Memory systems interaction in the pigeon: working and reference memory.
Roberts, William A; Strang, Caroline; Macpherson, Krista
2015-04-01
Pigeons' performance on a working memory task, symbolic delayed matching-to-sample, was used to examine the interaction between working memory and reference memory. Reference memory was established by training pigeons to discriminate between the comparison cues used in delayed matching as S+ and S- stimuli. Delayed matching retention tests then measured accuracy when working and reference memory were congruent and incongruent. In 4 experiments, it was shown that the interaction between working and reference memory is reciprocal: Strengthening either type of memory leads to a decrease in the influence of the other type of memory. A process dissociation procedure analysis of the data from Experiment 4 showed independence of working and reference memory, and a model of working memory and reference memory interaction was shown to predict the findings reported in the 4 experiments. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
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...
ERIC Educational Resources Information Center
Branson, Diane; Bingham, Ann
2017-01-01
Despite the benefits of early intervention for children, the majority of children with developmental delays are not identified prior to the age of 5 years. Child care providers could aid in recognition of children at risk for developmental delays; however, there is little research on this topic. This article reports on a qualitative research study…
Subfertility in relation to welding. A case referent study among male welders.
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.
Effects of cockpit lateral stick characteristics on handling qualities and pilot dynamics
NASA Technical Reports Server (NTRS)
Mitchell, David G.; Aponso, Bimal L.; Klyde, David H.
1992-01-01
This report presents the results of analysis of cockpit lateral control feel-system studies. Variations in feel-system natural frequency, damping, and command sensing reference (force and position) were investigated, in combination with variations in the aircraft response characteristics. The primary data for the report were obtained from a flight investigation conducted with a variable-stability airplane, with additional information taken from other flight experiments and ground-based simulations for both airplanes and helicopters . The study consisted of analysis of handling qualities ratings and extraction of open-loop, pilot-vehicle describing functions from sum-of-sines tracking data, including, for a limited subset of these data, the development of pilot models. The study confirms the findings of other investigators that the effects on pilot opinion of cockpit feel-system dynamics are not equivalent to a comparable level of added time delay, and until a more comprehensive set of criteria are developed, it is recommended that feel-system dynamics be considered a delay-inducing element in the aircraft response. The best correlation with time-delay requirements was found when the feel-system dynamics were included in the delay measurements, regardless of the command reference. This is a radical departure from past approaches.
Kumar, Kamal; Zhang, Yu; Sung, Chi -Jen; ...
2015-04-13
We study the influence of blending n-butanol on the ignition delay times of n-heptane and iso-octane, the primary reference fuels for gasoline. The ignition delay times are measured using a rapid compression machine, with an emphasis on the low-to-intermediate temperature conditions. The experiments are conducted at equivalence ratios of 0.4 and 1.0, for a compressed pressure of 20 bar, with the temperatures at the end of compression ranging from 613 K to 979 K. The effect of n-butanol addition on the development of the two-stage ignition characteristics for the two primary reference fuels is also examined. The experimental results aremore » compared to predictions obtained using a detailed chemical kinetic mechanism, which has been obtained by a systematic merger of previously reported base models for the combustion of the individual fuel constituents. In conclusion, a sensitivity analysis on the base, and the merged models, is also performed to understand the dependence of autoignition delay times on the model parameters.« less
Malerba, Kirsten Hawkins; Tecklin, Jan Stephen
2013-06-01
Children often are referred for physical therapy with the diagnosis of hypotonia when the definitive cause of hypotonia is unknown. The purpose of this case report is to describe the clinical decision-making process using the Hypothesis-Oriented Algorithm for Clinicians II (HOAC II) for an infant with hypotonia and gross motor delay. The patient was a 5-month-old infant who had been evaluated by a neurologist and then referred for physical therapy by his pediatrician. Physical therapist evaluation results and clinical observations of marked hypotonia, significant gross motor delay, tongue fasciculations, feeding difficulties, and respiratory abnormalities prompted necessary referral to specialists. Recognition of developmental, neurologic, and respiratory abnormalities facilitated clinical decision making for determining the appropriate physical therapy plan of care. During the brief episode of physical therapy care, the patient was referred to a feeding specialist and diagnosed with pharyngeal-phase dysphasia and mild aspiration. Continued global weakness, signs and symptoms of type 1 spinal muscular atrophy (SMA), and concerns about increased work of breathing and respiratory compromise were discussed with the referring physician. After inconclusive laboratory testing for metabolic etiologies of hypotonia, a genetics consult was recommended and confirmed the diagnosis of type 1 SMA at 9 months of age. Physical therapists use clinical decision making to determine whether to treat patients or to refer them to other medical professionals. Accurate and timely referral to appropriate specialists may assist families in obtaining a diagnosis for their child and guide necessary interventions. In the case of type 1 SMA, early diagnosis may affect outcomes and survival rate in this pediatric population.
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.
National Airspace System Delay Estimation Using Weather Weighted Traffic Counts
NASA Technical Reports Server (NTRS)
Chatterji, Gano B.; Sridhar, Banavar
2004-01-01
Assessment of National Airspace System performance, which is usually measured in terms of delays resulting from the application of traffic flow management initiatives in response to weather conditions, volume, equipment outages and runway conditions, is needed both for guiding flow control decisions during the day of operations and for post operations analysis. Comparison of the actual delay, resulting from the traffic flow management initiatives, with the expected delay, based on traffic demand and other conditions, provides the assessment of the National Airspace System performance. This paper provides a method for estimating delay using the expected traffic demand and weather. In order to identify the cause of delays, 517 days of National Airspace System delay data reported by the Federal Aviation Administration s Operations Network were analyzed. This analysis shows that weather is the most important causal factor for delays followed by equipment and runway delays. Guided by these results, the concept of weather weighted traffic counts as a measure of system delay is described. Examples are given to show the variation of these counts as a function of time of the day. The various datasets, consisting of aircraft position data, enroute severe weather data, surface wind speed and visibility data, reported delay data and number of aircraft handled by the Centers data, and their sources are described. The procedure for selecting reference days on which traffic was minimally impacted by weather is described. Different traffic demand on each reference day of the week, determined by analysis of 42 days of traffic and delay data, was used as the expected traffic demand for each day of the week. Next, the method for computing the weather weighted traffic counts using the expected traffic demand, derived from reference days, and the expanded regions around severe weather cells is discussed. It is shown via a numerical example that this approach improves the dynamic range of the weather weighted traffic counts considerably. Time histories of these new weather weighted traffic counts are used for synthesizing two statistical features, six histogram features and six time domain features. In addition to these enroute weather features, two surface weather features of number of major airports in the United States with high mean winds and low mean visibility are also described. A least squares procedure for establishing a functional relation between the features, using combinations of these features, and system delays is explored using 36 days of data. Best correlations between the estimated delays using the functional relation and the actual delays provided by the Operations Network are obtained with two different combinations of features: 1) six time domain features of weather weighted traffic counts plus two surface weather features, and 2) six histogram features and mean of weather weighted traffic counts along with the two surface weather features. Correlation coefficient values of 0.73 and 0.83 were found in these two instances.
Toddler Developmental Delays After Extensive Hospitalization: Primary Care Practitioner Guidelines.
Lehner, Dana C; Sadler, Lois S
2015-01-01
This review investigated developmental delays toddlers may encounter after a lengthy pediatric hospitalization (30 days or greater). Physical, motor, cognitive, and psychosocial development of children aged 1 to 3 years was reviewed to raise awareness of factors associated with developmental delay after extensive hospitalization. Findings from the literature suggest that neonatal and pediatric intensive care unit (NICU/PICU) graduates are most at risk for developmental delays, but even non-critical hospital stays interrupt development to some extent. Primary care practitioners (PCPs) may be able to minimize risk for delays through the use of formal developmental screening tests and parent report surveys. References and resources are described for developmental assessment to help clinicians recognize delays and to educate families about optimal toddler development interventions. Pediatric PCPs play a leading role in coordinating health and developmental services for the young child following an extensive hospital stay.
Psychosocial correlates of immediate versus delayed reconstruction of the breast.
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)
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.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kumar, Kamal; Zhang, Yu; Sung, Chi -Jen
We study the influence of blending n-butanol on the ignition delay times of n-heptane and iso-octane, the primary reference fuels for gasoline. The ignition delay times are measured using a rapid compression machine, with an emphasis on the low-to-intermediate temperature conditions. The experiments are conducted at equivalence ratios of 0.4 and 1.0, for a compressed pressure of 20 bar, with the temperatures at the end of compression ranging from 613 K to 979 K. The effect of n-butanol addition on the development of the two-stage ignition characteristics for the two primary reference fuels is also examined. The experimental results aremore » compared to predictions obtained using a detailed chemical kinetic mechanism, which has been obtained by a systematic merger of previously reported base models for the combustion of the individual fuel constituents. In conclusion, a sensitivity analysis on the base, and the merged models, is also performed to understand the dependence of autoignition delay times on the model parameters.« less
Marine Fuel Cell Technology Verification Trainer Program: Operator Curriculum Development
2004-06-01
collection of tnormiratin is estimiate to average 1 hour per response, Including the time INr reviewing InatruCtlona. ear-ching existing =ata aourcas...guidelines and standards are provided. With the anticipation that up to several years’ delay will occur between the time of this report and the maturity of...reference only, given as foundation sources available at the time of this project. The supplemental references to published materials are considered the
Profile of referrals for early childhood developmental delay to ambulatory subspecialty clinics.
Shevell, M I; Majnemer, A; Rosenbaum, P; Abrahamowicz, M
2001-09-01
The objective of this study was to determine the profile and pattern of referral to subspecialty clinics of young children with suspected developmental delay together with the factors prompting their referral. All children under 5 years of age referred to either developmental pediatrics or pediatric neurology clinics at a single tertiary hospital over an 18-month period were prospectively identified. Standardized demographic and referral information were collected at intake, final developmental delay subtype diagnosed was identified, and referring physicians were surveyed regarding factors prompting referral. A total of 224 children met study criteria. There was a marked male preponderance (166/224), especially among those with either cognitive or language delay. Two delay subtypes, global developmental delay and developmental language disorder, accounted for two thirds of the diagnoses made. For slightly more than one third of the children (75/224), the delay subtype diagnosed following specialty evaluation was different from that initially suspected by the referring physician. A mean delay of 15.5 months was observed for the cohort as a whole between initial parental concern and specialty assessment. For referring physicians, the major factor prompting referral was the severity of the observed delay. The most important aspects of the specialty evaluation according to referral sources were the identification of a possible etiology and confirmation of delay. A profile of referrals and the rationale thereof for a cohort of children with suspected developmental delay is presented that, although locale specific, has implications for service provision and training.
Beauchaine, Theodore P; Ben-David, Itzhak; Sela, Aner
2017-01-01
Delay discounting-often referred to as hyperbolic discounting in the financial literature-is defined by a consistent preference for smaller, immediate rewards over larger, delayed rewards, and by failure of future consequences to curtail current consummatory behaviors. Previous research demonstrates (1) excessive delay discounting among individuals with attention-deficit/hyperactivity disorder (ADHD), (2) common neural substrates of delay discounting and hyperactive-impulsive symptoms of ADHD, and (3) associations between delay discounting and both debt burden and high interest rate borrowing. This study extends prior research by examining associations between ADHD symptoms, delay discounting, and an array of previously unevaluated financial outcomes among 544 individuals (mean age 35 years). Controlling for age, income, sex, education, and substance use, ADHD symptoms were associated with delay discounting, late credit card payments, credit card balances, use of pawn services, personal debt, and employment histories (less time spent at more jobs). Consistent with neural models of reward processing and associative learning, more of these relations were attributable to hyperactive-impulsive symptoms than inattentive symptoms. Implications for financial decision-making and directions for future research are discussed.
Cavallaro, Francesca L; Marchant, Tanya J
2013-05-01
We reviewed the evidence on the duration, causes and effects of delays in providing emergency obstetric care to women attending health facilities (the third delay) in low- and middle-income countries. We performed a critical literature review using terms related to obstetric care, birth outcome, delays and developing countries. A manual search of reference lists of key articles was also performed. 69 studies met the inclusion criteria. Most studies reported long delays in providing care, and the mean waiting time for women admitted with complications was as much as 24 h before treatment. The three most cited barriers to providing timely care were shortage of treatment materials, surgery facilities and qualified staff. Existing evidence is insufficient to estimate the effect of delays on birth outcomes. Delays in providing emergency obstetric care seem common in resource-constrained settings but further research is necessary to determine the effect of the third delay on birth outcomes. © 2013 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.
Uranus, H P; Zhuang, L; Roeloffzen, C G H; Hoekstra, H J W M
2007-09-01
We report experimental observations of the negative-group-velocity (v(g)) phenomenon in an integrated-optical two-port ring-resonator circuit. We demonstrate that when the v(g) is negative, the (main) peak of output pulse appears earlier than the peak of a reference pulse, while for a positive v(g), the situation is the other way around. We observed that a pulse splitting phenomenon occurs in the neighborhood of the critical-coupling point. This pulse splitting limits the maximum achievable delay and advancement of a single device as well as facilitating a smooth transition from highly advanced to highly delayed pulse, and vice versa, across the critical-coupling point.
Bowen, Diana K; Yerkes, Elizabeth B; Lindgren, Bruce W; Gong, Edward M; Faasse, Mark A
2015-07-01
We report 4 pediatric cases of ureteropelvic junction obstruction involving delayed progression of initially mild postnatal hydronephrosis. All 4 children became symptomatic; however, 3 already had a substantial decrement of ipsilateral kidney function by the time of diagnosis. Two of these 3 patients had previous renal scintigraphy demonstrating normal differential function. We caution that counseling regarding hydronephrosis should emphasize the importance of prompt re-evaluation for any symptoms potentially referable to delayed presentation of ureteropelvic junction obstruction, irrespective of initial hydronephrosis grade. Future studies are needed to determine the optimal follow-up regimen for conservative management of hydronephrosis. Copyright © 2015 Elsevier Inc. All rights reserved.
Traffic Management in ATM Networks Over Satellite Links
NASA Technical Reports Server (NTRS)
Goyal, Rohit; Jain, Raj; Goyal, Mukul; Fahmy, Sonia; Vandalore, Bobby; vonDeak, Thomas
1999-01-01
This report presents a survey of the traffic management Issues in the design and implementation of satellite Asynchronous Transfer Mode (ATM) networks. The report focuses on the efficient transport of Transmission Control Protocol (TCP) traffic over satellite ATM. First, a reference satellite ATM network architecture is presented along with an overview of the service categories available in ATM networks. A delay model for satellite networks and the major components of delay and delay variation are described. A survey of design options for TCP over Unspecified Bit Rate (UBR), Guaranteed Frame Rate (GFR) and Available Bit Rate (ABR) services in ATM is presented. The main focus is on traffic management issues. Several recommendations on the design options for efficiently carrying data services over satellite ATM networks are presented. Most of the results are based on experiments performed on Geosynchronous (GEO) latencies. Some results for Low Earth Orbits (LEO) and Medium Earth Orbit (MEO) latencies are also provided.
Delay Discounting: Pigeon, Rat, Human – Does it Matter?
Vanderveldt, Ariana; Oliveira, Luís; Green, Leonard
2016-01-01
Delay discounting refers to the decrease in subjective value of an outcome as the time to its receipt increases. Across species and situations, animals discount delayed rewards, and their discounting is well-described by a hyperboloid function. The current review begins with a comparison of discounting models and the procedures used to assess delay discounting in nonhuman animals. We next discuss the generality of discounting, reviewing the effects of different variables on the degree of discounting delayed reinforcers by nonhuman animals. Despite the many similarities in discounting observed between human and nonhuman animals, several differences have been proposed (e.g., the magnitude effect; nonhuman animals discount over a matter of seconds whereas humans report willing to wait months, if not years before receiving a reward), raising the possibility of fundamental species differences in intertemporal choice. After evaluating these differences, we discuss delay discounting from an adaptationist perspective. The pervasiveness of discounting across species and situations suggests it is a fundamental process underlying decision making. PMID:26881899
Coping with Deferred Maintenance.
ERIC Educational Resources Information Center
Suber, L. Terry
1982-01-01
The deferred maintenance problem on college and university campuses is addressed. Deferred maintenance refers to larger or more expansive maintenance work that can be delayed and is not performed when needed or reported, usually because its cost is beyond the annual maintenance and operating budget of the physical plant department. Eventually…
Observing Behavior and Atypically Restricted Stimulus Control
ERIC Educational Resources Information Center
Dube, William V.; Dickson, Chata A.; Balsamo, Lyn M.; O'Donnell, Kristin Lombard; Tomanari, Gerson Y.; Farren, Kevin M.; Wheeler, Emily E.; McIlvane, William J.
2010-01-01
Restricted stimulus control refers to discrimination learning with atypical limitations in the range of controlling stimuli or stimulus features. In the study reported here, 4 normally capable individuals and 10 individuals with intellectual disabilities (ID) performed two-sample delayed matching to sample. Sample-stimulus observing was recorded…
Athanasopoulos, Georgios I; Carey, Stephen J; Hatfield, John V
2011-07-01
This paper describes the design of a programmable transmit beamformer application-specific integrated circuit (ASIC) with 8 channels for ultrasound imaging systems. The system uses a 20-MHz reference clock. A digital delay-locked loop (DLL) was designed with 50 variable delay elements, each of which provides a clock with different phase from a single reference. Two phase detectors compare the phase difference of the reference clock with the feedback clock, adjusting the delay of the delay elements to bring the feedback clock signal in phase with the reference clock signal. Two independent control voltages for the delay elements ensure that the mark space ratio of the pulses remain at 50%. By combining a 10- bit asynchronous counter with the delays from the DLL, each channel can be programmed to give a maximum time delay of 51 μs with 1 ns resolution. It can also give bursts of up to 64 pulses. Finally, for a single pulse, it can adjust the pulse width between 9 ns and 100 ns by controlling the current flowing through a capacitor in a one-shot circuit, for use with 40-MHz and 5-MHz transducers, respectively.
Bounded Linear Stability Analysis - A Time Delay Margin Estimation Approach for Adaptive Control
NASA Technical Reports Server (NTRS)
Nguyen, Nhan T.; Ishihara, Abraham K.; Krishnakumar, Kalmanje Srinlvas; Bakhtiari-Nejad, Maryam
2009-01-01
This paper presents a method for estimating time delay margin for model-reference adaptive control of systems with almost linear structured uncertainty. The bounded linear stability analysis method seeks to represent the conventional model-reference adaptive law by a locally bounded linear approximation within a small time window using the comparison lemma. The locally bounded linear approximation of the combined adaptive system is cast in a form of an input-time-delay differential equation over a small time window. The time delay margin of this system represents a local stability measure and is computed analytically by a matrix measure method, which provides a simple analytical technique for estimating an upper bound of time delay margin. Based on simulation results for a scalar model-reference adaptive control system, both the bounded linear stability method and the matrix measure method are seen to provide a reasonably accurate and yet not too conservative time delay margin estimation.
[Neuropsychomotor developmental delay: conceptual map, term definitions, uses and limitations].
Dornelas, Lílian de Fátima; Duarte, Neuza Maria de Castro; Magalhães, Lívia de Castro
2015-01-01
To retrieve the origin of the term neuropsychomotor developmental delay" (NPMD), its conceptual evolution over time, and to build a conceptual map based on literature review. A literature search was performed in the SciELO Brazil, Web of Science, Science Direct, OneFile (GALE), Pubmed (Medline), Whiley Online, and Springer databases, from January of 1940 to January of 2013, using the following keywords NPMD delay, NPMD retardation, developmental delay, and global developmental delay. A total of 71 articles were selected, which were used to build the conceptual map of the term. Of the 71 references, 55 were international and 16 national. The terms developmental delay and global developmental delay were the most frequently used in the international literature and, in Brazil, delayed NPMD was the most often used. The term developmental delay emerged in the mid 1940s, gaining momentum in the 1990 s. In Brazil, the term delayed NPMD started to be used in the 1980s, and has been frequently cited and published in the literature. Delayed development was a characteristic of 13 morbidities described in 23 references. Regarding the type of use, 19 references were found, with seven forms of use. Among the references, 34 had definitions of the term, and 16 different concepts were identified. Developmental delay is addressed in the international and national literature under different names, various applications, and heterogeneous concepts. Internationally, ways to improve communication between professionals have been indicated, with standardized definition of the term and use in very specific situations up to the fifth year of life, which was not found in Brazilian publications. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.
Neuropsychomotor developmental delay: conceptual map, term definitions, uses and limitations
Dornelas, Lílian de Fátima; Duarte, Neuza Maria de Castro; Magalhães, Lívia de Castro
2015-01-01
OBJECTIVE: To retrieve the origin of the term neuropsychomotor developmental delay" (NPMD), its conceptual evolution over time, and to build a conceptual map based on literature review. DATA SOURCE: A literature search was performed in the SciELO Brazil, Web of Science, Science Direct, OneFile (GALE), Pubmed (Medline), Whiley Online, and Springer databases, from January of 1940 to January of 2013, using the following keywords: NPMD delay, NPMD retardation, developmental delay, and global developmental delay. A total of 71 articles were selected, which were used to build the conceptual map of the term. DATA SYNTHESIS: Of the 71 references, 55 were international and 16 national. The terms developmental delay and global developmental delay were the most frequently used in the international literature and, in Brazil, delayed NPMD was the most often used. The term developmental delay emerged in the mid 1940s, gaining momentum in the 1990s. In Brazil, the term delayed NPMD started to be used in the 1980s, and has been frequently cited and published in the literature. Delayed development was a characteristic of 13 morbidities described in 23 references. Regarding the type of use, 19 references were found, with seven forms of use. Among the references, 34 had definitions of the term, and 16 different concepts were identified. CONCLUSIONS: Developmental delay is addressed in the international and national literature under different names, various applications, and heterogeneous concepts. Internationally, ways to improve communication between professionals have been indicated, with standardized definition of the term and use in very specific situations up to the fifth year of life, which was not found in Brazilian publications. PMID:25662016
2017-01-01
Delay discounting—often referred to as hyperbolic discounting in the financial literature—is defined by a consistent preference for smaller, immediate rewards over larger, delayed rewards, and by failure of future consequences to curtail current consummatory behaviors. Previous research demonstrates (1) excessive delay discounting among individuals with attention-deficit/hyperactivity disorder (ADHD), (2) common neural substrates of delay discounting and hyperactive-impulsive symptoms of ADHD, and (3) associations between delay discounting and both debt burden and high interest rate borrowing. This study extends prior research by examining associations between ADHD symptoms, delay discounting, and an array of previously unevaluated financial outcomes among 544 individuals (mean age 35 years). Controlling for age, income, sex, education, and substance use, ADHD symptoms were associated with delay discounting, late credit card payments, credit card balances, use of pawn services, personal debt, and employment histories (less time spent at more jobs). Consistent with neural models of reward processing and associative learning, more of these relations were attributable to hyperactive-impulsive symptoms than inattentive symptoms. Implications for financial decision-making and directions for future research are discussed. PMID:28481903
DOE Office of Scientific and Technical Information (OSTI.GOV)
Zachor, D.A.; Lofton, M.
1994-09-01
We report 3 year old male, referred for evaluation of developmental delays. Pregnancy was complicated by oligohydramnios, proteinuria and prematurity. Medical history revealed: bilateral inguinal hernia, small scrotal sac, undescended testes, developmental delays and behavioral problems. The child had: microcephaly, facial dysmorphic features, single palmar creases, hypopigmented skin lesions of variable size, intermittent exotropia and small retracted testes. Neurological examination was normal. Cognitive level was at the average range with mild delay in his adaptive behavior. Expressive language delays and severe articulation disorder were noted, as well as clumsiness, poor control and precision of gross and fine motor skills. Chromosomalmore » analysis of peripheral leukocytes indicated that one of the number 11 chromosomes had undergone a pericentric inversion with breakpoints on the short (p) arm at band p14.3 and the long (q) arm at band q21. An MRI of the brain showed mild delay in myelinization pattern of white matter. Chromosome 11 inversion in other sites was associated with Beckwith-Wiedemann syndrome and several malignancies. To our knowledge this is the first description of inv(11)(p14.3q21) that is associated with microcephaly, dysmorphic features, hypopigmented skin lesions and speech delay. This inversion may disrupt the expression of the involved genes. However, additional cases with the same cytogenetic anomaly are needed to explore the phenotypic significance of this disorder.« less
Precision digital pulse phase generator
McEwan, T.E.
1996-10-08
A timing generator comprises a crystal oscillator connected to provide an output reference pulse. A resistor-capacitor combination is connected to provide a variable-delay output pulse from an input connected to the crystal oscillator. A phase monitor is connected to provide duty-cycle representations of the reference and variable-delay output pulse phase. An operational amplifier drives a control voltage to the resistor-capacitor combination according to currents integrated from the phase monitor and injected into summing junctions. A digital-to-analog converter injects a control current into the summing junctions according to an input digital control code. A servo equilibrium results that provides a phase delay of the variable-delay output pulse to the output reference pulse that linearly depends on the input digital control code. 2 figs.
Precision digital pulse phase generator
McEwan, Thomas E.
1996-01-01
A timing generator comprises a crystal oscillator connected to provide an output reference pulse. A resistor-capacitor combination is connected to provide a variable-delay output pulse from an input connected to the crystal oscillator. A phase monitor is connected to provide duty-cycle representations of the reference and variable-delay output pulse phase. An operational amplifier drives a control voltage to the resistor-capacitor combination according to currents integrated from the phase monitor and injected into summing junctions. A digital-to-analog converter injects a control current into the summing junctions according to an input digital control code. A servo equilibrium results that provides a phase delay of the variable-delay output pulse to the output reference pulse that linearly depends on the input digital control code.
Wong, George Kwok Chu; Poon, Wai Sang
2010-01-01
Aneurysmal subarachnoid hemorrhage (SAH) has the highest morbidity and mortality rates of all types of stroke. Many aneurysmal SAH patients continue to suffer from significant neurological morbidity and mortality directly related to delayed cerebral ischemia. Pilot clinical studies of the use of Hydroxymethylglutaryl-CoA Reductase Inhibitors (statins) in aneurysmal SAH patients have reported a reduction in delayed cerebral ischemia and better clinical outcomes. We review the biochemical effects of statins on endothelium vascular function, glutamate-mediated neurotoxicity, inflammatory changes, and oxidative injuries, with reference to their possible neuroprotective effects in aneurysmal SAH.
Determinants of late presentation for induced abortion care.
Waddington, Ashley; Hahn, Philip M; Reid, Robert
2015-01-01
To determine whether demographic or patient factors contribute to later presentation (10 to 12 weeks' gestational age) for induced abortion in a Canadian abortion clinic. Women attending a hospital-based abortion clinic between April and September 2012 were asked to complete a survey. The characteristics of women who presented early (EPs; gestational age < 10 weeks) were compared with those of late presenters (LPs; gestational age ≥ 10 weeks) using t tests for means and Fisher exact tests for rates. Among women referred to the clinic by a primary care provider, LPs were more likely than EPs to report "a delay in obtaining a referral" (20.8% vs. 6.1%; P = 0.007). While there was no significant difference between the groups in reporting that "someone tried to discourage [them] from having an abortion" (26.45% for EPs, 32.4% for LPs; P = 0.421), LPs were more likely to report that discouragement "caused a delay in making arrangements" (45.5% vs. 16.7%; P = 0.019). Of women who had access to a primary care provider, it was more common for the primary care provider to be aware of the pregnancy among LPs than among EPs (80.6% vs. 63.1%; P = 0.015). Some women delay presenting for abortion because of discouragement from friends and family. It is unclear whether there are educational or policy interventions that can have an impact on this delay, and this warrants further study. There may be ways of addressing the delay in referral by primary care providers. Further study into the causes for delay in referral for abortion is warranted.
Exonic deletions of AUTS2 in Chinese patients with developmental delay and intellectual disability.
Fan, Yanjie; Qiu, Wenjuan; Wang, Lili; Gu, Xuefan; Yu, Yongguo
2016-02-01
Genomic rearrangements involving dosage change of genes have been implicated in a range of developmental disorders. Increasing evidences suggest copy number variations (CNVs) of autism susceptibility candidate gene 2 (AUTS2) are associated with a syndromic form of developmental delay and intellectual disability. However, the genetic and clinical profiles involving AUTS2 variations have not been fully characterized in Asian patients yet, and the outcome of treatments has not been reported. Here we report de novo exonic deletions of AUTS2 detected by chromosomal microarray analysis (CMA) in three Chinese children referred to the clinic for developmental delay, including two deletions involving only exon 6 (98.4 and 262 kb, respectively) and one deletion involving the C-terminal of AUTS2 (2147 kb). The phenotypic presentations of these three patients were described and compared with previous cases in literature. In addition, we presented the outcome of hormonal treatment for short stature in one patient. © 2015 Wiley Periodicals, Inc.
Relationship between Weather, Traffic and Delay Based on Empirical Methods
NASA Technical Reports Server (NTRS)
Sridhar, Banavar; Swei, Sean S. M.
2006-01-01
The steady rise in demand for air transportation over the years has put much emphasis on the need for sophisticated air traffic flow management (TFM) within the National Airspace System (NAS). The NAS refers to hardware, software and people, including runways, radars, networks, FAA, airlines, etc., involved in air traffic management (ATM) in the US. One of the metrics that has been used to assess the performance of NAS is the actual delays provided through FAA's Air Traffic Operations Network (OPSNET). The OPSNET delay data includes those reportable delays, i.e. delays of 15 minutes or more experienced by Instrument Flight Rule (IFR) flights, submitted by the FAA facilities. These OPSNET delays are caused by the application of TFM initiatives in response to, for instance, weather conditions, increased traffic volume, equipment outages, airline operations, and runway conditions. TFM initiatives such as, ground stops, ground delay programs, rerouting, airborne holding, and miles-in-trail restrictions, are actions which are needed to control the air traffic demand to mitigate the demand-capacity imbalance due to the reduction in capacity. Consequently, TFM initiatives result in NAS delays. Of all the causes, weather has been identified as the most important causal factor for NAS delays. Therefore, in order to accurately assess the NAS performance, it has become necessary to create a baseline for NAS performance and establish a model which characterizes the relation between weather and NAS delays.
Maternal Obesity: Risks for Developmental Delays in Early Childhood.
Duffany, Kathleen O'Connor; McVeigh, Katharine H; Kershaw, Trace S; Lipkind, Heather S; Ickovics, Jeannette R
2016-02-01
To assess the risk for neurodevelopmental delays for children of mothers who were obese (≥200 pounds) prior to pregnancy, and to characterize delays associated with maternal obesity among children referred to and found eligible to receive Early Intervention Program services. We conducted a retrospective cohort study (N = 541,816) using a population-based New York City data warehouse with linked birth and Early Intervention data. Risks for children suspected of a delay and 'significantly delayed', with two moderate or one severe delay, were calculated. Among the group of children eligible by delay for Early Intervention, analyses assessed risk for being identified with a moderate-to-severe delay across each of five functional domains as well as risks for multiple delays. Children of mothers who were obese were more likely to be suspected of a delay (adjusted RR 1.19 [CI 1.15-1.22]) and borderline association for 'significantly delayed' (adjusted RR 1.01 [CI 1.00-1.02). Among children eligible by delay, children of mothers who were obese evidenced an increased risk for moderate-to-severe cognitive (adjusted RR 1.04 [CI 1.02-1.07]) and physical (adjusted RR 1.04 [CI 1.01-1.08]) delays and for global developmental delay (adjusted RR 1.05 [CI 1.01-1.08]). Maternal obesity is associated with increased risk of developmental delay in offspring. Among children with moderate or severe delays, maternal obesity is associated with increased risk of cognitive and physical delays as well as with increased risk for global developmental delay. While causation remains uncertain, this adds to the growing body of research reporting an association between maternal obesity and neurodevelopmental delays in offspring.
Discounting of Delayed Food Rewards in Pigeons and Rats: Is There a Magnitude Effect
ERIC Educational Resources Information Center
Green, Leonard; Myerson, Joel; Holt, Daniel D.; Slavin, John R.; Estle, Sara J.
2004-01-01
Temporal discounting refers to the decrease in the present, subjective value of a reward as the time to its receipt increases. Results from humans have shown that a hyperbola-like function describes the form of the discounting function when choices involve hypothetical monetary rewards. In addition, magnitude effects have been reported in which…
Laser-Induced Fluorescence Velocity Measurements in Supersonic Underexpanded Impinging Jets
NASA Technical Reports Server (NTRS)
Inman, Jennifer A.; Danehy, Paul M.; Barthel, Brett; Alderfer, David W.; Novak, Robert J.
2010-01-01
We report on an application of nitric oxide (NO) flow-tagging velocimetry to impinging underexpanded jet flows issuing from a Mach 2.6 nozzle. The technique reported herein utilizes a single laser, single camera system to obtain planar maps of the streamwise component of velocity. Whereas typical applications of this technique involve comparing two images acquired at different time delays, this application uses a single image and time delay. The technique extracts velocity by assuming that particular regions outside the jet flowfield have negligible velocity and may therefore serve as a stationary reference against which to measure motion of the jet flowfield. By taking the average of measurements made in 100 single-shot images for each flow condition, streamwise velocities of between -200 and +1,000 m/s with accuracies of between 15 and 50 m/s are reported within the jets. Velocity measurements are shown to explain otherwise seemingly anomalous impingement surface pressure measurements.
Propranolol reduces reference-dependence in intertemporal choice
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
Root, James C; Ryan, Elizabeth; Barnett, Gregory; Andreotti, Charissa; Bolutayo, Kemi; Ahles, Tim
2015-05-01
While forgetfulness is widely reported by breast cancer survivors, studies documenting objective memory performance yield mixed, largely inconsistent, results. Failure to find consistent, objective memory issues may be due to the possibility that cancer survivors misattribute their experience of forgetfulness to primary memory issues rather than to difficulties in attention at the time of learning. To clarify potential attention issues, factor scores for Attention Span, Learning Efficiency, Delayed Memory, and Inaccurate Memory were analyzed for the California Verbal Learning Test-Second Edition (CVLT-II) in 64 clinically referred breast cancer survivors with self-reported cognitive complaints; item analysis was conducted to clarify specific contributors to observed effects, and contrasts between learning and recall trials were compared with normative data. Performance on broader cognitive domains is also reported. The Attention Span factor, but not Learning Efficiency, Delayed Memory, or Inaccurate Memory factors, was significantly affected in this clinical sample. Contrasts between trials were consistent with normative data and did not indicate greater loss of information over time than in the normative sample. Results of this analysis suggest that attentional dysfunction may contribute to subjective and objective memory complaints in breast cancer survivors. These results are discussed in the context of broader cognitive effects following treatment for clinicians who may see cancer survivors for assessment. Copyright © 2014 John Wiley & Sons, Ltd.
Link calibration against receiver calibration: an assessment of GPS time transfer uncertainties
NASA Astrophysics Data System (ADS)
Rovera, G. D.; Torre, J.-M.; Sherwood, R.; Abgrall, M.; Courde, C.; Laas-Bourez, M.; Uhrich, P.
2014-10-01
We present a direct comparison between two different techniques for the relative calibration of time transfer between remote time scales when using the signals transmitted by the Global Positioning System (GPS). Relative calibration estimates the delay of equipment or the delay of a time transfer link with respect to reference equipment. It is based on the circulation of some travelling GPS equipment between the stations in the network, against which the local equipment is measured. Two techniques can be considered: first a station calibration by the computation of the hardware delays of the local GPS equipment; second the computation of a global hardware delay offset for the time transfer between the reference points of two remote time scales. This last technique is called a ‘link’ calibration, with respect to the other one, which is a ‘receiver’ calibration. The two techniques require different measurements on site, which change the uncertainty budgets, and we discuss this and related issues. We report on one calibration campaign organized during Autumn 2013 between Observatoire de Paris (OP), Paris, France, Observatoire de la Côte d'Azur (OCA), Calern, France, and NERC Space Geodesy Facility (SGF), Herstmonceux, United Kingdom. The travelling equipment comprised two GPS receivers of different types, along with the required signal generator and distribution amplifier, and one time interval counter. We show the different ways to compute uncertainty budgets, leading to improvement factors of 1.2 to 1.5 on the hardware delay uncertainties when comparing the relative link calibration to the relative receiver calibration.
Physical Therapy for a Child With Infantile Idiopathic Scoliosis and Motor Delay.
Hall, Rhea K; Rapport, Mary Jane
2017-07-01
The purpose of this case report is to describe physical therapy (PT) for a child with infantile idiopathic scoliosis and motor delay. A 10-month-old boy with a 28° left thoracolumbar scoliosis was referred for PT and was seen weekly in his home over a 6-month period following a diagnosis of scoliosis and delayed gross motor milestones. Before the initiation of PT, the child was scheduled to undergo serial casting for correction of the spinal curve and was not yet rolling or transitioning in or out of sitting. By the end of the 6-month intervention period, the spinal curve had resolved to 12° without the need for serial casting and the child was walking independently. PT appeared to have a positive effect on reduction of the spinal curve and achievement of gross motor milestones.
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.
ERIC Educational Resources Information Center
Stefanou, Charis; Revesz, Andrea
2015-01-01
This article reports on a classroom-based study that investigated the effectiveness of direct written corrective feedback in relation to learner differences in grammatical sensitivity and knowledge of metalanguage. The study employed a pretest-posttest-delayed posttest design with two treatment sessions. Eighty-nine Greek English as a foreign…
Development in children with achondroplasia: a prospective clinical cohort study.
Ireland, Penelope J; Donaghey, Samantha; McGill, James; Zankl, Andreas; Ware, Robert S; Pacey, Verity; Ault, Jenny; Savarirayan, Ravi; Sillence, David; Thompson, Elizabeth; Townshend, Sharron; Johnston, Leanne M
2012-06-01
Achondroplasia is characterized by delays in the development of communication and motor skills. While previously reported developmental profiles exist across gross motor, fine motor, feeding, and communication skills, there has been no prospective study of development across multiple areas simultaneously. This Australasian population-based study utilized a prospective questionnaire to quantify developmental data for skills in children born from 2000 to 2009. Forty-eight families from Australia and New Zealand were asked to report every 3 months on their child's attainment of 41 milestones. Results include reference to previously available prospective information. Information from questionnaires was used to develop an achondroplasia-specific developmental recording form. The 25th, 50th, 75th, and 90th centiles were plotted to offer clear guidelines for development across gross motor, fine motor, feeding, and communication skills in children with achondroplasia. Consistent with results from previous research, children with achondroplasia are delayed in development of gross motor and ambulatory skills. Young children with achondroplasia demonstrate a number of unique movement strategies that appear compensatory for the biomechanical changes. While delays were seen in development of later communication items, there were fewer delays seen across development of early communication, fine motor, and feeding skills. © The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.
ERIC Educational Resources Information Center
Chu, Ching-Lin; Chiang, Chung-Hsin; Wu, Chin-Chin; Hou, Yuh-Ming; Liu, Jiun-Horng
2017-01-01
Chiayi is a rural county located in southwestern Taiwan, and the effectiveness of its early intervention service system for autism spectrum disorders was studied in detail. A total of 71 children with autism spectrum disorders (n = 35) and developmental delay (n = 36) aged 2.5 years were referred from the only Early Intervention Reporting and…
Khalil, A; Suff, N; Thilaganathan, B; Hurrell, A; Cooper, D; Carvalho, J S
2014-01-01
Studies have demonstrated an association between congenital heart disease (CHD) and neurodevelopmental delay. Neuroimaging studies have also demonstrated a high incidence of preoperative brain abnormalities. The aim of this study was to perform a systematic review to quantify the non-surgical risk of brain abnormalities and of neurodevelopmental delay in infants with CHD. MEDLINE, EMBASE and The Cochrane Library were searched electronically without language restrictions, utilizing combinations of the terms congenital heart, cardiac, neurologic, neurodevelopment, magnetic resonance imaging, ultrasound, neuroimaging, autopsy, preoperative and outcome. Reference lists of relevant articles and reviews were hand-searched for additional reports. Cohort and case-control studies were included. Studies reporting neurodevelopmental outcomes and/or brain lesions on neuroimaging in infants with CHD before heart surgery were included. Cases of chromosomal or genetic abnormalities, case reports and editorials were excluded. Between-study heterogeneity was assessed using the I(2) test. The search yielded 9129 citations. Full text was retrieved for 119 and the following were included in the review: 13 studies (n = 425 cases) reporting on brain abnormalities either preoperatively or in those who did not undergo congenital cardiac surgery and nine (n = 512 cases) reporting preoperative data on neurodevelopmental assessment. The prevalence of brain lesions on neuroimaging was 34% (95% CI, 24-46; I(2) = 0%) in transposition of the great arteries, 49% (95% CI, 25-72; I(2) = 65%) in left-sided heart lesions and 46% (95% CI, 40-52; I(2) =18.1%) in mixed/unspecified cardiac lesions, while the prevalence of neurodevelopmental delay was 42% (95% CI, 34-51; I(2) = 68.9). In the absence of chromosomal or genetic abnormalities, infants with CHD are at increased risk of brain lesions as revealed by neuroimaging and of neurodevelopmental delay. These findings are independent of the surgical risk, but it is unclear whether the time of onset is fetal or postnatal. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.
Siotos, Charalampos; Hassanein, Aladdin H; Bello, Ricardo J; Sebai, Mohamad E; Seal, Stella M; Manahan, Michele A; Cooney, Damon S; Cooney, Carisa M; Rosson, Gedge D
2018-06-26
Breast cancer-related lymphedema (BCRL) is a debilitating condition with morbidity, hindered quality of life, and increased health-related costs. Experimental studies support the use of musculocutaneous flaps for managing animal models with lymphedema. Although vascularized lymph node transfer (VLNT) and lymphovenous anastomosis are used to surgically treat patients with lymphedema, it is not known whether musculocutaneous or adipocutaneous flaps (eg, delayed autologous breast reconstruction) are effective for treating refractory upper extremity BCRL. We conducted a systematic review and pooled analysis to assess the impact of delayed breast reconstruction on developed BCRL. Following PRISMA guidelines, we systematically searched PubMed, Scopus, EMBASE, and Google Scholar databases for relevant studies published through November 11, 2016. We screened 934 unique articles. Of these, we conducted full-text and reference screening on 37 articles. We then performed a pooled and sensitivity analysis using random effects. Eight studies met our inclusion criteria. One study was a case report; 7 studies were case series with sample sizes ranging from 3 to 38 patients. According to our pooled analysis 58% of patients reported improvement after breast reconstruction with or without VLNT. Sensitivity analysis revealed that 84% (95% confidence interval, 0.74-0.95) of patients who underwent breast reconstruction and VLNT reported improvement, whereas only 22% (95% confidence interval, 0.12-0.32) of those who had breast reconstruction alone reported improvement. Our review summarizes the current evidence regarding the effect of delayed breast reconstruction on established lymphedema. The VLNT component of the autologous breast reconstruction procedures may be the largest contributing factor leading to lymphedema improvement.
Mareri, Arianna; Iezzi, MariaLaura; Salvatore, Alessia; Ligas, Claudio; D'Alessandro, Elvira
2016-07-01
Maleness associated with a 45,X karyotype is a rare condition in childhood. It is usually diagnosed in adult age because of infertility. We report a unique case of an unbalanced translocation t(Y;21) in a 14-year-old boy with 45,X karyotype referred because of short stature, thin habitus and puberty delay. Hormone analysis showed low serum levels of basal testosterone, insulin-like growth factor (IGF-I) and gonadotrophins. Diagnosis of GH deficiency and puberty delay were made. He was treated with human chorionic gonadotropin (hCG) and GH therapy, respectively, for 6 and 24 months.
Academic Delay of Gratification and Academic Achievement
ERIC Educational Resources Information Center
Bembenutty, Hefer
2011-01-01
The ability to delay gratification is the cornerstone of all academic achievement and education. It is by delaying gratification that learners can pursue long-term academic and career goals. In general, "delay of gratification" refers to an individual's ability to forgo immediate rewards for the sake of more valuable ones later (Mischel, 1996).…
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.
Zhao, Mei; Lv, Xiaozhen; Tuerxun, Maimaitirexiati; He, Jincai; Luo, Benyan; Chen, Wei; Wang, Kai; Gu, Ping; Kuang, Weihong; Zhou, Yuying; Qu, Qiumin; He, Jianhua; Zhang, Nan; Feng, Yongping; Wang, Yanping; Yu, Xin; Wang, Huali
2016-02-01
The prevalence and factors associated with delays in help seeking for people with dementia in China are unknown. Within 1,010 consecutively registered participants in the Clinical Pathway for Alzheimer's Disease in China (CPAD) study (NCT01779310), 576 persons with dementia (PWDs) and their informants reported the estimated time from symptom onset to first medical visit seeking diagnosis. Univariate analysis of general linear model was used to examine the potential factors associated with the delayed diagnosis seeking. The median duration from the first noticeable symptom to the first visit seeking diagnosis or treatment was 1.77 years. Individuals with a positive family history of dementia had longer duration (p = 0.05). Compared with other types of dementia, people with vascular dementia (VaD) were referred for diagnosis earliest, and the sequence for such delays was: VaD < Alzheimer's disease (AD) < frontotemporal dementia (FTD) (p < 0.001). Subtypes of dementia (p < 0.001), family history (p = 0.01), and education level (p = 0.03) were associated with the increased delay in help seeking. In China, seeking diagnosis for PWDs is delayed for approximately 2 years, even in well-established memory clinics. Clinical features, family history, and less education may impede help seeking in dementia care.
High Precision Temperature Insensitive Strain Sensor Based on Fiber-Optic Delay
Yang, Ning; Su, Jun; Fan, Zhiqiang; Qiu, Qi
2017-01-01
A fiber-optic delay based strain sensor with high precision and temperature insensitivity was reported, which works on detecting the delay induced by strain instead of spectrum. In order to analyze the working principle of this sensor, the elastic property of fiber-optic delay was theoretically researched and the elastic coefficient was measured as 3.78 ps/km·με. In this sensor, an extra reference path was introduced to simplify the measurement of delay and resist the cross-effect of environmental temperature. Utilizing an optical fiber stretcher driven by piezoelectric ceramics, the performance of this strain sensor was tested. The experimental results demonstrate that temperature fluctuations contribute little to the strain error and that the calculated strain sensitivity is as high as 4.75 με in the range of 350 με. As a result, this strain sensor is proved to be feasible and practical, which is appropriate for strain measurement in a simple and economical way. Furthermore, on basis of this sensor, the quasi-distributed measurement could be also easily realized by wavelength division multiplexing and wavelength addressing for long-distance structure health and security monitoring. PMID:28468323
Parents' Experiences Navigating Intervention Systems for Young Children with Mild Language Delays
ERIC Educational Resources Information Center
Marshall, Jennifer; Adelman, Andrea; Kesten, Stacey M.; Natale, Ruby A.; Elbaum, Batya
2017-01-01
The purpose of this study was to explore the experiences of parents of children with mild language delays who were referred to an Individuals With Disabilities Education Act (IDEA) birth-to-3 or preschool program, were determined not eligible for services, and were referred on to a community-based program for short-term speech-language therapy.…
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
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.
Test Anxiety and Academic Delay of Gratification
ERIC Educational Resources Information Center
Bembenutty, Hefer
2009-01-01
The present study examined the relationship between college students' willingness to delay gratification, motivation, self-regulation of learning, and their level of test anxiety (N = 364). Academic delay of gratification refers to students' postponement of immediately available opportunities to satisfy impulses in favor of pursuing academic…
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.
Centering a DDR Strobe in the Middle of a Data Packet
NASA Technical Reports Server (NTRS)
Johnson, Michael; Nelson, Dave; Seefeldt, James; Roper, Weston; Passow, Craig
2014-01-01
The Orion CEV Northstar ASIC (application- specific integrated circuit) project required a DDR (double data rate) memory bus driver/receiver (DDR PHY block) to interface with external DDR memory. The DDR interface (JESD79C) is based on a source synchronous strobe (DQS\\) that is sent along with each packet of data (DQ). New data is provided concurrently with each edge of strobe and is sent irregularly. In order to capture this data, the strobe needs to be delayed and used to latch the data into a register. A circuit solves the need for training a DDR PRY block by incorporating a PVT-compensated delay element in the strobe path. This circuit takes an external reference clock signal and uses the regular clock to calibrate a known delay through a data path. The compensated delay DQS signal is then used to capture the DQ data in a normal register. This register structure can be configured as a FIFO (first in first out), in order to transfer data from the DDR domain to the system clock domain. This design is different in that it does not rely upon the need for training the system response, nor does it use a PLL (phase locked loop) or a DLL (delay locked loop) to provide an offset of the strobe signal. The circuit is created using standard ASIC building blocks, plus the PVT (process, voltage, and temperature) compensated delay line. The design uses a globally available system clock as a reference, alleviating the need to operate synchronously with the remote memory. The reference clock conditions the PVT compensated delay line to provide a pre-determined amount of delay to any data signal that passes through this delay line. The delay line is programmed in degrees of offset, so that one could think of the clock period representing 360deg of delay. In an ideal environment, delaying the strobe 1/4 of a clock cycle (90deg) would place the strobe in the middle of the data packet. This delayed strobe can then be used to clock the data into a register, satisfying setup and hold requirements of the system.
ERIC Educational Resources Information Center
MacKillop, James
2013-01-01
Delayed reward discounting is a behavioral economic index of impulsivity, referring to how much an individual devalues a reward based on its delay in time. As a behavioral process that varies considerably across individuals, delay discounting has been studied extensively as a model for self-control, both in the general population and in clinical…
Discounting of Delayed Rewards Is Not Hyperbolic
ERIC Educational Resources Information Center
Luhmann, Christian C.
2013-01-01
Delay discounting refers to decision-makers' tendency to value immediately available goods more than identical goods available only after some delay. In violation of standard economic theory, decision-makers frequently exhibit dynamic inconsistency; their preferences change simply due to the passage of time. The standard explanation for this…
Transient delayed facial nerve palsy after inferior alveolar nerve block anesthesia.
Tzermpos, Fotios H; Cocos, Alina; Kleftogiannis, Matthaios; Zarakas, Marissa; Iatrou, Ioannis
2012-01-01
Facial nerve palsy, as a complication of an inferior alveolar nerve block anesthesia, is a rarely reported incident. Based on the time elapsed, from the moment of the injection to the onset of the symptoms, the paralysis could be either immediate or delayed. The purpose of this article is to report a case of delayed facial palsy as a result of inferior alveolar nerve block, which occurred 24 hours after the anesthetic administration and subsided in about 8 weeks. The pathogenesis, treatment, and results of an 8-week follow-up for a 20-year-old patient referred to a private maxillofacial clinic are presented and discussed. The patient's previous medical history was unremarkable. On clinical examination the patient exhibited generalized weakness of the left side of her face with a flat and expressionless appearance, and she was unable to close her left eye. One day before the onset of the symptoms, the patient had visited her dentist for a routine restorative procedure on the lower left first molar and an inferior alveolar block anesthesia was administered. The patient's medical history, clinical appearance, and complete examinations led to the diagnosis of delayed facial nerve palsy. Although neurologic occurrences are rare, dentists should keep in mind that certain dental procedures, such as inferior alveolar block anesthesia, could initiate facial nerve palsy. Attention should be paid during the administration of the anesthetic solution.
Transient Delayed Facial Nerve Palsy After Inferior Alveolar Nerve Block Anesthesia
Tzermpos, Fotios H.; Cocos, Alina; Kleftogiannis, Matthaios; Zarakas, Marissa; Iatrou, Ioannis
2012-01-01
Facial nerve palsy, as a complication of an inferior alveolar nerve block anesthesia, is a rarely reported incident. Based on the time elapsed, from the moment of the injection to the onset of the symptoms, the paralysis could be either immediate or delayed. The purpose of this article is to report a case of delayed facial palsy as a result of inferior alveolar nerve block, which occurred 24 hours after the anesthetic administration and subsided in about 8 weeks. The pathogenesis, treatment, and results of an 8-week follow-up for a 20-year-old patient referred to a private maxillofacial clinic are presented and discussed. The patient's previous medical history was unremarkable. On clinical examination the patient exhibited generalized weakness of the left side of her face with a flat and expressionless appearance, and she was unable to close her left eye. One day before the onset of the symptoms, the patient had visited her dentist for a routine restorative procedure on the lower left first molar and an inferior alveolar block anesthesia was administered. The patient's medical history, clinical appearance, and complete examinations led to the diagnosis of delayed facial nerve palsy. Although neurologic occurrences are rare, dentists should keep in mind that certain dental procedures, such as inferior alveolar block anesthesia, could initiate facial nerve palsy. Attention should be paid during the administration of the anesthetic solution. PMID:22428971
Barton, Andrea; Sevcik, Rose A; Romski, Mary Ann
2006-03-01
The process of language acquisition requires an individual to organize the world through a system of symbols and referents. For children with severe intellectual disabilities and language delays, the ability to link a symbol to its referent may be a difficult task. In addition to the intervention strategy, issues such as the visual complexity and iconicity of a symbol arise when deciding what to select as a medium to teach language. This study explored the ability of four pre-school age children with developmental and language delays to acquire the meanings of Blissymbols and lexigrams using an observational experiential language intervention. In production, all four of the participants demonstrated symbol-referent relationships, while in comprehension, three of the four participants demonstrated at least emerging symbol-referent relationships. Although the number of symbols learned across participants varied, there were no differences between the learning of arbitrary and comparatively iconic symbols. The participants' comprehension skills appeared to influence their performance.
Bayley-III Cognitive and Language Scales in Preterm Children.
Spencer-Smith, Megan M; Spittle, Alicia J; Lee, Katherine J; Doyle, Lex W; Anderson, Peter J
2015-05-01
This study aimed to assess the sensitivity and specificity of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III), Cognitive and Language scales at 24 months for predicting cognitive impairments in preterm children at 4 years. Children born <30 weeks' gestation completed the Bayley-III at 24 months and the Differential Ability Scale, Second Edition (DAS-II), at 4 years to assess cognitive functioning. Test norms and local term-born reference data were used to classify delay on the Bayley-III Cognitive and Language scales. Impairment on the DAS-II Global Conceptual Ability, Verbal, and Nonverbal Reasoning indices was classified relative to test norms. Scores < -1 SD relative to the mean were classified as mild/moderate delay or impairment, and scores < -2 SDs were classified as moderate delay or impairment. A total of 105 children completed the Bayley-III and DAS-II. The sensitivity of mild/moderate cognitive delay on the Bayley-III for predicting impairment on DAS-II indices ranged from 29.4% to 38.5% and specificity ranged from 92.3% to 95.5%. The sensitivity of mild/moderate language delay on the Bayley-III for predicting impairment on DAS-II indices ranged from 40% to 46.7% and specificity ranged from 81.1% to 85.7%. The use of local reference data at 24 months to classify delay increased sensitivity but reduced specificity. Receiver operating curve analysis identified optimum cut-point scores for the Bayley-III that were more consistent with using local reference data than Bayley-III normative data. In our cohort of very preterm children, delay on the Bayley-III Cognitive and Language scales was not strongly predictive of future impairments. More children destined for later cognitive impairment were identified by using cut-points based on local reference data than Bayley-III norms. Copyright © 2015 by the American Academy of Pediatrics.
Monolithic mm-wave phase shifter using optically activated superconducting switches
NASA Technical Reports Server (NTRS)
Romanofsky, Robert R. (Inventor); Bhasin, Kul B. (Inventor)
1992-01-01
A phase shifter is disclosed having a reference path and a delay path, light sources, and superconductive switches. Each of the superconductive switches is terminated in a virtual short circuit, which may be a radial stub. Switching between the reference path and delayed path is accomplished by illuminating the superconductive switches connected to the desired path, while not illuminating the superconductive switches connected to the other path.
Screening for Speech and Language Delay in Children 5 Years Old and Younger: A Systematic Review.
Wallace, Ina F; Berkman, Nancy D; Watson, Linda R; Coyne-Beasley, Tamera; Wood, Charles T; Cullen, Katherine; Lohr, Kathleen N
2015-08-01
No recommendation exists for or against routine use of brief, formal screening instruments in primary care to detect speech and language delay in children through 5 years of age. This review aimed to update the evidence on screening and treating children for speech and language since the 2006 US Preventive Services Task Force systematic review. Medline, the Cochrane Library, PsycInfo, Cumulative Index to Nursing and Allied Health Literature, ClinicalTrials.gov, and reference lists. We included studies reporting diagnostic accuracy of screening tools and randomized controlled trials reporting benefits and harms of treatment of speech and language. Two independent reviewers extracted data, checked accuracy, and assigned quality ratings using predefined criteria. We found no evidence for the impact of screening on speech and language outcomes. In 23 studies evaluating the accuracy of screening tools, sensitivity ranged between 50% and 94%, and specificity ranged between 45% and 96%. Twelve treatment studies improved various outcomes in language, articulation, and stuttering; little evidence emerged for interventions improving other outcomes or for adverse effects of treatment. Risk factors associated with speech and language delay were male gender, family history, and low parental education. A limitation of this review is the lack of well-designed, well-conducted studies addressing whether screening for speech and language delay or disorders improves outcomes. Several screening tools can accurately identify children for diagnostic evaluations and interventions, but evidence is inadequate regarding applicability in primary care settings. Some treatments for young children identified with speech and language delays and disorders may be effective. Copyright © 2015 by the American Academy of Pediatrics.
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
Measurement of optical to electrical and electrical to optical delays with ps-level uncertainty.
Peek, H Z; Pinkert, T J; Jansweijer, P P M; Koelemeij, J C J
2018-05-28
We present a new measurement principle to determine the absolute time delay of a waveform from an optical reference plane to an electrical reference plane and vice versa. We demonstrate a method based on this principle with 2 ps uncertainty. This method can be used to perform accurate time delay determinations of optical transceivers used in fiber-optic time-dissemination equipment. As a result the time scales in optical and electrical domain can be related to each other with the same uncertainty. We expect this method will be a new breakthrough in high-accuracy time transfer and absolute calibration of time-transfer equipment.
First steps of processing VLBI data of space probes with VieVS
NASA Astrophysics Data System (ADS)
Plank, L.; Böhm, J.; Schuh, H.
2011-07-01
Since 2008 the VLBI group at the Institute of Geodesy and Geophysics (IGG) of the Vienna University of Technology has developed the Vienna VLBI Software VieVS which is capable to process geodetic VLBI data in NGS format. Constantly we are working on upgrading the new software, e.g. by developing a scheduling tool or extending the software from single session solution to a so-called global solution, allowing the joint analysis of many sessions covering several years. In this presentation we report on first steps to enable the processing of space VLBI data with the software. Driven by the recently increasing number of space VLBI applications, our goal is the geodetic usage of such data, primarily concerning frame ties between various reference frames, e. g. by connecting the dynamic reference frame of a space probe with the kinematically defined International Celestial Reference Frame (ICRF). Main parts of the software extension w.r.t. the existing VieVS are the treatment of fast moving targets, the implementation of a delay model for radio emitters at finite distances, and the adequate mathematical model and adjustment of the particular unknowns. Actual work has been done for two mission scenarios so far: On the one hand differential VLBI (D-VLBI) data from the two sub-satellites of the Japanese lunar mission Selene were processed, on the other hand VLBI observations of GNSS satellites were modelled in VieVS. Besides some general aspects, we give details on the calculation of the theoretical delay (delay model for moving sources at finite distances) and its realization in VieVS. First results with real data and comparisons with best fit mission orbit data are also presented.'
Swept Frequency Laser Metrology System
NASA Technical Reports Server (NTRS)
Zhao, Feng (Inventor)
2010-01-01
A swept frequency laser ranging system having sub-micron accuracy that employs multiple common-path heterodyne interferometers, one coupled to a calibrated delay-line for use as an absolute reference for the ranging system. An exemplary embodiment uses two laser heterodyne interferometers to create two laser beams at two different frequencies to measure distance and motions of target(s). Heterodyne fringes generated from reflections off a reference fiducial X(sub R) and measurement (or target) fiducial X(sub M) are reflected back and are then detected by photodiodes. The measured phase changes Delta phi(sub R) and Delta phi (sub m) resulting from the laser frequency swept gives target position. The reference delay-line is the only absolute reference needed in the metrology system and this provides an ultra-stable reference and simple/economical system.
Hypopituitarism in children with cerebral palsy.
Uday, Suma; Shaw, Nick; Krone, Ruth; Kirk, Jeremy
2017-06-01
Poor growth and delayed puberty in children with cerebral palsy is frequently felt to be related to malnutrition. Although growth hormone deficiency is commonly described in these children, multiple pituitary hormone deficiency (MPHD) has not been previously reported. We present a series of four children with cerebral palsy who were born before 29 weeks gestation who were referred to the regional endocrinology service, three for delayed puberty and one for short stature, in whom investigations identified MPHD. All patients had a height well below -2 standard deviation score (2nd centile) at presentation and three who had MRI scans had an ectopic posterior pituitary gland. We therefore recommend that the possibility of MPHD should be considered in all children with cerebral palsy and poor growth or delayed puberty. Early diagnosis and treatment is essential to maximise growth and prevent associated morbidity and mortality. 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/.
Chu, Ching-Lin; Chiang, Chung-Hsin; Wu, Chin-Chin; Hou, Yuh-Ming; Liu, Jiun-Horng
2017-07-01
Chiayi is a rural county located in southwestern Taiwan, and the effectiveness of its early intervention service system for autism spectrum disorders was studied in detail. A total of 71 children with autism spectrum disorders ( n = 35) and developmental delay ( n = 36) aged 2.5 years were referred from the only Early Intervention Reporting and Referral Center in Chiayi and followed up at 4 years. Results showed relatively low and varied services of early intervention for both groups during two time-point periods and a relative lack of specific early intervention programs for children with autism spectrum disorders. It was found, however, that cognitive abilities were increased for autism spectrum disorders and developmental delay groups. Additionally, the Early Learning Score at the initial evaluation could contribute to the high learner autism spectrum disorders subgroup. Parental socio-economic level was also determined to benefit the high learner developmental delay subgroup.
Microduplication of 3p26.3 Implicated in Cognitive Development
Te Weehi, Leah; Maikoo, Raj; Mc Cormack, Adrian; Mazzaschi, Roberto; Ashton, Fern; Zhang, Liangtao; George, Alice M.; Love, Donald R.
2014-01-01
We report here a 34-month-old boy with global developmental delay referred for molecular karyotyping and fragile X studies. Molecular karyotype analysis revealed a microduplication in the 3p26.3 region involving part of the CHL1 and CNTN6 genes. Several deletions, one translocation, and one duplication have previously been described in this region of chromosome 3. The CHL1 gene has been proposed as a dosage-sensitive gene with a central role in cognitive development, and so the microduplication reported here appears to be implicated in our patient's phenotype. PMID:24778888
Credibility assessment in child sexual abuse investigations: A descriptive analysis.
Melkman, Eran P; Hershkowitz, Irit; Zur, Ronit
2017-05-01
A major challenge in cases of child sexual abuse (CSA) is determining the credibility of children's reports. Consequently cases may be misclassified as false or deemed 'no judgment possible'. Based on a large national sample of reports of CSA made in Israel in 2014, the study examines child and event characteristics contributing to the probability that reports of abuse would be judged credible. National data files of all children aged 3-14, who were referred for investigation following suspected victimization of sexual abuse, and had disclosed sexual abuse, were analyzed. Cases were classified as either 'credible' or 'no judgment possible'. The probability of reaching a 'credible' judgment was examined in relation to characteristics of the child (age, gender, cognitive delay, marital status of the parents,) and of the abusive event (abuse severity, frequency, perpetrator-victim relationship, perpetrator's use of grooming, and perpetrator's use of coercion), controlling for investigator's identity at the cluster level of the analysis. Of 1563 cases analyzed, 57.9% were assessed as credible. The most powerful predictors of a credible judgment were older age and absence of a cognitive delay. Reports of children to married parents, who experienced a single abusive event that involved perpetrator's use of grooming, were also more likely to be judged as credible. Rates of credible judgments found are lower than expected suggesting under-identification of truthful reports of CSA. In particular, those cases of severe and multiple abuse involving younger and cognitively delayed children are the ones with the lowest chances of being assessed as credible. Copyright © 2017 Elsevier Ltd. All rights reserved.
Conctact dermatitis: some important topics.
Pigatto, P D
2015-11-01
Allergic contact dermatitis (ACD) is a type IV delayed hypersensitivity reaction. The gold standard for diagnosis is patch testing. The prevalence of positive patch tests in referred patients with suspected ACD ranges from 27 to 95.6%. The relationship between ACD and atopic dermatitis (AD) is complicated with conflicting reports of prevalence in the literature; however, in a patient with dermatitis not responding to traditional therapies, or with new areas of involvement, ACD should be considered as part of the work-up.
Balci, Tugce B; Davila, Jorge; Lewis, Denice; Boafo, Addo; Sell, Erick; Richer, Julie; Nikkel, Sarah M; Armour, Christine M; Tomiak, Eva; Lines, Matthew A; Sawyer, Sarah L
2018-01-01
White matter lesions have been described in patients with PTEN hamartoma tumor syndrome (PHTS). How these lesions correlate with the neurocognitive features associated with PTEN mutations, such as autism spectrum disorder (ASD) or developmental delay, has not been well established. We report nine patients with PTEN mutations and white matter changes on brain magnetic resonance imaging (MRI), eight of whom were referred for reasons other than developmental delay or ASD. Their clinical presentations ranged from asymptomatic macrocephaly with normal development/intellect, to obsessive compulsive disorder, and debilitating neurological disease. To our knowledge, this report constitutes the first detailed description of PTEN-related white matter changes in adult patients and in children with normal development and intelligence. We present a detailed assessment of the neuropsychological phenotype of our patients and discuss the relationship between the wide array of neuropsychiatric features and observed white matter findings in the context of these individuals. © 2017 Wiley Periodicals, Inc.
Autism in Early Childhood: An Unusual Developmental Course—Three Case Reports
Cohen-Ophir, Michal; Castel-Deutsh, Tsophia; Tirosh, Emanuel
2012-01-01
Autistic spectrum disorder (ASD) is typically characterized by either an emerging and gradual course or developmental regression in early childhood. The versatile clinical course is progressively acknowledged in recent years. Children with developmental disorders in general are referred to the Child Development Center for a multidisciplinary assessment, investigation, treatment and followup. We report three infants with an initial diagnosis of developmental delays, recovery of normal development following intervention in a multidisciplinary center, and subsequent regression into classic autism following their discharge from the program. An extensive medical workup was noncontributory. This unusual presentation, to our knowledge not reported previously, should be recognized by professionals involved in child development and psychiatry. PMID:22937419
Wang, Carolyn L; Schopp, Jennifer G; Petscavage, Jonelle M; Paladin, Angelisa M; Richardson, Michael L; Bush, William H
2011-06-01
The objective of our study was to assess whether high-fidelity simulation-based training is more effective than traditional didactic lecture to train radiology residents in the management of contrast reactions. This was a prospective study of 44 radiology residents randomized into a simulation group versus a lecture group. All residents attended a contrast reaction didactic lecture. Four months later, baseline knowledge was assessed with a written test, which we refer to as the "pretest." After the pretest, the 21 residents in the lecture group attended a repeat didactic lecture and the 23 residents in the simulation group underwent high-fidelity simulation-based training with five contrast reaction scenarios. Next, all residents took a second written test, which we refer to as the "posttest." Two months after the posttest, both groups took a third written test, which we refer to as the "delayed posttest," and underwent performance testing with a high-fidelity severe contrast reaction scenario graded on predefined critical actions. There was no statistically significant difference between the simulation and lecture group pretest, immediate posttest, or delayed posttest scores. The simulation group performed better than the lecture group on the severe contrast reaction simulation scenario (p = 0.001). The simulation group reported improved comfort in identifying and managing contrast reactions and administering medications after the simulation training (p ≤ 0.04) and was more comfortable than the control group (p = 0.03), which reported no change in comfort level after the repeat didactic lecture. When compared with didactic lecture, high-fidelity simulation-based training of contrast reaction management shows equal results on written test scores but improved performance during a high-fidelity severe contrast reaction simulation scenario.
Graziano, Martin; Sigman, Mariano
2008-05-23
When a stimulus is presented, its sensory trace decays rapidly, lasting for approximately 1000 ms. This brief and labile memory, referred as iconic memory, serves as a buffer before information is transferred to working memory and executive control. Here we explored the effect of different factors--geometric, spatial, and experience--with respect to the access and the maintenance of information in iconic memory and the progressive distortion of this memory. We studied performance in a partial report paradigm, a design wherein recall of only part of a stimulus array is required. Subjects had to report the identity of a letter in a location that was cued in a variable delay after the stimulus onset. Performance decayed exponentially with time, and we studied the different parameters (time constant, zero-delay value, and decay amplitude) as a function of the different factors. We observed that experience (determined by letter frequency) affected the access to iconic memory but not the temporal decay constant. On the contrary, spatial position affected the temporal course of delay. The entropy of the error distribution increased with time reflecting a progressive morphological distortion of the iconic buffer. We discuss our results on the context of a model of information access to executive control and how it is affected by learning and attention.
Lashkari, A; Khalafi, H; Kazeminejad, H
2013-05-01
In this work, kinetic parameters of Tehran research reactor (TRR) mixed cores have been calculated. The mixed core configurations are made by replacement of the low enriched uranium control fuel elements with highly enriched uranium control fuel elements in the reference core. The MTR_PC package, a nuclear reactor analysis tool, is used to perform the analysis. Simulations were carried out to compute effective delayed neutron fraction and prompt neutron lifetime. Calculation of kinetic parameters is necessary for reactivity and power excursion transient analysis. The results of this research show that effective delayed neutron fraction decreases and prompt neutron lifetime increases with the fuels burn-up. Also, by increasing the number of highly enriched uranium control fuel elements in the reference core, the prompt neutron lifetime increases, but effective delayed neutron fraction does not show any considerable change.
Effective delayed neutron fraction and prompt neutron lifetime of Tehran research reactor mixed-core
Lashkari, A.; Khalafi, H.; Kazeminejad, H.
2013-01-01
In this work, kinetic parameters of Tehran research reactor (TRR) mixed cores have been calculated. The mixed core configurations are made by replacement of the low enriched uranium control fuel elements with highly enriched uranium control fuel elements in the reference core. The MTR_PC package, a nuclear reactor analysis tool, is used to perform the analysis. Simulations were carried out to compute effective delayed neutron fraction and prompt neutron lifetime. Calculation of kinetic parameters is necessary for reactivity and power excursion transient analysis. The results of this research show that effective delayed neutron fraction decreases and prompt neutron lifetime increases with the fuels burn-up. Also, by increasing the number of highly enriched uranium control fuel elements in the reference core, the prompt neutron lifetime increases, but effective delayed neutron fraction does not show any considerable change. PMID:24976672
Romeiro Lopes, Tiara Cristina; Gravena, Angela Andréia França; Demitto, Marcela de Oliveira; Borghesan, Deise Helena Pelloso; Dell`Agnolo, Cátia Millene; Brischiliari, Sheila Cristina Rocha; Carvalho, Maria Dalva de Barros; Pelloso, Sandra Marisa
2017-11-26
Background: Cancer is a major public health problem. Early diagnosis and treatment are essential for reducing mortality. This study aimed to analyze factors associated with delay in breast cancer diagnosis and treatment among women attending a reference cancer service. Methods: This retrospective, cross-sectional study was performed with data collected from medical records and interviews conducted with women diagnosed with breast cancer and treated from October 2013 to October 2014 at a cancer reference hospital in Paraná, Southern Brazil. Results: A total of 82 participants were enrolled during the study period; their average age was 58.2 ± 11.5 years. The average time taken for final diagnosis of breast cancer was 102.5 ± 165.5 days. Treatment onset was delayed in the majority of cases, and the average time elapsing from diagnostic biopsy to onset of primary treatment was 72.3 ± 54.0 days. The odds of treatment delay were higher among the women with a low educational level. Conclusions: The results underline the need for proposals aimed at early detection, identification of risk factors and timely provision of treatment by health managers that focus on this group. Creative Commons Attribution License
Factors affecting delays in first trimester pregnancy termination services in New Zealand.
Silva, Martha; McNeill, Rob; Ashton, Toni
2011-04-01
To identify the factors affecting the timeliness of services in first trimester abortion service in New Zealand. Primary data were collected from all patients attending nine abortion clinics between February and May 2009. The outcome measured was delay between the first visit with a referring doctor and the date of the abortion procedure. Patient records (n=2,950) were audited to determine the timeline between the first point of entry to the health system and the date of abortion. Women were also invited to fill out a questionnaire identifying personal factors affecting access to services (n=1,086, response rate = 36.8%). Women who went to private clinic had a significantly shorter delay compared to public clinics. Controlling for clinic type, women who went to clinics that offered medical abortions or clinics that offered single day services experienced less delay. Also, women who had more than one visit with their referring doctor experienced a greater delay than those who had a single visit. The earlier in pregnancy women sought services the longer the delay. Women's decision-making did not have a significant effect on delay. Several clinic level and systemic factors are significantly associated with delay in first trimester abortion services. In order to ensure the best physical and emotional outcomes, timeliness of services must improve. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.
Uranium in NIMROC standard igneous rock samples
NASA Technical Reports Server (NTRS)
Rowe, M. W.; Herndon, J. M.
1976-01-01
Results are reported for analysis of the uranium in multiple samples of each of six igneous-rock standards (dunite, granite, lujavrite, norite, pyroxenite, and syenite) prepared as geochemical reference standards for elemental and isotopic compositions. Powdered rock samples were examined by measuring delayed neutron emission after irradiation with a flux of the order of 10 to the 13th power neutrons/sq cm per sec in a nuclear reactor. The measurements are shown to compare quite favorably with previous uranium determinations for other standard rock samples.
Angiographic and Interventional Management for a Esophagopericardial Fistula
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wu, Keng, E-mail: zjwukeng@hotmail.com; You, Qiong, E-mail: qiong_you@yahoo.cn; He, Song-Jian
2013-06-19
We reported a case of a 78-year-old patient with esophagopericardial fistula who was referred for angiographic and interventional management. Emergent implantation of the esophageal stent could not lengthen or even save the patient’s life. One week later, the patient died of multiple organ failure, which was probably from formation of granulation tissue and stent migration. Therefore, if the inflammatory to the esophagopericardial fistula had been better controlled initially, and the implantation of the esophageal stent delayed, our patient would have survived.
Project CHECO Southeast Asia Report. Air Operations in Northern Laos, 1 November 1970 - 1 April 1971
1971-05-03
to be of sufficient size and scope to warrant a significant increase in the daily tacair sortie rate provided by Seventh Air Force. The execution of...weather, however, delayed the operation. A last-minute change of HLZs was made by CAS, but weather and faulty execution precluded proper zone...Artillery Airborne Battlefield Command and Control Center Attacks by Fire Jtq 1£4+, .. Auto Defense du Choc . Technically an obsolete tenn now. Refers
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.
Zhang, Lili; Maruno, Shun'ichi
2010-10-01
Academic delay of gratification refers to the postponement of immediate rewards by students and the pursuit of more important, temporally remote academic goals. A path model was designed to identify the causal relationships among academic delay of gratification and motivation, self-regulated learning strategies (as specified in the Motivated Strategies for Learning Questionnaire), and grades among 386 Chinese elementary school children. Academic delay of gratification was found to be positively related to motivation and metacognition. Cognitive strategy, resource management, and grades mediated these two factors and were indirectly related to academic delay of gratification.
Analysis of functions of delayed echolalia in autistic children.
Prizant, B M; Rydell, P J
1984-06-01
This study was a preliminary attempt to determine how autistic children used delayed echolalia in naturalistic interactions with familiar people. Fourteen functional categories of delayed echolalia were derived based on videotape analyses of linguistic, extralinguistic, and paralinguistic features. Individual differences in functional usage were apparent across the three subjects. Delayed echolalia was found to vary along the dimensions of interactiveness, comprehension of the utterance produced, and relevance to linguistic or situational context. The diversity of delayed echolalic behavior is discussed in reference to its conventionality, the presence or absence of communicative intent, and its status as symbolic communicative activity.
ERIC Educational Resources Information Center
Daugherty, Stefanie; Grisham-Brown, Jennifer; Hemmeter, Mary Louise
2001-01-01
In the current study, a constant time delay (CTD) procedure was embedded in classroom activities and routines to teach counting to three preschool children with speech and language delays. CTD was effective in teaching numbers to all three children. One child out of two also was able to acquire non-target information. (Contains references.) (CR)
Programmable Differential Delay Circuit With Fine Delay Adjustment
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.
Nahar, Shamsun; Banu, Morsheda; Nasreen, Hashima E
2011-01-30
Recognizing the burden of maternal mortality in urban slums, in 2007 BRAC (formally known as Bangladesh Rural Advancement Committee) has established a woman-focused development intervention, Manoshi (the Bangla abbreviation of mother, neonate and child), in urban slums of Bangladesh. The intervention emphasizes strengthening the continuum of maternal, newborn and child care through community, delivery centre (DC) and timely referral of the obstetric complications to the emergency obstetric care (EmOC) facilities. This study aimed to assess whether Manoshi DCs reduces delays in accessing EmOC. This cross-sectional study was conducted during October 2008 to January 2009 in the slums of Dhaka city among 450 obstetric complicated cases referred either from DCs of Manoshi or from their home to the EmOC facilities. Trained female interviewers interviewed at their homestead with structured questionnaire. Pearson's chi-square test, t-test and Mann-Whitney test were performed. The median time for making the decision to seek care was significantly longer among women who were referred from home than referred from DCs (9.7 hours vs. 5.0 hours, p < 0.001). The median time to reach a facility and to receive treatment was found to be similar in both groups. Time taken to decide to seek care was significantly shorter in the case of life-threatening complications among those who were referred from DC than home (0.9 hours vs.2.3 hours, p = 0.002). Financial assistance from Manoshi significantly reduced the first delay in accessing EmOC services for life-threatening complications referred from DC (p = 0.006). Reasons for first delay include fear of medical intervention, inability to judge maternal condition, traditional beliefs and financial constraints. Role of gender was found to be an important issue in decision making. First delay was significantly higher among elderly women, multiparity, non life-threatening complications and who were not involved in income-generating activities. Manoshi program reduces the first delay for life-threatening conditions but not non-life-threatening complications even though providing financial assistance. Programme should give more emphasis on raising awareness through couple/family-based education about maternal complications and dispel fear of clinical care to accelerate seeking EmOC.
Wolff, Mathieu; Benhassine, Narimane; Costet, Pierre; Hen, Rene; Segu, Louis; Buhot, Marie-Christine
2003-01-01
Serotonin (5-HT) plays a modulatory role in mnemonic functions, especially by interacting with the cholinergic system. The 5-HT1B receptor is a key target of this interaction. The 5-HT1B receptor knockout mice were found previously to exhibit a facilitation in hippocampal-dependent spatial reference memory learning. In the present study, we submitted mice to a delayed spatial working memory task, allowing the introduction of various delays between an exposure trial and a test trial. The 5-HT1BKO and wild-type mice learned the task in a radial-arm water maze (returning to the most recent presented arm containing the escape platform), and exhibited a high level of performance at delays of 0 and 5 min. However, at the delay of 60 min, only 5-HT1BKO mice exhibited an impairment. At a delay of 90 min, all mice were impaired. Treatment by scopolamine (0.8 mg/kg) induced the same pattern of performance in wild type as did the mutation for short (5 min, no impairment) and long (60 min, impairment) delays. The 22-month-old wild-type and knockout mice exhibited an impairment at short delays (5 and 15 min). The effect of the mutation affected both young-adult and aged mice at delays of 15, 30, and 60 min. Neurobiological data show that stimulation of the 5-HT1B receptor inhibits the release of acetylcholine in the hippocampus, but stimulates this in the frontal cortex. This dual function might, at least in part, explain the opposite effect of the mutation on reference memory (facilitation) and delay-dependent working memory (impairment). These results support the idea that cholinergic-serotonergic interactions play an important role in memory processes.
Delay to orthopedic consultation for isolated limb injury
Rouleau, Dominique M.; Feldman, Debbie Ehrmann; Parent, Stefan
2009-01-01
ABSTRACT OBJECTIVE To describe referral mechanisms for referral to orthopedic surgery for isolated limb injuries in a public health care system and to identify factors affecting access. DESIGN Cross-sectional survey. SETTING Orthopedic surgery service in a level 1 trauma centre in Montreal, Que. PARTICIPANTS We conducted a prospective study of 166 consecutive adults (mean age 48 years) referred to orthopedic surgery for isolated limb injuries during a 4-month period. MAIN OUTCOME MEASURES Self-reported data on the nature of the trauma, the elapsed time between injury and orthopedic consultation, the number and type of previous primary care consultations, sociodemographic characteristics, and the level of satisfaction with care. RESULTS Average time between the injury and orthopedic consultation was 89 hours (range 3 to 642), with an average of 68 hours (range 0 to 642) for delay between primary care consultation and orthopedic consultation. A total of 36% of patients with time-sensitive diagnoses had unacceptable delays to orthopedic consultation according to the Quebec Orthopaedic Association guidelines. Lower limb injury, consulting first at another hospital, living far from the trauma centre, patient perception of low severity, and having a soft tissue injury were associated with longer delays. CONCLUSION Identifying gaps and risk factors for slower access might help improve referral mechanisms for orthopedic consultation. PMID:19826162
Emotional arousal and discount rate in intertemporal choice are reference dependent.
Lempert, Karolina M; Glimcher, Paul W; Phelps, Elizabeth A
2015-04-01
Many decisions involve weighing immediate gratification against future consequences. In such intertemporal choices, people often choose smaller, immediate rewards over larger delayed rewards. It has been proposed that emotional responses to immediate rewards lead us to choose them at our long-term expense. Here we utilize an objective measure of emotional arousal-pupil dilation-to examine the role of emotion in these decisions. We show that emotional arousal responses, as well as choices, in intertemporal choice tasks are reference-dependent and reflect the decision-maker's recent history of offers. Arousal increases when less predictable rewards are better than expected, whether those rewards are immediate or delayed. Furthermore, when immediate rewards are less predictable than delayed rewards, participants tend to be patient. When delayed rewards are less predictable, immediate rewards are preferred. Our findings suggest that we can encourage people to be more patient by changing the context in which intertemporal choices are made. (c) 2015 APA, all rights reserved).
Lin, Jin-Ding; Tung, Ho-Jui; Hsieh, Yu-Hsin; Lin, Fu-Gong
2011-01-01
Shorter sleep time was reported to be associated with psychological functioning in children. We intended to examine the relationship between nocturnal sleep duration and depression status by investigating if delayed bedtime could be one of the enhancement factors for depression in children. A cross-sectional study was performed to investigate the depression status in elementary school children in middle Taiwan. Total 676 participants from 29 schools, in grades 3-6 were recruited to participate in the study. A modified depression scale for domestic school children was used to determine the depression status. Data of depression-related demographic characteristics, family, school variables and bedtime data were collected with a structured questionnaire. The results showed that almost one in five children (18%) had depression status. Delayed bedtime, child-parent relationship, family climate, and peer relationship were found to be the main predictors of childhood depression. Further stratification analysis showed that delayed bedtime significantly interacted with family climate and peer relationship on childhood depression. The risk of depression for children with a delayed bedtime of 10 PM and either in a non-harmonious family life or without a close parent-child relationship was 4.35 and 4.73 times greater than the reference group respectively. This study provides evidence for interactive effects between delayed bedtime and family concern factors which synergistically elevated the risk of childhood depression. This information may serve as a practical guide for parents and school teachers by recognizing that an adequate bedtime schedule could serve as a preventive measure against depression in children. Copyright © 2011 Elsevier Ltd. All rights reserved.
An ultrasonic pseudorandom signal-correlation system
NASA Astrophysics Data System (ADS)
Elias, C. M.
1980-01-01
A working ultrasonic pseudorandom signal-correlation system is described which, unlike ultrasonic random signal-correlation systems, does not require an acoustic delay line. Elimination of the delay line allows faster data acquisition and better range resolution. The system uses two identical shift-register type generators to produce pseudonoise bursts which are subsequences of a 65 535-bit complementary m-sequence. One generator produces the transmitted bursts while the other generates identical reference bursts which start at a variable correlation delay time after the transmitted bursts. The reference bursts are cross-correlated with the received echoes to obtain the approximate impulse response of the transducer/specimen system under test. Range sidelobes are reduced by transmitting and correlating many bursts at a given correlation delay before incrementing the delay. Signal-to-sidelobe ratios of greater than 47 dB have been obtained using this method. Limitations of the system due to sampling constraints and the pseudonoise power spectrum are discussed, and the system design and implementation are outlined. Results of experimental characterization of the system show that the pseudorandom signal-correlation system has approximately the same range resolution as a conventional pulse-echo system but can yield a significant increase in signal-to-noise ratio (SNR).
International comparison of activity measurements of a solution of 75Se
NASA Astrophysics Data System (ADS)
Ratel, Guy
2002-04-01
Activity measurements of a solution of 75Se, supplied by the BIPM, have been carried out by 21 laboratories within the framework of an international comparison. Seven different methods were used. Details on source preparation, experimental facilities and counting data are reported. The measured activity-concentration values show a total spread of 6.62% before correction and 6.02% after correction for delayed events, with standard deviations of the unweighted means of 0.45% and 0.36%, respectively. The correction for delayed events was measured directly by four laboratories. Unfortunately no consensus on the activity value could be deduced from their results. The results of the comparison have been entered in the tables of the International Reference System (SIR) for γ-ray emitting radionuclides. The half-life of the metastable state was also determined by two laboratories and found to be in good agreement with the values found in the literature.
7 CFR 1755.405 - Voiceband data transmission measurements.
Code of Federal Regulations, 2014 CFR
2014-01-01
... inspection during normal business hours at RUS, room 2845, U.S. Department of Agriculture, STOP 1598..., room 2845, U.S. Department of Agriculture, STOP 1598, Washington, DC 20250-1598, or at the National... (RED). (3) EDD is specifically defined as the delay relative to the envelope delay at the reference...
7 CFR 1755.405 - Voiceband data transmission measurements.
Code of Federal Regulations, 2011 CFR
2011-01-01
... inspection during normal business hours at RUS, room 2845, U.S. Department of Agriculture, STOP 1598..., room 2845, U.S. Department of Agriculture, STOP 1598, Washington, DC 20250-1598, or at the National... (RED). (3) EDD is specifically defined as the delay relative to the envelope delay at the reference...
7 CFR 1755.405 - Voiceband data transmission measurements.
Code of Federal Regulations, 2012 CFR
2012-01-01
... inspection during normal business hours at RUS, room 2845, U.S. Department of Agriculture, STOP 1598..., room 2845, U.S. Department of Agriculture, STOP 1598, Washington, DC 20250-1598, or at the National... (RED). (3) EDD is specifically defined as the delay relative to the envelope delay at the reference...
7 CFR 1755.405 - Voiceband data transmission measurements.
Code of Federal Regulations, 2013 CFR
2013-01-01
... inspection during normal business hours at RUS, room 2845, U.S. Department of Agriculture, STOP 1598..., room 2845, U.S. Department of Agriculture, STOP 1598, Washington, DC 20250-1598, or at the National... (RED). (3) EDD is specifically defined as the delay relative to the envelope delay at the reference...
NASA Astrophysics Data System (ADS)
Guo, Liwen
The desire to create more complex visual scenes in modern flight simulators outpaces recent increases in processor speed. As a result, the simulation transport delay remains a problem. Because of the limitations shown in the three prominent existing delay compensators---the lead/lag filter, the McFarland compensator and the Sobiski/Cardullo predictor---new approaches of compensating the transport delay in a flight simulator have been developed. The first novel compensator is the adaptive predictor making use of the Kalman filter algorithm in a unique manner so that the predictor can provide accurately the desired amount of prediction, significantly reducing the large spikes caused by the McFarland predictor. Among several simplified online adaptive predictors it 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. Piloted simulation tests were conducted for assessing the effectiveness of the two novel compensators in comparison to the McFarland predictor and no compensation. Thirteen pilots with heterogeneous flight experience executed straight-in and offset approaches, at various delay configurations, on a flight simulator where different predictors were applied to compensate for transport delay. Four metrics---the glide slope and touchdown errors, power spectral density of the pilot control inputs, NASA Task Load Index, and Cooper-Harper rating on the handling qualities---were employed for the analyses. The overall analyses show that while the adaptive predictor results in slightly poorer compensation for short added delay (up to 48 ms) and better compensation for long added delay (up to 192 ms) than the McFarland compensator, the state space predictor is fairly superior for short delay and significantly superior for long delay to the McFarland compensator. The state space predictor also achieves better compensation than the adaptive predictor. The results of the evaluation on the effectiveness of these predictors in the piloted tests agree with those in the theoretical offline tests conducted with the recorded simulation aircraft states.
Borgonovo, Andrea; Bianchi, Albino; Marchetti, Andrea; Censi, Rachele; Maiorana, Carlo
2012-05-01
After an inferior alveolar nerve (IAN) injury, the onset of altered sensation usually begins immediately after surgery. However, it sometimes begins after several days, which is referred to as delayed paresthesia. The authors considered three different etiologies that likely produce inflammation along the nerve trunk and cause delayed paresthesia: compression of the clot, fibrous reorganization of the clot, and nerve trauma caused by bone fragments during clot organization. The aim of this article was to evaluate the etiology of IAN delayed paresthesia, analyze the literature, present a case series related to three different causes of this pathology, and compare delayed paresthesia with the classic immediate symptomatic paresthesia.
Delayed detection of cleft palate: an audit of newborn examination.
Habel, A; Elhadi, N; Sommerlad, B; Powell, J
2006-03-01
To identify prevalence of delayed detection of cleft palate, and associated factors that could lead to improved identification at neonatal clinical examination. Audit of hospital notes, parental questionnaire incorporating open ended questions, and telephone questionnaire of junior doctors in the referring hospitals incorporating fixed choice questions. Of 344 cleft palate patients without cleft lip or submucous cleft palate, the day the cleft was detected was recorded in 92%. Delayed detection, after the first day, was 28% overall, distributed as 37% with isolated cleft palate and 23% with syndromic cleft palate. Narrow V shaped clefts were more likely to be delayed in detection compared with broad U shaped clefts, as were soft palate clefts compared with hard palate clefts. Five with isolated cleft palates were not detected until after the first year. Babies born at home were unlikely to be detected on day 1. Symptoms were significantly increased in the delayed detection group for feeding problems and nasal regurgitation. A telephone questionnaire of trainee paediatricians in referring units revealed that digital examination was more commonly practised than visual inspection, and few recalled receiving specific instruction on examination of the palate. Delayed detection of cleft palate was not uncommon, and the features of those more likely to be missed suggested digital examination was related. Trainee doctors and midwives should be instructed to inspect visually using a light and tongue depressor, then digitally if submucous cleft palate is suspected.
System and method for adaptively deskewing parallel data signals relative to a clock
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.
NASA Astrophysics Data System (ADS)
Poormohammadi, Jaber; Rezagholizadeh, Hessam
The idea of action immediate propagation has been in physicists' mind from the beginning, until Faraday raised the idea of delayed propagation. Using this idea and the delayed theory of fields, we face consequences which can be interesting for anyone who has learned physics. We can mention non-equivalency between stationary frames and moving frames, dependency of field to medium, different velocity barriers for different mediums and non-equivalency of inertial reference frames are among these consequences. By designing an experiment we can challenge this theory and its consequences. All of these sections processed in the article titled ''The delayed theory of fields''.
A data-driven search for semen-related phenotypes in conception delay
Patel, C. J.; Sundaram, R.; Buck Louis, G. M.
2016-01-01
SUMMARY Sperm count, morphology, and motility have been reported to be predictive of pregnancy, although with equivocal basis prompting some authors to question the prognostic value of semen analysis. To assess the utility of including semen quality data in predicting conception delay or requiring >6 cycles to become pregnant (referred to as conception delay), we utilized novel data-driven analytic techniques in a pre-conception cohort of couples prospectively followed up for time-to-pregnancy. The study cohort comprised 402 (80%) male partners who provided semen samples and had time-to-pregnancy information. Female partners used home pregnancy tests and recorded results in daily journals. Odds ratios (OR), false discovery rates, and 95% confidence intervals (CIs) for conception delay (time-to-pregnancy > 6 cycles) were estimated for 40 semen quality phenotypes comprising 35 semen quality endpoints and 5 closely related fecundity determinants (body mass index, time of contraception, lipids, cotinine and seminal white blood cells). Both traditional and strict sperm phenotype measures were associated with lower odds of conception delay. Specifically, for an increase in percent morphologically normal spermatozoa using traditional methods, we observed a 40% decrease in conception delay (OR = 0.6, 95% CI = 0.50, 0.81; p = 0.0003). Similarly, for an increase in strict criteria, we observed a 30% decrease in odds for conception delay (OR = 0.7, 95% CI = 0.52, 0.83; p = 0.001). On the other hand, an increase in percent coiled tail spermatozoa was associated with a 40% increase in the odds for conception delay (OR = 1.4, 95% CI = 1.12, 1.75; p = 0.003). However, our findings suggest that semen phenotypes have little predictive value of conception delay (area under the curve of 73%). In a multivariate model containing significant semen factors and traditional risk factors (i.e. age, body mass index, cotinine and ever having fathered a pregnancy), there was a modest improvement in prediction of conception delay (16% increase in area under the curve, p < 0.0002). PMID:27792860
Nelson, Heidi D; Nygren, Peggy; Walker, Miranda; Panoscha, Rita
2006-02-01
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275). Published in the public domain by the American Academy of Pediatrics. Speech and language development is a useful indicator of a child's overall development and cognitive ability and is related to school success. Identification of children at risk for developmental delay or related problems may lead to intervention services and family assistance at a young age, when the chances for improvement are best. However, optimal methods for screening for speech and language delay have not been identified, and screening is practiced inconsistently in primary care. We sought to evaluate the strengths and limits of evidence about the effectiveness of screening and interventions for speech and language delay in preschool-aged children to determine the balance of benefits and adverse effects of routine screening in primary care for the development of guidelines by the US Preventive Services Task Force. The target population includes all children up to 5 years old without previously known conditions associated with speech and language delay, such as hearing and neurologic impairments. Studies were identified from Medline, PsycINFO, and CINAHL databases (1966 to November 19, 2004), systematic reviews, reference lists, and experts. The evidence review included only English-language, published articles that are available through libraries. Only randomized, controlled trials were considered for examining the effectiveness of interventions. Outcome measures were considered if they were obtained at any time or age after screening and/or intervention as long as the initial assessment occurred while the child was < or =5 years old. Outcomes included speech and language measures and other functional and health outcomes such as social behavior. A total of 745 full-text articles met our eligibility criteria and were reviewed. Data were extracted from each included study, summarized descriptively, and rated for quality by using criteria specific to different study designs developed by the US Preventive Services Task Force. The use of risk factors for selective screening has not been evaluated, and a list of specific risk factors to guide primary care physicians has not been developed or tested. Sixteen studies about potential risk factors for speech and language delay in children enrolled heterogeneous populations, had dissimilar inclusion and exclusion criteria, and measured different risk factors and outcomes. The most consistently reported risk factors included a family history of speech and language delay, male gender, and perinatal factors. Other risk factors reported less consistently included educational levels of the mother and father, childhood illnesses, birth order, and family size. The performance characteristics of evaluation techniques that take < or =10 minutes to administer were described in 24 studies relevant to screening. Studies that were rated good to fair quality reported wide ranges of sensitivity and specificity when compared with reference standards (sensitivity: 17-100%; specificity: 45-100%). Most of the evaluations, however, were not designed for screening purposes, the instruments measured different domains, and the study populations and settings were often outside of primary care. No "gold standard" has been developed and tested for screening, reference standards varied across studies, few studies compared the performance of > or =2 screening techniques in 1 population, and comparisons of a single screening technique across different populations are lacking. Fourteen good- and fair-quality randomized, controlled trials of interventions reported significantly improved speech and language outcomes compared with control groups. Improvement was demonstrated in several domains including articulation, phonology, expressive language, receptive language, lexical acquisition, and syntax among children in all age groups studied and across multiple therapeutic settings. Improvement in other functional outcomes such as socialization skills, self-esteem, and improved play themes were demonstrated in some, but not all, of the 4 studies that measured them. In general, studies of interventions were small and heterogeneous, may be subject to plateau effects, and reported short-term outcomes based on various instruments and measures. As a result, long-term outcomes are not known, interventions could not be compared directly, and generalizability is questionable. Use of risk factors to guide selective screening is not supported by studies. Several aspects of screening have been inadequately studied to determine optimal methods, including which instrument to use, the age at which to screen, and which interval is most useful. Trials of interventions demonstrate improvement in some outcome measures, but conclusions and generalizability are limited. Data are not available addressing other key issues including the effectiveness of screening in primary care settings, role of enhanced surveillance by primary care physicians before referral for diagnostic evaluation, non-speech and language and long-term benefits of interventions, and adverse effects of screening and interventions.
Sustaining Learning through Academic Delay of Gratification: Choice and Strategy.
ERIC Educational Resources Information Center
Bembenutty, Hefer; Karabenick, Stuart A.
Academic delay of gratification (ADOG) refers to students' postponement of immediately available opportunities to satisfy impulses in favor of pursuing academic goals that are temporally remote but ostensibly more valuable. This important form of self-regulation was studied among college students to determine how it serves to sustain effort over…
Perceived Discrimination and Reported Delay of Pharmacy Prescriptions and Medical Tests
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.
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.
Hospital variation in time to defibrillation after in-hospital cardiac arrest.
Chan, Paul S; Nichol, Graham; Krumholz, Harlan M; Spertus, John A; Nallamothu, Brahmajee K
2009-07-27
Delays to defibrillation are associated with worse survival after in-hospital cardiac arrest, but the degree to which hospitals vary in defibrillation response times and hospital predictors of delays remain unknown. Using hierarchical models, we evaluated hospital variation in rates of delayed defibrillation (>2 minutes) and its impact on survival among 7479 adult inpatients with cardiac arrests at 200 hospitals within the National Registry of Cardiopulmonary Resuscitation. Adjusted rates of delayed defibrillation varied substantially among hospitals (range, 2.4%-50.9%), with hospital-level effects accounting for a significant amount of the total variation in defibrillation delays after adjusting for patient factors. We found a 46% greater odds of patients with identical covariates getting delayed defibrillation at one randomly selected hospital compared with another. Among traditional hospital factors evaluated, however, only bed volume (reference category: <200 beds; 200-499 beds: odds ratio [OR], 0.62 [95% confidence interval {CI}, 0.48-0.80]; >or=500 beds: OR, 0.74 [95% CI, 0.53-1.04]) and arrest location (reference category: intensive care unit; telemetry unit: OR, 1.92 [95% CI, 1.65-2.22]; nonmonitored unit: OR, 1.90 [95% CI, 1.61-2.24]) were associated with differences in rates of delayed defibrillation. Wide variation also existed in adjusted hospital rates of survival to discharge (range, 5.3%-49.6%), with higher survival among hospitals in the top-performing quartile for defibrillation time (compared with the bottom quartile: OR for top quartile, 1.41 [95% CI, 1.11-1.77]). Rates of delayed defibrillation vary widely among hospitals but are largely unexplained by traditional hospital factors. Given its association with improved survival, future research is needed to better understand best practices in the delivery of defibrillation at top-performing hospitals.
Wen, Wen; Yamashita, Atsushi; Asama, Hajime
2015-11-01
The sense of agency refers to the feeling of being able to initiate and control events through one's actions. The "intentional binding" effect (Haggard, Clark, & Kalogeras, 2002), refers to a subjective compression of the temporal interval between actions and their effects. The present study examined the influence of action-outcome delays and arousal on both the subjective judgment of agency and the intentional binding effect. In the experiment, participants pressed a key to trigger a central square to jump after various delays. A red central square was used in the high-arousal condition. Results showed that a longer interval between actions and their effects was associated with a lower sense of agency but a stronger intentional binding effect. Furthermore, although arousal enhanced the intentional binding effect, it did not influence the judgment of agency. Copyright © 2015 Elsevier Inc. All rights reserved.
So, Joyce; Müller, Ines; Kunath, Melanie; Herrmann, Susanne; Ullmann, Reinhard; Schweiger, Susann
2008-01-01
Opitz G/BBB syndrome (OS) is a congenital midline malformation syndrome characterized by hypertelorism, hypospadias, cleft lip/palate, laryngotracheoesophageal abnormalities, imperforate anus, developmental delay and cardiac defects. The X-linked form is caused by mutations in the MID1 gene, while no gene has yet been identified for the autosomal dominant form. Here, we report on a 15-year-old boy who was referred for MID1 mutation analysis with findings typical of OS, including apparent hypertelorism, hypospadias, a history of feeding difficulties, dysphagia secondary to esophageal arteria lusoria, growth retardation and developmental delay. No MID1 mutation was found, but subsequent sub-megabase resolution array CGH unexpectedly documented a 2.34 Mb terminal 4p deletion, suggesting a diagnosis of WHS, and a duplication in Xp22.31. Wolf-Hirschhorn syndrome (WHS) is a contiguous gene deletion syndrome involving terminal chromosome 4p deletions, in particular 4p16.3. WHS is characterized by typical facial appearance ("Greek helmet facies"), mental retardation, congenital hypotonia, and growth retardation. While the severity of developmental delay in this patient supports the diagnosis of WHS rather than OS, this case illustrates the striking similarities of clinical findings in seemingly unrelated syndromes, suggesting common or interacting pathways at the molecular and pathogenetic level. This is the first report of arteria lusoria (esophageal vascular ring) in a patient with WHS. (c) 2007 Wiley-Liss, Inc.
Quantifying Reporting Timeliness to Improve Outbreak Control
Swaan, Corien; van Steenbergen, Jim; Kretzschmar, Mirjam
2015-01-01
The extent to which reporting delays should be reduced to gain substantial improvement in outbreak control is unclear. We developed a model to quantitatively assess reporting timeliness. Using reporting speed data for 6 infectious diseases in the notification system in the Netherlands, we calculated the proportion of infections produced by index and secondary cases until the index case is reported. We assumed interventions that immediately stop transmission. Reporting delays render useful only those interventions that stop transmission from index and secondary cases. We found that current reporting delays are adequate for hepatitis A and B control. However, reporting delays should be reduced by a few days to improve measles and mumps control, by at least 10 days to improve shigellosis control, and by at least 5 weeks to substantially improve pertussis control. Our method provides quantitative insight into the required reporting delay reductions needed to achieve outbreak control and other transmission prevention goals. PMID:25625374
Garara, Bhavin; Wood, Alasdair; Marcus, Hani J; Tsang, Kevin; Wilson, Mark H; Khan, Mansoor
2016-03-01
Intramuscular diaphragmatic stimulation using an abdominal laparoscopic approach has been proposed as a safer alternative to traditional phrenic nerve stimulation. It has also been suggested that early implementation of diaphragmatic pacing may prevent diaphragm atrophy and lead to earlier ventilator independence. The aim of this study was therefore to systematically review the safety and effectiveness of intramuscular diaphragmatic stimulators in the treatment of patients with traumatic high cervical injuries resulting in long-term ventilator dependence, with particular emphasis on the affect of timing of insertion of such stimulators. The Cochrane database and PubMed were searched between January 2000 and June 2015. Reference lists of selected papers were also reviewed. The inclusion criteria used to select from the pool of eligible studies were: (1) reported on adult patients with traumatic high cervical injury, who were ventilator-dependant, (2) patients underwent intramuscular diaphragmatic stimulation, and (3) commented on safety and/or effectiveness. 12 articles were included in the review. Reported safety issues post insertion of intramuscular electrodes included pneumothorax, infection, and interaction with pre-existing cardiac pacemaker. Only one procedural failure was reported. The percentage of patients reported as independent of ventilatory support post procedure ranged between 40% and 72.2%. The mean delay of insertion ranged from 40 days to 9.7 years; of note the study with the average shortest delay in insertion reported the greatest percentage of fully weaned patients. Although evidence for intramuscular diaphragmatic stimulation in patients with high cervical injuries and ventilator dependent respiratory failure is currently limited, the technique appears to be safe and effective. Earlier implantation of such devices does not appear to be associated with greater surgical risk, and may be more effective. Further high quality studies are warranted to investigate the impact of delay of insertion on ventilator weaning. Copyright © 2016 Elsevier Ltd. All rights reserved.
Spatial resolution in visual memory.
Ben-Shalom, Asaf; Ganel, Tzvi
2015-04-01
Representations in visual short-term memory are considered to contain relatively elaborated information on object structure. Conversely, representations in earlier stages of the visual hierarchy are thought to be dominated by a sensory-based, feed-forward buildup of information. In four experiments, we compared the spatial resolution of different object properties between two points in time along the processing hierarchy in visual short-term memory. Subjects were asked either to estimate the distance between objects or to estimate the size of one of the objects' features under two experimental conditions, of either a short or a long delay period between the presentation of the target stimulus and the probe. When different objects were referred to, similar spatial resolution was found for the two delay periods, suggesting that initial processing stages are sensitive to object-based properties. Conversely, superior resolution was found for the short, as compared with the long, delay when features were referred to. These findings suggest that initial representations in visual memory are hybrid in that they allow fine-grained resolution for object features alongside normal visual sensitivity to the segregation between objects. The findings are also discussed in reference to the distinction made in earlier studies between visual short-term memory and iconic memory.
A Novel Multiple-Access Correlation-Delay-Shift-Keying
NASA Astrophysics Data System (ADS)
Duan, J. Y.; Jiang, G. P.; Yang, H.
In Correlation-Delay-Shift-Keying (CDSK), the reference signal and the information-bearing signal are added together during a certain time delay. Because the reference signal is not strictly orthogonal to the information-bearing signal, the cross-correlation between the adjacent chaotic signal (Intra-signal Interference, ISI) will be introduced into the demodulation at the receiver. Therefore, the Bit-Error Ratio (BER) of CDSK is higher than that of Differential-Chaos-Shift-Keying (DCSK). To avoid the ISI component and enhance the BER performance of CDSK in multiuser scenario, Multiple-Access CDSK with No Intra-signal Interference (MA-CDSK-NII) is proposed. By constructing the repeated chaotic generator and applying the Walsh code sequence to modulate the reference signal, in MA-CDSK-NII, the ISI component will be eliminated during the demodulation. Gaussian approximation method is adopted here to obtain the exact performance analysis of MA-CDSK-NII over additive white Gaussian noise (AWGN) channel and Rayleigh multipath fading channels. Results show that, due to no ISI component and lower transmitting power, the BER performance of MA-CDSK-NII can be better than that of multiple-access CDSK and Code-Shifted Differential-Chaos-Shift-Keying (CS-DCSK).
Nielsen, Tore A; Kuiken, Don; Alain, Geneviève; Stenstrom, Philippe; Powell, Russell A
2004-12-01
The incorporation of memories into dreams is characterized by two types of temporal effects: the day-residue effect, involving immediate incorporations of events from the preceding day, and the dream-lag effect, involving incorporations delayed by about a week. This study was designed to replicate these two effects while controlling several prior methodological problems and to provide preliminary information about potential functions of delayed event incorporations. Introductory Psychology students were asked to recall dreams at home for 1 week. Subsequently, they were instructed to select a single dream and to retrieve past events related to it that arose from one of seven randomly determined days prior to the dream (days 1-7). They then rated both their confidence in recall of events and the extent of correspondence between events and dreams. Judges evaluated qualities of the reported events using scales derived from theories about the function of delayed incorporations. Average ratings of correspondences between dreams and events were high for predream days 1 and 2, low for days 3 and 4 and high again for days 5-7, but only for participants who rated their confidence in recall of events as high and only for females. Delayed incorporations were more likely than immediate incorporations to refer to events characterized by interpersonal interactions, spatial locations, resolved problems and positive emotions. The findings are consistent with the possibility that processes with circaseptan (about 7 days) morphology underlie dream incorporation and that these processes subserve the functions of socio-emotional adaptation and memory consolidation.
Nair, M K C; Mini, A O; Leena, M L; George, Babu; Harikumaran Nair, G S; Bhaskaran, Deepa; Russell, Paul Swamidhas Sudhakar
2014-12-01
To assess the effect of systematic clinic and home based early language intervention program in children reporting to the early language intervention clinic with full partnership of specially trained developmental therapist and the parents. All babies between 0 and 3 y referred to Child Development Centre (CDC) Kerala for suspected speech/language delay were assessed and those without hearing impairment were screened first using Language Evaluation Scale Trivandrum (LEST) and assessed in detail using Receptive Expressive Emergent Language Scale (REELS). Those having language delay are enrolled into the early language intervention program for a period of 6 mo, 1 h at the CDC clinic once every month followed by home stimulation for rest of the month by the mother trained at CDC. Out of the total 455 children between 0 and 3 y, who successfully completed 6 mo intervention, the mean pre and post intervention language quotient (LQ) were 60.79 and 70.62 respectively and the observed 9.83 increase was statistically significant. The developmental diagnosis included developmental delay (62.4%), global developmental delay (18.5%), Trisomy and other chromosomal abnormalities (10.5%), microcephaly and other brain problems (9.9%), misarticulation (8.4%), autistic features (5.3%) and cleft palate and lip (3.3%) in the descending order. In the present study among 455 children between 0 and 3 y without hearing impairment, who successfully completed 6 mo early language intervention, the mean pre and post intervention LQ were 60.79 and 70.62 respectively and the observed 9.83 increase was statistically significant.
Delayed repair of post-traumatic posterior urethral distraction injuries: long-term results.
Tunc, H M; Tefekli, A H; Kaplancan, T; Esen, T
2000-06-01
There is still controversy regarding the treatment of post-traumatic posterior urethral distraction injuries. Initial suprapubic cystostomy and delayed perineal urethral reconstruction has been considered the reference standard. In this report, we review our experience with delayed perineal urethral reconstruction, with a focus on the long-term outcome and complications. A total of 77 men with posterior urethral distraction injury due to pelvic trauma underwent reconstruction with delayed perineal approach. In all cases, the area of fibrosis was aggressively excised, the corpus spongiosum was mobilized, and a tension-free, spatulated end-to-end anastomosis was achieved by splitting the corporeal bodies in 66.2% and by an additional perineally performed inferior pubectomy in 49.3% of the patients. The median time from injury to surgical repair was 12 months. The preoperative evaluation consisted of combined antegrade and retrograde cystourethrograms and cystourethrography. A detailed sexual history was obtained in 58 patients (75.3%). After a mean follow-up of 47 months (range 15 months to 14 years), the urethral continuity was adequate in 94. 8%; however, 2 patients required a perineal surgical revision (total of 79 operations). Postoperative incontinence was observed in 7 (9. 1%) of 77 patients. Postoperative erectile dysfunction was noted in 16.2% of patients who were known to be potent by history before surgery. Our results support the belief that delayed perineal reconstruction with extensive excision of fibrosis and a tension-free, spatulated end-to-end anastomosis is a successful treatment alternative for posterior urethral distraction defects, with acceptable morbidity.
77 FR 29305 - Federal Acquisition Regulation; Updated Postretirement Benefit (PRB) References
Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-17
... remove references to specific paragraphs in an accounting standard that were deleted in the Financial... Accounting Principles (GAAP). The immediate and delayed recognition procedures for the initial application transition obligation in paragraphs 111, 112, and 113, respectively, of superseded Financial Accounting...
Study of the GPS inter-frequency calibration of timing receivers
NASA Astrophysics Data System (ADS)
Defraigne, P.; Huang, W.; Bertrand, B.; Rovera, D.
2018-02-01
When calibrating Global Positioning System (GPS) stations dedicated to timing, the hardware delays of P1 and P2, the P(Y)-codes on frequencies L1 and L2, are determined separately. In the international atomic time (TAI) network the GPS stations of the time laboratories are calibrated relatively against reference stations. This paper aims at determining the consistency between the P1 and P2 hardware delays (called dP1 and dP2) of these reference stations, and to look at the stability of the inter-signal hardware delays dP1-dP2 of all the stations in the network. The method consists of determining the dP1-dP2 directly from the GPS pseudorange measurements corrected for the frequency-dependent antenna phase center and the frequency-dependent ionosphere corrections, and then to compare these computed dP1-dP2 to the calibrated values. Our results show that the differences between the computed and calibrated dP1-dP2 are well inside the expected combined uncertainty of the two quantities. Furthermore, the consistency between the calibrated time transfer solution obtained from either single-frequency P1 or dual-frequency P3 for reference laboratories is shown to be about 1.0 ns, well inside the 2.1 ns uB uncertainty of a time transfer link based on GPS P3 or Precise Point Positioning. This demonstrates the good consistency between the P1 and P2 hardware delays of the reference stations used for calibration in the TAI network. The long-term stability of the inter-signal hardware delays is also analysed from the computed dP1-dP2. It is shown that only variations larger than 2 ns can be detected for a particular station, while variations of 200 ps can be detected when differentiating the results between two stations. Finally, we also show that in the differential calibration process as used in the TAI network, using the same antenna phase center or using different positions for L1 and L2 signals gives maximum differences of 200 ps on the hardware delays of the separate codes P1 and P2; however, the final impact on the P3 combination is less than 10 ps.
New Predictive Filters for Compensating the Transport Delay on a Flight Simulator
NASA Technical Reports Server (NTRS)
Guo, Liwen; Cardullo, Frank M.; Houck, Jacob A.; Kelly, Lon C.; Wolters, Thomas E.
2004-01-01
The problems of transport delay in a flight simulator, such as its sources and effects, are reviewed. Then their effects on a pilot-in-the-loop control system are investigated with simulations. Three current prominent delay compensators the lead/lag filter, McFarland filter, and the Sobiski/Cardullo filter were analyzed and compared. This paper introduces two novel delay compensation techniques an adaptive predictor using the Kalman estimator and a state space predictive filter using a reference aerodynamic model. Applications of these two new compensators on recorded data from the NASA Langley Research Center Visual Motion Simulator show that they achieve better compensation over the current ones.
A time reference distribution concept for a time division communication network
NASA Technical Reports Server (NTRS)
Stover, H. A.
1973-01-01
Starting with an assumed ideal network having perfect clocks at every node and known fixed transmission delays between nodes, the effects of adding tolerances to both transmission delays and nodal clocks is described. The advantages of controlling tolerances on time rather than frequency are discussed. Then a concept is presented for maintaining these tolerances on time throughout the network. This concept, called time reference distribution, is a systematic technique for distributing time reference to all nodes of the network. It is reliable, survivable and possesses many other desirable characteristics. Some of its features such as an excellent self monitoring capability will be pointed out. Some preliminary estimates of the accuracy that might be expected are developed and there is a brief discussion of the impact upon communication system costs. Time reference distribution is a concept that appears very attractive. It has not had experimental evaluation and has not yet been endorsed for use in any communication network.
Influenza vaccine delivery delays from the perspective of primary care physicians.
O'Leary, Sean T; Barrow, Jennifer C; McQuillan, Lon; Daley, Matthew F; Crane, Lori A; Beaty, Brenda L; Babbel, Christine I; Dickinson, L Miriam; Kempe, Allison
2011-06-01
The effects of delayed influenza vaccine delivery on primary practices are currently unknown. To describe, among primary care physicians nationally regarding the 2006-2007 influenza season: (1) how physicians defined influenza vaccine delay; (2) the extent of reported vaccine delays; and (3) the perceived effects of vaccine delays. Between March and June 2007, a total of 1268 primary care physicians nationally were surveyed. Survey response was 74% (n=940). The majority of physicians (79%) defined "influenza vaccine delay" as not receiving vaccine by November 1. Fifty-three percent reported a vaccine delay. Providers reported the following as effects of delays: reduced satisfaction of patients or parents in the practice (72%); decreased percentage in their practice who received the vaccination (65%); disruption of scheduling influenza clinics (55%); increased referral of patients elsewhere for vaccination (55%); and negative financial impact caused by unused vaccine (46%). Those who reported experiencing delays more often reported not meeting demand for vaccine (adjusted risk ratio [ARR]=1.83, 95% CI=1.64, 2.07); that grocery stores, retail outlets, or pharmacies had vaccine before their practices did (ARR=1.82, 95% CI=1.53, 2.26); not receiving all vaccine that was ordered (ARR=1.19, 95% CI=1.06, 1.36); and having leftover vaccine (ARR=1.17, 95% CI=1.04, 1.32). During the 2006-2007 influenza season, a non-shortage season, the majority of respondents reported experiencing an influenza vaccine delivery delay. Experiencing a delay was thought to decrease vaccination use, increase referrals elsewhere, and have a negative financial impact on practices. Delayed delivery of influenza vaccine is disruptive for primary care practices, and it consequently may affect vaccination coverage. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
ERIC Educational Resources Information Center
Grigorenok, Elena L.; Klin, Ami; Pauls, David L.; Senft, Riley; Hooper, Catalina; Volkmar, Fred
2002-01-01
This study of hyperlexia in 80 children with developmental delays found no significant differences in the frequency of hyperlexia in girls compared with boys; a significantly elevated frequency of hyperlexia in children diagnosed with pervasive developmental disorders (PDD) compared with children with non-PDD diagnoses; and a similar range of IQ…
Folic Acid Supplements in Pregnancy and Severe Language Delay in Children
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
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.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Shilyagin, P A; Gelikonov, G V; Gelikonov, V M
2014-07-31
We have thoroughly investigated the method of simultaneous reception of spectral components with the achromatised quadrature phase shift between two portions of a reference wave, designed for the effective suppression of the 'mirror' artefact in the resulting image obtained by means of spectral domain optical coherence tomography (SD OCT). We have developed and experimentally tested a phase-shifting element consisting of a beam divider, which splits the reference optical beam into the two beams, and of delay lines being individual for each beam, which create a mutual phase difference of π/2 in the double pass of the reference beam. The phasemore » shift achromatism over a wide spectral range is achieved by using in the delay lines the individual elements with different dispersion characteristics. The ranges of admissible adjustment parameters of the achromatised delay line are estimated for exact and inexact conformity of the geometric characteristics of its components to those calculated. A possibility of simultaneous recording of the close-to-quadrature spectral components with a single linear photodetector element is experimentally confirmed. The suppression of the artefact mirror peak in the OCT-signal by an additional 9 dB relative to the level of its suppression is experimentally achieved when the air delay line is used. Two-dimensional images of the surface positioned at an angle to the axis of the probe beam are obtained with the correction of the 'mirror' artefact while maintaining the dynamic range of the image. (laser biophotonics)« less
Quantitative Measures of Swallowing Deficits in Patients With Parkinson's Disease.
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.
Genetics Home Reference: aspartylglucosaminuria
... PDF) Disease InfoSearch: Aspartylglucosaminuria KidsHealth: Delayed Speech or Language Development MalaCards: aspartylglucosaminuria Orphanet: Aspartylglucosaminuria Patient Support and Advocacy ...
Moshirfar, Majid; McCaughey, Michael V; Fenzl, Carlton R; Santiago-Caban, Luis; Kramer, Gregory D; Mamalis, Nick
2015-01-01
Purpose To report a case of delayed-onset bilateral scleral thinning and calcium deposition following a cosmetic ocular-whitening procedure (I-BRITE®). Methods A 33-year-old male patient with a history of right-sided ptosis repair and left-sided anterior uveitis had previously undergone bilateral I-BRITE treatment for chronic conjunctival hyperemia. Four years after the procedure, the patient was referred to our institution with bilateral scleral thinning and overlying calcific depositions. A literature review was performed through PubMed from 1980 through 2014 using the search terms ‘cosmetic’, ‘ocular’, ‘conjunctivectomy’, ‘regional conjunctivectomy’, ‘I-BRITE’, ‘eye-whitening’, ‘scleritis’, ‘necrotizing scleritis’, ‘anterior uveitis’, ‘mitomycin C’, ‘5-fluorouracil’, and ‘bevacizumab’, along with associated cross-referencing from relevant articles. Results Examination of the patient revealed bilateral necrotizing scleritis within the nasal region of both eyes. Calcified plaques were also present within the areas of scleromalacia, along with epithelial defects demonstrated with fluorescein staining. Although evidence of previous intraocular inflammation was apparent within the left eye, there were no active signs of inflammation evident within either eye on initial presentation. Complication rates reported in the literature include: scleral thinning (1.8%), calcific plaque formation (2.9%), fibrovascular proliferation (13%), diplopia (1.2%), elevation of intraocular pressure (4.2%), and recurrence of conjunctival hyperemia (2.1%). Conclusion Cosmetic ocular whitening procedures have an attendant high complication rate, and have been associated with several adverse postoperative complications, which have in turn generated several reservations regarding the veritable benefit of the procedure. Many postsurgical complications may demonstrate delayed apparition, varying from several months to several years after primary surgical intervention as in the case reported here. PMID:25784790
Moshirfar, Majid; McCaughey, Michael V; Fenzl, Carlton R; Santiago-Caban, Luis; Kramer, Gregory D; Mamalis, Nick
2015-01-01
To report a case of delayed-onset bilateral scleral thinning and calcium deposition following a cosmetic ocular-whitening procedure (I-BRITE(®)). A 33-year-old male patient with a history of right-sided ptosis repair and left-sided anterior uveitis had previously undergone bilateral I-BRITE treatment for chronic conjunctival hyperemia. Four years after the procedure, the patient was referred to our institution with bilateral scleral thinning and overlying calcific depositions. A literature review was performed through PubMed from 1980 through 2014 using the search terms 'cosmetic', 'ocular', 'conjunctivectomy', 'regional conjunctivectomy', 'I-BRITE', 'eye-whitening', 'scleritis', 'necrotizing scleritis', 'anterior uveitis', 'mitomycin C', '5-fluorouracil', and 'bevacizumab', along with associated cross-referencing from relevant articles. Examination of the patient revealed bilateral necrotizing scleritis within the nasal region of both eyes. Calcified plaques were also present within the areas of scleromalacia, along with epithelial defects demonstrated with fluorescein staining. Although evidence of previous intraocular inflammation was apparent within the left eye, there were no active signs of inflammation evident within either eye on initial presentation. Complication rates reported in the literature include: scleral thinning (1.8%), calcific plaque formation (2.9%), fibrovascular proliferation (13%), diplopia (1.2%), elevation of intraocular pressure (4.2%), and recurrence of conjunctival hyperemia (2.1%). Cosmetic ocular whitening procedures have an attendant high complication rate, and have been associated with several adverse postoperative complications, which have in turn generated several reservations regarding the veritable benefit of the procedure. Many postsurgical complications may demonstrate delayed apparition, varying from several months to several years after primary surgical intervention as in the case reported here.
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).
Ganly, Peter S; Keeman, Helen; Spearing, Ruth L; Smith, Mark P; Patton, Nigel; Merriman, Eileen G; Gibbons, Steve S
2008-01-07
To measure the safety and acceptability of providing written advice (WA) for selected patients referred to a haematology service, as an alternative to inpatient or outpatient assessment. Review of the initial management and subsequent course of patients newly referred to a tertiary referral hospital in Christchurch, New Zealand, between 16 October 2003 and 8 June 2006. Structured questionnaires were sent to all referring doctors and patients recently managed with WA. Numbers and diagnoses of patients managed with WA, early assessment or delayed assessment; re-referral and treatment details; characteristics of WA letters; and opinions of referring doctors and their patients on the WA process. 26% of new referrals (714/2785) were managed with prompt WA, while 16% (455/2785) received the alternative of delayed assessment. After a median follow-up of 23 months (range, 8-40 months), 13% of those managed with WA (91/714) were re-referred back to the same haematologists; 7% (52/714) were assessed in hospital and 2% (15/714) eventually required treatment. There were no deaths due to haematological causes. Over 90% of responding referring doctors said the WA process was rapid and effective, and 77% of recently managed patients were pleased to be treated by their own doctors. Using WA to manage a substantial minority of patients referred to haematologists can be rapid and safe. It is widely accepted by referring doctors.
Hoffman, A N; Krigbaum, A; Ortiz, J B; Mika, A; Hutchinson, K M; Bimonte-Nelson, H A; Conrad, C D
2011-09-01
Chronic stress results in reversible spatial learning impairments in the Morris water maze that correspond with hippocampal CA3 dendritic retraction in male rats. Whether chronic stress impacts different types of memory domains, and whether these can similarly recover, is unknown. This study assessed the effects of chronic stress with and without a post-stress delay to evaluate learning and memory deficits within two memory domains, reference and working memory, in the radial arm water maze (RAWM). Three groups of 5-month-old male Sprague-Dawley rats were either not stressed [control (CON)], or restrained (6 h/day for 21 days) and then tested on the RAWM either on the next day [stress immediate (STR-IMM)] or following a 21-day delay [stress delay (STR-DEL)]. Although the groups learned the RAWM task similarly, groups differed in their 24-h retention trial assessment. Specifically, the STR-IMM group made more errors within both the spatial reference and working memory domains, and these deficits corresponded with a reduction in apical branch points and length of hippocampal CA3 dendrites. In contrast, the STR-DEL group showed significantly fewer errors in both the reference and working memory domains than the STR-IMM group. Moreover, the STR-DEL group showed better RAWM performance in the reference memory domain than did the CON group, and this corresponded with restored CA3 dendritic complexity, revealing long-term enhancing actions of chronic stress. These results indicate that chronic stress-induced spatial working and reference memory impairments, and CA3 dendritic retraction, are reversible, with chronic stress having lasting effects that can benefit spatial reference memory, but with these lasting beneficial effects being independent of CA3 dendritic complexity. © 2011 The Authors. European Journal of Neuroscience © 2011 Federation of European Neuroscience Societies and Blackwell Publishing Ltd.
Brain Structure Linking Delay Discounting and Academic Performance.
Wang, Song; Kong, Feng; Zhou, Ming; Chen, Taolin; Yang, Xun; Chen, Guangxiang; Gong, Qiyong
2017-08-01
As a component of self-discipline, delay discounting refers to the ability to wait longer for preferred rewards and plays a pivotal role in shaping students' academic performance. However, the neural basis of the association between delay discounting and academic performance remains largely unknown. Here, we examined the neuroanatomical substrates underlying delay discounting and academic performance in 214 adolescents via voxel-based morphometry (VBM) by performing structural magnetic resonance imaging (S-MRI). Behaviorally, we confirmed the significant correlation between delay discounting and academic performance. Neurally, whole-brain regression analyses indicated that regional gray matter volume (rGMV) of the left dorsolateral prefrontal cortex (DLPFC) was associated with both delay discounting and academic performance. Furthermore, delay discounting partly accounted for the association between academic performance and brain structure. Differences in the rGMV of the left DLPFC related to academic performance explained over one-third of the impact of delay discounting on academic performance. Overall, these results provide the first evidence for the common neural basis linking delay discounting and academic performance. Hum Brain Mapp 38:3917-3926, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.
Assessment of medical practitioners' knowledge of fibromyalgia in Saudi Arabia.
Kaki, Abdullah Mohammad; Hazazi, Abdulaziz A
2018-01-01
Fibromyalgia (FM), a relatively common disease, is difficult to diagnose owing to its subjective symptoms and poor knowledge among medical practitioners. The purpose of this study was to assess the knowledge regarding FM among medical practitioners in Saudi Arabia and the need for educational programs at the undergraduate level. An online survey was administered to physicians, nurses, and technologist/technicians in different regions of the country. Responses were obtained from 104 medical practitioners. Knowledge regarding FM including clinical symptoms, diagnosis, and treatment was assessed. Only 26% of the respondents reported that FM was part of their undergraduate curriculum, and only 8.7% attended educational programs about FM. (Approximately 50% of the medical practitioners either referred FM patients to unrelated specialty or did not know whom to refer these patients to). Only 33.7% of the respondents were familiar with the diagnostic criteria. Physiotherapy (69.4%) and pharmacological treatment (63.9%) were predominantly reported as the appropriate treatment. Knowledge regarding FM among medical practitioners in Saudi Arabia is poor. Further education at the undergraduate level is needed to improve knowledge and avoid delays in diagnosis and treatment.
Constitutional Chromoanagenesis of Distal 13q in a Young Adult with Recurrent Strokes.
Burnside, Rachel D; Harris, April; Speyer, Darrow; Burgin, W Scott; Rose, David Z; Sanchez-Valle, Amarilis
2016-01-01
Constitutional chromoanagenesis events, which include chromoanasynthesis and chromothripsis and result in highly complex rearrangements, have been reported for only a few individuals. While rare, these phenomena have likely been underestimated in a constitutional setting as technologies that can accurately detect such complexity are relatively new to the mature field of clinical cytogenetics. G-banding is not likely to accurately identify chromoanasynthesis or chromothripsis, since the banding patterns of chromosomes are likely to be misidentified or oversimplified due to a much lower resolution. We describe a patient who was initially referred for cytogenetic testing as a child for speech delay. As a young adult, he was referred again for recurrent strokes. Chromosome analysis was performed, and the rearrangement resembled a simple duplication of 13q32q34. However, SNP microarray analysis showed a complex pattern of copy number gains and a loss consistent with chromoanasynthesis involving distal 13q (13q32.1q34). This report emphasizes the value of performing microarray analysis for individuals with abnormal or complex chromosome rearrangements. © 2016 S. Karger AG, Basel.
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.
A Comprehensive Study of Three Delay Compensation Algorithms for Flight Simulators
NASA Technical Reports Server (NTRS)
Guo, Liwen; Cardullo, Frank M.; Houck, Jacob A.; Kelly, Lon C.; Wolters, Thomas E.
2005-01-01
This paper summarizes a comprehensive study of three predictors used for compensating the transport delay in a flight simulator; The McFarland, Adaptive and State Space Predictors. The paper presents proof that the stochastic approximation algorithm can achieve the best compensation among all four adaptive predictors, and intensively investigates the relationship between the state space predictor s compensation quality and its reference model. Piloted simulation tests show that the adaptive predictor and state space predictor can achieve better compensation of transport delay than the McFarland predictor.
Global developmental delay with sodium valproate-induced gingival hyperplasia.
Patil, Ravi B; Urs, Pallavi; Kiran, Shital; Bargale, Seema Dinesh
2014-01-22
Global developmental delay (GDD) refers to a disturbance in an individual child across one or more developmental domains, which include motor, cognition, daily activities, speech and language. The present case discusses a 5-year-old child with GDD associated with infantile spasms treated with sodium valproate. Delay in the widespread acquisition of skills, epilepsy and poor oral hygiene with gingival enlargement was the main concern to seek medical aid. This case is special as the child was suffering from GDD associated with sodium valproate-induced gingival enlargement.
Replantation surgery in Quebec: The bottlenecks to rapid care
Borsuk, Daniel E; Zadeh, Teanoosh; Lee, Chen; Moore, Karl; Tan, Grace
2006-01-01
INTRODUCTION Time delays resulting in prolonged ischemia have a significant impact on the successful reattachment of amputated body parts. No studies have addressed the issues surrounding delays from the time of the accident to the start of replantation surgery. The present paper identifies the bottlenecks that prolong the time before patients are able to gain access to a replant team. METHODS A total of 50 patients underwent microsurgical replantation, because of traumatic amputation, at a university-based hospital from 1996 to 2003. The charts were analyzed to ascertain individual time intervals from the onset of injury until the beginning of replant surgery. RESULTS The average length of time for patients who came directly to the replant centre was 3 h 40 min before surgery began. In contrast, for those referred from outlying hospitals, the elapsed time was 6 h 21 min. CONCLUSIONS Two major bottlenecks were found. First, for patients who were referred from other health centres, delays were due to a lack of information as to where patients could receive appropriate replant surgery. Second, delays at the replant centre were primarily due to insufficient physical and human resources in the operating room. PMID:19554107
DOE Office of Scientific and Technical Information (OSTI.GOV)
Doll, D.C.; Ringenberg, Q.S.; Yarbro, J.W.
Although cancer during pregnancy is infrequent, its management is difficult for patients, their families, and their physicians. When termination of the pregnancy is unacceptable, decisions regarding the use of irradiation and chemotherapy are complicated by the well-known high risks of abortion and fetal malformation. This risk is concentrated in the first trimester and varies with the choice of chemotherapeutic agents or combinations of agents. There is only minimal evidence of increased risk of malformation or abortion in the second or third trimester. Recent progress in cancer therapy has made cure a reasonable goal, and for some malignant neoplasms, cure ismore » still possible even when initial therapy is modified or delayed. When cure is a reasonable goal, curative therapy should not be compromised by modification or delay. When treatment for cure or significant palliation is not possible, however, the goal should shift to protection of the fetus from damage by the injudicious use of teratogenic cancer therapy. This report will review the available data that may assist in these difficult decisions. 114 references.« less
Blanchard, P C
2006-01-01
The air transportation of infectious materials is regulated by international air transport associations and based on United Nations Model regulations which have become more practical in addressing animal disease agents. However, individual countries' import and interstate requirements determine what materials can be imported and transported, and this approval process can be long, resulting in delays in organism confirmation, use of international OIE and other reference laboratories, and acquisition of reference materials, proficiency test panels, and reagents for performing necessary testing. Delays can be prevented for permits that are required for the routine work performed by a laboratory through the use of comprehensive and annually renewed permits. This process, however, does not address new and exotic agents where time is critical to an effective emergency response. This paper suggests actions by both the OIE and regulatory authorities which can assist in streamlining and expediting the permit process.
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.
Report #11-R-0179, March 28, 2011. While DERA project officers were aware of Recovery Act grant project delays, they did not always document delays in EPA’s grants management system or, in some cases, take action to reduce the impact of project delays.
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.
Rapid Antimicrobial Susceptibility Testing Using Forward Laser Light Scatter Technology
Clinton, Lani K.; Hewitt, Carolyn; Koyamatsu, Terri; Sun, Yilun; Jamison, Ginger; Perkins, Rosalie; Tang, Li; Pounds, Stanley; Bankowski, Matthew J.
2016-01-01
The delayed reporting of antimicrobial susceptibility testing remains a limiting factor in clinical decision-making in the treatment of bacterial infection. This study evaluates the use of forward laser light scatter (FLLS) to measure bacterial growth for the early determination of antimicrobial susceptibility. Three isolates each (two clinical isolates and one reference strain) of Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa were tested in triplicate using two commercial antimicrobial testing systems, the Vitek2 and the MicroScan MIC panel, to challenge the BacterioScan FLLS. The BacterioScan FLLS showed a high degree of categorical concordance with the commercial methods. Pairwise comparison with each commercial system serving as a reference standard showed 88.9% agreement with MicroScan (two minor errors) and 72.2% agreement with Vitek (five minor errors). FLLS using the BacterioScan system shows promise as a novel method for the rapid and accurate determination of antimicrobial susceptibility. PMID:27558176
He, Wangli; Qian, Feng; Han, Qing-Long; Cao, Jinde
2012-10-01
This paper investigates the problem of master-slave synchronization of two delayed Lur'e systems in the presence of parameter mismatches. First, by analyzing the corresponding synchronization error system, synchronization with an error level, which is referred to as quasi-synchronization, is established. Some delay-dependent quasi-synchronization criteria are derived. An estimation of the synchronization error bound is given, and an explicit expression of error levels is obtained. Second, sufficient conditions on the existence of feedback controllers under a predetermined error level are provided. The controller gains are obtained by solving a set of linear matrix inequalities. Finally, a delayed Chua's circuit is chosen to illustrate the effectiveness of the derived results.
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.
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.
Yatsuga, Shuichi; Saikusa, Tomoko; Sasaki, Takako; Ushijima, Kikumi; Kitamura, Miyuki; Nishioka, Junko; Koga, Yasutoshi
2016-08-10
Thyroid dysfunction can induce developmental delay and failure to thrive in infancy. Congenital hypothyroidism is one of the common causes of these symptoms in infancy. By contrast, hyperthyroidism is a rare cause of these symptoms in infancy. A 7-month-old Japanese baby boy was examined for developmental delay and failure to thrive. Blood tests were performed, which showed low levels of thyroid-stimulating hormone (<0.01 μU/mL) and high levels of free thyroxine (2.14 pg/mL). He was referred to our hospital at 8 months of age. His height was 64 cm (-2.7 standard deviation) and his weight was 6085 g (-2.5 standard deviation). No goiter was detected on examination. His thyrotropin receptor antibody was slightly high (3.9 IU/L), whereas thyroid stimulating antibody, anti-thyroglobulin antibody, and thyroid peroxidase antibody were within normal range. These blood findings indicated hyperthyroidism, most likely Graves' disease. His free thyroxine level decreased in the first month after our examination. No increased vascularity of his thyroid gland was noted. The technetium uptake of his thyroid gland in scintigraphy was relatively increased compared to the intake of his salivary gland. We elected to observe rather than treat with anti-thyroid medications. We have to rule out spontaneous transient Graves' thyrotoxicosis when babies have symptoms of developmental delay and fail to thrive.
Acosta, Jazmin I; Mayer, Loretta; Talboom, Joshua S; Zay, Cynthia; Scheldrup, Melissa; Castillo, Jonathan; Demers, Laurence M; Enders, Craig K; Bimonte-Nelson, Heather A
2009-03-01
Conjugated equine estrogen (CEE) is the most commonly prescribed estrogen therapy, and is the estrogen used in the Women's Health Initiative study. While in-vitro studies suggest that CEE is neuroprotective, no study has evaluated CEE's effects on a cognitive battery and brain immunohistochemistry in an animal model. The current experiment tested whether CEE impacted: I) spatial learning, reference memory, working memory and long-term retention, as well as ability to handle mnemonic delay and interference challenges; and, II) the cholinergic system, via pharmacological challenge during memory testing and ChAT-immunoreactive cell counts in the basal forebrain. Middle-aged ovariectomized (Ovx) rats received chronic cyclic injections of either Oil (vehicle), CEE-Low (10 microg), CEE-Medium (20 microg) or CEE-High (30 microg) treatment. Relative to the Oil group, all three CEE groups showed less overnight forgetting on the spatial reference memory task, and the CEE-High group had enhanced platform localization during the probe trial. All CEE groups exhibited enhanced learning on the spatial working memory task, and CEE dose-dependently protected against scopolamine-induced amnesia with every rat receiving the highest CEE dose maintaining zero errors after scopolamine challenge. CEE also increased number of ChAT-immunoreactive neurons in the vertical diagonal band of the basal forebrain. Neither the ability to remember after a delay nor interference, nor long-term retention, was influenced by the CEE regimen used in this study. These findings are similar to those reported previously for 17 beta-estradiol, and suggest that CEE can provide cognitive benefits on spatial learning, reference and working memory, possibly through cholinergic mechanisms.
Strand, Edythe A.; Fourakis, Marios; Jakielski, Kathy J.; Hall, Sheryl D.; Karlsson, Heather B.; Mabie, Heather L.; McSweeny, Jane L.; Tilkens, Christie M.; Wilson, David L.
2017-01-01
Purpose The goal of this article (PM I) is to describe the rationale for and development of the Pause Marker (PM), a single-sign diagnostic marker proposed to discriminate early or persistent childhood apraxia of speech from speech delay. Method The authors describe and prioritize 7 criteria with which to evaluate the research and clinical utility of a diagnostic marker for childhood apraxia of speech, including evaluation of the present proposal. An overview is given of the Speech Disorders Classification System, including extensions completed in the same approximately 3-year period in which the PM was developed. Results The finalized Speech Disorders Classification System includes a nosology and cross-classification procedures for childhood and persistent speech disorders and motor speech disorders (Shriberg, Strand, & Mabie, 2017). A PM is developed that provides procedural and scoring information, and citations to papers and technical reports that include audio exemplars of the PM and reference data used to standardize PM scores are provided. Conclusions The PM described here is an acoustic-aided perceptual sign that quantifies one aspect of speech precision in the linguistic domain of phrasing. This diagnostic marker can be used to discriminate early or persistent childhood apraxia of speech from speech delay. PMID:28384779
Foo, Yong-Lin; Chow, Julie Chi; Lai, Ming-Chi; Tsai, Wen-Hui; Tung, Li-Chen; Kuo, Mei-Chin; Lin, Shio-Jean
2015-08-01
This review article aims to introduce the screening and referral network of genetic evaluation for children with developmental delay in Taiwan. For these children, integrated systems provide services from the medical, educational, and social welfare sectors. All cities and counties in Taiwan have established a network for screening, detection, referral, evaluation, and intervention services. Increased awareness improves early detection and intervention. There remains a gap between supply and demand, especially with regard to financial resources and professional manpower. Genetic etiology has a major role in prenatal causes of developmental delay. A summary of reports on some related genetic disorders in the Taiwanese population is included in this review. Genetic diagnosis allows counseling with regard to recurrence risk and prevention. Networking with neonatal screening, laboratory diagnosis, genetic counseling, and orphan drugs logistics systems can provide effective treatment for patients. In Taiwan, several laboratories provide genetic tests for clinical diagnosis. Accessibility to advanced expensive tests such as gene chips or whole exome sequencing is limited because of funding problems; however, the service system in Taiwan can still operate in a relatively cost-effective manner. This experience in Taiwan may serve as a reference for other countries. Copyright © 2014. Published by Elsevier B.V.
Reason for Referral Predicts Utilization and Perceived Impact of Early Intervention Services.
Javalkar, Karina; Litt, Jonathan S
Children participating in early intervention (EI) vary in their medical needs and degree of delay, and previous studies have shown significant differences in EI enrollment based on the reason for referral. The effect of reason for referral on service provision and family satisfaction is largely unknown. We used data from the National Early Intervention Longitudinal Study for our secondary data analysis. The main predictor was the reason for referral: a diagnosed condition, documented developmental delay, or other risk factors. Outcomes included unmet service needs, program dropout, and family satisfaction with services. The 2966 participants were mostly white (51.9%), male (60.3%), and had an annual household income at or below $50,000 (77.0%). There were 1924 referred due to diagnosis, 691 due to delay, and 351 due to other risks. Compared with the diagnosis group, children with delays were more likely (adjusted odds ratio [aOR] 1.38, 95% confidence interval [CI], 1.02-1.87) to have unmet service needs and to drop out of EI programs (aOR 1.44, 95% CI, 1.07-1.96); their families were less likely to report that services were highly individualized (aOR 0.80, 95% CI, 0.65-0.98) or had an impact on their children's development (aOR 0.77, 95% CI, 0.62-0.96). Children participating in EI because of developmental delays are more likely to have unmet service needs, drop out of services because of a reason other than ineligibility (family or child-related reason), and have lower caregiver satisfaction than those participating because of diagnosed conditions. It is important to determine reasons for these differences and their impact on developmental outcomes.
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.
Gao, Mingwu; Olivier, N Bari; Mukkamala, Ramakrishna
2016-05-01
Pulse transit time (PTT) measured as the time delay between invasive proximal and distal blood pressure (BP) or flow waveforms (invasive PTT [I-PTT]) tightly correlates with BP PTT estimated as the time delay between noninvasive proximal and distal arterial waveforms could therefore permit cuff-less BP monitoring. A popular noninvasive PTT estimate for this application is the time delay between ECG and photoplethysmography (PPG) waveforms (pulse arrival time [PAT]). Another estimate is the time delay between proximal and distal PPG waveforms (PPG-PTT). PAT and PPG-PTT were assessed as markers of BP over a wide physiologic range using I-PTT as a reference. Waveforms for determining I-PTT, PAT, and PPG-PTT through central arteries were measured from swine during baseline conditions and infusions of various hemodynamic drugs. Diastolic, mean, and systolic BP varied widely in each subject (group average (mean ± SE) standard deviation between 25 ± 2 and 36 ± 2 mmHg). I-PTT correlated well with all BP levels (group average R(2) values between 0.86 ± 0.03 and 0.91 ± 0.03). PPG-PTT also correlated well with all BP levels (group average R(2) values between 0.81 ± 0.03 and 0.85 ± 0.02), and its R(2) values were not significantly different from those of I-PTT PAT correlated best with systolic BP (group average R(2) value of 0.70 ± 0.04), but its R(2) values for all BP levels were significantly lower than those of I-PTT (P < 0.005) and PPG-PTT (P < 0.02). The pre-ejection period component of PAT was responsible for its inferior correlation with BP In sum, PPG-PTT was not different from I-PTT and superior to the popular PAT as a marker of BP. © 2016 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.
Giant thoracic schwannoma presenting with abrupt onset of abdominal pain: a case report
2009-01-01
Introduction Giant intradural extramedullary schwannomas of the thoracic spine are not common. Schwannomas, that is, tumors derived from neoplastic Schwann cells, and neurofibromas represent the most common intradural extramedullary spinal lesions. We report the case of a patient with a giant thoracic schwannoma presenting unusually with acute abdominal pain and with delayed neurological impairment. Case presentation A 26-year-old Hispanic man with no previous medical problems presented with acute periumbilical pain. After extensive work-up including an exploratory laparotomy for appendectomy, magnetic resonance imaging scans of the lumbar and thoracic spine revealed a giant intradural extramedullary thoracic schwannoma within the spinal canal posterior to the T9, T10, and T11 vertebral bodies. Magnetic resonance imaging signal prolongation was noted in the spinal cord both rostral and caudal to the schwannoma. The patient underwent an urgent laminectomy from T8 to L1. After sacrificing the T10 root, the tumor was removed en bloc. Postoperatively, the patient improved significantly gaining antigravity strength in both lower extremities. Conclusion The T10 dermatome is represented by the umbilical region. This referred pain may represent a mechanism by which a giant thoracic schwannoma may present as acute abdominal pain. Acute, intense abdominal pain with delayed neurologic deficit is a rare presentation of a thoracic schwannoma but should be considered as a possible cause of abdominal pain presenting without clear etiology. Although these lesions may be delayed in their diagnosis, early diagnosis and treatment may lead to an improved clinical outcome. PMID:19946504
Radiometric errors in complex Fourier transform spectrometry.
Sromovsky, Lawrence A
2003-04-01
A complex spectrum arises from the Fourier transform of an asymmetric interferogram. A rigorous derivation shows that the rms noise in the real part of that spectrum is indeed given by the commonly used relation sigmaR = 2X x NEP/(etaAomega square root(tauN)), where NEP is the delay-independent and uncorrelated detector noise-equivalent power per unit bandwidth, +/- X is the delay range measured with N samples averaging for a time tau per sample, eta is the system optical efficiency, and Aomega is the system throughput. A real spectrum produced by complex calibration with two complex reference spectra [Appl. Opt. 27, 3210 (1988)] has a variance sigmaL2 = sigmaR2 + sigma(c)2 (Lh - Ls)2/(Lh - Lc)2 + sigma(h)2 (Ls - Lc)2/(Lh - Lc)2, valid for sigmaR, sigma(c), and sigma(h) small compared with Lh - Lc, where Ls, Lh, and Lc are scene, hot reference, and cold reference spectra, respectively, and sigma(c) and sigma(h) are the respective combined uncertainties in knowledge and measurement of the hot and cold reference spectra.
Epithelioid sarcoma: a diagnostic challenge.
Pai, Kanthilatha K; Pai, Sathish B; Sripathi, H; Rao, Purnima
2006-01-01
Epithelioid sarcoma is an uncommon slow-growing soft tissue malignancy, associated with a high incidence of local recurrence and metastasis. We report a 26-year-old male with epithelioid sarcoma on the right palm with a long history of over seven years, which was initially misdiagnosed as cutaneous tuberculosis and epithelioid hemangioendothelioma, as a result of which the treatment was delayed. No metastasis was found in our patient. The patient was referred to the oncology centre where he underwent wide excision of the lesion followed by radiotherapy. The review of the literature including clinical and histological differential diagnosis is presented as it mimics inflammatory, benign tumors as well as other malignant conditions.
Tuberculosis mimicking lung cancer
Hammen, I.
2015-01-01
Tuberculosis (TB) is well known as a diagnostic chameleon and can resemble malignancy. In thorax TB can be manifested as pulmonary infiltrates and/or mediastinal lymphadenopathy. In low incident countries with high incidence of lung cancer and varying clinical presentations, TB often gets misdiagnosed with the result of delayed treatment start and unnecessary diagnostic procedures. Our case report presents two patients, who were referred to the Thorax diagnostic centre at the Department of Respiratory Medicine, Odense University Hospital, with presumptive diagnosis of neoplasm and had proved lung TB with no evidence of malignancy instead. In the first case diagnosis was confirmed after thoracotomy, in the second case after bronchoscopy. PMID:26744652
Swords, Kelly; Martinez, Daniel R; Lockhart, Jorge L; Carrion, Rafael
2013-04-01
Currently, the surgical treatment of infected penile prostheses is complete removal and either immediate salvage procedure, which carries a significant infection risk, or delayed implantation. With delayed implantation the risk of infection is lower, but the patient loses penile length and width due to corporal fibrosis. We present our experience with the use of a novel temporary synthetic high purity calcium sulfate (SHPCaSO4) component that acts as a "spacer" at the time of removal of an infected prosthesis while providing constant delivery of local antibiotic elution to the infected area. Demonstrate that the use of a novel material, SHPCaSO4, can be an innovative way to bridge the gap between removal of an infected penile implant and delayed reimplantation. Two patients (Patient A and B) presented with pain and erythema and were found to have infected malleable penile prosthesis. Both underwent removal of all infected components, and sent for tissue culture. The SHPCaSO4 was mixed with vancomycin and tobramycin, allowed to set up for 5 minutes, and then injected into the corporal space followed by closure with 2-0 Vicryl sutures. The injected SHPCaSO4 was palpable in the penile shaft both proximally and distally, as an "intracorporal casts." Patients denied pain postoperatively. Delayed implantation occurred at 6 weeks for patient A. This went uneventful and a new three-piece inflatable implant was inserted. Patient B underwent salvage placement of right malleable implant at 15 weeks, and here significant corporal fibrosis was encountered. Patients have had no infection since their delayed implantation (mean follow-up 4 months). Data in reference to SHPCaSO4 shows that this product dissolves in approximately 4-6 weeks. This may account for the difference in the ease of delayed implantation between the two patients. Further investigation is warranted. © 2013 International Society for Sexual Medicine.
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.
Immediate rather than delayed memory impairment in older adults with latent toxoplasmosis.
Mendy, Angelico; Vieira, Edgar R; Albatineh, Ahmed N; Gasana, Janvier
2015-03-01
The neurotropic parasite Toxoplasma gondii infects one third of the world population, but its effect on memory remains ambiguous. To examine a potential relationship of the infection with immediate and delayed memory, a population-based study was conducted in 4485 participants of the Third National Health and Nutrition Examination Survey aged 60years and older. Serum anti-Toxoplasma IgG antibodies were measured by enzyme immune assay and verbal memory was assessed using the Mini-Mental State Examination and the East Boston Memory Test. The prevalence of latent toxoplasmosis was 41%; in one way analysis of variance, anti-Toxoplasma IgG antibody levels significantly differed across tertiles for immediate (P=0.006) but not delayed memory scores (P=0.22). In multinomial logistic regression adjusting for covariates, Toxoplasma seropositivity was associated with lower immediate memory performance (OR: 0.65, 95% CI: 0.44, 0.97 for medium tertile and OR: 0.61, 95% CI: 0.37, 0.98 for highest tertile in reference to the lowest tertile), especially in non-Hispanic Whites (OR: 0.56, 95% CI: 0.36, 0.88 for medium tertile and OR: 0.51, 95% CI: 0.30, 0.87 for highest tertile in reference to the lowest tertile). However, no relationship with delayed memory was observed. In conclusion, latent toxoplasmosis is widespread in older adults and may primarily affect immediate rather than delayed memory, particularly in White Americans. Copyright © 2014 Elsevier Inc. All rights reserved.
Losing track of time through delayed body representations.
Fritz, Thomas H; Steixner, Agnes; Boettger, Joachim; Villringer, Arno
2015-01-01
The ability to keep track of time is perceived as crucial in most human societies. However, to lose track of time may also serve an important social role, associated with recreational purpose. To this end a number of social technologies are employed, some of which may relate to a manipulation of time perception through a modulation of body representation. Here, we investigated an influence of real-time or delayed videos of own-body representations on time perception in an experimental setup with virtual mirrors. Seventy participants were asked to either stay in the installation until they thought that a defined time (90 s) had passed, or they were encouraged to stay in the installation as long as they wanted and after exiting were asked to estimate the duration of their stay. Results show that a modulation of body representation by time-delayed representations of the mirror-video displays influenced time perception. Furthermore, these time-delayed conditions were associated with a greater sense of arousal and intoxication. We suggest that feeding in references to the immediate past into working memory could be the underlying mental mechanism mediating the observed modulation of time perception. We argue that such an influence on time perception would probably not only be achieved visually, but might also work with acoustic references to the immediate past (e.g., with music).
The Role of Private Health Sector for Tuberculosis Control in Debre Markos Town, Northwest Ethiopia.
Reta, Alemayehu; Simachew, Addis
2018-01-01
Tuberculosis has been declared to be a global epidemic. Despite all the effort, only less than half the annual estimated cases are reported by health authorities to the WHO. This could be due to poor reporting from the private sector. In Ethiopia, tuberculosis has also been a major public health problem. The aim of this study was to assess the role of the private health sector in tuberculosis control in Debre Markos. An institution based cross-sectional descriptive study was carried out in private health facilities. A total of 260 tuberculosis suspects attending the private clinics were interviewed. Focus group discussion, checklist, and structured questionnaire were used. Majority of the private clinics were less equipped, poorly regulated, and owned by health workers who were self-employed on a part-time basis. Provider delay of 4 and more months was significantly associated higher likelihood of turning to a private provider (OR = 2.70, 95% CI = (1.20, 6.08)). There is significant delay among tuberculosis patients. Moreover, there is poor regulation of the private health sector by public health authorities. The involvement of the private sector in tuberculosis control should be limited to identification and refer to tuberculosis cases and suspects.
Coded acoustic wave sensors and system using time diversity
NASA Technical Reports Server (NTRS)
Solie, Leland P. (Inventor); Hines, Jacqueline H. (Inventor)
2012-01-01
An apparatus and method for distinguishing between sensors that are to be wirelessly detected is provided. An interrogator device uses different, distinct time delays in the sensing signals when interrogating the sensors. The sensors are provided with different distinct pedestal delays. Sensors that have the same pedestal delay as the delay selected by the interrogator are detected by the interrogator whereas other sensors with different pedestal delays are not sensed. Multiple sensors with a given pedestal delay are provided with different codes so as to be distinguished from one another by the interrogator. The interrogator uses a signal that is transmitted to the sensor and returned by the sensor for combination and integration with the reference signal that has been processed by a function. The sensor may be a surface acoustic wave device having a differential impulse response with a power spectral density consisting of lobes. The power spectral density of the differential response is used to determine the value of the sensed parameter or parameters.
Genetics Home Reference: SADDAN
... CLOSE navigation Home Page Search Home Health ... delay and acanthosis nigricans) is a rare disorder of bone growth characterized by skeletal, brain, and skin abnormalities. All people with this ...
Reference Directions and Reference Objects in Spatial Memory of a Briefly Viewed Layout
ERIC Educational Resources Information Center
Mou, Weimin; Xiao, Chengli; McNamara, Timothy P.
2008-01-01
Two experiments investigated participants' spatial memory of a briefly viewed layout. Participants saw an array of five objects on a table and, after a short delay, indicated whether the target object indicated by the experimenter had been moved. Experiment 1 showed that change detection was more accurate when non-target objects were stationary…
Delay compensation - Its effect in reducing sampling errors in Fourier spectroscopy
NASA Technical Reports Server (NTRS)
Zachor, A. S.; Aaronson, S. M.
1979-01-01
An approximate formula is derived for the spectrum ghosts caused by periodic drive speed variations in a Michelson interferometer. The solution represents the case of fringe-controlled sampling and is applicable when the reference fringes are delayed to compensate for the delay introduced by the electrical filter in the signal channel. Numerical results are worked out for several common low-pass filters. It is shown that the maximum relative ghost amplitude over the range of frequencies corresponding to the lower half of the filter band is typically 20 times smaller than the relative zero-to-peak velocity error, when delayed sampling is used. In the lowest quarter of the filter band it is more than 100 times smaller than the relative velocity error. These values are ten and forty times smaller, respectively, than they would be without delay compensation if the filter is a 6-pole Butterworth.
Radar wideband digital beamforming based on time delay and phase compensation
NASA Astrophysics Data System (ADS)
Fu, Wei; Jiang, Defu
2018-07-01
In conventional phased array radars, analogue time delay devices and phase shifters have been used for wideband beamforming. These methods suffer from insertion losses, gain mismatches and delay variations, and they occupy a large chip area. To solve these problems, a compact architecture of digital array antennas based on subarrays was considered. In this study, the receiving beam patterns of wideband linear frequency modulation (LFM) signals were constructed by applying analogue stretch processing via mixing with delayed reference signals at the subarray level. Subsequently, narrowband digital time delaying and phase compensation of the tone signals were implemented with reduced arithmetic complexity. Due to the differences in amplitudes, phases and time delays between channels, severe performance degradation of the beam patterns occurred without corrections. To achieve good beamforming performance, array calibration was performed in each channel to adjust the amplitude, frequency and phase of the tone signal. Using a field-programmable gate array, wideband LFM signals and finite impulse response filters with continuously adjustable time delays were implemented in a polyphase structure. Simulations and experiments verified the feasibility and effectiveness of the proposed digital beamformer.
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…
Wittmann, Marc; Leland, David S; Paulus, Martin P
2007-06-01
Delay discounting refers to the fact that an immediate reward is valued more than the same reward if it occurs some time in the future. To examine the neural substrates underlying this process, we studied 13 healthy volunteers who repeatedly had to decide between an immediate and parametrically varied delayed hypothetical reward using a delay discounting task during event-related functional magnetic resonance imaging. Subject's preference judgments resulted in different discounting slopes for shorter (<1 year) and for longer (> or =1 year) delays. Neural activation associated with the shorter delays relative to the longer delays was associated with increased activation in the head of the left caudate nucleus and putamen. When individuals selected the delayed relative to the immediate reward, a strong activation was found in bilateral posterior insular cortex. Several brain areas including the left caudate nucleus showed a correlation between the behaviorally determined discounting and brain activation for the contrast of intervals with delays <1 and > or =1 year. These results suggest that (1) the posterior insula, which is a critical component of the decision-making neural network, is involved in delaying gratification and (2) the degree of neural activation in the striatum, which plays a fundamental role in reward prediction and in time estimation, may code for the time delay.
Chronic health effects of sulphur mustard exposure with special reference to Iranian veterans
Balali-Mood, M; Mousavi, SH; Balali-Mood, B
2008-01-01
The widespread use of sulphur mustard (SM) as an incapacitating chemical warfare agent in the past century has proved its long-lasting toxic effects. It may also be used as a chemical terrorist agent. Therefore, all health professionals should have sufficient knowledge and be prepared for any such chemical attack. SM exerts direct toxic effects on the eyes, skin, and respiratory tissue, with subsequent systemic action on the nervous, immunological, haematological, digestive, and reproductive systems. SM is an alkylating agent that affects DNA synthesis, and, thus, delayed complications have been seen since the First World War. Cases of malignancies in the target organs, particularly in haematopoietic, respiratory, and digestive systems, have been reported. Important delayed respiratory complications include chronic bronchitis, bronchiectasis, frequent bronchopneumonia, and pulmonary fibrosis, all of which tend to deteriorate with time. Severe dry skin, delayed keratitis, and reduction of natural killer cells with subsequent increased risk of infections and malignancies are also among the most distressing long-term consequences of SM intoxication. However, despite a lot of research over the past decades on Iranian veterans, there are still major gaps in the SM literature. Immunological and neurological dysfunction, as well as the relationship between SM exposure and mutagenicity, carcinogenicity, and teratogenicity are important fields that require further studies, particularly on Iranian veterans with chronic health effects of SM poisoning. There is also a paucity of information on the medical management of acute and delayed toxic effects of SM poisoning—a subject that greatly challenges health care specialists. PMID:22460216
Towards acute pediatric status epilepticus intervention teams: Do we need "Seizure Codes"?
Stredny, Coral M; Abend, Nicholas S; Loddenkemper, Tobias
2018-05-01
To identify areas of treatment delay and barriers to care in pediatric status epilepticus, review ongoing quality improvement initiatives, and provide suggestions for further innovations to improve and standardize these patient care processes. Narrative review of current status epilepticus management algorithms, anti-seizure medication administration and outcomes associated with delays, and initiatives to improve time to treatment. Articles reviewing or reporting quality improvement initiatives were identified through a PubMed search with keywords "status epilepticus," "quality improvement," "guideline adherence," and/or "protocol;" references of included articles were also reviewed. Rapid initiation and escalation of status epilepticus treatment has been associated with shortened seizure duration and more favorable outcomes. Current evidence-based guidelines for management of status epilepticus propose medication algorithms with suggested times for each management step. However, time to antiseizure medication administration for pediatric status epilepticus remains delayed in both the pre- and in-hospital settings. Barriers to timely treatment include suboptimal preventive care, inaccurate seizure detection, infrequent or restricted use of home rescue medications by caregivers and pre-hospital emergency personnel, delayed summoning and arrival of emergency personnel, and use of inappropriately dosed medications. Ongoing quality improvement initiatives in the pre- and in-hospital settings targeting these barriers are reviewed. Improved preventive care, seizure detection, and rescue medication education may advance pre-hospital management, and we propose the use of acute status epilepticus intervention teams to initiate and incorporate in-hospital interventions as time-sensitive "Seizure Code" emergencies. Copyright © 2018 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
Course of Near-hanging Victims Succumbed to Death: A Seven Year Study
Mugadlimath, Anand B.; Zine, K.U.; Farooqui, Jamebaseer M.; Phalke, Balaji J.
2015-01-01
Introduction: Near hanging refers to victims who survive a hanging injury following attempted hanging, long enough to reach hospital. Delayed deaths in near hanging patients are mostly due to complication of hanging. The purpose of this study was to evaluate the demographics, mortality patterns and cause of delayed deaths in near hanging victims. Materials and Methods: In this study autopsy files over a seven year period from 2007 to 2013 were reviewed, and data of near hanging deaths (attempted hanging cases who succumbed to death and subjected for medicolegal autopsy) was extracted. Records of 14,000 autopsies was reviewed, and 10 deceased having died delayed deaths after near hanging episode were identified. In each case, the patients’ details, including gender, age, type of suspension, type of ligature material used for hanging and subsequent hanging mark produced were reviewed using autopsy reports and photographs taken during autopsy. Results: Demographic and pathological aspects of the each case discussed to throw light on autopsy findings in victims who died following near hanging. Complete suspension was present in 3 cases, while partial suspension was present in 7 cases. Survivals in delayed death after near hanging episode have ranged from 9 h to 72 d. Hypoxic encephalopathy was the most common cause of death, followed by pneumonia. Conclusion: Most of the near hanging patients did succumb to hypoxic encephalopathy; however, consolidation of lungs (pneumonia) was the next common cause of death reflecting need for aggressive oxygen therapy and selective resuscitation should be performed in all such cases. PMID:25954634
Buccafusco, Jerry J; Terry, Alvin V; Webster, Scott J; Martin, Daniel; Hohnadel, Elizabeth J; Bouchard, Kristy A; Warner, Samantha E
2008-08-01
The scopolamine-reversal model is enjoying a resurgence of interest in clinical studies as a reversible pharmacological model for Alzheimer's disease (AD). The cognitive impairment associated with scopolamine is similar to that in AD. The scopolamine model is not simply a cholinergic model, as it can be reversed by drugs that are noncholinergic cognition-enhancing agents. The objective of the study was to determine relevance of computer-assisted operant-conditioning tasks in the scopolamine-reversal model in rats and monkeys. Rats were evaluated for their acquisition of a spatial reference memory task in the Morris water maze. A separate cohort was proficient in performance of an automated delayed stimulus discrimination task (DSDT). Rhesus monkeys were proficient in the performance of an automated delayed matching-to-sample task (DMTS). The AD drug donepezil was evaluated for its ability to reverse the decrements in accuracy induced by scopolamine administration in all three tasks. In the DSDT and DMTS tasks, the effects of donepezil were delay (retention interval)-dependent, affecting primarily short delay trials. Donepezil produced significant but partial reversals of the scopolamine-induced impairment in task accuracies after 2 mg/kg in the water maze, after 1 mg/kg in the DSDT, and after 50 microg/kg in the DMTS task. The two operant-conditioning tasks (DSDT and DMTS) provided data most in keeping with those reported in clinical studies with these drugs. The model applied to nonhuman primates provides an excellent transitional model for new cognition-enhancing drugs before clinical trials.
Method of steering the gain of a multiple antenna global positioning system receiver
NASA Astrophysics Data System (ADS)
Evans, Alan G.; Hermann, Bruce R.
1992-06-01
A method for steering the gain of a multiple antenna Global Positioning System (GPS) receiver toward a plurality of a GPS satellites simultaneously is provided. The GPS signals of a known wavelength are processed digitally for a particular instant in time. A range difference or propagation delay between each antenna for GPS signals received from each satellite is first resolved. The range difference consists of a fractional wavelength difference and an integer wavelength difference. The fractional wavelength difference is determined by each antenna's tracking loop. The integer wavelength difference is based upon the known wavelength and separation between each antenna with respect to each satellite position. The range difference is then used to digitally delay the GPS signals at each antenna with respect to a reference antenna. The signal at the reference antenna is then summed with the digitally delayed signals to generate a composite antenna gain. The method searches for the correct number of integer wavelengths to maximize the composite gain. The range differences are also used to determine the attitude of the array.
On Time Delay Margin Estimation for Adaptive Control and Optimal Control Modification
NASA Technical Reports Server (NTRS)
Nguyen, Nhan T.
2011-01-01
This paper presents methods for estimating time delay margin for adaptive control of input delay systems with almost linear structured uncertainty. The bounded linear stability analysis method seeks to represent an adaptive law by a locally bounded linear approximation within a small time window. The time delay margin of this input delay system represents a local stability measure and is computed analytically by three methods: Pade approximation, Lyapunov-Krasovskii method, and the matrix measure method. These methods are applied to the standard model-reference adaptive control, s-modification adaptive law, and optimal control modification adaptive law. The windowing analysis results in non-unique estimates of the time delay margin since it is dependent on the length of a time window and parameters which vary from one time window to the next. The optimal control modification adaptive law overcomes this limitation in that, as the adaptive gain tends to infinity and if the matched uncertainty is linear, then the closed-loop input delay system tends to a LTI system. A lower bound of the time delay margin of this system can then be estimated uniquely without the need for the windowing analysis. Simulation results demonstrates the feasibility of the bounded linear stability method for time delay margin estimation.
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.
Delay-based signal shapers and acfa 2020 blended wing body flight control system
NASA Astrophysics Data System (ADS)
Kucera, V.; Hromčík, M.
2013-12-01
The purpose of this paper is twofold. First: results related to application of signal shapers, imposed on pilot's commands, in cooperation with feedback flight control system (FCS) are reported for the case of ACFA2020 (Active Control for Flexible 2020 Aircraft) blended-wingbody (BWB) design. The results suggest that signal shapers can cooperate nicely both with FCS focused on the rigid-body dynamics only, as well as with an implemented and properly working active damping system. In both cases, the amount of vibrations due to pilot's inputs (manoeuvres) can be substantially reduced. Second: combination of signal shapers and rate-limiters is discussed in detail. Rate-limiters, representing finite achievable rates of servos for control surfaces, deteriorate considerably performance of the delay-based shapers. Configuration proposes only open-loop response of the free aircraft (without controller) for shaped reference respect to nonlinearities at action surface. Standard versions of the shapers cannot be therefore directly applied, especially for higher control surfaces deflections. Instead, two efficient alternatives can be used, suggested in the paper, that take the rate limitations into account at the design stage already.
A Low Cost Simulation System to Demonstrate Pilot Induced Oscillation Phenomenon
NASA Technical Reports Server (NTRS)
Ali, Syed Firasat
1997-01-01
A flight simulation system with graphics and software on Silicon Graphics computer workstations has been installed in the Flight Vehicle Design Laboratory at Tuskegee University. The system has F-15E flight simulation software from NASA Dryden which uses the graphics of SGI flight simulation demos. On the system, thus installed, a study of pilot induced oscillations is planned for future work. Preliminary research is conducted by obtaining two sets of straight level flights with pilot in the loop. In one set of flights no additional delay is used between the stick input and the appearance of airplane response on the computer monitor. In another set of flights, a 500 ms additional delay is used. The flight data is analyzed to find cross correlations between deflections of control surfaces and response of the airplane. The pilot dynamics features depicted from cross correlations of straight level flights are discussed in this report. The correlations presented here will serve as reference material for the corresponding correlations in a future study of pitch attitude tracking tasks involving pilot induced oscillations.
NASA Astrophysics Data System (ADS)
Larger, Laurent; Baylón-Fuentes, Antonio; Martinenghi, Romain; Udaltsov, Vladimir S.; Chembo, Yanne K.; Jacquot, Maxime
2017-01-01
Reservoir computing, originally referred to as an echo state network or a liquid state machine, is a brain-inspired paradigm for processing temporal information. It involves learning a "read-out" interpretation for nonlinear transients developed by high-dimensional dynamics when the latter is excited by the information signal to be processed. This novel computational paradigm is derived from recurrent neural network and machine learning techniques. It has recently been implemented in photonic hardware for a dynamical system, which opens the path to ultrafast brain-inspired computing. We report on a novel implementation involving an electro-optic phase-delay dynamics designed with off-the-shelf optoelectronic telecom devices, thus providing the targeted wide bandwidth. Computational efficiency is demonstrated experimentally with speech-recognition tasks. State-of-the-art speed performances reach one million words per second, with very low word error rate. Additionally, to record speed processing, our investigations have revealed computing-efficiency improvements through yet-unexplored temporal-information-processing techniques, such as simultaneous multisample injection and pitched sampling at the read-out compared to information "write-in".
Root, James C; Andreotti, Charissa; Tsu, Loretta; Ellmore, Timothy M; Ahles, Tim A
2016-06-01
Our previous retrospective analysis of clinically referred breast cancer survivors' performance on learning and memory measures found a primary weakness in initial encoding of information into working memory with intact retention and recall of this same information at a delay. This suggests that survivors may misinterpret cognitive lapses as being due to forgetting when, in actuality, they were not able to properly encode this information at the time of initial exposure. Our objective in this study was to replicate and extend this pattern of performance to a research sample to increase the generalizability of this finding in a sample in which subjects were not clinically referred for cognitive issues. We contrasted learning and memory performance between breast cancer survivors on endocrine therapy 2 to 6 years post-treatment with age- and education-matched healthy controls. We then stratified lower- and higher-performing breast cancer survivors to examine specific patterns of learning and memory performance. Contrasts were generated for four aggregate visual and verbal memory variables from the California Verbal Learning Test-2 (CVLT-2) and the Brown Location Test (BLT): Single-trial Learning: Trial 1 performance, Multiple-trial Learning: Trial 5 performance, Delayed Recall: Long-delay Recall performance, and Memory Errors: False-positive errors. As predicted, breast cancer survivors' performance as a whole was significantly lower on Single-trial Learning than the healthy control group but exhibited no significant difference in Delayed Recall. In the secondary analysis contrasting lower- and higher-performing survivors on cognitive measures, the same pattern of lower Single-trial Learning performance was exhibited in both groups, with the additional finding of significantly weaker Multiple-trial Learning performance in the lower-performing breast cancer group and intact Delayed Recall performance in both groups. As with our earlier finding of weaker initial encoding with intact recall in a cohort of clinically referred breast cancer survivors, our results indicate this same profile in a research sample of breast cancer survivors. Further, when the breast cancer group was stratified by lower and higher performance, both groups exhibited significantly lower performance on initial encoding, with more pronounced encoding weakness in the lower-performing group. As in our previous research, survivors did not lose successfully encoded information over longer delays, either in the lower- or higher-performing group, again arguing against memory decay in survivors. The finding of weaker initial encoding of information together with intact delayed recall in survivors points to specific treatment interventions in rehabilitation of cognitive dysfunction. The finding of weaker initial encoding of information together with intact delayed recall in survivors points to specific treatment interventions in rehabilitation of cognitive dysfunction and is discussed.
A study on delay in treatment of kala-azar patients in Bangladesh.
Arif, Syed M; Basher, Ariful; Rahman, Mohammad R; Faiz, Mohammad A
2012-01-01
Visceral leishmaniasis (kala-azar) continues to be a major rural public health problem in Bangladesh. A cross-sectional study was carried out in two subdistricts of Mymensingh district from January 2006 to June 2007 to evaluate the delay kala-azar treatment. Suspected patients who attended to out patient department (OPD) were subjected to a dipstick test (RK39) for kala-azar. Sixty five from Bhaluka and 60 positive patients from Gafargaon subdistrict were enrolled. Most of the patients (80%) first visited nonqualified private practitioners, while only 15.2% consulted registered doctors. Fifty per cent were referred to the Upazilla health complex (UZHC) by the family members or relatives. About 49% and 43% patients required third and second health-care providers for kala-azar treatment, respectively. Patient delay ranged from 2 to 30 days; median 4 (IQR 3 to 7 days), the system delay ranged from 0 days to 225 days; median 54 (IQR 40-66 days). Residential status (p value <0.05) had impact on patient delay. Educational status and number of treatment providers had impact on system delay (p<0.05). System delay rather than patient delay is the important weakness of the kala-azar control programme in Bangladesh. Residence in rural areas, low educational background and treatment providers are associated with these delays. A proper educational programme may reduce the delay.
Arrhythmic hazard map for a 3D whole-ventricles model under multiple ion channel block.
Okada, Jun-Ichi; Yoshinaga, Takashi; Kurokawa, Junko; Washio, Takumi; Furukawa, Tetsushi; Sawada, Kohei; Sugiura, Seiryo; Hisada, Toshiaki
2018-05-10
To date, proposed in silico models for preclinical cardiac safety testing are limited in their predictability and usability. We previously reported a multi-scale heart simulation that accurately predicts arrhythmogenic risk for benchmark drugs. We extend this approach and report the first comprehensive hazard map of drug-induced arrhythmia based on the exhaustive in silico electrocardiogram (ECG) database of drug effects, developed using a petaflop computer. A total of 9075 electrocardiograms constitute the five-dimensional hazard map, with coordinates representing the extent of the block of each of the five ionic currents (rapid delayed rectifier potassium current (IKr), fast (INa) and late (INa,L) components of the sodium current, L-type calcium current (ICa,L) and slow delayed rectifier current (IKs)), involved in arrhythmogenesis. Results of the evaluation of arrhythmogenic risk based on this hazard map agreed well with the risk assessments reported in three references. ECG database also suggested that the interval between the J-point and the T-wave peak is a superior index of arrhythmogenicity compared to other ECG biomarkers including the QT interval. Because concentration-dependent effects on electrocardiograms of any drug can be traced on this map based on in vitro current assay data, its arrhythmogenic risk can be evaluated without performing costly and potentially risky human electrophysiological assays. Hence, the map serves as a novel tool for use in pharmaceutical research and development. This article is protected by copyright. All rights reserved.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Cogan, D.G.; Martin, S.F.; Kimura, S.J.
1959-01-01
This document contains 3 reports dealing with the delayed effects of radiation on the eyes of survivors of the atomic explosions in Hiroshima and Nagasaki. In the first study, 1000 persons who were listed as having been in the open and within two kilometers of the hypocenter at the time of the explosion were selected at random from the census files of the Atomic Bomb Casualty Commission for study. In addition, 231 others, comprising the total available number of surviving persons listed at present in the census files as having been within one kilometer of the hypocenter, were examined, asmore » were several hundred others who were contacted through newspaper publicity, referrals from local ophthalmologists, or through hearsay. The survey resulted in bringing in persons having, or having had, a variety of ocular conditions. Those connected with the atomic bomb included the following diagnoses; multiple injuries of eyes and eyelids; keratoconjunctivitis from ultraviolet and ionizing radiations; thermal burn of the cornea and of the retina; retinitis proliferans; and radiation cataracts. The cataracts were the only delayed manifestations of ocular injury from the atomic bomb. The second paper is a case report of a histopathologic study of atomic bomb radiation cataract. The third paper presents the results of medical examinations of survivors having radiation induced cataracts. 32 references, 8 figures. (DMC)« less
White, Richard A.; Lu, Chunling; Rodriguez, Carly A.; Bayona, Jaime; Becerra, Mercedes C.; Burgos, Marcos; Centis, Rosella; Cohen, Theodore; Cox, Helen; D'Ambrosio, Lia; Danilovitz, Manfred; Falzon, Dennis; Gelmanova, Irina Y.; Gler, Maria T.; Grinsdale, Jennifer A.; Holtz, Timothy H.; Keshavjee, Salmaan; Leimane, Vaira; Menzies, Dick; Milstein, Meredith B.; Mishustin, Sergey P.; Pagano, Marcello; Quelapio, Maria I.; Shean, Karen; Shin, Sonya S.; Tolman, Arielle W.; van der Walt, Martha L.; Van Deun, Armand; Viiklepp, Piret
2016-01-01
Debate persists about monitoring method (culture or smear) and interval (monthly or less frequently) during treatment for multidrug-resistant tuberculosis (MDR-TB). We analysed existing data and estimated the effect of monitoring strategies on timing of failure detection. We identified studies reporting microbiological response to MDR-TB treatment and solicited individual patient data from authors. Frailty survival models were used to estimate pooled relative risk of failure detection in the last 12 months of treatment; hazard of failure using monthly culture was the reference. Data were obtained for 5410 patients across 12 observational studies. During the last 12 months of treatment, failure detection occurred in a median of 3 months by monthly culture; failure detection was delayed by 2, 7, and 9 months relying on bimonthly culture, monthly smear and bimonthly smear, respectively. Risk (95% CI) of failure detection delay resulting from monthly smear relative to culture is 0.38 (0.34–0.42) for all patients and 0.33 (0.25–0.42) for HIV-co-infected patients. Failure detection is delayed by reducing the sensitivity and frequency of the monitoring method. Monthly monitoring of sputum cultures from patients receiving MDR-TB treatment is recommended. Expanded laboratory capacity is needed for high-quality culture, and for smear microscopy and rapid molecular tests. PMID:27587552
Sun, Miaoping; Nian, Xiaohong; Dai, Liqiong; Guo, Hua
2017-05-01
In this paper, the delay-dependent wide-area dynamic output feedback controller (DOFC) with prescribed degree of stability is proposed for interconnected power system to damp inter-area low-frequency oscillations. Here, the prescribed degree of stability α is used to maintain all the poles on the left of s=-α in the s-plane. Firstly, residue approach is adopted to select input-output control signals and the schur balanced truncation model reduction method is utilized to obtain the reduced power system model. Secondly, based on Lyapunov stability theory and transformation operation in complex plane, the sufficient condition of asymptotic stability for closed-loop power system with prescribed degree of stability α is derived. Then, a novel method based on linear matrix inequalities (LMIs) is presented to obtain the parameters of DOFC and calculate delay margin of the closed-loop system considering the prescribed degree of stability α. Finally, case studies are carried out on the two-area four-machine system, which is controlled by classical wide-area power system stabilizer (WAPSS) in reported reference and our proposed DOFC respectively. The effectiveness and advantages of the proposed method are verified by the simulation results under different operating conditions. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.
Raschle, Nora Maria; Becker, Bryce Larkin Chessell; Smith, Sara; Fehlbaum, Lynn Valérie; Wang, Yingying; Gaab, Nadine
2017-01-01
Abstract Early language delay has often been associated with atypical language/literacy development. Neuroimaging studies further indicate functional disruptions during language and print processing in school-age children with a retrospective report of early language delay. Behavioral data of 114 5-year-olds with a retrospective report of early language delay in infancy (N = 34) and those without (N = 80) and with a familial risk for dyslexia and those without are presented. Behaviorally, children with a retrospective report of early language delay exhibited reduced performance in language/reading-related measures. A voxel-based morphometry analysis in a subset (N = 46) demonstrated an association between reduced gray matter volume and early language delay in left-hemispheric middle temporal, occipital, and frontal regions. Alterations in middle temporal cortex in children with a retrospective report of early language delay were observed regardless of familial risk for dyslexia. Additionally, while children with isolated familial risk for dyslexia showed gray matter reductions in temporoparietal and occipitotemporal regions, these effects were most profound in children with both risk factors. An interaction effect of early language delay and familial risk was revealed in temporoparietal, occipital, and frontal cortex. Our findings support a cumulative effect of early behavioral and genetic risk factors on brain development and may ultimately inform diagnosis/treatment. PMID:26585334
Chiang, Kai-Wei; Duong, Thanh Trung; Liao, Jhen-Kai
2013-01-01
The integration of an Inertial Navigation System (INS) and the Global Positioning System (GPS) is common in mobile mapping and navigation applications to seamlessly determine the position, velocity, and orientation of the mobile platform. In most INS/GPS integrated architectures, the GPS is considered to be an accurate reference with which to correct for the systematic errors of the inertial sensors, which are composed of biases, scale factors and drift. However, the GPS receiver may produce abnormal pseudo-range errors mainly caused by ionospheric delay, tropospheric delay and the multipath effect. These errors degrade the overall position accuracy of an integrated system that uses conventional INS/GPS integration strategies such as loosely coupled (LC) and tightly coupled (TC) schemes. Conventional tightly coupled INS/GPS integration schemes apply the Klobuchar model and the Hopfield model to reduce pseudo-range delays caused by ionospheric delay and tropospheric delay, respectively, but do not address the multipath problem. However, the multipath effect (from reflected GPS signals) affects the position error far more significantly in a consumer-grade GPS receiver than in an expensive, geodetic-grade GPS receiver. To avoid this problem, a new integrated INS/GPS architecture is proposed. The proposed method is described and applied in a real-time integrated system with two integration strategies, namely, loosely coupled and tightly coupled schemes, respectively. To verify the effectiveness of the proposed method, field tests with various scenarios are conducted and the results are compared with a reliable reference system. PMID:23955434
Self-injurious behaviours in children and adults with autism spectrum disorder (ASD).
Gulsrud, A; Lin, C E; Park, M N; Hellemann, G; McCracken, J
2018-04-25
Self-injurious behaviours (SIB) are concerning, maladaptive behaviours that commonly occur in people with neurodevelopmental conditions and delays but seem to be particularly prevalent in children and adults with autism spectrum disorder (ASD). There has been increasing research examining the risk markers associated with the presence of SIB in people with ASD. Some of the factors associated with SIB have included cognitive abilities, adaptive functioning deficits and behaviour regulation impairments (e.g. impulsivity and repetitive behaviours). However, many of the findings in the literature are mixed and only explain a small proportion of the variance contributing to SIB. Limitations in the previous literature have centred on lack of availability of large and diverse samples, restricted age ranges and constraints of measurement. This study characterises a clinic-referred sample of children and adults currently presenting with and without SIB using a range of standardised and parent-report measures. The sample includes 144 individuals with ASD between the ages of 2.5 and 60.1 years. After adjusting for multiple tests, none of the variables maintained statistical significance between the group of individuals with and without SIB, but medium to large effect sizes were noted. These variables include parent-reported early motor and toileting delays and perinatal risk, and current cognitive and social impairment. The remaining variables, including current autism severity levels, early ASD symptomatology, impulsivity, executive functioning impairments, adaptive functioning, mood and anxiety, did not differ between those with and without current engagement in SIB. Utilising a diverse clinic-referred sample and standardised diagnostic tools, this study explored retrospective and current correlate risk markers of SIB in individuals with ASD. In addition to impairments in current functioning, specific early developmental delays and perinatal risk factors were preliminarily associated with the presence of SIB in individuals with ASD. Together these findings suggest that a set of specific characteristics may be related to both early risk and concurrent manifestation of SIB. Identifying this set of characteristics in early development may lead to faster identification and better intervention services, but future work utilising longitudinal design and multivariate analysis is warranted. © 2018 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Autistic enterocolitis: fact or fiction?
Galiatsatos, Polymnia; Gologan, Adrian; Lamoureux, Esther
2009-02-01
Autism spectrum disorder refers to syndromes of varying severity, typified by impaired social interactions, communicative delays and restricted, repetitive behaviours and interests. The prevalence of autism spectrum disorders has been on the rise, while the etiology remains unclear and most likely multifactorial. There have been several reports of a link between autism and chronic gastrointestinal symptoms. Endoscopy trials have demonstrated a higher prevalence of nonspecific colitis, lymphoid hyperplasia and focally enhanced gastritis compared with controls. Postulated mechanisms include aberrant immune responses to some dietary proteins, abnormal intestinal permeability and unfavourable gut microflora. Two autism spectrum disorder patients with chronic intestinal symptoms and abnormal endoscopic findings are described, followed by a review of this controversial topic.
Rapid Antimicrobial Susceptibility Testing Using Forward Laser Light Scatter Technology.
Hayden, Randall T; Clinton, Lani K; Hewitt, Carolyn; Koyamatsu, Terri; Sun, Yilun; Jamison, Ginger; Perkins, Rosalie; Tang, Li; Pounds, Stanley; Bankowski, Matthew J
2016-11-01
The delayed reporting of antimicrobial susceptibility testing remains a limiting factor in clinical decision-making in the treatment of bacterial infection. This study evaluates the use of forward laser light scatter (FLLS) to measure bacterial growth for the early determination of antimicrobial susceptibility. Three isolates each (two clinical isolates and one reference strain) of Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa were tested in triplicate using two commercial antimicrobial testing systems, the Vitek2 and the MicroScan MIC panel, to challenge the BacterioScan FLLS. The BacterioScan FLLS showed a high degree of categorical concordance with the commercial methods. Pairwise comparison with each commercial system serving as a reference standard showed 88.9% agreement with MicroScan (two minor errors) and 72.2% agreement with Vitek (five minor errors). FLLS using the BacterioScan system shows promise as a novel method for the rapid and accurate determination of antimicrobial susceptibility. Copyright © 2016, American Society for Microbiology. All Rights Reserved.
Quality of radiologists' communication with other clinicians--As experienced by radiologists.
Fatahi, Nabi; Krupic, Ferid; Hellström, Mikael
2015-06-01
The objective was to study radiologists' experiences of written and oral communication with referring clinicians, and its potential implications for decision making and patient care. Focus group discussions with 12 radiologists were carried out. Content analysis was used for interpretation of the data. Radiologists reported many problems with the request forms: improper choice of imaging examinations and procedures, insufficient patient history/information, unclear clinical questions, lack of specific terms and unclear abbreviations on the request form. Radiologists also mentioned other difficulties: insufficient attention among participating clinicians during conferences, difficulties in reaching the referring clinicians by telephone, and communication difficulties in making priorities between patients. To overcome these problems, radiologists suggested increased contacts between radiologists and clinicians, and educational activities. A number of difficulties in oral and written communication were highlighted. The use of medical imaging may be optimized by joint discussions on indications and methodology and educational activities, such as lectures, seminars and conferences, directed to the medical community at large. Improved communication between radiologists and referring clinicians should be encouraged to ensure diagnostic quality, correct patient prioritization and patient safety, and to avoid unnecessary delays and costs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Noise Effects Upon a Simple Timing Channel
1990-12-21
used to quantify the resulting information flow across the chan- nel. Possible Trojan Horse strategies are also discussed. 14. SUBJECT TERMS 15. NUMBER...performed by a program referred to as a Trojan Horse . The Trojan Horse has the ability to instigate the delaying procedure to low, read high’s file. code it...and pass it through this delaying procedure. Such a means of communication between high and low, with or without the Trojan Horse in place, will be
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.
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.
Consistency properties of chaotic systems driven by time-delayed feedback
NASA Astrophysics Data System (ADS)
Jüngling, T.; Soriano, M. C.; Oliver, N.; Porte, X.; Fischer, I.
2018-04-01
Consistency refers to the property of an externally driven dynamical system to respond in similar ways to similar inputs. In a delay system, the delayed feedback can be considered as an external drive to the undelayed subsystem. We analyze the degree of consistency in a generic chaotic system with delayed feedback by means of the auxiliary system approach. In this scheme an identical copy of the nonlinear node is driven by exactly the same signal as the original, allowing us to verify complete consistency via complete synchronization. In the past, the phenomenon of synchronization in delay-coupled chaotic systems has been widely studied using correlation functions. Here, we analytically derive relationships between characteristic signatures of the correlation functions in such systems and unequivocally relate them to the degree of consistency. The analytical framework is illustrated and supported by numerical calculations of the logistic map with delayed feedback for different replica configurations. We further apply the formalism to time series from an experiment based on a semiconductor laser with a double fiber-optical feedback loop. The experiment constitutes a high-quality replica scheme for studying consistency of the delay-driven laser and confirms the general theoretical results.
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
Troposphere Delay Raytracing Applied in VLBI Analysis
NASA Astrophysics Data System (ADS)
Eriksson, David; MacMillan, Daniel; Gipson, John
2014-12-01
Tropospheric delay modeling error is one of the largest sources of error in VLBI analysis. For standard operational solutions, we use the VMF1 elevation-dependent mapping functions derived from European Centre for Medium Range Forecasting (ECMWF) data. These mapping functions assume that tropospheric delay at a site is azimuthally symmetric. As this assumption does not reflect reality, we have instead determined the raytrace delay along the signal path through the three-dimensional troposphere refractivity field for each VLBI quasar observation. We calculated the troposphere refractivity fields from the pressure, temperature, specific humidity, and geopotential height fields of the NASA GSFC GEOS-5 numerical weather model. We discuss results using raytrace delay in the analysis of the CONT11 R&D sessions. When applied in VLBI analysis, baseline length repeatabilities were better for 70% of baselines with raytraced delays than with VMF1 mapping functions. Vertical repeatabilities were better for 2/3 of all stations. The reference frame scale bias error was 0.02 ppb for raytracing versus 0.08 ppb and 0.06 ppb for VMF1 and NMF, respectively.
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
Genetics Home Reference: CHARGE syndrome
... hormones that direct sexual development. As a result, males with CHARGE syndrome are often born with an ... Puberty can be incomplete or delayed in affected males and females. Another minor feature of CHARGE syndrome ...
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...
Context controls access to working and reference memory in the pigeon (Columba livia).
Roberts, William A; Macpherson, Krista; Strang, Caroline
2016-01-01
The interaction between working and reference memory systems was examined under conditions in which salient contextual cues were presented during memory retrieval. Ambient colored lights (red or green) bathed the operant chamber during the presentation of comparison stimuli in delayed matching-to-sample training (working memory) and during the presentation of the comparison stimuli as S+ and S- cues in discrimination training (reference memory). Strong competition between memory systems appeared when the same contextual cue appeared during working and reference memory training. When different contextual cues were used, however, working memory was completely protected from reference memory interference. © 2016 Society for the Experimental Analysis of Behavior.
NASA Astrophysics Data System (ADS)
Aditya, A. K.; Douglass, David Allen; Bhattacharya, Mahua
2017-09-01
A handsome project is undertaken by the Govt. of India with funding under either foreign investments or from their own resources. Though the projects are targeted to be implemented within a certain time frame these are never achieved because of the frequent delay in implementation. This has caused time and cost overruns as well as delay in delivering the benefits to the commuters. An insight into the critical problems and affairs by the experts who are engaged in the process of execution/implementation through various consultants has brought to light some key recurring issues with remedial measures requiring action from the different stakeholders for such projects.
Delayed wound healing after tooth extraction and self-reported kyphosis in Japanese men and women
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.
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.
Design of a delay-locked-loop-based time-to-digital converter
NASA Astrophysics Data System (ADS)
Zhaoxin, Ma; Xuefei, Bai; Lu, Huang
2013-09-01
A time-to-digital converter (TDC) based on a reset-free and anti-harmonic delay-locked loop (DLL) circuit for wireless positioning systems is discussed and described. The DLL that generates 32-phase clocks and a cycle period detector is employed to avoid “false locking". Driven by multiphase clocks, an encoder detects pulses and outputs the phase of the clock when the pulse arrives. The proposed TDC was implemented in SMIC 0.18 μm CMOS technology, and its core area occupies 0.7 × 0.55 mm2. The reference frequency ranges from 20 to 150 MHz. An LSB resolution of 521 ps can be achieved by using a reference clock of 60 MHz and the DNL is less than ±0.75 LSB. It dissipates 31.5 mW at 1.8 V supply voltage.
Effects of Stress After Hurricanes Katrina and Rita on Pubertal Disorders in Children
Ponnapakkam, Adharsh; Gensure, Robert
2008-01-01
Hurricanes Katrina and Rita caused widespread damage that resulted in increased stress levels for families living in the New Orleans area. This study examined the relationship between this stress and the onset of puberty in children by conducting a retrospective chart review of patients referred before and after the storm to a pediatric endocrine practice in New Orleans. The total number of new patients referred and the incidence of diagnoses that are unlikely to be affected by stress (ie, thyroid disease and premature adrenarche) were essentially unchanged. On the other hand, the incidence of central precocious puberty decreased by 52% after the storm, while the incidence of pubertal delay increased by 9% in the post storm period. This study thus provides evidence that stress delays the onset of puberty in children. PMID:21603464
Pipelined digital SAR azimuth correlator using hybrid FFT-transversal filter
NASA Technical Reports Server (NTRS)
Wu, C.; Liu, K. Y. (Inventor)
1984-01-01
A synthetic aperture radar system (SAR) having a range correlator is provided with a hybrid azimuth correlator which utilizes a block-pipe-lined fast Fourier transform (FFT). The correlator has a predetermined FFT transform size with delay elements for delaying SAR range correlated data so as to embed in the Fourier transform operation a corner-turning function as the range correlated SAR data is converted from the time domain to a frequency domain. The azimuth correlator is comprised of a transversal filter to receive the SAR data in the frequency domain, a generator for range migration compensation and azimuth reference functions, and an azimuth reference multiplier for correlation of the SAR data. Following the transversal filter is a block-pipelined inverse FFT used to restore azimuth correlated data in the frequency domain to the time domain for imaging.
The influence of performance on action-effect integration in sense of agency.
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.
Delayed/back up antibiotic prescriptions: what do the public think?
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
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…
NASA Astrophysics Data System (ADS)
Carey, S. K.; Shatilla, N. J.; Szmudrowska, B.; Rastelli, J.; Wellen, C.
2014-12-01
Surface mining is a common method of accessing coal. Blasting of overburden rock allows access to mineable ore. In high-elevation environments, the removed overburden rock is deposited in adjacent valleys as waste rock spoils. As part of a multi-year R&D program examining the influence of surface mining on watershed hydrological and water quality responses in the Elk Valley, British Columbia, this study reports on how surface mining affects streamflow hydrological and geochemical response at four reference and four mine-influenced catchments. The hydrology of this environment is dominated by snowmelt and steep topographic gradients. Flows were attenuated in mine-influenced catchments, with spring freshet delayed and more muted responses to precipitation events observed. Dissolved ions were an order of magnitude greater in mine-influenced streams, with more dilution-based responses to flows compared with chemostatic behavior observed in reference streams. Stable isotope signatures in stream water suggested that in both mine-influenced and reference watersheds, stream water was derived from well mixed groundwater as annual variability of stream isotope signatures was dampened compared with precipitation signatures. However, deflection of stream isotopes in response to precipitation were more apparent in reference watersheds. As a group, mine influenced catchments had a heavier isotope signature than reference watersheds, suggesting an enhanced influence of rainfall on recharge. Transit time distributions indicate existing waste rock spoils increase the average time water takes to move through the catchment.
Ausania, Fabio; Tsirlis, Theodoris; White, Steven A; French, Jeremy J; Jaques, Bryon C; Charnley, Richard M; Manas, Derek M
2013-01-01
Introduction Patients with incidental pT2-T3 gallbladder cancer (IGC) after a cholecystectomy may benefit from a radical re-resection although their optimal treatment strategy is not well defined. In this Unit, such patients undergo delayed staging at 3 months after a cholecystectomy to assess the evidence of a residual tumour, extra hepatic spread and the biological behaviour of the tumour. The aim of this study was to evaluate the outcome of patients who had delayed staging at 3 months after a cholecystectomy. Methods From July 2003 to July 2011, 56 patients with T2-T3 gallbladder cancer were referred to this Unit of which 49 were diagnosed incidentally on histology after a cholecystectomy. All 49 patients underwent delayed pre-operative staging using multi-detector computed tomography (MDCT) followed selectively by laparoscopy at 3 months after a cholecystectomy. Data were collected from a prospectively held database. The peri-operative and long-term outcomes of patients were analysed. SPSS software was used for statistical analysis. Results There were 38 pT2 and 11 pT3 tumours. After delayed staging, 24/49 (49%) patients underwent a radical resection, 24/49 (49%) were found to be inoperable on pre-operative assessment and 1/49 (2%) patient underwent an exploratory laparotomy and were found to be unresectable. The overall median survival from referral was 20.7 months (54.8 months for the group who had a radical re-resection versus 9.7 months for the group who had unresectable disease, P < 0.001). These results compare favourably with the reported outcome of fast-track management for incidental pT2-T3 gallbladder cancer from other major series in the literature. Conclusion Delayed staging in patients with incidental T2-T3 gallbladder cancer after a cholecystectomy is a useful strategy to select patients who will benefit from a resection and avoid unnecessary major surgery. PMID:23458168
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.
IVS Working Group 2 for Product Specification and Observing Programs
NASA Astrophysics Data System (ADS)
Schuh, H.; Charlot, P.; Hase, H.; Himwich, E.; Kingham, K.; Klatt, C.; Ma, C.; Malkin, Z.; Niell, A.; Nothnagel, A.; Schluter, W.; Takashima, K.; Vandenberg, N.
2002-03-01
After the scientific rationale is given in the introduction the Terms of Reference and the proceeding of IVS Working Group 2 are presented. Then the present status and future goals of all international activities within IVS are described. In particular the current products of IVS are described in terms of accuracy, reliability, frequency of observing sessions, temporal resolution of the parameters estimated by VLBI data analysis, time delay from observing to product, i.e. time which has passed after the end of the last session included in the VLBI solution till availability of the final products and frequency of solution (in the case of "global solutions";, when all existing or a high number of VLBI sessions are used to determine so-called global parameters). All IVS products and their potential users are covered in the report. This includes the Earth orientation parameters (EOP), the reference frames (TRF and CRF), geodynamical and geophysical parameters and physical parameters. Measures which should be taken within IVS to meet the goals defined in the first steps are presented. As most of the measures are related to the observing programs, these are the main focus for improving the current status of IVS products. The report shows that due to various requirements of the different users of IVS products the following aspects must be accomplished: - significant improvement of the accuracy of VLBI products, - shorter time delay from observation to availability of results, - almost continuous temporal coverage by VLBI sessions. A first scenario of the IVS observing program for 2002 and 2003 considers an increase of observing time by about 30%-40% and includes sessions carried out by S2 and K4 technology. The midterm observing program for the next 4-5 years seems to be rather ambitious. However, it appears feasible if all efforts are concentrated and the necessary resources are made available. From: Bidzina Kapanadze (Ilia State Iniversity) Address: bidzina_kapanadze@iliauni.edu.ge Database: ast
Willson, Robert J.; Wilkie, Donald M.
1991-01-01
Six pigeons were tested on a one-trial-per-day variant of delayed matching of key location. In one condition, a trial began with the illumination of a pair of quasi-randomly selected pecking keys in a large 10-key test box. Pigeons' pecks to one key (the sample) were reinforced with 8-second access to grain on a variable-interval 30-second schedule, whereas pecks to the other key (the distractor) had no scheduled consequences. In the second condition, the nonreinforced distractor was not presented. In both conditions, subjects were removed from the apparatus after 15 minutes and placed in a holding cage. Subjects were subsequently replaced in the box after a delay (retention interval) of 30 seconds and were reexposed to the illuminated sample and distractor keys for 1 minute. If a pigeon made more pecks to the sample during this interval, the distractor was extinguished and subsequent pecks to the sample were reinforced on the previous schedule for an additional 15 minutes. If, however, a pigeon made more pecks to the distractor, both keys were extinguished and the subject was returned to its home cage. For all subjects, matching-to-sample accuracy was higher in the first condition. In a second experiment, the retention interval was increased to 5, 15, and 30 minutes, and then to 1, 2, 4, 8, 12, and 24 hours. Most subjects remembered the correct key location for up to 4 hours, and in one case, up to 24 hours, demonstrating a spatial-memory proficiency far better than previously reported in this species on delayed matching tasks. The results are discussed in terms of the commonly held distinction between working and reference memory. PMID:16812633
Sparrow, Annie; Almilaji, Khaled; Tajaldin, Bachir; Teodoro, Nicholas; Langton, Paul
2016-01-01
Background Public health breakdown from the Syrian government's targeting of healthcare systems in politically unsympathetic areas has yielded a resurgence of infectious diseases. Suspected cholera recently reappeared but conflict-related constraints impede laboratory confirmation. Given the government's previous under-reporting of infectious outbreaks and the reliance of the WHO on government reporting, we sought to assess the reliability of current surveillance systems. Methods We compared weekly surveillance reports of waterborne diseases from the Syrian government's (WHO-associated) Early Warning and Response System (EWARS), based in Damascus, and the independent, non-governmental Early Warning and Response Network (EWARN) headquartered in Gaziantep, Turkey. We compared raw case rates by EWARS and EWARN and assessed the quality of reporting against the WHO benchmarks. Results We identified significant under-reporting and delays in the government's surveillance. On average, EWARS reports were published 24 days (range 12–61) after the reference week compared with 11 days (5–21) for EWARN. Average completeness for EWARS was 75% (55–84%), compared with 92% for EWARN (85–99%). Average timeliness for EWARS was 79% (51–100%), compared with 88% for EWARN (70–97%). EWARS made limited use of rapid diagnostic tests, and rates of collection of stool samples for laboratory cholera testing were well below reference levels. Conclusions In the context of the current Syrian war, the government's surveillance is inadequate due to lack of access to non-government held territory, an incentive to under-report the consequence of government attacks on health infrastructure, and an impractical insistence on laboratory confirmation. These findings should guide the WHO reform for surveillance in conflict zones. PMID:28588951
Real-Time Tropospheric Product Establishment and Accuracy Assessment in China
NASA Astrophysics Data System (ADS)
Chen, M.; Guo, J.; Wu, J.; Song, W.; Zhang, D.
2018-04-01
Tropospheric delay has always been an important issue in Global Navigation Satellite System (GNSS) processing. Empirical tropospheric delay models are difficult to simulate complex and volatile atmospheric environments, resulting in poor accuracy of the empirical model and difficulty in meeting precise positioning demand. In recent years, some scholars proposed to establish real-time tropospheric product by using real-time or near-real-time GNSS observations in a small region, and achieved some good results. This paper uses real-time observing data of 210 Chinese national GNSS reference stations to estimate the tropospheric delay, and establishes ZWD grid model in the country wide. In order to analyze the influence of tropospheric grid product on wide-area real-time PPP, this paper compares the method of taking ZWD grid product as a constraint with the model correction method. The results show that the ZWD grid product estimated based on the national reference stations can improve PPP accuracy and convergence speed. The accuracy in the north (N), east (E) and up (U) direction increase by 31.8 %,15.6 % and 38.3 %, respectively. As with the convergence speed, the accuracy of U direction experiences the most improvement.
ERIC Educational Resources Information Center
Schutte, Anne R.; Spencer, John P.
2009-01-01
This study tested a dynamic field theory (DFT) of spatial working memory and an associated spatial precision hypothesis (SPH). Between 3 and 6 years of age, there is a qualitative shift in how children use reference axes to remember locations: 3-year-olds' spatial recall responses are biased toward reference axes after short memory delays, whereas…
Genetics Home Reference: PPP2R5D-related intellectual disability
... and delayed speech development. Recurrent seizures (epilepsy) and autism spectrum disorder , which is characterized by impaired communications ... Increased Head Circumference Encyclopedia: Intellectual Disability Health Topic: Autism Spectrum ... Topic: Developmental Disabilities Additional NIH ...
Genetics Home Reference: 22q13.3 deletion syndrome
... delayed speech. Some people with this condition have autism or autistic-like behavior that affects communication and ... National Institute on Deafness and Other Communication Disorders: Autism and Communication National Institute on Deafness and Other ...
Genetics Home Reference: Gordon Holmes syndrome
... production of hormones that direct sexual development (hypogonadotropic hypogonadism). Many affected individuals have a delay in development ... a lack of RNF216 protein function causes hypogonadotropic hypogonadism or cerebellar ataxia. The PNPLA6 gene provides instructions ...
Simultaneous Ka-Band Site Characterization: Goldstone, CA, White Sands, NM, and Guam, USA
NASA Technical Reports Server (NTRS)
Acosta, Roberto; Morse, Jacquelynne; Zemba, Michael; Nessel, James; Morabito, David; Caroglanian, Armen
2011-01-01
To statistically characterize atmospheric effects on Ka-band links at NASA operational sites, NASA has constructed site test interferometers (STI s) which directly measure the tropospheric phase stability and rain attenuation. These instruments observe an unmodulated beacon signal broadcast from a geostationary satellite (e.g., Anik F2) and measure the phase difference between the signals received by the two antennas and its signal attenuation. Three STI s have been deployed so far: the first one at the NASA Deep Space Network Tracking Complex in Goldstone, California (May 2007); the second at the NASA White Sands Complex, in Las Cruses, New Mexico (February 2009); and the third at the NASA Tracking and Data Relay Satellite (TDRS) Remote Ground Terminal (GRGT) complex in Guam (May 2010). Two station-years of simultaneous atmospheric phase fluctuation data have been collected at Goldstone and White Sands, while one year of data has been collected in Guam. With identical instruments operating simultaneously, we can directly compare the phase stability and rain attenuation at the three sites. Phase stability is analyzed statistically in terms of the root-mean-square (rms) of the tropospheric induced time delay fluctuations over 10 minute blocks. For two years, the time delay fluctuations at the DSN site in Goldstone, CA, have been better than 2.5 picoseconds (ps) for 90% of the time (with reference to zenith), meanwhile at the White Sands, New Mexico site, the time delay fluctuations have been better than 2.2 ps with reference to zenith) for 90% of time. For Guam, the time delay fluctuations have been better than 12 ps (reference to zenith) at 90% of the time, the higher fluctuations are as expected from a high humidity tropical rain zone. This type of data analysis, as well as many other site quality characteristics (e.g., rain attenuation, infrastructure, etc.) will be used to determine the suitability of all the sites for NASA s future communication services at Ka-band.
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
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
Bronner Murrison, L; Ananthakrishnan, R; Swaminathan, A; Auguesteen, S; Krishnan, N; Pai, M; Dowdy, D W
2016-04-01
The diagnosis and treatment of tuberculosis (TB) in India are characterized by heavy private-sector involvement. Delays in treatment remain poorly characterized among patients seeking care in the Indian private sector. To assess delays in TB diagnosis and treatment initiation among patients diagnosed in the private sector, and pathways to care in an urban setting. Cross-sectional survey of 289 consecutive patients diagnosed with TB in the private sector and referred for anti-tuberculosis treatment through a public-private mix program in Chennai from January 2014 to February 2015. Among 212 patients with pulmonary TB, 90% first contacted a formal private provider, and 78% were diagnosed by the first or second provider seen after a median of three visits per provider. Median total delay was 51 days (mean 68). Consulting an informal (rather than formally trained) provider first was associated with significant increases in total delay (absolute increase 22.8 days, 95%CI 6.2-39.5) and in the risk of prolonged delay >90 days (aRR 2.4, 95%CI 1.3-4.4). Even among patients seeking care in the formal (vs. informal) private sector in Chennai, diagnostic delays are substantial. Novel strategies are required to engage private providers, who often serve as the first point of contact.
Kuroda, Yukiko; Ohashi, Ikuko; Saito, Toshiyuki; Nagai, Jun-ichi; Ida, Kazumi; Naruto, Takuya; Iai, Mizue; Kurosawa, Kenji
2014-08-01
Kuechler et al. [2011] reported five patients with interstitial deletions in 8q22.2-q22.3 who had intellectual disability, epilepsy, and dysmorphic features. We report on a new patient with the smallest overlapping de novo deletion in 8q22.3 and refined the phenotype. The proposita was an 8-year-old girl, who developed seizures at 10 months, and her epileptic seizure became severe and difficult to control with antiepileptic drugs. She also exhibited developmental delay and walked alone at 24 months. She was referred to us for evaluation for developmental delay and epilepsy at the age of 8 years. She had intellectual disability (IQ 37 at 7 years) and autistic behavior, and spoke two word sentences at 8 years. She had mild dysmorphic features, including telecanthus and thick vermilion of the lips. Array comparative genomic hybridization detected a 1.36 Mb deletion in 8q22.3 that encompassed RRM2B and NCALD, which encode the small subunit of p53-inducible ribonucleotide reductase and neurocalcin delta in the neuronal calcium sensor family of calcium-binding proteins, respectively. The minimum overlapping region between the present and previously reported patients is considered to be a critical region for the phenotype of the deletion in 8q22.3. We suggest that the deletion in 8q22.3 may represent a clinically recognizable condition, which is characterized by intellectual disability and epilepsy. © 2014 Wiley Periodicals, Inc.
Van Wyk Grumbach Syndrome: A Rare Consequence of Hypothyroidism.
Reddy, Pavan; Tiwari, Kritika; Kulkarni, Abhishek; Parikh, Ketan; Khubchandani, Raju
2018-05-19
Long standing hypothyroidism presenting as an ovarian mass has been well described in literature as the Van Wyk Grumbach syndrome (hypothyroidism, isosexual precocious puberty and ovarian mass). Here, authors report this entity in a 11 y 7 mo old girl child who was referred to a surgeon in view of intestinal obstruction along with a multiloculated ovarian cyst. On evaluation, she was found to have raised serum creatinine, short stature, delayed bone age and pituitary enlargement. She was diagnosed with autoimmune thyroiditis and was started on replacement therapy with thyroxine, after which the ovarian cysts regressed. This entity should be kept in mind in cases of ovarian cysts, especially those with isosexual precocity, to prevent unnecessary evaluation and surgical misadventures.
D'Arrigo, Stefano; Gavazzi, Francesco; Alfei, Enrico; Zuffardi, Orsetta; Montomoli, Cristina; Corso, Barbara; Buzzi, Erika; Sciacca, Francesca L; Bulgheroni, Sara; Riva, Daria; Pantaleoni, Chiara
2016-05-01
Microarray-based comparative genomic hybridization is a method of molecular analysis that identifies chromosomal anomalies (or copy number variants) that correlate with clinical phenotypes. The aim of the present study was to apply a clinical score previously designated by de Vries to 329 patients with intellectual disability/developmental disorder (intellectual disability/developmental delay) referred to our tertiary center and to see whether the clinical factors are associated with a positive outcome of aCGH analyses. Another goal was to test the association between a positive microarray-based comparative genomic hybridization result and the severity of intellectual disability/developmental delay. Microarray-based comparative genomic hybridization identified structural chromosomal alterations responsible for the intellectual disability/developmental delay phenotype in 16% of our sample. Our study showed that causative copy number variants are frequently found even in cases of mild intellectual disability (30.77%). We want to emphasize the need to conduct microarray-based comparative genomic hybridization on all individuals with intellectual disability/developmental delay, regardless of the severity, because the degree of intellectual disability/developmental delay does not predict the diagnostic yield of microarray-based comparative genomic hybridization. © The Author(s) 2015.
[Diagnosis delay of pleural and pulmonary tuberculosis].
Cherif, J; Mjid, M; Ladhar, A; Toujani, S; Mokadem, S; Louzir, B; Mehiri, N; Béji, M
2014-08-01
Tuberculosis (TB) is still being endemic in our country. Time until management determines both evolution and prognosis of this condition. The aim of this work is to evaluate the delay in diagnosis of TB in a respiratory unit from a university hospital series. The authors conducted a cross-sectional study including patients with pulmonary TBC and/or pleural. An evaluation of time management was conducted from the beginning of symptoms and various consultations with reference to the date of hospitalization and treatment set up. One hundred patients were included (pulmonary TB: 68 cases, pleural TB 23 cases, miliary pulmonary TB: 4 cases, pulmonary TB associated with other extrathoracic locations: 5 cases). The mean time of patient delay and total delay institution were respectively 43.6, 25.7 and 69.3 days. Variables responsible for long delays were: number of consultations more than 3 before hospitalization, empirical antibiotic therapy, of a regional hospital first consultation and the presence of extra-respiratory impairment. The patient delay was considered long. A reorganization of the TB control program, in particular by partial decentralization of care and health education is imperative in order to improve the quality of tuberculosis management in our country. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Background Noise Reduction Using Adaptive Noise Cancellation Determined by the Cross-Correlation
NASA Technical Reports Server (NTRS)
Spalt, Taylor B.; Brooks, Thomas F.; Fuller, Christopher R.
2012-01-01
Background noise due to flow in wind tunnels contaminates desired data by decreasing the Signal-to-Noise Ratio. The use of Adaptive Noise Cancellation to remove background noise at measurement microphones is compromised when the reference sensor measures both background and desired noise. The technique proposed modifies the classical processing configuration based on the cross-correlation between the reference and primary microphone. Background noise attenuation is achieved using a cross-correlation sample width that encompasses only the background noise and a matched delay for the adaptive processing. A present limitation of the method is that a minimum time delay between the background noise and desired signal must exist in order for the correlated parts of the desired signal to be separated from the background noise in the crosscorrelation. A simulation yields primary signal recovery which can be predicted from the coherence of the background noise between the channels. Results are compared with two existing methods.
Pointing at targets by children with congenital and transient blindness.
Gaunet, Florence; Ittyerah, Miriam; Rossetti, Yves
2007-04-01
The study investigated pointing at memorized targets in reachable space in congenitally blind (CB) and blindfolded sighted (BS) children (6, 8, 10 and 12 years; ten children in each group). The target locations were presented on a sagittal plane by passive positioning of the left index finger. A go signal for matching the target location with the right index finger was provided 0 or 4 s after demonstration. An age effect was found only for absolute distance errors and the surface area of pointing was smaller for the CB children. Results indicate that early visual experience and age are not predictive factors for pointing in children. The delay was an important factor at all ages and for both groups, indicating distinct spatial representations such as egocentric and allocentric frames of reference, for immediate and delayed pointing, respectively. Therefore, the CB like the BS children are able to use both ego- and allocentric frames of reference.
Experimental evaluation of fluctuating density and radiated noise from a high temperature jet
NASA Technical Reports Server (NTRS)
Massier, P. F.; Parthasarathy, S. P.; Cuffel, R. F.
1973-01-01
An experimental investigation has been conducted to characterize the fluctuating density within a high-temperature (1100 K) subsonic jet and to characterize by the noise radiated to the surroundings. Cross correlations obtained by introducing time delay to the signals detected from spatially separated crossed laser beams set up as a Schlieren system were used to determine radial and axial distributions of the convection velocity of the moving noise sources (eddies). In addition, the autocorrelation of the fluctuating density was evaluated in the moving frame of reference of the eddies. Also, the autocorrelation of the radiated noise in the moving reference frame was evaluated from cross correlations by introducing time delay to the signals detected by spatially separated pairs of microphones. Radial distributions of the mean velocity were obtained from measurements of the stagnation temperature, and stagnation and static pressures with the use of probes.
Harrison, Thomas R.
1989-08-22
A proximity fuze system includes an optical ranging apparatus, a detonation circuit controlled by the optical ranging apparatus, and an explosive charge detonated by the detonation cirtcuit. The optical ranging apparatus includes a pulsed laser light source for generating target ranging light pulses and optical reference light pulses. A single lens directs ranging pulses to a target and collects reflected light from the target. An optical fiber bundle is used for delaying the optical reference pulses to correspond to a predetermined distance from the target. The optical ranging apparatus includes circuitry for providing a first signal depending upon the light pulses reflected from the target, a second signal depending upon the light pulses from the optical delay fiber bundle, and an output signal when the first and second signals coincide with each other. The output signal occurs when the distance from the target is equal to the predetermined distance form the target. Additional circuitry distinguishes pulses reflected from the target from background solar radiation.
Ruha, Anne-Michelle; Curry, Steven C; Beuhler, Michael; Katz, Ken; Brooks, Daniel E; Graeme, Kimberlie A; Wallace, Kevin; Gerkin, Richard; Lovecchio, Frank; Wax, Paul; Selden, Brad
2002-06-01
We describe our postmarketing experience with patients receiving Crotalidae polyvalent immune Fab (CroFab; FabAV) antivenom for treatment of rattlesnake envenomation. The charts of 28 patients admitted between March 1 and September 9, 2001, with rattlesnake envenomation and treated with FabAV were reviewed for demographic information, time until antivenom treatment, laboratory findings, evidence of hypersensitivity reaction, length of hospital stay, and readmission to the hospital. All patients had swelling, 20 patients had elevated prothrombin times (>14 seconds), 12 patients had low fibrinogen levels (<170 mg/dL), and 6 patients had thrombocytopenia (platelet count <120,000/mm(3)) on presentation. The total dose of FabAV ranged from 10 to 47 vials per patient. Hypofibrinogenemia was resistant to FabAV in some patients. On follow-up, recurrence of coagulopathy was detected in 3 patients, and recurrence of thrombocytopenia was detected in 1 patient. Two patients demonstrated delayed-onset severe thrombocytopenia. Recurrence or delayed-onset toxicity might have been underestimated because of incomplete follow-up in some patients. No acute hypersensitivity reactions occurred. Two patients reported mild symptoms of possible serum sickness on follow-up. FabAV effectively controlled the effects of envenomation; however, initial control of coagulopathy was difficult to achieve in some cases, and recurrence or delayed-onset hematotoxicity was common. When initially managing hematotoxicity, a trend toward normalization of laboratory values might be a more reasonable end point for FabAV treatment than attainment of normal reference values in nonbleeding patients.
Tunnel vision information: a paradox of ethics, economics, politics and science.
Bilton, D; Stephens, D; Gorman, F
1998-09-01
Improvement in vision with spinal manipulation was first observed in the early 1970s. Reports of the phenomenon appeared in the 1980s in the popular press and at scientific meetings, but it was not until the mid-1990s that general discussion of the potential value of this knowledge occurred. Considering the far-reaching implications of the possible ability to improve brain function by spinal manipulation, the delay in consideration and implementation of this concept is a paradox in general terms and a total mystery in the case of the chiropractic profession. To provide explanations for the delay in scientific assessment of the discovery that vision improves, in appropriate patients, when the spine is manipulated and to discuss the implications of this finding. This discovery is now called the "tunnel vision information." A schema of pathological hierarchy is depicted in which the level of intervention of spinal manipulation outranks other forms of treatment. The significance of this precedence is portrayed. Possible reasons for the failure to address this hierarchy in light of the tunnel vision information are discussed with reference to established protocols, medical politics, the presentation of the data, the failure of scientific editorship and the illogical aspects of the illness itself. In the future, the delay from the initial observation of the tunnel vision discovery to its free discussion in scientific literature may seem incongruous, particularly if the health benefits which it augurs are realized.
McCambridge, Sarah A; Consedine, Nathan S
2014-04-01
This study was designed to experimentally determine whether disgust and embarrassment predict anticipated delay and avoidance in sexual healthcare decision-making and for whom. In the study, 90 participants, aged 18-30, completed web-based questionnaires assessing demographics, current health, and past health behaviors before being gender block randomized to conditions in which disgust, embarrassment, or control (no emotion) were induced. Participants completed health decision-making vignettes covering the disgusting and embarrassing aspects of sexual healthcare. Factorial ANOVAs showed that although there were some complexities in the manipulation, disgust and embarrassment predicted greater anticipated delay and avoidance of elicitors, but only among specific groups. Embarrassment predicted anticipated help-seeking delays for embarrassment elicitors (i.e. sexual history assessment and physical examination), while disgust predicted anticipated help-seeking delays involving disgust elicitors (i.e. collecting genital discharge). However, these effects were moderated, with embarrassment only predicting anticipated delays among individuals reporting multiple sexual partners and disgust predicting anticipated delays and avoidance among persons reporting poorer subjective health. In sum, the current report provides among the first empirical demonstrations that emotions such as embarrassment and disgust may be causally implicated in anticipated delays and avoidance in sexual healthcare. Emotion frameworks may be usefully incorporated into clinical and public health efforts to reduce sexual healthcare delays and avoidance.
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...
Djomou, François; Nkouo, Yves Christian Andjock; Mindja, Eko David; Nchinda, Choffor; Meka, Luc; Mbamyah-Lyonga, Emilia; Ndjolo, Alexis
2016-01-01
Sensorineural emergencies (SNE) are rare clinical situations. Few patients consult early explaining subsequent difficulty in having accurate data and management. Three clinical conditions are considered SNE in otolaryngology; they include sudden sensorineural hearing loss (SSHL), Bell's palsy and acute vertigo. There is very little data available on sensorineural emergencies in our setting. The aim of this study was to provide preliminary data on the management of Ear Nose and Throat (ENT) sensorineural emergency cases in Yaoundé Reference Hospital. A descriptive retrospective study was carried out based on data collected over a period of 5 years, January 2010 to July 2014 at the Yaoundé Reference Hospital. Information was obtained from patients' files collected from the archives of the institution. Patients presenting with SSHL, Bell's palsy, acute vertigo who consulted during the study period were included in the study. A total of 22 patients were included in the study out of 6406 patients who consulted at the ENT Unit. The prevalence of SNE in ENT consultations was 0.003, distributed as follows; 13 patients (59.1%) of SNE had Bell's palsy, seven (31.8%) had vestibular neuritis and two (9.1%) had SSHL. The prevalence of SNE was low with idiopathic Bell's palsy being the most frequent. There was a general delay in arrival of patients hence delay in diagnosis. This delay could equally be a factor for treatment failure and poor prognosis. More effort should be made in terms of population sensitization about the necessity of getting early medical attention.
Hibbert, M; Wolton, A; Crenna-Jennings, W; Benton, L; Kirwan, P; Lut, I; Okala, S; Ross, M; Furegato, M; Nambiar, K; Douglas, N; Roche, J; Jeffries, J; Reeves, I; Nelson, M; Weerawardhana, C; Jamal, Z; Hudson, A; Delpech, V
2018-07-01
The People Living with HIV StigmaSurvey UK 2015 was a community led national survey investigating experiences of people living with HIV in the UK in the past 12 months. Participants aged 18 and over were recruited through over 120 cross-sector community organisations and 46 HIV clinics to complete an anonymous online survey. Trans is an umbrella term which refers to individuals whose current gender identity is different to the gender they were assigned at birth. Trans participants self-identified via gender identity and gender at birth questions. Descriptive analyses of reported experiences in social and health care settings were conducted and multivariate logistic regression analyses were used to identify sociodemographic predictors of reporting being treated differently to non-HIV patients, and being delayed or refused healthcare treatment in the past 12 months. 31 out of 1576 participants (2%) identified as trans (19 trans women, 5 trans men, 2 gender queer/non-binary, 5 other). High levels of social stigma were reported for all participants, with trans participants significantly more likely to report worrying about verbal harassment (39% vs. 23%), and exclusion from family gatherings (23% vs. 9%) in the last 12 months, compared to cisgender participants. Furthermore, 10% of trans participants reported physical assault in the last 12 months, compared to 4% of cisgender participants. Identifying as trans was a predictor of reporting being treated differently to non-HIV patients (48% vs. 30%; aOR 2.61, CI 1.06, 6.42) and being delayed or refused healthcare (41% vs. 16%; aOR 4.58, CI 1.83, 11.44). Trans people living with HIV in the UK experience high levels of stigma and discrimination, including within healthcare settings, which is likely to impact upon health outcomes. Trans-specific education and awareness within healthcare settings could help to improve service provision for this demographic.
Diagnostic delay in psychogenic seizures and the association with anti-seizure medication trials.
Kerr, Wesley T; Janio, Emily A; Le, Justine M; Hori, Jessica M; Patel, Akash B; Gallardo, Norma L; Bauirjan, Janar; Chau, Andrea M; D'Ambrosio, Shannon R; Cho, Andrew Y; Engel, Jerome; Cohen, Mark S; Stern, John M
2016-08-01
The average delay from first seizure to diagnosis of psychogenic non-epileptic seizures (PNES) is over 7 years. The reason for this delay is not well understood. We hypothesized that a perceived decrease in seizure frequency after starting an anti-seizure medication (ASM) may contribute to longer delays, but the frequency of such a response has not been well established. Time from onset to diagnosis, medication history and associated seizure frequency was acquired from the medical records of 297 consecutive patients with PNES diagnosed using video-electroencephalographic monitoring. Exponential regression was used to model the effect of medication trials and response on diagnostic delay. Mean diagnostic delay was 8.4 years (min 1 day, max 52 years). The robust average diagnostic delay was 2.8 years (95% CI: 2.2-3.5 years) based on an exponential model as 10 to the mean of log10 delay. Each ASM trial increased the robust average delay exponentially by at least one third of a year (Wald t=3.6, p=0.004). Response to ASM trials did not significantly change diagnostic delay (Wald t=-0.9, p=0.38). Although a response to ASMs was observed commonly in these patients with PNES, the presence of a response was not associated with longer time until definitive diagnosis. Instead, the number of ASMs tried was associated with a longer delay until diagnosis, suggesting that ASM trials were continued despite lack of response. These data support the guideline that patients with seizures should be referred to epilepsy care centers after failure of two medication trials. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
Hosseini, Jalil; Tavakkoli Tabassi, Kamyar; Razi, Abdollah
2009-01-01
The objective of the present study was to evaluate the results and the complications of delayed retropubic urethroplasty of completely transected urethra associated with pelvic fracture in girls. From 2002 to 2008, a total of 7 girls with complete urethral disruption after pelvic fracture were referred to our center and all of them underwent delayed retropubic urethroplasty with end-to-end anastomosis of the urethra. Seven female patients with a median age of 6 years old underwent delayed end-to-end anastomosis. The median time to surgery was 6 months from the trauma. Voiding was normal after catheter removal in all of the patients. The median follow-up was 36 months. Three patients had mild stress urinary incontinence after catheter removal. There are some different strategies for management of complete urethral avulsion in females who have sustained pelvic fracture, including early realignment, bladder flaps, and end-to-end anastomosis. The strategy of delayed end-to-end anastomosis urethroplasty with retropubic approach is sound and produces acceptable results. The use of flexible cystoscope and omental flap is effective in achieving continence after urethroplasty in such cases.
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...
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...
Space-based augmentation for global navigation satellite systems.
Grewal, Mohinder S
2012-03-01
This paper describes space-based augmentation for global navigation satellite systems (GNSS). Space-based augmentations increase the accuracy and integrity of the GNSS, thereby enhancing users' safety. The corrections for ephemeris, ionospheric delay, and clocks are calculated from reference station measurements of GNSS data in wide-area master stations and broadcast via geostationary earth orbit (GEO) satellites. This paper discusses the clock models, satellite orbit determination, ionospheric delay estimation, multipath mitigation, and GEO uplink subsystem (GUS) as used in the Wide Area Augmentation System developed by the FAA.
Removing Repeated Executive Delays to Transboundary Approvals of Pipelines and Engineering Act
Sen. Walsh, John E. [D-MT
2014-05-08
Senate - 05/08/2014 Read twice and referred to the Committee on Homeland Security and Governmental Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
Genetics Home Reference: adermatoglyphia
... that are the basis for each person's unique fingerprints. Because no two people have the same patterns, fingerprints have long been used as a way to ... and so they cannot be identified by their fingerprints. Adermatoglyphia has been called the "immigration delay disease" ...
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.
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.
Longest delayed hemothorax reported after blunt chest injury.
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.
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.
NASA Astrophysics Data System (ADS)
Kodet, J.; Schreiber, K. U.; Eckl, J.; Plötz, C.; Mähler, S.; Schüler, T.; Klügel, T.; Riepl, S.
2018-01-01
The quality of the links between the different space geodetic techniques (VLBI, SLR, GNSS and DORIS) is still one of the major limiting factors for the realization of a unique global terrestrial reference frame that is accurate enough to allow the monitoring of the Earth system, i.e., of processes like sea level change, postglacial rebound and silent earthquakes. According to the specifications of the global geodetic observing system of the International Association of Geodesy, such a reference frame should be accurate to 1 mm over decades, with rates of change stable at the level of 0.1 mm/year. The deficiencies arise from inaccurate or incomplete local ties at many fundamental sites as well as from systematic instrumental biases in the individual space geodetic techniques. Frequently repeated surveys, the continuous monitoring of antenna heights and the geometrical mount stability (Lösler et al. in J Geod 90:467-486, 2016. https://doi.org/10.1007/s00190-016-0887-8) have not provided evidence for insufficient antenna stability. Therefore, we have investigated variations in the respective system delays caused by electronic circuits, which is not adequately captured by the calibration process, either because of subtle differences in the circuitry between geodetic measurement and calibration, high temporal variability or because of lacking resolving bandwidth. The measured system delay variations in the electric chain of both VLBI- and SLR systems reach the order of 100 ps, which is equivalent to 3 cm of path length. Most of this variability is usually removed by the calibrations but by far not all. This paper focuses on the development of new technologies and procedures for co-located geodetic instrumentation in order to identify and remove systematic measurement biases within and between the individual measurement techniques. A closed-loop optical time and frequency distribution system and a common inter-technique reference target provide the possibility to remove variable system delays. The main motivation for the newly established central reference target, locked to the station clock, is the combination of all space geodetic instruments at a single reference point at the observatory. On top of that it provides the unique capability to perform a closure measurement based on the observation of time.
Automated Tobacco Assessment and Cessation Support for Cancer Patients
Warren, Graham W.; Marshall, James R.; Cummings, K. Michael; Zevon, Michael A.; Reed, Robert; Hysert, Pat; Mahoney, Martin C.; Hyland, Andrew J.; Nwogu, Chukwumere; Demmy, Todd; Dexter, Elisabeth; Kelly, Maureen; O’Connor, Richard J.; Houstin, Teresa; Jenkins, Dana; Germain, Pamela; Singh, Anurag K.; Epstein, Jennifer; Dobson Amato, Katharine A.; Reid, Mary E.
2015-01-01
BACKGROUND Tobacco assessment and cessation support are not routinely included in cancer care. An automated tobacco assessment and cessation program was developed to increase the delivery of tobacco cessation support for cancer patients. METHODS A structured tobacco assessment was incorporated into the electronic health record at Roswell Park Cancer Institute to identify tobacco use in cancer patients at diagnosis and during follow-up. All patients who reported tobacco use within the past 30 days were automatically referred to a dedicated cessation program that provided cessation counseling. Data were analyzed for referral accuracy and interest in cessation support. RESULTS Between October 2010 and December 2012, 11,868 patients were screened for tobacco use, and 2765 were identified as tobacco users and were referred to the cessation service. In referred patients, 1381 of those patients received only a mailed invitation to contact the cessation service, and 1384 received a mailing as well as telephone contact attempts from the cessation service. In the 1126 (81.4%) patients contacted by telephone, 51 (4.5%) reported no tobacco use within the past 30 days, 35 (3.1%) were medically unable to participate, and 30 (2.7%) declined participation. Of the 1381 patients who received only a mailed invitation, 16 (1.2%) contacted the cessation program for assistance. Three questions at initial consult and follow-up generated over 98% of referrals. Tobacco assessment frequency every 4 weeks delayed referral in <1% of patients. CONCLUSIONS An automated electronic health record-based tobacco assessment and cessation referral program can identify substantial numbers of smokers who are receptive to enrollment in a cessation support service. PMID:24496870
Longitudinal Outcomes of Start Time Delay on Sleep, Behavior, and Achievement in High School
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.
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.
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.
Cai, Shuiming; Hao, Junjun; Liu, Zengrong
2011-06-01
This paper studies the synchronization of coupled chaotic systems with time-varying delays in the presence of parameter mismatches by means of periodically intermittent control. Some novel and useful quasisynchronization criteria are obtained by using the methods which are different from the techniques employed in the existing works, and the derived results are less conservative. Especially, a strong constraint on the control width that the control width should be larger than the time delay imposed by the current references is released in this paper. Moreover, our results show that the synchronization criteria depend on the ratio of control width to control period, but not the control width or the control period. Finally, some numerical simulations are given to show the effectiveness of the theoretical results.
Zhao, Hua; Wang, Qian-qian; Liu, Kai; Ge, Cong-hui
2012-03-01
Laser-induced breakdown spectroscopy is a technology that can be used for high-speed, real time, multi-component, online, remote detection, and it has considerable superiority in explosives detection. In the present experiment, using 1 064 nm Q-switch laser beam as the resource, the authors investigated a common inorganic explosive (black powder) and one of its key components (KNO3), while choosing NaNO3 as the reference. We obtained the LIBS spectroscopy of these three samples in two surrounding atmospheres (air and Ar gas) at different time delay. And we analysed the change in line intensity ratio of N, O along with the increase in time delay, and found that the maximum of the value of O/N is obtained at time delay 596 ns.
Estimating Real-Time Zenith Tropospheric Delay over Africa Using IGS-RTS Products
NASA Astrophysics Data System (ADS)
Abdelazeem, M.
2017-12-01
Zenith Tropospheric Delay (ZTD) is a crucial parameter for atmospheric modeling, severe weather monitoring and forecasting applications. Currently, the international global navigation satellite system (GNSS) real-time service (IGS-RTS) products are used extensively in real-time atmospheric modeling applications. The objective of this study is to develop a real time zenith tropospheric delay estimation model over Africa using the IGS-RTS products. The real-time ZTDs are estimated based on the real-time precise point positioning (PPP) solution. GNSS observations from a number of reference stations are processed over a period of 7 days. Then, the estimated real-time ZTDs are compared with the IGS tropospheric products counterparts. The findings indicate that the estimated real-time ZTDs have millimeter level accuracy in comparison with the IGS counterparts.
Probing electron delays in above-threshold ionization
Zipp, Lucas J.; Natan, Adi; Bucksbaum, Philip H.
2014-11-21
Recent experiments have revealed attosecond delays in the emission of electrons from atoms ionized by extreme UV light, offering a glimpse into the ultrafast nature of light-induced electron dynamics. In this work, we extend these measurements to the strong-field above-threshold ionization (ATI) regime, by measuring delays in the photoemission of electrons from argon in the presence of an intense laser field. We probe the ATI process with a weak coherent reference, at half the laser frequency. The interfering ionization signal reveals the relative spectral phase of adjacent ATI channels, with an equivalent resolution of a few attoseconds. These relative delaysmore » depend on the strong field, and approach zero at higher intensity. Our phase measurements of ATI electrons show how strong fields alter ionization dynamics in atoms.« less
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...
Tonn, Christopher R; Grundfast, Kenneth M
2014-03-01
Otolaryngologists are asked to evaluate children who a parent, physician, or someone else believes is slow in developing speech. Therefore, an otolaryngologist should be familiar with milestones for normal speech development, the causes of delay in speech development, and the best ways to help assure that children develop the ability to speak in a normal way. To provide information for otolaryngologists that is helpful in the evaluation and management of children perceived to be delayed in developing speech. Data were obtained via literature searches, online databases, textbooks, and the most recent national guidelines on topics including speech delay and language delay and the underlying disorders that can cause delay in developing speech. Emphasis was placed on epidemiology, pathophysiology, most common presentation, and treatment strategies. Most of the sources referenced were published within the past 5 years. Our article is a summary of major causes of speech delay based on reliable sources as listed herein. Speech delay can be the manifestation of a spectrum of disorders affecting the language comprehension and/or speech production pathways, ranging from disorders involving global developmental limitations to motor dysfunction to hearing loss. Determining the cause of a child's delay in speech production is a time-sensitive issue because a child loses valuable opportunities in intellectual development if his or her communication defect is not addressed and ameliorated with treatment. Knowing several key items about each disorder can help otolaryngologists direct families to the correct health care provider to maximize the child's learning potential and intellectual growth curve.
Scanlon, P H; Aldington, S J; Stratton, I M
2014-04-01
To assess whether there is a relationship between delay in retinopathy screening after diagnosis of type 2 diabetes and level of retinopathy detected. Patients were referred from 88 primary care practices to an English National Health Service diabetic eye screening programme. Data for screened patients were extracted from the primary care databases using semi-automated data collection algorithms supplemented by validation processes. The programme uses two-field mydriatic digital photographs graded by a quality assured team. Data were available for 8183 screened patients with diabetes newly diagnosed in 2005, 2006 or 2007. Only 163 with type 1 diabetes were identified and were insufficient for analysis. Data were available for 8020 with newly diagnosed type 2 diabetes. Of these, 3569 were screened within 6 months, 2361 between 6 and 11 months, 1058 between 12 and 17 months, 366 between 18 and 23 months, 428 between 24 and 35 months, and 238 at 3 years or more after diagnosis. There were 5416 (67.5%) graded with no retinopathy, 1629 (20.3%) with background retinopathy in one eye, 753 (9.4%) with background retinopathy in both eyes and 222 (2.8%) had referable diabetic retinopathy. There was a significant trend (P = 0.0004) relating time from diagnosis to screening detecting worsening retinopathy. Of those screened within 6 months of diagnosis, 2.3% had referable retinopathy and, 3 years or more after diagnosis, 4.2% had referable retinopathy. The rate of detection of referable diabetic retinopathy is elevated in those who were not screened promptly after diagnosis of type 2 diabetes. © 2013 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.
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.
Two vicious circles contributing to a diagnostic delay for tuberculosis patients in Arkhangelsk
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
Wechkunanukul, Kannikar; Grantham, Hugh; Damarell, Raechel; Clark, Robyn A
2016-07-01
Acute coronary syndrome (ACS) is a leading cause of mortality and morbidity worldwide, and chest pain is one of the most common symptoms of ACSs. A rapid response to chest pain by patients and appropriate management by health professionals are vital to improve survival rates.People from different ethnic groups are likely to have different perceptions of chest pain, its severity and the need for urgent treatment. These differences in perception may contribute to differences in response to chests pain and precipitate unique coping strategies. Delay in seeking medical care for chest pain in the general population has been well documented; however, limited studies have focused on delay times within ethnic groups. There is little research to date as to whether ethnicity is associated with the time taken to seek medical care for chest pain. Consequently, addressing this gap in knowledge will play a crucial role in improving the health outcomes of culturally and linguistically diverse (CALD) patients suffering from chest pain and for developing appropriate clinical practice and public awareness for these populations. The current review aimed to determine if there is an association between ethnicity and delay in seeking medical care for chest pain among CALD populations. Patients from different ethnic minority groups presenting to emergency departments (EDs) with chest pain. The current review will examine studies that evaluate the association between ethnicity and delay in seeking medical care for chest pain among CALD populations. The current review will consider quantitative studies including randomized controlled trials (RCTs), non-RCTs, quasi-experimental, before and after studies, prospective and retrospective cohort studies, case-control studies and analytical cross-sectional studies. The current review will consider studies that measure delay time as the main outcome. The time will be measured as the interval between the time of symptom onset and time to reach an ED. A comprehensive search was undertaken for relevant published and unpublished studies written in English with no date restriction. All searches were conducted in October 2014. We searched the following databases: MEDLINE, PubMed, Cochrane Central Register of Controlled Trials, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, ProQuest (health databases only), Informit, Sociological Abstracts, Scopus and Web of Science. The search for unpublished studies included a wide range of 'gray literature' sources including national libraries, digital theses repositories and clinical trial registries. We also targeted specific health research, specialist cardiac, migrant health, and emergency medicine organizational websites and/or conferences. We also checked the reference lists of included studies and contacted authors when further details about reported data was required to make a decision about eligibility. Papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to being included in the review. Validity was assessed using standardized critical appraisal instruments from the Joanna Briggs Institute. Adjudication was produced by the third reviewer. Data were extracted from included articles by two independent reviewers using the standardized data extraction tool from the Joanna Briggs Institute. The extracted data were synthesized into a narrative summary. Meta-analysis could not be performed due to the heterogeneity of study protocols and methods used to measure outcomes. A total of 10 studies, with a total of 1,511,382 participants, investigating the association between ethnicity and delay met the inclusion criteria. Delay times varied across ethnic groups, including Black, Hispanic, Asian, South Asian, Southeast Asian and Chinese. Seven studies reported delay in hours and ranged from 1.90 to 3.10 h. Delay times were longer among CALD populations than the majority population. The other three studies reported delay time in categories of time (e.g. <1, <4 and <6 h) and found larger proportions of later presentations to the EDs among ethnic groups compared with the majority groups. There is evidence of an association between ethnicity and time taken in seeking medical care for chest pain, with patients from some ethnic minorities (e.g. Black, Asian, Hispanic and South Asian) taking longer than those of the majority population. Health promotions and health campaigns focusing on these populations are indicated.
[Cancer chemotherapy with special reference to pharmacokinetics of nitrosoureas].
Wakui, A
1982-08-01
This paper provides an overview of cancer chemotherapy with special reference to the pharmacokinetics of the nitrosoureas. At physiological PH, the chloroethylnitrosoureas can be decomposed into an isocyanate and 2-chloroethyl diazene hydroxide. Therefore, it is clear that they have both alkylation and carbamoylation actions. In addition to the spontaneous chemical dissociation, the nitrosoureas can be metabolized by liver microsomal enzymes to more polar hydroxylated products, and certain nitrosoureas can be denitrosated by these enzymes to the parent urea. Since the lipid-soluble nitrosoureas and some of the water-soluble nitrosoureas such as ACNU and MCNU demonstrated to cross the blood-brain barrier, they have been used in the treatment of primary brain tumors and tumors and tumors of metastatic origin. It has been demonstrated from the results of our study and other reports that the alkylation of DNA by ACNU progresses more slowly as compared with that of other alkylating agents. This is an important finding in relation to the appearance of delayed myelosuppression of the nitrosoureas and in the design of dose schedules of these agents. The major clinical emphasis has been directed towards the more active chloroethylnitrosoureas with reduced myelosuppression, and attempts are now made for this purpose. Unfortunately, the results of phase I and II trials of the newly developed nitrosoureas suggest that these agents produce delayed and cumulative bone marrow toxicity. Antitumor activity of the nitrosoureas is frequestly observed in chronic myelocytic leukemia, malignant lymphoma, brain tumors and small cell carcinoma of the lung, and less frequently in gastrointestinal carcinoma, multiple myeloma and malignant melanoma. In order to enhance clinical effects of the nitrosoureas, further investigation of the design in therapeutic schedules on the basis of their pharmacokinetic characteristics will be needed.
Robust stability of interval bidirectional associative memory neural network with time delays.
Liao, Xiaofeng; Wong, Kwok-wo
2004-04-01
In this paper, the conventional bidirectional associative memory (BAM) neural network with signal transmission delay is intervalized in order to study the bounded effect of deviations in network parameters and external perturbations. The resultant model is referred to as a novel interval dynamic BAM (IDBAM) model. By combining a number of different Lyapunov functionals with the Razumikhin technique, some sufficient conditions for the existence of unique equilibrium and robust stability are derived. These results are fairly general and can be verified easily. To go further, we extend our investigation to the time-varying delay case. Some robust stability criteria for BAM with perturbations of time-varying delays are derived. Besides, our approach for the analysis allows us to consider several different types of activation functions, including piecewise linear sigmoids with bounded activations as well as the usual C1-smooth sigmoids. We believe that the results obtained have leading significance in the design and application of BAM neural networks.
Manickchund, Yashoda; Hadley, G P
2017-10-01
Paediatric surgical disease is a neglected health problem. Patients travel great distances to tertiary level care for management. This study aimed at analysing referral patterns to design an outreach programme for paediatric surgery in KwaZulu Natal. Data forms of patients referred to the service between January and July 2016 were correlated with the clinical record. Delays in management were compared to morbidity and mortality. Out of 781, 158 referrals were accepted as emergencies. The majority (62%) were children aged < 1 year. Gastro-intestinal problems (38.4%) and congenital anomalies (26.9%) formed the majority. Patients who died had a significantly longer delay in transfer. Longer total delay was associated with statistically significant greater morbidity. In a setting where a large rural population is served by single-centre tertiary care, delays exist and contribute to morbidity. The authors advocate the establishment of an outreach programme to address these issues.
Accurate Time/Frequency Transfer Method Using Bi-Directional WDM Transmission
NASA Technical Reports Server (NTRS)
Imaoka, Atsushi; Kihara, Masami
1996-01-01
An accurate time transfer method is proposed using b-directional wavelength division multiplexing (WDM) signal transmission along a single optical fiber. This method will be used in digital telecommunication networks and yield a time synchronization accuracy of better than 1 ns for long transmission lines over several tens of kilometers. The method can accurately measure the difference in delay between two wavelength signals caused by the chromatic dispersion of the fiber in conventional simple bi-directional dual-wavelength frequency transfer methods. We describe the characteristics of this difference in delay and then show that the accuracy of the delay measurements can be obtained below 0.1 ns by transmitting 156 Mb/s times reference signals of 1.31 micrometer and 1.55 micrometers along a 50 km fiber using the proposed method. The sub-nanosecond delay measurement using the simple bi-directional dual-wavelength transmission along a 100 km fiber with a wavelength spacing of 1 nm in the 1.55 micrometer range is also shown.
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.
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.
Correction of ultrasonic wave aberration with a time delay and amplitude filter.
Måsøy, Svein-Erik; Johansen, Tonni F; Angelsen, Bjørn
2003-04-01
Two-dimensional simulations with propagation through two different heterogeneous human body wall models have been performed to analyze different correction filters for ultrasonic wave aberration due to forward wave propagation. The different models each produce most of the characteristic aberration effects such as phase aberration, relatively strong amplitude aberration, and waveform deformation. Simulations of wave propagation from a point source in the focus (60 mm) of a 20 mm transducer through the body wall models were performed. Center frequency of the pulse was 2.5 MHz. Corrections of the aberrations introduced by the two body wall models were evaluated with reference to the corrections obtained with the optimal filter: a generalized frequency-dependent phase and amplitude correction filter [Angelsen, Ultrasonic Imaging (Emantec, Norway, 2000), Vol. II]. Two correction filters were applied, a time delay filter, and a time delay and amplitude filter. Results showed that correction with a time delay filter produced substantial reduction of the aberration in both cases. A time delay and amplitude correction filter performed even better in both cases, and gave correction close to the ideal situation (no aberration). The results also indicated that the effect of the correction was very sensitive to the accuracy of the arrival time fluctuations estimate, i.e., the time delay correction filter.
Factors associated with delayed diagnosis of mood and/or anxiety disorders
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
Marshall, Julie; Goldbart, Juliet; Phillips, Julie
2007-01-01
Parental and speech and language therapist (SLT) explanatory models may affect engagement with speech and language therapy, but there has been dearth of research in this area. This study investigated parents' and SLTs' views about language development, delay and intervention in pre-school children with language delay. The aims were to describe, explore and explain the thoughts, understandings, perceptions, beliefs, knowledge and feelings held by: a group of parents from East Manchester, UK, whose pre-school children had been referred with suspected language delay; and SLTs working in the same area, in relation to language development, language delay and language intervention. A total of 24 unstructured interviews were carried out: 15 with parents whose children had been referred for speech and language therapy and nine with SLTs who worked with pre-school children. The interviews were transcribed verbatim and coded using Atlas/ti. The data were analysed, subjected to respondent validation, and grounded theories and principled descriptions developed to explain and describe parents' and SLTs' beliefs and views. Parent and SLT data are presented separately. There are commonalities and differences between the parents and the SLTs. Both groups believe that language development and delay are influenced by both external and internal factors. Parents give more weight to the role of gender, imitation and personality and value television and videos, whereas the SLTs value the 'right environment' and listening skills and consider that health/disability and socio-economic factors are important. Parents see themselves as experts on their child and have varied ideas about the role of SLTs, which do not always accord with SLTs' views. The parents and SLTs differ in their views of the roles of imitation and play in intervention. Parents typically try strategies before seeing an SLT. These data suggest that parents' ideas vary and that, although parents and SLTs may share some views, there are some important differences. These views have implications for the provision of appropriate services. Although this is a small sample from one group in the UK, the results indicate the need to investigate the views of other groups of parents.
Rectal metastasis from breast cancer: an interval of 17 years.
Amin, Aliasger A; Reddy, Anil; Jha, Madan; Prasad, Kolanu
2011-05-12
Metastasis to gastrointestinal (GI) tract from breast cancer is rare. Commonly affected organ in GI tract is stomach, followed by colon and then rectum. The authors report a case of a 61-year-old woman who had a mastectomy for lobular carcinoma of the breast 17 years ago and was referred to colorectal clinic with increased frequency of stools. Colonoscopy showed a stricture in the rectum, but biopsy was inconclusive. As she was symptomatic, she had a Hartmann's resection 5 months after she initially presented to the clinic. Histopathology of the resected specimen showed it to be metastasis from lobular carcinoma of the breast. Awareness of potential long delays in the presentation of metastatic breast cancer especially lobular carcinoma helps in the earlier diagnosis and clinical management.
Pseudohypoparathyroidism with Hashimoto's thyroiditis and Turner syndrome: a case report.
Zeng, Wen-Heng; Xu, Jiao-Jun; Jia, Min-Yue; Ren, Yue-Zhong
2014-10-01
To report the case of an individual with PHP, Turner syndrome and Hashimoto's thyroiditis. A 16-year-old girl was referred to our hospital with chief complaint of short stature. She presented with round chubby facies, short neck, obesity and short stature. Radiography indicated short metatarsals and metacarpals, which mainly affected the second, third and fourth digits. Biochemistry revealed hyperphosphatemia, increased serum concentrations of parathyroid hormone and thyroid stimulating hormone, elevated levels of follicular-stimulating hormone and prolactin, and increased thyroid peroxidase antibody and thyroglobulin antibody. Radiographic examination revealed delayed bone age and pelvic ultrasonography demonstrated an immature uterus. Karyotype analysis showed 46,X,i(Xq10), while molecular analysis revealed a same sense mutation in exon 5 of GNAS (ATC → ATT, Ile).The specific diagnosis was made of Turner syndrome in the presence of Hashimoto's thyroiditis and PHP. She was treated with calcium supplementation, calcitriol and thyroxine. This is the first case report to describe a combination of Turner syndrome with these other clinical entities, and their co-existence should be considered and further investigated.
Predictors of delay in heart failure patients and consequences for outcomes.
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.
Analysis of ten years of publishing in Pharmacy Practice.
Mendes, Antonio E; Tonin, Fernanda S; Fernandez-Llimos, Fernando
2016-01-01
The aim of this study is to characterize the patterns and trends in the editorial process and features of the first decade of Pharmacy Practice, with the final goal of initiating a benchmarking process to enhance the quality of the journal. Metadata of all of the articles published from 2006 issue #3 to 2016 issue #2 were extracted from PubMed and complemented by a manual data extraction process on the full-text articles. Citations of these articles were retrieved from Web of Science (WOS), Scopus, and Google Scholar on August 15, 2016. The references from all of the articles published by Pharmacy Practice in 2015 were also extracted. International collaboration was explored with a network analysis. A total of 40 issues were published in this timespan, including 349 articles, 91.1% of which were original research articles. The number of citations received by these articles varies from 809, as reported by the WOS, to the 1162 reported by Scopus and the 2610 reported by Google Scholar. The journals cited by Pharmacy Practice are mainly pharmacy journals, including Pharm Pract (Granada), Int J Clin Pharm, Am J Health-Syst Pharm, Am J Pharm Educ, and Ann Pharmacother. Only 17.3% of the articles involved international collaboration. Delays in the editorial process increased in 2013, mainly due to an increase in acceptance delay (mean=138 days). Pharmacy Practice has improved its visibility and impact over the past decade, especially after 2014, when the journal became indexed in PubMed Central. The editorial process duration is one of the weaknesses that should be tackled. Further studies should investigate if the low international collaboration rate is common across other pharmacy journals.
Analysis of ten years of publishing in Pharmacy Practice
Mendes, Antonio E.; Tonin, Fernanda S.; Fernandez-Llimos, Fernando
2016-01-01
Objective: The aim of this study is to characterize the patterns and trends in the editorial process and features of the first decade of Pharmacy Practice, with the final goal of initiating a benchmarking process to enhance the quality of the journal. Methods: Metadata of all of the articles published from 2006 issue #3 to 2016 issue #2 were extracted from PubMed and complemented by a manual data extraction process on the full-text articles. Citations of these articles were retrieved from Web of Science (WOS), Scopus, and Google Scholar on August 15, 2016. The references from all of the articles published by Pharmacy Practice in 2015 were also extracted. International collaboration was explored with a network analysis. Results: A total of 40 issues were published in this timespan, including 349 articles, 91.1% of which were original research articles. The number of citations received by these articles varies from 809, as reported by the WOS, to the 1162 reported by Scopus and the 2610 reported by Google Scholar. The journals cited by Pharmacy Practice are mainly pharmacy journals, including Pharm Pract (Granada), Int J Clin Pharm, Am J Health-Syst Pharm, Am J Pharm Educ, and Ann Pharmacother. Only 17.3% of the articles involved international collaboration. Delays in the editorial process increased in 2013, mainly due to an increase in acceptance delay (mean=138 days). Conclusion: Pharmacy Practice has improved its visibility and impact over the past decade, especially after 2014, when the journal became indexed in PubMed Central. The editorial process duration is one of the weaknesses that should be tackled. Further studies should investigate if the low international collaboration rate is common across other pharmacy journals. PMID:28042357
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.
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 laboratory assessment of the measurement accuracy of weighing type rainfall intensity gauges
NASA Astrophysics Data System (ADS)
Colli, M.; Chan, P. W.; Lanza, L. G.; La Barbera, P.
2012-04-01
In recent years the WMO Commission for Instruments and Methods of Observation (CIMO) fostered noticeable advancements in the accuracy of precipitation measurement issue by providing recommendations on the standardization of equipment and exposure, instrument calibration and data correction as a consequence of various comparative campaigns involving manufacturers and national meteorological services from the participating countries (Lanza et al., 2005; Vuerich et al., 2009). Extreme events analysis is proven to be highly affected by the on-site RI measurement accuracy (see e.g. Molini et al., 2004) and the time resolution of the available RI series certainly constitutes another key-factor in constructing hyetographs that are representative of real rain events. The OTT Pluvio2 weighing gauge (WG) and the GEONOR T-200 vibrating-wire precipitation gauge demonstrated very good performance under previous constant flow rate calibration efforts (Lanza et al., 2005). Although WGs do provide better performance than more traditional Tipping Bucket Rain gauges (TBR) under continuous and constant reference intensity, dynamic effects seem to affect the accuracy of WG measurements under real world/time varying rainfall conditions (Vuerich et al., 2009). The most relevant is due to the response time of the acquisition system and the derived systematic delay of the instrument in assessing the exact weight of the bin containing cumulated precipitation. This delay assumes a relevant role in case high resolution rain intensity time series are sought from the instrument, as is the case of many hydrologic and meteo-climatic applications. This work reports the laboratory evaluation of Pluvio2 and T-200 rainfall intensity measurements accuracy. Tests are carried out by simulating different artificial precipitation events, namely non-stationary rainfall intensity, using a highly accurate dynamic rainfall generator. Time series measured by an Ogawa drop counter (DC) at a field test site located within the Hong Kong International Airport (HKIA) were aggregated at a 1-minute scale and used as reference for the artificial rain generation (Colli et al., 2012). The preliminary development and validation of the rainfall simulator for the generation of variable time steps reference intensities is also shown. The generator is characterized by a sufficiently short time response with respect to the expected weighing gauges behavior in order to ensure effective comparison of the measured/reference intensity at very high resolution in time.
Real-time estimation of ionospheric delay using GPS measurements
NASA Astrophysics Data System (ADS)
Lin, Lao-Sheng
1997-12-01
When radio waves such as the GPS signals propagate through the ionosphere, they experience an extra time delay. The ionospheric delay can be eliminated (to the first order) through a linear combination of L1 and L2 observations from dual-frequency GPS receivers. Taking advantage of this dispersive principle, one or more dual- frequency GPS receivers can be used to determine a model of the ionospheric delay across a region of interest and, if implemented in real-time, can support single-frequency GPS positioning and navigation applications. The research objectives of this thesis were: (1) to develop algorithms to obtain accurate absolute Total Electron Content (TEC) estimates from dual-frequency GPS observables, and (2) to develop an algorithm to improve the accuracy of real-time ionosphere modelling. In order to fulfil these objectives, four algorithms have been proposed in this thesis. A 'multi-day multipath template technique' is proposed to mitigate the pseudo-range multipath effects at static GPS reference stations. This technique is based on the assumption that the multipath disturbance at a static station will be constant if the physical environment remains unchanged from day to day. The multipath template, either single-day or multi-day, can be generated from the previous days' GPS data. A 'real-time failure detection and repair algorithm' is proposed to detect and repair the GPS carrier phase 'failures', such as the occurrence of cycle slips. The proposed algorithm uses two procedures: (1) application of a statistical test on the state difference estimated from robust and conventional Kalman filters in order to detect and identify the carrier phase failure, and (2) application of a Kalman filter algorithm to repair the 'identified carrier phase failure'. A 'L1/L2 differential delay estimation algorithm' is proposed to estimate GPS satellite transmitter and receiver L1/L2 differential delays. This algorithm, based on the single-site modelling technique, is able to estimate the sum of the satellite and receiver L1/L2 differential delay for each tracked GPS satellite. A 'UNSW grid-based algorithm' is proposed to improve the accuracy of real-time ionosphere modelling. The proposed algorithm is similar to the conventional grid-based algorithm. However, two modifications were made to the algorithm: (1) an 'exponential function' is adopted as the weighting function, and (2) the 'grid-based ionosphere model' estimated from the previous day is used to predict the ionospheric delay ratios between the grid point and reference points. (Abstract shortened by UMI.)
Towards an SEMG-based tele-operated robot for masticatory rehabilitation.
Kalani, Hadi; Moghimi, Sahar; Akbarzadeh, Alireza
2016-08-01
This paper proposes a real-time trajectory generation for a masticatory rehabilitation robot based on surface electromyography (SEMG) signals. We used two Gough-Stewart robots. The first robot was used as a rehabilitation robot while the second robot was developed to model the human jaw system. The legs of the rehabilitation robot were controlled by the SEMG signals of a tele-operator to reproduce the masticatory motion in the human jaw, supposedly mounted on the moving platform, through predicting the location of a reference point. Actual jaw motions and the SEMG signals from the masticatory muscles were recorded and used as output and input, respectively. Three different methods, namely time-delayed neural networks, time delayed fast orthogonal search, and time-delayed Laguerre expansion technique, were employed and compared to predict the kinematic parameters. The optimal model structures as well as the input delays were obtained for each model and each subject through a genetic algorithm. Equations of motion were obtained by the virtual work method. Fuzzy method was employed to develop a fuzzy impedance controller. Moreover, a jaw model was developed to demonstrate the time-varying behavior of the muscle lengths during the rehabilitation process. The three modeling methods were capable of providing reasonably accurate estimations of the kinematic parameters, although the accuracy and training/validation speed of time-delayed fast orthogonal search were higher than those of the other two aforementioned methods. Also, during a simulation study, the fuzzy impedance scheme proved successful in controlling the moving platform for the accurate navigation of the reference point in the desired trajectory. SEMG has been widely used as a control command for prostheses and exoskeleton robots. However, in the current study by employing the proposed rehabilitation robot the complete continuous profile of the clenching motion was reproduced in the sagittal plane. Copyright © 2016. Published by Elsevier Ltd.
Demiri, Efterpi C; Dionyssiou, Dimitrios D; Tsimponis, Antonios; Goula, Christina-Olga; Pavlidis, Leonidas C; Spyropoulou, Georgia-Alexandra
2018-06-01
Although free abdominal flaps constitute the gold standard in post-radiation delayed breast reconstruction, latissimus dorsi-based methods offer alternative reconstructive options. This retrospective study aims to compare outcomes of delayed breast reconstruction using the fat-augmented latissimus dorsi (FALD) autologous reconstruction and the latissimus dorsi-plus-implant reconstruction in irradiated women. We reviewed the files of 47 post-mastectomy irradiated patients (aged 29-73 years), who underwent delayed latissimus dorsi-based breast reconstruction between 2010 and 2016. Twenty-three patients (Group A) had an extended FALD flap and twenty-four patients (Group B) an implant-based latissimus dorsi reconstruction. Patients' age, BMI, pregnancies, volume of injected fat, implant size, postoperative complications, and secondary surgical procedures were recorded and analyzed. Age, BMI, pregnancies, and donor-site complications were similar in both groups (p > 0.05). Mean fat volume injected initially was 254 cc (ranged 130-380 cc/session); mean implant volume was 323 cc (ranged 225-420 cc). Breast complications were significantly fewer in Group A (one wound dehiscence, two oily cysts) compared to Group B (three cases with wound dehiscence, two extrusions, thirteen severe capsular contractions). Non-statistically significant difference was documented for secondary procedures between groups; although the mean number of additional surgeries/patient was higher in Group A, they referred to secondary lipofilling, whereas in Group B they were revision surgeries for complications. The FALD flap constitutes an alternative method for delayed autologous reconstruction after post-mastectomy irradiation, avoiding implant-related complications. Although additional fat graft sessions might be required, it provides an ideal autogenous reconstructive option for thin nulliparous women, with a small opposite breast and adequate fat donor sites. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Welsh, John P.; Oristaglio, Jeffrey T.
2016-01-01
Changes in the timing performance of conditioned responses (CRs) acquired during trace and delay eyeblink conditioning (EBC) are presented for diagnostic subgroups of children having autism spectrum disorder (ASD) aged 6–15 years. Children diagnosed with autistic disorder (AD) were analyzed separately from children diagnosed with either Asperger’s syndrome or Pervasive developmental disorder (Asp/PDD) not otherwise specified and compared to an age- and IQ-matched group of children who were typically developing (TD). Within-subject and between-groups contrasts in CR performance on sequential exposure to trace and delay EBC were analyzed to determine whether any differences would expose underlying functional heterogeneities of the cerebral and cerebellar systems, in ASD subgroups. The EBC parameters measured were percentage CRs, CR onset latency, and CR peak latency. Neither AD nor Asp/PDD groups were impaired in CR acquisition during trace or delay EBC. Both AD and Asp/PDD altered CR timing, but not always in the same way. Although the AD group showed normal CR timing during trace EBC, the Asp/PDD group showed a significant 27 and 28 ms increase in CR onset and peak latency, respectively, during trace EBC. In contrast, the direction of the timing change was opposite during delay EBC, during which the Asp/PDD group showed a significant 29 ms decrease in CR onset latency and the AD group showed a larger 77 ms decrease in CR onset latency. Only the AD group showed a decrease in CR peak latency during delay EBC, demonstrating another difference between AD and Asp/PDD. The difference in CR onset latency during delay EBC for both AD and Asp/PDD was due to an abnormal prevalence of early onset CRs that were intermixed with CRs having normal timing, as observed both in CR onset histograms and mean CR waveforms. In conclusion, significant heterogeneity in EBC performance was apparent between diagnostic groups, and this may indicate that EBC performance can report the heterogeneity in the neurobiological predispositions for ASD. The findings will inform further explorations with larger cohorts, different sensory modalities, and different EBC paradigms and provide a reference set for future EBC studies of children having ASD and non-human models. PMID:27563293
The Laser Ablation of Aluminum at 193, 248 and 351 nm
1991-05-01
36, 462 (1965); c. R.K Singh, D. Bhattacharya, and J. Narayan,AppL Phys. Lett. 57, 2022 (1990). 16. R.Welle and H . Helvajian , AIP Conference...function of delay time with the probe laser at a fixed distance from h ,:.,1 disk. Delay times are typically varied from 50ns to 51Ls. Typical velocity...SUj~j GIID10 H ~4~ 2o V V- rn AI!SUGIUaI GAID 00 co to CDo 0O 0O CJ! 0GIU19A 9 References 1. R.K. Singh, AXK Singh, C.B.Lee and J. Narayan, J. Appi
Pagani, G; Thilaganathan, B; Prefumo, F
2014-09-01
The finding of fetal ventriculomegaly is variably associated with other fetal abnormalities and, even when isolated, is thought to be linked to abnormal neurodevelopmental outcome. The aim of this study was to undertake a systematic review and meta-analysis of the current literature to assess the prevalence of neurodevelopmental delay in cases of isolated mild fetal ventriculomegaly, as well as the false-negative rate of prenatal imaging for the diagnosis of associated abnormalities in patients referred for isolated mild ventriculomegaly. Studies that assessed neurodevelopmental outcome in isolated ventriculomegaly were identified from a search of scientific databases. Studies that did not check for karyotype or that excluded cases of bilateral ventriculomegaly were not included in the analysis. Ventriculomegaly was defined as mild when the width of the ventricular atrium was between 10 and 15 mm. Cases in which an associated abnormality (abnormal karyotype, structural abnormality or fetal infection) was observed either before or after birth were not considered as part of the isolated group. Neurodevelopmental delay was defined as an abnormal quotient score, according to the test used. The search yielded 961 possible citations; of these, 904 were excluded by review of the title or abstract as they did not meet the selection criteria. Full manuscripts were retrieved for 57 studies, and 20 were included in the review with a total of 699 cases of isolated mild ventriculomegaly. The overall prevalence of neurodevelopmental delay was 7.9% (95% CI, 4.7-11.1%). Of the 20 studies included in the systematic review, nine reported data on postnatal imaging, showing a prevalence of previously undiagnosed findings of 7.4% (95% CI, 3.1-11.8%). The false-negative rate of prenatal imaging is 7.4% in apparently isolated fetal ventriculomegaly of ≤ 15 mm. The incidence of neurodevelopmental delay in truly isolated ventriculomegaly of ≤ 15 mm is 7.9%. As the latter rate is similar to that noted in the general population, large prospective cohort studies assessing the prevalence of childhood disability, rather than subtle neurodevelopmental delay, are required. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.
Functional performance in young Australian children with achondroplasia.
Ireland, Penelope Jane; McGill, James; Zankl, Andreas; Ware, Robert S; Pacey, Verity; Ault, Jenny; Savarirayan, Ravi; Sillence, David; Thompson, Elizabeth M; Townshend, Sharron; Johnston, Leanne Marie
2011-10-01
The aim of this study was to determine population-specific developmental milestones for independence in self-care, mobility, and social cognitive skills in children with achondroplasia, the most common skeletal dysplasia. Population-based recruitment from October 2008 to October 2010 identified 44 Australian children with achondroplasia aged 3 to 7 years. Consenting parents of 35 children (16 males, 19 females 14 aged 3y; 12 aged 5y; nine aged 7y) reported their child's self-care, mobility, and social cognition function using the Functional Independence Measure for Children (WeeFIM-II) at the ages of 3 (n=14), 5 (n=12), or 7 (n=9) years. Children were excluded from the study if they had an additional neurological or musculoskeletal condition. Functioning improved in children with achondroplasia between the ages of 3 and 5 years, but not subsequently. Milestones in the achondroplasia group were delayed across all ages and domains compared with normative reference data. Children with achondroplasia required greater caregiver assistance for self-care and mobility skills than typically developing children based on normative data. Social cognition appeared to be an area of relative strength. Children up to 7 years of age with achondroplasia show delayed milestone acquisition and a greater need for caregiver assistance for all domains. As functional delays are likely to be related to common musculoskeletal impairments associated with achondroplasia, access to physiotherapists, occupational therapists, and speech and language pathologists skilled in achondroplasia management may assist children and families to become more independent, particularly around the time of starting school. © The Authors. Developmental Medicine & Child Neurology © 2011 Mac Keith Press.
Magnetic FB injuries: an old yet unresolved hazard.
Gregori, Dario; Morra, Bruno; Gulati, Achal
2012-05-14
Among foreign bodies causing injuries in children, magnets have been reported to cause serious complications and being life-threatening. The aim of this study is to design a risk profile and an epidemiological figure of such injuries, for being used for prevention. Data on 366 injuries have been collected from public surveillance databases and from published scientific literature, and compared with the data of the Susy Safe registry, which is a pan-European registry of foreign bodies injuries co-funded by the European Commission. A median age of 48 months was observed, with a 63% prevalence of males is characterizing the injuries. Magnets have a median volume of 87.9 mm(3) vs the median volume of 41.86 mm(3) of the overall foreign bodies of the Susy Safe registry). Only 43% of the magnets were involving only on piece or objects, with a median number of two objects per injury, up to a maximum of 32 objects. Children are referred to the medical care system with a median delay of 3 days after onset of symptoms. Median length of stay in the hospital was 7 days with respect to 1 day as in the Susy Safe registry. Most of complications, and event the death of a child can be eventually re-conducted to either or both a delay in patient referral or appropriate diagnosis. Thus, it is an absolute priority that an information initiative is taken toward families and emergency doctors to avoid unnecessarily delays respectively in patient referral and in diagnosis. Copyright © 2012. Published by Elsevier Ireland Ltd.
The State of Essential Newborn Care by Delivery Location in Bangladesh.
Kim, Eunsoo Timothy; Singh, Kavita
2017-11-01
Introduction Essential newborn care (ENC) around the time of birth is critical in improving neonatal survival. There is currently a gap in our knowledge of the use of ENC by place of delivery in Bangladesh. This study assesses the provision of ENC and examines the odds of newborns receiving ENC by different levels of delivery care in Bangladesh. Methods Descriptive statistics and logistic regressions were performed on ENC practices from the 2011 Bangladesh Demographic and Health Survey dataset. ENC practices included nonapplication of substances to the cord; application of antiseptic to the cord; drying newborn within 5 min; wrapping newborn within 5 min; delaying first bath until the first 72 h; and breastfeeding within 1 h. Key predictors included home delivery with a lay attendant, delivery with primary healthcare services and delivery with higher-level healthcare services. Results Coverage of ENC practices was low. Women who delivered with primary and higher-level healthcare services generally reported greater odds of their newborns receiving recommended ENC than women who had home delivery with a lay attendant, the referent category. However, the odds of delayed first bath until 72 h and breastfeeding within 1 h were not statistically different for newborns who were delivered with primary healthcare services. Discussion These findings have significant public health implications as primary healthcare facilities are the first point of entry into the healthcare system. Provision of ENC, particularly delayed first bath until 72 h and breastfeeding within 1 h, should be encouraged for all healthy mother-newborn pairs in Bangladesh.
Delayed Partial Nephrectomy for Hydronephrosis After Renal Trauma.
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.
Juvenile myelomonocytic leukemia: report of seven cases and review of literature.
Urs, Latha; Qualman, Stephen J; Kahwash, Samir B
2009-01-01
Juvenile myelomonocytic leukemia (JMML) is a rare, aggressive, clonal hematopoietic disorder of childhood with features of both myelodysplasia (thrombocytopenia, anemia) and myeloproliferation (leukocytosis, monocytosis). In most cases there is marrow hypercellularity, splenomegaly, and extramedullary involvement. In 1997 an international consensus on terminology was reached and guidelines/criteria for diagnosis were proposed. A recent World Health Organization classification described the current diagnostic criteria of JMML. Although the diagnosis of JMML has been facilitated, it can be challenging, especially in the early stages or when it 1st presents as an extramedullary tumor. We report a series of 7 cases diagnosed over a period of 10 years (from January 1, 1996, to December 31, 2005). Two cases had interesting associated findings that would potentially lead to delay in diagnosis or misdiagnosis. Two other cases had extramedullary involvement with symptoms referable to the organs of involvement at presentation. Clinical and pathologic findings are summarized with a review of relevant literature.
Primary tuberculosis of the glans penis.
Jimenez Parra, Jose David; Alvarez Bandres, Silvia; Garcia Garcia, Diego; Torres Varas, Lorena; Sotil Arrieta, Amaia; Jimenez Calvo, Jesus
2014-03-01
Tuberculosis of the penis is an extremely rare disease with few cases reported in the literature. We present the case of a 64 year-old man with a whitish papular-ampullary eruption in the glans penis. After antibiotic/antimycotic therapy and several topical ointments for 3 months without response he was referred to our Department. Biopsy of the ulceration edge was performed and pathology result showed a chronic granulomatous inflammatory necrotizing lesion with granulomatous vasculitis lesions, without tumor infiltration. Systemic examination to rule out other tuberculosis foci was negative. With de suspicion of primary tuberculosis of the glans penis, anti tuberculosis therapy with Isoniazid and Piridoxine was started. Within a period of five months the ulceration healed significantly. Currently, the patient is still asymptomatic without glans penis lesions. Primary glans penis tuberculosis is a rare disease, but we must consider it (both primary and secondary forms) to try to avoid diagnostic delays that may cause prejudice for the patient. This condition promptly responds to anti tuberculosis therapy as evidenced by our case and many other reports.
Vaginismus and subfertility: case reports on the association observed in clinical practice.
Ramli, M; Nora, Mz; Roszaman, R; Hatta, S
2012-01-01
To analyse the features of patients with vaginismus first presented to a gynaecologist for infertility before being referred for psychiatric evaluation and management. The case series aim to provide some insight on features and presentations of Asian women with vaginismus. Vaginismus is characterised by persistent or recurrent difficulties in vaginal penetration despite the woman's wish for coitus. Avoidance, phobia, anticipatory fear of pain and involuntary pelvic muscle contraction are the most common symptoms. We report a series of cases of Malaysian women who had been suffering from vaginismus and 'infertility'. All the cases had never been attended to medically and there were long delays in seeking intervention. There was no history of traumatic sexual experience or any major psychiatric illness in these patients. Majority of the patients had prominent symptoms of anxiety. The cases illustrate that it is important to rule out the possibility of vaginismus among patients with infertility. The former have unique psychological features which require psychological interventions.
Risk, benefits and complications of epidural steroid injections: a case report.
Snarr, Jared
2007-06-01
Acute low back pain, radiculopathy, and associated disabilities have a prevalence of 2% in the United States, which represents a significant health problem and a major cause of workplace absence. The condition primarily affects 25- to 45-year-old men and women. Epidural steroid injections (ESIs) are commonly administered to relieve this pain and improve mobility without surgery. This case report presents issues related to the treatment of an epidural hematoma in an 87-year-old man receiving long-term anticoagulant therapy. It reviews the risks, benefits, side effects, complications, and contraindications to ESI and the American Society of Regional Anesthesia consensus recommendations for the performance of neuraxial procedures in patients receiving anticoagulant therapy. It is imperative that any provider who performs ESIs know the risks, benefits, complications, and contraindications for this procedure. Practitioners must also be able to recognize and manage or appropriately refer patients having immediate or delayed complications related to the placement of an ESI.
A review on high-resolution CMOS delay lines: towards sub-picosecond jitter performance.
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.
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.
Kim, Kyungsoo; Lim, Sung-Ho; Lee, Jaeseok; Kang, Won-Seok; Moon, Cheil; Choi, Ji-Woong
2016-01-01
Electroencephalograms (EEGs) measure a brain signal that contains abundant information about the human brain function and health. For this reason, recent clinical brain research and brain computer interface (BCI) studies use EEG signals in many applications. Due to the significant noise in EEG traces, signal processing to enhance the signal to noise power ratio (SNR) is necessary for EEG analysis, especially for non-invasive EEG. A typical method to improve the SNR is averaging many trials of event related potential (ERP) signal that represents a brain’s response to a particular stimulus or a task. The averaging, however, is very sensitive to variable delays. In this study, we propose two time delay estimation (TDE) schemes based on a joint maximum likelihood (ML) criterion to compensate the uncertain delays which may be different in each trial. We evaluate the performance for different types of signals such as random, deterministic, and real EEG signals. The results show that the proposed schemes provide better performance than other conventional schemes employing averaged signal as a reference, e.g., up to 4 dB gain at the expected delay error of 10°. PMID:27322267
NASA Astrophysics Data System (ADS)
Yuan, Y.; Tscherning, C. C.; Knudsen, P.; Xu, G.; Ou, J.
2008-01-01
A new method for modeling the ionospheric delay using global positioning system (GPS) data is proposed, called the ionospheric eclipse factor method (IEFM). It is based on establishing a concept referred to as the ionospheric eclipse factor (IEF) λ of the ionospheric pierce point (IPP) and the IEF’s influence factor (IFF) bar{λ}. The IEF can be used to make a relatively precise distinction between ionospheric daytime and nighttime, whereas the IFF is advantageous for describing the IEF’s variations with day, month, season and year, associated with seasonal variations of total electron content (TEC) of the ionosphere. By combining λ and bar{λ} with the local time t of IPP, the IEFM has the ability to precisely distinguish between ionospheric daytime and nighttime, as well as efficiently combine them during different seasons or months over a year at the IPP. The IEFM-based ionospheric delay estimates are validated by combining an absolute positioning mode with several ionospheric delay correction models or algorithms, using GPS data at an international Global Navigation Satellite System (GNSS) service (IGS) station (WTZR). Our results indicate that the IEFM may further improve ionospheric delay modeling using GPS data.
46 CFR 252.20 - Subsidized and nonsubsidized voyages.
Code of Federal Regulations, 2010 CFR
2010-10-01
..., idleness, delay or lay-up—(i) Report by operator. The operator shall report promptly to the Region Director any reduced crew period and any period of idleness, lay-up or delay occurring during or between... the event the nonsubsidized voyage follows a subsidized period of reduced crew, idleness or lay-up...
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...
Dark-Blood Delayed Enhancement Cardiac Magnetic Resonance of Myocardial Infarction.
Kim, Han W; Rehwald, Wolfgang G; Jenista, Elizabeth R; Wendell, David C; Filev, Peter; van Assche, Lowie; Jensen, Christoph J; Parker, Michele A; Chen, Enn-Ling; Crowley, Anna Lisa C; Klem, Igor; Judd, Robert M; Kim, Raymond J
2017-12-08
This study introduced and validated a novel flow-independent delayed enhancement technique that shows hyperenhanced myocardium while simultaneously suppressing blood-pool signal. The diagnosis and assessment of myocardial infarction (MI) is crucial in determining clinical management and prognosis. Although delayed enhancement cardiac magnetic resonance (DE-CMR) is an in vivo reference standard for imaging MI, an important limitation is poor delineation between hyperenhanced myocardium and bright LV cavity blood-pool, which may cause many infarcts to become invisible. A canine model with pathology as the reference standard was used for validation (n = 22). Patients with MI and normal controls were studied to ascertain clinical performance (n = 31). In canines, the flow-independent dark-blood delayed enhancement (FIDDLE) technique was superior to conventional DE-CMR for the detection of MI, with higher sensitivity (96% vs. 85%, respectively; p = 0.002) and accuracy (95% vs. 87%, respectively; p = 0.01) and with similar specificity (92% vs, 92%, respectively; p = 1.0). In infarcts that were identified by both techniques, the entire length of the endocardial border between infarcted myocardium and adjacent blood-pool was visualized in 33% for DE-CMR compared with 100% for FIDDLE. There was better agreement for FIDDLE-measured infarct size than for DE-CMR infarct size (95% limits-of-agreement, 2.1% vs. 5.5%, respectively; p < 0.0001). In patients, findings were similar. FIDDLE demonstrated higher accuracy for diagnosis of MI than DE-CMR (100% [95% confidence interval [CI]: 89% to 100%] vs. 84% [95% CI: 66% to 95%], respectively; p = 0.03). The study introduced and validated a novel CMR technique that improves the discrimination of the border between infarcted myocardium and adjacent blood-pool. This dark-blood technique provides diagnostic performance that is superior to that of the current in vivo reference standard for the imaging diagnosis of MI. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
40 CFR 798.4100 - Dermal sensitization.
Code of Federal Regulations, 2010 CFR
2010-07-01
... (allergic contact dermatitis) is an immunologically mediated cutaneous reaction to a substance. In the human... the following references should be consulted: (1) Buehler, E.V. “Delayed Contact Hypersensitivity in... Cosmetic Law Journal. 10:722-732 (1955). (3) Klecak, G. “Identification of Contact Allergens: Predictive...
ERIC Educational Resources Information Center
Ayoob, Keith-Thomas; And Others
1994-01-01
Thirteen children (ages 3.1 to 5.2 years) referred for developmental delay and excessive eating (without obesity) were evaluated. Commonalities included being in foster care, prenatal drug exposure, and abnormally withdrawn and/or aggressive behavior. (Author/DB)
Harrison, T.R.
1987-07-10
A proximity fuze system includes an optical ranging apparatus, a detonation circuit controlled by the optical ranging apparatus, and an explosive charge detonated by the detonation circuit. The optical ranging apparatus includes a pulsed laser light source for generating target ranging light pulses and optical reference light pulses. A single lens directs ranging pulses to a target and collects reflected light from the target. An optical fiber bundle is used for delaying the optical reference pulses to correspond to a predetermined distance from the target. The optical ranging apparatus includes circuitry for providing a first signal depending upon the light pulses reflected from the target, a second signal depending upon the light pulses from the optical delay fiber bundle, and an output signal when the first and second signals coincide with each other. The output signal occurs when the distance from the target is equal to the predetermined distance from the target. Additional circuitry distinguishes pulses reflected from the target from background solar radiation. 3 figs.
A delay differential equation model of follicle waves in women.
Panza, Nicole M; Wright, Andrew A; Selgrade, James F
2016-01-01
This article presents a mathematical model for hormonal regulation of the menstrual cycle which predicts the occurrence of follicle waves in normally cycling women. Several follicles of ovulatory size that develop sequentially during one menstrual cycle are referred to as follicle waves. The model consists of 13 nonlinear, delay differential equations with 51 parameters. Model simulations exhibit a unique stable periodic cycle and this menstrual cycle accurately approximates blood levels of ovarian and pituitary hormones found in the biological literature. Numerical experiments illustrate that the number of follicle waves corresponds to the number of rises in pituitary follicle stimulating hormone. Modifications of the model equations result in simulations which predict the possibility of two ovulations at different times during the same menstrual cycle and, hence, the occurrence of dizygotic twins via a phenomenon referred to as superfecundation. Sensitive parameters are identified and bifurcations in model behaviour with respect to parameter changes are discussed. Studying follicle waves may be helpful for improving female fertility and for understanding some aspects of female reproductive ageing.
Lo, Kam W
2016-05-01
The acoustic signal emitted by a turbo-prop aircraft consists of a strong narrowband tone superimposed on a broadband random component. A ground-based three-element planar acoustic array can be used to estimate the full set of flight parameters of a turbo-prop aircraft in transit by measuring the time delay (TD) between the signal received at the reference sensor and the signal received at each of the other two sensors of the array over a sufficiently long period of time. This paper studies the possibility of using instantaneous frequency (IF) measurements from the reference sensor to improve the precision of the flight parameter estimates. A simplified Cramer-Rao lower bound analysis shows that the standard deviations in the estimates of the aircraft velocity and altitude can be greatly reduced when IF measurements are used together with TD measurements. Two flight parameter estimation algorithms that utilize both IF and TD measurements are formulated and their performances are evaluated using both simulated and real data.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Harrison, T.R.
1987-07-10
A proximity fuze system includes an optical ranging apparatus, a detonation circuit controlled by the optical ranging apparatus, and an explosive charge detonated by the detonation circuit. The optical ranging apparatus includes a pulsed laser light source for generating target ranging light pulses and optical reference light pulses. A single lens directs ranging pulses to a target and collects reflected light from the target. An optical fiber bundle is used for delaying the optical reference pulses to correspond to a predetermined distance from the target. The optical ranging apparatus includes circuitry for providing a first signal depending upon the lightmore » pulses reflected from the target, a second signal depending upon the light pulses from the optical delay fiber bundle, and an output signal when the first and second signals coincide with each other. The output signal occurs when the distance from the target is equal to the predetermined distance from the target. Additional circuitry distinguishes pulses reflected from the target from background solar radiation. 3 figs.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Harrison, T.R.
1989-08-22
A proximity fuze system is described. It includes an optical ranging apparatus, a detonation circuit controlled by the optical ranging apparatus, and an explosive charge detonated by the detonation circuit. The optical ranging apparatus includes a pulsed laser light source for generating target ranging light pulses and optical reference light pulses. A single lens directs ranging pulses to a target and collects reflected light from the target. An optical fiber bundle is used for delaying the optical reference pulses to correspond to a predetermined distance from the target. The optical ranging apparatus includes circuitry for providing a first signal dependingmore » upon the light pulses reflected from the target, a second signal depending upon the light pulses from the optical delay fiber bundle, and an output signal when the first and second signals coincide with each other. The output signal occurs when the distance from the target is equal to the predetermined distance from the target. Additional circuitry distinguishes pulses reflected from the target from background solar radiation.« less
Sutton, Katherine S; Stratton, Natalie; Pytyck, Jennifer; Kolla, Nathan J; Cantor, James M
2015-01-01
Hypersexuality remains an increasingly common but poorly understood patient complaint. Despite diversity in clinical presentations of patients referred for hypersexuality, the literature has maintained treatment approaches that are assumed to apply to the entire phenomenon. This approach has proven ineffective, despite its application over several decades. The present study used quantitative methods to examine demographic, mental health, and sexological correlates of common clinical subtypes of hypersexuality referrals. Findings support the existence of subtypes, each with distinct clusters of features. Paraphilic hypersexuals reported greater numbers of sexual partners, more substance abuse, initiation to sexual activity at an earlier age, and novelty as a driving force behind their sexual behavior. Avoidant masturbators reported greater levels of anxiety, delayed ejaculation, and use of sex as an avoidance strategy. Chronic adulterers reported premature ejaculation and later onset of puberty. Designated patients were less likely to report substance abuse, employment, or finance problems. Although quantitative, this article nonetheless presents a descriptive study in which the underlying typology emerged from features most salient in routine sexological assessment. Future studies might apply purely empirical statistical techniques, such as cluster analyses, to ascertain to what extent similar typologies emerge when examined prospectively.
Florea, Simona Mihaela; Faure, Alice; Brunel, Hervé; Girard, Nadine; Scavarda, Didier
2018-06-01
The embryological development of the central nervous system takes place during the neurulation process, which includes primary and secondary neurulation. A new form of dysraphism, named junctional neural tube defect (JNTD), was recently reported, with only 4 cases described in the literature. The authors report a fifth case of JNTD. This 5-year-old boy, who had been operated on during his 1st month of life for a uretero-rectal fistula, was referred for evaluation of possible spinal dysraphism. He had urinary incontinence, clubfeet, and a history of delayed walking ability. MRI showed a spinal cord divided in two, with an upper segment ending at the T-11 level and a lower segment at the L5-S1 level, with a thickened filum terminale. The JNTDs represent a recently classified dysraphism caused by an error during junctional neurulation. The authors suggest that their patient should be included in this category as the fifth case reported in the literature and note that this would be the first reported case of JNTD in association with a lipomatous filum terminale.
Efficacy of Liposuction as a Delay Method for Improving Flap Survival.
Orhan, Erkan; Erol, Yağmur Reyyan; Deren, Orgun; Altun, Serdar; Erdoğan, Bülent
2016-12-01
Flaps are often used in repairing tissue defects and partial or full flap loss is still an important morbidity cause. Several techniques have been tried to increase flap circulation but none of these could replace the delay technique. Our goal in this study is to show the efficacy of liposuction in delay of dorsal rat cutaneous flaps and improvement in flap survival. Twenty-four Wistar rats were used. The rats in group 1 received 9 × 3-sized caudally-based random pattern skin flaps. In group 2, liposuction was done under the tissue island spotted as the flap and after 14 days, standard flap surgery was done. In group 3, surgical delay was done and after 14 days, standard flap surgery was done. In group 4, liposuction was done under the tissue island spotted as the flap and standard flap surgery was done right after the liposuction. The rate of necrotic tissue in group 3 (surgical delay; mean % 13.7) was less than the rate in group 2 (liposuction delay; mean % 15.1), although the difference was not statistically significant. The necrosis rates in group 3 (surgical delay) and group 2 (liposuction delay) were less than the rates in both group 1 (only flap; mean % 41.5) and group 4 (liposuction flap; mean % 40.0) and this difference was statistically significant (p < 0.0001). Liposuction can be an alternative to surgical delay as a less invasive method in the clinic. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Health system delay and its effect on clinical stage of breast cancer: Multicenter study.
Unger-Saldaña, Karla; Miranda, Alfonso; Zarco-Espinosa, Gelasio; Mainero-Ratchelous, Fernando; Bargalló-Rocha, Enrique; Miguel Lázaro-León, Jesús
2015-07-01
The objective of this study was to determine the correlation between health system delay and clinical disease stage in patients with breast cancer. This was a cross-sectional study of 886 patients who were referred to 4 of the largest public cancer hospitals in Mexico City for the evaluation of a probable breast cancer. Data on time intervals, sociodemographic factors, and clinical stage at diagnosis were retrieved. A logistic regression model was used to estimate the average marginal effects of delay on the probability of being diagnosed with advanced breast cancer (stages III and IV). The median time between problem identification and the beginning of treatment was 7 months. The subinterval with the largest delay was that between the first medical consultation and diagnosis (median, 4 months). Only 15% of the patients who had cancer were diagnosed with stage 0 and I disease, and 48% were diagnosed with stage III and IV disease. Multivariate analyses confirmed independent correlations for the means of problem identification, patient delay, health system delay, and age with a higher probability that patients would begin cancer treatment in an advanced stage. In the sample studied, the majority of patients with breast cancer began treatment after a delay. Both patient delays and provider delays were associated with advanced disease. Research aimed at identifying specific access barriers to medical services is much needed to guide the design of tailored health policies that go beyond the promotion of breast care awareness and screening participation to include improvements in health services that facilitate access to timely diagnosis and treatment. © 2015 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.
Seoane, J; Takkouche, B; Varela-Centelles, P; Tomás, I; Seoane-Romero, J M
2012-04-01
To address the contradictory information on the role of delay in diagnosis on head and neck cancer survival. Systematic review and meta-analysis. Search on MEDLINE (1966 to March 2011), EMBASE (1980 to March 2011) and ISI proceedings (from inception to March 2011). The terms used were ('Head and neck cancers') AND ('delay'OR'prognostic'OR'survival') both in MeSH terms and free-text words. The reference lists of the retrieved articles were also revised manually to identify other potentially relevant papers. All searches were independently undertaken by two clinicians and one epidemiologist, and the results merged. Primary and specialised care levels. Meta-analysis of data from papers on the subject published from 1966 to 2011. Survival. After search in Medline and other databases, we computed pooled relative risks (RR) and 95% confidence interval (95%CI) from the 10 studies retrieved. The estimate of the relative risk of mortality related to any diagnostic delay (either patient or professional delay) was 1.34 (95%CI 1.12-1.61). Referral delay was associated with a three-fold increase in mortality. Total delay was marginally related to mortality (RR: 1.04, 95%CI: 1.01-1.07). By anatomic location, pharynx cancer shows the highest association (RR: 1.68, 95%CI: 1.22-2.31). Diagnostic delay is a moderate risk factor of mortality from head and neck cancer. However, part of the effect observed may be due to residual confounding (confounding from unknown variables that are not eliminated by adjustment). © 2012 Blackwell Publishing Ltd.
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.
ERIC Educational Resources Information Center
Avtgis, Theodore A.; Polack, E. Phillips; Martin, Matthew M.; Rossi, Daniel
2010-01-01
Time delays in the treatment and transfer of trauma patients is a contributing factor responsible for many fatalities. Time delays are more characteristic of rural trauma systems due to factors such as greater distance, and delays in accident reporting. Efforts to reduce the trauma transfer process have resulted in many changes in protocol and use…
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...
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.
Wellman, Tyler J.; Winkler, Tilo; Vidal Melo, Marcos F.
2015-01-01
18F-FDG-PET is increasingly used to assess pulmonary inflammatory cell activity. However, current models of pulmonary 18F-FDG kinetics do not account for delays in 18F-FDG transport between the plasma sampling site and the lungs. We developed a three-compartment model of 18F-FDG kinetics that includes a delay between the right heart and the local capillary blood pool, and used this model to estimate regional pulmonary perfusion. We acquired dynamic 18F-FDG scans in 12 mechanically ventilated sheep divided into control and lung injury groups (n=6 each). The model was fit to tracer kinetics in three isogravitational regions-of-interest to estimate regional lung transport delays and regional perfusion. 13NN bolus infusion scans were acquired during a period of apnea to measure regional perfusion using an established reference method. The delayed input function model improved description of 18F-FDG kinetics (lower Akaike Information Criterion) in 98% of studied regions. Local transport delays ranged from 2.0–13.6s, averaging 6.4±2.9s, and were highest in non-dependent regions. Estimates of regional perfusion derived from model parameters were highly correlated with perfusion measurements based on 13NN-PET (R2=0.92, p<0.001). By incorporating local vascular transports delays, this model of pulmonary 18F-FDG kinetics allows for simultaneous assessment of regional lung perfusion, transit times, and inflammation. PMID:25940652
Peebles, Emma; Subbe, Christian P; Hughes, Paul; Gemmell, Les
2012-06-01
Rapid Response Teams aim to accelerate recognition and treatment of acutely unwell patients. Delays in delivery might undermine efficiency of the intervention. Our understanding of the causes of these delays is, as yet, incomplete. To identify modifiable causes of delays in the treatment of critically ill patients outside intensive care with a focus on factors amenable to system design. Review of care records and direct observation with process mapping of care delivered to 17 acutely unwell patients attended by a Rapid Response Team in a District General Hospital in the United Kingdom. Delays were defined as processes with no added value for patient care. Essential diagnostic and therapeutic procedures accounted for only 31% of time of care processes. Causes for delays could be classified into themes as (1) delays in call-out of the Rapid Response Team, (2) problems with team cohesion including poor communication and team efficiency and (3) lack of resources including lack of first line antibiotics, essential equipment, experienced staff and critical care beds. We identified a number of potentially modifiable causes for delays in care of acutely ill patients. Improved process design could include automated call-outs, a dedicated kit for emergency treatment in relevant clinical areas, increased usage of standard operating procedures and staff training using crew resource management techniques. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Obturator externus abscess in a 9-year-old child: A case report and literature review.
de Bodman, Charlotte; Ceroni, Dimitri; Dufour, Justine; Crisinel, Pierre-Alex; Bregou-Bourgeois, Aline; Zambelli, Pierre-Yves
2017-03-01
Obturator pyomyositis is a rare condition in children. Diagnosis is often delayed because of its rarity, and the vagaries of its presentation cause it to be easily be missed. Physicians should therefore familiarize themselves with this condition and consider it as a possible differential diagnosis in patients presenting with an acutely painful hip. Inflammatory syndrome is also frequent among sufferers and the MRI is a very sensitive diagnostic tool for obturator pyomyositis. Additionally, joint fluid aspirations and blood cultures are also useful in identifying the pathogen. The appropriate antibiotic therapy provides a rapid regression of symptoms during the early stage of pyomyositis. In cases of MRI-confirmed abscess, surgical treatment is indicated. Our report focuses on a case of obturator pyomyositis in a 9-year-old boy. The child was febrile for 5 days and could only manage to walk a few steps. His hip range of motion was restricted in all directions. In addition, the patient had presented pain and swelling of his right elbow for a day, with a restriction of motion in the joint. There was a clear inflammatory syndrome. A diagnosis of hip and elbow septic arthritis was suspected, and the child underwent joint aspiration of the both cited joints. The aspiration of the elbow returned pus. Conversely, no effusion was found in the hip aspiration. The administration of empiric intravenous antibiotherapy was started. An MRI revealed an osteomyelitis of the ischio-pubic area associated with a subperiosteal abscess. Subsequently, 3 days after elbow arthrotomy, a surgical treatment was performed on the patient's right hip in order to evacuate the subperiosteal abscess and muscular collection because of the persistence of the patient's symptoms and inflammatory syndrome despite susceptible intravenous antibiotics. Postsurgery the patient showed steady improvement. Such cases demonstrate how diagnosis can be difficult because pelvic pyomyositis is often mistaken for more common pathologies such as septic arthritis, osteomyelitis, or appendicitis. This may delay the diagnosis or refer misdiagnosis. We discuss this rare infection in light of the literature with particular reference to its incidence, clinical features, bacteriological etiology, biological, and radiological presentation, and above all, its treatment.
Speech and language delay in two children: an unusual presentation of hyperthyroidism.
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.
Creatine and guanidinoacetate reference values in a French population.
Joncquel-Chevalier Curt, Marie; Cheillan, David; Briand, Gilbert; Salomons, Gajja S; Mention-Mulliez, Karine; Dobbelaere, Dries; Cuisset, Jean-Marie; Lion-François, Laurence; Des Portes, Vincent; Chabli, Allel; Valayannopoulos, Vassili; Benoist, Jean-François; Pinard, Jean-Marc; Simard, Gilles; Douay, Olivier; Deiva, Kumaran; Tardieu, Marc; Afenjar, Alexandra; Héron, Delphine; Rivier, François; Chabrol, Brigitte; Prieur, Fabienne; Cartault, François; Pitelet, Gaëlle; Goldenberg, Alice; Bekri, Soumeya; Gerard, Marion; Delorme, Richard; Porchet, Nicole; Vianey-Saban, Christine; Vamecq, Joseph
2013-11-01
Creatine and guanidinoacetate are biomarkers of creatine metabolism. Their assays in body fluids may be used for detecting patients with primary creatine deficiency disorders (PCDD), a class of inherited diseases. Their laboratory values in blood and urine may vary with age, requiring that reference normal values are given within the age range. Despite the long known role of creatine for muscle physiology, muscle signs are not necessarily the major complaint expressed by PCDD patients. These disorders drastically affect brain function inducing, in patients, intellectual disability, autistic behavior and other neurological signs (delays in speech and language, epilepsy, ataxia, dystonia and choreoathetosis), being a common feature the drop in brain creatine content. For this reason, screening of PCDD patients has been repeatedly carried out in populations with neurological signs. This report is aimed at providing reference laboratory values and related age ranges found for a large scale population of patients with neurological signs (more than 6 thousand patients) previously serving as a background population for screening French patients with PCDD. These reference laboratory values and age ranges compare rather favorably with literature values for healthy populations. Some differences are also observed, and female participants are discriminated from male participants as regards to urine but not blood values including creatine on creatinine ratio and guanidinoacetate on creatinine ratio values. Such gender differences were previously observed in healthy populations; they might be explained by literature differential effects of testosterone and estrogen in adolescents and adults, and by estrogen effects in prepubertal age on SLC6A8 function. Finally, though they were acquired on a population with neurological signs, the present data might reasonably serve as reference laboratory values in any future medical study exploring abnormalities of creatine metabolism and transport. © 2013 Elsevier Inc. All rights reserved.
Contribution of the community health volunteers in the control of Buruli ulcer in Bénin.
Barogui, Yves Thierry; Sopoh, Ghislain Emmanuel; Johnson, Roch Christian; de Zeeuw, Janine; Dossou, Ange Dodji; Houezo, Jean Gabin; Chauty, Annick; Aguiar, Julia; Agossadou, Didier; Edorh, Patrick A; Asiedu, Kingsley; van der Werf, Tjip S; Stienstra, Ymkje
2014-10-01
Buruli ulcer (BU) is a neglected tropical disease caused by Mycobacterium ulcerans. Usually BU begins as a painless nodule, plaque or edema, ultimately developing into an ulcer. The high number of patients presenting with ulcers in an advanced stage is striking. Such late presentation will complicate treatment and have long-term disabilities as a consequence. The disease is mainly endemic in West Africa. The primary strategy for control of this disease is early detection using community village volunteers. In this retrospective, observational study, information regarding Buruli ulcer patients that reported to one of the four BU centers in Bénin between January 2008 and December 2010 was collected using the WHO/BU01 forms. Information used from these forms included general characteristics of the patient, the results of diagnostic tests, the presence of functional limitations at start of treatment, lesion size, patient delay and the referral system. The role of the different referral systems on the stage of disease at presentation in the hospital was analyzed by a logistic regression analysis. About a quarter of the patients (26.5%) were referred to the hospital by the community health volunteers. In our data set, patients referred to the hospital by community health volunteers appeared to be in an earlier stage of disease than patients referred by other methods, but after adjustment by the regression analysis for the health center, this effect could no longer be seen. The Polymerase Chain Reaction (PCR) for IS2404 positivity rate among patients referred by the community health volunteers was not systematically lower than in patients referred by other systems. This study clarifies the role played by community health volunteers in Bénin, and shows that they play an important role in the control of BU.
Electrically Tunable Optical Delay Lines
2003-04-01
layers [24]. References [1] Bendickson, J. M., J. P. Dowling, and M. Scalora , “Analytic expressions for the electromagnetic mode density in...finite, one-dimensional, photonic band-gap structures,” Phys. Rev. E 53, 4107 (1996). [2] Scalora , M., R. J. Flynn, S. B. Reinhardt, R. L. Fork, M. J
40 CFR 164.50 - Prehearing conference and primary discovery.
Code of Federal Regulations, 2012 CFR
2012-07-01
... possibility of obtaining stipulations of fact and documents which will avoid unnecessary delay; (4) Matters of... any party desires that questions of scientific fact be referred to a committee designated by the National Academy of Sciences. (2) Preparation of questions. On determining an affirmative intent, the...
40 CFR 164.50 - Prehearing conference and primary discovery.
Code of Federal Regulations, 2011 CFR
2011-07-01
... possibility of obtaining stipulations of fact and documents which will avoid unnecessary delay; (4) Matters of... any party desires that questions of scientific fact be referred to a committee designated by the National Academy of Sciences. (2) Preparation of questions. On determining an affirmative intent, the...
40 CFR 164.50 - Prehearing conference and primary discovery.
Code of Federal Regulations, 2010 CFR
2010-07-01
... possibility of obtaining stipulations of fact and documents which will avoid unnecessary delay; (4) Matters of... any party desires that questions of scientific fact be referred to a committee designated by the National Academy of Sciences. (2) Preparation of questions. On determining an affirmative intent, the...
40 CFR 164.50 - Prehearing conference and primary discovery.
Code of Federal Regulations, 2013 CFR
2013-07-01
... possibility of obtaining stipulations of fact and documents which will avoid unnecessary delay; (4) Matters of... any party desires that questions of scientific fact be referred to a committee designated by the National Academy of Sciences. (2) Preparation of questions. On determining an affirmative intent, the...
40 CFR 164.50 - Prehearing conference and primary discovery.
Code of Federal Regulations, 2014 CFR
2014-07-01
... possibility of obtaining stipulations of fact and documents which will avoid unnecessary delay; (4) Matters of... any party desires that questions of scientific fact be referred to a committee designated by the National Academy of Sciences. (2) Preparation of questions. On determining an affirmative intent, the...
Planning Ahead: College Seniors' Concerns about Career-Marriage Conflict.
ERIC Educational Resources Information Center
Barnett, Rosalind Chait; Gareis, Karen C.; James, Jacquelyn Boone; Steele, Jennifer
2003-01-01
Analysis of data from 234 college seniors supported the social-role theory hypothesis. Those whose mothers had worked outside the home were less concerned about career-marriage conflict. Those who planned to delay having a family had fewer concerns about conflict. (Contains 55 references.) (SK)
NASA Technical Reports Server (NTRS)
Lutes, G.; Tu, M.; McWatters, D.
1999-01-01
The Photonic Systems for Antenna Applications Symposium (PSAA) is the primary conference devoted exclusively to the exchange of information on the technology and application of photonics in antenna, phased array, and sensor systems.
Timeliness of lung cancer care in Victoria: a retrospective cohort study.
Evans, Sue M; Earnest, Arul; Bower, Wendy; Senthuren, Meera; McLaughlin, Peta; Stirling, Rob
2016-02-01
To assess factors associated with second-line delays in the management of patients diagnosed with lung cancer. A retrospective cohort study, conducted in six public and two private Victorian hospitals, of 1417 patients aged 18 years or more who were diagnosed between July 2011 and October 2014 with an incident case of lung cancer identified by International Classification of Diseases, 10th revision codes (C34.0-C34.9, Z85.1, Z85.2) on the basis of either a clinical or pathological diagnosis. Time intervals between referral, diagnosis and initial definitive management. The median time from referral to diagnosis was 15 days (interquartile range [IQR], 5-36); from diagnosis to initial definitive management, 30 days (IQR, 6-84); and from referral to initial definitive management, 53 days (IQR, 25-106). Factors that were significantly associated with delay between referral and initial definitive management include declining or not being referred to palliative care (hazard ratio [HR], v patients referred for palliation, 0.73; 95% CI, 0.62-0.86; P < 0.001), and being treated in a public hospital (HR, v patients managed in a private hospital, 0.55; 95% CI, 0.48-0.64; P < 0.001). The median time from referral to initial definitive management in public and private hospitals was 61 days (IQR, 35-118) and 30 days (IQR, 13-76) respectively; 48% of patients in public hospitals waited longer than the British National Health Service target of a maximum 62 days between referral and first definitive treatment. There are significant delays at various stages of the patient journey after referral for initial definitive management. Having a greater understanding of these delays will enable strategies to be developed that improve the timeliness of care for patients with lung cancer.
Transient Deformation of Stable Continental Lithosphere by the 2011 M9.0 Tohoku-Oki Megatrust
NASA Astrophysics Data System (ADS)
Hong, T. K.; Chi, D.
2015-12-01
The Korean Peninsula was dislocated laterally by 1-6cm after the 11 March 2011 M9.0 Tohoku-Oki megathrust at a distance of ~1300 km. These lateral displacements produced apparent tensional stresses of 1-7 kPa in the crust of the peninsula, perturbing the medium. Temporal variation of seismic velocities is investigated to assess the lithospheric responses to the megatrust. The Green's function over inter-station paths are retrieved from ambient noises recorded at broadband seismic stations that are densely deployed over the peninsula. The ambient noises are bandpass-filtered between 0.03 and 0.08 Hz, and spectral whitening and one-bit normalization are applied. The fundamental-mode Rayleigh waves are retrieved by stacking the cross-correlation functions of 10-days-long ambient noises from 2010 to 2015. The traveltime changes of Rayleigh waves with respect to the reference traveltimes are calculated by comparing the stacked cross-correlation functions. The reference Rayleigh waves are calculated by stacking the cross-correlation functions for 4 to 6 months before the megathrust. The traveltime changes are normalized by the inter-station distances. Abrupt traveltime delays are observed right after the megathrust, which are particularly strong along paths subparallel to the great-circle direction to the megathrust. The peak traveltime delay reaches 0.028 s/km, which corresponds to shear velocity decrease of 8.9 %. The traveltime delays are weak along the paths deviated from the great-circle directions. The observation suggests that the transient tension stress field caused longitudinal lithospheric perturbation with preferential mineral orientation and fluid migration, decreasing the seismic velocities. The traveltime delays were recovered with rates of 0.000025 to 0.000059 s/km per day, completing the recovery in several hundred days after the megathrust.
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.
ERIC Educational Resources Information Center
Faja, Susan; Dawson, Geraldine
2015-01-01
We explored internal control of behavior using direct observation and parent report. Previous research has found that both the delay of gratification task and parent-reported effortful control predict later social ability and more positive outcomes in typically developing children. Children with autism spectrum disorder have previously been…
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...
Stassen, Marinke J M; Preeker, N Louise; Ragas, Ad M J; van de Ven, Max W P M; Smolders, Alfons J P; Roeleveld, Nel
2012-06-15
The Pilcomayo River is polluted by tailings and effluents from upstream mining activities, which contain high levels of metals. The Weenhayek live along this river and are likely to have elevated exposure. To assess whether the Weenhayek have increased risk of reproductive and developmental disorders related to elevated metal exposure in comparison with a reference population. We assessed reproductive and developmental outcomes, i.e. fertility, fetal loss, congenital anomalies, and walking onset by means of structured interviews. We sampled hair, water and fish to assess the relative exposure of the Weenhayek. Samples were analyzed for Pb and Cd with ICP-MS techniques. The Weenhayek communities studied had a higher prevalence of small families (OR 2.7, 95% CI 1.3-6.0) and delayed walking onset (OR 2.7, 95% CI 1.4-5.1) than the reference population. Median Pb levels in Weenhayek hair were 2-5 times higher than in the reference population, while Cd levels were not elevated. In water and fish, both Pb and Cd levels were increased in the Weenhayek area. We found indications for increased risks of small families and delayed walking onset among the Weenhayek living along the Pilcomayo River. Lactants form a high risk group for lead exposure. Copyright © 2012 Elsevier B.V. All rights reserved.
Delayed and forgone care for families with chronic conditions in high-deductible health plans.
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.
Dickerson, Jane A; Cole, Bonnie; Conta, Jessie H; Wellner, Monica; Wallace, Stephanie E; Jack, Rhona M; Rutledge, Joe; Astion, Michael L
2014-01-01
Tests that are performed outside of the ordering institution, send-out tests, represent an area of risk to patients because of complexity associated with sending tests out. Risks related to send-out tests include increased number of handoffs, ordering the wrong or unnecessary test, specimen delays, data entry errors, preventable delays in reporting and acknowledging results, and excess financial liability. Many of the most expensive and most misunderstood tests are send-out genetic tests. To design and develop an active utilization management program to reduce the risk to patients and improve value of genetic send-out tests. Send-out test requests that met defined criteria were reviewed by a rotating team of doctoral-level consultants and a genetic counselor in a pediatric tertiary care center. Two hundred fifty-one cases were reviewed during an 8-month period. After review, nearly one-quarter of genetic test requests were modified in the downward direction, saving a total of 2% of the entire send-out bill and 19% of the test requests under management. Ultimately, these savings were passed on to patients. Implementing an active utilization strategy for expensive send-out tests can be achieved with minimal technical resources and results in improved value of testing to patients.
The Parallax of the Red Hypergiant VX Sgr with Accurate Tropospheric Delay Calibration
NASA Astrophysics Data System (ADS)
Xu, Shuangjing; Zhang, Bo; Reid, Mark J.; Menten, Karl M.; Zheng, Xingwu; Wang, Guangli
2018-05-01
We report astrometric results of VLBI phase-referencing observations of 22 GHz H2O masers emission toward the red hypergiant VX Sgr, one of most massive and luminous red hypergiant stars in our Galaxy, using the Very Long Baseline Array. A background source, J1820‑2528, projected 4.°4 from the target VX Sgr, was used as the phase reference. For the low decl. of these sources, such a large separation normally would seriously degrade the relative astrometry. We use a two-step method of tropospheric delay calibration, which combines the VLBI geodetic-block (or Global Positioning System) calibration with an image-optimization calibration, to obtain a trigonometric parallax of 0.64 ± 0.04 mas, corresponding to a distance of {1.56}-0.10+0.11 kpc. The measured proper motion of VX Sgr is 0.36 ± 0.76 and ‑2.92 ± 0.78 mas yr‑1 in the eastward and northward directions. The parallax and proper motion confirms that VX Sgr belong to the Sgr OB1 association. Rescaling bolometric luminosities in the literature to our parallax distance, we find that the luminosity of VX Sgr is (1.95 ± 0.62) × 105 L ⊙, where the uncertainty is dominated by differing photometry measurements.
'Lost to follow up': rethinking delayed and interrupted HIV treatment among married Swazi women.
Dlamini-Simelane, Thandeka T T; Moyer, Eileen
2017-03-01
Through various campaigns and strategies, more women are being tested for HIV in countries with a high prevalence of the virus. Despite the ready availability of treatment at government clinics in sub-Saharan African countries like Swaziland, women consistently report difficulty in maintaining access to treatment. Drawing on two individual case studies selected from a larger study of the so-called leaky cascade in Swaziland, we illustrate the protracted journeys married women undertake to initiate treatment. We demonstrate how women manoeuvre tactically after diagnosis, highlight factors that influence their decisions related to initiating treatment, and detail the actors involved in the decision-making process. Our research shows the persistence of structural factors that inhibit access, including economic constraints, gender inequality and patriarchal social norms. Patients referred as ‘lost to follow up’ are in many cases actively pursuing treatment within a context that includes the biomedical health system, but also extends well beyond it. We argue that the phrase ‘lost to follow up’ conceals the complex social navigation required by women to initiate and maintain access to treatment. Further, we suggest that many of the logistical challenges of monitoring and tracking people with HIV can be better addressed by taking into account the structural and social aspects of delayed treatment initiative.
Phytotoxic effects of Sicyos deppei (Cucurbitaceae) in germinating tomato seeds.
Lara-Núñez, Aurora; Sánchez-Nieto, Sobeida; Luisa Anaya, Ana; Cruz-Ortega, Rocio
2009-06-01
The phytotoxic effect of allelochemicals is referred to as allelochemical stress and it is considered a biotic stress. Sicyos deppei G. Don (Cucurbitaceae) is an allelopathic weed that causes phytotoxicity in Lycopersicon esculentum, delaying seed germination and severely inhibiting radicle growth. This paper reports in in vitro conditions, the effects of the aqueous leachate of S. deppei-throughout tomato germination times-on (1) the dynamics of starch and sugars metabolism, (2) activity and expression of the cell wall enzymes involved in endosperm weakening that allows the protrusion of the radicle, and (3) whether abscisic acid (ABA) is involved in this altered metabolic processes. Results showed that S. deppei leachate on tomato seed germination mainly caused: (1) delay in starch degradation as well as in sucrose hydrolysis; (2) lower activity of sucrose phosphate synthase, cell wall invertase, and alpha-amylase; being sucrose phosphate synthase (SPS) gene expression down-regulated, and the last two up regulated; (3) also, lower activity of endo beta-mannanase, beta-1,3 glucanase, alpha-galactosidase, and exo-polygalacturonase with altered gene expression; and (4) higher content of ABA during all times of germination. The phytotoxic effect of S. deppei aqueous leachate is because of the sum of many metabolic processes affected during tomato seed germination that finally is evidenced by a strong inhibition of radicle growth.
Pancreatic Laceration in a Female Collegiate Soccer Athlete: A Case Report
Powers, Michael E.; Tropeano, Michelle; Priestman, Diana
2013-01-01
Objective: To characterize the diagnosis of pancreatic trauma in an athletic population and to raise awareness among health care providers of the possibility of this life- and organ-threatening injury. Background: An 18-year-old, previously healthy female collegiate soccer athlete sustained a direct blow from an opponent's knee between the left and right upper abdominal quadrants while attempting to head the ball. She initially presented with only minimal nausea and discomfort, but this progressed to abdominal pain, tenderness, spasm, and vomiting. She was referred to the emergency department, where she was diagnosed with a pancreatic laceration. Differential Diagnosis: Duodenal, hepatic, or splenic contusion or laceration; hemorrhagic ovarian cyst. Treatment: The patient underwent a distal pancreatectomy and total splenectomy. Uniqueness: Pancreatic injuries, particularly those severe enough to warrant surgical intervention, are extremely rare in athletes. Conclusions: Recognition of a pancreatic injury can be very challenging outside the hospital setting. This is problematic, because a delay in diagnosis is a significant source of preventable morbidity and mortality after this rare injury. Thus, early identification depends on a high index of suspicion, a thorough examination, and close observation. It is imperative that athletic trainers and other health care professionals be able to identify this condition so that referral and management can occur without delay. PMID:23672392
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.
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.
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
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…
Aviation system capacity : annual report
DOT National Transportation Integrated Search
1993-10-01
The Aviation System Capacity Plan is published annually and, in addition to providing airport delay statistics, serves to identify programs that have potential for increasing capacity and reducing delay.
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.
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.
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
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
Birefringence imaging in biological tissue using polarization sensitive optical coherent tomography
De Boer, Johannes F.; Milner, Thomas E.; Nelson, J. Stuart
2001-01-01
Employing a low coherence Michelson interferometer, two dimensional images of optical birefringence in turbid samples as a function of depth are measured. Polarization sensitive detection of the signal formed by interference of backscattered light from the sample and a mirror or reference plane in the reference arm which defines a reference optical path length, give the optical phase delay between light propagating along the fast and slow axes of the birefringence sample. Images showing the change in birefringence in response to irradiation of the sample are produced as an example of the detection apparatus and methodology. The technique allow rapid, noncontact investigation of tissue or sample diagnostic imaging for various medical or materials procedures.
Application of ray-traced tropospheric slant delays to geodetic VLBI analysis
NASA Astrophysics Data System (ADS)
Hofmeister, Armin; Böhm, Johannes
2017-08-01
The correction of tropospheric influences via so-called path delays is critical for the analysis of observations from space geodetic techniques like the very long baseline interferometry (VLBI). In standard VLBI analysis, the a priori slant path delays are determined using the concept of zenith delays, mapping functions and gradients. The a priori use of ray-traced delays, i.e., tropospheric slant path delays determined with the technique of ray-tracing through the meteorological data of numerical weather models (NWM), serves as an alternative way of correcting the influences of the troposphere on the VLBI observations within the analysis. In the presented research, the application of ray-traced delays to the VLBI analysis of sessions in a time span of 16.5 years is investigated. Ray-traced delays have been determined with program RADIATE (see Hofmeister in Ph.D. thesis, Department of Geodesy and Geophysics, Faculty of Mathematics and Geoinformation, Technische Universität Wien. http://resolver.obvsg.at/urn:nbn:at:at-ubtuw:1-3444, 2016) utilizing meteorological data provided by NWM of the European Centre for Medium-Range Weather Forecasts (ECMWF). In comparison with a standard VLBI analysis, which includes the tropospheric gradient estimation, the application of the ray-traced delays to an analysis, which uses the same parameterization except for the a priori slant path delay handling and the used wet mapping factors for the zenith wet delay (ZWD) estimation, improves the baseline length repeatability (BLR) at 55.9% of the baselines at sub-mm level. If no tropospheric gradients are estimated within the compared analyses, 90.6% of all baselines benefit from the application of the ray-traced delays, which leads to an average improvement of the BLR of 1 mm. The effects of the ray-traced delays on the terrestrial reference frame are also investigated. A separate assessment of the RADIATE ray-traced delays is carried out by comparison to the ray-traced delays from the National Aeronautics and Space Administration Goddard Space Flight Center (NASA GSFC) (Eriksson and MacMillan in http://lacerta.gsfc.nasa.gov/tropodelays, 2016) with respect to the analysis performances in terms of BLR results. If tropospheric gradient estimation is included in the analysis, 51.3% of the baselines benefit from the RADIATE ray-traced delays at sub-mm difference level. If no tropospheric gradients are estimated within the analysis, the RADIATE ray-traced delays deliver a better BLR at 63% of the baselines compared to the NASA GSFC ray-traced delays.
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
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.
There's Little Return for Attentional Momentum
ERIC Educational Resources Information Center
Snyder, Janice J.; Schmidt, William C.; Kingstone, Alan
2009-01-01
Inhibition of return (IOR) refers to a delay in response time (RT) to targets appearing at a previously cued location. The prevailing view is that IOR reflects visual-motor inhibition. The "attentional momentum" account rejects this idea, and instead proposes that IOR reflects an automatic shift of attention away from the cued location…
Children with SLI Exhibit Delays Resolving Ambiguous Reference
ERIC Educational Resources Information Center
Estis, Julie M.; Beverly, Brenda L.
2015-01-01
Fast mapping weaknesses in children with specific language impairment (SLI) may be explained by differences in disambiguation, mapping an unknown word to an unnamed object. The impact of language ability and linguistic stimulus on disambiguation was investigated. Sixteen children with SLI (8 preschool, 8 school-age) and sixteen typically…
NASA Astrophysics Data System (ADS)
Long, GuiLu; Qin, Wei; Yang, Zhe; Li, Jun-Lin
2018-05-01
In our article [1] we made a mistake in citing ref. [32], which is the same as ref. [28]. We now replace ref. [32] with the correct reference "L. Hao, D. Liu, and G. L. Long, Sci. China Phys. Mech. Astron. 53, 1765 (2010)" [2].
ERIC Educational Resources Information Center
de Bruin, Anique B. H.; Thiede, Keith W.; Camp, Gino; Redford, Joshua
2011-01-01
The ability to monitor understanding of texts, usually referred to as metacomprehension accuracy, is typically quite poor in adult learners; however, recently interventions have been developed to improve accuracy. In two experiments, we evaluated whether generating delayed keywords prior to judging comprehension improved metacomprehension accuracy…
Reducing Flight Delays Act of 2013
Sen. Collins, Susan M. [R-ME
2013-04-25
Senate - 04/25/2013 Read twice and referred to the Committee on Commerce, Science, and Transportation. (All Actions) Notes: For further action, see H.R.1765, which became Public Law 113-9 on 5/1/2013. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
Dynamical Behaviors in Complex-Valued Love Model With or Without Time Delays
NASA Astrophysics Data System (ADS)
Deng, Wei; Liao, Xiaofeng; Dong, Tao
2017-12-01
In this paper, a novel version of nonlinear model, i.e. a complex-valued love model with two time delays between two individuals in a love affair, has been proposed. A notable feature in this model is that we separate the emotion of one individual into real and imaginary parts to represent the variation and complexity of psychophysiological emotion in romantic relationship instead of just real domain, and make our model much closer to reality. This is because love is a complicated cognitive and social phenomenon, full of complexity, diversity and unpredictability, which refers to the coexistence of different aspects of feelings, states and attitudes ranging from joy and trust to sadness and disgust. By analyzing associated characteristic equation of linearized equations for our model, it is found that the Hopf bifurcation occurs when the sum of time delays passes through a sequence of critical value. Stability of bifurcating cyclic love dynamics is also derived by applying the normal form theory and the center manifold theorem. In addition, it is also shown that, for some appropriate chosen parameters, chaotic behaviors can appear even without time delay.
Lee, Cha Gon; Park, Sang-Jin; Yim, Shin-Young; Sohn, Young Bae
2013-08-01
Potocki-Lupski syndrome (PTLS [MIM 610883]) is a recently recognized microduplication syndrome associated with 17p11.2. It is characterized by mild facial dysmorphic features, hypermetropia, infantile hypotonia, failure to thrive, mental retardation, autistic spectrum disorders, behavioral abnormalities, sleep apnea, and cardiovascular anomalies. In several studies, the critical PTLS region was deduced to be 1.3Mb in length, and included RAI1 and 17 other genes. We report a 3-year-old Korean boy with the smallest duplication in 17p11.2 and a milder phenotype. He had no family history of neurologic disease or developmental delay and no history of seizure, autistic features, or behavior problems. He showed subtle facial dysmorphic features (dolichocephaly and a mildly asymmetric smile) and flat feet. All laboratory tests were normal and he had no evidence of internal organ anomalies. He was found to have mild intellectual disabilities (full scale IQ 65 on K-WPPSI) and language developmental delay (age of 2.2year-old on PRESS). Array comparative genomic hybridization (CGH) showed about a 0.25Mb microduplication on chromosome 17p11.2 containing four Refseq (NCBI reference sequence) genes, including RAI1 [arr 17p11.2(17,575,978-17,824,623)×3]. When compared with previously reported cases, the milder phenotype of our patient may be associated with the smallest duplication in 17p11.2, 0.25Mb in length. Copyright © 2012 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
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.
Milne, Susan; McDonald, Jenny; Comino, Elizabeth J
2012-02-01
In response to concerns that the Bayley Scales of Infant and Toddler Development III (BSIDIII) underestimate delay in clinical populations, this study explores developmental quotient scores as an alternative to composite scores for these children. One hundred and twenty-two children aged ≤42 months, referred for diagnosis of developmental disability from January 2007 to May 2010, were assessed, and their composite and developmental quotient scores on each scale were compared. Composite scores identified only 22% (cognitive), 27% (motor), and 47.5% (language) of children as having a developmental disability. Developmental quotient scores were significantly lower than composite scores, giving rates of developmental disability of 56.6% (cognitive), 48.4% (motor), and 74.6% (language) and more closely matching both clinical impressions of delay and the proportions of those children who were also delayed on standardized tests of adaptive function.
Patterns of Early Skill Attainment and Loss in Young Children with Autism
Thurm, Audrey; Manwaring, Stacy S.; Luckenbaugh, David A.; Lord, Catherine; Swedo, Susan E.
2015-01-01
The purpose of this study was to extend the literature on the ontogeny of autism spectrum disorder (ASD) by examining early attainment and loss of specific sociocommunicative skills in children with autism (AUT; n = 125), pervasive developmental disorder not otherwise specified (PDD-NOS; n = 42), nonspectrum developmental delays (n = 46), and typical development (n = 31). The ages of skill attainment and loss were obtained from a caregiver interview. The findings indicated that children with AUT, PDD-NOS, and developmental delays diverged from typically developing children in attainment of sociocommunicative skills early in the first year of life. Loss of at least one skill was reported in a majority of children with AUT and PDD-NOS. Significant delays in attainment of skills were also reported in children who lost skills. The wide variation in skill attainment and loss reported across children indicates that symptom onset and regression may be best represented continuously, with at least some early delay and loss present for a great majority of children with ASD. PMID:24274034
Patterns of skill attainment and loss in young children with autism.
Thurm, Audrey; Manwaring, Stacy S; Luckenbaugh, David A; Lord, Catherine; Swedo, Susan E
2014-02-01
The purpose of this study was to extend the literature on the ontogeny of autism spectrum disorder (ASD) by examining early attainment and loss of specific sociocommunicative skills in children with autism (AUT; n = 125), pervasive developmental disorder not otherwise specified (PDD-NOS; n = 42), nonspectrum developmental delays (n = 46), and typical development (n = 31). The ages of skill attainment and loss were obtained from a caregiver interview. The findings indicated that children with AUT, PDD-NOS, and developmental delays diverged from typically developing children in attainment of sociocommunicative skills early in the first year of life. Loss of at least one skill was reported in a majority of children with AUT and PDD-NOS. Significant delays in attainment of skills were also reported in children who lost skills. The wide variation in skill attainment and loss reported across children indicates that symptom onset and regression may be best represented continuously, with at least some early delay and loss present for a great majority of children with ASD.
Coles, Meredith E; Sharkey, Katherine M
2011-06-15
Individuals with treatment-resistant obsessive compulsive disorder (OCD) have elevated rates of delayed sleep phase. This report describes a patient with severe OCD who had failed prior trials of pharmacotherapy and psychotherapy, and whose symptoms were associated with delayed bedtimes and delays in the time she initiated her nighttime compulsions. Case report. A 54 year-old woman with OCD kept sleep/symptom logs as an adjunct to traditional cognitive-behavioral therapy for OCD. At presentation, she reported habitual bedtime = 06:00, wake time = 13:00, sleep latency ' 5 min, and total sleep time = 6.5-7.5 h. Later time of initiating her compulsions was associated with longer time performing the compulsions (r = 0.86, p < 0.001). Cognitive-behavioral therapy with adjunctive chronotherapy was associated with substantial improvement. OCD patients with nighttime compulsions may receive light exposure that results in delayed sleep times/circadian phase. Chronotherapy may enhance outcomes for refractory OCD patients, particularly those who perform compulsions at night.
Lian, Wee Bin; Ho, Selina Kah Ying
2012-12-01
There has been a rising trend in childhood developmental and behavioural disorders (CDABD). This study reports the profile of children with autistic spectrum disorders (ASD) initially referred for evaluation of CDABD. The CDABD database prospectively collected data of all consenting children referred in 2003 to the then Child Development Unit at KK Women's and Children's Hospital. All received medical consultation, followed by further assessments and intervention. Patients were tracked for one year. Among 542 referred children, 32% (n = 170) received a diagnosis of ASD one year after the first consultation. Most were male, with a male to female ratio of 4.5:1. The median age at the first consultation was 41 (19,109) months. The main presenting concern was a delay in the development of speech and language skills in 78% of the children. A significant number had behavioural (63%) and social interaction (34%) issues. Criteria for the diagnosis of ASD according to the Diagnostic Statistical Manual IV-Revised were fulfilled in almost 90%. With the remaining refusing or deferring evaluation, only 74% received a psychological assessment. ASD was assessed to be severe or moderate in 86% of the children. Three-quarters remained on follow-up one year after the first consultation. The majority were referred for either centre- or school-based intervention programmes, with 70% assessed to have improved at the one-year mark. This is the first presentation of local data that aids programme planning and resource allocation. Children with ASD have varied outcomes. It is important to identify and intervene early in order to optimise development and functionality.
Endometrioid Adenocarcinoma Arising from Endometriosis of the Uterine Cervix: A Case Report
Park, Han Moie; Lee, Sang Soo; Eom, Dae Woon; Kang, Gil Hyun; Yi, Sang Wook
2009-01-01
Endometrioid adenocarcinoma arising from endometriosis of the uterine cervix is rare in premenopausal woman. We describe here a patient with this condition and review the clinical and pathological features of these tumors. A 48-yr-old woman complaining of severe dysmenorrhea was referred for investigation of a pelvic mass. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. Histological examination revealed an endometrioid adenocarcinoma directly adjacent to the endometriosis at the uterine cervix, with a transition observed between endometriosis and endometrioid adenocarcinoma. The patient was diagnosed as having endometrioid adenocarcinoma arising from endometriosis of the uterine cervix and underwent postoperative chemotherapy. Gynecologists and pathologists should be aware of the difficulties associated with a delay in diagnosis of endometrioid adenocarcinoma arising from endometriosis when the tumor presents as a benign looking endometrioma. PMID:19654969
Towards Dynamic Contrast Specific Ultrasound Tomography
NASA Astrophysics Data System (ADS)
Demi, Libertario; van Sloun, Ruud J. G.; Wijkstra, Hessel; Mischi, Massimo
2016-10-01
We report on the first study demonstrating the ability of a recently-developed, contrast-enhanced, ultrasound imaging method, referred to as cumulative phase delay imaging (CPDI), to image and quantify ultrasound contrast agent (UCA) kinetics. Unlike standard ultrasound tomography, which exploits changes in speed of sound and attenuation, CPDI is based on a marker specific to UCAs, thus enabling dynamic contrast-specific ultrasound tomography (DCS-UST). For breast imaging, DCS-UST will lead to a more practical, faster, and less operator-dependent imaging procedure compared to standard echo-contrast, while preserving accurate imaging of contrast kinetics. Moreover, a linear relation between CPD values and ultrasound second-harmonic intensity was measured (coefficient of determination = 0.87). DCS-UST can find clinical applications as a diagnostic method for breast cancer localization, adding important features to multi-parametric ultrasound tomography of the breast.
Towards Dynamic Contrast Specific Ultrasound Tomography.
Demi, Libertario; Van Sloun, Ruud J G; Wijkstra, Hessel; Mischi, Massimo
2016-10-05
We report on the first study demonstrating the ability of a recently-developed, contrast-enhanced, ultrasound imaging method, referred to as cumulative phase delay imaging (CPDI), to image and quantify ultrasound contrast agent (UCA) kinetics. Unlike standard ultrasound tomography, which exploits changes in speed of sound and attenuation, CPDI is based on a marker specific to UCAs, thus enabling dynamic contrast-specific ultrasound tomography (DCS-UST). For breast imaging, DCS-UST will lead to a more practical, faster, and less operator-dependent imaging procedure compared to standard echo-contrast, while preserving accurate imaging of contrast kinetics. Moreover, a linear relation between CPD values and ultrasound second-harmonic intensity was measured (coefficient of determination = 0.87). DCS-UST can find clinical applications as a diagnostic method for breast cancer localization, adding important features to multi-parametric ultrasound tomography of the breast.
Towards Dynamic Contrast Specific Ultrasound Tomography
Demi, Libertario; Van Sloun, Ruud J. G.; Wijkstra, Hessel; Mischi, Massimo
2016-01-01
We report on the first study demonstrating the ability of a recently-developed, contrast-enhanced, ultrasound imaging method, referred to as cumulative phase delay imaging (CPDI), to image and quantify ultrasound contrast agent (UCA) kinetics. Unlike standard ultrasound tomography, which exploits changes in speed of sound and attenuation, CPDI is based on a marker specific to UCAs, thus enabling dynamic contrast-specific ultrasound tomography (DCS-UST). For breast imaging, DCS-UST will lead to a more practical, faster, and less operator-dependent imaging procedure compared to standard echo-contrast, while preserving accurate imaging of contrast kinetics. Moreover, a linear relation between CPD values and ultrasound second-harmonic intensity was measured (coefficient of determination = 0.87). DCS-UST can find clinical applications as a diagnostic method for breast cancer localization, adding important features to multi-parametric ultrasound tomography of the breast. PMID:27703251
Solar UV-A and UV-B radiation fluxes at two Alpine stations at different altitudes
NASA Astrophysics Data System (ADS)
Blumthaler, M.; Ambach, W.; Rehwald, W.
1992-03-01
Daily totals of UV-A and UV-B radiation fluxes and global radiation were measured since 1981 at Jungfraujoch (3576 m) a.s.l.) and in Innsbruck (577 m a.s.l.) in their seasonal course. The altitude effect of annual totals yields 19%/1000 m (UV-B), 11%/1000 m (UV-A) and 9%/1000 m (global radiation) with reference to Innsbruck station. The ratio of the daily totals of UV-B/global radiation shows a significant seasonal course with the maximum in summer, whereas the ratio of the daily totals of UV-A/global radiation shows no significant seasonal variation. The biological effective doses of erythema reaction, delayed tanning and immediate tanning by UV-A and UV-B radiant exposure are reported in the seasonal course at Jungfraujoch and in Innsbruck.
NASA Astrophysics Data System (ADS)
Deng, Liansheng; Jiang, Weiping; Li, Zhao; Chen, Hua; Wang, Kaihua; Ma, Yifang
2017-02-01
Higher-order ionospheric (HOI) delays are one of the principal technique-specific error sources in precise global positioning system analysis and have been proposed to become a standard part of precise GPS data processing. In this research, we apply HOI delay corrections to the Crustal Movement Observation Network of China's (CMONOC) data processing (from January 2000 to December 2013) and furnish quantitative results for the effects of HOI on CMONOC coordinate time series. The results for both a regional reference frame and global reference frame are analyzed and compared to clarify the HOI effects on the CMONOC network. We find that HOI corrections can effectively reduce the semi-annual signals in the northern and vertical components. For sites with lower semi-annual amplitudes, the average decrease in magnitude can reach 30 and 10 % for the northern and vertical components, respectively. The noise amplitudes with HOI corrections and those without HOI corrections are not significantly different. Generally, the HOI effects on CMONOC networks in a global reference frame are less obvious than the results in the regional reference frame, probably because the HOI-induced errors are smaller in comparison to the higher noise levels seen when using a global reference frame. Furthermore, we investigate the combined contributions of environmental loading and HOI effects on the CMONOC stations. The largest loading effects on the vertical displacement are found in the mid- to high-latitude areas. The weighted root mean square differences between the corrected and original weekly GPS height time series of the loading model indicate that the mass loading adequately reduced the scatter on the CMONOC height time series, whereas the results in the global reference frame showed better agreements between the GPS coordinate time series and the environmental loading. When combining the effects of environmental loading and HOI corrections, the results with the HOI corrections reduced the scatter on the observed GPS height coordinates better than the height when estimated without HOI corrections, and the combined solutions in the regional reference frame indicate more preferred improvements. Therefore, regional reference frames are recommended to investigate the HOI effects on regional networks.
Computing the Algebraic Immunity of Boolean Functions on the SRC-6 Reconfigurable Computer
2012-03-01
and Budget, Paperwork Reduction Project (0704-0188) Washington DC 20503. 1. AGENCY USE ONLY (Leave blank) 2 . REPORT DATE March 2012 3. REPORT... CA 93943-5000 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING /MONITORING AGENCY NAME(S) AND ADDRESS(ES) N/A 10. SPONSORING...developed for this conversion. This reduced form requires many fewer gates and has ( )n delay versus ( 2 ) n delay for a full transeunt triangle
A Web-Based System for Early Detection of Symptoms of Depression
ERIC Educational Resources Information Center
Pandya, Bhairavi D.
2013-01-01
Background: According to data reported by the World Health Organization Depression is a common disorder, affecting about 121 million people worldwide. The Centers for Disease Control report in the US an estimated 10% of the general population will experience a depressive episode in a given year. Delay in diagnosis and subsequent delay in treatment…
Immediate and delayed recall of a small-scale spatial array.
Tlauka, Michael; Donaldson, Phillip; Bonnar, Daniel
2015-01-01
The study examined people's spatial memory of a small-scale array of objects. Earlier work has primarily relied on short-retention intervals, and to date it is not known whether performance is affected by longer intervals between learning and recall. In the present investigation, university students studied seven target objects. Recall was tested immediately after learning and after an interval of seven days. Performance was found to be similar in the immediate and delayed conditions, and the results suggested that recall was facilitated by egocentric and intrinsic cues. The findings are discussed with reference to recent investigations that have shown task parameters can influence spatial recall.
Thibodeau, Marie-Pierre; Miller, Bruce L
2013-01-01
This article is a translation of a French article by Delay, Brion, and Escourolle. In a seminal article published in French in 1957 these authors summarized the work of previous researchers and reviewed a wide sample of frontotemporal dementia (FTD) cases formerly referred to as Pick's disease. The authors were among the first to define the critical clinical and anatomical differences between Alzheimer's disease (AD) and FTD and they even delineated distinctive FTD subtypes making possible the advances that now constitute the base of our studies. Reviewing their work allows us to appreciate the progress research has made.
Craft, D V; Good, R P
1994-06-01
The number of arthroscopic procedures performed annually for the management of intraarticular injuries has grown at an exponential rate. Whether done with the patient under general anesthesia or local anesthesia supplemented with intravenous sedation, it is common practice to postoperatively inject each portal as well as the joint with a local anesthetic to provide pain relief in the transition to the recovery room and discharge after outpatient surgery. To our knowledge, no previous reports of localized urticaria and delayed hypersensitivity reaction have been reported in the postarthroscopy setting. We are reporting a case of delayed hypersensitivity reaction and urticaria of the knee that presented after bupivacaine (Marcaine) injection of arthroscopic portals after routine meniscectomy.
Risk factors for delay in symptomatic presentation: a survey of cancer patients
Forbes, L J L; Warburton, F; Richards, M A; Ramirez, A J
2014-01-01
Background: Delay in symptomatic presentation leading to advanced stage at diagnosis may contribute to poor cancer survival. To inform public health approaches to promoting early symptomatic presentation, we aimed to identify risk factors for delay in presentation across several cancers. Methods: We surveyed 2371 patients with 15 cancers about nature and duration of symptoms using a postal questionnaire. We calculated relative risks for delay in presentation (time from symptom onset to first presentation >3 months) by cancer, symptoms leading to diagnosis and reasons for putting off going to the doctor, controlling for age, sex and deprivation group. Results: Among 1999 cancer patients reporting symptoms, 21% delayed presentation for >3 months. Delay was associated with greater socioeconomic deprivation but not age or sex. Patients with prostate (44%) and rectal cancer (37%) were most likely to delay and patients with breast cancer least likely to delay (8%). Urinary difficulties, change of bowel habit, systemic symptoms (fatigue, weight loss and loss of appetite) and skin symptoms were all common and associated with delay. Overall, patients with bleeding symptoms were no more likely to delay presentation than patients who did not have bleeding symptoms. However, within the group of patients with bleeding symptoms, there were significant differences in risk of delay by source of bleeding: 35% of patients with rectal bleeding delayed presentation, but only 9% of patients with urinary bleeding. A lump was a common symptom but not associated with delay in presentation. Twenty-eight percent had not recognised their symptoms as serious and this was associated with a doubling in risk of delay. Embarrassment, worry about what the doctor might find, being too busy to go to the doctor and worry about wasting the doctor's time were also strong risk factors for delay, but were much less commonly reported (<6%). Interpretation: Approaches to promote early presentation should aim to increase awareness of the significance of cancer symptoms and should be designed to work for people of the lowest socioeconomic status. In particular, awareness that rectal bleeding is a possible symptom of cancer should be raised. PMID:24918824
Effect of delayed reporting of band recoveries on survival estimates
Anderson, David R.; Burnham, Kenneth P.
1980-01-01
Brownie et al. (U.S. Fish and Wildl. Serv., Resource Publ. 131, 1978) presented 14 models based on an array of explicit assumptions for the study of survival in avian populations. These methods are replacing the life table methods previously used to estimate survival rates (e.g., Burnham and Anderson, J. Wildl. Manage., 43: 356-366, 1979). The new methods allow survival or recovery rates, or both, to be constant, time-specific, or time- and age-specific. In studies to estimate survival rates for birds the data are often from recoveries of birds shot or found dead during the hunting season and reported to the Bird Banding Laboratory by sportsmen, conservation agency employees, or the general public. This note examines the bias in estimating annual survival due to a proportion of the recoveries being incorrectly reported a year late. Specifically, a few recoveries each year of, for example, adult male American Widgeon (Anas americana) banded in California are reported as being recovered in year i + 1 when in fact they were actually recovered the previous year i. Delayed reporting might typically be caused by people finding a band in their health clothing in the fall of the year and, being embarrassed about their failure to report the band when it was taken, report it a year late not mentioning the actual year of recovery. Heuristically, delayed reporting should bias estimated annual survival rates upwards because it appears from the data that the birds corresponding to the "delayed" recoveries actually lived an additional year.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-19
... and analyze air traffic delays. Wheels-up and wheels-down times are used in conjunction with departure and arrival times to show the extent of ground delays. Actual elapsed flight time, wheels-down minus wheels- up time, is compared to scheduled elapsed flight time to identify airborne delays. The reporting...
ERIC Educational Resources Information Center
Bernheimer, Lucinda P.; Keogh, Barbara K.; Guthrie, Donald
2006-01-01
We report on a 20-year follow-up of 30 children with developmental delays identified at age 3. Our purpose was to assess the relationship of early indicators of delay to cognitive and personal-social status in young adulthood. Predictors were Developmental and Personal-Social factors derived from standardized tests and parent questionnaires…
Landeiro, F; Leal, J; Gray, A M
2016-02-01
Delayed discharges represent an inefficient use of acute hospital beds. Social isolation and referral to a public-funded rehabilitation unit were significant predictors of delayed discharges while admission from an institution was a protective factor for older hip fracture patients. Preventing delays could save between 11.2 and 30.7 % of total hospital costs for this patient group. Delayed discharges of older patients from acute care hospitals are a major challenge for administrative, humanitarian, and economic reasons. At the same time, older people are particularly vulnerable to social isolation which has a detrimental effect on their health and well-being with cost implications for health and social care services. The purpose of the present study was to determine the impact and costs of social isolation on delayed hospital discharge. A prospective study of 278 consecutive patients aged 75 or older with hip fracture admitted, as an emergency, to the Orthopaedics Department of Hospital Universitário de Santa Maria, Portugal, was conducted. A logistic regression model was used to examine the impact of relevant covariates on delayed discharges, and a negative binomial regression model was used to examine the main drivers of days of delayed discharges. Costs of delayed discharges were estimated using unit costs from national databases. Mean age at admission was 85.5 years and mean length of stay was 13.1 days per patient. Sixty-two (22.3 %) patients had delayed discharges, resulting in 419 bed days lost (11.5 % of the total length of stay). Being isolated or at a high risk of social isolation, measured with the Lubben social network scale, was significantly associated with delayed discharges (odds ratio (OR) 3.5) as was being referred to a public-funded rehabilitation unit (OR 7.6). These two variables also increased the number of days of delayed discharges (2.6 and 4.9 extra days, respectively, holding all else constant). Patients who were admitted from an institution were less likely to have delayed discharges (OR 0.2) with 5.5 fewer days of delay. Total costs of delayed discharges were between 11.2 and 30.7 % of total costs (€2352 and €9317 per patient with delayed discharge) conditional on whether waiting costs for placement in public-funded rehabilitation unit were included. High risk of social isolation, social isolation and referral to public-funded rehabilitation units increase delays in patients' discharges from acute care hospitals.
Kirby, Kris N; Petry, Nancy M
2004-04-01
To test a prediction of the discounting model of impulsiveness that discount rates would be positively associated with addiction. The delay-discount rate refers to the rate of reduction in the present value of a future reward as the delay to that reward increases. We estimated participants' discount rates on the basis of their pattern of choices between smaller immediate rewards ($11-80) and larger, delayed rewards ($25-85; at delays from 1 week to 6 months) in a questionnaire format. Participants had a one-in-six chance of winning a reward that they chose on one randomly selected trial. Heroin (n = 27), cocaine (n = 41) and alcohol (n = 33) abusers and non-drug-using controls (n = 44) were recruited from advertisements. They were tested in a drug abuse research clinic at a medical school. On average, the cocaine and heroin groups had higher rates than controls (both P < 0.001), but alcoholics did not (P = 0.44). Abstinence was associated with lower rates for heroin abusers (P = 0.03), but not for cocaine or alcohol abusers (both P > 0.50). These data suggest that discount rates vary with the preferred drug of abuse, and that high discount rates should be considered in the development of substance abuse prevention and treatment efforts.
Temporal horizon: modulation by smoking status and gender
Jones, Bryan A.; Landes, Reid D.; Yi, Richard; Bickel, Warren K.
2009-01-01
Recently, delay discounting has been argued to be conceptually consistent with the notion of temporal horizon (Bickel et al., 2008). Temporal horizon refers to the temporal distance over which behavioral events or objects can influence behavior. Here we examine the results on two putative measures of temporal horizon, future time perspective (FTP) and delay discounting, collected over three separate studies (n = 227), to determine the influence of smoking and gender on temporal horizon. By comparing the results on these temporal horizon measures we address our population of interest: women who smoke. One of the measures of FTP indicates that smoking women have a shorter temporal horizon than their nonsmoking counterparts. Additionally, the story completion measures of FTP are positively correlated with delay discounting. In contrast, results of delay discounting measures showed no difference between smoking women and nonsmoking women, while results of delay discounting measures indicated smoking men have a shorter temporal horizon than non-smoking men. Additionally, the results of the FTP story completion measure indicated that lower third income earners had a shortened temporal horizon compared to upper third income earners. A possible explanation for these results is explored, and the implications of the modulation of temporal horizon by gender and smoking are discussed. PMID:19446407
Li, Zhijun; Su, Chun-Yi
2013-09-01
In this paper, adaptive neural network control is investigated for single-master-multiple-slaves teleoperation in consideration of time delays and input dead-zone uncertainties for multiple mobile manipulators carrying a common object in a cooperative manner. Firstly, concise dynamics of teleoperation systems consisting of a single master robot, multiple coordinated slave robots, and the object are developed in the task space. To handle asymmetric time-varying delays in communication channels and unknown asymmetric input dead zones, the nonlinear dynamics of the teleoperation system are transformed into two subsystems through feedback linearization: local master or slave dynamics including the unknown input dead zones and delayed dynamics for the purpose of synchronization. Then, a model reference neural network control strategy based on linear matrix inequalities (LMI) and adaptive techniques is proposed. The developed control approach ensures that the defined tracking errors converge to zero whereas the coordination internal force errors remain bounded and can be made arbitrarily small. Throughout this paper, stability analysis is performed via explicit Lyapunov techniques under specific LMI conditions. The proposed adaptive neural network control scheme is robust against motion disturbances, parametric uncertainties, time-varying delays, and input dead zones, which is validated by simulation studies.
Assessment Regarding Impact of Atmospheric Conditions on Space Shuttle Launch Delays
NASA Technical Reports Server (NTRS)
Johnson D. L.; Pearson, S. D.; Vaughan, W. W.; Batts, G. W.
1998-01-01
The atmospheric environment definition has played a key role in the development and operation of the NASA Space Shuttle as it has in other NASA Space Vehicle Programs. The objective of any definition of natural environment design requirements for a space vehicle development is to insure that the vehicle will perform safely and in a timely manner relative to the mission(s) for which the vehicle is being developed. The NASA Space Shuttle has enjoyed the longest tenure of any Space Vehicle from an operational standpoint. As such, it has provided a wealth of information on many engineering aspects of a Space Vehicle plus the influence of the atmosphere on operational endeavors. The atmospheric environment associated with the NASA Space Shuttle launches at the NASA Kennedy Space Center in Florida has been reviewed and studied over the entire NASA Space Shuttle flight history. The results of the analysis of atmospheric environment related launch delays relative to other sources of launch delays has been assessed. This paper will provide a summary of those conditions as well as mission analysis examples focused on atmospheric constraints for launch. Atmospheric conditions associated with NASA Space Shuttle launch delays will be presented to provide a reference as to the type conditions experienced which have mainly caused the delays.
NASA Astrophysics Data System (ADS)
Magri, Fabien; Möller, Sebastian; Inbar, Nimrod; Siebert, Christian; Möller, Peter; Rosenthal, Eliyahu; Kühn, Michael
2015-04-01
It has been shown that thermal convection in faults can also occur for subcritical Rayleigh conditions. This type of convection develops after a certain period and is referred to as "delayed convection" (Murphy, 1979). The delay in the onset is due to the heat exchange between the damage zone and the surrounding units that adds a thermal buffer along the fault walls. Few numerical studies investigated delayed thermal convection in fractured zones, despite it has the potential to transport energy and minerals over large spatial scales (Tournier, 2000). Here 3D numerical simulations of thermally driven flow in faults are presented in order to investigate the impact of delayed convection on deep fluid processes at basin-scale. The Tiberias Basin (TB), in the Jordan Rift Valley, serves as study area. The TB is characterized by upsurge of deep-seated hot waters along the faulted shores of Lake Tiberias and high temperature gradient that can locally reach 46 °C/km, as in the Lower Yarmouk Gorge (LYG). 3D simulations show that buoyant flow ascend in permeable faults which hydraulic conductivity is estimated to vary between 30 m/yr and 140 m/yr. Delayed convection starts respectively at 46 and 200 kyrs and generate temperature anomalies in agreement with observations. It turned out that delayed convective cells are transient. Cellular patterns that initially develop in permeable units surrounding the faults can trigger convection also within the fault plane. The combination of these two convective modes lead to helicoidal-like flow patterns. This complex flow can explain the location of springs along different fault traces of the TB. Besides being of importance for understanding the hydrogeological processes of the TB (Magri et al., 2015), the presented simulations provide a scenario illustrating fault-induced 3D cells that could develop in any geothermal system. References Magri, F., Inbar, N., Siebert, C., Rosenthal, E., Guttman, J., Möller, P., 2015. Transient simulations of large-scale hydrogeological processes causing temperature and salinity anomalies in the Tiberias Basin. Journal of Hydrology, 520(0), 342-355. Murphy, H.D., 1979. Convective instabilities in vertical fractures and faults. Journal of Geophysical Research: Solid Earth, 84(B11), 6121-6130. Tournier, C., Genthon, P., Rabinowicz, M., 2000. The onset of natural convection in vertical fault planes: consequences for the thermal regime in crystalline basementsand for heat recovery experiments. Geophysical Journal International, 140(3), 500-508.
Gullate, Mary
2006-01-01
African American women (AAW) are 25% more likely to present with late stage breast cancer and 20% more likely to die from their disease than Caucasian women. Researchers report that a treatment delay of 3 months is a significant factor in breast cancer mortality. Socioeconomic factors, lack of access and knowledge, spiritual and religious beliefs, fear and fatalism are reported as contributing factors to screening delays. Studies have primarily applied the Health Belief Model (HBM) and modified versions like the Champion HBM to preventive health practices. Neither have significant inclusion of spirituality or religiosity. The TRA/TPB focus on beliefs, intent and attitude as individual determinants of the likelihood of performing a specific behavior; but have not had wide utility in studies related to screening delays among AAW. This paper explores the utility of applying the TRA/TPB as the theoretical framework for determining cultural relevance of spirituality and religiosity to screening delays among AAW.
Language Delay in 3-Year-Old Children With ADHD Symptoms.
Rohrer-Baumgartner, Nina; Zeiner, Pål; Eadie, Patricia; Egeland, Jens; Gustavson, Kristin; Reichborn-Kjennerud, Ted; Aase, Heidi
2016-10-01
Little is known about cognition in preschoolers with ADHD and language delay (LD). The objective was to investigate cognitive functions in preschoolers with ADHD symptoms and LD compared with children with ADHD symptoms only and to estimate the frequency of children with ADHD symptoms, co-occurring language delay, and delays on cognitive measures. Participants were recruited from the Norwegian Mother and Child Cohort Study. The teacher report of expressive language and the cognitive tests from 119 3-year-old children with parent reported ADHD symptoms and LD were compared with those of 258 children with ADHD symptoms only. The ADHD + LD group performed significantly worse than the ADHD group on most language-related measures. There were no differences between the groups on most nonverbal measures. Single measures had a limited potential of differentiating between the groups. ADHD symptoms and co-occurring LD in preschoolers were characterized by cognitive deficits associated with both disorders, not with global neurodevelopmental delay. © The Author(s) 2013.
Spofford, Lisa; Dimian, Adele; Tervo, Raymond; MacLean, William E.; Symons, Frank J.
2016-01-01
Objective To compare the prevalence of self-injurious behavior (SIB) and stereotyped motor behavior (STY) of preschool-aged children with developmental delays (DD group) and their peers without developmental delays (TD group) using a standardized caregiver report scale. Methods The Repetitive Behavior Scale-Revised was completed by caregivers of children with developmental delays and their peers without developmental delays. Frequency of occurrence and severity ratings for SIB and STY were compared between groups. Results SIB and STY were reported more often and at a greater level of severity in the DD group. Older chronological age was associated with more severe STY in the DD group but not the TD group. Gender was not related to STY or SIB for either group. Conclusions Differences in STY and SIB were evident between preschoolers with and without DD. Findings are discussed from developmental and behavioral psychology perspectives regarding the expression of repetitive behavior in developmentally at-risk pediatric populations. PMID:26514642
Wellman, Tyler J; Winkler, Tilo; Vidal Melo, Marcos F
2015-11-01
¹⁸F-FDG-PET is increasingly used to assess pulmonary inflammatory cell activity. However, current models of pulmonary ¹⁸F-FDG kinetics do not account for delays in ¹⁸F-FDG transport between the plasma sampling site and the lungs. We developed a three-compartment model of ¹⁸F-FDG kinetics that includes a delay between the right heart and the local capillary blood pool, and used this model to estimate regional pulmonary perfusion. We acquired dynamic ¹⁸F-FDG scans in 12 mechanically ventilated sheep divided into control and lung injury groups (n = 6 each). The model was fit to tracer kinetics in three isogravitational regions-of-interest to estimate regional lung transport delays and regional perfusion. ¹³NN bolus infusion scans were acquired during a period of apnea to measure regional perfusion using an established reference method. The delayed input function model improved description of ¹⁸F-FDG kinetics (lower Akaike Information Criterion) in 98% of studied regions. Local transport delays ranged from 2.0 to 13.6 s, averaging 6.4 ± 2.9 s, and were highest in non-dependent regions. Estimates of regional perfusion derived from model parameters were highly correlated with perfusion measurements based on ¹³NN-PET (R² = 0.92, p < 0.001). By incorporating local vascular transports delays, this model of pulmonary ¹⁸F-FDG kinetics allows for simultaneous assessment of regional lung perfusion, transit times, and inflammation.
Observations on early and delayed colostomy closure.
Tade, A O; Salami, B A; Ayoade, B A
2011-06-01
Traditional treatment of a variety of colorectal pathologies had included a diverting colostomy that was closed eight or more weeks later during a readmission. The aim of this retrospective study was to determine the outcomes of early colostomy closure and delayed colostomy closure in patients with temporary colostomies following traumatic and non-traumatic colorectal pathologies. In this study early colostomy closure was the closure of a colostomy within three weeks of its construction, while delayed colostomy closure referred to closure after 3 weeks. Complete records of the 37 adult patients who had temporary colostomy constructed and closed between Jan. 1997 December 2003 for various colorectal pathologies were studied. Fourteen patients had early colostomy closure while 23 had delayed closure. In the early colostomy closure group there were 10 men and 4 women. The mean age of the patients was 28yr with a range of 18-65yr. Colostomies were closed 9-18 days after initial colostomy construction. There was no mortality. Morbidity rate 28.6% (4 out of 14). There were two faecal fistulas (14.3%). Twenty-three patients had delayed colostomy closure 8 weeks to 18 months after initial colostomy construction. These were patients unfit for early surgery after initial colostomy construction because of carcinoma, significant weight loss, or sepsis. There was no mortality. Morbidity rate was 26.1%. There were 3 faecal fistulas (13.2%). Outcomes following early colostomy closure and delayed closure were comparable. Patients fit for surgery should have early closure whilst patients who may have compromised health should have delayed closure.
Typical versus delayed speech onset influences verbal reporting of autistic interests.
Chiodo, Liliane; Majerus, Steve; Mottron, Laurent
2017-01-01
The distinction between autism and Asperger syndrome has been abandoned in the DSM-5. However, this clinical categorization largely overlaps with the presence or absence of a speech onset delay which is associated with clinical, cognitive, and neural differences. It is unknown whether these different speech development pathways and associated cognitive differences are involved in the heterogeneity of the restricted interests that characterize autistic adults. This study tested the hypothesis that speech onset delay, or conversely, early mastery of speech, orients the nature and verbal reporting of adult autistic interests. The occurrence of a priori defined descriptors for perceptual and thematic dimensions were determined, as well as the perceived function and benefits, in the response of autistic people to a semi-structured interview on their intense interests. The number of words, grammatical categories, and proportion of perceptual / thematic descriptors were computed and compared between groups by variance analyses. The participants comprised 40 autistic adults grouped according to the presence ( N = 20) or absence ( N = 20) of speech onset delay, as well as 20 non-autistic adults, also with intense interests, matched for non-verbal intelligence using Raven's Progressive Matrices. The overall nature, function, and benefit of intense interests were similar across autistic subgroups, and between autistic and non-autistic groups. However, autistic participants with a history of speech onset delay used more perceptual than thematic descriptors when talking about their interests, whereas the opposite was true for autistic individuals without speech onset delay. This finding remained significant after controlling for linguistic differences observed between the two groups. Verbal reporting, but not the nature or positive function, of intense interests differed between adult autistic individuals depending on their speech acquisition history: oral reporting of intense interests was characterized by perceptual dominance for autistic individuals with delayed speech onset and thematic dominance for those without. This may contribute to the heterogeneous presentation observed among autistic adults of normal intelligence.
Wu, Huali; Yoon, Miyoung; Verner, Marc-André; Xue, Jianping; Luo, Man; Andersen, Melvin E; Longnecker, Matthew P; Clewell, Harvey J
2015-09-01
An association between serum levels of two perfluoroalkyl substances (PFAS) and delayed age at menarche was reported in a cross-sectional study of adolescents. Because perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) have half-lives of years, growth dilution and the development of a new route of excretion (menstruation) could account for some or all of the reported association. To assess how much of the epidemiologic association between PFAS and delayed menarche can be explained by the correlation of growth and maturation with PFAS body burden. We developed a Monte Carlo (MC) physiologically-based pharmacokinetic (PBPK) model of PFAS to simulate plasma PFAS levels in a hypothetical female population aged 2 to 20years old. Realistic distributions of physiological parameters as well as timing of growth spurts and menarche were incorporated in the model. The association between PFAS level and delayed menarche in the simulated data was compared with the reported association. The prevalence of menarche, distributions of age-dependent physiological parameters, and quartiles of serum PFAS concentrations in the simulated subjects were comparable to those reported in the epidemiologic study. The delay of menarche in days per natural log increase in PFAS concentrations in the simulated data were about one third as large as the observed values. The reported relationship between PFAS and age at menarche appears to be at least partly explained by pharmacokinetics rather than a toxic effect of these substances. Copyright © 2015 Elsevier Ltd. All rights reserved.
Johnson, Matthew W; Bruner, Natalie R
2013-08-01
The Sexual Discounting Task uses the delay discounting framework to examine sexual HIV risk behavior. Previous research showed task performance to be significantly correlated with self-reported HIV risk behavior in cocaine dependence. Test-retest reliability and gender differences had remained unexamined. The present study examined the test-retest reliability of the Sexual Discounting Task. Cocaine-dependent individuals (18 men, 13 women) completed the task in two laboratory visits ∼7 days apart. Participants selected photographs of individuals with whom they were willing to have casual sex. Among these, participants identified the individual most (and least) likely to have a sexually transmitted infection (STI), and the individual with whom he or she most (and least) wanted to have sex. In reference to these individuals, participants rated their likelihood of having unprotected sex versus waiting to have sex with a condom, at various delays. A money delay discounting task was also completed at the first visit. Significant differences in discounting among partner conditions were shown. Differential stability was demonstrated by significant, positive correlations between test and retest for all four partner conditions. Absolute stability was demonstrated by statistical equivalence tests between test and retest, and also supported by a lack of significant differences between test and retest. Men generally discounted significantly more than women for sexual outcomes but not money. Results suggest the Sexual Discounting Task to be a reliable measure in cocaine-dependent individuals, which supports its use as a repeated measure in clinical research, for example, studies examining acute drug effects on sexual risk and the effects of addiction treatment and HIV prevention interventions on sexual risk. PsycINFO Database Record (c) 2013 APA, all rights reserved
Attosecond Delays in Molecular Photoionization.
Huppert, Martin; Jordan, Inga; Baykusheva, Denitsa; von Conta, Aaron; Wörner, Hans Jakob
2016-08-26
We report measurements of energy-dependent photoionization delays between the two outermost valence shells of N_{2}O and H_{2}O. The combination of single-shot signal referencing with the use of different metal foils to filter the attosecond pulse train enables us to extract delays from congested spectra. Remarkably large delays up to 160 as are observed in N_{2}O, whereas the delays in H_{2}O are all smaller than 50 as in the photon-energy range of 20-40 eV. These results are interpreted by developing a theory of molecular photoionization delays. The long delays measured in N_{2}O are shown to reflect the population of molecular shape resonances that trap the photoelectron for a duration of up to ∼110 as. The unstructured continua of H_{2}O result in much smaller delays at the same photon energies. Our experimental and theoretical methods make the study of molecular attosecond photoionization dynamics accessible.
Dorell, Christina; Yankey, David; Jeyarajah, Jenny; Stokley, Shannon; Fisher, Allison; Markowitz, Lauri; Smith, Philip J
2014-03-01
Human papillomavirus (HPV) vaccine coverage among girls is low. We used data reported by parents of 4103 girls, 13 to 17 years old, to assess associations with, and reasons for, delaying or refusing HPV vaccination. Sixty-nine percent of parents neither delayed nor refused vaccination, 11% delayed only, 17% refused only, and 3% both delayed and refused. Eighty-three percent of girls who delayed only, 19% who refused only, and 46% who both delayed and refused went on to initiate the vaccine series or intended to initiate it within the next 12 months. A significantly higher proportion of parents of girls who were non-Hispanic white, lived in households with higher incomes, and had mothers with higher education levels, delayed and/or refused vaccination. The most common reasons for nonvaccination were concerns about lasting health problems from the vaccine, wondering about the vaccine's effectiveness, and believing the vaccine is not needed.
ERIC Educational Resources Information Center
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…
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.
Factors Associated with Delayed Ejection in Mishaps Between 1993 and 2013.
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.
Delayed splenic rupture presenting 70 days following blunt abdominal trauma.
Resteghini, Nancy; Nielsen, Jonpaul; Hoimes, Matthew L; Karam, Adib R
2014-01-01
Delayed splenic rupture following conservative management of splenic injury is an extremely rare complication. We report a case of an adult patient who presented with delayed splenic rupture necessitating splenectomy, 2 months following blunt abdominal trauma. Imaging at the initial presentation demonstrated only minimal splenic contusion and the patient was discharge following 24 hours of observation. © 2014.
ERIC Educational Resources Information Center
Park, So-Youn; Glidden, Laraine M.; Shin, Jin Y.
2010-01-01
Background: This study reports development of a social support scale appropriate to the Vietnamese culture and the impact of social support on mothers of children with cognitive delays by using the developing scale. Method: Interview surveys were conducted with 225 mothers of children with and without cognitive delays in Vietnam. The structural…
Collado, Anahí; Johnson, Patrick S; Loya, Jennifer M; Johnson, Matthew W; Yi, Richard
2017-10-01
The study examined sexual delay discounting, or the devaluation of condom-protected sex in the face of delay, as a risk factor for sexually transmitted infection (STI) among college students. Participants (143 females, 117 males) completed the sexual delay discounting task (Johnson & Bruner, 2012) and questionnaires of risky sexual behavior, risk perception, and knowledge. Participants exhibited steeper sexual delay discounting (above and beyond general likelihood of having unprotected sex) when partners were viewed as more desirable or less likely to have a STI, with males demonstrating greater sexual delay discounting than females across most conditions. Importantly, greater self-reported risky sexual behaviors were associated with higher rates of sexual delay discounting, but not with likelihood of using a condom in the absence of delay. These results provide support for considering sexual delay discounting, with particular emphasis on potential delays to condom use, as a risk factor for STI among college students.
A Case Report of Cushing's Disease Presenting as Hair Loss
Lefkowitz, Emily G.; Cossman, Jack P.; Fournier, John B.
2017-01-01
Cushing's syndrome is a rare endocrine disorder that comprises a large group of signs and symptoms resulting from chronic exposure to excess corticosteroids. Most cases of Cushing's syndrome are due to increased adrenocorticotropic hormone production from a pituitary adenoma, which is referred to as Cushing's disease. Most of the signs and symptoms are nonspecific and common in the general population, making a diagnosis often challenging. However, several dermatological manifestations, such as fragile skin, easy bruising, and reddish purple striae, are more discriminatory. Because uncontrolled Cushing's syndrome of any etiology is associated with substantial morbidity, including increased cardiovascular disease and mortality, it is important to make an early diagnosis. Unfortunately, median delays of 2 years to diagnosis have been reported. We report a case of a woman who had multiple dermatological findings, including facial plethora, easy bruising, violaceous striae, hirsutism, and acne, the latter 2 signs reflecting androgen excess. Of interest, our patient presented with a chief complaint of hair loss, a common complaint in the general population that occurs with a greater frequency in patients with Cushing's disease and is attributed to androgenetic alopecia, but it is rarely the presenting symptom. PMID:28413388
A Case Report of Cushing's Disease Presenting as Hair Loss.
Lefkowitz, Emily G; Cossman, Jack P; Fournier, John B
2017-01-01
Cushing's syndrome is a rare endocrine disorder that comprises a large group of signs and symptoms resulting from chronic exposure to excess corticosteroids. Most cases of Cushing's syndrome are due to increased adrenocorticotropic hormone production from a pituitary adenoma, which is referred to as Cushing's disease. Most of the signs and symptoms are nonspecific and common in the general population, making a diagnosis often challenging. However, several dermatological manifestations, such as fragile skin, easy bruising, and reddish purple striae, are more discriminatory. Because uncontrolled Cushing's syndrome of any etiology is associated with substantial morbidity, including increased cardiovascular disease and mortality, it is important to make an early diagnosis. Unfortunately, median delays of 2 years to diagnosis have been reported. We report a case of a woman who had multiple dermatological findings, including facial plethora, easy bruising, violaceous striae, hirsutism, and acne, the latter 2 signs reflecting androgen excess. Of interest, our patient presented with a chief complaint of hair loss, a common complaint in the general population that occurs with a greater frequency in patients with Cushing's disease and is attributed to androgenetic alopecia, but it is rarely the presenting symptom.
ERIC Educational Resources Information Center
Wilson, L. R.
1975-01-01
This study, by comparing for learning disabled and control children parental frequency rating of physical punishment and of completion of tasks, hypothesized that parental indulgence is associated with learning disorders. Referral children with learning problems (N=18), were rated significantly lower on both measures that students referred for…
The Half-Second Delay: What Follows?
ERIC Educational Resources Information Center
Wiliam, Dylan
2006-01-01
There is an increasing body of evidence that only a minuscule proportion of the sensory data processed by the unconscious mind (capable of processing approximately 11 million bits per second) is referred to the conscious mind (capable of processing approximately 50 bits per second). It is also clear that conscious awareness of stimuli from the…
ERIC Educational Resources Information Center
Fussner, Hannah
2004-01-01
In this paper I reflect on claims that artifacts, as alternatives to texts, can provide an effective means of access to learning. With reference to the work of Walter Benjamin, I analyse the role the aura of a ritual object played in engaging a group of Year 6 students, all of whom experienced various degrees of delayed literacy. Drawing on…
Mentoring Graduate Students: The Good, Bad, and Gray
ERIC Educational Resources Information Center
Ballantine, Jeanne H.; Jolly-Ballantine, John-Andrew
2015-01-01
Good mentoring of graduate students influences their perseverance and success to completion, whereas bad mentoring can result in negative outcomes, including delayed degree completion or non-completion. What the authors refer to as the gray zone is that which falls between good and bad mentoring. Examples are partial mentoring or changes in…
Does Delaying Judgments of Learning Really Improve the Efficacy of Study Decisions? Not So Much
ERIC Educational Resources Information Center
Kimball, Daniel R.; Smith, Troy A.; Muntean, William J.
2012-01-01
A widely held assumption in metamemory is that better, more accurate metamemory monitoring leads to better, more efficacious restudy decisions, reflected in better memory performance--we refer to this causal chain as the "restudy selectivity hypothesis". In 3 sets of experiments, we tested this hypothesis by factorially manipulating…
Children's Visual Processing of Egocentric Cues in Action Planning for Reach
ERIC Educational Resources Information Center
Cordova, Alberto; Gabbard, Carl
2011-01-01
In this study the authors examined children's ability to code visual information into an egocentric frame of reference for planning reach movements. Children and adults estimated reach distance via motor imagery in immediate and response-delay conditions. Actual maximum reach was compared to estimates in multiple locations in peripersonal and…
Localization suppression and fusion measure of the precedence effect in young children
NASA Astrophysics Data System (ADS)
Litovsky, Ruth; Godar, Shelly; Yu, Gongqiang
2004-05-01
This study investigated aspects of the precedence effect (PE) known as fusion and localization dominance in children 4-5 years of age. Stimuli were three, 25-ms noise bursts (2-ms rise/fall times) with 250-ms ISI. On PE conditions the lead stimulus was presented from one of six locations in azimuth, and the lag was at 0 deg. Lead-lag delays varied from 5 to 100 ms. Localization was measured using an identification paradigm. Fusion was measured separately whereby subjects reported whether a single auditory event or two auditory events were perceived. Children reported two sounds on 75% of trials (fusion threshold) at delays ranging from 15 to 35 ms. Below fusion thresholds, the localization of the lead was similar to that of single-source stimuli. Above fusion thresholds lead localization was significantly degraded, persisting out to 100 ms. Localization of the lag was poor at all delays on which it was reported as being heard. According to these results localization dominance (difficulty localizing the lag) in children persists at greater delays than fusion, which is consistent with findings obtained in adult subjects. The range of delays over which these effects are robust in children is longer than the range observed in adults.
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
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.
Delayed blastocyst formation or an extra day culture increases apoptosis in pig blastocysts.
Lin, Tao; Lee, Jae Eun; Oqani, Reza K; Kim, So Yeon; Cho, Eun Seok; Jeong, Yong Dae; Baek, Jun Jong; Jin, Dong Il
2017-10-01
In the present study, the timing was examined of blastocyst collection/formation or of how the duration of post-blastulation culture affected the quality and developmental competence of in vitro-produced pig parthenogenetic embryos. The earliest apoptotic signals were observed at the morula stage while the earliest cytoplasmic fragmentation was observed before the 4- to 8-cell stage of embryo development. Nuclear condensation was detected in morulae and blastocysts, but not all condensed nuclei were positive for the apoptotic signal (TUNEL staining). The mean blastocyst diameter increased with delayed blastocyst collection or extended post-blastulation culture, but decreased with delayed blastocyst formation. Delayed blastocyst collection/formation or an additional day of post-blastulation culture increased the frequencies of apoptosis, condensed nuclei, and low quality blastocysts (those showing a nuclear destruction that negated counting of the nuclei); increased the expression of the pro-apoptotic BAX gene; and reduced the ratio of ICM (inner cell mass) cells to TE (trophectoderm) cells. In addition, delayed blastocyst formation decreased POU5F1 gene expression. These results suggest that a delay in blastocyst collection/formation or an additional day of culture could increase the incidence of apoptosis, decrease the ICM:TE cell ratio, and influence the gene expression and diameter of blastocysts derived from in vitro-produced pig embryos. These findings provide a useful reference for improving the quality of in vitro-produced embryos. Copyright © 2017 Elsevier B.V. All rights reserved.
Skeletal maturity of the hand in an East African group from Sudan.
Elamin, Fadil; Abdelazeem, Nihal; Elamin, Ahmed; Saif, Duaa; Liversidge, Helen M
2017-08-01
Studies of skeletal maturity from Africa indicate a delay, reflected in a negative relative skeletal age (RSA). This study aims to evaluate the influence of age, socioeconomic status (SES) and nutritional status on skeletal maturation in a large sample of children from North Sudan. The sample consisted 665 males and 1018 females from 3-25 years from Khartoum. Height, weight, age of menarche and, SES were recorded of patients attending for dental treatment. Skeletal age was assigned from hand-wrist radiographs using the Greulich-Pyle (GP) atlas (1952). RSA (difference between skeletal and chronological ages) was compared in groups divided by age, sex, height-for-age and body-mass-index z scores, and SES. Spearman's correlation and student t-test was used to compare groups. Delayed skeletal age was noted across all age in boys. In girls, a delay was observed between ages 6-10, while advancement occurred between ages 13-18. Maturity was delayed in low height groups (p < .05) and low SES groups. RSA was negatively associated with HAZ in low SES males (R = -0.0.27, p < .001) and low SES females (R = -0.32, p < .001). There were statistically significant skeletal delays in North Sudanese males and most pre-menarche females, low height and low SES groups. Post-menarche females were advanced relative to males and GP references. Low SES impacts were statistically correlated to skeletal delay. © 2017 Wiley Periodicals, Inc.
Substance Use to Cope with Stigma in Healthcare Among U.S. Female-to-Male Trans Masculine Adults.
Reisner, Sari L; Pardo, Seth T; Gamarel, Kristi E; White Hughto, Jaclyn M; Pardee, Dana J; Keo-Meier, Colton L
2015-12-01
Enacted and anticipated stigma exist within healthcare settings for transgender people, but research has yet to examine the effects of these forms of stigma on the substance use behaviors of female-to-male (FTM) trans masculine people. Data were analyzed from the cross-sectional U.S. National Transgender Discrimination Survey, a convenience sample of transgender adults purposively sampled in 2008. Trans masculine respondents (n=2,578) were identified using a two-step method: Step 1, Assigned birth sex; Step 2, Current gender identity. A gender minority stress model of substance use was tested to examine the relation of enacted and anticipated stigma with substance use to cope with mistreatment. Overall, 14.1% of the sample reported having been refused care by a provider (enacted stigma), 32.8% reported delaying needed medical care when sick/injured, and 39.1% delayed routine preventive care (anticipated stigma). Having been refused care was significantly associated with avoidance of healthcare, including delaying needed medical care when sick/injured and delaying routine preventive medical care. Substance use to cope with mistreatment was self-reported by 27.6% of the sample. Enacted stigma by providers was associated with self-reported substance use to cope. Delays in both needed and preventive care (anticipated stigma) were highly associated with substance use, and attenuated the effect of enacted stigma. Gender minority-related stressors, particularly enacted and anticipated stigma in healthcare, should be integrated into substance use and abuse prevention and intervention efforts with this underserved population.
Missed nursing care: a concept analysis.
Kalisch, Beatrice J; Landstrom, Gay L; Hinshaw, Ada Sue
2009-07-01
This paper is a report of the analysis of the concept of missed nursing care. According to patient safety literature, missed nursing care is an error of omission. This concept has been conspicuously absent in quality and patient safety literature, with individual aspects of nursing care left undone given only occasional mention. An 8-step method of concept analysis - select concept, determine purpose, identify uses, define attributes, identify model case, describe related and contrary cases, identify antecedents and consequences and define empirical referents - was used to examine the concept of missed nursing care. The sources for the analysis were identified by systematic searches of the World Wide Web, MEDLINE, CINAHL and reference lists of related journal articles with a timeline of 1970 to April 2008. Missed nursing care, conceptualized within the Missed Nursing Care Model, is defined as any aspect of required patient care that is omitted (either in part or in whole) or delayed. Various attribute categories reported by nurses in acute care settings contribute to missed nursing care: (1) antecedents that catalyse the need for a decision about priorities; (2) elements of the nursing process and (3) internal perceptions and values of the nurse. Multiple elements in the nursing environment and internal to nurses influence whether needed nursing care is provided. Missed care as conceptualized within the Missed Care Model is a universal phenomenon. The concept is expected to occur across all cultures and countries, thus being international in scope.
Discriminative stimuli that follow a delay have added value for pigeons.
DiGian, Kelly A; Friedrich, Andrea M; Zentall, Thomas R
2004-10-01
Clement, Feltus, Kaiser, and Zentall (2000) reported that pigeons prefer discriminative stimuli that require greater effort (more pecks) to obtain over those that require less effort. In the present experiment, we examined two variables associated with this phenomenon. First, we asked whether delay of reinforcement, presumably a relatively aversive event similar to effort, would produce similar effects. Second, we asked whether the stimulus preference produced by a prior relatively aversive event depends on its anticipation. Anticipation of delay was accomplished by signaling its occurrence. Results indicated that delays can produce preferences similar to those produced by increased effort, but only if the delays are signaled.
Nair, M K C; Resmi, V R; Krishnan, Rajee; Harikumaran Nair, G S; Leena, M L; Bhaskaran, Deepa; George, Babu; Russell, Paul Swamidhas Sudhakar
2014-12-01
To document the experiences of the intervention given to children who attended the developmental therapy clinic of Child Development Centre (CDC) Kerala, a specialized clinic for providing developmental intervention/therapy for babies less than two years with developmental delay/disability. All the babies referred to this speciality clinic from developmental screening/evaluation clinics of CDC were registered in the clinic and re-evaluation was done using CDC grading for head holding, sitting, standing, Amiel Tison passive angles, and Trivandrum Developmental Screening Chart (TDSC) 0-2 y. Out of a total of 600 consecutive babies below 2 y with developmental delay/disability referred to developmental therapy clinic, on comparing the test results at enrollment and after 6 mo of intervention, a statistically significant reduction was observed (i) in the 2-4 mo age group with regard to abnormal TDSC (25.5%), (ii) in the 4-8 mo age group with regard to abnormal head holding grade (87.1%) and abnormal TDSC (19.4%), (iii) in the 8-12 mo age group, with regard to abnormal sitting grade (71.7%) and (iv) in the above 12 mo age group with regard to abnormal sitting grade (35.3%) and abnormal standing grade (78.8%). The experience of organizing the developmental intervention/therapy clinic at CDC Kerala has shown that therapy services by developmental therapists in a centre and supportive therapy by mother at home is useful in improving the developmental status of children with developmental delay.
Zhang, Yong; Wang, Qing; Jiang, Xinyuan
2017-01-01
The real-time estimation of the wide-lane and narrow-lane Uncalibrated Phase Delay (UPD) of satellites is realized by real-time data received from regional reference station networks; The properties of the real-time UPD product and its influence on real-time precise point positioning ambiguity resolution (RTPPP-AR) are experimentally analyzed according to real-time data obtained from the regional Continuously Operating Reference Stations (CORS) network located in Tianjin, Shanghai, Hong Kong, etc. The results show that the real-time wide-lane and narrow-lane UPD products differ significantly from each other in time-domain characteristics; the wide-lane UPDs have daily stability, with a change rate of less than 0.1 cycle/day, while the narrow-lane UPDs have short-term stability, with significant change in one day. The UPD products generated by different regional networks have obvious spatial characteristics, thus significantly influencing RTPPP-AR: the adoption of real-time UPD products employing the sparse stations in the regional network for estimation is favorable for improving the regional RTPPP-AR up to 99%; the real-time UPD products of different regional networks slightly influence PPP-AR positioning accuracy. After ambiguities are successfully fixed, the real-time dynamic RTPPP-AR positioning accuracy is better than 3 cm in the plane and 8 cm in the upward direction. PMID:28534844
Zhang, Yong; Wang, Qing; Jiang, Xinyuan
2017-05-19
The real-time estimation of the wide-lane and narrow-lane Uncalibrated Phase Delay (UPD) of satellites is realized by real-time data received from regional reference station networks; The properties of the real-time UPD product and its influence on real-time precise point positioning ambiguity resolution (RTPPP-AR) are experimentally analyzed according to real-time data obtained from the regional Continuously Operating Reference Stations (CORS) network located in Tianjin, Shanghai, Hong Kong, etc. The results show that the real-time wide-lane and narrow-lane UPD products differ significantly from each other in time-domain characteristics; the wide-lane UPDs have daily stability, with a change rate of less than 0.1 cycle/day, while the narrow-lane UPDs have short-term stability, with significant change in one day. The UPD products generated by different regional networks have obvious spatial characteristics, thus significantly influencing RTPPP-AR: the adoption of real-time UPD products employing the sparse stations in the regional network for estimation is favorable for improving the regional RTPPP-AR up to 99%; the real-time UPD products of different regional networks slightly influence PPP-AR positioning accuracy. After ambiguities are successfully fixed, the real-time dynamic RTPPP-AR positioning accuracy is better than 3 cm in the plane and 8 cm in the upward direction.
Phase-sensitive multiple reference optical coherence tomography (Conference Presentation)
NASA Astrophysics Data System (ADS)
Dsouza, Roshan I.; Subhash, Hrebesh; Neuhaus, Kai; Hogan, Josh; Wilson, Carol; Leahy, Martin
2016-03-01
Multiple reference OCT (MR-OCT) is a recently developed novel time-domain OCT platform based on a miniature reference arm optical delay, which utilizes a single miniature actuator and a partial mirror to generate recirculating optical delay for extended axial-scan range. MR-OCT technology promises to fit into a robust and cost-effective design, compatible with integration into consumer-level devices for addressing wide applications in mobile healthcare and biometry applications. Using conventional intensity based OCT processing techniques, the high-resolution structural imaging capability of MR-OCT has been recently demonstrated for various applications including in vivo human samples. In this study, we demonstrate the feasibility of implementing phase based processing with MR-OCT for various functional applications such as Doppler imaging and sensing of blood vessels, and for tissue vibrography applications. The MR-OCT system operates at 1310nm with a spatial resolution of ~26 µm and an axial scan rate of 600Hz. Initial studies show a displacement-sensitivity of ~20 nm to ~120 nm for the first 1 to 9 orders of reflections, respectively with a mirror as test-sample. The corresponding minimum resolvable velocity for these orders are ~2.3 µm/sec and ~15 µm/sec respectively. Data from a chick chorioallantoic membrane (CAM) model will be shown to demonstrate the feasibility of MR-OCT for imaging in-vivo blood flow.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 32 National Defense 2 2010-07-01 2010-07-01 false Reporting of accounts receivable and sales under... sales under 120 days delayed payment terms (short-term credit). (a) General. (1) Amounts payable to DoD Components for sales of Defense articles and services on terms which require payment of cash in advance of...
Code of Federal Regulations, 2011 CFR
2011-07-01
... 32 National Defense 2 2011-07-01 2011-07-01 false Reporting of accounts receivable and sales under... sales under 120 days delayed payment terms (short-term credit). (a) General. (1) Amounts payable to DoD Components for sales of Defense articles and services on terms which require payment of cash in advance of...
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
A History of the Improvement of Internet Protocols Over Satellites Using ACTS
NASA Technical Reports Server (NTRS)
Allman, Mark; Kruse, Hans; Ostermann, Shawn
2000-01-01
This paper outlines the main results of a number of ACTS experiments on the efficacy of using standard Internet protocols over long-delay satellite channels. These experiments have been jointly conducted by NASAs Glenn Research Center and Ohio University over the last six years. The focus of our investigations has been the impact of long-delay networks with non-zero bit-error rates on the performance of the suite of Internet protocols. In particular, we have focused on the most widely used transport protocol, the Transmission Control Protocol (TCP), as well as several application layer protocols. This paper presents our main results, as well as references to more verbose discussions of our experiments.
The Role of Covert Retrieval in Working Memory Span Tasks: Evidence from Delayed Recall Tests
ERIC Educational Resources Information Center
McCabe, David P.
2008-01-01
The current study examined delayed recall of items that had been processed during simple and complex span tasks. Three experiments were reported showing that despite more items being recalled initially from a simple span task (i.e., word span) than a complex span task (i.e., operation span), on a delayed recall test more items were recalled that…
Phase and group delay of S-band megawatt Cassegrain diplexer and S-band megawatt transmit filter
NASA Technical Reports Server (NTRS)
Lay, R.
1977-01-01
The phase characteristics and group delay of the S-band Megawatt Cassegrain Diplexer (MCD) and S-band Megawatt Transmit Filter (MTF) are reported. These phase measurements on the MCD and MTF were done in response to the need to obtain the total DSS hardware ground delay required for very long baseline interferometry and ranging radio metric measurements.
A Longitudinal Investigation of Conflict and Delay Inhibitory Control in Toddlers and Preschoolers
ERIC Educational Resources Information Center
Joyce, Amanda W.; Kraybill, Jessica H.; Chen, Nan; Cuevas, Kimberly; Deater-Deckard, Kirby; Bell, Martha Ann
2016-01-01
Research Findings: A total of 81 children participated in a longitudinal investigation of inhibitory control (IC) from 2 to 4 years of age. Child IC was measured via maternal report and laboratory measures under conditions of conflict and delay. Performance on delay IC tasks at 3 years was related to performance on these same tasks at 2 and…
Ackers, Louise; Ioannou, Elena; Ackers-Johnson, James
2016-11-01
Maternal mortality in low- and middle-income countries continues to remain high. The Ugandan Ministry of Health's Strategic Plan suggests that little, if any, progress has been made in Uganda in terms of improvements in Maternal Health [Millennium Development Goal (MDG) 5] and, more specifically, in reducing maternal mortality. Furthermore, the UNDP report on the MDGs describes Uganda's progress as 'stagnant'. The importance of understanding the impact of delays on maternal and neonatal outcomes in low resource settings has been established for some time. Indeed, the '3-delays' model has exposed the need for holistic multi-disciplinary approaches focused on systems change as much as clinical input. The model exposes the contribution of social factors shaping individual agency and care-seeking behaviour. It also identifies complex access issues which, when combined with the lack of timely and adequate care at referral facilities, contributes to extensive and damaging delays. It would be hard to find a piece of research on this topic that does not reference human resource factors or 'staff shortages' as a key component of this 'puzzle'. Having said that, it is rare indeed to see these human resource factors explored in any detail. In the absence of detailed critique (implicit) 'common sense' presumptions prevail: namely that the economic conditions at national level lead to inadequacies in the supply of suitably qualified health professionals exacerbated by losses to international emigration. Eight years' experience of action-research interventions in Uganda combining a range of methods has lead us to a rather stark conclusion: the single most important factor contributing to delays and associated adverse outcomes for mothers and babies in Uganda is the failure of doctors to be present at work during contracted hours. Failure to acknowledge and respond to this sensitive problem will ultimately undermine all other interventions including professional voluntarism which relies on local 'co-presence' to be effective. Important steps forward could be achieved within the current resource framework, if the political will existed. International NGOs have exacerbated this problem encouraging forms of internal 'brain drain' particularly among doctors. Arguably the system as it is rewards doctors for non-compliance resulting in massive resource inefficiencies. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.
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.
Discrete-time bidirectional associative memory neural networks with variable delays
NASA Astrophysics Data System (ADS)
Liang, variable delays [rapid communication] J.; Cao, J.; Ho, D. W. C.
2005-02-01
Based on the linear matrix inequality (LMI), some sufficient conditions are presented in this Letter for the existence, uniqueness and global exponential stability of the equilibrium point of discrete-time bidirectional associative memory (BAM) neural networks with variable delays. Some of the stability criteria obtained in this Letter are delay-dependent, and some of them are delay-independent, they are less conservative than the ones reported so far in the literature. Furthermore, the results provide one more set of easily verified criteria for determining the exponential stability of discrete-time BAM neural networks.
Hall, Charlotte L; Walker, Gemma M; Valentine, Althea Z; Guo, Boliang; Kaylor-Hughes, Catherine; James, Marilyn; Daley, David; Sayal, Kapil; Hollis, Chris
2014-12-01
The National Institute for Health and Care Excellence (NICE) guidelines for attention deficit/hyperactivity disorder (ADHD) state that young people need to have access to the best evidence-based care to improve outcome. The current 'gold standard' ADHD diagnostic assessment combines clinical observation with subjective parent, teacher and self-reports. In routine practice, reports from multiple informants may be unavailable or contradictory, leading to diagnostic uncertainty and delay. The addition of objective tests of attention and activity may help reduce diagnostic uncertainty and delays in initiating treatment leading to improved outcomes. This trial investigates whether providing clinicians with an objective report of levels of attention, impulsivity and activity can lead to an earlier, and more accurate, clinical diagnosis and improved patient outcome. This multisite randomised controlled trial will recruit young people (aged 6-17 years old) who have been referred for an ADHD diagnostic assessment at Child and Adolescent Mental Health Services (CAMHS) and Community Paediatric clinics across England. Routine clinical assessment will be augmented by the QbTest, incorporating a continuous performance test (CPT) and infrared motion tracking of activity. The participant will be randomised into one of two study arms: QbOpen (clinician has immediate access to a QbTest report): QbBlind (report is withheld until the study end). Primary outcomes are time to diagnosis and diagnostic accuracy. Secondary outcomes include clinician's diagnostic confidence and routine clinical outcome measures. Cost-effective analysis will be conducted, alongside a qualitative assessment of the feasibility and acceptability of incorporating QbTest in routine practice. The findings from the study will inform commissioners, clinicians and managers about the feasibility, acceptability, clinical utility and cost-effectiveness of incorporating QbTest into routine diagnostic assessment of young people with ADHD. The results will be submitted for publication in peer-reviewed journals. The study has received ethical approval. NCT02209116. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Hall, Charlotte L; Walker, Gemma M; Valentine, Althea Z; Guo, Boliang; Kaylor-Hughes, Catherine; James, Marilyn; Daley, David; Sayal, Kapil; Hollis, Chris
2014-01-01
Introduction The National Institute for Health and Care Excellence (NICE) guidelines for attention deficit/hyperactivity disorder (ADHD) state that young people need to have access to the best evidence-based care to improve outcome. The current ‘gold standard’ ADHD diagnostic assessment combines clinical observation with subjective parent, teacher and self-reports. In routine practice, reports from multiple informants may be unavailable or contradictory, leading to diagnostic uncertainty and delay. The addition of objective tests of attention and activity may help reduce diagnostic uncertainty and delays in initiating treatment leading to improved outcomes. This trial investigates whether providing clinicians with an objective report of levels of attention, impulsivity and activity can lead to an earlier, and more accurate, clinical diagnosis and improved patient outcome. Methods and analysis This multisite randomised controlled trial will recruit young people (aged 6–17 years old) who have been referred for an ADHD diagnostic assessment at Child and Adolescent Mental Health Services (CAMHS) and Community Paediatric clinics across England. Routine clinical assessment will be augmented by the QbTest, incorporating a continuous performance test (CPT) and infrared motion tracking of activity. The participant will be randomised into one of two study arms: QbOpen (clinician has immediate access to a QbTest report): QbBlind (report is withheld until the study end). Primary outcomes are time to diagnosis and diagnostic accuracy. Secondary outcomes include clinician's diagnostic confidence and routine clinical outcome measures. Cost-effective analysis will be conducted, alongside a qualitative assessment of the feasibility and acceptability of incorporating QbTest in routine practice. Ethics and dissemination The findings from the study will inform commissioners, clinicians and managers about the feasibility, acceptability, clinical utility and cost-effectiveness of incorporating QbTest into routine diagnostic assessment of young people with ADHD. The results will be submitted for publication in peer-reviewed journals. The study has received ethical approval. Trial registration number NCT02209116. PMID:25448628
Paprottka, Felix J.; Klimas, Dalius; Hebebrand, Detlev
2018-01-01
Large and ulcerating skin tumors have become a rarity in the modern Western world. However, these conditions can cause serious life-threatening complications. The case of a 60-year-old male Caucasian patient is reported, who had suffered from an extensive basal cell carcinoma in the right shoulder region for several years. The patient kept the lesion secret from his friends and family and delayed presentation to health care services. After an episode of tumor-related heavy bleeding, the patient was referred to our clinic and received a radical surgical tumor resection—followed by defect coverage with a latissimus dorsi myocutaneous flap. An alternative treatment option that could be offered to the patient would have been a mutilating surgical procedure with an arm amputation. By using this plastic reconstructive surgical technique, the main function of the shoulder joint was conserved. The presented case demonstrates options for defect coverage of problematic wounds in anatomically complex body regions—like the shoulder—by using a functional reconstruction using myocutaneous flaps. PMID:29896564
Li, Jiaqi; Li, Jianwei; Jiang, Shu; Yu, Ruichao; Yu, Yerong
2018-01-01
Thyrotropin-secreting adenoma (TSHoma) is rare, diagnosis and treatment are often delayed if the condition coexists with Hashimoto thyroiditis. The enlarged pituitary adenoma may eventually induce panhypopituitarism, infertility, or the compression of optic nerves and optic chiasma. This patient was a 36-year-old man who had been referred to the pituitary disease multidisciplinary team (MDT) of the West China Hospital, due to infertility. Examinations revealed pituitary thyrotropin-secreting macroadenoma. We conducted trans-sphenoidal surgery. Human chorionic gonadotropin (HCG) and human menopausal gonadotropin (HMG) were used for reproductive reconstruction after surgery. This patient successfully fathered a child. To date, the multidisciplinary team treatment of TSHoma was rare, TSHomas are often misdiagnosed as macroadenomas, because the clinical features are varied and it often takes a long time to be diagnosed. So the purpose of this case report is to attract attention to the manifestation of increased thyroid stimulating hormone (TSH) concentration and discuss MDT treatment for TSH-secreting adenoma. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.
Investigation of suspected chronic fatigue syndrome/myalgic encephalopathy.
Owe, Jone Furlund; Næss, Halvor; Gjerde, Ivar Otto; Bødtker, Jørn Eilert; Tysnes, Ole-Bjørn
2016-02-09
Chronic fatigue is a frequently occurring problem in both the primary and specialist health services. The Department of Neurology at Haukeland University Hospital has established a standard assessment for patients referred with suspected CFS/ME. This study reports diagnoses and findings upon assessment, and considers the benefit of supplementary examinations. Diagnoses and findings from examinations of 365 patients assessed for suspected CFS/ME are retrospectively reported. A total of 48 patients (13.2%) were diagnosed with CFS/ME, while a further 18 patients (4.9%) were diagnosed with post-infectious fatigue. Mental and behavioural disorders were diagnosed in 169 patients (46.3%), and these represented by far the largest group. Serious, but unrecognised somatic illness was discovered in two patients, while changes of uncertain significance were identified by MRI and lumbar puncture in a few patients. Fatigue is a frequently occurring symptom in the population. Thorough somatic and psychiatric investigation is necessary before referral to the specialist health services. Mental disorders and reactions to life crises are common and important differential diagnoses for CFS/ME. Long waiting times in the specialist health services may result in delayed diagnosis for these patients.
Pregnancy outcomes among female hairdressers who participated in the Danish National Birth Cohort.
Zhu, Jin Liang; Vestergaard, Mogens; Hjollund, Niels Henrik; Olsen, Jørn
2006-02-01
The Danish National Birth Cohort (DNBC) was used to examine pregnancy outcomes among female hairdressers and neurodevelopment in their offspring. A population-based cohort study was conducted of 550 hairdressers and 3216 shop assistants (reference group) by using data from the Danish National Birth Cohort between 1997 and 2003. Information on job characteristics was reported by the women in the first interview (around 17 weeks of gestation). Pregnancy outcomes were obtained by linkage to the national registers. Developmental milestones were reported by the mother at the fourth interview, when the child was approximately 19 months old. Cox regression was applied to analyze fetal loss and congenital malformation. Logistic regression was used to analyze other pregnancy outcomes and developmental milestones. We found no significant differences in fetal loss, multiple births, gender ratio, preterm birth, small-for-gestational age, congenital malformations, or achievement of developmental milestones among the children of hairdressers and shop assistants. The results do not indicate that children of hairdressers in Denmark currently have a high risk of fetal impairment or delayed psychomotor development.
NASA Astrophysics Data System (ADS)
Fernandes, Joana; Lázaro, Clara; Ambrózio, Américo; Restano, Marco; Benveniste, Jérôme
2017-04-01
Satellite altimetry missions provide the sea surface height above a reference ellipsoid with centimetric accuracy as long as all terms involved in the altimeter measurement system (satellite orbit, altimeter range between the satellite and the sea surface, and instrumental, range and geophysical corrections) are known with the same accuracy. The wet tropospheric correction (WTC), the range correction that accounts for the delay induced by the presence of water vapour and liquid water in the troposphere, has an absolute value less than 50 cm but large space-time variability, being therefore difficult to model. Despite the progress observed in WTC modelling from numerical weather models (NWM), the accuracy of present NWM-derived WTC is still deficient for most altimetry applications such as e.g. sea level variation. Actually, accurate WTC at time and location of the altimetric measurements can only be achieved through observations of the atmospheric water vapour content, acquired by on-board microwave radiometers (MWR). In open ocean, MWR-derived WTC are centimeter-level accurate; in coastal regions, WTC degrades due to several reasons, among which is the contamination, from the surrounding land surfaces, of the signal measured by the MWR. Also the presence of ice and rain contaminates the MWR observations. Therefore, MWR-derived WTC are generally incorrect or invalid in coastal, rainy and high-latitude regions, and altimeter measurements cannot benefit from MWR corrections. The GNSS-derived Path Delay (GPD) algorithm was developed by the University of Porto (UPorto) aiming at computing the WTC for coastal regions where MWR observations are invalid, envisaging the recovery of the altimeter data in these regions. The GPD-derived WTC is based on a space-time optimal interpolation that combines path delays measured by MWR and computed at more than 800 coastal/island GNSS stations. Its most recent version, the GPD Plus (GPD+) estimates the WTC globally relying also on path delay observations from 19 scanning imaging MWR on-board various remote sensing missions. After adequate tuning, the GPD+ is applicable to any altimetric mission with or without an on-board MWR, as CryoSat-2 for which only a NWM-derived WTC would be, otherwise, available. To ensure consistency and WTC long term stability, and prior to their use in the GPD+, path delay observations from all radiometers were previously inter-calibrated with respect to the Special Sensor Microwave Imager (SSM/I) and SSMI/I Sounder (SSM/IS). The GPD+ WTC were computed, in the scope of several ESA-funded projects e.g., Sea Level CCI, CP4O, for 9 altimetry missions and were independently validated through statistical analyses of sea level anomaly variance. Overall, results show that GPD+ recovers a significant number of measurements in the coastal regions, ensuring the continuity and consistency of the correction in the open-ocean/coastal transition zone and also at high latitudes. As a consequence, GPD+ WTC have been chosen as the best available WTC for climate studies and adopted as reference in the Sea Level CCI products; the GPD+ has also been adopted as reference in CrySat-2 Level 2 IOP and GOP products. The GPD+ algorithm, its implementation, path delay datasets used and sensor calibration are here described.
Relation between early motor delay and later communication delay in infants at risk for autism.
Bhat, A N; Galloway, J C; Landa, R J
2012-12-01
Motor delays have been reported in retrospective studies of young infants who later develop Autism Spectrum Disorders (ASDs). In this study, we prospectively compared the gross motor development of a cohort at risk for ASDs; infant siblings of children with ASDs (AU sibs) to low risk typically developing (LR) infants. 24 AU sibs and 24 LR infants were observed at 3 and 6 months using a standardized motor measure, the Alberta Infant Motor Scale (AIMS). In addition, as part of a larger study, the AU sibs also received a follow-up assessment to determine motor and communication performance at 18 months using the Mullen Scales of Early Learning. Significantly more AU sibs showed motor delays at 3 and 6 months than LR infants. The majority of the AU sibs showed both early motor delays and later communication delays. Small sample size and limited follow-up. Early motor delays are more common in AU sibs than LR infants. Communication delays later emerged in 67-73% of the AU sibs who had presented with early motor delays. Overall, early motor delays may be predictive of future communication delays in children at risk for autism. Copyright © 2012 Elsevier Inc. All rights reserved.
Severe developmental delay and multiple strawberry naevi: a new syndrome?
Upton, C J; Young, I D
1993-01-01
An 18 month old girl with dysmorphic features, severe developmental delay, multiple strawberry naevi, and capillary naevi is described. No previous report of a similar association of features has been identified. Images PMID:8230170
Hamilton, Preci L; Cruickshank, Garth
2018-01-01
Abstract CHIKV is a relatively new virus and we are still learning about the illness. Very little is known about CNS its involvement and even less about its delayed or long-term manifestations if any. It therefore behoves us to consider delayed CNS involvement when assessing patients with CHIKV infections that may not have had an acute neurological manifestation at the time of diagnosis coupled with new onset neurological manifestations and MRI abnormalities. It seems likely that patients with CHIKV may experience delayed CNS manifestation of the viral infection. This report highlights the importance of a travel history when assessing patients with a neurological complaint. The pathway to best manage such cases is with repeated imaging to assess if the signal changes either progress, resolve or more importantly if there is any MRI correlation should changes in neurology develop during the surveillance period. PMID:29942482
The law and ethics in relation to dentists treating HIV-positive patients: two recent court cases.
Graham, P E; Miller, N M; Harel-Raviv, M
1995-06-01
Two recent Canadian judgements regarding the application of human rights legislation to dentistry and HIV-seropositive patients are summarized and discussed. In the Ontario case of Jerome v. DeMarco, the Ontario Human Rights tribunal found that seropositivity constitutes a "handicap" under human rights legislation. However, the tribunal dismissed the claim by a seropositive patient that he had been illegally discriminated against by a dentist who, on learning the patient was seropositive, delayed treating him until the end of the day. This decision served as a precedent in the lengthy Quebec small claims court judgment of Hamel v. Malaxos. In this case, the dentist was held to have violated Quebec human rights legislation by trying to refer an HIV-seropositive patient to a hospital treatment centre rather than performing the appropriate dental treatment himself. Court judgments regarding this problem are reported and discussed.
The eccentricity effect of inhibition of return is resistant to practice.
Bao, Yan; Sander, Tilmann; Trahms, Lutz; Pöppel, Ernst; Lei, Quan; Zhou, Bin
2011-08-01
Inhibition of return (IOR) refers to a delayed responding to targets appeared at previously cued location relative to an uncued novel location. In a recent study, Bao and Pöppel reported a functional dissociation of inhibitory processing in the visual field with much stronger IOR magnitude in the far periphery relative to the perifoveal visual field up to 15° eccentricity. The present study aimed to examine whether this effect is sensitive to participant experience or practice. Consistent with previous findings, our data demonstrated a larger IOR magnitude at 21° relative to 7° stimulus eccentricity. More importantly, no practice-related IOR magnitude changes were observed for both perifoveal and peripheral stimuli, although response times did decrease significantly with practice. These results suggest that the eccentricity effect of IOR is a robust phenomenon which is resistant to practice. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
46,XY hypergonadotropic hypogonadism and myasthenia gravis.
Lichiardopol, Corina; Herlea, V; Ioan, Virginia; Tomulescu, V; Mixich, F
2006-01-01
Both hypergonadotropic hypogonadism and myasthenia gravis can be parts of type II autoimmune polyendocrine syndrome and association between the two disorders has been reported in few cases. A 14 year old male patient with a personal history of bilateral cryptorchidism and ptosis was referred for delayed puberty. Clinical examination revealed eunuchoid habitus, small, soft testes, gynecomastia, ptosis, a myasthenic deficit score of 22.5 points and an IQ of 84 points. Decreased testosterone (0.064 ng/mL) and elevated LH (64.5 mUI/mL) were consistent with hypergonadotropic hypogonadism and karyotype was normal: 46,XY. Thyroid function, haematologic evaluation, BUN, electrolytes, and glycemia were in the normal range. Therapy consisted of anticholinesterase inhibitors, immunosuppressants, corticotherapy, testosterone; thoracoscopic thymectomy was performed showing thymic lymphoid hyperplasia on histopathologic examination. Myasthenic score improved (12.5 points), progressive virilization occurred, and a year later the patient presented with cushingoid features and obesity.
Liu, Shu-Yu; Hu, Chang-Qin
2007-10-17
This study introduces the general method of quantitative nuclear magnetic resonance (qNMR) for the calibration of reference standards of macrolide antibiotics. Several qNMR experimental conditions were optimized including delay, which is an important parameter of quantification. Three kinds of macrolide antibiotics were used to validate the accuracy of the qNMR method by comparison with the results obtained by the high performance liquid chromatography (HPLC) method. The purities of five common reference standards of macrolide antibiotics were measured by the 1H qNMR method and the mass balance method, respectively. The analysis results of the two methods were compared. The qNMR is quick and simple to use. In a new medicine research and development process, qNMR provides a new and reliable method for purity analysis of the reference standard.
NASA Astrophysics Data System (ADS)
Sivavaraprasad, G.; Venkata Ratnam, D.
2017-07-01
Ionospheric delay is one of the major atmospheric effects on the performance of satellite-based radio navigation systems. It limits the accuracy and availability of Global Positioning System (GPS) measurements, related to critical societal and safety applications. The temporal and spatial gradients of ionospheric total electron content (TEC) are driven by several unknown priori geophysical conditions and solar-terrestrial phenomena. Thereby, the prediction of ionospheric delay is challenging especially over Indian sub-continent. Therefore, an appropriate short/long-term ionospheric delay forecasting model is necessary. Hence, the intent of this paper is to forecast ionospheric delays by considering day to day, monthly and seasonal ionospheric TEC variations. GPS-TEC data (January 2013-December 2013) is extracted from a multi frequency GPS receiver established at K L University, Vaddeswaram, Guntur station (geographic: 16.37°N, 80.37°E; geomagnetic: 7.44°N, 153.75°E), India. An evaluation, in terms of forecasting capabilities, of three ionospheric time delay models - an Auto Regressive Moving Average (ARMA) model, Auto Regressive Integrated Moving Average (ARIMA) model, and a Holt-Winter's model is presented. The performances of these models are evaluated through error measurement analysis during both geomagnetic quiet and disturbed days. It is found that, ARMA model is effectively forecasting the ionospheric delay with an accuracy of 82-94%, which is 10% more superior to ARIMA and Holt-Winter's models. Moreover, the modeled VTEC derived from International Reference Ionosphere, IRI (IRI-2012) model and new global TEC model, Neustrelitz TEC Model (NTCM-GL) have compared with forecasted VTEC values of ARMA, ARIMA and Holt-Winter's models during geomagnetic quiet days. The forecast results are indicating that ARMA model would be useful to set up an early warning system for ionospheric disturbances at low latitude regions.
Vázquez-Costa, J F; Martínez-Molina, M; Fernández-Polo, M; Fornés-Ferrer, V; Frasquet-Carrera, M; Sevilla-Mantecón, T
2018-06-11
Amyotrophic lateral sclerosis (ALS) is an insidious, clinically heterogeneous neurodegenerative disease associated with a diagnostic delay of approximately 12 months. No study conducted to date has analysed the diagnostic pathway in Spain. We gathered data on variables related to the diagnostic pathway and delay for patients diagnosed with ALS between October 2013 and July 2017. The study included 143 patients with ALS (57% men; 68% spinal onset). Patients were diagnosed in public centres in 86% of cases and in private centres in 14%.The mean diagnostic delay was 13.1 months (median 11.7). Patients were examined by neurologists a mean time of 7.9 months after symptom onset, with diagnosis being made 5.2 months later. Half of all patients underwent unnecessary diagnostic tests and multiple electrophysiological studies before diagnosis was established. Diagnostic delay was longer in cases of spinal onset (P = .008) due to onset of the disease in the lower limbs. No differences were found between the public and private healthcare systems (P = .897). The diagnostic delay in ALS in Spain is similar to that of neighboring countries and seems to depend on disease-related factors, not on the healthcare system. Patients with lower-limb onset ALS constitute the greatest diagnostic challenge. Misdiagnosis is frequent, and partly attributable to an incorrect approach or erroneous interpretation of electrophysiological studies. Specific training programmes for neurologists and general neurophysiologists and early referral to reference centers may help to reduce diagnostic delay. Copyright © 2018 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.
Stoltman, Jonathan J K; Woodcock, Eric A; Lister, Jamey J; Lundahl, Leslie H; Greenwald, Mark K
2015-12-01
Delay discounting (DD) refers to how rapidly an individual devalues goods based on delays to receipt. DD usually is considered a trait variable but can be state dependent, yet few studies have assessed commodity valuation at short, naturalistically relevant time intervals that might enable state-dependent analysis. This study aimed to determine whether drug-use impulsivity and intelligence influence heroin DD at short (ecologically relevant) delays during two pharmacological states (heroin satiation and withdrawal). Out-of-treatment, intensive heroin users (n = 170; 53.5% African American; 66.7% male) provided complete DD data during imagined heroin satiation and withdrawal. Delays were 3, 6, 12, 24, 48, 72, and 96 hours; maximum delayed heroin amount was thirty $10 bags. Indifference points were used to calculate area under the curve (AUC). We also assessed drug-use impulsivity (subscales from the Impulsive Relapse Questionnaire [IRQ]) and estimated intelligence (Shipley IQ) as predictors of DD. Heroin discounting was greater (smaller AUC) during withdrawal than satiation. In regression analyses, lower intelligence and IRQ Capacity for Delay as well as higher IRQ Speed (to return to drug use) predicted greater heroin discounting in the satiation condition. Lower intelligence and higher IRQ Speed predicted greater discounting in the withdrawal condition. Sex, race, substance use variables, and other IRQ subscales were not significantly related to the withdrawal or satiation DD behavior. In summary, heroin discounting was temporally rapid, pharmacologically state dependent, and predicted by drug-use impulsivity and estimated intelligence. These findings highlight a novel and sensitive measure of acute DD that is easy to administer. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
Predictor-based control for an inverted pendulum subject to networked time delay.
Ghommam, J; Mnif, F
2017-03-01
The inverted pendulum is considered as a special class of underactuated mechanical systems with two degrees of freedom and a single control input. This mechanical configuration allows to transform the underactuated system into a nonlinear system that is referred to as the normal form, whose control design techniques for stabilization are well known. In the presence of time delays, these control techniques may result in inadequate behavior and may even cause finite escape time in the controlled system. In this paper, a constructive method is presented to design a controller for an inverted pendulum characterized by a time-delayed balance control. First, the partial feedback linearization control for the inverted pendulum is modified and coupled with a state predictor to compensate for the delay. Several coordinate transformations are processed to transform the estimated partial linearized system into an upper-triangular form. Second, nested saturation and backstepping techniques are combined to derive the control law of the transformed system that would complete the design of the whole control input. The effectiveness of the proposed technique is illustrated by numerical simulations. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.
2017-05-19
The Health Resources and Services Administration (HRSA) administers section 340B of the Public Health Service Act (PHSA), referred to as the "340B Drug Pricing Program" or the "340B Program." HRSA published a final rule on January 5, 2017, that set forth the calculation of the ceiling price and application of civil monetary penalties. The final rule applied to all drug manufacturers that are required to make their drugs available to covered entities under the 340B Program. In accordance with a January 20, 2017, memorandum from the Assistant to the President and Chief of Staff, entitled "Regulatory Freeze Pending Review," HRSA issued an interim final rule that delayed the effective date of the final rule published in the Federal Register (82 FR 1210, (January 5, 2017)) to May 22, 2017. HHS invited commenters to provide their views on whether a longer delay of the effective date to October 1, 2017, would be more appropriate. After consideration of the comments received on the interim final rule, HHS is delaying the effective date of the January 5, 2017 final rule, to October 1, 2017.
Advanced access: reducing waiting and delays in primary care.
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.
A favorable outcome despite a 39-hour treatment delay for arterial gas embolism: case report.
Covington, Derek; Bielawski, Anthony; Sadler, Charlotte; Latham, Emi
2016-01-01
Cerebral arterial gas embolism (CAGE) occurs when gas enters the cerebral arterial vasculature. CAGE can occur during sitting craniotomies, cranial trauma or secondary to gas embolism from the heart. A far less common cause of CAGE is vascular entrainment of gas during endoscopic procedures. We present the case of a 49-year-old male who developed a CAGE following an esophagoduodenoscopy (EGD) biopsy. Due to a delay in diagnosis, the patient was not treated with hyperbaric oxygen (HBO₂) therapy until 39 hours after the inciting event. Despite presenting to our institution non-responsive and with decorticate posturing, the patient was eventually discharged to a rehabilitation facility, with only mild left upper extremity weakness. This delay in HBO₂ treatment represents the longest delay in treatment to our knowledge for a patient suffering from CAGE secondary to EGD. In addition to the clinical case report, we discuss the etiology of CAGE and the evidence supporting early HBO₂ treatment, as well as the data demonstrating efficacy even after considerable treatment delay. Copyright© Undersea and Hyperbaric Medical Society.
Mechanism of delayed intracranial hypertension after cerebroventricular infusions in conscious rats
NASA Technical Reports Server (NTRS)
Morrow, B. A.; Holt, M. R.; Starcevic, V. P.; Keil, L. C.; Severs, W. B.
1992-01-01
Prior studies showed that cerebroventricular infusions of artificial cerebrospinal fluid, 8 microliter/min for 10 min, followed by a 10 min rest and a 24 h infusion of 0.5 microliters/min, raised cerebrospinal fluid pressure (CSFp) of conscious, unrestrained rats after about 2 h. Here, we report that the 10 min infusion alone evoked a delayed, prolonged rise in CSFp. Pressure during the infusion itself rose and recovered quickly, as is usually reported. Pressure/volume tests, used to calculate resistance to outflow (Ro) and compliance (C), revealed that infusions increased Ro and decreased C, after a delay (P less than 0.05). The rise in CSFp after infusion was blocked by pretreatment with acetazolamide + ouabain (P less than 0.05), but the delayed changes in Ro and C were unaffected. We suggest that the 10 min infusion of a sterile, balanced salt solution has a primary effect that increases Ro; as CSF synthesis continues, C is exhausted and the delayed rise in CSFp ensues. This non-traumatic method of raising CSFp may be a useful method to study intracranial fluid dynamics.
Shin, Jin Y; Nhan, Nguyen Viet
2009-03-01
The study examined whether Vietnamese mothers of children with cognitive delay experienced more parenting stress compared to mothers of children without delay, and the factors that contribute to the parenting stress. The study sample included 225 mothers of children with and without cognitive delays from Hue City in Vietnam. The study protocol included mothers reporting on the scales of parenting stress and perceived social support, and on demographic questions. Mothers of children with cognitive delay experienced more stress. They were poorer and less educated, and perceived less social support. More mothers of these children had health issues. Having a child with cognitive delay was the strongest predictor of stress after controlling other demographic and psychosocial variables. Special education and early intervention services should be developed and available to educate the children with cognitive delay and support their mothers in Vietnam. Effective services also need to address their poverty and health care needs.
Li, Jiaqi; Tan, Huiwen; Huang, Juan; Luo, Dan; Tang, Ying; Yu, Ruichao; Huang, Hui
2018-06-01
Thyrotropin-secreting adenoma (TSHoma) is rare. Even though the thyrotoxicosis is mild in patients with TSHoma, it is still a rare cause of arrhythmia, ignore of mild disfunction of thyroid function of TSHoma can lead to the delayed diagnosis of pituitary tumor or leading to recurring of complications. Graves' disease is an auto-immue endocrinological disorder. Association of TSHoma and Graves's disease is extremely rare. Coexistence of these two diseases made the diagnosis and treatment complicated. This patient was a 55-year-old man who had been referred to the department of endocrinology and metabolism of the West China Hospital due to recurrent atrial fibrillation (AF) and thyroxicosis. Examinations revealed pituitary thyrotropin-secreting macroadenoma with Graves' disease. We conducted transsphenoidal surgery. Thyrozol was used to treat the recurrence of Graves' disease after pituitary surgery. The TSHoma was successfully cured, and recurrent Graves' disease was controlled very well. The association of TSHoma and Graves' disease is extremely rare. Even though the clinical features of thyrotoxicosis are milder in patients with TSHoma, thyroid function tests are still important clinical assessment of patients with AF, which is an arrhythmia associated with hyperthyroidism. TSHoma is a rare cause of thyrotoxicosis; however, ignoring of the mild disfunction caused by TSHoma can lead to the delayed diagnosis of pituitary tumors or to recurring of complications of TSHoma.
Nguyen, K; Putoux, A; Busa, T; Cordier, M P; Sigaudy, S; Till, M; Chabrol, B; Michel-Calemard, L; Bernard, R; Julia, S; Malzac, P; Labalme, A; Missirian, C; Edery, P; Popovici, C; Philip, N; Sanlaville, D
2015-05-01
Array comparative genomic hybridization (aCGH) has progressively replaced conventional karyotype in the diagnostic strategy of intellectual disability (ID) and congenital malformations. This technique increases not only the diagnostic rate but also the possibility of finding unexpected variants unrelated to the indication of referral, namely incidental findings. The incidental finding of copy number variants (CNVs) located in X-linked genes in girls addresses the crucial question of genetic counseling in the family. We report here five cases of CNVs involving the dystrophin gene detected by aCGH in girls referred for developmental delay, without any family history of dystrophinopathy. The rearrangements included three in-frame deletions; one maternally and two paternally inherited, and two frameshift duplications: one de novo and one from undetermined inheritance. In two cases, the deletion identified in a girl was transmitted by the asymptomatic father. In the case of the maternally inherited deletion, prenatal diagnosis of dystrophinopathy was proposed for an ongoing pregnancy, whereas the cause of developmental delay in the index case remained unknown. Through these cases, we discussed the challenges of genetic counseling in the family, regarding the predictive issues for male individuals at risk for a muscular dystrophy without precise knowledge of the clinical consequences of some CNVs in the DMD gene. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Jamsheer, Aleksander; Sowińska-Seidler, Anna; Olech, Ewelina M; Socha, Magdalena; Kozłowski, Kazimierz; Pyrkosz, Antoni; Trzeciak, Tomasz; Materna-Kiryluk, Anna; Latos-Bieleńska, Anna
2016-05-01
Brachydactyly refers to shortening of digits due to hypoplasia or aplasia of bones forming the hands and/or feet. Isolated brachydactyly type E (BDE), which is characterized by shortened metacarpals and/or metatarsals, results in a small proportion of patients from HOXD13 or PTHLH mutations, although in the majority of cases molecular lesion remains unknown. BDE, like other brachydactylies, shows clinical heterogeneity with highly variable intrafamilial and interindividual expressivity. In this study, we investigated two Polish cases (one familial and one sporadic) presenting with BDE and additional symptoms due to novel PTHLH mutations. Apart from BDE, the affected family showed short stature, mild craniofacial dysmorphism and delayed bone age. Sanger sequencing of PTHLH revealed a novel heterozygous frameshift mutation c.258delC(p.N87Tfs*18) in two affected individuals and one relative manifesting mild brachydactyly. The sporadic patient, in addition to BDE, presented with craniofacial dysmorphism, normal stature and bone age, and was demonstrated to carry a de novo heterozygous c.166C>T(p.R56*) mutation. Our paper reports on the two novel truncating PTHLH variants, resulting in variable combination of BDE and other symptoms. Data shown here expand the knowledge on the phenotypic presentation of PTHLH mutations, highlighting significant clinical variability and incomplete penetrance of the PTHLH-related symptoms.
Normal Anal Examination After Penetration: A Case Report.
Slingsby, Brett; Goldberg, Amy
2018-03-01
Physical findings are rare after anal penetration. Furthermore, children delay in disclosing or are reticent to discuss penetration. A 12-year-old boy presented to medical care multiple times over a several-week period complaining of abdominal pain, bloody diarrhea, and poor appetite. On colonoscopy, he was found to have a cylindrical foreign body (measuring 7 cm tall and 7 cm in diameter) in his rectum, which had been present for at least 2 weeks. He initially denied knowing how the object got into his rectum and later stated that he inserted it himself out of curiosity. One week after the object was removed, follow-up examination using video colposcopy revealed a completely normal anal examination; the patient had a normal anal examination despite known anal penetration and removal of the object. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Children can have a normal anal examination despite anal penetration, and do not always disclose anal penetration. The aforementioned concepts can be applied to situations related to child sexual abuse in the emergency department, where physical examinations are frequently normal and children delay in disclosing the abuse. When there is concern for sexual abuse, even in the absence of a disclosure or examination findings, patients should be referred for a child abuse pediatrics evaluation if available. Copyright © 2017 Elsevier Inc. All rights reserved.
Angular dependence of EWS time delay for photoionization of @Xe
NASA Astrophysics Data System (ADS)
Mandal, Ankur; Deshmukh, Pranawa; Kheifets, Anatoli; Dolmatov, Valeriy; Manson, Steven
2017-04-01
Interference between photoionization channels leads to angular dependence in photoionization time delay. Angular dependence is found to be a common effect for two-photon absorption experiments very recently. The effect of confinement on the time delay where each partial wave contributions to the ionization are studied. In this work we report angular dependence and confinement effects on Eisenbud-Wigner-Smith (EWS) time delay in atomic photoionization. Using and we computed the EWS time delay for free and confined Xe atom for photoionization from inner 4d3/2 and 4d5/2 and outer 5p1/2 and 5p3/2 subshells at various angles. The calculated EWS time delay is few tens to few hundreds of attoseconds (10-18 second). The photoionization time delay for @Xe follows that in the free Xe atom on which the confinement oscillations are built. The present work reveals the effect of confinement on the photoionization time delay at different angles between photoelectron ejection and the photon polarization.
Neurodevelopmental delay associated with nonconvulsive status epilepticus in a toddler.
Shinawi, M; Shahar, E
2001-03-01
Nonconvulsive status epilepticus is a prolonged and continuous state of increased unawareness without overt motor seizures linked with repetitive generalized epileptic discharges. In children, it may occur de novo but more commonly may complicate a preexisting epileptic disorder. We report on a 2-year-old female who presented with global developmental delay as the main manifestation of nonconvulsive status epilepticus. Following valproic acid treatment, her motor, cognitive, and speech delays had gradually subsided and nearly completely resolved, in concert with normalization of electroencephalography (EEG). Hence, given a possible, albeit rare, presentation of nonconvulsive status epilepticus with global developmental delay, we suggest that EEG should be recommended in any infant who manifests neurodevelopmental delay.
Time delay induced different synchronization patterns in repulsively coupled chaotic oscillators
NASA Astrophysics Data System (ADS)
Yao, Chenggui; Yi, Ming; Shuai, Jianwei
2013-09-01
Time delayed coupling plays a crucial role in determining the system's dynamics. We here report that the time delay induces transition from the asynchronous state to the complete synchronization (CS) state in the repulsively coupled chaotic oscillators. In particular, by changing the coupling strength or time delay, various types of synchronous patterns, including CS, antiphase CS, antiphase synchronization (ANS), and phase synchronization, can be generated. In the transition regions between different synchronous patterns, bistable synchronous oscillators can be observed. Furthermore, we show that the time-delay-induced phase flip bifurcation is of key importance for the emergence of CS. All these findings may light on our understanding of neuronal synchronization and information processing in the brain.
ERIC Educational Resources Information Center
Lindstrom, David R.; Shipman, Virginia C.
An adaptation of a technique devised by Mischel (1958) was used in the longitudinal study to measure delay of gratification. Adaptations involved (1) asking the child to identify the larger of two pieces of candy to facilitate comprehension of the rewards, (2) specifying a standard time limit for receipt of the delayed reward which would be…
Public Key Infrastructure Increment 2 (PKI Inc 2)
2016-03-01
DoD - Department of Defense DoDAF - DoD Architecture Framework FD - Full Deployment FDD - Full Deployment Decision FY - Fiscal Year IA...experienced due to a delay in achieving the FDD . The Critical Change Report was provided to Congress on July 11, 2014. Firm, Fixed-Price Feasibility...to a delay in achieving the FDD . To support the Critical Change Report, the NSA Cost Estimating organization prepared a cost estimate that was
ERIC Educational Resources Information Center
Lieberman, Amy M.; Borovsky, Arielle; Hatrak, Marla; Mayberry, Rachel I.
2015-01-01
Sign language comprehension requires visual attention to the linguistic signal and visual attention to referents in the surrounding world, whereas these processes are divided between the auditory and visual modalities for spoken language comprehension. Additionally, the age-onset of first language acquisition and the quality and quantity of…
Objective Evaluation of Muscle Strength in Infants with Hypotonia and Muscle Weakness
ERIC Educational Resources Information Center
Reus, Linda; van Vlimmeren, Leo A.; Staal, J. Bart; Janssen, Anjo J. W. M.; Otten, Barto J.; Pelzer, Ben J.; Nijhuis-van der Sanden, Maria W. G.
2013-01-01
The clinical evaluation of an infant with motor delay, muscle weakness, and/or hypotonia would improve considerably if muscle strength could be measured objectively and normal reference values were available. The authors developed a method to measure muscle strength in infants and tested 81 typically developing infants, 6-36 months of age, and 17…
Rep. Sablan, Gregorio Kilili Camacho [D-MP-At Large
2009-09-24
House - 10/19/2009 Referred to the Subcommittee on Immigration, Citizenship, Refugees, Border Security, and International Law. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
Rep. Castle, Michael N. [R-DE-At Large
2010-07-30
House - 09/20/2010 Referred to the Subcommittee on Immigration, Citizenship, Refugees, Border Security, and International Law. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
Screening for ASD with the Korean CBCL/1½-5
ERIC Educational Resources Information Center
Rescorla, Leslie; Kim, Young Ah; Oh, Kyung Ja
2015-01-01
To test the Child Behavior Checklist's (CBCL/1½-5) ability to screen for autism spectrum disorders (ASD), we studied Korean preschoolers: 46 with ASD, 111 with developmental delay (DD), 71 with other psychiatric disorders (OPD), and 228 non-referred (NR). The ASD group scored significantly higher than the other groups on the Withdrawn and…
[Iodinated contrast media and iodine allergy: myth or reality?].
Meunier, B; Joskin, J; Damas, F; Meunier, P
2013-09-01
The term "iodine allergy" is an old phrase that refers to a reaction to iodinated contrast media. After a brief review of definitions, pathophysiological mechanisms and risk factors of this clinical entity, management is urged immediate and delayed according to the most recent recommendations from the literature. We underline that iodine allergy, as such, does not really exist.
Rosenthal, Eric S; Biswal, Siddharth; Zafar, Sahar F; O'Connor, Kathryn L; Bechek, Sophia; Shenoy, Apeksha V; Boyle, Emily J; Shafi, Mouhsin M; Gilmore, Emily J; Foreman, Brandon P; Gaspard, Nicolas; Leslie-Mazwi, Thabele M; Rosand, Jonathan; Hoch, Daniel B; Ayata, Cenk; Cash, Sydney S; Cole, Andrew J; Patel, Aman B; Westover, M Brandon
2018-04-16
Delayed cerebral ischemia (DCI) is a common, disabling complication of subarachnoid hemorrhage (SAH). Preventing DCI is a key focus of neurocritical care, but interventions carry risk and cannot be applied indiscriminately. Although retrospective studies have identified continuous electroencephalographic (cEEG) measures associated with DCI, no study has characterized the accuracy of cEEG with sufficient rigor to justify using it to triage patients to interventions or clinical trials. We therefore prospectively assessed the accuracy of cEEG for predicting DCI, following the Standards for Reporting Diagnostic Accuracy Studies. We prospectively performed cEEG in nontraumatic, high-grade SAH patients at a single institution. The index test consisted of clinical neurophysiologists prospectively reporting prespecified EEG alarms: (1) decreasing relative alpha variability, (2) decreasing alpha-delta ratio, (3) worsening focal slowing, or (4) late appearing epileptiform abnormalities. The diagnostic reference standard was DCI determined by blinded, adjudicated review. Primary outcome measures were sensitivity and specificity of cEEG for subsequent DCI, determined by multistate survival analysis, adjusted for baseline risk. One hundred three of 227 consecutive patients were eligible and underwent cEEG monitoring (7.7-day mean duration). EEG alarms occurred in 96.2% of patients with and 19.6% without subsequent DCI (1.9-day median latency, interquartile range = 0.9-4.1). Among alarm subtypes, late onset epileptiform abnormalities had the highest predictive value. Prespecified EEG findings predicted DCI among patients with low (91% sensitivity, 83% specificity) and high (95% sensitivity, 77% specificity) baseline risk. cEEG accurately predicts DCI following SAH and may help target therapies to patients at highest risk of secondary brain injury. Ann Neurol 2018. © 2018 American Neurological Association.
Breath-collection device for delayed breath-alcohol analysis
DOT National Transportation Integrated Search
1980-12-01
The report includes the details of a study to develop, evaluate, and validate a breath collection device (BCD) for delayed breath-alcohol analysis. Primary applications of the BCD include collection of breath-alcohol samples for field surveys or for ...
Delays affecting ITS projects : summary of findings
DOT National Transportation Integrated Search
2003-11-01
This report documents the findings of a program review conducted from October 2002 to September 2003 that investigated what delays continue to affect ITS projects. The program review also identified what actions staffs at state DOTs are taking to add...
Delay of Gratification: Decisional Self-Control and Experience with Delay Intervals
ERIC Educational Resources Information Center
And Others; Litrownik, Alan J.
1977-01-01
Actual and verbally reported decisional self-control choices (e.g., one penny now or two pennies in 1 minute) were obtained from 40 educable and trainable mentally retarded adolescents who participated in a sheltered workshop. (Author)
Souza, Alessandra S; Rerko, Laura; Lin, Hsuan-Yu; Oberauer, Klaus
2014-10-01
Performance in working memory (WM) tasks depends on the capacity for storing objects and on the allocation of attention to these objects. Here, we explored how capacity models need to be augmented to account for the benefit of focusing attention on the target of recall. Participants encoded six colored disks (Experiment 1) or a set of one to eight colored disks (Experiment 2) and were cued to recall the color of a target on a color wheel. In the no-delay condition, the recall-cue was presented after a 1,000-ms retention interval, and participants could report the retrieved color immediately. In the delay condition, the recall-cue was presented at the same time as in the no-delay condition, but the opportunity to report the color was delayed. During this delay, participants could focus attention exclusively on the target. Responses deviated less from the target's color in the delay than in the no-delay condition. Mixture modeling assigned this benefit to a reduction in guessing (Experiments 1 and 2) and transposition errors (Experiment 2). We tested several computational models implementing flexible or discrete capacity allocation, aiming to explain both the effect of set size, reflecting the limited capacity of WM, and the effect of delay, reflecting the role of attention to WM representations. Both models fit the data better when a spatially graded source of transposition error is added to its assumptions. The benefits of focusing attention could be explained by allocating to this object a higher proportion of the capacity to represent color.
Asynchronous reference frame agreement in a quantum network
NASA Astrophysics Data System (ADS)
Islam, Tanvirul; Wehner, Stephanie
2016-03-01
An efficient implementation of many multiparty protocols for quantum networks requires that all the nodes in the network share a common reference frame. Establishing such a reference frame from scratch is especially challenging in an asynchronous network where network links might have arbitrary delays and the nodes do not share synchronised clocks. In this work, we study the problem of establishing a common reference frame in an asynchronous network of n nodes of which at most t are affected by arbitrary unknown error, and the identities of the faulty nodes are not known. We present a protocol that allows all the correctly functioning nodes to agree on a common reference frame as long as the network graph is complete and not more than t\\lt n/4 nodes are faulty. As the protocol is asynchronous, it can be used with some assumptions to synchronise clocks over a network. Also, the protocol has the appealing property that it allows any existing two-node asynchronous protocol for reference frame agreement to be lifted to a robust protocol for an asynchronous quantum network.