry and eye-movement measures to compare high vs. low anxious individuals hyper-reactivity to emotional stimuli (facial expressions) and subsequent attentional biases in a memory-guided pro- and antisaccade task during conditions of low and high cognitive load (short vs. long delay). High anxious individuals produced larger and slower pupillary responses to face stimuli, and more erroneous eye-movements, particularly following long delay. Low anxious individuals' pupillary responses were sensitive to task demand (reduced during short delay), whereas high anxious individuals' were not. These findings provide evidence in anxiety of enhanced, sustained and inflexible patterns of pupil responding during affective stimulus processing and cognitive load that precede deficits in task performance. Copyright © 2017. Published by Elsevier B.V.

Gender ratio in a clinical population sample, age of diagnosis and duration of assessment in children and adults with autism spectrum disorder.

PubMed

Rutherford, Marion; McKenzie, Karen; Johnson, Tess; Catchpole, Ciara; O'Hare, Anne; McClure, Iain; Forsyth, Kirsty; McCartney, Deborah; Murray, Aja

2016-07-01

This article reports on gender ratio, age of diagnosis and the duration of assessment procedures in autism spectrum disorder diagnosis in a national study which included all types of clinical services for children and adults. Findings are reported from a retrospective case note analysis undertaken with a representative sample of 150 Scottish children and adults recently diagnosed with autism spectrum disorder. The study reports key findings that the gender ratio in this consecutively referred cohort is lower than anticipated in some age groups and reduces with increasing age. The gender ratio in children, together with the significant difference in the mean age of referral and diagnosis for girls compared to boys, adds evidence of delayed recognition of autism spectrum disorder in younger girls. There was no significant difference in duration of assessment for males and females suggesting that delays in diagnosis of females occur prior to referral for assessment. Implications for practice and research are considered. © The Author(s) 2016.

An Effective Delay Reduction Approach through a Portion of Nodes with a Larger Duty Cycle for Industrial WSNs

PubMed Central

Wu, Minrui; Wu, Yanhui; Liu, Chuyao; Cai, Zhiping; Ma, Ming

2018-01-01

For Industrial Wireless Sensor Networks (IWSNs), sending data with timely style to the stink (or control center, CC) that is monitored by sensor nodes is a challenging issue. However, in order to save energy, wireless sensor networks based on a duty cycle are widely used in the industrial field, which can bring great delay to data transmission. We observe that if the duty cycle of a small number of nodes in the network is set to 1, the sleep delay caused by the duty cycle can be effectively reduced. Thus, in this paper, a novel Portion of Nodes with Larger Duty Cycle (PNLDC) scheme is proposed to reduce delay and optimize energy efficiency for IWSNs. In the PNLDC scheme, a portion of nodes are selected to set their duty cycle to 1, and the proportion of nodes with the duty cycle of 1 is determined according to the energy abundance of the area in which the node is located. The more the residual energy in the region, the greater the proportion of the selected nodes. Because there are a certain proportion of nodes with the duty cycle of 1 in the network, the PNLDC scheme can effectively reduce delay in IWSNs. The performance analysis and experimental results show that the proposed scheme significantly reduces the delay for forwarding data by 8.9~26.4% and delay for detection by 2.1~24.6% without reducing the network lifetime when compared with the fixed duty cycle method. Meanwhile, compared with the dynamic duty cycle strategy, the proposed scheme has certain advantages in terms of energy utilization and delay reduction. PMID:29757236

An Effective Delay Reduction Approach through a Portion of Nodes with a Larger Duty Cycle for Industrial WSNs.

PubMed

Wu, Minrui; Wu, Yanhui; Liu, Chuyao; Cai, Zhiping; Xiong, Neal N; Liu, Anfeng; Ma, Ming

2018-05-12

For Industrial Wireless Sensor Networks (IWSNs), sending data with timely style to the stink (or control center, CC) that is monitored by sensor nodes is a challenging issue. However, in order to save energy, wireless sensor networks based on a duty cycle are widely used in the industrial field, which can bring great delay to data transmission. We observe that if the duty cycle of a small number of nodes in the network is set to 1, the sleep delay caused by the duty cycle can be effectively reduced. Thus, in this paper, a novel Portion of Nodes with Larger Duty Cycle (PNLDC) scheme is proposed to reduce delay and optimize energy efficiency for IWSNs. In the PNLDC scheme, a portion of nodes are selected to set their duty cycle to 1, and the proportion of nodes with the duty cycle of 1 is determined according to the energy abundance of the area in which the node is located. The more the residual energy in the region, the greater the proportion of the selected nodes. Because there are a certain proportion of nodes with the duty cycle of 1 in the network, the PNLDC scheme can effectively reduce delay in IWSNs. The performance analysis and experimental results show that the proposed scheme significantly reduces the delay for forwarding data by 8.9~26.4% and delay for detection by 2.1~24.6% without reducing the network lifetime when compared with the fixed duty cycle method. Meanwhile, compared with the dynamic duty cycle strategy, the proposed scheme has certain advantages in terms of energy utilization and delay reduction.

Factors associated with delayed bleeding after resection of large nonpedunculated colorectal polyps.

PubMed

Elliott, Timothy R; Tsiamoulos, Zacharias P; Thomas-Gibson, Siwan; Suzuki, Noriko; Bourikas, Leonidas A; Hart, Ailsa; Bassett, Paul; Saunders, Brian P

2018-04-06

 Delayed bleeding is the most common significant complication after piecemeal endoscopic mucosal resection (p-EMR) of large nonpedunculated colorectal polyps (NPCPs). Risk factors for delayed bleeding are incompletely defined. We aimed to determine risk factors for delayed bleeding following p-EMR.  Data were analyzed from a prospective tertiary center audit of patients with NPCPs ≥ 20 mm who underwent p-EMR between 2010 and 2012. Patient, polyp, and procedure-related data were collected. Four post p-EMR defect factors were evaluated for interobserver agreement and included in analysis. Delayed bleeding severity was reported in accordance with guidelines. Predictors of bleeding were identified.  Delayed bleeding requiring hospitalization occurred after 22 of 330 procedures (6.7 %). A total of 11 patients required blood transfusion; of these, 4 underwent urgent colonoscopy, 1 underwent radiological embolization, and 1 required surgery. Interobserver agreement for identification of the four post p-EMR defect factors was moderate (kappa range 0.52 - 0.57). Factors associated with delayed bleeding were visible muscle fibers ( P  = 0.03) and the presence of a "cherry red spot" ( P  = 0.05) in the post p-EMR defect. Factors not associated with delayed bleeding were American Association of Anesthesiologists class, aspirin use, polyp size, site, and use of argon plasma coagulation.  Visible muscle fibers and the presence of a "cherry red spot" in the resection defect were associated with delayed bleeding after p-EMR. These findings suggest evaluation and photodocumentation of the post p-EMR defect is important and, when considered alongside other patient and procedural factors, may help to reduce the incidence and severity of delayed bleeding. © Georg Thieme Verlag KG Stuttgart · New York.

Increasing preload volume with water reduces rated appetite but not food intake in healthy men even with minimum delay between preload and test meal.

PubMed

Gray, Richard W; French, Stephen J; Robinson, Tristan M; Yeomans, Martin R

2003-02-01

The role of gastric volume in the short-term control of eating in humans remains unclear, with some studies reporting that food volume alone can reduce appetite but others finding no such effect. A recent study in our laboratory, found effects of preload volume on subjective appetite (hunger, fullness) but not intake, and found effects of preload energy on intake but not appetite. That study used an interval of 30 min between serving preloads and the test meal, and the present study attempted to maximise the effects of the volume manipulation by removing the delay between the preload and test meal. We administered four soup-based preloads varying in volume (150 and 450 ml) using water, and energy density (1.4 and 4.2 kJ/ml) using maltodextrin, producing three energy levels (209, 629, 629 and 1886 kJ; repeated measures). These were followed immediately by an unlimited hot pasta lunch, during which food weight was monitored continuously by computer. Increasing soup volume at constant energy (629 kJ) reduced appetite ratings, but not intake. In contrast, increasing soup energy at constant volume (450 ml) reduced intake, without affecting appetite. The discrepancies between our results and other reported studies suggest that volume is more influential when intakes are large, or that there may be a threshold concentration for nutrients in the GI tract before volume alone is tangibly expressed in subsequent eating.

Lack of endogenous parathyroid hormone delays fracture healing by inhibiting vascular endothelial growth factor‑mediated angiogenesis.

PubMed

Ding, Qingfeng; Sun, Peng; Zhou, Hao; Wan, Bowen; Yin, Jian; Huang, Yao; Li, Qingqing; Yin, Guoyong; Fan, Jin

2018-07-01

Intermittent low‑dose injections of parathyroid hormone (PTH) have been reported to exert bone anabolic effects and to promote fracture healing. As an important proangiogenic cytokine, vascular endothelial growth factor (VEGF) is secreted by bone marrow mesenchymal stem cells (BMSCs) and osteoblasts, and serves a crucial regulatory role in the process of vascular development and regeneration. To investigate whether lack of endogenous PTH causes reduced angiogenic capacity and thereby delays the process of fracture healing by downregulating the VEGF signaling pathway, a PTH knockout (PTHKO) mouse fracture model was generated. Fracture healing was observed using X‑ray and micro‑computerized tomography. Bone anabolic and angiogenic markers were analyzed by immunohistochemistry and western blot analysis. The expression levels of VEGF and associated signaling pathways in murine BMSC‑derived osteoblasts were measured by quantitative polymerase chain reaction and western blot analysis. The expression levels of protein kinase A (PKA), phosphorylated‑serine/threonine protein kinase (pAKT), hypoxia‑inducible factor‑1α (HIF1α) and VEGF were significantly decreased in BMSC‑derived osteoblasts from PTHKO mice. In addition, positive platelet endothelial cell adhesion molecule staining was reduced in PTHKO mice, as determined by immunohistochemistry. The expression levels of HIF1α, VEGF, runt‑related transcription factor 2, osteocalcin and alkaline phosphatase were also decreased in PTHKO mice, and fracture healing was delayed. In conclusion, lack of endogenous PTH may reduce VEGF expression in BMSC‑derived osteoblasts by downregulating the activity of the PKA/pAKT/HIF1α/VEGF pathway, thus affecting endochondral bone formation by causing a reduction in angiogenesis and osteogenesis, ultimately leading to delayed fracture healing.

Deliberate self-harm as a cause of persistent discharge from arthroscopic portals.

PubMed

Brown, J N; Redden, J F; Fagg, P S

1997-08-01

Persistent discharge and bleeding from arthroscopy portals are rare complications. We report three cases which occurred as a result of deliberate self-harm. To our knowledge the occurrence of self-inflicted injury following arthroscopy has not been reported. Although suspicion of such activity may be delayed we consider it important to be aware of the possibility of this behaviour and to seek specialist help early in order to reduce the likelihood of further permanent physical damage.

A case report: delayed high fever and maculopapules during Sorafenib treatment of ectopic hepatocellular carcinoma.

PubMed

Cui, Tianxiang; Diao, Xinwei; Chen, Xiewan; Huang, Shaojiang; Sun, Jianguo

2016-07-27

Sorafenib is the standard first-line therapy for hepatocellular carcinoma (HCC) and probably ectopic hepatocellular carcinoma (EHCC) as well. No report involves a side effect of delayed high fever of sorafenib. This manuscript describes a case of EHCC in the thoracic and abdominal cavities, who showed a delayed high fever and maculopapules during sorafenib treatment. The patient is a 63-year-old Chinese male with advanced EHCC, taking sorafenib 400 mg twice daily. On the tenth day, red maculopapules appeared all over the body. On the same day, the patient began to suffer from continuous high fever. Due to these effects, the patient was asked to cease sorafenib treatment, and the high fever and maculopapules were alleviated quickly. However, the symptoms were present again upon re-challenge of sorafenib. Prednisone was then administered to control the symptoms, with the dosage gradually reduced from 30 to 5 mg/day in 1.5 months. No recurrence of fever or maculopapules has been found. Tumor response reached partial response (PR) and progression free survival (PFS) reached 392 days + by the date of Apr. 14th, 2016. EHCC could be treated like orthotopic HCC by oral administration of sorafenib, which shows good tumor response and survival benefit. Delayed high fever and maculopapules are potential, rare and severe side effects of sorafenib, and could be effectively controlled by glucocorticoid.

Condom use errors and problems in a national sample of young Croatian adults.

PubMed

Baćak, Valerio; Stulhofer, Aleksandar

2012-08-01

In this study, we examined the correlates of condom use errors and problems in a population-based study conducted in 2010 among young Croatian adults aged 18-25 years. Out of a total sample of 1,005 participants, 679 reported condom use in the preceding year. The analyses focused on four outcomes: condom breakage, condom slippage, condom-related erection loss, and delayed condom application. Eighteen percent of participants experienced breakage, 13% reported slippage, 17% reported erection loss, and 34% applied a condom after intercourse started. Multivariate logistic regression analyses were performed to examine the correlates of these condom use errors and problems. Condom breakage was less likely to be reported by women and older participants. The odds of breakage were increased for participants who reported being under the influence of drugs during sex and who reported other condom use errors and problems in the past year. Condom slippage was more likely to occur among younger participants and those who reported condom breakage and delayed condom application. Condom-related erection loss was positively associated with a higher number of sexual partners in the preceding year, condom breakage, and a higher score on the Anti-Erotic Obstacles to Condom Use Scale. Odds of delayed condom application were increased for participants who experienced condom breakage and for those who consumed alcohol before sex in the past year. Having used a condom at first sex significantly reduced the odds of applying a condom after intercourse started. In comparison to non-habitual condom users, habitual users were found less likely to report any of the assessed condom use errors and problems. Improving condom use skills remains an important task in Croatia, which is currently hampered by the absence of evidence-based sex education in schools.

E-VLBI-activities at the FS Wettzell

NASA Astrophysics Data System (ADS)

Kronschnabl, Gerhard; Dassing, Reiner

The FS-Wettzell carries out the daily-INTENSIVE observations which were required for the rapid determination of DUT1. The data volume is roughly 40 GB. So fare the data were shipped via currier services to the correlator which requires 2-3 days transportation time. The INTENSIVE time series is a real candidate for E-VLBI. It will reduce the delay due to data transport strongly. Considering the remote location of Wettzell - apart from the fast INTERNET links, considering the current high cost for a fast connection, in the next future the installation of a 34 Gbps-internet connection will be realistic. It will strongly support the data transmission on start the delay time to only a few hours. This report give an overview about the activities on the realisation of such a fast link. First attempts are reported made from the next nodal point at the University Regensburg, making use of a 155Mbps connection.

Ethanol exposure can inhibit red spruce ( Picea rubens ) seed germination

Treesearch

John R. Butnor; Brittany M. Verrico; Victor Vankus; Stephen R. Keller

2018-01-01

Flotation of seeds in solvents is a common means of separating unfilled and filled seeds. While a few protocols for processing red spruce (Picea rubens) seeds recommend ethanol flotation, delayed and reduced germination have been reported. We conducted an ethanol bioassay on seeds previously stored at -20°C to quantify the concentration required to separate red spruce...

The Relations of Sleep and Quality of Life to School Performance in Youth with Type 1 Diabetes

ERIC Educational Resources Information Center

Perfect, Michelle M.

2014-01-01

This study examined parent and youth self-reports to test the hypothesis that perceived insufficient sleep duration, inconsistent sleep habits, reduced quality of life, less frequent blood glucose monitoring, and higher hemoglobin A1c would predict poorer school functioning among 50 youth with type 1 diabetes. The data suggested that a delay in…

Quantitative Measures of Swallowing Deficits in Patients With Parkinson's Disease.

PubMed

Ellerston, Julia K; Heller, Amanda C; Houtz, Daniel R; Kendall, Katherine A

2016-05-01

Dysphagia and associated aspiration pneumonia are commonly reported sequelae of Parkinson's disease (PD). Previous studies of swallowing in patients with PD have described prolonged pharyngeal transit time, delayed onset of pharyngeal transit, cricopharyngeal (CP) achalasia, reduced pharyngeal constriction, and slowed hyolaryngeal elevation. These studies were completed using inconsistent evaluation methodology, reliance on qualitative analysis, and a lack of a large control group, resulting in concerns regarding diagnostic precision. The purpose of this study was to investigate swallowing function in patients with PD using a norm-referenced, quantitative approach. This retrospective study includes 34 patients with a diagnosis of PD referred to a multidisciplinary voice and swallowing clinic. Modified barium swallow studies were performed using quantitative measures of pharyngeal transit time, hyoid displacement, CP sphincter opening, area of the pharynx at maximal constriction, and timing of laryngeal vestibule closure relative to bolus arrival at the CP sphincter. Reduced pharyngeal constriction was found in 30.4%, and a delay in airway closure relative to arrival of the bolus at the CP sphincter was the most common abnormality, present in 62% of patients. Previously reported findings of prolonged pharyngeal transit, poor hyoid elevation, and CP achalasia were not identified as prominent features. © The Author(s) 2015.

An adaptive, individualized fMRI delay discounting procedure to increase flexibility and optimize scanner time.

PubMed

Koffarnus, Mikhail N; Deshpande, Harshawardhan U; Lisinski, Jonathan M; Eklund, Anders; Bickel, Warren K; LaConte, Stephen M

2017-11-01

Research on the rate at which people discount the value of future rewards has become increasingly prevalent as discount rate has been shown to be associated with many unhealthy patterns of behavior such as drug abuse, gambling, and overeating. fMRI research points to a fronto-parietal-limbic pathway that is active during decisions between smaller amounts of money now and larger amounts available after a delay. Researchers in this area have used different variants of delay discounting tasks and reported various contrasts between choice trials of different types from these tasks. For instance, researchers have compared 1) choices of delayed monetary amounts to choices of the immediate monetary amounts, 2) 'hard' choices made near one's point of indifference to 'easy' choices that require little thought, and 3) trials where an immediate choice is available versus trials where one is unavailable, regardless of actual eventual choice. These differences in procedure and analysis make comparison of results across studies difficult. In the present experiment, we designed a delay discounting task with the intended capability of being able to construct contrasts of all three comparisons listed above while optimizing scanning time to reduce costs and avoid participant fatigue. This was accomplished with an algorithm that customized the choice trials presented to each participant with the goal of equalizing choice trials of each type. We compared this task, which we refer to here as the individualized discounting task (IDT), to two other delay discounting tasks previously reported in the literature (McClure et al., 2004; Amlung et al., 2014) in 18 participants. Results show that the IDT can examine each of the three contrasts mentioned above, while yielding a similar degree of activation as the reference tasks. This suggests that this new task could be used in delay discounting fMRI studies to allow researchers to more easily compare their results to a majority of previous research while minimizing scanning duration. Copyright © 2017 Elsevier Inc. All rights reserved.

Delayed and Unreported Drug-Susceptibility Testing Results in the US National Tuberculosis Surveillance System, 1993-2014.

PubMed

Jones, Jefferson Michael; Armstrong, Lori R

Drug-susceptibility testing (DST) of Mycobacterium tuberculosis is necessary for identifying drug-resistant tuberculosis, administering effective treatment regimens, and preventing the spread of drug-resistant tuberculosis. DST is recommended for all culture-confirmed cases of tuberculosis. We examined trends in delayed and unreported DST results in the Centers for Disease Control and Prevention's National Tuberculosis Surveillance System. We analyzed culture-confirmed tuberculosis cases reported to the National Tuberculosis Surveillance System during 1993-2014 for annual trends in initial DST reporting for first-line antituberculosis drugs and trends in on-time, delayed, and unreported results. We defined on-time reporting as DST results received during the same calendar year in which the patient's case was reported or ≤4 months after the calendar year ended and delayed reporting as DST results received after the calendar year. We compared cases with on-time, delayed, and unreported DST results by patient and tuberculosis program characteristics. The proportion of cases with reported results for all first-line antituberculosis drugs increased during 1993-2011. Reporting of pyrazinamide results was lower than reporting of other drugs. However, during 2000-2012, of 134 787 tuberculosis cases reported to the National Tuberculosis Surveillance System, reporting was on time for 125 855 (93.4%) cases, delayed for 5332 (4.0%) cases, and unreported for 3600 (2.7%) cases. Despite increases in the proportion of cases with on-time DST results, delayed and unreported results persisted. Carefully assessing causes for delayed and unreported DST results should lead to more timely reporting of drug-resistant tuberculosis.

Random noise can help to improve synchronization of excimer laser pulses.

PubMed

Mingesz, Róbert; Barna, Angéla; Gingl, Zoltán; Mellár, János

2016-02-01

Recently, we have reported on a compact microcontroller-based unit developed to accurately synchronize excimer laser pulses (Mingesz et al. 2012 Fluct. Noise Lett. 11, 1240007 (doi:10.1142/S021947751240007X)). We have shown that dithering based on random jitter noise plus pseudorandom numbers can be used in the digital control system to radically reduce the long-term drift of the laser pulse from the trigger and to improve the accuracy of the synchronization. In this update paper, we present our new experimental results obtained by the use of the delay-controller unit to tune the timing of a KrF excimer laser as an addition to our previous numerical simulation results. The hardware was interfaced to the laser using optical signal paths in order to reduce sensitivity to electromagnetic interference and the control algorithm tested by simulations was applied in the experiments. We have found that the system is able to reduce the delay uncertainty very close to the theoretical limit and performs well in real applications. The simple, compact and flexible system is universal enough to also be used in various multidisciplinary applications.

An estimate of the effectiveness of an in-vehicle automatic collision notification system in reducing road crash fatalities in South Australia.

PubMed

Ponte, G; Ryan, G A; Anderson, R W G

2016-01-01

The aim of this study was to estimate the potential effectiveness of an in-vehicle automatic collision notification (ACN) system in reducing all road crash fatalities in South Australia (SA). For the years 2008 to 2009, traffic accident reporting system (TARS) data, emergency medical services (EMS) road crash dispatch data, and coroner's reports were matched and examined. This was done to initially determine the extent to which there were differences between the reported time of a fatal road crash in the mass crash data and the time EMS were notified and dispatched. In the subset of fatal crashes where there was a delay, injuries detailed by a forensic pathologist in individual coroner's reports were examined to determine the likelihood of survival had there not been a delay in emergency medical assistance. In 25% (N = 53) of fatalities in SA in the period 2008 to 2009, there was a delay in the notification of the crash event, and hence dispatch of EMS, that exceeded 10 min. In the 2-year crash period, 5 people were likely to have survived through more prompt crash notification enabling quicker emergency medical assistance. Additionally, 3 people potentially would have survived if surgical intervention (or emergency medical assistance to sustain life until surgery) occurred more promptly. The minimum effectiveness rate of an ACN system in SA with full deployment is likely to be in the range of 2.4 to 3.8% of all road crash fatalities involving all vehicle types and all vulnerable road users (pedestrians, cyclists, and motorcyclists) from 2008 to 2009. Considering only passenger vehicle occupants, the benefit is likely to be 2.6 to 4.6%. These fatality reductions could only have been achieved through earlier notification of each crash and their location to enable a quicker medical response. This might be achievable through a fully deployed in-vehicle ACN system.

Space-Based Information Infrastructure Architecture for Broadband Services

NASA Technical Reports Server (NTRS)

Price, Kent M.; Inukai, Tom; Razdan, Rajendev; Lazeav, Yvonne M.

1996-01-01

This study addressed four tasks: (1) identify satellite-addressable information infrastructure markets; (2) perform network analysis for space-based information infrastructure; (3) develop conceptual architectures; and (4) economic assessment of architectures. The report concludes that satellites will have a major role in the national and global information infrastructure, requiring seamless integration between terrestrial and satellite networks. The proposed LEO, MEO, and GEO satellite systems have satellite characteristics that vary widely. They include delay, delay variations, poorer link quality and beam/satellite handover. The barriers against seamless interoperability between satellite and terrestrial networks are discussed. These barriers are the lack of compatible parameters, standards and protocols, which are presently being evaluated and reduced.

Analysis and optimization of RC delay in vertical nanoplate FET

NASA Astrophysics Data System (ADS)

Woo, Changbeom; Ko, Kyul; Kim, Jongsu; Kim, Minsoo; Kang, Myounggon; Shin, Hyungcheol

2017-10-01

In this paper, we have analyzed short channel effects (SCEs) and RC delay with Vertical nanoplate FET (VNFET) using 3-D Technology computer-aided design (TCAD) simulation. The device is based on International Technology Road-map for Semiconductor (ITRS) 2013 recommendations, and it has initially gate length (LG) of 12.2 nm, channel thickness (Tch) of 4 nm, and spacer length (LSD) of 6 nm. To obtain improved performance by reducing RC delay, each dimension is adjusted (LG = 12.2 nm, Tch = 6 nm, LSD = 11.9 nm). It has each characteristic in this dimension (Ion/Ioff = 1.64 × 105, Subthreshold swing (S.S.) = 73 mV/dec, Drain-induced barrier lowering (DIBL) = 60 mV/V, and RC delay = 0.214 ps). Furthermore, with long shallow trench isolation (STI) length and thick insulator thickness (Ti), we can reduce RC delay from 0.214 ps to 0.163 ps. It is about a 23.8% reduction. Without decreasing drain current, there is a reduction of RC delay as reducing outer fringing capacitance (Cof). Finally, when source/drain spacer length is set to be different, we have verified RC delay to be optimum.

Risk factors for delayed presentation and referral of symptomatic cancer: evidence for common cancers

PubMed Central

Macleod, U; Mitchell, E D; Burgess, C; Macdonald, S; Ramirez, A J

2009-01-01

Background: It has been suggested that the known poorer survival from cancer in the United Kingdom, compared with other European countries, can be attributed to more advanced cancer stage at presentation. There is, therefore, a need to understand the diagnostic process, and to ascertain the risk factors for increased time to presentation. Methods: We report the results from two worldwide systematic reviews of the literature on patient-mediated and practitioner-mediated delays, identifying the factors that may influence these. Results: Across cancer sites, non-recognition of symptom seriousness is the main patient-mediated factor resulting in increased time to presentation. There is strong evidence of an association between older age and patient delay for breast cancer, between lower socio-economic status and delay for upper gastrointestinal and urological cancers and between lower education level and delay for breast and colorectal cancers. Fear of cancer is a contributor to delayed presentation, while sanctioning of help seeking by others can be a powerful mediator of reduced time to presentation. For practitioner delay, ‘misdiagnosis' occurring either through treating patients symptomatically or relating symptoms to a health problem other than cancer, was an important theme across cancer sites. For some cancers, this could also be linked to inadequate patient examination, use of inappropriate tests or failing to follow-up negative or inconclusive test results. Conclusion: Having sought help for potential cancer symptoms, it is therefore important that practitioners recognise these symptoms, and examine, investigate and refer appropriately. PMID:19956172

Cost-effectiveness of emergency versus delayed laparoscopic cholecystectomy for acute gallbladder pathology.

PubMed

Sutton, A J; Vohra, R S; Hollyman, M; Marriott, P J; Buja, A; Alderson, D; Pasquali, S; Griffiths, E A

2017-01-01

The optimal timing of cholecystectomy for patients admitted with acute gallbladder pathology is unclear. Some studies have shown that emergency cholecystectomy during the index admission can reduce length of hospital stay with similar rates of conversion to open surgery, complications and mortality compared with a 'delayed' operation following discharge. Others have reported that cholecystectomy during the index acute admission results in higher morbidity, extended length of stay and increased costs. This study examined the cost-effectiveness of emergency versus delayed cholecystectomy for acute benign gallbladder disease. Using data from a prospective population-based cohort study examining the outcomes of cholecystectomy in the UK and Ireland, a model-based cost-utility analysis was conducted from the perspective of the UK National Health Service, with a 1-year time horizon for costs and outcomes. Probabilistic sensitivity analysis was used to investigate the impact of parameter uncertainty on the results obtained from the model. Emergency cholecystectomy was found to be less costly (£4570 versus £4720; €5484 versus €5664) and more effective (0·8868 versus 0·8662 QALYs) than delayed cholecystectomy. Probabilistic sensitivity analysis showed that the emergency strategy is more than 60 per cent likely to be cost-effective across willingness-to-pay values for the QALY from £0 to £100 000 (€0-120 000). Emergency cholecystectomy is less costly and more effective than delayed cholecystectomy. This approach is likely to be beneficial to patients in terms of improved health outcomes and to the healthcare provider owing to the reduced costs. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

Neural activation during delay discounting is associated with 6-month change in risky sexual behavior in adolescents.

PubMed

Gardiner, Casey K; Karoly, Hollis C; Thayer, Rachel E; Gillman, Arielle S; Sabbineni, Amithrupa; Bryan, Angela D

2018-04-19

Identifying cognitive and neural mechanisms of decision making in adolescence can enhance understanding of, and interventions to reduce, risky health behaviors in adolescence. Delay discounting, or the propensity to discount the magnitude of temporally distal rewards, has been associated with diverse health risk behaviors, including risky sex. This cognitive process involves recruitment of reward and cognitive control brain regions, which develop on different trajectories in adolescence and are also implicated in real-world risky decision making. However, no extant research has examined how neural activation during delay discounting is associated with adolescents' risky sexual behavior. To determine whether a relationship exists between adolescents' risky sexual behavior and neural activation during delay discounting. Adolescent participants completed a delay discounting paradigm during functional magnetic resonance imaging (fMRI) scanning, and they reported risky sexual behavior at baseline, 3-, 6-, 9-, and 12-month follow-up time points. Latent growth curve models were employed to determine relationships between brain activation during delay discounting and change in risky sexual behavior over time. Greater activation in brain regions associated with reward and cognitive control (caudate, putamen, nucleus accumbens, anterior cingulate, insula, orbitofrontal cortex, inferior frontal gyrus, dorsolateral prefrontal cortex) during delay discounting was associated with lower mean levels of risky sexual behavior but greater growth over the period from baseline to 6 months. Neural activation during delay discounting is cross-sectionally and prospectively associated with risky sexual behavior in adolescence, highlighting a neural basis of risky decision-making as well as opportunities for early identification and intervention.

Interaction of Airspace Partitions and Traffic Flow Management Delay with Weather

NASA Technical Reports Server (NTRS)

Lee, Hak-Tae; Chatterji, Gano B.; Palopo, Kee

2011-01-01

The interaction of partitioning the airspace and delaying flights in the presence of convective weather is explored to study how re-partitioning the airspace can help reduce congestion and delay. Three approaches with varying complexities are employed to compute the ground delays.In the first approach, an airspace partition of 335 high-altitude sectors that is based on clear weather day traffic is used. Routes are then created to avoid regions of convective weather. With traffic flow management, this approach establishes the baseline with per-flight delay of 8.4 minutes. In the second approach, traffic flow management is used to select routes and assign departure delays such that only the airport capacity constraints are met. This results in 6.7 minutes of average departure delay. The airspace is then partitioned with a specific capacity. It is shown that airspace-capacity-induced delay can be reduced to zero ata cost of 20percent more sectors for the examined scenario.

Behavioral effects of delayed timeouts from reinforcement.

PubMed

Byrne, Tom; Poling, Alan

2017-03-01

Timeouts are sometimes used in applied settings to reduce target responses, and in some circumstances delays are unavoidably imposed between the onset of a timeout and the offset of the response that produces it. The present study examined the effects of signaled and unsignaled timeouts in rats exposed to concurrent fixed-ratio 1 fixed-ratio 1 schedules of food delivery, where each response on one lever, the location of which changed across conditions, produced both food and a delayed 10-s timeout. Delays of 0 to 38 s were examined. Delayed timeouts often, but not always, substantially reduced the number of responses emitted on the lever that produced timeouts relative to the number emitted on the lever that did not produce timeouts. In general, greater sensitivity was observed to delayed timeouts when they were signaled. These results demonstrate that delayed timeouts, like other delayed consequences, can affect behavior, albeit less strongly than immediate consequences. © 2017 Society for the Experimental Analysis of Behavior.

The use of cell phones and radio communication systems to reduce delays in getting help for pregnant women in low- and middle-income countries: a scoping review.

PubMed

Oyeyemi, Sunday O; Wynn, Rolf

2015-01-01

Delays in getting medical help are important factors in the deaths of many pregnant women and unborn children in the low- and middle-income countries (LMIC). Studies have suggested that the use of cell phones and radio communication systems might reduce such delays. We review the literature regarding the impact of cell phones and radio communication systems on delays in getting medical help by pregnant women in the LMIC. Cochrane Library, PubMed, Maternity and Infant care (Ovid), Web of Science (ISI), and Google Scholar were searched for studies relating to the use of cell phones for maternal and child health services, supplemented with hand searches. We included studies in LMIC and in English involving the simple use of cell phones (or radio communication) to either make calls or send text messages. Fifteen studies met the inclusion criteria. All the studies, while of various designs, demonstrated positive contributory effects of cell phones or radio communication systems in reducing delays experienced by pregnant women in getting medical help. While the results suggested that cell phones could contribute in reducing delays, more studies of a longer duration are needed to strengthen the finding.

The use of cell phones and radio communication systems to reduce delays in getting help for pregnant women in low- and middle-income countries: a scoping review

PubMed Central

Oyeyemi, Sunday O.; Wynn, Rolf

2015-01-01

Background Delays in getting medical help are important factors in the deaths of many pregnant women and unborn children in the low- and middle-income countries (LMIC). Studies have suggested that the use of cell phones and radio communication systems might reduce such delays. Objectives We review the literature regarding the impact of cell phones and radio communication systems on delays in getting medical help by pregnant women in the LMIC. Design Cochrane Library, PubMed, Maternity and Infant care (Ovid), Web of Science (ISI), and Google Scholar were searched for studies relating to the use of cell phones for maternal and child health services, supplemented with hand searches. We included studies in LMIC and in English involving the simple use of cell phones (or radio communication) to either make calls or send text messages. Results Fifteen studies met the inclusion criteria. All the studies, while of various designs, demonstrated positive contributory effects of cell phones or radio communication systems in reducing delays experienced by pregnant women in getting medical help. Conclusions While the results suggested that cell phones could contribute in reducing delays, more studies of a longer duration are needed to strengthen the finding. PMID:26362421

Delayed transfer from hospital to community settings: the older person's perspective.

PubMed

Swinkels, Annette; Mitchell, Theresa

2009-02-01

Prevention and management of delayed transfer of older people from hospital to community settings is an enduring issue in industrialised societies and is the subject of many recent policies in the United Kingdom. A deeper, evidence-based understanding of the complex organizational and interprofessional issues which contribute to delays in transfer has emerged in recent years. Despite this, and the relative success of recent policies, two recent reviews of the area highlight the lack of studies on patients' perspectives. We sought to address this deficit by using conversational interviews and a phenomenological approach to explore and interpret participants' perceptions of delayed transfer from hospital into the community. A purposive sampling strategy was employed to incorporate participants from different categories of delay identified on weekly Situation Reports. Participants aged 65 years and over (mean age 82 +/- 5.4 years) and with a mean delay of 32 days (+/- 26) were recruited from three hospitals based in two NHS Trusts in the South of England. This paper focuses on their perceptions of the effects of delayed transfer into the community, their involvement in discharge planning and future community care needs. Our findings show that participants actively or passively relinquished their involvement in the processes of discharge planning because of the perceived expertise of others and also feelings of disempowerment secondary to poor health, low mood, dependency, lack of information and the intricacies of discharge planning processes for complex community care needs. Participants expressed a longing for continuity, emphasised the importance of social contact and sometimes appeared unrealistic about their future care needs. While current policies may have helped reduce overall numbers of delayed patients in the UK, our study suggests that there is scope for improvement in the involvement of delayed patients in planning their discharge into the community.

Simulation analysis of the effect of initial delay on flight delay diffusion

NASA Astrophysics Data System (ADS)

Que, Zufu; Yao, Hongguang; Yue, Wei

2018-01-01

The initial delay of the flight is an important factor affecting the spread of flight delays, so clarifying their relationship conduces to control flight delays in the aeronautical network. Through establishing a model of the chain aviation network and making simulation analysis of the effects of initial delay on the delay longitudinal diffusion, it’s found that the number of delayed airports in the air network, the total delay time and the average delay time of the delayed airport are generally positively correlated with the initial delay. This indicates that the occurrence of the initial delay should be avoided or reduced as much as possible to improve the punctuality of the flight.

In-vitro and In-vivo Pharmacokinetic Evaluation of Guar Gum-Eudragit® S100 Based Colon-targeted Spheroids of Sulfasalazine Co-administered with Probiotics.

PubMed

Sharma, Abhinav; Kumar, Bimlesh; Singh, Sachin Kumar; Gulati, Monica; Vaidya, Yogyata; Rathee, Harish; Ghai, Deepak; Malik, Adil Hussain; Yadav, Ankit Kumar; Maharshi, Peddi; Bawa, Palak; Rajesh, Sarvi Yadav; Sharma, Parth; Pandey, Narendra Kumar; Mohanta, Souvik

2018-01-01

Polysaccharide based delivery systems have been successfully used to target drugs to colon. In some recent reports, the superiority of concomitant administration of probiotics with such systems has been established. However, the pharmacokinetics of such symbiotic therapy remain unexplored hitherto. This study deciphers the pharmacokinetic parameters of guar gum based colon targeted spheroids of sulfasalazine with co-administration of probiotics in experimental rats. Thirty rats were divided into five groups using Latin square design. These were subjected to treatment with delayed release formulation, uncoated spheroids, coated spheroid and coated spheroids along with probiotics. In case of delayed release formulation, negligible presence of sulfasalazine in plasma was observed in first 2h, followed by significant increase in sulfasalazine concentration after 3h. Higher plasma concentrations of sulfasalazine were detected for uncoated spheroids with and without probiotics. Negligible release of drug upto 5h and delayed Tmax in case of guar-gum coated sulfasalazine spheroids with or without probiotics clearly indicated successful formulation of colon targeted spheroids. Further, for coated spheroids (both with and without probiotics), the value of Tmax is found to be significantly higher than those with the other treatments. Colon targeted spheroids were therefore, found to reduce absorption of drug which, in turn, is expected to reduce the side effects as only local action in colon is required for treatment of colitis. This is the first report on pharmacokinetic study of a colon targeted delivery system co-administered with probiotics. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

A Case of Prolonged Delayed Postdural Puncture Headache in a Patient with Multiple Sclerosis Exacerbated by Air Travel

PubMed Central

Porhomayon, Jahan; Zadeii, Gino; Yarahamadi, Alireza; Nader, Nader D.

2013-01-01

The developments of new spinal needles and needle tip designs have reduced the incidence of postdural puncture headache (PDPH). Although it is clear that reducing the loss of CSF leak from dural puncture reduces the headache, there are areas regarding the pathogenesis, treatment, and prevention of PDPH that remain controversial. Air travel by itself may impose physiological alteration in central nervous system that may be detrimental to patients with PDPH. This case report highlights a case of a young female patient who suffered from a severe incapacitating PDPH headache during high-altitude flight with a commercial jet. PMID:23401803

Human factors optimization of virtual environment attributes for a space telerobotic control station

NASA Astrophysics Data System (ADS)

Lane, Jason Corde

2000-10-01

Remote control of underwater vehicles and other robotic systems has, up until now, proved to be a challenging task for the human operator. With technology advancements in computers and displays, computer interfaces can be used to alleviate the workload on the operator. This research introduces the concept of a commanded display, which is a graphical simulation that shows the commands sent to the actual system in real-time. The primary goal of this research was to show a commanded display as an alternative to the traditional predictive display for reducing the effects of time delay. Several experiments were used to investigate how subjects compensated for time delay under a variety of conditions while controlling a 7-degree of freedom robotic manipulator. Results indicate that time delay increased completion time linearly; this linear relationship occurred even at different manipulator speeds, varying levels of error, and when using a commanded display. The commanded display alleviated the majority of time delay effects, up to 91% reduction. The commanded display also facilitated more accurate control, reducing the number of inadvertent impacts to the task worksite, even when compared to no time delay. Even with a moderate error between the commanded and actual displays, the commanded display was still a useful tool for mitigating time delay. The way subjects controlled the manipulator with the input device was tracked and their control strategies were extracted. A correlation between the subjects' use of the input device and their task completion time was determined. The importance of stereo vision and head tracking was examined and shown to improve a subject's depth perception within a virtual environment. Reports of simulator sickness induced by display equipment, including a head mounted display and LCD shutter glasses, were compared. The results of the above testing were used to develop an effective virtual environment control station to control a multi-arm robot.

Trail-Based Search for Efficient Event Report to Mobile Actors in Wireless Sensor and Actor Networks.

PubMed

Xu, Zhezhuang; Liu, Guanglun; Yan, Haotian; Cheng, Bin; Lin, Feilong

2017-10-27

In wireless sensor and actor networks, when an event is detected, the sensor node needs to transmit an event report to inform the actor. Since the actor moves in the network to execute missions, its location is always unavailable to the sensor nodes. A popular solution is the search strategy that can forward the data to a node without its location information. However, most existing works have not considered the mobility of the node, and thus generate significant energy consumption or transmission delay. In this paper, we propose the trail-based search (TS) strategy that takes advantage of actor's mobility to improve the search efficiency. The main idea of TS is that, when the actor moves in the network, it can leave its trail composed of continuous footprints. The search packet with the event report is transmitted in the network to search the actor or its footprints. Once an effective footprint is discovered, the packet will be forwarded along the trail until it is received by the actor. Moreover, we derive the condition to guarantee the trail connectivity, and propose the redundancy reduction scheme based on TS (TS-R) to reduce nontrivial transmission redundancy that is generated by the trail. The theoretical and numerical analysis is provided to prove the efficiency of TS. Compared with the well-known expanding ring search (ERS), TS significantly reduces the energy consumption and search delay.

Keeping adolescent orphans in school to prevent human immunodeficiency virus infection: evidence from a randomized controlled trial in Kenya.

PubMed

Cho, Hyunsan; Hallfors, Denise D; Mbai, Isabella I; Itindi, Janet; Milimo, Benson W; Halpern, Carolyn T; Iritani, Bonita J

2011-05-01

We report the findings from a pilot study in western Kenya, using an experimental design to test whether comprehensive support used to keep adolescent orphans in school can reduce risk factors associated with infection with human immunodeficiency virus. Adolescent orphans aged 12-14 years (N = 105) in Nyanza Province were randomized to condition, after stratifying by household, gender, and baseline survey report of sexual behavior. The intervention comprised school fees, uniforms, and a "community visitor" who monitored school attendance and helped to resolve problems that would lead to absence or dropout. Data were analyzed using generalized estimating equations over two time points, controlling for gender and age. Compared with the control group, intervention students were less likely to drop out of school, commence sexual intercourse, or report attitudes supporting early sex. School support also increased prosocial bonding and gender equity attitudes. After 1 year of exposure to the intervention, we found evidence suggesting that comprehensive school support can prevent school dropout, delay sexual debut, and reduce risk factors associated with infection with human immunodeficiency virus. Further research, with much larger samples, is needed to better understand factors that mediate the association between educational support and delayed sexual debut, and how gender might moderate these relationships. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

All dressed up but nowhere to go? Delayed hospital discharges and older people.

PubMed

Glasby, Jon; Littlechild, Rosemary; Pryce, Kathryn

2006-01-01

Delayed hospital discharges are a key concern in a number of industrialized nations and are the subject of a range of government initiatives in the English National Health Service. The aim of this paper was to review the UK literature on delayed hospital discharges and older people in order to identify and explore the rate and causes of delayed hospital discharges, together with policies and practices that may reduce delayed discharges and improve the experiences of older people. Literature review based on searches of major health/social-care databases. Sources which explore the rate and cause of delayed discharges in the UK were included. Relevant documents were categorized using the research hierarchy set out in the National Service Framework for Older People and analysed according to criteria for appraising the quality of qualitative research proposed by Mays et al. The review identified 21 studies, which suggest very different rates and causes of delayed discharge in different settings. The studies reveal the importance of rehabilitation services to reduce the rate of delayed discharge, the prevalence of delayed discharges caused by internal hospital factors, and the complex and multi-faceted nature of the factors contributing to delayed discharge. Despite this, the studies have a number of methodological flaws and often fail to include a patient perspective or to consider detailed policies and approaches to reduce the number of delayed discharges. There is also a failure to consider the needs of older people with mental health problems or people from minority ethnic communities. The evidence, as it currently stands, raises a number of issues about current hospital discharge policy, supporting some aspects of the current government agenda in England, but questioning other aspects.

Short nights reduce light-induced circadian phase delays in humans.

PubMed

Burgess, Helen J; Eastman, Charmane I

2006-01-01

Short sleep episodes are common in modern society. We recently demonstrated that short nights reduce phase advances to light. Here we show that short nights also reduce phase delays to light. Two weeks of 6-hour sleep episodes in the dark (short nights) and 2 weeks of long 9-hour sleep episodes (long nights) in counterbalanced order, separated by 7 days. Following each series of nights, there was a dim-light phase assessment to assess baseline phase. Three days later, subjects were exposed to a phase-delaying light stimulus for 2 days, followed by a final phase assessment. Subjects slept at home in dark bedrooms but came to the laboratory for the phase assessments and light stimulus. Seven young healthy subjects. The 3.5-hour light stimulus was four 30-minute pulses of bright light (-5000 lux) separated by 30-minute intervals of room light. The stimulus began 2.5 hours after each subject's dim-light melatonin onset, followed by a 6- or 9-hour sleep episode. On the second night, the bright light and sleep episode began 1 hour later. The dim-light melatonin onset and dimlight melatonin offset phase delayed 1.4 and 0.7 hours less in the short nights, respectively (both p < or = .015). These results indicate for the first time that short nights can reduce circadian phase delays, that long nights can increase phase delays to light, or both. People who curtail their sleep may inadvertently reduce their circadian responsiveness to evening light.

Stigma- and non-stigma-related treatment barriers to mental healthcare reported by service users and caregivers.

PubMed

Dockery, Lisa; Jeffery, Debra; Schauman, Oliver; Williams, Paul; Farrelly, Simone; Bonnington, Oliver; Gabbidon, Jheanell; Lassman, Francesca; Szmukler, George; Thornicroft, Graham; Clement, Sarah

2015-08-30

Delayed treatment seeking for people experiencing symptoms of mental illness is common despite available mental healthcare. Poor outcomes are associated with untreated mental illness and caregivers may eventually need to seek help on the service user's behalf. More attention has recently focused on the role of stigma in delayed treatment seeking. This study aimed to establish the frequency of stigma- and non-stigma-related treatment barriers reported by 202 service users and 80 caregivers; to compare treatment barriers reported by service users and caregivers; and to investigate demographic predictors of reporting stigma-related treatment barriers. The profile of treatment barriers differed between service users and caregivers. Service users were more likely to report stigma-related treatment barriers than caregivers across all stigma-related items. Service users who were female, had a diagnosis of schizophrenia or with GCSEs (UK qualifications usually obtained at age 16) were significantly more likely to report stigma-related treatment barriers. Caregivers who were female or of Black ethnicities were significantly more likely to report stigma-related treatment barriers. Multifaceted approaches are needed to reduce barriers to treatment seeking for both service users and caregivers, with anti-stigma interventions being of particular importance for the former group. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Angiomatous lesion and delayed cyst formation after gamma knife surgery for intracranial meningioma: case report and review of literatures.

PubMed

Liu, Zhiyong; He, Min; Chen, Hongxu; Liu, Yi; Li, Qiang; Li, Lin; Li, Jin; Chen, Haifeng; Xu, Jianguo

2015-01-01

Gamma Knife has become a major therapeutic method for intracranial meningiomas, vascular malformations and schwannomas with exact effect. In recent years an increasing number of delayed complications after Gamma Knife surgery have been reported, such as secondary tumors, cystic changes or cyst formation. But angiomatous lesion and delayed cyst formation after Gamma Knife for intracranial lesion has rarely been reported. Here we report the first case of angiomatous lesion and delayed cyst formation following Gamma Knife for intracranial meningioma and discuss its pathogenesis.

Value of evidence from syndromic surveillance with cumulative evidence from multiple data streams with delayed reporting.

PubMed

Struchen, R; Vial, F; Andersson, M G

2017-04-26

Delayed reporting of health data may hamper the early detection of infectious diseases in surveillance systems. Furthermore, combining multiple data streams, e.g. aiming at improving a system's sensitivity, can be challenging. In this study, we used a Bayesian framework where the result is presented as the value of evidence, i.e. the likelihood ratio for the evidence under outbreak versus baseline conditions. Based on a historical data set of routinely collected cattle mortality events, we evaluated outbreak detection performance (sensitivity, time to detection, in-control run length) under the Bayesian approach among three scenarios: presence of delayed data reporting, but not accounting for it; presence of delayed data reporting accounted for; and absence of delayed data reporting (i.e. an ideal system). Performance on larger and smaller outbreaks was compared with a classical approach, considering syndromes separately or combined. We found that the Bayesian approach performed better than the classical approach, especially for the smaller outbreaks. Furthermore, the Bayesian approach performed similarly well in the scenario where delayed reporting was accounted for to the scenario where it was absent. We argue that the value of evidence framework may be suitable for surveillance systems with multiple syndromes and delayed reporting of data.

Sublethal effects of atrazine on embryo-larval development of Rhinella arenarum (Anura: Bufonidae).

PubMed

Svartz, Gabriela V; Herkovits, Jorge; Pérez-Coll, Cristina S

2012-05-01

Atrazine (ATR), one of the most widely used herbicides in the world, affects not only target organisms but also the biota in general. Here, the teratogenic and neurotoxic effects of ATR on Rhinella arenarum (South American toad) embryos, and larvae were evaluated by means of standardized bioassays during acute and chronic exposures. The herbicide had a significant incidence of malformations, with a Teratogenic Index (TI) of 3.28. The main effects were delayed development, reduced body size, microcephaly, axial flexures, wavy tail and edema. In addition, delayed development, reduced development of forelimbs, and edema were recorded at metamorphosis stages. Scanning electron microscopy allowed observing different degrees of cellular dissociation and persistent cilliar cells in specific regions like the adhesive structure and tail fin. Results obtained by ATR 24 h pulse exposures at six developmental stages pointed out blastula as the most susceptible developmental stage both for immediate and delayed adverse effects. A noteworthy recovery capacity from acute toxic effects was recorded from the neural plate stage onwards. Regarding neurotoxic effects, abnormal, and erratic swimming and spasmodic contractions were recorded. Both the teratogenic and neurotoxic effects reported in this study demonstrate the importance of evaluating sublethal effects in non-target organisms as they could imply reduced fitness of individuals and eventually a population decline. The Hazard Quotients (HQ) for ATR ranged from 0.14 to 10.80, and the fact that some of these values are above USEPA's level of concern indicate that ATR is likely a risk to R. arenarum.

Reduced turning frequency and delayed poultry manure addition reduces N loss from sugarcane compost.

PubMed

Bryndum, S; Muschler, R; Nigussie, A; Magid, J; de Neergaard, A

2017-07-01

Composting is an effective method to recycle biodegradable waste as soil amendment in smallholder farming systems. Although all essential plant nutrients are found in compost, a substantial amount of nitrogen is lost during composting. This study therefore investigated the potential of reducing N losses by (i) delaying the addition of nitrogen-rich substrates (i.e. poultry manure), and (ii) reducing the turning frequency during composting. Furthermore, we tested the effect of compost application method on nitrogen mineralization. Sugarcane-waste was composted for 54days with addition of poultry manure at the beginning (i.e. early addition) or after 21days of composting (delayed addition). The compost pile was then turned either every three or nine days. Composts were subsequently applied to soil as (i) homogeneously mixed, or (ii) stratified, and incubated for 28days to test the effect of compost application on nitrogen mineralization. The results showed that delayed addition of poultry manure reduced total nitrogen loss by 33% and increased mineral nitrogen content by >200% compared with early addition. Similarly, less frequent turning reduced total N loss by 12% compared with frequent turning. Stratified placement of compost did not enhance N mineralization compared to a homogeneous mixing. Our results suggested that simple modifications of the composting process (i.e. delayed addition and/or turning frequency) could significantly reduce N losses and improve the plant-nutritional value of compost. Copyright © 2017 Elsevier Ltd. All rights reserved.

Brought in Dead: An Avoidable Delay in Maternal Deaths.

PubMed

Kumar, Aruna; Agrawal, Neha

2016-10-01

Maternal brought in dead are the patient who dies in the need of adequate medical care. These deaths are often not analyzed sincerely as they are not institutional deaths. Our aim is to find out actual life threatening cause of delay leading to death. Patients brought dead to casualty were seen by the doctors on duty in Department of Obstetrics and Gynaecology,Gandhi Medical College, Bhopal round the clock. Cause of death was analyzed by verbal autopsy of attendants and referral letter from the institute. In this analytical study a complete evaluation of brought deaths from January 2011 to Decmeber 2014 was done. A total of 64 brought in deaths were reported in this 4 year duration. Most common cause of death was postpartum hemorrhage (54.68 %) followed by hypertension (15.62 %) and the most common cause of delay was delay in getting adequate treatment (56.25 %). The brought in dead are the indicator of the three delays in getting health care. Challenges appear to be enormous to be tackled. Timely management proves to be critical in preventing maternal death. Thus it appears that community education about pregnancy and its complications, EmOC training at FRU and strict adherence to referral protocol may help us to reduce the brought dead burden.

Design and Fabrication of Ta filled microcavites in the delay paths of SAW devices for improved power transfer

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

Richardson, Mandek; Sankaranarayanan, S. K. R. S.; Bhethanabotla, V. R.

2015-03-01

The authors report the design and fabrication of a surface acoustic wave (SAW) device with improved power transfer due to modification of its delay path. Typically, SAW delay-line devices suffer from relatively high insertion loss (IL) (similar to 10-30 dB). Our approach is to incorporate an array of microcavities, having square cross-sectional area (lambda/2 x lambda/2) and filled with tantalum, within the delay path to maximize acoustic confinement to the surface and reduce IL. To determine the effectiveness of the cavities without expending too many resources and to explain trends found in actual devices, a finite element model of amore » SAW device with tantalum filled cavities having various depths was utilized. For each depth simulated, IL was decreased compared to a standard SAW device. Microcavities 2.5 mu m deep filled with tantalum showed the best performance (Delta IL = 17.93 dB). To validate simulated results, the authors fabricated a SAW device on ST 90 degrees-X quartz with microcavities etched into its delay path using deep reactive ion etching and filled with tantalum. Measurement of fabricated devices showed inclusion of tantalum filled microcavities increased power transfer compared to a device without cavities. (C) 2015 American Vacuum Society.« less

Airport Surface Delays and Causes: A Preliminary Analysis

NASA Technical Reports Server (NTRS)

Chin, David K.; Goldberg, Jay; Tang, Tammy

1997-01-01

This report summarizes FAA Program Analysis and Operations Research Service (ASD-400)/Lockheed Martin activities and findings related to airport surface delays and causes, in support of NASA Langley Research Center's Terminal Area Productivity (TAP) Program. The activities described in this report were initiated in June 1995. A preliminary report was published on September 30, 1995. The final report incorporates data collection forms filled out by traffic managers, other FAA staff, and an airline for the New York City area, some updates, data previously requested from various sources to support this analysis, and further quantification and documentation than in the preliminary report. This final report is based on data available as of April 12, 1996. This report incorporates data obtained from review and analysis of data bases and literature, discussions/interviews with engineers, air-traffic staff, other FAA technical personnel, and airline staff, site visits, and a survey on surface delays and causes. It includes analysis of delay statistics; preliminary findings and conclusions on surface movement, surface delay sources and causes, runway occupancy time (ROT), and airport characteristics impacting surface operations and delays; and site-specific data on the New York City area airports, which are the focus airports for this report.

Testing the Bed-Blocking Hypothesis: Does Nursing and Care Home Supply Reduce Delayed Hospital Discharges?

PubMed Central

Gaughan, James; Gravelle, Hugh; Siciliani, Luigi

2015-01-01

Hospital bed-blocking occurs when hospital patients are ready to be discharged to a nursing home, but no place is available, so that hospital care acts as a more costly substitute for long-term care. We investigate the extent to which greater supply of nursing home beds or lower prices can reduce hospital bed-blocking using a new Local Authority (LA) level administrative data from England on hospital delayed discharges in 2009–2013. The results suggest that delayed discharges respond to the availability of care home beds, but the effect is modest: an increase in care home beds by 10% (250 additional beds per LA) would reduce social care delayed discharges by about 6–9%. We also find strong evidence of spillover effects across LAs: more care home beds or fewer patients aged over 65 years in nearby LAs are associated with fewer delayed discharges. © 2015 The Authors. Health Economics Published by John Wiley & Sons Ltd. PMID:25760581

Effects of morphology parameters on anti-icing performance in superhydrophobic surfaces

NASA Astrophysics Data System (ADS)

Nguyen, Thanh-Binh; Park, Seungchul; Lim, Hyuneui

2018-03-01

In this paper, we report the contributions of actual ice-substrate contact area and nanopillar height to passive anti-icing performance in terms of adhesion force and freezing time. Well-textured nanopillars with various parameters were fabricated via colloidal lithography and a dry etching process. The nanostructured quartz surface was coated with low-energy material to confer water-repellent properties. These superhydrophobic surfaces were investigated to determine the parameters essential for reducing adhesion strength and delaying freezing time. A well-textured surface with nanopillars of very small top diameter, regardless of height, could reduce adhesion force and delay freezing time in a subsequent de-icing process. Small top diameters of nanopillars also ensured the metastable Cassie-Baxter state based on energy barrier calculations. The results demonstrated the important role of areal fraction in anti-icing efficiency, and the negligible contribution of texture height. This insight into icing phenomena should lead to design of improved ice-phobic surfaces in the future.

Vital Signs: Human Immunodeficiency Virus Testing and Diagnosis Delays — United States

PubMed Central

Dailey, Andre F.; Hoots, Brooke E.; Song, Ruiguang; Hayes, Demorah; Fulton, Paul; Prejean, Joseph; Hernandez, Angela L.; Koenig, Linda J.; Valleroy, Linda A.

2017-01-01

Background Persons unaware of their human immunodeficiency virus (HIV) infection account for approximately 40% of ongoing transmissions in the United States. Persons are unaware of their infection because of delayed HIV diagnoses that represent substantial missed opportunities to improve health outcomes and prevent HIV transmission. Methods Data from CDC’s National HIV Surveillance System were used to estimate, among persons with HIV infection diagnosed in 2015, the median interval (and range) from infection to diagnosis (diagnosis delay), based on the first CD4 test after HIV diagnosis and a CD4 depletion model indicating disease progression and, among persons living with HIV in 2015, the percentage with undiagnosed infection. Data from CDC’s National HIV Behavioral Surveillance were analyzed to determine the percentage of persons at increased risk for HIV infection who had tested in the past 12 months and who had missed opportunities for testing. Results An estimated 15% of persons living with HIV in 2015 were unaware of their infection. Among the 39,720 persons with HIV infection diagnosed in 2015, the estimated median diagnosis delay was 3.0 years (interquartile range = 0.7–7.8 years); diagnosis delay varied by race/ethnicity (from 2.2 years among whites to 4.2 years among Asians) and transmission category (from 2.0 years among females who inject drugs to 4.9 years among heterosexual males). Among persons interviewed through National HIV Behavioral Surveillance, 71% of men who have sex with men, 58% of persons who inject drugs, and 41% of heterosexual persons at increased risk for HIV infection reported testing in the past 12 months. In each risk group, at least two thirds of persons who did not have an HIV test had seen a health care provider in the past year. Conclusions Delayed HIV diagnoses continue to be substantial for some population groups and prevent early entry to care to improve health outcomes and reduce HIV transmission to others. Implications for Public Health Practice Health care providers and others providing HIV testing can reduce HIV-related adverse health outcomes and risk for HIV transmission by implementing routine and targeted HIV testing to decrease diagnosis delays. PMID:29190267

Vital Signs: Human Immunodeficiency Virus Testing and Diagnosis Delays - United States.

PubMed

Dailey, Andre F; Hoots, Brooke E; Hall, H Irene; Song, Ruiguang; Hayes, Demorah; Fulton, Paul; Prejean, Joseph; Hernandez, Angela L; Koenig, Linda J; Valleroy, Linda A

2017-12-01

Persons unaware of their human immunodeficiency virus (HIV) infection account for approximately 40% of ongoing transmissions in the United States. Persons are unaware of their infection because of delayed HIV diagnoses that represent substantial missed opportunities to improve health outcomes and prevent HIV transmission. Data from CDC's National HIV Surveillance System were used to estimate, among persons with HIV infection diagnosed in 2015, the median interval (and range) from infection to diagnosis (diagnosis delay), based on the first CD4 test after HIV diagnosis and a CD4 depletion model indicating disease progression and, among persons living with HIV in 2015, the percentage with undiagnosed infection. Data from CDC's National HIV Behavioral Surveillance were analyzed to determine the percentage of persons at increased risk for HIV infection who had tested in the past 12 months and who had missed opportunities for testing. An estimated 15% of persons living with HIV in 2015 were unaware of their infection. Among the 39,720 persons with HIV infection diagnosed in 2015, the estimated median diagnosis delay was 3.0 years (interquartile range = 0.7-7.8 years); diagnosis delay varied by race/ethnicity (from 2.2 years among whites to 4.2 years among Asians) and transmission category (from 2.0 years among females who inject drugs to 4.9 years among heterosexual males). Among persons interviewed through National HIV Behavioral Surveillance, 71% of men who have sex with men, 58% of persons who inject drugs, and 41% of heterosexual persons at increased risk for HIV infection reported testing in the past 12 months. In each risk group, at least two thirds of persons who did not have an HIV test had seen a health care provider in the past year. Delayed HIV diagnoses continue to be substantial for some population groups and prevent early entry to care to improve health outcomes and reduce HIV transmission to others. Health care providers and others providing HIV testing can reduce HIV-related adverse health outcomes and risk for HIV transmission by implementing routine and targeted HIV testing to decrease diagnosis delays.

Changes in cocaine consumption are associated with fluctuations in self-reported impulsivity and gambling decision-making.

PubMed

Hulka, L M; Vonmoos, M; Preller, K H; Baumgartner, M R; Seifritz, E; Gamma, A; Quednow, B B

2015-10-01

In cross-sectional studies, cocaine users generally display elevated levels of self-reported and cognitive impulsivity. To what extent these impairments are stable v. variable markers of cocaine use disorder, and, thus, are pre-existing or drug-induced, has not yet been systematically investigated. We conducted a longitudinal study with cocaine users who changed or maintained their consumption intensity, measuring self-reported impulsivity with the Barratt Impulsiveness Scale (BIS-11), and cognitive impulsivity with the Rapid Visual Processing task (RVP), Iowa Gambling task (IGT), and Delay Discounting task (DD) at baseline and at 1-year follow-up. We assessed 48 psychostimulant-naive controls and 19 cocaine users with decreased, 19 users with increased, and 19 users with unchanged cocaine intake after 1 year as confirmed by hair analysis. Results of linear multilevel modelling showed significant group × time interactions for the BIS-11 total score and the IGT total card ratio. Increasers showed a trend for elevated scores, whereas decreasers exhibited reduced self-reported impulsivity scores within 1 year. Surprisingly, increasers' IGT performance was improved after 1 year, whereas decreasers' performance deteriorated. By contrast, neither RVP response bias B" nor DD total score showed substantial group × time interactions. Importantly, BIS-11 and DD revealed strong test-retest reliabilities. Self-reported impulsivity (BIS-11) and decision-making impulsivity (IGT) covary with changing cocaine use, whereas response bias and delay discounting remain largely unaffected. Thus, self-reported impulsivity and gambling decision-making were strongly state-dependent in a stimulant-using population and may be suitable to monitor treatment success, whereas delay of gratification was confirmed as a potential endophenotype of stimulant addiction.

Perceived Delay in Healthcare-seeking for Episodes of Serious Illness and Its Implications for Safe Motherhood Interventions in Rural Bangladesh

PubMed Central

Killewo, J.; Bashir, I.; Yunus, M.; Chakraborty, J.

2006-01-01

Delay in accessing emergency obstetric-care facilities during life-threatening obstetric complications is a significant determinant of high maternal mortality in developing countries. To examine the factors associated with delays in seeking care for episodes of serious illness and their possible implications for safe motherhood interventions in rural Bangladesh, a cross-sectional study was initiated in Matlab sub-district on the perceptions of household heads regarding delays in seeking care for episodes of serious illness among household members. Of 2,177 households in the study, 881 (40.5%) reported at least one household member who experienced an illness perceived to be serious enough to warrant care-seeking either from health facilities or from providers. Of these, 775 (88.0%) actually visited some providers for treatment, of whom 79.1% used transport. Overall, 69.3% perceived a delay in deciding to seek care, while 12.1% and 24.6% perceived a delay in accessing transport and in reaching the provider respectively. The median time required to make a decision to seek care was 72 minutes, while the same was 10 minutes to get transport and 80 minutes to reach a facility or a provider. Time to decide to seek care was shortest for pregnancy-related conditions and longest for illnesses classified as chronic, while time to reach a facility was longest for pregnancy-related illnesses and shortest for illnesses classified as acute. However, the perceived delay in seeking care did not differ significantly across socioeconomic levels or gender categories but differed significantly between those seeking care from informal providers compared to formal providers. Reasons for the delay included waiting time for results of informal treatment, inability to judge the graveness of disease, and lack of money. For pregnancy-related morbidities, 45% reported ‘inability to judge the graveness of the situation’ as a reason for delay in making decision. After controlling for possible confounders in multivariate analysis, type of illness and facility visited were the strongest determinants of delay in making decision to seek care. To reduce delays in making decision to seek care in rural Bangladesh, safe motherhood interventions should intensify behaviour change-communication efforts to educate communities to recognize pregnancy-danger signs for which a prompt action must be taken to save life. This strategy should be combined with efforts to train community-based skilled birth attendants, upgrading public facilities to provide emergency obstetric care, introduce voucher schemes to improve access by the poorest of the poor, and improve the quality of care at all levels. PMID:17591337

The administrative population report on children with developmental delays in Taiwan, 2003 through 2007.

PubMed

Lin, Jin-Ding; Yen, Chia-Feng; Wu, Jia-Ling; Kang, Shih-Wan

2009-01-01

This paper was a population study with developmental delays and it included an examination of the trends the overtime change trend and reported channels of this group of people in Taiwan. We analyzed data for the present study mainly from the Department of Statistics, Ministry of the Interiors, Taipei, Taiwan: "Number of early intervention for children with developmental delays in Taiwan" from 2003 through 2007. The reported number of children with developmental delays slightly increased from 13,231 to 14,250 (increase rate=7.7%) from the year of 2003 through 2007 in Taiwan. More than one-half of children with developmental delays were reported during the age 3-5 years. Aged 0-2 group has the highest increasing reported numbers in the previous 5 years which changed dramatically increased from 4139 (31.3%) in 2003 to 6201 (43.5%) in 2007 (increase rate=49.8%). The medical care setting was the main reported channel of the children with developmental delays and the results also showed that the reported prevalence of the aged 0-2 developmentally delayed children was 57.4-102.2 per 10,000 children; aged 3-5 was 79.0-105.1 per 10,000 children from the year 2003-2007 in Taiwan. The present concluded that early intervention based on the precise affected population would provide important supports for families of children with developmental delays. Therefore, the health care system should be strengthened to increase the proportion of children identified at the earlier age and to decrease the variability in the age at identification for most of the conditions of children with developmental delays.

Improving Autopsy Report Turnaround Times by Implementing Lean Management Principles.

PubMed

Cromwell, Susan; Chiasson, David A; Cassidy, Debra; Somers, Gino R

2018-01-01

The autopsy is an integral part of the service of a large academic pathology department. Timely reporting is central to providing good service and is beneficial for many stakeholders, including the families, the clinical team, the hospital, and the wider community. The current study aimed to improve hospital-consented autopsy reporting times (turnaround time, TAT) by using lean principles modified for a healthcare setting, with an aim of signing out 90% of autopsies in 90 days. An audit of current and historical TATs was performed, and a working group incorporating administrative, technical, and professional staff constructed a value stream map documenting the steps involved in constructing an autopsy report. Two areas of delay were noted: examination of the microscopy and time taken to sign-out the report after the weekly autopsy conference. Several measures were implemented to address these delays, including visual tracking using a whiteboard and individualized tracking sheets, weekly whiteboard huddles, and timelier scheduling of clinicopathologic conference rounds. All measures resulted in an improvement of TATs. In the 30 months prior to the institution of lean, 37% of autopsies (53/144) were signed out in 90 days, with a wide variation in reporting times. In the 30 months following the institution of lean, this improved to 74% (136/185) ( P < .0001, Fisher exact test), with a marked reduction in variability. Further, the time from autopsy to presentation at weekly clinicopathological rounds was also reduced (median: 73 days prior to lean; 63 days post-lean). The application of lean principles to autopsy sign-out workflow can significantly improve TATs and reduce variability, without changing staffing levels or significantly altering scheduling structure.

Evening daylight may cause adolescents to sleep less in spring than in winter

PubMed Central

Figueiro, Mariana G.; Rea, Mark S.

2012-01-01

Sleep restriction commonly experienced by adolescents can stem from greater sleep pressure by the homeostatic processes and from phase delays of the circadian system. With regard to the latter potential cause, we hypothesized that because there is more natural evening light during the spring than winter, a sample of adolescent students would be more phase delayed in spring than in winter, would have later sleep onset times and, because of fixed school schedules, would have shorter sleep durations. Sixteen eighth-grade subjects were recruited for the study. We collected sleep logs and saliva samples to determine their dim light melatonin onset (DLMO), a well-established circadian marker. Actual circadian light exposures experienced by a subset of twelve subjects over the course of seven days in winter and in spring using a personal, head-worn, circadian light measurement device are also reported here. Results showed that this sample of adolescents was exposed to significantly more circadian light in spring than in winter, especially in the evening hours when light exposure would likely delay circadian phase. Consistent with the light data, DLMO and sleep onset times were significantly more delayed, and sleep durations were significantly shorter in spring than in winter. The present ecological study of light, circadian phase, and self-reported sleep suggests that greater access to evening daylight in the spring may lead to sleep restriction in adolescents while attending school. Therefore, lighting schemes that reduce evening light in the spring may encourage longer sleep times in adolescents. PMID:20653452

Introspective responses to cues and motivation to reduce cigarette smoking influence state and behavioral responses to cue exposure.

PubMed

Veilleux, Jennifer C; Skinner, Kayla D

2016-09-01

In the current study, we aimed to extend smoking cue-reactivity research by evaluating delay discounting as an outcome of cigarette cue exposure. We also separated introspection in response to cues (e.g., self-reporting craving and affect) from cue exposure alone, to determine if introspection changes behavioral responses to cigarette cues. Finally, we included measures of quit motivation and resistance to smoking to assess motivational influences on cue exposure. Smokers were invited to participate in an online cue-reactivity study. Participants were randomly assigned to view smoking images or neutral images, and were randomized to respond to cues with either craving and affect questions (e.g., introspection) or filler questions. Following cue exposure, participants completed a delay discounting task and then reported state affect, craving, and resistance to smoking, as well as an assessment of quit motivation. We found that after controlling for trait impulsivity, participants who introspected on craving and affect showed higher delay discounting, irrespective of cue type, but we found no effect of response condition on subsequent craving (e.g., craving reactivity). We also found that motivation to quit interacted with experimental conditions to predict state craving and state resistance to smoking. Although asking about craving during cue exposure did not increase later craving, it resulted in greater delaying of discounted rewards. Overall, our findings suggest the need to further assess the implications of introspection and motivation on behavioral outcomes of cue exposure. Copyright © 2016 Elsevier Ltd. All rights reserved.

Development and testing of a decision aid for women considering delayed breast reconstruction.

PubMed

Metcalfe, Kelly; Zhong, Toni; O'Neill, Anne C; McCready, David; Chan, Linda; Butler, Kate; Brennenstuhl, Sarah; Hofer, Stefan O P

2018-03-01

The decision to have post-mastectomy breast reconstruction (PMBR) is highly complex and many women feel ill equipped to make this decision. Decision aids have been advocated to promote patient involvement in decision-making by streamlining and standardizing communication between the patient and the health care professional. In this study, we report on the development and testing of a decision aid (DA) for breast cancer survivors considering delayed PMBR. The DA was developed and evaluated in three phases. The first phase included the development of the DA with input and review by practitioners and key stakeholders. The second phase involved pilot testing of the feasibility and acceptability of the DA with a convenience sample of women with delayed PMBR. The third phase involved a pretest/post-test evaluation of the DA for women who were making decisions about their PMBR options. The DA was developed using the Ottawa Decision Support Framework. In the second phase of the study, 21 women completed the acceptability survey, of whom 100% reported that they would recommend the DA to other women. In the third phase, decisional conflict decreased significantly (p < 0.001) and knowledge increased significantly (p < 0.001) from prior to using the DA to 1-2 weeks after using the DA. The DA is feasible and acceptable to women considering delayed PMBR. Furthermore, the DA is effective at reducing decisional conflict and increasing knowledge about delayed PMBR. The DA is an appropriate tool to be used in addition with standard care in women considering PMBR. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Strategic Attention Deployment for Delay of Gratification in Working and Waiting Situations.

ERIC Educational Resources Information Center

Peake, Philip K.; Hebl, Michelle; Mischel, Walter

2002-01-01

Two studies examined whether effects of attention to rewards during a delay of gratification task in waiting situations affects preschoolers' ability to delay gratification in working situations. Findings show that when work provides distraction, attention on rewards reduces delay time whether working or waiting; when work is not engaging,…

Impulsive choice and pre-exposure to delays: iv. effects of delay- and immediacy-exposure training relative to maturational changes in impulsivity.

PubMed

Renee Renda, C; Rung, Jillian M; Hinnenkamp, Jay E; Lenzini, Stephanie N; Madden, Gregory J

2018-04-23

Impulsive choice describes preference for smaller, sooner rewards over larger, later rewards. Excessive delay discounting (i.e., rapid devaluation of delayed rewards) underlies some impulsive choices, and is observed in many maladaptive behaviors (e.g., substance abuse, gambling). Interventions designed to reduce delay discounting may provide therapeutic gains. One such intervention provides rats with extended training with delayed reinforcers. When compared to a group given extended training with immediate reinforcers, delay-exposed rats make significantly fewer impulsive choices. To what extent is this difference due to delay-exposure training shifting preference toward self-control or immediacy-exposure training (the putative control group) shifting preference toward impulsivity? The current study compared the effects of delay- and immediacy-exposure training to a no-training control group and evaluated within-subject changes in impulsive choice across 51 male Wistar rats. Delay-exposed rats made significantly fewer impulsive choices than immediacy-exposed and control rats. Between-group differences in impulsive choice were not observed in the latter two groups. While delay-exposed rats showed large, significant pre- to posttraining reductions in impulsive choice, immediacy-exposed and control rats showed small reductions in impulsive choice. These results suggest that extended training with delayed reinforcers reduces impulsive choice, and that extended training with immediate reinforcers does not increase impulsive choice. © 2018 Society for the Experimental Analysis of Behavior.

Reducing the Handover Delay in FMIPv6 Using Proactive Care-of Address Scheme

NASA Astrophysics Data System (ADS)

Li, Yong; Jin, Depeng; Su, Li; Zeng, Lieguang

To deal with the increasing number of mobile devices accessing the Internet and the increasing demands of mobility management, IETF has proposed Mobile IPv6 and its fast handover protocol FMIPv6. In FMIPv6, the possibility of Care-of Address (CoA) collision and the time for Return Routability (RR) procedure result in long handover delay, which makes it unsuitable for real-time applications. In this paper, we propose an improved handover scheme for FMIPv6, which reduces the handover delay by using proactive CoA acquisition, configuration and test method. In our proposal, collision-free CoA is proactively prepared, and the time for RR procedure does not contribute to the handover delay. Furthermore, we analyze our proposal's benefits and overhead tradeoff. The numerical results demonstrate that it outperforms the current schemes, such as FMIPv6 and enhanced FMIPv6, on the aspect of handover delay and packet transmission delay.

Pathways to multidrug-resistant tuberculosis diagnosis and treatment initiation: a qualitative comparison of patients' experiences in the era of rapid molecular diagnostic tests.

PubMed

Naidoo, Pren; van Niekerk, Margaret; du Toit, Elizabeth; Beyers, Nulda; Leon, Natalie

2015-10-28

Although new molecular diagnostic tests such as GenoType MTBDRplus and Xpert® MTB/RIF have reduced multidrug-resistant tuberculosis (MDR-TB) treatment initiation times, patients' experiences of diagnosis and treatment initiation are not known. This study aimed to explore and compare MDR-TB patients' experiences of their diagnostic and treatment initiation pathway in GenoType MTBDRplus and Xpert® MTB/RIF-based diagnostic algorithms. The study was undertaken in Cape Town, South Africa where primary health-care services provided free TB diagnosis and treatment. A smear, culture and GenoType MTBDRplus diagnostic algorithm was used in 2010, with Xpert® MTB/RIF phased in from 2011-2013. Participants diagnosed in each algorithm at four facilities were purposively sampled, stratifying by age, gender and MDR-TB risk profiles. We conducted in-depth qualitative interviews using a semi-structured interview guide. Through constant comparative analysis we induced common and divergent themes related to symptom recognition, health-care access, testing for MDR-TB and treatment initiation within and between groups. Data were triangulated with clinical information and health visit data from a structured questionnaire. We identified both enablers and barriers to early MDR-TB diagnosis and treatment. Half the patients had previously been treated for TB; most recognised recurring symptoms and reported early health-seeking. Those who attributed symptoms to other causes delayed health-seeking. Perceptions of poor public sector services were prevalent and may have contributed both to deferred health-seeking and to patient's use of the private sector, contributing to delays. However, once on treatment, most patients expressed satisfaction with public sector care. Two patients in the Xpert® MTB/RIF-based algorithm exemplified its potential to reduce delays, commencing MDR-TB treatment within a week of their first health contact. However, most patients in both algorithms experienced substantial delays. Avoidable health system delays resulted from providers not testing for TB at initial health contact, non-adherence to testing algorithms, results not being available and failure to promptly recall patients with positive results. Whilst the introduction of rapid tests such as Xpert® MTB/RIF can expedite MDR-TB diagnosis and treatment initiation, the full benefits are unlikely to be realised without reducing delays in health-seeking and addressing the structural barriers present in the health-care system.

EXPOSURE TO DIETHYL HEXYL PHTHALATE (DEHP) DELAYS PUBERTY AND REDUCES ANDROGEN-DEPENDENT TISSUE WEIGHTS IN LONG EVANS HOODED AND SPRAGUE DAWLEY MALE RATS

EPA Science Inventory

DEHP is a plasticizer that alters sexual differentiation in the male rat by reducing fetal Leydig cell testosterone synthesis and insl3 mRNA levels. When exposure includes the pubertal stage of life, DEHP and other phthalates delay puberty and reduce androgen-dependent tissue wei...

Implementing the Bounce Back trauma intervention in urban elementary schools: A real-world replication trial.

PubMed

Santiago, Catherine DeCarlo; Raviv, Tali; Ros, Anna Maria; Brewer, Stephanie K; Distel, Laura M L; Torres, Stephanie A; Fuller, Anne K; Lewis, Krystal M; Coyne, Claire A; Cicchetti, Colleen; Langley, Audra K

2018-03-01

The current study provides the first replication trial of Bounce Back, a school-based intervention for elementary students exposed to trauma, in a different school district and geographical area. Participants in this study were 52 1st through 4th graders (Mage = 7.76 years; 65% male) who were predominately Latino (82%). Schools were randomly assigned to immediate treatment or waitlist control. Differential treatment effects (Time × Group Interaction) were found for child-reported posttraumatic stress disorder (PTSD) and parent-reported child coping, indicating that the immediate treatment group showed greater reductions in PTSD and improvements in coping compared with the delayed group. Differential treatment effects were not significant for depression or anxiety. Significant maintenance effects were found for both child-reported PTSD and depression as well as parent-reported PTSD and coping for the immediate treatment group at follow-up. Significant treatment effects were also found in the delayed treatment group, showing reductions in child-reported PTSD, depression, and anxiety as well as parent-reported depression and coping upon receiving treatment. In conclusion, the current study suggests that Bounce Back is an effective intervention for reducing PTSD symptoms and improving coping skills, even among a sample experiencing high levels of trauma and other ongoing stressors. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Dramatic robustness of a multiple delay dispersed interferometer to spectrograph errors: how mixing delays reduces or cancels wavelength drift

NASA Astrophysics Data System (ADS)

Erskine, David J.; Linder, E.; Wishnow, E.; Edelstein, J.; Sirk, M.; Muirhead, P.; Lloyd, J.; Kim, A.

2016-08-01

We describe demonstrations of remarkable robustness to instrumental noises by using a multiple delay externally dispersed interferometer (EDI) on stellar observations at the Hale telescope. Previous observatory EDI demonstrations used a single delay. The EDI (also called "TEDI") boosted the 2,700 resolution of the native TripleSpec NIR spectrograph (950-2450 nm) by as much as 10x to 27,000, using 7 overlapping delays up to 3 cm. We observed superb rejection of fixed pattern noises due to bad pixels, since the fringing signal responds only to changes in multiple exposures synchronous to the applied delay dithering. Remarkably, we observed a 20x reduction of reaction in the output spectrum to PSF shifts of the native spectrograph along the dispersion direction, using our standard processing. This allowed high resolution observations under conditions of severe and irregular PSF drift otherwise not possible without the interferometer. Furthermore, we recently discovered an improved method of weighting and mixing data between pairs of delays that can theoretically further reduce the net reaction to PSF drift to zero. We demonstrate a 350x reduction in reaction to a native PSF shift using a simple simulation. This technique could similarly reduce radial velocity noise for future EDI's that use two delays overlapped in delay space (or a single delay overlapping the native peak). Finally, we show an extremely high dynamic range EDI measurement of our ThAr lamp compared to a literature ThAr spectrum, observing weak features ( 0.001x height of nearest strong line) that occur between the major lines. Because of individuality of each reference lamp, accurate knowledge of its spectrum between the (unfortunately) sparse major lines is important for precision radial velocimetry.

Interaction of Airspace Partitions and Traffic Flow Management Delay

NASA Technical Reports Server (NTRS)

Palopo, Kee; Chatterji, Gano B.; Lee, Hak-Tae

2010-01-01

To ensure that air traffic demand does not exceed airport and airspace capacities, traffic management restrictions, such as delaying aircraft on the ground, assigning them different routes and metering them in the airspace, are implemented. To reduce the delays resulting from these restrictions, revising the partitioning of airspace has been proposed to distribute capacity to yield a more efficient airspace configuration. The capacity of an airspace partition, commonly referred to as a sector, is limited by the number of flights that an air traffic controller can safely manage within the sector. Where viable, re-partitioning of the airspace distributes the flights over more efficient sectors and reduces individual sector demand. This increases the overall airspace efficiency, but requires additional resources in some sectors in terms of controllers and equipment, which is undesirable. This study examines the tradeoff of the number of sectors designed for a specified amount of traffic in a clear-weather day and the delays needed for accommodating the traffic demand. Results show that most of the delays are caused by airport arrival and departure capacity constraints. Some delays caused by airspace capacity constraints can be eliminated by re-partitioning the airspace. Analyses show that about 360 high-altitude sectors, which are approximately today s operational number of sectors of 373, are adequate for delays to be driven solely by airport capacity constraints for the current daily air traffic demand. For a marginal increase of 15 seconds of average delay, the number of sectors can be reduced to 283. In addition, simulations of traffic growths of 15% and 20% with forecasted airport capacities in the years 2018 and 2025 show that delays will continue to be governed by airport capacities. In clear-weather days, for small increases in traffic demand, increasing sector capacities will have almost no effect on delays.

Delays in healthcare delivery to sick neonates in Enugu South-East Nigeria: an analysis of causes and effects.

PubMed

Ekwochi, Uchenna; Ndu, Ikenna K; Osuorah, Chidiebere D I; Onah, Kenechi S; Obuoha, Ejike; Odetunde, Odutola I; Nwokoye, Ikenna; Obumneme-Anyim, Nnenne I; Okeke, Ifeyinwa B; Amadi, Ogechukwu F

2016-06-01

In most parts of the world, neonatal mortality rates have shown a slower decline when compared with under-5 mortality decline. A sick newborn can die within minutes if there is a delay in presentation, thus early diagnosis and treatment are essential for the survival of a critically ill newborn. This study investigated factors responsible for delays in healthcare services for the sick newborn and maternal socio-demographic variables that influence these delays in Enugu, South-East Nigeria. This was a community-based descriptive study. A total of 376 respondents were randomly selected from 4 of the 17 local government areas of Enugu State. Mothers and/or caregivers that were nursing or had nursed a child in the previous 2 years were enrolled. Self-reported data on delays encountered during healthcare for sick newborn were collected using pretested structured questionnaire. Chi-square and multivariate logistic regression were used to determine the association between causes of delays in newborn healthcare services, maternal socio-demographics and relationships with newborn mortality. Delays in reaching healthcare facilities accounted for the most common delays encountered by respondents, 78.0%, in this study, followed by delays at household level, 24.2% and delays at health facility level 16.0% (P = 0.000). Mothers with knowledge of ≥3 WHO recognized danger signs compared with those with ≤2 were significantly less likely to delay at household (level 1: 40.7 versus 59.3%) (P = 0.017) and reaching healthcare service (level 2: 19.9 versus 80.1%) (P = 0.028). Delays at health facility level (level 3) occurred more at tertiary health facilities (59.0%), secondary health facilities (39.1%) and primary healthcare facilities (19.7%) compared with private health facilities (13.5%) (P = 0.000). Delays in seeking healthcare at all levels especially those related to transporting the sick newborn to the hospital are a contributor to newborn mortality in Nigeria. Improving access to healthcare could potentially reduce mortality in the sick newborn. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Adaptive Aggregation Routing to Reduce Delay for Multi-Layer Wireless Sensor Networks.

PubMed

Li, Xujing; Liu, Anfeng; Xie, Mande; Xiong, Neal N; Zeng, Zhiwen; Cai, Zhiping

2018-04-16

The quality of service (QoS) regarding delay, lifetime and reliability is the key to the application of wireless sensor networks (WSNs). Data aggregation is a method to effectively reduce the data transmission volume and improve the lifetime of a network. In the previous study, a common strategy required that data wait in the queue. When the length of the queue is greater than or equal to the predetermined aggregation threshold ( N t ) or the waiting time is equal to the aggregation timer ( T t ), data are forwarded at the expense of an increase in the delay. The primary contributions of the proposed Adaptive Aggregation Routing (AAR) scheme are the following: (a) the senders select the forwarding node dynamically according to the length of the data queue, which effectively reduces the delay. In the AAR scheme, the senders send data to the nodes with a long data queue. The advantages are that first, the nodes with a long data queue need a small amount of data to perform aggregation; therefore, the transmitted data can be fully utilized to make these nodes aggregate. Second, this scheme balances the aggregating and data sending load; thus, the lifetime increases. (b) An improved AAR scheme is proposed to improve the QoS. The aggregation deadline ( T t ) and the aggregation threshold ( N t ) are dynamically changed in the network. In WSNs, nodes far from the sink have residual energy because these nodes transmit less data than the other nodes. In the improved AAR scheme, the nodes far from the sink have a small value of T t and N t to reduce delay, and the nodes near the sink are set to a large value of T t and N t to reduce energy consumption. Thus, the end to end delay is reduced, a longer lifetime is achieved, and the residual energy is fully used. Simulation results demonstrate that compared with the previous scheme, the performance of the AAR scheme is improved. This scheme reduces the delay by 14.91%, improves the lifetime by 30.91%, and increases energy efficiency by 76.40%.

Adaptive Aggregation Routing to Reduce Delay for Multi-Layer Wireless Sensor Networks

PubMed Central

Li, Xujing; Xie, Mande; Zeng, Zhiwen; Cai, Zhiping

2018-01-01

The quality of service (QoS) regarding delay, lifetime and reliability is the key to the application of wireless sensor networks (WSNs). Data aggregation is a method to effectively reduce the data transmission volume and improve the lifetime of a network. In the previous study, a common strategy required that data wait in the queue. When the length of the queue is greater than or equal to the predetermined aggregation threshold (Nt) or the waiting time is equal to the aggregation timer (Tt), data are forwarded at the expense of an increase in the delay. The primary contributions of the proposed Adaptive Aggregation Routing (AAR) scheme are the following: (a) the senders select the forwarding node dynamically according to the length of the data queue, which effectively reduces the delay. In the AAR scheme, the senders send data to the nodes with a long data queue. The advantages are that first, the nodes with a long data queue need a small amount of data to perform aggregation; therefore, the transmitted data can be fully utilized to make these nodes aggregate. Second, this scheme balances the aggregating and data sending load; thus, the lifetime increases. (b) An improved AAR scheme is proposed to improve the QoS. The aggregation deadline (Tt) and the aggregation threshold (Nt) are dynamically changed in the network. In WSNs, nodes far from the sink have residual energy because these nodes transmit less data than the other nodes. In the improved AAR scheme, the nodes far from the sink have a small value of Tt and Nt to reduce delay, and the nodes near the sink are set to a large value of Tt and Nt to reduce energy consumption. Thus, the end to end delay is reduced, a longer lifetime is achieved, and the residual energy is fully used. Simulation results demonstrate that compared with the previous scheme, the performance of the AAR scheme is improved. This scheme reduces the delay by 14.91%, improves the lifetime by 30.91%, and increases energy efficiency by 76.40%. PMID:29659535

Reconciling quality and cost: A case study in interventional radiology.

PubMed

Zhang, Li; Domröse, Sascha; Mahnken, Andreas

2015-10-01

To provide a method to calculate delay cost and examine the relationship between quality and total cost. The total cost including capacity, supply and delay cost for running an interventional radiology suite was calculated. The capacity cost, consisting of labour, lease and overhead costs, was derived based on expenses per unit time. The supply cost was calculated according to actual procedural material use. The delay cost and marginal delay cost derived from queueing models was calculated based on waiting times of inpatients for their procedures. Quality improvement increased patient safety and maintained the outcome. The average daily delay costs were reduced from 1275 € to 294 €, and marginal delay costs from approximately 2000 € to 500 €, respectively. The one-time annual cost saved from the transfer of surgical to radiological procedures was approximately 130,500 €. The yearly delay cost saved was approximately 150,000 €. With increased revenue of 10,000 € in project phase 2, the yearly total cost saved was approximately 290,000 €. Optimal daily capacity of 4.2 procedures was determined. An approach for calculating delay cost toward optimal capacity allocation was presented. An overall quality improvement was achieved at reduced costs. • Improving quality in terms of safety, outcome, efficiency and timeliness reduces cost. • Mismatch of demand and capacity is detrimental to quality and cost. • Full system utilization with random demand results in long waiting periods and increased cost.

School Start Times, Sleep, Behavioral, Health, and Academic Outcomes: a Review of the Literature

PubMed Central

Chapman, Daniel P.; Croft, Janet B.

2015-01-01

BACKGROUND Insufficient sleep in adolescents has been shown to be associated with a wide variety of adverse outcomes, from poor mental and physical health to behavioral problems and lower academic grades. However, most high school students do not get sufficient sleep. Delaying school start times for adolescents has been proposed as a policy change to address insufficient sleep in this population and potentially to improve students’ academic performance, reduce engagement in risk behaviors, and improve health. METHODS This paper reviews 38 reports examining the association between school start times, sleep, and other outcomes among adolescent students. RESULTS Most studies reviewed provide evidence that delaying school start time increases weeknight sleep duration among adolescents, primarily by delaying rise times. Most of the studies saw a significant increase in sleep duration even with relatively small delays in start times of half an hour or so. Later start times also generally correspond to improved attendance, less tardiness, less falling asleep in class, better grades, and fewer motor vehicle crashes. CONCLUSIONS Although additional research is necessary, research results that are already available should be disseminated to stakeholders to enable the development of evidence-based school policies. PMID:27040474

International Workshop on Neuroimmunomodulation (2nd) Held in Dubrovnik (Yugoslavia) on 1-6 June 1986.

DTIC Science & Technology

1986-09-18

systemically with doses of reaction) were sharply reduced. Histo- naltrexone or naloxone and subsequently logically, the infiltration of the dermis...challenged with a lethal dose of antigen. with polymorphonuclear (Arthus reaction) Both naloxone and naltrexone were found and mononuclear cells (delayed...for Integrative Biomedical Research, Eb- roendocrine cell type present in low num- matingen, Switzerland) reported on the bers in the spleen, lymph

Altered neural reward representations in pathological gamblers revealed by delay and probability discounting.

PubMed

Miedl, Stephan F; Peters, Jan; Büchel, Christian

2012-02-01

The neural basis of excessive delay discounting and reduced risk sensitivity of pathological gamblers with a particular focus on subjective neural reward representations has not been previously examined. To examine how pathological gamblers represent subjective reward value at a neural level and how this is affected by gambling severity. Model-based functional magnetic resonance imaging study with patients and control subjects. Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf. Participants were recruited from the local community by advertisement and through self-help groups. A sample of 16 pathological gamblers (according to the DSM-IV definition) was matched by age, sex, smoking status, income, educational level, and handedness to 16 healthy controls. Pathological gamblers showed increased discounting of delayed rewards and a trend toward decreased discounting of probabilistic rewards compared with matched controls. At the neural level, a significant group × condition interaction indicated that reward representations in the gamblers were modulated in a condition-specific manner, such that they exhibited increased (delay discounting) and decreased (probability discounting) neural value correlations in the reward system. In addition, throughout the reward system, neuronal value signals for delayed rewards were negatively correlated with gambling severity. The results extend previous reports of a generally hypoactive reward system in pathological gamblers by showing that, even when subjective reward valuation is accounted for, gamblers still show altered reward representations. Furthermore, results point toward a gradual degradation of mesolimbic reward representations for delayed rewards during the course of pathological gambling.

Heterogeneity of residuals from comparison of GNSS and raytracing based troposphere slant total delays, as an indicator of hydrometeors

NASA Astrophysics Data System (ADS)

Hordyniec, Paweł; Rohm, Witold; Kapłon, Jan

2017-04-01

Post-fit residuals from Precise Point Positioning (PPP) carry the troposphere information except of multipath and residual antenna Phase Centre Variations (PCVs), when precise satellite orbits and clocks were introduced. Slant total delay (STD) of GNSS signal is a sum of a priori slant hydrostatic delay, estimated wet delay, asymetry introduced by the estimated zenith total delay (ZTD) horizontal gradients and a post-fit residual reduced by the systematic (site-dependant) effect. It was revealed, that application of reduced post-fit residuls to the slant total delays obtained from GNSS data processing increases the discrepancy with slant delays from raytracing (RT) through the Numerical Weather Model (NWM). One of the possible sources of that effect is neglected influence of hydrometeors in raytracing procedures. If the assumption of hydrometeor information existence in the PPP post-fit residuals is correct, we expect the diversity of slant delay discrepancies for satellite-receiver rays pointing or not the hydrometeors. Paper presents the spatial and temporal correlation analysis of the slant delay residuals (GNSS - RT) with hydrometeor phenomena recorded during the COST ES1206 GNSS4SWEC benchmark period (May 5th - June 29th, 2013). It presents the discussion of the results from different GNSS PPP slant delay estimation approaches including coordinates unconstraining or heavy constraining, and the calculation of slant delays with and without ZTD horizontal gradients estimation.

A World Wide Web-based antimicrobial stewardship program improves efficiency, communication, and user satisfaction and reduces cost in a tertiary care pediatric medical center.

PubMed

Agwu, Allison L; Lee, Carlton K K; Jain, Sanjay K; Murray, Kara L; Topolski, Jason; Miller, Robert E; Townsend, Timothy; Lehmann, Christoph U

2008-09-15

Antimicrobial stewardship programs aim to reduce inappropriate hospital antimicrobial use. At the Johns Hopkins Children's Medical and Surgical Center (Baltimore, MD), we implemented a World Wide Web-based antimicrobial restriction program to address problems with the existing restriction program. A user survey identified opportunities for improvement of an existing antimicrobial restriction program and resulted in subsequent design, implementation, and evaluation of a World Wide Web-based antimicrobial restriction program at a 175-bed, tertiary care pediatric teaching hospital. The program provided automated clinical decision support, facilitated approval, and enhanced real-time communication among prescribers, pharmacists, and pediatric infectious diseases fellows. Approval status, duration, and rationale; missing request notifications; and expiring approvals were stored in a database that is accessible via a secure Intranet site. Before and after implementation of the program, user satisfaction, reports of missed and/or delayed doses, antimicrobial dispensing times, and cost were evaluated. After implementation of the program, there was a $370,069 reduction in projected annual cost associated with restricted antimicrobial use and an 11.6% reduction in the number of dispensed doses. User satisfaction increased from 22% to 68% and from 13% to 69% among prescribers and pharmacists, respectively. There were 21% and 32% reductions in the number of prescriber reports of missed and delayed doses, respectively, and there was a 37% reduction in the number of pharmacist reports of delayed approvals; measured dispensing times were unchanged (P = .24). In addition, 40% fewer restricted antimicrobial-related phone calls were noted by the pharmacy. The World Wide Web-based antimicrobial approval program led to improved communication, more-efficient antimicrobial administration, increased user satisfaction, and significant cost savings. Integrated tools, such as this World Wide Web-based antimicrobial approval program, will effectively enhance antimicrobial stewardship programs.

A new VOX technique for reducing noise in voice communication systems. [voice operated keying

NASA Technical Reports Server (NTRS)

Morris, C. F.; Morgan, W. C.; Shack, P. E.

1974-01-01

A VOX technique for reducing noise in voice communication systems is described which is based on the separation of voice signals into contiguous frequency-band components with the aid of an adaptive VOX in each band. It is shown that this processing scheme can effectively reduce both wideband and narrowband quasi-periodic noise since the threshold levels readjust themselves to suppress noise that exceeds speech components in each band. Results are reported for tests of the adaptive VOX, and it is noted that improvements can still be made in such areas as the elimination of noise pulses, phoneme reproduction at high-noise levels, and the elimination of distortion introduced by phase delay.

Episodic Future Thinking: Expansion of the Temporal Window in Individuals with Alcohol Dependence.

PubMed

Snider, Sarah E; LaConte, Stephen M; Bickel, Warren K

2016-07-01

Episodic future thinking (EFT) requires an individual to vividly pre-experience a realistic future event. Inspired by previous reports of reducing delay discounting following EFT in other populations, we examined the effects of engaging alcohol-dependent individuals in EFT or episodic recent thinking (ERT; control) to examine its effects on delay discounting and alcohol purchasing. Participants (n = 50) with alcohol dependence were allocated into EFT or ERT groups and asked to generate positive future or recent past events for each of 5 time points. Participants then completed a delay-discounting task, during which event cues were displayed, and a hypothetical alcohol purchase task. EFT significantly increased valuation of future monetary rewards, while decreasing initial consumption (Q0 ) of alcoholic drinks indicative of lower demand intensity. Two additional findings suggest potential moderators of this effect. EFT more readily influenced individuals with lower Alcohol Use Disorders Identification Test scores, and self-reported cue valence differed between groups. Together, these results suggest a widening of alcohol-dependent individuals' temporal window following engagement of EFT. While our data suggest that EFT may be moderated by certain susceptibility criteria, exercises such as EFT could be easily adaptable as a potential therapeutic tool for use in rehabilitation programs. Copyright © 2016 by the Research Society on Alcoholism.

Time-delayed chameleon: Analysis, synchronization and FPGA implementation

NASA Astrophysics Data System (ADS)

Rajagopal, Karthikeyan; Jafari, Sajad; Laarem, Guessas

2017-12-01

In this paper we report a time-delayed chameleon-like chaotic system which can belong to different families of chaotic attractors depending on the choices of parameters. Such a characteristic of self-excited and hidden chaotic flows in a simple 3D system with time delay has not been reported earlier. Dynamic analysis of the proposed time-delayed systems are analysed in time-delay space and parameter space. A novel adaptive modified functional projective lag synchronization algorithm is derived for synchronizing identical time-delayed chameleon systems with uncertain parameters. The proposed time-delayed systems and the synchronization algorithm with controllers and parameter estimates are then implemented in FPGA using hardware-software co-simulation and the results are presented.

A common haplotype lowers PU.1 expression in myeloid cells and delays onset of Alzheimer's disease.

PubMed

Huang, Kuan-Lin; Marcora, Edoardo; Pimenova, Anna A; Di Narzo, Antonio F; Kapoor, Manav; Jin, Sheng Chih; Harari, Oscar; Bertelsen, Sarah; Fairfax, Benjamin P; Czajkowski, Jake; Chouraki, Vincent; Grenier-Boley, Benjamin; Bellenguez, Céline; Deming, Yuetiva; McKenzie, Andrew; Raj, Towfique; Renton, Alan E; Budde, John; Smith, Albert; Fitzpatrick, Annette; Bis, Joshua C; DeStefano, Anita; Adams, Hieab H H; Ikram, M Arfan; van der Lee, Sven; Del-Aguila, Jorge L; Fernandez, Maria Victoria; Ibañez, Laura; Sims, Rebecca; Escott-Price, Valentina; Mayeux, Richard; Haines, Jonathan L; Farrer, Lindsay A; Pericak-Vance, Margaret A; Lambert, Jean Charles; van Duijn, Cornelia; Launer, Lenore; Seshadri, Sudha; Williams, Julie; Amouyel, Philippe; Schellenberg, Gerard D; Zhang, Bin; Borecki, Ingrid; Kauwe, John S K; Cruchaga, Carlos; Hao, Ke; Goate, Alison M

2017-08-01

A genome-wide survival analysis of 14,406 Alzheimer's disease (AD) cases and 25,849 controls identified eight previously reported AD risk loci and 14 novel loci associated with age at onset. Linkage disequilibrium score regression of 220 cell types implicated the regulation of myeloid gene expression in AD risk. The minor allele of rs1057233 (G), within the previously reported CELF1 AD risk locus, showed association with delayed AD onset and lower expression of SPI1 in monocytes and macrophages. SPI1 encodes PU.1, a transcription factor critical for myeloid cell development and function. AD heritability was enriched within the PU.1 cistrome, implicating a myeloid PU.1 target gene network in AD. Finally, experimentally altered PU.1 levels affected the expression of mouse orthologs of many AD risk genes and the phagocytic activity of mouse microglial cells. Our results suggest that lower SPI1 expression reduces AD risk by regulating myeloid gene expression and cell function.

Delay Discounting of Losses in Alcohol Use Disorders and Antisocial Psychopathology: Effects of a Working Memory Load.

PubMed

Gerst, Kyle R; Gunn, Rachel L; Finn, Peter R

2017-10-01

Alcohol use disorders (AUDs) are associated with increased discounting of delayed rewards and reduced executive working memory (eWM) capacity. This association is amplified when comorbid with antisocial psychopathology (AP). Furthermore, recent studies suggest that reduced WM capacity is associated with disinhibited decisions reflected by increased impulsive decision making on the delay discounting of rewards task. While discounting of delayed rewards is well studied, the discounting of delayed losses has received significantly less experimental attention. The current study investigated (i) the rate of discounting of delayed losses in individuals with AUD only (n = 61), AUD with comorbid AP (n = 79) and healthy controls (n = 64); (ii) the relationship between eWM capacity and discounting of delayed losses; and (iii) the effect of a WM load on discounting of delayed losses. Discounting performance was assessed using a computerized discounting of delayed losses task. Results showed that the AUD-only and AUD-AP groups had higher rates of discounting of delayed losses and lower eWM capacity compared to the control groups. Lower individual eWM capacity was associated with increased discounting of delayed losses. However, WM load did not increase discounting rates overall. These results support the hypothesis that greater discounting of delayed losses is associated with AUD and comorbid AP problems and lower individual eWM capacity. Copyright © 2017 by the Research Society on Alcoholism.

Advanced Control Algorithms for Compensating the Phase Distortion Due to Transport Delay in Human-Machine Systems

NASA Technical Reports Server (NTRS)

Guo, Liwen; Cardullo, Frank M.; Kelly, Lon C.

2007-01-01

The desire to create more complex visual scenes in modern flight simulators outpaces recent increases in processor speed. As a result, simulation transport delay remains a problem. New approaches for compensating the transport delay in a flight simulator have been developed and are presented in this report. The lead/lag filter, the McFarland compensator and the Sobiski/Cardullo state space filter are three prominent compensators. The lead/lag filter provides some phase lead, while introducing significant gain distortion in the same frequency interval. The McFarland predictor can compensate for much longer delay and cause smaller gain error in low frequencies than the lead/lag filter, but the gain distortion beyond the design frequency interval is still significant, and it also causes large spikes in prediction. Though, theoretically, the Sobiski/Cardullo predictor, a state space filter, can compensate the longest delay with the least gain distortion among the three, it has remained in laboratory use due to several limitations. The first novel compensator is an adaptive predictor that makes use of the Kalman filter algorithm in a unique manner. In this manner the predictor can accurately provide the desired amount of prediction, while significantly reducing the large spikes caused by the McFarland predictor. Among several simplified online adaptive predictors, this report illustrates mathematically why the stochastic approximation algorithm achieves the best compensation results. A second novel approach employed a reference aircraft dynamics model to implement a state space predictor on a flight simulator. The practical implementation formed the filter state vector from the operator s control input and the aircraft states. The relationship between the reference model and the compensator performance was investigated in great detail, and the best performing reference model was selected for implementation in the final tests. Theoretical analyses of data from offline simulations with time delay compensation show that both novel predictors effectively suppress the large spikes caused by the McFarland compensator. The phase errors of the three predictors are not significant. The adaptive predictor yields greater gain errors than the McFarland predictor for short delays (96 and 138 ms), but shows smaller errors for long delays (186 and 282 ms). The advantage of the adaptive predictor becomes more obvious for a longer time delay. Conversely, the state space predictor results in substantially smaller gain error than the other two predictors for all four delay cases.

Improving traffic flow at a 2-to-1 lane reduction with wirelessly connected, adaptive cruise control vehicles

NASA Astrophysics Data System (ADS)

Davis, L. C.

2016-06-01

Wirelessly connected vehicles that exchange information about traffic conditions can reduce delays caused by congestion. At a 2-to-1 lane reduction, the improvement in flow past a bottleneck due to traffic with a random mixture of 40% connected vehicles is found to be 52%. Control is based on connected-vehicle-reported velocities near the bottleneck. In response to indications of congestion the connected vehicles, which are also adaptive cruise control vehicles, reduce their speed in slowdown regions. Early lane changes of manually driven vehicles from the terminated lane to the continuous lane are induced by the slowing connected vehicles. Self-organized congestion at the bottleneck is thus delayed or eliminated, depending upon the incoming flow magnitude. For the large majority of vehicles, travel times past the bottleneck are substantially reduced. Control is responsible for delaying the onset of congestion as the incoming flow increases. Adaptive cruise control increases the flow out of the congested state at the bottleneck. The nature of the congested state, when it occurs, appears to be similar under a variety of conditions. Typically 80-100 vehicles are approximately equally distributed between the lanes in the 500 m region prior to the end of the terminated lane. Without the adaptive cruise control capability, connected vehicles can delay the onset of congestion but do not increase the asymptotic flow past the bottleneck. Calculations are done using the Kerner-Klenov three-phase theory, stochastic discrete-time model for manual vehicles. The dynamics of the connected vehicles is given by a conventional adaptive cruise control algorithm plus commanded deceleration. Because time in the model for manual vehicles is discrete (one-second intervals), it is assumed that the acceleration of any vehicle immediately in front of a connected vehicle is constant during the time interval, thereby preserving the computational simplicity and speed of a discrete-time model.

Residency Training: Quality improvement projects in neurology residency and fellowship: applying DMAIC methodology.

PubMed

Kassardjian, Charles D; Williamson, Michelle L; van Buskirk, Dorothy J; Ernste, Floranne C; Hunderfund, Andrea N Leep

2015-07-14

Teaching quality improvement (QI) is a priority for residency and fellowship training programs. However, many medical trainees have had little exposure to QI methods. The purpose of this study is to review a rigorous and simple QI methodology (define, measure, analyze, improve, and control [DMAIC]) and demonstrate its use in a fellow-driven QI project aimed at reducing the number of delayed and canceled muscle biopsies at our institution. DMAIC was utilized. The project aim was to reduce the number of delayed muscle biopsies to 10% or less within 24 months. Baseline data were collected for 12 months. These data were analyzed to identify root causes for muscle biopsy delays and cancellations. Interventions were developed to address the most common root causes. Performance was then remeasured for 9 months. Baseline data were collected on 97 of 120 muscle biopsies during 2013. Twenty biopsies (20.6%) were delayed. The most common causes were scheduling too many tests on the same day and lack of fasting. Interventions aimed at patient education and biopsy scheduling were implemented. The effect was to reduce the number of delayed biopsies to 6.6% (6/91) over the next 9 months. Familiarity with QI methodologies such as DMAIC is helpful to ensure valid results and conclusions. Utilizing DMAIC, we were able to implement simple changes and significantly reduce the number of delayed muscle biopsies at our institution. © 2015 American Academy of Neurology.

Trail-Based Search for Efficient Event Report to Mobile Actors in Wireless Sensor and Actor Networks †

PubMed Central

Xu, Zhezhuang; Liu, Guanglun; Yan, Haotian; Cheng, Bin; Lin, Feilong

2017-01-01

In wireless sensor and actor networks, when an event is detected, the sensor node needs to transmit an event report to inform the actor. Since the actor moves in the network to execute missions, its location is always unavailable to the sensor nodes. A popular solution is the search strategy that can forward the data to a node without its location information. However, most existing works have not considered the mobility of the node, and thus generate significant energy consumption or transmission delay. In this paper, we propose the trail-based search (TS) strategy that takes advantage of actor’s mobility to improve the search efficiency. The main idea of TS is that, when the actor moves in the network, it can leave its trail composed of continuous footprints. The search packet with the event report is transmitted in the network to search the actor or its footprints. Once an effective footprint is discovered, the packet will be forwarded along the trail until it is received by the actor. Moreover, we derive the condition to guarantee the trail connectivity, and propose the redundancy reduction scheme based on TS (TS-R) to reduce nontrivial transmission redundancy that is generated by the trail. The theoretical and numerical analysis is provided to prove the efficiency of TS. Compared with the well-known expanding ring search (ERS), TS significantly reduces the energy consumption and search delay. PMID:29077017

Waiting to Attend College. Undergraduates Who Delay Their Postsecondary Enrollment. Postsecondary Education Descriptive Analysis Report. NCES 2005?152

ERIC Educational Resources Information Center

Horn, Laura; Cataldi, Emily Forrest; Sikora, Anna

2005-01-01

The purpose of this report is to provide a profile of students who delay their postsecondary enrollment and then to distinguish among students who delay their postsecondary enrollment with respect to how long they wait to enroll. In particular, it addresses the ways in which those who delay a shorter amount of time differ from those who delay…

Fracture of the penis: an atypical presentation.

PubMed

Waseem, Muhammad; Upadhyay, Ruchi; Kapoor, Ramnath; Agyare, Samuel

2013-08-13

Fracture of the penis is an uncommon injury presenting to the emergency department (ED). Personal embarrassment and social scenarios associated with this condition may result in underreporting. Patients often delay seeking medical attention, and even when they do, as in our case report, they may withhold the condition for a significant time. ED physicians need to be aware of the social inhibitions and the need for early diagnosis and prompt treatment. A delay in treatment increases the risk of complications such as ischemia, necrosis and penile deformity.Fracture of the penis is caused by rupture of the tunica albuginea of one or both corpora cavernosa by a blunt trauma to the erect penis. Diagnosis is usually clinical as evident by the characteristic history and clinical presentation. Diagnostic modalities aid in the management of the fracture and associated injuries if present. But promptness in the recognition and initiation of treatment can significantly reduce the chances of post-injury complications. We present a case of penile fracture in a young male who presented to the ED with abdominal pain, but careful history and physical examination revealed penile fracture. A delay in diagnosis could have led to complications. Our case report is an attempt to emphasize the need to suspect injury to the penis in a young adult who might present to the emergency department with an entirely different complaint and also to treat any penile trauma as an emergency. This report provides evidence of an uncommon and underreported clinical entity. A review of the pertinent literature is included.

Advanced access: reducing waiting and delays in primary care.

PubMed

Murray, Mark; Berwick, Donald M

2003-02-26

Delay of care is a persistent and undesirable feature of current health care systems. Although delay seems to be inevitable and linked to resource limitations, it often is neither. Rather, it is usually the result of unplanned, irrational scheduling and resource allocation. Application of queuing theory and principles of industrial engineering, adapted appropriately to clinical settings, can reduce delay substantially, even in small practices, without requiring additional resources. One model, sometimes referred to as advanced access, has increasingly been shown to reduce waiting times in primary care. The core principle of advanced access is that patients calling to schedule a physician visit are offered an appointment the same day. Advanced access is not sustainable if patient demand for appointments is permanently greater than physician capacity to offer appointments. Six elements of advanced access are important in its application balancing supply and demand, reducing backlog, reducing the variety of appointment types, developing contingency plans for unusual circumstances, working to adjust demand profiles, and increasing the availability of bottleneck resources. Although these principles are powerful, they are counter to deeply held beliefs and established practices in health care organizations. Adopting these principles requires strong leadership investment and support.

Way-Scaling to Reduce Power of Cache with Delay Variation

NASA Astrophysics Data System (ADS)

Goudarzi, Maziar; Matsumura, Tadayuki; Ishihara, Tohru

The share of leakage in cache power consumption increases with technology scaling. Choosing a higher threshold voltage (Vth) and/or gate-oxide thickness (Tox) for cache transistors improves leakage, but impacts cell delay. We show that due to uncorrelated random within-die delay variation, only some (not all) of cells actually violate the cache delay after the above change. We propose to add a spare cache way to replace delay-violating cache-lines separately in each cache-set. By SPICE and gate-level simulations in a commercial 90nm process, we show that choosing higher Vth, Tox and adding one spare way to a 4-way 16KB cache reduces leakage power by 42%, which depending on the share of leakage in total cache power, gives up to 22.59% and 41.37% reduction of total energy respectively in L1 instruction- and L2 unified-cache with a negligible delay penalty, but without sacrificing cache capacity or timing-yield.

Alzheimer Disease: Pharmacologic and Nonpharmacologic Therapies for Cognitive and Functional Symptoms.

PubMed

Epperly, Ted; Dunay, Megan A; Boice, Jack L

2017-06-15

Alzheimer disease comprises a syndrome of progressive cognitive and functional decline. Treatments should target cognitive and functional symptoms. Cholinesterase inhibitors, memantine, and a combination of a cholinesterase inhibitor and memantine have produced statistically significant but clinically small delays in various domains of cognitive and functional decline in select patients with Alzheimer disease. Vitamin E has been shown to delay functional decline in patients with mild to moderate Alzheimer disease, especially when taken in combination with a cholinesterase inhibitor. Structured programs of physical exercise improve physical function and reduce rates of neuropsychiatric symptoms in patients with mild to severe Alzheimer disease. Cognitive stimulation programs show benefit in maintenance of cognitive function and improved self-reported quality of life in patients with mild to moderate Alzheimer disease.

Reduced order modelling in searches for continuous gravitational waves - I. Barycentring time delays

NASA Astrophysics Data System (ADS)

Pitkin, M.; Doolan, S.; McMenamin, L.; Wette, K.

2018-06-01

The frequencies and phases of emission from extra-solar sources measured by Earth-bound observers are modulated by the motions of the observer with respect to the source, and through relativistic effects. These modulations depend critically on the source's sky-location. Precise knowledge of the modulations are required to coherently track the source's phase over long observations, for example, in pulsar timing, or searches for continuous gravitational waves. The modulations can be modelled as sky-location and time-dependent time delays that convert arrival times at the observer to the inertial frame of the source, which can often be the Solar system barycentre. We study the use of reduced order modelling for speeding up the calculation of this time delay for any sky-location. We find that the time delay model can be decomposed into just four basis vectors, and with these the delay for any sky-location can be reconstructed to sub-nanosecond accuracy. When compared to standard routines for time delay calculation in gravitational wave searches, using the reduced basis can lead to speed-ups of 30 times. We have also studied components of time delays for sources in binary systems. Assuming eccentricities <0.25, we can reconstruct the delays to within 100 s of nanoseconds, with best case speed-ups of a factor of 10, or factors of two when interpolating the basis for different orbital periods or time stamps. In long-duration phase-coherent searches for sources with sky-position uncertainties, or binary parameter uncertainties, these speed-ups could allow enhancements in their scopes without large additional computational burdens.

Metformin improves defective hematopoiesis and delays tumor formation in Fanconi anemia mice.

PubMed

Zhang, Qing-Shuo; Tang, Weiliang; Deater, Matthew; Phan, Ngoc; Marcogliese, Andrea N; Li, Hui; Al-Dhalimy, Muhsen; Major, Angela; Olson, Susan; Monnat, Raymond J; Grompe, Markus

2016-12-15

Fanconi anemia (FA) is an inherited bone marrow failure disorder associated with a high incidence of leukemia and solid tumors. Bone marrow transplantation is currently the only curative therapy for the hematopoietic complications of this disorder. However, long-term morbidity and mortality remain very high, and new therapeutics are badly needed. Here we show that the widely used diabetes drug metformin improves hematopoiesis and delays tumor formation in Fancd2 -/- mice. Metformin is the first compound reported to improve both of these FA phenotypes. Importantly, the beneficial effects are specific to FA mice and are not seen in the wild-type controls. In this preclinical model of FA, metformin outperformed the current standard of care, oxymetholone, by improving peripheral blood counts in Fancd2 -/- mice significantly faster. Metformin increased the size of the hematopoietic stem cell compartment and enhanced quiescence in hematopoietic stem and progenitor cells. In tumor-prone Fancd2 -/- Trp53 +/- mice, metformin delayed the onset of tumors and significantly extended the tumor-free survival time. In addition, we found that metformin and the structurally related compound aminoguanidine reduced DNA damage and ameliorated spontaneous chromosome breakage and radials in human FA patient-derived cells. Our results also indicate that aldehyde detoxification might be one of the mechanisms by which metformin reduces DNA damage in FA cells. © 2016 by The American Society of Hematology.

Incidence of osteonecrosis of the jaw in women with postmenopausal osteoporosis in the health outcomes and reduced incidence with zoledronic acid once yearly pivotal fracture trial.

PubMed

Grbic, John T; Landesberg, Regina; Lin, Shou-Qing; Mesenbrink, Peter; Reid, Ian R; Leung, Ping-Chung; Casas, Noemi; Recknor, Christopher P; Hua, Ye; Delmas, Pierre D; Eriksen, Erik F

2008-01-01

The authors determined incidence of osteonecrosis of the jaw (ONJ) in a large, prospective three-year clinical trial of zoledronic acid in women with postmenopausal osteoporosis (PMO). A total of 7,714 women with PMO received intravenous zoledronic acid 5 mg or a placebo. No spontaneous reports of ONJ were received. An independent, blinded adjudication committee searched the trial's adverse event database by using 60 terms. On an ongoing basis, the committee reviewed the identified events, and it defined ONJ as exposed bone in the maxillofacial area with delayed healing for more than six weeks despite appropriate care. One participant who received a placebo and one participant who received zoledronic acid experienced delayed healing associated with infection. Both conditions resolved after antibiotic therapy, débridement or both. The occurrence of ONJ is rare in a PMO population, and delayed healing of lesions can occur with and without bisphosphonate use over three years. The low incidence of ONJ must be assessed in the context of the clinical benefit of zoledronic acid therapy in reducing hip, vertebral and nonvertebral fractures in this at-risk population. There is no evidence to suggest that healthy patients with osteoporosis who are receiving bisphosphonates require any special treatment beyond routine dental care or to support altering standard treatment practices.

A Mechanism for Reducing Delay Discounting by Altering Temporal Attention

ERIC Educational Resources Information Center

Radu, Peter T.; Yi, Richard; Bickel, Warren K.; Gross, James J.; McClure, Samuel M.

2011-01-01

Rewards that are not immediately available are discounted compared to rewards that are immediately available. The more a person discounts a delayed reward, the more likely that person is to have a range of behavioral problems, including clinical disorders. This latter observation has motivated the search for ions that reduce discounting. One…

Factors influencing diagnosis delay of advanced breast cancer in Moroccan women.

PubMed

Maghous, A; Rais, F; Ahid, S; Benhmidou, N; Bellahamou, K; Loughlimi, H; Marnouche, E; Elmajjaoui, S; Elkacemi, H; Kebdani, T; Benjaafar, N

2016-06-07

Delay in the diagnosis of breast cancer in symptomatic women of 3 months or more is associated with advanced stage and low survival. We conducted this study to learn more about the extent and reasons behind diagnosis delay of advanced breast cancer in Moroccan women. A group of patients with advanced breast cancer were interviewed at the National Institute of Oncology in Rabat during the period from February to December 2014. Diagnosis delay was devised into patient delay and system delay. Patient delay was defined as time from first symptoms until first medical consultation. System delay was defined as time from first presentation to a health care provider until definite diagnosis or treatment. Prospective information and clinical data were collected on a form during an interview with each patient and from medical records. In all, 137 patients were interviewed. The mean age of women was 48.3 ± 10.4 years. The median of consultation time was 6[4,12] months and the median of diagnosis time was 1[1,3] months. Diagnosis delay was associated to a personal reason in 96 (70.1 %) patients and to a medical reason in 19 (13.9 %) patients. A number of factors predicted diagnosis delay: symptoms were not considered serious in 66 (55.9 %) patients; traditional therapy was applied in 15 (12.7 %) patients and fear of cancer diagnosis and/or treatment in 14 (11.9 %) patients. A use of traditional methods was significantly associated with rural residence and far away from basic health center (p = 0.000). Paradoxically, a family history of breast cancer was significantly higher in who report a fear of cancer diagnosis and/or treatment to diagnosis delay (p < 0.001). Also, a significantly higher risk of more than 6 months delay was found among rural women (P = 0.035) and women who live far away from specialized care center (P = 0.001). Diagnosis delay is very serious problem in Morocco. Diagnosis delay was associated with complex interactions between several factors and with advanced stages. There is a need for improving breast cancer information in our populations and training of general practitioners to reduce advanced breast cancer by promoting early detection.

Interventions to reduce unintended pregnancies among adolescents: systematic review of randomised controlled trials

PubMed Central

DiCenso, Alba; Guyatt, Gordon; Willan, A; Griffith, L

2002-01-01

Objective To review the effectiveness of primary prevention strategies aimed at delaying sexual intercourse, improving use of birth control, and reducing incidence of unintended pregnancy in adolescents. Data sources 12 electronic bibliographic databases, 10 key journals, citations of relevant articles, and contact with authors. Study selection 26 trials described in 22 published and unpublished reports that randomised adolescents to an intervention or a control group (alternate intervention or nothing). Data extraction Two independent reviewers assessed methodological quality and abstracted data. Data synthesis The interventions did not delay initiation of sexual intercourse in young women (pooled odds ratio 1.12; 95% confidence interval 0.96 to 1.30) or young men (0.99; 0.84 to 1.16); did not improve use of birth control by young women at every intercourse (0.95; 0.69 to 1.30) or at last intercourse (1.05; 0.50 to 2.19) or by young men at every intercourse (0.90; 0.70 to 1.16) or at last intercourse (1.25; 0.99 to 1.59); and did not reduce pregnancy rates in young women (1.04; 0.78 to 1.40). Four abstinence programmes and one school based sex education programme were associated with an increase in number of pregnancies among partners of young male participants (1.54; 1.03 to 2.29). There were significantly fewer pregnancies in young women who received a multifaceted programme (0.41; 0.20 to 0.83), though baseline differences in this study favoured the intervention. Conclusions Primary prevention strategies evaluated to date do not delay the initiation of sexual intercourse, improve use of birth control among young men and women, or reduce the number of pregnancies in young women. What is already known on this topicUnintended pregnancies among adolescents pose a considerable problem for the young parents, the child, and societyWhat this study addsPrimary prevention strategies evaluated to date do not delay the initiation of sexual intercourse or improve use of birth control among adolescentsPrimary prevention strategies have not reduced the rate of pregnancies in adolescent womenMeta-analysis of five studies, four of which evaluated abstinence programmes, has shown an increase in pregnancies in partners of male participants PMID:12065267

Evening daylight may cause adolescents to sleep less in spring than in winter.

PubMed

Figueiro, Mariana G; Rea, Mark S

2010-07-01

Sleep restriction commonly experienced by adolescents can stem from a slower increase in sleep pressure by the homeostatic processes and from phase delays of the circadian system. With regard to the latter potential cause, the authors hypothesized that because there is more natural evening light during the spring than winter, a sample of adolescent students would be more phase delayed in spring than in winter, would have later sleep onset times, and because of fixed school schedules would have shorter sleep durations. Sixteen eighth-grade subjects were recruited for the study. The authors collected sleep logs and saliva samples to determine their dim light melatonin onset (DLMO), a well-established circadian marker. Actual circadian light exposures experienced by a subset of 12 subjects over the course of 7 days in winter and in spring using a personal, head-worn, circadian light measurement device are also reported here. Results showed that this sample of adolescents was exposed to significantly more circadian light in spring than in winter, especially during the evening hours when light exposure would likely delay circadian phase. Consistent with the light data, DLMO and sleep onset times were significantly more delayed, and sleep durations were significantly shorter in spring than in winter. The present ecological study of light, circadian phase, and self-reported sleep suggests that greater access to evening daylight in the spring may lead to sleep restriction in adolescents while attending school. Therefore, lighting schemes that reduce evening light in the spring may encourage longer sleep times in adolescents.

[Chemotherapy-induced diarrhea].

PubMed

Kobayashi, Kunihiko

2003-06-01

Chemotherapy-induced diarrhea is a well-documented side effect of many cancer treatments and is associated with increased morbidity and mortality. Chemotherapy-induced diarrhea negatively impacts patient quality of life and treatment outcome by requiring dose limitations or treatment interruption. The chemotherapeutic agent CPT-11 (irinotecan) has shown promising results as a single agent and in combination chemotherapy for the treatment of colorectal and small cell lung cancer. However, delayed onset diarrhea is considered to be its major dose-limiting toxicity. In some cases, it can be life threatening. To prevent CPT-11-induced delayed diarrhea, oral alkalization (OA) and control of defecation (CD) [Int J Cancer 92: 269-275, 2001] were developed based on fundamental studies [Int J Cancer 83: 491-496, 1999; Cancer Res 62: 179-187, 2002]. Oral administration of antibiotics [Cancer Res 56: 3752-3757, 1996; Clin Cancer Res 7: 1136-1141, 2001] or kampo medicine [Jpn J Cancer Res 86: 978-984, 1995; Jpn J Cancer Res 86: 985-989, 1995] to decrease beta-glucuronidase activity derived from bacteria in the large intestine was also reported to be successful in preventing delayed diarrhea. When CPT-11-induced delayed diarrhea occurs, the conventional treatment is loperamide [J Natl Cancer Inst 86: 446-449, 1994], and the early recognition and treatment of diarrhea with this opioid has reduced, although not entirely eliminated, patient morbidity. Other therapies are needed to treat patients with loperamide-refractory CPT-11 induced diarrhea, and the successful use of the somatostatin analogue octreotide has been reported [Support Care Cancer 9: 258-260, 2001; Ann Oncol 12: 227-229, 2001; Proc Am Soc Clin Oncol 21: 387a, 2002].

Understanding Reasons for Delay in Seeking Acute Stroke Care in an Underserved Urban Population

PubMed Central

Hsia, Amie W.; Castle, Amanda; Wing, Jeffrey J.; Edwards, Dorothy F.; Brown, Nina C.; Higgins, Tara M.; Wallace, Jasmine L.; Koslosky, Sara S.; Gibbons, M. Chris; Sánchez, Brisa N.; Fokar, Ali; Shara, Nawar; Morgenstern, Lewis B.; Kidwell, Chelsea S.

2011-01-01

Background and Purpose Few patients arrive early enough at hospitals to be eligible for emergent stroke treatment. There may be barriers specific to underserved, urban populations that need to be identified before effective educational interventions to reduce delay times can be developed. Methods A survey of respondents’ likely action in a hypothetical stroke situation was given to 253 community volunteers in the catchment areas of a large urban community hospital. Concurrently, 100 structured interviews were conducted in the same hospital with acute stroke patients or proxy. Results In this predominantly urban, black population, if faced with a hypothetical stroke, 89% of community volunteers surveyed said they would call 911 first, and few felt any of the suggested potential barriers applied to them. However, only 12% of stroke patients interviewed actually called 911 first (OR 63.9; 95% CI 29.5 to 138.2). Instead, 75% called a relative/friend. Eighty-nine percent of stroke patients reported significant delay in seeking medical attention, and almost half said the reason for delay was thinking the symptoms were not serious and/or they would self-resolve. For those arriving by ambulance, only 25% did so because they thought it would be faster, while 35% cited having no other transportation options. Conclusions In this predominantly black urban population, while 89% of community volunteers report the intent of calling 911 during a stroke only 12% of actual stroke patients did so. Further research is needed to determine and conquer the barriers between behavioral intent and actual behavior to call 911 for witnessed stroke. PMID:21546471

Making Time for Nature: Visual Exposure to Natural Environments Lengthens Subjective Time Perception and Reduces Impulsivity

PubMed Central

Berry, Meredith S.; Repke, Meredith A.; Nickerson, Norma P.; Conway, Lucian G.; Odum, Amy L.; Jordan, Kerry E.

2015-01-01

Impulsivity in delay discounting is associated with maladaptive behaviors such as overeating and drug and alcohol abuse. Researchers have recently noted that delay discounting, even when measured by a brief laboratory task, may be the best predictor of human health related behaviors (e.g., exercise) currently available. Identifying techniques to decrease impulsivity in delay discounting, therefore, could help improve decision-making on a global scale. Visual exposure to natural environments is one recent approach shown to decrease impulsive decision-making in a delay discounting task, although the mechanism driving this result is currently unknown. The present experiment was thus designed to evaluate not only whether visual exposure to natural (mountains, lakes) relative to built (buildings, cities) environments resulted in less impulsivity, but also whether this exposure influenced time perception. Participants were randomly assigned to either a natural environment condition or a built environment condition. Participants viewed photographs of either natural scenes or built scenes before and during a delay discounting task in which they made choices about receiving immediate or delayed hypothetical monetary outcomes. Participants also completed an interval bisection task in which natural or built stimuli were judged as relatively longer or shorter presentation durations. Following the delay discounting and interval bisection tasks, additional measures of time perception were administered, including how many minutes participants thought had passed during the session and a scale measurement of whether time "flew" or "dragged" during the session. Participants exposed to natural as opposed to built scenes were less impulsive and also reported longer subjective session times, although no differences across groups were revealed with the interval bisection task. These results are the first to suggest that decreased impulsivity from exposure to natural as opposed to built environments may be related to lengthened time perception. PMID:26558610

Urocortin2 prolongs action potential duration and modulates potassium currents in guinea pig myocytes and HEK293 cells.

PubMed

Yang, Li-Zhen; Zhu, Yi-Chun

2015-07-05

We previously reported that activation of corticotropin releasing factor receptor type 2 by urocortin2 up-regulates both L-type Ca(2+) channels and intracellular Ca(2+) concentration in ventricular myocytes and plays an important role in cardiac contractility and arrhythmogenesis. This study goal was to further test the hypothesis that urocortin2 may modulate action potentials as well as rapidly and slowly activating delayed rectifier potassium currents. With whole cell patch-clamp techniques, action potentials and slowly activating delayed rectifier potassium currents were recorded in isolated guinea pig ventricular myocytes, respectively. And rapidly activating delayed rectifier potassium currents were tested in hERG-HEK293 cells. Urocortin2 produced a time- and concentration-dependent prolongation of action potential duration. The EC50 values of action potential duration and action potential duration at 90% of repolarization were 14.73 and 24.3nM respectively. The prolongation of action potential duration of urocortin2 was almost completely or partly abolished by H-89 (protein kinase A inhibitor) or KB-R7943 (Na(+)/Ca(2+) exchange inhibitor) pretreatment respectively. And urocortin2 caused reduction of rapidly activating delayed rectifier potassium currents in hERG-HEK293 cells. In addition, urocortin2 slowed the rate of slowly activating delayed rectifier potassium channel activation, and rightward shifted the threshold of slowly activating delayed rectifier potassium currents to more positive potentials. Urocortin2 prolonged action potential duration via activation of protein kinase A and Na(+)/ Ca(2+) exchange in isolated guinea pig ventricular myocytes in a time- and concentration- dependent manner. In hERG-HEK293 cells, urocortin2 reduced rapidly activating delayed rectifier potassium current density which may contribute to action potential duration prolongation. Copyright © 2015 Elsevier B.V. All rights reserved.

Factors associated with patient, and diagnostic delays in Chinese TB patients: a systematic review and meta-analysis.

PubMed

Li, Ying; Ehiri, John; Tang, Shenglan; Li, Daikun; Bian, Yongqiao; Lin, Hui; Marshall, Caitlin; Cao, Jia

2013-07-02

Delay in seeking care is a major impediment to effective management of tuberculosis (TB) in China. To elucidate factors that underpin patient and diagnostic delays in TB management, we conducted a systematic review and meta-analysis of factors that are associated with delays in TB care-seeking and diagnosis in the country. This review was prepared following standard procedures of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and checklist. Relevant studies published up to November 2012 were identified from three major international and Chinese literature databases: Medline/PubMed, EMBASE and CNKI (China National Knowledge Infrastructure). We included 29 studies involving 38,947 patients from 17 provinces in China. Qualitative analysis showed that key individual level determinants of delays included socio-demographic and economic factors, mostly poverty, rural residence, lack of health insurance, lower educational attainment, stigma and poor knowledge of TB. Health facility determinants included limited availability of resources to perform prompt diagnosis, lack of qualified health workers and geographical barriers.Quantitative meta-analysis indicated that living in rural areas was a risk factor for patient delays (pooled odds ratio (OR) (95% confidence interval (CI)): 1.79 (1.62, 1.98)) and diagnostic delays (pooled OR (95% CI): 1.40 (1.23, 1.59)). Female patients had higher risk of patient delay (pooled OR (95% CI): 1.94 (1.13, 3.33)). Low educational attainment (primary school and below) was also a risk factor for patient delay (pooled OR (95% CI): 2.14 (1.03, 4.47)). The practice of seeking care first from Traditional Chinese Medicine (TMC) providers was also identified as a risk factor for diagnostic delay (pooled OR (95% CI): 5.75 (3.03, 10.94)). Patient and diagnostic delays in TB care are mediated by individual and health facility factors. Population-based interventions that seek to reduce TB stigma and raise awareness about the benefits of early diagnosis and prompt treatment are needed. Policies that remove patients' financial barriers in access to TB care, and integration of the informal care sector into TB control in urban and rural settings are central factors in TB control.

Clinical characteristic and risk factors of recurrent sexual abuse and delayed reported sexual abuse in childhood.

PubMed

Hu, Mei-Hua; Huang, Go-Shine; Huang, Jing-Long; Wu, Chang-Teng; Chao, An-Shine; Lo, Fu-Sung; Wu, Han-Ping

2018-04-01

Child sexual abuse (CSA) is a global problem that affects children of all ages, and the evaluation of these victims by psychologic and gynecologic experts in pediatric emergency departments is an important issue. Few data are available on the characteristics of children admitted to pediatric emergency department with recurrent CSA and delayed reported CSA. The aim of the present study was to describe the clinical features of, and risk factors for, recurrent CSA and delayed reported CSA. The study retrospectively analyzed victims of CSA who were admitted to a pediatric emergency department. Chi-square tests and univariate analyses were performed to assess the risk factors of recurrent or delayed reported CSA. Of the 91 CSA cases, 32 (35.2%) were recurrent assaults. Of the 70 cases recorded the duration of the event, 22 (31.4%) were delayed report cases. Comparisons of the non-recurrent and recurrent CSA assault groups revealed a significant increase in comorbidities (odds ratio [OR]: 4.46, 95% confidence interval [CI]: 1.54-12.93), acute psychiatric problems (OR: 3.18, CI: 1.26-8.06), attempted suicide (OR: 4.23, CI: 1.28-13.99), and the need for treatment with antipsychotic medications (OR: 5.57, CI: 1.37-22.65). Compared with non-delayed reported cases, the delay reported cases of CSA were significantly more likely to have anxiety (P < .05). The CSA victims in the present study exhibited acute medical and/or psychosocial problems, which indicate that pediatric emergency professionals have a responsibility to look for and recognize particular characteristics in these victims.

Exploiting geo-distributed clouds for a e-health monitoring system with minimum service delay and privacy preservation.

PubMed

Shen, Qinghua; Liang, Xiaohui; Shen, Xuemin; Lin, Xiaodong; Luo, Henry Y

2014-03-01

In this paper, we propose an e-health monitoring system with minimum service delay and privacy preservation by exploiting geo-distributed clouds. In the system, the resource allocation scheme enables the distributed cloud servers to cooperatively assign the servers to the requested users under the load balance condition. Thus, the service delay for users is minimized. In addition, a traffic-shaping algorithm is proposed. The traffic-shaping algorithm converts the user health data traffic to the nonhealth data traffic such that the capability of traffic analysis attacks is largely reduced. Through the numerical analysis, we show the efficiency of the proposed traffic-shaping algorithm in terms of service delay and privacy preservation. Furthermore, through the simulations, we demonstrate that the proposed resource allocation scheme significantly reduces the service delay compared to two other alternatives using jointly the short queue and distributed control law.

Low Emissions and Delay Optimization for an Isolated Signalized Intersection Based on Vehicular Trajectories

PubMed Central

2015-01-01

A traditional traffic signal control system is established based on vehicular delay, queue length, saturation and other indicators. However, due to the increasing severity of urban environmental pollution issues and the development of a resource-saving and environmentally friendly social philosophy, the development of low-carbon and energy-efficient urban transport is required. This paper first defines vehicular trajectories and the calculation of vehicular emissions based on VSP. Next, a regression analysis method is used to quantify the relationship between vehicular emissions and delay, and a traffic signal control model is established to reduce emissions and delay using the enumeration method combined with saturation constraints. Finally, one typical intersection of Changchun is selected to verify the model proposed in this paper; its performance efficiency is also compared using simulations in VISSIM. The results of this study show that the proposed model can significantly reduce vehicle delay and traffic emissions simultaneously. PMID:26720095

Low Emissions and Delay Optimization for an Isolated Signalized Intersection Based on Vehicular Trajectories.

PubMed

Lin, Ciyun; Gong, Bowen; Qu, Xin

2015-01-01

A traditional traffic signal control system is established based on vehicular delay, queue length, saturation and other indicators. However, due to the increasing severity of urban environmental pollution issues and the development of a resource-saving and environmentally friendly social philosophy, the development of low-carbon and energy-efficient urban transport is required. This paper first defines vehicular trajectories and the calculation of vehicular emissions based on VSP. Next, a regression analysis method is used to quantify the relationship between vehicular emissions and delay, and a traffic signal control model is established to reduce emissions and delay using the enumeration method combined with saturation constraints. Finally, one typical intersection of Changchun is selected to verify the model proposed in this paper; its performance efficiency is also compared using simulations in VISSIM. The results of this study show that the proposed model can significantly reduce vehicle delay and traffic emissions simultaneously.

High-speed and low-power repeater for VLSI interconnects

NASA Astrophysics Data System (ADS)

Karthikeyan, A.; Mallick, P. S.

2017-10-01

This paper proposes a repeater for boosting the speed of interconnects with low power dissipation. We have designed and implemented at 45 and 32 nm technology nodes. Delay and power dissipation performances are analyzed for various voltage levels at these technology nodes using Spice simulations. A significant reduction in delay and power dissipation are observed compared to a conventional repeater. The results show that the proposed high-speed low-power repeater has a reduced delay for higher load capacitance. The proposed repeater is also compared with LPTG CMOS repeater, and the results shows that the proposed repeater has reduced delay. The proposed repeater can be suitable for high-speed global interconnects and has the capacity to drive large loads.

A Cultivated Form of a Red Seaweed (Chondrus crispus), Suppresses β-Amyloid-Induced Paralysis in Caenorhabditis elegans.

PubMed

Sangha, Jatinder Singh; Wally, Owen; Banskota, Arjun H; Stefanova, Roumiana; Hafting, Jeff T; Critchley, Alan T; Prithiviraj, Balakrishnan

2015-10-20

We report here the protective effects of a methanol extract from a cultivated strain of the red seaweed, Chondrus crispus, against β-amyloid-induced toxicity, in a transgenic Caenorhabditis elegans, expressing human Aβ1-42 gene. The methanol extract of C. crispus (CCE), delayed β-amyloid-induced paralysis, whereas the water extract (CCW) was not effective. The CCE treatment did not affect the transcript abundance of amy1; however, Western blot analysis revealed a significant decrease of Aβ species, as compared to untreated worms. The transcript abundance of stress response genes; sod3, hsp16.2 and skn1 increased in CCE-treated worms. Bioassay guided fractionation of the CCE yielded a fraction enriched in monogalactosyl diacylglycerols (MGDG) that significantly delayed the onset of β-amyloid-induced paralysis. Taken together, these results suggested that the cultivated strain of C. crispus, whilst providing dietary nutritional value, may also have significant protective effects against β-amyloid-induced toxicity in C. elegans, partly through reduced β-amyloid species, up-regulation of stress induced genes and reduced accumulation of reactive oxygen species (ROS).

Blocking NMDA receptors delays death in rats with acute liver failure by dual protective mechanisms in kidney and brain.

PubMed

Cauli, Omar; González-Usano, Alba; Cabrera-Pastor, Andrea; Gimenez-Garzó, Carla; López-Larrubia, Pilar; Ruiz-Sauri, Amparo; Hernández-Rabaza, Vicente; Duszczyk, Malgorzata; Malek, Michal; Lazarewicz, Jerzy W; Carratalá, Arturo; Urios, Amparo; Miguel, Alfonso; Torregrosa, Isidro; Carda, Carmen; Montoliu, Carmina; Felipo, Vicente

2014-06-01

Treatment of patients with acute liver failure (ALF) is unsatisfactory and mortality remains unacceptably high. Blocking NMDA receptors delays or prevents death of rats with ALF. The underlying mechanisms remain unclear. Clarifying these mechanisms will help to design more efficient treatments to increase patient's survival. The aim of this work was to shed light on the mechanisms by which blocking NMDA receptors delays rat's death in ALF. ALF was induced by galactosamine injection. NMDA receptors were blocked by continuous MK-801 administration. Edema and cerebral blood flow were assessed by magnetic resonance. The time course of ammonia levels in brain, muscle, blood, and urine; of glutamine, lactate, and water content in brain; of glomerular filtration rate and kidney damage; and of hepatic encephalopathy (HE) and intracranial pressure was assessed. ALF reduces kidney glomerular filtration rate (GFR) as reflected by reduced inulin clearance. GFR reduction is due to both reduced renal perfusion and kidney tubular damage as reflected by increased Kim-1 in urine and histological analysis. Blocking NMDA receptors delays kidney damage, allowing transient increased GFR and ammonia elimination which delays hyperammonemia and associated changes in brain. Blocking NMDA receptors does not prevent cerebral edema or blood-brain barrier permeability but reduces or prevents changes in cerebral blood flow and brain lactate. The data show that dual protective effects of MK-801 in kidney and brain delay cerebral alterations, HE, intracranial pressure increase and death. NMDA receptors antagonists may increase survival of patients with ALF by providing additional time for liver transplantation or regeneration.

Feasibility and acceptability of interventions to delay gun access in VA mental health settings.

PubMed

Walters, Heather; Kulkarni, Madhur; Forman, Jane; Roeder, Kathryn; Travis, Jamie; Valenstein, Marcia

2012-01-01

The majority of VA patient suicides are completed with firearms. Interventions that delay patients' gun access during high-risk periods may reduce suicide, but may not be acceptable to VA stakeholders or may be challenging to implement. Using qualitative methods, stakeholders' perceptions about gun safety and interventions to delay gun access during high-risk periods were explored. Ten focus groups and four individual interviews were conducted with key stakeholders, including VA mental health patients, mental health clinicians, family members and VA facility leaders (N=60). Transcripts were consensus-coded by two independent coders, and structured summaries were developed and reviewed using a consensus process. All stakeholder groups indicated that VA health system providers had a role in increasing patient safety and emphasized the need for providers to address gun access with their at-risk patients. However, VA mental health patients and clinicians reported limited discussion regarding gun access in VA mental health settings during routine care. Most, although not all, patients and clinicians indicated that routine screening for gun access was acceptable, with several noting that it was more acceptable for mental health patients. Most participants suggested that family and friends be involved in reducing gun access, but expressed concerns about potential family member safety. Participants generally found distribution of trigger locks acceptable, but were skeptical about its effectiveness. Involving Veteran Service Organizations or other individuals in temporarily holding guns during high-risk periods was acceptable to many participants but only with numerous caveats. Patients, clinicians and family members consider the VA health system to have a legitimate role in addressing gun safety. Several measures to delay gun access during high-risk periods for suicide were seen as acceptable and feasible if implemented thoughtfully. Published by Elsevier Inc.

Specific inhibition of c-Jun N-terminal kinase delays preterm labour and reduces mortality

PubMed Central

Pirianov, Grisha; MacIntyre, David A; Lee, Yun; Waddington, Simon N; Terzidou, Vasso; Mehmet, Huseyin; Bennett, Phillip R

2015-01-01

Preterm labour (PTL) is commonly associated with infection and/or inflammation. Lipopolysaccharide (LPS) from different bacteria can be used to independently or mutually activate Jun N-terminal kinase (JNK)/AP1- or NF-κB-driven inflammatory pathways that lead to PTL. Previous studies using Salmonella abortus LPS, which activates both JNK/AP-1 and NF-κB, showed that selective inhibition of NF-κB delays labour and improves pup outcome. Where labour is induced using Escherichia coli LPS (O111), which upregulates JNK/AP-1 but not NF-κB, inhibition of JNK/AP-1 activation also delays labour. In this study, to determine the potential role of JNK as a therapeutic target in PTL, we investigated the specific contribution of JNK signalling to S. Abortus LPS-induced PTL in mice. Intrauterine administration of S. Abortus LPS to pregnant mice resulted in the activation of JNK in the maternal uterus and fetal brain, upregulation of pro-inflammatory proteins COX-2, CXCL1, and CCL2, phosphorylation of cPLA2 in myometrium, and induction of PTL. Specific inhibition of JNK by co-administration of specific D-JNK inhibitory peptide (D-JNKI) delayed LPS-induced preterm delivery and reduced fetal mortality. This is associated with inhibition of myometrial cPLA2 phosphorylation and proinflammatory proteins synthesis. In addition, we report that D-JNKI inhibits the activation of JNK/JNK3 and caspase-3, which are important mediators of neural cell death in the neonatal brain. Our data demonstrate that specific inhibition of TLR4-activated JNK signalling pathways has potential as a therapeutic approach in the management of infection/inflammation-associated PTL and prevention of the associated detrimental effects to the neonatal brain. PMID:26183892

The small-molecule TNF-α inhibitor, UTL-5g, delays deaths and increases survival rates for mice treated with high doses of cisplatin

PubMed Central

Media, Joseph; Chen, Ben; Valeriote, Fredrick

2013-01-01

Purpose UTL-5g is a novel small-molecule chemoprotector that lowers hepatotoxicity, nephrotoxicity, and myelotoxicity induced by cisplatin through TNF-α inhibition among other factors. The objective of this study was to investigate whether UTL-5g can reduce the overall acute toxicity of cisplatin and increase cisplatin tolerability in mice. Materials and Methods BDF1 female mice were treated individually with UTL-5g (suspended in Ora-Plus) by oral gavage at 60 mg/kg, 30 min before i.p. injection of cisplatin at 10, 15, and 20 mg/kg respectively on Day 0. Starting from Day 1, individual mice were again treated daily by the same dose of UTL-5g for 4 consecutive days. Survivals and bodyweights were monitored. Results UTL-5g treatment increased the survival rate and delayed the time to death for mice treated with 150% of the maximum tolerated dose (MTD) of cisplatin (15 mg/kg). Likewise, at 200% of the MTD of cisplatin (20 mg/kg), treatment of UTL-5g increased the survival rate and delayed the time to death. Treatment of UTL-5g did not have a significant effect on weight-loss induced by cisplatin indicating that bodyweight may not be a sensitive enough measure for chemoprotection of UTL-5g against cisplatin. Conclusions In summary, UTL-5g delayed deaths and increased survival rates of mice treated by high doses of cisplatin indicating that UTL-5g is capable of reducing the overall acute toxicity of cisplatin and increased cisplatin tolerability in mice; this is in line with the specific chemoprotective effects of UTL-5g previously reported. Further investigation of UTL-5g in combination with cisplatin is warranted. PMID:23881213

The small-molecule TNF-α inhibitor, UTL-5g, delays deaths and increases survival rates for mice treated with high doses of cisplatin.

PubMed

Shaw, Jiajiu; Media, Joseph; Chen, Ben; Valeriote, Fredrick

2013-09-01

UTL-5g is a novel small-molecule chemoprotector that lowers hepatotoxicity, nephrotoxicity, and myelotoxicity induced by cisplatin through TNF-α inhibition among other factors. The objective of this study was to investigate whether UTL-5g can reduce the overall acute toxicity of cisplatin and increase cisplatin tolerability in mice. BDF1 female mice were treated individually with UTL-5g (suspended in Ora-Plus) by oral gavage at 60 mg/kg, 30 min before i.p. injection of cisplatin at 10, 15, and 20 mg/kg, respectively, on Day 0. Starting from Day 1, individual mice were again treated daily by the same dose of UTL-5g for 4 consecutive days. Survivals and body weights were monitored. UTL-5g treatment increased the survival rate and delayed the time to death for mice treated with 150 % of the maximum tolerated dose (MTD) of cisplatin (15 mg/kg). Likewise, at 200 % of the MTD of cisplatin (20 mg/kg), treatment of UTL-5g increased the survival rate and delayed the time to death. Treatment of UTL-5g did not have a significant effect on weight loss induced by cisplatin, indicating that body weight may not be a sensitive-enough measure for chemoprotection of UTL-5g against cisplatin. In summary, UTL-5g delayed deaths and increased survival rates of mice treated by high doses of cisplatin, indicating that UTL-5g is capable of reducing the overall acute toxicity of cisplatin and increased cisplatin tolerability in mice; this is in line with the specific chemoprotective effects of UTL-5g previously reported. Further investigation of UTL-5g in combination with cisplatin is warranted.

Testing the Oregon delinquency model with 9-year follow-up of the Oregon Divorce Study.

PubMed

Forgatch, Marion S; Patterson, Gerald R; Degarmo, David S; Beldavs, Zintars G

2009-01-01

This paper presents experimental tests of the Oregon delinquency model applied within a randomized design of an at-risk sample of single mothers and their elementary school-aged sons. In the theoretical model, ineffective parenting practices and deviant peer association serve as the primary mechanisms for growth in adolescent delinquent behavior and early arrests. Multiple-method assessments of 238 mothers and sons include delinquency as measured by teacher reports and official arrest records, parenting skills measured by observations of parent-child interactions, and deviant peer association as reported by focal boys. Analyses of the 9-year follow-up data indicate that the Oregon model of parent management training significantly reduced teacher-reported delinquency and police arrests for focal boys. As hypothesized, the experiments demonstrated that improving parenting practices and reducing contacts with deviant peers served as mediating mechanisms for reducing rates of adolescent delinquency. As predicted, there was also a significant delay in the timing of police arrests for youth in the experimental as compared to the control group.

How long can fisheries management delay action in response to ecosystem and climate change?

PubMed

Brown, Christopher J; Fulton, Elizabeth A; Possingham, Hugh P; Richardson, Anthony J

2012-01-01

Sustainable management of fisheries is often compromised by management delaying implementation of regulations that reduce harvest, in order to maintain higher catches in the short-term. Decreases or increases in fish population growth rate driven by environmental change, including ecosystem and climate change, affect the harvest that can be taken sustainably. If not acted on rapidly, environmental change could result in unsustainable fishing or missed opportunity for higher catches. Using simulation models of harvested fish populations influenced by environmental change, we explore how long fisheries managers can afford to wait before changing harvest regulations in response to changes in population growth. If environmental change causes population declines, delays greater than five years increase the probability of population collapse. Species with fast and highly variable population growth rates are more susceptible to collapse under delays and should be a priority for revised management where delays occur. Generally, the long-term cost of delay, in terms of lost fishing opportunity, exceeds the short-term benefits of overfishing. Lowering harvest limits and monitoring for environmental change can alleviate the impact of delays; however, these measures may be more costly than reducing delays. We recommend that management systems that allow rapid responses to population growth changes be enacted for fisheries management to adapt to ecosystem and climate change.

Temporary Losses of Highway Capacity and Impacts on Performance

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

Chin, S.M.

2002-07-31

Traffic congestion and its impacts significantly affect the nation's economic performance and the public's quality of life. In most urban areas, travel demand routinely exceeds highway capacity during peak periods. In addition, events such as crashes, vehicle breakdowns, work zones, adverse weather, and suboptimal signal timing cause temporary capacity losses, often worsening the conditions on already congested highway networks. The impacts of these temporary capacity losses include delay, reduced mobility, and reduced reliability of the highway system. They can also cause drivers to re-route or reschedule trips. Prior to this study, no nationwide estimates of temporary losses of highway capacitymore » had been made by type of capacity-reducing event. Such information is vital to formulating sound public policies for the highway infrastructure and its operation. This study is an initial attempt to provide nationwide estimates of the capacity losses and delay caused by temporary capacity-reducing events. The objective of this study was to develop and implement methods for producing national-level estimates of the loss of capacity on the nation's highway facilities due to temporary phenomena as well as estimates of the impacts of such losses. The estimates produced by this study roughly indicate the magnitude of problems that are likely be addressed by the Congress during the next re-authorization of the Surface Transportation Programs. The scope of the study includes all urban and rural freeways and principal arterials in the nation's highway system for 1999. Specifically, this study attempts to quantify the extent of temporary capacity losses due to crashes, breakdowns, work zones, weather, and sub-optimal signal timing. These events can cause impacts such as capacity reduction, delays, trip rescheduling, rerouting, reduced mobility, and reduced reliability. This study focuses on the reduction of capacity and resulting delays caused by the temporary events mentioned above. Impacts other than capacity losses and delay, such as re-routing, rescheduling, reduced mobility, and reduced reliability, are not covered in this phase of research.« less

Quantum cost optimized design of 4-bit reversible universal shift register using reduced number of logic gate

NASA Astrophysics Data System (ADS)

Maity, H.; Biswas, A.; Bhattacharjee, A. K.; Pal, A.

In this paper, we have proposed the design of quantum cost (QC) optimized 4-bit reversible universal shift register (RUSR) using reduced number of reversible logic gates. The proposed design is very useful in quantum computing due to its low QC, less no. of reversible logic gate and less delay. The QC, no. of gates, garbage outputs (GOs) are respectively 64, 8 and 16 for proposed work. The improvement of proposed work is also presented. The QC is 5.88% to 70.9% improved, no. of gate is 60% to 83.33% improved with compared to latest reported result.

Propranolol reduces reference-dependence in intertemporal choice

PubMed Central

Lempert, Karolina M.; Lackovic, Sandra F.; Tobe, Russell H.; Glimcher, Paul W.

2017-01-01

Abstract In intertemporal choices between immediate and delayed rewards, people tend to prefer immediate rewards, often even when the delayed reward is larger. This is known as temporal discounting. It has been proposed that this tendency emerges because immediate rewards are more emotionally arousing than delayed rewards. However, in our previous research, we found no evidence for this but instead found that arousal responses (indexed with pupil dilation) in intertemporal choice are context-dependent. Specifically, arousal tracks the subjective value of the more variable reward option in the paradigm, whether it is immediate or delayed. Nevertheless, people tend to choose the less variable option in the choice task. In other words, their choices are reference-dependent and depend on variance in their recent history of offers. This suggests that there may be a causal relationship between reference-dependent choice and arousal, which we investigate here by reducing arousal pharmacologically using propranolol. Here, we show that propranolol reduces reference-dependence, leading to choices that are less influenced by recent history and more internally consistent. PMID:28992268

Episodic future thinking reduces delay discounting and cigarette demand: an investigation of the good-subject effect.

PubMed

Stein, Jeffrey S; Tegge, Allison N; Turner, Jamie K; Bickel, Warren K

2018-04-01

Episodic future thinking (EFT), an intervention involving mental simulation of future events, has been shown to reduce both delay discounting and cigarette self-administration. In the present study, we extended these findings by showing that EFT in a web-based sample of smokers reduces delay discounting and intensity of demand for cigarettes (ad libitum consumption) in a hypothetical purchase task. No effect was observed on elasticity of demand (sensitivity to price) or cigarette craving. We also explored whether demand characteristics (specifically, the "good-subject" effect) might be responsible for observed effects. EFT participants were significantly better able than control participants to discern the experimental hypothesis. However, EFT participants were not better than controls at identifying whether they had been assigned to the experimental group and, likewise, showed no differences in attitudes about the experiment and experimenter. Importantly, effects of EFT on delay discounting and demand remained significant even when controlling for measures of demand characteristics, indicating that EFT's effects are independent of participants' perceptions about the experiment.

[Computer-supported patient history: a workplace analysis].

PubMed

Schubiger, G; Weber, D; Winiker, H; Desgrandchamps, D; Imahorn, P

1995-04-29

Since 1991, an extensive computer network has been developed and implemented at the Cantonal Hospital of Lucerne. The medical applications include computer aided management of patient charts, medical correspondence, and compilation of diagnosis statistics according to the ICD-9 code. In 1992, the system was introduced as a pilot project in the departments of pediatrics and pediatric surgery of the Lucerne Children's Hospital. This new system has been prospectively evaluated using a workplace analysis. The time taken to complete patient charts and surgical reports was recorded for 14 days before and after the introduction of the computerized system. This analysis was performed for both physicians and secretarial staff. The time delay between the discharge of the patient and the mailing of the discharge letter to the family doctor was also recorded. By conventional means, the average time for the physician to generate a patient chart (26 minutes, n = 119) was slightly lower than the time needed with the computer system (28 minutes, n = 177). However, for a discharge letter, the time needed by the physician was reduced by one third with the computer system and by more than one half for the secretarial staff (32 and 66 minutes conventionally; 22 and 24 minutes respectively with the computer system; p < 0.0001). The time required for the generation of surgical reports was reduced from 17 to 13 minutes per patient and the processing time by secretaries from 37 to 14 minutes. The time delay between the discharge of the patient and the mailing of the discharge letter was reduced by 50% from 7.6 to 3.9 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Primary Dietary Intervention Study to Reduce the Risk of Islet Autoimmunity in Children at Increased Risk for Type 1 Diabetes

PubMed Central

Hummel, Sandra; Pflüger, Maren; Hummel, Michael; Bonifacio, Ezio; Ziegler, Anette-G.

2011-01-01

OBJECTIVE To determine whether delaying the introduction of gluten in infants with a genetic risk of islet autoimmunity is feasible, safe, and may reduce the risk of type 1 diabetes–associated islet autoimmunity. RESEARCH DESIGN AND METHODS A total of 150 infants with a first-degree family history of type 1 diabetes and a risk HLA genotype were randomly assigned to a first gluten exposure at age 6 months (control group) or 12 months (late-exposure group) and were followed 3 monthly until the age of 3 years and yearly thereafter for safety (for growth and autoantibodies to transglutaminase C [TGCAs]), islet autoantibodies to insulin, GAD, insulinoma-associated protein 2, and type 1 diabetes. RESULTS Adherence to the dietary-intervention protocol was reported from 70% of families. During the first 3 years, weight and height were similar in children in the control and late-exposure groups, as was the probability of developing TGCAs (14 vs. 4%; P = 0.1). Eleven children in the control group and 13 children in the late-exposure group developed islet autoantibodies (3-year risk: 12 vs. 13%; P = 0.6). Seven children developed diabetes, including four in the late-exposure group. No significant differences were observed when children were analyzed as per protocol on the basis of the reported first gluten exposure of the children. CONCLUSIONS Delaying gluten exposure until the age of 12 months is safe but does not substantially reduce the risk for islet autoimmunity in genetically at-risk children. PMID:21515839

School Start Times, Sleep, Behavioral, Health, and Academic Outcomes: A Review of the Literature.

PubMed

Wheaton, Anne G; Chapman, Daniel P; Croft, Janet B

2016-05-01

Insufficient sleep in adolescents has been shown to be associated with a wide variety of adverse outcomes, from poor mental and physical health to behavioral problems and lower academic grades. However, most high school students do not get sufficient sleep. Delaying school start times for adolescents has been proposed as a policy change to address insufficient sleep in this population and potentially to improve students' academic performance, reduce engagement in risk behaviors, and improve health. This article reviews 38 reports examining the association between school start times, sleep, and other outcomes among adolescent students. Most studies reviewed provide evidence that delaying school start time increases weeknight sleep duration among adolescents, primarily by delaying rise times. Most of the studies saw a significant increase in sleep duration even with relatively small delays in start times of half an hour or so. Later start times also generally correspond to improved attendance, less tardiness, less falling asleep in class, better grades, and fewer motor vehicle crashes. Although additional research is necessary, research results that are already available should be disseminated to stakeholders to enable the development of evidence-based school policies. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Delays in diagnosis of young females with symptomatic cervical cancer in England: an interview-based study

PubMed Central

Lim, Anita W; Ramirez, Amanda J; Hamilton, William; Sasieni, Peter; Patnick, Julietta; Forbes, Lindsay JL

2014-01-01

Background Diagnosis may be delayed in young females with cervical cancer because of a failure to recognise symptoms. Aim To examine the extent and determinants of delays in diagnosis of young females with symptomatic cervical cancer. Design and setting A national descriptive study of time from symptoms to diagnosis of cervical cancer and risk factors for delay in diagnosis at all hospitals diagnosing cervical cancer in England. Method One-hundred and twenty-eight patients <30 years with a recent diagnosis of cervical cancer were interviewed. Patient delay was defined as ≥3 months from symptom onset to first presentation and provider delay as ≥ 3 months from first presentation to diagnosis. Results Forty (31%) patients had presented symptomatically: 11 (28%) delayed presentation. Patient delay was more common in patients <25 than patients aged 25–29 (40% versus 15%, P = 0.16). Vaginal discharge was more common among patients who delayed presentation than those who did not; many reported not recognising this as a possible cancer symptom. Provider delay was reported by 24/40 (60%); in some no report was found in primary care records of a visual inspection of the cervix and some did not re-attend after the first presentation for several months. Gynaecological symptoms were common (84%) among patients who presented via screening. Conclusions Young females with cervical cancer frequently delay presentation, and not recognising symptoms as serious may increase the risk of delay. Delay in diagnosis after first presentation is also common. There is some evidence that UK guidelines for managing young females with abnormal bleeding are not being followed. PMID:25267045

On the estimation of the reproduction number based on misreported epidemic data.

PubMed

Azmon, Amin; Faes, Christel; Hens, Niel

2014-03-30

Epidemic data often suffer from underreporting and delay in reporting. In this paper, we investigated the impact of delays and underreporting on estimates of reproduction number. We used a thinned version of the epidemic renewal equation to describe the epidemic process while accounting for the underlying reporting system. Assuming a constant reporting parameter, we used different delay patterns to represent the delay structure in our model. Instead of assuming a fixed delay distribution, we estimated the delay parameters while assuming a smooth function for the reproduction number over time. In order to estimate the parameters, we used a Bayesian semiparametric approach with penalized splines, allowing both flexibility and exact inference provided by MCMC. To show the performance of our method, we performed different simulation studies. We conducted sensitivity analyses to investigate the impact of misspecification of the delay pattern and the impact of assuming nonconstant reporting parameters on the estimates of the reproduction numbers. We showed that, whenever available, additional information about time-dependent underreporting can be taken into account. As an application of our method, we analyzed confirmed daily A(H1N1) v2009 cases made publicly available by the World Health Organization for Mexico and the USA. Copyright © 2013 John Wiley & Sons, Ltd.

[Factors associated with prehospital delay in men and women with acute coronary syndrome].

PubMed

Daponte-Codina, A; Bolívar-Muñoz, J; Sánchez-Cantalejo, E; Mateo-Rodríguez, I; Babio, G; Romo-Avilés, N; Rosell-Ortiz, F

2016-04-30

To identify factors associated with prehospital delay in people who have had an acute coronary syndrome. Using a survey we studied patients admitted due to acute coronary syndrome in the 33 Andalusian public hospitals, obtaining information about different types of variables: socio-demographic, contextual,clinical, perception, action, and transportation.Multivariate logistic regression models were applied to calculate the odds ratios for the delay. Of the 1,416 patients studied, more than half had a delay of more than an hour. This is associated to distance to the hospital and means of transport: when the event occurs in the same city,using the patient's own means of transport increases the delay, odds ratio = 1.51 (1.02 to 2.23); if the distance is 1 to 25 kilometers from the hospital,there is no difference between the patient's own means of transport and an ambulance, odds ratio =1.41 and odds ratio =1.43 respectively; and when the distance exceeds 25 kilometers transport by ambulance means more delay, odds ratio = 3.13 and odds ratio = 2.20 respectively. Also, typical symptoms reduce delay amongst men but increase amongst women. Also, not caring and waiting for the resolution of symptoms, seeking health care other than a hospital or emergency services, previous clinical history, being away from home, and having an income under 1,500 euros, all increase delay. Respiratory symptoms reduce delay. Prehospital delay times do not meet health recommendations. The physical and social environment,in addition to clinical, perceptual and attitudinal factors, are associated with this delay.

A Strain-Sonde Technique for the Measurement of Mechanical Time-Delay Fuze Function Times and Performance

DTIC Science & Technology

1983-09-01

AD IV) MEMORANDUM REPORT ARBRL-MR-03309 N(Supersedes IMR No. 760) A STRAIN -SONDE TECHNIQUE FOR THE MEASUREMENT OF MECHANICAL TIME- DELAY FUZE...and BkuWel) S. TYPE OF REPORT & PERIOD COVERED A STRAIN -SONDE TECHNIQUE FOR THE MEASUREMENT OF Final MECHANICAL TIME-DELAY FUZE FUNCTION TIMES AND S...nmber) M577 Mechanical Time-Delay Fuze F"/FM Telemeter Interlock Pin Release Semiconductor Strain Gage Rotor Signal Condition Amplifier Firing Pin In

Clinical characteristic and risk factors of recurrent sexual abuse and delayed reported sexual abuse in childhood

PubMed Central

Hu, Mei-Hua; Huang, Go-Shine; Huang, Jing-Long; Wu, Chang-Teng; Chao, An-Shine; Lo, Fu-Sung; Wu, Han-Ping

2018-01-01

Abstract Child sexual abuse (CSA) is a global problem that affects children of all ages, and the evaluation of these victims by psychologic and gynecologic experts in pediatric emergency departments is an important issue. Few data are available on the characteristics of children admitted to pediatric emergency department with recurrent CSA and delayed reported CSA. The aim of the present study was to describe the clinical features of, and risk factors for, recurrent CSA and delayed reported CSA. The study retrospectively analyzed victims of CSA who were admitted to a pediatric emergency department. Chi-square tests and univariate analyses were performed to assess the risk factors of recurrent or delayed reported CSA. Of the 91 CSA cases, 32 (35.2%) were recurrent assaults. Of the 70 cases recorded the duration of the event, 22 (31.4%) were delayed report cases. Comparisons of the non-recurrent and recurrent CSA assault groups revealed a significant increase in comorbidities (odds ratio [OR]: 4.46, 95% confidence interval [CI]: 1.54–12.93), acute psychiatric problems (OR: 3.18, CI: 1.26–8.06), attempted suicide (OR: 4.23, CI: 1.28–13.99), and the need for treatment with antipsychotic medications (OR: 5.57, CI: 1.37–22.65). Compared with non-delayed reported cases, the delay reported cases of CSA were significantly more likely to have anxiety (P < .05). The CSA victims in the present study exhibited acute medical and/or psychosocial problems, which indicate that pediatric emergency professionals have a responsibility to look for and recognize particular characteristics in these victims. PMID:29620636

A low delay transmission method of multi-channel video based on FPGA

NASA Astrophysics Data System (ADS)

Fu, Weijian; Wei, Baozhi; Li, Xiaobin; Wang, Quan; Hu, Xiaofei

2018-03-01

In order to guarantee the fluency of multi-channel video transmission in video monitoring scenarios, we designed a kind of video format conversion method based on FPGA and its DMA scheduling for video data, reduces the overall video transmission delay.In order to sace the time in the conversion process, the parallel ability of FPGA is used to video format conversion. In order to improve the direct memory access (DMA) writing transmission rate of PCIe bus, a DMA scheduling method based on asynchronous command buffer is proposed. The experimental results show that this paper designs a low delay transmission method based on FPGA, which increases the DMA writing transmission rate by 34% compared with the existing method, and then the video overall delay is reduced to 23.6ms.

Favipiravir (T-705) protects against peracute Rift Valley fever virus infection and reduces delayed-onset neurologic disease observed with ribavirin treatment.

PubMed

Scharton, Dionna; Bailey, Kevin W; Vest, Zachary; Westover, Jonna B; Kumaki, Yohichi; Van Wettere, Arnaud; Furuta, Yousuke; Gowen, Brian B

2014-04-01

Rift Valley fever is a zoonotic, arthropod-borne disease that affects livestock and humans. The etiologic agent, Rift Valley fever virus (RVFV; Bunyaviridae, Phlebovirus) is primarily transmitted through mosquito bites, but can also be transmitted by exposure to infectious aerosols. There are presently no licensed vaccines or therapeutics to prevent or treat severe RVFV infection in humans. We have previously reported on the activity of favipiravir (T-705) against the MP-12 vaccine strain of RVFV and other bunyaviruses in cell culture. In addition, efficacy has also been documented in mouse and hamster models of infection with the related Punta Toro virus. Here, hamsters challenged with the highly pathogenic ZH501 strain of RVFV were used to evaluate the activity of favipiravir against lethal infection. Subcutaneous RVFV challenge resulted in substantial serum and tissue viral loads and caused severe disease and mortality within 2-3 days of infection. Oral favipiravir (200 mg/kg/day) prevented mortality in 60% or greater of hamsters challenged with RVFV when administered within 1 or 6h post-exposure and reduced RVFV titers in serum and tissues relative to the time of treatment initiation. In contrast, although ribavirin (75 mg/kg/day) was effective at protecting animals from the peracute RVFV disease, most ultimately succumbed from a delayed-onset neurologic disease associated with high RVFV burden observed in the brain in moribund animals. When combined, T-705 and ribavirin treatment started 24 h post-infection significantly improved survival outcome and reduced serum and tissue virus titers compared to monotherapy. Our findings demonstrate significant post-RVFV exposure efficacy with favipiravir against both peracute disease and delayed-onset neuroinvasion, and suggest added benefit when combined with ribavirin. Copyright © 2014 Elsevier B.V. All rights reserved.

Lithium, but not Valproate, Reduces Impulsive Choice in the Delay-Discounting Task in Mice

PubMed Central

Halcomb, Meredith E; Gould, Todd D; Grahame, Nicholas J

2013-01-01

Both lithium and valproate are well-established treatments for bipolar disorder. Studies have also found that lithium is effective at reducing suicidal behaviors in patients with mood disorders. Impulsivity is a validated endophenotype of both bipolar disorder and suicidal behavior. We assessed effects of treatment with lithium or valproate on cognitive impulsivity in selectively bred mice previously shown to manifest relatively high levels of cognitive impulsivity. Mice were trained in the delay-discounting paradigm, a measure of cognitive impulsivity reflecting a behavioral bias towards immediacy, and then treated with lithium, valproate, or control chow. After 3 weeks of drug treatment, mice were tested at various delays to a large, delayed reward. Drug treatment continued during this time. Lithium reduced impulsivity, whereas valproate had no effect on choice behavior. Both drugs increased the number of choice trials and reinforcer intake, but effects on choice behavior did not depend on these motivational changes. To our knowledge, this is the first study demonstrating lithium's effects to reduce cognitive impulsivity. Future studies may focus on the ability of putative pharmacotherapies for patients at risk for bipolar disorder or suicide to modify the impulsive choice dimension of this diseases. PMID:23584261

40 CFR 63.1090 - What reports must I submit?

Code of Federal Regulations, 2013 CFR

2013-07-01

...) National Emission Standards for Ethylene Manufacturing Process Units: Heat Exchange Systems and Waste Operations Recordkeeping and Reporting Requirements for Heat Exchange Systems § 63.1090 What reports must I submit? If you delay repair for your heat exchange system, you must report the delay of repair in the...

40 CFR 63.1090 - What reports must I submit?

Code of Federal Regulations, 2010 CFR

2010-07-01

...) National Emission Standards for Ethylene Manufacturing Process Units: Heat Exchange Systems and Waste Operations Recordkeeping and Reporting Requirements for Heat Exchange Systems § 63.1090 What reports must I submit? If you delay repair for your heat exchange system, you must report the delay of repair in the...

40 CFR 63.1090 - What reports must I submit?

Code of Federal Regulations, 2011 CFR

2011-07-01

...) National Emission Standards for Ethylene Manufacturing Process Units: Heat Exchange Systems and Waste Operations Recordkeeping and Reporting Requirements for Heat Exchange Systems § 63.1090 What reports must I submit? If you delay repair for your heat exchange system, you must report the delay of repair in the...

40 CFR 63.1090 - What reports must I submit?

Code of Federal Regulations, 2014 CFR

2014-07-01

...) National Emission Standards for Ethylene Manufacturing Process Units: Heat Exchange Systems and Waste Operations Recordkeeping and Reporting Requirements for Heat Exchange Systems § 63.1090 What reports must I submit? If you delay repair for your heat exchange system, you must report the delay of repair in the...

40 CFR 63.1090 - What reports must I submit?

Code of Federal Regulations, 2012 CFR

2012-07-01

...) National Emission Standards for Ethylene Manufacturing Process Units: Heat Exchange Systems and Waste Operations Recordkeeping and Reporting Requirements for Heat Exchange Systems § 63.1090 What reports must I submit? If you delay repair for your heat exchange system, you must report the delay of repair in the...

A Demonstration of Precise Calibration of Tropospheric Delay Fluctuations with Water Vapor Radiometers

NASA Technical Reports Server (NTRS)

Teitelbaum, L. P.; Keihm, S. J.; Linfield, R. P.; Mahoney, M. J.; Resch, G. M.

1996-01-01

The ability of water vapor radiometers (WVRs) to calibrate changes in tropospheric delay was demonstrated during very long baseline radio interferometer (VLBI) observations at Goldstone, California. WVR measurements reduced the observed VLBI delay variations over a 13 hr period by a factor of approx. = 2.5. When applied to shorter time scales, a approx. = 50% reduction in 100-700 s delay variations was achieved during conditions of high tropospheric activity. Thermal WVR noise precluded calibration of short time scale delay fluctuations during quiet tropospheric conditions.

Ignition Delay of Combustible Materials in Normoxic Equivalent Environments

NASA Technical Reports Server (NTRS)

McAllister, Sara; Fernandez-Pello, Carlos; Ruff, Gary; Urban, David

2009-01-01

Material flammability is an important factor in determining the pressure and composition (fraction of oxygen and nitrogen) of the atmosphere in the habitable volume of exploration vehicles and habitats. The method chosen in this work to quantify the flammability of a material is by its ease of ignition. The ignition delay time was defined as the time it takes a combustible material to ignite after it has been exposed to an external heat flux. Previous work in the Forced Ignition and Spread Test (FIST) apparatus has shown that the ignition delay in the currently proposed space exploration atmosphere (approximately 58.6 kPa and32% oxygen concentration) is reduced by 27% compared to the standard atmosphere used in the Space Shuttle and Space Station. In order to determine whether there is a safer environment in terms of material flammability, a series of piloted ignition delay tests using polymethylmethacrylate (PMMA) was conducted in the FIST apparatus to extend the work over a range of possible exploration atmospheres. The exploration atmospheres considered were the normoxic equivalents, i.e. reduced pressure conditions with a constant partial pressure of oxygen. The ignition delay time was seen to decrease as the pressure was reduced along the normoxic curve. The minimum ignition delay observed in the normoxic equivalent environments was nearly 30% lower than in standard atmospheric conditions. The ignition delay in the proposed exploration atmosphere is only slightly larger than this minimum. Interms of material flammability, normoxic environments with a higher pressure relative to the proposed pressure would be desired.

The fourth delay and community-driven solutions to reduce maternal mortality in rural Haiti: a community-based action research study.

PubMed

MacDonald, Tonya; Jackson, Suzanne; Charles, Marie-Carmèle; Periel, Marius; Jean-Baptiste, Marie-Véna; Salomon, Alex; Premilus, Éveillard

2018-06-20

In Haiti, the number of women dying in pregnancy, during childbirth and the weeks after giving birth remains unacceptably high. The objective of this research was to explore determinants of maternal mortality in rural Haiti through Community-Based Action Research (CBAR), guided by the delays that lead to maternal death. This paper focuses on socioecological determinants of maternal mortality from the perspectives of women of near-miss maternal experiences and community members, and their solutions to reduce maternal mortality in their community. The study draws on five semi-structured Individual Interviews with women survivors of near-misses, and on four Focus Group Discussions with Community Leaders and with Traditional Birth Attendants. Data collection took place in July 2013. A Community Research Team within a resource-limited rural community in Haiti undertook the research. The methods and analysis process were guided by participatory research and CBAR. Participants identified three delays that lead to maternal death but also described a fourth delay with respect to community responsibility for maternal mortality. They included women being carried from the community to a healthcare facility as a special example of the fourth delay. Women survivors of near-miss maternal experiences and community leaders suggested solutions to reduce maternal death that centered on prevention and community infrastructure. Most of the strategies for action were related to the fourth delay and include: community mobilization by way of the formation of Neighbourhood Maternal Health/Well-being Committees, and community support through the provision/sharing of food for undernourished women, offering monetary support and establishment of a communication relay/transport system in times of crisis. Finding sustainable ways to reduce maternal mortality requires a community-based/centred and community-driven comprehensive approach to maternal health/well-being. This includes engagement of community members that is dependent upon community knowledge, political will, mobilization, accountability and empowerment. An engaged/empowered community is one that is well placed to find ways that work in their community to reduce the fourth delay and in turn, maternal death. Potentially, community ownership of challenges and solutions can lead to more sustainable improvements in maternal health/well-being in Haiti.

Time delays in the response to the Neisseria meningitidis serogroup C outbreak in Nigeria - 2017.

PubMed

Hassan, Assad; Mustapha, G U; Lawal, Bola B; Na'uzo, Aliyu M; Ismail, Raji; Womi-Eteng Oboma, Eteng; Oyebanji, Oyeronke; Agenyi, Jeremiah; Thomas, Chima; Balogun, Muhammad Shakir; Dalhat, Mahmood M; Nguku, Patrick; Ihekweazu, Chikwe

2018-01-01

Nigeria reports high rates of mortality linked with recurring meningococcal meningitis outbreaks within the African meningitis belt. Few studies have thoroughly described the response to these outbreaks to provide strong and actionable public health messages. We describe how time delays affected the response to the 2016/2017 meningococcal meningitis outbreak in Nigeria. Using data from Nigeria Centre for Disease Control (NCDC), National Primary Health Care Development Agency (NPHCDA), World Health Organisation (WHO), and situation reports of rapid response teams, we calculated attack and death rates of reported suspected meningococcal meningitis cases per week in Zamfara, Sokoto and Yobe states respectively, between epidemiological week 49 in 2016 and epidemiological week 25 in 2017. We identified when alert and epidemic thresholds were crossed and determined when the outbreak was detected and notified in each state. We examined response activities to the outbreak. There were 12,535 suspected meningococcal meningitis cases and 877 deaths (CFR: 7.0%) in the three states. It took an average time of three weeks before the outbreaks were detected and notified to NCDC. Four weeks after receiving notification, an integrated response coordinating centre was set up by NCDC and requests for vaccines were sent to International Coordinating Group (ICG) on vaccine provision. While it took ICG one week to approve the requests, it took an average of two weeks for approximately 41% of requested vaccines to arrive. On the average, it took nine weeks from the date the epidemic threshold was crossed to commencement of reactive vaccination in the three states. There were delays in detection and notification of the outbreak, in coordinating response activities, in requesting for vaccines and their arrival from ICG, and in initiating reactive vaccination. Reducing these delays in future outbreaks could help decrease the morbidity and mortality linked with meningococcal meningitis outbreaks.

Delayed grafting for banked skin graft in lymph node flap transfer.

PubMed

Ciudad, Pedro; Date, Shivprasad; Orfaniotis, Georgios; Dower, Rory; Nicoli, Fabio; Maruccia, Michele; Lin, Shu-Ping; Chuang, Chu-Yi; Chuang, Tsan-Yu; Wang, Gou-Jen; Chen, Hung-Chi

2017-02-01

Over the last decade, lymph node flap (LNF) transfer has turned out to be an effective method in the management of lymphoedema of extremities. Most of the time, the pockets created for LNF cannot be closed primarily and need to be resurfaced with split thickness skin grafts. Partial graft loss was frequently noted in these cases. The need to prevent graft loss on these iatrogenic wounds made us explore the possibility of attempting delayed skin grafting. We have herein reported our experience with delayed grafting with autologous banked split skin grafts in cases of LNF transfer for lymphoedema of the extremities. Ten patients with International Society of Lymphology stage II-III lymphoedema of upper or lower extremity were included in this study over an 8-month period. All patients were thoroughly evaluated and subjected to lymph node flap transfer. The split skin graft was harvested and banked at the donor site, avoiding immediate resurfacing over the flap. The same was carried out in an aseptic manner as a bedside procedure after confirming flap viability and allowing flap swelling to subside. Patients were followed up to evaluate long-term outcomes. Flap survival was 100%. Successful delayed skin grafting was done between the 4th and 6th post-operative day as a bedside procedure under local anaesthesia. The split thickness skin grafts (STSG) takes more than 97%. One patient needed additional medications during the bedside procedure. All patients had minimal post-operative pain and skin graft requirement. The patients were also reported to be satisfied with the final aesthetic results. There were no complications related to either the skin grafts or donor sites during the entire period of follow-up. Delayed split skin grafting is a reliable method of resurfacing lymph node flaps and has been shown to reduce the possibility of flap complications as well as the operative time and costs. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Delayed wound healing after tooth extraction and self-reported kyphosis in Japanese men and women

PubMed Central

Taguchi, Akira; Kamimura, Mikio; Nakamura, Yukio; Sugino, Noriyuki; Ichinose, Akira; Maezumi, Hisayoshi; Fukuzawa, Takashi; Ashizawa, Ryouhei; Takahara, Kenji; Gushiken, Susumu; Mukaiyama, Keijiro; Ikegami, Shota; Uchiyama, Shigeharu; Kato, Hiroyuki

2016-01-01

It is unclear whether osteoporosis itself is a main risk factor for delayed wound healing after tooth extraction in humans. In this study, we evaluated the association between experience of delayed wound healing after last tooth extraction and self-reported kyphosis, with the possibility of having vertebral fractures, in Japanese patients. Among the 1,504 patients who responded to the structured questionnaire survey, 518 patients (134 men and 384 women) aged 55–97 years finally participated in this study. Patients who self-reported mild-moderate kyphosis were more likely to have problematic delayed wound healing after last tooth extraction than those who reported severe kyphosis (odds ratio [OR] 4.98; 95% confidence interval [CI], 1.86–13.38 and OR 2.30; 95% CI, 0.52–10.22, respectively) (p for trend = 0.005). Japanese patients with vertebral fractures may have a higher risk of having problematic delayed wound healing after tooth extraction. PMID:27848958

Delayed wound healing after tooth extraction and self-reported kyphosis in Japanese men and women.

PubMed

Taguchi, Akira; Kamimura, Mikio; Nakamura, Yukio; Sugino, Noriyuki; Ichinose, Akira; Maezumi, Hisayoshi; Fukuzawa, Takashi; Ashizawa, Ryouhei; Takahara, Kenji; Gushiken, Susumu; Mukaiyama, Keijiro; Ikegami, Shota; Uchiyama, Shigeharu; Kato, Hiroyuki

2016-11-16

It is unclear whether osteoporosis itself is a main risk factor for delayed wound healing after tooth extraction in humans. In this study, we evaluated the association between experience of delayed wound healing after last tooth extraction and self-reported kyphosis, with the possibility of having vertebral fractures, in Japanese patients. Among the 1,504 patients who responded to the structured questionnaire survey, 518 patients (134 men and 384 women) aged 55-97 years finally participated in this study. Patients who self-reported mild-moderate kyphosis were more likely to have problematic delayed wound healing after last tooth extraction than those who reported severe kyphosis (odds ratio [OR] 4.98; 95% confidence interval [CI], 1.86-13.38 and OR 2.30; 95% CI, 0.52-10.22, respectively) (p for trend = 0.005). Japanese patients with vertebral fractures may have a higher risk of having problematic delayed wound healing after tooth extraction.

Essential fatty acid deficiency delays the onset of puberty in the female rat.

PubMed

Smith, S S; Neuringer, M; Ojeda, S R

1989-09-01

This study assessed the effect of a dietary deficiency in the essential fatty acids (EFA) linoleic and linolenic acids on the onset of female puberty. EFA deficiency was produced in female rats by means of a semipurified diet and was biochemically documented by analyzing serum and erythrocyte fatty acid levels of more than 30 fatty acids, including all members of the n-6 and n-3 series. Levels of linoleic acid (18:2 n-6) and all n-6 derivatives, particularly arachidonic acid, were strikingly reduced. A less pronounced but clear-cut decrease in n-3 fatty acids, including docosahexaenoic acid (22:6 n-3) was also found. The times of puberty and first ovulation, as assessed by the ages at vaginal opening and first diestrus, were significantly delayed in EFA-deficient rats. The mechanisms underlying this delay appear to reside at both hypothalamic and ovarian sites. Simulation of preovulatory plasma estradiol (E2) levels via implantation of E2-containing Silastic capsules evoked a LH surge 30 h later in control juvenile rats, but not in EFA-deficient animals, indicating a delay in the development of the hypothalamic component of E2-positive feedback in the latter group. This delay appears to be due at least in part to reduced prostaglandin E2 (PGE2) synthesis, as the ability of the neurotransmitter norepinephrine to induce PGE2 release from median eminence nerve terminals was markedly reduced in EFA-deficient rats compared with that in controls. The decrease in hypothalamic PGE2 release was related to the EFA deficiency and not to reduced PG synthase activity, as determined by HPLC analysis of PG synthase products derived from exogenous [14C]arachidonic acid. Basal and hCG-stimulated PGE2 synthesis was also compromised in ovaries from EFA-deficient rats. Depressed gonadal function resulting from the EFA deficiency was further evidenced by a reduced gonadotropin receptor content, a blunted E2 response to hCG in vitro, and an increase in mean serum FSH levels. These results suggest that the delay in puberty resulting from EFA deficiency is due to a reduced availability of arachidonic acid for synthesis of bioactive metabolites. This results in delayed development of both the hypothalamic and ovarian components of the reproductive axis.

Reinforcement of wheel running in BALB/c mice: role of motor activity and endogenous opioids.

PubMed

Vargas-Pérez, Héctor; Sellings, Laurie H L; Paredes, Raúl G; Prado-Alcalá, Roberto A; Díaz, José-Luis

2008-11-01

The authors investigated the effect of the opioid antagonist naloxone on wheel-running behavior in Balb/c mice. Naloxone delayed the acquisition of wheel-running behavior, but did not reduce the expression of this behavior once acquired. Delayed acquisition was not likely a result of reduced locomotor activity, as naloxone-treated mice did not exhibit reduced wheel running after the behavior was acquired, and they performed normally on the rotarod test. However, naloxone-blocked conditioned place preference for a novel compartment paired previously with wheel running, suggesting that naloxone may delay wheel-running acquisition by blocking the rewarding or reinforcing effects of the behavior. These results suggest that the endogenous opioid system mediates the initial reinforcing effects of wheel running that are important in acquisition of the behavior.

Mindfulness-based stress reduction for parents of young children with developmental delays: implications for parental mental health and child behavior problems.

PubMed

Neece, Cameron L

2014-03-01

Parents of children with developmental delays (DD) typically report elevated levels of parental stress compared with parents of typically developing children. Children with DD are also at high risk for exhibiting significant behaviour problems. Parental stress has been shown to impact the development of these behaviour problems; however, it is rarely addressed in interventions aimed at reducing child behaviour problems. The current study examined the efficacy of mindfulness-based stress reduction (MBSR) for parents of children with DD by investigating whether this intervention is effective in reducing parenting stress and whether decreases in parenting stress lead to reductions in behaviour problems among children with DD. Forty six parents of children with DD were randomly assigned to an immediate treatment or wait list-control group. Participants completed questionnaires assessing parental stress and child behaviour problems at intake and at a second assessment, which took place after only the immediate treatment group had received the MBSR. Parents who participated in MBSR reported significantly less stress and depression as well as greater life satisfaction compared with wait list-control parents. Regarding child outcomes, children whose parents participated in MBSR were reported to have fewer behaviour problems following the intervention, specifically in the areas of attention problems and ADHD symptomatology. Results indicated that MBSR may be an effective intervention for ameliorating parental stress and mental health problems among parents of children with DD. Additionally, these benefits may 'spill over' and improve behaviour challenges among these children. © 2013 John Wiley & Sons Ltd.

Timing of routine infant vaccinations and risk of food allergy and eczema at one year of age.

PubMed

Kiraly, N; Koplin, J J; Crawford, N W; Bannister, S; Flanagan, K L; Holt, P G; Gurrin, L C; Lowe, A J; Tang, M L K; Wake, M; Ponsonby, A-L; Dharmage, S C; Allen, K J

2016-04-01

Epidemiological evidence suggests that routine vaccinations can have nontargeted effects on susceptibility to infections and allergic disease. Such effects may depend on age at vaccination, and a delay in pertussis vaccination has been linked to reduced risk of allergic disease. We aimed to test the hypothesis that delay in vaccines containing diphtheria-tetanus-acellular pertussis (DTaP) is associated with reduced risk of food allergy and other allergic diseases. HealthNuts is a population-based cohort in Melbourne, Australia. Twelve-month-old infants were skin prick-tested to common food allergens, and sensitized infants were offered oral food challenges to determine food allergy status. In this data linkage study, vaccination data for children in the HealthNuts cohort were obtained from the Australian Childhood Immunisation Register. Associations were examined between age at the first dose of DTaP and allergic disease. Of 4433 children, 109 (2.5%) received the first dose of DTaP one month late (delayed DTaP). Overall, delayed DTaP was not associated with primary outcomes of food allergy (adjusted odds ratio (aOR) 0.77; 95% CI: 0.36-1.62, P = 0.49) or atopic sensitization (aOR: 0.66; 95% CI: 0.35-1.24, P = 0.19). Amongst secondary outcomes, delayed DTaP was associated with reduced eczema (aOR: 0.57; 95% CI: 0.34-0.97, P = 0.04) and reduced use of eczema medication (aOR: 0.45; 95% CI: 0.24-0.83, P = 0.01). There was no overall association between delayed DTaP and food allergy; however, children with delayed DTaP had less eczema and less use of eczema medication. Timing of routine infant immunizations may affect susceptibility to allergic disease. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Programmable Differential Delay Circuit With Fine Delay Adjustment

DOEpatents

DeRyckere, John F.; Jenkins, Philip Nord; Cornett, Frank Nolan

2002-07-09

Circuitry that provides additional delay to early arriving signals such that all data signals arrive at a receiving latch with same path delay. The delay of a forwarded clock reference is also controlled such that the capturing clock edge will be optimally positioned near quadrature (depending on latch setup/hold requirements). The circuitry continuously adapts to data and clock path delay changes and digital filtering of phase measurements reduce errors brought on by jittering data edges. The circuitry utilizes only the minimum amount of delay necessary to achieve objective thereby limiting any unintended jitter. Particularly, this programmable differential delay circuit with fine delay adjustment is designed to allow the skew between ASICS to be minimized. This includes skew between data bits, between data bits and clocks as well as minimizing the overall skew in a channel between ASICS.

Timeliness of notification systems for infectious diseases: A systematic literature review.

PubMed

Swaan, Corien; van den Broek, Anouk; Kretzschmar, Mirjam; Richardus, Jan Hendrik

2018-01-01

Timely notification of infectious diseases is crucial for prompt response by public health services. Adequate notification systems facilitate timely notification. A systematic literature review was performed to assess outcomes of studies on notification timeliness and to determine which aspects of notification systems are associated with timely notification. Articles reviewing timeliness of notifications published between 2000 and 2017 were searched in Pubmed and Scopus. Using a standardized notification chain, timeliness of reporting system for each article was defined as either sufficient (≥ 80% notifications in time), partly sufficient (≥ 50-80%), or insufficient (< 50%) according to the article's predefined timeframe, a standardized timeframe for all articles, and a disease specific timeframe. Electronic notification systems were compared with conventional methods (postal mail, fax, telephone, email) and mobile phone reporting. 48 articles were identified. In almost one third of the studies with a predefined timeframe (39), timeliness of notification systems was either sufficient or insufficient (11/39, 28% and 12/39, 31% resp.). Applying the standardized timeframe (45 studies) revealed similar outcomes (13/45, 29%, sufficient notification timeframe, vs 15/45, 33%, insufficient). The disease specific timeframe was not met by any study. Systems involving reporting by laboratories most often complied sufficiently with predefined or standardized timeframes. Outcomes were not related to electronic, conventional notification systems or mobile phone reporting. Electronic systems were faster in comparative studies (10/13); this hardly resulted in sufficient timeliness, neither according to predefined nor to standardized timeframes. A minority of notification systems meets either predefined, standardized or disease specific timeframes. Systems including laboratory reporting are associated with timely notification. Electronic systems reduce reporting delay, but implementation needs considerable effort to comply with notification timeframes. During outbreak threats, patient, doctors and laboratory testing delays need to be reduced to achieve timely detection and notification. Public health authorities should incorporate procedures for this in their preparedness plans.

Size reduction techniques for vital compliant VHDL simulation models

DOEpatents

Rich, Marvin J.; Misra, Ashutosh

2006-08-01

A method and system select delay values from a VHDL standard delay file that correspond to an instance of a logic gate in a logic model. Then the system collects all the delay values of the selected instance and builds super generics for the rise-time and the fall-time of the selected instance. Then, the system repeats this process for every delay value in the standard delay file (310) that correspond to every instance of every logic gate in the logic model. The system then outputs a reduced size standard delay file (314) containing the super generics for every instance of every logic gate in the logic model.

Delay-tunable gap-soliton-based slow-light system

NASA Astrophysics Data System (ADS)

Mok, Joe T.; de Sterke, C. Martijn; Eggleton, Benjamin J.

2006-12-01

We numerically and analytically evaluate the delay of solitons propagating slowly, and without broadening, in an apodized Bragg grating. Simulations indicate that a 100 mm Bragg grating with Δn = 10-3 can delay sub-nanosecond pulses by nearly 20 pulse widths without any change in the output pulse width. Delay tunability is achieved by simultaneously adjusting the launch power and detuning. A simple analytic model is developed to describe the monotonic dependence of delay on Δn and compared with simulations. As the intensity may be greatly enhanced due to a reduced velocity, a procedure for improving the delay while avoiding material damage is outlined.

The characterization of a full-thickness excision open foot wound model in n5-streptozotocin (STZ)-induced type 2 diabetic rats that mimics diabetic foot ulcer in terms of reduced blood circulation, higher C-reactive protein, elevated inflammation, and reduced cell proliferation.

PubMed

Yu, Caroline Oi-Ling; Leung, Kwok-Sui; Fung, Kwok-Pui; Lam, Francis Fu-Yuen; Ng, Ethel Sau-Kuen; Lau, Kit-Man; Chow, Simon Kwoon-Ho; Cheung, Wing-Hoi

2017-08-05

Delayed foot wound healing is a major complication attributed to hyperglycemia in type 2 diabetes mellitus (DM) patients, and these wounds may develop into foot ulcers. There are at least two types of DM wound models used in rodents to study delayed wound healing. However, clinically relevant animal models are not common. Most models use type 1 DM rodents or wounds created on the back rather than on the foot. An open full-thickness excision wound on the footpad of type 2 DM rats is more clinically relevant, but such a model has not yet been characterized systematically. The objective of this study was to investigate and characterize how DM affected a full-thickness excision open foot wound in n5-streptozotocin (n5-STZ)-induced type 2 DM rats. We hypothesized that elevated inflammation, reduced blood circulation, and cell proliferation due to hyperglycemia could delay the wound healing of DM rats. The wounds of DM rats were compared with those of non-DM rats (Ctrl) at Days 1 and 8 post wounding. The wound healing process of the DM rats was significantly delayed compared with that of the Ctrl rats. The DM rats also had higher C-reactive protein (CRP) and lower blood circulation and proliferating cell nuclear antigen (PCNA) in DM wounds. This confirmed that elevated inflammation and reduced blood flow and cell proliferation delayed foot wound healing in the n5-STZ rats. Hence, this open foot wound animal model provides a good approach to study the process of delayed wound healing.

The characterization of a full-thickness excision open foot wound model in n5-streptozotocin (STZ)-induced type 2 diabetic rats that mimics diabetic foot ulcer in terms of reduced blood circulation, higher C-reactive protein, elevated inflammation, and reduced cell proliferation

PubMed Central

Yu, Caroline Oi-Ling; Leung, Kwok-Sui; Fung, Kwok-Pui; Lam, Francis Fu-Yuen; Ng, Ethel Sau-Kuen; Lau, Kit-Man; Chow, Simon Kwoon-Ho; Cheung, Wing-Hoi

2017-01-01

Delayed foot wound healing is a major complication attributed to hyperglycemia in type 2 diabetes mellitus (DM) patients, and these wounds may develop into foot ulcers. There are at least two types of DM wound models used in rodents to study delayed wound healing. However, clinically relevant animal models are not common. Most models use type 1 DM rodents or wounds created on the back rather than on the foot. An open full-thickness excision wound on the footpad of type 2 DM rats is more clinically relevant, but such a model has not yet been characterized systematically. The objective of this study was to investigate and characterize how DM affected a full-thickness excision open foot wound in n5-streptozotocin (n5-STZ)-induced type 2 DM rats. We hypothesized that elevated inflammation, reduced blood circulation, and cell proliferation due to hyperglycemia could delay the wound healing of DM rats. The wounds of DM rats were compared with those of non-DM rats (Ctrl) at Days 1 and 8 post wounding. The wound healing process of the DM rats was significantly delayed compared with that of the Ctrl rats. The DM rats also had higher C-reactive protein (CRP) and lower blood circulation and proliferating cell nuclear antigen (PCNA) in DM wounds. This confirmed that elevated inflammation and reduced blood flow and cell proliferation delayed foot wound healing in the n5-STZ rats. Hence, this open foot wound animal model provides a good approach to study the process of delayed wound healing. PMID:28413186

Delayed/back up antibiotic prescriptions: what do the public think?

PubMed Central

McNulty, Cliodna A M; Lecky, Donna M; Hawking, Meredith K D; Quigley, Anna; Butler, Chris C

2015-01-01

Objective To describe the general public's understanding, acceptance and use of delayed antibiotics. Design Face to face computer-assisted survey using an Ipsos MORI Capibus survey. Setting Randomly selected households in England using multistage sampling. Respondents A representative sample of 1625 adults aged over 15 years and recruited from household visits in England, using age and gender quotas for each area. Data collection and analysis The survey was undertaken in January 2014. Weights based on gender, age, ethnicity, working status, social grade, housing tenure and Government Office Region corrected for selection biases, so that results are broadly representative of the population. Main outcomes measures Proportion of respondents; understanding the meaning of the term delayed antibiotic prescription and how the strategy is used in general practice; in favour of, or opposed to clinicians offering them a delayed antibiotic; reporting receipt, use and acceptability of delayed antibiotic prescriptions in the past year. Results 17% reported fully understanding the meaning of delayed antibiotic prescription and strategy use in general practice;72% were unaware of the term or strategy; 36–39% were in favour of, and 28–30% opposed to clinicians offering them a delayed antibiotic for throat, urine, ear or chest infections. Half of those who were fully aware of the term and practice were in favour of delayed antibiotics. Women, and older respondents, were more strongly opposed to delayed prescribing. Only 4% of all respondents, and 15% of those prescribed an antibiotic, reported being offered a delayed antibiotic in the last year. Conclusions Wider understanding and acceptance of delayed prescribing may facilitate increased uptake. Further research is needed to determine why groups are so strongly in favour or opposed to delayed prescribing. PMID:26614626

Gender and Geographic Differences in Developmental Delays among Young Children: Analysis of the Data from the National Registry in Taiwan

ERIC Educational Resources Information Center

Lai, Der-Chung; Tseng, Yen-Cheng; Guo, How-Ran

2011-01-01

Although developmental delays are not uncommon in children, the incidence is seldom assessed, and the reported prevalence varies widely. In Taiwan, the government mandates the reporting of suspected cases. Using the national registry data, we conducted a study to estimate the incidence and prevalence of developmental delays in young children in…

Action of (R)-sila-venlafaxine and reboxetine to antagonize cisplatin-induced acute and delayed emesis in the ferret

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

Warneck, Julie B.; Cheng, Frankie H.M.; Barnes, Matthew J.

2008-11-01

The chemotherapeutic drug cisplatin is associated with severe gastrointestinal toxicity that can last for several days. A recent strategy to treat the nausea and emesis includes the combination of a 5-HT{sub 3} receptor antagonist, a glucocorticoid, and an NK{sub 1} receptor antagonist. The present studies explore the use of the selective noradrenaline reuptake inhibitors, (R)-sila-venlafaxine, (R,R)-reboxetine and (S,S)-reboxetine to prevent cisplatin (5 mg/kg, i.p.)-induced acute (0-24 h) and delayed (24-72 h) emesis in ferrets. The positive control regimen of ondansetron and dexamethasone, both at 1 mg/kg/8 h, reduced acute and delayed emesis by 100 (P < 0.001) and 61% (Pmore » < 0.05). (R)-sila-venlafaxine at 5 and 15 mg/kg/4 h reduced acute emesis by 86 (P < 0.01) and 66% (P < 0.05), respectively and both enantiomers of reboxetine at 1 mg/kg/12 h also reduced the response by {approx} 70-90% (P < 0.05). Out of the reuptake inhibitors, only (R)-sila-venlafaxine at 15 mg/kg/4 h was active to reduce delayed emesis (a 57% reduction was observed (P < 0.05)); its terminal plasma levels were positively correlated with an inhibition of emesis during the delayed phase (P < 0.05). (R)-sila-venlafaxine was also examined against a higher dose of cisplatin 10 mg/kg, i.p. (3 h test) and it dose-dependently antagonized the response (maximum reduction was 94% at 10 mg/kg, p.o.; P < 0.01) but it was ineffective against apomorphine (0.125 mg/kg, s.c.) and ipecacuanha (2 mg/kg, p.o.)-induced emesis (P > 0.05). In conclusion, the studies provide the first evidence for an anti-emetic potential of noradrenaline reuptake inhibitors to reduce chemotherapy-induced acute and delayed emesis.« less

Infant Development and Pre- and Post-partum Depression in Rural South African HIV-Infected Women.

PubMed

Rodriguez, Violeta J; Matseke, Gladys; Cook, Ryan; Bellinger, Seanna; Weiss, Stephen M; Alcaide, Maria L; Peltzer, Karl; Patton, Doyle; Lopez, Maria; Jones, Deborah L

2017-10-06

HIV-exposed infants born to depressed women may be at risk for adverse developmental outcomes. Half of HIV-infected women in rural South Africa (SA) may suffer from pregnancy-related depression. This pilot study examined the impact of depression in HIV-infected women in rural SA on infant development. Mother-infant dyads (N = 69) were recruited in rural SA. Demographics, HIV disclosure, depression, male involvement, and alcohol use at baseline (18.35 ± 5.47 weeks gestation) were assessed. Male involvement, depression, infant HIV serostatus and development were assessed 12 months postnatally. Half of the women (age = 29 ± 5) reported depression prenatally and one-third reported depression postnatally. In multivariable logistic regression, not cohabiting with their male partner, nondisclosure of HIV status, and postnatal depression predicted cognitive delay; decreased prenatal male involvement predicted delayed gross motor development (ps < 0.05). Assessing pregnancy-related depression among HIV-infected women and infant development and increasing male involvement may reduce negative developmental outcomes among HIV-exposed or infected infants.

Acupressure bands do not improve chemotherapy-induced nausea control in pediatric patients receiving highly emetogenic chemotherapy: A single-blinded, randomized controlled trial.

PubMed

Dupuis, L Lee; Kelly, Kara M; Krischer, Jeffrey P; Langevin, Anne-Marie; Tamura, Roy N; Xu, Ping; Chen, Lu; Kolb, E Anders; Ullrich, Nicole J; Sahler, Olle Jane Z; Hendershot, Eleanor; Stratton, Ann; Sung, Lillian; McLean, Thomas W

2018-03-15

Chemotherapy-induced nausea and vomiting remain common, distressing side effects of chemotherapy. It has been reported that acupressure prevents chemotherapy-induced nausea in adults, but it has not been well studied in children. In this multicenter, prospective, randomized, single-blind, sham-controlled trial, the authors compared acute-phase nausea severity in patients ages 4 to 18 years who were receiving highly emetic chemotherapy using standard antiemetic agents combined with acupressure wrist bands, the most common type of acupressure, versus sham bands. Patients wore acupressure or sham bands continuously on each day of chemotherapy and for up to 7 days afterward. Chemotherapy-induced nausea severity in the delayed phase and chemotherapy-induced vomiting control in the acute and delayed phases also were compared. Of the 187 patients randomized, 165 contributed nausea severity assessments during the acute phase. Acupressure bands did not reduce the severity of chemotherapy-induced nausea in the acute phase (odds ratio [OR], 1.33; 95% confidence limits, 0.89-2.00, in which an OR <1.00 favored acupressure) or in the delayed phase (OR, 1.23; 95% CL, 0.75-2.01). Furthermore, acupressure bands did not improve daily vomiting control during the acute phase (OR, 1.57; 95% CL, 0.95-2.59) or the delayed phase (OR, 0.84; 95% CL, 0.45-1.58). No serious adverse events were reported. Acupressure bands were safe but did not improve chemotherapy-induced nausea or vomiting in pediatric patients who were receiving highly emetic chemotherapy. Cancer 2018;124:1188-96. © 2017 American Cancer Society. © 2017 American Cancer Society.

Foregone benefits of important food crop improvements in Sub-Saharan Africa

PubMed Central

2017-01-01

A number of new crops have been developed that address important traits of particular relevance for smallholder farmers in Africa. Scientists, policy makers, and other stakeholders have raised concerns that the approval process for these new crops causes delays that are often scientifically unjustified. This article develops a real option model for the optimal regulation of a risky technology that enhances economic welfare and reduces malnutrition. We consider gradual adoption of the technology and show that delaying approval reduces uncertainty about perceived risks of the technology. Optimal conditions for approval incorporate parameters of the stochastic processes governing the dynamics of risk. The model is applied to three cases of improved crops, which either are, or are expected to be, delayed by the regulatory process. The benefits and costs of the crops are presented in a partial equilibrium that considers changes in adoption over time and the foregone benefits caused by a delay in approval under irreversibility and uncertainty. We derive the equilibrium conditions where the net-benefits of the technology equal the costs that would justify a delay. The sooner information about the safety of the technology arrive, the lower the costs for justifying a delay need to be i.e. it pays more to delay. The costs of a delay can be substantial: e.g. a one year delay in approval of the pod-borer resistant cowpea in Nigeria will cost the country about 33 million USD to 46 million USD and between 100 and 3,000 lives. PMID:28749984

Experimental verification of arm-locking for LISA using electronic phase delay [rapid communication

NASA Astrophysics Data System (ADS)

Thorpe, J. I.; Mueller, G.

2005-07-01

We present results of an electronic model of arm-locking, a proposed technique for reducing the laser phase noise in the laser interferometer space antenna (LISA). The model is based on a delay of 500 ms, achieved using the electronic phase delay (EPD) method. The observed behavior is consistent with predictions.

Hybrid Ag 2VO 2PO 4/CF x as a High Capacity and Energy Cathode for Primary Batteries

DOE PAGES

Li, Yue Ru; Bruck, Andrea M.; Brady, Alexander B.; ...

2017-08-18

In this report, we describe the electrochemistry of hybrid dual silver vanadium phosphorus oxide/carbon fluoride (Ag 2VO 2PO 4/CF x) cathodes with various weight ratios. Through modification of the Ag 2VO 2PO 4/CF x ratio, we can control the gravimetric and volumetric capacity, as well as mitigate the voltage drop during high current pulses. The increase in impedance caused by irreversible LiF formation in CFx was reduced by the silver reduction-displacement during electrochemical discharge of the Ag 2VO 2PO 4. Moreover, the addition of graphite was shown to reduce initial voltage delay. When Ag 2VO 2PO 4 dominates the electrodemore » mass (i.e. 75/25 Ag 2VO 2PO 4/CF x) in the hybrid cathode, pulse testing shows less voltage drop and delay, but at the expense of capacity and energy density. As the amount of CFx in the composite increases (i.e. Ag 2VO 2PO 4/CF x ratio of to 50/50 or 25/75), charge capacity and energy density increases, but at the expense of larger voltage drops and delays early in the discharge process. Thus, controlling the Ag 2VO 2PO 4/CF x ratio can be used to tune the electrochemical properties of the dual cathode, allowing for optimization of capacity and power depending on the application.« less

Hybrid Ag 2VO 2PO 4/CF x as a High Capacity and Energy Cathode for Primary Batteries

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

Li, Yue Ru; Bruck, Andrea M.; Brady, Alexander B.

In this report, we describe the electrochemistry of hybrid dual silver vanadium phosphorus oxide/carbon fluoride (Ag 2VO 2PO 4/CF x) cathodes with various weight ratios. Through modification of the Ag 2VO 2PO 4/CF x ratio, we can control the gravimetric and volumetric capacity, as well as mitigate the voltage drop during high current pulses. The increase in impedance caused by irreversible LiF formation in CFx was reduced by the silver reduction-displacement during electrochemical discharge of the Ag 2VO 2PO 4. Moreover, the addition of graphite was shown to reduce initial voltage delay. When Ag 2VO 2PO 4 dominates the electrodemore » mass (i.e. 75/25 Ag 2VO 2PO 4/CF x) in the hybrid cathode, pulse testing shows less voltage drop and delay, but at the expense of capacity and energy density. As the amount of CFx in the composite increases (i.e. Ag 2VO 2PO 4/CF x ratio of to 50/50 or 25/75), charge capacity and energy density increases, but at the expense of larger voltage drops and delays early in the discharge process. Thus, controlling the Ag 2VO 2PO 4/CF x ratio can be used to tune the electrochemical properties of the dual cathode, allowing for optimization of capacity and power depending on the application.« less

Impact of health care system delay in patients with ST-elevation myocardial infarction on return to labor market and work retirement.

PubMed

Laut, Kristina Grønborg; Hjort, Jacob; Engstrøm, Thomas; Jensen, Lisette Okkels; Tilsted Hansen, Hans-Henrik; Jensen, Jan Skov; Pedersen, Frants; Jørgensen, Erik; Holmvang, Lene; Pedersen, Alma Becic; Christensen, Erika Frischknecht; Lippert, Freddy; Lang-Jensen, Torsten; Jans, Henning; Hansen, Poul Anders; Trautner, Sven; Kristensen, Steen Dalby; Lassen, Jens Flensted; Lash, Timothy L; Clemmensen, Peter; Terkelsen, Christian Juhl

2014-12-15

System delay (delay from emergency medical service call to reperfusion with primary percutaneous coronary intervention [PPCI]) is acknowledged as a performance measure in ST-elevation myocardial infarction (STEMI), as shorter system delay is associated with lower mortality. It is unknown whether system delay also impacts ability to stay in the labor market. Therefore, the aim of the study was to evaluate whether system delay is associated with duration of absence from work or time to retirement from work among patients with STEMI treated with PPCI. We conducted a population-based cohort study including patients ≤67 years of age who were admitted with STEMI from January 1, 1999, to December 1, 2011 and treated with PPCI. Data were derived from Danish population-based registries. Only patients who were full- or part-time employed before their STEMI admission were included. Association between system delay and time to return to the labor market was analyzed using a competing-risk regression analysis. Association between system delay and time to retirement from work was analyzed using a Cox regression model. A total of 4,061 patients were included. Ninety-three percent returned to the labor market during 4 years of follow-up, and 41% retired during 8 years of follow-up. After adjustment, system delay >120 minutes was associated with reduced resumption of work (subhazard ratio 0.86, 95% confidence interval 0.81 to 0.92) and earlier retirement from work (hazard ratio 1.21, 95% confidence interval 1.08 to 1.36). In conclusion, system delay was associated with reduced work resumption and earlier retirement. This highlights the value of system delay as a performance measure in treating patients with STEMI. Copyright © 2014 Elsevier Inc. All rights reserved.

The Role of Web-Based Health Information in Help-Seeking Behavior Prior to a Diagnosis of Lung Cancer: A Mixed-Methods Study

PubMed Central

Jay, Caroline; Harper, Simon; Todd, Chris

2017-01-01

Background Delays to diagnosis in lung cancer can lead to reduced chance of survival, and patients often wait for several months before presenting symptoms. The time between first symptom recognition until diagnosis has been theorized into three intervals: symptom appraisal, help-seeking, and diagnostic interval (here: “pathway to diagnosis”). Interventions are needed to reduce delays to diagnosis in lung cancer. The Web has become an important lay health information source and could potentially play a role in this pathway to diagnosis. Objective Our overall aim was to gain a preliminary insight into whether Web-based information plays a role in the pathway to diagnosis in lung cancer in order to assess whether it may be possible to leverage this information source to reduce delays to diagnosis. Methods Patients diagnosed with lung cancer in the 6 months before study entry completed a survey about whether (and how, if yes) they had used the Web to appraise their condition prior to diagnosis. Based on survey responses, we purposively sampled patients and their next-of-kin for semistructured interviews (24 interviews; 33 participants). Interview data were analyzed qualitatively using Framework Analysis in the context of the pathway to diagnosis model. Results A total of 113 patients completed the survey (age: mean 67.0, SD 8.8 years). In all, 20.4% (23/113) reported they or next-of-kin had researched their condition online before the diagnosis. The majority of searches (20/23, 87.0%) were conducted by or with the help of next-of-kin. Interview results suggest that patients and next-of-kin perceived an impact of the information found online on all three intervals in the time to diagnosis. In the appraisal interval, participants used online information to evaluate symptoms and possible causes. In the help-seeking interval, the Web was used to inform the decision of whether to present to health services. In the diagnostic interval, it was used to evaluate health care professionals’ advice, to support requests for further investigation of symptoms, and to understand medical jargon. Within this interval, we identified two distinct subintervals (before/after relevant diagnostic tests were initiated), in which the Web reportedly played different roles. Conclusions Because only 20.4% of the sample reported prediagnosis Web searches, it seems the role of the Web before diagnosis of lung cancer is at present still limited, but this proportion is likely to increase in the future, when barriers such as unfamiliarity with technology and unwillingness to be informed about one’s own health are likely to decrease. Participants’ perceptions suggest that the Web can have an impact on all three intervals in the pathway to diagnosis. Thus, the Web may hold the potential to reduce delays in the diagnostic process, and this should be explored in future research and interventions. Our results also suggest a division of the diagnostic interval into two subintervals may be useful. PMID:28596146

The Role of Web-Based Health Information in Help-Seeking Behavior Prior to a Diagnosis of Lung Cancer: A Mixed-Methods Study.

PubMed

Mueller, Julia; Jay, Caroline; Harper, Simon; Todd, Chris

2017-06-08

Delays to diagnosis in lung cancer can lead to reduced chance of survival, and patients often wait for several months before presenting symptoms. The time between first symptom recognition until diagnosis has been theorized into three intervals: symptom appraisal, help-seeking, and diagnostic interval (here: "pathway to diagnosis"). Interventions are needed to reduce delays to diagnosis in lung cancer. The Web has become an important lay health information source and could potentially play a role in this pathway to diagnosis. Our overall aim was to gain a preliminary insight into whether Web-based information plays a role in the pathway to diagnosis in lung cancer in order to assess whether it may be possible to leverage this information source to reduce delays to diagnosis. Patients diagnosed with lung cancer in the 6 months before study entry completed a survey about whether (and how, if yes) they had used the Web to appraise their condition prior to diagnosis. Based on survey responses, we purposively sampled patients and their next-of-kin for semistructured interviews (24 interviews; 33 participants). Interview data were analyzed qualitatively using Framework Analysis in the context of the pathway to diagnosis model. A total of 113 patients completed the survey (age: mean 67.0, SD 8.8 years). In all, 20.4% (23/113) reported they or next-of-kin had researched their condition online before the diagnosis. The majority of searches (20/23, 87.0%) were conducted by or with the help of next-of-kin. Interview results suggest that patients and next-of-kin perceived an impact of the information found online on all three intervals in the time to diagnosis. In the appraisal interval, participants used online information to evaluate symptoms and possible causes. In the help-seeking interval, the Web was used to inform the decision of whether to present to health services. In the diagnostic interval, it was used to evaluate health care professionals' advice, to support requests for further investigation of symptoms, and to understand medical jargon. Within this interval, we identified two distinct subintervals (before/after relevant diagnostic tests were initiated), in which the Web reportedly played different roles. Because only 20.4% of the sample reported prediagnosis Web searches, it seems the role of the Web before diagnosis of lung cancer is at present still limited, but this proportion is likely to increase in the future, when barriers such as unfamiliarity with technology and unwillingness to be informed about one's own health are likely to decrease. Participants' perceptions suggest that the Web can have an impact on all three intervals in the pathway to diagnosis. Thus, the Web may hold the potential to reduce delays in the diagnostic process, and this should be explored in future research and interventions. Our results also suggest a division of the diagnostic interval into two subintervals may be useful. ©Julia Mueller, Caroline Jay, Simon Harper, Chris Todd. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 08.06.2017.

Wind-dragged corolla enhances self-pollination: a new mechanism of delayed self-pollination.

PubMed

Qu, Rongming; Li, Xiaojie; Luo, Yibo; Dong, Ming; Xu, Huanli; Chen, Xuan; Dafni, Amots

2007-12-01

Delayed self-pollination is a mechanism that allows animal-pollinated plants to outcross while ensuring seed production in the absence of pollinators. This study aims to explore a new mechanism of delayed self-pollination facilitated by wind-driven corolla abscission in Incarvillea sinensis var. sinensis. Floral morphology and development, and the process of delayed self-pollination were surveyed. Experiments dealing with pollinator and wind exclusion, pollination manipulations, and pollinator observations were conducted in the field. Delayed self-pollination occurs when the abscising corolla driven by wind drags the adherent epipetalous stamens, thus leading to contact of anthers with stigma in late anthesis. There is no dichogamy and self-incompatibility in this species. The significantly higher proportion of abscised corolla under natural conditions as compared with that in wind-excluding tents indicates the importance of wind in corolla abscission. When pollinators were excluded, corolla abscission significantly increased the number of pollen grains deposited on the stigma and, as a result, the fruit and seed set. Only half of the flowers in plots were visited by pollinators, and the fruit set of emasculated flowers was significantly lower than that of untreated flowers in open pollination. This species has a sensitive stigma, and its two open stigmatic lobes closed soon after being touched by a pollinator, but always reopened if no or only little pollen was deposited. This delayed self-pollination, which involved the movement of floral parts, the active participation of the wind and sensitive stigma, is quite different from that reported previously. This mechanism provides reproductive assurance for this species. The sensitive stigma contributes to ensuring seed production and reducing the interference of selfing with outcrossing. The pollination pattern, which combines actions by bees with indirect participation by wind, is also a new addition to ambophily.

Mechanisms of Firing Patterns in Fast-Spiking Cortical Interneurons

PubMed Central

Golomb, David; Donner, Karnit; Shacham, Liron; Shlosberg, Dan; Amitai, Yael; Hansel, David

2007-01-01

Cortical fast-spiking (FS) interneurons display highly variable electrophysiological properties. Their spike responses to step currents occur almost immediately following the step onset or after a substantial delay, during which subthreshold oscillations are frequently observed. Their firing patterns include high-frequency tonic firing and rhythmic or irregular bursting (stuttering). What is the origin of this variability? In the present paper, we hypothesize that it emerges naturally if one assumes a continuous distribution of properties in a small set of active channels. To test this hypothesis, we construct a minimal, single-compartment conductance-based model of FS cells that includes transient Na+, delayed-rectifier K+, and slowly inactivating d-type K+ conductances. The model is analyzed using nonlinear dynamical system theory. For small Na+ window current, the neuron exhibits high-frequency tonic firing. At current threshold, the spike response is almost instantaneous for small d-current conductance, g d, and it is delayed for larger g d. As g d further increases, the neuron stutters. Noise substantially reduces the delay duration and induces subthreshold oscillations. In contrast, when the Na+ window current is large, the neuron always fires tonically. Near threshold, the firing rates are low, and the delay to firing is only weakly sensitive to noise; subthreshold oscillations are not observed. We propose that the variability in the response of cortical FS neurons is a consequence of heterogeneities in their g d and in the strength of their Na+ window current. We predict the existence of two types of firing patterns in FS neurons, differing in the sensitivity of the delay duration to noise, in the minimal firing rate of the tonic discharge, and in the existence of subthreshold oscillations. We report experimental results from intracellular recordings supporting this prediction. PMID:17696606

Mechanisms of firing patterns in fast-spiking cortical interneurons.

PubMed

Golomb, David; Donner, Karnit; Shacham, Liron; Shlosberg, Dan; Amitai, Yael; Hansel, David

2007-08-01

Cortical fast-spiking (FS) interneurons display highly variable electrophysiological properties. Their spike responses to step currents occur almost immediately following the step onset or after a substantial delay, during which subthreshold oscillations are frequently observed. Their firing patterns include high-frequency tonic firing and rhythmic or irregular bursting (stuttering). What is the origin of this variability? In the present paper, we hypothesize that it emerges naturally if one assumes a continuous distribution of properties in a small set of active channels. To test this hypothesis, we construct a minimal, single-compartment conductance-based model of FS cells that includes transient Na(+), delayed-rectifier K(+), and slowly inactivating d-type K(+) conductances. The model is analyzed using nonlinear dynamical system theory. For small Na(+) window current, the neuron exhibits high-frequency tonic firing. At current threshold, the spike response is almost instantaneous for small d-current conductance, gd, and it is delayed for larger gd. As gd further increases, the neuron stutters. Noise substantially reduces the delay duration and induces subthreshold oscillations. In contrast, when the Na(+) window current is large, the neuron always fires tonically. Near threshold, the firing rates are low, and the delay to firing is only weakly sensitive to noise; subthreshold oscillations are not observed. We propose that the variability in the response of cortical FS neurons is a consequence of heterogeneities in their gd and in the strength of their Na(+) window current. We predict the existence of two types of firing patterns in FS neurons, differing in the sensitivity of the delay duration to noise, in the minimal firing rate of the tonic discharge, and in the existence of subthreshold oscillations. We report experimental results from intracellular recordings supporting this prediction.

1α,25-Dihydroxyvitamin D3-3β-bromoacetate, a potential cancer therapeutic agent: synthesis and molecular mechanism of action

PubMed Central

Ray, Rahul; Lambert, James R.

2011-01-01

Synthesis of 1α,25-dihydroxyvitamin D3-3β-bromoacetate (1,25(OH)2D3-3-BE), a potential anti-cancer agent is presented. We also report that mechanism of action of 1,25(OH)2D3-3-BE may involve reduction of its catabolism, as evidenced by the reduced and delayed expression of 1α,25-dihydroxyvitamin D3-24-hydroxylase (CYP24) gene in cellular assays. PMID:21392983

Flexible, High-Speed CdSe Nanocrystal Integrated Circuits.

PubMed

Stinner, F Scott; Lai, Yuming; Straus, Daniel B; Diroll, Benjamin T; Kim, David K; Murray, Christopher B; Kagan, Cherie R

2015-10-14

We report large-area, flexible, high-speed analog and digital colloidal CdSe nanocrystal integrated circuits operating at low voltages. Using photolithography and a newly developed process to fabricate vertical interconnect access holes, we scale down device dimensions, reducing parasitic capacitances and increasing the frequency of circuit operation, and scale up device fabrication over 4 in. flexible substrates. We demonstrate amplifiers with ∼7 kHz bandwidth, ring oscillators with <10 μs stage delays, and NAND and NOR logic gates.

Flight Departure Delay and Rerouting Under Uncertainty in En Route Convective Weather

NASA Technical Reports Server (NTRS)

Mukherjee, Avijit; Grabbe, Shon; Sridhar, Banavar

2011-01-01

Delays caused by uncertainty in weather forecasts can be reduced by improving traffic flow management decisions. This paper presents a methodology for traffic flow management under uncertainty in convective weather forecasts. An algorithm for assigning departure delays and reroutes to aircraft is presented. Departure delay and route assignment are executed at multiple stages, during which, updated weather forecasts and flight schedules are used. At each stage, weather forecasts up to a certain look-ahead time are treated as deterministic and flight scheduling is done to mitigate the impact of weather on four-dimensional flight trajectories. Uncertainty in weather forecasts during departure scheduling results in tactical airborne holding of flights. The amount of airborne holding depends on the accuracy of forecasts as well as the look-ahead time included in the departure scheduling. The weather forecast look-ahead time is varied systematically within the experiments performed in this paper to analyze its effect on flight delays. Based on the results, longer look-ahead times cause higher departure delays and additional flying time due to reroutes. However, the amount of airborne holding necessary to prevent weather incursions reduces when the forecast look-ahead times are higher. For the chosen day of traffic and weather, setting the look-ahead time to 90 minutes yields the lowest total delay cost.

Construction procedures using self hardening fly ash

NASA Astrophysics Data System (ADS)

Thornton, S. I.; Parker, D. G.

1980-07-01

Fly ash produced in Arkansas from burning Wyoming low sulfur coal is self-hardening and can be effective as a soil stabilizing agent for clays and sands. The strength of soil-self hardening fly ash develops rapidly when compacted immediately after mixing. Seven day unconfined compressive strengths up to 1800 psi were obtained from 20% fly ash and 80% sand mixtures. A time delay between mixing the fly ash with the soil and compaction of the mixture reduced the strength. With two hours delay, over a third of the strength was lost and with four hours delay, the loss was over half. Gypsum and some commercial concrete retarders were effective in reducing the detrimental effect of delayed compaction. Adequate mixing of the soil and fly ash and rapid compaction of the mixtures were found to be important parameters in field construction of stabilized bases.

CPT-11-Induced Delayed Diarrhea Develops via Reduced Aquaporin-3 Expression in the Colon

PubMed Central

Kon, Risako; Tsubota, Yuika; Minami, Moe; Kato, Saki; Matsunaga, Yukari; Kimura, Hiroshi; Murakami, Yuta; Fujikawa, Tetsuya; Sakurai, Ryoya; Tomimoto, Rei; Machida, Yoshiaki; Ikarashi, Nobutomo; Sugiyama, Kiyoshi

2018-01-01

While irinotecan (CPT-11) has a potent anti-cancer effect, it also causes serious diarrhea as an adverse reaction. In this study, we analyzed the pathogenic mechanism of CPT-11-induced delayed diarrhea by focusing on water channel aquaporin-3 (AQP3) in the colon. When rats received CPT-11, the expression level of AQP3 was reduced during severe diarrhea. It was found that the expression levels of inflammatory cytokines and the loss of crypt cells were increased in the colon when CPT-11 was administered. When celecoxib, an anti-inflammatory drug, was concomitantly administered, both the diarrhea and the reduced expression of AQP3 induced by CPT-11 were suppressed. The inflammation in the rat colon during diarrhea was caused via activated macrophage by CPT-11. These results showed that when CPT-11 is administered, the expression level of AQP3 in the colon is reduced, resulting in delayed diarrhea by preventing water transport from the intestinal tract. It was also suggested that the reduced expression of AQP3 might be due to the inflammation that occurs following the loss of colonic crypt cells and to the damage caused by the direct activation of macrophages by CPT-11. Therefore, it was considered that anti-inflammatory drugs that suppress the reduction of AQP3 expression could prevent CPT-11-induced delayed diarrhea. PMID:29316651

CPT-11-Induced Delayed Diarrhea Develops via Reduced Aquaporin-3 Expression in the Colon.

PubMed

Kon, Risako; Tsubota, Yuika; Minami, Moe; Kato, Saki; Matsunaga, Yukari; Kimura, Hiroshi; Murakami, Yuta; Fujikawa, Tetsuya; Sakurai, Ryoya; Tomimoto, Rei; Machida, Yoshiaki; Ikarashi, Nobutomo; Sugiyama, Kiyoshi

2018-01-06

While irinotecan (CPT-11) has a potent anti-cancer effect, it also causes serious diarrhea as an adverse reaction. In this study, we analyzed the pathogenic mechanism of CPT-11-induced delayed diarrhea by focusing on water channel aquaporin-3 (AQP3) in the colon. When rats received CPT-11, the expression level of AQP3 was reduced during severe diarrhea. It was found that the expression levels of inflammatory cytokines and the loss of crypt cells were increased in the colon when CPT-11 was administered. When celecoxib, an anti-inflammatory drug, was concomitantly administered, both the diarrhea and the reduced expression of AQP3 induced by CPT-11 were suppressed. The inflammation in the rat colon during diarrhea was caused via activated macrophage by CPT-11. These results showed that when CPT-11 is administered, the expression level of AQP3 in the colon is reduced, resulting in delayed diarrhea by preventing water transport from the intestinal tract. It was also suggested that the reduced expression of AQP3 might be due to the inflammation that occurs following the loss of colonic crypt cells and to the damage caused by the direct activation of macrophages by CPT-11. Therefore, it was considered that anti-inflammatory drugs that suppress the reduction of AQP3 expression could prevent CPT-11-induced delayed diarrhea.

Prevalence of prenatal brain abnormalities in fetuses with congenital heart disease: a systematic review.

PubMed

Khalil, A; Bennet, S; Thilaganathan, B; Paladini, D; Griffiths, P; Carvalho, J S

2016-09-01

Studies have shown an association between congenital heart defects (CHDs) and postnatal brain abnormalities and neurodevelopmental delay. Recent evidence suggests that some of these brain abnormalities are present before birth. The primary aim of this study was to perform a systematic review to quantify the prevalence of prenatal brain abnormalities in fetuses with CHDs. MEDLINE, EMBASE and The Cochrane Library were searched electronically. Reference lists within each article were hand-searched for additional reports. The outcomes observed included structural brain abnormalities (on magnetic resonance imaging (MRI)) and changes in brain volume (on MRI, three-dimensional (3D) volumetric MRI, 3D ultrasound and phase-contrast MRI), brain metabolism or maturation (on magnetic resonance spectroscopy and phase-contrast MRI) and brain blood flow (on Doppler ultrasound, phase-contrast MRI and 3D power Doppler ultrasound) in fetuses with CHDs. Cohort and case-control studies were included and cases of chromosomal or genetic abnormalities, case reports and editorials were excluded. Proportion meta-analysis was used for analysis. Between-study heterogeneity was assessed using the I(2) test. The search yielded 1943 citations, and 20 studies (n = 1175 cases) were included in the review. Three studies reported data on structural brain abnormalities, while data on altered brain volume, metabolism and blood flow were reported in seven, three and 14 studies, respectively. The three studies (221 cases) reporting on structural brain abnormalities were suitable for inclusion in a meta-analysis. The prevalence of prenatal structural brain abnormalities in fetuses with CHD was 28% (95% CI, 18-40%), with a similar prevalence (25% (95% CI, 14-39%)) when tetralogy of Fallot was considered alone. These abnormalities included ventriculomegaly (most common), agenesis of the corpus callosum, ventricular bleeding, increased extra-axial space, vermian hypoplasia, white-matter abnormalities and delayed brain development. Fetuses with CHD were more likely than those without CHD to have reduced brain volume, delay in brain maturation and altered brain circulation, most commonly in the form of reduced middle cerebral artery pulsatility index and cerebroplacental ratio. These changes were usually evident in the third trimester, but some studies reported them from as early as the second trimester. In the absence of known major aneuploidy or genetic syndromes, fetuses with CHD are at increased risk of brain abnormalities, which are discernible prenatally. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Exploring emergency department 4-hour target performance and cancelled elective operations: a regression analysis of routinely collected and openly reported NHS trust data.

PubMed

Keogh, Brad; Culliford, David; Guerrero-Ludueña, Richard; Monks, Thomas

2018-05-24

To quantify the effect of intrahospital patient flow on emergency department (ED) performance targets and indicate if the expectations set by the National Health Service (NHS) England 5-year forward review are realistic in returning emergency services to previous performance levels. Linear regression analysis of routinely reported trust activity and performance data using a series of cross-sectional studies. NHS trusts in England submitting routine nationally reported measures to NHS England. 142 acute non-specialist trusts operating in England between 2012 and 2016. The primary outcome measures were proportion of 4-hour waiting time breaches and cancelled elective operations. Univariate and multivariate linear regression models were used to show relationships between the outcome measures and various measures of trust activity including empty day beds, empty night beds, day bed to night bed ratio, ED conversion ratio and delayed transfers of care. Univariate regression results using the outcome of 4-hour breaches showed clear relationships with empty night beds and ED conversion ratio between 2012 and 2016. The day bed to night bed ratio showed an increasing ability to explain variation in performance between 2015 and 2016. Delayed transfers of care showed little evidence of an association. Multivariate model results indicated that the ability of patient flow variables to explain 4-hour target performance had reduced between 2012 and 2016 (19% to 12%), and had increased in explaining cancelled elective operations (7% to 17%). The flow of patients through trusts is shown to influence ED performance; however, performance has become less explainable by intratrust patient flow between 2012 and 2016. Some commonly stated explanatory factors such as delayed transfers of care showed limited evidence of being related. The results indicate some of the measures proposed by NHS England to reduce pressure on EDs may not have the desired impact on returning services to previous performance levels. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Improving Reports Turnaround Time: An Essential Healthcare Quality Dimension.

PubMed

Khan, Mustafa; Khalid, Parwaiz; Al-Said, Youssef; Cupler, Edward; Almorsy, Lamia; Khalifa, Mohamed

2016-01-01

Turnaround time is one of the most important healthcare performance indicators. King Faisal Specialist Hospital and Research Center in Jeddah, Saudi Arabia worked on reducing the reports turnaround time of the neurophysiology lab from more than two weeks to only five working days for 90% of cases. The main quality improvement methodology used was the FOCUS PDCA. Using root cause analysis, Pareto analysis and qualitative survey methods, the main factors contributing to the delay of turnaround time and the suggested improvement strategies were identified and implemented, through restructuring transcriptionists daily tasks, rescheduling physicians time and alerting for new reports, engaging consultants, consistent coordination and prioritizing critical reports. After implementation; 92% of reports are verified within 5 days compared to only 6% before implementation. 7% of reports were verified in 5 days to 2 weeks and only 1% of reports needed more than 2 weeks compared to 76% before implementation.

A Reduced Antigen Load In Vivo, Rather Than Weak Inflammation, Causes a Substantial Delay in CD8+ T Cell Priming against Mycobacterium bovis (Bacillus Calmette-Guérin)1

PubMed Central

Russell, Marsha S.; Iskandar, Monica; Mykytczuk, Oksana L.; Nash, John H. E.; Krishnan, Lakshmi; Sad, Subash

2014-01-01

Regardless of the dose of Ag, Ag presentation occurs rapidly within the first few days which results in rapid expansion of the CD8+ T cell response that peaks at day 7. However, we have previously shown that this rapid priming of CD8+ T cells is absent during infection of mice with Mycobacterium bovis (bacillus Calmette-Guérin (BCG)). In this study, we have evaluated the mechanisms responsible for the delayed CD8+ T cell priming. Because BCG replicates poorly and survives within phagosomes we considered whether 1) generation of reduced amounts of Ag or 2) weaker activation by pathogen-associated molecular patterns (PAMPs) during BCG infection is responsible for the delay in CD8+ T cell priming. Using rOVA-expressing bacteria, our results indicate that infection of mice with BCG-OVA generates greatly reduced levels of OVA, which are 70-fold lower in comparison to the levels generated during infection of mice with Listeria monocytogenes-expressing OVA. Furthermore, increasing the dose of OVA, but not PAMP signaling during BCG-OVA infection resulted in rapid Ag presentation and consequent expansion of the CD8+ T cell response, indicating that the generation of reduced Ag levels, not lack of PAMP-associated inflammation, was responsible for delayed priming of CD8+ T cells. There was a strong correlation between the relative timing of Ag presentation and the increase in the level of OVA in vivo. Taken together, these results reveal that some slowly replicating pathogens, such as mycobacteria, may facilitate their chronicity by generating reduced Ag levels which causes a substantial delay in the development of acquired immune responses. PMID:17579040

A high resolution on-chip delay sensor with low supply-voltage sensitivity for high-performance electronic systems.

PubMed

Sheng, Duo; Lai, Hsiu-Fan; Chan, Sheng-Min; Hong, Min-Rong

2015-02-13

An all-digital on-chip delay sensor (OCDS) circuit with high delay-measurement resolution and low supply-voltage sensitivity for efficient detection and diagnosis in high-performance electronic system applications is presented. Based on the proposed delay measurement scheme, the quantization resolution of the proposed OCDS can be reduced to several picoseconds. Additionally, the proposed cascade-stage delay measurement circuit can enhance immunity to supply-voltage variations of the delay measurement resolution without extra self-biasing or calibration circuits. Simulation results show that the delay measurement resolution can be improved to 1.2 ps; the average delay resolution variation is 0.55% with supply-voltage variations of ±10%. Moreover, the proposed delay sensor can be implemented in an all-digital manner, making it very suitable for high-performance electronic system applications as well as system-level integration.

Are We Doing Enough to Stem the Tide of Acquired MDR-TB in Countries with High TB Burden? Results of a Mixed Method Study in Chongqing, China

PubMed Central

Li, Ying; Ehiri, John; Oren, Eyal; Hu, Daiyu; Luo, Xingneng; Liu, Ying; Li, Daikun; Wang, Qingya

2014-01-01

Multi-drug resistant tuberculosis (MDR-TB) represents a threat to health and development in countries with high TB burden. China’s MDR-TB prevalence rate of 6.8% is the highest in the world. Interventions to remove barriers against effective TB control, and prevention of MDR-TB are urgently needed in the country. This paper reports a cross-sectional questionnaire survey of 513 pulmonary TB (PTB) patients, and qualitative interviews of 10 healthcare workers (HCWs), and 15 PTB patients. The objective was to assess barriers against effective control of PTB and prevention of MDR-TB by elucidating the perspectives of patients and healthcare providers. Results showed that more than half of the patients experienced patient delay of over 12.5 days. A similar proportion also experienced detection delay of over 30 days, and delay in initiating treatment of over 31 days. Consulting a non-TB health facility ≥3 times before seeking care at TB dispensary was a risk factor for both detection delay [AOR (95% CI): 1.89(1.07, 3.34) and delay in initiating treatment[AOR (95% CI): 1.88 (1.06, 3.36). Results revealed poor implementation of Directly Observed Therapy (DOT), whereby treatment of 34.3% patients was never monitored by HCWs. Only 31.8% patients had ever accessed TB health education before their TB diagnosis. Qualitative data consistently disclosed long patient delay, and indicated that patient’s poor TB knowledge and socioeconomic barriers were primary reasons for patient delay. Seeking care and being treated at a non-TB hospital was an important reason for detection delay. Patient’s long work hours and low income increased risk for treatment non-adherence. Evidence-based measures to improve TB health seeking behavior, reduce patient and detection delays, improve the quality of DOT, address financial and system barriers, and increase access to TB health promotion are urgently needed to address the burgeoning prevalence of MDR-TB in China. PMID:24505476

Optical Diagnostics of Multi-Gap Gas Switches for Linear Transformer Drivers

NASA Astrophysics Data System (ADS)

Sheng, Liang; Li, Yang; Sun, Tieping; Cong, Peitian; Zhang, Mei; Peng, Bodong; Zhao, Jizhen; Yue, Zhiqin; Wei, Fuli; Yuan, Yuan

2014-07-01

The trigger characteristics of a multi-gap gas switch with double insulating layers, a square-groove electrode supporter and a UV pre-ionizing structure are investigated aided by a high sensitivity fiber-bundle array detector, a UV fiber detector, and a framing camera, in addition to standard electrical diagnostics. The fiber-bundle-array detector is used to track the turn-on sequence of each electrode gap at a timing precision of 0.6 ns. Each fiber bundle, including five fibers with different azimuth angles, aims at the whole emitting area of each electrode gap and is fed to a photomultiplier tube. The UV fiber detector with a spectrum response of 260-320 nm, including a fused-quartz fiber of 200 μm in diameter and a solar-blinded photomultiplier tube, is adopted to study the effect of UV pre-ionizing on trigger characteristics. The framing camera, with a capacity of 4 frames per shot and an exposure time of 5 ns, is employed to capture the evolution of channel arcs. Based on the turn-on light signal of each electrode gap, the breakdown delay is divided into statistical delay and formative delay. A decrease in both of them, a smaller switch jitter and more channel arcs are observed with lower gas pressure. An increase in trigger voltage can reduce the statistical delay and its jitter, while higher trigger voltage has a relatively small influence on the formative delay and the number of channel arcs. With the UV pre-ionizing structure at 0.24 MPa gas pressure and 60 kV trigger voltage, the statistical delay and its jitter can be reduced by 1.8 ns and 0.67 ns, while the formative delay and its jitter can only be reduced by 0.5 ns and 0.25 ns.

Potential adjustment methodology for missing data and reporting delay in the HIV Surveillance System, European Union/European Economic Area, 2015.

PubMed

Rosinska, Magdalena; Pantazis, Nikos; Janiec, Janusz; Pharris, Anastasia; Amato-Gauci, Andrew J; Quinten, Chantal; Ecdc Hiv/Aids Surveillance Network

2018-06-01

Accurate case-based surveillance data remain the key data source for estimating HIV burden and monitoring prevention efforts in Europe. We carried out a literature review and exploratory analysis of surveillance data regarding two crucial issues affecting European surveillance for HIV: missing data and reporting delay. Initial screening showed substantial variability of these data issues, both in time and across countries. In terms of missing data, the CD4+ cell count is the most problematic variable because of the high proportion of missing values. In 20 of 31 countries of the European Union/European Economic Area (EU/EEA), CD4+ counts are systematically missing for all or some years. One of the key challenges related to reporting delays is that countries undertake specific one-off actions in effort to capture previously unreported cases, and that these cases are subsequently reported with excessive delays. Slightly different underlying assumptions and effectively different models may be required for individual countries to adjust for missing data and reporting delays. However, using a similar methodology is recommended to foster harmonisation and to improve the accuracy and usability of HIV surveillance data at national and EU/EEA levels.

Coagulation syndrome: Delayed perforation after colorectal endoscopic treatments

PubMed Central

Hirasawa, Kingo; Sato, Chiko; Makazu, Makomo; Kaneko, Hiroaki; Kobayashi, Ryosuke; Kokawa, Atsushi; Maeda, Shin

2015-01-01

Various procedure-related adverse events related to colonoscopic treatment have been reported. Previous studies on the complications of colonoscopic treatment have focused primarily on perforation or bleeding. Coagulation syndrome (CS), which is synonymous with transmural burn syndrome following endoscopic treatment, is another typical adverse event. CS is the result of electrocoagulation injury to the bowel wall that induces a transmural burn and localized peritonitis resulting in serosal inflammation. CS occurs after polypectomy, endoscopic mucosal resection (EMR), and even endoscopic submucosal dissection (ESD). The occurrence of CS after polypectomy or EMR varies according previous reports; most report an occurrence rate around 1%. However, artificial ulcers after ESD are largely theoretical, and CS following ESD was reported in about 9% of cases, which is higher than that for CS after polypectomy or EMR. Most cases of post-polypectomy syndrome (PPS) have an excellent prognosis, and they are managed conservatively with medical therapy. PPS rarely develops into delayed perforation. Delayed perforation is a severe adverse event that often requires emergency surgery. Since few studies have reported on CS and delayed perforation associated with CS, we focused on CS after colonoscopic treatments in this review. Clinicians should consider delayed perforation in CS patients. PMID:26380051

Methodology for Analysis, Modeling and Simulation of Airport Gate-waiting Delays

NASA Astrophysics Data System (ADS)

Wang, Jianfeng

This dissertation presents methodologies to estimate gate-waiting delays from historical data, to identify gate-waiting-delay functional causes in major U.S. airports, and to evaluate the impact of gate operation disruptions and mitigation strategies on gate-waiting delay. Airport gates are a resource of congestion in the air transportation system. When an arriving flight cannot pull into its gate, the delay it experiences is called gate-waiting delay. Some possible reasons for gate-waiting delay are: the gate is occupied, gate staff or equipment is unavailable, the weather prevents the use of the gate (e.g. lightning), or the airline has a preferred gate assignment. Gate-waiting delays potentially stay with the aircraft throughout the day (unless they are absorbed), adding costs to passengers and the airlines. As the volume of flights increases, ensuring that airport gates do not become a choke point of the system is critical. The first part of the dissertation presents a methodology for estimating gate-waiting delays based on historical, publicly available sources. Analysis of gate-waiting delays at major U.S. airports in the summer of 2007 identifies the following. (i) Gate-waiting delay is not a significant problem on majority of days; however, the worst delay days (e.g. 4% of the days at LGA) are extreme outliers. (ii) The Atlanta International Airport (ATL), the John F. Kennedy International Airport (JFK), the Dallas/Fort Worth International Airport (DFW) and the Philadelphia International Airport (PHL) experience the highest gate-waiting delays among major U.S. airports. (iii) There is a significant gate-waiting-delay difference between airlines due to a disproportional gate allocation. (iv) Gate-waiting delay is sensitive to time of a day and schedule peaks. According to basic principles of queueing theory, gate-waiting delay can be attributed to over-scheduling, higher-than-scheduled arrival rate, longer-than-scheduled gate-occupancy time, and reduced gate availability. Analysis of the worst days at six major airports in the summer of 2007 indicates that major gate-waiting delays are primarily due to operational disruptions---specifically, extended gate occupancy time, reduced gate availability and higher-than-scheduled arrival rate (usually due to arrival delay). Major gate-waiting delays are not a result of over-scheduling. The second part of this dissertation presents a simulation model to evaluate the impact of gate operational disruptions and gate-waiting-delay mitigation strategies, including building new gates, implementing common gates, using overnight off-gate parking and adopting self-docking gates. Simulation results show the following effects of disruptions: (i) The impact of arrival delay in a time window (e.g. 7 pm to 9 pm) on gate-waiting delay is bounded. (ii) The impact of longer-than-scheduled gate-occupancy times in a time window on gate-waiting delay can be unbounded and gate-waiting delay can increase linearly as the disruption level increases. (iii) Small reductions in gate availability have a small impact on gate-waiting delay due to slack gate capacity, while larger reductions have a non-linear impact as slack gate capacity is used up. Simulation results show the following effects of mitigation strategies: (i) Implementing common gates is an effective mitigation strategy, especially for airports with a flight schedule not dominated by one carrier, such as LGA. (ii) The overnight off-gate rule is effective in mitigating gate-waiting delay for flights stranded overnight following departure cancellations. This is especially true at airports where the gate utilization is at maximum overnight, such as LGA and DFW. The overnight off-gate rule can also be very effective to mitigate gate-waiting delay due to operational disruptions in evenings. (iii) Self-docking gates are effective in mitigating gate-waiting delay due to reduced gate availability.

Process-Improvement Cost Model for the Emergency Department.

PubMed

Dyas, Sheila R; Greenfield, Eric; Messimer, Sherri; Thotakura, Swati; Gholston, Sampson; Doughty, Tracy; Hays, Mary; Ivey, Richard; Spalding, Joseph; Phillips, Robin

2015-01-01

The objective of this report is to present a simplified, activity-based costing approach for hospital emergency departments (EDs) to use with Lean Six Sigma cost-benefit analyses. The cost model complexity is reduced by removing diagnostic and condition-specific costs, thereby revealing the underlying process activities' cost inefficiencies. Examples are provided for evaluating the cost savings from reducing discharge delays and the cost impact of keeping patients in the ED (boarding) after the decision to admit has been made. The process-improvement cost model provides a needed tool in selecting, prioritizing, and validating Lean process-improvement projects in the ED and other areas of patient care that involve multiple dissimilar diagnoses.

School-based sex education is associated with reduced risky sexual behaviour and sexually transmitted infections in young adults.

PubMed

Vivancos, R; Abubakar, I; Phillips-Howard, P; Hunter, P R

2013-01-01

To quantify the effectiveness of school-based sexual education on risky sexual behaviour and sexually transmitted infection (STI) acquisition in adulthood. Online survey of sexual attitudes and behaviours. Students at a British university were surveyed regarding where they learnt most about sex at 14 years of age, how easy they found talking about sexual issues with their parents and age at first intercourse. The effects of these factors were modelled on risk of recent unprotected intercourse and self-reported STIs in adulthood. Seventy-eight of 711 (11%) students reported unprotected intercourse in the 4 weeks before the survey, and 44 (6.2%) students had ever been diagnosed with an STI. Both age at first intercourse (risk reduced by 11% per year of delayed intercourse, 95% confidence interval (CI) 3-19%) and learning about sex from lessons at school (66% reduction in risk compared with learning from one's mother, 95% CI 5-88%) were associated with reductions in risk of unprotected intercourse. Factors associated with fewer STIs were age at first intercourse (17% reduction per year of delayed intercourse, 95% CI 5-28%); and learning about sex from lessons at school (85% reduction, 95% CI 32-97%), from friends of the same age (54% reduction, CI 7-77%) and from first boy/girlfriend (85% reduction, 95% CI 35-97%) compared with learning from one's mother. School-based sexual education is effective at reducing the risk of unprotected intercourse and STIs in early adulthood. Influence from friends in adolescence may also have a positive effect on the risk of STIs in later life. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Mutation in ATG5 reduces autophagy and leads to ataxia with developmental delay.

PubMed

Kim, Myungjin; Sandford, Erin; Gatica, Damian; Qiu, Yu; Liu, Xu; Zheng, Yumei; Schulman, Brenda A; Xu, Jishu; Semple, Ian; Ro, Seung-Hyun; Kim, Boyoung; Mavioglu, R Nehir; Tolun, Aslıhan; Jipa, Andras; Takats, Szabolcs; Karpati, Manuela; Li, Jun Z; Yapici, Zuhal; Juhasz, Gabor; Lee, Jun Hee; Klionsky, Daniel J; Burmeister, Margit

2016-01-26

Autophagy is required for the homeostasis of cellular material and is proposed to be involved in many aspects of health. Defects in the autophagy pathway have been observed in neurodegenerative disorders; however, no genetically-inherited pathogenic mutations in any of the core autophagy-related (ATG) genes have been reported in human patients to date. We identified a homozygous missense mutation, changing a conserved amino acid, in ATG5 in two siblings with congenital ataxia, mental retardation, and developmental delay. The subjects' cells display a decrease in autophagy flux and defects in conjugation of ATG12 to ATG5. The homologous mutation in yeast demonstrates a 30-50% reduction of induced autophagy. Flies in which Atg5 is substituted with the mutant human ATG5 exhibit severe movement disorder, in contrast to flies expressing the wild-type human protein. Our results demonstrate the critical role of autophagy in preventing neurological diseases and maintaining neuronal health.

Ultralow-frequency-noise stabilization of a laser by locking to an optical fiber-delay line.

PubMed

Kéfélian, Fabien; Jiang, Haifeng; Lemonde, Pierre; Santarelli, Giorgio

2009-04-01

We report the frequency stabilization of an erbium-doped fiber distributed-feedback laser using an all-fiber-based Michelson interferometer of large arm imbalance. The interferometer uses a 1 km SMF-28 optical fiber spool and an acousto-optic modulator allowing heterodyne detection. The frequency-noise power spectral density is reduced by more than 40 dB for Fourier frequencies ranging from 1 Hz to 10 kHz, corresponding to a level well below 1 Hz2/Hz over the entire range; it reaches 10(-2) Hz2/Hz at 1 kHz. Between 40 Hz and 30 kHz, the frequency noise is shown to be comparable to the one obtained by Pound-Drever-Hall locking to a high-finesse Fabry-Perot cavity. Locking to a fiber delay line could consequently represent a reliable, simple, and compact alternative to cavity stabilization for short-term linewidth reduction.

Efficient laser noise reduction method via actively stabilized optical delay line.

PubMed

Li, Dawei; Qian, Cheng; Li, Ye; Zhao, Jianye

2017-04-17

We report a fiber laser noise reduction method by locking it to an actively stabilized optical delay line, specifically a fiber-based Mach-Zehnder interferometer with a 10 km optical fiber spool. The fiber spool is used to achieve large arm imbalance. The heterodyne signal of the two arms converts the laser noise from the optical domain to several megahertz, and it is used in laser noise reduction by a phase-locked loop. An additional phase-locked loop is induced in the system to compensate the phase noise due to environmentally induced length fluctuations of the optical fiber spool. A major advantage of this structure is the efficient reduction of out-of-loop frequency noise, particularly at low Fourier frequency. The frequency noise reaches -30 dBc/Hz at 1 Hz, which is reduced by more than 90 dB compared with that of the laser in its free-running state.

Memantine Attenuates Delayed Vasospasm after Experimental Subarachnoid Hemorrhage via Modulating Endothelial Nitric Oxide Synthase.

PubMed

Huang, Chih-Yuan; Wang, Liang-Chao; Shan, Yan-Shen; Pan, Chia-Hsin; Tsai, Kuen-Jer

2015-06-23

Delayed cerebral vasospasm is an important pathological feature of subarachnoid hemorrhage (SAH). The cause of vasospasm is multifactorial. Impairs nitric oxide availability and endothelial nitric oxide synthase (eNOS) dysfunction has been reported to underlie vasospasm. Memantine, a low-affinity uncompetitive N-methyl-d-aspartate (NMDA) blocker has been proven to reduce early brain injury after SAH. This study investigated the effect of memantine on attenuation of vasospasm and restoring eNOS functionality. Male Sprague-Dawley rats weighing 350-450 g were randomly divided into three weight-matched groups, sham surgery, SAH + vehicle, and SAH + memantine groups. The effects of memantine on SAH were evaluated by assessing the severity of vasospasm and the expression of eNOS. Memantine effectively ameliorated cerebral vasospasm by restoring eNOS functionality. Memantine can prevent vasospasm in experimental SAH. Treatment strategies may help combat SAH-induced vasospasm in the future.

Sleep deprivation decreases phase-shift responses of circadian rhythms to light in the mouse: role of serotonergic and metabolic signals.

PubMed

Challet, E; Turek, F W; Laute, M; Van Reeth, O

2001-08-03

The circadian pacemaker in the suprachiasmatic nuclei is primarily synchronized to the daily light-dark cycle. The phase-shifting and synchronizing effects of light can be modulated by non-photic factors, such as behavioral, metabolic or serotonergic cues. The present experiments examine the effects of sleep deprivation on the response of the circadian pacemaker to light and test the possible involvement of serotonergic and/or metabolic cues in mediating the effects of sleep deprivation. Photic phase-shifting of the locomotor activity rhythm was analyzed in mice transferred from a light-dark cycle to constant darkness, and sleep-deprived for 8 h from Zeitgeber Time 6 to Zeitgeber Time 14. Phase-delays in response to a 10-min light pulse at Zeitgeber Time 14 were reduced by 30% in sleep-deprived mice compared to control mice, while sleep deprivation without light exposure induced no significant phase-shifts. Stimulation of serotonin neurotransmission by fluoxetine (10 mg/kg), a serotonin reuptake inhibitor that decreases light-induced phase-delays in non-deprived mice, did not further reduce light-induced phase-delays in sleep-deprived mice. Impairment of serotonin neurotransmission with p-chloroamphetamine (three injections of 10 mg/kg), which did not increase light-induced phase-delays in non-deprived mice significantly, partially normalized light-induced phase-delays in sleep-deprived mice. Injections of glucose increased light-induced phase-delays in control and sleep-deprived mice. Chemical damage of the ventromedial hypothalamus by gold-thioglucose (600 mg/kg) prevented the reduction of light-induced phase-delays in sleep-deprived mice, without altering phase-delays in control mice. Taken together, the present results indicate that sleep deprivation can reduce the light-induced phase-shifts of the mouse suprachiasmatic pacemaker, due to serotonergic and metabolic changes associated with the loss of sleep.

Physical examination performed by psychiatrists.

PubMed

Hodgson, Richard; Adeyemo, Olubukola

2004-01-01

Too little, too late? Physical examinations performed by trainee psychiatrists on newly admitted psychiatric patients. To assess the comprehensiveness of the physical examination carried out by psychiatric trainees on acute in-patient units. To quantify delays in undertaking physical examination on psychiatric inpatients. A prospective case note study of 60 consecutive admissions to acute psychiatric wards in North Staffordshire. Information regarding demography, details of physical examination and routine blood investigations was collected. The case notes of 60 inpatients were studied. Mean age was 38.7 years and the sex ratio equal. A delay in performing a physical occurred in 17 (28.8%) patients. No explanation for a delay was given in six (10.0%) cases. The mean time to physical examination from admission was 61.8 h (range 0-612 h). The standard of physical examination was variable. The central nervous system (CNS) was reported as 'grossly intact' in six (10.2%) cases with only 34 (57.6%) of patients having a comprehensive CNS examination. Psychiatric patients are not receiving a comprehensive physical examination. Whilst the patient's ability to co-operate may account for a delay in the examination, it is unlikely to be the reason for the CNS being examined in just half the patients. Opportunities to reduce the physical morbidity associated with mental illness may be being lost. (MJ Psych Clin Pract 2004; 8: 57-60).

Effects of delayed metamorphosis on larval survival, metamorphosis, and juvenile performance of four closely related species of tropical sea urchins (genus Echinometra).

PubMed

Rahman, M Aminur; Yusoff, Fatimah Md; Arshad, A; Uehara, Tsuyoshi

2014-01-01

We report here, the effects of extended competency on larval survival, metamorphosis, and postlarval juvenile growth of four closely related species of tropical sea urchins, Echinometra sp. A (Ea), E. mathaei (Em), Echinometra sp. C (Ec), and E. oblonga (Eo). Planktotrophic larvae of all four species fed on cultured phytoplankton (Chaetoceros gracilis) attained metamorphic competence within 22-24 days after fertilization. Competent larvae were forced to delay metamorphosis for up to 5 months by preventing them from settling in culture bottles with continuous stirring on a set of 10 rpm rotating rollers and larval survival per monthly intervals was recorded. Larval survival was highest at 24 days, when competence was attained (0 delayed period), and there were no significant differences among the four species. Larvae that had experienced a prolonged delay had reduced survival rate, metamorphosis success, and juvenile survival, but among older larvae, Em had the highest success followed by Ea, Eo, and Ec. Juveniles from larvae of all four species that metamorphosed soon after becoming competent tended to have higher growth rates (test diameter and length of spines) than juveniles from larvae that metamorphosed after a prolonged period of competence with progressively slower growth the longer the prolonged period. Despite the adverse effects of delaying metamorphosis on growth parameters, competent larvae of all four species were able to survive up to 5 months and after metamorphosis grew into 1-month-old juveniles in lab condition. Overall, delayed larvae of Em showed significantly higher larval survival, metamorphosis, and juvenile survival than Ea and Eo, while Ec showed the lowest values in these performances. Em has the most widespread distribution of these species ranging from Africa to Hawaii, while Ec probably has the most restricted distribution. Consequently, differences in distribution may be related to differences in the ability to delay metamorphosis.

Effects of Delayed Metamorphosis on Larval Survival, Metamorphosis, and Juvenile Performance of Four Closely Related Species of Tropical Sea Urchins (Genus Echinometra)

PubMed Central

Rahman, M. Aminur; Yusoff, Fatimah Md.; Arshad, A.; Uehara, Tsuyoshi

2014-01-01

We report here, the effects of extended competency on larval survival, metamorphosis, and postlarval juvenile growth of four closely related species of tropical sea urchins, Echinometra sp. A (Ea), E. mathaei (Em), Echinometra sp. C (Ec), and E. oblonga (Eo). Planktotrophic larvae of all four species fed on cultured phytoplankton (Chaetoceros gracilis) attained metamorphic competence within 22–24 days after fertilization. Competent larvae were forced to delay metamorphosis for up to 5 months by preventing them from settling in culture bottles with continuous stirring on a set of 10 rpm rotating rollers and larval survival per monthly intervals was recorded. Larval survival was highest at 24 days, when competence was attained (0 delayed period), and there were no significant differences among the four species. Larvae that had experienced a prolonged delay had reduced survival rate, metamorphosis success, and juvenile survival, but among older larvae, Em had the highest success followed by Ea, Eo, and Ec. Juveniles from larvae of all four species that metamorphosed soon after becoming competent tended to have higher growth rates (test diameter and length of spines) than juveniles from larvae that metamorphosed after a prolonged period of competence with progressively slower growth the longer the prolonged period. Despite the adverse effects of delaying metamorphosis on growth parameters, competent larvae of all four species were able to survive up to 5 months and after metamorphosis grew into 1-month-old juveniles in lab condition. Overall, delayed larvae of Em showed significantly higher larval survival, metamorphosis, and juvenile survival than Ea and Eo, while Ec showed the lowest values in these performances. Em has the most widespread distribution of these species ranging from Africa to Hawaii, while Ec probably has the most restricted distribution. Consequently, differences in distribution may be related to differences in the ability to delay metamorphosis. PMID:24624048

Risk factors for delay in age-appropriate vaccinations among Gambian children.

PubMed

Odutola, Aderonke; Afolabi, Muhammed O; Ogundare, Ezra O; Lowe-Jallow, Yamu Ndow; Worwui, Archibald; Okebe, Joseph; Ota, Martin O

2015-08-28

Vaccination has been shown to reduce mortality and morbidity due to vaccine-preventable diseases. However, these diseases are still responsible for majority of childhood deaths worldwide especially in the developing countries. This may be due to low vaccine coverage or delay in receipt of age-appropriate vaccines. We studied the timeliness of routine vaccinations among children aged 12-59 months attending infant welfare clinics in semi-urban areas of The Gambia, a country with high vaccine coverage. A cross-sectional survey was conducted in four health centres in the Western Region of the Gambia. Vaccination dates were obtained from health cards and timeliness assessed based on the recommended age ranges for BCG (birth-8 weeks), Diphtheria-Pertussis-Tetanus (6 weeks-4 months; 10 weeks-5 months; 14 weeks-6 months) and measles vaccines (38 weeks-12 months). Risk factors for delay in age-appropriate vaccinations were determined using logistic regression. Analysis was limited to BCG, third dose of Diphtheria-Pertussis -Tetanus (DPT3) and measles vaccines. Vaccination records of 1154 children were studied. Overall, 63.3% (95 % CI 60.6-66.1%) of the children had a delay in the recommended time to receiving at least one of the studied vaccines. The proportion of children with delayed vaccinations increased from BCG [5.8% (95 % CI 4.5-7.0%)] to DPT3 [60.4% (95 % CI 57.9%-63.0%)] but was comparatively low for the measles vaccine [10.8% (95 % CI 9.1%-12.5%)]. Mothers of affected children gave reasons for the delay, and their profile correlated with type of occupation, place of birth and mode of transportation to the health facilities. Despite high vaccination coverage reported in The Gambia, a significant proportion of the children's vaccines were delayed for reasons related to health services as well as profile of mothers. These findings are likely to obtain in several countries and should be addressed by programme managers in order to improve and optimize the impact of the immunization coverage rates.

Durations and Delays in Care Seeking, Diagnosis and Treatment Initiation in Uncomplicated Pulmonary Tuberculosis Patients in Mumbai, India.

PubMed

Mistry, Nerges; Rangan, Sheela; Dholakia, Yatin; Lobo, Eunice; Shah, Shimoni; Patil, Akshaya

2016-01-01

Timely diagnosis and treatment initiation are critical to reduce the chain of transmission of Tuberculosis (TB) in places like Mumbai, where almost 60% of the inhabitants reside in overcrowded slums. This study documents the pathway from the onset of symptoms suggestive of TB to initiation of TB treatment and examines factors responsible for delay among uncomplicated pulmonary TB patients in Mumbai. A population-based retrospective survey was conducted in the slums of 15 high TB burden administrative wards to identify 153 self-reported TB patients. Subsequently in-depth interviews of 76 consenting patients that fit the inclusion criteria were undertaken using an open-ended interview schedule. Mean total, first care seeking, diagnosis and treatment initiation duration and delays were computed for new and retreatment patients. Patients showing defined delays were divided into outliers and non-outliers for all three delays using the median values. The mean duration for the total pathway was 65 days with 29% of patients being outliers. Importantly the mean duration of first care seeking was similar in new (24 days) and retreatment patients (25 days). Diagnostic duration contributed to 55% of the total pathway largely in new patients. Treatment initiation was noted to be the least among the three durations with mean duration in retreatment patients twice that of new patients. Significantly more female patients experienced diagnostic delay. Major shift of patients from the private to public sector and non-allopaths to allopaths was observed, particularly for treatment initiation. Achieving positive behavioural changes in providers (especially non-allopaths) and patients needs to be considered in TB control strategies. Specific attention is required in counselling of TB patients so that timely care seeking is effected at the time of relapse. Prioritizing improvement of environmental health in vulnerable locations and provision of point of care diagnostics would be singularly effective in curbing pathway delays.

Durations and Delays in Care Seeking, Diagnosis and Treatment Initiation in Uncomplicated Pulmonary Tuberculosis Patients in Mumbai, India

PubMed Central

Mistry, Nerges; Rangan, Sheela; Dholakia, Yatin; Lobo, Eunice; Shah, Shimoni; Patil, Akshaya

2016-01-01

Background Timely diagnosis and treatment initiation are critical to reduce the chain of transmission of Tuberculosis (TB) in places like Mumbai, where almost 60% of the inhabitants reside in overcrowded slums. This study documents the pathway from the onset of symptoms suggestive of TB to initiation of TB treatment and examines factors responsible for delay among uncomplicated pulmonary TB patients in Mumbai. Methods A population-based retrospective survey was conducted in the slums of 15 high TB burden administrative wards to identify 153 self-reported TB patients. Subsequently in-depth interviews of 76 consenting patients that fit the inclusion criteria were undertaken using an open-ended interview schedule. Mean total, first care seeking, diagnosis and treatment initiation duration and delays were computed for new and retreatment patients. Patients showing defined delays were divided into outliers and non-outliers for all three delays using the median values. Results The mean duration for the total pathway was 65 days with 29% of patients being outliers. Importantly the mean duration of first care seeking was similar in new (24 days) and retreatment patients (25 days). Diagnostic duration contributed to 55% of the total pathway largely in new patients. Treatment initiation was noted to be the least among the three durations with mean duration in retreatment patients twice that of new patients. Significantly more female patients experienced diagnostic delay. Major shift of patients from the private to public sector and non-allopaths to allopaths was observed, particularly for treatment initiation. Conclusion Achieving positive behavioural changes in providers (especially non-allopaths) and patients needs to be considered in TB control strategies. Specific attention is required in counselling of TB patients so that timely care seeking is effected at the time of relapse. Prioritizing improvement of environmental health in vulnerable locations and provision of point of care diagnostics would be singularly effective in curbing pathway delays. PMID:27018589

Fluoride metabolism when added to salt.

PubMed

Whitford, Gary M

2005-01-01

The purpose of this review is to present the general characteristics of the metabolism of fluoride particularly as it occurs when ingested with fluoridated salt. Following the absorption of salt-borne fluoride from the stomach and intestines, its metabolism is identical to that of water-borne fluoride or other vehicles containing ionized fluoride. Because fluoridated salt is almost always ingested with food, however, absorption from the gastrointestinal tract may be delayed or reduced. Reports dealing with this subject have shown that fluoride absorption is delayed and, therefore, peak plasma concentrations are lower than when fluoride is ingested with water. The amount of ingested fluoride that is finally absorbed, however, is not appreciably affected unless the meal is composed mainly of components with high calcium concentrations. In this case, the extent of absorption can be reduced by as much as 50%. Fluoridated salt is also ingested less frequently than fluoridated water. Data are presented to show that the dose size and frequency of ingestion have only minor effects on fluoride retention in the body and on the concentrations in plasma, bone and enamel. Finally, calculations are presented to show that the risk of acute toxicity from fluoridated salt is virtually non-existent.

Comparison of obese adults with poor versus good sleep quality during a functional neuroimaging delay discounting task: A pilot study.

PubMed

Martin, Laura E; Pollack, Lauren; McCune, Ashley; Schulte, Erica; Savage, Cary R; Lundgren, Jennifer D

2015-10-30

This study aimed to determine if obese adults with poor versus good sleep quality demonstrate reduced self-regulatory capacity and different patterns of neural activation when making impulsive monetary choices. Six obese, good quality sleepers (M age=44.7 years, M BMI=38.1 kg/m(2)) were compared to 13 obese, poor quality sleepers (M age=42.6, M BMI=39.2 kg/m(2)) on sleep and eating behavior and brain activation in prefrontal and insular regions while engaging in a delay discounting task during functional magnetic resonance imaging (fMRI). Poor quality sleepers demonstrated significantly lower brain activation in the right inferior frontal gyrus, right middle frontal gyrus, and bilateral insula when making immediate and smaller (impulsive) monetary choices compared to the baseline condition. Behaviorally, poor compared to good quality sleepers reported higher scores in the night eating questionnaire. Obese adults with poor sleep quality demonstrate decreased brain activation in multiple regions that regulate cognitive control and interceptive awareness, possibly reducing self-regulatory capacity when making immediately gratifying decisions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Control system estimation and design for aerospace vehicles with time delay

NASA Technical Reports Server (NTRS)

Allgaier, G. R.; Williams, T. L.

1972-01-01

The problems of estimation and control of discrete, linear, time-varying systems are considered. Previous solutions to these problems involved either approximate techniques, open-loop control solutions, or results which required excessive computation. The estimation problem is solved by two different methods, both of which yield the identical algorithm for determining the optimal filter. The partitioned results achieve a substantial reduction in computation time and storage requirements over the expanded solution, however. The results reduce to the Kalman filter when no delays are present in the system. The control problem is also solved by two different methods, both of which yield identical algorithms for determining the optimal control gains. The stochastic control is shown to be identical to the deterministic control, thus extending the separation principle to time delay systems. The results obtained reduce to the familiar optimal control solution when no time delays are present in the system.

Presence and Implication of Temporal Nonuniformity of Early Diastolic Left Ventricular Wall Expansion in Patients With Heart Failure.

PubMed

Iwano, Hiroyuki; Kamimura, Daisuke; Fox, Ervin R; Hall, Michael E; Vlachos, Pavlos; Little, William C

2016-12-01

Early-diastolic left ventricular (LV) longitudinal expansion is delayed with diastolic dysfunction. We hypothesized that, in patients with heart failure (HF), regardless of LV ejection fraction (EF), there is diastolic temporal nonuniformity with a delay of longitudinal relative to circumferential expansion. Echocardiography was performed in 143 HF patients-50 with preserved EF (HFpEF) and 93 with reduced EF (HFrEF)-as well as 31 normal control subjects. The delay of early-diastolic mitral annular velocity from the mitral Doppler E (T E-e' ) was measured as a parameter of the longitudinal expansion delay. The delay of the longitudinal early-diastolic global strain rate (SR E ) relative to circumferential SR E (Delay C-L ) was calculated as a parameter of temporal nonuniformity. Intra-LV pressure difference (IVPD) was estimated with the use of color M-mode Doppler data as a parameter of LV diastolic suction. Although normal control subjects had symmetric LV expansion in early diastole, T E-e' and Delay C-L were significantly prolonged in HF regardless of EF (P < .01 vs control for all). Multivariate analysis revealed that Delay C-L was the independent determinant of IVPD among the parameters of LV geometry and contraction (β = -0.21; P < .05). An abnormal temporal nonuniformity of early-diastolic expansion is present in HF regardless of EF, which was associated with reduced LV suction. Copyright © 2016 Elsevier Inc. All rights reserved.

Barriers to emergency obstetric care services: accounts of survivors of life threatening obstetric complications in Malindi District, Kenya.

PubMed

Echoka, Elizabeth; Makokha, Anselimo; Dubourg, Dominique; Kombe, Yeri; Nyandieka, Lillian; Byskov, Jens

2014-01-01

Pregnancy-related mortality and morbidity in most low and middle income countries can be reduced through early recognition of complications, prompt access to care and appropriate medical interventions following obstetric emergencies. We used the three delays framework to explore barriers to emergency obstetric care (EmOC) services by women who experienced life threatening obstetric complications in Malindi District, Kenya. A facility-based qualitative study was conducted between November and December 2010. In-depth interviews were conducted with 30 women who experienced obstetric "near miss" at the only public hospital with capacity to provide comprehensive EmOC services in the district. Findings indicate that pregnant women experienced delays in making decision to seek care and in reaching an appropriate care facility. The "first" delay was due to lack of birth preparedness, including failure to identify a health facility for delivery services regardless of antenatal care and to seek care promptly despite recognition of danger signs. The "second" delay was influenced by long distance and inconvenient transport to hospital. These two delays resulted in some women arriving at the hospital too late to save the life of the unborn baby. Delays in making the decision to seek care when obstetric complications occur, combined with delays in reaching the hospital, contribute to ineffective treatment upon arrival at the hospital. Interventions to reduce maternal mortality and morbidity must adequately consider the pre-hospital challenges faced by pregnant women in order to influence decision making towards addressing the three delays.

Delayed antibiotic prescription for upper respiratory tract infections in children under primary care: Physicians' views.

PubMed

Raft, Camilla Flintholm; Bjerrum, Lars; Arpi, Magnus; Jarløv, Jens Otto; Jensen, Jette Nygaard

2017-12-01

Overprescribing antibiotics for common or inaccurately diagnosed childhood infections is a frequent problem in primary healthcare in most countries. Delayed antibiotic prescriptions have been shown to reduce the use of antibiotics in primary healthcare. The aim was to examine primary care physicians' views on delayed antibiotic prescriptions to preschool children with symptoms of upper respiratory tract infections (URTIs). A questionnaire was sent to 1180 physicians working in general practice in the Capital Region of Denmark, between January and March 2015. The questions focused on physicians' attitude and use of delayed antibiotic prescriptions to children with URTIs. The response rate was 49% (n = 574). Seven per cent of the physicians often used delayed prescriptions to children with symptoms of URTI, but 46% believed that delayed prescription could reduce antibiotic use. The physicians' views on delayed antibiotic prescription were significantly associated with their number of years working in general practice. Parents' willingness to wait-and-see, need for reassurance, and knowledge about antibiotics influenced the physicians' views. Also, clinical symptoms and signs, parents' willingness to shoulder the responsibility, the capability of observation without antibiotic treatment, and structural factors like out-of-hour services were relevant factors in the decision. Most physicians, especially those with fewer years of practice, had a positive attitude towards delayed antibiotic prescription. Several factors influence the views of the physicians-from perceptions of parents to larger structural elements and years of experience.

A Comparison between Chocolate Milk and a Raw Milk Honey Solution’s Influence on Delayed Onset of Muscle Soreness

PubMed Central

Hatchett, Andrew; Berry, Christopher; Oliva, Claudia; Wiley, Douglas; St. Hilaire, Jacob; LaRochelle, Alex

2016-01-01

This investigation sought to examine the effect that a chocolate milk solution (CMS) and a raw milk solution (RMS) had on lower extremity induced delayed onset of muscle soreness (DOMS). Twenty trained male participants completed a set of questionnaires, prior to completing a lower extremity DOMS protocol, to determine the level of discomfort and functional limitations. Once the DOMS protocol was completed, participants were randomly assigned to either the CM or RM group. Once assigned, participants ingested 240 mL of the respective solution and completed the same set of questionnaires immediately post, 24-, 48- and 72-h post DOMS protocol. Additionally, for 10 days post-ingestion participants were contacted to learn if any negative effects were experienced as a result of ingesting either solution. Both groups reported an increase in lower extremity discomfort at each data collection interval post-DOMS protocol (post, 24-, 48- and 72-h). Participants assigned to the RM group reported high discomfort post and a relative decline in discomfort from immediately post-DOMS protocol to 72-h post. The RMS group reported substantially less discomfort at 72-h when compared to the CMS group. Ingestion of a raw milk solution immediately post strength exercise can substantially reduce the level of self-reported discomfort associated with DOMS. PMID:29910267

Lipid overloading during liver regeneration causes delayed hepatocyte DNA replication by increasing ER stress in mice with simple hepatic steatosis.

PubMed

Hamano, Mina; Ezaki, Hisao; Kiso, Shinichi; Furuta, Kunimaro; Egawa, Mayumi; Kizu, Takashi; Chatani, Norihiro; Kamada, Yoshihiro; Yoshida, Yuichi; Takehara, Tetsuo

2014-02-01

Impaired fatty liver regeneration has already been reported in many genetic modification models. However, in diet-induced simple hepatic steatosis, which showed similar phenotype with clinical pathology, whether liver regeneration is impaired or not remains unclear. In this study, we evaluated liver regeneration in mice with diet-induced simple hepatic steatosis, and focused on excess lipid accumulation occurring during liver regeneration. Mice were fed high fat diet (HFD) or control diet for 9-10 weeks. We analyzed intrahepatic lipid accumulation, DNA replication, and various signaling pathways including cell proliferation and ER stress during liver regeneration after partial hepatectomy. In addition, some of mice were pretreated with tauroursodeoxycholic acid (TUDCA), a chemical chaperone which alleviates ER stress, and then we estimated TUDCA effects on liver regeneration. The peak of hepatocyte BrdU incorporation, the expression of proliferation cell nuclear antigen (PCNA) protein, and the expressions of cell cycle-related genes were observed in delayed time in HFD mice. The expression of phosphorylated Erk1/2 was also delayed in HFD mice. The amounts of liver triglyceride were at least twofold higher in HFD mice at each time point. Intrahepatic palmitic acid was increased especially in HFD mice. ER stress induced during liver regeneration was significantly higher in HFD mice. In HFD mice, pretreatment with TUDCA reduced ER stress and resulted in improvement of delayed liver regeneration. In simple hepatic steatosis, lipid overloading occurring during liver regeneration might be caused ER stress and results in delayed hepatocyte DNA replication.

Later school start time is associated with improved sleep and daytime functioning in adolescents.

PubMed

Boergers, Julie; Gable, Christopher J; Owens, Judith A

2014-01-01

Chronic insufficient sleep is a growing concern among adolescents and is associated with a host of adverse health consequences. Early school start times may be an environmental contributor to this problem. The purpose of this study was to examine the impact of a delay in school start time on sleep patterns, sleepiness, mood, and health-related outcomes. Boarding students (n = 197, mean age = 15.6 yr) attending an independent high school completed the School Sleep Habits Survey before and after the school start time was experimentally delayed from 8:00 a.m. to 8:25 a.m. The delay in school start time was associated with a significant (29 min) increase in sleep duration on school nights. The percentage of students receiving 8 or more hours of sleep on a school night increased to more than double, from 18% to 44%. Students in 9th and 10th grade and those with lower baseline sleep amounts were more likely to report improvements in sleep duration after the schedule change. Daytime sleepiness, depressed mood, and caffeine use were all significantly reduced after the delay in school start time. Sleep duration reverted to baseline levels when the original (earlier) school start time was reinstituted. A modest (25 min) delay in school start time was associated with significant improvements in sleep duration, daytime sleepiness, mood, and caffeine use. These findings have important implications for public policy and add to research suggesting the health benefits of modifying school schedules to more closely align with adolescents' circadian rhythms and sleep needs.

VRX-03011, a novel 5-HT4 agonist, enhances memory and hippocampal acetylcholine efflux.

PubMed

Mohler, Eric G; Shacham, Sharon; Noiman, Silvia; Lezoualc'h, Frank; Robert, Sylvain; Gastineau, Monique; Rutkowski, Joseph; Marantz, Yael; Dumuis, Aline; Bockaert, Joel; Gold, Paul E; Ragozzino, Michael E

2007-09-01

Recent evidence suggests that 5-hydroxytryptamine (5-HT)(4) receptor activity enhances cognition and provides neuroprotection. Here we report the effects of VRX-03011, a novel partial 5-HT(4) agonist, that is both potent (K(i) approximately 30 nM) and highly selective (K(i) > 5 microM for all other 5-HT receptors tested). In separate experiments, rats received VRX-03011 (0.1-10 mg/kg i.p.) 30 min prior to spontaneous alternation testing in a no-delay or a 30-s delay condition. VRX-03011 (1, 5 and 10 mg/kg, but not 0.1 mg/kg) significantly enhanced delayed spontaneous alternation performance while none of the doses enhanced performance in the no-delay test. VRX-03011 (1 and 5 mg/kg) concomitantly enhanced hippocampal acetylcholine output and delayed spontaneous alternation scores compared to that of vehicle controls, but had no effect on hippocampal acetylcholine release under a resting condition. Moreover, suboptimal doses of VRX-03011 and the acetylcholinesterase inhibitor galanthamine combined to enhance memory. VRX-03011 also regulated amyloid precursor protein (APP) metabolism by inducing a concentration-dependent increase in the non-amyloidogenic soluble form of APP (sAPPalpha) with an EC(50) approximately 1--10 nM. VRX-03011 had no effect on contractile properties in guinea pig ileum or colon preparations with an EC(50) > 10 microM and did not alter rat intestinal transit at doses up to 10 mg/kg. These findings suggest that VRX-03011 may represent a novel treatment for Alzheimer's disease that reduces cognitive impairments and provides neuroprotection without gastrointestinal side effects.

Addressing the third delay: implementing a novel obstetric triage system in Ghana.

PubMed

Goodman, David M; Srofenyoh, Emmanuel K; Ramaswamy, Rohit; Bryce, Fiona; Floyd, Liz; Olufolabi, Adeyemi; Tetteh, Cecilia; Owen, Medge D

2018-01-01

Institutional delivery has been proposed as a method for reducing maternal morbidity and mortality, but little is known about how referral hospitals in low-resource settings can best manage the expected influx of patients. In this study, we assess the impact of an obstetric triage improvement programme on reducing hospital-based delay in a referral hospital in Accra, Ghana. An Active Implementation Framework is used to describe a 5-year intervention to introduce and monitor obstetric triage capabilities. Baseline data, collected from September to November 2012, revealed significant delays in patient assessment on arrival. A triage training course and monitoring of quality improvement tools occurred in 2013 and 2014. Implementation barriers led to the construction of a free-standing obstetric triage pavilion, opened January 2015, with dedicated midwives. Data were collected at three time intervals following the triage pavilion opening and compared with baseline including: referral indications, patient and labour characteristics, waiting time from arrival to assessment and the documentation of a care plan. An obstetric triage improvement programme reduced the median (IQR) patient waiting time from facility arrival to first assessment by a midwife from 40 min (15-100) to 5 min (2-6) (p<0.001) over the 5-year intervention. The triage pavilion enhanced performance resulting in the elimination of previous delays associated with the time of admission and disease acuity. Care plan documentation increased from 51% to 96%. Obstetric triage, when properly implemented, reduced delay in a busy, low-resource hospital. The implementation process was sustained under local leadership during transition to a new hospital.

76 FR 26787 - Short Sale Reporting Study Required by Dodd-Frank Act Section 417(a)(2)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-09

... benefits and costs be if this real time reporting information were to be made public on a delayed basis..., benefits, and costs be if this real time reporting information were to be made public on a delayed basis... feasibility, benefits, and costs of requiring reporting in real time, either publicly or, in the alternative...

Iconic Decay in Schizophrenia

PubMed Central

Hahn, Britta; Kappenman, Emily S.; Robinson, Benjamin M.; Fuller, Rebecca L.; Luck, Steven J.; Gold, James M.

2011-01-01

Working memory impairment is considered a core deficit in schizophrenia, but the precise nature of this deficit has not been determined. Multiple lines of evidence implicate deficits at the encoding stage. During encoding, information is held in a precategorical sensory store termed iconic memory, a literal image of the stimulus with high capacity but rapid decay. Pathologically increased iconic decay could reduce the number of items that can be transferred into working memory before the information is lost and could thus contribute to the working memory deficit seen in the illness. The current study used a partial report procedure to test the hypothesis that patients with schizophrenia (n = 37) display faster iconic memory decay than matched healthy control participants (n = 28). Six letters, arranged in a circle, were presented for 50 ms. Following a variable delay of 0–1000 ms, a central arrow cue indicated the item to be reported. In both patients and control subjects, recall accuracy decreased with increasing cue delay, reflecting decay of the iconic representation of the stimulus array. Patients displayed impaired memory performance across all cue delays, consistent with an impairment in working memory, but the rate of iconic memory decay did not differ between patients and controls. This provides clear evidence against faster loss of iconic memory representations in schizophrenia, ruling out iconic decay as an underlying source of the working memory impairment in this population. Thus, iconic decay rate can be added to a growing list of unimpaired cognitive building blocks in schizophrenia. PMID:20053864

Iconic decay in schizophrenia.

PubMed

Hahn, Britta; Kappenman, Emily S; Robinson, Benjamin M; Fuller, Rebecca L; Luck, Steven J; Gold, James M

2011-09-01

Working memory impairment is considered a core deficit in schizophrenia, but the precise nature of this deficit has not been determined. Multiple lines of evidence implicate deficits at the encoding stage. During encoding, information is held in a precategorical sensory store termed iconic memory, a literal image of the stimulus with high capacity but rapid decay. Pathologically increased iconic decay could reduce the number of items that can be transferred into working memory before the information is lost and could thus contribute to the working memory deficit seen in the illness. The current study used a partial report procedure to test the hypothesis that patients with schizophrenia (n = 37) display faster iconic memory decay than matched healthy control participants (n = 28). Six letters, arranged in a circle, were presented for 50 ms. Following a variable delay of 0-1000 ms, a central arrow cue indicated the item to be reported. In both patients and control subjects, recall accuracy decreased with increasing cue delay, reflecting decay of the iconic representation of the stimulus array. Patients displayed impaired memory performance across all cue delays, consistent with an impairment in working memory, but the rate of iconic memory decay did not differ between patients and controls. This provides clear evidence against faster loss of iconic memory representations in schizophrenia, ruling out iconic decay as an underlying source of the working memory impairment in this population. Thus, iconic decay rate can be added to a growing list of unimpaired cognitive building blocks in schizophrenia.

Delay and environmental costs of truck crashes

DOT National Transportation Integrated Search

2013-03-01

This report presents estimates of certain categories of costs of truck- and bus-involved crashes. Crash related costs estimated as part of this study include vehicle delay costs, emission costs, and fuel consumption costs. In addition, this report al...

The Effects of Financial Education on Impulsive Decision Making

PubMed Central

DeHart, William B.; Friedel, Jonathan E.; Lown, Jean M.; Odum, Amy L.

2016-01-01

Delay discounting, as a behavioral measure of impulsive choice, is strongly related to substance abuse and other risky behaviors. Therefore, effective techniques that alter delay discounting are of great interest. We explored the ability of a semester long financial education course to change delay discounting. Participants were recruited from a financial education course (n = 237) and an abnormal psychology course (n = 80). Both groups completed a delay-discounting task for $100 during the first two weeks (Time 1) of the semester as well as during the last two weeks (Time 2) of the semester. Participants also completed a personality inventory and financial risk tolerance scale both times and a delay-discounting task for $1,000 during Time 2. Delay discounting decreased in the financial education group at the end of the semester whereas there was no change in delay discounting in the abnormal psychology group. Financial education may be an effective method for reducing delay discounting. PMID:27442237

The Effects of Financial Education on Impulsive Decision Making.

PubMed

DeHart, William B; Friedel, Jonathan E; Lown, Jean M; Odum, Amy L

2016-01-01

Delay discounting, as a behavioral measure of impulsive choice, is strongly related to substance abuse and other risky behaviors. Therefore, effective techniques that alter delay discounting are of great interest. We explored the ability of a semester long financial education course to change delay discounting. Participants were recruited from a financial education course (n = 237) and an abnormal psychology course (n = 80). Both groups completed a delay-discounting task for $100 during the first two weeks (Time 1) of the semester as well as during the last two weeks (Time 2) of the semester. Participants also completed a personality inventory and financial risk tolerance scale both times and a delay-discounting task for $1,000 during Time 2. Delay discounting decreased in the financial education group at the end of the semester whereas there was no change in delay discounting in the abnormal psychology group. Financial education may be an effective method for reducing delay discounting.

Robustness of delayed multistable systems with application to droop-controlled inverter-based microgrids

NASA Astrophysics Data System (ADS)

Efimov, Denis; Schiffer, Johannes; Ortega, Romeo

2016-05-01

Motivated by the problem of phase-locking in droop-controlled inverter-based microgrids with delays, the recently developed theory of input-to-state stability (ISS) for multistable systems is extended to the case of multistable systems with delayed dynamics. Sufficient conditions for ISS of delayed systems are presented using Lyapunov-Razumikhin functions. It is shown that ISS multistable systems are robust with respect to delays in a feedback. The derived theory is applied to two examples. First, the ISS property is established for the model of a nonlinear pendulum and delay-dependent robustness conditions are derived. Second, it is shown that, under certain assumptions, the problem of phase-locking analysis in droop-controlled inverter-based microgrids with delays can be reduced to the stability investigation of the nonlinear pendulum. For this case, corresponding delay-dependent conditions for asymptotic phase-locking are given.

Barriers to early presentation of self-discovered breast cancer in Singapore and Malaysia: a qualitative multicentre study

PubMed Central

Lim, Jennifer NW; Potrata, Barbara; Simonella, Leonardo; Ng, Celene WQ; Aw, Tar-Ching; Dahlui, Maznah; Hartman, Mikael; Mazlan, Rifhan; Taib, Nur Aishah

2015-01-01

Objective To explore and compare barriers to early presentation of self-discovered breast cancer in Singapore and Malaysia. Design A qualitative interview study with thematic analysis of transcripts. Participants 67 patients with self-discovered breast symptoms were included in the analysis. Of these, 36% were of Malay ethnicity, 39% were Chinese and 25% Indian, with an average age of 58 years (range 24–82 years). The number of women diagnosed at early stages of cancer almost equalled those at advanced stages. Approximately three-quarters presented with a painless lump, one-quarter experienced a painful lump and 10% had atypical symptoms. Setting University hospital setting in Singapore and Malaysia. Results Patients revealed barriers to early presentation not previously reported: the poor quality of online website information about breast symptoms, financial issues and the negative influence of relatives in both countries, while perceived poor quality of care and services in state-run hospitals and misdiagnosis by healthcare professionals were reported in Malaysia. The pattern of presentation by ethnicity remained unchanged where more Malay delayed help-seeking and had more advanced cancer compared to Chinese and Indian patients. Conclusions There are few differences in the pattern of presentation and in the reported barriers to seek medical care after symptom discovery between Singapore and Malaysia despite their differing economic status. Strategies to reduce delayed presentation are: a need to improve knowledge of disease, symptoms and causes, quality of care and services, and quality of online information; and addressing fear of diagnosis, treatment and hospitalisation, with more effort focused on the Malay ethnic group. Training is needed to avoid missed diagnoses and other factors contributing to delay among health professionals. PMID:26692558

The Phe932Ile mutation in KCNT1 channels associated with severe epilepsy, delayed myelination and leukoencephalopathy produces a loss-of-function channel phenotype.

PubMed

Evely, Katherine M; Pryce, Kerri D; Bhattacharjee, Arin

2017-05-20

Sodium-activated potassium (K Na ) channels contribute to firing frequency adaptation and slow after hyperpolarization. The KCNT1 gene (also known as SLACK) encodes a K Na subunit that is expressed throughout the central and peripheral nervous systems. Missense mutations of the SLACK C-terminus have been reported in several patients with rare forms of early onset epilepsy and in some cases severely delayed myelination. To date, such mutations identified in patients with autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE), epilepsy of infancy with migrating focal seizures (EIMFS) and Ohtahara syndrome (OS) have been reported to be gain-of-function mutations (Villa and Combi, 2016). An exome sequencing study identified a p.Phe932Ile KCNT1 mutation as the disease-causing change in a child with severe early infantile epileptic encephalopathy and abnormal myelination (Vanderver et al., 2014). We characterized an analogous mutation in the rat Slack channel and unexpectedly found this mutation to produce a loss-of-function phenotype. In an effort to restore current, we tested the known Slack channel opener loxapine. Loxapine exhibited no effect, indicating that this mutation either caused the channel to be insensitive to this established opener or proper translation and trafficking to the membrane was disrupted. Protein analysis confirmed that while total mutant protein did not differ from wild type, membrane expression of the mutant channel was substantially reduced. Although gain-of-function mutations to the Slack channel are linked to epileptic phenotypes, this is the first reported loss-of-function mutation linked to severe epilepsy and delayed myelination. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

Sleep restriction and delayed sleep associate with psychological health and biomarkers of stress and inflammation in women.

PubMed

Tartar, Jaime L; Fins, Ana I; Lopez, Andrea; Sierra, Linett A; Silverman, Sarah A; Thomas, Samuel V; Craddock, Travis J A

2015-12-01

Despite strong associations between sleep duration and health, there is no clear understanding of how volitional chronic sleep restriction (CSR) alters the physiological processes that lead to poor health in women. We focused on biochemical and psychological factors that previous research suggests are essential to uncovering the role of sleep in health. Cross-sectional study. University-based. Sixty female participants (mean age, 19.3; SD, 2.1 years). We analyzed the association between self-reported volitional CSR and time to go to sleep on a series of sleep and psychological health measures as well as biomarkers of immune functioning/inflammation (interleukin [IL]-1β), stress (cortisol), and sleep regulation (melatonin). Across multiple measures, poor sleep was associated with decreased psychological health and a reduced perception of self-reported physical health. Volitional CSR was related to increased cortisol and increased IL-1β levels. We separately looked at individuals who experienced CSR with and without delayed sleep time and found that IL-1β levels were significantly elevated in CSR alone and in CSR combined with a late sleep time. Cortisol, however, was only elevated in those women who experienced CSR combined with a late sleep time. We did not observe any changes in melatonin across groups, and melatonin levels were not related to any sleep measures. New to our study is the demonstration of how an increase in a proinflammatory process and an increase in hypothalamic-pituitary-adrenal axis activity both relate to volitional CSR, with and without a delayed sleep time. We further show how these mechanisms relate back to psychological and self-reported health in young adult women. Copyright © 2015 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

7 CFR 59.202 - Mandatory daily reporting for barrows and gilts.

Code of Federal Regulations, 2010 CFR

2010-01-01

... live weight basis; and (iv) The base price and premiums and discounts paid for carcass characteristics... unavailable due to pricing that is determined on a delayed basis. The packer shall report information on such... reporting day, unless such information is unavailable due to pricing that is determined on a delayed basis...

Parents who refuse or delay HPV vaccine: Differences in vaccination behavior, beliefs, and clinical communication preferences

PubMed Central

Gilkey, Melissa B.; Calo, William A.; Marciniak, Macary W.

2017-01-01

ABSTRACT Background: We sought to estimate the national prevalence of HPV vaccine refusal and delay in a nationally-representative sample of parents of adolescents. We also compared parents who refused versus delayed HPV vaccine in terms of their vaccination beliefs and clinical communication preferences. Methods: In 2014 to 2015, we conducted an online survey of 1,484 US parents who reported on an 11- to 17-year-old child in their household. We used weighted multinomial logistic regression to assess correlates of HPV vaccine refusal and delay. Results: Overall, 28% of parents reported that they had ever “refused or decided not to get” HPV vaccine for their child, and an additional 8% of parents reported that they had “delayed or put off getting” HPV vaccine. Compared to no refusal/delay, refusal was associated with lower confidence in adolescent vaccination (relative risk ratio [RRR] = 0.66, 95% confidence interval [CI], 0.48–0.91), lower perceived HPV vaccine effectiveness (RRR = 0.68, 95% CI, 0.50–0.91), and higher perceived harms (RRR = 3.49, 95% CI, 2.65–4.60). In contrast, delay was associated with needing more information (RRR = 1.76, 95% CI, 1.08–2.85). Most parents rated physicians and information sheets as helpful for making decisions about HPV vaccination, although parents who reported refusal endorsed these resources less often. Conclusions: Our findings suggest that HPV vaccine refusal is common among parents of adolescents and may have increased relative to previous estimates. Because the vaccination beliefs and communication preferences of parents who refuse appear to differ from those who delay, targeted communication strategies may be needed to effectively address HPV vaccine hesitancy. PMID:27763818

Longitudinal Outcomes of Start Time Delay on Sleep, Behavior, and Achievement in High School.

PubMed

Thacher, Pamela V; Onyper, Serge V

2016-02-01

To establish whether sleep, health, mood, behavior, and academics improved after a 45-minute delay in high school start time, and whether changes persisted longitudinally. We collected data from school records and student self-report across a number of domains at baseline (May 2012) and at two follow-up time points (November 2012 and May 2013), at a public high school in upstate New York. Students enrolled during academic years (AY) 2011-2012 and 2012-2013 completed the Pittsburgh Sleep Quality Index; the DASS-21; the "Owl-Lark" Scale; the Daytime Sleepiness Index; and a brief self-report of health. Reports from school records regarding attendance, tardiness, disciplinary violations, and academic performance were collected for AY 2010-2011 through 2013-2014. Students delayed but did not extend their sleep period; we found lasting improvements in tardiness and disciplinary violations after the start-time delay, but no changes to other variables. At the first follow-up, students reported 20 minutes longer sleep, driven by later rise times and stable bed times. At the second follow-up, students maintained later rise times but delayed bedtimes, returning total sleep to baseline levels. A delay in rise time, paralleling the delay in the start time that occurred, resulted in less tardiness and decreased disciplinary incidents, but larger improvements to sleep patterns may be necessary to affect health, attendance, sleepiness, and academic performance. Later start times improved tardiness and disciplinary issues at this school district. A delay in start time may be a necessary but not sufficient means to increase sleep time and may depend on preexisting individual differences. A commentary on this article appears in this issue on page 267. © 2016 Associated Professional Sleep Societies, LLC.

Kisspeptin regulates ovarian steroidogenesis during delayed embryonic development in the fruit bat, Cynopterus sphinx.

PubMed

Anuradha; Krishna, Amitabh

2017-11-01

Cynopterus sphinx, a fruit bat, undergoes delayed embryonic development during the winter months, a period that corresponds to low levels of progesterone and estradiol synthesis by the ovary. Kisspeptins (KPs) are a group of neuropeptide hormones that act via G-protein coupled receptor 54 (GPR54) to stimulate hypothalamic secretion of Gonadotropin-releasing hormone, thereby regulating ovarian steroidogenesis, folliculogenesis, and ovulation. GPR54 is also expressed in the ovary, suggesting a direct role for KPs in ovarian steroidogenesis. The aim of present study was to determine if a low serum level of KP is responsible for reduced progesterone and estradiol levels during the period of delayed embryonic development in C. sphinx. Indeed, low serum KP abundance corresponded to reduced expression of GPR54 in ovarian luteal cells during the period of delayed development compared to normal development. In vitro and in vivo treatment with KP increased GPR54 abundance, via Extracellular signal regulated kinase and its downstream mediators, leading to increased progesterone synthesis in the ovary during delayed embryonic development. KP treatment also increased cholesterol uptake and elevated expression of Luteinizing hormone receptor and Steroid acute regulatory protein in the ovary, suggesting that elevation in circulating KP during delayed embryonic development may reactivate luteal activity. KPs may also enhance cell survival (BCL-2, reduced Caspase 3 activity) and angiogenesis (Vascular endothelium growth factor) during this period. The findings of this study thus demonstrate a regulatory role for KPs in the maintenance of luteal steroidogenesis during pregnancy in C. sphinx. © 2017 Wiley Periodicals, Inc.

Karrikins delay soybean seed germination by mediating abscisic acid and gibberellin biogenesis under shaded conditions

PubMed Central

Meng, Yongjie; Chen, Feng; Shuai, Haiwei; Luo, Xiaofeng; Ding, Jun; Tang, Shengwen; Xu, Shuanshuan; Liu, Jianwei; Liu, Weiguo; Du, Junbo; Liu, Jiang; Yang, Feng; Sun, Xin; Yong, Taiwen; Wang, Xiaochun; Feng, Yuqi; Shu, Kai; Yang, Wenyu

2016-01-01

Karrikins (KAR) are a class of signal compounds, discovered in wildfire smoke, which affect seed germination. Currently, numerous studies have focused on the model plant Arabidopsis in the KAR research field, rather than on crops. Thus the regulatory mechanisms underlying KAR regulation of crop seed germination are largely unknown. Here, we report that KAR delayed soybean seed germination through enhancing abscisic acid (ABA) biosynthesis, while impairing gibberellin (GA) biogenesis. Interestingly, KAR only retarded soybean seed germination under shaded conditions, rather than under dark and white light conditions, which differs from in Arabidopsis. Phytohormone quantification showed that KAR enhanced ABA biogenesis while impairing GA biosynthesis during the seed imbibition process, and subsequently, the ratio of active GA4 to ABA was significantly reduced. Further qRT-PCR analysis showed that the transcription pattern of genes involved in ABA and GA metabolic pathways are consistent with the hormonal measurements. Finally, fluridone, an ABA biogenesis inhibitor, remarkably rescued the delayed-germination phenotype of KAR-treatment; and paclobutrazol, a GA biosynthesis inhibitor, inhibited soybean seed germination. Taken together, these evidences suggest that KAR inhibit soybean seed germination by mediating the ratio between GA and ABA biogenesis. PMID:26902640

Karrikins delay soybean seed germination by mediating abscisic acid and gibberellin biogenesis under shaded conditions.

PubMed

Meng, Yongjie; Chen, Feng; Shuai, Haiwei; Luo, Xiaofeng; Ding, Jun; Tang, Shengwen; Xu, Shuanshuan; Liu, Jianwei; Liu, Weiguo; Du, Junbo; Liu, Jiang; Yang, Feng; Sun, Xin; Yong, Taiwen; Wang, Xiaochun; Feng, Yuqi; Shu, Kai; Yang, Wenyu

2016-02-23

Karrikins (KAR) are a class of signal compounds, discovered in wildfire smoke, which affect seed germination. Currently, numerous studies have focused on the model plant Arabidopsis in the KAR research field, rather than on crops. Thus the regulatory mechanisms underlying KAR regulation of crop seed germination are largely unknown. Here, we report that KAR delayed soybean seed germination through enhancing abscisic acid (ABA) biosynthesis, while impairing gibberellin (GA) biogenesis. Interestingly, KAR only retarded soybean seed germination under shaded conditions, rather than under dark and white light conditions, which differs from in Arabidopsis. Phytohormone quantification showed that KAR enhanced ABA biogenesis while impairing GA biosynthesis during the seed imbibition process, and subsequently, the ratio of active GA4 to ABA was significantly reduced. Further qRT-PCR analysis showed that the transcription pattern of genes involved in ABA and GA metabolic pathways are consistent with the hormonal measurements. Finally, fluridone, an ABA biogenesis inhibitor, remarkably rescued the delayed-germination phenotype of KAR-treatment; and paclobutrazol, a GA biosynthesis inhibitor, inhibited soybean seed germination. Taken together, these evidences suggest that KAR inhibit soybean seed germination by mediating the ratio between GA and ABA biogenesis.

Early prophylactic autogenous bone grafting in type III open tibial fractures.

PubMed

Kesemenli, Cumhur C; Kapukaya, Ahmet; Subaşi, Mehmet; Arslan, Huseyin; Necmioğlu, Serdar; Kayikçi, Cuma

2004-08-01

The authors report the results achieved in patients with type III open tibial fractures who underwent primary autogenous bone grafting at the time of debridement and skeletal stabilisation. Twenty patients with a mean age of 35.8 years (range, 24-55) were treated between 1996 and 1999. Eight fractures were type IIIA, 11 were type IIIB, and 1 was type IIIC. At the index procedure, wound debridement, external fixation and autogenous bone grafting with bone coverage were achieved. The mean follow-up period was 46 months (range, 34-55). The mean time to fixator removal was 21 weeks (range, 14-35), and the mean time to union was 28 weeks (range, 19-45). Skin coverage was achieved by a myocutaneous flap in 2 patients, late primary closure in 4, and split skin grafting in 14. One (5%) of the patients experienced delayed union, and 1 (5%) developed infection. In tibial type III open fractures, skin coverage may be delayed, using the surrounding soft tissue to cover any exposed bone after thorough débridement and wound cleansing. Primary prophylactic bone grafting performed at the same time reduces the rate of delayed union, shortens the time to union, and does not increase the infection rate.

Towards a Low-Cost Remote Memory Attestation for the Smart Grid

PubMed Central

Yang, Xinyu; He, Xiaofei; Yu, Wei; Lin, Jie; Li, Rui; Yang, Qingyu; Song, Houbing

2015-01-01

In the smart grid, measurement devices may be compromised by adversaries, and their operations could be disrupted by attacks. A number of schemes to efficiently and accurately detect these compromised devices remotely have been proposed. Nonetheless, most of the existing schemes detecting compromised devices depend on the incremental response time in the attestation process, which are sensitive to data transmission delay and lead to high computation and network overhead. To address the issue, in this paper, we propose a low-cost remote memory attestation scheme (LRMA), which can efficiently and accurately detect compromised smart meters considering real-time network delay and achieve low computation and network overhead. In LRMA, the impact of real-time network delay on detecting compromised nodes can be eliminated via investigating the time differences reported from relay nodes. Furthermore, the attestation frequency in LRMA is dynamically adjusted with the compromised probability of each node, and then, the total number of attestations could be reduced while low computation and network overhead can be achieved. Through a combination of extensive theoretical analysis and evaluations, our data demonstrate that our proposed scheme can achieve better detection capacity and lower computation and network overhead in comparison to existing schemes. PMID:26307998

Towards a Low-Cost Remote Memory Attestation for the Smart Grid.

PubMed

Yang, Xinyu; He, Xiaofei; Yu, Wei; Lin, Jie; Li, Rui; Yang, Qingyu; Song, Houbing

2015-08-21

In the smart grid, measurement devices may be compromised by adversaries, and their operations could be disrupted by attacks. A number of schemes to efficiently and accurately detect these compromised devices remotely have been proposed. Nonetheless, most of the existing schemes detecting compromised devices depend on the incremental response time in the attestation process, which are sensitive to data transmission delay and lead to high computation and network overhead. To address the issue, in this paper, we propose a low-cost remote memory attestation scheme (LRMA), which can efficiently and accurately detect compromised smart meters considering real-time network delay and achieve low computation and network overhead. In LRMA, the impact of real-time network delay on detecting compromised nodes can be eliminated via investigating the time differences reported from relay nodes. Furthermore, the attestation frequency in LRMA is dynamically adjusted with the compromised probability of each node, and then, the total number of attestations could be reduced while low computation and network overhead can be achieved. Through a combination of extensive theoretical analysis and evaluations, our data demonstrate that our proposed scheme can achieve better detection capacity and lower computation and network overhead in comparison to existing schemes.

Boosted Regeneration and Reduced Denervated Muscle Atrophy by NeuroHeal in a Pre-clinical Model of Lumbar Root Avulsion with Delayed Reimplantation.

PubMed

Romeo-Guitart, David; Forés, Joaquim; Navarro, Xavier; Casas, Caty

2017-09-20

The "gold standard" treatment of patients with spinal root injuries consists of delayed surgical reconnection of nerves. The sooner, the better, but problems such as injury-induced motor neuronal death and muscle atrophy due to long-term denervation mean that normal movement is not restored. Herein we describe a preclinical model of root avulsion with delayed reimplantation of lumbar roots that was used to establish a new adjuvant pharmacological treatment. Chronic treatment (up to 6 months) with NeuroHeal, a new combination drug therapy identified using a systems biology approach, exerted long-lasting neuroprotection, reduced gliosis and matrix proteoglycan content, accelerated nerve regeneration by activating the AKT pathway, promoted the formation of functional neuromuscular junctions, and reduced denervation-induced muscular atrophy. Thus, NeuroHeal is a promising treatment for spinal nerve root injuries and axonal regeneration after trauma.

Assessment of tropospheric delay mapping function models in Egypt: Using PTD database model

NASA Astrophysics Data System (ADS)

Abdelfatah, M. A.; Mousa, Ashraf E.; El-Fiky, Gamal S.

2018-06-01

For space geodetic measurements, estimates of tropospheric delays are highly correlated with site coordinates and receiver clock biases. Thus, it is important to use the most accurate models for the tropospheric delay to reduce errors in the estimates of the other parameters. Both the zenith delay value and mapping function should be assigned correctly to reduce such errors. Several mapping function models can treat the troposphere slant delay. The recent models were not evaluated for the Egyptian local climate conditions. An assessment of these models is needed to choose the most suitable one. The goal of this paper is to test the quality of global mapping function which provides high consistency with precise troposphere delay (PTD) mapping functions. The PTD model is derived from radiosonde data using ray tracing, which consider in this paper as true value. The PTD mapping functions were compared, with three recent total mapping functions model and another three separate dry and wet mapping function model. The results of the research indicate that models are very close up to zenith angle 80°. Saastamoinen and 1/cos z model are behind accuracy. Niell model is better than VMF model. The model of Black and Eisner is a good model. The results also indicate that the geometric range error has insignificant effect on slant delay and the fluctuation of azimuth anti-symmetric is about 1%.

Time delays in flight simulator visual displays

NASA Technical Reports Server (NTRS)

Crane, D. F.

1980-01-01

It is pointed out that the effects of delays of less than 100 msec in visual displays on pilot dynamic response and system performance are of particular interest at this time because improvements in the latest computer-generated imagery (CGI) systems are expected to reduce CGI displays delays to this range. Attention is given to data which quantify the effects of display delays in the range of 0-100 msec on system stability and performance, and pilot dynamic response for a particular choice of aircraft dynamics, display, controller, and task. The conventional control system design methods are reviewed, the pilot response data presented, and data for long delays, all suggest lead filter compensation of display delay. Pilot-aircraft system crossover frequency information guides compensation filter specification.

Email notification combined with off site signing substantially reduces resident approval to faculty verification time.

PubMed

Deitte, Lori A; Moser, Patricia P; Geller, Brian S; Sistrom, Chris L

2011-06-01

Attending radiologist signature time (AST) is a variable and modifiable component of overall report turnaround time. Delays in finalized reports have potential to undermine radiologists' value as consultants and adversely affect patient care. This study was performed to evaluate the impact of notebook computer distribution and daily automated e-mail notification on reducing AST. Two simultaneous interventions were initiated in the authors' radiology department in February 2010. These included the distribution of a notebook computer with preloaded software for each attending radiologist to sign radiology reports and daily automated e-mail notifications for unsigned reports. The digital dictation system archive and the radiology information system were queried for all radiology reports produced from January 2009 through August 2010. The time between resident approval and attending radiologist signature before and after the intervention was analyzed. Potential unintended "side effects" of the intervention were also studied. Resident-authored reports were signed, on average, 2.53 hours sooner after the intervention. This represented a highly significant (P = .003) decrease in AST with all else held equal. Postintervention reports were authored by residents at the same rate (about 70%). An unintended "side effect" was that attending radiologists were less likely to make changes to resident-authored reports after the intervention. E-mail notification combined with offsite signing can reduce AST substantially. Notebook computers with preloaded software streamline the process of accessing, editing, and signing reports. The observed decrease in AST reflects a positive change in the timeliness of report signature. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

Longest delayed hemothorax reported after blunt chest injury.

PubMed

Yap, Darren; Ng, Miane; Chaudhury, Madhu; Mbakada, Nik

2018-01-01

Blunt chest injury is a common presentation to the emergency department. However, a delayed hemothorax after blunt trauma is rare; current literature reports a delay of up to 30days. We present a case of 44-day delay in hemothorax which has not been previously reported in current literature. A 52-year-old Caucasian male first presented to the emergency department complaining of persistent right sided chest pain 2weeks after having slipped on a wet surface at home. His initial chest X-ray showed fractures of the right 7th and 8th ribs without a hemothorax or pneumothorax. He returned 30days after the initial consultation (44days post-trauma) having increasing shortness of breath. A chest X-ray this time revealed a large right hemothorax and 1850ml of blood drained from his chest. There was a complete resolution of the hemothorax within 48h and the patient was discharged after a 6-week follow-up with the chest physicians. Delayed hemothorax after blunt trauma is a rare clinical occurrence but associated with significant morbidity and mortality. The management of delayed hemothorax includes draining the hemothorax and controlling the bleeding. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be vigilant and weary that hemothorax could be a possibility after a chest injury despite a delay in presentation. A knowledge of delayed hemothorax will prompt physicians in providing important advice, warning signs and information to patients after a chest injury to avoid a delay in seeking medical attention. Copyright © 2017 Elsevier Inc. All rights reserved.

Objective Cognitive Functioning in Self-reported Habitual Short Sleepers not Reporting Daytime Dysfunction: Examination of Impulsivity via Delay Discounting.

PubMed

Curtis, Brian J; Williams, Paula G; Anderson, Jeffrey S

2018-05-30

1) Examine performance on an objective measure of reward-related cognitive impulsivity (delay discounting) among self-reported habitual short sleepers and medium (i.e., recommended 7-9 hours) length sleepers either reporting or not reporting daytime dysfunction; 2) Inform the debate regarding what type and duration of short sleep (e.g., 21 to 24 hours of total sleep deprivation, self-reported habitual short sleep duration) meaningfully influences cognitive impulsivity; 3) Compare the predictive utility of sleep duration and perceived dysfunction to other factors previously shown to influence cognitive impulsivity via delay discounting performance (age, income, education, and fluid intelligence). We analyzed data from 1,190 adults from the Human Connectome Project database. Participants were grouped on whether they reported habitual short (≤ 6 hours) vs. medium length (7-9 hours) sleep duration and whether they perceived daytime dysfunction using the Pittsburgh Sleep Quality Index. All short sleepers exhibited increased delay discounting compared to all medium length sleepers, regardless of perceived dysfunction. Of the variables examined, self-reported sleep duration was the strongest predictor of delay discounting behavior between groups and across all 1,190 participants. Individuals who report habitual short sleep are likely to exhibit increased reward-related cognitive impulsivity regardless of perceived sleep-related daytime impairment. Therefore, there is reason to suspect that these individuals exhibit more daytime dysfunction, in the form of reward-related cognitive impulsivity, than they may assume. Current findings suggest that assessment of sleep duration over the prior month has meaningful predictive utility for human reward-related impulsivity.

A Cross-Layer Optimized Opportunistic Routing Scheme for Loss-and-Delay Sensitive WSNs

PubMed Central

Xu, Xin; Yuan, Minjiao; Liu, Xiao; Cai, Zhiping; Wang, Tian

2018-01-01

In wireless sensor networks (WSNs), communication links are typically error-prone and unreliable, so providing reliable and timely data routing for loss- and delay-sensitive applications in WSNs it is a challenge issue. Additionally, with specific thresholds in practical applications, the loss and delay sensitivity implies requirements for high reliability and low delay. Opportunistic Routing (OR) has been well studied in WSNs to improve reliability for error-prone and unreliable wireless communication links where the transmission power is assumed to be identical in the whole network. In this paper, a Cross-layer Optimized Opportunistic Routing (COOR) scheme is proposed to improve the communication link reliability and reduce delay for loss-and-delay sensitive WSNs. The main contribution of the COOR scheme is making full use of the remaining energy in networks to increase the transmission power of most nodes, which will provide a higher communication reliability or further transmission distance. Two optimization strategies referred to as COOR(R) and COOR(P) of the COOR scheme are proposed to improve network performance. In the case of increasing the transmission power, the COOR(R) strategy chooses a node that has a higher communication reliability with same distance in comparison to the traditional opportunistic routing when selecting the next hop candidate node. Since the reliability of data transmission is improved, the delay of the data reaching the sink is reduced by shortening the time of communication between candidate nodes. On the other hand, the COOR(P) strategy prefers a node that has the same communication reliability with longer distance. As a result, network performance can be improved for the following reasons: (a) the delay is reduced as fewer hops are needed while the packet reaches the sink in longer transmission distance circumstances; (b) the reliability can be improved since it is the product of the reliability of every hop of the routing path, and the count is reduced while the reliability of each hop is the same as the traditional method. After analyzing the energy consumption of the network in detail, the value of optimized transmission power in different areas is given. On the basis of a large number of experimental and theoretical analyses, the results show that the COOR scheme will increase communication reliability by 36.62–87.77%, decrease delay by 21.09–52.48%, and balance the energy consumption of 86.97% of the nodes in the WSNs. PMID:29751589

A Cross-Layer Optimized Opportunistic Routing Scheme for Loss-and-Delay Sensitive WSNs.

PubMed

Xu, Xin; Yuan, Minjiao; Liu, Xiao; Liu, Anfeng; Xiong, Neal N; Cai, Zhiping; Wang, Tian

2018-05-03

In wireless sensor networks (WSNs), communication links are typically error-prone and unreliable, so providing reliable and timely data routing for loss- and delay-sensitive applications in WSNs it is a challenge issue. Additionally, with specific thresholds in practical applications, the loss and delay sensitivity implies requirements for high reliability and low delay. Opportunistic Routing (OR) has been well studied in WSNs to improve reliability for error-prone and unreliable wireless communication links where the transmission power is assumed to be identical in the whole network. In this paper, a Cross-layer Optimized Opportunistic Routing (COOR) scheme is proposed to improve the communication link reliability and reduce delay for loss-and-delay sensitive WSNs. The main contribution of the COOR scheme is making full use of the remaining energy in networks to increase the transmission power of most nodes, which will provide a higher communication reliability or further transmission distance. Two optimization strategies referred to as COOR(R) and COOR(P) of the COOR scheme are proposed to improve network performance. In the case of increasing the transmission power, the COOR(R) strategy chooses a node that has a higher communication reliability with same distance in comparison to the traditional opportunistic routing when selecting the next hop candidate node. Since the reliability of data transmission is improved, the delay of the data reaching the sink is reduced by shortening the time of communication between candidate nodes. On the other hand, the COOR(P) strategy prefers a node that has the same communication reliability with longer distance. As a result, network performance can be improved for the following reasons: (a) the delay is reduced as fewer hops are needed while the packet reaches the sink in longer transmission distance circumstances; (b) the reliability can be improved since it is the product of the reliability of every hop of the routing path, and the count is reduced while the reliability of each hop is the same as the traditional method. After analyzing the energy consumption of the network in detail, the value of optimized transmission power in different areas is given. On the basis of a large number of experimental and theoretical analyses, the results show that the COOR scheme will increase communication reliability by 36.62⁻87.77%, decrease delay by 21.09⁻52.48%, and balance the energy consumption of 86.97% of the nodes in the WSNs.

Control of amplitude chimeras by time delay in oscillator networks

NASA Astrophysics Data System (ADS)

Gjurchinovski, Aleksandar; Schöll, Eckehard; Zakharova, Anna

2017-04-01

We investigate the influence of time-delayed coupling in a ring network of nonlocally coupled Stuart-Landau oscillators upon chimera states, i.e., space-time patterns with coexisting partially coherent and partially incoherent domains. We focus on amplitude chimeras, which exhibit incoherent behavior with respect to the amplitude rather than the phase and are transient patterns, and we show that their lifetime can be significantly enhanced by coupling delay. To characterize their transition to phase-lag synchronization (coherent traveling waves) and other coherent structures, we generalize the Kuramoto order parameter. Contrasting the results for instantaneous coupling with those for constant coupling delay, for time-varying delay, and for distributed-delay coupling, we demonstrate that the lifetime of amplitude chimera states and related partially incoherent states can be controlled, i.e., deliberately reduced or increased, depending upon the type of coupling delay.

Delay-aware adaptive sleep mechanism for green wireless-optical broadband access networks

NASA Astrophysics Data System (ADS)

Wang, Ruyan; Liang, Alei; Wu, Dapeng; Wu, Dalei

2017-07-01

Wireless-Optical Broadband Access Network (WOBAN) is capacity-high, reliable, flexible, and ubiquitous, as it takes full advantage of the merits from both optical communication and wireless communication technologies. Similar to other access networks, the high energy consumption poses a great challenge for building up WOBANs. To shot this problem, we can make some load-light Optical Network Units (ONUs) sleep to reduce the energy consumption. Such operation, however, causes the increased packet delay. Jointly considering the energy consumption and transmission delay, we propose a delay-aware adaptive sleep mechanism. Specifically, we develop a new analytical method to evaluate the transmission delay and queuing delay over the optical part, instead of adopting M/M/1 queuing model. Meanwhile, we also analyze the access delay and queuing delay of the wireless part. Based on such developed delay models, we mathematically derive ONU's optimal sleep time. In addition, we provide numerous simulation results to show the effectiveness of the proposed mechanism.

When good pigeons make bad decisions: Choice with probabilistic delays and outcomes.

PubMed

Pisklak, Jeffrey M; McDevitt, Margaret A; Dunn, Roger M; Spetch, Marcia L

2015-11-01

Pigeons chose between an (optimal) alternative that sometimes provided food after a 10-s delay and other times after a 40-s delay and another (suboptimal) alternative that sometimes provided food after 10 s but other times no food after 40 s. When outcomes were not signaled during the delays, pigeons strongly preferred the optimal alternative. When outcomes were signaled, choices of the suboptimal alternative increased and most pigeons preferred the alternative that provided no food after the long delay despite the cost in terms of obtained food. The pattern of results was similar whether the short delays occurred on 25% or 50% of the trials. Shortening the 40-s delay to food sharply reduced suboptimal choices, but shortening the delay to no food had little effect. The results suggest that a signaled delay to no food does not punish responding in probabilistic choice procedures. The findings are discussed in terms of conditioned reinforcement by signals for good news. © Society for the Experimental Analysis of Behavior.

Comparison principle for impulsive functional differential equations with infinite delays and applications

NASA Astrophysics Data System (ADS)

Li, Xiaodi; Shen, Jianhua; Akca, Haydar; Rakkiyappan, R.

2018-04-01

We introduce the Razumikhin technique to comparison principle and establish some comparison results for impulsive functional differential equations (IFDEs) with infinite delays, where the infinite delays may be infinite time-varying delays or infinite distributed delays. The idea is, under the help of Razumikhin technique, to reduce the study of IFDEs with infinite delays to the study of scalar impulsive differential equations (IDEs) in which the solutions are easy to deal with. Based on the comparison principle, we study the qualitative properties of IFDEs with infinite delays , which include stability, asymptotic stability, exponential stability, practical stability, boundedness, etc. It should be mentioned that the developed results in this paper can be applied to IFDEs with not only infinite delays but also persistent impulsive perturbations. Moreover, even for the special cases of non-impulsive effects or/and finite delays, the criteria prove to be simpler and less conservative than some existing results. Finally, two examples are given to illustrate the effectiveness and advantages of the proposed results.

Longitudinal Outcomes of Start Time Delay on Sleep, Behavior, and Achievement in High School

PubMed Central

Thacher, Pamela V.; Onyper, Serge V.

2016-01-01

Study Objectives: To establish whether sleep, health, mood, behavior, and academics improved after a 45-minute delay in high school start time, and whether changes persisted longitudinally. Methods: We collected data from school records and student self-report across a number of domains at baseline (May 2012) and at two follow-up time points (November 2012 and May 2013), at a public high school in upstate New York. Students enrolled during academic years (AY) 2011–2012 and 2012–2013 completed the Pittsburgh Sleep Quality Index; the DASS-21; the “Owl-Lark” Scale; the Daytime Sleepiness Index; and a brief self-report of health. Reports from school records regarding attendance, tardiness, disciplinary violations, and academic performance were collected for AY 2010–2011 through 2013–2014. Results: Students delayed but did not extend their sleep period; we found lasting improvements in tardiness and disciplinary violations after the start-time delay, but no changes to other variables. At the first follow-up, students reported 20 minutes longer sleep, driven by later rise times and stable bed times. At the second follow-up, students maintained later rise times but delayed bedtimes, returning total sleep to baseline levels. A delay in rise time, paralleling the delay in the start time that occurred, resulted in less tardiness and decreased disciplinary incidents, but larger improvements to sleep patterns may be necessary to affect health, attendance, sleepiness, and academic performance. Conclusions: Later start times improved tardiness and disciplinary issues at this school district. A delay in start time may be a necessary but not sufficient means to increase sleep time and may depend on preexisting individual differences. Commentary: A commentary on this article appears in this issue on page 267. Citation: Thacher PV, Onyper SV. Longitudinal outcomes of start time delay on sleep, behavior, and achievement in high school. SLEEP 2016;39(2):271–281. PMID:26446106

Single-shot transient absorption spectroscopy with a 45  ps pump-probe time delay range.

PubMed

Wilson, Kelly S; Wong, Cathy Y

2018-02-01

We report a single-shot transient absorption apparatus that successfully uses a tilted pump pulse to spatially encode a 45 ps pump-probe time delay. The time delay range is significantly improved over other reported instruments by using a spatial light modulator to flatten the intensity of the excitation field at the sample position. The full time delay range of the instrument is demonstrated by measuring a long-lived dye. A signal-to-noise ratio of >35 is attained in 8 s. This advance will enable the measurement of excited state dynamics of systems that are not at structural equilibrium.

Avoidant conversations about death by clinicians cause delays in reporting of neutropenic sepsis: Grounded theory study.

PubMed

Oakley, Catherine; Taylor, Cath; Ream, Emma; Metcalfe, Alison

2017-10-01

Evidence suggests that patients delay reporting symptoms of neutropenic sepsis (NS) despite the risk to their life. This study aimed to elicit factors that contribute to delayed patient reporting of NS symptoms. A constructivist grounded theory study used observations of chemotherapy consultations (13 h) and 31 in-depth interviews to explore beliefs, experiences, and behaviors related to NS. Participants included women with breast cancer, their carers (partners, family, or friends), and clinicians. An explanation for patient delays was developed through theoretical sampling of participants to explore emerging areas of interest and through constant comparison of data and their coding. This entailed iterative and concurrent data collection and analysis. Data were collected until saturation. All patients who developed NS-type symptoms delayed presenting to hospital (2.5 h-8 days), sometimes repeatedly. Moderators of delay included metastatic disease, bereavement, fatalism, religious beliefs, and quality of relationships with clinicians. There was an interplay of behaviors between clinicians, patients, and carers where they subconsciously conspired to underplay the seriousness and possibility of NS occurring. Findings have implications for health risk communication and development of holistic service models. Copyright © 2016 John Wiley & Sons, Ltd.

Using theory to explore facilitators and barriers to delayed prescribing in Australia: a qualitative study using the Theoretical Domains Framework and the Behaviour Change Wheel.

PubMed

Sargent, Lucy; McCullough, Amanda; Del Mar, Chris; Lowe, John

2017-02-13

Delayed antibiotic prescribing reduces antibiotic use for acute respiratory infections in trials in general practice, but the uptake in clinical practice is low. The aim of the study was to identify facilitators and barriers to general practitioners' (GPs') use of delayed prescribing and to gain pharmacists' and the public's views about delayed prescribing in Australia. This study used the Theoretical Domains Framework and the Behaviour Change Wheel to explore facilitators and barriers to delayed prescribing in Australia. Forty-three semi-structured, face-to-face interviews with general practitioners, pharmacists and patients were conducted. Responses were coded into domains of the Theoretical Domains Framework, and specific criteria from the Behaviour Change Wheel were used to identify which domains were relevant to increasing the use of delayed prescribing by GPs. The interviews revealed nine key domains that influence GPs' use of delayed prescribing: knowledge; cognitive and interpersonal skills; memory, attention and decision-making processes; optimism; beliefs about consequences; intentions; goals; emotion; and social influences: GPs knew about delayed prescribing; however, they did not use it consistently, preferring to bring patients back for review and only using it with patients in a highly selective way. Pharmacists would support GPs and the public in delayed prescribing but would fill the prescription if people insisted. The public said they would delay taking their antibiotics if asked by their GP and given the right information on managing symptoms and when to take antibiotics. Using a theory-driven approach, we identified nine key domains that influence GPs' willingness to provide a delayed prescription to patients with an acute respiratory infection presenting to general practice. These data can be used to develop a structured intervention to change this behaviour and thus reduce antibiotic use for acute respiratory infections in general practice.

Identification of a pathogenic FTO mutation by next-generation sequencing in a newborn with growth retardation and developmental delay.

PubMed

Daoud, Hussein; Zhang, Dong; McMurray, Fiona; Yu, Andrea; Luco, Stephanie M; Vanstone, Jason; Jarinova, Olga; Carson, Nancy; Wickens, James; Shishodia, Shifali; Choi, Hwanho; McDonough, Michael A; Schofield, Christopher J; Harper, Mary-Ellen; Dyment, David A; Armour, Christine M

2016-03-01

A homozygous loss-of-function mutation p.(Arg316Gln) in the fat mass and obesity-associated (FTO) gene, which encodes for an iron and 2-oxoglutarate-dependent oxygenase, was previously identified in a large family in which nine affected individuals present with a lethal syndrome characterised by growth retardation and multiple malformations. To date, no other pathogenic mutation in FTO has been identified as a cause of multiple congenital malformations. We investigated a 21-month-old girl who presented distinctive facial features, failure to thrive, global developmental delay, left ventricular cardiac hypertrophy, reduced vision and bilateral hearing loss. We performed targeted next-generation sequencing of 4813 clinically relevant genes in the patient and her parents. We identified a novel FTO homozygous missense mutation (c.956C>T; p.(Ser319Phe)) in the affected individual. This mutation affects a highly conserved residue located in the same functional domain as the previously characterised mutation p.(Arg316Gln). Biochemical studies reveal that p.(Ser319Phe) FTO has reduced 2-oxoglutarate turnover and N-methyl-nucleoside demethylase activity. Our findings are consistent with previous reports that homozygous mutations in FTO can lead to rare growth retardation and developmental delay syndrome, and further support the proposal that FTO plays an important role in early development of human central nervous and cardiovascular systems. 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/

Cholinergic depletion in nucleus accumbens impairs mesocortical dopamine activation and cognitive function in rats.

PubMed

Laplante, François; Zhang, Zi-Wei; Huppé-Gourgues, Frédéric; Dufresne, Marc M; Vaucher, Elvire; Sullivan, Ron M

2012-11-01

In rats, selective depletion of the cholinergic interneurons in the ventral striatum (nucleus accumbens or N.Acc.) results in heightened behavioural sensitivity to amphetamine and impaired sensorimotor gating processes, suggesting a hyper-responsiveness to dopamine (DA) activity in the N.Acc. We hypothesized that local cholinergic depletion may also trigger distal functional alterations, particularly in prefrontal cortex (PFC). Adult male Sprague-Dawley rats were injected bilaterally in the N.Acc. with an immunotoxin targeting choline acetyltransferase. Two weeks later, cognitive function was assessed using the delayed alternation paradigm in the T-maze. The rats were then implanted with voltammetric recording electrodes in the ventromedial PFC to measure in vivo extracellular DA release in response to mild tail pinch stress. The PFC was also examined for density of tyrosine hydroxylase (TH)-labelled varicosities. In another cohort of control and lesioned rats, we measured post mortem tissue content of DA. Depletion of cholinergic neurons (restricted to N.Acc.) significantly impaired delayed alternation performance across delay intervals. While (basal) post mortem indices of PFC DA function were unaffected by N.Acc. lesions, in vivo mesocortical DA activation was markedly reduced; this deficit correlated significantly with cognitive impairments. TH-labelled varicosities however, were unaffected in cortical layer V relative to controls. These data suggest that selective depletion of cholinergic interneurons in N.Acc. triggers widespread functional impairments in mesocorticolimbic DA function and cognition. The possible relevance of these findings is also discussed in relation to schizophrenia, where reduced density of cholinergic neurons in ventral striatum has been reported. Copyright © 2012 Elsevier Ltd. All rights reserved.

Effectiveness of travel restrictions in the rapid containment of human influenza: a systematic review.

PubMed

Mateus, Ana L P; Otete, Harmony E; Beck, Charles R; Dolan, Gayle P; Nguyen-Van-Tam, Jonathan S

2014-12-01

To assess the effectiveness of internal and international travel restrictions in the rapid containment of influenza. We conducted a systematic review according to the requirements of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Health-care databases and grey literature were searched and screened for records published before May 2014. Data extraction and assessments of risk of bias were undertaken by two researchers independently. Results were synthesized in a narrative form. The overall risk of bias in the 23 included studies was low to moderate. Internal travel restrictions and international border restrictions delayed the spread of influenza epidemics by one week and two months, respectively. International travel restrictions delayed the spread and peak of epidemics by periods varying between a few days and four months. Travel restrictions reduced the incidence of new cases by less than 3%. Impact was reduced when restrictions were implemented more than six weeks after the notification of epidemics or when the level of transmissibility was high. Travel restrictions would have minimal impact in urban centres with dense populations and travel networks. We found no evidence that travel restrictions would contain influenza within a defined geographical area. Extensive travel restrictions may delay the dissemination of influenza but cannot prevent it. The evidence does not support travel restrictions as an isolated intervention for the rapid containment of influenza. Travel restrictions would make an extremely limited contribution to any policy for rapid containment of influenza at source during the first emergence of a pandemic virus.

Effectiveness of travel restrictions in the rapid containment of human influenza: a systematic review

PubMed Central

Mateus, Ana LP; Otete, Harmony E; Beck, Charles R; Dolan, Gayle P; Nguyen-Van-Tam, Jonathan S

2014-01-01

Abstract Objective To assess the effectiveness of internal and international travel restrictions in the rapid containment of influenza. Methods We conducted a systematic review according to the requirements of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Health-care databases and grey literature were searched and screened for records published before May 2014. Data extraction and assessments of risk of bias were undertaken by two researchers independently. Results were synthesized in a narrative form. Findings The overall risk of bias in the 23 included studies was low to moderate. Internal travel restrictions and international border restrictions delayed the spread of influenza epidemics by one week and two months, respectively. International travel restrictions delayed the spread and peak of epidemics by periods varying between a few days and four months. Travel restrictions reduced the incidence of new cases by less than 3%. Impact was reduced when restrictions were implemented more than six weeks after the notification of epidemics or when the level of transmissibility was high. Travel restrictions would have minimal impact in urban centres with dense populations and travel networks. We found no evidence that travel restrictions would contain influenza within a defined geographical area. Conclusion Extensive travel restrictions may delay the dissemination of influenza but cannot prevent it. The evidence does not support travel restrictions as an isolated intervention for the rapid containment of influenza. Travel restrictions would make an extremely limited contribution to any policy for rapid containment of influenza at source during the first emergence of a pandemic virus. PMID:25552771

Genetic studies in a patient with X-linked retinoschisis coexisting with developmental delay and sensorineural hearing loss.

PubMed

Sudha, Dhandayuthapani; Patric, Irene Rosita Pia; Ganapathy, Aparna; Agarwal, Smitha; Krishna, Shuba; Neriyanuri, Srividya; Sripriya, Sarangapani; Sen, Parveen; Chidambaram, Subbulakshmi; Arunachalam, Jayamuruga Pandian

2017-01-01

In this study, we present a juvenile retinoschisis patient with developmental delay, sensorineural hearing loss, and reduced axial tone. X-linked juvenile retinoschisis (XLRS) is a retinal dystrophy, most often not associated with systemic anomalies and also not showing any locus heterogeneity. Therefore it was of interest to understand the genetic basis of the condition in this patient. RS1 gene screening for XLRS was performed by Sanger sequencing. Whole genome SNP 6.0 array analysis was carried out to investigate gross chromosomal aberrations that could result in systemic phenotype. In addition, targeted next generation sequencing (NGS) was employed to determine any possible involvement of X-linked syndromic and non-syndromic mental retardation genes. This NGS panel consisted of 550 genes implicated in several other rare inherited diseases. RS1 gene screening revealed a pathogenic hemizygous splice site mutation (c.78+1G>T), inherited from the mother. SNP 6.0 array analysis did not indicate any significant chromosomal aberrations that could be disease-associated. Targeted resequencing did not identify any mutations in the X-linked mental retardation genes. However, variations in three other genes (NSD1, LARGE, and POLG) were detected, which were all inherited from the patient's unaffected father. Taken together, RS1 mutation was found to segregate with retinoschisis phenotype while none of the other identified variations were co-segregating with the systemic defects. Hereby, we infer that the multisystemic defects harbored by the patient are a rare coexistence of XLRS, developmental delay, sensorineural hearing loss, and reduced axial tone reported for the first time in the literature.

Reconciling Estimates of the Value to Firms of Reduced Regulatory Delay in the Marketing of Their New Drugs.

PubMed

Wilmoth, Daniel R

2015-12-01

The prescription drug user fee program provides additional resources to the U.S. Food and Drug Administration at the expense of regulated firms. Those resources accelerate the review of new drugs. Faster approvals allow firms to realize profits sooner, and the program is supported politically by industry. However, published estimates of the value to firms of reduced regulatory delay vary dramatically. It is shown here that this variation is driven largely by differences in methods that correspond to differences in implicit assumptions about the effects of reduced delay. Theoretical modeling is used to derive an equation describing the relationship between estimates generated using different methods. The method likely to yield the most accurate results is identified. A reconciliation of published estimates yields a value to a firm for a one-year reduction in regulatory delay at the time of approval of about $60 million for a typical drug. Published 2015. This article is a U.S. Government work and is in the public domain in the U.S.A. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

Deficiency in Monocarboxylate Transporter 1 (MCT1) in Mice Delays Regeneration of Peripheral Nerves following Sciatic Nerve Crush

PubMed Central

Morrison, Brett M.; Tsingalia, Akivaga; Vidensky, Svetlana; Lee, Youngjin; Jin, Lin; Farah, Mohamed H.; Lengacher, Sylvain; Magistretti, Pierre J.; Pellerin, Luc; Rothstein, Jeffrey D.

2014-01-01

Peripheral nerve regeneration following injury occurs spontaneously, but many of the processes require metabolic energy. The mechanism of energy supply to axons has not previously been determined. In the central nervous system, monocarboxylate transporter 1 (MCT1), expressed in oligodendroglia, is critical for supplying lactate or other energy metabolites to axons. In the current study, MCT1 is shown to localize within the peripheral nervous system to perineurial cells, dorsal root ganglion neurons, and Schwann cells by MCT1 immunofluorescence and MCT1 tdTomato BAC reporter mice. To investigate whether MCT1 is necessary for peripheral nerve regeneration, sciatic nerves in MCT1 heterozygous null mice are crushed and peripheral nerve regeneration quantified electrophysiologically and anatomically. Compound muscle action potential (CMAP) recovery is delayed from a median of 21 days in wild-type mice to greater than 38 days in MCT1 heterozygote null mice. In fact, half of the MCT1 heterozygote null mice have no recovery of CMAP at 42 days, while all of the wild-type mice recovered. In addition, muscle fibers remain 40% more atrophic and neuromuscular junctions 40% more denervated at 42 days post-crush in the MCT1 heterozygote null mice than wild-type mice. The delay in nerve regeneration is not only in motor axons, as the number of regenerated axons in the sural sensory nerve of MCT1 heterozygote null mice at 4 weeks and tibial mixed sensory and motor nerve at 3 weeks is also significantly reduced compared to wild-type mice. This delay in regeneration may be partly through failed Schwann cell function, as there is reduced early phagocytosis of myelin debris and remyelination of axon segments. These data for the first time demonstrate that MCT1 is critical for regeneration of both sensory and motor axons in mice following sciatic nerve crush. PMID:25447940

Deficiency in monocarboxylate transporter 1 (MCT1) in mice delays regeneration of peripheral nerves following sciatic nerve crush.

PubMed

Morrison, Brett M; Tsingalia, Akivaga; Vidensky, Svetlana; Lee, Youngjin; Jin, Lin; Farah, Mohamed H; Lengacher, Sylvain; Magistretti, Pierre J; Pellerin, Luc; Rothstein, Jeffrey D

2015-01-01

Peripheral nerve regeneration following injury occurs spontaneously, but many of the processes require metabolic energy. The mechanism of energy supply to axons has not previously been determined. In the central nervous system, monocarboxylate transporter 1 (MCT1), expressed in oligodendroglia, is critical for supplying lactate or other energy metabolites to axons. In the current study, MCT1 is shown to localize within the peripheral nervous system to perineurial cells, dorsal root ganglion neurons, and Schwann cells by MCT1 immunofluorescence in wild-type mice and tdTomato fluorescence in MCT1 BAC reporter mice. To investigate whether MCT1 is necessary for peripheral nerve regeneration, sciatic nerves of MCT1 heterozygous null mice are crushed and peripheral nerve regeneration was quantified electrophysiologically and anatomically. Compound muscle action potential (CMAP) recovery is delayed from a median of 21 days in wild-type mice to greater than 38 days in MCT1 heterozygote null mice. In fact, half of the MCT1 heterozygote null mice have no recovery of CMAP at 42 days, while all of the wild-type mice recovered. In addition, muscle fibers remain 40% more atrophic and neuromuscular junctions 40% more denervated at 42 days post-crush in the MCT1 heterozygote null mice than wild-type mice. The delay in nerve regeneration is not only in motor axons, as the number of regenerated axons in the sural sensory nerve of MCT1 heterozygote null mice at 4 weeks and tibial mixed sensory and motor nerve at 3 weeks is also significantly reduced compared to wild-type mice. This delay in regeneration may be partly due to failed Schwann cell function, as there is reduced early phagocytosis of myelin debris and remyelination of axon segments. These data for the first time demonstrate that MCT1 is critical for regeneration of both sensory and motor axons in mice following sciatic nerve crush. Copyright © 2014 Elsevier Inc. All rights reserved.

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

NASA Astrophysics Data System (ADS)

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

2018-02-01

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

Effects of diet and host access on fecundity and lifespan in two fruit fly species with different life history patterns

PubMed Central

Harwood, James F.; Chen, Kehui; Müller, Hans-Georg; Wang, Jane-Ling; Vargas, Roger I.; Carey, James R.

2013-01-01

The reproductive ability of female tephritids can be limited and prevented by denying access to host plants and restricting the dietary precursors of vitellogenesis. The mechanisms underlying the delayed egg production in each case are initiated by different physiological processes that are anticipated to have dissimilar effects on lifespan and reproductive ability later in life. The egg laying abilities of laboratory reared females of the Mediterranean fruit fly (Ceratitis capitata Wiedmann) and melon fly (Bactrocera cucurbitae Coquillett) from Hawaii are delayed or suppressed by limiting access to host fruits and dietary protein. In each case, this is expected to prevent the loss of lifespan associated with reproduction until protein or hosts are introduced. Two trends are observed in each species: Firstly, access to protein at eclosion leads to a greater probability of survival and higher reproductive ability than if it is delayed, and secondly, that delayed host access reduces lifetime reproductive ability without improving life expectancy. When host access and protein availability are delayed, the rate of reproductive senescence is reduced in the medfly, whereas the rate of reproductive senescence is generally increased in the melon fly. Overall, delaying reproduction lowers the fitness of females by constraining their fecundity for the remainder of the lifespan without extending the lifespan. PMID:23483775

An assessment of alternatives to the Eichleay formula for unabsorbed overhead in delay claims : final report.

DOT National Transportation Integrated Search

1988-01-01

This report presents an assessment of the accuracy of alternatives available to calculate unabsorbed overhead in construction delay claims submitted by contractors. It reviews the alternatives available, concludes that the Eichleay method, used by ma...

Infection of male rats with Toxoplasma gondii induces effort-aversion in a T-maze decision-making task.

PubMed

Tan, Donna; Vyas, Ajai

2016-03-01

Rats chronically infected with protozoan Toxoplasma gondii exhibit greater delay aversion in an inter-temporal task. Moreover T. gondii infection also results in dendritic atrophy of basolateral amygdala neurons. Basolateral amygdala is reported to bias decision making towards greater effortful alternatives. In this context, we report that T. gondii increases effort aversion in infected male rats. This host-parasite association has been widely studied in the context of loss of innate fear in the infected males. It is suggested that reduced fear towards predators reflects a parasitic behavioral manipulation to enhance trophic transmission of T. gondii. Observations reported here extend this paradigm away from a monolithic change in fear and towards a multi-dimensional change in decision making. Copyright © 2016 Elsevier Inc. All rights reserved.

Two vicious circles contributing to a diagnostic delay for tuberculosis patients in Arkhangelsk

PubMed Central

Kuznetsov, Vladimir N.; Grjibovski, Andrej M.; Mariandyshev, Andrej O.; Johansson, Eva; Bjune, Gunnar A.

2014-01-01

Setting Delay in tuberculosis (TB) diagnosis increases the infectious pool in the community and the risk of development of resistance of mycobacteria, which results in an increased number of deaths. Objective To describe patients’ and doctors’ perceptions of diagnostic delay in TB patients in the Arkhangelsk region and to develop a substantive model to better understand the mechanisms of how these delays are linked to each other. Design A grounded theory approach was used to study the phenomenon of diagnostic delay. Patients with TB diagnostic delay and doctors–phthisiatricians were interviewed. Results A model named ‘sickness trajectory in health-seeking behaviour among tuberculosis patients’ was developed and included two core categories describing two vicious circles of diagnostic delay in patients with TB: ‘limited awareness of the importance to contact the health system’ and ‘limited resources of the health system’ and the categories: ‘factors influencing health-seeking behaviour’ and ‘factors influencing the health system effectiveness’. Men were more likely to report patient delay, while women were more likely to report health system delay. Conclusions To involve people in early medical examinations, it is necessary to increase alertness on TB among patients and to improve health systems in the districts. PMID:25163673

An auditory cue-depreciation effect.

PubMed

Gibson, J M; Watkins, M J

1991-01-01

An experiment is reported in which subjects first heard a list of words and then tried to identify these same words from degraded utterances. Paralleling previous findings in the visual modality, the probability of identifying a given utterance was reduced when the utterance was immediately preceded by other, more degraded, utterances of the same word. A second experiment replicated this "cue-depreciation effect" and in addition found the effect to be weakened, if not eliminated, when the target word was not included in the initial list or when the test was delayed by two days.

Assisted Writing in Spin Transfer Torque Magnetic Tunnel Junctions

NASA Astrophysics Data System (ADS)

Ganguly, Samiran; Ahmed, Zeeshan; Datta, Supriyo; Marinero, Ernesto E.

2015-03-01

Spin transfer torque driven MRAM devices are now in an advanced state of development, and the importance of reducing the current requirement for writing information is well recognized. Different approaches to assist the writing process have been proposed such as spin orbit torque, spin Hall effect, voltage controlled magnetic anisotropy and thermal excitation. In this work,we report on our comparative study using the Spin-Circuit Approach regarding the total energy, the switching speed and energy-delay products for different assisted writing approaches in STT-MTJ devices using PMA magnets.

Inadequacies of Physical Examination as a Cause of Medical Errors and Adverse Events: A Collection of Vignettes.

PubMed

Verghese, Abraham; Charlton, Blake; Kassirer, Jerome P; Ramsey, Meghan; Ioannidis, John P A

2015-12-01

Oversights in the physical examination are a type of medical error not easily studied by chart review. They may be a major contributor to missed or delayed diagnosis, unnecessary exposure to contrast and radiation, incorrect treatment, and other adverse consequences. Our purpose was to collect vignettes of physical examination oversights and to capture the diversity of their characteristics and consequences. A cross-sectional study using an 11-question qualitative survey for physicians was distributed electronically, with data collected from February to June of 2011. The participants were all physicians responding to e-mail or social media invitations to complete the survey. There were no limitations on geography, specialty, or practice setting. Of the 208 reported vignettes that met inclusion criteria, the oversight was caused by a failure to perform the physical examination in 63%; 14% reported that the correct physical examination sign was elicited but misinterpreted, whereas 11% reported that the relevant sign was missed or not sought. Consequence of the physical examination inadequacy included missed or delayed diagnosis in 76% of cases, incorrect diagnosis in 27%, unnecessary treatment in 18%, no or delayed treatment in 42%, unnecessary diagnostic cost in 25%, unnecessary exposure to radiation or contrast in 17%, and complications caused by treatments in 4%. The mode of the number of physicians missing the finding was 2, but many oversights were missed by many physicians. Most oversights took up to 5 days to identify, but 66 took longer. Special attention and skill in examining the skin and its appendages, as well as the abdomen, groin, and genitourinary area could reduce the reported oversights by half. Physical examination inadequacies are a preventable source of medical error, and adverse events are caused mostly by failure to perform the relevant examination. Copyright © 2015 Elsevier Inc. All rights reserved.

Delay, doubt, and decision: how delaying a choice reduces the appeal of (descriptively) normative options.

PubMed

van de Ven, Niels; Gilovich, Thomas; Zeelenberg, Marcel

2010-04-01

To help explain a regularity in democratic elections, we examined whether choosing to delay making a choice between a focal option and an alternative tends to make people subsequently less likely to choose what they would otherwise have chosen. The results of two experiments demonstrated that participants who were induced to delay making a decision were indeed less likely to choose the descriptively normative option. An additional experiment that primed a sense of doubt in participants provided support for a self-perception account of this result. Electing to delay making a choice is interpreted as an indication of doubt--doubt that tends to be attributed to the most prominent option. Delay-induced doubt about the normative option makes it less likely to be selected.

Delayed pan-hypopituitarism as a complication following endovascular treatment of bilateral internal carotid artery aneurysms. A case report and review.

PubMed

Hall, Jonathan; Caputo, Carmela; Chung, Carlos; Holt, Michael; Wang, Yi Yuen

2015-04-01

Pan-hypopituitarism has been reported in patients who are subsequently found to have a cerebral aneurysm and there have been reports of pituitary dysfunction immediately following both surgical and endovascular treatment. The authors report a rare case of delayed pan-hypopituitarism following endovascular treatment of bilateral internal carotid artery aneurysms with coil embolisation and flow-diverting stents.

Single Agent Polysaccharopeptide Delays Metastases and Improves Survival in Naturally Occurring Hemangiosarcoma

PubMed Central

Brown, Dorothy Cimino; Reetz, Jennifer

2012-01-01

The 2008 World Health Organization World Cancer Report describes global cancer incidence soaring with many patients living in countries that lack resources for cancer control. Alternative treatment strategies that can reduce the global disease burden at manageable costs must be developed. Polysaccharopeptide (PSP) is the bioactive agent from the mushroom Coriolus versicolor. Studies indicate PSP has in vitro antitumor activities and inhibits the growth of induced tumors in animal models. Clear evidence of clinically relevant benefits of PSP in cancer patients, however, is lacking. The investment of resources required to complete large-scale, randomized controlled trials of PSP in cancer patients is more easily justified if antitumor and survival benefits are documented in a complex animal model of a naturally occurring cancer that parallels human disease. Because of its high metastatic rate and vascular origin, canine hemangiosarcoma is used for investigations in antimetastatic and antiangiogenic therapies. In this double-blind randomized multidose pilot study, high-dose PSP significantly delayed the progression of metastases and afforded the longest survival times reported in canine hemangiosarcoma. These data suggest that, for those cancer patients for whom advanced treatments are not accessible, PSP as a single agent might offer significant improvements in morbidity and mortality. PMID:22988473

Factors associated with delayed diagnosis of mood and/or anxiety disorders

PubMed Central

Ricky, Cheung; Siobhan, O’Donnell; Nawaf, Madi; Elliot M., Goldner

2017-01-01

Abstract Introduction: This study examined the association between time to diagnosis and sociodemographic and clinical characteristics as well as time to diagnosis and physical and mental health status, among Canadian adults with a self-reported mood and/or anxiety disorder diagnosis. Methods: We used data from the 2014 Survey on Living with Chronic Diseases in Canada—Mood and Anxiety Disorders Component. The study sample (n=3212) was divided into three time to diagnosis subgroups: long (> 5 years), moderate (1–5 years) and short (< 1 year). We performed descriptive and multinomial multivariate logistic regression analyses. Estimates were weighted to represent the Canadian adult household population living in the 10 provinces with diagnosed mood and/or anxiety disorders. Results: The majority (61.6%) of Canadians with a mood and/or anxiety disorder diagnosis reported having received their diagnosis more than one year after symptom onset (30.0% reported a moderate delay and 31.6% a long delay). Upon controlling for individual characteristics, we found significant associations between a moderate delay and having no or few physical comorbidities; a long delay and older age; and both moderate and long delays and early age of symptom onset. In addition, a long delay was significantly associated with “poor” or “fair” perceived mental health and the greatest number of activity limitations. Conclusion: These findings affirm that a long delay in diagnosis is associated with negative health outcomes among Canadian adults with mood and/or anxiety disorders. Time to diagnosis is particularly suboptimal among older adults and people with early symptom onset. Tailored strategies to facilitate an early diagnosis for those at greatest risk of a delayed diagnosis, especially for those with early symptom onset, are needed. PMID:28493658

Permutation entropy with vector embedding delays

NASA Astrophysics Data System (ADS)

Little, Douglas J.; Kane, Deb M.

2017-12-01

Permutation entropy (PE) is a statistic used widely for the detection of structure within a time series. Embedding delay times at which the PE is reduced are characteristic timescales for which such structure exists. Here, a generalized scheme is investigated where embedding delays are represented by vectors rather than scalars, permitting PE to be calculated over a (D -1 ) -dimensional space, where D is the embedding dimension. This scheme is applied to numerically generated noise, sine wave and logistic map series, and experimental data sets taken from a vertical-cavity surface emitting laser exhibiting temporally localized pulse structures within the round-trip time of the laser cavity. Results are visualized as PE maps as a function of embedding delay, with low PE values indicating combinations of embedding delays where correlation structure is present. It is demonstrated that vector embedding delays enable identification of structure that is ambiguous or masked, when the embedding delay is constrained to scalar form.

The effect of reinforcer magnitude on probability and delay discounting of experienced outcomes in a computer game task in humans.

PubMed

Greenhow, Anna K; Hunt, Maree J; Macaskill, Anne C; Harper, David N

2015-09-01

Delay and uncertainty of receipt both reduce the subjective value of reinforcers. Delay has a greater impact on the subjective value of smaller reinforcers than of larger ones while the reverse is true for uncertainty. We investigated the effect of reinforcer magnitude on discounting of delayed and uncertain reinforcers using a novel approach: embedding relevant choices within a computer game. Participants made repeated choices between smaller, certain, immediate outcomes and larger, but delayed or uncertain outcomes while experiencing the result of each choice. Participants' choices were generally well described by the hyperbolic discounting function. Smaller numbers of points were discounted more steeply than larger numbers as a function of delay but not probability. The novel experiential choice task described is a promising approach to investigating both delay and probability discounting in humans. © Society for the Experimental Analysis of Behavior.

Noninvasive, automatic optimization strategy in cardiac resynchronization therapy.

PubMed

Reumann, Matthias; Osswald, Brigitte; Doessel, Olaf

2007-07-01

Optimization of cardiac resynchronization therapy (CRT) is still unsolved. It has been shown that optimal electrode position,atrioventricular (AV) and interventricular (VV) delays improve the success of CRT and reduce the number of non-responders. However, no automatic, noninvasive optimization strategy exists to date. Cardiac resynchronization therapy was simulated on the Visible Man and a patient data-set including fiber orientation and ventricular heterogeneity. A cellular automaton was used for fast computation of ventricular excitation. An AV block and a left bundle branch block were simulated with 100%, 80% and 60% interventricular conduction velocity. A right apical and 12 left ventricular lead positions were set. Sequential optimization and optimization with the downhill simplex algorithm (DSA) were carried out. The minimal error between isochrones of the physiologic excitation and the therapy was computed automatically and leads to an optimal lead position and timing. Up to 1512 simulations were carried out per pathology per patient. One simulation took 4 minutes on an Apple Macintosh 2 GHz PowerPC G5. For each electrode pair an optimal pacemaker delay was found. The DSA reduced the number of simulations by an order of magnitude and the AV-delay and VV - delay were determined with a much higher resolution. The findings are well comparable with clinical studies. The presented computer model of CRT automatically evaluates an optimal lead position and AV-delay and VV-delay, which can be used to noninvasively plan an optimal therapy for an individual patient. The application of the DSA reduces the simulation time so that the strategy is suitable for pre-operative planning in clinical routine. Future work will focus on clinical evaluation of the computer models and integration of patient data for individualized therapy planning and optimization.

Neuregulin-1 is neuroprotective in a rat model of organophosphate-induced delayed neuronal injury

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

Li, Yonggang; Lein, Pamela J.; Liu, Cuimei

2012-07-15

Current medical countermeasures against organophosphate (OP) nerve agents are effective in reducing mortality, but do not sufficiently protect the CNS from delayed brain damage and persistent neurological symptoms. In this study, we examined the efficacy of neuregulin-1 (NRG-1) in protecting against delayed neuronal cell death following acute intoxication with the OP diisopropylflurophosphate (DFP). Adult male Sprague–Dawley rats were pretreated with pyridostigmine (0.1 mg/kg BW, i.m.) and atropine methylnitrate (20 mg/kg BW, i.m.) prior to DFP (9 mg/kg BW, i.p.) intoxication to increase survival and reduce peripheral signs of cholinergic toxicity but not prevent DFP-induced seizures or delayed neuronal injury. Pretreatmentmore » with NRG-1 did not protect against seizures in rats exposed to DFP. However, neuronal injury was significantly reduced in most brain regions by pretreatment with NRG-1 isoforms NRG-EGF (3.2 μg/kg BW, i.a) or NRG-GGF2 (48 μg/kg BW, i.a.) as determined by FluroJade-B labeling in multiple brain regions at 24 h post-DFP injection. NRG-1 also blocked apoptosis and oxidative stress-mediated protein damage in the brains of DFP-intoxicated rats. Administration of NRG-1 at 1 h after DFP injection similarly provided significant neuroprotection against delayed neuronal injury. These findings identify NRG-1 as a promising adjuvant therapy to current medical countermeasures for enhancing neuroprotection against acute OP intoxication. -- Highlights: ► NRG-1 blocked DFP induced neuronal injury. ► NRG-1 did not protect against seizures in rats exposed to DFP. ► NRG-1 blocked apoptosis and oxidative stress in the brains of DFP-intoxicated rats. ► Administration of NRG-1 at 1 h after DFP injection prevented delayed neuronal injury.« less

Investigation of impulsivity in binge-eating rats in a delay-discounting task and its prevention by the d-amphetamine prodrug, lisdexamfetamine.

PubMed

Vickers, Steven P; Goddard, Simon; Brammer, Richard J; Hutson, Peter H; Heal, David J

2017-06-01

Freely-fed, female, rats were trained in a two-lever, delay-discounting task: one lever delivered a single chocolate-flavoured pellet immediately and the other a three-pellet reward after increasing delay (0, 4, 8, 16, 32 s). Rats were divided into two groups (i.e. binge-eating rats given irregular, limited access to chocolate in addition to normal chow and controls maintained on normal chow). Both groups exhibited increased preference for the immediate reward as the delay interval was lengthened. The discounting rate was significantly greater in binge-eating rats than non-binge-eating controls, especially as the behaviour became more established indicating that increased impulsivity and intolerance of delayed reward are part of the psychopathology of binge-eating. Lisdexamfetamine (0.8 mg/kg, orally ( d-amphetamine base)) reversed the reduced preference of binge-eating rats for larger rewards at delay intervals of 4 s, 8 s and 32 s and across all sessions. Lisdexamfetamine-treated binge-eating rats consumed the same number of pellets as vehicle-treated, binge-eating rats and non-binge-eating controls eliminating the possibility lisdexamfetamine's actions on appetite or satiety mediated its effects on operant responding for food pellets in delay-discounting. In summary, binge-eating rats showed increased impulsive choice compared with non-binge-eating controls that was reversed by lisdexamfetamine, complementing results showing lisdexamfetamine reduced impulsiveness scores in patients with binge-eating disorder.

Improved result on stability analysis of discrete stochastic neural networks with time delay

NASA Astrophysics Data System (ADS)

Wu, Zhengguang; Su, Hongye; Chu, Jian; Zhou, Wuneng

2009-04-01

This Letter investigates the problem of exponential stability for discrete stochastic time-delay neural networks. By defining a novel Lyapunov functional, an improved delay-dependent exponential stability criterion is established in terms of linear matrix inequality (LMI) approach. Meanwhile, the computational complexity of the newly established stability condition is reduced because less variables are involved. Numerical example is given to illustrate the effectiveness and the benefits of the proposed method.

Dynamic Resource Allocation and Access Class Barring Scheme for Delay-Sensitive Devices in Machine to Machine (M2M) Communications.

PubMed

Li, Ning; Cao, Chao; Wang, Cong

2017-06-15

Supporting simultaneous access of machine-type devices is a critical challenge in machine-to-machine (M2M) communications. In this paper, we propose an optimal scheme to dynamically adjust the Access Class Barring (ACB) factor and the number of random access channel (RACH) resources for clustered machine-to-machine (M2M) communications, in which Delay-Sensitive (DS) devices coexist with Delay-Tolerant (DT) ones. In M2M communications, since delay-sensitive devices share random access resources with delay-tolerant devices, reducing the resources consumed by delay-sensitive devices means that there will be more resources available to delay-tolerant ones. Our goal is to optimize the random access scheme, which can not only satisfy the requirements of delay-sensitive devices, but also take the communication quality of delay-tolerant ones into consideration. We discuss this problem from the perspective of delay-sensitive services by adjusting the resource allocation and ACB scheme for these devices dynamically. Simulation results show that our proposed scheme realizes good performance in satisfying the delay-sensitive services as well as increasing the utilization rate of the random access resources allocated to them.

Characteristics and Causes for Non-Accrued Clinical Research (NACR) at an Academic Medical Institution

PubMed Central

Tice, Debra G.; Carroll, Kelly A.; Bhatt, Karishma H.; Belknap, Steven M.; Mai, David; Gipson, Heather J.; West, Dennis P.

2013-01-01

Background The impact of non-accrued clinical research (NACR) represents an important economic burden that is under consideration as the U.S. Department of Health and Human Services looks into reforming the regulations governing IRB review. NACR refers to clinical research projects that fail to enroll subjects. A delineation of the issues surrounding NACR is expected to enhance subject accrual and to minimize occurrence of NACR. The authors assessed demographics, characteristics, and reasons for NACR at an academic medical center, including time trends, funding source, research team (principal investigator, department), IRB resource utilization (IRB level of review, number of required IRB reviews, initial IRB turn-around time, and duration of NACR). Methods The authors analyzed data from 848 clinical research study closures during 2010 and 2011 to determine proportion, incidence, and characteristics of NACR. Studies with subject enrollment during the same time period were used as a comparative measure. Results Data from 704 (83.0%) study closures reported enrollment of 1 or more subjects while 144 (17.0 %) reported NACR (zero enrollment). PI-reported reasons for NACR included: 32 (22.2%) contract or funding issues; 43 (30.0%) insufficient study-dedicated resources; 41 (28.4%) recruitment issues; 17 (11.8%) sponsor-initiated study closure and 11 (7.6%) were “other/reason unreported”. Conclusions NACR is not uncommon, affecting about one in six clinical research projects in the study population and reported to be more common in some other institutions. The complex and fluid nature of research conduct, non-realistic enrollment goals, and delays in both the approval and/or accrual processes contribute to NACR. Results suggest some simple strategies that investigators and institutions may use to reduce NACR, including careful feasibility assessment, reduction of institutional delays, and prompt initiation of subject accrual for multi-center studies using competitive enrollment. Institutional action to support investigators in the conduct clinical research is also encouraged to reduce likelihood of NACR. PMID:23671544

Characteristics and Causes for Non-Accrued Clinical Research (NACR) at an Academic Medical Institution.

PubMed

Tice, Debra G; Carroll, Kelly A; Bhatt, Karishma H; Belknap, Steven M; Mai, David; Gipson, Heather J; West, Dennis P

2013-06-01

The impact of non-accrued clinical research (NACR) represents an important economic burden that is under consideration as the U.S. Department of Health and Human Services looks into reforming the regulations governing IRB review. NACR refers to clinical research projects that fail to enroll subjects. A delineation of the issues surrounding NACR is expected to enhance subject accrual and to minimize occurrence of NACR. The authors assessed demographics, characteristics, and reasons for NACR at an academic medical center, including time trends, funding source, research team (principal investigator, department), IRB resource utilization (IRB level of review, number of required IRB reviews, initial IRB turn-around time, and duration of NACR). The authors analyzed data from 848 clinical research study closures during 2010 and 2011 to determine proportion, incidence, and characteristics of NACR. Studies with subject enrollment during the same time period were used as a comparative measure. Data from 704 (83.0%) study closures reported enrollment of 1 or more subjects while 144 (17.0 %) reported NACR (zero enrollment). PI-reported reasons for NACR included: 32 (22.2%) contract or funding issues; 43 (30.0%) insufficient study-dedicated resources; 41 (28.4%) recruitment issues; 17 (11.8%) sponsor-initiated study closure and 11 (7.6%) were "other/reason unreported". NACR is not uncommon, affecting about one in six clinical research projects in the study population and reported to be more common in some other institutions. The complex and fluid nature of research conduct, non-realistic enrollment goals, and delays in both the approval and/or accrual processes contribute to NACR. Results suggest some simple strategies that investigators and institutions may use to reduce NACR, including careful feasibility assessment, reduction of institutional delays, and prompt initiation of subject accrual for multi-center studies using competitive enrollment. Institutional action to support investigators in the conduct clinical research is also encouraged to reduce likelihood of NACR.

The cost of construction delays and traffic control for life-cycle cost analysis of pavements

DOT National Transportation Integrated Search

2002-03-01

The objective of this report is to provide the Kentucky Transportation Cabinet a reliable approach to quantifying/calculating "Road User Cost"--often referred to as total user delay costs. To meet this objective, this report is divided into three mai...

Predictors of delay in heart failure patients and consequences for outcomes.

PubMed

Sethares, Kristen A; Chin, Elizabeth; Jurgens, Corrine Y

2015-02-01

Persons with heart failure (HF) symptoms delay up to 7 days before seeking treatment. Delay can result in worse symptoms and potentially impact outcomes. The purpose of this review was to describe predictors and outcomes of delay in HF patients. Demographic factors, increased symptom number, social factors, greater HF knowledge, lower anxiety, and depression predicted increased delay. HF patients had difficulty recognizing and interpreting symptoms of HF. Results are conflicting related to symptom pattern, time of care seeking, and history of HF as predictors of delay. The only outcome predicted by delay was length of stay with those delaying longer reporting longer lengths of stay. Future research related to delay should include theoretical frameworks and larger, more ethnically diverse samples from multiple sites and link delay to outcomes. Valid and reliable instruments are needed to measure delay and related factors. HF education should include supportive others.

Digital signal processor and processing method for GPS receivers

NASA Technical Reports Server (NTRS)

Thomas, Jr., Jess B. (Inventor)

1989-01-01

A digital signal processor and processing method therefor for use in receivers of the NAVSTAR/GLOBAL POSITIONING SYSTEM (GPS) employs a digital carrier down-converter, digital code correlator and digital tracking processor. The digital carrier down-converter and code correlator consists of an all-digital, minimum bit implementation that utilizes digital chip and phase advancers, providing exceptional control and accuracy in feedback phase and in feedback delay. Roundoff and commensurability errors can be reduced to extremely small values (e.g., less than 100 nanochips and 100 nanocycles roundoff errors and 0.1 millichip and 1 millicycle commensurability errors). The digital tracking processor bases the fast feedback for phase and for group delay in the C/A, P.sub.1, and P.sub.2 channels on the L.sub.1 C/A carrier phase thereby maintaining lock at lower signal-to-noise ratios, reducing errors in feedback delays, reducing the frequency of cycle slips and in some cases obviating the need for quadrature processing in the P channels. Simple and reliable methods are employed for data bit synchronization, data bit removal and cycle counting. Improved precision in averaged output delay values is provided by carrier-aided data-compression techniques. The signal processor employs purely digital operations in the sense that exactly the same carrier phase and group delay measurements are obtained, to the last decimal place, every time the same sampled data (i.e., exactly the same bits) are processed.

Dissecting delays in trauma care using corporate lean six sigma methodology.

PubMed

Parks, Jennifer K; Klein, Jorie; Frankel, Heidi L; Friese, Randall S; Shafi, Shahid

2008-11-01

The Institute of Medicine has identified trauma center overcrowding as a crisis. We applied corporate Lean Six Sigma methodology to reduce overcrowding by quantifying patient dwell times in trauma resuscitation units (TRU) and to identify opportunities for reducing them. TRU dwell time of all patients treated at a Level I trauma center were measured prospectively during a 3-month period (n = 1,184). Delays were defined as TRU dwell time >6 hours. Using personnel trained in corporate Lean Six Sigma methodology, we created a detailed process map of patient flow through our TRU and measured time spent at each step prospectively during a 24/7 week-long time study (n = 43). Patients with TRU dwell time below the median (3 hours) were compared with those with longer dwell times to identify opportunities for improvement. TRU delays occurred in 183 of 1,184 trauma patients (15%), and peaked on days with >15 patients or with presence of five simultaneous patients. However, 135 delays (74%) occurred on days when

Neuregulin-1 is Neuroprotective in a Rat Model of Organophosphate-Induced Delayed Neuronal Injury

PubMed Central

Li, Yonggang; Lein, Pamela J.; Liu, Cuimei; Bruun, Donald A.; Giulivi, Cecilia; Ford, Gregory; Tewolde, Teclemichael; Ross-Inta, Catherine; Ford, Byron D.

2012-01-01

Current medical countermeasures against organophosphate (OP) nerve agents are effective in reducing mortality, but do not sufficiently protect the CNS from delayed brain damage and persistent neurological symptoms. In this study, we examined the efficacy of neuregulin-1 (NRG-1) in protecting against delayed neuronal cell death following acute intoxication with the OP diisopropylfluorophosphate (DFP). Adult male Sprague Dawley rats were pretreated with pyridostigmine (0.1 mg/kg BW, i.m.) and atropine methylnitrate (20 mg/kg BW, i.m.) prior to DFP (9 mg/kg BW, i.p.) intoxication to increase survival and reduce peripheral signs of cholinergic toxicity but not prevent DFP-induced seizures or delayed neuronal injury. Pretreatment with NRG-1 did not protect against seizures in rats exposed to DFP. However, neuronal injury was significantly reduced in most brain regions by pretreatment with NRG-1 isoforms NRG-EGF (3.2 μg/kg BW, i.a) or NRG-GGF2 (48 μg/kg BW, i.a.) as determined by FluroJade-B labeling in multiple brain regions at 24 h post-DFP injection. NRG-1 also blocked apoptosis and oxidative stress-mediated protein damage in the brains of DFP-intoxicated rats. Administration of NRG-1 at 1 h after DFP injection similarly provided significant neuroprotection against delayed neuronal injury. These findings identify NRG-1 as a promising adjuvant therapy to current medical countermeasures for enhancing neuroprotection against acute OP intoxication. PMID:22583949

MMAPDNG: A new, fast code backed by a memory-mapped database for simulating delayed γ-ray emission with MCNPX package

NASA Astrophysics Data System (ADS)

Lou, Tak Pui; Ludewigt, Bernhard

2015-09-01

The simulation of the emission of beta-delayed gamma rays following nuclear fission and the calculation of time-dependent energy spectra is a computational challenge. The widely used radiation transport code MCNPX includes a delayed gamma-ray routine that is inefficient and not suitable for simulating complex problems. This paper describes the code "MMAPDNG" (Memory-Mapped Delayed Neutron and Gamma), an optimized delayed gamma module written in C, discusses usage and merits of the code, and presents results. The approach is based on storing required Fission Product Yield (FPY) data, decay data, and delayed particle data in a memory-mapped file. When compared to the original delayed gamma-ray code in MCNPX, memory utilization is reduced by two orders of magnitude and the ray sampling is sped up by three orders of magnitude. Other delayed particles such as neutrons and electrons can be implemented in future versions of MMAPDNG code using its existing framework.

Somatotropic Signaling: Trade-Offs Between Growth, Reproductive Development, and Longevity

PubMed Central

Sun, Liou Y.; Longo, Valter

2013-01-01

Growth hormone (GH) is a key determinant of postnatal growth and plays an important role in the control of metabolism and body composition. Surprisingly, deficiency in GH signaling delays aging and remarkably extends longevity in laboratory mice. In GH-deficient and GH-resistant animals, the “healthspan” is also extended with delays in cognitive decline and in the onset of age-related disease. The role of hormones homologous to insulin-like growth factor (IGF, an important mediator of GH actions) in the control of aging and lifespan is evolutionarily conserved from worms to mammals with some homologies extending to unicellular yeast. The combination of reduced GH, IGF-I, and insulin signaling likely contributes to extended longevity in GH or GH receptor-deficient organisms. Diminutive body size and reduced fecundity of GH-deficient and GH-resistant mice can be viewed as trade-offs for extended longevity. Mechanisms responsible for delayed aging of GH-related mutants include enhanced stress resistance and xenobiotic metabolism, reduced inflammation, improved insulin signaling, and various metabolic adjustments. Pathological excess of GH reduces life expectancy in men as well as in mice, and GH resistance or deficiency provides protection from major age-related diseases, including diabetes and cancer, in both species. However, there is yet no evidence of increased longevity in GH-resistant or GH-deficient humans, possibly due to non-age-related deaths. Results obtained in GH-related mutant mice provide striking examples of mutations of a single gene delaying aging, reducing age-related disease, and extending lifespan in a mammal and providing novel experimental systems for the study of mechanisms of aging. PMID:23589828

Terrestrial Planet Finder cryogenic delay line development

NASA Technical Reports Server (NTRS)

Smythe, Robert F.; Swain, Mark R.; Alvarez-Salazar, Oscar; Moore, James D.

2004-01-01

Delay lines provide the path-length compensation that makes the measurement of interference fringes possible. When used for nulling interferometry, the delay line must control path-lengths so that the null is stable and controlled throughout the measurement. We report on a low noise, low disturbance, and high bandwidth optical delay line capable of meeting the TPF interferometer optical path length control requirements at cryogenic temperatures.

The Effects of Short Interval Delay of Reinforcement Upon Human Discrimination Learning. IMRID Papers and Reports Vol. 4 No. 12.

ERIC Educational Resources Information Center

Kral, Paul A.; And Others

Investigates the effect of delay of reinforcement upon human discrimination learning with particular emphasis on the form of the gradient within the first few seconds of delay. In previous studies subjects are usually required to make an instrumental response to a stimulus, this is followed by the delay interval, and finally, the reinforcement…

A double-blind comparison of clebopride and placebo in dyspepsia secondary to delayed gastric emptying.

PubMed

Bavestrello, L; Caimi, L; Barbera, A

1985-01-01

Seventy-six patients suffering from dyspeptic symptoms secondary to roentgenologically demonstrated delayed gastric emptying were treated with clebopride (0.5 mg TID) or with placebo during a three-month double-blind trial. Clebopride was more effective (P less than or equal to 0.001) than placebo in reducing or relieving symptoms and roentgenological findings associated with delayed gastric emptying. No interactions of clebopride with concomitant drugs or coexisting disorders were observed, and the incidence of side effects was low. We conclude that clebopride will be beneficial in the management of patients with delayed gastric emptying.

System and method for adaptively deskewing parallel data signals relative to a clock

DOEpatents

Jenkins, Philip Nord; Cornett, Frank N.

2006-04-18

A system and method of reducing skew between a plurality of signals transmitted with a transmit clock is described. Skew is detected between the received transmit clock and each of received data signals. Delay is added to the clock or to one or more of the plurality of data signals to compensate for the detected skew. Each of the plurality of delayed signals is compared to a reference signal to detect changes in the skew. The delay added to each of the plurality of delayed signals is updated to adapt to changes in the detected skew.

Benefit Assessment of the Precision Departure Release Capability Concept

NASA Technical Reports Server (NTRS)

Palopo, Kee; Chatterji, Gano B.; Lee, Hak-Tae

2011-01-01

A Precision Departure Release Capability concept is being evaluated by both the National Aeronautics and Space Administration and the Federal Aviation Administration as part of a larger goal of improving throughput, efficiency and capacity in integrated departure, arrival and surface operations. The concept is believed to have the potential of increasing flight efficiency and throughput by avoiding missing assigned slots and minimizing speed increase or path stretch to recover the slot. The main thrust of the paper is determining the impact of early and late departures from the departure runway when an aircraft has a slot assigned either at a meter fix or at the arrival airport. Results reported in the paper are for two scenarios. The first scenario considers flights out of Dallas/Fort Worth destined for Hartsfield-Jackson International Airport in Atlanta flying through the Meridian meter-fix in the Memphis Center with miles-in-trail constraints. The second scenario considers flights destined to George Bush Intercontinental/Houston Airport with specified airport arrival rate constraint. Results show that delay reduction can be achieved by allowing reasonable speed changes in scheduling. It was determined that the traffic volume between Dallas/Fort Worth and Atlanta via the Meridian fix is low and the departures times are spread enough that large departure schedule uncertainty can be tolerated. Flights can depart early or late within 90 minutes without accruing much more delay due to miles-in-trail constraint at the Meridian fix. In the Houston scenario, 808 arrivals from 174 airports were considered. Results show that delay experienced by the 16 Dallas/Fort Worth departures is higher if initial schedules of the remaining 792 flights are kept unaltered while they are rescheduled. Analysis shows that the probability of getting the initially assigned slot back after perturbation and rescheduling decreases with increasing standard deviation of the departure delay distributions. Results show that most Houston arrivals can be expected to be on time based on the assumed zero-mean Normal departure delay distributions achievable by Precision Departure Release Capability. In the current system, airport-departure delay, which is the sum of gate-departure delay and taxi-out delay, is observed at the airports. This delay acts as a bias, which can be reduced by Precision Departure Release Capability.

National Airspace System : long-term capacity planning needed despite recent reduction in flight delays

DOT National Transportation Integrated Search

2001-12-01

The General Accounting Office (GAO) was asked to examine the aviation community's efforts to reduce flight delays. Specifically the GAO focused their work on the following questions: 1) What initiatives are planned or under way by the federal governm...

Psychosocial correlates of immediate versus delayed reconstruction of the breast.

PubMed

Wellisch, D K; Schain, W S; Noone, R B; Little, J W

1985-11-01

Two groups of consecutive patients from two different plastic surgical practice populations were evaluated to determine psychosocial differences between those who underwent immediate (n = 25) versus delayed (n = 38) breast reconstruction. Psychological assessment consisted of a standardized symptom inventory (BSI) and a specially designed self-report questionnaire investigating reactions unique to mastectomy and reconstruction. Both groups were extremely equivalent with regard to sociodemographic data, with the typical subject being a well-educated and employed Caucasian wife. Verbal reports of physical complaints revealed no significant differences between the two groups except for difficulty with arm movement, which was statistically higher for the immediate group (p = 0.006.). This difference most likely was due to the axillary dissection being performed simultaneously at the time of reconstruction. The relationship between timing of reconstruction and self-reported distress over the mastectomy experience revealed that only 25 percent of the women who underwent immediate repair reported "high distress" in recalling their mastectomy surgery compared with 60 percent of the delayed reconstruction group (p = 0.02). In reference to the two scales measuring psychological symptoms, a general trend was present, with the delayed group scoring higher (although not statistically significantly) on 9 of our 12 scales. Ninety-six percent of the immediate group and 89 percent of the delayed group reported satisfaction with results.(ABSTRACT TRUNCATED AT 250 WORDS)

Early Versus Delayed Colonoscopy in Hospitalized Patients With Lower Gastrointestinal Bleeding: A Meta-Analysis.

PubMed

Sengupta, Neil; Tapper, Elliot B; Feuerstein, Joseph D

2017-04-01

Early colonoscopy is recommended for patients with severe lower gastrointestinal bleeding (LGIB). There is limited data as to whether this is associated with improved outcomes. We performed a meta-analysis of studies comparing early (<24 h) versus delayed colonoscopy (>24 h). PubMed, Embase, and Web of Science were searched for manuscripts using colonoscopy as a diagnostic/treatment modality for patients hospitalized with LGIB. Studies were included if data were available on outcomes comparing early and delayed colonoscopy. Articles were reviewed for time to colonoscopy, rebleeding, mortality, length of stay (LOS), surgery, interventions, localization of LGIB, and number of packed red blood cells. Pooled measures were reported using the Mantel-Haenszel method. A total of 8491 studies were assessed of which 6 were included. There were 422 patients in the early arm and 479 in the delayed arm. There were no differences in age (64.2 vs. 65.7, P=0.85), admission hemoglobin (10.3 vs. 10.3 g/dL, P=0.96), LOS (5.21 vs. 6.09, P=0.52), and packed red blood cells transfusion (2.37 vs. 2.35, P=0.92) between the groups. In hospital mortality [odds ratio (OR), 1.64; 95% confidence interval (CI), 0.51-5.32], rebleeding (OR, 1.38; 95% CI, 0.85-2.23) and need for surgery (OR, 0.89; 95% CI, 0.42-1.89) were not different in delayed versus early colonoscopy. Early colonoscopy was associated with a higher detection of bleeding source (OR, 2.97; 95% CI, 2.11-4.19) and endoscopic intervention (OR, 3.99; 95% CI, 2.59-6.13). Early colonoscopy is not associated with reduced rebleeding, LOS, or surgery but is associated with a higher rate of source localization and endoscopic intervention.

Plasmodium falciparum malaria: Convergent evolutionary trajectories towards delayed clearance following artemisinin treatment.

PubMed

Wilairat, Prapon; Kümpornsin, Krittikorn; Chookajorn, Thanat

2016-05-01

Malaria is a major global health challenge with 300million new cases every year. The most effective regimen for treating Plasmodium falciparum malaria is based on artemisinin and its derivatives. The drugs are highly effective, resulting in rapid clearance of parasites even in severe P. falciparum malaria patients. During the last five years, artemisinin-resistant parasites have begun to emerge first in Cambodia and now in Thailand and Myanmar. At present, the level of artemisinin resistance is relatively low with clinical presentation of delayed artemisinin clearance (a longer time to reduce parasite load) and a small decrease in artemisinin sensitivity in cultured isolates. Nevertheless, multiple genetic loci associated with delayed parasite clearance have been reported, but they cannot account for a large portion of cases. Even the most well-studied kelch 13 propeller mutations cannot always predict the outcome of artemisinin treatment in vitro and in vivo. Here we propose that delayed clearance by artemisinin could be the result of convergent evolution, driven by multiple trajectories to overcome artemisinin-induced stress, but precluded to become full blown resistance by high fitness cost. Genetic association studies by several genome-wide approaches reveal linkage disequilibrium between multiple loci and delayed parasite clearance. Genetic manipulations at some of these loci already have resulted in loss in artemisinin sensitivity. The notion presented here is by itself consistent with existing evidence on artemisinin resistance and has the potential to be explored using available genomic data. Most important of all, molecular surveillance of artemisinin resistance based on multi-genic markers could be more informative than relying on any one particular molecular marker. Copyright © 2016 Elsevier Ltd. All rights reserved.

Delaying the start of iron until 28 days after antimalarial treatment is associated with lower incidence of subsequent illness in children with malaria and iron deficiency.

PubMed

Jaramillo, Ericka G; Mupere, Ezekiel; Opoka, Robert O; Hodges, James S; Lund, Troy C; Georgieff, Michael K; John, Chandy C; Cusick, Sarah E

2017-01-01

We evaluated the incidence of all-cause and malaria-specific clinic visits during follow-up of a recent trial of iron therapy. In the main trial, Ugandan children 6-59 months with smear-confirmed malaria and iron deficiency [zinc protoporphyrin (ZPP > = 80 μmol/mol heme)] were treated for malaria and randomized to start a 27-day course of oral iron concurrently with (immediate group) or 28 days after (delayed group) antimalarial treatment. All children were followed for the same 56-day period starting at the time of antimalarial treatment (Day 0) and underwent passive and active surveillance for malaria and other morbidity for the entire follow-up period. All ill children were examined and treated by the study physician. In this secondary analysis of morbidity data from the main trial, we report that although the incidence of malaria-specific visits did not differ between the groups, children in the immediate group had a higher incidence rate ratio of all-cause sick-child visits to the clinic during the follow-up period (Incidence Rate Ratio (IRR) immediate/delayed = 1.76; 95%CI: 1.05-3.03, p = 0.033). Although these findings need to be tested in a larger trial powered for malaria-specific morbidity, these preliminary results suggest that delaying iron by 28 days in children with coexisting malaria and iron deficiency is associated with a reduced risk of subsequent all-cause illness.

Delayed rotation of the cerebellar vermis: a pitfall in early second-trimester fetal magnetic resonance imaging.

PubMed

Pinto, J; Paladini, D; Severino, M; Morana, G; Pais, R; Martinetti, C; Rossi, A

2016-07-01

We describe two cases in which delayed rotation of the cerebellar vermis simulated a Dandy-Walker malformation (DWM) on early second-trimester magnetic resonance imaging (MRI). Two pregnant women with suspected fetal posterior fossa anomaly on ultrasound examination underwent fetal MRI at 21 (Case 1) and 19 (Case 2) weeks' gestation. In both cases, upward rotation of the cerebellar vermis was noted; on midsagittal imaging, the brainstem-vermis angle was 28° and 43°, respectively, while cerebellar morphometry showed a reduced vermian anteroposterior diameter compared to reference data. The posterior fossa appeared to be mildly enlarged, while all other findings were normal. Follow-up MRI at 28 + 3 weeks' gestation (Case 1) and at 1 postnatal year (Case 2) showed completely normal findings. Both children had normal psychomotor development and neurological examinations at 1 year of age. Incomplete rotation of the cerebellar vermis can be a physiological finding on early second-trimester fetal MRI examination and can simulate DWM or other forms of cerebellar hypoplasia. Embryologically, delayed permeabilization of Blake's pouch could account for the delayed vermian rotation. Follow-up imaging at a later gestational age is crucial to ensure that this condition is not over-reported and to avoid the potential risk of unnecessary pregnancy interruption. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

The Vivid Present: Visualization Abilities Are Associated with Steep Discounting of Future Rewards

PubMed Central

Parthasarathi, Trishala; McConnell, Mairead H.; Luery, Jeffrey; Kable, Joseph W.

2017-01-01

Humans and other animals discount the value of future rewards, a phenomenon known as delay discounting. Individuals vary widely in the extent to which they discount future rewards, and these tendencies have been associated with important life outcomes. Recent studies have demonstrated that imagining the future reduces subsequent discounting behavior, but no research to date has examined whether a similar principle applies at the trait level, and whether training visualization changes discounting. The current study examined if individual differences in visualization abilities are linked to individual differences in discounting and whether practicing visualization can change discounting behaviors in a lasting way. Participants (n = 48) completed the Vividness of Visual Imagery Questionnaire (VVIQ) and delay discounting task and then underwent a 4-week intervention consisting of visualization training (intervention) or relaxation training (control). Contrary to our hypotheses, participants who reported greater visualization abilities (lower scores) on the VVIQ were higher discounters. To further examine this relationship, an additional 106 participants completed the VVIQ and delay discounting task. In the total sample (n = 154), there was a significant negative correlation between VVIQ scores and discount rates, showing that individuals who are better visualizers are also higher discounters. Consistent with this relationship but again to our surprise, visualization training tended, albeit weakly, to increase discount rates, and those whose VVIQ decreased the most were those whose discount rates increased the most. These results suggest a novel association between visualization abilities and delay discounting. PMID:28321198

Root cause analysis of laboratory turnaround times for patients in the emergency department.

PubMed

Fernandes, Christopher M B; Worster, Andrew; Hill, Stephen; McCallum, Catherine; Eva, Kevin

2004-03-01

Laboratory investigations are essential to patient care and are conducted routinely in emergency departments (EDs). This study reports the turnaround times at an academic, tertiary care ED, using root cause analysis to identify potential areas of improvement. Our objectives were to compare the laboratory turnaround times with established benchmarks and identify root causes for delays. Turnaround and process event times for a consecutive sample of hemoglobin and potassium measurements were recorded during an 8-day study period using synchronized time stamps. A log transformation (ln [minutes + 1]) was performed to normalize the time data, which were then compared with established benchmarks using one-sample t tests. The turnaround time for hemoglobin was significantly less than the established benchmark (n = 140, t = -5.69, p < 0.001) and that of potassium was significantly greater (n = 121, t = 12.65, p < 0.001). The hemolysis rate was 5.8%, with 0.017% of samples needing recollection. Causes of delays included order-processing time, a high proportion (43%) of tests performed on patients who had been admitted but were still in the ED waiting for a bed, and excessive laboratory process times for potassium. The turnaround time for hemoglobin (18 min) met the established benchmark, but that for potassium (49 min) did not. Root causes for delay were order-processing time, excessive queue and instrument times for potassium and volume of tests for admitted patients. Further study of these identified causes of delays is required to see whether laboratory TATs can be reduced.

The Vivid Present: Visualization Abilities Are Associated with Steep Discounting of Future Rewards.

PubMed

Parthasarathi, Trishala; McConnell, Mairead H; Luery, Jeffrey; Kable, Joseph W

2017-01-01

Humans and other animals discount the value of future rewards, a phenomenon known as delay discounting. Individuals vary widely in the extent to which they discount future rewards, and these tendencies have been associated with important life outcomes. Recent studies have demonstrated that imagining the future reduces subsequent discounting behavior, but no research to date has examined whether a similar principle applies at the trait level, and whether training visualization changes discounting. The current study examined if individual differences in visualization abilities are linked to individual differences in discounting and whether practicing visualization can change discounting behaviors in a lasting way. Participants ( n = 48) completed the Vividness of Visual Imagery Questionnaire (VVIQ) and delay discounting task and then underwent a 4-week intervention consisting of visualization training (intervention) or relaxation training (control). Contrary to our hypotheses, participants who reported greater visualization abilities (lower scores) on the VVIQ were higher discounters. To further examine this relationship, an additional 106 participants completed the VVIQ and delay discounting task. In the total sample ( n = 154), there was a significant negative correlation between VVIQ scores and discount rates, showing that individuals who are better visualizers are also higher discounters. Consistent with this relationship but again to our surprise, visualization training tended, albeit weakly, to increase discount rates, and those whose VVIQ decreased the most were those whose discount rates increased the most. These results suggest a novel association between visualization abilities and delay discounting.

Data-Gathering Scheme Using AUVs in Large-Scale Underwater Sensor Networks: A Multihop Approach

PubMed Central

Khan, Jawaad Ullah; Cho, Ho-Shin

2016-01-01

In this paper, we propose a data-gathering scheme for hierarchical underwater sensor networks, where multiple Autonomous Underwater Vehicles (AUVs) are deployed over large-scale coverage areas. The deployed AUVs constitute an intermittently connected multihop network through inter-AUV synchronization (in this paper, synchronization means an interconnection between nodes for communication) for forwarding data to the designated sink. In such a scenario, the performance of the multihop communication depends upon the synchronization among the vehicles. The mobility parameters of the vehicles vary continuously because of the constantly changing underwater currents. The variations in the AUV mobility parameters reduce the inter-AUV synchronization frequency contributing to delays in the multihop communication. The proposed scheme improves the AUV synchronization frequency by permitting neighboring AUVs to share their status information via a pre-selected node called an agent-node at the static layer of the network. We evaluate the proposed scheme in terms of the AUV synchronization frequency, vertical delay (node→AUV), horizontal delay (AUV→AUV), end-to-end delay, and the packet loss ratio. Simulation results show that the proposed scheme significantly reduces the aforementioned delays without the synchronization time-out process employed in conventional works. PMID:27706042

Data-Gathering Scheme Using AUVs in Large-Scale Underwater Sensor Networks: A Multihop Approach.

PubMed

Khan, Jawaad Ullah; Cho, Ho-Shin

2016-09-30

In this paper, we propose a data-gathering scheme for hierarchical underwater sensor networks, where multiple Autonomous Underwater Vehicles (AUVs) are deployed over large-scale coverage areas. The deployed AUVs constitute an intermittently connected multihop network through inter-AUV synchronization (in this paper, synchronization means an interconnection between nodes for communication) for forwarding data to the designated sink. In such a scenario, the performance of the multihop communication depends upon the synchronization among the vehicles. The mobility parameters of the vehicles vary continuously because of the constantly changing underwater currents. The variations in the AUV mobility parameters reduce the inter-AUV synchronization frequency contributing to delays in the multihop communication. The proposed scheme improves the AUV synchronization frequency by permitting neighboring AUVs to share their status information via a pre-selected node called an agent-node at the static layer of the network. We evaluate the proposed scheme in terms of the AUV synchronization frequency, vertical delay (node→AUV), horizontal delay (AUV→AUV), end-to-end delay, and the packet loss ratio. Simulation results show that the proposed scheme significantly reduces the aforementioned delays without the synchronization time-out process employed in conventional works.

Delaying the international spread of pandemic influenza.

PubMed

Cooper, Ben S; Pitman, Richard J; Edmunds, W John; Gay, Nigel J

2006-06-01

The recent emergence of hypervirulent subtypes of avian influenza has underlined the potentially devastating effects of pandemic influenza. Were such a virus to acquire the ability to spread efficiently between humans, control would almost certainly be hampered by limited vaccine supplies unless global spread could be substantially delayed. Moreover, the large increases that have occurred in international air travel might be expected to lead to more rapid global dissemination than in previous pandemics. To evaluate the potential of local control measures and travel restrictions to impede global dissemination, we developed stochastic models of the international spread of influenza based on extensions of coupled epidemic transmission models. These models have been shown to be capable of accurately forecasting local and global spread of epidemic and pandemic influenza. We show that under most scenarios restrictions on air travel are likely to be of surprisingly little value in delaying epidemics, unless almost all travel ceases very soon after epidemics are detected. Interventions to reduce local transmission of influenza are likely to be more effective at reducing the rate of global spread and less vulnerable to implementation delays than air travel restrictions. Nevertheless, under the most plausible scenarios, achievable delays are small compared with the time needed to accumulate substantial vaccine stocks.

Delayed Partial Nephrectomy for Hydronephrosis After Renal Trauma.

PubMed

Setia, Shaan; Jackson, Jessica Nicole; Herndon, C D Anthony; Corbett, Sean T

2017-03-01

Delayed sequelae following conservative management of renal trauma in the pediatric population are uncommon. Reports of delayed operations to manage these sequelae are even less common. Here we present the case of a 16-year-old male patient who had delayed development of upper urinary tract obstruction with recurrent infections following high-grade renal trauma managed conservatively. Ultimately, he required a robotic-assisted partial nephrectomy 2 years after initial nonoperative management. This is unique as no prior studies to our knowledge have described delayed hydronephrosis and delayed partial nephrectomy over a year following renal trauma. Copyright © 2016 Elsevier Inc. All rights reserved.

A review on high-resolution CMOS delay lines: towards sub-picosecond jitter performance.

PubMed

Abdulrazzaq, Bilal I; Abdul Halin, Izhal; Kawahito, Shoji; Sidek, Roslina M; Shafie, Suhaidi; Yunus, Nurul Amziah Md

2016-01-01

A review on CMOS delay lines with a focus on the most frequently used techniques for high-resolution delay step is presented. The primary types, specifications, delay circuits, and operating principles are presented. The delay circuits reported in this paper are used for delaying digital inputs and clock signals. The most common analog and digitally-controlled delay elements topologies are presented, focusing on the main delay-tuning strategies. IC variables, namely, process, supply voltage, temperature, and noise sources that affect delay resolution through timing jitter are discussed. The design specifications of these delay elements are also discussed and compared for the common delay line circuits. As a result, the main findings of this paper are highlighting and discussing the followings: the most efficient high-resolution delay line techniques, the trade-off challenge found between CMOS delay lines designed using either analog or digitally-controlled delay elements, the trade-off challenge between delay resolution and delay range and the proposed solutions for this challenge, and how CMOS technology scaling can affect the performance of CMOS delay lines. Moreover, the current trends and efforts used in order to generate output delayed signal with low jitter in the sub-picosecond range are presented.

Linear-phase delay filters for ultra-low-power signal processing in neural recording implants.

PubMed

Gosselin, Benoit; Sawan, Mohamad; Kerherve, Eric

2010-06-01

We present the design and implementation of linear-phase delay filters for ultra-low-power signal processing in neural recording implants. We use these filters as low-distortion delay elements along with an automatic biopotential detector to perform integral waveform extraction and efficient power management. The presented delay elements are realized employing continuous-time OTA-C filters featuring 9th-order equiripple transfer functions with constant group delay. Such analog delay enables processing neural waveforms with reduced overhead compared to a digital delay since it does not requires sampling and digitization. It uses an allpass transfer function for achieving wider constant-delay bandwidth than all-pole does. Two filters realizations are compared for implementing the delay element: the Cascaded structure and the Inverse follow-the-leader feedback filter. Their respective strengths and drawbacks are assessed by modeling parasitics and non-idealities of OTAs, and by transistor-level simulations. A budget of 200 nA is used in both filters. Experimental measurements with the chosen filter topology are presented and discussed.

Early Vocabulary Delay and Behavioral/Emotional Problems in Early Childhood: The Generation R Study

ERIC Educational Resources Information Center

Henrichs, Jens; Rescorla, Leslie; Donkersloot, Cootje; Schenk, Jacqueline J.; Raat, Hein; Jaddoe, Vincent W. V.; Hofman, Albert; Verhulst, Frank C.; Tiemeier, Henning

2013-01-01

Purpose: The authors tested associations between (a) parent-reported temporary vs. persistent vocabulary delay and (b) parent-reported behavioral/emotional problems in a sample of 5,497 young Dutch children participating in a prospective population-based study. Method: Mothers completed the MacArthur Communicative Development…

14 CFR 234.4 - Reporting of on-time performance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... reportable flights held out in the Official Airline Guide (OAG), in the computer reservations systems (CRS... Director, Office of Airline Statistics, and shall contain the following information: (1) Carrier and flight... aviation system, if any. (20) Minutes of delay attributed to security, if any. (21) Minutes of delay...

14 CFR 234.4 - Reporting of on-time performance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... reportable flights held out in the Official Airline Guide (OAG), in the computer reservations systems (CRS... Director, Office of Airline Statistics, and shall contain the following information: (1) Carrier and flight... aviation system, if any. (20) Minutes of delay attributed to security, if any. (21) Minutes of delay...

14 CFR 234.4 - Reporting of on-time performance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... reportable flights held out in the Official Airline Guide (OAG), in the computer reservations systems (CRS... Director, Office of Airline Statistics, and shall contain the following information: (1) Carrier and flight... aviation system, if any. (20) Minutes of delay attributed to security, if any. (21) Minutes of delay...

14 CFR 234.4 - Reporting of on-time performance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... reportable flights held out in the Official Airline Guide (OAG), in the computer reservations systems (CRS... Director, Office of Airline Statistics, and shall contain the following information: (1) Carrier and flight... aviation system, if any. (20) Minutes of delay attributed to security, if any. (21) Minutes of delay...

An Integrative Literature Review of Organisational Factors Associated with Admission and Discharge Delays in Critical Care

PubMed Central

Peltonen, Laura-Maria; McCallum, Louise; Siirala, Eriikka; Haataja, Marjaana; Lundgrén-Laine, Heljä; Salanterä, Sanna; Lin, Frances

2015-01-01

The literature shows that delayed admission to the intensive care unit (ICU) and discharge delays from the ICU are associated with increased adverse events and higher costs. Identifying factors related to delays will provide information to practice improvements, which contribute to better patient outcomes. The aim of this integrative review was to explore the incidence of patients' admission and discharge delays in critical care and to identify organisational factors associated with these delays. Seven studies were included. The major findings are as follows: (1) explanatory research about discharge delays is scarce and one study on admission delays was found, (2) delays are a common problem mostly due to organisational factors, occurring in 38% of admissions and 22–67% of discharges, and (3) redesigning care processes by improving information management and coordination between units and interdisciplinary teams could reduce discharge delays. In conclusion, patient outcomes can be improved through efficient and safe care processes. More exploratory research is needed to identify factors that contribute to admission and discharge delays to provide evidence for clinical practice improvements. Shortening delays requires an interdisciplinary and multifaceted approach to the whole patient flow process. Conclusions should be made with caution due to the limited number of articles included in this review. PMID:26558286

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

Covington, E; Younge, K; Chen, X

Purpose: To evaluate the effectiveness of an automated plan check tool to improve first-time plan quality as well as standardize and document performance of physics plan checks. Methods: The Plan Checker Tool (PCT) uses the Eclipse Scripting API to check and compare data from the treatment planning system (TPS) and treatment management system (TMS). PCT was created to improve first-time plan quality, reduce patient delays, increase efficiency of our electronic workflow, and to standardize and partially automate plan checks in the TPS. A framework was developed which can be configured with different reference values and types of checks. One examplemore » is the prescribed dose check where PCT flags the user when the planned dose and the prescribed dose disagree. PCT includes a comprehensive checklist of automated and manual checks that are documented when performed by the user. A PDF report is created and automatically uploaded into the TMS. Prior to and during PCT development, errors caught during plan checks and also patient delays were tracked in order to prioritize which checks should be automated. The most common and significant errors were determined. Results: Nineteen of 33 checklist items were automated with data extracted with the PCT. These include checks for prescription, reference point and machine scheduling errors which are three of the top six causes of patient delays related to physics and dosimetry. Since the clinical roll-out, no delays have been due to errors that are automatically flagged by the PCT. Development continues to automate the remaining checks. Conclusion: With PCT, 57% of the physics plan checklist has been partially or fully automated. Treatment delays have declined since release of the PCT for clinical use. By tracking delays and errors, we have been able to measure the effectiveness of automating checks and are using this information to prioritize future development. This project was supported in part by P01CA059827.« less

No economic benefit of early knee reconstruction over optional delayed reconstruction for ACL tears: registry enriched randomised controlled trial data.

PubMed

Kiadaliri, Aliasghar A; Englund, Martin; Lohmander, L Stefan; Carlsson, Katarina Steen; Frobell, Richard B

2016-05-01

To analyse 5-year cost-effectiveness of early versus optional delayed acute anterior cruciate ligament (ACL) reconstruction. 121 young, active adults with acute ACL injury to a previously uninjured knee were randomised to early ACL reconstruction (n=62, within 10 weeks of injury) or optional delayed ACL reconstruction (n=59; 30 with ACL reconstruction within 6-55 months); all patients received similar structured rehabilitation. Real life data on health care utilisation and sick leave were obtained from regional and national registers. Costs and quality-adjusted life years (QALYs) were discounted at 3%. Full-analysis set (based on study randomisation) and as-treated analysis (according to actual treatment over 5 years) principles were applied. Mean cost of early ACL reconstruction was €4695 higher than optional delayed ACL reconstruction (p=0.19) and provided an additional 0.13 QALYs (p=0.11). Full-analysis set showed incremental net benefit of early versus optional delayed ACL reconstruction was not statistically significantly different from zero at any level. As-treated analysis showed that costs for rehabilitation alone were €13 650 less than early ACL reconstruction (p<0.001). Results were robust to sensitivity analyses. In young active adults with acute ACL injury, a strategy of early ACL reconstruction did not provide extra economic value over a strategy of optional delayed ACL reconstruction over a 5-year period. Results from this and previous reports of the KANON-trial imply that early identification of individuals who would benefit from either early ACL reconstruction or rehabilitation alone might reduce resource consumption and decrease risk of unnecessary overtreatment. ISRCTN84752559. 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/

Why wait? The social determinants underlying tuberculosis diagnostic delay

PubMed Central

Saunders, Matthew James; Zegarra, Roberto; Evans, Carlton; Alegria-Flores, Kei; Guio, Heinner

2017-01-01

Background Early detection and diagnosis of tuberculosis remain major global priorities for tuberculosis control. Few studies have used a qualitative approach to investigate the social determinants contributing to diagnostic delay and none have compared data collected from individual, community, and health-system levels. We aimed to characterize the social determinants that contribute to diagnostic delay among persons diagnosed with tuberculosis living in resource-constrained settings. Methods/Principle findings Data were collected in public health facilities with high tuberculosis incidence in 19 districts of Lima, Peru. Semi-structured interviews with persons diagnosed with tuberculosis (n = 105) and their family members (n = 63) explored health-seeking behaviours, community perceptions of tuberculosis and socio-demographic circumstances. Focus groups (n = 6) were conducted with health personnel (n = 35) working in the National Tuberculosis Program. All interview data were transcribed and analysed using a grounded theory approach. The median delay between symptom onset and the public health facility visit that led to the first positive diagnostic sample was 57 days (interquartile range 28–126). The great majority of persons diagnosed with tuberculosis distrusted the public health system and sought care at public health facilities only after exhausting other options. It was universally agreed that persons diagnosed with tuberculosis faced discrimination by public and health personnel. Self-medication with medicines bought at local pharmacies was reported as the most common initial health-seeking behaviour due to the speed and low-cost of treatment in pharmacies. Most persons diagnosed with tuberculosis initially perceived their illness as a simple virus. Conclusions Diagnostic delay was common and prolonged. When individuals reached a threshold of symptom severity, they addressed their health with the least time-consuming, most economically feasible, and well-known healthcare option available to them. In high-burden settings, more human and material resources are required to promote tuberculosis case-finding initiatives, reduce tuberculosis associated stigma and address the social determinants underlying diagnostic delay. PMID:28945782

The impact of command signal power distribution, processing delays, and speed scaling on neurally-controlled devices.

PubMed

Marathe, A R; Taylor, D M

2015-08-01

Decoding algorithms for brain-machine interfacing (BMI) are typically only optimized to reduce the magnitude of decoding errors. Our goal was to systematically quantify how four characteristics of BMI command signals impact closed-loop performance: (1) error magnitude, (2) distribution of different frequency components in the decoding errors, (3) processing delays, and (4) command gain. To systematically evaluate these different command features and their interactions, we used a closed-loop BMI simulator where human subjects used their own wrist movements to command the motion of a cursor to targets on a computer screen. Random noise with three different power distributions and four different relative magnitudes was added to the ongoing cursor motion in real time to simulate imperfect decoding. These error characteristics were tested with four different visual feedback delays and two velocity gains. Participants had significantly more trouble correcting for errors with a larger proportion of low-frequency, slow-time-varying components than they did with jittery, higher-frequency errors, even when the error magnitudes were equivalent. When errors were present, a movement delay often increased the time needed to complete the movement by an order of magnitude more than the delay itself. Scaling down the overall speed of the velocity command can actually speed up target acquisition time when low-frequency errors and delays are present. This study is the first to systematically evaluate how the combination of these four key command signal features (including the relatively-unexplored error power distribution) and their interactions impact closed-loop performance independent of any specific decoding method. The equations we derive relating closed-loop movement performance to these command characteristics can provide guidance on how best to balance these different factors when designing BMI systems. The equations reported here also provide an efficient way to compare a diverse range of decoding options offline.

Adaptation for Planting and Irrigation Decisions to Changing Monsoon Regime in Northeast India: Risk-based Hydro-economic Optimization

NASA Astrophysics Data System (ADS)

Zhu, T.; Cai, X.

2013-12-01

Delay in onset of Indian summer monsoon becomes increasingly frequent. Delayed monsoon and occasional monsoon failures seriously affect agricultural production in the northeast as well as other parts of India. In the Vaishali district of the Bihar State, Monsoon rainfall is very skewed and erratic, often concentrating in shorter durations. Farmers in Vaishali reported that delayed Monsoon affected paddy planting and, consequently delayed cropping cycle, putting crops under the risks of 'terminal heat.' Canal system in the district does not function due to lack of maintenance; irrigation relies almost entirely on groundwater. Many small farmers choose not to irrigate when monsoon onset is delayed due to high diesel price, leading to reduced production or even crop failure. Some farmers adapt to delayed onset of Monsoon by planting short-duration rice, which gives the flexibility for planting the next season crops. Other sporadic autonomous adaptation activities were observed as well, with various levels of success. Adaptation recommendations and effective policy interventions are much needed. To explore robust options to adapt to the changing Monsoon regime, we build a stochastic programming model to optimize revenues of farmer groups categorized by landholding size, subject to stochastic Monsoon onset and rainfall amount. Imperfect probabilistic long-range forecast is used to inform the model onset and rainfall amount probabilities; the 'skill' of the forecasting is measured using probabilities of correctly predicting events in the past derived through hindcasting. Crop production functions are determined using self-calibrating Positive Mathematical Programming approach. The stochastic programming model aims to emulate decision-making behaviors of representative farmer agents through making choices in adaptation, including crop mix, planting dates, irrigation, and use of weather information. A set of technological and policy intervention scenarios are tested, including irrigation subsidies, drought and heat-tolerant crop varieties, and enhancing agricultural extension. A portfolio of prioritized adaption options are recommended for the study area.

Why wait? The social determinants underlying tuberculosis diagnostic delay.

PubMed

Bonadonna, Lily Victoria; Saunders, Matthew James; Zegarra, Roberto; Evans, Carlton; Alegria-Flores, Kei; Guio, Heinner

2017-01-01

Early detection and diagnosis of tuberculosis remain major global priorities for tuberculosis control. Few studies have used a qualitative approach to investigate the social determinants contributing to diagnostic delay and none have compared data collected from individual, community, and health-system levels. We aimed to characterize the social determinants that contribute to diagnostic delay among persons diagnosed with tuberculosis living in resource-constrained settings. Data were collected in public health facilities with high tuberculosis incidence in 19 districts of Lima, Peru. Semi-structured interviews with persons diagnosed with tuberculosis (n = 105) and their family members (n = 63) explored health-seeking behaviours, community perceptions of tuberculosis and socio-demographic circumstances. Focus groups (n = 6) were conducted with health personnel (n = 35) working in the National Tuberculosis Program. All interview data were transcribed and analysed using a grounded theory approach. The median delay between symptom onset and the public health facility visit that led to the first positive diagnostic sample was 57 days (interquartile range 28-126). The great majority of persons diagnosed with tuberculosis distrusted the public health system and sought care at public health facilities only after exhausting other options. It was universally agreed that persons diagnosed with tuberculosis faced discrimination by public and health personnel. Self-medication with medicines bought at local pharmacies was reported as the most common initial health-seeking behaviour due to the speed and low-cost of treatment in pharmacies. Most persons diagnosed with tuberculosis initially perceived their illness as a simple virus. Diagnostic delay was common and prolonged. When individuals reached a threshold of symptom severity, they addressed their health with the least time-consuming, most economically feasible, and well-known healthcare option available to them. In high-burden settings, more human and material resources are required to promote tuberculosis case-finding initiatives, reduce tuberculosis associated stigma and address the social determinants underlying diagnostic delay.

The impact of command signal power distribution, processing delays, and speed scaling on neurally-controlled devices

NASA Astrophysics Data System (ADS)

Marathe, A. R.; Taylor, D. M.

2015-08-01

Objective. Decoding algorithms for brain-machine interfacing (BMI) are typically only optimized to reduce the magnitude of decoding errors. Our goal was to systematically quantify how four characteristics of BMI command signals impact closed-loop performance: (1) error magnitude, (2) distribution of different frequency components in the decoding errors, (3) processing delays, and (4) command gain. Approach. To systematically evaluate these different command features and their interactions, we used a closed-loop BMI simulator where human subjects used their own wrist movements to command the motion of a cursor to targets on a computer screen. Random noise with three different power distributions and four different relative magnitudes was added to the ongoing cursor motion in real time to simulate imperfect decoding. These error characteristics were tested with four different visual feedback delays and two velocity gains. Main results. Participants had significantly more trouble correcting for errors with a larger proportion of low-frequency, slow-time-varying components than they did with jittery, higher-frequency errors, even when the error magnitudes were equivalent. When errors were present, a movement delay often increased the time needed to complete the movement by an order of magnitude more than the delay itself. Scaling down the overall speed of the velocity command can actually speed up target acquisition time when low-frequency errors and delays are present. Significance. This study is the first to systematically evaluate how the combination of these four key command signal features (including the relatively-unexplored error power distribution) and their interactions impact closed-loop performance independent of any specific decoding method. The equations we derive relating closed-loop movement performance to these command characteristics can provide guidance on how best to balance these different factors when designing BMI systems. The equations reported here also provide an efficient way to compare a diverse range of decoding options offline.

Patient-independent variables affecting the assessment of aspirin responsiveness by serum thromboxane measurement.

PubMed

Petrucci, Giovanna; Rizzi, Alessandro; Cavalca, Viviana; Habib, Aida; Pitocco, Dario; Veglia, Fabrizio; Ranalli, Paola; Zaccardi, Francesco; Pagliaccia, Francesca; Tremoli, Elena; Patrono, Carlo; Rocca, Bianca

2016-10-28

The serum TXB 2 (sTXB 2 ) assay reflects the pharmacodynamics of platelet inhibition by low-dose aspirin. However, different studies reported variable sTXB 2 values. sTXB 2 assay requires whole blood incubation at 37 °C as a condition for optimal thrombin generation, arachidonic acid release and its metabolism by platelet cyclooxygenase-1 to form TXA 2 . Access to 37 °C incubation may be variably delayed, and different methods to quantitate sTXB 2 may contribute to variable results between different Centers. We investigated whether delaying 37 °C incubation and/or analytical issues affect sTXB 2 concentrations, biasing the assessment of aspirin responsiveness. Sixty-eight samples from 54 volunteers, on- and off-aspirin, were incubated at 37 °C immediately after sampling (reference sample) or after 5, 10, 15, 20, 30 or 60 minutes at room temperature (RT); 8 samples remained at RT 60 minutes, without subsequent incubation; 314 sera were measured by enzyme immunoassay (EIA) and liquid chromatography-tandem mass-spectrometry (LC/MS-MS) methods. sTXB 2 concentrations decreased exponentially as a function of the delay before 37 °C incubation, ranging from 94 ± 11 % at 5 minutes to 23 ± 22 % of the reference sample after 60 minutes at RT. There was high agreement between EIA and LC/MS-MS. Moreover, we simulated the influence of a 15- or 30-minute delayed incubation on 300 sTXB2 measurements from previously-studied, aspirin-treated patients. Delayed incubation reduced the percentage of aspirin 'non-responders' by 22 % to 52 %, depending on the response threshold. In conclusion, a variable delay in the 37 °C incubation of blood samples may affect the assessment of platelet cyclooxygenase-1 inhibition by aspirin and confound the characterization of the determinants of aspirin responsiveness.

Wind-Dragged Corolla Enhances Self-Pollination: A New Mechanism of Delayed Self-Pollination

PubMed Central

Qu, Rongming; Li, Xiaojie; Luo, Yibo; Dong, Ming; Xu, Huanli; Chen, Xuan; Dafni, Amots

2007-01-01

Background and Aims Delayed self-pollination is a mechanism that allows animal-pollinated plants to outcross while ensuring seed production in the absence of pollinators. This study aims to explore a new mechanism of delayed self-pollination facilitated by wind-driven corolla abscission in Incarvillea sinensis var. sinensis. Methods Floral morphology and development, and the process of delayed self-pollination were surveyed. Experiments dealing with pollinator and wind exclusion, pollination manipulations, and pollinator observations were conducted in the field. Key Results Delayed self-pollination occurs when the abscising corolla driven by wind drags the adherent epipetalous stamens, thus leading to contact of anthers with stigma in late anthesis. There is no dichogamy and self-incompatibility in this species. The significantly higher proportion of abscised corolla under natural conditions as compared with that in wind-excluding tents indicates the importance of wind in corolla abscission. When pollinators were excluded, corolla abscission significantly increased the number of pollen grains deposited on the stigma and, as a result, the fruit and seed set. Only half of the flowers in plots were visited by pollinators, and the fruit set of emasculated flowers was significantly lower than that of untreated flowers in open pollination. This species has a sensitive stigma, and its two open stigmatic lobes closed soon after being touched by a pollinator, but always reopened if no or only little pollen was deposited. Conclusions This delayed self-pollination, which involved the movement of floral parts, the active participation of the wind and sensitive stigma, is quite different from that reported previously. This mechanism provides reproductive assurance for this species. The sensitive stigma contributes to ensuring seed production and reducing the interference of selfing with outcrossing. The pollination pattern, which combines actions by bees with indirect participation by wind, is also a new addition to ambophily. PMID:17881336

Feedback enhances the positive effects and reduces the negative effects of multiple-choice testing.

PubMed

Butler, Andrew C; Roediger, Henry L

2008-04-01

Multiple-choice tests are used frequently in higher education without much consideration of the impact this form of assessment has on learning. Multiple-choice testing enhances retention of the material tested (the testing effect); however, unlike other tests, multiple-choice can also be detrimental because it exposes students to misinformation in the form of lures. The selection of lures can lead students to acquire false knowledge (Roediger & Marsh, 2005). The present research investigated whether feedback could be used to boost the positive effects and reduce the negative effects of multiple-choice testing. Subjects studied passages and then received a multiple-choice test with immediate feedback, delayed feedback, or no feedback. In comparison with the no-feedback condition, both immediate and delayed feedback increased the proportion of correct responses and reduced the proportion of intrusions (i.e., lure responses from the initial multiple-choice test) on a delayed cued recall test. Educators should provide feedback when using multiple-choice tests.

Social isolation and cancer management - advanced rectal cancer with patient delay following the 2011 triple disaster in Fukushima, Japan: a case report.

PubMed

Ozaki, Akihiko; Leppold, Claire; Sawano, Toyoaki; Tsubokura, Masaharu; Tsukada, Manabu; Tanimoto, Tetsuya; Kami, Masahiro; Ohira, Hiromichi

2017-05-16

Little is known about the effects of social isolation in the elderly on their process of gaining health information and seeking health care. In March 2011, Fukushima, Japan experienced an earthquake, tsunami, and nuclear disaster, also known as Japan's triple disaster. In June 2016, an 80-year-old Japanese man, who lived alone after divorce at the age of 42, presented to our hospital with bloody stools and dizziness. Although his bloody stools initially occurred in May 2015, a year earlier, he did not pursue the possibility of malignancy. He was diagnosed as having stage IIIA rectal cancer. Detailed history taking revealed that he experienced social isolation after the disaster, due to the evacuation of his friends, losing his regular opportunities for socialization. He additionally reported that the current diagnosis of rectal cancer made him feel he had lost his health in addition to his social relationships. Although radical surgery was attempted, it failed to resect the lesion completely, and thereafter his disease gradually progressed. As support from family or friends was not available, he was not able to receive palliative radiation therapy or home-based care in his end-of-life period. He died at a long-term care facility in February 2017. This case suggests that intense social isolation after the Fukushima disaster was a likely contributor to the patient delay, poor treatment course, and poor outcome of an elderly patient with rectal cancer. Direct communication with family and friends may play an indispensable role in increasing health awareness and promoting health-seeking behaviors, and in the midst of social isolation, elderly patients with cancer may lose these opportunities and experience increased risk of patient delay. Although health care providers may be able to alleviate isolation-induced delay by promoting cancer knowledge and awareness widely among local residents, policy-led interventions at the community level may be essential to reducing social isolation and its health consequences.

Toward diagnostic and phenotype markers for genetically transmitted speech delay.

PubMed

Shriberg, Lawrence D; Lewis, Barbara A; Tomblin, J Bruce; McSweeny, Jane L; Karlsson, Heather B; Scheer, Alison R

2005-08-01

Converging evidence supports the hypothesis that the most common subtype of childhood speech sound disorder (SSD) of currently unknown origin is genetically transmitted. We report the first findings toward a set of diagnostic markers to differentiate this proposed etiological subtype (provisionally termed speech delay-genetic) from other proposed subtypes of SSD of unknown origin. Conversational speech samples from 72 preschool children with speech delay of unknown origin from 3 research centers were selected from an audio archive. Participants differed on the number of biological, nuclear family members (0 or 2+) classified as positive for current and/or prior speech-language disorder. Although participants in the 2 groups were found to have similar speech competence, as indexed by their Percentage of Consonants Correct scores, their speech error patterns differed significantly in 3 ways. Compared with children who may have reduced genetic load for speech delay (no affected nuclear family members), children with possibly higher genetic load (2+ affected members) had (a) a significantly higher proportion of relative omission errors on the Late-8 consonants; (b) a significantly lower proportion of relative distortion errors on these consonants, particularly on the sibilant fricatives /s/, /z/, and //; and (c) a significantly lower proportion of backed /s/ distortions, as assessed by both perceptual and acoustic methods. Machine learning routines identified a 3-part classification rule that included differential weightings of these variables. The classification rule had diagnostic accuracy value of 0.83 (95% confidence limits = 0.74-0.92), with positive and negative likelihood ratios of 9.6 (95% confidence limits = 3.1-29.9) and 0.40 (95% confidence limits = 0.24-0.68), respectively. The diagnostic accuracy findings are viewed as promising. The error pattern for this proposed subtype of SSD is viewed as consistent with the cognitive-linguistic processing deficits that have been reported for genetically transmitted verbal disorders.

Recommendations for the Avoidance of Delayed-Onset Muscle Soreness.

ERIC Educational Resources Information Center

Szymanski, David J.

2001-01-01

Describes the possible causes of delayed-onset muscle soreness (DOMS), which include buildup of lactic acid in muscle, increased intracellular calcium concentration, increased intramuscular inflammation, and muscle fiber and connective tissue damage. Proposed methods to reduce DOMS include warming up before exercise and performing repeated bouts…

IPRODIONE DELAYS MALE RAT PUBERTAL DEVELOPMENT, REDUCING SERUM TESTOSTERONE AND EX VIVO TESTOSTERONE PRODUCTION

EPA Science Inventory

Iprodione (IPRO) is a dichlorophenyl dicarboximide fungicide similar to the androgen receptor (AR) antagonist vinclozolin. The current studies were designed to determine if IPRO would delay male rat pubertal development like vinclozolin and to identify the mechanism(s) of action...

Training Rapid Stepping Responses in an Individual With Stroke

PubMed Central

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

2011-01-01

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

Symptoms and signs of acromegaly: an ongoing need to raise awareness among healthcare practitioners.

PubMed

Zarool-Hassan, Redzuan; Conaglen, Helen M; Conaglen, John V; Elston, Marianne S

2016-06-01

INTRODUCTION Chronic excess growth hormone production results in acromegaly, a condition associated with widespread physical changes, including soft tissue and bony overgrowth. When untreated, acromegaly reduces life expectancy. Patients usually remain undiagnosed for years after the onset of symptoms, by which stage irreversible physical changes have often occurred. METHOD A cross-sectional questionnaire study involving patients with acromegaly from the Waikato Endocrine Unit and the New Zealand Acromegaly Society evaluated features of acromegaly that were present before diagnosis. The aim of this study was to identify acromegaly features that were most prevalent to promote increased awareness about the disease by healthcare providers. RESULTS 81 participants were included. The main pre-diagnosis physical changes participants reported were acral changes, alterations in facial features and oral symptoms. For some, these features were present for more than 10 years before the acromegaly diagnosis. Multiple co-morbidities associated with acromegaly were reported. Two-thirds of the participants felt that an earlier diagnosis was possible. Most participants were in contact with General Practitioners (GPs) and/or dentists before diagnosis. Endocrinologists had the highest diagnosis rate, followed by GPs. Dentists had a low diagnosis rate despite a high prevalence of oral symptoms among study participants. CONCLUSION Increased awareness of acromegaly among primary care clinicians is important as they are the first-point-of-contact with the healthcare system for most patients. Health professionals' early recognition of symptoms and signs of acromegaly would reduce delays in time-to-diagnosis, enable earlier treatment and may improve outcomes for patients with acromegaly. MESH KEYWORDS Acromegaly; symptoms; delayed diagnosis; clinicians; primary healthcare.

Delayed introduction of progressive enteral feeds to prevent necrotising enterocolitis in very low birth weight infants.

PubMed

Morgan, Jessie; Young, Lauren; McGuire, William

2014-01-01

The introduction of enteral feeds for very preterm (less than 32 weeks' gestation) or very low birth weight (VLBW; less than 1500 g) infants is often delayed for several days or longer after birth due to concern that early introduction may not be tolerated and may increase the risk of necrotising enterocolitis (NEC). However, delaying enteral feeding could diminish the functional adaptation of the gastrointestinal tract and prolong the need for parenteral nutrition with its attendant infectious and metabolic risks. To determine the effect of delayed introduction of progressive enteral feeds on the incidence of NEC, mortality and other morbidities in very preterm or VLBW infants. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2014, Issue 8), MEDLINE (1966 to September 2014), EMBASE (1980 to September 2014), CINAHL (1982 to September 2014), conference proceedings and previous reviews. We included randomised or quasi-randomised controlled trials that assessed the effect of delayed (more than four days after birth) versus earlier introduction of progressive enteral feeds on the incidence of NEC, mortality and other morbidities in very preterm or VLBW infants. Two review authors independently assessed trial eligibility and risk of bias and undertook data extraction. We analysed the treatment effects in the individual trials and reported the risk ratio (RR) and risk difference for dichotomous data and mean difference for continuous data, with respective 95% confidence intervals (CI). We used a fixed-effect model in meta-analyses and explored the potential causes of heterogeneity in sensitivity analyses. We identified nine randomised controlled trials in which 1106 infants participated. Few participants were extremely preterm (less 28 weeks' gestation) or extremely low birth weight (less than 1000 g). The trials defined delayed introduction of progressive enteral feeds as later than four to seven days after birth and early introduction as four days or less after birth. Meta-analyses did not detect statistically significant effects on the risk of NEC (typical RR 0.93, 95% CI 0.64 to 1.34; 8 trials; 1092 infants) or all-cause mortality (typical RR 1.18, 95% CI 0.75 to 1.88; 7 trials; 967 infants). Four of the trials restricted participation to growth-restricted infants with Doppler ultrasound evidence of abnormal fetal circulatory distribution or flow. Planned subgroup analyses of these trials found no statistically significant effects on the risk of NEC or all-cause mortality. Infants who had delayed introduction of enteral feeds took longer to establish full enteral feeding (reported median differences two to four days). The evidence available from randomised controlled trials suggested that delaying the introduction of progressive enteral feeds beyond four days after birth did not reduce the risk of developing NEC in very preterm or VLBW infants, including growth-restricted infants. Delaying the introduction of progressive enteral feeds resulted in a few days' delay in establishing full enteral feeds but the clinical importance of this effect was unclear. The applicability of these findings to extremely preterm or extremely low birth weight was uncertain. Further randomised controlled trials in this population may be warranted.

Determining the optimal window length for pattern recognition-based myoelectric control: balancing the competing effects of classification error and controller delay.

PubMed

Smith, Lauren H; Hargrove, Levi J; Lock, Blair A; Kuiken, Todd A

2011-04-01

Pattern recognition-based control of myoelectric prostheses has shown great promise in research environments, but has not been optimized for use in a clinical setting. To explore the relationship between classification error, controller delay, and real-time controllability, 13 able-bodied subjects were trained to operate a virtual upper-limb prosthesis using pattern recognition of electromyogram (EMG) signals. Classification error and controller delay were varied by training different classifiers with a variety of analysis window lengths ranging from 50 to 550 ms and either two or four EMG input channels. Offline analysis showed that classification error decreased with longer window lengths (p < 0.01 ). Real-time controllability was evaluated with the target achievement control (TAC) test, which prompted users to maneuver the virtual prosthesis into various target postures. The results indicated that user performance improved with lower classification error (p < 0.01 ) and was reduced with longer controller delay (p < 0.01 ), as determined by the window length. Therefore, both of these effects should be considered when choosing a window length; it may be beneficial to increase the window length if this results in a reduced classification error, despite the corresponding increase in controller delay. For the system employed in this study, the optimal window length was found to be between 150 and 250 ms, which is within acceptable controller delays for conventional multistate amplitude controllers.

Nucleus accumbens core lesions induce sub-optimal choice and reduce sensitivity to magnitude and delay in impulsive choice tasks

PubMed Central

Steele, Catherine C.; Peterson, Jennifer R.; Marshall, Andrew T.; Stuebing, Sarah L.; Kirkpatrick, Kimberly

2017-01-01

The nucleus accumbens core (NAc) has long been recognized as an important contributor to the computation of reward value that is critical for impulsive choice behavior. Impulsive choice refers to choosing a smaller-sooner (SS) over a larger-later (LL) reward when the LL is more optimal in terms of the rate of reward delivery. Two experiments examined the role of the NAc in impulsive choice and its component processes of delay and magnitude processing. Experiment 1 delivered an impulsive choice task with manipulations of LL reward magnitude, followed by a reward magnitude discrimination task. Experiment 2 tested impulsive choice under manipulations of LL delay, followed by temporal bisection and progressive interval tasks. NAc lesions, in comparison to sham control lesions, produced suboptimal preferences that resulted in lower reward earning rates, and led to reduced sensitivity to magnitude and delay within the impulsive choice task. The secondary tasks revealed intact reward magnitude and delay discrimination abilities, but the lesion rats persisted in responding more as the progressive interval increased during the session. The results suggest that the NAc is most critical for demonstrating good sensitivity to magnitude and delay, and adjusting behavior accordingly. Ultimately, the NAc lesions induced suboptimal choice behavior rather than simply promoting impulsive choice, suggesting that an intact NAc is necessary for optimal decision making. PMID:29146281

Drifting cavity solitons and dissipative rogue waves induced by time-delayed feedback in Kerr optical frequency comb and in all fiber cavities

NASA Astrophysics Data System (ADS)

Tlidi, Mustapha; Panajotov, Krassimir; Ferré, Michel; Clerc, Marcel G.

2017-11-01

Time-delayed feedback plays an important role in the dynamics of spatially extended systems. In this contribution, we consider the generic Lugiato-Lefever model with delay feedback that describes Kerr optical frequency comb in all fiber cavities. We show that the delay feedback strongly impacts the spatiotemporal dynamical behavior resulting from modulational instability by (i) reducing the threshold associated with modulational instability and by (ii) decreasing the critical frequency at the onset of this instability. We show that for moderate input intensities it is possible to generate drifting cavity solitons with an asymmetric radiation emitted from the soliton tails. Finally, we characterize the formation of rogue waves induced by the delay feedback.

The fragility of intergroup relations: divergent effects of delayed audiovisual feedback in intergroup and intragroup interaction.

PubMed

Pearson, Adam R; West, Tessa V; Dovidio, John F; Powers, Stacie Renfro; Buck, Ross; Henning, Robert

2008-12-01

Intergroup interactions between racial or ethnic majority and minority groups are often stressful for members of both groups; however, the dynamic processes that promote or alleviate tension in intergroup interaction remain poorly understood. Here we identify a behavioral mechanism-response delay-that can uniquely contribute to anxiety and promote disengagement from intergroup contact. Minimally acquainted White, Black, and Latino participants engaged in intergroup or intragroup dyadic conversation either in real time or with a subtle temporal disruption (1-s delay) in audiovisual feedback. Whereas intergroup dyads reported greater anxiety and less interest in contact after engaging in delayed conversation than after engaging in real-time conversation, intragroup dyads reported less anxiety in the delay condition than they did after interacting in real time. These findings have theoretical and practical implications for understanding intergroup communication and social dynamics and for promoting positive intergroup contact.

78 FR 79564 - Discontinuance of Annual Financial Assessments-Delay in Implementation

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-30

... that due to delays in modifying computer software, VA is postponing implementation of this change. FOR... computer matching of income reported to the Internal Revenue Service (IRS) and Social Security... implemented by December 31, 2013. Due to delays in revising and updating supporting computer software, VA is...

Case Report: The Specter of Untreated Congenital Hypothyroidism in Immigrant Families

PubMed Central

Hamdoun, Elwaseila; Karachunski, Peter; Nathan, Brandon; Fischer, Melissa; Torkelson, Jane L.; Drilling, Amy

2016-01-01

Newborn screening has dramatically reduced rates of untreated congenital hypothyroidism (CH). However, in low-income nations where newborn screening programs do not exist, untreated CH remains a significant health and societal challenge. The goal of this report is to alert health care providers about the potential of undiagnosed CH in unscreened immigrant children. We report 3 siblings of Somali descent with CH who started treatment with levothyroxine at age 0.5 years, 7.7 years, and 14.8 years and were followed for 8 years. This case series demonstrates a spectrum of severity, response to treatment, and neurocognitive and growth outcomes depending on the age at treatment initiation. Patient 1, now 22 years old, went undiagnosed for 14.8 years. On diagnosis, his height was –7.5 SDs with a very delayed bone age of –13.5 SDs. His longstanding CH was associated with empty sella syndrome, static encephalopathy, and severe musculoskeletal deformities. Even after treatment, his height (–5.2 SDs) and cognitive deficits remained the most severe of the 3 siblings. Patient 2, diagnosed at 7.7 years, had moderate CH manifestations and thus a relatively intermediate outcome after treatment. Patient 3, who had the earliest diagnosis at 0.5 years, displayed the best response, but continues to have residual global developmental delay. In conclusion, untreated CH remains an important diagnostic consideration among immigrant children. PMID:27244801

Case Report: The Specter of Untreated Congenital Hypothyroidism in Immigrant Families.

PubMed

Hamdoun, Elwaseila; Karachunski, Peter; Nathan, Brandon; Fischer, Melissa; Torkelson, Jane L; Drilling, Amy; Petryk, Anna

2016-05-01

Newborn screening has dramatically reduced rates of untreated congenital hypothyroidism (CH). However, in low-income nations where newborn screening programs do not exist, untreated CH remains a significant health and societal challenge. The goal of this report is to alert health care providers about the potential of undiagnosed CH in unscreened immigrant children. We report 3 siblings of Somali descent with CH who started treatment with levothyroxine at age 0.5 years, 7.7 years, and 14.8 years and were followed for 8 years. This case series demonstrates a spectrum of severity, response to treatment, and neurocognitive and growth outcomes depending on the age at treatment initiation. Patient 1, now 22 years old, went undiagnosed for 14.8 years. On diagnosis, his height was -7.5 SDs with a very delayed bone age of -13.5 SDs. His longstanding CH was associated with empty sella syndrome, static encephalopathy, and severe musculoskeletal deformities. Even after treatment, his height (-5.2 SDs) and cognitive deficits remained the most severe of the 3 siblings. Patient 2, diagnosed at 7.7 years, had moderate CH manifestations and thus a relatively intermediate outcome after treatment. Patient 3, who had the earliest diagnosis at 0.5 years, displayed the best response, but continues to have residual global developmental delay. In conclusion, untreated CH remains an important diagnostic consideration among immigrant children. Copyright © 2016 by the American Academy of Pediatrics.

Ethylene: Response of Fruit Dehiscence to CO2 and Reduced Pressure 1

PubMed Central

Lipe, John A.; Morgan, Page W.

1972-01-01

These studies were conducted to determine whether ethylene serves as a natural regulator of fruit wall dehiscence, a major visible feature of ripening in some fruits. We employed treatments to inhibit ethylene action or remove ethylene and observed their effect on fruit dehiscence. CO2 (13%), a competitive inhibitor of ethylene action in many systems, readily delayed dehiscence of detached fruits of cotton (Gossypium hirsutum L.), pecan (Carya illinoensis [Wang.] K. Koch), and okra (Hibiscus esculentus L.). The CO2 effect was duplicated by placing fruits under reduced pressure (200 millimeters mercury), to promote the escape of ethylene from the tissue. Dehiscence of detached fruits of these species as well as attached cotton fruits was delayed. The delay of dehiscence of cotton and okra by both treatments was achieved with fruit harvested at intervals from shortly after anthesis until shortly before natural dehiscence. Pecan fruits would not dehisce until approximately 1 month before natural dehiscence, and during that time, CO2 and reduced pressure delayed dehiscence. CO2 and ethylene were competitive in their effects on cotton fruit dehiscence. All of the results are compatible with a hypothetical role of ethylene as a natural regulator of dehiscence, a dominant aspect of ripening of cotton, pecan, and some other fruits. PMID:16658260

Ethylene: Response of Fruit Dehiscence to CO(2) and Reduced Pressure.

PubMed

Lipe, J A; Morgan, P W

1972-12-01

These studies were conducted to determine whether ethylene serves as a natural regulator of fruit wall dehiscence, a major visible feature of ripening in some fruits. We employed treatments to inhibit ethylene action or remove ethylene and observed their effect on fruit dehiscence. CO(2) (13%), a competitive inhibitor of ethylene action in many systems, readily delayed dehiscence of detached fruits of cotton (Gossypium hirsutum L.), pecan (Carya illinoensis [Wang.] K. Koch), and okra (Hibiscus esculentus L.). The CO(2) effect was duplicated by placing fruits under reduced pressure (200 millimeters mercury), to promote the escape of ethylene from the tissue. Dehiscence of detached fruits of these species as well as attached cotton fruits was delayed. The delay of dehiscence of cotton and okra by both treatments was achieved with fruit harvested at intervals from shortly after anthesis until shortly before natural dehiscence. Pecan fruits would not dehisce until approximately 1 month before natural dehiscence, and during that time, CO(2) and reduced pressure delayed dehiscence. CO(2) and ethylene were competitive in their effects on cotton fruit dehiscence. All of the results are compatible with a hypothetical role of ethylene as a natural regulator of dehiscence, a dominant aspect of ripening of cotton, pecan, and some other fruits.

A dual V t disturb-free subthreshold SRAM with write-assist and read isolation

NASA Astrophysics Data System (ADS)

Bhatnagar, Vipul; Kumar, Pradeep; Pandey, Neeta; Pandey, Sujata

2018-02-01

This paper presents a new dual V t 8T SRAM cell having single bit-line read and write, in addition to Write Assist and Read Isolation (WARI). Also a faster write back scheme is proposed for the half selected cells. A high V t device is used for interrupting the supply to one of the inverters for weakening the feedback loop for assisted write. The proposed cell provides an improved read static noise margin (RSNM) due to the bit-line isolation during the read. Static noise margins for data read (RSNM), write (WSNM), read delay, write delay, data retention voltage (DRV), leakage and average powers have been calculated. The proposed cell was found to operate properly at a supply voltage as small as 0.41 V. A new write back scheme has been suggested for half-selected cells, which uses a single NMOS access device and provides reduced delay, pulse timing hardware requirements and power consumption. The proposed new WARI 8T cell shows better performance in terms of easier write, improved read noise margin, reduced leakage power, and less delay as compared to the existing schemes that have been available so far. It was also observed that with proper adjustment of the cell ratio the supply voltage can further be reduced to 0.2 V.

Phase delaying the human circadian clock with a single light pulse and moderate delay of the sleep/dark episode: no influence of iris color.

PubMed

Canton, Jillian L; Smith, Mark R; Choi, Ho-Sun; Eastman, Charmane I

2009-07-17

Light exposure in the late evening and nighttime and a delay of the sleep/dark episode can phase delay the circadian clock. This study assessed the size of the phase delay produced by a single light pulse combined with a moderate delay of the sleep/dark episode for one day. Because iris color or race has been reported to influence light-induced melatonin suppression, and we have recently reported racial differences in free-running circadian period and circadian phase shifting in response to light pulses, we also tested for differences in the magnitude of the phase delay in subjects with blue and brown irises. Subjects (blue-eyed n = 7; brown eyed n = 6) maintained a regular sleep schedule for 1 week before coming to the laboratory for a baseline phase assessment, during which saliva was collected every 30 minutes to determine the time of the dim light melatonin onset (DLMO). Immediately following the baseline phase assessment, which ended 2 hours after baseline bedtime, subjects received a 2-hour bright light pulse (~4,000 lux). An 8-hour sleep episode followed the light pulse (i.e. was delayed 4 hours from baseline). A final phase assessment was conducted the subsequent night to determine the phase shift of the DLMO from the baseline to final phase assessment.Phase delays of the DLMO were compared in subjects with blue and brown irises. Iris color was also quantified from photographs using the three dimensions of red-green-blue color axes, as well as a lightness scale. These variables were correlated with phase shift of the DLMO, with the hypothesis that subjects with lighter irises would have larger phase delays. The average phase delay of the DLMO was -1.3 +/- 0.6 h, with a maximum delay of ~2 hours, and was similar for subjects with blue and brown irises. There were no significant correlations between any of the iris color variables and the magnitude of the phase delay. A single 2-hour bright light pulse combined with a moderate delay of the sleep/dark episode delayed the circadian clock an average of ~1.5 hours. There was no evidence that iris color influenced the magnitude of the phase shift. Future studies are needed to replicate our findings that iris color does not impact the magnitude of light-induced circadian phase shifts, and that the previously reported differences may be due to race.

Role of the nurse in preserving patients' independence.

PubMed

Maxwell, Cathy

2007-01-01

Patients with metastatic bone disease may be treated with bisphosphonates to reduce or delay skeletal complications including pathologic fracture, radiotherapy to bone, and hypercalcemia of malignancy. Nurses can provide important education to patients and support or encourage the use of bisphosphonates throughout therapy. Literature and congress reports were reviewed for relevant efficacy information on bisphosphonates and adverse events that may occur during bisphosphonate therapy. Bisphosphonates can provide meaningful benefits to patients, and zoledronic acid is now approved for the treatment of bone metastases secondary to any solid tumor. To optimize care, nurses can monitor pain scores, changes in mobility, adverse events, and serum creatinine levels. A useful tool for recording these parameters is a patient diary. The nurse should fill out the diary at each patient visit and compare it with baseline information before treatment is administered. Patients should also be counseled on the importance of adequate hydration, good dental hygiene, the need for calcium and vitamin D supplements, and how to best manage potential side effects. Bisphosphonates are effective in reducing and delaying skeletal complications, and zoledronic acid has demonstrated significant efficacy in preventing skeletal complications across a wide range of solid tumors and multiple myeloma. Nurses play an important role in enabling patients to optimize bisphosphonate therapy and in supporting patients to continue treatment to preserve their functional independence.

Distinct neural markers of TVA-based visual processing speed and short-term storage capacity parameters.

PubMed

Wiegand, Iris; Töllner, Thomas; Habekost, Thomas; Dyrholm, Mads; Müller, Hermann J; Finke, Kathrin

2014-08-01

An individual's visual attentional capacity is characterized by 2 central processing resources, visual perceptual processing speed and visual short-term memory (vSTM) storage capacity. Based on Bundesen's theory of visual attention (TVA), independent estimates of these parameters can be obtained from mathematical modeling of performance in a whole report task. The framework's neural interpretation (NTVA) further suggests distinct brain mechanisms underlying these 2 functions. Using an interindividual difference approach, the present study was designed to establish the respective ERP correlates of both parameters. Participants with higher compared to participants with lower processing speed were found to show significantly reduced visual N1 responses, indicative of higher efficiency in early visual processing. By contrast, for participants with higher relative to lower vSTM storage capacity, contralateral delay activity over visual areas was enhanced while overall nonlateralized delay activity was reduced, indicating that holding (the maximum number of) items in vSTM relies on topographically specific sustained activation within the visual system. Taken together, our findings show that the 2 main aspects of visual attentional capacity are reflected in separable neurophysiological markers, validating a central assumption of NTVA. © The Author 2013. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Delayed management of traumatic bilateral cervical facet dislocation: surgical strategy. Report of three cases.

PubMed

Bartels, Ronald H M A; Donk, Roland

2002-10-01

Postinjury cervical spine instability typically requires surgical treatment in the acute or semiacute stage. The authors, however, report on three patients with older (> 8 weeks) untreated bilateral cervical facet dislocation. In two patients they attempted a classic anterior-posterior-anterior approach but failed. The misalignment in the second stage of the procedure could not be corrected, and they had to add a fourth, posterior, stage. To avoid the fourth stage, thereby reducing operating time and risk of neurological damage while turning the patient, they propose the following sequence: 1) a posterior approach to perform a complete facetectomy bilaterally with no attempt to reduce the dislocation; 2) an anterior microscopic discectomy with reduction of the dislocation and anterior fixation; and 3) posterior fixation. This sequence of procedures was successfully performed in the third patient. Based on this experience, they suggest that in cases of nonacute bilateral cervical facet dislocations the operating sequence should be posterior-anterior-posterior.

The Early Use of Blinding in Therapeutic Clinical Research of Neurological Disorders

PubMed Central

Jensen, Matthew B.; Janik, Erika L.; Waclawik, Andrew J.

2016-01-01

We sought to identify early uses of blinding in therapeutic clinical trials of neurological disorders by multiple search methods. A 1784 report by Benjamin Franklin and others described the evaluation of the use of Mesmerism to treat neurological and other syndromes including headache and epilepsy, using blindfolds and screens. This report demonstrated the usefulness of blinding to reduce bias in clinical research, yet despite this early discovery, blinding was not widely accepted or routinely used until the 20th century. Blinded clinical trials began to be used for various neurological syndromes in the 1950s, sporadically at first and then increasing in frequency in subsequent years. The reason for this delay is unclear, but we propose several hypotheses. PMID:27617324

Speech and language delay in two children: an unusual presentation of hyperthyroidism.

PubMed

Sohal, Aman P S; Dasarathi, Madhuri; Lodh, Rajib; Cheetham, Tim; Devlin, Anita M

2013-01-01

Hyperthyroidism is rare in pre-school children. Untreated, it can have a profound effect on normal growth and development, particularly in the first 2 years of life. Although neurological manifestations of dysthyroid states are well known, specific expressive speech and language disorder as a presentation of hyperthyroidism is rarely documented. Case reports of two children with hyperthyroidism presenting with speech and language delay. We report two pre-school children with hyperthyroidism, who presented with expressive speech and language delay, and demonstrated a significant improvement in their language skills following treatment with anti-thyroid medication. Hyperthyroidism must be considered in all children presenting with speech and language difficulties, particularly expressive speech delay. Prompt recognition and early treatment are likely to improve outcome.

GEOTAIL Spacecraft historical data report

NASA Technical Reports Server (NTRS)

Boersig, George R.; Kruse, Lawrence F.

1993-01-01

The purpose of this GEOTAIL Historical Report is to document ground processing operations information gathered on the GEOTAIL mission during processing activities at the Cape Canaveral Air Force Station (CCAFS). It is hoped that this report may aid management analysis, improve integration processing and forecasting of processing trends, and reduce real-time schedule changes. The GEOTAIL payload is the third Delta 2 Expendable Launch Vehicle (ELV) mission to document historical data. Comparisons of planned versus as-run schedule information are displayed. Information will generally fall into the following categories: (1) payload stay times (payload processing facility/hazardous processing facility/launch complex-17A); (2) payload processing times (planned, actual); (3) schedule delays; (4) integrated test times (experiments/launch vehicle); (5) unique customer support requirements; (6) modifications performed at facilities; (7) other appropriate information (Appendices A & B); and (8) lessons learned (reference Appendix C).

Delaying postpartum supplementation in cows consuming low-quality forage does not alter cow and calf productivity

USDA-ARS?s Scientific Manuscript database

Reducing the amount of supplemental feed postpartum without affecting productivity may enhance profitability of cow-calf operations. Therefore, sixteen 2-yr-old fall calving cows were used to evaluate effects of delaying postpartum supplementation on milk production, serum metabolites, cow and calf ...

UVB Radiation Delays Tribolium castaneum Metamorphosis by Influencing Ecdysteroid Metabolism.

PubMed

Sang, Wen; Yu, Lin; He, Li; Ma, Wei-Hua; Zhu, Zhi-Hui; Zhu, Fen; Wang, Xiao-Ping; Lei, Chao-Liang

2016-01-01

Ultraviolet B (UVB) radiation is an important environmental factor. It is generally known that UVB exhibits high genotoxicity due to causing DNA damage, potentially leading to skin carcinogenesis and aging in mammals. However, little is known about the effects of UVB on the development and metamorphosis of insects, which are the most abundant terrestrial animals. In the present study, we performed dose-response analyses of the effects UVB irradiation on Tribolium castaneum metamorphosis, assessed the function of the T. castaneum prothoracicotropic hormone gene (Trcptth), and analyzed ecdysteroid pathway gene expression profile and ecdysterone titers post-UVB irradiation. The results showed that UVB not only caused death of T. castaneum larvae, but also delayed larval-pupal metamorphosis and reduced the size and emergence rate of pupae. In addition, we verified the function of Trcptth, which is responsible for regulating metamorphosis. It was also found that the expression profiles of Trcptth as well as ecdysteroidogenesis and response genes were influenced by UVB radiation. Therefore, a disturbance pulse of ecdysteroid may be involved in delaying development under exposure to irradiation. To our knowledge, this is the first report indicating that UVB can influence the metamorphosis of insects. This study will contribute to a better understanding of the impact of UVB on signaling mechanisms in insect metamorphosis.

Delay in treatment of biliary disease during pregnancy increases morbidity and can be avoided with safe laparoscopic cholecystectomy.

PubMed

Muench, J; Albrink, M; Serafini, F; Rosemurgy, A; Carey, L; Murr, M M

2001-06-01

Recent reports indicate that laparoscopic cholecystectomy in pregnancy is safe. The aim of this study was to evaluate whether delays in definitive treatment of symptomatic cholelithiasis increase morbidity. We reviewed the records of 16 women who underwent laparoscopic cholecystectomy during pregnancy between 1992 and 1999. Mean age was 24 +/- 5 years (mean +/- standard error). Symptom onset was during the first trimester in nine patients, second trimester in six patients, and third trimester in one patient. Patients had abdominal pain (93%), nausea (93%), emesis (80%), and fever (66%) for a median of 45 days (range 1-195 days) before cholecystectomy. Nine of 11 women who underwent cholecystectomy more than 5 weeks after onset of symptoms experienced recurrent attacks necessitating 15 hospital admissions and four emergency room visits. Moreover four women who developed symptoms in the first and second trimesters but whose operations were delayed to the third trimester had 11 hospital admissions and four emergency room visits; three of those four (75%) women developed premature contractions necessitating tocolytics. Cholecystectomy was completed laparoscopically in 14 women. There was no hospital infant or maternal mortality or morbidity. We recommend prompt laparoscopic cholecystectomy in pregnant women with symptomatic biliary disease because it is safe and it reduces hospital admissions and frequency of premature labor.

Syntax for calculation of discounting indices from the monetary choice questionnaire and probability discounting questionnaire.

PubMed

Gray, Joshua C; Amlung, Michael T; Palmer, Abraham A; MacKillop, James

2016-09-01

The 27-item Monetary Choice Questionnaire (MCQ; Kirby, Petry, & Bickel, 1999) and 30-item Probability Discounting Questionnaire (PDQ; Madden, Petry, & Johnson, 2009) are widely used, validated measures of preferences for immediate versus delayed rewards and guaranteed versus risky rewards, respectively. The MCQ measures delayed discounting by asking individuals to choose between rewards available immediately and larger rewards available after a delay. The PDQ measures probability discounting by asking individuals to choose between guaranteed rewards and a chance at winning larger rewards. Numerous studies have implicated these measures in addiction and other health behaviors. Unlike typical self-report measures, the MCQ and PDQ generate inferred hyperbolic temporal and probability discounting functions by comparing choice preferences to arrays of functions to which the individual items are preconfigured. This article provides R and SPSS syntax for processing the MCQ and PDQ. Specifically, for the MCQ, the syntax generates k values, consistency of the inferred k, and immediate choice ratios; for the PDQ, the syntax generates h indices, consistency of the inferred h, and risky choice ratios. The syntax is intended to increase the accessibility of these measures, expedite the data processing, and reduce risk for error. © 2016 Society for the Experimental Analysis of Behavior.

AToMS: A Ubiquitous Teleconsultation System for Supporting AMI Patients with Prehospital Thrombolysis.

PubMed

Correa, Bruno S P M; Gonçalves, Bernardo; Teixeira, Iuri M; Gomes, Antônio T A; Ziviani, Artur

2011-01-01

The latest population-based studies in the medical literature worldwide indicate that acute myocardial infarction (AMI) patients still experience prolonged delay to be rescued, which often results in morbidity and mortality. This paper reports from a technological standpoint a teleconsultation and monitoring system named AToMS. This system addresses the problem of prehospital delivery of thrombolysis to AMI patients by enabling the remote interaction of the paramedics and a cardiologist available at a Coronary Care Unit (CCU). Such interaction allows the diagnosis of the patient eligibility to the immediate application of thrombolysis, which is meant to reduce the delay between the onset of symptoms and the eventual application of proper treatment. Such delay reduction is meant to increase the AMI patient's chances of survival and decrease the risks of postinfarction sequels. The teleconsultation is held with the support of wireless and mobile technologies, which also allows the cardiologist to monitor the patient while he/she is being taken to the nearest CCU. All exchanged messages among paramedics and cardiologists are recorded to render an auditable system. AToMS has been deployed in a first stage in the city of Rio de Janeiro, where the medical team involved in the project has conducted commissioned tests.

Primary Fat Grafting to the Pectoralis Muscle during Latissimus Dorsi Breast Reconstruction.

PubMed

Niddam, Jeremy; Vidal, Luciano; Hersant, Barbara; Meningaud, Jean Paul

2016-11-01

Latissimus dorsi flap is one of the best options for immediate and delayed breast reconstruction. However, this technique is limited by the tissue volume provided by the flap. To improve breast volume while reducing complications, fat grafting is now very often used in addition to latissimus dorsi flap. To the best of our knowledge, fat grafting was always performed as a second-line surgery, at least a few months after the flap procedure. We aimed to report our experience with an associated breast reconstruction technique combining musculocutaneous latissimus dorsi flap with intrapectoral lipofilling for totally autologous breast reconstruction. Between September 2014 and January 2015, 20 patients underwent this technique for unilateral autologous breast reconstruction (14 delayed and 6 immediate breast reconstructions). A mean harvested fat volume of 278 ml (range: 190-350 ml) and a mean injected fat volume of 228 ml (range: 170-280 ml) were used. None of the patients experienced complications, such as flap necrosis, breast skin necrosis, hematomas, or infection. One of the patients developed a seroma, which was treated with 3 drainage punctions. Only 2 patients underwent delayed fat grafting procedure. Totally autologous breast reconstruction combining latissimus dorsi flap and intrapectoral fat grafting in the same procedure is a new technique allowing increased breast volume in a single surgery.

Return of visual function after bilateral visual loss following flow diversion embolization of a giant ophthalmic aneurysm due to both reduction in mass effect and reduction in aneurysm pulsation.

PubMed

Patel, Saharsh; Fargen, Kyle M; Peters, Keith; Krall, Peter; Samy, Hazem; Hoh, Brian L

2014-01-10

Large and giant paraclinoid aneurysms are challenging to treat by either surgical or endovascular means. Visual dysfunction secondary to optic nerve compression and its relationship with aneurysm size, pulsation and thrombosis is poorly understood. We present a patient with a giant paraclinoid aneurysm resulting in bilateral visual loss that worsened following placement of a Pipeline Embolization Device and adjunctive coiling. Visual worsening occurred in conjunction with aneurysm thrombosis, increase in maximal aneurysm diameter and new adjacent edema. Her visual function spontaneously improved in a delayed fashion to better than pre-procedure, in conjunction with reduced aneurysmal mass effect, size and pulsation artifact on MRI. This report documents detailed ophthalmologic and MRI evidence for the role of thrombosis, aneurysm mass effect and aneurysm pulsation as causative etiologies for both cranial nerve dysfunction and delayed resolution following flow diversion treatment of large cerebral aneurysms.

Improved pupil dilation with medication-soaked pledget sponges.

PubMed

Weddle, Celeste; Thomas, Nikki; Dienemann, Jacqueline

2013-08-01

Use of multiple preoperative drops for pupil dilation has been shown to be inexact, to delay surgery, and to cause dissatisfaction among perioperative personnel. This article reports on an evidence-based, quality improvement project to locate and appraise research on improved effectiveness and efficiency of mydriasis (ie, pupillary dilation), and the subsequent implementation of a pledget-sponge procedure for pupil dilation at one ambulatory surgery center. Project leaders used an evidence-based practice model to assess the problem, research options for improvement, define goals, and implement a pilot project to test the new dilation technique. Outcomes from the pilot project showed a reduced number of delays caused by poor pupil dilation and a decrease in procedure turnover time. The project team solicited informal feedback from preoperative nurses, which reflected increased satisfaction in preparing patients for cataract procedures. After facility administrators and surgeons accepted the procedure change, it was adopted for preoperative use for all patients undergoing cataract surgery at the ambulatory surgery center. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Effects of a group rational-emotive behavior therapy program on the Type A behavior pattern.

PubMed

Möller, A T; Botha, H C

1996-06-01

A sample of 44 male Type A insurance representatives, selected by means of the Videotaped Structured Interview, were randomly assigned to a treatment (n = 22) and a delayed treatment control group (n = 22). The treatment group participated in 9 weekly sessions of group Rational-Emotive Behavior Therapy and were followed up after 10 weeks. After the control period, the delayed treatment control group received the same treatment program. Repeated measurements were obtained by means of the Videotaped Structured Interview, Jenkins Activity Survey, Cook-Medley Hostility Scale, and Type A Cognitive Questionnaire. Self and spouse/friend ratings of Type A behavior were obtained by means of the Bortner Rating Scale. Analysis indicated that, compared to the control condition, the therapy significantly reduced the intensity of Type A behavior and its time urgency component. These improvements were maintained at follow-up and were accompanied by self-reports of significant positive changes in Type A behavior and irrational beliefs.

Use of nicotine replacement therapy to reduce or delay smoking but not to quit: prevalence and association with subsequent cessation efforts.

PubMed

Levy, Douglas E; Thorndike, Anne N; Biener, Lois; Rigotti, Nancy A

2007-12-01

To assess the prevalence of nicotine replacement therapy (NRT) use for purposes other than quitting smoking and examine the relation of this non-standard NRT use (NSNRT) with subsequent smoking cessation efforts. A population based cohort study of adult smokers who were interviewed by telephone at baseline (2001-2) and at two year follow-up. The association between NSNRT use to cut down on smoking or to delay smoking before baseline and cessation attempts and smoking outcomes at two year follow-up was assessed using logistic regression to adjust for multiple potential confounding factors. Massachusetts, USA. 1712 adult smokers in Massachusetts who were selected using a random digit dial telephone survey. Quit attempt in 12 months before follow-up, NRT use at quit attempt in 12 months before follow-up, smoking cessation by follow-up, or 50% reduction in cigarettes smoked per day between baseline and follow-up. 18.7% of respondents reported ever having used NSNRT. In a multiple logistic regression analysis, there was no statistically significant association between past NSNRT use and quit attempts (OR(cut down) = 0.89, 95% CI 0.59 to 1.33; OR(delay) = 1.29, 95% CI 0.73 to 2.29), smoking cessation (OR(cut down) = 0.74, 95% CI 0.43 to 1.24; OR(delay) = 1.22, 95% CI 0.60 to 2.50) or 50% reduction in cigarettes smoked per day (OR(cut down) = 0.93, 95% CI 0.62 to 1.38; OR(delay) = 0.80, 95% CI 0.43 to 1.49) at follow-up. Past use of NRT to cut down on cigarettes was associated with use of NRT at a follow-up quit attempt (OR(cut down) = 2.28, 95% CI 1.50 to 3.47) but past use of NRT to delay smoking was not (OR(delay) = 1.25, 95% CI 0.67 to 2.34). Use of NRT for reasons other than quitting smoking may be more common than was previously estimated. This population based survey finds no strong evidence that NRT use for purposes other than quitting smoking is either harmful or helpful.

Executive function mediates prospective relationships between sleep duration and sedentary behavior in children.

PubMed

Warren, Christopher; Riggs, Nathaniel; Pentz, Mary Ann

2016-10-01

Childhood sedentary behavior has been linked to increased obesity risk. Prior work has identified associations between sedentary behavior, executive function (EF), and sleep. This study tested the hypothesis that reduced sleep duration may adversely impact EF and lead to increased childhood sedentary behavior. Southern California schoolchildren participating in the school-based health promotion program Pathways to Health (N=709) were assessed annually from 4th through 6th grades (2010-2013) on self-report measures of sedentary behavior, sleep duration, and executive function. A series of path models were specified treating average nightly sleep duration and weekend wake/bed-time shift at 4th grade as predictors of 6th grade sedentary behavior. Four EF subdomains were tested as potential mediators of longitudinal associations at 5th grade. Significant associations between average nightly sleep duration, EF and sedentary behavior were identified (p<0.05), adjusting for participant gender, physical activity, SES, ethnicity, program group assignment, and the presence/absence of parental screen time rules. Fifth grade overall EF (p<0.05)-and in particular the subdomains of inhibitory control (p<0.05) and organization of materials (p<0.01)-significantly mediated the relationship between 4th grade sleep duration and 6th grade sedentary behavior (p<0.05). Furthermore, delay of weekend bed- or wake-times relative to weekdays was prospectively associated with decreased overall EF (p<0.05), but not increased sedentary behavior (p=0.35 for bed-time delay; p=0.64 for wake-time delay), irrespective of average nightly sleep duration. Findings suggest that sleep promotion efforts may reduce children's sedentary behavior both directly and indirectly through changes in EF. Copyright © 2016 Elsevier Inc. All rights reserved.

Prolongation of ERP latency and reaction time (RT) in simultaneous EEG/fMRI data acquisition.

PubMed

Chun, Jinsoo; Peltier, Scott J; Yoon, Daehyun; Manschreck, Theo C; Deldin, Patricia J

2016-08-01

Recording EEG and fMRI data simultaneously inside a fully-operating scanner has been recognized as a novel approach in human brain research. Studies have demonstrated high concordance between the EEG signals and hemodynamic response. However, a few studies reported altered cognitive process inside the fMRI scanner such as delayed reaction time (RT) and reduced and/or delayed N100 and P300 event-related brain potential (ERP) components. The present study investigated the influence of electromagnetic field (static magnetic field, radio frequency (RF) pulse, and gradient switching) and experimental environment on posterior N100 and P300 ERP components in four different settings with six healthy subjects using a visual oddball task: (1) classic fMRI acquisition inside the scanner (e.g., supine position, mirror glasses for stimulus presentation), (2) standard behavioral experiment outside the scanner (e.g., seated position, keyboard response), (3) controlled fMRI acquisition inside the scanner (e.g., organic light-emitting diode (OLED) goggles for stimulus presentation) inside; and (4) modified behavioral experiment outside the scanner (e.g., supine position, OLED goggles). The study findings indicated that the experimental environment in simultaneous EEG/fMRI acquisition could substantially delay N1P, P300 latency, and RT inside the scanner, and was associated with a reduced N1P amplitude. There was no effect of electromagnetic field in the prolongation of RT, N1P and P300 latency inside the scanner. N1P, but not P300, latency was sensitive to stimulus presentation method inside the scanner. Future simultaneous EEG/fMRI data collection should consider experimental environment in both design and analysis. Copyright © 2016 Elsevier B.V. All rights reserved.

Are German patients burdened by the practice charge for physician visits ('Praxisgebuehr')? A cross sectional analysis of socio-economic and health related factors

PubMed Central

Rückert, Ina-Maria; Böcken, Jan; Mielck, Andreas

2008-01-01

Background In 2004, a practice charge for physician visits ('Praxisgebuehr') was implemented in the German health care system, mainly in order to reduce expenditures of sickness funds by reducing outpatient physician visits. In the statutory sickness funds, all adults now have to pay € 10 at their first physician visit in each 3 month period, except for vaccinations and preventive services. This study looks at the effect of this new patient fee on delaying or avoiding physician visits, with a special emphasis on different income groups. Methods Six representative surveys (conducted between 2004 and 2006) of the Bertelsmann Healthcare Monitor were analysed, comprising 7,769 women and men aged 18 to 79 years. The analyses are based on stratified analyses and logistic regression models, including a focus on the subgroup having a chronic disease. Results Two results can be highlighted. First, avoiding or delaying a physician visit due to this fee is seen most often among younger and healthier adults. Second, those in the lowest income group are much more affected in this way than the better of. The multivariate analysis in the subgroup of respondents having a chronic disease shows, for example, that this reaction is reported 2.45 times more often in the lowest income group than in the highest income group (95% CI: 1.90–3.15). Conclusion The analyses indicate that the effects of the practice charge differ by socio-economic group. It would be important to assess these effects in more detail, especially the effects on health care quality and health outcomes. It can be assumed, however, that avoiding or delaying physician visits jeopardizes both, and that health inequalities are increasing due to the practice charge. PMID:19014476

Novel flashlamp-based time-resolved fluorescence microscope reduces autofluorescence for 30-fold contrast enhancement in environmental samples

NASA Astrophysics Data System (ADS)

Connally, Russell; Veal, Duncan; Piper, James A.

2003-07-01

The abundance of naturally fluorescing components (autofluorophors) encountered in environmentally sourced samples can greatly hinder the detection and identification of fluorescently labeled target using fluorescence microscopy. Time-resolved fluorescence microscopy (TRFM) is a technique that reduces the effects of autofluorescence through precisely controlled time delays. Lanthanide chelates have fluorescence lifetimes many orders of magnitude greater than typical autofluorophors, and persist in their luminescence long after autofluorescence has ceased. An intense short pulse of (UV) light is used to excite fluorescence in the sample and after a short delay period the longer persisting fluorescence from the chelate is captured with an image-intensified CCD camera. The choice of pulsed excitation source for TRFM has a large impact on the price and performance of the instrument. A flashlamp with a short pulse duration was selected for our instrument because of the high spectral energy in the UV region and short pulse length. However, flash output decays with an approximate lifetime of 18μs and the TRFM requires a long-lived chelate to ensure probe fluorescence is still visible after decay of the flash plasma. We synthesized a recently reported fluorescent chelate (BHHCT) and conjugated it to a monoclonal antibody directed against the water-borne parasite Giardia lamblia. Fluorescence lifetime of the construct was determined to be 339μs +/- 14μs and provided a 45-fold enhancement of labeled Giardia over background using a gate delay of 100μs. Despite the sub-optimal decay characteristics of the light pulse, flashlamps have many advantages compared to optical chopper wheels and modulated lasers. Their low cost, lack of vibration, ease of interface and small footprint are important factors to consider in TRFM design.

Executive function mediates prospective relationships between sleep duration and sedentary behavior in children

PubMed Central

Warren, Christopher; Riggs, Nathaniel; Pentz, Mary Ann

2016-01-01

Childhood sedentary behavior has been linked to increased obesity risk. Prior work has identified associations between sedentary behavior, executive function (EF), and sleep. This study tested the hypothesis that reduced sleep duration may adversely impact EF and lead to increased childhood sedentary behavior. Southern California schoolchildren participating in the school-based health promotion program Pathways to Health (N = 709) were assessed annually from 4th through 6th grades (2010–2013) on self-report measures of sedentary behavior, sleep duration, and executive function. A series of path models were specified treating average nightly sleep duration and weekend wake/bed-time shift at 4th grade as predictors of 6th grade sedentary behavior. Four EF subdomains were tested as potential mediators of longitudinal associations at 5th grade. Significant associations between average nightly sleep duration, EF and sedentary behavior were identified (p < 0.05), adjusting for participant gender, physical activity, SES, ethnicity, program group assignment, and the presence/absence of parental screen time rules. Fifth grade overall EF (p < 0.05)—and in particular the subdomains of inhibitory control (p < 0.05) and organization of materials (p < 0.01)—significantly mediated the relationship between 4th grade sleep duration and 6th grade sedentary behavior (p < 0.05). Furthermore, delay of weekend bed- or wake-times relative to weekdays was prospectively associated with decreased overall EF (p < 0.05), but not increased sedentary behavior (p = 0.35 for bed-time delay; p = 0.64 for wake-time delay), irrespective of average nightly sleep duration. Findings suggest that sleep promotion efforts may reduce children’s sedentary behavior both directly and indirectly through changes in EF. PMID:27477059

Effects of emotion on prospection during decision-making.

PubMed

Worthy, Darrell A; Byrne, Kaileigh A; Fields, Sherecce

2014-01-01

In two experiments we examined the role of emotion, specifically worry, anxiety, and mood, on prospection during decision-making. Worry is a particularly relevant emotion to study in the context of prospection because high levels of worry may make individuals more aversive toward the uncertainty associated with the prospect of obtaining future improvements in rewards or states. Thus, high levels of worry might lead to reduced prospection during decision-making and enhance preference for immediate over delayed rewards. In Experiment 1 participants performed a two-choice dynamic decision-making task where they were required to choose between one option (the decreasing option) which provided larger immediate rewards but declines in future states, and another option (the increasing option) which provided smaller immediate rewards but improvements in future states, making it the optimal choice. High levels of worry were associated with poorer performance in the task. Additionally, fits of a sophisticated reinforcement-learning model that incorporated both reward-based and state-based information suggested that individuals reporting high levels of worry gave greater weight to the immediate rewards they would receive on each trial than to the degree to which each action would lead to improvements in their future state. In Experiment 2 we found that high levels of worry were associated with greater delay discounting using a standard delay discounting task. Combined, the results suggest that high levels of worry are associated with reduced prospection during decision-making. We attribute these results to high worriers' aversion toward the greater uncertainty associated with attempting to improve future rewards than to maximize immediate reward. These results have implications for researchers interested in the effects of emotion on cognition, and suggest that emotion strongly affects the focus on temporal outcomes during decision-making.

The Effect of Age in the Alteration in Fluid Balance of Rats in Response to Centrifugation

NASA Technical Reports Server (NTRS)

Fuller, Charles A.

2000-01-01

With an increase in gravity load induced by centrifugation or upon return to Earth following spaceflight, there is a period of adjustment in fluid balance in rats. With centrifugation there is a reduced fluid intake with maintenance of the rate of urine excretion. Following spaceflight there is an increase in urine output and maintenance of fluid intake. The initial period of acclimation to hypergravity is associated with a net loss of fluids. In the present study in response to centrifugation at 2.0 G this period of acclimation is present in mature rats for a longer period of time, about 24 hours. Following this initial response a period of over compensation has previously been reported. In the present study this was not observed. The net effect of these alterations in water intake and output in response to centrifugation for 14 days was slight increase in the percent total body water, with effective compensation seen in both young and mature rats. Older rats have been shown to have a reduced relative thirst and compensatory renal function in response to hypohydration, hyperosmolality and pharmacological stimuli. Responsiveness to these stimuli are delayed and/or attenuated in older animals. Similar findings were noted in the present study in the initial response to centrifugation. The older animal had a delayed return of fluid intake to control levels. The delay of one day did not appear to effect long-term fluid homeostasis, as there was difference in the response of percent total body water at the end of 14 days of centrifugation with both age groups having a slight but significant increase. This increase has been attributed to the increase in lean body mass induced by centrifugation.

Practice guideline update summary: Corticosteroid treatment of Duchenne muscular dystrophy: Report of the Guideline Development Subcommittee of the American Academy of Neurology.

PubMed

Gloss, David; Moxley, Richard T; Ashwal, Stephen; Oskoui, Maryam

2016-02-02

To update the 2005 American Academy of Neurology (AAN) guideline on corticosteroid treatment of Duchenne muscular dystrophy (DMD). We systematically reviewed the literature from January 2004 to July 2014 using the AAN classification scheme for therapeutic articles and predicated recommendations on the strength of the evidence. Thirty-four studies met inclusion criteria. In children with DMD, prednisone should be offered for improving strength (Level B) and pulmonary function (Level B). Prednisone may be offered for improving timed motor function (Level C), reducing the need for scoliosis surgery (Level C), and delaying cardiomyopathy onset by 18 years of age (Level C). Deflazacort may be offered for improving strength and timed motor function and delaying age at loss of ambulation by 1.4-2.5 years (Level C). Deflazacort may be offered for improving pulmonary function, reducing the need for scoliosis surgery, delaying cardiomyopathy onset, and increasing survival at 5-15 years of follow-up (Level C for each). Deflazacort and prednisone may be equivalent in improving motor function (Level C). Prednisone may be associated with greater weight gain in the first years of treatment than deflazacort (Level C). Deflazacort may be associated with a greater risk of cataracts than prednisone (Level C). The preferred dosing regimen of prednisone is 0.75 mg/kg/d (Level B). Over 12 months, prednisone 10 mg/kg/weekend is equally effective (Level B), with no long-term data available. Prednisone 0.75 mg/kg/d is associated with significant risk of weight gain, hirsutism, and cushingoid appearance (Level B). © 2016 American Academy of Neurology.

Scalp defects, polythelia, microcephaly, and developmental delay: a new syndrome with apparent autosomal dominant inheritance.

PubMed

Marble, Michael; Pridjian, Gabriella

2002-04-01

We report a family with apparent autosomal dominant inheritance of scalp defects, polythelia, microcephaly, and developmental delay. A review of the literature revealed no previous report of this combination of anomalies. We conclude that these patients have a new autosomal dominant syndrome. Copyright 2002 Wiley-Liss, Inc.

31 CFR 361.7 - Report of loss, destruction or damage.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT CLAIMS PURSUANT TO THE GOVERNMENT... the Bureau of the Public Debt, Division of Financial Management, Room 201, P. O. Box 1328, Parkersburg...,000 or if delay in reporting is likely to delay the Government in recovering such valuables, the...

Delayed and forgone care for families with chronic conditions in high-deductible health plans.

PubMed

Galbraith, Alison A; Soumerai, Stephen B; Ross-Degnan, Dennis; Rosenthal, Meredith B; Gay, Charlene; Lieu, Tracy A

2012-09-01

High-deductible health plans (HDHPs) are an increasingly common strategy to contain health care costs. Individuals with chronic conditions are at particular risk for increased out-of-pocket costs in HDHPs and resulting cost-related underuse of essential health care. To evaluate whether families with chronic conditions in HDHPs have higher rates of delayed or forgone care due to cost, compared with those in traditional health insurance plans. This mail and phone survey used multiple logistic regression to compare family-level rates of reporting delayed/forgone care in HDHPs vs. traditional plans. We selected families with children that had at least one member with a chronic condition. Families had employer-sponsored insurance in a Massachusetts health plan and >12 months of enrollment in an HDHP or a traditional plan. The primary outcome was report of any delayed or forgone care due to cost (acute care, emergency department visits, chronic care, checkups, or tests) for adults or children during the prior 12 months. Respondents included 208 families in HDHPs and 370 in traditional plans. Membership in an HDHP and lower income were each independently associated with higher probability of delayed/forgone care due to cost. For adult family members, the predicted probability of delayed/forgone care due to cost was higher in HDHPs than in traditional plans [40.0% vs 15.1% among families with incomes <400% of the federal poverty level (FPL) and 16.0% vs 4.8% among those with incomes ≥400% FPL]. Similar associations were observed for children. Among families with chronic conditions, reporting of delayed/forgone care due to cost is higher for both adults and children in HDHPs than in traditional plans. Families with lower incomes are also at higher risk for delayed/forgone care.

A Deadline-Aware Scheduling and Forwarding Scheme in Wireless Sensor Networks.

PubMed

Dao, Thi-Nga; Yoon, Seokhoon; Kim, Jangyoung

2016-01-05

Many applications in wireless sensor networks (WSNs) require energy consumption to be minimized and the data delivered to the sink within a specific delay. A usual solution for reducing energy consumption is duty cycling, in which nodes periodically switch between sleep and active states. By increasing the duty cycle interval, consumed energy can be reduced more. However, a large duty cycle interval causes a long end-to-end (E2E) packet delay. As a result, the requirement of a specific delay bound for packet delivery may not be satisfied. In this paper, we aim at maximizing the duty cycle while still guaranteeing that the packets arrive at the sink with the required probability, i.e., the required delay-constrained success ratio (DCSR) is achieved. In order to meet this objective, we propose a novel scheduling and forwarding scheme, namely the deadline-aware scheduling and forwarding (DASF) algorithm. In DASF, the E2E delay distribution with the given network model and parameters is estimated in order to determine the maximum duty cycle interval, with which the required DCSR is satisfied. Each node independently selects a wake-up time using the selected interval, and packets are forwarded to a node in the potential forwarding set, which is determined based on the distance between nodes and the sink. DASF does not require time synchronization between nodes, and a node does not need to maintain neighboring node information in advance. Simulation results show that the proposed scheme can satisfy a required delay-constrained success ratio and outperforms existing algorithms in terms of E2E delay and DCSR.

A Deadline-Aware Scheduling and Forwarding Scheme in Wireless Sensor Networks

PubMed Central

Dao, Thi-Nga; Yoon, Seokhoon; Kim, Jangyoung

2016-01-01

Many applications in wireless sensor networks (WSNs) require energy consumption to be minimized and the data delivered to the sink within a specific delay. A usual solution for reducing energy consumption is duty cycling, in which nodes periodically switch between sleep and active states. By increasing the duty cycle interval, consumed energy can be reduced more. However, a large duty cycle interval causes a long end-to-end (E2E) packet delay. As a result, the requirement of a specific delay bound for packet delivery may not be satisfied. In this paper, we aim at maximizing the duty cycle while still guaranteeing that the packets arrive at the sink with the required probability, i.e., the required delay-constrained success ratio (DCSR) is achieved. In order to meet this objective, we propose a novel scheduling and forwarding scheme, namely the deadline-aware scheduling and forwarding (DASF) algorithm. In DASF, the E2E delay distribution with the given network model and parameters is estimated in order to determine the maximum duty cycle interval, with which the required DCSR is satisfied. Each node independently selects a wake-up time using the selected interval, and packets are forwarded to a node in the potential forwarding set, which is determined based on the distance between nodes and the sink. DASF does not require time synchronization between nodes, and a node does not need to maintain neighboring node information in advance. Simulation results show that the proposed scheme can satisfy a required delay-constrained success ratio and outperforms existing algorithms in terms of E2E delay and DCSR. PMID:26742046

Low-noise delays from dynamic Brillouin gratings based on perfect Golomb coding of pump waves.

PubMed

Antman, Yair; Levanon, Nadav; Zadok, Avi

2012-12-15

A method for long variable all-optical delay is proposed and simulated, based on reflections from localized and stationary dynamic Brillouin gratings (DBGs). Inspired by radar methods, the DBGs are inscribed by two pumps that are comodulated by perfect Golomb codes, which reduce the off-peak reflectivity. Compared with random bit sequence coding, Golomb codes improve the optical signal-to-noise ratio (OSNR) of delayed waveforms by an order of magnitude. Simulations suggest a delay of 5  Gb/s data by 9 ns, or 45 bit durations, with an OSNR of 13 dB.

Equalizer tap length requirement for mode group delay-compensated fiber link with weakly random mode coupling.

PubMed

Bai, Neng; Li, Guifang

2014-02-24

The equalizer tap length requirement is investigated analytically and numerically for differential modal group delay (DMGD) compensated fiber link with weakly random mode coupling. Each span of the DMGD compensated link comprises multiple pairs of fibers which have opposite signs of DMGD. The result reveals that under weak random mode coupling, the required tap length of the equalizer is proportional to modal group delay of a single DMGD compensated pair, instead of the total modal group delay (MGD) of the entire link. By using small DMGD compensation step sizes, the required tap length (RTL) can be potentially reduced by 2 orders of magnitude.

Tracking delays in report availability caused by incorrect exam status with Web-based issue tracking: a quality initiative.

PubMed

Awan, Omer Abdulrehman; van Wagenberg, Frans; Daly, Mark; Safdar, Nabile; Nagy, Paul

2011-04-01

Many radiology information systems (RIS) cannot accept a final report from a dictation reporting system before the exam has been completed in the RIS by a technologist. A radiologist can still render a report in a reporting system once images are available, but the RIS and ancillary systems may not get the results because of the study's uncompleted status. This delay in completing the study caused an alarming number of delayed reports and was undetected by conventional RIS reporting techniques. We developed a Web-based reporting tool to monitor uncompleted exams and automatically page section supervisors when a report was being delayed by its incomplete status in the RIS. Institutional Review Board exemption was obtained. At four imaging centers, a Python script was developed to poll the dictation system every 10 min for exams in five different modalities that were signed by the radiologist but could not be sent to the RIS. This script logged the exams into an existing Web-based tracking tool using PHP and a MySQL database. The script also text-paged the modality supervisor. The script logged the time at which the report was finally sent, and statistics were aggregated onto a separate Web-based reporting tool. Over a 1-year period, the average number of uncompleted exams per month and time to problem resolution decreased at every imaging center and in almost every imaging modality. Automated feedback provides a vital link in improving technologist performance and patient care without assigning a human resource to manage report queues.

The delay period as an opportunity to think about future intentions: Effects of delay length and delay task difficulty on young adult's prospective memory performance.

PubMed

Mahy, Caitlin E V; Schnitzspahn, Katharina; Hering, Alexandra; Pagobo, Jacqueline; Kliegel, Matthias

2018-05-01

The current study examined the impact of length and difficulty of the delay task on young adult's event-based prospective memory (PM). Participants engaged in either a short (2.5 min) or a long (15 min) delay that was filled with either a simple item categorization task or a difficult cognitive task. They also completed a questionnaire on whether they thought about the PM intention during the delay period and how often they thought about it. Results revealed that participants' PM was better after a difficult delay task compared to an easy delay task. Participants thought about the PM intention more often during the difficult delay task than during the easy delay task. PM performance was positively related to participants' reports of how many times they thought about their intentions. The important role of delay task difficulty in allowing or preventing individuals from refreshing their future intentions is discussed.

Models of Weather Impact on Air Traffic

NASA Technical Reports Server (NTRS)

Kulkarni, Deepak; Wang, Yao

2017-01-01

Flight delays have been a serious problem in the national airspace system costing about $30B per year. About 70 of the delays are attributed to weather and upto two thirds of these are avoidable. Better decision support tools would reduce these delays and improve air traffic management tools. Such tools would benefit from models of weather impacts on the airspace operations. This presentation discusses use of machine learning methods to mine various types of weather and traffic data to develop such models.

System and method for adaptively deskewing parallel data signals relative to a clock

DOEpatents

Jenkins, Philip Nord [Eau Claire, WI; Cornett, Frank N [Chippewa Falls, WI

2008-10-07

A system and method of reducing skew between a plurality of signals transmitted with a transmit clock is described. Skew is detected between the received transmit clock and each of received data signals. Delay is added to the clock or to one or more of the plurality of data signals to compensate for the detected skew. The delay added to each of the plurality of delayed signals is updated to adapt to changes in detected skew.

System and method for adaptively deskewing parallel data signals relative to a clock

DOEpatents

Jenkins, Philip Nord [Redwood Shores, CA; Cornett, Frank N [Chippewa Falls, WI

2011-10-04

A system and method of reducing skew between a plurality of signals transmitted with a transmit clock is described. Skew is detected between the received transmit clock and each of received data signals. Delay is added to the clock or to one or more of the plurality of data signals to compensate for the detected skew. The delay added to each of the plurality of delayed signals is updated to adapt to changes in detected skew.

Process improvement to enhance existing stroke team activity toward more timely thrombolytic treatment.

PubMed

Cho, Han-Jin; Lee, Kyung Yul; Nam, Hyo Suk; Kim, Young Dae; Song, Tae-Jin; Jung, Yo Han; Choi, Hye-Yeon; Heo, Ji Hoe

2014-10-01

Process improvement (PI) is an approach for enhancing the existing quality improvement process by making changes while keeping the existing process. We have shown that implementation of a stroke code program using a computerized physician order entry system is effective in reducing the in-hospital time delay to thrombolysis in acute stroke patients. We investigated whether implementation of this PI could further reduce the time delays by continuous improvement of the existing process. After determining a key indicator [time interval from emergency department (ED) arrival to intravenous (IV) thrombolysis] and conducting data analysis, the target time from ED arrival to IV thrombolysis in acute stroke patients was set at 40 min. The key indicator was monitored continuously at a weekly stroke conference. The possible reasons for the delay were determined in cases for which IV thrombolysis was not administered within the target time and, where possible, the problems were corrected. The time intervals from ED arrival to the various evaluation steps and treatment before and after implementation of the PI were compared. The median time interval from ED arrival to IV thrombolysis in acute stroke patients was significantly reduced after implementation of the PI (from 63.5 to 45 min, p=0.001). The variation in the time interval was also reduced. A reduction in the evaluation time intervals was achieved after the PI [from 23 to 17 min for computed tomography scanning (p=0.003) and from 35 to 29 min for complete blood counts (p=0.006)]. PI is effective for continuous improvement of the existing process by reducing the time delays between ED arrival and IV thrombolysis in acute stroke patients.

Digital tanlock loop architecture with no delay

NASA Astrophysics Data System (ADS)

Al-Kharji AL-Ali, Omar; Anani, Nader; Al-Araji, Saleh; Al-Qutayri, Mahmoud; Ponnapalli, Prasad

2012-02-01

This article proposes a new architecture for a digital tanlock loop which eliminates the time-delay block. The ? (rad) phase shift relationship between the two channels, which is generated by the delay block in the conventional time-delay digital tanlock loop (TDTL), is preserved using two quadrature sampling signals for the loop channels. The proposed system outperformed the original TDTL architecture, when both systems were tested with frequency shift keying input signal. The new system demonstrated better linearity and acquisition speed as well as improved noise performance compared with the original TDTL architecture. Furthermore, the removal of the time-delay block enables all processing to be digitally performed, which reduces the implementation complexity. Both the original TDTL and the new architecture without the delay block were modelled and simulated using MATLAB/Simulink. Implementation issues, including complexity and relation to simulation of both architectures, are also addressed.

Data Assimilation by delay-coordinate nudging

NASA Astrophysics Data System (ADS)

Pazo, Diego; Lopez, Juan Manuel; Carrassi, Alberto

2016-04-01

A new nudging method for data assimilation, delay-coordinate nudging, is presented. Delay-coordinate nudging makes explicit use of present and past observations in the formulation of the forcing driving the model evolution at each time-step. Numerical experiments with a low order chaotic system show that the new method systematically outperforms standard nudging in different model and observational scenarios, also when using an un-optimized formulation of the delay-nudging coefficients. A connection between the optimal delay and the dominant Lyapunov exponent of the dynamics is found based on heuristic arguments and is confirmed by the numerical results, providing a guideline for the practical implementation of the algorithm. Delay-coordinate nudging preserves the easiness of implementation, the intuitive functioning and the reduced computational cost of the standard nudging, making it a potential alternative especially in the field of seasonal-to-decadal predictions with large Earth system models that limit the use of more sophisticated data assimilation procedures.

Synchronization of Switched Neural Networks With Communication Delays via the Event-Triggered Control.

PubMed

Wen, Shiping; Zeng, Zhigang; Chen, Michael Z Q; Huang, Tingwen

2017-10-01

This paper addresses the issue of synchronization of switched delayed neural networks with communication delays via event-triggered control. For synchronizing coupled switched neural networks, we propose a novel event-triggered control law which could greatly reduce the number of control updates for synchronization tasks of coupled switched neural networks involving embedded microprocessors with limited on-board resources. The control signals are driven by properly defined events, which depend on the measurement errors and current-sampled states. By using a delay system method, a novel model of synchronization error system with delays is proposed with the communication delays and event-triggered control in the unified framework for coupled switched neural networks. The criteria are derived for the event-triggered synchronization analysis and control synthesis of switched neural networks via the Lyapunov-Krasovskii functional method and free weighting matrix approach. A numerical example is elaborated on to illustrate the effectiveness of the derived results.

Strategic attention deployment for delay of gratification in working and waiting situations.

PubMed

Peake, Philip K; Mischel, Walter; Hebl, Michelle

2002-03-01

Two studies examined whether the detrimental effects of attention to rewards on delay of gratification in waiting situations holds-or reverses-in working situations. In Study 1, preschoolers waited or worked for desired delayed rewards. Delay times increased when children worked in the presence of rewards but, as predicted, this increase was due to the distraction provided by the work itself. not because attention to rewards motivated children to sustain work. Analysis of spontaneous attention deployment showed that attending to rewards reduces delay time regardless of the working or waiting nature of the task. Fixing attention on rewards was a particularly detrimental strategy regardless of the type of task. Study 2 showed that when the work is not engaging, however, attention to rewards can motivate instrumental work and facilitate delay of gratification as long as attention deployment does not become fixed on the rewards.

The influences of delay time on the stability of a market model with stochastic volatility

NASA Astrophysics Data System (ADS)

Li, Jiang-Cheng; Mei, Dong-Cheng

2013-02-01

The effects of the delay time on the stability of a market model are investigated, by using a modified Heston model with a cubic nonlinearity and cross-correlated noise sources. These results indicate that: (i) There is an optimal delay time τo which maximally enhances the stability of the stock price under strong demand elasticity of stock price, and maximally reduces the stability of the stock price under weak demand elasticity of stock price; (ii) The cross correlation coefficient of noises and the delay time play an opposite role on the stability for the case of the delay time <τo and the same role for the case of the delay time >τo. Moreover, the probability density function of the escape time of stock price returns, the probability density function of the returns and the correlation function of the returns are compared with other literatures.

Buspirone Reduces Sexual Risk-Taking Intent but not Cocaine Self-Administration

PubMed Central

Bolin, B. Levi; Lile, Joshua A.; Marks, Katherine R.; Beckmann, Joshua S.; Rush, Craig R.; Stoops, William W.

2016-01-01

Impulsive sexual decision-making may underlie sexual risk-taking behavior that contributes to the disproportionately high prevalence of HIV infection among cocaine users. Delay-discounting procedures measure impulsive decision-making and may provide insight into the underlying mechanisms of sexual risk-taking behavior. The anxiolytic drug buspirone reduces delay discounting in rats and blunts the reinforcing effects of cocaine in some preclinical studies suggesting that it might have utility in the treatment of cocaine-use disorders. This study determined whether buspirone mitigates impulsive risky sexual decision-making in cocaine users on a sexual delay-discounting procedure. The effects of buspirone maintenance on the abuse-related and physiological effects of cocaine were also tested. Nine (N = 9) current cocaine users completed a repeated-measures, inpatient protocol in which sexual delay discounting was assessed following three days of maintenance on placebo and buspirone (30 mg/day) in counterbalanced order. The reinforcing, subject-rated, and physiological effects of placebo and intranasal cocaine (15 and 45 mg) were also assessed during buspirone and placebo maintenance. Buspirone increased the likelihood of condom use for hypothetical sexual partners that were categorized as most likely to have a sexually transmitted infection and least sexually desirable. Cocaine functioned as a reinforcer and increased positive subjective effects ratings, but buspirone maintenance did not impact these effects of cocaine. Buspirone was also safe and tolerable when combined with cocaine and may have blunted some its cardiovascular effects. The results from the sexual delay-discounting procedure indicate that buspirone may reduce preference for riskier sex in cocaine users. PMID:27254258

Validity of False Belief Tasks in Blind Children

ERIC Educational Resources Information Center

Brambring, Michael; Asbrock, Doreen

2010-01-01

Previous studies have reported that congenitally blind children without any additional impairment reveal a developmental delay of at least 4 years in perspective taking based on testing first-order false-belief tasks. These authors interpret this delay as a sign of autism-like behavior. However, the delay may be caused by testing blind children…

Comparison of operative notes with real-time observation of adhesiolysis-related complications during surgery.

PubMed

ten Broek, R P G; van den Beukel, B A W; van Goor, H

2013-02-01

The operative report contains critical information for patient care, serves an educational purpose and is an important source for surgical research. Recent studies demonstrate that operative reports are unstructured and lack vital components. The accuracy of the operative notes has never been assessed. The aim of this study was to analyse the accuracy of operative reports by comparing notes with intraoperative observer-derived findings regarding adhesions and adhesiolysis-related complications. The incidence of adhesions and adhesiolysis-induced injury were scored from the reports by a researcher blinded to operative findings obtained prospectively by direct observation. In addition, factors influencing correct reporting were analysed, including sex, surgical experience, delay in dictation, and the gradual introduction of a new report template with a focus on describing operative findings rather than actions taken. A total of 755 consecutive operative reports were analysed. Sensitivity and specificity for the incidence of adhesions was 85·1 and 72·4 per cent respectively. Six of 43 inadvertent enterotomies, and 17 of 48 other organ injuries, had not been reported. All missed bowel injuries were found in reports written in the old template. A median delay in dictating of 3 (range 1-226) working days was found for 56 reports (7·4 per cent). Documentation of inadvertent enterotomies was missing more often in delayed reports (2 of 3 versus 4 of 40 reports dictated with no delay; P = 0·022). The sensitivity and specificity of operative reports noting adhesions and adhesiolysis were low. One in seven enterotomies was not reported. Effort should be put into teaching timely, meaningful, structured and accurate reporting of surgical procedures. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Stigma of Mental Illness-1: Clinical reflections

PubMed Central

Shrivastava, Amresh; Johnston, Megan; Bureau, Yves

2012-01-01

Although the quality and effectiveness of mental health treatments and services have improved greatly over the past 50 years, therapeutic revolutions in psychiatry have not yet been able to reduce stigma. Stigma is a risk factor leading to negative mental health outcomes. It is responsible for treatment seeking delays and reduces the likelihood that a mentally ill patient will receive adequate care. It is evident that delay due to stigma can have devastating consequences. This review will discuss the causes and consequences of stigma related to mental illness. PMID:22654383

Implementation of a "No Fly" safety culture in a multicenter radiation medicine department.

PubMed

Potters, Louis; Kapur, Ajay

2012-01-01

The safe delivery of radiation therapy requires multiple disciplines and interactions to perform flawlessly for each patient. Because treatment is individualized and every aspect of the patient's care is unique, it is difficult to regiment a delivery process that works flawlessly. The purpose of this study is to describe one safety-directed component of our quality program called the "No Fly Policy" (NFP). Our quality assurance program for radiation therapy reviewed the entire process of care prior, during, and after a patient's treatment course. Each component of care was broken down and rebuilt within a matrix of multidisciplinary safety quality checklists (QCL). The QCL process map was subsequently streamlined with revised task due dates and stopping rules. The NFP was introduced to place a holding pattern on treatment initiation pending reconciliation of associated stopping events. The NFP was introduced in a pilot phase using a Six-Sigma process improvement approach. Quantitative analysis on the performance of the new QCLs was performed using crystal reports in the Oncology Information Systems. Root cause analysis was conducted. Notable improvements in QCL performance were observed. The variances among staff in completing tasks reduced by a factor of at least 3, suggesting better process control. Steady improvements over time indicated an increasingly compliant and controlled adoption of the new safety-oriented process map. Stopping events led to rescheduling treatments with average and maximum delays of 2 and 4 days, respectively, with no reported adverse effects. The majority of stopping events were due to incomplete plan approvals stemming from treatment planning delays. Whereas these may have previously solicited last-minute interventions, including intensity modulated radiation therapy quality assurance, the NFP enabled nonpunitive, reasonable schedule adjustments to mitigate compromises in safe delivery. Implementation of the NFP has helped to mitigate risk from expedited care, convert reactive to proactive delays, and created a checklist, process driven, and variance-reducing culture in a large, multicenter department. Copyright © 2012 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Constructing Hopf bifurcation lines for the stability of nonlinear systems with two time delays

NASA Astrophysics Data System (ADS)

Nguimdo, Romain Modeste

2018-03-01

Although the plethora real-life systems modeled by nonlinear systems with two independent time delays, the algebraic expressions for determining the stability of their fixed points remain the Achilles' heel. Typically, the approach for studying the stability of delay systems consists in finding the bifurcation lines separating the stable and unstable parameter regions. This work deals with the parametric construction of algebraic expressions and their use for the determination of the stability boundaries of fixed points in nonlinear systems with two independent time delays. In particular, we concentrate on the cases for which the stability of the fixed points can be ascertained from a characteristic equation corresponding to that of scalar two-delay differential equations, one-component dual-delay feedback, or nonscalar differential equations with two delays for which the characteristic equation for the stability analysis can be reduced to that of a scalar case. Then, we apply our obtained algebraic expressions to identify either the parameter regions of stable microwaves generated by dual-delay optoelectronic oscillators or the regions of amplitude death in identical coupled oscillators.

Timely response to secure messages from primary care patients.

PubMed

Rohrer, James E; North, Frederick; Angstman, Kurt B; Oberhelman, Sara S; Meunier, Matthew R

2013-01-01

To assess delays in response to patient secure e-mail messages in primary care. Secure electronic messages are initiated by primary care patients. Timely response is necessary for patient safety and quality. A database of secure messages. A random sample of 353 secure electronic messages initiated by primary care patients treated in 4 clinics. Message not opened after 12 hours or messages not responded to after 36 hours. A total of 8.5% of electronic messages were not opened within 12 hours, and 17.6% did not receive a response in 36 hours. Clinic location, being a clinic employee, and patient sex were not related to delays. Patients older than 50 years were more likely to receive a delayed response (25.7% delayed, P = .013). The risk of both kinds of delays was higher on weekends (P < .001 for both). The e-mail message system resulted in high rates of delayed response. Delays were concentrated on weekends (Friday-Sunday). Reducing delayed responses may require automatic rerouting of messages to message centers staffed 24-7 or other mechanisms to manage this after-hours work flow.

Wigner time delay in photodetachment of Tm-and in photoionization of Yb: A comparative study

NASA Astrophysics Data System (ADS)

Saha, Soumyajit; Jose, Jobin; Deshmukh, Pranawa; Dolmatov, Valeriy; Kheifets, Anatoli; Manson, Steven

2017-04-01

Preliminary studies of Wigner time delay in photodetachment spectra of negative ions have been reported. Photodetachment time delay for some dipole channels of Tm- and of Cl- were calculated using relativistic random phase approximation (RRPA). Comparisons between photodetachment time delay of Cl- and photoionization time delay of Ar were made. We investigate the photodetachment time delay for all three relativistically split nd -> ɛ f channels of Tm- and for nd -> ɛ f channels of Yb (isoelectronic to Tm-) using RRPA. We study the effect of the shape resonance, brought about by the centrifugal barrier potential, on photodetachment time delay. A negative ion is a good laboratory for studying the effects of shape resonances on time delay since the phase is unaffected by the Coulomb component. Wigner time delay in photodetachment of Tm- and in photoionization of Yb: A comparative study.

Predictors of Delayed Healthcare Seeking Among American Muslim Women.

PubMed

Vu, Milkie; Azmat, Alia; Radejko, Tala; Padela, Aasim I

2016-06-01

Delayed care seeking is associated with adverse health outcomes. For Muslim women, delayed care seeking might include religion-related motivations, such as a preference for female clinicians, concerns about preserving modesty, and fatalistic beliefs. Our study assesses associations between religion-related factors and delayed care seeking due to a perceived lack of female clinicians. Surveys were distributed to Muslim women attending mosque and community events in Chicago. Survey items included measures of religiosity, religious fatalism, discrimination, modesty, and alternative medicine utilization and worship practices. The outcome measure asked for levels of agreement to the statement "I have delayed seeking medical care when no woman doctor is available to see me." Two hundred fifty-four women completed the survey with nearly equal numbers of African Americans (26%), Arab Americans (33%), and South Asians (33%). Fifty-three percent reported delays in care seeking due to a perceived lack of female clinicians. In multivariate analysis adjusting for sociodemographic factors, higher religiosity (odds ratio [OR] = 5.2, p < 0.01) and modesty levels (OR = 1.4, p < 0.001) were positively associated with delayed care seeking. Having lived in the United States for >20 years (OR = 0.22, p < 0.05) was negatively associated with delayed care seeking. Many American Muslim women reported delays in care seeking due to a perceived lack of female clinicians. Women with higher levels of modesty and self-rated religiosity had higher odds of delaying care. Women who had lived in the United States for longer durations had lower odds of delaying care. Our research highlights the need for gender-concordant providers and culturally sensitive care for American Muslims.

Predictors of Delayed Healthcare Seeking Among American Muslim Women

PubMed Central

Vu, Milkie; Azmat, Alia; Radejko, Tala

2016-01-01

Abstract Background: Delayed care seeking is associated with adverse health outcomes. For Muslim women, delayed care seeking might include religion-related motivations, such as a preference for female clinicians, concerns about preserving modesty, and fatalistic beliefs. Our study assesses associations between religion-related factors and delayed care seeking due to a perceived lack of female clinicians. Materials and Methods: Surveys were distributed to Muslim women attending mosque and community events in Chicago. Survey items included measures of religiosity, religious fatalism, discrimination, modesty, and alternative medicine utilization and worship practices. The outcome measure asked for levels of agreement to the statement “I have delayed seeking medical care when no woman doctor is available to see me.” Results: Two hundred fifty-four women completed the survey with nearly equal numbers of African Americans (26%), Arab Americans (33%), and South Asians (33%). Fifty-three percent reported delays in care seeking due to a perceived lack of female clinicians. In multivariate analysis adjusting for sociodemographic factors, higher religiosity (odds ratio [OR] = 5.2, p < 0.01) and modesty levels (OR = 1.4, p < 0.001) were positively associated with delayed care seeking. Having lived in the United States for >20 years (OR = 0.22, p < 0.05) was negatively associated with delayed care seeking. Conclusion: Many American Muslim women reported delays in care seeking due to a perceived lack of female clinicians. Women with higher levels of modesty and self-rated religiosity had higher odds of delaying care. Women who had lived in the United States for longer durations had lower odds of delaying care. Our research highlights the need for gender-concordant providers and culturally sensitive care for American Muslims. PMID:26890129

Tuberculosis diagnostic delay and therapy outcomes of non-national migrants in Tel Aviv, 1998-2008.

PubMed

Mor, Z; Kolb, H; Lidji, M; Migliori, Gb; Leventhal, A

2013-03-21

Non-national migrants have limited access to medical therapy. This study compares diagnostic delay and treatment outcomes of non-insured non-national migrants (NINNM) with insured Israeli citizens (IC) in the Tel Aviv tuberculosis (TB) clinic between 1998 and 2008. Patient delay was the time from symptoms onset to doctor's visit, while system delay was measured from doctor visit to anti-TB therapy administration. We randomly sampled 222 NINNM and 265 IC. NINNM were younger than IC, had lower male to female ratio and fewer smoked. They had less drug/alcohol abuse, more cavitations on chest radiography, longer patient and shorter system delay. Mean patient and system delays of all patients were 25 ± 14 and 79 ± 42 days, respectively. In multivariate analysis, being NINNM, asymptomatic or smoking predicted longer patient delay, while being asymptomatic or having additional co-morbidity predicted longer system delay. Treatment success in sputum smear-positive pulmonary TB NINNM was 81% and 95.7% in IC (p=0.01). Treatment success was not associated with patient or system delay. In multivariate analysis, work security and treatment adherence predicted treatment success. NINNM had longer patient delay and worse therapy outcome, while IC had longer system delay. Both delays should be reduced. NINNM should be informed that TB therapy is free and unlinked with deportation.

The performance of differential VLBI delay during interplanetary cruise

NASA Technical Reports Server (NTRS)

Moultrie, B.; Wolff, P. J.; Taylor, T. H.

1984-01-01

Project Voyager radio metric data are used to evaluate the orbit determination abilities of several data strategies during spacecraft interplanetary cruise. Benchmark performance is established with an operational data strategy of conventional coherent doppler, coherent range, and explicitly differenced range data from two intercontinental baselines to ameliorate the low declination singularity of the doppler data. Employing a Voyager operations trajectory as a reference, the performance of the operational data strategy is compared to the performances of data strategies using differential VLBI delay data (spacecraft delay minus quasar delay) in combinations with the aforementioned conventional data types. The comparison of strategy performances indicates that high accuracy cruise orbit determination can be achieved with a data strategy employing differential VLBI delay data, where the quantity of coherent radio metric data has been greatly reduced.

Outer synchronization of complex networks with internal delay and coupling delay via aperiodically intermittent pinning control

NASA Astrophysics Data System (ADS)

Zhang, Chuan; Wang, Xingyuan; Wang, Chunpeng; Xia, Zhiqiu

This paper concerns the outer synchronization problem between two complex delayed networks via the method of aperiodically intermittent pinning control. Apart from previous works, internal delay and coupling delay are both involved in this model, and the designed intermittent controllers can be aperiodic. The main work in this paper can be summarized as follows: First, two cases of aperiodically intermittent control with constant gain and adaptive gain are implemented, respectively. The intermittent control and pinning control are combined to reduce consumptions further. Then, based on the Lyapunov stability theory, synchronization protocols are given by strict derivation. Especially, the designed controllers are indeed simple and valid in application of theory to practice. Finally, numerical examples put the proposed control methods to the test.

Fusing human and machine skills for remote robotic operations

NASA Technical Reports Server (NTRS)

Schenker, Paul S.; Kim, Won S.; Venema, Steven C.; Bejczy, Antal K.

1991-01-01

The question of how computer assists can improve teleoperator trajectory tracking during both free and force-constrained motions is addressed. Computer graphics techniques which enable the human operator to both visualize and predict detailed 3D trajectories in real-time are reported. Man-machine interactive control procedures for better management of manipulator contact forces and positioning are also described. It is found that collectively, these novel advanced teleoperations techniques both enhance system performance and significantly reduce control problems long associated with teleoperations under time delay. Ongoing robotic simulations of the 1984 space shuttle Solar Maximum EVA Repair Mission are briefly described.