Additional band broadening of peptides in the first size-exclusion chromatographic dimension of an automated stop-flow two-dimensional high performance liquid chromatography.

PubMed

Xu, Jucai; Sun-Waterhouse, Dongxiao; Qiu, Chaoying; Zhao, Mouming; Sun, Baoguo; Lin, Lianzhu; Su, Guowan

2017-10-27

The need to improve the peak capacity of liquid chromatography motivates the development of two-dimensional analysis systems. This paper presented a fully automated stop-flow two-dimensional liquid chromatography system with size exclusion chromatography followed by reversed phase liquid chromatography (SEC×RPLC) to efficiently separate peptides. The effects of different stop-flow operational parameters (stop-flow time, peak parking position, number of stop-flow periods and column temperature) on band broadening in the first dimension (1 st D) SEC column were quantitatively evaluated by using commercial small proteins and peptides. Results showed that the effects of peak parking position and the number of stop-flow periods on band broadening were relatively small. Unlike stop-flow analysis of large molecules with a long running time, additional band broadening was evidently observed for small molecule analytes due to the relatively high effective diffusion coefficient (D eff ). Therefore, shorter analysis time and lower 1 st D column temperature were suggested for analyzing small molecules. The stop-flow two-dimensional liquid chromatography (2D-LC) system was further tested on peanut peptides and an evidently improved resolution was observed for both stop-flow heart-cutting and comprehensive 2D-LC analysis (in spite of additional band broadening in SEC). The stop-flow SEC×RPLC, especially heart-cutting analysis with shorter analysis time and higher 1 st D resolution for selected fractions, offers a promising approach for efficient analysis of complex samples. Copyright © 2017 Elsevier B.V. All rights reserved.

Adding moxifloxacin is associated with a shorter time to culture conversion in pulmonary tuberculosis.

PubMed

Wang, J-Y; Wang, J-T; Tsai, T-H; Hsu, C-L; Yu, C-J; Hsueh, P-R; Lee, L-N; Yang, P-C

2010-01-01

To investigate whether adding moxifloxacin (MXF) to the standard anti-tuberculosis regimen can shorten the time to sputum culture conversion in pulmonary tuberculosis (PTB). Adults with culture-positive PTB were divided into two treatment groups by their choice: standard regimen alone (HERZ group) and standard regimen plus daily 400 mg MXF in the first 2 months (MXF group). Sputum samples were collected thrice weekly in the first 8 weeks. The propensity score was calculated to estimate the conditional probability of entering the MXF group. Factors influencing time to culture conversion were investigated using Cox proportional hazards regression analysis stratified by propensity score. Sixty-two patients were enrolled in the MXF group and 88 in the HERZ group; respectively 51 and 72 completed the study. The regimen was modified before culture conversion in respectively 6 (12%) and 12 (16%; P = 0.47) patients, due to adverse effects. The time to culture conversion was shorter in the MXF group (HR 2.1, 95%CI 1.4-3.2). The culture conversion rate after 6 weeks of treatment was respectively 82% and 61% (P = 0.011, <0.05/4, calculated using the modified Bonferroni method). Adding MXF to the standard anti-tuberculosis regimen in the first 2 months was associated with a shorter time to culture conversion, a higher 6-week culture conversion rate and reduced transmission of tuberculosis.

An application of a relational database system for high-throughput prediction of elemental compositions from accurate mass values.

PubMed

Sakurai, Nozomu; Ara, Takeshi; Kanaya, Shigehiko; Nakamura, Yukiko; Iijima, Yoko; Enomoto, Mitsuo; Motegi, Takeshi; Aoki, Koh; Suzuki, Hideyuki; Shibata, Daisuke

2013-01-15

High-accuracy mass values detected by high-resolution mass spectrometry analysis enable prediction of elemental compositions, and thus are used for metabolite annotations in metabolomic studies. Here, we report an application of a relational database to significantly improve the rate of elemental composition predictions. By searching a database of pre-calculated elemental compositions with fixed kinds and numbers of atoms, the approach eliminates redundant evaluations of the same formula that occur in repeated calculations with other tools. When our approach is compared with HR2, which is one of the fastest tools available, our database search times were at least 109 times shorter than those of HR2. When a solid-state drive (SSD) was applied, the search time was 488 times shorter at 5 ppm mass tolerance and 1833 times at 0.1 ppm. Even if the search by HR2 was performed with 8 threads in a high-spec Windows 7 PC, the database search times were at least 26 and 115 times shorter without and with the SSD. These improvements were enhanced in a low spec Windows XP PC. We constructed a web service 'MFSearcher' to query the database in a RESTful manner. Available for free at http://webs2.kazusa.or.jp/mfsearcher. The web service is implemented in Java, MySQL, Apache and Tomcat, with all major browsers supported. sakurai@kazusa.or.jp Supplementary data are available at Bioinformatics online.

News and Trading Rules

DTIC Science & Technology

2003-01-01

indexes or small groups of forex series. Although I use a shorter time period – five years for the work on technical analysis and machine learning, only...products. (“Indus International to Provide Transocean Sedco Forex With Robust Enterprise Asset Management Solution”, IINT, 3/7/2001) – Industry Group

HIGH VOLUME INJECTION FOR GCMS ANALYSIS OF PARTICULATE ORGANIC SPECIES IN AMBIENT AIR

EPA Science Inventory

Detection of organic species in ambient particulate matter typically requires large air sample volumes, frequently achieved by grouping samples into monthly composites. Decreasing the volume of air sample required would allow shorter collection times and more convenient sample c...

Improvement of the Management of Infants, Children and Adults with a Molecular Diagnosis of Enterovirus Meningitis during Two Observational Study Periods

PubMed Central

Archimbaud, Christine; Ouchchane, Lemlih; Mirand, Audrey; Chambon, Martine; Demeocq, François; Labbé, André; Laurichesse, Henri; Schmidt, Jeannot; Clavelou, Pierre; Aumaître, Olivier; Regagnon, Christel; Bailly, Jean-Luc; Henquell, Cécile; Peigue-Lafeuille, Hélène

2013-01-01

Enteroviruses (EVs) are a major cause of aseptic meningitis, and RNA detection using molecular assay is the gold standard diagnostic test. The aim of this study was to assess the impact of an EV positive diagnosis on the clinical management of patients admitted for meningitis over the course of two observational study periods (2005 and 2008–09) in the same clinical departments. We further investigated in multivariate analysis various factors possibly associated with hospital length of stay (LOS) in all age groups (infants, children, and adults). The results showed an overall improvement in the management of patients (n = 142) between the study periods, resulting in a significantly shorter hospital LOS for adults and children, and a shorter duration of antibiotic use for adults and infants. In multivariate analysis, we observed that the time from molecular test results to discharge of patients and the median duration of antibiotic treatment were associated with an increase in LOS in all age groups. In addition, among adults, the turnaround time of the molecular assay was significantly correlated with LOS. The use of CT scan in children and hospital admission outside the peak of EV prevalence in infants tended to increase LOS. In conclusion, the shorter length of stay of patients with meningitis in this study was due to various factors including the rapidity of the EV molecular test (particularly in adults), greater physician responsiveness after a positive result (in adults and children), and greater experience on the part of physicians in handling EV meningitis, as evidenced by the shorter duration of antibiotic use in adults and infants. PMID:23874676

Denosumab and Bone Metastasis–Free Survival in Men With Nonmetastatic Castration-Resistant Prostate Cancer: Exploratory Analyses by Baseline Prostate-Specific Antigen Doubling Time

PubMed Central

Smith, Matthew R.; Saad, Fred; Oudard, Stephane; Shore, Neal; Fizazi, Karim; Sieber, Paul; Tombal, Bertrand; Damiao, Ronaldo; Marx, Gavin; Miller, Kurt; Van Veldhuizen, Peter; Morote, Juan; Ye, Zhishen; Dansey, Roger; Goessl, Carsten

2013-01-01

Purpose Denosumab, an anti–RANK ligand monoclonal antibody, significantly increases bone metastasis–free survival (BMFS; hazard ratio [HR], 0.85; P = .028) and delays time to first bone metastasis in men with nonmetastatic castration-resistant prostate cancer (CRPC) and baseline prostate-specific antigen (PSA) ≥ 8.0 ng/mL and/or PSA doubling time (PSADT) ≤ 10.0 months. To identify men at greatest risk for bone metastasis or death, we evaluated relationships between PSA and PSADT with BMFS in the placebo group and the efficacy and safety of denosumab in men with PSADT ≤ 10, ≤ 6, and ≤ 4 months. Patients and Methods A total of 1,432 men with nonmetastatic CRPC were randomly assigned 1:1 to monthly subcutaneous denosumab 120 mg or placebo. Enrollment began February 2006; primary analysis cutoff was July 2010, when approximately 660 men were anticipated to have developed bone metastases or died. Results In the placebo group, shorter BMFS was observed as PSADT decreased below 8 months. In analyses by shorter baseline PSADT, denosumab consistently increased BMFS by a median of 6.0, 7.2, and 7.5 months among men with PSADT ≤ 10 (HR, 0.84; P = .042), ≤ 6 (HR, 0.77; P = .006), and ≤ 4 months (HR, 0.71; P = .004), respectively. Denosumab also consistently increased time to bone metastasis by PSADT subset. No difference in survival was observed between treatment groups for the overall study population or PSADT subsets. Conclusion Patients with shorter PSADT are at greater risk for bone metastasis or death. Denosumab consistently improves BMFS in men with shorter PSADT and seems to have the greatest treatment effects in men at high risk for progression. PMID:24043751

Denosumab and bone metastasis-free survival in men with nonmetastatic castration-resistant prostate cancer: exploratory analyses by baseline prostate-specific antigen doubling time.

PubMed

Smith, Matthew R; Saad, Fred; Oudard, Stephane; Shore, Neal; Fizazi, Karim; Sieber, Paul; Tombal, Bertrand; Damiao, Ronaldo; Marx, Gavin; Miller, Kurt; Van Veldhuizen, Peter; Morote, Juan; Ye, Zhishen; Dansey, Roger; Goessl, Carsten

2013-10-20

Denosumab, an anti-RANK ligand monoclonal antibody, significantly increases bone metastasis-free survival (BMFS; hazard ratio [HR], 0.85; P = .028) and delays time to first bone metastasis in men with nonmetastatic castration-resistant prostate cancer (CRPC) and baseline prostate-specific antigen (PSA) ≥ 8.0 ng/mL and/or PSA doubling time (PSADT) ≤ 10.0 months. To identify men at greatest risk for bone metastasis or death, we evaluated relationships between PSA and PSADT with BMFS in the placebo group and the efficacy and safety of denosumab in men with PSADT ≤ 10, ≤ 6, and ≤ 4 months. A total of 1,432 men with nonmetastatic CRPC were randomly assigned 1:1 to monthly subcutaneous denosumab 120 mg or placebo. Enrollment began February 2006; primary analysis cutoff was July 2010, when approximately 660 men were anticipated to have developed bone metastases or died. In the placebo group, shorter BMFS was observed as PSADT decreased below 8 months. In analyses by shorter baseline PSADT, denosumab consistently increased BMFS by a median of 6.0, 7.2, and 7.5 months among men with PSADT ≤ 10 (HR, 0.84; P = .042), ≤ 6 (HR, 0.77; P = .006), and ≤ 4 months (HR, 0.71; P = .004), respectively. Denosumab also consistently increased time to bone metastasis by PSADT subset. No difference in survival was observed between treatment groups for the overall study population or PSADT subsets. Patients with shorter PSADT are at greater risk for bone metastasis or death. Denosumab consistently improves BMFS in men with shorter PSADT and seems to have the greatest treatment effects in men at high risk for progression.

Predicting the time of conversion to MCI in the elderly: role of verbal expression and learning.

PubMed

Oulhaj, Abderrahim; Wilcock, Gordon K; Smith, A David; de Jager, Celeste A

2009-11-03

Increasing awareness that minimal or mild cognitive impairment (MCI) in the elderly may be a precursor of dementia has led to an increase in the number of people attending memory clinics. We aimed to develop a way of predicting the period of time before cognitive impairment occurs in community-dwelling elderly. The method is illustrated by the use of simple tests of different cognitive domains. A cohort of 241 normal elderly volunteers was followed for up to 20 years with regular assessments of cognitive abilities using the Cambridge Cognitive Examination (CAMCOG); 91 participants developed MCI. We used interval-censored survival analysis statistical methods to model which baseline cognitive tests best predicted the time to convert to MCI. Out of several baseline variables, only age and CAMCOG subscores for expression and learning/memory were predictors of the time to conversion. The time to conversion was 14% shorter for each 5 years of age, 17% shorter for each point lower in the expression score, and 15% shorter for each point lower in the learning score. We present in tabular form the probability of converting to MCI over intervals between 2 and 10 years for different combinations of expression and learning scores. In apparently normal elderly people, subtle measurable cognitive deficits that occur within the normal range on standard testing protocols reliably predict the time to clinically relevant cognitive impairment long before clinical symptoms are reported.

Efficacy of bendamustine and rituximab as first salvage treatment in chronic lymphocytic leukemia and indirect comparison with ibrutinib: a GIMEMA, ERIC and UK CLL FORUM study.

PubMed

Cuneo, Antonio; Follows, George; Rigolin, Gian Matteo; Piciocchi, Alfonso; Tedeschi, Alessandra; Trentin, Livio; Medina Perez, Angeles; Coscia, Marta; Laurenti, Luca; Musuraca, Gerardo; Farina, Lucia; Rivas Delgado, Alfredo; Orlandi, Ester Maria; Galieni, Piero; Mauro, Francesca Romana; Visco, Carlo; Amendola, Angela; Billio, Atto; Marasca, Roberto; Chiarenza, Annalisa; Meneghini, Vittorio; Ilariucci, Fiorella; Marchetti, Monia; Molica, Stefano; Re, Francesca; Gaidano, Gianluca; Gonzalez, Marcos; Forconi, Francesco; Ciolli, Stefania; Cortelezzi, Agostino; Montillo, Marco; Smolej, Lukas; Schuh, Anna; Eyre, Toby A; Kennedy, Ben; Bowles, Kris M; Vignetti, Marco; de la Serna, Javier; Moreno, Carol; Foà, Robin; Ghia, Paolo

2018-04-19

We performed an observational study on the efficacy of bendamustine and rituximab as first salvage regimen in chronic lymphocytic leukemia. In an intention-to-treat analysis including 237 patients, the median progression free survival was 25 months. The presence of del(17p), unmutated IGHV and advanced stage were associated with a shorter progression free survival at multivariate analysis. The median time-to-next treatment was 31.3 months. Front-line treatment with a chemoimmunotherapy regimen was the only predictive factor for a shorter time to next treatment at multivariate analysis. The median overall survival was 74.5 months. Advanced Binet stage (i.e. III-IV or C) and resistant disease were the only parameters significantly associated with a shorter OS. Grade 3-5 infections were recorded in 6.3% of patients. A matched-adjusted indirect comparison with ibrutinib given second-line within named patient programs in the United Kingdom and in Italy was carried out with overall survival as objective endpoint. When restricting the analysis to patients with intact 17p who had received chemoimmunotherapy in first line, the overall survival did not differ between patients treated with ibrutinib (63% alive at 36 months) and patients treated with BR (74.4% alive at 36 months). BR is an efficacious first salvage regimen in chronic lymphocytic leukemia in a real-life population, including the elderly and unfit patients. BR and ibrutinib may be equally effective in terms of overall survival when used as first salvage treatment in patients without 17p deletion. ClinicalTrials.gov identifier: NCT02491398. Copyright © 2018, Ferrata Storti Foundation.

Local versus general anesthesia for transcatheter aortic valve implantation (TAVR)--systematic review and meta-analysis.

PubMed

Fröhlich, Georg M; Lansky, Alexandra J; Webb, John; Roffi, Marco; Toggweiler, Stefan; Reinthaler, Markus; Wang, Duolao; Hutchinson, Nevil; Wendler, Olaf; Hildick-Smith, David; Meier, Pascal

2014-03-10

The hypothesis of this study was that local anesthesia with monitored anesthesia care (MAC) is not harmful in comparison to general anesthesia (GA) for patients undergoing Transcatheter Aortic Valve Implantation (TAVR).TAVR is a rapidly spreading treatment option for severe aortic valve stenosis. Traditionally, in most centers, this procedure is done under GA, but more recently procedures with MAC have been reported. This is a systematic review and meta-analysis comparing MAC versus GA in patients undergoing transfemoral TAVR. Trials were identified through a literature search covering publications from 1 January 2005 through 31 January 2013. The main outcomes of interest of this literature meta-analysis were 30-day overall mortality, cardiac-/procedure-related mortality, stroke, myocardial infarction, sepsis, acute kidney injury, procedure time and duration of hospital stay. A random effects model was used to calculate the pooled relative risks (RR) with 95% confidence intervals. Seven observational studies and a total of 1,542 patients were included in this analysis. None of the studies were randomized. Compared to GA, MAC was associated with a shorter hospital stay (-3.0 days (-5.0 to -1.0); P = 0.004) and a shorter procedure time (MD -36.3 minutes (-58.0 to -15.0 minutes); P <0.001). Overall 30-day mortality was not significantly different between MAC and GA (RR 0.77 (0.38 to 1.56); P = 0.460), also cardiac- and procedure-related mortality was similar between both groups (RR 0.90 (0.34 to 2.39); P = 0.830). These data did not show a significant difference in short-term outcomes for MAC or GA in TAVR. MAC may be associated with reduced procedural time and shorter hospital stay. Now randomized trials are needed for further evaluation of MAC in the setting of TAVR.

Robotic assisted versus pure laparoscopic surgery of the adrenal glands: a case-control study comparing surgical techniques.

PubMed

Morelli, Luca; Tartaglia, Dario; Bronzoni, Jessica; Palmeri, Matteo; Guadagni, Simone; Di Franco, Gregorio; Gennai, Andrea; Bianchini, Matteo; Bastiani, Luca; Moglia, Andrea; Ferrari, Vincenzo; Fommei, Enza; Pietrabissa, Andrea; Di Candio, Giulio; Mosca, Franco

2016-11-01

The role of the da Vinci Robotic System ® in adrenal gland surgery is not yet well defined. The goal of this study was to compare robotic-assisted surgery with pure laparoscopic surgery in a single center. One hundred and 16 patients underwent minimally invasive adrenalectomies in our department between June 1994 and December 2014, 41 of whom were treated with a robotic-assisted approach (robotic adrenalectomy, RA). Patients who underwent RA were matched according to BMI, age, gender, and nodule dimensions, and compared with 41 patients who had undergone laparoscopic adrenalectomies (LA). Statistical analysis was performed using the Student's t test for independent samples, and the relationship between the operative time and other covariates were evaluated with a multivariable linear regression model. P < 0.05 was considered significant. Mean operative time was significantly shorter in the RA group compared to the LA group. The subgroup analysis showed a shorter mean operative time in the RA group in patients with nodules ≥6 cm, BMI ≥ 30 kg/m 2 and in those who had previous abdominal surgery (p < 0.05). Results from the multiple regression model confirmed a shorter mean operative time with RA with nodules ≥6 cm (p = 0.010). Conversion rate and postoperative complications were 2.4 and 4.8 % in the LA group and 0 and 4.8 % in the RA group. In our experience, RA shows potential benefits compared to classic LA, in particular on patients with nodules ≥6 cm, BMI ≥ 30 kg/m2, and with previous abdominal surgery.

Effectiveness of Acupuncture for Early Recovery of Bowel Function in Cancer: A Systematic Review and Meta-Analysis.

PubMed

Liu, Yi-Hua; Dong, Guang-Tong; Ye, Yang; Zheng, Jia-Bin; Zhang, Ying; Lin, Hong-Sheng; Wang, Xue-Qian

2017-01-01

The aim of this study was to evaluate the effects of acupuncture therapy to reduce the duration of postoperative ileus (POI) and to enhance bowel function in cancer patients. A systematic search of electronic databases for studies published from inception until January 2017 was carried out from six databases. Randomized controlled trials (RCTs) involving the use of acupuncture and acupressure for POI and bowel function in cancer patients were identified. Outcomes were extracted from each study and pooled to determine the risk ratio and standardized mean difference. 10 RCTs involving 776 cancer patients were included. Compared with control groups (no acupuncture, sham acupuncture, and other active therapies), acupuncture was associated with shorter time to first flatus and time to first defecation. A subgroup analysis revealed that manual acupuncture was more effective on the time to first flatus and the time to first defecation; electroacupuncture was better in reducing the length of hospital stay. Compared with control groups (sham or no acupressure), acupressure was associated with shorter time to first flatus. However, GRADE approach indicated a low quality of evidence. Acupuncture and acupressure showed large effect size with significantly poor or inferior quality of included trials for enhancing bowel function in cancer patients after surgery. Further well-powered evidence is needed.

Motion illusions in optical art presented for long durations are temporally distorted.

PubMed

Nather, Francisco Carlos; Mecca, Fernando Figueiredo; Bueno, José Lino Oliveira

2013-01-01

Static figurative images implying human body movements observed for shorter and longer durations affect the perception of time. This study examined whether images of static geometric shapes would affect the perception of time. Undergraduate participants observed two Optical Art paintings by Bridget Riley for 9 or 36 s (group G9 and G36, respectively). Paintings implying different intensities of movement (2.0 and 6.0 point stimuli) were randomly presented. The prospective paradigm in the reproduction method was used to record time estimations. Data analysis did not show time distortions in the G9 group. In the G36 group the paintings were differently perceived: that for the 2.0 point one are estimated to be shorter than that for the 6.0 point one. Also for G36, the 2.0 point painting was underestimated in comparison with the actual time of exposure. Motion illusions in static images affected time estimation according to the attention given to the complexity of movement by the observer, probably leading to changes in the storage velocity of internal clock pulses.

Turbulent transport measurements with a laser Doppler velocimeter.

NASA Technical Reports Server (NTRS)

Edwards, R. V.; Angus, J. C.; Dunning, J. W., Jr.

1972-01-01

The power spectrum of phototube current from a laser Doppler velocimeter operating in the heterodyne mode has been computed. The spectral width and shape predicted by the theory are in agreement with experiment. For normal operating parameters the time-average spectrum contains information only for times shorter than the Lagrangian-integral time scale of the turbulence. To examine the long-time behavior, one must use either extremely small scattering angles, much-longer-wavelength radiation, or a different mode of signal analysis, e.g., FM detection.

Complete Versus Incomplete Angiography Prior to Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction.

PubMed

Stiver, Kevin; Gao, Xu; Shreenivas, Satya; Boudoulas, Konstantinos Dean; Mazzaferri, Ernie; Makki, Nader; Lilly, Scott M

2017-08-01

Shorter reperfusion times in ST-elevation myocardial infarction (STEMI) are associated with improved survival. Prehospital strategies have been developed to minimize door-to-balloon (DTB) time, but few strategies within the catheterization laboratory itself have been evaluated. Incomplete angiography (IA) prior to percutaneous coronary intervention (PCI) is undertaken in clinical practice as a means to further reduce DTB time. We sought to determine whether or not those with STEMI who underwent IA prior to PCI had different preprocedural characteristics or post-PCI outcomes. We retrospectively reviewed patients presenting to our institution between March 2013 and December 2015. Clinical, demographic, and angiographic data were reviewed. The frequency, predictors, and outcomes among those who received IA vs complete angiography (CA) prior to PCI were compared with analysis of variance. Two hundred fifty-six patients were identified; 68 patients (26.6%) underwent IA and 188 patients (73.4%) had CA prior to PCI. Patients who received IA were younger, but no other preprocedural factors were predictive of IA. The practice of IA did vary by operator (range, 0%-47%; P<.01). DTB times were shorter in the IA group (28.1 min vs 37.3 min; P<.01). Overall outcomes, including peak troponin values, length of stay, in-hospital mortality, and discharge ejection fraction did not differ between the groups. IA is associated with shorter DTB times, although in this population was not associated with improvements in short-term outcomes.

Surgical team composition has a major impact on effectiveness and costs in laparoscopic donor nephrectomy.

PubMed

Özdemir-van Brunschot, Denise M D; Warlé, Michiel C; van der Jagt, Michel F; Grutters, Janneke P C; van Horne, Sharon B C E; Kloke, Heinrich J; van der Vliet, Johannes A; Langenhuijsen, Johan F; d'Ancona, Frank C

2015-05-01

Limited evidence exists that optimization of surgical team composition may improve effectiveness of laparoscopic donor nephrectomy (LDN). A retrospective cohort study with 541 consecutive LDNs. From 2003 to 2012, surgical team composition was gradually optimized with regard to the surgeons' experience, proficient assistance and the use of fixed teams. Multivariable analysis showed that a surgical team with an experienced surgeon had a significantly shorter operation time (OT) (-18 min, 95% CI -28 to -9), less estimated blood loss (EBL) (-64 mL, 95% CI -108 to -19) and shorter length of stay (LOS) (-1 day, 95% CI -1.6 to 0). Proficient assistance was also independently associated with a shorter OT (-43 min, 95% CI -53 to -33) and reduced EBL (-58 mL, 95% CI -109 to -6), whereas those procedures performed by fixed teams were related to a shorter operation (-50 min, 95% CI -59 to -43) and warm ischemia time (-1.8, 95% CI -2.1 to -1.5), a reduced mean complication grade (-0.14 per patient, 95% CI -0.3 to -0.02) and a shorter LOS (-1.1 day, 95% CI -1.7 to -05). Health care costs for LDN by one staff surgeon with unproficient assistance were 7.707 Euro, whereas costs for LDN by two staff surgeons in fixed teams were 5.614 Euro. Surgical team composition has a major impact on variables that reflect the effectiveness of LDN from the donors' perspective. Health care costs are lower for LDNs performed by two experienced surgeons in fixed team composition. We advocate the use of two experienced surgeons in fixed team composition for LDN.

Time-frequency analysis of stimulus frequency otoacoustic emissions and their changes with efferent stimulation in guinea pigs

NASA Astrophysics Data System (ADS)

Berezina-Greene, Maria A.; Guinan, John J.

2015-12-01

To aid in understanding their origin, stimulus frequency otoacoustic emissions (SFOAEs) were measured at a series of tone frequencies using the suppression method, both with and without stimulation of medial olivocochlear (MOC) efferents, in anesthetized guinea pigs. Time-frequency analysis showed SFOAE energy peaks in 1-3 delay components throughout the measured frequency range (0.5-12 kHz). One component's delay usually coincided with the phase-gradient delay. When multiple delay components were present, they were usually near SFOAE dips. Below 2 kHz, SFOAE delays were shorter than predicted from mechanical measurements. With MOC stimulation, SFOAE amplitude was decreased at most frequencies, but was sometimes enhanced, and all SFOAE delay components were affected. The MOC effects and an analysis of model data suggest that the multiple SFOAE delay components arise at the edges of the traveling-wave peak, not far basal of the peak. Comparisons with published guinea-pig neural data suggest that the short latencies of low-frequency SFOAEs may arise from coherent reflection from an organ-of-Corti motion that has a shorter group delay than the traveling wave.

Noise characteristics analysis of short wave infrared InGaAs focal plane arrays

NASA Astrophysics Data System (ADS)

Yu, Chunlei; Li, Xue; Yang, Bo; Huang, Songlei; Shao, Xiumei; Zhang, Yaguang; Gong, Haimei

2017-09-01

The increasing application of InGaAs short wave infrared (SWIR) focal plane arrays (FPAs) in low light level imaging requires ultra-low noise FPAs. This paper presents the theoretical analysis of FPA noise, and point out that both dark current and detector capacitance strongly affect the FPA noise. The impact of dark current and detector capacitance on FPA noise is compared in different situations. In order to obtain low noise performance FPAs, the demand for reducing detector capacitance is higher especially when pixel pitch is smaller, integration time is shorter, and integration capacitance is larger. Several InGaAs FPAs were measured and analyzed, the experiments' results could be well fitted to the calculated results. The study found that the major contributor of FPA noise is coupled noise with shorter integration time. The influence of detector capacitance on FPA noise is more significant than that of dark current. To investigate the effect of detector performance on FPA noise, two kinds of photodiodes with different concentration of the absorption layer were fabricated. The detectors' performance and noise characteristics were measured and analyzed, the results are consistent with that of theoretical analysis.

Emerging spectra of singular correlation matrices under small power-map deformations

NASA Astrophysics Data System (ADS)

Vinayak; Schäfer, Rudi; Seligman, Thomas H.

2013-09-01

Correlation matrices are a standard tool in the analysis of the time evolution of complex systems in general and financial markets in particular. Yet most analysis assume stationarity of the underlying time series. This tends to be an assumption of varying and often dubious validity. The validity of the assumption improves as shorter time series are used. If many time series are used, this implies an analysis of highly singular correlation matrices. We attack this problem by using the so-called power map, which was introduced to reduce noise. Its nonlinearity breaks the degeneracy of the zero eigenvalues and we analyze the sensitivity of the so-emerging spectra to correlations. This sensitivity will be demonstrated for uncorrelated and correlated Wishart ensembles.

Emerging spectra of singular correlation matrices under small power-map deformations.

PubMed

Vinayak; Schäfer, Rudi; Seligman, Thomas H

2013-09-01

Correlation matrices are a standard tool in the analysis of the time evolution of complex systems in general and financial markets in particular. Yet most analysis assume stationarity of the underlying time series. This tends to be an assumption of varying and often dubious validity. The validity of the assumption improves as shorter time series are used. If many time series are used, this implies an analysis of highly singular correlation matrices. We attack this problem by using the so-called power map, which was introduced to reduce noise. Its nonlinearity breaks the degeneracy of the zero eigenvalues and we analyze the sensitivity of the so-emerging spectra to correlations. This sensitivity will be demonstrated for uncorrelated and correlated Wishart ensembles.

An extraction algorithm of pulmonary fissures from multislice CT image

NASA Astrophysics Data System (ADS)

Tachibana, Hiroyuki; Saita, Shinsuke; Yasutomo, Motokatsu; Kubo, Mitsuru; Kawata, Yoshiki; Niki, Noboru; Nakano, Yasutaka; Sasagawa, Michizo; Eguchi, Kenji; Moriyama, Noriyuki

2005-04-01

Aging and smoking history increases number of pulmonary emphysema. Alveoli restoration destroyed by pulmonary emphysema is difficult and early direction is important. Multi-slice CT technology has been improving 3-D image analysis with higher body axis resolution and shorter scan time. And low-dose high accuracy scanning becomes available. Multi-slice CT image helps physicians with accurate measuring but huge volume of the image data takes time and cost. This paper is intended for computer added emphysema region analysis and proves effectiveness of proposed algorithm.

Increased phosphatidylethanolamine N-methyltransferase gene expression in non-small-cell lung cancer tissue predicts shorter patient survival

PubMed Central

ZINRAJH, DAVID; HÖRL, GERD; JÜRGENS, GÜNTHER; MARC, JANJA; SOK, MIHA; CERNE, DARKO

2014-01-01

Lipid mobilization is of great importance for tumor growth and studies have suggested that cancer cells exhibit abnormal choline phospholipid metabolism. In the present study, we hypothesized that phosphatidylethanolamine N-methyltransferase (PEMT) gene expression is increased in non-small-cell lung cancer (NSCLC) tissues and that increased gene expression acts as a predictor of shorter patient survival. Forty-two consecutive patients with resected NSCLC were enrolled in this study. Paired samples of lung cancer tissues and adjacent non-cancer lung tissues were collected from resected specimens for the estimation of PEMT expression. SYBR Green-based real-time polymerase chain reaction was used for quantification of PEMT mRNA in lung cancer tissues. Lipoprotein lipase (LPL) and fatty acid synthase (FASN) activities had already been measured in the same tissues. During a four-year follow-up, 21 patients succumbed to tumor progression. One patient did not survive due to non-cancer reasons and was not included in the analysis. Cox regression analysis was used to assess the prognostic value of PEMT expression. Our findings show that elevated PEMT expression in the cancer tissue, relative to that in the adjacent non-cancer lung tissue, predicts shorter patient survival independently of standard prognostic factors and also independently of increased LPL or FASN activity, the two other lipid-related predictors of shorter patient survival. These findings suggest that active phosphatidylcholine and/or choline metabolism are essential for tumor growth and progression. PMID:24932311

Increased phosphatidylethanolamine N-methyltransferase gene expression in non-small-cell lung cancer tissue predicts shorter patient survival.

PubMed

Zinrajh, David; Hörl, Gerd; Jürgens, Günther; Marc, Janja; Sok, Miha; Cerne, Darko

2014-06-01

Lipid mobilization is of great importance for tumor growth and studies have suggested that cancer cells exhibit abnormal choline phospholipid metabolism. In the present study, we hypothesized that phosphatidylethanolamine N-methyltransferase (PEMT) gene expression is increased in non-small-cell lung cancer (NSCLC) tissues and that increased gene expression acts as a predictor of shorter patient survival. Forty-two consecutive patients with resected NSCLC were enrolled in this study. Paired samples of lung cancer tissues and adjacent non-cancer lung tissues were collected from resected specimens for the estimation of PEMT expression. SYBR Green-based real-time polymerase chain reaction was used for quantification of PEMT mRNA in lung cancer tissues. Lipoprotein lipase (LPL) and fatty acid synthase (FASN) activities had already been measured in the same tissues. During a four-year follow-up, 21 patients succumbed to tumor progression. One patient did not survive due to non-cancer reasons and was not included in the analysis. Cox regression analysis was used to assess the prognostic value of PEMT expression. Our findings show that elevated PEMT expression in the cancer tissue, relative to that in the adjacent non-cancer lung tissue, predicts shorter patient survival independently of standard prognostic factors and also independently of increased LPL or FASN activity, the two other lipid-related predictors of shorter patient survival. These findings suggest that active phosphatidylcholine and/or choline metabolism are essential for tumor growth and progression.

Acute procedural outcomes of orbital atherectomy for the treatment of common femoral artery disease: Sub-analysis of the CONFIRM Registries.

PubMed

Lee, Michael S; Heikali, Daniel; Mustapha, Jihad; Adams, George; Mahmud, Ehtisham

2017-08-01

This analysis compared the angiographic outcomes of patients treated with orbital atherectomy for calcified common femoral artery (CFA) and superficial femoral artery (SFA) disease. The ideal revascularization strategy for CFA disease is unknown. Endarterectomy has been considered the standard of care for CFA disease for over 50 years. Endovascular intervention is becoming more commonly used to revascularize the CFA given the advances in technology and the less invasive nature of the procedure. Patient demographics, lesion characteristics, and procedure data for all CONFIRM patients with at least one CFA lesion location ( n=147 patients; n=200 lesions) were compared to patients with at least one SFA lesion location ( n=1508 patients; n=2367 lesions). The primary endpoint was angiographic complication, defined as the composite of dissection, perforation, slow flow, closure, spasm, embolism, or thrombosis. The CFA group had more patients with Rutherford class 4 and shorter lesion length. The CFA group had a higher final residual stenosis, shorter total run time, and shorter total inflation time. The primary endpoint was lower in the CFA group compared with the SFA group (17% vs 24%, p=0.02), driven by a lower dissection rate (10% vs 15%, p=0.04). Plaque modification of the CFA with orbital atherectomy was safe and compared favorably with SFA disease. The need for bail-out stenting was low. A randomized trial is needed to determine the ideal treatment strategy for calcified CFA disease.

Stapled haemorrhoidopexy for the treatment of haemorrhoids: a systematic review.

PubMed

Burch, J; Epstein, D; Sari, A Baba-Akbari; Weatherly, H; Jayne, D; Fox, D; Woolacott, N

2009-03-01

This systematic review aimed to evaluate the short- and long-term safety, efficacy and costs of stapled haemorrhoidopexy (SH) compared with conventional haemorrhoidectomy. We searched 26 electronic databases and websites for studies in any language up to July 2006. Inclusion criteria were predefined, and each stage of the review process was conducted in duplicate. Twenty-seven randomized controlled trials were included (n = 2279). All had some methodological flaws. Postoperatively, 19 trials (95%) reported less pain, 17 (89%) reported a shorter operating time, 14 (88%) a shorter hospital stay, and 14 (93%) a shorter convalescence time following SH. However, prolapse was significantly more common after SH (OR 3.38; 95% CI: 1.00, 11.47). In the longer term, prolapse was significantly more common after SH (OR 4.34; 95% CI: 1.67, 11.28) as was reintervention for prolapse (OR 6.78; 95% CI: 2.00, 23.00). There were no differences in the rate or type of complications. Conventional haemorrhoidectomy and SH had similar costs during the initial admission. Compared with conventional haemorrhoidectomy, SH resulted in less postoperative pain, shorter operating time, a shorter hospital stay, and a shorter convalescence, but a higher rate of prolapse and reintervention for prolapse.

The influence of insurance status on waiting times in German acute care hospitals: an empirical analysis of new data

PubMed Central

2009-01-01

Background There is an ongoing debate in Germany about the assumption that patients with private health insurance (PHI) benefit from better access to medical care, including shorter waiting times (Lüngen et al. 2008), compared to patients with statutory health insurance (SHI). Problem Existing analyses of the determinants for waiting times in Germany are a) based on patient self-reports and b) do not cover the inpatient sector. This paper aims to fill both gaps by (i) generating new primary data and (ii) analyzing waiting times in German hospitals. Methods We requested individual appointments from 485 hospitals within an experimental study design, allowing us to analyze the impact of PHI versus SHI on waiting times (Asplin et al. 2005). Results In German acute care hospitals patients with PHI have significantly shorter waiting times than patients with SHI. Conclusion Discrimination in waiting times by insurance status does occur in the German acute hospital sector. Since there is very little transparency in treatment quality in Germany, we do not know whether discrimination in waiting times leads to discrimination in the quality of treatment. This is an important issue for future research. PMID:20025744

Self-motion perception compresses time experienced in return travel.

PubMed

Seno, Takeharu; Ito, Hiroyuki; Shoji, Sunaga

2011-01-01

It is often anecdotally reported that time experienced in return travel (back to the start point) seems shorter than time spent in outward travel (travel to a new destination). Here, we report the first experimental results showing that return travel time is experienced as shorter than the actual time. This discrepancy is induced by the existence of self-motion perception.

Effects of shortened host life span on the evolution of parasite life history and virulence in a microbial host-parasite system

PubMed Central

Nidelet, Thibault; Koella, Jacob C; Kaltz, Oliver

2009-01-01

Background Ecological factors play an important role in the evolution of parasite exploitation strategies. A common prediction is that, as shorter host life span reduces future opportunities of transmission, parasites compensate with an evolutionary shift towards earlier transmission. They may grow more rapidly within the host, have a shorter latency time and, consequently, be more virulent. Thus, increased extrinsic (i.e., not caused by the parasite) host mortality leads to the evolution of more virulent parasites. To test these predictions, we performed a serial transfer experiment, using the protozoan Paramecium caudatum and its bacterial parasite Holospora undulata. We simulated variation in host life span by killing hosts after 11 (early killing) or 14 (late killing) days post inoculation; after killing, parasite transmission stages were collected and used for a new infection cycle. Results After 13 cycles (≈ 300 generations), parasites from the early-killing treatment were less infectious, but had shorter latency time and higher virulence than those from the late-killing treatment. Overall, shorter latency time was associated with higher parasite loads and thus presumably with more rapid within-host replication. Conclusion The analysis of the means of the two treatments is thus consistent with theory, and suggests that evolution is constrained by trade-offs between virulence, transmission and within-host growth. In contrast, we found little evidence for such trade-offs across parasite selection lines within treatments; thus, to some extent, these traits may evolve independently. This study illustrates how environmental variation (experienced by the host) can lead to the evolution of distinct parasite strategies. PMID:19320981

Robotic vs. Retropubic radical prostatectomy in prostate cancer: A systematic review and a meta-analysis update

PubMed Central

Chen, Hongbo; Chen, Zhiqiang; Xu, Hua; Ye, Zhangqun

2017-01-01

CONTEXT The safety and feasibility of robotic-assisted radical prostatectomy (RARP) compared with retropubic radical prostatectomy(RRP) is debated. Recently, a number of large-scale and high-quality studies have been conducted. OBJECTIVE To obtain a more valid assessment, we update the meta-analysis of RARP compared with RRP to assessed its safety and feasibility in treatment of prostate cancer. METHODS A systematic search of Medline, Embase, Pubmed, and the Cochrane Library was performed to identify studies that compared RARP with RRP. Outcomes of interest included perioperative, pathologic variables and complications. RESULTS 78 studies assessing RARP vs. RRP were included for meta-analysis. Although patients underwent RRP have shorter operative time than RARP (WMD: 39.85 minutes; P < 0.001), patients underwent RARP have less intraoperative blood loss (WMD = -507.67ml; P < 0.001), lower blood transfusion rates (OR = 0.13; P < 0.001), shorter time to remove catheter (WMD = -3.04day; P < 0.001), shorter hospital stay (WMD = -1.62day; P < 0.001), lower PSM rates (OR:0.88; P = 0.04), fewer positive lymph nodes (OR:0.45;P < 0.001), fewer overall complications (OR:0.43; P < 0.001), higher 3- and 12-mo potent recovery rate (OR:3.19;P = 0.02; OR:2.37; P = 0.005, respectively), and lower readmission rate (OR:0.70, P = 0.03). The biochemical recurrence free survival of RARP is better than RRP (OR:1.33, P = 0.04). All the other calculated results are similar between the two groups. CONCLUSIONS Our results indicate that RARP appears to be safe and effective to its counterpart RRP in selected patients. PMID:27852051

Investigating the in-vitro and in-vivo flavour release from 21 fresh-cut apples.

PubMed

Ting, Valentina J L; Romano, Andrea; Soukoulis, Christos; Silcock, Patrick; Bremer, Phil J; Cappellin, Luca; Biasioli, Franco

2016-12-01

In-vitro and in-vivo flavour release from 21 different apple cultivars was studied using proton transfer reaction time-of-flight mass spectrometry (PTR-ToF-MS) with a focus on the relationship between texture and volatile organic compound (VOC) emission. Generally, firm-juicy cultivars had a shorter time to first swallow (Tswal) and a higher number of swallows (Nswal), while softer-mealy cultivars had a longer Tswal and a lower Nswal. Firm-juicy cultivars containing high VOC concentrations had a short time to maximum intensity (Tmax) owing to a shorter Tswal and a higher Nswal as juice was released during mastication. Swallowing increased VOC flow through the nasal cavity. These results differ from previous flavour release studies with gel/gel-like model systems as juiciness/release of fluids is not a factor in such matrices. The current study, therefore, highlights the benefits of using in-vivo analysis to gain a better understanding of flavour release in real food products. Copyright © 2016 Elsevier Ltd. All rights reserved.

Influence of motion on face recognition.

PubMed

Bonfiglio, Natale S; Manfredi, Valentina; Pessa, Eliano

2012-02-01

The influence of motion information and temporal associations on recognition of non-familiar faces was investigated using two groups which performed a face recognition task. One group was presented with regular temporal sequences of face views designed to produce the impression of motion of the face rotating in depth, the other group with random sequences of the same views. In one condition, participants viewed the sequences of the views in rapid succession with a negligible interstimulus interval (ISI). This condition was characterized by three different presentation times. In another condition, participants were presented a sequence with a 1-sec. ISI among the views. That regular sequences of views with a negligible ISI and a shorter presentation time were hypothesized to give rise to better recognition, related to a stronger impression of face rotation. Analysis of data from 45 participants showed a shorter presentation time was associated with significantly better accuracy on the recognition task; however, differences between performances associated with regular and random sequences were not significant.

Predictors of shorter sleep in early childhood

PubMed Central

McDonald, Laura; Wardle, Jane; Llewellyn, Clare H.; van Jaarsveld, Cornelia H.M.; Fisher, Abigail

2014-01-01

Objective The aim of this study was to identify socio-demographic and home environmental predictors of shorter sleep in early childhood, and to examine whether effects were mediated by the timing of bedtime or wake time. Methods Participants were from Gemini, a British birth cohort of twins, and included 1702 children; one randomly selected from each twin pair. Parents reported night-time sleep duration at an average age of 15.8 months (range 14–27 months) using a modified version of the Brief Infant Sleep Questionnaire. Multiple logistic regression models were used to identify predictors of shorter sleep for this study. Results Using a cut-off of <11 h a night, shorter sleep was reported in 14.1% of children. Lower maternal education, non-white ethnic background, being male, low birth weight, living in a home with >1 older child and watching >1 h of TV in the evening were independently associated with shorter sleep. Mediation analyses showed that associations between education, ethnicity, evening TV viewing and sleep were driven predominantly by later bedtimes, while sex differences were driven predominantly by earlier wake times in boys. Conclusion In this sample, multiple environmental factors were associated with shorter sleep in young children, with several operating predominantly through later bedtime. An emphasis on the importance of an early and consistent bedtime could help promote healthy sleep and reduce inequalities in child health. PMID:24726571

Percutaneous Radiofrequency Ablation of Colorectal Cancer Liver Metastases: Factors Affecting Outcomes—A 10-year Experience at a Single Center

PubMed Central

Shady, Waleed; Petre, Elena N.; Gonen, Mithat; Erinjeri, Joseph P.; Brown, Karen T.; Covey, Anne M.; Alago, William; Durack, Jeremy C.; Maybody, Majid; Brody, Lynn A.; Siegelbaum, Robert H.; D’Angelica, Michael I.; Jarnagin, William R.; Solomon, Stephen B.; Kemeny, Nancy E.

2016-01-01

Purpose To identify predictors of oncologic outcomes after percutaneous radiofrequency ablation (RFA) of colorectal cancer liver metastases (CLMs) and to describe and evaluate a modified clinical risk score (CRS) adapted for ablation as a patient stratification and prognostic tool. Materials and Methods This study consisted of a HIPAA-compliant institutional review board–approved retrospective review of data in 162 patients with 233 CLMs treated with percutaneous RFA between December 2002 and December 2012. Contrast material–enhanced CT was used to assess technique effectiveness 4–8 weeks after RFA. Patients were followed up with contrast-enhanced CT every 2–4 months. Overall survival (OS) and local tumor progression–free survival (LTPFS) were calculated from the time of RFA by using the Kaplan-Meier method. Log-rank tests and Cox regression models were used for univariate and multivariate analysis to identify predictors of outcomes. Results Technique effectiveness was 94% (218 of 233). Median LTPFS was 26 months. At univariate analysis, predictors of shorter LTPFS were tumor size greater than 3 cm (P < .001), ablation margin size of 5 mm or less (P < .001), high modified CRS (P = .009), male sex (P = .03), and no history of prior hepatectomy (P = .04) or hepatic arterial infusion chemotherapy (P = .01). At multivariate analysis, only tumor size greater than 3 cm (P = .01) and margin size of 5 mm or less (P < .001) were independent predictors of shorter LTPFS. Median and 5-year OS were 36 months and 31%. At univariate analysis, predictors of shorter OS were tumor size larger than 3 cm (P = .005), carcinoembryonic antigen level greater than 30 ng/mL (P = .003), high modified CRS (P = .02), and extrahepatic disease (EHD) (P < .001). At multivariate analysis, tumor size greater than 3 cm (P = .006) and more than one site of EHD (P < .001) were independent predictors of shorter OS. Conclusion Tumor size of less than 3 cm and ablation margins greater than 5 mm are essential for satisfactory local tumor control. Tumor size of more than 3 cm and the presence of more than one site of EHD are associated with shorter OS. © RSNA, 2015 PMID:26267832

Differing manifestations of hepatitis C and tacrolimus on hospitalized diabetes mellitus occurring after kidney transplantation.

PubMed

Abbott, Kevin C; Bernet, Victor J; Agodoa, Lawrence Y; Yuan, Christina M

2005-09-01

Previous studies suggest the association of recipient hepatitis C seropositivity (HCV+) and use of tacrolimus (TAC) with post-transplant diabetes mellitus (PTDM) may differ by manifestations of type I or type II diabetes, but this has not been assessed in the era of current immunosuppression. We performed a retrospective cohort study of 10,342 Medicare primary renal transplantation recipients without evidence of diabetes at the time of listing in the United States Renal Data System between January 1, 1998 and July 31, 2000, followed until December 31, 2000. Outcomes were hospitalizations for a primary diagnosis of diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar syndrome (HHS). Cox regression analysis was used to calculate adjusted hazard ratios (AHR) for time to DKA or HHS, stratified by diabetes status at the time of transplant. In Cox regression analysis, use of TAC at discharge was independently associated with shorter time to DKA (AHR, 1.88; 95% CI, 1.05-3.37, p=0.034) but not HHS. In contrast, recipient HCV+ was independently associated with shorter time to HHS (AHR, 3.90; 1.59-9.60, p=.003), but not DKA. There was no interaction between TAC and HCV+ for either outcome. These results confirm earlier findings that TAC and HCV+ may mediate the risk of PTDM through different mechanisms, even in the modern era.

The influence of coping styles on long-term employment in multiple sclerosis: A prospective study.

PubMed

Grytten, Nina; Skår, Anne Br; Aarseth, Jan Harald; Assmus, Jorg; Farbu, Elisabeth; Lode, Kirsten; Nyland, Harald I; Smedal, Tori; Myhr, Kjell Morten

2017-06-01

The aim was to investigate predictive values of coping styles, clinical and demographic factors on time to unemployment in patients diagnosed with multiple sclerosis (MS) during 1998-2002 in Norway. All patients ( N = 108) diagnosed with MS 1998-2002 in Hordaland and Rogaland counties, Western Norway, were invited to participate in the long-term follow-up study in 2002. Baseline recordings included disability scoring (Expanded Disability Status Scale (EDSS)), fatigue (Fatigue Severity Scale (FSS)), depression (Beck Depression Inventory (BDI)), and questionnaire assessing coping (the Dispositional Coping Styles Scale (COPE)). Logistic regression analysis was used to identify factors associated with unemployed at baseline, and Cox regression analysis to identify factors at baseline associated with time to unemployment during follow-up. In all, 41 (44%) were employed at baseline. After 13 years follow-up in 2015, mean disease duration of 22 years, 16 (17%) were still employed. Median time from baseline to unemployment was 6 years (±5). Older age at diagnosis, female gender, and depression were associated with patients being unemployed at baseline. Female gender, long disease duration, and denial as avoidant coping strategy at baseline predicted shorter time to unemployment. Avoidant coping style, female gender, and longer disease duration were associated with shorter time to unemployment. These factors should be considered when advising patients on MS and future employment.

Retrospective Analysis Of CO2 Laser Myringotomy

NASA Astrophysics Data System (ADS)

Lipman, Sidney P.; Guelcher, Robert T.

1988-06-01

A retrospective review of the author's series of 91 carbon dioxide (CO2) laser myringotomy cases performed between 1983 and 1986 is presented. Patients with chronic otitis media with effusion (COME) were selected on the basis of possible benefit from shorter ventilation time than tympanostomy tube insertion. The proceedings were performed on an outpatient basis with topical iontophoretic anesthesia, which offers significant cost savings and a lack of possible complications. The CO2 laser gives clean precise 0.8mm perforations which remain open for 2-4 weeks, this shorter ventilation time minimizing the period of water precautions and other side effects. The laser perforations heal well. With a success rate of 52 % reported, which could be increased with careful patient selection, we feel that the advantages of carbon dioxide laser myringotomy over myringotomy plus intubation outweight the risk of recurrent otitis media with effusion formation in those patients to whom this procedure is applicable.

Survival analysis with functional covariates for partial follow-up studies.

PubMed

Fang, Hong-Bin; Wu, Tong Tong; Rapoport, Aaron P; Tan, Ming

2016-12-01

Predictive or prognostic analysis plays an increasingly important role in the era of personalized medicine to identify subsets of patients whom the treatment may benefit the most. Although various time-dependent covariate models are available, such models require that covariates be followed in the whole follow-up period. This article studies a new class of functional survival models where the covariates are only monitored in a time interval that is shorter than the whole follow-up period. This paper is motivated by the analysis of a longitudinal study on advanced myeloma patients who received stem cell transplants and T cell infusions after the transplants. The absolute lymphocyte cell counts were collected serially during hospitalization. Those patients are still followed up if they are alive after hospitalization, while their absolute lymphocyte cell counts cannot be measured after that. Another complication is that absolute lymphocyte cell counts are sparsely and irregularly measured. The conventional method using Cox model with time-varying covariates is not applicable because of the different lengths of observation periods. Analysis based on each single observation obviously underutilizes available information and, more seriously, may yield misleading results. This so-called partial follow-up study design represents increasingly common predictive modeling problem where we have serial multiple biomarkers up to a certain time point, which is shorter than the total length of follow-up. We therefore propose a solution to the partial follow-up design. The new method combines functional principal components analysis and survival analysis with selection of those functional covariates. It also has the advantage of handling sparse and irregularly measured longitudinal observations of covariates and measurement errors. Our analysis based on functional principal components reveals that it is the patterns of the trajectories of absolute lymphocyte cell counts, instead of the actual counts, that affect patient's disease-free survival time. © The Author(s) 2014.

Duration of blastulation may be associated with ongoing pregnancy rate in single euploid blastocyst transfer cycles.

PubMed

Mumusoglu, Sezcan; Ozbek, Irem Y; Sokmensuer, Lale K; Polat, Mehtap; Bozdag, Gurkan; Papanikolaou, Evangelos; Yarali, Hakan

2017-12-01

Not all euploid embryos implant, necessitating additional tools to select viable blastocysts in preimplantation genetic screening cycles. In this retrospective cohort study, 129 consecutive patients who underwent 129 single euploid blastocyst transfers in cryopreserved embryo transfer cycles were included. All embryos were individually cultured in a time-lapse incubator from intracytoplasmic sperm injection up to trophoectoderm biopsy. Twenty-three time-lapse morphokinetic variables were tested among patients with (n = 68) or without (n = 61) ongoing pregnancy. All 23 time-lapse morphokinetic variables, apart from duration of blastulation (tB-tSB), were comparable between patients with or without ongoing pregnancy. Duration of blastulation was significantly shorter in patients with ongoing pregnancy (8.1 ± 3.2 versus 9.5 ± 3.4 h; P = 0.014); shorter duration of blastulation remained an independent predictor for ongoing pregnancy, when tested by logistic regression analysis (OR 0.81; 95% CI 0.70 to 0.93). One important limitation of this study, and a reason for caution, is the use of multiple comparisons, which can lead to differences at the 0.05 level simply by chance or random variation. Nonetheless, the study suggests that when more than one euploid blastocyst is available, priority might be given to those with a shorter duration of blastulation. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Common Atrial Fibrillation Risk Alleles at 4q25 Predict Recurrence after Catheter-based Atrial Fibrillation Ablation

PubMed Central

Shoemaker, M. Benjamin; Muhammad, Raafia; Parvez, Babar; White, Brenda W.; Streur, Megan; Song, Yanna; Stubblefield, Tanya; Kucera, Gayle; Blair, Marcia; Rytlewski, Jason; Parvathaneni, Sunthosh; Nagarakanti, Rangadham; Saavedra, Pablo; Ellis, Christopher; Whalen, S. Patrick; Roden, Dan M; Darbar, Dawood

2012-01-01

Background Common single nucleotide polymorphisms (SNPs) at chromosome 4q25 (rs2200733, rs10033464) are associated with both lone and typical AF. Risk alleles at 4q25 have recently been shown to predict recurrence of AF after ablation in a population of predominately lone AF, but lone AF represents only 5–30% of AF cases. Objective To test the hypothesis that 4q25 AF risk alleles can predict response to AF ablation in the majority of AF cases. Methods Patients enrolled in the Vanderbilt AF Registry underwent 378 catheter-based AF ablations (median age 60 years, 71% male, 89% typical AF) between 2004 and 2011. The primary endpoint was time to recurrence of any non-sinus atrial tachyarrhythmia (atrial tachycardia, atrial flutter, or AF; [AT/AF]). Results Two-hundred AT/AF recurrences (53%) were observed. In multivariable analysis, the rs2200733 risk allele predicted a 24% shorter recurrence-free time (survival time ratio 0.76 95% confidence interval [CI] 0.6–0.95, P=0.016) compared with wild-type. The heterozygous haplotype demonstrated a 21% shorter recurrence-free time (survival time ratio = 0.79, 95% CI 0.62–0.99) and the homozygous risk allele carriers a 39% shorter recurrence-free time (survival time ratio = 0.61, 95% CI 0.37–1.0) (P=0.037). Conclusion Risk alleles at the 4q25 loci predict impaired clinical response to AF ablation in a population of predominately typical AF patients. Our findings suggest the rs2200733 polymorphism may hold promise as an as an objectively measured patient characteristic that can used as a clinical tool for selection of patients for AF ablation. PMID:23178686

Utilization of Total Joint Arthroplasty in Physician-Owned Specialty Hospitals vs Acute Care Facilities.

PubMed

Chen, Antonia F; Pflug, Emily; O'Brien, Daniel; Maltenfort, Mitchell G; Parvizi, Javad

2017-07-01

The recent emergence of physician-owned specialty hospitals has sparked controversy about overutilization. Thus, the purpose of this study was to compare utilization patterns of total joint arthroplasty (TJA) between physician-specialty hospitals (PSHs) and acute care hospitals (ACHs). A retrospective study was conducted from January 2010 to August 2014 comparing primary TJA patients between a PSH and an ACH; 103 PSH patients were matched to 103 ACH patients by age, gender, BMI, and ASA classification with similar case distribution between facilities. All surgeons in the study operated at both hospitals and were shareholders of the PSH. Information on nonoperative treatments, and timing to the initial appointment, consent, and surgery were analyzed using univariate analysis. Nonoperative treatments before surgery were similar between hospitals (P = 1.00). The time from the initial appointment to consent was longer for PSH (P = .0001). However, the time from consent to the date of surgery (P = .04) and the timing from symptoms to initial appointment (P = .006) was shorter for PSH. The time from initial appointment to the day of surgery was similar between groups (P = .20). Patients were more likely to be consented for surgery on their first clinic visit when undergoing surgery at ACH (87 of 103, 84.4%) compared to PSH (61 of 103; 59.2%; P < .001). Length of stay was significantly shorter for both total knee arthroplasty (P = .001) and total hip arthroplasty patients (P = .001) at PSH. Facility ownership in PSH resulted in similar conservative treatment before TJA. The time to surgical consent after the initial appointment was longer PSH, whereas the time from consent to the date of surgery was shorter at the PSH. Copyright © 2017 Elsevier Inc. All rights reserved.

Molecular dynamics analysis of transitions between rotational isomers in polymethylene

NASA Astrophysics Data System (ADS)

Zúñiga, Ignacio; Bahar, Ivet; Dodge, Robert; Mattice, Wayne L.

1991-10-01

Molecular dynamics trajectories have been computed and analyzed for linear chains, with sizes ranging from C10H22 to C100H202, and for cyclic C100H200. All hydrogen atoms are included discretely. All bond lengths, bond angles, and torsion angles are variable. Hazard plots show a tendency, at very short times, for correlations between rotational isomeric transitions at bond i and i±2, in much the same manner as in the Brownian dynamics simulations reported by Helfand and co-workers. This correlation of next nearest neighbor bonds in isolated polyethylene chains is much weaker than the correlation found for next nearest neighbor CH-CH2 bonds in poly(1,4-trans-butadiene) confined to the channel formed by crystalline perhydrotriphenylene [Dodge and Mattice, Macromolecules 24, 2709 (1991)]. Less than half of the rotational isomeric transitions observed in the entire trajectory for C50H102 can be described as strongly coupled next nearest neighbor transitions. If correlated motions are identified with successive transitions, which occur within a time interval of Δt≤1 ps, only 18% of the transitions occur through cooperative motion of bonds i and i±2. An analysis of the entire data set of 2482 rotational isomeric state transitions, observed in a 3.7 ns trajectory for C50H102 at 400 K, was performed using a formalism that treats the transitions at different bonds as being independent. On time scales of 0.1 ns or longer, the analysis based on independent bonds accounts reasonably well for the results from the molecular dynamics simulations. At shorter times the molecular dynamics simulation reveals a higher mobility than implied by the analysis assuming independent bonds, presumably due to the influence of correlations that are important at shorter times.

Analysis of anthocyanins in commercial fruit juices by using nano-liquid chromatography-electrospray-mass spectrometry and high-performance liquid chromatography with UV-vis detector.

PubMed

Fanali, Chiara; Dugo, Laura; D'Orazio, Giovanni; Lirangi, Melania; Dachà, Marina; Dugo, Paola; Mondello, Luigi

2011-01-01

Nano-LC and conventional HPLC techniques were applied for the analysis of anthocyanins present in commercial fruit juices using a capillary column of 100 μm id and a 2.1 mm id narrow-bore C(18) column. Analytes were detected by UV-Vis at 518 nm and ESI-ion trap MS with HPLC and nano-LC, respectively. Commercial blueberry juice (14 anthocyanins detected) was used to optimize chromatographic separation of analytes and other analysis parameters. Qualitative identification of anthocyanins was performed by comparing the recorded mass spectral data with those of published papers. The use of the same mobile phase composition in both techniques revealed that the miniaturized method exhibited shorter analysis time and higher sensitivity than narrow-bore chromatography. Good intra-day and day-to-day precision of retention time was obtained in both methods with values of RSD less than 3.4 and 0.8% for nano-LC and HPLC, respectively. Quantitative analysis was performed by external standard curve calibration of cyanidin-3-O-glucoside standard. Calibration curves were linear in the concentration ranges studied, 0.1-50 and 6-50 μg/mL for HPLC-UV/Vis and nano-LC-MS, respectively. LOD and LOQ values were good for both methods. In addition to commercial blueberry juice, qualitative and quantitative analysis of other juices (e.g. raspberry, sweet cherry and pomegranate) was performed. The optimized nano-LC-MS method allowed an easy and selective identification and quantification of anthocyanins in commercial fruit juices; it offered good results, shorter analysis time and reduced mobile phase volume with respect to narrow-bore HPLC. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Generalized activity equations for spiking neural network dynamics.

PubMed

Buice, Michael A; Chow, Carson C

2013-01-01

Much progress has been made in uncovering the computational capabilities of spiking neural networks. However, spiking neurons will always be more expensive to simulate compared to rate neurons because of the inherent disparity in time scales-the spike duration time is much shorter than the inter-spike time, which is much shorter than any learning time scale. In numerical analysis, this is a classic stiff problem. Spiking neurons are also much more difficult to study analytically. One possible approach to making spiking networks more tractable is to augment mean field activity models with some information about spiking correlations. For example, such a generalized activity model could carry information about spiking rates and correlations between spikes self-consistently. Here, we will show how this can be accomplished by constructing a complete formal probabilistic description of the network and then expanding around a small parameter such as the inverse of the number of neurons in the network. The mean field theory of the system gives a rate-like description. The first order terms in the perturbation expansion keep track of covariances.

Efficacy and safety of cryoballoon ablation versus radiofrequency catheter ablation in atrial fibrillation: an updated meta-analysis

PubMed Central

Ma, Honglan; Sun, Dongdong; Luan, Hui; Feng, Wei; Zhou, Yaqiong; Wu, Jine; He, Caiyun

2017-01-01

Introduction Cryoballoon ablation (CBA) and irrigated radiofrequency catheter ablation (RFCA) are the main treatments for drug-refractory symptomatic atrial fibrillation (AF). Aim To compare the efficacy and safety between CBA and RFCA for the treatment of AF. Material and methods We searched the Embase and Medline databases for clinical studies published up to December 2016. Studies that satisfied our predefined inclusion criteria were included. Results After searching through the literature in the two major databases, 20 studies with a total of 9,141 patients were included in our study. The CBA had a significantly shorter procedure time (weighted mean difference (WMD) –30.38 min; 95% CI: –46.43 to –14.33, p = 0.0002) and non-significantly shorter fluoroscopy time (WMD –3.18 min; 95% CI: –6.43 to 0.07, p = 0.06) compared with RFCA. There was no difference in freedom from AF between CBA and RFCA (CBA 78.55% vs. RFCA 83.13%, OR = 1.15, 95% CI: 0.95–1.39, p = 0.14). The CBA was associated with a high risk of procedure-related complications (CBA 9.02% vs. RFCA 6.56%, OR = 1.56, 95% CI: 1.05–2.31, p = 0.03), especially phrenic nerve paralysis (PNP, OR = 10.72, 95% CI: 5.59–20.55, p < 0.00001). The risk of pericardial effusions/cardiac tamponade was low in the CBA group (CBA 1.05% vs. RFCA 1.86%, OR = 0.62, 95% CI: 0.41–0.93, p = 0.02). Conclusions For AF, CBA was as effective as RFCA. However, CBA had a shorter procedure time and a non-significantly shorter fluoroscopy time, a significantly high risk of PNP and a low incidence of pericardial effusions/cardiac tamponade compared with RFCA. PMID:29056997

Anterolateral minithoracotomy versus median sternotomy for the treatment of congenital heart defects: a meta-analysis and systematic review.

PubMed

Ding, Chao; Wang, Chunmao; Dong, Aiqiang; Kong, Minjian; Jiang, Daming; Tao, Kaiyu; Shen, Zhonghua

2012-05-04

Anterolateral Minithoracotomy (ALMT) for the radical correction of Congenital Heart Defects is an alternative to Median Sternotomy (MS) due to reduce operative trauma accelerating recovery and yield a better cosmetic outcome after surgery. Our purpose is to conduct whether ALMT would bring more short-term benefits to patients than conventional Median Sternotomy by using a meta-analysis of case-control study in the published English Journal. 6 case control studies published in English from 1997 to 2011 were identified and synthesized to compare the short-term postoperative outcomes between ALMT and MS. These outcomes were cardiopulmonary bypass time, aortic cross-clamp time, intubation time, intensive care unit stay time, and postoperative hospital stay time. ALMT had significantly longer cardiopulmonary bypass times (8.00 min more, 95% CI 0.36 to 15.64 min, p = 0.04). Some evidence proved that aortic cross-clamp time of ALMT was longer, yet not significantly (2.38 min more, 95% CI -0.15 to 4.91 min, p = 0.06). In addition, ALMT had significantly shorter intubation time (1.66 hrs less, 95% CI -3.05 to -0.27 hrs, p = 0.02). Postoperative hospital stay time was significantly shorter with ALMT (1.52 days less, 95% CI -2.71 to -0.33 days, p = 0.01). Some evidence suggested a reduction in ICU stay time in the ALMT group. However, this did not prove to be statistically significant (0.88 days less, 95% CI -0.81 to 0.04 days, p = 0.08). ALMT can bring more benefits to patients with Congenital Heart Defects by reducing intubation time and postoperative hospital stay time, though ALMT has longer CPB time and aortic cross-clamp time.

SHORT ACCELERATION TIMES FROM SUPERDIFFUSIVE SHOCK ACCELERATION IN THE HELIOSPHERE

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

Perri, S.; Zimbardo, G., E-mail: silvia.perri@fis.unical.it

2015-12-10

The analysis of time profiles of particles accelerated at interplanetary shocks allows particle transport properties to be inferred. The frequently observed power-law decay upstream, indeed, implies a superdiffusive particle transport when the level of magnetic field variance does not change as the time interval from the shock front increases. In this context, a superdiffusive shock acceleration (SSA) theory has been developed, allowing us to make predictions of the acceleration times. In this work we estimate for a number of interplanetary shocks, including the solar wind termination shock, the acceleration times for energetic protons in the framework of SSA and wemore » compare the results with the acceleration times predicted by standard diffusive shock acceleration. The acceleration times due to SSA are found to be much shorter than in the classical model, and also shorter than the interplanetary shock lifetimes. This decrease of the acceleration times is due to the scale-free nature of the particle displacements in the framework of superdiffusion. Indeed, very long displacements are possible, increasing the probability for particles far from the front of the shock to return, and short displacements have a high probability of occurrence, increasing the chances for particles close to the front to cross the shock many times.« less

Propofol for procedural sedation and analgesia reduced dedicated emergency nursing time while maintaining safety in a community emergency department.

PubMed

Reynolds, Joshua C; Abraham, Michael K; Barrueto, Fermin F; Lemkin, Daniel L; Hirshon, Jon M

2013-09-01

Procedural sedation and analgesia is a core competency in emergency medicine. Propofol is replacing midazolam in many emergency departments. Barriers to performing procedural sedation include resource utilization. We hypothesized that emergency nursing time is shorter with propofol than midazolam, without increasing complications. Retrospective analysis of a procedural sedation registry for two community emergency departments with combined census of 100,000 patients/year. Demographics, procedure, and ASA physical classification status of adult patients receiving procedural sedation between 2007-2010 with midazolam or propofol were analyzed. Primary outcome was dedicated emergency nursing time. Secondary outcomes were procedural success, ED length of stay, and complication rate. Comparative statistics were performed with Mann-Whitney, Kruskal-Wallis, chi-square, or Fisher's exact test. Linear regression was performed with log-transformed procedural sedation time to define predictors. Of 328 procedural sedation and analgesia, 316 met inclusion criteria, of which 60 received midazolam and 256 propofol. Sex distribution varied between groups (midazolam 3% male; propofol 55% male; P = 0.04). Age, procedure, and ASA status were not significantly different. Propofol had shorter procedural sedation time (propofol 32.5 ± 24.2 minutes; midazolam 78.7 ± 51.5 minutes; P < 0.001) and higher rates of procedural success (propofol 98%; midazolam 92%; P = 0.02). There were no significant differences between complication rates (propofol 14%; midazolam 13%; P = 0.88) or emergency department length of stay (propofol 262.5 ± 132.8 minutes; midazolam 288.6 ± 130.6 minutes; P = 0.09). Use of propofol resulted in shorter emergency nursing time and higher procedural success rate than midazolam with a comparable safety profile. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

Electroacupuncture reduces duration of postoperative ileus after laparoscopic surgery for colorectal cancer.

PubMed

Ng, Simon S M; Leung, Wing Wa; Mak, Tony W C; Hon, Sophie S F; Li, Jimmy C M; Wong, Cherry Y N; Tsoi, Kelvin K F; Lee, Janet F Y

2013-02-01

We investigated the efficacy of electroacupuncture in reducing the duration of postoperative ileus and hospital stay after laparoscopic surgery for colorectal cancer. We performed a prospective study of 165 patients undergoing elective laparoscopic surgery for colonic and upper rectal cancer, enrolled from October 2008 to October 2010. Patients were assigned randomly to groups that received electroacupuncture (n = 55) or sham acupuncture (n = 55), once daily from postoperative days 1-4, or no acupuncture (n = 55). The acupoints Zusanli, Sanyinjiao, Hegu, and Zhigou were used. The primary outcome was time to defecation. Secondary outcomes included postoperative analgesic requirement, time to ambulation, and length of hospital stay. Patients who received electroacupuncture had a shorter time to defecation than patients who received no acupuncture (85.9 ± 36.1 vs 122.1 ± 53.5 h; P < .001) and length of hospital stay (6.5 ± 2.2 vs 8.5 ± 4.8 days; P = .007). Patients who received electroacupuncture also had a shorter time to defecation than patients who received sham acupuncture (85.9 ± 36.1 vs 107.5 ± 46.2 h; P = .007). Electroacupuncture was more effective than no or sham acupuncture in reducing postoperative analgesic requirement and time to ambulation. In multiple linear regression analysis, an absence of complications and electroacupuncture were associated with a shorter duration of postoperative ileus and hospital stay after the surgery. In a clinical trial, electroacupuncture reduced the duration of postoperative ileus, time to ambulation, and postoperative analgesic requirement, compared with no or sham acupuncture, after laparoscopic surgery for colorectal cancer. ClinicalTrials.gov number, NCT00464425. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

Turbulent transport measurements with a laser Doppler velocimeter

NASA Technical Reports Server (NTRS)

Edwards, R. V.; Angus, J. C.; Dunning, J. W., Jr.

1972-01-01

The power spectrum of phototube current from a laser Doppler velocimeter operating in the heterodyne mode has been computed. The spectrum is obtained in terms of the space time correlation function of the fluid. The spectral width and shape predicted by the theory are in agreement with experiment. For normal operating parameters the time average spectrum contains information only for times shorter than the Lagrangian integral time scale of the turbulence. To examine the long time behavior, one must use either extremely small scattering angles, much longer wavelength radiation or a different mode of signal analysis, e.g., FM detection.

Single-incision versus conventional three-port laparoscopic appendectomy: A meta-analysis of randomized controlled trials.

PubMed

Chen, Jiang-Ming; Geng, Wei; Xie, Sheng-Xue; Liu, Fu-Bao; Zhao, Yi-Jun; Yu, Li-Quan; Geng, Xiao-Ping

2015-01-01

The aim of this article was to compare the advantages and disadvantages of single-incision laparoscopic appendectomy (SILA) and conventional three-port laparoscopic appendectomy (CTLA). A meta-analysis was performed by analyzing all randomized controlled trials (RCTs) published in English that compared SILA and CTLA for appendicitis in adults and children. These studies compared these two methods from different angles including outcomes of interest, patient characteristics, operative time, pain visual analogue scales scores (VAS scores), length of hospital stay, time to return to full activity, resumption of diet, postoperative complications and cosmetic results The risk ratios (RR) and mean difference (MD) with 95% confidence intervals (CIs) were employed to assess the outcome. Seven recent RCTs encompassing 1170 patients (586 SILA and 584 CTLA cases) were included in this meta-analysis. The pooled results demonstrated that conversion rate, drain inserted, reoperation, length of hospital stay, resumption of normal diet and postoperative complications were statistically comparable between the two groups. The postoperative abdominal pain within 24 h was -0.57 in favor of the SILA technique (p = 0.05). Compared with CTLA, SILA showed a better cosmetic satisfaction score (SMD, 0.58; 95% CI, 0.32-0.83; p < 0.0001) and shorter time to recover normal activity (WMD, -0.69; 95% CI, -1.11-0.26; p = 0.001). However, SILA has a longer operative time (WMD, 5.38; 95% CI, 2.94-7.83; p < 0.0001). In selected patients, SILA was confirmed to be as safe and effective as CTLA. Despite the longer operative time, SILA has higher cosmetic satisfaction and shorter recovery time to normal activity. Due to the limitations of the available data, further research is needed.

Waiting times for hospital admissions: the impact of GP fundholding.

PubMed

Propper, Carol; Croxson, Bronwyn; Shearer, Arran

2002-03-01

Waiting times for hospital care are a significant issue in the UK National Health Service (NHS). The reforms of the health service in 1990 gave a subset of family doctors (GP fundholders) both the ability to choose the hospital where their patients were treated and the means to pay for some services. One of the key factors influencing family doctors' choice of hospital was patient waiting time. However, without cash inducements, hospitals would get no direct reward from giving shorter waiting times to a subset of patients. Using a unique dataset, we investigate whether GP fundholders were able to secure shorter waiting times for their patients, whether they were able to do so in cases where they had no financial rewards to offer hospitals, and whether the impact of fundholding spilled over into shorter waiting times for all patients.

Pediatric procedural sedation with ketamine: time to discharge after intramuscular versus intravenous administration.

PubMed

Ramaswamy, Preeti; Babl, Franz E; Deasy, Conor; Sharwood, Lisa N

2009-02-01

Ketamine is an attractive agent for pediatric procedural sedation. There are limited data on time to discharge comparing intramuscular (IM) vs. intravenous (IV) ketamine. The authors set out to determine whether IM or IV ketamine leads to quicker discharge from the emergency department (ED) and how side effect profiles compare. All patients who had received ketamine IM or IV at a tertiary children's hospital ED during the 3-year study period (2004-2007) were identified. Prospective sedation registry data, retrospective medical records, and administrative data were reviewed for drug dosages, use of additional agents, time of drug administration to discharge, total ED time (triage to discharge), and adverse events. A subgroup analysis for patients requiring five or fewer sutures (short suture group) was performed. A total of 229 patients were enrolled (60% male) with median age of 2.8 years (IQR =1.8-4.3 years) and median weight of 15.7 kg (range = 8.7-74 kg). Ketamine was most frequently employed for laceration repair (80%) and foreign body removal (9%). Overall, 48% received ketamine IM and 52% received it IV. In the short-suture subgroup, 52% received ketamine IM, while 48% received it IV. Multivariate linear regression analysis determined time from drug administration to patient discharge as 21 minutes shorter for IV compared with IM administration, adjusted for age and number of additional doses (R(2) = -0.35; 95% CI = -0.5 to -0.19; p < 0.001). Total time in the ED (triage to discharge) comparing IV versus IM administration, adjusting for age and gender and number of additional doses, was not significantly different (p = 0.16). In the short-suture subgroup, time to discharge from administration was also shorter in the IV ketamine group (R(2) = -0.454; 95%CI = -0.66 to -0.25; p < 0.001) but similar for total time in ED (p = 0.16). Overall, adverse events occurred in 35% (95% CI = 27% to 45%) of the IM group and 20% (95% CI = 13% to 28%) of the IV group (p = 0.01). Only one patient required brief bag-mask ventilation. In this institution, time from drug injection to discharge was shorter in the IV compared to IM ketamine group, both overall and for the short-suture group. However, time from triage to discharge was similar.

7 CFR 58.101 - Meaning of words.

Code of Federal Regulations, 2012 CFR

2012-01-01

... solution for the destruction of most human pathogens and other vegetative microorganisms to a level... the milk product, or the health of consumers. Sanitizing solutions shall comply with 21 CFR 178.1010... (higher heat shorter time pasteurization) 1.0 second. 194 °F (higher heat shorter time pasteurization) 0.5...

7 CFR 58.101 - Meaning of words.

Code of Federal Regulations, 2013 CFR

2013-01-01

... solution for the destruction of most human pathogens and other vegetative microorganisms to a level... the milk product, or the health of consumers. Sanitizing solutions shall comply with 21 CFR 178.1010... (higher heat shorter time pasteurization) 1.0 second. 194 °F (higher heat shorter time pasteurization) 0.5...

7 CFR 58.101 - Meaning of words.

Code of Federal Regulations, 2014 CFR

2014-01-01

... solution for the destruction of most human pathogens and other vegetative microorganisms to a level... the milk product, or the health of consumers. Sanitizing solutions shall comply with 21 CFR 178.1010... (higher heat shorter time pasteurization) 1.0 second. 194 °F (higher heat shorter time pasteurization) 0.5...

One-shot versus gradual dilation technique for tract creation in percutaneous nephrolithotomy: a systematic review and meta-analysis.

PubMed

Li, Yutao; Yang, Lu; Xu, Peng; Shen, Pengfei; Qian, Shengqiang; Wei, Wuran; Wang, Jia

2013-10-01

The aim of this study is to evaluate the efficacy and safety of one-shot versus gradual dilation technique for tract creation in percutaneous nephrolithotomy (PCNL). A systematic research of Pubmed, Embase and the Cochrane Library was performed to identify all relevant studies. The quality of the included trials was assessed and the data were extracted independently by two reviewers. The Cochrane Collaboration's Review Manager (RevMan) 5.0.2 software was used for statistical analysis. Four randomized controlled trials were included in analysis involving 346 patients in total. Of these patients 174 were in the one-shot group and 172 in the gradual group. Our meta-analysis showed that there were no significant differences in successful dilation rate [risk ratio (RR): 0.96; 95 % confidence interval (CI): 0.92-1.00, p = 0.05], transfusion rate (RR: 0.62; 95 % CI: 0.20-1.96; p = 0.42), and hemoglobin decrease [mean difference (MD): -0.34; 95 % CI: from -0.67 to -0.00; p = 0.05] between one-shot dilation and gradual dilation. One-shot dilation had significant shorter access time (MD: -1.03; 95 % CI: from -1.57 to -0.49; p = 0.0002) and X-ray exposure time (MD: -42.71; 95 % CI: from -45.05 to -40.37; p < 0.00001) than gradual dilation. Our results show that One-shot dilation is an effective and safe procedure for tract creation in PCNL, with shorter access time and X-ray exposure time and without increased complications. As only four studies with small study populations were available, more high-quality larger trials with longer follow-up are recommended.

Failed Deglutitive Upper Esophageal Sphincter Relaxation Is a Risk Factor for Aspiration in Stroke Patients with Oropharyngeal Dysphagia.

PubMed

Lee, Taeheon; Park, Jung Ho; Sohn, Chongil; Yoon, Kyung Jae; Lee, Yong-Taek; Park, Jung Hwan; Jung, Il Seok

2017-01-30

We attempted to examine the relationship between abnormal findings on high-resolution manometry (HRM) and videofluoroscopic swallowing study (VFSS) of the pharynx and upper esophageal sphincter (UES), and to identify the risk factors for aspiration. We performed VFSS and HRM on the same day in 36 ischemic stroke patients (mean age, 67.5 years) with dysphagia. Pressure (basal, median intra bolus, and nadir), relaxation time interval of the UES, and mesopharyngeal and hypopharyngeal contractility (as a contractile integral) were examined using HRM. The parameters of VFSS were vallecular residue, pyriform sinus residue, vallecular overflow, penetration, and aspiration. The association between the parameters of VFSS and HRM was analyzed by the Student's t test. Three (8.3%) and 4 (11.1%) stroke patients with dysphagia had pyriform sinus residue and vallecular sinus residue, respectively, and 5 (13.8%) patients showed aspiration. Mesopharyngeal and hypopharyngeal contractile integrals in patients with residue in the pyriform sinus were significantly lower than those in patients without residue in the pyriform sinus ( P < 0.05). Relaxation time intervals in patients with aspiration were significantly shorter than those in patients without aspiration ( P < 0.05), and multivariate regression analysis revealed a shorter relaxation time interval as the main risk factor for aspiration (OR, 0.03; 95% CI, 0.01-0.65; P < 0.05). Manometric measurements of the pharynx and UES were well correlated with abnormal findings in the VFSS, and a shorter relaxation time interval of the UES during deglutition is an important parameter for the development of aspiration.

A Meta-Analysis Examining Differences in Short-Term Outcomes Between Sutureless and Conventional Aortic Valve Prostheses.

PubMed

Hurley, Eoghan T; O'Sullivan, Katie E; Segurado, Ricardo; Hurley, John P

2015-01-01

Sutureless aortic valve prostheses are anchored by radial force in a mechanism similar to that of transcatheter aortic valve implantation. Transcatheter aortic valve implantation is associated with an increased permanent pacemaker (PPM) requirement in a significant proportion of patients. We undertook a meta-analysis to examine the incidence of PPM insertion associated with sutureless compared with conventional surgical aortic valve replacement. A systematic review was conducted in accordance with the Prisma guidelines. All searches were performed on August 10, 2014. Studies between 2007 and 2014 were included in the search. A total of 832 patients were included in the sutureless group and 3,740 in the conventional group. Aortic cross-clamp (39.8 vs 62.4 minutes; P < 0.001) and cardiopulmonary bypass (64.9 vs 86.7 minutes; P = 0.002) times were shorter in the sutureless group. Permanent pacemaker implantation rate was higher in the sutureless cohort (9.1% vs 2.4%; P = 0.025). Sutureless aortic valve prostheses are associated with significantly shorter cardiopulmonary bypass and aortic cross-clamp times and a higher incidence of PPM insertion than conventional. Further investigation of the prognostic significance is required.

The incubation period distribution of tuberculosis estimated with a molecular epidemiological approach.

PubMed

Borgdorff, Martien W; Sebek, Maruschka; Geskus, Ronald B; Kremer, Kristin; Kalisvaart, Nico; van Soolingen, Dick

2011-08-01

There is limited information on the distribution of incubation periods of tuberculosis (TB). In The Netherlands, patients whose Mycobacterium tuberculosis isolates have identical DNA fingerprints in the period 1993-2007 were interviewed to identify epidemiological links between cases. We determined the incubation period distribution in secondary cases. Survival analysis techniques were used to include secondary cases not yet symptomatic at diagnosis with weighting to adjust for lower capture probabilities of couples with longer time intervals between their diagnoses. In order to deal with missing data, we used multiple imputations. We identified 1095 epidemiologically linked secondary cases, attributed to 688 source cases with pulmonary TB. Of those developing disease within 15 years, the Kaplan-Meier probability to fall ill within 1 year was 45%, within 2 years 62% and within 5 years 83%. The incubation time was shorter in secondary cases who were men, young, those with extra-pulmonary TB and those not reporting previous TB or previous preventive therapy. Molecular epidemiological analysis has allowed a more precise description of the incubation period of TB than was possible in previous studies, including the identification of risk factors for shorter incubation periods.

The association between post-traumatic stress disorder and shorter telomere length: A systematic review and meta-analysis.

PubMed

Li, Xuemei; Wang, Jiang; Zhou, Jianghua; Huang, Pan; Li, Jiping

2017-08-15

Post-traumatic stress disorder (PTSD) is a common psychiatric disorder, which may accelerate aging. Many study have investigated the association between telomeres length and PTSD, but results from published studies are contradictory. Therefore, Meta-analysis approaches were conducted to give more precise estimate of relationship between telomere length and PTSD. We systematically reviewed the databases of PUBMED, PsycINFO, Medline(Ovid SP) and EMBASE for all articles on the association between telomere length and PTSD. Data were summarized by using random-effects in the meta-analysis. The heterogeneity among studies were examined by using Cochrane's Q statistic and I-squared. Five eligible studies containing 3851 participants were included in our meta-analysis. Shorten telomere length was significantly associated with PTSD with mean difference of -0.19( 95% CI: -0.27, -0.01; P<0.001) with I-square of 96%. The results from subgroup analysis demonstrated that shorter telomere length was significantly associated with PTSD across all gender groups, with mean difference of -0.15( 95% CI: -0.29, -0.01; P=0.04) for female, mean difference of -0.17( 95% CI: -0.19, -0.15; P<0.001) for male. Meanwhile, shorten telomere length was significantly associated with sexual assault(mean difference =-0.15, 95% CI: -0.29, -0.01), childhood trauma (mean difference =-0.08, 95% CI: -0.19, -0.07), but not combat (mean difference =-0.39, 95% CI: -0.83, 0.05). Compared to the individuals without PTSD, individuals with PTSD have shorter telomere length, which has implications for early intervention and timely treatment to prevent future adverse health outcomes. Copyright © 2017. Published by Elsevier B.V.

Testosterone, migration distance, and migratory timing in song sparrows Melospiza melodia.

PubMed

Lymburner, Alannah H; Kelly, Tosha R; Hobson, Keith A; MacDougall-Shackleton, Elizabeth A; MacDougall-Shackleton, Scott A

2016-09-01

In seasonally migratory animals, migration distance often varies substantially within populations such that individuals breeding at the same site may overwinter different distances from the breeding grounds. Shorter migration may allow earlier return to the breeding grounds, which may be particularly advantageous to males competing to acquire a breeding territory. However, little is known about potential mechanisms that may mediate migration distance. We investigated naturally-occurring variation in androgen levels at the time of arrival to the breeding site and its relationship to overwintering latitude in male and female song sparrows (Melospiza melodia). We used stable isotope analysis of hydrogen (δ(2)H) in winter-grown claw tissue to infer relative overwintering latitude (migration distance), combined with 14years of capture records from a long-term study population to infer the arrival timing of males versus females. Relative to females, males had higher circulating androgen levels, migrated shorter distances, and were more likely to be caught early in the breeding season. Males that migrate short distances may benefit from early arrival at the breeding grounds, allowing them to establish a breeding territory. Even after controlling for sex and date, androgen levels were highest in individuals that migrated shorter distances. Our findings indicate that androgens and migration distance are correlated traits within and between sexes that may reflect individual variation within an integrated phenotype in which testosterone has correlated effects on behavioral traits such as migration. Copyright © 2016 Elsevier Inc. All rights reserved.

Randomized, double-blind, placebo-controlled clinical trial of loperamide plus simethicone versus loperamide alone and simethicone alone in the treatment of acute diarrhea with gas-related abdominal discomfort.

PubMed

Hanauer, Stephen B; DuPont, Herbert L; Cooper, Kimberly M; Laudadio, Charles

2007-05-01

To compare efficacy and tolerability of a loperamide/simethicone (LOP/SIM) combination product with that of loperamide (LOP) alone, simethicone (SIM) alone, and placebo (PBO) for acute nonspecific diarrhea with gas-related abdominal discomfort. In this multicenter, double-blind, 48-h study, patients were randomly assigned to receive two tablets, each containing either LOP/SIM 2 mg/125 mg (n = 121), LOP 2 mg (n = 120), SIM 125 mg (n = 123), or PBO (n = 121), followed by one tablet after each unformed stool, up to four tablets in any 24-h period. The primary outcome measures were time to last unformed stool and time to complete relief of gas-related abdominal discomfort. For time to last unformed stool, an unformed stool after a 24-h period of formed stools or no stools was considered a continuance of the original episode (stricter definition) or a new episode (alternate definition). A total of 483 patients were included in the intent-to-treat analysis. The median time to last unformed stool for LOP/SIM (7.6 h) was significantly shorter than that of LOP (11.5 h), SIM (26.0 h), and PBO (29.4 h) (p < or = 0.0232 in comparison with survival curves) using the alternate definition; it was numerically but not significantly shorter than that of LOP (p = 0.0709) and significantly shorter than that of SIM and PBO (p = 0.0001) using the stricter definition. LOP/SIM-treated patients had a shorter time to complete relief of gas-related abdominal discomfort than patients who received either ingredient alone or placebo (all p = 0.0001). Few patients reported adverse events in the four treatment groups, none of which were serious in nature. Potential study limitations include the ability to generalize study results to the population at large, variability in total dose consumed, and subjectivity of patient diary data. LOP/SIM was well-tolerated and more efficacious than LOP alone, SIM alone, or placebo for acute nonspecific diarrhea and gas-related abdominal discomfort.

A Perishable Inventory Model with Return

NASA Astrophysics Data System (ADS)

Setiawan, S. W.; Lesmono, D.; Limansyah, T.

2018-04-01

In this paper, we develop a mathematical model for a perishable inventory with return by assuming deterministic demand and inventory dependent demand. By inventory dependent demand, it means that demand at certain time depends on the available inventory at that time with certain rate. In dealing with perishable items, we should consider deteriorating rate factor that corresponds to the decreasing quality of goods. There are also costs involved in this model such as purchasing, ordering, holding, shortage (backordering) and returning costs. These costs compose the total costs in the model that we want to minimize. In the model we seek for the optimal return time and order quantity. We assume that after some period of time, called return time, perishable items can be returned to the supplier at some returning costs. The supplier will then replace them in the next delivery. Some numerical experiments are given to illustrate our model and sensitivity analysis is performed as well. We found that as the deteriorating rate increases, returning time becomes shorter, the optimal order quantity and total cost increases. When considering the inventory-dependent demand factor, we found that as this factor increases, assuming a certain deteriorating rate, returning time becomes shorter, optimal order quantity becomes larger and the total cost increases.

mStroke: "Mobile Stroke"-Improving Acute Stroke Care with Smartphone Technology.

PubMed

Andrew, Benjamin Y; Stack, Colleen M; Yang, Julian P; Dodds, Jodi A

2017-07-01

This study aimed to evaluate the effect of method and time of system activation on clinical metrics in cases utilizing the Stop Stroke (Pulsara, Inc.) mobile acute stroke care coordination application. A retrospective cohort analysis of stroke codes at 12 medical centers using Stop Stroke from March 2013 to May 2016 was performed. Comparison of metrics (door-to-needle time [DTN] and door-to-CT time [DTC], and rate of DTN ≤ 60 minutes [goal DTN]) was performed between subgroups based on method (emergency medical service [EMS] versus emergency department [ED]) and time of activation. Effects were adjusted for confounders (age, sex, National Institutes of Health Stroke Scale [NIHSS] score) using multiple linear and logistic regression. The final dataset included 2589 cases. Cases activated by EMS were more severe (median NIHSS score 8 versus 4, P < .0001) and more likely to receive recombinant tissue plasminogen activator (20% versus 12%, P < .0001) than those with ED activation. After adjustment, cases with EMS activation had shorter DTC (6.1 minutes shorter, 95% CI [-10.3, -2]) and DTN (12.8 minutes shorter, 95% CI [-21, -4.6]) and were more likely to meet goal DTN (OR 1.83, 95% CI [1.1, 3]). Cases between 1200 and 1800 had longer DTC (7.7 minutes longer, 95% CI [2.4, 13]) and DTN (21.1 minutes longer, 95% CI [9.3, 33]), and reduced rate of goal DTN (OR .3, 95% CI [.15, .61]) compared to those between 0000 and 0600. Incorporating real-time prehospital data obtained via smartphone technology provides unique insight into acute stroke codes. Activation of mobile electronic stroke coordination in the field appears to promote a more expedited and successful care process. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Report on Integration of Existing Grid Models for N-R HES Interaction Focused on Balancing Authorities for Sub-hour Penalties and Opportunities

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

McJunkin, Timothy; Epiney, Aaron; Rabiti, Cristian

2017-06-01

This report provides a summary of the effort in the Nuclear-Renewable Hybrid Energy System (N-R HES) project on the level 4 milestone to consider integration of existing grid models into the factors for optimization on shorter time intervals than the existing electric grid models with the Risk Analysis Virtual Environment (RAVEN) and Modelica [1] optimizations and economic analysis that are the focus of the project to date.

Generalization of Turbulent Pair Dispersion to Large Initial Separations

NASA Astrophysics Data System (ADS)

Shnapp, Ron; Liberzon, Alex; International Collaboration for Turbulence Research

2018-06-01

We present a generalization of turbulent pair dispersion to large initial separations (η

Conventional and narrow bore short capillary columns with cyclodextrin derivatives as chiral selectors to speed-up enantioselective gas chromatography and enantioselective gas chromatography-mass spectrometry analyses.

PubMed

Bicchi, Carlo; Liberto, Erica; Cagliero, Cecilia; Cordero, Chiara; Sgorbini, Barbara; Rubiolo, Patrizia

2008-11-28

The analysis of complex real-world samples of vegetable origin requires rapid and accurate routine methods, enabling laboratories to increase sample throughput and productivity while reducing analysis costs. This study examines shortening enantioselective-GC (ES-GC) analysis time following the approaches used in fast GC. ES-GC separations are due to a weak enantiomer-CD host-guest interaction and the separation is thermodynamically driven and strongly influenced by temperature. As a consequence, fast temperature rates can interfere with enantiomeric discrimination; thus the use of short and/or narrow bore columns is a possible approach to speeding-up ES-GC analyses. The performance of ES-GC with a conventional inner diameter (I.D.) column (25 m length x 0.25 mm I.D., 0.15 microm and 0.25 microm d(f)) coated with 30% of 2,3-di-O-ethyl-6-O-tert-butyldimethylsilyl-beta-cyclodextrin in PS-086 is compared to those of conventional I.D. short column (5m length x 0.25 mm I.D., 0.15 microm d(f)) and of different length narrow bore columns (1, 2, 5 and 10 m long x 0.10 mm I.D., 0.10 microm d(f)) in analysing racemate standards of pesticides and in the flavour and fragrance field and real-world-samples. Short conventional I.D. columns gave shorter analysis time and comparable or lower resolutions with the racemate standards, depending mainly on analyte volatility. Narrow-bore columns were tested under different analysis conditions; they provided shorter analysis time and resolutions comparable to those of conventional I.D. ES columns. The narrow-bore columns offering the most effective compromise between separation efficiency and analysis time are the 5 and 2m columns; in combination with mass spectrometry as detector, applied to lavender and bergamot essential oil analyses, these reduced analysis time by a factor of at least three while separation of chiral markers remained unaltered.

Mathematical analysis of endothelial sibling pair cell-cell interactions using time-lapse cinematography data.

PubMed

Brown, L M; Ryan, U S; Absher, M; Olazabal, B M

1982-01-01

The sibling pairs from two different endothelial cell cultures were analysed by time-lapse cinematography. It was shown that wounded and regular (low density seeded) cultures differed in the behaviour patterns of their siblings. The cultures differed most significantly in the minimum interdivision time (IDT) which was 27% lower for the wounded culture. In the wounded culture there was a greater correlation of IDT values between sibling pairs. IDT values recorded both for paired and for unpaired cells were shorter for the wounded than for the regular culture. The mean IDT for unpaired cells was longer than the mean IDT for paired cells in the regular culture. Thus paired cells in the regular culture, had shorter IDTs, but not as short as in the wounded culture. It was significant that in the wounded culture the first generation of siblings were very close (less than 150 microns apart) at division. Overall the behaviour differences between the two cultures resulted in a higher rate of increase in cell numbers, and thus faster repair, of the wounded monolayer.

Evaluation of production tests in oil wells stimulated by massive acid fracturing offshore Qatar

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

McDonald, S.W.

This paper presents the evaluation of pressure-buildup data from production tests in wells that have been stimulated by massive acid fracturing. Fracture type curves are used in combination with conventional semilog analysis techniques. Fracture characteristics are calculated from a match of the early-time pressure data with the type curves, and reservoir characteristics are calculated from a conventional semilog plot of late-time data. Unexpectedly high formation permeabilities are evaluated, and fracture half-lengths are much shorter than design values.

Comparing the Efficiencies of Third Molar Surgeries With and Without a Dentist Anesthesiologist.

PubMed

Reebye, Uday; Young, S; Boukas, E; Davidian, E; Carnahan, J

2017-01-01

Two different anesthesia models were compared in terms of surgical duration, safer outcomes, and economic implications. Third molar surgeries performed with and without a separate dentist anesthesiologist were evaluated by a retrospective data analysis of the surgical operative times. For more difficult surgeries, substantially shorter operative times were observed with the dentist anesthesiologist model, leading to a more favorable surgical outcome. An example calculation is presented to demonstrate economic advantages of scheduling the participation of a dentist anesthesiologist for more difficult surgeries.

Attentional sensitivity and asymmetries of vertical saccade generation in monkey

NASA Technical Reports Server (NTRS)

Zhou, Wu; King, W. M.; Shelhamer, M. J. (Principal Investigator)

2002-01-01

The first goal of this study was to systematically document asymmetries in vertical saccade generation. We found that visually guided upward saccades have not only shorter latencies, but higher peak velocities, shorter durations and smaller errors. The second goal was to identify possible mechanisms underlying the asymmetry in vertical saccade latencies. Based on a recent model of saccade generation, three stages of saccade generation were investigated using specific behavioral paradigms: attention shift to a visual target (CUED paradigm), initiation of saccade generation (GAP paradigm) and release of the motor command to execute the saccade (DELAY paradigm). Our results suggest that initiation of a saccade (or "ocular disengagement") and its motor release contribute little to the asymmetry in vertical saccade latency. However, analysis of saccades made in the CUED paradigm indicated that it took less time to shift attention to a target in the upper visual field than to a target in the lower visual field. These data suggest that higher attentional sensitivity to targets in the upper visual field may contribute to shorter latencies of upward saccades.

Relationship between interpersonal sensitivity and leukocyte telomere length.

PubMed

Suzuki, Akihito; Matsumoto, Yoshihiko; Enokido, Masanori; Shirata, Toshinori; Goto, Kaoru; Otani, Koichi

2017-10-10

Telomeres are repetitive DNA sequences located at the ends of chromosomes, and telomere length represents a biological marker for cellular aging. Interpersonal sensitivity, excessive sensitivity to the behavior and feelings of others, is one of the vulnerable factors to depression. In the present study, we examined the effect of interpersonal sensitivity on telomere length in healthy subjects. The subjects were 159 unrelated healthy Japanese volunteers. Mean age ± SD (range) of the subjects was 42.3 ± 7.8 (30-61) years. Interpersonal sensitivity was assessed by the Japanese version of the Interpersonal Sensitivity Measure (IPSM). Leukocyte telomere length was determined by a quantitative real-time PCR method. Higher scores of the total IPSM were significantly (β = -0.163, p = 0.038) related to shorter telomere length. In the sub-scale analysis, higher scores of timidity were significantly (β = -0.220, p = 0.044) associated with shorter telomere length. The present study suggests that subjects with higher interpersonal sensitivity have shorter leukocyte telomere length, implying that interpersonal sensitivity has an impact on cellular aging.

[Comparison of the results of laparotomy and laparoscopic surgery in patients with Crohn's disease].

PubMed

Horváth, Gyula; Simonka, Zsolt; Lázár, György

2014-01-05

Crohn's disease is an inflammatory bowel disease which may affect different parts of the gastrointestinal tract. To compare retrospectively the results of laparotomy and laparoscopic surgery performed in patients with Crohn's disease between January 1, 2005 and October 31, 2012 in the Department of Surgery, University of Szeged, Hungary. Patients were divided into two groups based on the types of surgery; 103 patients underwent laparotomy and 30 patients had laparoscopic surgery programmed. 22 patients had 24 primary acute interventions. The mean age was significantly lower in the laparoscopic surgery group (p = 0.042). The laparoscopic ileocecal resections have been found significantly shorter than laparotomies (p = 0.033). When ileocecal resection was performed the operation time was significantly longer (p = 0.033) while hospitalization time (p = 0.025) and intensive care unit treatment time (p<0.001) were shorter and the bowel passage also started earlier in the laparoscopic group as compared to the laparotomy group. Laparoscopic surgery results in smaller surgical trauma, better cosmetic outcome, shorter hospitalization time and not higher complication- and morbidity-rate as well as shorter operation time in certain cases. However, it requires more qualified surgical team and the operation expenses are higher.

Aging and Directed Forgetting in Episodic Memory: A Meta-Analysis

PubMed Central

Titz, Cora; Verhaeghen, Paul

2009-01-01

This meta-analysis examines the effects of aging on directed forgetting. A cue to forget is more effective in younger (d = 1.17) than in older adults (d = 0.81). Directed-forgetting effects were larger: (a) with the item method rather than the list method; (b) with longer presentation times; (c) with longer postcue rehearsal times; (d) with single words rather than verbal action phrases as stimuli; (e) with shorter lists; and (f) when recall rather than recognition was tested. Age effects were reliably larger when the item method was used, suggesting that these effects are mainly due to encoding differences. PMID:20545424

The effect of solids retention times on the characterization of extracellular polymeric substances and soluble microbial products in a submerged membrane bioreactor.

PubMed

Duan, Liang; Song, Yonghui; Yu, Huibin; Xia, Siqing; Hermanowicz, Slawomir W

2014-07-01

In this study, the effect of solids retention times (SRTs) on extracellular polymeric substances (EPS) and soluble microbial products (SMPs) were investigated in a membrane bioreactor (MBR) at SRTs of 10, 5 and 3 days. The results showed that more carbohydrates and proteins were accumulated at short SRT, which can due to the higher biomass activity in the reactor. The molecular weight (MW) distribution analysis suggested that macromolecules (MW>30 kDa) and small molecules (MW<1 kDa) were the dominant fraction of EPS and SMP, respectively. The reactor at shorter SRT had more small molecules and less macromolecules of carbohydrates. The MW distribution of total organic carbon (TOC) suggested that other organic moieties were exuded by microbes into the solution. The shorter SRT had more undefined microbial by-product-like substances and different O − H bonds in hydroxyl functional groups. Copyright © 2014 Elsevier Ltd. All rights reserved.

77 FR 7640 - Self-Regulatory Organizations; BATS Y-Exchange, Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-13

... 30 days after the date of the filing, or such shorter time as the Commission may designate, it has...-4(f)(6)(iii) \\8\\ permits the Commission to designate a shorter time if such action is consistent... without further delay. The Exchange notes that the introduction of the additional optional variation of...

77 FR 7642 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-13

... 30 days after the date of the filing, or such shorter time as the Commission may designate, it has...-4(f)(6)(iii) \\8\\ permits the Commission to designate a shorter time if such action is consistent... trading costs without further delay. The Exchange notes that the introduction of the additional optional...

Temperature and time variations during osteotomies performed with different piezosurgical devices: an in vitro study.

PubMed

Delgado-Ruiz, R A; Sacks, D; Palermo, A; Calvo-Guirado, J L; Perez-Albacete, C; Romanos, G E

2016-09-01

The aim of this experimental in vitro study was to evaluate the effects of the piezoelectric device in temperature and time variations in standardized osteotomies performed with similar tip inserts in bovine bone blocks. Two different piezosurgical devices were used the OE-F15(®) (Osada Inc., Los Angeles, California, USA) and the Surgybone(®) (Silfradent Inc., Sofia, Forli Cesena, Italy). Serrated inserts with similar geometry were coupled with each device (ST94 insert/test A and P0700 insert/test B). Osteotomies 10 mm long and 3 mm deep were performed in bone blocks resembling type II (dense) and type IV (soft) bone densities with and without irrigation. Thermal changes and time variations were recorded. The effects of bone density, irrigation, and device on temperature changes and time necessary to accomplish the osteotomies were analyzed. Thermal analysis showed significant higher temperatures during piezosurgery osteotomies in hard bone without irrigation (P < 0.05). The type of piezosurgical device did not influence thermal variations (P > 0.05). Time analysis showed that the mean time values necessary to perform osteotomies were shorter in soft bone than in dense bone (P < 0.05). Within the limitations of this in vitro study, it may be concluded that the temperature increases more in piezosurgery osteotomies in dense bone without irrigation; the time to perform the osteotomy with piezosurgery is shorter in soft bone compared to hard bone; and the piezosurgical device have a minimal influence in the temperature and time variations when a similar tip design is used during piezosurgery osteotomies. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Effect of Optimally Timed Osteopathic Manipulative Treatment on Length of Hospital Stay in Moderate and Late Preterm Infants: Results from a RCT.

PubMed

Pizzolorusso, Gianfranco; Cerritelli, Francesco; Accorsi, Alessandro; Lucci, Chiara; Tubaldi, Lucia; Lancellotti, Jenny; Barlafante, Gina; Renzetti, Cinzia; D'Incecco, Carmine; Perri, Francesco Paolo

2014-01-01

Introduction. Little research has been conducted looking at the effects of osteopathic manipulative treatment (OMT) on preterm infants. Aim of the Study. This study hypothesized that osteopathic care is effective in reducing length of hospital stay and that early OMT produces the most pronounced benefit, compared to moderately early and late OMT. A secondary outcome was to estimate hospital cost savings by the use of OMT. Methods. 110 newborns ranging from 32- to 37-week gestation were randomized to receive either OMT or usual pediatric care. Early, moderately early, and late OMT were defined as <4, <9, and <14 days from birth, respectively. Result. Hospital stay was shorter in infants receiving late OMT (-2.03; 95% CI -3.15, -0.91; P < 0.01) than controls. Subgroup analysis of infants receiving early and moderately early OMT resulted in shorter LOS (early OMT: -4.16; -6.05, -2.27; P < 0.001; moderately early OMT: -3.12; -4.36, -1.89; P < 0.001). Costs analysis showed that OMT significantly produced a net saving of €740 (-1309.54, -170.33; P = 0.01) per newborn per LOS. Conclusions. This study shows evidence that the sooner OMT is provided, the shorter their hospital stay is. There is also a positive association of OMT with overall reduction in cost of care.

Memory and long-range correlations in chess games

NASA Astrophysics Data System (ADS)

Schaigorodsky, Ana L.; Perotti, Juan I.; Billoni, Orlando V.

2014-01-01

In this paper we report the existence of long-range memory in the opening moves of a chronologically ordered set of chess games using an extensive chess database. We used two mapping rules to build discrete time series and analyzed them using two methods for detecting long-range correlations; rescaled range analysis and detrended fluctuation analysis. We found that long-range memory is related to the level of the players. When the database is filtered according to player levels we found differences in the persistence of the different subsets. For high level players, correlations are stronger at long time scales; whereas in intermediate and low level players they reach the maximum value at shorter time scales. This can be interpreted as a signature of the different strategies used by players with different levels of expertise. These results are robust against the assignation rules and the method employed in the analysis of the time series.

Comparison between Minimally Invasive Transforaminal Lumbar Interbody Fusion and Conventional Open Transforaminal Lumbar Interbody Fusion: An Updated Meta-analysis.

PubMed

Xie, Lei; Wu, Wen-Jian; Liang, Yu

2016-08-20

The previous studies agree that minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has better function outcomes, less blood loss, and shorter hospital stay, when compared to open-TLIF. However, there are no significance differences on operative time, complication, and reoperation rate between the two procedures. This could be from less relative literatures and lower grade evidence. The further meta-analysis is needed with more and higher grade evidences to compare the above two TLIF procedures. Prospective and retrospective studies that compared open-TLIF and MIS-TLIF were identified by searching the Medline, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, and VIP database (the literature search comprised Medical Subject Heading terms and key words or Emtree term). The retrieval time ranged from the date when the database was founded to January 2015. Pooled risk ratios (RR s) and weighted mean differences (WMDs) with 95% confidence intervals were calculated for the clinical outcomes and perioperative data. Twenty-four studies (n = 1967 patients) were included in this review (n = 951, open-TLIF, n = 1016, MIS-TLIF). MIS-TLIF was associated with a significant decrease in the visual analog score (VAS)-back pain score (WMD = -0.44; P = 0.001), Oswestry Disabilities Index (WMD = -1.57; P = 0.005), early ambulation (WMD = -1.77; P = 0.0001), less blood loss (WMD = -265.59; P < 0.00001), and a shorter hospital stay (WMD = -1.89; P < 0.0001). However, there were no significant differences in the fusion rate (RR = 0.99; P = 0.34), VAS-leg pain (WMD = -0.10; P = 0.26), complication rate (RR = 0.84; P = 0.35), operation time (WMD = -5.23; P = 0.82), or reoperation rate (RR = 0.73; P = 0.32). MIS-TLIF resulted in a similar fusion rate with better functional outcome, less blood loss, shorter ambulation, and hospital stay; furthermore, it did not increase the complication or reoperation rate based on the existing evidence.

Development and validation of an ultra-performance convergence chromatography method for the quality control of Angelica gigas Nakai.

PubMed

Kim, Hyo Seon; Chun, Jin Mi; Kwon, Bo-In; Lee, A-Reum; Kim, Ho Kyoung; Lee, A Yeong

2016-10-01

Ultra-performance convergence chromatography, which integrates the advantages of supercritical fluid chromatography and ultra high performance liquid chromatography technologies, is an environmentally friendly analytical method that uses dramatically reduced amounts of organic solvents. An ultra-performance convergence chromatography method was developed and validated for the quantification of decursinol angelate and decursin in Angelica gigas using a CSH Fluoro-Phenyl column (2.1 mm × 150 mm, 1.7 μm) with a run time of 4 min. The method had an improved resolution and a shorter analysis time in comparison to the conventional high-performance liquid chromatography method. This method was validated in terms of linearity, precision, and accuracy. The limits of detection were 0.005 and 0.004 μg/mL for decursinol angelate and decursin, respectively, while the limits of quantitation were 0.014 and 0.012 μg/mL, respectively. The two components showed good regression (correlation coefficient (r 2 ) > 0.999), excellent precision (RSD < 2.28%), and acceptable recoveries (99.75-102.62%). The proposed method can be used to efficiently separate, characterize, and quantify decursinol angelate and decursin in Angelica gigas and its related medicinal materials or preparations, with the advantages of a shorter analysis time, greater sensitivity, and better environmental compatibility. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Failed Deglutitive Upper Esophageal Sphincter Relaxation Is a Risk Factor for Aspiration in Stroke Patients with Oropharyngeal Dysphagia

PubMed Central

Lee, Taeheon; Park, Jung Ho; Sohn, Chongil; Yoon, Kyung Jae; Lee, Yong-Taek; Park, Jung Hwan; Jung, Il Seok

2017-01-01

Background/Aims We attempted to examine the relationship between abnormal findings on high-resolution manometry (HRM) and videofluoroscopic swallowing study (VFSS) of the pharynx and upper esophageal sphincter (UES), and to identify the risk factors for aspiration. Methods We performed VFSS and HRM on the same day in 36 ischemic stroke patients (mean age, 67.5 years) with dysphagia. Pressure (basal, median intra bolus, and nadir), relaxation time interval of the UES, and mesopharyngeal and hypopharyngeal contractility (as a contractile integral) were examined using HRM. The parameters of VFSS were vallecular residue, pyriform sinus residue, vallecular overflow, penetration, and aspiration. The association between the parameters of VFSS and HRM was analyzed by the Student’s t test. Results Three (8.3%) and 4 (11.1%) stroke patients with dysphagia had pyriform sinus residue and vallecular sinus residue, respectively, and 5 (13.8%) patients showed aspiration. Mesopharyngeal and hypopharyngeal contractile integrals in patients with residue in the pyriform sinus were significantly lower than those in patients without residue in the pyriform sinus (P < 0.05). Relaxation time intervals in patients with aspiration were significantly shorter than those in patients without aspiration (P < 0.05), and multivariate regression analysis revealed a shorter relaxation time interval as the main risk factor for aspiration (OR, 0.03; 95% CI, 0.01–0.65; P < 0.05). Conclusions Manometric measurements of the pharynx and UES were well correlated with abnormal findings in the VFSS, and a shorter relaxation time interval of the UES during deglutition is an important parameter for the development of aspiration. PMID:27510474

Risk Factors for Extended Duration and Timing of Peak Severity of Hot Flashes

PubMed Central

Gallicchio, Lisa; Miller, Susan R.; Zacur, Howard A.; Flaws, Jodi A.

2016-01-01

Objective To identify risk factors associated with the duration of hot flashes and the time of peak hot flash severity in mid-life women. Methods A cohort of 647 women reporting hot flashes were followed for 1–7 years, with survey data and hormone measurements. Survival analysis determined the association of risk factors with the duration of hot flashes. Linear regression determined the association of risk factors with the time of peak severity. Final models were determined through stepwise model selection. Results Average hot flash duration was 2.5 years (range: 1–33), with peak severity on average at 2.96 years (range: 1–20). Duration of hot flashes was associated with race, education, menopause status, smoking history, BMI, alcohol consumption, leisure activity levels, and levels of estradiol and progesterone. In the final model, only race, alcohol consumption, leisure activity, and menopause were retained. White women had significantly shorter hot flash durations than non-white women. Women consuming at least 12 alcoholic drinks in the previous year had a significantly shorter duration of hot flashes with a smaller effect of hot flash duration on increasing in time to peak severity compared to those who consumed less than 12 alcoholic drinks in that year. Higher serum progesterone levels were associated with later peak severity if the duration of the hot flashes was less than 2 years and an earlier peak severity otherwise. Conclusions These results suggest that some behaviors (such as moderate alcohol consumption) are associated with shorter durations of hot flashes, and that progesterone was associated with the dynamics of hot flash severity. PMID:27149066

Nanoparticle separation with a miniaturized asymmetrical flow field-flow fractionation cartridge

PubMed Central

Müller, David; Cattaneo, Stefano; Meier, Florian; Welz, Roland; de Mello, Andrew J.

2015-01-01

Asymmetrical Flow Field-Flow Fractionation (AF4) is a separation technique applicable to particles over a wide size range. Despite the many advantages of AF4, its adoption in routine particle analysis is somewhat limited by the large footprint of currently available separation cartridges, extended analysis times and significant solvent consumption. To address these issues, we describe the fabrication and characterization of miniaturized AF4 cartridges. Key features of the down-scaled platform include simplified cartridge and reagent handling, reduced analysis costs and higher throughput capacities. The separation performance of the miniaturized cartridge is assessed using certified gold and silver nanoparticle standards. Analysis of gold nanoparticle populations indicates shorter analysis times and increased sensitivity compared to conventional AF4 separation schemes. Moreover, nanoparticulate titanium dioxide populations exhibiting broad size distributions are analyzed in a rapid and efficient manner. Finally, the repeatability and reproducibility of the miniaturized platform are investigated with respect to analysis time and separation efficiency. PMID:26258119

Nanoparticle separation with a miniaturized asymmetrical flow field-flow fractionation cartridge

NASA Astrophysics Data System (ADS)

Müller, David; Cattaneo, Stefano; Meier, Florian; Welz, Roland; deMello, Andrew

2015-07-01

Asymmetrical Flow Field-Flow Fractionation (AF4) is a separation technique applicable to particles over a wide size range. Despite the many advantages of AF4, its adoption in routine particle analysis is somewhat limited by the large footprint of currently available separation cartridges, extended analysis times and significant solvent consumption. To address these issues, we describe the fabrication and characterization of miniaturized AF4 cartridges. Key features of the scale-down platform include simplified cartridge and reagent handling, reduced analysis costs and higher throughput capacities. The separation performance of the miniaturized cartridge is assessed using certified gold and silver nanoparticle standards. Analysis of gold nanoparticle populations indicates shorter analysis times and increased sensitivity compared to conventional AF4 separation schemes. Moreover, nanoparticulate titanium dioxide populations exhibiting broad size distributions are analyzed in a rapid and efficient manner. Finally, the repeatability and reproducibility of the miniaturized platform are investigated with respect to analysis time and separation efficiency.

[Amelanotic melanoma and nuclear magnetic resonance tomography--case report].

PubMed

Schilling, A; Seiler, T; Bende, T; Wollensak, J

1989-01-01

In MRI choroidal melanoma shows a very short relaxation time (T2), shorter than that of any other intraocular tumor. This short T2 time is referred to the high concentration of paramagnetic melanine in this tumor. Therefore, it is of interest to measure the relaxation time in an amelanotic melanoma and compare it with the histological analysis. The duration of T2 for the amelanotic melanoma examined ranged from 130 to 160 ms. The small concentration of melanine is not a sufficient explanation, but it is possible that there are some precursors of melanine with paramagnetic characteristics.

Perioperative surgical outcome of conventional and robot-assisted total laparoscopic hysterectomy.

PubMed

van Weelden, W J; Gordon, B B M; Roovers, E A; Kraayenbrink, A A; Aalders, C I M; Hartog, F; Dijkhuizen, F P H L J

2017-01-01

To evaluate surgical outcome in a consecutive series of patients with conventional and robot assisted total laparoscopic hysterectomy. A retrospective cohort study was performed among patients with benign and malignant indications for a laparoscopic hysterectomy. Main surgical outcomes were operation room time and skin to skin operating time, complications, conversions, rehospitalisation and reoperation, estimated blood loss and length of hospital stay. A total of 294 patients were evaluated: 123 in the conventional total laparoscopic hysterectomy (TLH) group and 171 in the robot TLH group. After correction for differences in basic demographics with a multivariate linear regression analysis, the skin to skin operating time was a significant 18 minutes shorter in robot assisted TLH compared to conventional TLH (robot assisted TLH 92m, conventional TLH 110m, p0.001). The presence or absence of previous abdominal surgery had a significant influence on the skin to skin operating time as did the body mass index and the weight of the uterus. Complications were not significantly different. The robot TLH group had significantly less blood loss and lower rehospitalisation and reoperation rates. This study compares conventional TLH with robot assisted TLH and shows shorter operating times, less blood loss and lower rehospitalisation and reoperation rates in the robot TLH group.

An extensive molecular cytogenetic characterization in high-risk chronic lymphocytic leukemia identifies karyotype aberrations and TP53 disruption as predictors of outcome and chemorefractoriness

PubMed Central

Cavallari, Maurizio; Quaglia, Francesca Maria; Lista, Enrico; Urso, Antonio; Guardalben, Emanuele; Martinelli, Sara; Saccenti, Elena; Bassi, Cristian; Lupini, Laura; Bardi, Maria Antonella; Volta, Eleonora; Tammiso, Elisa; Melandri, Aurora; Negrini, Massimo

2017-01-01

We investigated whether karyotype analysis and mutational screening by next generation sequencing could predict outcome in 101 newly diagnosed chronic lymphocytic leukemia patients with high-risk features, as defined by the presence of unmutated IGHV gene and/or 11q22/17p13 deletion by FISH and/or TP53 mutations. Cytogenetic analysis showed favorable findings (normal karyotype and isolated 13q14 deletion) in 30 patients, unfavorable (complex karyotype and/or 17p13/11q22 deletion) in 34 cases and intermediate (all other abnormalities) in 36 cases. A complex karyotype was present in 21 patients. Mutations were detected in 56 cases and were associated with unmutated IGHV status (p = 0.040) and complex karyotype (p = 0.047). TP53 disruption (i.e. TP53 mutations and/or 17p13 deletion by FISH) correlated with the presence of ≥ 2 mutations (p = 0.001) and a complex karyotype (p = 0.012). By multivariate analysis, an advanced Binet stage (p < 0.001) and an unfavorable karyotype (p = 0.001) predicted a shorter time to first treatment. TP53 disruption (p = 0.019) and the unfavorable karyotype (p = 0.028) predicted a worse overall survival. A shorter time to chemorefractoriness was associated with TP53 disruption (p = 0.001) and unfavorable karyotype (p = 0.025). Patients with both unfavorable karyotype and TP53 disruption presented a dismal outcome (median overall survival and time to chemorefractoriness of 28.7 and 15.0 months, respectively). In conclusion, karyotype analysis refines risk stratification in high-risk CLL patients and could identify a subset of patients with highly unfavorable outcome requiring alternative treatments. PMID:28427204

77 FR 67409 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-09

...), 7410A (Definitions), 7420A (Applicability), 7430A (Synchronization of Member Business Clocks), 7440A... days after the date of the filing, or such shorter time as the Commission may designate if consistent... the proposed rule change, or such shorter time as designated by the Commission. \\11\\ 15 U.S.C. 78s(b...

Impact of Antiretroviral Treatment Containing Tenofovir Difumarate on the Telomere Length of Aviremic HIV-Infected Patients.

PubMed

Montejano, Rocio; Stella-Ascariz, Natalia; Monge, Susana; Bernardino, José I; Pérez-Valero, Ignacio; Montes, María L; Valencia, Eulalia; Martín-Carbonero, Luz; Moreno, Victoria; González-García, Juan; Arnalich, Francisco; Mingorance, Jesús; Pintado Berniches, Laura; Perona, Rosario; Arribas, José R

2017-09-01

To evaluate the in vivo relevance of the inhibitory effect of tenofovir on telomerase activity observed in vitro. Cross-sectional study of HIV-infected patients with suppressed virological replication (HIV RNA <50 copies/mL for more than 1 year). Telomere length in whole blood was measured by quantitative real-time polymerase chain reaction. We performed a multivariate analysis to elucidate variables associated with telomere length and also evaluated the association between telomere length and use of tenofovir difumarate (TDF) adjusted by significant confounders. 200 patients included, 72% men, median age 49 (IQR 45-54.5), 103 with exposure to a TDF containing antiretroviral treatment (ART) regimen (69.9% for more than 5 years) and 97 never exposed to a TDF containing ART regimen. In the multivariate analysis, significant predictors of shorter telomere length were older age (P = 0.008), parental age at birth (P = 0.038), white race (P = 0.048), and longer time of known HIV infection (10-20 and ≥20 years compared with <10 years, P = 0.003 and P = 0.056, respectively). There was no association between TDF exposure and telomere length after adjusting for possible confounding factors (age, parental age at birth, race, and time of HIV infection). Total time receiving ART and duration of treatment with nucleoside reverse transcriptase inhibitors were associated with shorter telomere length, but these associations were explained by time of known HIV infection. Our data do not suggest that telomerase activity inhibition caused by TDF in vitro leads to telomere shortening in peripheral blood of HIV-infected patients.

Comparative analysis between percutaneous nephrolithotomy and flexible ureteroscopy in kidney stones of 2-3cm.

PubMed

Pieras, E; Tubau, V; Brugarolas, X; Ferrutxe, J; Pizá, P

2017-04-01

To compare percutaneous nephrolithotomy and flexible ureterorenoscopy for treating kidney stones between 2 and 3cm. A prospective, comparative, nonrandomised study was conducted with 108 patients with kidney stones between 2 and 3cm. Fifty-four patients underwent percutaneous nephrolithotomy and 54 underwent flexible ureteroscopy. We compared the following variables: lithiasis-free rate (%), surgical time, the need for an auxiliary process, postoperative complications, hospital stay, readmission rates and recovery time. There were no differences in the lithiasis-free rate between the 2 surgical techniques (76% for ureteroscopy vs. 87% for nephrolithotomy; P=.1) or in the complications (29% for nephrolithotomy vs. 27% for ureteroscopy; P=.4). A larger number of auxiliary process were needed for the ureteroscopy group (20%) than for the nephrolithotomy group (7%) (P=.04). The surgical time was longer for the nephrolithotomy group (121±52min) than for the ureteroscopy group (93±42min) (P=.004). The ureteroscopy group had shorter hospital stays (2.1±1.6 vs. 3.9±1.9 days; P=.002), shorter convalescence (8.1±4.9 vs. 13.3±4.2 days; P=.005) and higher readmission rates (7.4% vs. 0%, P=.05) than the nephrolithotomy group. Nephrolithotomy and ureteroscopy have similar efficacy for treating kidney stones measuring 2-3cm, with no differences in complications. Ureteroscopy results in shorter hospital stays, quicker recoveries but more readmissions and a greater need for auxiliary procedures. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

A polymorphism in a transporter of testosterone is a determinant of androgen independence in prostate cancer.

PubMed

Sharifi, Nima; Hamada, Akinobu; Sissung, Tristan; Danesi, Romano; Venzon, David; Baum, Caitlin; Gulley, James L; Price, Douglas K; Dahut, William L; Figg, William D

2008-08-05

To determine if patients with advanced prostate cancer carrying a polymorphism that codes for a more active testosterone transporter have less durable responses to androgen-deprivation therapy (ADT) than patients not carrying this polymorphism. We previously determined that a polymorphism in SLCO1B3 affects testosterone transport and that those men who have at least one wild-type T allele at the 334 T > G polymorphism in this gene have a shorter survival. We hypothesized that the T allele which increases testosterone transport would be associated with a shorter interval from ADT to androgen independence. We examined the association between this SLCO1B3 polymorphism and time from ADT to androgen independence, ADT to prostate-specific antigen (PSA) nadir and PSA nadir to androgen independence in 68 Caucasian patients with advanced prostate cancer who were treated with ADT with metastatic disease (D2) or biochemical failure with no metastatic disease (D0). When examined separately, patients in the individual stages tended to have a shorter time to androgen independence with the T allele in the D0 (P = 0.11) and D2 (P = 0.18) groups. Combining these groups and stratifying by stage yielded a statistically significant shorter time to androgen independence with the T allele (P = 0.048). A polymorphism in a transporter that increases testosterone import is associated with a shorter time to androgen independence in patients with prostate cancer who are treated with ADT.

Anterolateral minithoracotomy versus median sternotomy for the treatment of congenital heart defects: a meta-analysis and systematic review

PubMed Central

2012-01-01

Background Anterolateral Minithoracotomy (ALMT) for the radical correction of Congenital Heart Defects is an alternative to Median Sternotomy (MS) due to reduce operative trauma accelerating recovery and yield a better cosmetic outcome after surgery. Our purpose is to conduct whether ALMT would bring more short-term benefits to patients than conventional Median Sternotomy by using a meta-analysis of case–control study in the published English Journal. Methods 6 case control studies published in English from 1997 to 2011 were identified and synthesized to compare the short-term postoperative outcomes between ALMT and MS. These outcomes were cardiopulmonary bypass time, aortic cross-clamp time, intubation time, intensive care unit stay time, and postoperative hospital stay time. Results ALMT had significantly longer cardiopulmonary bypass times (8.00 min more, 95% CI 0.36 to 15.64 min, p = 0.04). Some evidence proved that aortic cross-clamp time of ALMT was longer, yet not significantly (2.38 min more, 95% CI −0.15 to 4.91 min, p = 0.06). In addition, ALMT had significantly shorter intubation time (1.66 hrs less, 95% CI −3.05 to −0.27 hrs, p = 0.02). Postoperative hospital stay time was significantly shorter with ALMT (1.52 days less, 95% CI −2.71 to −0.33 days, p = 0.01). Some evidence suggested a reduction in ICU stay time in the ALMT group. However, this did not prove to be statistically significant (0.88 days less, 95% CI −0.81 to 0.04 days, p = 0.08). Conclusion ALMT can bring more benefits to patients with Congenital Heart Defects by reducing intubation time and postoperative hospital stay time, though ALMT has longer CPB time and aortic cross-clamp time. PMID:22559820

Shorter telomere length in peripheral blood lymphocytes of workers exposed to polycyclic aromatic hydrocarbons.

PubMed

Pavanello, Sofia; Pesatori, Angela-C; Dioni, Laura; Hoxha, Mirjam; Bollati, Valentina; Siwinska, Ewa; Mielzyńska, Danuta; Bolognesi, Claudia; Bertazzi, Pier-Alberto; Baccarelli, Andrea

2010-02-01

Shorter telomere length (TL) in peripheral blood lymphocytes (PBLs) is predictive of lung cancer risk. Polycyclic aromatic hydrocarbons (PAHs) are established lung carcinogens that cause chromosome instability. Whether PAH exposure and its molecular effects are linked with shorter TL has never been evaluated. In the present study, we investigated the effect of chronic exposure to PAHs on TL measured in PBLs of Polish male non-current smoking cokeoven workers and matched controls. PAH exposure and molecular effects were characterized using measures of internal dose (urinary 1-pyrenol), effective dose [anti-benzo[a]pyrene diolepoxide (anti-BPDE)-DNA adduct], genetic instability (micronuclei, MN) and DNA methylation [p53 promoter and Alu and long interspersed nuclear element-1 (LINE-1) repetitive elements, as surrogate measures of global methylation] in PBLs. TL was measured by real-time polymerase chain reaction. Cokeoven workers were heavily exposed to PAHs (79% exceeded the urinary 1-pyrenol biological exposure index) and exhibited lower TL (P = 0.038) than controls, as well as higher levels of genetic and chromosomal alterations [i.e. anti-BPDE-DNA adduct and MN (P < 0.0001)] and epigenetic changes [i.e. p53 gene-specific promoter and global methylation (P

Shorter telomere length in peripheral blood lymphocytes of workers exposed to polycyclic aromatic hydrocarbons

PubMed Central

Pavanello, Sofia; Pesatori, Angela-C.; Dioni, Laura; Hoxha, Mirjam; Bollati, Valentina; Siwinska, Ewa; Mielzyńska, Danuta; Bolognesi, Claudia; Bertazzi, Pier-Alberto; Baccarelli, Andrea

2010-01-01

Shorter telomere length (TL) in peripheral blood lymphocytes (PBLs) is predictive of lung cancer risk. Polycyclic aromatic hydrocarbons (PAHs) are established lung carcinogens that cause chromosome instability. Whether PAH exposure and its molecular effects are linked with shorter TL has never been evaluated. In the present study, we investigated the effect of chronic exposure to PAHs on TL measured in PBLs of Polish male non-current smoking cokeoven workers and matched controls. PAH exposure and molecular effects were characterized using measures of internal dose (urinary 1-pyrenol), effective dose [anti-benzo[a]pyrene diolepoxide (anti-BPDE)–DNA adduct], genetic instability (micronuclei, MN) and DNA methylation [p53 promoter and Alu and long interspersed nuclear element-1 (LINE-1) repetitive elements, as surrogate measures of global methylation] in PBLs. TL was measured by real-time polymerase chain reaction. Cokeoven workers were heavily exposed to PAHs (79% exceeded the urinary 1-pyrenol biological exposure index) and exhibited lower TL (P = 0.038) than controls, as well as higher levels of genetic and chromosomal alterations [i.e. anti-BPDE–DNA adduct and MN (P < 0.0001)] and epigenetic changes [i.e. p53 gene-specific promoter and global methylation (P ≤ 0.001)]. TL decreased with longer duration of work as cokeoven worker (P = 0.039) and in all subjects with higher levels of anti-BPDE–DNA adduct (P = 0.042), p53 hypomethylation (P = 0.005) and MN (P = 0.009). In multivariate analysis, years of work in cokery (P = 0.008) and p53 hypomethylation (P = 0.001) were the principal determinants of shorter TL. Our results indicate that shorter TL is associated with chronic PAH exposure. The interrelations with other genetic and epigenetic mechanisms in our data suggest that shorter TL could be a central event in PAH carcinogenesis. PMID:19892797

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

ERIC Educational Resources Information Center

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

2005-01-01

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

The Association of Visit Length and Measures of Patient-Centered Communication in HIV Care

PubMed Central

Epstein, Lauren; Lee, Yoojin; Rogers, William; Beach, Mary Catherine; Wilson, Ira B.

2011-01-01

Introduction Patient centered clinical communication may be associated with longer encounters. Methods We used the General Medical Interaction Analysis System (GMIAS) to code transcripts of routine outpatient visits in HIV care, and create 5 measures of patient-centeredness. We defined visit length as number of utterances. To better understand properties of encounters reflected in these measures, we conducted a qualitative analysis of the 15 longest and 15 shortest visits. Results All 5 measures were significantly associated with visit length (P<.05, rank order correlations .21 to .44). In multivariate regressions, association of patient centeredness with visit length was attenuated for 4 measures, and increased for 1; two were no longer statistically significant (p>0.05). Black and Hispanic race were associated with shorter visits compared with white race. Some of the longest visits featured content that could be considered extraneous to appropriate care. Conclusion Patient centeredness is weakly related to visit length, but may reflect inefficient use of time in long encounters. Practice Implications Efforts to make visits more patient centered should focus on improving dialogue quality and efficient use of time, not on making visits longer. Shorter visits for Black and Hispanic patients could contribute to health disparities related to race and ethnicity. PMID:21592716

Reduced birth intervals following the birth of children with long-term illness: evidence supporting a conditional evolved response.

PubMed

Waynforth, David

2015-10-01

Human birth interval length is indicative of the level of parental investment that a child will receive: a short interval following birth means that parental resources must be split with a younger sibling during a period when the older sibling remains highly dependent on their parents. From a life-history theoretical perspective, it is likely that there are evolved mechanisms that serve to maximize fitness depending on context. One context that would be expected to result in short birth intervals, and lowered parental investment, is after a child with low expected fitness is born. Here, data drawn from a longitudinal British birth cohort study were used to test whether birth intervals were shorter following the birth of a child with a long-term health problem. Data on the timing of 4543 births were analysed using discrete-time event history analysis. The results were consistent with the hypothesis: birth intervals were shorter following the birth of a child diagnosed by a medical professional with a severe but non-fatal medical condition. Covariates in the analysis were also significantly associated with birth interval length: births of twins or multiple births, and relationship break-up were associated with significantly longer birth intervals. © 2015 The Author(s).

Characteristics in the beat-to-beat laser-Doppler waveform indices in subjects with diabetes.

PubMed

Hsiu, Hsin; Hu, Hsiao-Feng; Wu, Guan-Shian; Hsiao, Fone-Ching

2014-01-01

The present study performed laser-Doppler flowmetry (LDF) measurements on the skin surface around the ankle with the aim of verifying if beat-to-beat analysis of the LDF waveform can help to discriminate the microcirculatory-blood-flow (MBF) characteristics between diabetic, prediabetic, and healthy subjects. 84 subjects were assigned to three groups (diabetic, prediabetic, and normal) according to the results of oral glucose tolerance tests. Beat-to-beat analysis was performed on the pulsatile LDF waveform to obtain foot delay time (FDT), flow rise time (FRT), and the corresponding MBF-variability parameters (FDTCV and FRTCV). Relative to the control group, FDT and FRT were significantly shorter in prediabetic subjects, FDT was significantly shorter in diabetic subjects, and FRTCV and FDTCV were significantly larger in prediabetic and diabetic subjects. There were no significant associations for FRT after adjustment for age and gender. The present results indicate that FRT may help to discriminate differences in the elastic properties of local vascular beds during diabetes or even during prediabetic stages. The proposed blood-filling-volume model can help to explain the underlying mechanism. The present findings may aid the noninvasive early detection of diabetes-associated vascular damage, and could be used in the development of home-care and telemedicine applications.

Comparing the Efficiencies of Third Molar Surgeries With and Without a Dentist Anesthesiologist

PubMed Central

Young, S.; Boukas, E.; Davidian, E.; Carnahan, J.

2017-01-01

Two different anesthesia models were compared in terms of surgical duration, safer outcomes, and economic implications. Third molar surgeries performed with and without a separate dentist anesthesiologist were evaluated by a retrospective data analysis of the surgical operative times. For more difficult surgeries, substantially shorter operative times were observed with the dentist anesthesiologist model, leading to a more favorable surgical outcome. An example calculation is presented to demonstrate economic advantages of scheduling the participation of a dentist anesthesiologist for more difficult surgeries. PMID:28128661

Analysis of the release process of phenylpropanolamine hydrochloride from ethylcellulose matrix granules V. Release properties of ethylcellulose layered matrix granules.

PubMed

Fukui, Atsuko; Fujii, Ryuta; Yonezawa, Yorinobu; Sunada, Hisakazu

2008-04-01

In the pharmaceutical preparation of a controlled release drug, it is very important and necessary to understand the release properties. In previous papers, a combination of the square-root time law and cube-root law equations was confirmed to be a useful equation for qualitative treatment. It was also confirmed that the combination equation could analyze the release properties of layered granules as well as matrix granules. The drug release property from layered granules is different from that of matrix granules. A time lag occurs before release, and the entire release property of layered granules was analyzed using the combination of the square-root time law and cube-root law equations. It is considered that the analysis method is very useful and efficient for both matrix and layered granules. Comparing the granulation methods, it is easier to control the manufacturing process by tumbling granulation (method B) than by tumbling-fluidized bed granulation (method C). Ethylcellulose (EC) layered granulation by a fluidized bed granulator might be convenient for the preparation of controlled release dosage forms as compared with a tumbling granulator, because the layered granules prepared by the fluidized bed granulator can granulate and dry at the same time. The time required for drying by the fluidized bed granulator is shorter than that by the tumbling granulator, so the fluidized bed granulator is convenient for preparation of granules in handling and shorter processing time than the tumbling granulator. It was also suggested that the EC layered granules prepared by the fluidized bed granulator were suitable for a controlled release system as well as the EC matrix granules.

Laparoscopic versus open incisional hernia repair: a retrospective cohort study with costs analysis on 269 patients.

PubMed

Soliani, G; De Troia, A; Portinari, M; Targa, S; Carcoforo, P; Vasquez, G; Fisichella, P M; Feo, C V

2017-08-01

To compare clinical outcomes and institutional costs of elective laparoscopic and open incisional hernia mesh repairs and to identify independent predictors of prolonged operative time and hospital length of stay (LOS). Retrospective observational cohort study on 269 consecutive patients who underwent elective incisional hernia mesh repair, laparoscopic group (N = 94) and open group (N = 175), between May 2004 and July 2014. Operative time was shorter in the laparoscopic versus open group (p < 0.0001). Perioperative morbidity and mortality were similar in the two groups. Patients in the laparoscopic group were discharged a median of 2 days earlier (p < 0.0001). At a median follow-up over 50 months, no difference in hernia recurrence was detected between the groups. In laparoscopic group total institutional costs were lower (p = 0.02). At Cox regression analysis adjusted for potential confounders, large wall defect (W3) and higher operative risk (ASA score 3-4) were associated with prolonged operative time, while midline hernia site was associated with increased hospital LOS. Open surgical approach was associated with prolongation of both operative time and LOS. Laparoscopic approach may be considered safely to all patients for incisional hernia repair, regardless of patients' characteristics (age, gender, BMI, ASA score, comorbidities) and size of the wall defect (W2-3), with the advantage of shorter operating time and hospital LOS that yields reduced total institutional costs. Patients with higher ASA score and large hernia defects are at risk of prolonged operative time, while an open approach is associated with longer duration of surgical operation and hospital LOS.

Spatial epidemiology of suspected clinical leptospirosis in Sri Lanka.

PubMed

Robertson, C; Nelson, T A; Stephen, C

2012-04-01

Leptospirosis is one of the most widespread zoonoses in the world. A large outbreak of suspected human leptospirosis began in Sri Lanka during 2008. This study investigated spatial variables associated with suspected leptospirosis risk during endemic and outbreak periods. Data were obtained for monthly numbers of reported cases of suspected clinical leptospirosis for 2005-2009 for all of Sri Lanka. Space-time scan statistics were combined with regression modelling to test associations during endemic and outbreak periods. The cross-correlation function was used to test association between rainfall and leptospirosis at four locations. During the endemic period (2005-2007), leptospirosis risk was positively associated with shorter average distance to rivers and with higher percentage of agriculture made up of farms <0·20 hectares. Temporal correlation analysis of suspected leptospirosis cases and rainfall revealed a 2-month lag in rainfall-case association during the baseline period. Outbreak locations in 2008 were characterized by shorter distance to rivers and higher population density. The analysis suggests the possibility of household transmission in densely populated semi-urban villages as a defining characteristic of the outbreak. The role of rainfall in the outbreak remains to be investigated, although analysis here suggests a more complex relationship than simple correlation.

Randomized prospective study of olecranon fracture fixation: cable pin system versus tension band wiring.

PubMed

Liu, Q-H; Fu, Z-G; Zhou, J-L; Lu, T; Liu, T; Shan, L; Liu, Y; Bai, L

2012-01-01

This prospective, randomized study compared the effectiveness of the cable pin system (CPS) versus tension band wiring (TBW) for olecranon fracture fixation. Patients with acute transverse or slight oblique olecranon fractures were randomly divided into two groups: one fixed by CPS and the other by TBW. Clinical outcome data were collected and analysed following a mean duration of 21 months. The mean ± SD fracture healing time was significantly shorter in the CPS group (n = 30; 9.73 ± 2.02 weeks) compared with the TBW group (n = 32; 11.13 ± 2.21 weeks). One patient in the CPS group and seven patients in the TBW group experienced postoperative complications; this difference was statistically significant. The mean ± SD Mayo Elbow Performance Score in the CPS group was significantly higher (88.67 ± 6.42) than that in the TBW group (80.78 ± 11.99). Logistic regression analysis showed an association between fixation method and fracture healing time, complications and elbow function. Internal fixation by CPS is an effective method for olecranon fracture and is associated with a shorter healing time, fewer complications and better function than TBW.

Passive haptics in a knee arthroscopy simulator: is it valid for core skills training?

PubMed

McCarthy, Avril D; Moody, Louise; Waterworth, Alan R; Bickerstaff, Derek R

2006-01-01

Previous investigation of a cost-effective virtual reality arthroscopic training system, the Sheffield Knee Arthroscopy Training System (SKATS), indicated the desirability of including haptic feedback. A formal task analysis confirmed the importance of knee positioning as a core skill for trainees learning to navigate the knee arthroscopically. The system cost and existing limb interface, which permits knee positioning, would be compromised by the addition of commercial active haptic devices available currently. The validation results obtained when passive haptic feedback (resistance provided by physical structures) is provided indicate that SKATS has construct, predictive and face validity for navigation and triangulation training. When tested using SKATS, experienced surgeons (n = 11) performed significantly faster, located significantly more pathologies, and showed significantly shorter arthroscope path lengths than a less experienced surgeon cohort (n = 12). After SKATS training sessions, novices (n = 3) showed significant improvements in: task completion time, shorter arthroscope path lengths, shorter probe path lengths, and fewer arthroscope tip contacts. Main improvements occurred after the first two practice sessions, indicating rapid familiarization and a training effect. Feedback from questionnaires completed by orthopaedic surgeons indicates that the system has face validity for its remit of basic arthroscopic training.

Discrimination in waiting times by insurance type and financial soundness of German acute care hospitals.

PubMed

Schwierz, Christoph; Wübker, Achim; Wübker, Ansgar; Kuchinke, Björn A

2011-10-01

This paper shows that patients with private health insurance (PHI) are being offered significantly shorter waiting times than patients with statutory health insurance (SHI) in German acute hospital care. This behavior may be driven by the higher expected profitability of PHI relative to SHI holders. Further, we find that hospitals offering private insurees shorter waiting times when compared with SHI holders have a significantly better financial performance than those abstaining from or with less discrimination.

An OPTIMIZE study retrospective analysis for management of telaprevir-treated hepatitis C virus (HCV)-infected patients by use of the Abbott RealTime HCV RNA assay.

PubMed

Sarrazin, Christoph; Dierynck, Inge; Cloherty, Gavin; Ghys, Anne; Janssen, Katrien; Luo, Donghan; Witek, James; Buti, Maria; Picchio, Gaston; De Meyer, Sandra

2015-04-01

Protease inhibitor (PI)-based response-guided triple therapies for hepatitis C virus (HCV) infection are still widely used. Noncirrhotic treatment-naive and prior relapser patients receiving telaprevir-based treatment are eligible for shorter, 24-week total therapy if HCV RNA is undetectable at both weeks 4 and 12. In this study, the concordance in HCV RNA assessments between the Roche High Pure System/Cobas TaqMan and Abbott RealTime HCV RNA assays and the impacts of different HCV RNA cutoffs on treatment outcome were evaluated. A total of 2,629 samples from 663 HCV genotype 1 patients receiving telaprevir/pegylated interferon/ribavirin in OPTIMIZE were analyzed using the High Pure System and reanalyzed using Abbott RealTime (limits of detection, 15.1 IU/ml versus 8.3 IU/ml; limits of quantification, 25 IU/ml versus 12 IU/ml, respectively). Overall, good concordance was observed between the assays. Using undetectable HCV RNA at week 4, 34% of the patients would be eligible for shorter treatment duration with Abbott RealTime versus 72% with the High Pure System. However, using <12 IU/ml for Abbott RealTime, a similar proportion (74%) would be eligible. Of the patients receiving 24-week total therapy, 87% achieved a sustained virologic response with undetectable HCV RNA by the High Pure System or <12 IU/ml by Abbott RealTime; however, 92% of the patients with undetectable HCV RNA by Abbott RealTime achieved a sustained virologic response. Using undetectable HCV RNA as the cutoff, the more sensitive Abbott RealTime assay would identify fewer patients eligible for shorter treatment than the High Pure System. Our data confirm the <12-IU/ml cutoff, as previously established in other studies of the Abbott RealTime assay, to determine eligibility for shortened PI-based HCV treatment. (The study was registered with ClinicalTrials.gov under registration no. NCT01241760.). Copyright © 2015, American Society for Microbiology. All Rights Reserved.

In transit sentinel node drainage as a prognostic factor for patients with cutaneous melanoma.

PubMed

Brandão, Paulo H D M; Bertolli, Eduardo; Doria-Filho, Eduardo; Santos Filho, Ivan D A O; de Macedo, Mariana P; Pinto, Clovis A L; Duprat Neto, João P

2018-02-26

Minor basin or in transit node drainage can be found in patients with cutaneous melanoma who undergo sentinel node biopsy. Its clinical impact is still unclear. Our objective is to evaluate clinical outcomes in patients who presented with in transit sentinel node (ITN) drainage. Retrospective analysis of patients who underwent sentinel node biopsy (SNB) in a single Brazilian institution between 2000 and 2015. Our cohort comprised 1223 SNB. There were 64 patients (5.2%) with ITN. Melanoma of the limbs (OR 10.61, P < 0.0001) and acral subtype (OR 3.49, P < 0.0001) were associated with ITN drainage. Among these 64 patients, 14 (21.9%) had a positive SNB. The ITN was positive for metastases in five patients, four in a popliteal basin and one on the trunk. Regarding completion node dissection (CND), two patients had positive non-sentinel nodes (NSN), both in major basins. In patients who developed recurrence, time to recurrence was shorter (mean time 18 vs 31.4 months, P = 0.001) and time to death was shorter (mean time 31.6 vs 40 months, P = 0.039) in those who had ITN drainage. ITN drainage was associated with earlier recurrences and deaths from melanoma. © 2018 Wiley Periodicals, Inc.

The Effect of Optimally Timed Osteopathic Manipulative Treatment on Length of Hospital Stay in Moderate and Late Preterm Infants: Results from a RCT

PubMed Central

Pizzolorusso, Gianfranco; Cerritelli, Francesco; Accorsi, Alessandro; Lucci, Chiara; Tubaldi, Lucia; Lancellotti, Jenny; Barlafante, Gina; Renzetti, Cinzia; D'Incecco, Carmine; Perri, Francesco Paolo

2014-01-01

Introduction. Little research has been conducted looking at the effects of osteopathic manipulative treatment (OMT) on preterm infants. Aim of the Study. This study hypothesized that osteopathic care is effective in reducing length of hospital stay and that early OMT produces the most pronounced benefit, compared to moderately early and late OMT. A secondary outcome was to estimate hospital cost savings by the use of OMT. Methods. 110 newborns ranging from 32- to 37-week gestation were randomized to receive either OMT or usual pediatric care. Early, moderately early, and late OMT were defined as <4, <9, and <14 days from birth, respectively. Result. Hospital stay was shorter in infants receiving late OMT (−2.03; 95% CI −3.15, −0.91; P < 0.01) than controls. Subgroup analysis of infants receiving early and moderately early OMT resulted in shorter LOS (early OMT: −4.16; −6.05, −2.27; P < 0.001; moderately early OMT: −3.12; −4.36, −1.89; P < 0.001). Costs analysis showed that OMT significantly produced a net saving of €740 (−1309.54, −170.33; P = 0.01) per newborn per LOS. Conclusions. This study shows evidence that the sooner OMT is provided, the shorter their hospital stay is. There is also a positive association of OMT with overall reduction in cost of care. PMID:25506381

Is Alcohol Use Disorder Identification Test (AUDIT) or Its Shorter Versions More Useful to Identify Risky Drinkers in a Chinese Population? A Diagnostic Study

PubMed Central

Yip, Benjamin H. K.; Chung, Roger Y.; Chung, Vincent C. H.; Kim, Jean; Chan, Iris W. T.; Wong, Martin C. S.; Wong, Samuel Y. S.; Griffiths, Sian M.

2015-01-01

Objective To examine the diagnostic performance of shorter versions of Alcohol Use Disorder Identification Test (AUDIT), including Alcohol Consumption (AUDIT-C), in identifying risky drinkers in primary care settings using conventional performance measures, supplemented by decision curve analysis and reclassification table. Study design and Setting A cross-sectional study of adult males in general outpatient clinics in Hong Kong. The study included only patients who reported at least sometimes drinking alcoholic beverages. Timeline follow back alcohol consumption assessment method was used as the reference standard. A Chinese translated and validated 10-item AUDIT (Ch-AUDIT) was used as a screening tool of risky drinking. Results Of the participants, 21.7% were classified as risky drinkers. AUDIT-C has the best overall performance among the shorter versions of Ch-AUDIT. The AUC of AUDIT-C was comparable to Ch-AUDIT (0.898 vs 0.901, p-value = 0.959). Decision curve analysis revealed that when the threshold probability ranged from 15–30%, the AUDIT-C had a higher net-benefit than all other screens. AUDIT-C improved the reclassification of risky drinking when compared to Ch-AUDIT (net reclassification improvement = 0.167). The optimal cut-off of AUDIT-C was at ≥5. Conclusion Given the rising levels of alcohol consumption in the Chinese regions, this Chinese translated 3-item instrument provides convenient and time-efficient risky drinking screening and may become an increasingly useful tool. PMID:25756353

Laparoscopic versus open repair for perforated peptic ulcer: A meta analysis of randomized controlled trials.

PubMed

Tan, Shanjun; Wu, Guohao; Zhuang, Qiulin; Xi, Qiulei; Meng, Qingyang; Jiang, Yi; Han, Yusong; Yu, Chao; Yu, Zhen; Li, Ning

2016-09-01

The role of laparoscopic surgery in the repair for peptic ulcer disease is unclear. The present study aimed to compare the safety and efficacy of laparoscopic versus open repair for peptic ulcer disease. Randomized controlled trials (RCTs) comparing laparoscopic versus open repair for peptic ulcer disease were identified from MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and references of identified articles and relevant reviews. Primary outcomes were postoperative complications, mortality, and reoperation. Secondary outcomes were operative time, postoperative pain, postoperative hospital stay, nasogastric tube duration, and time to resume diet. Statistical analysis was carried out by Review Manage software. Five RCTs investigating a total of 549 patients, of whom, 279 received laparoscopic repair and 270 received open repair, were included in the final analysis. There were no significant differences between these two procedures in some primary outcomes including overal postoperative complication rate, mortality, and reoperation rate. Subcategory analysis of postoperative complications showed that laparoscopic repair had also similar rates of repair site leakage, intra-abdominal abscess, postoperative ileus, pneumonia, and urinary tract infection as open surgery, except of the lower surgical site infection rate (P < 0.05). In addition, there were also no significant differences between these two procedures in some second outcomes including operative time, postoperative hospital stay, and time to resume diet, but laparoscopic repair had shorter nasogastric tube duration (P < 0.05) and less postoperative pain (P < 0.05) than open surgery. Laparoscopic surgery is comparable with open surgery in the setting of repair for perforated peptic ulcer. The obvious advantages of laparoscopic surgery are the lower surgical site infection rate, shorter nasogastric tube duration and less postoperative pain. However, more higher quality studies should be undertaken to further assess the safety and efficacy of laparoscopic repair for peptic ulcer disease. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Maximum entropy analysis of polarized fluorescence decay of (E)GFP in aqueous solution

NASA Astrophysics Data System (ADS)

Novikov, Eugene G.; Skakun, Victor V.; Borst, Jan Willem; Visser, Antonie J. W. G.

2018-01-01

The maximum entropy method (MEM) was used for the analysis of polarized fluorescence decays of enhanced green fluorescent protein (EGFP) in buffered water/glycerol mixtures, obtained with time-correlated single-photon counting (Visser et al 2016 Methods Appl. Fluoresc. 4 035002). To this end, we used a general-purpose software module of MEM that was earlier developed to analyze (complex) laser photolysis kinetics of ligand rebinding reactions in oxygen binding proteins. We demonstrate that the MEM software provides reliable results and is easy to use for the analysis of both total fluorescence decay and fluorescence anisotropy decay of aqueous solutions of EGFP. The rotational correlation times of EGFP in water/glycerol mixtures, obtained by MEM as maxima of the correlation-time distributions, are identical to the single correlation times determined by global analysis of parallel and perpendicular polarized decay components. The MEM software is also able to determine homo-FRET in another dimeric GFP, for which the transfer correlation time is an order of magnitude shorter than the rotational correlation time. One important advantage utilizing MEM analysis is that no initial guesses of parameters are required, since MEM is able to select the least correlated solution from the feasible set of solutions.

A characterization of persistence at short times in the WFC3/IR detector

NASA Astrophysics Data System (ADS)

Gennaro, M.; Bajaj, V.; Long, K.

2018-05-01

Persistence in the WFC3/IR detector appears to decay as a power law as a function of time elapsed since the end of a stimulus. In this report we study departures from the power law at times shorter than a few hundreds seconds after the stimulus. In order to have better short-time cadence, we use the Multiaccum (.ima) files, which trace the accumulated charge in the pixels as function of time, rather than the final pipeline products (.flt files), which instead report the electron rate estimated via a linear fit to the accumulated charge vs. time relation. We note that at short times after the stimulus, the absolute change in persistence is the strongest, thus a linear fit to the accumulated signal (the .flt values) can be a poor representation of the strongly varying persistence signal. The already observed power-law decay of the persistence signal, still holds at shorter times, with typical values of the power law index, gamma in [-0.8,-1] for stimuli that saturate the WFC3 pixels. To a good degree of approximation, a single power law is a good fit to the persistence signal decay from 100 to 5000 seconds. We also detect a tapering-off in the power-law decay at increasingly shorter times. This change in behavior is of the order of Delta Gamma 0.02 - 0.05 when comparing power-law fits performed to the persistence signal from 0 up to 250 seconds and from 0 up to 4000 seconds after the stimulus, indicating that persistence decays slightly more rapidly as time progresses. Our results may suggest that for even shorter times, not probed by our study, the WFC3 persistence signal might deviate from a single power-law model.

[A comparison of laparoscopic versus open repair for the surgical treatment of perforated peptic ulcers].

PubMed

Domínguez-Vega, Gerardo; Pera, Manuel; Ramón, José M; Puig, Sonia; Membrilla, Estela; Sancho, Joan; Grande, Luis

2013-01-01

To analyse the outcomes of laparoscopic versus open repair for perforated peptic ulcers (PPU). All patients undergoing PPU repair between January 2002 and March 2012 were included in the study. Demographic characteristics, operation time, complications, and length of hospital stay were evaluated. Two hundred and twelve patients (median age, 49 years) were included, 60 in the laparoscopic group and 52 in the open group. Patients operated laparoscopically were significantly younger and had a higher consumption of tobacco, alcohol and cannabis. Median acute symptoms time was shorter in the laparoscopic group (6h) compared to the open group (12h; P=.025) Symptoms time was shorter in the laparoscopic group. Median operating time was significantly longer in the laparoscopic group (104.5min vs. 76min, P=.025). The percentage of conversion to open repair was 25%. There was no difference in morbidity between 2 groups, but there were 3 deaths in the open group. Median hospital stay was significantly shorter in patients treated laparoscopically when compared with the open group (6 days vs. 8 days; P=.041). Laparoscopic and open repair are equally safe in the management of PPU. A shorter hospital stay can be achieved in the laparoscopic group. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

[Association between sleep and leukocyte telomere length in middle-aged and older adults].

PubMed

Liu, H F; Li, F; Wang, Y H; Chen, J H; Peng, D X; Chen, J; Tan, L H; Mi, X; Zhao, B H

2017-07-10

Objective: To understand the association between peripheral leukocytes telomere length (TL) and sleep in middle-aged and old adults. Methods: A total of 176 middle-aged and old adults were investigated by using the Pittsburgh Sleep Quality Index and questionnaire. TL was measured by fluorescence quantitative PCR. The correlation and regression analysis between sleep and telomere length was performed. Results: TL had a mean T/S ratio of 0.995±0.23. There was a negative correlation between TL and age ( r =-0.241, P =0.003). With increasing age, sleep quality became worse ( r =-0.230, P <0.01), the time to fall asleep became longer ( r =0.227, P <0.01), sleep duration was shorter ( r =-0.486, P <0.01), sleep efficiency became worse ( r =-0.226, P <0.01). After controlling for the effects of gender, age, marital status, income level, residence, smoking, drinking, physical exercise and disease status, multiple linear regression analysis indicated that sleep quality ( β =0.057, P <0.01), time to fall asleep ( β =-0.046, P <0.01), sleep duration ( β =0.086, P <0.01) were independent influencing factors of telomere length, suggesting that the people who had better sleep quality, the shorter time to fall asleep, the longer sleep time would have longer telomere length. Conclusions: Sleep is a relevant factor affecting TL in middle-aged and elderly population. Good sleep may delay aging by slowing TL. We encourage to conduct health education about the importance of sleep quality in community.

Assessing Microneurosurgical Skill with Medico-Engineering Technology.

PubMed

Harada, Kanako; Morita, Akio; Minakawa, Yoshiaki; Baek, Young Min; Sora, Shigeo; Sugita, Naohiko; Kimura, Toshikazu; Tanikawa, Rokuya; Ishikawa, Tatsuya; Mitsuishi, Mamoru

2015-10-01

Most methods currently used to assess surgical skill are rather subjective or not adequate for microneurosurgery. Objective and quantitative microneurosurgical skill assessment systems that are capable of accurate measurements are necessary for the further development of microneurosurgery. Infrared optical motion tracking markers, an inertial measurement unit, and strain gauges were mounted on tweezers to measure many parameters related to instrument manipulation. We then recorded the activity of 23 neurosurgeons. The task completion time, tool path, and needle-gripping force were evaluated for three stitches made in an anastomosis of 0.7-mm artificial blood vessels. Videos of the activity were evaluated by three blinded expert surgeons. Surgeons who had recently done many bypass procedures demonstrated better skills. These skilled surgeons performed the anastomosis with in a shorter time, with a shorter tool path, and with a lesser force when extracting the needle. These results show the potential contribution of the system to microsurgical skill assessment. Quantitative and detailed analysis of surgical tasks helps surgeons better understand the key features of the required skills. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

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

NASA Astrophysics Data System (ADS)

Ficchì, Andrea; Perrin, Charles; Andréassian, Vazken

2016-07-01

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

Transperitoneal approach versus retroperitoneal approach: a meta-analysis of laparoscopic partial nephrectomy for renal cell carcinoma.

PubMed

Ren, Tong; Liu, Yan; Zhao, Xiaowen; Ni, Shaobin; Zhang, Cheng; Guo, Changgang; Ren, Minghua

2014-01-01

To compare the efficiency and safety of the transperitoneal approaches with retroperitoneal approaches in laparoscopic partial nephrectomy for renal cell carcinoma and provide evidence-based medicine support for clinical treatment. A systematic computer search of PUBMED, EMBASE, and the Cochrane Library was executed to identify retrospective observational and prospective randomized controlled trials studies that compared the outcomes of the two approaches in laparoscopic partial nephrectomy. Two reviewers independently screened, extracted, and evaluated the included studies and executed statistical analysis by using software STATA 12.0. Outcomes of interest included perioperative and postoperative variables, surgical complications and oncological variables. There were 8 studies assessed transperitoneal laparoscopic partial nephrectomy (TLPN) versus retroperitoneal laparoscopic partial nephrectomy (RLPN) were included. RLPN had a shorter operating time (SMD = 1.001,95%confidence interval[CI] 0.609-1.393,P<0.001), a lower estimated blood loss (SMD = 0.403,95%CI 0.015-0.791,P = 0.042) and a shorter length of hospital stay (WMD = 0.936 DAYS,95%CI 0.609-1.263,P<0.001) than TLPN. There were no significant differences between the transperitoneal and retroperitoneal approaches in other outcomes of interest. This meta-analysis indicates that, in appropriately selected patients, especially patients with intraperitoneal procedures history or posteriorly located renal tumors, the RLPN can shorten the operation time, reduce the estimated blood loss and shorten the length of hospital stay. RLPN may be equally safe and be faster compared with the TLPN.

A comparison among four tract dilation methods of percutaneous nephrolithotomy: a systematic review and meta-analysis.

PubMed

Dehong, Cao; Liangren, Liu; Huawei, Liu; Qiang, Wei

2013-11-01

The purpose of this study was to evaluate the efficacy and safety of the Amplatz dilation (AD), metal telescopic dilation (MTD), balloon dilation (BD), and one-shot dilation (OSD) methods for tract dilation during percutaneous nephrolithotomy (PCNL). Relevant eligible studies were identified using three electronic databases (Medline, EMBASE, and Cochrane CENTRAL). Database acquisition and quality evaluation were independently performed by two reviewers. Efficacy (stone-free rate, surgical duration, and tract dilatation fluoroscopy time) and safety (transfusion rate and hemoglobin decrease) were evaluated using Review Manager 5.2. Four randomized controlled trials and eight clinical controlled trials involving 6,820 patients met the inclusion criteria. The pooled result from a meta-analysis showed statistically significant differences in tract dilatation fluoroscopy time and hemoglobin decrease between the OSD and MTD groups, which showed comparable stone-free and transfusion rates. Significant differences in transfusion rate were found between the BD and MTD groups. Among patients without previous open renal surgery, those who underwent BD exhibited a lower blood transfusion rate and a shorter surgical duration compared with those who underwent AD. The OSD technique is safer and more efficient than the MTD technique for tract dilation during PCNL, particularly in patients with previous open renal surgery, resulting in a shorter tract dilatation fluoroscopy time and a lesser decrease in hemoglobin. The efficacy and safety of BD are better than AD in patients without previous open renal surgery. The OSD technique should be considered for most patients who undergo PCNL therapy.

Comparison of oxygen saturation values and measurement times by pulse oximetry in various parts of the body.

PubMed

Yönt, Gülendam Hakverdioğlu; Korhan, Esra Akin; Khorshid, Leyla

2011-11-01

The aim of this study, which included 40 patients, was to compare the values pulse oximetry and the measurement times in various regions of the body. Data were analyzed using intraclass correlation coefficient test and paired-sample test. The confidence power value was found to be .81 for the comparison of oxygen saturation values by arterial blood gas analysis and measurement by the forehead probe. It was found that the time for oxygen saturation measurement using the forehead probe was shorter than those using the finger and toe probes. Copyright © 2011 Elsevier Inc. All rights reserved.

The limited role of recombination energy in common envelope removal

NASA Astrophysics Data System (ADS)

Grichener, Aldana; Sabach, Efrat; Soker, Noam

2018-05-01

We calculate the outward energy transport time by convection and photon diffusion in an inflated common envelope and find this time to be shorter than the envelope expansion time. We conclude therefore that most of the hydrogen recombination energy ends in radiation rather than in kinetic energy of the outflowing envelope. We use the stellar evolution code MESA and inject energy inside the envelope of an asymptotic giant branch star to mimic energy deposition by a spiraling-in stellar companion. During 1.7 years the envelope expands by a factor of more than 2. Along the entire evolution the convection can carry the energy very efficiently outwards, to the radius where radiative transfer becomes more efficient. The total energy transport time stays within several months, shorter than the dynamical time of the envelope. Had we included rapid mass loss, as is expected in the common envelope evolution, the energy transport time would have been even shorter. It seems that calculations that assume that most of the recombination energy ends in the outflowing gas might be inaccurate.

Sleep in schizophrenia: A systematic review and meta-analysis of polysomnographic findings in case-control studies.

PubMed

Chan, Man-Sum; Chung, Ka-Fai; Yung, Kam-Ping; Yeung, Wing-Fai

2017-04-01

Polysomnographic studies have been performed to examine the sleep abnormalities in schizophrenia, but the results are inconsistent. An updated systematic review, meta-analysis, and moderator analysis was conducted. Major databases were searched without language restriction from 1968 to January 2014. Data were analyzed using the random-effects model and summarized using the Hedges's g. Thirty-one studies with 574 patients and 515 healthy controls were evaluated. Limited by the number of studies and a lack of patient-level data, moderator analysis was restricted to medication status, duration of medication withdrawal, and illness duration. We showed that patients with schizophrenia have significantly shorter total sleep time, longer sleep onset latency, more wake time after sleep onset, lower sleep efficiency, and decreased stage 4 sleep, slow wave sleep, and duration and latency of rapid eye movement sleep compared to healthy controls. The findings on delta waves and sleep spindles were inconsistent. Moderator analysis could not find any abnormalities in sleep architecture in medication-naïve patients. Patients with antipsychotic withdrawal for longer than eight weeks were shown to have less sleep architectural abnormalities, compared to shorter duration of withdrawal, but the abnormalities in sleep continuity were similar. Slow wave sleep deficit was found in patients with schizophrenia for more than three years, while sleep onset latency was increased in medication-naïve, medication-withdrawn, and medicated patients. Our study showed that polysomnographic abnormalities are present in schizophrenia. Illness duration, medication status, and duration of medication withdrawal are several of the clinical factors that contribute to the heterogeneity between studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

Gender differences among recidivist trauma patients.

PubMed

Kwan, Rita O; Cureton, Elizabeth L; Dozier, Kristopher C; Victorino, Gregory P

2011-01-01

Gender differences among trauma recidivist patients are not well-understood. We hypothesized that males are more likely to be repeatedly involved in the trauma system and have a shorter time to recurrence between repeat episodes of injury compared with females. A retrospective analysis of trauma patients treated at an urban university-based trauma center was performed. Variables including gender, race, insurance status, age, mechanism of injury, outcomes, and injury secondary to domestic violence were compared. Differences were compared using χ(2) tests and log-rank (Mantel-Cox) Kaplan-Meier cumulative event curves. We identified 689 trauma recidivist patients (4.0% of all trauma visits) over a 10-y period. Compared to single-visit patients, recidivist patients were more likely to be male (87% versus 73%), uninsured (78% versus 66%), and have injuries secondary to assaults (54% versus 37%) (P < 0.05). Time from the first to second trauma visit was shorter for females compared with males (23 ± 2.5 versus 30 ± 1.2 mo, P < 0.02). Additionally, female recidivists were more likely to be involved in blunt trauma than were male recidivists (69% versus 43%, P < 0.001). Furthermore, domestic violence was identified in a higher proportion of female recidivist patients than female single-visit patients (3.5% versus 1.6%, P < 0.0003). Contrary to our hypothesis, female recidivist trauma patients have a much shorter time to recurrence for a second traumatic injury than do males. Female recidivists have a high likelihood of assault-associated injuries and domestic violence. Trauma centers should screen for domestic violence among trauma patients to aid in preventing further repeat episodes of injury. Copyright © 2011 Elsevier Inc. All rights reserved.

Short Operative Duration and Surgical Site Infection Risk in Hip and Knee Arthroplasty Procedures

PubMed Central

Dicks, Kristen V.; Baker, Arthur W.; Durkin, Michael J.; Anderson, Deverick J.; Moehring, Rebekah W.; Chen, Luke F.; Sexton, Daniel J.; Weber, David J.; Lewis, Sarah S.

2016-01-01

OBJECTIVE To determine the association (1) between shorter operative duration and surgical site infection (SSI) and (2) between surgeon median operative duration and SSI risk among first-time hip and knee arthroplasties. DESIGN Retrospective cohort study SETTING A total of 43 community hospitals located in the southeastern United States. PATIENTS Adults who developed SSIs according to National Healthcare Safety Network criteria within 365 days of first-time knee or hip arthroplasties performed between January 1, 2008 and December 31, 2012. METHODS Log-binomial regression models estimated the association (1) between operative duration and SSI outcome and (2) between surgeon median operative duration and SSI outcome. Hip and knee arthroplasties were evaluated in separate models. Each model was adjusted for American Society of Anesthesiology score and patient age. RESULTS A total of 25,531 hip arthroplasties and 42,187 knee arthroplasties were included in the study. The risk of SSI in knee arthroplasties with an operative duration shorter than the 25th percentile was 0.40 times the risk of SSI in knee arthroplasties with an operative duration between the 25th and 75th percentile (risk ratio [RR], 0.40; 95% confidence interval [CI], 0.38–0.56; P <.01). Short operative duration did not demonstrate significant association with SSI for hip arthroplasties (RR, 1.04; 95% CI, 0.79–1.37; P =.36). Knee arthroplasty surgeons with shorter median operative durations had a lower risk of SSI than surgeons with typical median operative durations (RR, 0.52; 95% CI, 0.43–0.64; P <.01). CONCLUSIONS Short operative durations were not associated with a higher SSI risk for knee or hip arthroplasty procedures in our analysis. PMID:26391277

Retroperitoneal versus transperitoneal robotic-assisted laparoscopic partial nephrectomy: a matched-pair, bicenter analysis with cost comparison using time-driven activity-based costing.

PubMed

Laviana, Aaron A; Tan, Hung-Jui; Hu, Jim C; Weizer, Alon Z; Chang, Sam S; Barocas, Daniel A

2018-03-01

To perform a bicenter, retrospective study of perioperative outcomes of retroperitoneal versus transperitoneal robotic-assisted laparoscopic partial nephrectomy (RALPN) and assess costs using time-driven activity-based costing (TDABC). We identified 355 consecutive patients who underwent RALPN at University of California Los Angeles and the University of Michigan during 2009-2016. We matched according to RENAL nephrometry score, date, and institution for 78 retroperitoneal versus 78 transperitoneal RALPN. Unadjusted analyses were performed using McNemar's Chi-squared or paired t test, and adjusted analyses were performed using multivariable repeated measures regression analysis. From multivariable models, predicted probabilities were derived according to approach. Cost analysis was performed using TDABC. Patients treated with retroperitoneal versus transperitoneal RALPN were similar in age (P = 0.490), sex (P = 0.715), BMI (P = 0.273), and comorbidity (P = 0.393). Most tumors were posterior or lateral in both the retroperitoneal (92.3%) and transperitoneal (85.9%) groups. Retroperitoneal RALPN was associated with shorter operative times (167.0 versus 191.1 min, P = 0.001) and length of stay (LOS) (1.8 versus 2.7 days, P < 0.001). There were no differences in renal function preservation or cancer control. In adjusted analyses, retroperitoneal RALPN was 17.6-min shorter (P < 0.001) and had a 76% lower probability of LOS at least 2 days (P < 0.001). Utilizing TDABC, transperitoneal RALPN added $2337 in cost when factoring in disposable equipment, operative time, LOS, and personnel. In two high-volume, tertiary centers, retroperitoneal RALPN is associated with reduced operative times and shortened LOS in posterior and lateral tumors, whereas sharing similar clinicopathologic outcomes, which may translate into lower healthcare costs. Further investigation into anterior tumors is needed.

In-vitro comparison of instrumentation time and cleaning capacity between endodontic handpiece and manual preparation techniques in primary molar teeth.

PubMed

Seraj, B; Ramezani, G; Ghadimi, S; Mosharrafian, S H; Motahhary, P; Safari, M

2013-01-01

The aim of this study was to evaluate and compare the cleaning ability and instrumentation time of manual method and use of endodontic handpiece for preparation of primary molar teeth. Forty primary teeth canals were used in this experimental study. Access cavities were prepared and India ink was injected into the canals. The samples were divided into three groups according to the preparation technique. In the first group the root canals were manually instrumented by k_files. Endodontic handpiece (TEP-ER10, NSK, Japan) were used for canal preparation in the second group and the samples in the third group (control) were not instrumented. After preparing the canal, the teeth were cleared with methyl salicylate and the removal of India ink was measured in the cervical, middle and apical thirds. The instrumentation time was transcribed by chronometer. Statistical analysis was performed using Mann-Whitney and t-test. There was no significant difference in cleaning capacity between the two techniques, but results of the first and second group differ from those of the control group. In fact, time taken for preparation was significantly shorter with endodontic handpiece system. Seen the shorter working time of endodontic handpiece and the similar cleaning ability of the two techniques, the application of the endodontic handpiece is recommended for preparation of deciduous root canals during pulpectomy.

Potential sulfur-free pulping methods

Treesearch

Edward L. Springer; Rajai H. Atalla; Richard S. Reiner

2002-01-01

Lodgepole pine chips were pulped to Kappa numbers of about 70 using soda–AQ, soda–ODiMAQ, and kraft methods. At a catalyst level of 0.20% (oven-dry wood basis), cooking times for the soda cooks were significantly shorter than that for the kraft cook. The ODiMAQ catalyzed cooking time was much shorter than that of the AQ cook. It might be possible to replace the kraft...

The effect of tonal changes on voice onset time in Mandarin esophageal speech.

PubMed

Liu, Hanjun; Ng, Manwa L; Wan, Mingxi; Wang, Supin; Zhang, Yi

2008-03-01

The present study investigated the effect of tonal changes on voice onset time (VOT) between normal laryngeal (NL) and superior esophageal (SE) speakers of Mandarin Chinese. VOT values were measured from the syllables /pha/, /tha/, and /kha/ produced at four tone levels by eight NL and seven SE speakers who were native speakers of Mandarin. Results indicated that Mandarin tones were associated with significantly different VOT values for NL speakers, in which high-falling tone was associated with significantly shorter VOT values than mid-rising tone and falling-rising tone. Regarding speaker group, SE speakers showed significantly shorter VOT values than NL speakers across all tone levels. This may be related to their use of pharyngoesophageal (PE) segment as another sound source. SE speakers appear to take a shorter time to start PE segment vibration compared to NL speakers using the vocal folds for vibration.

Implementation of enhanced recovery programme for laparoscopic distal pancreatectomy: feasibility, safety and cost analysis.

PubMed

Richardson, John; Di Fabio, Francesco; Clarke, Hannah; Bajalan, Mohammed; Davids, Joe; Abu Hilal, Mohammed

2015-01-01

The adoption of laparoscopy for distal pancreatectomy has proven to substantially improve short-term outcomes. Stress response after major surgery can be further minimized within an enhanced recovery programme (ERP). However, data on the potential benefit of an ERP for laparoscopic distal pancreatectomy are still lacking. The aim was to assess the feasibility, safety and cost of ERP for patients undergoing laparoscopic distal pancreatectomy. This is a case-control study from a Tertiary University Hospital. Sixty-six consecutive patients who underwent laparoscopic distal pancreatectomy were analyzed. Twenty-two patients were enrolled for the ERP and compared with previous consecutive 44 patients managed traditionally (1:2 ratio). Operative details, post-operative outcome and cost analysis were compared in the two groups. Patients enrolled in the ERP had similar intraoperative blood loss (median 165 ml vs. 200 ml; p = 0.176), operation time (225 min vs. 210 min; p = 0.633), time to remove naso-gastric tube (1 vs. 1 day; p = 0.081) but significantly shorter time to mobilization (median 1 vs. 2 days; p = 0.0001), start solid diet (2 vs. 3 days; p = 0004), and pass stools (3 vs. 5 days; p = 0.002) compared to the control group. Median length of stay was significantly shorter in the ERP group (3 vs. 6 days; p < 0.0001). No significant difference in readmission or complication rate was observed. Cost analysis was significantly in favor of the ERP group (p = 0.0004). Implementation of ERP optimizes outcomes for laparoscopic distal pancreatectomy with significant earlier return to normal gut function, reduced length of stay and cost saving. Copyright © 2015 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Antegrade versus retrograde cerebral perfusion for hemiarch replacement with deep hypothermic circulatory arrest: Does it matter? A propensity-matched analysis

PubMed Central

Ganapathi, Asvin M.; Hanna, Jennifer M.; Schechter, Matthew A.; Englum, Brian R.; Castleberry, Anthony W.; Gaca, Jeffrey G.; Hughes, G. Chad

2015-01-01

Objective The choice of cerebral perfusion strategy for aortic arch surgery has been debated, and the superiority of antegrade (ACP) or retrograde (RCP) cerebral perfusion has not been shown. We examined the early and late outcomes for ACP versus RCP in proximal (hemi-) arch replacement using deep hypothermic circulatory arrest (DHCA). Methods A retrospective analysis of a prospectively maintained database was performed for all patients undergoing elective and nonelective hemiarch replacement at a single referral institution from June 2005 to February 2013. Total arch cases were excluded to limit the analysis to shorter DHCA times and a more uniform patient population for whom clinical equipoise regarding ACP versus RCP exists. A total of 440 procedures were identified, with 360 (82%) using ACP and 80 (18%) using RCP. The endpoints included 30-day/in-hospital and late outcomes. A propensity score with 1:1 matching of 40 pre- and intraoperative variables was used to adjust for differences between the 2 groups. Results All 80 RCP patients were propensity matched to a cohort of 80 similar ACP patients. The pre- and intra-operative characteristics were not significantly different between the 2 groups after matching. No differences were found in 30-day/in-hospital mortality or morbidity outcomes. The only significant difference between the 2 groups was a shorter mean operative time in the RCP cohort (P = .01). No significant differences were noted in late survival (P = .90). Conclusions In proximal arch operations using DHCA, equivalent early and late outcomes can be achieved with RCP and ACP, although the mean operative time is significantly less with RCP, likely owing to avoidance of axillary cannulation. Questions remain regarding comparative outcomes with straight DHCA and lesser degrees of hypothermia. PMID:24908350

Intramuscular midazolam versus intravenous lorazepam for the prehospital treatment of status epilepticus in the pediatric population.

PubMed

Welch, Robert D; Nicholas, Katherine; Durkalski-Mauldin, Valerie L; Lowenstein, Daniel H; Conwit, Robin; Mahajan, Prashant V; Lewandowski, Christopher; Silbergleit, Robert

2015-02-01

To examine the effectiveness of intramuscular (IM) midazolam versus intravenous (IV) lorazepam for the treatment of pediatric patients with status epilepticus (SE) in the prehospital care setting. This multicenter clinical trial randomized patients diagnosed with SE to receive either IM midazolam or IV lorazepam administered by paramedics in the prehospital care setting. Included in this secondary analysis were only patients younger than 18 years of age. Evaluated were the associations of the treatment group (IM vs. IV) with the primary outcome, defined as seizure cessation prior to emergency department (ED) arrival, and with patient characteristics, time to important events, and adverse events. Descriptive statistics and 99% confidence intervals (CIs) were used for the analysis. Of 893 primary study subjects, 120 met criteria for this study (60 in each treatment group). There were no differences in important baseline characteristics or seizure etiologies between groups. The primary outcome was met in 41 (68.3%) and 43 (71.7%) of subjects in the IM and IV groups, respectively (risk difference [RD] -3.3%, 99% CI -24.9% to 18.2%). Similar results were noted for those younger than 11 years (RD -1.3%, 99% CI -25.7% to 23.1%). Time from initiating the treatment protocol was shorter for children who received IM midazolam, mainly due to the shorter time to administer the active treatment. Safety profiles were similar. IM midazolam can be rapidly administered and appears to be safe and effective for the management of children with SE treated in the prehospital setting. The results must be interpreted in the context of the secondary analysis design and sample size of the study. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

How many hours do people sleep in Bangladesh? A country-representative survey.

PubMed

Yunus, Fakir M; Khan, Safayet; Akter, Tahera; Jhohura, Fatema T; Reja, Saifur; Islam, Akramul; Rahman, Mahfuzar

2016-06-01

This study investigated total sleep time in the Bangladeshi population and identified the proportion of the population at greater risk of developing chronic diseases due to inadequate sleep. Using a cross-sectional survey, total sleep time was captured and analysed in 3968 respondents aged between 6 and 106 years in 24 (of 64) districts in Bangladesh. Total sleep time was defined as the hours of total sleep in the previous 24 h. We used National Sleep Foundation (2015) guidelines to determine the recommended sleep hours in different age categories. Less or more than the recommended total sleep time (in hours) was considered 'shorter' and 'longer' sleep time, respectively. Linear and multinomial logistic regression models were used to determine the relationship between demographic variables and estimated risk of shorter and longer total sleep time. The mean (±standard deviation) total sleep time of children (6-13 years), teenagers (14-17 years), young adults and adults (18-64 years) and older adults (≥65 years) were 8.6 (±1.1), 8.1 (±1.0), 7.7 (±0.9) and 7.8 (±1.4) h, respectively, which were significantly different (P < 0.01). More than half of school-age children (55%) slept less than, and 28.2% of older adults slept longer than, recommended. Residents in all divisions (except Chittagong) in Bangladesh were less likely to sleep longer than in the Dhaka division. Rural populations had a 3.96× greater chance of sleeping for a shorter time than urban residents. The Bangladeshi population tends to sleep for longer and/or shorter times than their respective recommended sleep hours, which is detrimental to health. © 2016 European Sleep Research Society.

Computer aided detection system for Osteoporosis using low dose thoracic 3D CT images

NASA Astrophysics Data System (ADS)

Tsuji, Daisuke; Matsuhiro, Mikio; Suzuki, Hidenobu; Kawata, Yoshiki; Niki, Noboru; Nakano, Yasutaka; Harada, Masafumi; Kusumoto, Masahiko; Tsuchida, Takaaki; Eguchi, Kenji; Kaneko, Masahiro

2018-02-01

The patient of osteoporosis is about 13 million people in Japan and it is one of healthy life problems in the aging society. It is necessary to do early stage detection and treatment in order to prevent the osteoporosis. Multi-slice CT technology has been improving the three dimensional (3D) image analysis with higher resolution and shorter scan time. The 3D image analysis of thoracic vertebra can be used for supporting to diagnosis of osteoporosis. This analysis can be used for lung cancer detection at the same time. We develop method of shape analysis and CT values of spongy bone for the detection osteoporosis. Osteoporosis and lung cancer screening show high extraction rate by the thoracic vertebral evaluation CT images. In addition, we created standard pattern of CT value per thoracic vertebra for male age group using 298 low dose data.

Computer-aided diagnosis for osteoporosis using chest 3D CT images

NASA Astrophysics Data System (ADS)

Yoneda, K.; Matsuhiro, M.; Suzuki, H.; Kawata, Y.; Niki, N.; Nakano, Y.; Ohmatsu, H.; Kusumoto, M.; Tsuchida, T.; Eguchi, K.; Kaneko, M.

2016-03-01

The patients of osteoporosis comprised of about 13 million people in Japan and it is one of the problems the aging society has. In order to prevent the osteoporosis, it is necessary to do early detection and treatment. Multi-slice CT technology has been improving the three dimensional (3-D) image analysis with higher body axis resolution and shorter scan time. The 3-D image analysis using multi-slice CT images of thoracic vertebra can be used as a support to diagnose osteoporosis and at the same time can be used for lung cancer diagnosis which may lead to early detection. We develop automatic extraction and partitioning algorithm for spinal column by analyzing vertebral body structure, and the analysis algorithm of the vertebral body using shape analysis and a bone density measurement for the diagnosis of osteoporosis. Osteoporosis diagnosis support system obtained high extraction rate of the thoracic vertebral in both normal and low doses.

Thick-target bremsstrahlung interpretation of short time-scale solar hard X-ray features

NASA Technical Reports Server (NTRS)

Emslie, A. G.

1983-01-01

Steady-state analyses of bremsstrahlung hard X-ray production in solar flares are appropriate only if the lifetime of the high energy electrons in the X-ray source is much shorter than the duration of the observed X-ray burst. For a thick-target nonthermal model, this implies that a full time-dependent analysis is required when the duration of the burst is comparable to the collisional lifetime of the injected electrons, in turn set by the lengths and densities of the flaring region. In this paper we present the results of such a time-dependent analysis, and we point out that the intrinsic temporal signature of the thick-target production mechanism, caused by the finite travel time of the electrons through the target, may indeed rule out such a mechanism for extremely short duration hard X-ray events.

Comprehensive Numerical Analysis of Finite Difference Time Domain Methods for Improving Optical Waveguide Sensor Accuracy

PubMed Central

Samak, M. Mosleh E. Abu; Bakar, A. Ashrif A.; Kashif, Muhammad; Zan, Mohd Saiful Dzulkifly

2016-01-01

This paper discusses numerical analysis methods for different geometrical features that have limited interval values for typically used sensor wavelengths. Compared with existing Finite Difference Time Domain (FDTD) methods, the alternating direction implicit (ADI)-FDTD method reduces the number of sub-steps by a factor of two to three, which represents a 33% time savings in each single run. The local one-dimensional (LOD)-FDTD method has similar numerical equation properties, which should be calculated as in the previous method. Generally, a small number of arithmetic processes, which result in a shorter simulation time, are desired. The alternating direction implicit technique can be considered a significant step forward for improving the efficiency of unconditionally stable FDTD schemes. This comparative study shows that the local one-dimensional method had minimum relative error ranges of less than 40% for analytical frequencies above 42.85 GHz, and the same accuracy was generated by both methods.

Accelerate Healthcare Data Analytics: An Agile Practice to Perform Collaborative and Reproducible Analyses.

PubMed

Hao, Bibo; Sun, Wen; Yu, Yiqin; Li, Jing; Hu, Gang; Xie, Guotong

2016-01-01

Recent advances in cloud computing and machine learning made it more convenient for researchers to gain insights from massive healthcare data, while performing analyses on healthcare data in current practice still lacks efficiency for researchers. What's more, collaborating among different researchers and sharing analysis results are challenging issues. In this paper, we developed a practice to make analytics process collaborative and analysis results reproducible by exploiting and extending Jupyter Notebook. After applying this practice in our use cases, we can perform analyses and deliver results with less efforts in shorter time comparing to our previous practice.

How High Frequency Trading Affects a Market Index

PubMed Central

Kenett, Dror Y.; Ben-Jacob, Eshel; Stanley, H. Eugene; gur-Gershgoren, Gitit

2013-01-01

The relationship between a market index and its constituent stocks is complicated. While an index is a weighted average of its constituent stocks, when the investigated time scale is one day or longer the index has been found to have a stronger effect on the stocks than vice versa. We explore how this interaction changes in short time scales using high frequency data. Using a correlation-based analysis approach, we find that in short time scales stocks have a stronger influence on the index. These findings have implications for high frequency trading and suggest that the price of an index should be published on shorter time scales, as close as possible to those of the actual transaction time scale. PMID:23817553

Association between coagulation function and patients with primary angle closure glaucoma: a 5-year retrospective case-control study.

PubMed

Li, Shengjie; Gao, Yanting; Shao, Mingxi; Tang, Binghua; Cao, Wenjun; Sun, Xinghuai

2017-11-04

To evaluate the association between coagulation function and patients with primary angle closure glaucoma (PACG). A retrospective, hospital-based, case-control study. Shanghai, China. A total of 1778 subjects were recruited from the Eye & ENT Hospital of Fudan University from January 2010 to December 2015, including patients with PACG (male=296; female=569) and control subjects (male=290; female=623). Sociodemographic data and clinical data were collected. The one-way analysis of variance test was used to compare the levels of laboratory parameters among the mild, moderate and severe PACG groups. Multivariate logistic regression analyses were performed to identify the independent risk factors for PACG. The nomogram was constructed based on the logistic regression model using the R project for statistical computing (R V.3.3.2). The activated partial thromboplastin time (APTT) of the PACG group was approximately 4% shorter (p<0.001) than that of the control group. The prothrombin time (PT) was approximately 2.40% shorter (p<0.001) in patients with PACG compared with the control group. The thrombin time was also approximately 2.14% shorter (p<0.001) in patients with PACG compared with the control group. The level of D-dimer was significantly higher (p=0.042) in patients with PACG. Moreover, the mean platelet volume (MPV) of the PACG group was significantly higher (p=0.013) than that of the control group. A similar trend was observed when coagulation parameters were compared between the PACG and control groups with respect to gender and/or age. Multiple logistic regression analyses revealed that APTT (OR=1.032, 95% CI 1.000 to 1.026), PT (OR=1.249, 95% CI 1.071 to 1.457) and MPV (OR=1.185, 95% CI 1.081 to 1.299) were independently associated with PACG. Patients with PACG had a shorter coagulation time. Our results suggest that coagulation function is significantly associated with patients with PACG and may play an important role in the onset and development of PACG. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Serum Iron Level Is Associated with Time to Antibiotics in Cystic Fibrosis.

PubMed

Gifford, Alex H; Dorman, Dana B; Moulton, Lisa A; Helm, Jennifer E; Griffin, Mary M; MacKenzie, Todd A

2015-12-01

Serum levels of hepcidin-25, a peptide hormone that reduces blood iron content, are elevated when patients with cystic fibrosis (CF) develop pulmonary exacerbation (PEx). Because hepcidin-25 is unavailable as a clinical laboratory test, we questioned whether a one-time serum iron level was associated with the subsequent number of days until PEx, as defined by the need to receive systemic antibiotics (ABX) for health deterioration. Clinical, biochemical, and microbiological parameters were simultaneously checked in 54 adults with CF. Charts were reviewed to determine when they first experienced a PEx after these parameters were assessed. Time to ABX was compared in subgroups with and without specific attributes. Multivariate linear regression was used to identify parameters that significantly explained variation in time to ABX. In univariate analyses, time to ABX was significantly shorter in subjects with Aspergillus-positive sputum cultures and CF-related diabetes. Multivariate linear regression models demonstrated that shorter time to ABX was associated with younger age, lower serum iron level, and Aspergillus sputum culture positivity. Serum iron, age, and Aspergillus sputum culture positivity are factors associated with shorter time to subsequent PEx in CF adults. © 2015 Wiley Periodicals, Inc.

Use of a disposable circumcision suture device versus conventional circumcision: a systematic review and meta-analysis

PubMed Central

Huo, Zhong-Chao; Liu, Gang; Li, Xiao-Yan; Liu, Fei; Fan, Wen-Ju; Guan, Ru-Hua; Li, Pei-Feng; Mo, De-Yang; He, Yong-Zhi

2017-01-01

This systematic review assessed the safety and efficacy of the disposable circumcision suture device (DCSD) and conventional circumcision (CC) in the treatment of redundant prepuce and phimosis. Two independent reviewers conducted a literature search for randomized controlled trials (RCTs) using the DCSD and CC for the treatment of redundant prepuce or phimosis in China and abroad. Nine RCTs (1898 cases) were included. Compared with the CC group, the DCSD group had a shorter operative time (standardized mean difference [SMD] = −21.44; 95% confidence intervals [95% CIs] [−25.08, −17.79]; P < 0.00001), shorter wound healing time (SMD = −3.66; 95% CI [−5.46, −1.85]; P < 0.0001), less intraoperative blood loss (SMD = −9.64; 95% CI [−11.37, −7.90]; P < 0.00001), better cosmetic penile appearance (odds ratio [OR] =8.77; 95% CI [5.90, 13.02]; P < 0.00001), lower intraoperative pain score, lower 24-h postoperative pain score, lower incidence of infection, less incision edema, and fewer adverse events. There were no differences between the CC and DCSD groups in the incidences of dehiscence, or hematoma. The results of this meta-analysis indicate that the DCSD appears to be safer and more effective than CC. However, additional high-quality RCTs with larger study populations are needed. PMID:26975486

A systematic review and meta-analysis of randomized controlled trials comparing hysteroscopic morcellation with resectoscopy for patients with endometrial lesions.

PubMed

Li, Chunbo; Dai, Zhiyuan; Gong, Yuping; Xie, Bingying; Wang, Bei

2017-01-01

Results on the efficacy of hysteroscopic morcellation for patients with endometrial lesions remain conflicting. To compare hysteroscopic morcellation with conventional resectoscopy for removal of endometrial lesions. Electronic databases were searched for reports published up to February 1, 2016, using terms such as "morcellator," "morcellators," "morcellate," "morcellation," "morcellated," "hysteroscopy," "hysteroscopy," "uteroscope," and "transcervical." Randomized controlled trials were included if they assessed success rate, procedure speed, complications, tolerability, and/or learning curve. Data were extracted by two independent reviewers and a meta-analysis was performed. Four trials including 392 patients were analyzed. Successful removal of all endometrial lesions was more frequent with hysteroscopic morcellation than conventional resectoscopy (odds ratio 4.49, 95% confidence interval [CI] 1.94-10.41; P<0.001). Total operative time was also shorter with hysteroscopic morcellation (mean difference -4.94 minutes, 95% CI -7.20 to -2.68; P<0.001). No significant differences in complications were found. Meta-analyses were not possible for tolerability and learning curve. In one study, hysteroscopic morcellation was acceptable to more patients (P=0.009). Hysteroscopic morcellation is associated with a higher operative success rate and a shorter operative time among patients with endometrial lesions than is resectoscopy. More high-quality trials are required to validate these results. © 2016 International Federation of Gynecology and Obstetrics.

Facial palsy in children: emergency department management and outcome.

PubMed

Wang, Cheng-Hsien; Chang, Yu-Che; Shih, Hong-Mo; Chen, Chun-Yu; Chen, Jih-Chang

2010-02-01

To describe the characteristics of children who present to an emergency department (ED) with facial palsy and determine the association of outcome with etiology, degree of initial paralysis, and ED management. This was a retrospective cohort study of children who presented to an ED with facial nerve paralysis (FNP). There were 85 patients with a mean age of 8.0 (SD, 6.1) years; 60% (n = 51) of the patients were male, and 65.9% (n = 56) were admitted to the hospital. Bell palsy (50.6%) was the most common etiology followed by infectious (22.4%), traumatic (16.5%), congenital (7.1%), and neoplastic etiologies (3.5%). Patients with Bell palsy had shorter recovery times (P = 0.049), and traumatic cases required a longer time for recovery (P = 0.016). Acute otitis media (AOM)-related pediatric FNP had shorter recovery times than non-AOM-related cases (P = 0.005) in infectious group. Patients given steroid therapy did not have a shorter recovery time (P = 0.237) or a better recovery (P = 0.269). There was no difference in recovery rate of pediatric patients with Bell palsy between hospitalization or not (P = 0.952). Bell palsy, infection, and trauma were most common etiologies of pediatric FNP. Recovery times were shorter in pediatric patients with Bell palsy and AOM-related FNP, whereas recovery took longer in traumatic cases. Steroid therapy did not seem beneficial for pediatric FNP. Hospitalization is not indicated for pediatric patients with Bell palsy.

18F-FET PET prior to recurrent high-grade glioma re-irradiation-additional prognostic value of dynamic time-to-peak analysis and early static summation images?

PubMed

Fleischmann, Daniel F; Unterrainer, Marcus; Bartenstein, Peter; Belka, Claus; Albert, Nathalie L; Niyazi, Maximilian

2017-04-01

Most high-grade gliomas (HGG) recur after initial multimodal therapy and re-irradiation (Re-RT) has been shown to be a valuable re-treatment option in selected patients. We evaluated the prognostic value of dynamic time-to-peak analysis and early static summation images in O-(2- 18 F-fluoroethyl)-l-tyrosine ( 18 F-FET) PET for patients treated with Re-RT ± concomitant bevacizumab. We retrospectively analyzed 72 patients suffering from recurrent HGG with 18 F-FET PET prior to Re-RT. PET analysis revealed the maximal tumor-to-background-ratio (TBR max ), the biological tumor volume, the number of PET-foci and pattern of time-activity-curves (TACs; increasing vs. decreasing). Furthermore, the novel PET parameters early TBR max (at 5-15 min post-injection) and minimal time-to-peak (TTP min ) were evaluated. Additional analysis was performed for gender, age, KPS, O6-methylguanine-DNA methyltransferase methylation status, isocitrate dehydrogenase 1 mutational status, WHO grade and concomitant bevacizumab therapy. The influence of PET and clinical parameters on post-recurrence survival (PRS) was investigated. Shorter TTP min was related to shorter PRS after Re-RT with 6 months for TTP min  < 12.5 min, 7 months for TTP min 12.5-25 min and 11 months for TTP min >25 min (p = 0.027). TTP min had a significant impact on PRS both on univariate (p = 0.027; continuous) and multivariate analysis (p = 0.011; continuous). Other factors significantly related to PRS on multivariate analysis were increasing vs. decreasing TACs (p = 0.008) and Karnofsky Performance Score (p = 0.015; <70 vs. ≥70). Early TBR max as well as the other conventional PET parameters were not significantly related to PRS on univariate analysis. Dynamic 18 F-FET PET with TTP min provides a high prognostic value for recurrent HGG prior to Re-RT, whereas early TBR max does not. Dynamic 18 F-FET PET using TTP min might help to personalize Re-RT treatment regimens in future through voxelwise TTP min analysis for dose painting purposes and PET-guided dose escalation.

Comparison of posterior retroperitoneal and transabdominal lateral approaches in robotic adrenalectomy: an analysis of 200 cases.

PubMed

Kahramangil, Bora; Berber, Eren

2018-04-01

Although numerous studies have been published on robotic adrenalectomy (RA) in the literature, none has done a comparison of posterior retroperitoneal (PR) and transabdominal lateral (TL) approaches. The aim of this study was to compare the outcomes of robotic PR and TL adrenalectomy. This is a retrospective analysis of a prospectively maintained database. Between September 2008 and January 2017, perioperative outcomes of patients undergoing RA through PR and TL approaches were recorded into an IRB-approved database. Clinical and perioperative parameters were compared using Student's t test, Wilcoxon rank-sum test, and χ 2 test. Multivariate regression analysis was performed to determine factors associated with total operative time. 188 patients underwent 200 RAs. 110 patients were operated through TL and 78 patients through PR approach. Overall, conversion rate to open was 2.5% and 90-day morbidity 4.8%. The perioperative outcomes of TL and PR approaches were similar regarding estimated blood loss, rate of conversion to open, length of hospital stay, and 90-day morbidity. PR approach resulted in a shorter mean ± SD total operative time (136.3 ± 38.7 vs. 154.6 ± 48.4 min; p = 0.005) and lower visual analog scale pain score on postoperative day #1 (4.3 ± 2.5 vs. 5.4 ± 2.4; p = 0.001). After excluding tumors larger than 6 cm operated through TL approach, the difference in operative times persisted (136.3 ± 38.7 vs. 153.7 ± 45.7 min; p = 0.009). On multivariate regression analysis, increasing BMI and TL approaches were associated with longer total operative time. This study shows that robotic PR and TL approaches are equally safe and efficacious. With experience, shorter operative time and less postoperative pain can be achieved with PR technique. This supports the preferential utilization of PR approach in high-volume centers with enough experience.

Recurrence time statistics of landslide events simulated by a cellular automaton model

NASA Astrophysics Data System (ADS)

Piegari, Ester; Di Maio, Rosa; Avella, Adolfo

2014-05-01

The recurrence time statistics of a cellular automaton modelling landslide events is analyzed by performing a numerical analysis in the parameter space and estimating Fano factor behaviors. The model is an extended version of the OFC model, which is a paradigm for SOC in non-conserved systems, but it works differently from the original OFC model as a finite value of the driving rate is applied. By driving the system to instability with different rates, the model exhibits a smooth transition from a correlated to an uncorrelated regime as the effect of a change in predominant mechanisms to propagate instability. If the rate at which instability is approached is small, chain processes dominate the landslide dynamics, and power laws govern probability distributions. However, the power-law regime typical of SOC-like systems is found in a range of return intervals that becomes shorter and shorter by increasing the values of the driving rates. Indeed, if the rates at which instability is approached are large, domino processes are no longer active in propagating instability, and large events simply occur because a large number of cells simultaneously reach instability. Such a gradual loss of the effectiveness of the chain propagation mechanism causes the system gradually enter to an uncorrelated regime where recurrence time distributions are characterized by Weibull behaviors. Simulation results are qualitatively compared with those from a recent analysis performed by Witt et al.(Earth Surf. Process. Landforms, 35, 1138, 2010) for the first complete databases of landslide occurrences over a period as large as fifty years. From the comparison with the extensive landslide data set, the numerical analysis suggests that statistics of such landslide data seem to be described by a crossover region between a correlated regime and an uncorrelated regime, where recurrence time distributions are characterized by power-law and Weibull behaviors for short and long return times, respectively. Finally, in such a region of the parameter space, clear indications of temporal correlations and clustering by the Fano factor behaviors support, at least in part, the analysis performed by Witt et al. (2010).

Sufentanil and Bupivacaine Combination versus Bupivacaine Alone for Spinal Anesthesia during Cesarean Delivery: A Meta-Analysis of Randomized Trials

PubMed Central

Yan, Jianqin; Wang, Ruike; Wang, Ying; Xu, Mu

2016-01-01

Objective The addition of lipophilic opioids to local anesthetics for spinal anesthesia has become a widely used strategy for cesarean anesthesia. A meta-analysis to quantify the benefits and risks of combining sufentanil with bupivacaine for patients undergoing cesarean delivery was conducted. Methods A comprehensive literature search without language or date limitation was performed to identify clinical trials that compared the addition of sufentanil to bupivacaine with bupivacaine alone for spinal anesthesia in healthy parturients choosing cesarean delivery. The Q and I2 tests were used to assess heterogeneity of the data. Data from each trial were combined using relative ratios (RRs) for dichotomous data or weighted mean differences (WMDs) for continuous data and corresponding 95% confidence intervals (95% CIs) for each trial. Sensitivity analysis was conducted by removing one study a time to assess the quality and consistency of the results. Begg’s funnel plots and Egger’s linear regression test were used to detect any publication bias. Results This study included 9 trials containing 578 patients in the final meta-analysis. Sufentanil addition provided a better analgesia quality with less breakthrough pain during surgery than bupivacaine alone (RR = 0.10, 95% CI 0.06 to 0.18, P < 0.001). Sensory block onset time was shorter and first analgesic request time was longer in sufentanil added group compared with the bupivacaine-alone group (WMD = −1.0 min, 95% CI −1.5 to −0.58, P < 0.001 and WMD = 133 min, 95% CI 75 to 213, P < 192, respectively). There was no significant difference in the risk of hypotension and vomiting between these two groups. But pruritus was more frequentely reported in the group with sufentanil added (RR = 7.63, 95% CI 3.85 to 15.12, P < 0.001). Conclusion Bupivacaine and sufentanil combination is superior to that of bupivacaine alone for spinal anesthesia for cesarean delivery in analgesia quality. Women receiving the combined two drugs had less breakthrough pain, shorter sensory block onset time, and longer first analgesic request time. However, the addition of sufentanil to bupivacaine increased the incidence of pruritus. PMID:27032092

Sufentanil and Bupivacaine Combination versus Bupivacaine Alone for Spinal Anesthesia during Cesarean Delivery: A Meta-Analysis of Randomized Trials.

PubMed

Hu, Jiajia; Zhang, Chengliang; Yan, Jianqin; Wang, Ruike; Wang, Ying; Xu, Mu

2016-01-01

The addition of lipophilic opioids to local anesthetics for spinal anesthesia has become a widely used strategy for cesarean anesthesia. A meta-analysis to quantify the benefits and risks of combining sufentanil with bupivacaine for patients undergoing cesarean delivery was conducted. A comprehensive literature search without language or date limitation was performed to identify clinical trials that compared the addition of sufentanil to bupivacaine with bupivacaine alone for spinal anesthesia in healthy parturients choosing cesarean delivery. The Q and I2 tests were used to assess heterogeneity of the data. Data from each trial were combined using relative ratios (RRs) for dichotomous data or weighted mean differences (WMDs) for continuous data and corresponding 95% confidence intervals (95% CIs) for each trial. Sensitivity analysis was conducted by removing one study a time to assess the quality and consistency of the results. Begg's funnel plots and Egger's linear regression test were used to detect any publication bias. This study included 9 trials containing 578 patients in the final meta-analysis. Sufentanil addition provided a better analgesia quality with less breakthrough pain during surgery than bupivacaine alone (RR = 0.10, 95% CI 0.06 to 0.18, P < 0.001). Sensory block onset time was shorter and first analgesic request time was longer in sufentanil added group compared with the bupivacaine-alone group (WMD = -1.0 min, 95% CI -1.5 to -0.58, P < 0.001 and WMD = 133 min, 95% CI 75 to 213, P < 192, respectively). There was no significant difference in the risk of hypotension and vomiting between these two groups. But pruritus was more frequentely reported in the group with sufentanil added (RR = 7.63, 95% CI 3.85 to 15.12, P < 0.001). Bupivacaine and sufentanil combination is superior to that of bupivacaine alone for spinal anesthesia for cesarean delivery in analgesia quality. Women receiving the combined two drugs had less breakthrough pain, shorter sensory block onset time, and longer first analgesic request time. However, the addition of sufentanil to bupivacaine increased the incidence of pruritus.

Pre-hospital electrocardiogram triage with tele-cardiology support is associated with shorter time-to-balloon and higher rates of timely reperfusion even in rural areas: data from the Bari- Barletta/Andria/Trani public emergency medical service 118 registry on primary angioplasty in ST-elevation myocardial infarction.

PubMed

Brunetti, Natale Daniele; Di Pietro, Gaetano; Aquilino, Ambrogio; Bruno, Angela I; Dellegrottaglie, Giulia; Di Giuseppe, Giuseppe; Lopriore, Claudio; De Gennaro, Luisa; Lanzone, Saverio; Caldarola, Pasquale; Antonelli, Gianfranco; Di Biase, Matteo

2014-09-01

We report the preliminary data from a regional registry on ST-elevation myocardial infarction (STEMI) patients treated with primary angioplasty in Apulia, Italy; the region is covered by a single public health-care service, a single public emergency medical service (EMS), and a single tele-medicine service provider. Two hundred and ninety-seven consecutive patients with STEMI transferred by regional free public EMS 1-1-8 for primary-PCI were enrolled in the study; 123 underwent pre-hospital electrocardiograms (ECGs) triage by tele-cardiology support and directly referred for primary-PCI, those remaining were just transferred by 1-1-8 ambulances for primary percutaneous coronary intervention (PCI) (diagnosis not based on tele-medicine ECG; already hospitalised patients, emergency-room without tele-medicine support). Time from first ECG diagnostic for STEMI to balloon was recorded; a time-to-balloon <1 h was considered as optimal and patients as timely treated. Mean time-to-balloon with pre-hospital triage and tele-cardiology ECG was significantly shorter (0:41 ± 0:17 vs 1:34 ± 1:11 h, p<0.001, -0:53 h, -56%) and rates of patients timely treated higher (85% vs 35%, p<0.001, +141%), both in patients from the 'inner' zone closer to PCI catheterisation laboratories (0:34 ± 0:13 vs 0:54 ± 0:30 h, p<0.001; 96% vs 77%, p<0.01, +30%) and in the 'outer' zone (0:52 ± 0:17 vs 1:41 ± 1:14 h, p<0.001; 69% vs 29%, p<0.001, +138%). Results remained significant even after multivariable analysis (odds ratio for time-to-balloon 0.71, 95% confidence interval (CI) 0.63-0.80, p<0.001; 1.39, 95% CI 1.25-1.55, p<0.001, for timely primary-PCI). Pre-hospital triage with tele-cardiology ECG in an EMS registry from an area with more than one and a half million inhabitants was associated with shorter time-to-balloon and higher rates of timely treated patients, even in 'rural' areas. © The European Society of Cardiology 2014.

Comparison of Single-Port Percutaneous Extraperitoneal Repair and Three-Port Mini-Laparoscopic Repair for Pediatric Inguinal Hernia.

PubMed

Korkmaz, Mevlit; Güvenç, B Haluk

2018-03-01

Laparoscopy has been widely used in surgical practice in pediatric age, and many techniques for laparoscopic hernia repair have been described till now. In this study, we compared two laparoscopic techniques performed by two surgeons; each surgeon practicing only one of the two techniques. A retrospective analysis was performed on the surgical charts, enrolling 71 patients with uncomplicated inguinal hernia. Patients were divided into two groups according to the type of surgery: (Group A, 24 patients aged 2 months-8 years) laparoscopic percutaneous internal ring suturing technique and (Group B, 47 patients aged 35 days-12 years) three-port mini-laparoscopic technique. The hernia sac was ligated at the level of internal ring, using nonabsorbable 4/0-3/0 suture. Any unexpected contralateral opening was repaired in the same manner for both groups. Follow-up period was 4 months-2 years and 9 months-8 years, respectively. Operative time and complications were analyzed. Operation time (19.58 ± 7.06 minutes versus 35.87 ± 10.34 minutes, P < .001) was shorter in the percutaneous repair group. However, when subdivided by unilateral and bilateral presentation, only unilateral operative time was shorter compared to three-port group. There were no recurrences in Group A, while two recurrences occurred in Group B during the learning curve period. A contralateral opening accompanied the presenting unilateral hernia in 3 cases for Group A and 16 for Group B. One patient had to be converted open resulting from epigastric vessel injury, and postop hydrocele formation was seen in another in Group A. No intraoperative complications were seen in Group B. The overall experience shows that laparoscopic repair is a reliable approach regardless of the chosen technique. Percutaneous repair seems to be a less invasive method with shorter operative time, but it is not free of complications according to this series.

Impact of a rapid respiratory panel test on patient outcomes.

PubMed

Rogers, Beverly B; Shankar, Prabhu; Jerris, Robert C; Kotzbauer, David; Anderson, Evan J; Watson, J Renee; O'Brien, Lauren A; Uwindatwa, Francine; McNamara, Kelly; Bost, James E

2015-05-01

Evolution of polymerase chain reaction testing for infectious pathogens has occurred concurrent with a focus on value-based medicine. To determine if implementation of the FilmArray rapid respiratory panel (BioFire Diagnostics, Salt Lake City, Utah) (hereafter RRP), with a shorter time to the test result and expanded panel, results in different outcomes for children admitted to the hospital with an acute respiratory tract illness. Patient outcomes were compared before implementation of the RRP (November 1, 2011, to January 31, 2012) versus after implementation of the RRP (November 1, 2012, to January 31, 2013). The study included inpatients 3 months or older with an acute respiratory tract illness, most admitted through the emergency department. Testing before RRP implementation used batched polymerase chain reaction analysis for respiratory syncytial virus and influenza A and B, with additional testing for parainfluenza 1 through 3 in approximately 11% of patients and for human metapneumovirus in less than 1% of patients. The RRP tested for respiratory syncytial virus, influenza A and B, parainfluenza 1 through 4, human metapneumovirus, adenovirus, rhinovirus/enterovirus, and coronavirus NL62. The pre-RRP group had 365 patients, and the post-RRP group had 771 patients. After RRP implementation, the mean time to the test result was shorter (383 minutes versus 1119 minutes, P < .001), and the percentage of patients with a result in the emergency department was greater (51.6% versus 13.4%, P < .001). There was no difference in whether antibiotics were prescribed, but the duration of antibiotic use was shorter after RRP implementation (P = .003) and was dependent on receiving test results within 4 hours. If the test result was positive, the inpatient length of stay (P = .03) and the time in isolation (P = .03) were decreased after RRP implementation compared with before RRP implementation. The RRP decreases the duration of antibiotic use, the length of inpatient stay, and the time in isolation.

Legal Status, Time in the USA, and the Well-Being of Latinos in Los Angeles.

PubMed

Young, Maria-Elena De Trinidad; Pebley, Anne R

2017-12-01

In the USA, undocumented Latino immigrants may have poorer health because of barriers to health care, stressors, and detrimental effects of immigration enforcement. Previous immigrant health research, however, suggests that recently arrived Latino immigrants have better health than US-born Latinos and their health deteriorates over time. Given the current environments that undocumented immigrants face, legal status is a structural factor that likely influences the patterns of immigrant health. Therefore, the aim of this study was to examine the extent to which physical and mental health differed by legal status and duration in the USA for the Latino population in Los Angeles County, California. We conducted analysis of Latino respondents (n = 1396) to the Los Angeles Family and Neighborhood Survey (L.A.FANS) Wave II. We examined self-reported health, depression measured by the Composite International Diagnostic Interview-Short Form, and blood pressure collected by trained interviewers. Respondents reported their legal status, time in the USA, and other sociodemographic characteristics. Regression models were used to test associations between each outcome and 1) legal status and 2) legal status by duration (≤ 15 and > 15 years) in the USA. Without taking duration into account, we found no significant differences in outcomes between undocumented, documented, or US-born Latinos. Taking duration into account, shorter duration undocumented immigrants had worse self-reported health than the US born. Undocumented immigrants, regardless of duration, had higher blood pressure than documented immigrants who had been in the USA for less time and the same level of blood pressure as the US born. In contrast, shorter duration documented immigrants had lower blood pressure compared to longer duration documented immigrants and US-born counterparts, and marginally lower blood pressure than shorter duration undocumented immigrants. The findings suggest that the "health advantage" generally presumed to exist among immigrants may not affect undocumented immigrants.

Variations in High-frequency Oscillations of Tropical Cyclones over the Western North Pacific

NASA Astrophysics Data System (ADS)

Chen, Shumin; Li, Weibiao; Wen, Zhiping; Zhou, Mingsen; Lu, Youyu; Qian, Yu-Kun; Liu, Haoya; Fang, Rong

2018-04-01

Variations in the high-frequency oscillations of tropical cyclones (TCs) over the western North Pacific (WNP) are studied in numerical model simulations. Power spectrum analysis of maximum wind speeds at 10 m (MWS10) from an ensemble of 15 simulated TCs shows that oscillations are significant for all TCs. The magnitudes of oscillations in MWS10 are similar in the WNP and South China Sea (SCS); however, the mean of the averaged significant periods in the SCS (1.93 h) is shorter than that in the open water of the WNP (2.83 h). The shorter period in the SCS is examined through an ensemble of simulations, and a case simulation as well as a sensitivity experiment in which the continent is replaced by ocean for Typhoon Hagupit (2008). The analysis of the convergence efficiency within the boundary layer suggests that the shorter periods in the SCS are possibly due to the stronger terrain effect, which intensifies convergence through greater friction. The enhanced convergence strengthens the disturbance of the gradient and thermal wind balances, and then contributes to the shorter oscillation periods in the SCS.

Immunochromatographic strip assay for the rapid and sensitive detection of Salmonella Typhimurium in artificially contaminated tomato samples.

PubMed

Shukla, Shruti; Leem, Hyerim; Lee, Jong-Suk; Kim, Myunghee

2014-06-01

This study was designed to confirm the applicability of a liposome-based immunochromatographic assay for the rapid detection of Salmonella enterica subsp. enterica serovar Typhimurium (Salmonella Typhimurium) in artificially contaminated tomato samples. To determine the detection limit and pre-enrichment incubation time (10, 12, and 18 h pre-enrichment in 1% buffered peptone water), the tests were performed with different cell numbers of Salmonella Typhimurium (3 × 10(0), 3 × 10(1), 3 × 10(2), and 3 × 10(3) CFU·mL(-1)) inoculated into 25 g of crushed tomato samples. The assay was able to detect as few as 30 Salmonella Typhimurium cells per 25 g of tomato samples (1.2 cells·g(-1)) after 12 h pre-enrichment incubation. Moreover, when the developed assay was compared with traditional morphological and biochemical culture-based methods as well as colloidal gold nanoparticle-based commercial test strips, the developed assay yielded positive results for the detection of Salmonella Typhimurium within a shorter period time. These findings confirm that the developed assay may have practical application for the sensitive detection of Salmonella Typhimurium in various food samples, including raw vegetables, with a relatively low detection limit and shorter analysis time.

First ground-based observations of mesopause temperatures above the Eastern-Mediterranean Part II: OH*-climatology and gravity wave activity

NASA Astrophysics Data System (ADS)

Wüst, Sabine; Schmidt, Carsten; Bittner, Michael; Silber, Israel; Price, Colin; Yee, Jeng-Hwa; Mlynczak, Martin G.; Russell, James M.

2017-03-01

In this study, we present an analysis of approximately four years of nightly temperature data, acquired with the OH-spectrometer GRIPS 10 (GRound based Infrared P-branch Spectrometer), which was installed in Tel Aviv (32.11°N, 34.8°E), Israel in November 2011 for routine measurements. As our instrument does not give any height information, we use TIMED-SABER data in order to answer the question concerning the height region our measurement technique exactly addresses. For the first time, we estimate the density of wave potential energy for periods between some minutes and some hours for this station. These values are typical for gravity waves. Since GRIPS measurements do not currently provide vertically resolved data, the Brunt-Väisälä frequency, which is needed for the estimation of potential energy density, is calculated using TIMED-SABER measurements. The monthly mean density of wave potential energy is presented for periods shorter and longer than 60 min. For the winter months (November, December, and January), the data base allows the calculation of a seasonal mean for the different years. This publication is the companion paper to Silber et al. (2016). Here, we focus on oscillations with shorter periods.

Behavioral Health Care Needs, Detention-Based Care, and Criminal Recidivism at Community Reentry From Juvenile Detention: A Multisite Survival Curve Analysis

PubMed Central

White, Laura M.; Lau, Katherine S. L.; Perkins, Anthony; Monahan, Patrick; Grisso, Thomas

2015-01-01

Objectives. We examined the provision of behavioral health services to youths detained in Indiana between 2008 and 2012 and the impact of services on recidivism. Method. We obtained information about behavioral health needs, behavioral health treatment received, and recidivism within 12 months after release for 8363 adolescents (aged 12–18 years; 79.4% male). We conducted survival analyses to determine whether behavioral health services significantly affected time to recidivating. Results. Approximately 19.1% of youths had positive mental health screens, and 25.3% of all youths recidivated within 12 months after release. Of youths with positive screens, 29.2% saw a mental health clinician, 16.1% received behavioral health services during detention, and 30.0% received referrals for postdetention services. Survival analyses showed that being male, Black, and younger, and having higher scores on the substance use or irritability subscales of the screen predicted shorter time to recidivism. Receiving a behavior precaution, behavioral health services in detention, or an assessment in the community also predicted shorter time to recidivating. Conclusions. Findings support previous research showing that behavioral health problems are related to recidivism and that Black males are disproportionately rearrested after detention. PMID:25973804

Sex differences in time from self-reported heart trouble to heart disease death in the Alameda County Study. Significance of time dependence of risk variable effects.

PubMed

Cohn, B A; Wingard, D L; Cohen, R D; Cirillo, P M; Kaplan, G A

1990-03-01

In a previous analysis from the Alameda County Study, it was observed that although men had higher heart disease mortality rates than women, there was no male excess in the prevalence of self-reported heart disease morbidity at baseline or in new reports of morbidity 9 years past baseline. This apparent contradiction might occur because women report less severe heart disease than men. In the present study, this hypothesis was evaluated by examining whether self-reported heart trouble was more strongly associated with subsequent heart disease mortality for men than for women in a representative sample of the population of Alameda County, California, selected in 1965 and followed for mortality for 19 years (n = 3,742). In a time-dependent Cox model, self-reported heart trouble was a stronger predictor of heart disease mortality for men, but only during the early years of follow-up (p = 0.00). This effect was due to a shorter time to death for men who reported heart trouble. The relative hazard for men reporting heart trouble was 6.6 (95% confidence interval (CI) 3.7-11.6) at baseline, declining to 3.2 (95% CI 2.2-4.5) by 5 years past baseline and 1.5 (95% CI 0.9-2.5) by 10 years past baseline. Self-reported heart trouble was a consistent predictor of subsequent heart disease mortality for women over the 19-year follow-up period (relative hazard = 2.0, 95% CI 1.4-2.8). Sex differences in the prognosis of self-reported heart trouble were masked in non-time-dependent analyses. These results illustrate that consideration of time dependence may be required for meaningful analysis of long-term cohort studies. Possible explanations of the shorter time to death for men who reported heart trouble are discussed.

Trends of earlier palliative care consultation in advanced cancer patients receiving palliative radiation therapy.

PubMed

Chang, Sanders; Sigel, Keith; Goldstein, Nathan E; Wisnivesky, Juan; Dharmarajan, Kavita V

2018-06-06

The American Society of Clinical Oncology recommends that all patients with metastatic disease receive dedicated palliative care (PC) services early in their illness, ideally via interdisciplinary care teams. We investigated the time trends of specialty palliative care consultations from the date of metastatic cancer diagnosis among patients receiving palliative radiation therapy (PRT). A shorter time interval between metastatic diagnosis and first PC consultation suggests earlier involvement of palliative care in a patient's life with metastatic cancer. In this IRB-approved retrospective analysis, patients treated with PRT for solid tumors (bone and brain) at a single tertiary care hospital between 2010 and 2016 were included. Cohorts were arbitrarily established by metastatic diagnosis within approximately two-year intervals: (1) 1/1/2010-3/27/2012; (2) 3/28/2012-5/21/2014; and (3) 5/22/2014-12/31/2016. Cox-proportional hazards regression modelling was used to compare trends of PC consultation among cohorts. Of 284 patients identified, 184 patients received PC consultation, whereas 15 patients died before receiving a PC consult. Median follow-up time until an event or censor was 257 days (range: 1,900). Patients in the most recent cohort had a shorter median time to first PC consult (57 days) compared to those in the first (374 days) and second (186 days) cohorts. On multivariable analysis, patients in the third cohort were more likely to undergo a PC consultation earlier in their metastatic illness (HR: 1.8, 95% CI: 1.2,2.8). Over a six-year period, palliative care consultation occurred earlier for metastatic patients treated with PRT at our institution. Copyright © 2018. Published by Elsevier Inc.

Asymmetry in gait pattern following bicondylar tibial plateau fractures-A prospective one-year cohort study.

PubMed

Elsoe, Rasmus; Larsen, Peter

2017-07-01

Despite the high number of studies evaluating outcomes following tibial plateau fractures, the literature lacks studies including the objective assessment of gait pattern. The purpose of the present study was to evaluate asymmetry in gait patterns at 12 months after frame removal following ring fixation of a tibial plateau fracture. The study design was a prospective cohort study. The primary outcome measurement was the gait patterns 12 months after frame removal measured with a pressure-sensitive mat. The mat registers footprints and present gait speed, cadence, as well as temporal and spatial parameters of the gait cycle. Gait patterns were compared to a healthy reference population. Twenty-three patients were included with a mean age of 54.4 years (32-78 years). Patients presented with a shorter step-length of the injured leg compared to the non-injured leg (asymmetry of 11.3%). Analysis of single-support showed shorter support time of the injured leg compared to the non-injured leg (asymmetry of 8.7%). Moreover, analysis of swing-time showed increased swing-time of the injured leg (asymmetry of 8.9%). Compared to a healthy reference population, increased asymmetry in all gait patterns was observed. The association between asymmetry and health-related quality of life (HRQOL) showed moderate associations (single-support: R=0.50, P=0.03; step-length: R=0.43, P=0.07; swing-time: R=0.46, P=0.05). Compared to a healthy reference population, gait asymmetry is common 12 months after frame removal in patients treated with external ring fixation following a tibial plateau fracture of the tibia. Copyright © 2017 Elsevier Ltd. All rights reserved.

Simultaneous image reproduction on CRT screen: Moves ultrasonic sectional view and electrocardiogram curves

NASA Technical Reports Server (NTRS)

1978-01-01

A method for simultaneous reproduction of images, requiring different amounts of time to reproduce, on a cathode ray tube (CRT) screen is disclosed. Ultrasonic sectional views and electrocardiogram curves are simultaneously reproduced on the CRT screen by producing the images on different areas of a screen with two phosphors having different persistence times and luminous colors, within the times required for the appearance of the images. In front of the area on which is produced the image requiring the shorter time is a color filter which is permeable to the color of the phosphor with the shorter persistence time by which absorbs the color of the other phosphor.

An analysis of first-time blood donors return behaviour using regression models.

PubMed

Kheiri, S; Alibeigi, Z

2015-08-01

Blood products have a vital role in saving many patients' lives. The aim of this study was to analyse blood donor return behaviour. Using a cross-sectional follow-up design of 5-year duration, 864 first-time donors who had donated blood were selected using a systematic sampling. The behaviours of donors via three response variables, return to donation, frequency of return to donation and the time interval between donations, were analysed based on logistic regression, negative binomial regression and Cox's shared frailty model for recurrent events respectively. Successful return to donation rated at 49·1% and the deferral rate was 13·3%. There was a significant reverse relationship between the frequency of return to donation and the time interval between donations. Sex, body weight and job had an effect on return to donation; weight and frequency of donation during the first year had a direct effect on the total frequency of donations. Age, weight and job had a significant effect on the time intervals between donations. Aging decreases the chances of return to donation and increases the time interval between donations. Body weight affects the three response variables, i.e. the higher the weight, the more the chances of return to donation and the shorter the time interval between donations. There is a positive correlation between the frequency of donations in the first year and the total number of return to donations. Also, the shorter the time interval between donations is, the higher the frequency of donations. © 2015 British Blood Transfusion Society.

[Coronary bypass in treatment of high-risk patients].

PubMed

Avdagić, Harun; Mujanović, Emir; Mesanović, Nihad; Sijereić-Avdagić, Selma; Pirić, Melika

2009-01-01

Although it is possible to find a number of comparative studies in the world literature discussing the results of coronary artery bypass surgery (CABG) with and without cardiopulmonary bypass (CPB), until now such analysis has not been made in Bosnia and Herzegovina. The main aim of this scientific work was to compare morbidity and mortality, need for blood transfusions, length of stay in the intensive care unit, total length of hospitalisation and number of complication in two groups of patients operated with these methods. Patients with EuroScore > or =5 with CABG operated in Cardiovascular Clinic Tuzla, from May 2000 to May 2005 divided in two groups, were included in this study. There were 100 patients in the first group operated with CPB and 100 patients in the second group operated without CPB. The average time spent on respirators was shorter in patients operated without CPB (3.7 vs.9.74 hours, p = 0.023) and the time spent in Intensive care shorter too (19 vs. 23 days, p = 0.008). Volume of postoperative bleeding was less in patients operated without CPB (574.9 vs. 988.9 ml, p = 0.038), as volume after blood transfusion (168.8 vs. 350.3 mi, p = 0.001). Intraoperative inotrope support was less in patients operated without CPB (8.0 vs. 19.0%, p = 0.038) as postoperative inotrope support (6.0 vs. 17.0%, p = 0.027). The most usual postoperative complication was atrial fibrillation and there was no difference between patients operated with CPB and without CPB (24% vs. 17%, p = 0.293). Mortality was not different in patients operated with or without CPB (2.0% vs. 6.0%, p = 0.140). The average time of total hospitalisation was also shorter in patients operated without CPB (8.0 vs. 9.5 days, p = 0.039. In conclusion CABG without CPB has many advantages compared to the conventional method. Mortality and morbidity are reduced and there is less need for transfusion. The time spent on mechanical ventilation is reduced and less time is spent in intensive care. The total hospitalisation time is also reduced.

Comparison of the efficacy and feasibility of en bloc transurethral resection of bladder tumor versus conventional transurethral resection of bladder tumor: A meta-analysis.

PubMed

Wu, Yu-Peng; Lin, Ting-Ting; Chen, Shao-Hao; Xu, Ning; Wei, Yong; Huang, Jin-Bei; Sun, Xiong-Lin; Zheng, Qing-Shui; Xue, Xue-Yi; Li, Xiao-Dong

2016-11-01

The aim of this meta-analysis was to compare the feasibility of en bloc transurethral resection of bladder tumor (ETURBT) versus conventional transurethral resection of bladder tumor (CTURBT). Relevant trials were identified in a literature search of MEDLINE, EMBASE, Cochrane Library, Web of Science, and Google Scholar using appropriate search terms. All comparative studies reporting participant demographics, tumor characteristics, study characteristics, and outcome data were included. Seven trials with 886 participants were included, 438 underwent ETURBT and 448 underwent CTURBT. There was no significant difference in operation time between 2 groups (P = 0.38). The hospitalization time (HT) and catheterization time (CT) were shorter in ETURBT group (mean difference[MD] -1.22, 95% confidence interval [CI] -1.63 to -0.80, P < 0.01; MD -0.61, 95% CI -1.11 to -0.11, P < 0.01). There was significant difference in 24-month recurrence rate (24-month RR) (odds ratio [OR] 0.66, 95% CI 0.47-0.92, P = 0.02). The rate of complication with respect to bladder perforation (P = 0.004), bladder irritation (P < 0.01), and obturator nerve reflex (P < 0.01) was lower in ETURBT. The postoperative adjuvant intravesical chemotherapy was evaluated by subgroup analysis, and 24-month RR in CTURBT is higher than that in ETURBT in mitomycin intravesical irrigation group (P = 0.02). The first meta-analysis indicates that ETURBT might prove to be preferable alternative to CTURBT management of nonmuscle invasive bladder carcinoma. ETURBT is associated with shorter HT and CT, less complication rate, and lower recurrence-free rate. Moreover, it can provide high-qualified specimen for the pathologic diagnosis. Well designed randomized controlled trials are needed to make results comparable.

Root replacement using stentless valves in the small aortic root: a propensity score analysis.

PubMed

Kunihara, Takashi; Schmidt, Kathrin; Glombitza, Petra; Dzindzibadze, Vachtang; Lausberg, Henning; Schäfers, Hans-Joachim

2006-10-01

Root replacement using a stentless bioprosthesis may be the optimal approach to avoid patient-prosthesis mismatch in patients with a small aortic root. Primary root replacement, however, is considered to be associated with increased surgical risk. We compared early outcome of full root replacement with a stentless bioprosthesis with that of aortic valve replacement with a stented bioprosthesis using propensity score-matching analysis. Of 231 patients undergoing elective, first-time aortic valve replacement with a small root (< or = 22 mm), 120 patients were selected using propensity score-matching analysis. They underwent either root replacement using a 23-mm stentless bioprosthesis (stentless group, n = 60) or supra-annular aortic valve replacement using a 21-mm stented bioprosthesis (stented group, n = 60). Preoperative characteristics and frequency of concomitant operations were identical. Duration of operation (196 +/- 54 versus 174 +/- 49 minutes), cardiopulmonary bypass (112 +/- 36 versus 91 +/- 33 minutes), and aortic cross-clamping (76 +/- 21 versus 61 +/- 21 minutes) were significantly longer in the stentless group. However, the need for perioperative transfusion and the incidence of postoperative reexploration for bleeding (3% versus 8%) was lower, and ventilation time was shorter. Mean duration of intensive care and hospital stay were also significantly shorter (2.3 +/- 1.7 versus 4.0 +/- 3.9 days, 8.9 +/- 3.1 versus 12.4 +/- 5.7 days). In-hospital mortality was identical (5% each). No independent predictor for in-hospital mortality was identified. Full root replacement using a stentless bioprosthesis does not increase postoperative morbidity or mortality of aortic valve replacement and may be advantageous in patients with a small aortic root.

Comparative analysis of human gait while wearing thong-style flip-flops versus sneakers.

PubMed

Shroyer, Justin F; Weimar, Wendi H

2010-01-01

Flip-flops are becoming a common footwear option. Casual observation has indicated that individuals wear flip-flops beyond their structural limit and have a different gait while wearing flip-flops versus shoes. This alteration in gait may cause the anecdotal foot and lower-limb discomfort associated with wearing flip-flops. To investigate the effect of sneakers versus thong-style flip-flops on gait kinematics and kinetics, 56 individuals (37 women and 19 men) were randomly assigned to a footwear order (flip-flops or sneakers first) and were asked to wear the assigned footwear on the day before and the day of testing. On each testing day, participants were videotaped as they walked at a self-selected pace across a force platform. A 2 (sex) x 2 (footwear) repeated-measures analysis of variance (P = .05) was used for statistical analysis. Significant interaction effects of footwear and sex were found for maximal anterior force, attack angle, and ankle angle during the swing phase. Footwear significantly affected stride length, ankle angle at the beginning of double support and during the swing phase, maximal braking impulse, and stance time. Flip-flops resulted in a shorter stride, a larger ankle angle at the beginning of double support and during the swing phase, a smaller braking impulse, and a shorter stance time compared with sneakers. The effects of footwear on gait kinetics and kinematics is extensive, but there is limited research on the effect of thong-style flip-flops on gait. These results suggest that flip-flops have an effect on several kinetic and kinematic variables compared with sneakers.

Laparoscopic versus open distal pancreatectomy-a propensity score-matched analysis from the German StuDoQ|Pancreas registry.

PubMed

Wellner, Ulrich Friedrich; Lapshyn, Hryhoriy; Bartsch, Detlef K; Mintziras, Ioannis; Hopt, Ulrich Theodor; Wittel, Uwe; Krämling, Hans-Jörg; Preissinger-Heinzel, Hubert; Anthuber, Matthias; Geissler, Bernd; Köninger, Jörg; Feilhauer, Katharina; Hommann, Merten; Peter, Luisa; Nüssler, Natascha C; Klier, Thomas; Mansmann, Ulrich; Keck, Tobias

2017-02-01

The aim of this study was to assess intraoperative, postoperative, and oncologic outcome in patients undergoing laparoscopic distal pancreatectomy (LDP) versus open distal pancreatectomy (ODP) for benign and malignant lesions of the pancreas. Data from patients undergoing distal pancreatic resection were extracted from the StuDoQ|Pancreas registry of the German Society for General and Visceral Surgery. After propensity score case matching, groups of LDP and ODP were compared regarding demography, comorbidities, operative details, histopathology, and perioperative outcome. At the time of data extraction, the StuDoQ|Pancreas registry included over 3000 pancreatic resections from over 50 surgical departments in Germany. Data from 353 patients undergoing ODP (n = 254) or LDP (n = 99) from September 2013 to February 2016 at 29 institutions were included in the analysis. Baseline data showed a strong selection bias in LDP patients, which disappeared after 1:1 propensity score matching. A comparison of the matched groups disclosed a significantly longer operation time, higher rate of spleen preservation, more grade A pancreatic fistula, shorter hospital stay, and increased readmissions for LDP. In the small group of patients operated for pancreatic cancer, a lower lymph node yield with a lower lymph node ratio was apparent in LDP. LDP needed more time but potential advantages include increased spleen preservation and shorter hospital stay, as well as a trend for less transfusion, ventilation, and mortality. LDP for pancreatic cancer was performed rarely and will need critical evaluation in the future. Data from a prospective randomized registry trial is needed to confirm these results.

The Glycated Albumin (GA) to HbA1c Ratio Reflects Shorter-Term Glycemic Control than GA: Analysis of Patients with Fulminant Type 1 Diabetes.

PubMed

Koga, Masafumi; Inada, Shinya; Nakao, Taisei; Kawamori, Ryuzo; Kasayama, Soji

2017-01-01

Glycated albumin (GA) reflects shorter-term glycemic control than HbA1c. We have reported that HbA1c is paradoxically increased in diabetic patients whose glycemic control deteriorated before ameliorating. In this study, we analyzed paradoxical increases of glycemic control indicators after treatment in patients with fulminant type 1 diabetes (FT1D). We also investigated whether the GA/HbA1c ratio may reflect shorter-term glycemic control than GA. Five FT1D patients whose post-treatment HbA1c and GA levels were measured were enrolled. We also used a formula to estimate HbA1c and GA from the fictitious models of changes in plasma glucose in FT1D patients. In this model, the periods during which HbA1c, GA, and the GA/HbA1c ratio were higher than at the first visit were compared. In addition, the half-life for the GA/HbA1c ratio was calculated in accordance with the half-lives for HbA1c and GA (36 and 14 days, respectively). In all FT1D patients, HbA1c levels 2-4 weeks after treatment were increased, with three patients (60%) experiencing an increase of GA levels. In contrast, an increase of the GA/HbA1c ratio was observed in only one patient. In all of the different models of changes in plasma glucose in FT1D patients, the length of time during which the values were higher than at the first visit was in the order of HbA1c > GA > GA/HbA1c ratio. The half-life for the GA/HbA1c ratio was 9 days, shorter than GA. These findings suggest that the GA/HbA1c ratio reflects shorter-term glycemic control than GA. © 2016 Wiley Periodicals, Inc.

Serum Gamma-Glutamyl-Transferase Independently Predicts Outcome After Transarterial Chemoembolization of Hepatocellular Carcinoma: External Validation

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

Guiu, Boris, E-mail: boris.guiu@chu-dijon.fr; Deschamps, Frederic; Boulin, Mathieu

Purpose: An Asian study showed that gamma glutamyl transpeptidase (GGT) can predict survival after transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC). This study was designed to validate in a European population this biomarker as an independent predictor of outcome after TACE of HCC and to determine a threshold value for clinical use. Methods: In 88 consecutive patients treated by TACE for HCC, the optimal threshold for GGT serum level was determined by a ROC analysis. Endpoints were time-to-treatment failure (TTTF) and overall survival (OS). All multivariate models were internally validated using bootstrapping (90 replications). Results: Median follow-up lasted 373 days,more » and median overall survival was 748 days. The optimal threshold for GGT was 165 U/L (sensitivity: 89.3%; specificity: 56.7%; area under the ROC curve: 0.7515). Median TTTF was shorter when GGT was {>=}165 U/L (281 days vs. 850 days; P < 0.001). GGT {>=}165 U/L (hazard ratio (HR) = 2.06; P = 0.02), WHO PS of 2 (HR = 5.4; P = 0.002), and tumor size (HR = 1.12; P = 0.014) were independently associated with shorter TTTF. Median OS was shorter when GGT was {>=}165 U/L (508 days vs. not reached; P < 0.001). GGT {>=} 165 U/L (HR = 3.05; P = 0.029), WHO PS of 2 (HR = 12.95; P < 0.001), alfa-fetoprotein (HR = 2.9; P = 0.01), and tumor size (HR = 1.096; P = 0.013) were independently associated with shorter OS. The results were confirmed by bootstrapping. Conclusions: Our results provide in a European population the external validation of GGT as an independent predictor of outcome after TACE of HCC. A serum level of GGT {>=} 165 U/L is independently associated with both shorter TTTF and OS.« less

Comparison of Delta-Shape Anastomosis and Extracorporeal Billroth I Anastomosis after Laparoscopic Distal Gastrectomy for Gastric Cancer: A Systematic Review with Meta-Analysis of Short-Term Outcomes.

PubMed

Hu, Geng-Yuan; Tao, Feng; Ji, Ke-Wei; Wang, Wei

2016-01-01

The aim of this systematic review and meta-analysis is to evaluate the safety and relative benefits of delta-shape anastomosis (DA) by comparing to conventional laparoscopy-assisted distal gastrectomy with Billroth I gastroduodenostomy (LADG BI). Studies and relevant literature regarding DA versus LADG BI were searched in the electronic databases. Operation time, postoperative complications, estimated blood loss, number of retrieved lymph nodes, time to first flatus, time to oral intake, length of postoperative hospitalization in DA and LADG BI were pooled and compared using meta-analysis. Weighted mean differences (WMDs) and odds ratios (ORs) were calculated with 95% confidence intervals (CIs) to evaluate the effect of DA. Eight studies of 1739 patients were included in the meta-analysis. Compared with LADG BI, DA had shorter postoperative hospitalization (WMD = -0.47, 95%CI: -0.69 to -0.25, P<0.01), less blood loss (WMD = - 25.90, 95%CI: -43.11 to -8.70, P<0.01), shorter time to oral intake (WMD = -0.25, 95%CI: -0.49 to -0.01, P = 0.04), and more retrieved lymph nodes (WMD = 1.36, 95%CI: 0.30 to 2.43, P = 0.01). Operation time (WMD = -0.07, 95%CI -15.58 to 15.43, P = 0.99), overall postoperative complication rate (OR = 1.05, 95%CI: 0.74 to 1.49, P = 0.63), surgical complication rate (OR = 1.02, 95%CI: 0.70 to 1.49, P = 0.90), nonsurgical complication rate (OR = 1.21, 95%CI: 0.54 to 2.72, P = 0.64), leakage rate (OR = 2.54, 95%CI: 0.92 to 7.01, P = 0.07), stricture rate (OR = 0.36, 95%CI: 0.09 to 1.44, P = 0.15), wound complication rate (OR = 0.71, 95%CI: 0.33 to 1.55, P = 0.39), time to first flatus (WMD = -0.10, 95%CI: -0.27 to 0.07, P = 0.26), and proximal surgical margin (WMD = -0.25, 95%CI: -1.14 to 0.65, P = 0.59) was not statistically different. Compared with LADG BI, DA is a safe and feasible procedure, with significantly reduced blood loss, time to oral intake, and postoperative hospitalization.

Nebulization Reflux Concentrator

NASA Technical Reports Server (NTRS)

Cofer, Wesley R., III; Collins, V. G.

1986-01-01

Nebulization reflux concentrator extracts and concentrates trace quantities of water-soluble gases for subsequent chemical analysis. Hydrophobic membrane and nebulizing nozzles form scrubber for removing trace quantities of soluble gases or other contaminants from atmosphere. Although hydrophobic membrane virtually blocks all transport of droplets, it offers little resistance to gas flow; hence, device permits relatively large volumes of gas scrubbed efficiently with very small volumes of liquid. This means analyzable quantities of contaminants concentrate in extracting solutions in much shorter times than with conventional techniques.

Novel Analytic Methods Needed for Real-Time Continuous Core Body Temperature Data

PubMed Central

Hertzberg, Vicki; Mac, Valerie; Elon, Lisa; Mutic, Nathan; Mutic, Abby; Peterman, Katherine; Tovar-Aguilar, J. Antonio; Economos, Jeannie; Flocks, Joan; McCauley, Linda

2017-01-01

Affordable measurement of core body temperature, Tc, in a continuous, real-time fashion is now possible. With this advance comes a new data analysis paradigm for occupational epidemiology. We characterize issues arising after obtaining Tc data over 188 workdays for 83 participating farmworkers, a population vulnerable to effects of rising temperatures due to climate change. We describe a novel approach to these data using smoothing and functional data analysis. This approach highlights different data aspects compared to describing Tc at a single time point or summaries of the time course into an indicator function (e.g., did Tc ever exceed 38°C, the threshold limit value for occupational heat exposure). Participants working in ferneries had significantly higher Tc at some point during the workday compared to those working in nurseries, despite a shorter workday for fernery participants. Our results typify the challenges and opportunities in analyzing big data streams from real-time physiologic monitoring. PMID:27756853

Evaluation of beach cleanup effects using linear system analysis.

PubMed

Kataoka, Tomoya; Hinata, Hirofumi

2015-02-15

We established a method for evaluating beach cleanup effects (BCEs) based on a linear system analysis, and investigated factors determining BCEs. Here we focus on two BCEs: decreasing the total mass of toxic metals that could leach into a beach from marine plastics and preventing the fragmentation of marine plastics on the beach. Both BCEs depend strongly on the average residence time of marine plastics on the beach (τ(r)) and the period of temporal variability of the input flux of marine plastics (T). Cleanups on the beach where τ(r) is longer than T are more effective than those where τ(r) is shorter than T. In addition, both BCEs are the highest near the time when the remnants of plastics reach the local maximum (peak time). Therefore, it is crucial to understand the following three factors for effective cleanups: the average residence time, the plastic input period and the peak time. Copyright © 2014 Elsevier Ltd. All rights reserved.

Novel Analytic Methods Needed for Real-Time Continuous Core Body Temperature Data.

PubMed

Hertzberg, Vicki; Mac, Valerie; Elon, Lisa; Mutic, Nathan; Mutic, Abby; Peterman, Katherine; Tovar-Aguilar, J Antonio; Economos, Eugenia; Flocks, Joan; McCauley, Linda

2016-10-18

Affordable measurement of core body temperature (T c ) in a continuous, real-time fashion is now possible. With this advance comes a new data analysis paradigm for occupational epidemiology. We characterize issues arising after obtaining T c data over 188 workdays for 83 participating farmworkers, a population vulnerable to effects of rising temperatures due to climate change. We describe a novel approach to these data using smoothing and functional data analysis. This approach highlights different data aspects compared with describing T c at a single time point or summaries of the time course into an indicator function (e.g., did T c ever exceed 38 °C, the threshold limit value for occupational heat exposure). Participants working in ferneries had significantly higher T c at some point during the workday compared with those working in nurseries, despite a shorter workday for fernery participants. Our results typify the challenges and opportunities in analyzing big data streams from real-time physiologic monitoring. © The Author(s) 2016.

Characteristics study of the gears by the CAD/CAE

NASA Astrophysics Data System (ADS)

Wang, P. Y.; Chang, S. L.; Lee, B. Y.; Nguyen, D. H.; Cao, C. W.

2017-09-01

Gears are the most important transmission component in machines. The rapid development of the machines in industry requires a shorter time of the analysis process. In traditional, the gears are analyzed by setting up the complete mathematical model firstly, considering the profile of cutter and coordinate systems relationship between the machine and the cutter. It is a really complex and time-consuming process. Recently, the CAD/CAE software is well developed and useful in the mechanical design. In this paper, the Autodesk Inventor® software is introduced to model the spherical gears firstly, and then the models can also be transferred into ANSYS Workbench for the finite element analysis. The proposed process in this paper is helpful to the engineers to speed up the analyzing process of gears in the design stage.

A high throughput MATLAB program for automated force-curve processing using the AdG polymer model.

PubMed

O'Connor, Samantha; Gaddis, Rebecca; Anderson, Evan; Camesano, Terri A; Burnham, Nancy A

2015-02-01

Research in understanding biofilm formation is dependent on accurate and representative measurements of the steric forces related to brush on bacterial surfaces. A MATLAB program to analyze force curves from an AFM efficiently, accurately, and with minimal user bias has been developed. The analysis is based on a modified version of the Alexander and de Gennes (AdG) polymer model, which is a function of equilibrium polymer brush length, probe radius, temperature, separation distance, and a density variable. Automating the analysis reduces the amount of time required to process 100 force curves from several days to less than 2min. The use of this program to crop and fit force curves to the AdG model will allow researchers to ensure proper processing of large amounts of experimental data and reduce the time required for analysis and comparison of data, thereby enabling higher quality results in a shorter period of time. Copyright © 2014 Elsevier B.V. All rights reserved.

Call-to-balloon time dashboard in patients with ST-segment elevation myocardial infarction results in significant improvement in the logistic chain.

PubMed

Hermans, Maaike P J; Velders, Matthijs A; Smeekes, Martin; Drexhage, Olivier S; Hautvast, Raymond W M; Ytsma, Timon; Schalij, Martin J; Umans, Victor A W M

2017-08-04

Timely reperfusion with primary percutaneous coronary intervention (pPCI) in ST-segment elevation myocardial infarction (STEMI) patients is associated with superior clinical outcomes. Aiming to reduce ischaemic time, an innovative system for home-to-hospital (H2H) time monitoring was implemented, which enabled real-time evaluation of ischaemic time intervals, regular feedback and improvements in the logistic chain. The objective of this study was to assess the results after implementation of the H2H dashboard for monitoring and evaluation of ischaemic time in STEMI patients. Ischaemic time in STEMI patients transported by emergency medical services (EMS) and treated with pPCI in the Noordwest Ziekenhuis, Alkmaar before (2008-2009; n=495) and after the implementation of the H2H dashboard (2011-2014; n=441) was compared. Median time intervals were significantly shorter in the H2H group (door-to-balloon time 32 [IQR 25-43] vs. 40 [IQR 28-55] minutes, p-value <0.001, FMC-to-balloon time 62 [IQR 52-75] vs. 80 [IQR 67-103] minutes, p-value <0.001, and treatment delay 142 [IQR 103-221] vs. 159 [IQR 123-253] minutes, p-value <0.001). The H2H time dashboard was independently associated with shorter time delays. Real-time monitoring and feedback on time delay with the H2H dashboard improves the logistic chain in STEMI patients, resulting in shorter ischaemic time intervals.

Cost analysis of injection laryngoplasty performed under local anaesthesia versus general anaesthesia: an Australian perspective.

PubMed

Chandran, D; Woods, C M; Schar, M; Ma, N; Ooi, E H; Athanasiadis, T

2018-02-01

To conduct a cost analysis of injection laryngoplasty performed in the operating theatre under local anaesthesia and general anaesthesia. The retrospective study included patients who had undergone injection laryngoplasty as day cases between July 2013 and March 2016. Cost data were obtained, along with patient demographics, anaesthetic details, type of injectant, American Society of Anesthesiologists score, length of stay, total operating theatre time and surgeon procedure time. A total of 20 cases (general anaesthesia = 6, local anaesthesia = 14) were included in the cost analysis. The mean total cost under general anaesthesia (AU$2865.96 ± 756.29) was significantly higher than that under local anaesthesia (AU$1731.61 ± 290.29) (p < 0.001). The mean operating theatre time, surgeon procedure time and length of stay were all significantly lower under local anaesthesia compared to general anaesthesia. Time variables such as operating theatre time and length of stay were the most significant predictors of the total costs. Procedures performed under local anaesthesia in the operating theatre are associated with shorter operating theatre time and length of stay in the hospital, and provide significant cost savings. Further savings could be achieved if local anaesthesia procedures were performed in the office setting.

Comparison of pure laparoscopic versus open left hemihepatectomy by multivariate analysis: a retrospective cohort study.

PubMed

Cho, Hwui-Dong; Kim, Ki-Hun; Hwang, Shin; Ahn, Chul-Soo; Moon, Deok-Bog; Ha, Tae-Yong; Song, Gi-Won; Jung, Dong-Hwan; Park, Gil-Chun; Lee, Sung-Gyu

2018-02-01

To compare the outcomes of pure laparoscopic left hemihepatectomy (LLH) versus open left hemihepatectomy (OLH) for benign and malignant conditions using multivariate analysis. All consecutive cases of LLH and OLH between October 2007 and December 2013 in a tertiary referral hospital were enrolled in this retrospective cohort study. All surgical procedures were performed by one surgeon. The LLH and OLH groups were compared in terms of patient demographics, preoperative data, clinical perioperative outcomes, and tumor characteristics in patients with malignancy. Multivariate analysis of the prognostic factors associated with severe complications was then performed. The LLH group (n = 62) had a significantly shorter postoperative hospital stay than the OLH group (n = 118) (9.53 ± 3.30 vs 14.88 ± 11.36 days, p < 0.001). Multivariate analysis revealed that the OLH group had >4 times the risk of the LLH group in terms of developing severe complications (Clavien-Dindo grade ≥III) (odds ratio 4.294, 95% confidence intervals 1.165-15.832, p = 0.029). LLH was a safe and feasible procedure for selected patients. LLH required shorter hospital stay and resulted in less operative blood loss. Multivariate analysis revealed that LLH was associated with a lower risk of severe complications compared to OLH. The authors suggest that LLH could be a reasonable treatment option for selected patients.

Compartmentalized self-replication under fast PCR cycling conditions yields Taq DNA polymerase mutants with increased DNA-binding affinity and blood resistance.

PubMed

Arezi, Bahram; McKinney, Nancy; Hansen, Connie; Cayouette, Michelle; Fox, Jeffrey; Chen, Keith; Lapira, Jennifer; Hamilton, Sarah; Hogrefe, Holly

2014-01-01

Faster-cycling PCR formulations, protocols, and instruments have been developed to address the need for increased throughput and shorter turn-around times for PCR-based assays. Although run times can be cut by up to 50%, shorter cycle times have been correlated with lower detection sensitivity and increased variability. To address these concerns, we applied Compartmentalized Self Replication (CSR) to evolve faster-cycling mutants of Taq DNA polymerase. After five rounds of selection using progressively shorter PCR extension times, individual mutations identified in the fastest-cycling clones were randomly combined using ligation-based multi-site mutagenesis. The best-performing combinatorial mutants exhibit 35- to 90-fold higher affinity (lower Kd ) for primed template and a moderate (2-fold) increase in extension rate compared to wild-type Taq. Further characterization revealed that CSR-selected mutations provide increased resistance to inhibitors, and most notably, enable direct amplification from up to 65% whole blood. We discuss the contribution of individual mutations to fast-cycling and blood-resistant phenotypes.

Description of the life stages of quill mite Mironovia lagopus sp. nov. (Acari: Syringophilidae) parasitizing the rock ptarmigan Lagopus muta (Phasianidae) from Iceland.

PubMed

Bochkov, Andre V; Skirnisson, Karl

2011-03-01

A new species of syringophilid mites, Mironovia lagopus sp. nov. (Acari: Syringophilidae) is described from feather quills of the rock ptarigman Lagopus muta (Montin) (Phasianidae) from Iceland. Females of this new species differ from the closely related Mironovia rouloul Skoracki and Sikora by setae d2, which are subequal or 1.1-1.2 times shorter than setae e2 (vs. d2 1.4-1.5 times longer than e2 in Mironovia rouloul) and by setae ag1, which are 1.3-1.5 times shorter than ag2 (vs. ag1 1.7-1.8 times shorter than ag2). The postembryonic stages of this new species are figured and described in details. In ontogeny of Mironovia spp., the observed pattern of setal appearance is not different from the pattern in other galliform-associated genera such as Syringophilus and Colinophilus, with exception for tarsal setae p'I, II which are absent in protonymphs. The key to all four species of the genus Mironovia is also provided.

Comparative Investigation of Normal Modes and Molecular Dynamics of Hepatitis C NS5B Protein

NASA Astrophysics Data System (ADS)

Asafi, M. S.; Yildirim, A.; Tekpinar, M.

2016-04-01

Understanding dynamics of proteins has many practical implications in terms of finding a cure for many protein related diseases. Normal mode analysis and molecular dynamics methods are widely used physics-based computational methods for investigating dynamics of proteins. In this work, we studied dynamics of Hepatitis C NS5B protein with molecular dynamics and normal mode analysis. Principal components obtained from a 100 nanoseconds molecular dynamics simulation show good overlaps with normal modes calculated with a coarse-grained elastic network model. Coarse-grained normal mode analysis takes at least an order of magnitude shorter time. Encouraged by this good overlaps and short computation times, we analyzed further low frequency normal modes of Hepatitis C NS5B. Motion directions and average spatial fluctuations have been analyzed in detail. Finally, biological implications of these motions in drug design efforts against Hepatitis C infections have been elaborated.

waterData--An R package for retrieval, analysis, and anomaly calculation of daily hydrologic time series data, version 1.0

USGS Publications Warehouse

Ryberg, Karen R.; Vecchia, Aldo V.

2012-01-01

Hydrologic time series data and associated anomalies (multiple components of the original time series representing variability at longer-term and shorter-term time scales) are useful for modeling trends in hydrologic variables, such as streamflow, and for modeling water-quality constituents. An R package, called waterData, has been developed for importing daily hydrologic time series data from U.S. Geological Survey streamgages into the R programming environment. In addition to streamflow, data retrieval may include gage height and continuous physical property data, such as specific conductance, pH, water temperature, turbidity, and dissolved oxygen. The package allows for importing daily hydrologic data into R, plotting the data, fixing common data problems, summarizing the data, and the calculation and graphical presentation of anomalies.

The practical use of simplicity in developing ground water models

USGS Publications Warehouse

Hill, M.C.

2006-01-01

The advantages of starting with simple models and building complexity slowly can be significant in the development of ground water models. In many circumstances, simpler models are characterized by fewer defined parameters and shorter execution times. In this work, the number of parameters is used as the primary measure of simplicity and complexity; the advantages of shorter execution times also are considered. The ideas are presented in the context of constructing ground water models but are applicable to many fields. Simplicity first is put in perspective as part of the entire modeling process using 14 guidelines for effective model calibration. It is noted that neither very simple nor very complex models generally produce the most accurate predictions and that determining the appropriate level of complexity is an ill-defined process. It is suggested that a thorough evaluation of observation errors is essential to model development. Finally, specific ways are discussed to design useful ground water models that have fewer parameters and shorter execution times.

The impact of Sleep Time-Related Information and Communication Technology (STRICT) on sleep patterns and daytime functioning in American adolescents.

PubMed

Polos, Peter G; Bhat, Sushanth; Gupta, Divya; O'Malley, Richard J; DeBari, Vincent A; Upadhyay, Hinesh; Chaudhry, Saqib; Nimma, Anitha; Pinto-Zipp, Genevieve; Chokroverty, Sudhansu

2015-10-01

This cross-sectional study explored the extent and impact of mobile device-based Sleep Time-Related Information and Communication Technology (STRICT) use among American adolescents (N = 3139, 49.3% female, mean age = 13.3 years). Nearly 62% used STRICT after bedtime, 56.7% texted/tweeted/messaged in bed, and 20.8% awoke to texts. STRICT use was associated with insomnia, daytime sleepiness, eveningness, academic underperformance, later bedtimes and shorter sleep duration. Moderation analysis demonstrated that the association between STRICT use and insomnia increased with age, the association between STRICT use and daytime sleepiness decreased with age, and the association between STRICT use and shorter sleep duration decreased with age and was stronger in girls. Insomnia and daytime sleepiness partially mediated the relationship between STRICT use and academic underperformance. Our results illustrate the adverse interactions between adolescent STRICT use and sleep, with deleterious effects on daytime functioning. These worrisome findings suggest that placing reasonable limitations on adolescent STRICT use may be appropriate. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Moderating Effects of Religiousness and Marriage Duration on the Relation Between Sexual and Marital Satisfaction Among Jewish Women.

PubMed

Lazar, Aryeh

2017-02-01

This study examined the moderating effects of religiousness and relationship duration on the association between sexual and marital satisfaction. For this purpose, 240 married Jewish women-religious and secular-responded to an online survey. Hierarchical regression analysis indicated that religiousness moderated the association between sexual and marital satisfaction which was found to be stronger for secular women than for religious women. Relationship duration also moderated the association between sexual and marital satisfaction which was found to be stronger for longer marital duration than for shorter marital duration. In addition, a significant three-way interaction (religiousness × relationship duration × sexual satisfaction) was also found where the association between the two types of satisfaction was stronger for religious women married for a longer time in comparison with those married for a shorter time. For secular women, relationship duration did not moderate the relation between sexual and marital satisfaction. An explanation based on differences in the manner in which religious and secular women perceive and relate to the sexual aspects of their marital relationship at different stages of the marriage is offered.

The effects of in-vehicle tasks and time-gap selection while reclaiming control from adaptive cruise control (ACC) with bus simulator.

PubMed

Lin, Tsang-Wei; Hwang, Sheue-Ling; Su, Jau-Ming; Chen, Wan-Hui

2008-05-01

This research aimed to find out the effects of in-vehicle distractions and time-gap settings with a fix-based bus driving simulator in a following scenario. Professional bus drivers were recruited to perform in-vehicle tasks while driving with adaptive cruise control (ACC) of changeable time-gap settings in freeway traffic. Thirty subjects were divided equally into three groups for different in-vehicle task modes (between subjects), including no task distraction, hands-free, and manual modes. Further, time-gap settings for the experimental ACC were: shorter than 1.0 s, 1.0-1.5 s, 1.5-2.0 s, and longer than 2.0 s (within subjects). Longitudinal (mean headway, forward collision rate, and response time) and lateral control (mean lateral lane position and its standard deviation) performance was assessed. In the results, longitudinal control performance was worsened by both shorter time-gaps and heavier in-vehicle tasks. But the interaction indicated that the harm by heavier in-vehicle distraction could be improved by longer time-gaps. As for the lateral control, it would only be negatively affected by shorter time-gap settings. This research indicates the effects of time-gaps and in-vehicle distraction, as well as the interaction. Proper time-gap selection under different in-vehicle distractions can help avoid accidents and keep safe.

Effect of axial length on laser spot size during photodynamic therapy: an experimental study in monkeys.

PubMed

Kondo, Mineo; Ito, Yasuki; Miyata, Kentaro; Kondo, Nagako; Ishikawa, Kohei; Terasaki, Hiroko

2006-01-01

To investigate the effect of shorter axial length on the laser spot size and laser energy during photodynamic therapy (PDT) in monkeys. Experimental study with four rhesus monkeys. PDT was performed on the normal retina of monkeys whose ocular axial lengths are shorter (19.55 to 20.25 mm) than that of humans. After the PDT, the eyes were enucleated, and the diameter of the irradiated laser spot was measured with a microcaliper. The area of actual laser spot was only 0.56 to 0.61 times of the planned area, which indicated that the laser energy/area was 1.64 to 1.78 times more intense than planned initially. These results are the in vivo demonstration that the diameter of PDT laser spot is smaller for eyes with shorter axial lengths.

Choice with frequently changing food rates and food ratios.

PubMed

Baum, William M; Davison, Michael

2014-03-01

In studies of operant choice, when one schedule of a concurrent pair is varied while the other is held constant, the constancy of the constant schedule may exert discriminative control over performance. In our earlier experiments, schedules varied reciprocally across components within sessions, so that while food ratio varied food rate remained constant. In the present experiment, we held one variable-interval (VI) schedule constant while varying the concurrent VI schedule within sessions. We studied five conditions, each with a different constant left VI schedule. On the right key, seven different VI schedules were presented in seven different unsignaled components. We analyzed performances at several different time scales. At the longest time scale, across conditions, behavior ratios varied with food ratios as would be expected from the generalized matching law. At shorter time scales, effects due to holding the left VI constant became more and more apparent, the shorter the time scale. In choice relations across components, preference for the left key leveled off as the right key became leaner. Interfood choice approximated strict matching for the varied right key, whereas interfood choice hardly varied at all for the constant left key. At the shortest time scale, visit patterns differed for the left and right keys. Much evidence indicated the development of a fix-and-sample pattern. In sum, the procedural difference made a large difference to performance, except for choice at the longest time scale and the fix-and-sample pattern at the shortest time scale. © Society for the Experimental Analysis of Behavior.

Personality Disorder Symptom Severity Predicts Onset of Mood Episodes and Conversion to Bipolar I Disorder in Individuals with Bipolar Spectrum Disorder

PubMed Central

Ng, Tommy H.; Burke, Taylor A.; Stange, Jonathan P.; Walshaw, Patricia D.; Weiss, Rachel B.; Urosevic, Snezana; Abramson, Lyn Y.; Alloy, Lauren B.

2017-01-01

Although personality disorders (PDs) are highly comorbid with bipolar spectrum disorders (BSDs), little longitudinal research has been conducted to examine the prospective impact of PD symptoms on the course of BSDs. The aim of this study is to examine whether PD symptom severity predicts shorter time to onset of bipolar mood episodes and conversion to bipolar I disorder over time among individuals with less severe BSDs. Participants (n = 166) with bipolar II disorder, cyclothymia, or bipolar disorder not otherwise specified completed diagnostic interview assessments of PD symptoms and self-report measures of mood symptoms at baseline. They were followed prospectively with diagnostic interviews every four months for an average of 3.02 years. Cox proportional hazard regression analyses indicated that overall PD symptom severity significantly predicted shorter time to onset of hypomanic (hazard ratio [HR]= 1.42; p < .001) and major depressive episodes (HR = 1.51; p < .001) and conversion to bipolar I disorder (HR = 2.51; p < .001), after controlling for mood symptoms. Results also suggested that cluster B severity predicted shorter time to onset of hypomanic episodes (HR = 1.38; p = .002) and major depressive episodes (HR = 1.35; p = .01) and conversion to bipolar I disorder (HR = 2.77; p < .001), whereas cluster C severity (HR= 1.56; p < .001) predicted shorter time to onset of major depressive episodes. These results support predisposition models in suggesting that PD symptoms may act as a risk factor for a more severe course of BSDs. PMID:28368159

Personality disorder symptom severity predicts onset of mood episodes and conversion to bipolar I disorder in individuals with bipolar spectrum disorder.

PubMed

Ng, Tommy H; Burke, Taylor A; Stange, Jonathan P; Walshaw, Patricia D; Weiss, Rachel B; Urosevic, Snezana; Abramson, Lyn Y; Alloy, Lauren B

2017-04-01

Although personality disorders (PDs) are highly comorbid with bipolar spectrum disorders (BSDs), little longitudinal research has been conducted to examine the prospective impact of PD symptoms on the course of BSDs. The aim of this study is to examine whether PD symptom severity predicts shorter time to onset of bipolar mood episodes and conversion to bipolar I disorder over time among individuals with less severe BSDs. Participants (n = 166) with bipolar II disorder, cyclothymia, or bipolar disorder not otherwise specified completed diagnostic interview assessments of PD symptoms and self-report measures of mood symptoms at baseline. They were followed prospectively with diagnostic interviews every 4 months for an average of 3.02 years. Cox proportional hazard regression analyses indicated that overall PD symptom severity significantly predicted shorter time to onset of hypomanic (hazard ratio [HR] = 1.42; p < .001) and major depressive episodes (HR = 1.51; p < .001) and conversion to bipolar I disorder (HR = 2.51; p < .001), after controlling for mood symptoms. Results also suggested that cluster B severity predicted shorter time to onset of hypomanic episodes (HR = 1.38; p = .002) and major depressive episodes (HR = 1.35; p = .01) and conversion to bipolar I disorder (HR = 2.77; p < .001), whereas cluster C severity (HR = 1.56; p < .001) predicted shorter time to onset of major depressive episodes. These results support predisposition models in suggesting that PD symptoms may act as a risk factor for a more severe course of BSDs. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Characteristic variations of sea surface temperature with multiple time scales in the North Pacific

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

Tanimoto, Youichi; Hanawa, Kimio; Toba, Yoshiaki

1993-06-01

It is unclear whether the recent increases in global temperatures are really due to the increase of greenhouse gases or are a manifestation of natural variability. Temporal evolution and spectral structure of sea surface temperature (SST) anomalies in the North Pacific over the last 37 years are investigated on the three characteristic time scales: shorter than 24 months (HF), 24-60 months (ES), and longer than 60 months (DC). The leading empirical-orthogonal function (EOF) for the DC time scale is characterized by a zonally elongated monopole centered at around 40[degrees]N, 180[degrees]. The leading EOF for the HF time scale is somewhatmore » similar to that for the DC time scale, although there are two centers of action with the same polarity at the mid and western Pacific. The leading EOF for the ES time scale, however, exhibits a different pattern whose center of action at the mid Pacific is located farther southeastward. In the time evolution of the SST anomalies associated with the leading EOF of the DC time scale, several anomaly periods can be identified that last five years or longer. The transition from a persistent period to another with the opposite polarity is generally very brief, except for the one that lasts throughout the late 1960s. The EOF analysis was repeated separately on these persistent anomaly periods and the long transition period. The spatial structure of the leading EOF of the SST variability with the ES time scale is found to be sensitive to the polarity of the decadal anomaly. These results are suggestive of the possible influence of the decadal SST variability upon the spatial structure of the variability with shorter time scales. 31 refs., 8 figs.« less

Transition to chaos of a vertical collapsible tube conveying air flow

NASA Astrophysics Data System (ADS)

Castillo Flores, F.; Cros, A.

2009-05-01

"Sky dancers", the large collapsible tubes used as advertising, are studied in this work through a simple experimental device. Our study is devoted to the nonlinear dynamics of this system and to its transition to chaos. Firstly, we have shown that after a collapse occurs, the air fills the tube at a different speed rate from the flow velocity. Secondly, the temporal intermittency is studied as the flow rate is increased. A statistical analysis shows that the chaotic times maintain roughly the same value by increasing air speed. On the other hand, laminar times become shorter, until the system reaches a completely chaotic state.

The effects of publishing emergency department wait time on patient utilization patterns in a community with two emergency department sites: a retrospective, quasi-experiment design.

PubMed

Xie, Bin; Youash, Sabrina

2011-06-14

Providing emergency department (ED) wait time information to the public has been suggested as a mechanism to reduce lengthy ED wait times (by enabling patients to select the ED site with shorter wait time), but the effects of such a program have not been evaluated. We evaluated the effects of such a program in a community with two ED sites. Descriptive statistics for wait times of the two sites before and after the publication of wait time information were used to evaluate the effects of the publication of wait time information on wait times. Multivariate logistical regression was used to test whether or not individual patients used published wait time to decide which site to visit. We found that the rates of wait times exceeding 4 h, and the 95th percentile of wait times in the two sites decreased after the publication of wait time information, even though the average wait times experienced a slight increase. We also found that after controlling for other factors, the site with shorter wait time had a higher likelihood of being selected after the publication of wait time information, but there was no such relationship before the publication. These findings were consistent with the hypothesis that the publication of wait time information leads to patients selecting the site with shorter wait time. While publishing ED wait time information did not improve average wait time, it reduced the rates of lengthy wait times.

Properties of M components from currents measured at triggered lightning channel base

NASA Astrophysics Data System (ADS)

Thottappillil, Rajeev; Goldberg, Jon D.; Rakov, Vladimir A.; Uman, Martin A.; Fisher, Richard J.; Schnetzer, George H.

1995-12-01

Channel base currents from triggered lightning were measured at the NASA Kennedy Space Center, Florida, during summer 1990 and at Fort McClellan, Alabama, during summer 1991. An analysis of the return stroke data and overall continuing current data has been published by Fisher et al. [1993]. Here an analysis is given of the impulsive processes, called M components, that occur during the continuing current following return strokes. The 14 flashes analyzed contain 37 leader-return stroke sequences and 158 M components, both processes lowering negative charge from cloud to ground. Statistics are presented for the following M current pulse parameters: magnitude, rise time, duration, half-peak width, preceding continuing current level, M interval, elapsed time since the return stroke, and charge transferred by the M current pulse. A typical M component in triggered lightning is characterized by a more or less symmetrical current pulse having an amplitude of 100-200 A (2 orders of magnitude lower than that for a typical return stroke [Fisher et al., 1993]), a 10-90% rise time of 300-500 μs (3 orders of magnitude larger than that for a typical return stroke [Fisher et al., 1993]), and a charge transfer to ground of the order of 0.1 to 0.2 C (1 order of magnitude smaller than that for a typical subsequent return stroke pulse [Berger et al., 1975]). About one third of M components transferred charge greater than the minimum charge reported by Berger et al. [1975] for subsequent leader-return stroke sequences. No correlation was found between either the M charge or the magnitude of the M component current (the two are moderately correlated) and any other parameter considered. M current pulses occurring soon after the return stroke tend to have shorter rise times, shorter durations, and shorter M intervals than those which occur later. M current pulses were observed to be superimposed on continuing currents greater than 30 A or so, with one exception out of 140 cases, wherein the continuing current level was measured to be about 20 A. The first M component virtually always (one exception out of 34 cases) occurred within 4 ms of the return stroke. This relatively short separation time between return stroke and the first M component, coupled with the observation of Fisher et al. [1993] that continuing currents lasting longer than 10 ms never occur without M current pulses, implies that the M component is a necessary feature of the continuing current mode of charge transfer to ground.

Drawing from Memory: Hand-Eye Coordination at Multiple Scales

PubMed Central

Spivey, Michael J.

2013-01-01

Eyes move to gather visual information for the purpose of guiding behavior. This guidance takes the form of perceptual-motor interactions on short timescales for behaviors like locomotion and hand-eye coordination. More complex behaviors require perceptual-motor interactions on longer timescales mediated by memory, such as navigation, or designing and building artifacts. In the present study, the task of sketching images of natural scenes from memory was used to examine and compare perceptual-motor interactions on shorter and longer timescales. Eye and pen trajectories were found to be coordinated in time on shorter timescales during drawing, and also on longer timescales spanning study and drawing periods. The latter type of coordination was found by developing a purely spatial analysis that yielded measures of similarity between images, eye trajectories, and pen trajectories. These results challenge the notion that coordination only unfolds on short timescales. Rather, the task of drawing from memory evokes perceptual-motor encodings of visual images that preserve coarse-grained spatial information over relatively long timescales as well. PMID:23554894

Shorter Perceived Outpatient MRI Wait Times Associated With Higher Patient Satisfaction.

PubMed

Holbrook, Anna; Glenn, Harold; Mahmood, Rabia; Cai, Qingpo; Kang, Jian; Duszak, Richard

2016-05-01

The aim of this study was to assess differences in perceived versus actual wait times among patients undergoing outpatient MRI examinations and to correlate those times with patient satisfaction. Over 15 weeks, 190 patients presenting for outpatient MR in a radiology department in which "patient experience" is one of the stated strategic priorities were asked to (1) estimate their wait times for various stages in the imaging process and (2) state their satisfaction with their imaging experience. Perceived times were compared with actual electronic time stamps. Perceived and actual times were compared and correlated with standardized satisfaction scores using Kendall τ correlation. The mean actual wait time between patient arrival and examination start was 53.4 ± 33.8 min, whereas patients perceived a mean wait time of 27.8 ± 23.1 min, a statistically significant underestimation of 25.6 min (P < .001). Both shorter actual and perceived wait times at all points during patient encounters were correlated with higher satisfaction scores (P < .001). Patients undergoing outpatient MR examinations in an environment designed to optimize patient experience underestimated wait times at all points during their encounters. Shorter perceived and actual wait times were both correlated with higher satisfaction scores. As satisfaction surveys play a larger role in an environment of metric transparency and value-based payments, better understanding of such factors will be increasingly important. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Continuous Positive Airway Pressure Device Time to Procurement in a Disadvantaged Population.

PubMed

DelRosso, Lourdes M; Hoque, Romy; Chesson, Andrew L

2015-01-01

Introduction. The management of obstructive sleep apnea (OSA) in patients who cannot afford a continuous positive airway pressure (CPAP) device is challenging. In this study we compare time to CPAP procurement in three groups of patients diagnosed with OSA: uninsured subsidized by a humanitarian grant (Group 1), uninsured unsubsidized (Group 2), and those with Medicare or Medicaid (Group 3). We evaluate follow-up and adherence in Group 1. We hypothesize that additional factors, rather than just the ability to obtain CPAP, may uniquely affect follow-up and adherence in uninsured patients. Methods. 30 patients were in Groups 1 and 2, respectively. 12 patients were in Group 3. Time of CPAP procurement from OSA diagnosis to CPAP initiation was assessed in all groups. CPAP adherence data was collected for Group 1 patients at 1, 3, 6, and 9 months. Results. There were no significant differences between groups in gender, age, body mass index, or apnea hypopnea index. The mean time to procurement in Group 1 was shorter compared to Group 2 but not significant. Compared to both Group 1 and Group 2, Group 3 patients had significantly shorter times to device procurement. Conclusion. Time to procurement of CPAP was significantly shorter in those with Medicaid/Medicare insurance compared to the uninsured.

Discover cervical disc arthroplasty versus anterior cervical discectomy and fusion in symptomatic cervical disc diseases: A meta-analysis.

PubMed

Shangguan, Lei; Ning, Guang-Zhi; Tang, Yu; Wang, Zhe; Luo, Zhuo-Jing; Zhou, Yue

2017-01-01

Symptomatic cervical disc disease (SCDD) is a common degenerative disease, and Discover artificial cervical disc, a new-generation nonconstrained artificial disk, has been developed and performed gradually to treat it. We performed this meta-analysis to compare the efficacy and safety between Discover cervical disc arthroplasty (DCDA) and anterior cervical discectomy and fusion (ACDF) for SCDD. An exhaustive literature search of PubMed, EMBASE, and the Cochrane Library was conducted to identify randomized controlled trials that compared DCDA with ACDF for patients suffering SCDD. A random-effect model was used. Results were reported as standardized mean difference or risk ratio with 95% confidence interval. Of 33 articles identified, six studies were included. Compared with ACDF, DCDA demonstrated shorter operation time (P < 0.0001), and better range of motion (ROM) at the operative level (P < 0.00001). But no significant differences were observed in blood loss, neck disability index (NDI) scores, neck and arm pain scores, Japanese orthopaedic association (JOA) scores, secondary surgery procedures and adverse events (P > 0.05). Subgroup analyses did not demonstrated significant differences. In conclusion, DCDA presented shorter operation time, and better ROM at the operative level. However, no significant differences were observed in blood loss, NDI scores, neck and arm pain scores, JOA scores, secondary surgery procedures and adverse events between the two groups. Additionally, more studies of high quality with mid- to long-term follow-up are required in future.

Correlation of MFOLD-predicted DNA secondary structures with separation patterns obtained by capillary electrophoresis single-strand conformation polymorphism (CE-SSCP) analysis.

PubMed

Glavac, Damjan; Potocnik, Uros; Podpecnik, Darja; Zizek, Teofil; Smerkolj, Sava; Ravnik-Glavac, Metka

2002-04-01

We have studied 57 different mutations within three beta-globin gene promoter fragments with sizes 52 bp, 77 bp, and 193 bp by fluorescent capillary electrophoresis CE-SSCP analysis. For each mutation and wild type, energetically most-favorable predicted secondary structures were calculated for sense and antisense strands using the MFOLD DNA-folding algorithm in order to investigate if any correlation exists between predicted DNA structures and actual CE migration time shifts. The overall CE-SSCP detection rate was 100% for all mutations in three studied DNA fragments. For shorter 52 bp and 77 bp DNA fragments we obtained a positive correlation between the migration time shifts and difference in free energy values of predicted secondary structures at all temperatures. For longer 193 bp beta-globin gene fragments with 46 mutations MFOLD predicted different secondary structures for 89% of mutated strands at 25 degrees C and 40 degrees C. However, the magnitude of the mobility shifts did not necessarily correlate with their secondary structures and free energy values except for the sense strand at 40 degrees C where this correlation was statistically significant (r = 0.312, p = 0.033). Results of this study provided more direct insight into the mechanism of CE-SSCP and showed that MFOLD prediction could be helpful in making decisions about the running temperatures and in prediction of CE-SSCP data patterns, especially for shorter (50-100 bp) DNA fragments. Copyright 2002 Wiley-Liss, Inc.

Fast and Efficient Fragment-Based Lead Generation by Fully Automated Processing and Analysis of Ligand-Observed NMR Binding Data.

PubMed

Peng, Chen; Frommlet, Alexandra; Perez, Manuel; Cobas, Carlos; Blechschmidt, Anke; Dominguez, Santiago; Lingel, Andreas

2016-04-14

NMR binding assays are routinely applied in hit finding and validation during early stages of drug discovery, particularly for fragment-based lead generation. To this end, compound libraries are screened by ligand-observed NMR experiments such as STD, T1ρ, and CPMG to identify molecules interacting with a target. The analysis of a high number of complex spectra is performed largely manually and therefore represents a limiting step in hit generation campaigns. Here we report a novel integrated computational procedure that processes and analyzes ligand-observed proton and fluorine NMR binding data in a fully automated fashion. A performance evaluation comparing automated and manual analysis results on (19)F- and (1)H-detected data sets shows that the program delivers robust, high-confidence hit lists in a fraction of the time needed for manual analysis and greatly facilitates visual inspection of the associated NMR spectra. These features enable considerably higher throughput, the assessment of larger libraries, and shorter turn-around times.

Efficiency and cross-correlation in equity market during global financial crisis: Evidence from China

NASA Astrophysics Data System (ADS)

Ma, Pengcheng; Li, Daye; Li, Shuo

2016-02-01

Using one minute high-frequency data of the Shanghai Composite Index (SHCI) and the Shenzhen Composite Index (SZCI) (2007-2008), we employ the detrended fluctuation analysis (DFA) and the detrended cross correlation analysis (DCCA) with rolling window approach to observe the evolution of market efficiency and cross-correlation in pre-crisis and crisis period. Considering the fat-tail distribution of return time series, statistical test based on shuffling method is conducted to verify the null hypothesis of no long-term dependence. Our empirical research displays three main findings. First Shanghai equity market efficiency deteriorated while Shenzhen equity market efficiency improved with the advent of financial crisis. Second the highly positive dependence between SHCI and SZCI varies with time scale. Third financial crisis saw a significant increase of dependence between SHCI and SZCI at shorter time scales but a lack of significant change at longer time scales, providing evidence of contagion and absence of interdependence during crisis.

High-Throughput Analysis of Sucrose Fatty Acid Esters by Supercritical Fluid Chromatography/Tandem Mass Spectrometry

PubMed Central

Hori, Katsuhito; Tsumura, Kazunobu; Fukusaki, Eiichiro; Bamba, Takeshi

2014-01-01

Supercritical fluid chromatography (SFC) coupled with triple quadrupole mass spectrometry was applied to the profiling of sucrose fatty acid esters (SEs). The SFC conditions (column and modifier gradient) were optimized for the effective separation of SEs. In the column test, a silica gel reversed-phase column was selected. Then, the method was used for the detailed characterization of commercial SEs and the successful analysis of SEs containing different fatty acids. The present method allowed for fast and high-resolution separation of monoesters to tetra-esters within a shorter time (15 min) as compared to the conventional high-performance liquid chromatography. The applicability of our method for the analysis of SEs was thus demonstrated. PMID:26819875

77 FR 62191 - Approval and Promulgation of Air Quality Implementation Plans; New Mexico; Infrastructure and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-12

... such shorter period as EPA may prescribe. Section 110(a)(2) lists the specific infrastructure elements... Act (Act) requires that each state adopt and submit to EPA, within 3 years (or such shorter time... Tailoring Rule because the State does not have the authority to apply the meaning of the term ``subject to...

Reactive nanolaminate pulsed-laser ignition mechanism: Modeling and experimental evidence of diffusion limited reactions

DOE PAGES

Yarrington, C. D.; Abere, M. J.; Adams, D. P.; ...

2017-04-03

We irradiated Al/Pt nanolaminates with a bilayer thickness (tb, width of an Al/Pt pair-layer) of 164 nm with single laser pulses with durations of 10 ms and 0.5 ms at 189 W/cm 2 and 1189 W/cm 2, respectively. The time to ignition was measured for each pulse, and shorter ignition times were observed for the higher power/shorter pulse width. While the shorter pulse shows uniform brightness, videographic images of the irradiated area shortly after ignition show a non-uniform radial brightness for the longer pulse. A diffusion-limited single step reaction mechanism was implemented in a finite element package to model themore » progress from reactants to products at both pulse widths. Finally, the model captures well both the observed ignition delay and qualitative observations regarding the non-uniform radial temperature.« less

Optimization of a shorter variable-acquisition time for legs to achieve true whole-body PET/CT images.

PubMed

Umeda, Takuro; Miwa, Kenta; Murata, Taisuke; Miyaji, Noriaki; Wagatsuma, Kei; Motegi, Kazuki; Terauchi, Takashi; Koizumi, Mitsuru

2017-12-01

The present study aimed to qualitatively and quantitatively evaluate PET images as a function of acquisition time for various leg sizes, and to optimize a shorter variable-acquisition time protocol for legs to achieve better qualitative and quantitative accuracy of true whole-body PET/CT images. The diameters of legs to be modeled as phantoms were defined based on data derived from 53 patients. This study analyzed PET images of a NEMA phantom and three plastic bottle phantoms (diameter, 5.68, 8.54 and 10.7 cm) that simulated the human body and legs, respectively. The phantoms comprised two spheres (diameters, 10 and 17 mm) containing fluorine-18 fluorodeoxyglucose solution with sphere-to-background ratios of 4 at a background radioactivity level of 2.65 kBq/mL. All PET data were reconstructed with acquisition times ranging from 10 to 180, and 1200 s. We visually evaluated image quality and determined the coefficient of variance (CV) of the background, contrast and the quantitative %error of the hot spheres, and then determined two shorter variable-acquisition protocols for legs. Lesion detectability and quantitative accuracy determined based on maximum standardized uptake values (SUV max ) in PET images of a patient using the proposed protocols were also evaluated. A larger phantom and a shorter acquisition time resulted in increased background noise on images and decreased the contrast in hot spheres. A visual score of ≥ 1.5 was obtained when the acquisition time was ≥ 30 s for three leg phantoms, and ≥ 120 s for the NEMA phantom. The quantitative %errors of the 10- and 17-mm spheres in the leg phantoms were ± 15 and ± 10%, respectively, in PET images with a high CV (scan < 30 s). The mean SUV max of three lesions using the current fixed-acquisition and two proposed variable-acquisition time protocols in the clinical study were 3.1, 3.1 and 3.2, respectively, which did not significantly differ. Leg acquisition time per bed position of even 30-90 s allows axial equalization, uniform image noise and a maximum ± 15% quantitative accuracy for the smallest lesion. The overall acquisition time was reduced by 23-42% using the proposed shorter variable than the current fixed-acquisition time for imaging legs, indicating that this is a useful and practical protocol for routine qualitative and quantitative PET/CT assessment in the clinical setting.

A high proportion of cells carrying trisomy 12 is associated with a worse outcome in patients with chronic lymphocytic leukemia.

PubMed

González-Gascón Y Marín, Isabel; Hernández-Sánchez, María; Rodríguez-Vicente, Ana-Eugenia; Sanzo, Carmen; Aventín, Anna; Puiggros, Anna; Collado, Rosa; Heras, Cecilia; Muñoz, Carolina; Delgado, Julio; Ortega, Margarita; González, María-Teresa; Marugán, Isabel; de la Fuente, Ignacio; Recio, Isabel; Bosch, Francesc; Espinet, Blanca; González, Marcos; Hernández-Rivas, Jesús-María; Hernández, José-Ángel

2016-06-01

The prognosis of chronic lymphocytic leukemia (CLL) patients displaying trisomy 12 (+12) remains unclear. In this study, we analyzed the influence of the proportion of cells with +12, and other clinical and biologic factors, in time to first therapy (TTFT) and overall survival (OS), in 289 patients diagnosed with CLL carrying +12. Median OS was 129 months. One hundred seventy-four patients (60.2%) presented +12 in <60% of cells. TTFT and OS for this subgroup were longer than for the subgroup with +12 in ≥60% of cells, with a median TTFT of 49 months (CI95%, 39-58) vs 30 months (CI95%, 22-38) (P = 0.001); and a median OS of 159 months (CI95%, 119-182), vs 96 months (CI95%, 58-134) (P = 0.015). Other factors associated with a shorter TTFT were: Binet stage, B symptoms, lymphadenopathy, splenomegaly, high lymphocyte count, 11q-, high β2 microglobulin, and high LDH. In the multivariate analysis, clinical stage, +12 in ≥60% of cells, high lymphocyte count, B symptoms, and 11q- in addition, resulted of significance in predicting shorter TTFT. Significant variables for OS were: Binet stage, lymphadenopathy, splenomegaly, high LDH, high β2 microglobulin, 11q-, and CD38. In the multivariate analysis, only Binet stage, 11q-, and high β2microglobulin significantly predicted shorter OS. CLL with +12 entails a heterogeneous group with intermediate prognosis. However, a high proportion of cells carrying +12 separates a subgroup of patients with poor outcome. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Life history traits in selfing versus outcrossing annuals: exploring the 'time-limitation' hypothesis for the fitness benefit of self-pollination

PubMed Central

Snell, Rebecca; Aarssen, Lonnie W

2005-01-01

Background Most self-pollinating plants are annuals. According to the 'time-limitation' hypothesis, this association between selfing and the annual life cycle has evolved as a consequence of strong r-selection, involving severe time-limitation for completing the life cycle. Under this model, selection from frequent density-independent mortality in ephemeral habitats minimizes time to flower maturation, with selfing as a trade-off, and / or selection minimizes the time between flower maturation and ovule fertilization, in which case selfing has a direct fitness benefit. Predictions arising from this hypothesis were evaluated using phylogenetically-independent contrasts of several life history traits in predominantly selfing versus outcrossing annuals from a data base of 118 species distributed across 14 families. Data for life history traits specifically related to maturation and pollination times were obtained by monitoring the start and completion of different stages of reproductive development in a greenhouse study of selfing and outcrossing annuals from an unbiased sample of 25 species involving five pair-wise family comparisons and four pair-wise genus comparisons. Results Selfing annuals in general had significantly shorter plant heights, smaller flowers, shorter bud development times, shorter flower longevity and smaller seed sizes compared with their outcrossing annual relatives. Age at first flower did not differ significantly between selfing and outcrossing annuals. Conclusions This is the first multi-species study to report these general life-history differences between selfers and outcrossers among annuals exclusively. The results are all explained more parsimoniously by selection associated with time-limitation than by selection associated with pollinator/mate limitation. The shorter bud development time reported here for selfing annuals is predicted explicitly by the time-limitation hypothesis for the fitness benefit of selfing (and not by the alternative 'reproductive assurance' hypothesis associated with pollinator/mate limitation). Support for the time-limitation hypothesis is also evident from published surveys: whereas selfers and outcrossers are about equally represented among annual species as a whole, selfers occur in much higher frequencies among the annual species found in two of the most severely time-limited habitats where flowering plants grow – deserts and cultivated habitats. PMID:15707481

Photoselective vaporization of the prostate with GreenLight 120-W laser versus transurethral resection of the prostate for benign prostatic hyperplasia: a systematic review with meta-analysis of randomized controlled trials.

PubMed

Zang, Ya-Chen; Deng, Xin-Xi; Yang, Dong-Rong; Xue, Bo-Xin; Xu, Li-Jun; Liu, Xiao-Long; Zhou, Yi-Bin; Shan, Yu-Xi

2016-02-01

The aim of this study is to assess the overall efficacy and safety of photoselective vaporization of the prostate (PVP) with GreenLight 120-W laser versus transurethral resection of the prostate (TURP) for treating patients of benign prostate hyperplasia (BPH) with lower urinary tract symptoms (LUTS). We performed a literature search of The Cochrane Library and the electronic databases, including Embase, Medline, and Web of Science. Manual searches were conducted of the conference proceedings, including European Association of Urology and American Urological Association (2007 to 2012). Outcomes reviewed included clinical baseline characteristics, perioperative data, complications, and postoperative functional results, such as postvoid residual (PVR), international prostate symptom score (IPSS), quality of life (QoL), and maximum flow rate (Qmax). Six randomized controlled trials (RCTs) were enrolled. Three hundred and forty-seven patients undergone 120-W PVP, and 350 patients were treated with TURP in the RCTs. There were no significant differences for clinical characteristics in these trials. In perioperative data, catheterization time and length of hospital stay were shorter in the PVP group. However, the operation time was shorter in the TURP group. Capsular perforation, blood transfusion, clot retention, and macroscopic hematuria were markedly less likely in PVP-treated subjects. The other complications between PVP and TURP did not demonstrate a statistic difference. There were no significant differences in QoL, PVR, IPSS, and Qmax in the 1, 3, 6, 12, and 24 months of postoperative follow-up. There was no significant difference at postoperation follow-up of functional outcomes including IPSS, PVR, Qmax, and QoL between the TURP-treated subjects and PVP-treated subjects. Owing to a shorter catheterization time, reduced hospital duration and less complication, PVP could be used as an alternative and a promising minimal invasive surgical procedure for the treatment of BPH.

Evidence based medicine and surgical approaches for colon cancer: evidences, benefits and limitations of the laparoscopic vs open resection.

PubMed

Lorenzon, Laura; La Torre, Marco; Ziparo, Vincenzo; Montebelli, Francesco; Mercantini, Paolo; Balducci, Genoveffa; Ferri, Mario

2014-04-07

To report a meta-analysis of the studies that compared the laparoscopic with the open approach for colon cancer resection. Forty-seven manuscripts were reviewed, 33 of which employed for meta-analysis according to the PRISMA guidelines. The results were differentiated according to the study design (prospective randomized trials vs case-control series) and according to the tumor's location. Outcome measures included: (1) short-term results (operating times, blood losses, bowel function recovery, post-operative pain, return to the oral intake, complications and hospital stay); (2) oncological adequateness (number of nodes harvested in the surgical specimens); and (3) long-term results (including the survivals' rates and incidence of incisional hernias) and (4) costs. Meta-analysis of trials provided evidences in support of the laparoscopic procedures for a several short-term outcomes including: a lower blood loss, an earlier recovery of the bowel function, an earlier return to the oral intake, a shorter hospital stay and a lower morbidity rate. Opposite the operating time has been confirmed shorter in open surgery. The same trend has been reported investigating case-control series and cancer by sites, even though there are some concerns regarding the power of the studies in this latter field due to the small number of trials and the small sample of patients enrolled. The two approaches were comparable regarding the mean number of nodes harvested and long-term results, even though these variables were documented reviewing the literature but were not computable for meta-analysis. The analysis of the costs documented lower costs for the open surgery, however just few studies investigated the incidence of post-operative hernias. Laparoscopy is superior for the majority of short-term results. Future studies should better differentiate these approaches on the basis of tumors' location and the post-operative hernias.

Relationship between co-morbidities at diagnosis, survival and ultimate cause of death in patients with chronic lymphocytic leukaemia (CLL): a prospective cohort study.

PubMed

Strati, Paolo; Parikh, Sameer A; Chaffee, Kari G; Kay, Neil E; Call, Timothy G; Achenbach, Sara J; Cerhan, James R; Slager, Susan L; Shanafelt, Tait D

2017-08-01

The ultimate cause of death for most patients with newly diagnosed chronic lymphocytic leukaemia (CLL) and its relationship to co-morbid health conditions is poorly defined. We conducted a prospective cohort study that systematically followed 1143 patients diagnosed with CLL between June 2002 and November 2014. Comorbid health conditions at the time of CLL diagnosis and their relationship to survival and cause of death were evaluated. Collectively, 1061 (93%) patients had at least one co-morbid health condition at the time of CLL diagnosis (median number 3). Despite this, 89% of patients had a low-intermediate Charlson Comorbidity Index score (CCI) at diagnosis. After a median follow-up of 6 years, 225 patients have died. Death was due to CLL progression in 85 (46%) patients, infection in 14 (8%) patients, other cancer in 35 (19%) patients and comorbid health conditions in 50 (27%) patients. Higher CCI score and a greater number of major comorbid health conditions at the time of CLL diagnosis was associated with shorter non-CLL specific survival, but not with shorter CLL-specific survival on multivariate analysis. In conclusion, CLL and CLL-related complications (infections and second cancers) are the overwhelming cause of death in patients with CLL, regardless of CCI score and number of comorbid health conditions at diagnosis. © 2017 John Wiley & Sons Ltd.

The efficiency of simultaneous binaural ocular vestibular evoked myogenic potentials: a comparative study with monaural acoustic stimulation in healthy subjects.

PubMed

Kim, Min-Beom; Ban, Jae Ho

2012-12-01

To evaluate the test-retest reliability and convenience of simultaneous binaural acoustic-evoked ocular vestibular evoked myogenic potentials (oVEMP). Thirteen healthy subjects with no history of ear diseases participated in this study. All subjects underwent oVEMP test with both separated monaural acoustic stimulation and simultaneous binaural acoustic stimulation. For evaluating test-retest reliability, three repetitive sessions were performed in each ear for calculating the intraclass correlation coefficient (ICC) for both monaural and binaural tests. We analyzed data from the biphasic n1-p1 complex, such as latency of peak, inter-peak amplitude, and asymmetric ratio of amplitude in both ears. Finally, we checked the total time required to complete each test for evaluating test convenience. No significant difference was observed in amplitude and asymmetric ratio in comparison between monaural and binaural oVEMP. However, latency was slightly delayed in binaural oVEMP. In test-retest reliability analysis, binaural oVEMP showed excellent ICC values ranging from 0.68 to 0.98 in latency, asymmetric ratio, and inter-peak amplitude. Additionally, the test time was shorter in binaural than monaural oVEMP. oVEMP elicited from binaural acoustic stimulation yields similar satisfactory results as monaural stimulation. Further, excellent test-retest reliability and shorter test time were achieved in binaural than in monaural oVEMP.

Social inequalities and cancer: can the European deprivation index predict patients' difficulties in health care access? a pilot study

PubMed Central

Moriceau, Guillaume; Bourmaud, Aurélie; Tinquaut, Fabien; Oriol, Mathieu; Jacquin, Jean-Philippe; Fournel, Pierre; Magné, Nicolas; Chauvin, Franck

2016-01-01

Context The European Deprivation Index (EDI), is a new ecological estimate for Socio-Economic Status (SES). This study postulates that Time-To-Treatment could be used as a cancer quality-of -care surrogate in order to identify the association between cancer patient's SES and quality of care in a French comprehensive cancer center. Methods retrospective mono-centered cohort study. All consecutive incoming adult patients diagnosed for breast cancer(BC), prostate cancer(PC), colorectal cancer (CRC), lung cancer(LC) or sarcoma(S) were included between January 2013 and December 2013. The association of EDI and Time-To-Diagnosis(TTD), as well as Time-To-Treatment(TTT) was analyzed using a cox regression, and a strata analysis per tumor site was performed. Results 969 patients were included. Primitive tumor site was 505 BC(52%), 169 PC(17%), 145 LC(15%), 116 CRC(12%), and 34 S(4%). Median TTD was 1.41 months (Q1-Q3 0.5 to 3.5 months). Median TTT was 0.9 months (0.4 - 1.4). In a multivariate analysis, we identified the tumor site as a predictive factor to influence TTD, shorter for BC (0.75months, [0.30- 1.9]) than PC (4.69 months [1.6-29.7]), HR 0.27 95%CI= [0.22-0.34], p < 0.001. TTT was also shorter for BC (0.75months [0.4-1.1]) than PC (2.02 [0.9-3.2]), HR 0.32 95%CI= [0.27-0.39], p < 0.001. EDI quintiles were not found associated with either TTT or TTD. Conclusions Deprivation estimated by the EDI does not appear to be related to an extension of the Time-to-Diagnosis or Time-to-Treatment in our real-life population. Further research should be done to identify other frailty-sensitive factors that could be responsible for delays in care. PMID:26540571

Prespecified dose-response analysis for A Very Early Rehabilitation Trial (AVERT).

PubMed

Bernhardt, Julie; Churilov, Leonid; Ellery, Fiona; Collier, Janice; Chamberlain, Jan; Langhorne, Peter; Lindley, Richard I; Moodie, Marj; Dewey, Helen; Thrift, Amanda G; Donnan, Geoff

2016-06-07

Our prespecified dose-response analyses of A Very Early Rehabilitation Trial (AVERT) aim to provide practical guidance for clinicians on the timing, frequency, and amount of mobilization following acute stroke. Eligible patients were aged ≥18 years, had confirmed first (or recurrent) stroke, and were admitted to a stroke unit within 24 hours of stroke onset. Patients were randomized to receive very early and frequent mobilization, commencing within 24 hours, or usual care. We used regression analyses and Classification and Regression Trees (CART) to investigate the effect of timing and dose of mobilization on efficacy and safety outcomes, irrespective of assigned treatment group. A total of 2,104 patients were enrolled, of whom 2,083 (99.0%) were followed up at 3 months. We found a consistent pattern of improved odds of favorable outcome in efficacy and safety outcomes with increased daily frequency of out-of-bed sessions (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.09 to 1.18, p < 0.001), keeping time to first mobilization and mobilization amount constant. Increased amount (minutes per day) of mobilization reduced the odds of a good outcome (OR 0.94, 95% CI 0.91 to 0.97, p < 0.001). Session frequency was the most important variable in the CART analysis, after prognostic variables age and baseline stroke severity. These data suggest that shorter, more frequent mobilization early after acute stroke is associated with greater odds of favorable outcome at 3 months when controlling for age and stroke severity. This study provides Class III evidence that shorter, more frequent early mobilization improves the chance of regaining independence after stroke. © 2016 American Academy of Neurology.

Prespecified dose-response analysis for A Very Early Rehabilitation Trial (AVERT)

PubMed Central

Churilov, Leonid; Ellery, Fiona; Collier, Janice; Chamberlain, Jan; Langhorne, Peter; Lindley, Richard I.; Moodie, Marj; Dewey, Helen; Thrift, Amanda G.; Donnan, Geoff

2016-01-01

Objective: Our prespecified dose-response analyses of A Very Early Rehabilitation Trial (AVERT) aim to provide practical guidance for clinicians on the timing, frequency, and amount of mobilization following acute stroke. Methods: Eligible patients were aged ≥18 years, had confirmed first (or recurrent) stroke, and were admitted to a stroke unit within 24 hours of stroke onset. Patients were randomized to receive very early and frequent mobilization, commencing within 24 hours, or usual care. We used regression analyses and Classification and Regression Trees (CART) to investigate the effect of timing and dose of mobilization on efficacy and safety outcomes, irrespective of assigned treatment group. Results: A total of 2,104 patients were enrolled, of whom 2,083 (99.0%) were followed up at 3 months. We found a consistent pattern of improved odds of favorable outcome in efficacy and safety outcomes with increased daily frequency of out-of-bed sessions (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.09 to 1.18, p < 0.001), keeping time to first mobilization and mobilization amount constant. Increased amount (minutes per day) of mobilization reduced the odds of a good outcome (OR 0.94, 95% CI 0.91 to 0.97, p < 0.001). Session frequency was the most important variable in the CART analysis, after prognostic variables age and baseline stroke severity. Conclusion: These data suggest that shorter, more frequent mobilization early after acute stroke is associated with greater odds of favorable outcome at 3 months when controlling for age and stroke severity. Classification of evidence: This study provides Class III evidence that shorter, more frequent early mobilization improves the chance of regaining independence after stroke. PMID:26888985

Report of 111 Consecutive Patients Enrolled in the International Serial Transverse Enteroplasty (STEP) Data Registry: A Retrospective Observational Study

PubMed Central

Jones, Brian A; Hull, Melissa A; Potanos, Kristina M; Zurakowski, David; Fitzgibbons, Shimae C; Ching, Y Avery; Duggan, Christopher; Jaksic, Tom; Kim, Heung Bae

2016-01-01

Background The International Serial Transverse Enteroplasty (STEP) Data Registry is a voluntary online database created in 2004 to collect information on patients undergoing the STEP procedure. The aim of this study was to identify preoperative factors significantly associated with 1) transplantation or death, or 2) attainment of enteral autonomy following STEP. Study Design Data were collected from September 2004 to January 2010. Univariate and multivariate logistic regression analyses were applied to determine predictors of transplantation/death or enteral autonomy post-STEP. Time to reach full enteral nutrition was estimated using a Kaplan-Meier curve. Results Fourteen of the 111 patients in the Registry were excluded due to inadequate follow-up. Of the remaining 97 patients, 11 patients died, and 5 progressed to intestinal transplantation. On multivariate analysis, higher direct bilirubin and shorter pre-STEP bowel length were independently predictive of progression to transplantation or death (p = .05 and p < .001, respectively). Of the 78 patients who were ≥7 days of age and required parenteral nutrition (PN) at the time of STEP, 37 (47%) achieved enteral autonomy after the first STEP. Longer pre-STEP bowel length was also independently associated with enteral autonomy (p = .002). The median time to reach enteral autonomy based on Kaplan-Meier analysis was 21 months (95% CI: 12-30). Conclusions Overall mortality post-STEP was 11%. Pre-STEP risk factors for progressing to transplantation or death were higher direct bilirubin and shorter bowel length. Among patients who underwent STEP for short bowel syndrome, 47% attained full enteral nutrition post-STEP. Patients with longer pre-STEP bowel length were significantly more likely to achieve enteral autonomy. PMID:23357726

Sport, time pressure, and cognitive performance.

PubMed

Chiu, Chia N; Chen, Chiao-Yun; Muggleton, Neil G

2017-01-01

Sport participation, fitness, and expertise have been associated with a range of cognitive benefits in a range of populations but both the factors that confer such benefits and the nature of the resulting changes are relatively unclear. Additionally, the interactions between time pressure and cognitive performance for these groups is little studied. Using a flanker task, which measures the ability to selectively process information, and with different time limits for responding, we investigated the differences in performance for participants in (1) an unpredictable, open-skill sport (volleyball), (2) an exercise group engaged in predictable, closed-skill sports (running, swimming), and (3) nonsporting controls. Analysis by means of a drift diffusion analysis of response times was used to characterize the nature of any differences. Volleyball players were more accurate than controls and the exercise group, particularly for shorter time limits for responding, as well as tending to respond more quickly. Drift diffusion model analysis suggested that better performance by the volleyball group was due to factors such as stimulus encoding or motor programming and execution rather than decision making. Trends in the pattern of data seen also suggest less noisy cognitive processing (rather than greater efficiency) and should be further investigated. © 2017 Elsevier B.V. All rights reserved.

Complete Genome Sequence of an Avian Paramyxovirus Type 4 from North America Reveals a Shorter Genome and New Genotype

PubMed Central

Parthiban, Manoharan; Kaliyaperumal, Manimaran; Xiao, Sa; Nayak, Baibaswata; Paldurai, Anandan; Kim, Shin-Hee; Ladman, Brian S.; Preskenis, Lauren A.; Gelb, Jack; Collins, Peter L.

2013-01-01

An avian paramyxovirus type 4 (APMV-4) was isolated from a duck in Delaware in 2010. Its genome is 15,048 nucleotides (nt) long, which is shorter by 6 nt than those for all previously reported strains. Phylogenetic analysis revealed that this strain formed a separate cluster within APMV-4 strains. PMID:23405329

Resin Flow Behavior Simulation of Grooved Foam Sandwich Composites with the Vacuum Assisted Resin Infusion (VARI) Molding Process

PubMed Central

Zhao, Chenhui; Zhang, Guangcheng; Wu, Yibo

2012-01-01

The resin flow behavior in the vacuum assisted resin infusion molding process (VARI) of foam sandwich composites was studied by both visualization flow experiments and computer simulation. Both experimental and simulation results show that: the distribution medium (DM) leads to a shorter molding filling time in grooved foam sandwich composites via the VARI process, and the mold filling time is linearly reduced with the increase of the ratio of DM/Preform. Patterns of the resin sources have a significant influence on the resin filling time. The filling time of center source is shorter than that of edge pattern. Point pattern results in longer filling time than of linear source. Short edge/center patterns need a longer time to fill the mould compared with Long edge/center sources.

Antegrade versus retrograde cerebral perfusion for hemiarch replacement with deep hypothermic circulatory arrest: does it matter? A propensity-matched analysis.

PubMed

Ganapathi, Asvin M; Hanna, Jennifer M; Schechter, Matthew A; Englum, Brian R; Castleberry, Anthony W; Gaca, Jeffrey G; Hughes, G Chad

2014-12-01

The choice of cerebral perfusion strategy for aortic arch surgery has been debated, and the superiority of antegrade (ACP) or retrograde (RCP) cerebral perfusion has not been shown. We examined the early and late outcomes for ACP versus RCP in proximal (hemi-) arch replacement using deep hypothermic circulatory arrest (DHCA). A retrospective analysis of a prospectively maintained database was performed for all patients undergoing elective and nonelective hemiarch replacement at a single referral institution from June 2005 to February 2013. Total arch cases were excluded to limit the analysis to shorter DHCA times and a more uniform patient population for whom clinical equipoise regarding ACP versus RCP exists. A total of 440 procedures were identified, with 360 (82%) using ACP and 80 (18%) using RCP. The endpoints included 30-day/in-hospital and late outcomes. A propensity score with 1:1 matching of 40 pre- and intraoperative variables was used to adjust for differences between the 2 groups. All 80 RCP patients were propensity matched to a cohort of 80 similar ACP patients. The pre- and intraoperative characteristics were not significantly different between the 2 groups after matching. No differences were found in 30-day/in-hospital mortality or morbidity outcomes. The only significant difference between the 2 groups was a shorter mean operative time in the RCP cohort (P = .01). No significant differences were noted in late survival (P = .90). In proximal arch operations using DHCA, equivalent early and late outcomes can be achieved with RCP and ACP, although the mean operative time is significantly less with RCP, likely owing to avoidance of axillary cannulation. Questions remain regarding comparative outcomes with straight DHCA and lesser degrees of hypothermia. Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Analysis of free online physician advice services.

PubMed

Cohen, Raphael; Elhadad, Michael; Birk, Ohad

2013-01-01

Online Consumer Health websites are a major source of information for patients worldwide. We focus on another modality, online physician advice. We aim to evaluate and compare the freely available online expert physicians' advice in different countries, its scope and the type of content provided. Using automated methods for information retrieval and analysis, we compared consumer health portals from the US, Canada, the UK and Israel (WebMD,NetDoctor,AskTheDoctor and BeOK). The evaluated content was generated between 2002 and 2011. We analyzed the different sites, looking at the distribution of questions in the various health topics, answer lengths and content type. Answers could be categorized into longer broad-educational answers versus shorter patient-specific ones, with different physicians having personal preferences as to answer type. The Israeli website BeOK, providing 10 times the number of answers than in the other three health portals, supplied answers that are shorter on average than in the other websites. Response times in these sites may be rapid with 32% of the WebMD answers and 64% of the BeOK answers provided in less than 24 hours. The voluntary contribution model used by BeOK and WebMD enables generation of large numbers of physician expert answers at low cost, providing 50,000 and 3,500 answers per year, respectively. Unlike health information in online databases or advice and support in patient-forums, online physician advice provides qualified specialists' responses directly relevant to the questions asked. Our analysis showed that high numbers of expert answers could be generated in a timely fashion using a voluntary model. The length of answers varied significantly between the internet sites. Longer answers were associated with educational content while short answers were associated with patient-specific content. Standard site-specific guidelines for expert answers will allow for more desirable content (educational content) or better throughput (patient-specific content).

Gamma-ray Full Spectrum Analysis for Environmental Radioactivity by HPGe Detector

NASA Astrophysics Data System (ADS)

Jeong, Meeyoung; Lee, Kyeong Beom; Kim, Kyeong Ja; Lee, Min-Kie; Han, Ju-Bong

2014-12-01

Odyssey, one of the NASA¡¯s Mars exploration program and SELENE (Kaguya), a Japanese lunar orbiting spacecraft have a payload of Gamma-Ray Spectrometer (GRS) for analyzing radioactive chemical elements of the atmosphere and the surface. In these days, gamma-ray spectroscopy with a High-Purity Germanium (HPGe) detector has been widely used for the activity measurements of natural radionuclides contained in the soil of the Earth. The energy spectra obtained by the HPGe detectors have been generally analyzed by means of the Window Analysis (WA) method. In this method, activity concentrations are determined by using the net counts of energy window around individual peaks. Meanwhile, an alternative method, the so-called Full Spectrum Analysis (FSA) method uses count numbers not only from full-absorption peaks but from the contributions of Compton scattering due to gamma-rays. Consequently, while it takes a substantial time to obtain a statistically significant result in the WA method, the FSA method requires a much shorter time to reach the same level of the statistical significance. This study shows the validation results of FSA method. We have compared the concentration of radioactivity of 40K, 232Th and 238U in the soil measured by the WA method and the FSA method, respectively. The gamma-ray spectrum of reference materials (RGU and RGTh, KCl) and soil samples were measured by the 120% HPGe detector with cosmic muon veto detector. According to the comparison result of activity concentrations between the FSA and the WA, we could conclude that FSA method is validated against the WA method. This study implies that the FSA method can be used in a harsh measurement environment, such as the gamma-ray measurement in the Moon, in which the level of statistical significance is usually required in a much shorter data acquisition time than the WA method.

Electronic mail was not better than postal mail for surveying residents and faculty.

PubMed

Akl, Elie A; Maroun, Nancy; Klocke, Robert A; Montori, Victor; Schünemann, Holger J

2005-04-01

To compare response rate, time to response, and data quality of electronic and postal surveys in the setting of postgraduate medical education. A randomized controlled trial in a university-based internal medicine residency program. We randomized 119 residents and 83 faculty to an electronic versus a postal survey with up to two reminders and measured response rate, time to response, and data quality. For residents, the e-survey resulted in a lower response rate than the postal survey (63.3% versus 79.7%; difference -16.3%, 95% confidence interval (95% CI) -32.3% to -0.4%%; P=.049), but a shorter mean response time, by 3.8 days (95% CI 0.2-7.4; P=.042). For faculty, the e-survey did not result in a significantly lower response rate than the postal survey (85.4% vs. 81.0%; difference 4.4%, 95% CI -11.7 to 20.5%; P=.591), but resulted in a shorter average response time, by 8.4 days (95% CI 4.4 to 12.4; P < 0.001). There were no differences in the quality of data or responses to the survey between the two methods. E-surveys were not superior to postal surveys in terms of response rate, but resulted in shorter time to response and equivalent data quality.

Gelatin-thrombin hemostatic matrix in neurosurgical procedures: hemostasis effectiveness and economic value of clinical and surgical procedure-related benefits.

PubMed

Esposito, Felice; Cappabianca, Paolo; Angileri, Filippo F; Cavallo, Luigi M; Priola, Stefano M; Crimi, Salvatore; Solari, Domenico; Germanò, Antonino F; Tomasello, Francesco

2016-07-26

Gelatin-thrombin hemostatic matrix (FloSeal®) use is associated with shorter surgical times and less blood loss, parameters that are highly valued in neurosurgical procedures. We aimed to assess the effectiveness of gelatin-thrombin in neurosurgical procedures and estimate its economic value. In a 6-month retrospective evaluation at 2 hospitals, intraoperative and postoperative information were collected from patients undergoing neurosurgical procedures where bleeding was controlled with gelatin-thrombin matrix or according to local bleeding control guidelines (control group). Study endpoints were: length of surgery, estimated blood loss, hospitalization duration, blood units utilized, intensive care unit days, postoperative complications, and time-to-recovery. Statistical methods compared endpoints between the gelatin-thrombin and control groups and resource utilization costs were estimated. Seventy-eight patients (38 gelatin-thrombin; 40 control) were included. Gelatin-thrombin was associated with a shorter surgery duration than control 166±40 versus 185±55, p=0.0839); a lower estimated blood loss (185±80 versus 250±95ml; p=0.0017); a shorter hospital stay (10±3 versus 13±3 days; p<0.001); fewer intensive care unit days (10 days/3 patients and 20 days/4 patients); and shorter time-to-recovery (3±2.2 versus 4±2.8 weeks; p=0861). Fewer gelatin-thrombin patients experienced postoperative complications (3 minor) than the control group (5 minor; 3 major). No gelatin-thrombin patient required blood transfusion; 5 units were administered in the control group. The cost of gelatin-thrombin (€268.40/unit) was offset by the shorter surgery duration (difference of 19 minutes at €858 per hour) and the economic value of improved the other endpoint outcomes (ie, shorter hospital stay, less blood loss/lack of need for transfusion, fewer intensive care unit days, and complications). Gelatin-thrombin hemostatic matrix use in patients undergoing neurosurgical procedures was associated with better intra- and post-operative parameters than conventional hemostasis methods, with these parameters having substantial economic benefits.

Use of Variable Pressure Suits, Intermittent Recompression and Nitrox Breathing Mixtures during Lunar Extravehicular Activities

NASA Technical Reports Server (NTRS)

Gernhardt, Michael L.; Abercromby, Andrew F.

2009-01-01

This slide presentation reviews the use of variable pressure suits, intermittent recompression and Nitrox breathing mixtures to allow for multiple short extravehicular activities (EVAs) at different locations in a day. This new operational concept of multiple short EVAs requires short purge times and shorter prebreathes to assure rapid egress with a minimal loss of the vehicular air. Preliminary analysis has begun to evaluate the potential benefits of the intermittent recompression, and Nitrox breathing mixtures when used with variable pressure suits to enable reduce purges and prebreathe durations.

Officer Overexecution: Analysis and Solutions (Technical Background)

DTIC Science & Technology

2015-08-01

the shorter time period, as is generally reported, the retention of men is greater than that of women , and the retention of conventional SWOs is...greater than that of SWO(N)s. Table 1. Rates of retention for SWOs Rate or number Conventional SWO(N) Men Women All Men Women All Retention (MSR-1 to...the 0.001 level. Table 5. OOE and the retention of SWO(N)s OOE by paygrade Men Women O1 OOE -1 0.6 (0.7) (1) 0 0 O2 OOE 0.6 4.1*** (0.7

A new modified speculum guided single nostril technique for endoscopic transnasal transsphenoidal surgery: an analysis of nasal complications.

PubMed

Waran, Vicknes; Tang, Ing Ping; Karuppiah, Ravindran; Abd Kadir, Khairul Azmi; Chandran, Hari; Muthusamy, Kalai Arasu; Prepageran, Narayanan

2013-12-01

Abstract The endoscopic transnasal, transsphenoidal surgical technique for pituitary tumour excision has generally been regarded as a less invasive technique, ranging from single nostril to dual nostril techniques. We propose a single nostril technique using a modified nasal speculum as a preferred technique. We initially reviewed 25 patients who underwent pituitary tumour excision, via endoscopic transnasal transsphenoidal surgery, using this new modified speculum-guided single nostril technique. The results show shorter operation time with reduced intra- and post-operative nasal soft tissue injuries and complications.

Severe chronic bronchitis in advanced emphysema increases mortality and hospitalizations.

PubMed

Kim, Victor; Sternberg, Alice L; Washko, George; Make, Barry J; Han, Meilan K; Martinez, Fernando; Criner, Gerard J

2013-12-01

Chronic bronchitis in COPD has been associated with an increased exacerbation rate, more hospitalizations, and an accelerated decline in lung function. The clinical characteristics of patients with advanced emphysema and chronic bronchitis have not been well described. Patients randomized to medical therapy in the National Emphysema Treatment Trial were grouped based on their reports of cough and phlegm on the St. George's Respiratory Questionnaire(SGRQ) at baseline: chronic bronchitis(CB+) and no chronic bronchitis(CB-). The patients were similarly categorized into severe chronic bronchitis(SCB+) or no severe chronic bronchitis (SCB-) based on the above definition plus report of chest trouble. Kaplan-Meier survival analysis was used to determine the relationships between chronic bronchitis and severe chronic bronchitis and survival and time to hospitalization. Lung function and SGRQ scores over time were compared between groups. The CB+(N = 234; 38%) and CB- groups(N = 376; 62%) had similar survival (median 60.8 versus 65.7 months, p = 0.19) and time to hospitalization (median 26.9 versus 24.9 months, p = 0.84). The SCB+ group(N = 74; 12%) had worse survival (median 47.7 versus 65.7 months, p = 0.02) and shorter time to hospitalization (median 18.5 versus 26.7 months, p = 0.02) than the SCB- group (N = 536; 88%). Mortality and hospitalization rates were not increased when chest trouble was analyzed by itself. The CB+ and CB-groups had similar lung function and SGRQ scores over time. The SCB+ and SCB-groups had similar lung function over time, but the SCB+ group had significantly worse SGRQ scores. Severe chronic bronchitis is associated with worse survival, shorter time to hospitalization, and worse health-related quality of life.

Hemodialysis

MedlinePlus

... center, hemodialysis is usually done 3 times per week for about 4 hours at a time. People who choose to do ... at home may do dialysis treatment more frequently, 4-7 times per week for shorter hours each time. Your doctor will give you a ...

The Use of Continuous Wavelet Transform Based on the Fast Fourier Transform in the Analysis of Multi-channel Electrogastrography Recordings.

PubMed

Komorowski, Dariusz; Pietraszek, Stanislaw

2016-01-01

This paper presents the analysis of multi-channel electrogastrographic (EGG) signals using the continuous wavelet transform based on the fast Fourier transform (CWTFT). The EGG analysis was based on the determination of the several signal parameters such as dominant frequency (DF), dominant power (DP) and index of normogastria (NI). The use of continuous wavelet transform (CWT) allows for better visible localization of the frequency components in the analyzed signals, than commonly used short-time Fourier transform (STFT). Such an analysis is possible by means of a variable width window, which corresponds to the scale time of observation (analysis). Wavelet analysis allows using long time windows when we need more precise low-frequency information, and shorter when we need high frequency information. Since the classic CWT transform requires considerable computing power and time, especially while applying it to the analysis of long signals, the authors used the CWT analysis based on the fast Fourier transform (FFT). The CWT was obtained using properties of the circular convolution to improve the speed of calculation. This method allows to obtain results for relatively long records of EGG in a fairly short time, much faster than using the classical methods based on running spectrum analysis (RSA). In this study authors indicate the possibility of a parametric analysis of EGG signals using continuous wavelet transform which is the completely new solution. The results obtained with the described method are shown in the example of an analysis of four-channel EGG recordings, performed for a non-caloric meal.

Influence of enhanced recovery after surgery programs on laparoscopy-assisted gastrectomy for gastric cancer: a systematic review and meta-analysis of randomized control trials.

PubMed

Li, Zhengyan; Wang, Qian; Li, Bofei; Bai, Bin; Zhao, Qingchuan

2017-11-23

This meta-analysis is aimed to evaluate the feasibility and safety of enhanced recovery after surgery (ERAS) programs in gastric cancer patients undergoing laparoscopy-assisted gastrectomy (LAG). We performed a meta-analysis of randomized control trials involving either enhanced recovery after surgery (ERAS)/fast track surgery (FTS) for patients underwent LAG. EMBASE, Pubmed, Web of science, and Cochrane Library were searched. Primary outcomes included the length of postoperative hospital stay, cost of hospitalization, postoperative complications, and readmission rate. Five randomized control trials were eligible for analysis. There were 159 cases in FTS group and 156 cases in conventional care group. Compared with conventional care group, FTS group relates to shorter postoperative hospital stay (WMD - 2.16; 95% CI - 3.05 to - 1.26, P < 0.00001), less cost of hospitalization (WMD - 4.72; 95% CI - 6.88 to - 2.55, P < 0.00001), shorter time to first flatus (WMD - 9.72; 95% CI - 13.75 to - 5.81, P < 0.00001), lower level of C-reaction protein on postoperative days 3 or 4 (WMD - 19.66; 95% CI - 28.98 to - 10.34, P < 0.00001), higher level of albumin on postoperative day 4 (WMD 3.45; 95% CI 2.01 to 4.89, P < 0.00001), and postoperative day 7 (WMD 5.63; 95% CI 1.01 to 10.24, P = 0.02). Regarding postoperative complications, no significant differences were observed between FTS group and conventional care group (OR 0.63, 95% CI 0.37 to 1.09, P = 0.10). The readmission rate of FTS group was comparable to conventional care group (WMD 3.14; 95% CI 0.12 to 81.35, P = 0.49). Among patients undergoing LAG, FTS is associated with shorter postoperative hospital stay, rapid postoperative recovery, and decreased cost without increasing complications or readmission rate. The combined effects of the two methods could further accelerate clinical recovery of gastric cancer patients.

Sleeping Pill Administration Time and Patient Subjective Satisfaction.

PubMed

Chung, Seockhoon; Youn, Soyoung; Yi, Kikyoung; Park, Boram; Lee, Suyeon

2016-01-01

Taking hypnotic agents 30 min before bedtime is the usual suggested administration time, but some patients report dissatisfaction with their sleeping pills. We investigated whether the timing of sleeping pill administration influences patient subjective satisfaction with these drugs. One hundred twelve patients with primary insomnia currently taking benzodiazepine or nonbenzodiazepine gamma-aminobutyric acid (GABA) agonists as sleeping pills were selected. The time of administration for their sleeping pills, bedtime, sleep onset time, and wake up time were obtained from their medical records. Subjects were also categorized into satisfied or dissatisfied groups. Hypnotic agents administration time (p < 0.001) and bedtime (p < 0.001), but not sleep onset or wake up time, occurred later in the night in the satisfied group. The durations from administration of pills to sleep onset (33.6 ± 20.7 min) and to wake up time (7.2 ± 1.2 h) were significantly shorter in the satisfied group when compared to the dissatisfied group (135.9 ± 73.4 min and 9.3 ± 1.5 h for time to sleep onset and wake up, respectively). Logistic regression analysis revealed that patient subjective satisfaction with hypnotic agents could be predicted by a short duration from administration of pills to sleep onset (odds ratio = 0.01; 95% confidence interval [0.001-0.09]) and a short duration from administration of pills to wake up time (0.53; [0.31-0.89], F = 49.9, p < 0.001). Taking sleeping pills at a later time and a shorter interval between pill administration and wake up time may increase patient subjective satisfaction with hypnotic agents. We propose that physicians advise patients to take sleeping pills approximately 7 h before their usual getting-out-of-bed time instead of the current standard of 30 min before bedtime. © 2016 American Academy of Sleep Medicine.

Predictors of lapse in first week of smoking abstinence in PTSD and non-PTSD smokers.

PubMed

Beckham, Jean C; Calhoun, Patrick S; Dennis, Michelle F; Wilson, Sarah M; Dedert, Eric A

2013-06-01

Retrospective research suggests smokers with posttraumatic stress disorder (PTSD) lapse more quickly after their quit date. Ecological momentary assessment (EMA) research is needed to confirm the presence of early smoking lapse in PTSD and form conceptualizations that inform intervention. Smokers with (n = 55) and without (n = 52) PTSD completed alarm-prompted EMA of situational and psychiatric variables the week before and after a quit date, and self-initiated EMA following smoking lapses. Blood samples at baseline and on the quit date allowed assessment of dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA(S)). PTSD was related to shorter time to lapse (hazard ratio [HR] = 1.677, 95% CI: 1.106-2.544). Increased smoking abstinence self-efficacy was related to longer time to lapse (HR = 0.608, 95% CI: 0.430-0.860). Analyses of participants' real-time reports revealed that smokers with PTSD were more likely to attribute first-time lapses to negative affect ( = 5.412, p = .020), and trauma reminders (Fisher's exact p = .003**). Finally, the quit date decrease in DHEA(S) was related to shorter time to lapse (HR = 1.009, 95% CI: 1.000-1.018, p < .05). Results provide evidence of shorter time to first smoking lapse in PTSD, and add to evidence that early lapse occasions are more strongly related to trauma reminders, negative affect, and cravings in smokers with PTSD.

Retention time alignment of LC/MS data by a divide-and-conquer algorithm.

PubMed

Zhang, Zhongqi

2012-04-01

Liquid chromatography-mass spectrometry (LC/MS) has become the method of choice for characterizing complex mixtures. These analyses often involve quantitative comparison of components in multiple samples. To achieve automated sample comparison, the components of interest must be detected and identified, and their retention times aligned and peak areas calculated. This article describes a simple pairwise iterative retention time alignment algorithm, based on the divide-and-conquer approach, for alignment of ion features detected in LC/MS experiments. In this iterative algorithm, ion features in the sample run are first aligned with features in the reference run by applying a single constant shift of retention time. The sample chromatogram is then divided into two shorter chromatograms, which are aligned to the reference chromatogram the same way. Each shorter chromatogram is further divided into even shorter chromatograms. This process continues until each chromatogram is sufficiently narrow so that ion features within it have a similar retention time shift. In six pairwise LC/MS alignment examples containing a total of 6507 confirmed true corresponding feature pairs with retention time shifts up to five peak widths, the algorithm successfully aligned these features with an error rate of 0.2%. The alignment algorithm is demonstrated to be fast, robust, fully automatic, and superior to other algorithms. After alignment and gap-filling of detected ion features, their abundances can be tabulated for direct comparison between samples.

Sutureless versus Conventional Aortic Valve Replacement: Outcomes in 70 High-Risk Patients Undergoing Concomitant Cardiac Procedures.

PubMed

Hanedan, Muhammet Onur; Yuruk, Mehmet Ali; Parlar, Ali Ihsan; Ziyrek, Ugur; Arslan, Ali Kemal; Sayar, Ufuk; Mataraci, Ilker

2018-02-01

In elderly, high-risk surgical patients, sutureless aortic valve replacement (AVR) can often be an alternative to conventional AVR; shorter aortic cross-clamp and cardiopulmonary bypass times are the chief advantages. We compared the outcomes of sutureless AVR with those of conventional AVR in 70 elderly patients who underwent concomitant cardiac surgical procedures. We retrospectively analyzed the cases of 42 men and 28 women (mean age, 70.4 ± 10.3 yr; range, 34-93 yr) who underwent cardiac operations plus AVR with either a sutureless valve (group 1, n=38) or a conventional bioprosthetic or mechanical valve (group 2, n=32). Baseline patient characteristics were similar except for worse New York Heart Association functional status and the prevalence of diabetes mellitus in group 1. In group 1, the operative, cross-clamp, and cardiopulmonary bypass times were shorter (all P =0.001), postoperative drainage amounts were lower ( P =0.009), hospital stays were shorter ( P =0.004), and less red blood cell transfusion was needed ( P =0.037). Echocardiograms before patients' discharge from the hospital showed lower peak and mean aortic gradients in group 1 (mean transvalvular gradient, 8.4 ± 2.8 vs 12.2 ± 5.2 mmHg; P =0.012). We found that elderly, high-risk patients who underwent multiple cardiac surgical procedures and sutureless AVR had better hemodynamic outcomes and shorter ischemic times than did patients who underwent conventional AVR.

Concurrent schedules of wheel-running reinforcement: choice between different durations of opportunity to run in rats.

PubMed

Belke, Terry W

2006-02-01

How do animals choose between opportunities to run of different durations? Are longer durations preferred over shorter durations because they permit a greater number of revolutions? Are shorter durations preferred because they engender higher rates of running? Will longer durations be chosen because running is less constrained? The present study reports on three experiments that attempted to address these questions. In the first experiment, five male Wistar rats chose between 10-sec and 50-sec opportunities to run on modified concurrent variable-interval (VI) schedules. Across conditions, the durations associated with the alternatives were reversed. Response, time, and reinforcer proportions did not vary from indifference. In a second experiment, eight female Long-Evans rats chose between opportunities to run of equal (30 sec) and unequal durations (10 sec and 50 sec) on concurrent variable-ratio (VR) schedules. As in Experiment 1, between presentations of equal duration conditions, 10-sec and 50-sec durations were reversed. Results showed that response, time, and reinforcer proportions on an alternative did not vary with reinforcer duration. In a third experiment, using concurrent VR schedules, durations were systematically varied to decrease the shorter duration toward 0 sec. As the shorter duration decreased, response, time, and reinforcer proportions shifted toward the longer duration. In summary, differences in durations of opportunities to run did not affect choice behavior in a manner consistent with the assumption that a longer reinforcer is a larger reinforcer.

Employment among patients with multiple sclerosis-a population study.

PubMed

Bøe Lunde, Hanne Marie; Telstad, Wenche; Grytten, Nina; Kyte, Lars; Aarseth, Jan; Myhr, Kjell-Morten; Bø, Lars

2014-01-01

To investigate demographic and clinical factors associated with employment in MS. The study included 213 (89.9%) of all MS patients in Sogn and Fjordane County, Western Norway at December 31st 2010. The patients underwent clinical evaluation, structured interviews and completed self-reported questionnaires. Demographic and clinical factors were compared between patients being employed versus patients being unemployed and according to disease course of MS. Logistic regression analysis was used to identify factors independently associated with current employment. After a mean disease duration of almost 19 years, 45% of the population was currently full-time or part- time employed. Patients with relapsing -remitting MS (RRMS) had higher employment rate than patients with secondary (SPMS) and primary progressive (PPMS). Higher educated MS patients with lower age at onset, shorter disease duration, less severe disability and less fatigue were most likely to be employed. Nearly half of all MS patients were still employed after almost two decades of having MS. Lower age at onset, shorter disease duration, higher education, less fatigue and less disability were independently associated with current employment. These key clinical and demographic factors are important to understand the reasons to work ability in MS. The findings highlight the need for environmental adjustments at the workplace to accommodate individual 's needs in order to improve working ability among MS patients.

Clinical outcome of using gastric remnant or jejunum or colon conduit in surgery for esophageal carcinoma with previous gastrectomy.

PubMed

Jun, Wang; Wei, Wen; Weibing, Wu; Jing, Xu; Fuxi, Zhen; Xiaoxiang, Xi; Bihong, Lu; Tong, Zhou; Liang, Chen; Jinhua, Luo

2017-05-01

For esophageal carcinoma patients with early gastrectomy, individualized surgical plans-including selection of replacement conduit and operation route based on patient's new lesion and surgical history-can achieve the desired therapeutic effect and improve postoperative life quality. We investigated the outcomes at our institution. The clinical data of 42 esophageal carcinoma patients with early gastrectomy were analyzed retrospectively. Esophagectomy was performed combining replacement with remnant stomach in 16 patients, jejunum in 17, and colon in 9. Esophagectomy combining replacement with gastric remnant got advantages of shorter operation time and less bleeding over that of replacement with jejunum or colon. Gastric remnant group scored higher on the QLQ-C30 questionnaire than jejunum or colon group with respect to overall quality of life, physical function, and social relationships. In QLQ-OES18 questionnaire, the scores of appetite recovery and reflux mitigation were more favorable in remnant stomach group than those in jejunum or colon group. Survival analysis showed no significant difference in survival rate among the patients undergoing replacement with gastric remnant, jejunum, or colon. For esophageal carcinoma patients with early gastrectomy, esophagus-gastric remnant anastomosis possesses advantages of shorter operation time, less surgical trauma, and greater life quality after surgery. © 2017 Wiley Periodicals, Inc.

An efficient multiple exposure image fusion in JPEG domain

NASA Astrophysics Data System (ADS)

Hebbalaguppe, Ramya; Kakarala, Ramakrishna

2012-01-01

In this paper, we describe a method to fuse multiple images taken with varying exposure times in the JPEG domain. The proposed algorithm finds its application in HDR image acquisition and image stabilization for hand-held devices like mobile phones, music players with cameras, digital cameras etc. Image acquisition at low light typically results in blurry and noisy images for hand-held camera's. Altering camera settings like ISO sensitivity, exposure times and aperture for low light image capture results in noise amplification, motion blur and reduction of depth-of-field respectively. The purpose of fusing multiple exposures is to combine the sharp details of the shorter exposure images with high signal-to-noise-ratio (SNR) of the longer exposure images. The algorithm requires only a single pass over all images, making it efficient. It comprises of - sigmoidal boosting of shorter exposed images, image fusion, artifact removal and saturation detection. Algorithm does not need more memory than a single JPEG macro block to be kept in memory making it feasible to be implemented as the part of a digital cameras hardware image processing engine. The Artifact removal step reuses the JPEGs built-in frequency analysis and hence benefits from the considerable optimization and design experience that is available for JPEG.

Visual search performance on an lcd monitor: effects of color combination of figure and icon background, shape of icon, and line width of icon border.

PubMed

Huang, Kuo-Chen; Chiu, Tsai-Lan

2007-04-01

This study investigated the effects of color combinations for the figure/icon background, icon shape, and line width of the icon border on visual search performance on a liquid crystal display screen. In a circular stimulus array, subjects had to search for a target item which had a diameter of 20 cm and included one target and 19 distractors. Analysis showed that the icon shape significantly affected search performance. The correct response time was significantly shorter for circular icons than for triangular icons, for icon borders with a line width of 3 pixels than for 1 or 2 pixels, and for 2 pixels than for 1 pixel. The color combination also significantly affected the visual search performance: white/yellow, white/blue, black-red, and black/ yellow color combinations for the figure/icon background had shorter correct response times compared to yellow/blue, red/green, yellow/green, and blue/red. However, no effects were found for the line width of the icon border or the icon shape on the error rate. Results have implications for graphics-based design of interfaces, such as for mobile phones, Web sites, and PDAs, as well as complex industrial processes.

Determination of total sulfur in lichens and plants by combustion-infrared analysis

USGS Publications Warehouse

Jackson, L.L.; Engleman, E.E.; Peard, J.L.

1985-01-01

Sulfur was determined in plants and lichens by combustion of the sample and infrared detection of evolved sulfur dioxide using an automated sulfur analyzer. Vanadium pentaoxide was used as a combustion accelerator. Pelletization of the sample prior to combustion was not found to be advantageous. Washing studies showed that leaching of sulfur was not a major factor in the sample preparation. The combustion-IR analysis usually gave higher sulfur content than the turbidimetric analysis as well as shorter analysis time. Relative standard deviations of less than 7% were obtained by the combustion-IR technique when sulfur levels in plant material ranged from 0.05 to 0.70%. Determination of sulfur in National Bureau of Standards botanical reference materials showed good agreement between the combustion-IR technique and other instrumental procedures. Seven NBS botanical reference materials were analyzed.

TEMPORAL EVOLUTION AND SPATIAL DISTRIBUTION OF WHITE-LIGHT FLARE KERNELS IN A SOLAR FLARE

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

Kawate, T.; Ishii, T. T.; Nakatani, Y.

2016-12-10

On 2011 September 6, we observed an X2.1-class flare in continuum and H α with a frame rate of about 30 Hz. After processing images of the event by using a speckle-masking image reconstruction, we identified white-light (WL) flare ribbons on opposite sides of the magnetic neutral line. We derive the light curve decay times of the WL flare kernels at each resolution element by assuming that the kernels consist of one or two components that decay exponentially, starting from the peak time. As a result, 42% of the pixels have two decay-time components with average decay times of 15.6 andmore » 587 s, whereas the average decay time is 254 s for WL kernels with only one decay-time component. The peak intensities of the shorter decay-time component exhibit good spatial correlation with the WL intensity, whereas the peak intensities of the long decay-time components tend to be larger in the early phase of the flare at the inner part of the flare ribbons, close to the magnetic neutral line. The average intensity of the longer decay-time components is 1.78 times higher than that of the shorter decay-time components. If the shorter decay time is determined by either the chromospheric cooling time or the nonthermal ionization timescale and the longer decay time is attributed to the coronal cooling time, this result suggests that WL sources from both regions appear in 42% of the WL kernels and that WL emission of the coronal origin is sometimes stronger than that of chromospheric origin.« less

Targets of perioperative fluid therapy and their effects on postoperative outcome: a systematic review and meta-analysis.

PubMed

Berger, M M; Gradwohl-Matis, I; Brunauer, A; Ulmer, H; Dünser, M W

2015-07-01

Perioperative fluid management plays a fundamental role in maintaining organ perfusion, and is considered to affect morbidity and mortality. Targets according to which fluid therapy should be administered are poorly defined. This systematic review aimed to identify specific targets for perioperative fluid therapy. The PubMed database (January 1993-December 2013) and reference lists were searched to identify clinical trials which evaluated specific targets of perioperative fluid therapy and reported clinically relevant perioperative endpoints in adult patients. Only studies in which targeted fluid therapy was the sole intervention were included into the main data analysis. A pooled data analysis was used to compare mortality between goal-directed fluid therapy and control interventions. Thirty-six clinical studies were selected. Sixteen studies including 1224 patients specifically evaluated targeted fluid therapy and were included into the main data analysis. Three specific targets for perioperative fluid therapy were identified: a systolic or pulse pressure variation <10-12%, an increase in stroke volume <10%, and a corrected flow time of 0.35-0.4 s in combination with an increase in stroke volume <10%. Targeting any one of these goals resulted in less postoperative complications (pooled data analysis: OR 0.53; CI95, 0.34-0.83; P=0.005) and a shorter length of intensive care unit/hospital stay, but no difference in postoperative mortality (pooled data analysis: OR 0.61; CI95, 0.33-1.11; P=0.12). This systematic review identified three goals for perioperative fluid administration, targeting of which appeared to be associated with less postoperative complications and shorter intensive care unit/hospital lengths of stay. Perioperative mortality remained unaffected.

Modeling of ablation threshold dependence on pulse duration for dielectrics with ultrashort pulsed laser

NASA Astrophysics Data System (ADS)

Sun, Mingying; Zhu, Jianqiang; Lin, Zunqi

2017-01-01

We present a numerical model of plasma formation in ultrafast laser ablation on the dielectrics surface. Ablation threshold dependence on pulse duration is predicted with the model and the numerical results for water agrees well with the experimental data for pulse duration from 140 fs to 10 ps. Influences of parameters and approximations of photo- and avalanche-ionization on the ablation threshold prediction are analyzed in detail for various pulse lengths. The calculated ablation threshold is strongly dependent on electron collision time for all the pulse durations. The complete photoionization model is preferred for pulses shorter than 1 ps rather than the multiphoton ionization approximations. The transition time of inverse bremsstrahlung absorption needs to be considered when pulses are shorter than 5 ps and it can also ensure the avalanche ionization (AI) coefficient consistent with that in multiple rate equations (MREs) for pulses shorter than 300 fs. The threshold electron density for AI is only crucial for longer pulses. It is reasonable to ignore the recombination loss for pulses shorter than 100 fs. In addition to thermal transport and hydrodynamics, neglecting the threshold density for AI and recombination could also contribute to the disagreements between the numerical and the experimental results for longer pulses.

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

Jackson, L.L.; Engleman, E.E.; Peard, J.L.

Sulfur was determined in plants and lichens by combustion of the sample and infrared detection of evolved sulfur dioxide using an automated sulfur analyzer. Vanadium pentaoxide was used as a combustion accelerator. Pelletization of the sample prior to combustion was not found to be advantageous. Washing studies showed that leaching of sulfur was not a major factor in the sample preparation. The combustion-IR analysis usually gave higher sulfur content than the turbidimetric analysis as well as shorter analysis time. Relative standard deviations of less than 7% were obtained by the combustion-IR technique when sulfur levels in plant material range frommore » 0.05 to 0.70%. Determination of sulfur in National Bureau of Standards botanical reference materials showed good agreement between the combustion-IR technique and other instrumental procedures. Seven NBS botanical reference materials were analyzed.« less

Pressurization and expulsion of a flightweight liquid hydrogen tank

NASA Technical Reports Server (NTRS)

Vandresar, N. T.; Stochl, R. J.

1993-01-01

Experimental results are presented for pressurization and expulsion of a flight-weight 4.89 cu m liquid hydrogen storage tank under normal gravity conditions. Pressurization and expulsion times are parametrically varied to study the effects of longer transfer times expected in future space flight applications. It is found that the increase in pressurant consumption with increased operational time is significant at shorter pressurization or expulsion durations and diminishes as the duration lengthens. Gas-to-wall heat transfer in the ullage is the dominant mode of energy exchange, with more than 50 percent of the pressurant energy being lost to tank wall heating in expulsions and the long duration pressurizations. Advanced data analysis will require a multidimensional approach combined with improved measurement capabilities of liquid-vapor interfacial transport phenomena.

Axisymmetric elastodynamic response from normal and radial impact of layered composites with embedded penny-shaped cracks

NASA Technical Reports Server (NTRS)

Sih, G. C.; Chen, E. P.

1980-01-01

A method is developed for the dynamic stress analysis of a layered composite containing an embedded penny-shaped crack and subjected to normal and radial impact. Quantitatively, the time-dependent stresses near the crack border can be described by the dynamic stress intensity factors. Their magnitude depends on time, on the material properties of the composite and on the relative size of the crack compared to the composite local geometry. Results obtained show that, for the same material properties and geometry of the composite, the dynamic stress intensity factors for an embedded (penny-shaped) crack reach their peak values within a shorter period of time and with a lower magnitude than the corresponding dynamic stress factors for a through-crack.

Three-dimensional printing enhances preparation for repair of double outlet right ventricular surgery.

PubMed

Zhao, Liyun; Zhou, Sijie; Fan, Taibing; Li, Bin; Liang, Weijie; Dong, Haoju

2018-01-01

To assess the clinical value of three-dimensional (3D) printing technology for treatment strategies for complex double outlet right ventricle (DORV). Twenty-five patients with complex double outlet right ventricle were enrolled in this study. The patients were divided into two groups: 3D printing group (eight patients) and a non-3-D printing control group (17 patients). The cardiac images of patients in the 3D printing group were transformed to Digital Imaging and Communications and were segmented and reconstructed to create a heart model. No cardiac models were created in the control group. A Pearson coefficient analysis was used to assess the correlation between measurements of 3D printed models and computed tomography angiography (CTA) data. Pre-operative assessment and planning were performed with 3D printed models, and then operative time and recovery time were compared between the two groups. There was good correlation (r = 0.977) between 3D printed models and CTA data. Patients in the 3D printing group had shorter aortic cross-clamp time (102.88 vs 127.76 min, P = 0.094) and cardiopulmonary bypass time (151.63 vs 184.24 min; P = 0.152) than patients in the control group. Patients with 3D printed models had significantly lower mechanical ventilation time (56.43 vs 96.76 h, P = 0.040) and significantly shorter intensive care unit time (99.04 vs 166.94 h, P = 0.008) than patients in the control group. 3D printed models can accurately demonstrate anatomic structures and are useful for pre-operative treatment strategies in DORV. © 2018 Wiley Periodicals, Inc.

Temperature analysis during bonding of brackets using LED or halogen light base units.

PubMed

Silva, Paulo César Gomes; De Fátima Zanirato Lizarelli, Rosane; Moriyama, Lílian Tan; De Toledo Porto Neto, Sizenando; Bagnato, Vanderlei Salvador

2005-02-01

The purpose of our investigation is to compare the intrapulpal temperature changes following blue LED system and halogen lamp irradiation at the enamel surface of permanent teeth. The fixation of brackets using composite resin is more comfortable and faster when using a photo-curable composite. Several light sources can be used: halogens, arc plasma, lasers, and recently blue LED systems. An important aspect to be observed during such a procedures is the temperature change. In this study, we have used nine human extracted permanent teeth: three central incisors, three lateral incisors, and three canines. Teeth were exposed to two light sources: blue LED system (preliminary commercial model LEC 470-II) and halogen lamp (conventional photo-cure equipment). The surface of teeth was exposed for 20, 40, and 60 sec at the buccal and lingual enamel surface with an angle of 45 degrees. Temperature values measured by a thermistor placed at pulpar chamber were read in time intervals of 1 sec. We obtained plots showing the temperature evolution as a function of time for each experiment. There is a correlation between heating quantity and exposition time of light source: with increasing exposition time, heating increases into the pulpal chamber. The halogen lamp showed higher heating than the LED system, which showed a shorter time of cooling than halogen lamp. The blue LED system seems like the indicated light source for photo-cure of composite resin during the bonding of brackets. The fixation of brackets using composite resin is more comfortable and faster when using a photo-curable composite. Blue LED equipment did not heat during its use. This could permit a shorter clinical time of operation and better performance.

Conventional versus traction-assisted endoscopic submucosal dissection for gastric neoplasms: a multicenter, randomized controlled trial (with video).

PubMed

Yoshida, Masao; Takizawa, Kohei; Suzuki, Sho; Koike, Yoshiki; Nonaka, Satoru; Yamasaki, Yasushi; Minagawa, Takeyoshi; Sato, Chiko; Takeuchi, Chihiro; Watanabe, Ko; Kanzaki, Hiromitsu; Morimoto, Hiroyuki; Yano, Takafumi; Sudo, Kosuke; Mori, Keita; Gotoda, Takuji; Ono, Hiroyuki

2018-05-01

The aim of this study was to clarify whether dental floss clip (DFC) traction improves the technical outcomes of endoscopic submucosal dissection (ESD). A superiority, randomized control trial was conducted at 14 institutions across Japan. Patients with single gastric neoplasm meeting the indications of the Japanese guidelines for gastric treatment were enrolled and assigned to receive conventional ESD or DFC traction-assisted ESD (DFC-ESD). Randomization was performed according to a computer-generated random sequence with stratification by institution, tumor location, tumor size, and operator experience. The primary endpoint was ESD procedure time, defined as the time from the start of the submucosal injection to the end of the tumor removal procedure. Between July 2015 and September 2016, 640 patients underwent randomization. Of these, 316 patients who underwent conventional ESD and 319 patients who underwent DFC-ESD were included in our analysis. The mean ESD procedure time was 60.7 and 58.1 minutes for conventional ESD and DFC-ESD, respectively (P = .45). Perforation was less frequent in the DFC-ESD group (2.2% vs .3%, P = .04). For lesions located in the greater curvature of the upper or middle stomach, the mean procedure time was significantly shorter in the DFC-ESD group (104.1 vs 57.2 minutes, P = .01). Our findings suggest that DFC-ESD does not result in shorter procedure time in the overall patient population, but it can reduce the risk of perforation. When selectively applied to lesions located in the greater curvature of the upper or middle stomach, DFC-ESD provides a remarkable reduction in procedure time. Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Flight contaminant trace analyser. Phase 1: Chromatographic input system

NASA Technical Reports Server (NTRS)

1975-01-01

The development of a chromatographic column capable of resolving compounds associated with spacecraft atmospheres is presented. Consideration is given to sampling techniques, column parameters and operation, and column interface with a mass spectrometer. A capillary column coated with a mixture of polyalkylene glycols is found to provide the best selectivity for resolving multicomponent mixtures found in spacecraft atmospheres. Temperature programming and isothermal operation of the column are evaluated and it is found that temperature programming has a shorter analysis time for a given carrier gas flow rate and overall superior resolution. It is observed that hydrogen provides a 15% savings in analysis time over helium. Following the optimization of column operational parameters, a mixed phase Ucon capillary is prepared for evaluation during the column test period in which the test sample is automatically analyzed. Analysis of the multicomponent test mixture is completed within 45 minutes provided temperature programming is used. All but two of the test compounds are well resolved.

A Blue Spectral Shift of the Hemoglobin Soret Band Correlates with the Age (Time Since Deposition) of Dried Bloodstains

PubMed Central

Hanson, Erin K.; Ballantyne, Jack

2010-01-01

The ability to determine the time since deposition of a bloodstain found at a crime scene could prove invaluable to law enforcement investigators, defining the time frame in which the individual depositing the evidence was present. Although various methods of accomplishing this have been proposed, none has gained widespread use due to poor time resolution and weak age correlation. We have developed a method for the estimation of the time since deposition (TSD) of dried bloodstains using UV-VIS spectrophotometric analysis of hemoglobin (Hb) that is based upon its characteristic oxidation chemistry. A detailed study of the Hb Soret band (λmax = 412 nm) in aged bloodstains revealed a blue shift (shift to shorter wavelength) as the age of the stain increases. The extent of this shift permits, for the first time, a distinction to be made between bloodstains that were deposited minutes, hours, days and weeks prior to recovery and analysis. The extent of the blue shift was found to be a function of ambient relative humidity and temperature. The method is extremely sensitive, requiring as little as a 1 µl dried bloodstain for analysis. We demonstrate that it might be possible to perform TSD measurements at the crime scene using a portable low-sample-volume spectrophotometer. PMID:20877468

Autoregressive modeling for the spectral analysis of oceanographic data

NASA Technical Reports Server (NTRS)

Gangopadhyay, Avijit; Cornillon, Peter; Jackson, Leland B.

1989-01-01

Over the last decade there has been a dramatic increase in the number and volume of data sets useful for oceanographic studies. Many of these data sets consist of long temporal or spatial series derived from satellites and large-scale oceanographic experiments. These data sets are, however, often 'gappy' in space, irregular in time, and always of finite length. The conventional Fourier transform (FT) approach to the spectral analysis is thus often inapplicable, or where applicable, it provides questionable results. Here, through comparative analysis with the FT for different oceanographic data sets, the possibilities offered by autoregressive (AR) modeling to perform spectral analysis of gappy, finite-length series, are discussed. The applications demonstrate that as the length of the time series becomes shorter, the resolving power of the AR approach as compared with that of the FT improves. For the longest data sets examined here, 98 points, the AR method performed only slightly better than the FT, but for the very short ones, 17 points, the AR method showed a dramatic improvement over the FT. The application of the AR method to a gappy time series, although a secondary concern of this manuscript, further underlines the value of this approach.

Clinical and molecular predictors of disease severity and survival in chronic lymphocytic leukemia.

PubMed

Weinberg, J Brice; Volkheimer, Alicia D; Chen, Youwei; Beasley, Bethany E; Jiang, Ning; Lanasa, Mark C; Friedman, Daphne; Vaccaro, Gina; Rehder, Catherine W; Decastro, Carlos M; Rizzieri, David A; Diehl, Louis F; Gockerman, Jon P; Moore, Joseph O; Goodman, Barbara K; Levesque, Marc C

2007-12-01

Several parameters may predict disease severity and overall survival in chronic lymphocytic leukemia (CLL). The purpose of our study of 190 CLL patients was to compare immunoglobulin heavy chain variable region (IgV(H)) mutation status, cytogenetic abnormalities, and leukemia cell CD38 and Zap-70 to older, traditional parameters. We also wanted to construct a simple, inexpensive prognosis score that would significantly predict TTT and survival in patients at the time of diagnosis and help practicing clinicians. In univariate analyses, patients with higher clinical stage, higher leukocyte count at diagnosis, shorter leukocyte doubling time, elevated serum lactate dehydrogenase (LDH), unmutated immunoglobulin heavy chain variable region (IgV(H)) genes, and higher CD38 had a shorter overall survival and time-to-treatment (TTT). CLL cell Zap-70 expression was higher in patients with unmutated IgV(H), and those with higher Zap-70 tended to have shorter survival. IgV(H)4-34 or IgV(H)1-69 was the most common IgV(H) genes used (16 and 12%, respectively). Of those with IgV(H)1-69, 86% had unmutated IgV(H) and had a significantly shorter TTT. A cytogenetic abnormality was noted in 71% of the patients tested. Patients with 11q22 del and 17p13 del or complex abnormalities were significantly more likely to have unmutated IgV(H). We found that a prognostic score constructed using modified Rai stage, cellular CD38, and serum LDH (parameters easily obtained clinically) significantly predicted TTT and survival in patients at the time of diagnosis and performed as well or better than models using the newer markers.

The Role of Prophylactic Endoscopic Sphincterotomy for Prevention of Postoperative Bile Leak in Hydatid Liver Disease: A Randomized Controlled Study.

PubMed

El-Gendi, Ahmed M; El-Shafei, Mohamed; Bedewy, Essam

2018-03-12

Bile leak is the main cause of morbidity and mortality after surgery for hydatid liver cysts. Aim was to assess the role of prophylactic endoscopic sphincterotomy (ES) in reducing postoperative bile leak in patients undergoing partial cystectomy. Fifty-four patients with hepatic hydatid cyst met inclusion criteria, 27 were excluded or declined to participate. Twenty-six women and 28 men (mean age 44.6 ± 10.1, range: 22-61 years) were randomly assigned to either group I with ES (n = 27) or group II without ES (n = 27). Demographics and clinical, laboratory, and radiological characteristics of cysts were not statistically different between two groups. Group I had a significant decrease in bile leak rate compared with group II (11.1% versus 40.7%, P = .013), with significantly shorter duration of hospital stay (P < .0001). Biliary fistula in group I had significantly lower daily output (100 mL/day versus 350 mL/day) with gradual reduction till stoppage of leak in 3-4 days without intervention. Biliary fistula in group II had a significantly higher need for biliary intervention through postoperative endoscopic retrograde cholangiopancreatography with ES compared with biliary fistula in group I ( FE P = .002), with significantly longer mean time of fistula closure (P = .011) and longer time to drain removal (P < .0001). Nonbiliary complications were comparable between two groups. Prophylactic ES provides significant reduction in postoperative bile leak rate with shorter hospital stay after partial cystectomy of hydatid cyst. Biliary fistula in patients with ES has significantly lower daily output with shorter time of drain removal and shorter time to closure than patients without ES.

Size-exclusion chromatography using core-shell particles.

PubMed

Pirok, Bob W J; Breuer, Pascal; Hoppe, Serafine J M; Chitty, Mike; Welch, Emmet; Farkas, Tivadar; van der Wal, Sjoerd; Peters, Ron; Schoenmakers, Peter J

2017-02-24

Size-exclusion chromatography (SEC) is an indispensable technique for the separation of high-molecular-weight analytes and for determining molar-mass distributions. The potential application of SEC as second-dimension separation in comprehensive two-dimensional liquid chromatography demands very short analysis times. Liquid chromatography benefits from the advent of highly efficient core-shell packing materials, but because of the reduced total pore volume these materials have so far not been explored in SEC. The feasibility of using core-shell particles in SEC has been investigated and contemporary core-shell materials were compared with conventional packing materials for SEC. Columns packed with very small core-shell particles showed excellent resolution in specific molar-mass ranges, depending on the pore size. The analysis times were about an order of magnitude shorter than what could be achieved using conventional SEC columns. Copyright © 2016 Elsevier B.V. All rights reserved.

Measuring the quality-of-life effects of diagnostic and screening tests.

PubMed

Swan, J Shannon; Miksad, Rebecca A

2009-08-01

Health-related quality of life (HRQL) is a central concept for understanding the outcomes of medical care. When used in cost-effectiveness analysis, HRQL is typically measured for conditions persisting over long time frames (years), and quality-adjusted life year (QALY) values are generated. Consequently, years are the basic unit of time for cost-effectiveness analysis results: dollars spent per QALY gained. However, shorter term components of health care may also affect HRQL, and there is increased interest in measuring and accounting for these events. In radiology, the short-term HRQL effects of screening and diagnostic testing may affect a test's cost-effectiveness, even though they may only last for days. The unique challenge in radiology HRQL assessment is to realistically tap into the testing and screening experience while remaining consistent with QALY theory. The authors review HRQL assessment and highlight methods developed to specifically address the short-term effects of radiologic screening and testing.

Transtheoretical Model Constructs for Physical Activity Behavior are Invariant across Time among Ethnically Diverse Adults in Hawaii

PubMed Central

Nigg, Claudio R; Motl, Robert W; Horwath, Caroline; Dishman, Rod K

2012-01-01

Objectives Physical activity (PA) research applying the Transtheoretical Model (TTM) to examine group differences and/or change over time requires preliminary evidence of factorial validity and invariance. The current study examined the factorial validity and longitudinal invariance of TTM constructs recently revised for PA. Method Participants from an ethnically diverse sample in Hawaii (N=700) completed questionnaires capturing each TTM construct. Results Factorial validity was confirmed for each construct using confirmatory factor analysis with full-information maximum likelihood. Longitudinal invariance was evidenced across a shorter (3-month) and longer (6-month) time period via nested model comparisons. Conclusions The questionnaires for each validated TTM construct are provided, and can now be generalized across similar subgroups and time points. Further validation of the provided measures is suggested in additional populations and across extended time points. PMID:22778669

Time from Prior Chemotherapy Enhances Prognostic Risk Grouping in the Second-line Setting of Advanced Urothelial Carcinoma: A Retrospective Analysis of Pooled, Prospective Phase 2 Trials

PubMed Central

Sonpavde, Guru; Pond, Gregory R.; Fougeray, Ronan; Choueiri, Toni K.; Qu, Angela Q.; Vaughn, David J.; Niegisch, Guenter; Albers, Peter; James, Nicholas D.; Wong, Yu-Ning; Ko, Yoo-Joung; Sridhar, Srikala S.; Galsky, Matthew D.; Petrylak, Daniel P.; Vaishampayan, Ulka N.; Khan, Awais; Vogelzang, Nicholas J.; Beer, Tomasz M.; Stadler, Walter M.; O’Donnell, Peter H.; Sternberg, Cora N.; Rosenberg, Jonathan E.; Bellmunt, Joaquim

2014-01-01

Background Outcomes for patients in the second-line setting of advanced urothelial carcinoma (UC) are dismal. The recognized prognostic factors in this context are Eastern Cooperative Oncology Group (ECOG) performance status (PS) >0, hemoglobin level (Hb) <10 g/dl, and liver metastasis (LM). Objectives The purpose of this retrospective study of prospective trials was to investigate the prognostic value of time from prior chemotherapy (TFPC) independent of known prognostic factors. Design, setting, and participants: Data from patients from seven prospective trials with available baseline TFPC, Hb, PS, and LM values were used for retrospective analysis (n = 570). External validation was conducted in a second-line phase 3 trial comparing best supportive care (BSC) versus vinflunine plus BSC (n = 352). Outcome measurements and statistical analysis Cox proportional hazards regression was used to evaluate the association of factors, with overall survival (OS) and progression-free survival (PFS) being the respective primary and secondary outcome measures. Results and limitations ECOG-PS >0, LM, Hb <10 g/dl, and shorter TFPC were significant prognostic factors for OS and PFS on multivariable analysis. Patients with zero, one, two, and three to four factors demonstrated median OS of 12.2, 6.7, 5.1, and 3.0 mo, respectively (concordance statistic = 0.638). Setting of prior chemotherapy (metastatic disease vs perioperative) and prior platinum agent (cisplatin or carboplatin) were not prognostic factors. External validation demonstrated a significant association of TFPC with PFS on univariable and most multivariable analyses, and with OS on univariable analyses. Limitations of retrospective analyses are applicable. Conclusions Shorter TFPC enhances prognostic classification independent of ECOG-PS>0, Hb<10 g/ dl, and LM in the setting of second-line therapy for advanced UC. These data may facilitate drug development and interpretation of trials. PMID:23206856

Quantitative contrast-enhanced ultrasonography for the differential diagnosis of endometrial hyperplasia and endometrial neoplasms

PubMed Central

Liu, Ying; Xu, Yi; Cheng, Wen; Liu, Xinghan

2016-01-01

The present study aimed to investigate the feasibility of applying contrast-enhanced ultrasonography (CEUS) imaging technology for distinguishing between benign and malignant endometrial lesions, and to screen markers that could be correlated with the pathological results. In this study, endometrial diseases were diagnosed by biopsy under hysteroscopy and CEUS examinations. The intensity and time parameters of the time-intensity curve (TIC) were analyzed. The mean arrival time (AT), time-to-peak (TTP), rise time (RT), washout half-time and clearance half-time of malignant lesions were shorter than those of benign lesions (P<0.05), whereas the average peak intensity (PI) and enhancement intensity (EI) of malignant lesions were higher than those of benign lesions (P<0.05). The receiver operating characteristic curve showed the following cut-off values: PI, 29.2 dB; EI, 21.35 dB; AT, 12.75 sec; TTP, 26.75 sec; RT, 13.2 sec; clearance half-time, 89.3 sec; and washout half-time, 75.45 sec. The lesions with PI, an EI higher than that of the cut-off and lesions with an AT, TTP, RT, half clearing time and washout half-time shorter than the cut-off were considered malignant. The TTP, RT and half clearing time were negatively correlated with microvessel density (MVD), i.e., MVD was higher when the TTP, RT and half clearing time were shorter. Overall, changes in the enhancement and clearing of lesions could be quantitatively analyzed by CEUS TIC and further discriminate benign from malignant lesions. In the present study, CEUS appeared to indirectly reflect blood vessel changes inside the lesions and provided a pre-operative non-invasive fast imaging method for the diagnosis of endometrial disease. PMID:27895728

Cardiovascular, respiratory and sedative effects of intramuscular alfaxalone, butorphanol and dexmedetomidine compared with ketamine, butorphanol and dexmedetomidine in healthy cats.

PubMed

Cremer, Jeannette; Riccó, Carolina H

2017-11-01

Objectives The aim of the study was to evaluate the cardiorespiratory effects, quality of sedation and recovery of intramuscular alfaxalone-dexmedetomidine-butorphanol (ADB) and ketamine-dexmedetomidine-butorphanol (KDB), in cats. Methods Nine adult, healthy cats (6.63 ± 1.42 kg) were enrolled in a blinded, randomized, crossover experimental design. Cats were sedated twice intramuscularly, once with ADB (alfaxalone 1 mg/kg, dexmedetomidine 0.005 mg/kg, butorphanol 0.2 mg/kg), and once with KDB (ketamine 5 mg/kg, dexmedetomidine 0.005 mg/kg, butorphanol 0.2 mg/kg), in random order. Data collected included heart rate (HR), arterial blood pressure and blood gas analysis, respiratory rate, and sedation score. Analysis of variance with Bonferroni post-hoc correction was used for parametric data, and a Wilcoxon signed rank test was used for non-parametric data. Significance was set at P <0.05. Results Total sedation time was shorter for ADB (90.71 ± 15.12 mins vs 147.00 ± 47.75 mins). Peak sedation was observed within 15 mins in both groups. Quality of recovery was excellent in both groups. HR decreased over time in both groups. Diastolic and mean arterial pressure decreased over time for ADB, becoming significant after 30 mins. All cardiovascular variables were within the clinically acceptable range in both groups. Arterial partial pressure of oxygen was significantly decreased from baseline for KDB at all time points (73 ± 2.5 mmHg [9.7 ± 0.3 kPa] vs ADB 83 ± 2.6 mmHg [11 ± 0.3 kPa]). Hypoventilation was not observed. Conclusions and relevance Both protocols produced acceptable cardiovascular stability. Sedation and recovery quality were good, albeit sedation was shorter with ADB. Although oxygenation was better maintained in the ADB group, all sedated cats should receive oxygen supplementation.

A refined reaction-diffusion model of tau-microtubule dynamics and its application in FDAP analysis.

PubMed

Igaev, Maxim; Janning, Dennis; Sündermann, Frederik; Niewidok, Benedikt; Brandt, Roland; Junge, Wolfgang

2014-12-02

Fluorescence decay after photoactivation (FDAP) and fluorescence recovery after photobleaching (FRAP) are well established approaches for studying the interaction of the microtubule (MT)-associated protein tau with MTs in neuronal cells. Previous interpretations of FDAP/FRAP data have revealed dwell times of tau on MTs in the range of several seconds. However, this is difficult to reconcile with a dwell time recently measured by single-molecule analysis in neuronal processes that was shorter by two orders of magnitude. Questioning the validity of previously used phenomenological interpretations of FDAP/FRAP data, we have generalized the standard two-state reaction-diffusion equations by 1), accounting for the parallel and discrete arrangement of MTs in cell processes (i.e., homogeneous versus heterogeneous distribution of tau-binding sites); and 2), explicitly considering both active (diffusion upon MTs) and passive (piggybacking upon MTs at rates of slow axonal transport) motion of bound tau. For some idealized cases, analytical solutions were derived. By comparing them with the full numerical solution and Monte Carlo simulations, the respective validity domains were mapped. Interpretation of our FDAP data (from processes of neuronally differentiated PC12 cells) in light of the heterogeneous formalism yielded independent estimates for the association (∼2 ms) and dwell (∼100 ms) times of tau to/on a single MT rather than in an MT array. The dwell time was shorter by orders of magnitude than that in a previous report where a homogeneous topology of MTs was assumed. We found that the diffusion of bound tau was negligible in vivo, in contrast to an earlier report that tau diffuses along the MT lattice in vitro. Methodologically, our results demonstrate that the heterogeneity of binding sites cannot be ignored when dealing with reaction-diffusion of cytoskeleton-associated proteins. Physiologically, the results reveal the behavior of tau in cellular processes, which is noticeably different from that in vitro. Copyright © 2014 Biophysical Society. Published by Elsevier Inc. All rights reserved.

Analysis for collapse behavior of resist pattern in short develop time process using atomic force microscope

NASA Astrophysics Data System (ADS)

Sanada, Masakazu; Tamada, Osamu; Ishikawa, Atsushi; Kawai, Akira

2005-05-01

Adhesion property of resist is characterized with DPAT (direct peeling with atomic force microscope (AFM) tip) method using 193 nm resist patterns of 180 nm dot shape which were developed for various developing time between 12 and 120 seconds in order to analyze the phenomenon which the short develop time process had led to suppress the pattern collapse. Surface free energy and refractive index of resist film treated with the developing time were also investigated from a thermodynamic point of view. The balance model among surface energy was adopted for analyzing intrusion phenomenon of developer solution into the resist-substrate interface. It can be explained quantitatively that the intrusion energy of developer solution acts to weaken the adhesion strength of resist pattern to the substrate. Furthermore, the intrusion energy became larger with increasing developing time. Analysis with the DPAT method indicates that the pattern collapse occurs accompanied with interface and cohesion destruction. Interface-scientifically speaking, the short develop time process proved to be effective to suppress the pattern collapse because of higher adhesion energy of the resist pattern to the substrate in shorter developing time.

Race walking gait and its influence on race walking economy in world-class race walkers.

PubMed

Gomez-Ezeiza, Josu; Torres-Unda, Jon; Tam, Nicholas; Irazusta, Jon; Granados, Cristina; Santos-Concejero, Jordan

2018-03-06

The aim of this study was to determine the relationships between biomechanical parameters of the gait cycle and race walking economy in world-class Olympic race walkers. Twenty-One world-class race walkers possessing the Olympic qualifying standard participated in this study. Participants completed an incremental race walking test starting at 10 km·h -1 , where race walking economy (ml·kg -1 ·km -1 ) and spatiotemporal gait variables were analysed at different speeds. 20-km race walking performance was related to race walking economy, being the fastest race walkers those displaying reduced oxygen cost at a given speed (R = 0.760, p < 0.001). Longer ground contact times, shorter flight times, longer midstance sub-phase and shorter propulsive sub-phase during stance were related to a better race walking economy (moderate effect, p < 0.05). According to the results of this study, the fastest race walkers were more economi cal than the lesser performers. Similarly, shorter flight times are associated with a more efficient race walking economy. Coaches and race walkers should avoid modifying their race walking style by increasing flight times, as it may not only impair economy, but also lead to disqualification.

Early maternal depressive symptoms and child growth trajectories: a longitudinal analysis of a nationally representative US birth cohort

PubMed Central

2014-01-01

Background Maternal depressive symptoms are negatively associated with early child growth in developing countries; however, few studies have examined this relation in developed countries or used a longitudinal design with data past the second year of the child’s life. We investigated if and when early maternal depressive symptoms affect average growth in young children up to age 6 in a nationally representative sample of US children. Methods Using data from 6,550 singleton births from the Early Childhood Longitudinal Study -- Birth Cohort (ECLS-B), we fit growth trajectory models with random effects to examine the relation between maternal depressive symptoms at 9 months based on the twelve-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) and child height and body mass index (BMI) to age 6 years. Results Mothers with moderate/severe depressive symptoms at 9 months postpartum had children with shorter stature at this same point in time [average 0.26 cm shorter; 95% CI: 5 cm, 48 cm] than mothers without depressive symptoms; children whose mothers reported postpartum depressive symptoms remained significantly shorter throughout the child’s first 6 years. Conclusions Results suggest that the first year postpartum is a critical window for addressing maternal depressive symptoms in order to optimize child growth. Future studies should investigate the role of caregiving and feeding practices as potential mechanisms linking maternal depressive symptoms and child growth trajectories. PMID:25047367

The combination matters - distinct impact of lifestyle factors on sperm quality: a study on semen analysis of 1683 patients according to MSOME criteria

PubMed Central

2012-01-01

Background Poor sperm quality can negatively affect embryonic development and IVF outcome. This study is aimed at investigating the influence of various lifestyle factors on semen quality according to MSOME (motile sperm organelle morphology examination) criteria. Methods 1683 male patients undergoing assisted reproductive technologies (ART) in our clinic were surveyed about their age, BMI (body mass index), ejaculation frequency, nutrition, sports, sleeping habits and social behavior. Semen samples were collected and evaluation of semen parameters according to MSOME and WHO criteria was performed. Results were grouped and statistically analyzed. Results Although single parameters had minor effects on sperm parameter, the combination of age, BMI, coffee intake, ejaculatory frequency and duration of sexual abstinence were identified as factors having a negative effect on sperm motility. Additionally, we could demonstrate that MSOME quality was reduced. The negative impact of age, BMI and coffee intake on sperm quality could be compensated if patients had a high ejaculation frequency and shorter periods of sexual abstinence. Conclusions Combinations of adverse lifestyle factors could have a detrimental impact on sperm, not only in terms of motility and sperm count but also in terms of sperm head vacuolization. This negative impact was shown to be compensated by higher ejaculation frequency and a shorter period of sexual abstinence. The compensation is most likely due to a shorter storage time in the male gonads, thus reducing the duration of sperms’ exposure to reactive oxygen species (ROS). PMID:23265183

GATA3 rs3824662 gene polymorphism as possible risk factor in a cohort of Egyptian patients with pediatric acute lymphoblastic leukemia and its prognostic impact.

PubMed

Mosaad, Youssef M; Elashery, Rasha; Darwish, Ahmad; Sharaf Eldein, Omar A; Barakat, Tarek; Marouf, Samy; Abou El-Khier, Noha T; Youssef, Laila F; Fawzy, Iman M

2017-03-01

To investigate the possible role of GATA3 rs3824662 polymorphism as risk factor for the development of acute lymphoblastic leukemia (ALL) in a cohort of Egyptian children and to evaluate its prognostic role. Typing of GATA3 rs3824662 polymorphism was done using real-time PCR for 116 patients with ALL and 273 healthy controls. The A allele and AA genotype were significantly higher in ALL patients (p = .015 and .016, respectively) especially B-ALL (p = .014 and .01, respectively). The AA genotype was associated with shorter disease free survival (DFS) in univariate (p = .017) and multivariate cox regression analysis (p = .028), increased incidence of relapse (p = .008) and poor prognosis (p = .028) in pediatric ALL. The GATA3 rs3824662 A allele and AA genotype may be risk factors for the development of pediatric ALL especially B-ALL in the studied cohort of Egyptian patients. The AA genotype is associated with shorter DSF, increased incidence of relapse and poor prognosis in pediatric ALL.

Associations between recreational walking and attractiveness, size, and proximity of neighborhood open spaces.

PubMed

Sugiyama, Takemi; Francis, Jacinta; Middleton, Nicholas J; Owen, Neville; Giles-Corti, Billie

2010-09-01

We examined associations of attractiveness, size, and proximity of multiple neighborhood open spaces (NOSs) with recreational walking. Adults participating in the Residential Environments (RESIDE) study (n=1366) in Perth, Australia, reported time spent engaging in recreational walking within their neighborhoods. Park audit data and geographic information systems were used to identify the most attractive, largest, and nearest NOS within a 1.6-km radius from each participant's residential location. Regression analysis was used to examine attributes (attractiveness, size, and proximity) of these open spaces and their associations with participants' recreational walking. Shorter distance to attractive open spaces was associated with doing any recreational walking, but adults with larger attractive open spaces within 1.6 km of their home were more likely to walk 150 minutes or more in a week. For adults, the presence of a large, high-quality park within walking distance of one's home may be more important in promoting sufficient amounts of walking for health benefits than is the presence of an open space within a shorter distance.

Short-term climate change impacts on Mara basin hydrology

NASA Astrophysics Data System (ADS)

Demaria, E. M.; Roy, T.; Valdés, J. B.; Lyon, B.; Valdés-Pineda, R.; Serrat-Capdevila, A.; Durcik, M.; Gupta, H.

2017-12-01

The predictability of climate diminishes significantly at shorter time scales (e.g. decadal). Both natural variability as well as sampling variability of climate can obscure or enhance climate change signals in these shorter scales. Therefore, in order to assess the impacts of climate change on basin hydrology, it is important to design climate projections with exhaustive climate scenarios. In this study, we first create seasonal climate scenarios by combining (1) synthetic precipitation projections generated from a Vector Auto-Regressive (VAR) model using the University of East Anglia Climate Research Unit (UEA-CRU) data with (2) seasonal trends calculated from 31 models in the Coupled Model Intercomparison Project Phase 5 (CMIP). The seasonal climate projections are then disaggregated to daily level using the Agricultural Modern-Era Retrospective Analysis for Research and Applications (AgMERRA) data. The daily climate data are then bias-corrected and used as forcings to the land-surface model, Variable Infiltration Capacity (VIC), to generate different hydrological projections for the Mara River basin in East Africa, which are then evaluated to study the hydrologic changes in the basin in the next three decades (2020-2050).

Associations Between Recreational Walking and Attractiveness, Size, and Proximity of Neighborhood Open Spaces

PubMed Central

Francis, Jacinta; Middleton, Nicholas J.; Owen, Neville; Giles-Corti, Billie

2010-01-01

Objectives. We examined associations of attractiveness, size, and proximity of multiple neighborhood open spaces (NOSs) with recreational walking. Methods. Adults participating in the Residential Environments (RESIDE) study (n = 1366) in Perth, Australia, reported time spent engaging in recreational walking within their neighborhoods. Park audit data and geographic information systems were used to identify the most attractive, largest, and nearest NOS within a 1.6-km radius from each participant's residential location. Regression analysis was used to examine attributes (attractiveness, size, and proximity) of these open spaces and their associations with participants’ recreational walking. Results. Shorter distance to attractive open spaces was associated with doing any recreational walking, but adults with larger attractive open spaces within 1.6 km of their home were more likely to walk 150 minutes or more in a week. Conclusions. For adults, the presence of a large, high-quality park within walking distance of one's home may be more important in promoting sufficient amounts of walking for health benefits than is the presence of an open space within a shorter distance. PMID:20634455

Low-energy laser in the treatment of alopecia of the scalp

NASA Astrophysics Data System (ADS)

Ciuchita, Tavi; Usurelu, Mircea; Antipa, Ciprian

1997-12-01

The authors tried to verify the efficacy of low energy laser (LEL) in scalp alopecia. Sixty patients were divided in two groups: A) laser group, 33 patients treated with both LEL and classical therapy; B) control group, 27 patients treated only with classical therapy, Before, during and after treatment, historical samples were done. For the group A the results were rather superior but in a twice shorter time shorter time than group B. The maintenance of the good results needed classical therapy for a long period. We conclude that LEL therapy could have a useful complementary method for the treatment of scalp alopecia.

Cyclical Annealing Technique To Enhance Reliability of Amorphous Metal Oxide Thin Film Transistors.

PubMed

Chen, Hong-Chih; Chang, Ting-Chang; Lai, Wei-Chih; Chen, Guan-Fu; Chen, Bo-Wei; Hung, Yu-Ju; Chang, Kuo-Jui; Cheng, Kai-Chung; Huang, Chen-Shuo; Chen, Kuo-Kuang; Lu, Hsueh-Hsing; Lin, Yu-Hsin

2018-02-26

This study introduces a cyclical annealing technique that enhances the reliability of amorphous indium-gallium-zinc-oxide (a-IGZO) via-type structure thin film transistors (TFTs). By utilizing this treatment, negative gate-bias illumination stress (NBIS)-induced instabilities can be effectively alleviated. The cyclical annealing provides several cooling steps, which are exothermic processes that can form stronger ionic bonds. An additional advantage is that the total annealing time is much shorter than when using conventional long-term annealing. With the use of cyclical annealing, the reliability of the a-IGZO can be effectively optimized, and the shorter process time can increase fabrication efficiency.

Palliation of clinical signs in 48 dogs with nasal carcinomas treated with coarse-fraction radiation therapy.

PubMed

Gieger, Tracy; Rassnick, Kenneth; Siegel, Sheri; Proulx, David; Bergman, Philip; Anderson, Christine; LaDue, Tracy; Smith, Annette; Northrup, Nicole; Roberts, Royce

2008-01-01

Data from 48 dogs with nasal carcinomas treated with palliative radiation therapy (PRT) were retrospectively reviewed. Factors potentially influencing resolution of clinical signs and survival after PRT were evaluated. Clinical signs completely resolved in 66% of dogs for a median of 120 days. The overall median survival time was 146 days. Duration of response to PRT was shorter in dogs that had clinical signs for <90 days before PRT. Survival times were shorter in dogs that had partial or no resolution of clinical signs after PRT than in dogs that had complete resolution of clinical signs.

Anterior Cervical Corpectomy with free vascularized fibular graft versus multilevel discectomy and grafting for Cervical Spondylotic Myelopathy

PubMed Central

Addosooki, Ahmad I; El-deen, Mohamed Alam

2015-01-01

Purpose A retrospective study to compare the radiologic and clinical outcomes of 2 different anterior approaches, multilevel anterior cervical discectomy with fusion (ACDF) using autologus ticortical bone graft versus anterior cervical corpectomy with fusion (ACCF) using free vascularized fibular graft (FVFG) for the management of cervical spondylotic myelopathy(CSM). Methods A total of 15 patients who underwent ACDF or ACCF using FVFG for multilevel CSM were divided into two groups. Group A (n = 7) underwent ACDF and group B (n = 8) ACCF. Clinical outcomes using Japanese Orthopaedic Association (JOA) score, perioperative parameters including operation time and hospital stay, radiological parameters including fusion rate and cervical lordosis, and complications were compared. Results Both group A and group B demonstrated significant increases in JOA scores. Patients who underwent ACDF experienced significantly shorter operation times and hospital stay. Both groups showed significant increases in postoperative cervical lordosis and achieved the same fusion rate (100 %). No major complications were encountered in both groups. Conclusion Both ACDF and ACCF using FVFG provide satisfactory clinical outcomes and fusion rates for multilevel CSM. However, multilevel ACDF is associated with better radiologic parameters, shorter hospital stay and shorter operative times. PMID:26767152

Using a Virtual Environment to Study Pedestrian Behaviors: How Does Time Pressure Affect Children's and Adults' Street Crossing Behaviors?

PubMed

Morrongiello, Barbara A; Corbett, Michael; Switzer, Jessica; Hall, Tom

2015-08-01

The aim of this study was to examine how crossing under time pressure influences the pedestrian behaviors of children and adults. Using a highly immersive virtual reality system interfaced with a 3D movement measurement system, various indices of children's and adults' crossing behaviors were measured under time-pressure and no time-pressure conditions. Pedestrians engaged in riskier crossing behaviors on time-pressure trials as indicated by appraising traffic for a shorter period before initiating their crossing, selecting shorter more hazardous temporal gaps to cross into, and having the car come closer to them (less time to spare). There were no age or sex differences in how time pressure affected crossing behaviors. The current findings indicate that, at all ages, pedestrians experience greater exposure to traffic dangers when they cross under time pressure. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Endovascular aortic sealing with Nellix reduces intraoperative radiation dose when compared to endovascular aortic repair.

PubMed

Ockert, Stefan; Heinrich, Mirjam; Kaufmann, Thomas; Syburra, Thomas; Lopez, Ruben; Seelos, Robert

2018-04-01

To analyze radiation exposure during endovascular aortic sealing (EVAS) in comparison with standard endovascular aortic repair (EVAR) in clinical practice. From December 2013 to October 2016 (35 months), 60 patients were analyzed for intraoperative radiation exposure during EVAR: 30 consecutive patients (mean age, 73.10 years; 28 male) received EVAS (Nellix Endologix); within the same time frame, 30 patients were treated with standard EVAR (mean age, 71.87 years; 30 male). An indirect dose analysis was performed for both groups of patients, including effective dose and cumulative air kerma. Furthermore, fluoroscopy time (FT), dose area product, and time of procedure were included in the study. The effective dose was significantly reduced in the EVAS group (3.72 mSv) compared with the group treated with standard EVAR (6.8 mSv; P ≤ .001). The cumulative air kerma was also lowered in EVAS (67.65 mGy vs 139 mGy in EVAR; P ≤ .001). FT for the entire group was 13 minutes and was shorter (P < .001) for EVAS (9 minutes) in comparison with EVAR (19 minutes). The dose area product for the entire cohort was 16.95 Gy.cm 2 and was lower during EVAS (12.4 Gy.cm 2 ) than during EVAR (22.6 Gy.cm 2 ; P < .001). The median operating time for the entire group was 123.5 minutes and was significantly shorter (P < .01) for EVAS (119 minutes vs EVAR at 132 minutes). The FT shows a significant correlation with the patient's weight (P = .022), body mass index (P = .004), and time of procedure (P = .005). EVAS is associated with a relevant decrease in indirect measured radiation dose and time of procedure compared with standard EVAR. A relevant reduction in dose during EVAS is highly likely to result in lower exposure to radiation for physicians and staff. Such a result would be highly advantageous and calls for further analysis. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

The Block V Receiver fast acquisition algorithm for the Galileo S-band mission

NASA Technical Reports Server (NTRS)

Aung, M.; Hurd, W. J.; Buu, C. M.; Berner, J. B.; Stephens, S. A.; Gevargiz, J. M.

1994-01-01

A fast acquisition algorithm for the Galileo suppressed carrier, subcarrier, and data symbol signals under low data rate, signal-to-noise ratio (SNR) and high carrier phase-noise conditions has been developed. The algorithm employs a two-arm fast Fourier transform (FFT) method utilizing both the in-phase and quadrature-phase channels of the carrier. The use of both channels results in an improved SNR in the FFT acquisition, enabling the use of a shorter FFT period over which the carrier instability is expected to be less significant. The use of a two-arm FFT also enables subcarrier and symbol acquisition before carrier acquisition. With the subcarrier and symbol loops locked first, the carrier can be acquired from an even shorter FFT period. Two-arm tracking loops are employed to lock the subcarrier and symbol loops parameter modification to achieve the final (high) loop SNR in the shortest time possible. The fast acquisition algorithm is implemented in the Block V Receiver (BVR). This article describes the complete algorithm design, the extensive computer simulation work done for verification of the design and the analysis, implementation issues in the BVR, and the acquisition times of the algorithm. In the expected case of the Galileo spacecraft at Jupiter orbit insertion PD/No equals 14.6 dB-Hz, R(sym) equals 16 symbols per sec, and the predicted acquisition time of the algorithm (to attain a 0.2-dB degradation from each loop to the output symbol SNR) is 38 sec.

Assessment of respiratory flow cycle morphology in patients with chronic heart failure.

PubMed

Garde, Ainara; Sörnmo, Leif; Laguna, Pablo; Jané, Raimon; Benito, Salvador; Bayés-Genís, Antoni; Giraldo, Beatriz F

2017-02-01

Breathing pattern as periodic breathing (PB) in chronic heart failure (CHF) is associated with poor prognosis and high mortality risk. This work investigates the significance of a number of time domain parameters for characterizing respiratory flow cycle morphology in patients with CHF. Thus, our primary goal is to detect PB pattern and identify patients at higher risk. In addition, differences in respiratory flow cycle morphology between CHF patients (with and without PB) and healthy subjects are studied. Differences between these parameters are assessed by investigating the following three classification issues: CHF patients with PB versus with non-periodic breathing (nPB), CHF patients (both PB and nPB) versus healthy subjects, and nPB patients versus healthy subjects. Twenty-six CHF patients (8/18 with PB/nPB) and 35 healthy subjects are studied. The results show that the maximal expiratory flow interval is shorter and with lower dispersion in CHF patients than in healthy subjects. The flow slopes are much steeper in CHF patients, especially for PB. Both inspiration and expiration durations are reduced in CHF patients, mostly for PB. Using the classification and regression tree technique, the most discriminant parameters are selected. For signals shorter than 1 min, the time domain parameters produce better results than the spectral parameters, with accuracies for each classification of 82/78, 89/85, and 91/89 %, respectively. It is concluded that morphologic analysis in the time domain is useful, especially when short signals are analyzed.

Intervention on Surgical Systemic-to-Pulmonary Artery Shunts: Carotid Versus Femoral Access.

PubMed

Ligon, R Allen; Ooi, Yinn K; Kim, Dennis W; Vincent, Robert N; Petit, Christopher J

2017-09-11

The purpose of this study was to compare results between the femoral arterial (FA) and carotid arterial (CA) approaches in catheter-based interventions on Blalock-Taussig shunts (BTS). Transcatheter intervention on BTS is often performed in shunt-dependent, hypoxemic infants. The approach to BTS intervention likely has an impact on timeliness and overall success. The authors reviewed all cases of catheter intervention for BTS obstruction between 2012 and 2017 for their institution. They sought to compare procedural success rates and time, sheath time, time to arterial access, and time from access to stent implantation between FA and CA approaches. There were 42 BTS interventions between 34 patients. BTS intervention was more successful from the CA approach (p = 0.035). Among the FA cohort, BTS intervention was unsuccessful in 8 cases (25%), 5 of which were converted to CA with subsequent success. The CA cohort had lower procedure time (62 min vs. 104 min; p = 0.01) and anesthesia time (119 min vs. 151 min; p = 0.01). Additionally, CA access was associated with shorter time to arterial access (4.0 min vs. 9.3 min; p < 0.01), time to placement of the guidewire through the BTS (6.5 min vs. 13 min; p < 0.01), and time from the final sheath to BTS stent implantation (9 min vs. 20 min; p < 0.01). Operators should consider the route of access to the BTS deliberately. The authors' approach has been the carotid artery as an alternative access site-associated with greater procedural success, shorter procedural time, and shorter time to stent implantation. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

An Ultrathin Endoscope with a 2.4-mm Working Channel Shortens the Esophagogastroduodenoscopy Time by Shortening the Suction Time

PubMed Central

Shinozaki, Satoshi; Miura, Yoshimasa; Ino, Yuji; Shinozaki, Kenjiro; Lefor, Alan Kawarai; Yamamoto, Hironori

2015-01-01

Background/Aims: Poor suction ability through a narrow working channel prolongs esophagogastroduodenoscopy (EGD). The aim of this study was to evaluate suction with a new ultrathin endoscope (EG-580NW2; Fujifilm Corp.) having a 2.4-mm working channel in clinical practice. Methods: To evaluate in vitro suction, 200 mL water was suctioned and the suction time was measured. The clinical data of 117 patients who underwent EGD were retrospectively reviewed on the basis of recorded video, and the suction time was measured by using a stopwatch. Results: In vitro, the suction time with the EG-580NW2 endoscope was significantly shorter than that with the use of an ultrathin endoscope with a 2.0-mm working channel (EG-580NW; mean ± standard deviation, 22.7±1.1 seconds vs. 34.7±2.2 seconds; p<0.001). We analyzed the total time and the suction time for routine EGD in 117 patients (50 in the EG-580NW2 group and 67 in the EG-580NW group). In the EG-580NW2 group, the total time for EGD was significantly shorter than that in the EG-580NW group (275.3±42.0 seconds vs. 300.6±46.5 seconds, p=0.003). In the EG-580NW2 group, the suction time was significantly shorter than that in the EG-580NW group (19.2±7.6 seconds vs. 38.0±15.9 seconds, p<0.001). Conclusions: An ultrathin endoscope with a 2.4-mm working channel considerably shortens the routine EGD time by shortening the suction time, in comparison with an endoscope with a 2.0-mm working channel. PMID:26668798

Quantifying short-lived events in multistate ionic current measurements.

PubMed

Balijepalli, Arvind; Ettedgui, Jessica; Cornio, Andrew T; Robertson, Joseph W F; Cheung, Kin P; Kasianowicz, John J; Vaz, Canute

2014-02-25

We developed a generalized technique to characterize polymer-nanopore interactions via single channel ionic current measurements. Physical interactions between analytes, such as DNA, proteins, or synthetic polymers, and a nanopore cause multiple discrete states in the current. We modeled the transitions of the current to individual states with an equivalent electrical circuit, which allowed us to describe the system response. This enabled the estimation of short-lived states that are presently not characterized by existing analysis techniques. Our approach considerably improves the range and resolution of single-molecule characterization with nanopores. For example, we characterized the residence times of synthetic polymers that are three times shorter than those estimated with existing algorithms. Because the molecule's residence time follows an exponential distribution, we recover nearly 20-fold more events per unit time that can be used for analysis. Furthermore, the measurement range was extended from 11 monomers to as few as 8. Finally, we applied this technique to recover a known sequence of single-stranded DNA from previously published ion channel recordings, identifying discrete current states with subpicoampere resolution.

The Role of Bolus Injection of Saline with Arm Elevation on Rocuronium onset Time: A Randomized Control Study

PubMed Central

Kulkarni, Malavika; Chuchendra, L. S.; Bhavya, P. J.

2018-01-01

Background: The onset time of neuromuscular blockade is a crucial time associated with the risk of hypoxia and pulmonary aspiration. Various strategies have been undertaken to shorten this onset time. Therefore, we investigated the effects of bolus of 20 ml saline followed by limb elevation after administration of rocuronium in a dose of 0.6 mg/kg to study the onset time. Methodology: Thirty patients were randomly allocated to the bolus saline group or control group. General anesthesia was induced and maintained with fentanyl and propofol. Rocuronium 0.6 mg/kg intravenous (IV) was administered followed by 20 ml saline bolus and limb elevation in the study group compared to administration of 0.6 mg/kg in a running drip only in the control. Onset of neuromuscular block was assessed by acceleromyography at the adductor pollicis muscle with train-of-four stimulation. Results: The lag time was shorter in bolus group (34 s median) than in control group (45 s median), P < 0.017. The onset time was shorter in bolus group (55 s median) than in control group (110 s median), P < 0.001. The T1 recovery to 25% was longer in bolus group (42 min median) than in control group (39 min median) which was statistically not significant. Conclusion: Rocuronium 0.6 mg/kg IV followed by bolus 20 ml saline and concomitant limb elevation resulted in shorter lag time, faster onset of neuromuscular blockade, good intubating conditions without prolonging clinical duration of action when compared to the control. PMID:29628555

Independence of reaction time and response force control during isometric leg extension.

PubMed

Fukushi, Tamami; Ohtsuki, Tatsuyuki

2004-04-01

In this study, we examined the relative control of reaction time and force in responses of the lower limb. Fourteen female participants (age 21.2 +/- 1.0 years, height 1.62 +/- 0.05 m, body mass 54.1 +/- 6.1 kg; mean +/- s) were instructed to exert their maximal isometric one-leg extension force as quickly as possible in response to an auditory stimulus presented after one of 13 foreperiod durations, ranging from 0.5 to 10.0 s. In the 'irregular condition' each foreperiod was presented in random order, while in the 'regular condition' each foreperiod was repeated consecutively. A significant interactive effect of foreperiod duration and regularity on reaction time was observed (P < 0.001 in two-way ANOVA with repeated measures). In the irregular condition the shorter foreperiod induced a longer reaction time, while in the regular condition the shorter foreperiod induced a shorter reaction time. Peak amplitude of isometric force was affected only by the regularity of foreperiod and there was a significant variation of changes in peak force across participants; nine participants were shown to significantly increase peak force for the regular condition (P < 0.001), three to decrease it (P < 0.05) and two showed no difference. These results indicate the independence of reaction time and response force control in the lower limb motor system. Variation of changes in peak force across participants may be due to the different attention to the bipolar nature of the task requirements such as maximal force and maximal speed.

2D projection-based software application for mobile C-arms optimises wire placement in the proximal femur - An experimental study.

PubMed

Swartman, B; Frere, D; Wei, W; Schnetzke, M; Beisemann, N; Keil, H; Franke, J; Grützner, P A; Vetter, S Y

2017-10-01

A new software application can be used without fixed reference markers or a registration process in wire placement. The aim was to compare placement of Kirschner wires (K-wires) into the proximal femur with the software application versus the conventional method without guiding. As study hypothesis, we assumed less placement attempts, shorter procedure time and shorter fluoroscopy time using the software. The same precision inside a proximal femur bone model using the software application was premised. The software detects a K-wire within the 2D fluoroscopic image. By evaluating its direction and tip location, it superimposes a trajectory on the image, visualizing the intended direction of the K-wire. The K-wire was positioned in 20 artificial bones with the use of software by one surgeon; 20 bones served as conventional controls. A brass thumb tack was placed into the femoral head and its tip targeted with the wire. Number of placement attempts, duration of the procedure, duration of fluoroscopy time and distance to the target in a postoperative 3D scan were recorded. Compared with the conventional method, use of the application showed fewer attempts for optimal wire placement (p=0.026), shorter duration of surgery (p=0.004), shorter fluoroscopy time (p=0.024) and higher precision (p=0.018). Final wire position was achieved in the first attempt in 17 out of 20 cases with the software and in 9 out of 20 cases with the conventional method. The study hypothesis was confirmed. The new application optimised the process of K-wire placement in the proximal femur in an artificial bone model while also improving precision. Benefits lie especially in the reduction of placement attempts and reduction of fluoroscopy time under the aspect of radiation protection. The software runs on a conventional image intensifier and can therefore be easily integrated into the daily surgical routine. Copyright © 2017 Elsevier Ltd. All rights reserved.

A single center analysis of factors influencing study start-up timeline in clinical trials.

PubMed

Krafcik, Brianna M; Doros, Gheorghe; Malikova, Marina A

2017-11-01

Efficient start-up phase in clinical trials is crucial to execution. The goal was to determine factors contributing to delays. The start-up milestones were assessed for 38 studies and analyzed. Total start-up time was shorter for following studies: device trials, no outsourcing, fewer ancillary services used and in interventional versus observational designs. The use of a centralized Institutional Review Board (IRB) versus a local IRB reduced time to approval. Studies that never enrolled took longer on average to finalize their budget/contract, and obtain IRB than ones that did enroll. Different features of clinical trials can affect timeline of start-up process. An understanding of the impact of each feature allows for optimization.

Identifying high frequency signals in the daily swath mascon solutions from GRACE

NASA Astrophysics Data System (ADS)

Save, H.

2016-12-01

The Gravity Recovery and Climate Experiment (GRACE) mission has provided us with unique information about the total water column in the Earth system over the past 14 years. The GRACE project provides a monthly mean time-variable gravity solution. There has been significant progress in the community over the years to develop shorter time-window gravity solutions. The daily swath mascon solutions, which are under development at the Center for Space Research (CSR), are computed using daily GRACE observation data. This paper discusses the development and the progress of this product. This paper summarizes the analysis of these solutions with special emphasis on identifying the higher frequency natural processes observed by GRACE using these daily swath mascon solutions.

Dedicated Pediatricians in Emergency Department: Shorter Waiting Times and Lower Costs

PubMed Central

Melo, Manuel Rocha; Ferreira-Magalhães, Manuel; Flor-Lima, Filipa; Rodrigues, Mariana; Severo, Milton; Almeida-Santos, Luis; Caldas-Afonso, Alberto; Barros, Pedro Pita; Ferreira, António

2016-01-01

Background Dedicated pediatricians in emergency departments (EDs) may be beneficial, though no previous studies have assessed the related costs and benefits/harms. We aimed to evaluate the net benefits and costs of dedicated emergency pediatricians in a pediatric ED. Methods Cost-consequences analysis of visits to a pediatric ED of a tertiary hospital. Two pediatric ED Medical Teams (MT) were compared: MT-A (May–September 2012), with general pediatrics physicians only; and MT-B (May–September 2013), with emergency dedicated pediatricians. The main outcomes analyzed were relevant clinical outcomes, patient throughput time and costs. Results We included 8,694 children in MT-A and 9,417 in MT-B. Medication use in the ED increased from 42.3% of the children in MT-A to 49.6% in MT-B; diagnostic tests decreased from 24.2% in MT-A to 14.3% in MT-B. Hospitalization increased from 1.3% in MT-A to 3.0% in MT-B; however, there was no significant difference in diagnosis-related group relative weight of hospitalized children in MT-A and MT-B (MT-A, 0.979; MT-B, 1.075). No differences were observed in ED readmissions or in patients leaving without being seen by a physician. The patient throughput time was significantly shorter in MT-B, with faster times to first medical observation. Within the cost domains analyzed, the total expenditures per children observed in the ED were 16% lower in MT-B: 37.87 euros in MT-A; 31.97 euros in MT-B. Conclusion The presence of dedicated emergency pediatricians in a pediatric ED was associated with significantly lower waiting times in the ED, reduced costs, and similar clinical outcomes. PMID:27564093

[Coronary artery bypass grafting without use of cardiopulmonary bypass].

PubMed

Mujanović, Emir; Bergsland, Jacob; Hadziselimović, Mehdin; Softić, Muniba; Azabagic, Azur; Stanimirović-Mujanović, Sanja; Kabil, Emir

2002-01-01

Although it is possible to find a number of comparative studies in the world literature discussing the results of coronary artery bypass surgery (CABG) with and without cardiopulmonary bypass (CPB), until now such analysis has not been made in Bosnia and Herzegovina. The main aim of this scientific work was to compare morbidity and mortality, need for blood transfusions, length of stay in the intensive care unit and total length of hospitalisation in two groups of patients operated with these methods. One hundred and four patients with coronary artery disease operated in Cardiovascular Clinic Tuzla, from September, 1998 to September 2002 divided in two groups, were included in this study. There were 52 patients in the first group operated with CPB and 52 patients in the second group operated without CPB. The groups were matched for gender, age, ejection fraction and preoperative risk factors. The incidence of postoperative complications was lower in patients operated without CPB (5.77% vs. 21.15%). The mortality rate was reduced in patients operated without CPB (0.00% vs. 5.76%). There were reduced need for transfusion in patients operated without CPB (0.28 vs. 1.11 units of blood). The average time spent on respirators was shorter in patients operated without CPB (1.50 vs. 4.76 hours). The average time of total hospitalisation was also shorter in patients operated withouth CPB (6.53 vs. 8.13 days). In conclusion CABG without CPB has many advantages compared to the conventional method. Mortality and morbidity are reduced and there is less need for transfusion. The time spent on mechanical ventilation is reduced and less time is spent in intensive care and the total hospitalisation time is also less.

Cross-sectional Internet-based survey of Japanese permanent daytime workers' sleep and daily rest periods.

PubMed

Ikeda, Hiroki; Kubo, Tomohide; Sasaki, Takeshi; Liu, Xinxin; Matsuo, Tomoaki; So, Rina; Matsumoto, Shun; Yamauchi, Takashi; Takahashi, Masaya

2018-05-25

This study aimed to describe the sleep quantity, sleep quality, and daily rest periods (DRPs) of Japanese permanent daytime workers. Information about the usual DRP, sleep quantity, and sleep quality (Japanese version of the Pittsburgh Sleep Quality Index: PSQI-J) of 3,867 permanent daytime workers in Japan was gathered through an Internet-based survey. This information was analyzed and divided into the following eight DRP groups: <10, 10, 11, 12, 13, 14, 15, and ≥16 h. The sleep durations for workers in the <10, 10, 11, 12, 13, 14, 15, and ≥16 h DRP groups were found to be 5.3, 5.9, 6.1, 6.3, 6.5, 6.7, 6.7, and 6.9 h, respectively. The trend analysis revealed a significant linear trend as the shorter the DRP, the shorter was the sleep duration. The PSQI-J scores for the <10, 10, 11, 12, 13, 14, 15, and ≥16 h DRP groups were 7.1, 6.7, 6.7, 6.3, 6.0 (5.999), 5.6, 5.2, and 5.2, respectively. The trend analysis revealed a significant linear trend as the shorter the DRP, the lower was the sleep quality. This study described sleep quantity, sleep quality, and DRP in Japanese daytime workers. It was found that a shorter DRP was associated with poorer sleep quantity as well as quality.

Optimization and parallelization of the thermal–hydraulic subchannel code CTF for high-fidelity multi-physics applications

DOE PAGES

Salko, Robert K.; Schmidt, Rodney C.; Avramova, Maria N.

2014-11-23

This study describes major improvements to the computational infrastructure of the CTF subchannel code so that full-core, pincell-resolved (i.e., one computational subchannel per real bundle flow channel) simulations can now be performed in much shorter run-times, either in stand-alone mode or as part of coupled-code multi-physics calculations. These improvements support the goals of the Department Of Energy Consortium for Advanced Simulation of Light Water Reactors (CASL) Energy Innovation Hub to develop high fidelity multi-physics simulation tools for nuclear energy design and analysis.

Derivation of Continuum Models from An Agent-based Cancer Model: Optimization and Sensitivity Analysis.

PubMed

Voulgarelis, Dimitrios; Velayudhan, Ajoy; Smith, Frank

2017-01-01

Agent-based models provide a formidable tool for exploring complex and emergent behaviour of biological systems as well as accurate results but with the drawback of needing a lot of computational power and time for subsequent analysis. On the other hand, equation-based models can more easily be used for complex analysis in a much shorter timescale. This paper formulates an ordinary differential equations and stochastic differential equations model to capture the behaviour of an existing agent-based model of tumour cell reprogramming and applies it to optimization of possible treatment as well as dosage sensitivity analysis. For certain values of the parameter space a close match between the equation-based and agent-based models is achieved. The need for division of labour between the two approaches is explored. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Does Wait-List Size at Registration Influence Time to Surgery? Analysis of a Population-Based Cardiac Surgery Registry

PubMed Central

Sobolev, Boris; Levy, Adrian; Hayden, Robert; Kuramoto, Lisa

2006-01-01

Objective To determine whether the probability of undergoing coronary bypass surgery within a certain time was related to the number of patients on the wait list at registration for the operation in a publicly funded health system. Methods A prospective cohort study comparing waiting times among patients registered on wait lists at the hospitals delivering adult cardiac surgery. For each calendar week, the list size, the number of new registrations, and the number of direct admissions immediately after angiography characterized the demand for surgery. Results The length of delay in undergoing treatment was associated with list size at registration, with shorter times for shorter lists (log-rank test 1,198.3, p<.0001). When the list size at registration required clearance time over 1 week patients had 42 percent lower odds of undergoing surgery compared with lists with clearance time less than 1 week (odds ratio [OR] 0.58 percent, 95 percent, confidence interval [CI] 0.53–0.63), after adjustment for age, sex, comorbidity, period, and hospital. The weekly number of new registrations exceeding weekly service capacity had an independent effect toward longer service delays when the list size at registration required clearance time less than 1 week (OR 0.56 percent, 95 percent CI 0.45–0.71), but not for longer lists. Every time the operation was performed for a patient requiring surgery without registration on wait lists, the odds of surgery for listed patients were reduced by 6 percent (OR 0.94, CI 0.93–0.95). Conclusion For wait-listed patients, time to surgery depends on the list size at registration, the number of new registrations, as well as on the weekly number of patients who move immediately from angiography to coronary bypass surgery without being registered on a wait list. Hospital managers may use these findings to improve resource planning and to reduce uncertainty when providing advice on expected treatment delays. PMID:16430599

Exercise to improve sleep in insomnia: exploration of the bidirectional effects.

PubMed

Baron, Kelly Glazer; Reid, Kathryn J; Zee, Phyllis C

2013-08-15

Exercise improves sleep quality, mood, and quality of life among older adults with insomnia. The purpose of the study was to evaluate the daily bidirectional relationships between exercise and sleep in a sample of women with insomnia. Participants included 11 women (age M = 61.27, SD 4.15) with insomnia who engaged in 30 min of aerobic exercise 3 times per week. Self-reported sleep quality was assessed at baseline and at 16 weeks. Sleep and exercise logs and wrist activity were collected continuously. Sleep variables included subjective sleep quality and objective measures recorded via wrist actigraphy (sleep onset latency [SOL], total sleep time [TST], sleep efficiency [SE], wake after sleep onset [WASO], and fragmentation index [FI]). Age, subjective sleep quality, TST, SOL, and physical fitness at baseline were tested as moderators of the daily effects. TST, SE, and self-reported global sleep quality improved from baseline to 16 weeks (p values < 0.05). Baseline ratings of sleepiness were negatively correlated with exercise session duration (p < 0.05). Daily exercise was not associated with subjective or objective sleep variables during the corresponding night. However, participants had shorter exercise duration following nights with longer SOL (p < 0.05). TST at baseline moderated the daily relationship between TST and next day exercise duration (p < 0.05). The relationship between shorter TST and shorter next day exercise was stronger in participants who had shorter TST at baseline. Results suggest that sleep influences next day exercise rather than exercise influencing sleep. The relationship between TST and next day exercise was stronger for those with shorter TST at baseline. These results suggest that improving sleep may encourage exercise participation.

Effect of gum chewing on reducing postoperative ileus and recovery after colorectal surgery: A randomised controlled trial.

PubMed

Topcu, Sacide Yildizeli; Oztekin, Seher Deniz

2016-05-01

This study aimed to determine the effect of gum chewing on the reduction of postoperative ileus and recovery after surgery. This study was conducted a randomized controlled trial in 60 patients who underwent colorectal surgery between November 2011 and December 2012. Patients in the experimental group chewed gum three times a day. The time of flatus and defecation, the time to start feeding, pain levels and time of discharge were monitored. Post-surgery results for gum-chewing were first flatus and defecation times and the time to start feeding was shorter; pain levels were lower on the 3rd - 5th days; patients were discharged in a shorter time post-surgery. Chewing gum is a simple intervention for reducing postoperative ileus after colorectal surgery. Further studies that examine the effectiveness of gum chewing on other surgical interventions in which the development risk of postoperative ileus should be performed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluation of arm-leg coordination in flat breaststroke.

PubMed

Chollet, D; Seifert, L; Leblanc, H; Boulesteix, L; Carter, M

2004-10-01

This study proposes a new method to evaluate arm-leg coordination in flat breaststroke. Five arm and leg stroke phases were defined with a velocity-video system. Five time gaps quantified the time between arm and leg actions during three paces of a race (200 m, 100 m and 50 m) in 16 top level swimmers. Based on these time gaps, effective glide, effective propulsion, effective leg insweep and effective recovery were used to identify the different stroke phases of the body. A faster pace corresponded to increased stroke rate, decreased stroke length, increased propulsive phases, shorter glide phases, and a shorter T1 time gap, which measured the effective body glide. The top level swimmers showed short time gaps (T2, T3, T4, measuring the timing of arm-leg recoveries), which reflected the continuity in arm and leg actions. The measurement of these time gaps thus provides a pertinent evaluation of swimmers' skill in adapting their arm-leg coordination to biomechanical constraints.

Prior topical anesthesia reduces time to full cycloplegia in Chinese.

PubMed

Siu, A W; Sum, A C; Lee, D T; Tam, K W; Chan, S W

1999-01-01

To investigate the effect of prior anesthesia on the time to full cycloplegia in young Chinese subjects. The amplitude of accommodation was monitored over a 50-minute interval after the application of 1% cyclopentolate hydrochloride with a pretreatment of 0.4% benoxinate (oxybuprocaine) or 0.9% saline solution (control). Using a nonlinear mathematical model, the rate of accommodative loss (k) and the time required for 95% of total cycloplegia (T95%) were determined. Statistical analysis revealed a significantly faster rate of accommodative loss (P < .0001) after prior anesthesia (0.129 +/- 0.05) compared with the controls (0.103 +/- 0.04). T95% was noted at 26.43 +/- 10.22 minutes after prior anesthesia, which was significantly shorter (P < .0001) than that after the saline treatment (35.28 +/- 16.51 minutes). Prior application of topical anesthetic can shorten the time to full cycloplegia for people, such as the Chinese, with dark irides.

Nonlinear Landau damping in the ionosphere

NASA Technical Reports Server (NTRS)

Kiwamoto, Y.; Benson, R. F.

1978-01-01

A model is presented to explain the non-resonant waves which give rise to the diffuse resonance observed near 3/2 f sub H by the Alouette and ISIS topside sounders, where f sub H is the ambient electron cyclotron frequency. In a strictly linear analysis, these instability driven waves will decay due to Landau damping on a time scale much shorter than the observed time duration of the diffuse resonance. Calculations of the nonlinear wave particle coupling coefficients, however, indicate that the diffuse resonance wave can be maintained by the nonlinear Landau damping of the sounder stimulated 2f sub H wave. The time duration of the diffuse resonance is determined by the transit time of the instability generated and nonlinearly maintained diffuse resonance wave from the remote short lived hot region back to the antenna. The model is consistent with the Alouette/ISIS observations, and clearly demonstrates the existence of nonlinear wave-particle interactions in the ionosphere.

Biochip for Real-Time Monitoring of Hepatitis B Virus (HBV) by Combined Loop-Mediated Isothermal Amplification and Solution-Phase Electrochemical Detection

NASA Astrophysics Data System (ADS)

Tien, Bui Quang; Ngoc, Nguyen Thy; Loc, Nguyen Thai; Thu, Vu Thi; Lam, Tran Dai

2017-06-01

Accurate in situ diagnostic tests play a key role in patient management and control of most infectious diseases. To achieve this, use of handheld biochips that implement sample handling, sample analysis, and result readout together is an ideal approach. We present herein a fluid-handling biochip for real-time electrochemical monitoring of nucleic acid amplification based on loop-mediated isothermal amplification and real-time electrochemical detection on a microfluidic platform. Intercalation between amplifying DNA and free redox probe in solution phase was used to monitor the number of DNA copies. The whole diagnostic process is completed within 70 min. Our platform offers a fast and easy tool for quantification of viral pathogens in shorter time and with limited risk of all potential forms of cross-contamination. Such diagnostic tools have potential to make a huge difference to the lives of millions of people worldwide.

A time dependent difference theory for sound propagation in ducts with flow. [characteristic of inlet and exhaust ducts of turbofan engines

NASA Technical Reports Server (NTRS)

Baumeister, K. J.

1979-01-01

A time dependent numerical solution of the linearized continuity and momentum equation was developed for sound propagation in a two dimensional straight hard or soft wall duct with a sheared mean flow. The time dependent governing acoustic difference equations and boundary conditions were developed along with a numerical determination of the maximum stable time increments. A harmonic noise source radiating into a quiescent duct was analyzed. This explicit iteration method then calculated stepwise in real time to obtain the transient as well as the steady state solution of the acoustic field. Example calculations were presented for sound propagation in hard and soft wall ducts, with no flow and plug flow. Although the problem with sheared flow was formulated and programmed, sample calculations were not examined. The time dependent finite difference analysis was found to be superior to the steady state finite difference and finite element techniques because of shorter solution times and the elimination of large matrix storage requirements.

PTEN Loss as Determined by Clinical-grade Immunohistochemistry Assay Is Associated with Worse Recurrence-free Survival in Prostate Cancer

PubMed Central

Lotan, Tamara L.; Wei, Wei; Morais, Carlos L.; Hawley, Sarah T.; Fazli, Ladan; Hurtado-Coll, Antonio; Troyer, Dean; McKenney, Jesse K.; Simko, Jeffrey; Carroll, Peter R.; Gleave, Martin; Lance, Raymond; Lin, Daniel W.; Nelson, Peter S.; Thompson, Ian M.; True, Lawrence D.; Feng, Ziding; Brooks, James D.

2015-01-01

Background PTEN is the most commonly deleted tumor suppressor gene in primary prostate cancer (PCa) and its loss is associated with poor clinical outcomes and ERG gene rearrangement. Objective We tested whether PTEN loss is associated with shorter recurrence-free survival (RFS) in surgically treated PCa patients with known ERG status. Design, setting, and participants A genetically validated, automated PTEN immunohistochemistry (IHC) protocol was used for 1275 primary prostate tumors from the Canary Foundation retrospective PCa tissue microarray cohort to assess homogeneous (in all tumor tissue sampled) or heterogeneous (in a subset of tumor tissue sampled) PTEN loss. ERG status as determined by a genetically validated IHC assay was available for a subset of 938 tumors. Outcome measurements and statistical analysis Associations between PTEN and ERG status were assessed using Fisher’s exact test. Kaplan-Meier and multivariate weighted Cox proportional models for RFS were constructed. Results and limitations When compared to intact PTEN, homogeneous (hazard ratio [HR] 1.66, p = 0.001) but not heterogeneous (HR 1.24, p = 0.14) PTEN loss was significantly associated with shorter RFS in multivariate models. Among ERG-positive tumors, homogeneous (HR 3.07, p < 0.0001) but not heterogeneous (HR 1.46, p = 0.10) PTEN loss was significantly associated with shorter RFS. Among ERG-negative tumors, PTEN did not reach significance for inclusion in the final multivariate models. The interaction term for PTEN and ERG status with respect to RFS did not reach statistical significance (p = 0.11) for the current sample size. Conclusions These data suggest that PTEN is a useful prognostic biomarker and that there is no statistically significant interaction between PTEN and ERG status for RFS. Patient summary We found that loss of the PTEN tumor suppressor gene in prostate tumors as assessed by tissue staining is correlated with shorter time to prostate cancer recurrence after radical prostatectomy. PMID:27617307

Effect of Desflurane versus Sevoflurane in Pediatric Anesthesia: A Meta-Analysis.

PubMed

He, Jiaxuan; Zhang, Yong; Xue, Rongliang; Lv, Jianrui; Ding, Xiaoying; Zhang, Zhenni

2015-01-01

To compare the effect of desflurane versus sevoflurane in pediatric anesthesia by conducting meta-analysis. Studies were searched from PubMed, Medline, Springer, Elsevier Science Direct, Cochrane Library and Google Scholar up to July 2014. Weighted mean difference (WMD) or risk ratio (RR) and 95% confidence intervals (CIs) were considered as effect sizes. Heterogeneity across studies was assessed by Cochran Q test and I2 statistic. The random effects model was performed in the meta-analysis when heterogeneity was observed, or the fixed effect model was used. Review Manager 5.1 software was applied for the meta-analysis. A total of 11 studies (13 comparisons) involving 1,273 objects were included in this meta-analysis. No heterogeneity was observed between studies for any comparison but for postoperative extubation time. The results showed significant differences between desflurane and sevoflurane groups for postoperative extubation time (WMD = -3.87, 95%CI = -6.14 to -1.60, P < 0.01), eye opening time (WMD = -1.11, 95%CI = -1.49 to -0.72, P < 0.01), awakening time (WMD = -4.27, 95%CI = -5.28 to -3.26, P < 0.01) and agitation (RR = 1.44, 95%CI = 1.05 to 1.96, P = 0.02). No significant differences (P > 0.05) were detected for discharge from the recovery room, oculocardiac reflex, nausea and vomiting and severe pain. Desflurane may have less adverse effects than sevoflurane when used in pediatric anesthesia with significantly shorter postoperative extubation time, eye opening time and awakening time as well as slighter agitation.

EFFECTS OF LONG-TIME COMMUTING AND LONG-HOUR WORKING ON LIFESTYLE AND MENTAL HEALTH AMONG SCHOOL TEACHERS IN TOKYO, JAPAN.

PubMed

Nomoto, Marino; Hara, Akiko; Kikuchi, Kimiyo

2015-06-01

The objective of this study was to investigate the effects of long-time commuting and long-hour working on lifestyle including sleeping, physical exercise, breakfast, smoking, alcohol intake and mental health. In this cross-sectional study, data were collected from 146 school teachers in Tokyo. The binary associations of commuting time and working hours with lifestyle, mental stress measured by the General Health Questionnaire (GHQ) and stress coping measured by the Sense of Coherence (SOC) scores were examined. The Chi-square test was used for statistical analyses. Our results indicated that the mean commuting time and working hours per week of the respondents were 42.1 (SD 22.5) minutes and 50.4 (SD 8.6) hours, respectively. Longer commuting time was significantly associated with shorter working hours (p = 0.023), less physical exercise (p < 0.001) and shorter sleeping hours (p = 0.001). Longer working hours were significantly associated with more frequent working on holidays (p = 0.001), higher SOC scores (p = 0.001) and more smoking (p = 0.028). The negative association between GHQ and SOC scores was also significant (p < 0.001). Our findings revealed that long-time commuters were more likely to sleep less, exercise less and work less long. Long-hour workers were more likely to commute shorter, work on holidays more frequently, smoke more and their stress coping potentials were higher. Some kinds of strategies are required to improve the healthy lifestyle for long-time com- muters or long-hour workers. Key words: stress; stress coping; general health questionnaire; sense of coherence

Optical coherence tomography speckle decorrelation for detecting cell death

NASA Astrophysics Data System (ADS)

Farhat, Golnaz; Mariampillai, Adrian; Yang, Victor X. D.; Czarnota, Gregory J.; Kolios, Michael C.

2011-03-01

We present a dynamic light scattering technique applied to optical coherence tomography (OCT) for detecting changes in intracellular motion caused by cellular reorganization during apoptosis. We have validated our method by measuring Brownian motion in microsphere suspensions and comparing the measured values to those derived based on particle diffusion calculated using the Einstein-Stokes equation. Autocorrelations of OCT signal intensities acquired from acute myeloid leukemia cells as a function of treatment time demonstrated a significant drop in the decorrelation time after 24 hours of cisplatin treatment. This corresponded with nuclear fragmentation and irregular cell shape observed in histological sections. A similar analysis conducted with multicellular tumor spheroids indicated a shorter decorrelation time in the spheroid core relative to its edges. The spheroid core corresponded to a region exhibiting signs of cell death in histological sections and increased backscatter intensity in OCT images.

Femtosecond all-optical synchronization of an X-ray free-electron laser

DOE PAGES

Schulz, S.; Grguraš, I.; Behrens, C.; ...

2015-01-20

Many advanced applications of X-ray free-electron lasers require pulse durations and time resolutions of only a few femtoseconds. To generate these pulses and to apply them in time-resolved experiments, synchronization techniques that can simultaneously lock all independent components, including all accelerator modules and all external optical lasers, to better than the delivered free-electron laser pulse duration, are needed. Here we achieve all-optical synchronization at the soft X-ray free-electron laser FLASH and demonstrate facility-wide timing to better than 30 fs r.m.s. for 90 fs X-ray photon pulses. Crucially, our analysis indicates that the performance of this optical synchronization is limited primarilymore » by the free-electron laser pulse duration, and should naturally scale to the sub-10 femtosecond level with shorter X-ray pulses.« less

Femtosecond all-optical synchronization of an X-ray free-electron laser

PubMed Central

Schulz, S.; Grguraš, I.; Behrens, C.; Bromberger, H.; Costello, J. T.; Czwalinna, M. K.; Felber, M.; Hoffmann, M. C.; Ilchen, M.; Liu, H. Y.; Mazza, T.; Meyer, M.; Pfeiffer, S.; Prędki, P.; Schefer, S.; Schmidt, C.; Wegner, U.; Schlarb, H.; Cavalieri, A. L.

2015-01-01

Many advanced applications of X-ray free-electron lasers require pulse durations and time resolutions of only a few femtoseconds. To generate these pulses and to apply them in time-resolved experiments, synchronization techniques that can simultaneously lock all independent components, including all accelerator modules and all external optical lasers, to better than the delivered free-electron laser pulse duration, are needed. Here we achieve all-optical synchronization at the soft X-ray free-electron laser FLASH and demonstrate facility-wide timing to better than 30 fs r.m.s. for 90 fs X-ray photon pulses. Crucially, our analysis indicates that the performance of this optical synchronization is limited primarily by the free-electron laser pulse duration, and should naturally scale to the sub-10 femtosecond level with shorter X-ray pulses. PMID:25600823

Gender and socioeconomic status as determinants of waiting time for inpatient surgery in a system with implicit queue management.

PubMed

Arnesen, Kjell E; Erikssen, Jan; Stavem, Knut

2002-12-01

In a system with implicit queue management, to examine gender and socioeconomic status as determinants of waiting time for inpatient surgery, after adjusting for other potential predictors. A cohort of 452 subjects was examined in outpatient clinics of a general hospital and referred to inpatient surgery. They were followed until scheduled hospital admission (n=396) or until the requested procedure no longer was relevant (n=56). We compared waiting time between groups from referral date until hospital admission, using Kaplan-Meier estimates of waiting times and log rank test. A Cox proportional hazards model was used for assessing the risk ratio (RR) of hospital admission for scheduled surgery. Gender and socioeconomic status could not explain variations in waiting time. However, patients with suspected/verified neoplastic disease or a risk of serious deterioration without treatment had markedly shorter waiting times than the reference groups, with adjusted RR (95% confidence intervals (95%CI)) of time to receiving in-patient surgery of 2.3 (1.7-3.0) and 2.0 (1.3-3.0), respectively. Being on sick leave was associated with shorter waiting time, adjusted RR of 1.7 (1.2-2.5). Referrals from within the hospital or other hospitals had also shorter waiting times than referrals from primary health care physicians, adjusted RR=1.4 (1.1-1.8). There was no evidence of bias against women or people in lower socioeconomic classes in this implicit queue management system. However, patients' access to inpatient surgery was associated with malignancy, prognosis, sick leave status, physician experience, referral pattern and the major diagnosis category.

The risk of shorter fasting time for pediatric deep sedation.

PubMed

Clark, Mathew; Birisci, Esma; Anderson, Jordan E; Anliker, Christina M; Bryant, Micheal A; Downs, Craig; Dalabih, Abdallah

2016-01-01

Current guidelines adopted by the American Academy of Pediatrics calls for prolonged fasting times before performing pediatric procedural sedation and analgesia (PSA). PSA is increasingly provided to children outside of the operating theater by sedation trained pediatric providers and does not require airway manipulation. We investigated the safety of a shorter fasting time compared to a longer and guideline compliant fasting time. We tried to identify the association between fasting time and sedation-related complications. This is a prospective observational study that included children 2 months to 18 years of age and had an American Society of Anesthesiologists physical status classification of I or II, who underwent deep sedation for elective procedures, performed by pediatric critical care providers. Procedures included radiologic imaging studies, electroencephalograms, auditory brainstem response, echocardiograms, Botox injections, and other minor surgical procedures. Subjects were divided into two groups depending on the length of their fasting time (4-6 h and >6 h). Complication rates were calculated and compared between the three groups. In the studied group of 2487 subjects, 1007 (40.5%) had fasting time of 4-6 h and the remaining 1480 (59.5%) subjects had fasted for >6 h. There were no statistically significant differences in any of the studied complications between the two groups. This study found no difference in complication rate in regard to the fasting time among our subjects cohort, which included only healthy children receiving elective procedures performed by sedation trained pediatric critical care providers. This suggests that using shorter fasting time may be safe for procedures performed outside of the operating theater that does not involve high-risk patients or airway manipulation.

Regional analysis of tertiary volcanic Calderas (western U.S.) using Landsat Thematic Mapper imagery

NASA Technical Reports Server (NTRS)

Spatz, David M.; Taranik, James V.

1989-01-01

The Landsat Thematic Mapper (TM) imagery of the Basin and Range province of southern Nevada was analyzed to identify and map volcanic rock assemblages at three Tertiary calderas. It was found that the longer-wavelength visible and the NIR TM Bands 3, 5, and 7 provide more effective lithologic discrimination than the shorter-wavelength bands, due partly to deeper penetration of the longer-wavelength bands, resulting in more lithologically driven radiances. Shorter-wavelength TM Bands 1 and 2 are affected more by surficial weathering products including desert varnish which may or may not provide an indirect link to lithologic identity. Guidelines for lithologic analysis of volcanic terrains using Landsat TM imagery are outlined.

Sensory cortex hyperexcitability predicts short survival in amyotrophic lateral sclerosis.

PubMed

Shimizu, Toshio; Bokuda, Kota; Kimura, Hideki; Kamiyama, Tsutomu; Nakayama, Yuki; Kawata, Akihiro; Isozaki, Eiji; Ugawa, Yoshikazu

2018-05-01

To investigate somatosensory cortex excitability and its relationship to survival prognosis in patients with amyotrophic lateral sclerosis (ALS). A total of 145 patients with sporadic ALS and 73 healthy control participants were studied. We recorded compound muscle action potential and sensory nerve action potential of the median nerve and the median nerve somatosensory evoked potential (SEP), and we measured parameters, including onset-to-peak amplitude of N13 and N20 and peak-to-peak amplitude between N20 and P25 (N20p-P25p). Clinical prognostic factors, including ALS Functional Rating Scale-Revised, were evaluated. We followed up patients until the endpoints (death or tracheostomy) and analyzed factors associated with survival using multivariate analysis in the Cox proportional hazard model. Compared to controls, patients with ALS showed a larger amplitude of N20p-P25p in the median nerve SEP. Median survival time after examination was shorter in patients with N20p-P25p ≥8 μV (0.82 years) than in those with N20p-P25p <8 μV (1.68 years, p = 0.0002, log-rank test). Multivariate analysis identified a larger N20p-P25p amplitude as a factor that was independently associated with shorter survival ( p = 0.002). Sensory cortex hyperexcitability predicts short survival in patients with ALS. © 2018 American Academy of Neurology.

The significance of PIWI family expression in human lung embryogenesis and non-small cell lung cancer.

PubMed

Navarro, Alfons; Tejero, Rut; Viñolas, Nuria; Cordeiro, Anna; Marrades, Ramon M; Fuster, Dolors; Caritg, Oriol; Moises, Jorge; Muñoz, Carmen; Molins, Laureano; Ramirez, Josep; Monzo, Mariano

2015-10-13

The expression of Piwi-interacting RNAs, small RNAs that bind to PIWI proteins, was until recently believed to be limited to germinal stem cells. We have studied the expression of PIWI genes during human lung embryogenesis and in paired tumor and normal tissue prospectively collected from 71 resected non-small-cell lung cancer patients. The mRNA expression analysis showed that PIWIL1 was highly expressed in 7-week embryos and downregulated during the subsequent weeks of development. PIWIL1 was expressed in 11 of the tumor samples but in none of the normal tissue samples. These results were validated by immunohistochemistry, showing faint cytoplasmic reactivity in the PIWIL1-positive samples. Interestingly, the patients expressing PIWIL1 had a shorter time to relapse (TTR) (p = 0.006) and overall survival (OS) (p = 0.0076) than those without PIWIL1 expression. PIWIL2 and 4 were downregulated in tumor tissue in comparison to the normal tissue (p < 0.001) and the patients with lower levels of PIWIL4 had shorter TTR (p = 0.048) and OS (p = 0.033). In the multivariate analysis, PIWIL1 expression emerged as an independent prognostic marker. Using 5-Aza-dC treatment and bisulfite sequencing, we observed that PIWIL1 expression could be regulated in part by methylation. Finally, an in silico study identified a stem-cell expression signature associated with PIWIL1 expression.

Optimization and Management of Naval Hospital Bremerton’s Military-Medicare Population by Market Analysis of the Naval Hospital Bremerton Empanelled Population

DTIC Science & Technology

2001-04-30

coworkers, published in this issues, showed that shorter office visits were associated with more inappropriate prescribing of non - steroidal anti ... inflammatory drugs ( NSAIDs )” (Davidoff, 1997, p. 483). The article found that shorter visits lead to provider failure to obtain history that would have been...Population Information It is generally noted that the elderly have more contacts with medical providers than do the non - elderly . According to the

Employment among Patients with Multiple Sclerosis-A Population Study

PubMed Central

Bøe Lunde, Hanne Marie; Telstad, Wenche; Grytten, Nina; Kyte, Lars; Aarseth, Jan; Myhr, Kjell-Morten; Bø, Lars

2014-01-01

Objective To investigate demographic and clinical factors associated with employment in MS. Methods The study included 213 (89.9%) of all MS patients in Sogn and Fjordane County, Western Norway at December 31st 2010. The patients underwent clinical evaluation, structured interviews and completed self-reported questionnaires. Demographic and clinical factors were compared between patients being employed versus patients being unemployed and according to disease course of MS. Logistic regression analysis was used to identify factors independently associated with current employment. Results After a mean disease duration of almost 19 years, 45% of the population was currently full-time or part- time employed. Patients with relapsing –remitting MS (RRMS) had higher employment rate than patients with secondary (SPMS) and primary progressive (PPMS). Higher educated MS patients with lower age at onset, shorter disease duration, less severe disability and less fatigue were most likely to be employed. Conclusions Nearly half of all MS patients were still employed after almost two decades of having MS. Lower age at onset, shorter disease duration, higher education, less fatigue and less disability were independently associated with current employment. These key clinical and demographic factors are important to understand the reasons to work ability in MS. The findings highlight the need for environmental adjustments at the workplace to accommodate individual ’s needs in order to improve working ability among MS patients. PMID:25054972

Evaluation of Physicians’ Awareness of Pediatric Diseases in Iran

PubMed Central

Abolhassani, Hassan; Mirminachi, Babak; Daryabeigi, Maedeh; Agharahimi, Zahra; Aghamohammadi, Asghar; Rabbani, Ali; Rezaei, Nima

2014-01-01

Objective: Physicians’ awareness about pediatric health problems is very important in health system. This has not been investigated in Iran as yet. Therefore this study was conducted to characterize the knowledge of the Iranian physicians which has direct association with health status of children. Methods: One hundred and four physicians, mainly pediatric specialists (58.6%) working in the state hospitals (45.1%) were enrolled. They filled a valid and reliable questionnaire, containing 26 questions about basic and important pediatric issues before and after an educational pediatric program (EPP). Findings : Thirty nine (37.5%) physicians answered correctly more than 2/3 of all questions (passed the examination) before EPP, which increased to 42.3% after EEP. Subgroup analysis showed that the total scores of general practitioners (P=0.007) was significantly increased after the EPP. Moreover, physicians with shorter practicing time (P=0.006) and those with shorter time past graduation (P=0.01) had a significant improvement in their total scores after the program. The best scores of educational issues were documented in growth and development (16.0%; P=0.04), followed by dermatology (9.2%, P=0.04), urology (9.1%; P=0.04), and asthma and allergy (9.0%, P=0.04). Conclusion: This study revealed that there are gaps in the knowledge of professionals about the pediatric issues. PMID:25793051

Comparative Analysis of Protaper and Waveone Systems to Reduce Enterococcus Faecalis from Root Canal System in Primary Molars--An in Vitro Study.

PubMed

Pinheiro, Sérgio Luiz; Pessoa, Carolina; da Silva, Josianne Neres; Gonçalves, Rafael Orro; Duarte, Danilo Antonio; da Silveira Bueno, Carlos Eduardo

2016-01-01

To assess, in vitro, the ability of the ProTaper(™) and WaveOne(™) systems to reduce Enterococcus faecalis contamination in primary molars. Sixty roots of primary molars were contaminated with E. faecalis. Roots were randomly allocated to one of four groups (n=20): ProTaper(™), WaveOne(™), control A, or control B. The files used were S1 and S2/F1 and F2 (ProTaper(™) system) and 25.08 (WaveOne(™) system). In control group A, the root canal was left uninstrumented, whereas in control group B, the root canal was irrigated with NaCl 0.9%. E. faecalis was sampled from the root canal system before and after instrumentation and the Wilcoxon test and Mann-Whitney U were used. There were no differences in E. faecalis counts between pre-instrumentation counts in the ProTaper™ and WaveOne(™) (p>0.05). The ProTaper(™) system led to an 89.36% reduction in E. faecalis burden, versus 78.10% with the WaveOne(™) system (p>0.05). Instrumentation time was shorter with WaveOne(™) (p<0.0001). The ProTaper(™) and WaveOne™ systems were equally effective in reducing Enterococcus faecalis in primary molars. The WaveOne(™) system was associated with shorter instrumentation time.

[Meta-analysis of randomized controlled trials comparing procedure for prolapse and hemorrhoids with Milligan-Morgan hemorrhoidectomy in the treatment of prolapsed hemorrhoids].

PubMed

He, Ping; Chen, Hongliang

2015-12-01

To compare the safety and efficacy of procedure for prolapse and hemorrhoids (PPH) with Milligan-Morgan hemorrhoidectomy (MMH) in the treatment of prolapsed hemorrhoids. All the randomized controlled trials (RCT) comparing PPH with MMH in the treatment of prolapsed hemorrhoids published between January 1998 and January 2015 were retrieved from PubMed, Embase, Cochrane Library, CBM, CNKI, Wangfang, VIP databases. Hand search was applied in Chinese Journal of Gastrointestinal Surgery, Chinese Journal of Coloproctology and Journal of Colorectal and Anal Surgery from the library of Chengdu University of Traditional Chinese Medicine. Associated reference documents in enrolled trials were reviewed. The methodological quality of enrolled trials was evaluated according to the Cochrane handbook for systematic reviews of interventions. Meta-analysis was performed using RevMan 5.3 software. Sixteen RCTs recruiting 1411 patients were identified. Among them, 702 patients underwent PPH, and other 709 patients MMH. Meta-analysis showed that as compared to MMH, PPH had shorter operating time(WMD=-12.34, 95% CI:-17.87 to -6.80, P=0.000], shorter hospital stay (WMD=-1.48, 95% CI: -1.81 to -1.14, P=0.000) and shorter time to recover normal activity (WMD=-14.11, 95% CI: -24.51 to -3.70, P=0.008). Patients in PPH group experienced less pain at postoperative 24 h, postoperative 1 week and the first postoperative bowel movement (all P<0.01). PPH was more ascendant in terms of the requirement for analgesics(P<0.01). PPH group had higher ratio of wound-healing 2 weeks after surgery (RR=0.19, 95% CI: 0.07 to 0.51, P=0.001), lower ratio of postoperative anal stenosis (RR=0.39, 95% CI: 0.15 to 0.99, P=0.050) and lower ratio of anal incontinence (RR=0.62, 95% CI: 0.38 to 1.01, P=0.050), but higher ratio of recurrent disease after 1 year (RR=2.54, 95% CI: 1.21 to 5.31, P=0.010). No significant differences in ratios of postoperative bleeding, urinary retention, and postoperative morbidity of complication were found(all P>0.05). Satisfaction degree of patients in PPH group was better than that in MMH group (OR=2.36, 95% CI:1.36 to 4.07, P=0.002). Procedure for prolapse and hemorrhoids offers some short-term benefits over Milligan-Morgan hemorrhoidectomy, but is associated with a higher rate of recurrent disease.

Astrophysical implications of hypothetical stable TeV-scale black holes

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

Giddings, Steven B.; Mangano, Michelangelo L.

2008-08-01

We analyze macroscopic effects of TeV-scale black holes, such as could possibly be produced at the LHC, in what is regarded as an extremely hypothetical scenario in which they are stable and, if trapped inside Earth, begin to accrete matter. We examine a wide variety of TeV-scale gravity scenarios, basing the resulting accretion models on first-principles, basic, and well-tested physical laws. These scenarios fall into two classes, depending on whether accretion could have any macroscopic effect on the Earth at times shorter than the Sun's natural lifetime. We argue that cases with such an effect at shorter times than themore » solar lifetime are ruled out, since in these scenarios black holes produced by cosmic rays impinging on much denser white dwarfs and neutron stars would then catalyze their decay on time scales incompatible with their known lifetimes. We also comment on relevant lifetimes for astronomical objects that capture primordial black holes. In short, this study finds no basis for concerns that TeV-scale black holes from the LHC could pose a risk to Earth on time scales shorter than the Earth's natural lifetime. Indeed, conservative arguments based on detailed calculations and the best-available scientific knowledge, including solid astronomical data, conclude, from multiple perspectives, that there is no risk of any significance whatsoever from such black holes.« less

Influence of Day Length and Physical Activity on Sleep Patterns in Older Icelandic Men and Women

PubMed Central

Brychta, Robert J.; Arnardottir, Nanna Yr; Johannsson, Erlingur; Wright, Elizabeth C.; Eiriksdottir, Gudny; Gudnason, Vilmundur; Marinac, Catherine R.; Davis, Megan; Koster, Annemarie; Caserotti, Paolo; Sveinsson, Thorarinn; Harris, Tamara; Chen, Kong Y.

2016-01-01

Study Objectives: To identify cross-sectional and seasonal patterns of sleep and physical activity (PA) in community-dwelling, older Icelandic adults using accelerometers. Methods: A seven-day free-living protocol of 244 (110 female) adults aged 79.7 ± 4.9 years was conducted as part of a larger population-based longitudinal observational-cohort study in the greater Reykjavik area of Iceland. A subpopulation (n = 72) repeated the 7-day measurement during seasonal periods with greater (13.4 ± 1.4 h) and lesser (7.7 ± 1.8 h) daylight. Results: Cross-sectional analyses using multiple linear regression models revealed that day length was a significant independent predictor of sleep duration, mid-sleep, and rise time (all p < 0.05). However, the actual within-individual differences in sleep patterns of the repeaters were rather subtle between periods of longer and shorter day-lengths. Compared to women, men had a shorter sleep duration (462 ± 80 vs. 487 ± 68 minutes, p = 0.008), earlier rise time, and a greater number of awakenings per night (46.5 ± 18.3 vs. 40.2 ± 15.7, p = 0.007), but sleep efficiency and onset latency were similar between the two sexes. Daily PA was also similar between men and women and between periods of longer and shorter day-lengths. BMI, age, gender, and overall PA all contributed to the variations in sleep parameters using multiple regression analysis. Conclusions: The sleep and PA characteristics of this unique population revealed some gender differences, but there was limited variation in response to significant daylight changes which may be due to long-term adaptation. Citation: Brychta RJ, Arnardottir NY, Johannsson E, Wright EC, Eiriksdottir G, Gudnason V, Marinac CR, Davis M, Koster A, Caserotti P, Sveinsson T, Harris T, Chen KY. Influence of day length and physical activity on sleep patterns in older Icelandic men and women. J Clin Sleep Med 2016;12(2):203–213. PMID:26414978

Time Seeing a Hand Surgeon Is Not Associated With Patient Satisfaction.

PubMed

Teunis, Teun; Thornton, Emily R; Jayakumar, Prakash; Ring, David

2015-07-01

Previous studies, predominantly in the primary care setting, identified time spent with the physician as an important predictor of satisfaction. It is unknown if the same holds true in hand surgery. Is patient satisfaction measured immediately after an office visit associated with the duration of time spent with the hand surgeon? What other factors are associated with satisfaction directly after the visits and 2 weeks after the appointment? We prospectively enrolled 81 patients visiting our hand and upper extremity surgery outpatient clinic. We recorded their demographics and measured physical function, pain behavior, symptoms of depression, time spent in the waiting room, time spent with the physician, and patient satisfaction. Office times were measured using our patient ambulatory tracking system and by a research assistant outside the clinic room. To assess satisfaction we used items from the Consumer Assessment of Healthcare Providers and Systems survey (a federally developed standardized survey instrument) relevant to our study. Two weeks later, 51 (64%) patients were available for telephone followup and the same measures were completed. Mean time spent with the hand surgeon was 8 ± 5 minutes and mean in-office wait time to see the hand surgeon was 32 ± 18 minutes. A priori power analyses indicated that 77 patients would provide 80% power to detect an effect size f(2) = 0.18 for a regression with five predictors. This means that we would detect time spent with the physician as a significant factor if it accounted for 7% or more of the variability in satisfaction. Time spent with the hand surgeon was not associated with patient satisfaction measured directly after the visit (r = -0.023; p = 0.84). Longer time waiting to see the physician correlated with decreased patient satisfaction (r = -0.30; p = 0.0057). The final multivariable model for increased satisfaction directly after the office visit included shorter waiting time (regression coefficient [β] -0.0014; partial R(2) 0.094; 95% confidence interval [CI], -0.0024 to -0.00042; p = 0.006) and being married/living with a partner (β 0.057; partial R(2) 0.11; 95% CI, 0.021-0.093; p = 0.002 [adjusted R(2) 0.18; p < 0.001]). Similarly, multivariable analysis found higher patient satisfaction 2 weeks after the visit to be independently associated with shorter waiting time (β -0.0037; partial R(2) 0.10; 95% CI, -0.0070 to -0.00054; p = 0.023) and being married/living with a partner (β 0.15; partial R(2) 0.12; 95% CI, 0.033-0.26; p = 0.012 [adjusted R(2) 0.16; p = 0.0052]). Patient satisfaction among patients undergoing hand surgery may relate more to shorter time in the waiting room and to the quality more than the quantity of time spent with the patient. Level II, prognostic study.

Measuring Advance Care Planning: Optimizing the Advance Care Planning Engagement Survey.

PubMed

Sudore, Rebecca L; Heyland, Daren K; Barnes, Deborah E; Howard, Michelle; Fassbender, Konrad; Robinson, Carole A; Boscardin, John; You, John J

2017-04-01

A validated 82-item Advance Care Planning (ACP) Engagement Survey measures a broad range of behaviors. However, concise surveys are needed. The objective of this study was to validate shorter versions of the survey. The survey included 57 process (e.g., readiness) and 25 action items (e.g., discussions). For item reduction, we systematically eliminated questions based on face validity, item nonresponse, redundancy, ceiling effects, and factor analysis. We assessed internal consistency (Cronbach's alpha) and construct validity with cross-sectional correlations and the ability of the progressively shorter survey versions to detect change one week after exposure to an ACP intervention (Pearson correlation coefficients). Five hundred one participants (four Canadian and three US sites) were included in item reduction (mean age 69 years [±10], 41% nonwhite). Because of high correlations between readiness and action items, all action items were removed. Because of high correlations and ceiling effects, two process items were removed. Successive factor analysis then created 55-, 34-, 15-, nine-, and four-item versions; 664 participants (from three US ACP clinical trials) were included in validity analysis (age 65 years [±8], 72% nonwhite, 34% Spanish speaking). Cronbach's alphas were high for all versions (four items 0.84-55 items 0.97). Compared with the original survey, cross-sectional correlations were high (four items 0.85; 55 items 0.97) as were delta correlations (four items 0.68; 55 items 0.93). Shorter versions of the ACP Engagement Survey are valid, internally consistent, and able to detect change across a broad range of ACP behaviors for English and Spanish speakers. Shorter ACP surveys can efficiently measure broad ACP behaviors in research and clinical settings. Published by Elsevier Inc.

Ablation of silicon with bursts of femtosecond laser pulses

NASA Astrophysics Data System (ADS)

Gaudiuso, Caterina; Kämmer, Helena; Dreisow, Felix; Ancona, Antonio; Tünnermann, Andreas; Nolte, Stefan

2016-03-01

We report on an experimental investigation of ultrafast laser ablation of silicon with bursts of pulses. The pristine 1030nm-wavelength 200-fs pulses were split into bursts of up to 16 sub-pulses with time separation ranging from 0.5ps to 4080ps. The total ablation threshold fluence was measured depending on the burst features, finding that it strongly increases with the number of sub-pulses for longer sub-pulse delays, while a slowly increasing trend is observed for shorter separation time. The ablation depth per burst follows two different trends according to the time separation between the sub-pulses, as well as the total threshold fluence. For delays shorter than 4ps it decreases with the number of pulses, while for time separations longer than 510ps, deeper craters were achieved by increasing the number of subpulses in the burst, probably due to a change of the effective penetration depth.

Multivariable analysis of anesthetic factors associated with time to extubation in dogs.

PubMed

Kleine, Stephanie; Hofmeister, Erik; Egan, Katrina

2014-12-01

The purpose of this study was to identify factors that prolong the time to extubation in dogs. Anesthetic records of 900 dogs at a university teaching hospital were searched. Multiple linear regression was used to compare independent predictors (patient demographics, anesthetic and intraoperative variables) with the dependent variable (time to extubation). Induction with propofol (P < 0.025) was associated with a shorter time to extubation, while premedication with acepromazine (P = 0.000) was associated with a longer time to extubation. Time to extubation was increased by 0.311 minutes for every kilogram increase in body weight (P = 0.000), 5.924 minutes for every 1 °C loss in body temperature (P = 0.0000), and by 0.096 minutes for every 1 minute increase in anesthetic duration (P = 0.000). Anesthetic variables, which can be manipulated by the anesthetist, include choice of premedication and induction drugs, hypothermia, and duration of anesthesia. Published by Elsevier Ltd.

Temporal fractals in seabird foraging behaviour: diving through the scales of time

PubMed Central

MacIntosh, Andrew J. J.; Pelletier, Laure; Chiaradia, Andre; Kato, Akiko; Ropert-Coudert, Yan

2013-01-01

Animal behaviour exhibits fractal structure in space and time. Fractal properties in animal space-use have been explored extensively under the Lévy flight foraging hypothesis, but studies of behaviour change itself through time are rarer, have typically used shorter sequences generated in the laboratory, and generally lack critical assessment of their results. We thus performed an in-depth analysis of fractal time in binary dive sequences collected via bio-logging from free-ranging little penguins (Eudyptula minor) across full-day foraging trips (216 data points; 4 orders of temporal magnitude). Results from 4 fractal methods show that dive sequences are long-range dependent and persistent across ca. 2 orders of magnitude. This fractal structure correlated with trip length and time spent underwater, but individual traits had little effect. Fractal time is a fundamental characteristic of penguin foraging behaviour, and its investigation is thus a promising avenue for research on interactions between animals and their environments. PMID:23703258

Time-to-treatment of mental disorders in a community sample of Dutch adolescents. A TRAILS study.

PubMed

Raven, D; Jörg, F; Visser, E; Oldehinkel, A J; Schoevers, R A

2017-04-01

Timely recognition and treatment of mental disorders with an onset in childhood and adolescence is paramount, as these are characterized by greater severity and longer persistence than disorders with an onset in adulthood. Studies examining time-to-treatment, also referred to as treatment delay, duration of untreated illness or latency to treatment, and defined as the time between disorder onset and initial treatment contact, are sparse and all based on adult samples. The aim of this study was to describe time-to-treatment and its correlates for any health care professional (any care) and secondary mental health care (secondary care), for a broad range of mental disorders, in adolescents. Data from the Dutch community-based cohort study TRacking Adolescents' Individual Lives Survey (TRAILS; N = 2230) were used. The Composite International Diagnostic Interview (CIDI) was administered to assess DSM-IV disorders, the age of onset, and the age of initial treatment contact with any health care professional in 1584 adolescents of 18-20 years old. In total 43% of the adolescents (n = 675) were diagnosed with a lifetime DSM-IV disorder. The age of initial treatment contact with secondary care was based on administrative records from 321 adolescents without a disorder onset before the age of 10. Descriptive statistics, cumulative lifetime probability plots, and Cox regression analyses were used analyze time-to-treatment. The proportion of adolescents who reported lifetime treatment contact with any care varied from 15% for alcohol dependence to 82% for dysthymia. Regarding secondary care, proportions of lifetime treatment contact were lower for mood disorders and higher for substance dependence. Time-to-treatment for any care varied considerably between and within diagnostic classes. The probability of lifetime treatment contact for mood disorders was above 90%, whereas for other mental disorders this was substantially lower. An earlier age of onset predicted a longer, and the presence of a co-morbid mood disorder predicted a shorter time-to-treatment in general. Disorder severity predicted a shorter time-to-treatment for any care, but not for secondary care. Time-to-treatment for secondary care was shorter for adolescents from low and middle socioeconomic background than for adolescents from a high socioeconomic background. Although the time-to-treatment was shorter for adolescents than for adults, it was still substantial, and the overall patterns were remarkably similar to those found in adults. Efforts to reduce time-to-treatment should therefore be aimed at children and adolescents. Future research should address mechanisms underlying time-to-treatment and its consequences for early-onset disorders in particular.

Time to Detection with BacT/Alert FA Plus Compared to BacT/Alert FA Blood Culture Media.

PubMed

Nutman, A; Fisher Even-Tsur, S; Shapiro, G; Braun, T; Schwartz, D; Carmeli, Y

2016-09-01

Rapid identification of the causative pathogen in patients with bacteremia allows adjustment of antibiotic therapy and improves patient outcomes. We compared in vitro and real-life time to detection (TTD) of two blood culture media, BacT/Alert FA (FA) and BacT/Alert FA Plus (FA Plus), for the nine most common species of bacterial pathogens recovered from blood samples. Experimental data from simulated cultures was compared with microbiology records of TTD for both culture media with growth of the species of interest in clinical blood cultures. In the experimental conditions, median TTD was 3.8 hours (23.9 %) shorter using FA Plus media. The magnitude of reduction differed between species. Similarly, in real life data, FA Plus had shorter TTD than FA media; however, the difference between culture media was smaller, and median TTD was only 1 hour (8.5 %) less. We found shorter TTD with BacT/Alert FA Plus culture media, both experimentally and in real-life conditions and unrelated to antibiotic neutralization, highlighting the importance of appropriate blood culture media selection.

Is the bipolar vessel sealer device an effective tool in robotic surgery? A retrospective analysis of our experience and a meta-analysis of the literature about different robotic procedures by investigating operative data and post-operative course.

PubMed

Ortenzi, Monica; Ghiselli, Roberto; Baldarelli, Maddalena; Cardinali, Luca; Guerrieri, Mario

2018-04-01

The latest robotic bipolar vessel sealing tools have been described to be effective allowing to perform procedures with reduced blood loss and shorter operative times. The aim of this study was to assess the efficacy and reliability of these devices applied in different robotic procedures. All robotic operations, between 2014 and 2016, were performed using the EndoWrist One VesselSealer (EWO, Intuitive Surgical, Sunnyvale, CA), a bipolar fully wristed device. Data, including age, gender, body mass index (BMI), were collected. Robot docking time, intraoperative blood loss, robot malfunctioning and overall operative time were analyzed. A meta-analysis of the literature was carried out to point the attention to three different parameters (mean blood loss, operating time and hospital stay) trying to identify how different coagulation devices may affect them. In 73 robotic procedures, the mean operative time was 118.2 minutes (75-125 minutes). Mean hospital stay was four days (2-10 days). There were two post-operative complications (2.74%). The bipolar vessel sealer offers the efficacy of bipolar diathermy and the advantages of a fully wristed instrument. It does not require any change of instruments for coagulation or involvement of the bedside assistant surgeon. These characteristics lead to a reduction in operative time.

Urdu translation and validation of shorter version of Positive Affect and Negative Affect Schedule (PANAS) on Pakistani bank employees.

PubMed

Akhter, Noreen

2017-10-01

To translate, adapt and validate shorter version of positive affect and negative affect scale on Pakistani corporate employees. This cross-sectional study was conducted in the twin cities of Islamabad and Rawalpindi from October 2014 to December 2015. The study was completed into two independent parts. In part one, the scale was translated by forward translation. Then it was pilot-tested and administered on customer services employees from commercial banks and the telecommunication sector. Data of the pilot study was analysed by using exploratory factor analysis to extract the initial factor of positive affect and negative affect scale. Part two comprised the main study. Commercial bank employees were included in the sample using convenient sampling technique. Data of the main study was analysed using confirmatory factor analysis in order to establish construct validity of positive affect and negative affect scale. There were145 participants in the first part of the study and 495 in the second. Results of confirmatory factor analysis confirmed the two-factor structure of positive affect and negative affect scale suggesting that the scale has two distinct domains, i.e. positive affect and negative affect. The shorter version of positive affect and negative affect scale was found to be a valid and reliable measure.

A Comparison of Robotic Versus Laparoscopic Adrenalectomy in Patients With Primary Hyperaldosteronism.

PubMed

Colvin, Jennifer; Krishnamurthy, Vikram; Jin, Judy; Shin, Joyce; Siperstein, Allan; Berber, Eren

2017-10-01

Over the last decade, robotic approaches have been described for removing adrenal tumors. Although there are reports comparing robotic and laparoscopic techniques in general, there are limited data on outcomes in patients with primary hyperaldosteronism (PHA). The aim of this study is to compare the safety and efficacy of robotic adrenalectomy (RA) versus laparoscopic adrenalectomy (LA) for PHA. The records of 20 patients who underwent RA for PHA were compared with 16 patients who underwent LA between 2000 and 2014. Data were retrospectively reviewed from a prospectively maintained, IRB-approved adrenal database. Statistical analysis was performed using t test and the Fisher exact analysis. Continuous variables are reported as mean±SEM. Demographic and clinical parameters were similar between the groups. There were no conversions to open in either group. Estimated blood loss, length of stay, and complication rates were comparable. Operative time was shorter in the robotic versus laparoscopic group (130±8.94 vs. 159±11.1 min, P=0.0487). In follow-up, the improvement in patients' blood pressure after adrenalectomy, as assessed by the reduction in the number of antihypertensive medications, was similar between the 2 groups. However, 1 patient in the RA and 1 patient in the LA group were not cured, as determined by postoperative aldosterone:renin levels. The biochemical cure rate between the groups was similar (P=0.529). To our knowledge, this is the first study comparing robotic versus laparoscopic resection of PHA. Our results show that the robotic approach was similar to laparoscopic regarding safety and efficacy. Operative time was shorter with the robotic approach, which could be related to more efficient dissection with wristed instrumentation.

Awake Craniotomy Anesthesia: A Comparison of the Monitored Anesthesia Care and Asleep-Awake-Asleep Techniques.

PubMed

Eseonu, Chikezie I; ReFaey, Karim; Garcia, Oscar; John, Amballur; Quiñones-Hinojosa, Alfredo; Tripathi, Punita

2017-08-01

Commonly used sedation techniques for an awake craniotomy include monitored anesthesia care (MAC), using an unprotected airway, and the asleep-awake-asleep (AAA) technique, using a partially or totally protected airway. We present a comparative analysis of the MAC and AAA techniques, evaluating anesthetic management, perioperative outcomes, and complications in a consecutive series of patients undergoing the removal of an eloquent brain lesion. Eighty-one patients underwent awake craniotomy for an intracranial lesion over a 9-year period performed by a single-surgeon and a team of anesthesiologists. Fifty patients were treated using the MAC technique, and 31 were treated using the AAA technique. A retrospective analysis evaluated anesthetic management, intraoperative complications, postoperative outcomes, pain management, and complications. The MAC and AAA groups had similar preoperative patient and tumor characteristics. Mean operative time was shorter in the MAC group (283.5 minutes vs. 313.3 minutes; P = 0.038). Hypertension was the most common intraoperative complication seen (8% in the MAC group vs. 9.7% in the AAA group; P = 0.794). Intraoperative seizure occurred at a rate of 4% in the MAC group and 3.2% in the AAA group (P = 0.858). Awake cases were converted to general anesthesia in no patients in the MAC group and in 1 patient (3.2%) in the AAA group (P = 0.201). No cases were aborted in either group. The mean hospital length of stay was 3.98 days in the MAC group and 3.84 days in the AAA group (P = 0.833). Both the MAC and AAA sedation techniques provide an efficacious and safe method for managing awake craniotomy cases and produce similar perioperative outcomes, with the MAC technique associated with shorter operative time. Copyright © 2017 Elsevier Inc. All rights reserved.

Expression of the TPα and TPβ isoforms of the thromboxane prostanoid receptor (TP) in prostate cancer: clinical significance and diagnostic potential.

PubMed

Mulvaney, Eamon P; Shilling, Christine; Eivers, Sarah B; Perry, Antoinette S; Bjartell, Anders; Kay, Elaine W; Watson, R William; Kinsella, B Therese

2016-11-08

The prostanoid thromboxane (TX)A2 plays a central role in haemostasis and is increasingly implicated in cancer progression. TXA2 signals through two T Prostanoid receptor (TP) isoforms termed TPα and TPβ, with both encoded by the TBXA2R gene. Despite exhibiting several functional and regulatory differences, the role of the individual TP isoforms in neoplastic diseases is largely unknown.This study evaluated expression of the TPα and TPβ isoforms in tumour microarrays of the benign prostate and different pathological (Gleason) grades of prostate cancer (PCa). Expression of TPβ was significantly increased in PCa relative to benign tissue and strongly correlated with increasing Gleason grade. Furthermore, higher TPβ expression was associated with increased risk of biochemical recurrence (BCR) and significantly shorter disease-free survival time in patients post-surgery. While TPα was more variably expressed than TPβ in PCa, increased/high TPα expression within the tumour also trended toward increased BCR and shorter disease-free survival time. Comparative genomic CpG DNA methylation analysis revealed substantial differences in the extent of methylation of the promoter regions of the TBXA2R that specifically regulate expression of TPα and TPβ, respectively, both in benign prostate and in clinically-derived tissue representative of precursor lesions and progressive stages of PCa. Collectively, TPα and TPβ expression is differentially regulated both in the benign and tumourigenic prostate, and coincides with clinical pathology and altered CpG methylation of the TBXA2R gene. Analysis of TPβ, or a combination of TPα/TPβ, expression levels may have significant clinical potential as a diagnostic biomarker and predictor of PCa disease recurrence.

Analysis of phase II studies on targeted agents and subsequent phase III trials: what are the predictors for success?

PubMed

Chan, John K; Ueda, Stefanie M; Sugiyama, Valerie E; Stave, Christopher D; Shin, Jacob Y; Monk, Bradley J; Sikic, Branimir I; Osann, Kathryn; Kapp, Daniel S

2008-03-20

To identify the characteristics of phase II studies that predict for subsequent "positive" phase III trials (those that reached the proposed primary end points of study or those wherein the study drug was superior to the standard regimen investigating targeted agents in advanced tumors. We identified all phase III clinical trials of targeted therapies against advanced cancers published from 1985 to 2005. Characteristics of the preceding phase II studies were reviewed to identify predictive factors for success of the subsequent phase III trial. Data were analyzed using the chi(2) test and logistic regression models. Of 351 phase II studies, 167 (47.6%) subsequent phase III trials were positive and 184 (52.4%) negative. Phase II studies from multiple rather than single institutions were more likely to precede a successful trial (60.4% v 39.4%; P < .001). Positive phase II results were more likely to lead to a successful phase III trial (50.8% v 22.5%; P = .003). The percentage of successful trials from pharmaceutical companies was significantly higher compared with academic, cooperative groups, and research institutes (89.5% v 44.2%, 45.2%, and 46.3%, respectively; P = .002). On multivariate analysis, these factors and shorter time interval between publication of phase II results and III study publication were independent predictive factors for a positive phase III trial. In phase II studies of targeted agents, multiple- versus single-institution participation, positive phase II trial, pharmaceutical company-based trials, and shorter time period between publication of phase II to phase III trial were independent predictive factors of success in a phase III trial. Investigators should be cognizant of these factors in phase II studies before designing phase III trials.

Laparoscopic common bile duct exploration with primary closure for management of choledocholithiasis: a retrospective analysis and comparison with conventional T-tube drainage.

PubMed

Zhang, Hong-Wei; Chen, Ya-Jin; Wu, Chang-Hao; Li, Wen-Da

2014-02-01

Laparoscopic common bile duct exploration (LCBDE) had become one of the main options for management of choledocholithiasis. This retrospective comparative study aimed to evaluate on the feasibility and advantages of primary closure versus conventional T-tube drainage of the common bile duct (CBD) after laparoscopic choledochotomy. In this retrospective analysis, 100 patients (47 men and 53 women) with choledocholithiasis who underwent primary closure of the CBD (without T-tube drainage) after LCBDE (Group A) were compared with 92 patients who underwent LCBDE with T-tube drainage (Group B). Both groups were evaluated with regard to biliary complications, hospital stay, and recurrence of stones. The mean operation time was 104.12 minutes for Group A and 108.92 minutes for Group B (P = 0.069). The hospital stay was significantly shorter in Group A than that in Group B (6.95 days and 12.05 days, respectively; P < 0.001). In Group A, bile leakage occurred in two patients on postoperative Day 2 and Day 3, respectively. In Group B, bile leakage noted in one patient after removal of the T-tube on Day 14 after operation (P = 1.000). With a median follow-up time of 40 months for both groups, stone recurrence was noted in two patients in Group A and three patients in Group B (P = 0.672). Primary closure of the CBD is safe and feasible in selected patients after laparoscopic choledochotomy. It results in shorter duration of hospital stay without the need for carrying/care of a T-tube in the postoperative period and similar stone recurrence as that of the conventional method.

Effect of environmental factors on the kinetics of insulin fibril formation: elucidation of the molecular mechanism.

PubMed

Nielsen, L; Khurana, R; Coats, A; Frokjaer, S; Brange, J; Vyas, S; Uversky, V N; Fink, A L

2001-05-22

In the search for the molecular mechanism of insulin fibrillation, the kinetics of insulin fibril formation were studied under different conditions using the fluorescent dye thioflavin T (ThT). The effect of insulin concentration, agitation, pH, ionic strength, anions, seeding, and addition of 1-anilinonaphthalene-8-sulfonic acid (ANS), urea, TMAO, sucrose, and ThT on the kinetics of fibrillation was investigated. The kinetics of the fibrillation process could be described by the lag time for formation of stable nuclei (nucleation) and the apparent rate constant for the growth of fibrils (elongation). The addition of seeds eliminated the lag phase. An increase in insulin concentration resulted in shorter lag times and faster growth of fibrils. Shorter lag times and faster growth of fibrils were seen at acidic pH versus neutral pH, whereas an increase in ionic strength resulted in shorter lag times and slower growth of fibrils. There was no clear correlation between the rate of fibril elongation and ionic strength. Agitation during fibril formation attenuated the effects of insulin concentration and ionic strength on both lag times and fibril growth. The addition of ANS increased the lag time and decreased the apparent growth rate for insulin fibril formation. The ANS-induced inhibition appears to reflect the formation of amorphous aggregates. The denaturant, urea, decreased the lag time, whereas the stabilizers, trimethylamine N-oxide dihydrate (TMAO) and sucrose, increased the lag times. The results indicated that both nucleation and fibril growth were controlled by hydrophobic and electrostatic interactions. A kinetic model, involving the association of monomeric partially folded intermediates, whose concentration is stimulated by the air-water interface, leading to formation of the critical nucleus and thence fibrils, is proposed.

Sleeping Pill Administration Time and Patient Subjective Satisfaction

PubMed Central

Chung, Seockhoon; Youn, Soyoung; Yi, Kikyoung; Park, Boram; Lee, Suyeon

2016-01-01

Study Objectives: Taking hypnotic agents 30 min before bedtime is the usual suggested administration time, but some patients report dissatisfaction with their sleeping pills. We investigated whether the timing of sleeping pill administration influences patient subjective satisfaction with these drugs. Methods: One hundred twelve patients with primary insomnia currently taking benzodiazepine or nonbenzodiazepine gamma-aminobutyric acid (GABA) agonists as sleeping pills were selected. The time of administration for their sleeping pills, bedtime, sleep onset time, and wake up time were obtained from their medical records. Subjects were also categorized into satisfied or dissatisfied groups. Results: Hypnotic agents administration time (p < 0.001) and bedtime (p < 0.001), but not sleep onset or wake up time, occurred later in the night in the satisfied group. The durations from administration of pills to sleep onset (33.6 ± 20.7 min) and to wake up time (7.2 ± 1.2 h) were significantly shorter in the satisfied group when compared to the dissatisfied group (135.9 ± 73.4 min and 9.3 ± 1.5 h for time to sleep onset and wake up, respectively). Logistic regression analysis revealed that patient subjective satisfaction with hypnotic agents could be predicted by a short duration from administration of pills to sleep onset (odds ratio = 0.01; 95% confidence interval [0.001–0.09]) and a short duration from administration of pills to wake up time (0.53; [0.31–0.89], F = 49.9, p < 0.001). Conclusions: Taking sleeping pills at a later time and a shorter interval between pill administration and wake up time may increase patient subjective satisfaction with hypnotic agents. We propose that physicians advise patients to take sleeping pills approximately 7 h before their usual getting-out-of-bed time instead of the current standard of 30 min before bedtime. Citation: Chung S, Youn S, Yi K, Park B, Lee S. Sleeping pill administration time and patient subjective satisfaction. J Clin Sleep Med 2016;12(1):57–62. PMID:26285113

Gas Chromatograph Method Optimization Trade Study for RESOLVE: 20-meter Column v. 8-meter Column

NASA Technical Reports Server (NTRS)

Huz, Kateryna

2014-01-01

RESOLVE is the payload on a Class D mission, Resource Prospector, which will prospect for water and other volatile resources at a lunar pole. The RESOLVE payload's primary scientific purpose includes determining the presence of water on the moon in the lunar regolith. In order to detect the water, a gas chromatograph (GC) will be used in conjunction with a mass spectrometer (MS). The goal of the experiment was to compare two GC column lengths and recommend which would be best for RESOLVE's purposes. Throughout the experiment, an Inficon Fusion GC and an Inficon Micro GC 3000 were used. The Fusion had a 20m long column with 0.25mm internal diameter (Id). The Micro GC 3000 had an 8m long column with a 0.32mm Id. By varying the column temperature and column pressure while holding all other parameters constant, the ideal conditions for testing with each column length in their individual instrument configurations were determined. The criteria used for determining the optimal method parameters included (in no particular order) (1) quickest run time, (2) peak sharpness, and (3) peak separation. After testing numerous combinations of temperature and pressure, the parameters for each column length that resulted in the most optimal data given my three criteria were selected. The ideal temperature and pressure for the 20m column were 95 C and 50psig. At this temperature and pressure, the peaks were separated and the retention times were shorter compared to other combinations. The Inficon Micro GC 3000 operated better at lower temperature mainly due to the shorter 8m column. The optimal column temperature and pressure were 70 C and 30psig. The Inficon Micro GC 3000 8m column had worse separation than the Inficon Fusion 20m column, but was able to separate water within a shorter run time. Therefore, the most significant tradeoff between the two column lengths was peak separation of the sample versus run time. After performing several tests, it was concluded that better detection via good peak separation with a longer run time is a better asset than moderate peak separation with a shorter run time. Even given that RESOLVE is highly interested in water and that mission timeline is of significant importance given the short seven-to-ten-day mission timeline, worse detection with an 8m column may lead to overlooking other substances existing on the moon that could advance planetary science. Thus, I recommend the 20m column. However, if mission timeline and water separation are deemed the highest priority, the 8m column should be selected due to its ability to separate water within a shorter run time than the 20m column.

Techniques for caesarean section.

PubMed

Hofmeyr, G J; Mathai, M; Shah, A; Novikova, N

2008-01-23

Rates of caesarean section (CS) have been rising globally. It is important to use the most effective and safe technique. To compare the effects of complete methods of caesarean section; and to summarise the findings of reviews of individual aspects of caesarean section technique. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (August 2007), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2007, Issue 3) and reference lists of identified papers. Randomised controlled trials of intention to perform caesarean section using different techniques. Two review authors independently assessed studies and extracted data. 'Joel-Cohen based' compared with Pfannenstiel CS was associated with: less blood loss, (five trials, 481 women; weighted mean difference (WMD) -64.45 ml; 95% confidence interval (CI) -91.34 to -37.56 ml); shorter operating time (five trials, 581 women; WMD -18.65; 95% CI -24.84 to -12.45 minutes); postoperatively, reduced time to oral intake (five trials, 481 women; WMD -3.92; 95% CI -7.13 to -0.71 hours); less fever (eight trials, 1412 women; relative risk (RR) 0.47; 95% CI 0.28 to 0.81); shorter duration of postoperative pain (two comparisons from one trial, 172 women; WMD -14.18 hours; 95% CI -18.31 to -10.04 hours); fewer analgesic injections (two trials, 151 women; WMD -0.92; 95% CI -1.20 to -0.63); and shorter time from skin incision to birth of the baby (five trials, 575 women; WMD -3.84 minutes; 95% CI -5.41 to -2.27 minutes). Serious complications and blood transfusions were too few for analysis.Misgav-Ladach compared with the traditional method (lower midline abdominal incision) was associated with reduced: blood loss (339 women; WMD -93.00; 95% CI -132.72 to -53.28 ml); operating time (339 women; WMD-7.30; 95% CI -8.32 to -6.28 minutes); time to mobilisation (339 women; WMD -16.06; 95% CI -18.22 to -13.90 hours); and length of postoperative stay for the mother (339 women; WMD -0.82; 95% CI -1.08 to -0.56 days). Misgav-Ladach compared with modified Misgav-Ladach methods was associated with a longer time from skin incision to birth of the baby (116 women; WMD 2.10; 95% CI 1.10 to 3.10 minutes). 'Joel-Cohen based' methods have advantages compared to Pfannenstiel and to traditional (lower midline) CS techniques, which could translate to savings for the health system. However, these trials do not provide information on mortality and serious or long-term morbidity such as morbidly adherent placenta and scar rupture.

Isolation and characterization of nanocrystalline cellulose from roselle-derived microcrystalline cellulose.

PubMed

Kian, Lau Kia; Jawaid, Mohammad; Ariffin, Hidayah; Karim, Zoheb

2018-07-15

Roselle fiber is a renewable and sustainable agricultural waste enriched with cellulose polysaccharides. The isolation of Nanocrystalline cellulose (NCC) from roselle-derived microcrystalline cellulose (MCC) is an alternative approach to recover the agricultural roselle plant residue. In the present study, acid hydrolysis with different reaction time was carried out to degrade the roselle-derived MCC to form NCC. The characterizations of isolated NCC were conducted through Fourier Transform Infrared Ray (FTIR), Transmission Electron Microscopy (TEM), Field Emission Scanning Electron Microscopy (FESEM), Atomic Force Microscopy (AFM), Dynamic Light Scattering (DLS), Energy Dispersive Spectroscopy (EDS), X-ray Diffraction (XRD), Thermogravimetric Analysis (TGA) and Differential Scanning Calorimetry (DSC). As evaluated from the performed morphological investigations, the needle-like shape NCC nanostructures were observed under TEM and AFM microscopy studies, while irregular rod-like shape of NCC was observed under FESEM analysis. With 60min hydrolysis time, XRD analysis demonstrated the highest NCC crystallinity degree with 79.5%. In thermal analysis by TGA and DSC, the shorter hydrolysis time tended to produce NCC with higher thermal stability. Thus, the isolated NCC from roselle-derived MCC has high potential to be used in application of pharmaceutical and biomedical fields for nanocomposite fabrication. Copyright © 2018 Elsevier B.V. All rights reserved.

Estimation of error on the cross-correlation, phase and time lag between evenly sampled light curves

NASA Astrophysics Data System (ADS)

Misra, R.; Bora, A.; Dewangan, G.

2018-04-01

Temporal analysis of radiation from Astrophysical sources like Active Galactic Nuclei, X-ray Binaries and Gamma-ray bursts provides information on the geometry and sizes of the emitting regions. Establishing that two light-curves in different energy bands are correlated, and measuring the phase and time-lag between them is an important and frequently used temporal diagnostic. Generally the estimates are done by dividing the light-curves into large number of adjacent intervals to find the variance or by using numerically expensive simulations. In this work we have presented alternative expressions for estimate of the errors on the cross-correlation, phase and time-lag between two shorter light-curves when they cannot be divided into segments. Thus the estimates presented here allow for analysis of light-curves with relatively small number of points, as well as to obtain information on the longest time-scales available. The expressions have been tested using 200 light curves simulated from both white and 1 / f stochastic processes with measurement errors. We also present an application to the XMM-Newton light-curves of the Active Galactic Nucleus, Akn 564. The example shows that the estimates presented here allow for analysis of light-curves with relatively small (∼ 1000) number of points.

Time from prior chemotherapy enhances prognostic risk grouping in the second-line setting of advanced urothelial carcinoma: a retrospective analysis of pooled, prospective phase 2 trials.

PubMed

Sonpavde, Guru; Pond, Gregory R; Fougeray, Ronan; Choueiri, Toni K; Qu, Angela Q; Vaughn, David J; Niegisch, Guenter; Albers, Peter; James, Nicholas D; Wong, Yu-Ning; Ko, Yoo-Joung; Sridhar, Srikala S; Galsky, Matthew D; Petrylak, Daniel P; Vaishampayan, Ulka N; Khan, Awais; Vogelzang, Nicholas J; Beer, Tomasz M; Stadler, Walter M; O'Donnell, Peter H; Sternberg, Cora N; Rosenberg, Jonathan E; Bellmunt, Joaquim

2013-04-01

Outcomes for patients in the second-line setting of advanced urothelial carcinoma (UC) are dismal. The recognized prognostic factors in this context are Eastern Cooperative Oncology Group (ECOG) performance status (PS) >0, hemoglobin level (Hb) <10 g/dl, and liver metastasis (LM). The purpose of this retrospective study of prospective trials was to investigate the prognostic value of time from prior chemotherapy (TFPC) independent of known prognostic factors. Data from patients from seven prospective trials with available baseline TFPC, Hb, PS, and LM values were used for retrospective analysis (n=570). External validation was conducted in a second-line phase 3 trial comparing best supportive care (BSC) versus vinflunine plus BSC (n=352). Cox proportional hazards regression was used to evaluate the association of factors, with overall survival (OS) and progression-free survival (PFS) being the respective primary and secondary outcome measures. ECOG-PS >0, LM, Hb <10 g/dl, and shorter TFPC were significant prognostic factors for OS and PFS on multivariable analysis. Patients with zero, one, two, and three to four factors demonstrated median OS of 12.2, 6.7, 5.1, and 3.0 mo, respectively (concordance statistic=0.638). Setting of prior chemotherapy (metastatic disease vs perioperative) and prior platinum agent (cisplatin or carboplatin) were not prognostic factors. External validation demonstrated a significant association of TFPC with PFS on univariable and most multivariable analyses, and with OS on univariable analyses. Limitations of retrospective analyses are applicable. Shorter TFPC enhances prognostic classification independent of ECOG-PS >0, Hb <10 g/dl, and LM in the setting of second-line therapy for advanced UC. These data may facilitate drug development and interpretation of trials. Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Colorectal cancer surgery in the very elderly patient: a systematic review of laparoscopic versus open colorectal resection.

PubMed

Devoto, Laurence; Celentano, Valerio; Cohen, Richard; Khan, Jim; Chand, Manish

2017-09-01

Colorectal cancer is the second most common cause of death from neoplastic disease in men and third in women of all ages. Globally, life expectancy is increasing, and consequently, an increasing number of operations are being performed on more elderly patients with the trend set to continue. Elderly patients are more likely to have cardiovascular and pulmonary comorbidities that are associated with increased peri-operative risk. They further tend to present with more locally advanced disease, more likely to obstruct or have disseminated disease. The aim of this review was to investigate the feasibility of laparoscopic colorectal resection in very elderly patients, and whether there are benefits over open surgery for colorectal cancer. A systematic literature search was performed on Medline, Pubmed, Embase and Google Scholar. All comparative studies evaluating patients undergoing laparoscopic versus open surgery for colorectal cancer in the patients population over 85 were included. The primary outcomes were 30-day mortality and 30-day overall morbidity. Secondary outcomes were operating time, time to oral diet, number of retrieved lymph nodes, blood loss and 5-year survival. The search provided 1507 citations. Sixty-nine articles were retrieved for full text analysis, and only six retrospective studies met the inclusion criteria. Overall mortality for elective laparoscopic resection was 2.92% and morbidity 23%. No single study showed a significant difference between laparoscopic and open surgery for morbidity or mortality, but pooled data analysis demonstrated reduced morbidity in the laparoscopic group (p = 0.032). Patients undergoing laparoscopic surgery are more likely to have a shorter hospital stay and a shorter time to oral diet. Elective laparoscopic resection for colorectal cancer in the over 85 age group is feasible and safe and offers similar advantages over open surgery to those demonstrated in patients of younger ages.

Accounting for inter-annual and seasonal variability in regionalization of hydrologic response in the Great Lakes basin

NASA Astrophysics Data System (ADS)

Kult, J. M.; Fry, L. M.; Gronewold, A. D.

2012-12-01

Methods for predicting streamflow in areas with limited or nonexistent measures of hydrologic response typically invoke the concept of regionalization, whereby knowledge pertaining to gauged catchments is transferred to ungauged catchments. In this study, we identify watershed physical characteristics acting as primary drivers of hydrologic response throughout the US portion of the Great Lakes basin. Relationships between watershed physical characteristics and hydrologic response are generated from 166 catchments spanning a variety of climate, soil, land cover, and land form regimes through regression tree analysis, leading to a grouping of watersheds exhibiting similar hydrologic response characteristics. These groupings are then used to predict response in ungauged watersheds in an uncertainty framework. Results from this method are assessed alongside one historical regionalization approach which, while simple, has served as a cornerstone of Great Lakes regional hydrologic research for several decades. Our approach expands upon previous research by considering multiple temporal characterizations of hydrologic response. Due to the substantial inter-annual and seasonal variability in hydrologic response observed over the Great Lakes basin, results from the regression tree analysis differ considerably depending on the level of temporal aggregation used to define the response. Specifically, higher levels of temporal aggregation for the response metric (for example, indices derived from long-term means of climate and streamflow observations) lead to improved watershed groupings with lower within-group variance. However, this perceived improvement in model skill occurs at the cost of understated uncertainty when applying the regression to time series simulations or as a basis for model calibration. In such cases, our results indicate that predictions based on long-term characterizations of hydrologic response can produce misleading conclusions when applied at shorter time steps. This study suggests that measures of hydrologic response quantified at these shorter time steps may provide a more robust basis for making predictions in applications of water resource management, model calibration and simulations, and human health and safety.

Racial differences in advanced colorectal cancer outcomes and pharmacogenetics: a subgroup analysis of a large randomized clinical trial.

PubMed

Sanoff, Hanna K; Sargent, Daniel J; Green, Erin M; McLeod, Howard L; Goldberg, Richard M

2009-09-01

Racial disparities in colorectal cancer (CRC) survival are documented, but there are few data on comparative response to chemotherapy. A subgroup analysis of a multisite National Cancer Institute-sponsored trial (N9741) was performed comparing outcomes of black and white patients with metastatic CRC receiving uniform treatment. Adverse events (AEs), response rate (RR), time to progression (TTP), overall survival (OS), and dose-intensity were examined as a function of self-reported race in 1,412 patients treated with irinotecan/fluorouracil, fluorouracil/oxaliplatin, or irinotecan/oxaliplatin. Pharmacogenetic analysis was performed on 486 patients with blood available for germline DNA analysis. OS was 1.5 months shorter and TTP was 0.6 months shorter in black than white patients (OS: hazard ratio [HR] = 1.13; 95% CI, 0.90 to 1.42; TTP: HR = 0.91, 95% CI, 0.73 to 1.13); neither difference was statistically significant. RR was significantly higher in whites (41%) than blacks (28%; P = .008). Grade 3 or greater AEs were also higher in whites (48%) than blacks (34%; P = .004). These relationships were maintained in multivariate models adjusting for arm, age, sex, and performance status. There was no difference in dose-intensity of delivered therapy. Significant racial differences in prevalence of pharmacogenetic variants were observed, although small sample size precluded investigating the relationship between treatment, race, and genotype. OS and TTP are similar in black and white patients treated per protocol with standardized therapy for metastatic CRC. However, RR and AEs vary considerably by race. The marked racial differences in relevant pharmacogenetics, a potential explanation for differing RR and AEs, are worthy of future study.

Estimation of surface heat and moisture fluxes over a prairie grassland. II - Two-dimensional time filtering and site variability

NASA Technical Reports Server (NTRS)

Crosson, William L.; Smith, Eric A.

1992-01-01

The behavior of in situ measurements of surface fluxes obtained during FIFE 1987 is examined by using correlative and spectral techniques in order to assess the significance of fluctuations on various time scales, from subdiurnal up to synoptic, intraseasonal, and annual scales. The objectives of this analysis are: (1) to determine which temporal scales have a significant impact on areal averaged fluxes and (2) to design a procedure for filtering an extended flux time series that preserves the basic diurnal features and longer time scales while removing high frequency noise that cannot be attributed to site-induced variation. These objectives are accomplished through the use of a two-dimensional cross-time Fourier transform, which serves to separate processes inherently related to diurnal and subdiurnal variability from those which impact flux variations on the longer time scales. A filtering procedure is desirable before the measurements are utilized as input with an experimental biosphere model, to insure that model based intercomparisons at multiple sites are uncontaminated by input variance not related to true site behavior. Analysis of the spectral decomposition indicates that subdiurnal time scales having periods shorter than 6 hours have little site-to-site consistency and therefore little impact on areal integrated fluxes.

Breastfeeding Duration and Primary Reasons for Breastfeeding Cessation among Women with Postpartum Depressive Symptoms.

PubMed

Bascom, Erin McElderry; Napolitano, Melissa A

2016-05-01

Although postpartum depression is associated with lower breastfeeding initiation rates and shorter breastfeeding duration, the potential mechanisms through which this relationship functions are not well understood. This study examined the breastfeeding behaviors of women with postpartum depressive symptoms (PDS) to identify potential motivations for early breastfeeding cessation. An analysis of quantitative data from the Infant Feeding Practices Study II examined the relationship between PDS and breastfeeding behaviors, including breastfeeding duration and primary reasons for early breastfeeding cessation. Of the women in the sample, 30.9% met criteria for mild PDS. Women with PDS had shorter overall (18.4 vs 21.8 weeks, P = .001) and exclusive breastfeeding duration (3.6 vs 4.7 weeks, P = .012) than women without PDS. A larger proportion of women with PDS stopped breastfeeding before 6 months (68.7% vs 57.2%, P < .001). After controlling for socioeconomic status, education, marital status, employment status, race/ethnicity, maternal age, parity, and breastfeeding intentions, presence of PDS significantly predicted higher odds of reporting "too many household duties" (OR = 1.90, P = .011) as a primary reason for breastfeeding cessation among women who stopped breastfeeding before 6 months. After controlling for these same covariates, women with PDS had, on average, 2.4 weeks shorter breastfeeding duration than women without PDS (P = .025). There is a high prevalence of depressive symptoms among new mothers, and most do not breastfeed for recommended time periods. Increased PDS screening during prenatal and postpartum visits and promotion of lactation support services may better address the high rates of PDS and suboptimal breastfeeding behavior. © The Author(s) 2015.

Laparoscopic versus open abdominal surgery in children with sickle cell disease is associated with a shorter hospital stay.

PubMed

Goers, Trudie; Panepinto, Julie; Debaun, Michael; Blinder, Morey; Foglia, Robert; Oldham, Keith T; Field, Joshua J

2008-03-01

Limited information exists comparing the post-operative complication rate of laparoscopic or open abdominal surgeries in children with sickle cell disease (SCD). The primary objective of this study was to compare the outcomes in children with SCD who required laparoscopic or open abdominal surgery for a cholecystectomy or splenectomy. We conducted a retrospective analysis of laparoscopic and open abdominal surgeries performed in children with SCD (ages 0-20 years) at two medical centers from 1984 to 2004. The primary outcome measures were the rates of post-operative pain and acute chest syndrome (ACS) episodes following laparoscopic or open abdominal surgery. The secondary outcome was length of hospital stay following surgery. We also examined the potential contribution of pre-operative (transfusion) and intra-operative factors (operating time, estimated blood loss, and end-operative temperature) to post-operative SCD-related complications. A total of 140 cases were identified, 98 laparoscopic and 42 open. Episodes of post-operative pain and ACS episodes were comparable between laparoscopic and open procedures (pain: 4% vs. 3%, P = 0.619; ACS: 5% vs. 5%, P = 0.933). Additionally, laparoscopic surgeries were associated with a significantly shorter hospital stay (2.9 vs. 5.4 days, 95% CI -3.7 to -1.4, P < 0.001). There was no difference in the number of hospital readmissions within 1 month of the surgery. For children with SCD who need a cholecystectomy or splenectomy, laparoscopy is the preferred strategy because of a shorter hospital stay with a similar complication rate compared to open surgeries. (c) 2007 Wiley-Liss, Inc.

Ecomorphology of the external flight apparatus of blackcaps (Sylvia atricapilla) with different migration behavior.

PubMed

Fiedler, Wolfgang

2005-06-01

An analysis of the external flight apparatus of 700 blackcaps from eight different populations (sedentary to long-distance migrators) is presented. With increasing migration distances of populations, (1) wing length, aspect ratio, and wing pointedness increase; (2) wing load decreases; (3) slots on the wing tips become relatively shorter; (4) the alula tends to be shorter in relation to wing length; and (5) the tail is shorter in relation to wing length. Although body mass increases from southern to northern populations, changes in wing length and wing area are two to three times larger than expected for simple isometric relationships. Regarding the aerodynamic background of these changes, it can be stated that traits for energy-effective flight are more strongly developed and traits for maneuverability are less developed in birds traveling longer distances, presumably as a consequence of trade-offs. Nonmigratory blackcaps from Madeira and the Cape Verde islands do not always show the traits we would expect in view of their sedentary behavior. This can be seen as a result of recent colonization of these islands by migrants or of selection by factors other than migration behavior. In migratory populations, changes between the first and the second set of primaries during first complete molt show almost the same pattern as the changes from nonmigratory to migratory populations. During molt of the primaries, blackcaps of nonmigratory populations do not show these changes. Hybrids between migrating and nonmigrating blackcap populations (Moscow and Madeira) showed intermediate values between parent populations in wing length, wing shape, and wing area; in the other variables they resembled either parent population.

A comprehensive overview of the spatial and temporal variability of apple bud dormancy release and blooming phenology in Western Europe

NASA Astrophysics Data System (ADS)

Legave, Jean Michel; Blanke, Michael; Christen, Danilo; Giovannini, Daniela; Mathieu, Vincent; Oger, Robert

2013-03-01

In the current context of global warming, an analysis is required of spatially-extensive and long-term blooming data in fruit trees to make up for insufficient information on regional-scale blooming changes and determinisms that are key to the phenological adaptation of these species. We therefore analysed blooming dates over long periods at climate-contrasted sites in Western Europe, focusing mainly on the Golden Delicious apple that is grown worldwide. On average, blooming advances were more pronounced in northern continental (10 days) than in western oceanic (6-7 days) regions, while the shortest advance was found on the Mediterranean coastline. Temporal trends toward blooming phase shortenings were also observed in continental regions. These regional differences in temporal variability across Western Europe resulted in a decrease in spatial variability, i.e. shorter time intervals between blooming dates in contrasted regions (8-10-day decrease for full bloom between Mediterranean and continental regions). Fitted sequential models were used to reproduce phenological changes. Marked trends toward shorter simulated durations of forcing period (bud growth from dormancy release to blooming) and high positive correlations between these durations and observed blooming dates support the notion that blooming advances and shortenings are mainly due to faster satisfaction of the heating requirement. However, trends toward later dormancy releases were also noted in oceanic and Mediterranean regions. This could tend toward blooming delays and explain the shorter advances in these regions despite similar or greater warming. The regional differences in simulated chilling and forcing periods were consistent with the regional differences in temperature increases.

The new economics of radical prostatectomy: cost comparison of open, laparoscopic and robot assisted techniques.

PubMed

Lotan, Yair; Cadeddu, Jeffrey A; Gettman, Matthew T

2004-10-01

We evaluated the costs components of laparoscopic (LRP) and robot assisted prostatectomy (RAP), and compared their costs to those of open radical retropubic prostatectomy (RRP). A model was created using commercially available software to compare the costs of treatment with LRP, RAP or RRP. Hospital costs were obtained from a large county hospital. A literature search was performed to determine typical (average) robot costs, length of stay and operative time for RRP, LRP and RAP. We limited our analysis to mature series and included only the most recent efforts. The cost of the robot was estimated at 1,200,000 dollars with a 100,000 dollars yearly maintenance contract. It was assumed that the robot would be used across specialities for a total of 300 cases yearly in a 7-year period. We performed a series of 1 and 2-way sensitivity analyses to evaluate the costs of LRP, RAP and RRP, while varying robot costs, the number of robotic cases, hospital length of stay, operative time and cost of laparoscopic/robotic equipment. RRP was the most cost-effective approach with a cost advantage of 487 dollars and 1,726 dollars over LRP and RAP, respectively. If we excluded the initial cost of purchasing a robot, the cost difference between RRP and RAP was 1,155 dollars. This large difference in RRP and RAP costs resulted from a cost of 857 dollars per case to pay for robot purchase and maintenance, and the high cost of 1,705 dollars for equipment per case. An even shorter RAP operative time (140 vs 160 minutes) and length of stay (1.2 vs 2.5 days) did not compensate for the added expenditure. LRP cost more than RRP primarily due to equipment costs (533 dollars) since the shorter hospital stay (1.3 vs 2.5 days) was compensated for by longer operative time (200 vs 160 minutes). The costs of new technology are typically borne out in the first years of use and RAP is no exception with high robot costs for purchase, maintenance and operative equipment overshadowing savings gained by shorter length of stay. While RRP is currently the least costly approach, LRP has proved to be almost as cost competitive as RRP, whereas RAP will require a significant decrease in the cost of the device and maintenance fees.

Time profile of type 3 bursts in decameter and hectometer range

NASA Technical Reports Server (NTRS)

Takakura, T.; Naito, Y.; Ohki, K.

1973-01-01

The following new hypothesis is proposed. The decay time of plasma waves is much shorter than the time scale of type 3 bursts especially at low frequencies. Accordingly, the time variation of radio flux at a given frequency merely corresponds to the flux of fast electrons passing through the corresponding plasma layer.

Early declaration of death by neurologic criteria results in greater organ donor potential.

PubMed

Resnick, Shelby; Seamon, Mark J; Holena, Daniel; Pascual, Jose; Reilly, Patrick M; Martin, Niels D

2017-10-01

Aggressive management of patients prior to and after determination of death by neurologic criteria (DNC) is necessary to optimize organ recovery, transplantation, and increase the number of organs transplanted per donor (OTPD). The effects of time management are understudied but potentially pivotal component. The objective of this study was to analyze specific time points (time to DNC, time to procurement) and the time intervals between them to better characterize the optimal timeline of organ donation. Using data over a 5-year time period (2011-2015) from the largest US OPO, all patients with catastrophic brain injury and donated transplantable organs were retrospectively reviewed. Active smokers were excluded. Maximum donor potential was seven organs (heart, lungs [2], kidneys [2], liver, and pancreas). Time from admission to declaration of DNC and donation was calculated. Mean time points stratified by specific organ procurement rates and overall OTPD were compared using unpaired t-test. Of 1719 Declaration of Death by Neurologic Criteria organ donors, 381 were secondary to head trauma. Smokers and organs recovered but not transplanted were excluded leaving 297 patients. Males comprised 78.8%, the mean age was 36.0 (±16.8) years, and 87.6% were treated at a trauma center. Higher donor potential (>4 OTPD) was associated with shorter average times from admission to brain death; 66.6 versus 82.2 hours, P = 0.04. Lung donors were also associated with shorter average times from admission to brain death; 61.6 versus 83.6 hours, P = 0.004. The time interval from DNC to donation varied minimally among groups and did not affect donation rates. A shorter time interval between admission and declaration of DNC was associated with increased OTPD, especially lungs. Further research to identify what role timing plays in the management of the potential organ donor and how that relates to donor management goals is needed. Copyright © 2017 Elsevier Inc. All rights reserved.

Assessment of Time to Clinical Response, a Proxy for Discharge Readiness, among Hospitalized Patients with Community-Acquired Pneumonia Who Received either Ceftaroline Fosamil or Ceftriaxone in Two Phase III FOCUS Trials

PubMed Central

Anzueto, Antonio R.; Weber, David J.; Shorr, Andrew F.; Yang, Min; Smith, Alexander; Zhao, Qi; Huang, Xingyue; File, Thomas M.

2014-01-01

The primary driver of health care costs for patients with community-acquired pneumonia (CAP) is the hospital length of stay (LOS). Unfortunately, hospital LOS comparisons are difficult to make from phase III CAP trials because of their structured designs and prespecified treatment durations. However, an opportunity still exists to draw inferences about potential LOS differences between treatments through the use of surrogates for hospital discharge. The intent of this study was to quantify the time to a clinical response, a proxy for the time to discharge readiness, among hospitalized CAP patients who received either ceftaroline or ceftriaxone in two phase III CAP FOCUS clinical trials. On the basis of the Infectious Diseases Society of America and American Thoracic Society CAP management guidelines and recent FDA guidance documents for community-acquired bacterial pneumonia, a post hoc adjudication algorithm was constructed a priori to compare the time to a clinical response, a proxy for the time to discharge readiness, between patients who received ceftaroline or ceftriaxone. Overall, 1,116 patients (ceftaroline, n = 562; ceftriaxone, n = 554) from the pooled FOCUS trials met the selection criteria for this analysis. Kaplan-Meier analyses showed that ceftaroline was associated with a shorter time, measured in days, to meeting the clinical response criteria (P = 0.03). Of the patients on ceftaroline, 61.0, 76.1, and 83.6% achieved a clinical response by days 3, 4, and 5, compared to 54.3, 69.8, and 79.3% of the ceftriaxone-treated patients. In the Cox regression, ceftaroline was associated with a shorter time to a clinical response (HR, 1.16, P = 0.02). The methodology employed here provides a framework to draw comparative effectiveness inferences from phase III CAP efficacy trials. (The FOCUS trials whose data were analyzed in this study have been registered at ClinicalTrials.gov under registration no. NCT00621504 and NCT00509106.) PMID:25487791

Sleep Characteristics and Carotid Atherosclerosis Among Midlife Women.

PubMed

Thurston, Rebecca C; Chang, Yuefang; von Känel, Roland; Barinas-Mitchell, Emma; Jennings, J Richard; Hall, Martica H; Santoro, Nanette; Buysse, Daniel J; Matthews, Karen A

2017-02-01

Midlife, which encompasses the menopause transition in women, can be a time of disrupted sleep and accelerated atherosclerosis accumulation. Short or poor sleep quality has been associated with cardiovascular disease (CVD) risk; few studies have investigated relations among midlife women. We tested whether shorter actigraphy sleep time or poorer subjective sleep quality was associated with carotid atherosclerosis among midlife women. Two hundred fifty-six peri- and postmenopausal women aged 40-60 years completed 3 days of wrist actigraphy, hot flash monitoring, questionnaires (Pittsburgh Sleep Quality Index [PSQI], Berlin), a blood draw, and carotid ultrasound [intima media thickness (IMT), plaque]. Associations of objective (actigraphy) and subjective (PSQI) sleep with IMT/plaque were tested in regression models (covariates: age, race, education, body mass index, blood pressure, lipids, insulin resistance, medications, snoring, depressive symptoms, sleep hot flashes, and estradiol). Shorter objective sleep time was associated with higher odds of carotid plaque (for each hour shorter sleep, plaque score ≥ 2, odds ratio (OR) [95% confidence interval, CI] = 1.58 [1.11-2.27], p = .01; plaque score = 1, OR [95% CI] = 0.95 [0.68-1.32], p = .75, vs. no plaque, multivariable). Poorer subjective sleep quality was associated with higher mean IMT [β, b (standard error, SE) = 0.004 (0.002), p = .03], maximal IMT [b (SE) = 0.009 (0.003), p = .005], and plaque [plaque score ≥ 2, OR (95% CI) = 1.23 (1.09-1.40), p = .001; score = 1, OR (95% CI) = 1.06 (0.93-1.21), p = .37, vs. no plaque] in multivariable models. Findings persisted additionally adjusting for sleep hot flashes and estradiol. Shorter actigraphy-assessed sleep time and poorer subjective sleep quality were associated with increased carotid atherosclerosis among midlife women. Associations persisted adjusting for CVD risk factors, hot flashes, and estradiol. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Multicenter Clinical Evaluation of BacT/Alert Virtuo Blood Culture System.

PubMed

Jacobs, Michael R; Mazzulli, Tony; Hazen, Kevin C; Good, Caryn E; Abdelhamed, Ayman M; Lo, Pauline; Shum, Bianche; Roman, Katharine P; Robinson, Danielle C

2017-08-01

BacT/Alert Virtuo is an advanced, automated blood culture system incorporating improved automation and an enhanced detection algorithm to shorten time to detection. A multicenter study of the investigational Virtuo system (bioMérieux, Inc., Durham, NC) compared to BacT/Alert 3D (BTA3D) for detection of bacteremia/fungemia in four bottle types, SA and FA Plus (aerobic) and SN and FN Plus (anaerobic), was performed in a clinical setting with patient samples in a matched system design clinical trial. Blood was added to paired aerobic or anaerobic bottles, with the volume in each bottle in each pair required to be ≤10 ml and with the volumes required to be within 30% of each other. Of 5,709 bottle sets (52.5% aerobic pairs and 47.5% anaerobic pairs), 430 (7.5%) were positive for bacterial or fungal growth, with 342 (6.0%) clinically significant and 83 (1.5%) contaminated. A total of 3,539 sets (62.0%) were volume compliant, with 203 sets (5.7%) clinically significant. The positivity rates for volume-compliant bottle pairs determined by the two systems were comparable, with 68.7% of clinically significant isolates detected by both instruments, 15.7% by Virtuo only, and 15.7% by BTA3D only. Virtuo detected microbial growth nearly 2 h sooner overall than BTA3D (mean, 15.9 h versus 17.7 h). Shorter time to detection by Virtuo was related to organism group, with the time to detection being significantly shorter for enteric Gram-negative bacilli and enterococci (means, 3.6 h and 2.3 h shorter, respectively). This large clinical study demonstrated that the Virtuo blood culture system produced results comparable to those seen with the long-established BTA3D system, with significantly shorter time to detection. Copyright © 2017 Jacobs et al.

Efficacy and safety of mepivacaine compared with lidocaine in local anaesthesia in dentistry: a meta-analysis of randomised controlled trials.

PubMed

Su, Naichuan; Liu, Yan; Yang, Xianrui; Shi, Zongdao; Huang, Yi

2014-04-01

The objective of the study was to assess the efficacy and safety of mepivacaine compared with lidocaine used in local anaesthesia in dentistry. Medline, Cochrane Central Register of Controlled Trials, EMBASE, Chinese BioMedical Literature Database, China National Knowledge Infrastructure and WHO International Clinical Trials Registry Platform were searched electronically. Relevant journals and references of studies included were hand-searched for randomised controlled trials comparing mepivacaine with lidocaine in terms of efficacy and safety. Twenty-eight studies were included, of which 15 had low risk of bias and 13 had moderate risk of bias. In comparison with 2% lidocaine with 1:100,000 adrenaline, 3% mepivacaine showed a lower success rate (P = 0.05), a shorter onset time of pulpal anaesthesia (P = 0.0005), inferior pain control during injection phase and superior inhibition of heart rate increase (P < 0.0001). In contrast, 2% mepivacaine with 1:100,000 adrenaline gave a higher success rate (P < 0.00001), a similar onset time of pulpal anaesthesia (P = 0.34) and superior pain control during injection phase (P < 0.0001); 2% mepivacaine with 1:20,000 levonordefrin had the same success rate (P = 0.69) and similar onset time of pulpal anaesthesia (P = 0.90). In addition, 3% mepivacaine had shorter onset time (P = 0.004), same level of success rate (P = 0.28) and similar pain control during injection and postinjection compared with 2% lidocaine with 1:50,000 adrenaline. Given the efficacy and safety of the two solutions, 2% mepivacaine with vasoconstrictors is better than 2% lidocaine with vasoconstrictors in dental treatment. Meanwhile, 3% plain mepivacaine is better for patients with cardiac diseases. © 2014 FDI World Dental Federation.

Early return of continence in patients undergoing robot-assisted laparoscopic prostatectomy using modified maximal urethral length preservation technique.

PubMed

Hamada, Alaa; Razdan, Shirin; Etafy, Mohamed H; Fagin, Randy; Razdan, Sanjay

2014-08-01

To evaluate the impact of maximal urethral length preservation (MULP) technique in comparison with posterior urethral reconstruction and anterior bladder suspension (PRAS) technique on the continence rates (CR), time to achieve continence among patients with prostate cancer (PCa) undergoing robot-assisted laparoscopic prostatectomy (RALP). We prospectively analyzed the CR, time to achieve continence, pre- and postoperative prostate-specific antigen (PSA) levels, rates of positive margins among three groups of continent men with PCa undergoing RALP from whom consent was obtained. Each group consisted of 30 patients: PRAS was performed in group A, combined MULP and PRAS in group B, and MULP in group C. Continence was measured by patient self-reporting of the number of pads/24 h. No differences were detected in the age, preoperative PSA levels, biochemical recurrence, prostate volume, and positive margins for the three groups. Men in groups B and C had marked improvement in CR 1, 3, and 6 months after catheter removal vs group A (50% and 70% vs 10%, 90% and 96.66% vs 23.3% and 100%, 100% vs 53.3%, respectively, P<0.0001). The average and median times to continence were significantly shorter in group B (5.4 and 4 weeks) and C (3.8 and 3 weeks) vs group A (27.4 and 22.5 weeks), P<0.00001. Using Cox regression analysis, only MULP and MULP+PRAS techniques were significantly correlated with continence outcomes 1, 3, and 6 months after catheter removal. MULP rather than PRAS confers higher postoperative CR and shorter time to achieve continence among patients with PCa who underwent RALP without increasing risk of positive margin.

Preliminary Investigation of Cardiovascular-Renal Disorders in Dogs with Chronic Mitral Valve Disease.

PubMed

Martinelli, E; Locatelli, C; Bassis, S; Crosara, S; Paltrinieri, S; Scarpa, P; Spalla, I; Zanaboni, A M; Quintavalla, C; Brambilla, P

2016-09-01

Veterinary literature lacks data about cardiovascular-renal disorders (CvRD) and cardiorenal-anemia syndrome (CRAS) in dogs. A direct correlation exists between ACVIM class and IRIS stage; chronic kidney disease (CKD) complicates chronic mitral valve disease (CMVD) more often than does anemia in dogs. One hundred and fifty-eight client-owned dogs with CMVD. Signalment, physical examination findings, electrocardiography, thoracic radiographs, echocardiography, and blood analysis were retrospectively evaluated to assess the prevalence of CKD and anemia in dogs with CMVD and to investigate the relationships among ACVIM class, IRIS stage, and survival. The prevalence of CKD and anemia in dogs with CMVD was significantly higher than in the general population of dogs. Dogs being treated for heart failure had a significantly higher prevalence of CKD than did dogs that had not received treatment. A statistically significant direct correlation was found between ACVIM class and IRIS stage. Severe heart disease, severe renal disease or both, furosemide administration, and advanced age at diagnosis of heart disease were associated with shorter survival time. Survival time of dogs affected by CvRD was statistically shorter than survival time of dogs affected by CMVD alone. Chronic mitral valve disease is associated with increased prevalence of CKD and anemia in dogs. Treatment for medical management of heart failure may play a role in inducing CKD. Class of heart disease and IRIS stage were directly correlated. Cardiovascular-renal disorders decrease survival time compared to the only presence of CMVD alone, whereas anemia does not play a central role in worsening heart function. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Transition-Tempered Metadynamics Is a Promising Tool for Studying the Permeation of Drug-like Molecules through Membranes.

PubMed

Sun, Rui; Dama, James F; Tan, Jeffrey S; Rose, John P; Voth, Gregory A

2016-10-11

Metadynamics is an important enhanced sampling technique in molecular dynamics simulation to efficiently explore potential energy surfaces. The recently developed transition-tempered metadynamics (TTMetaD) has been proven to converge asymptotically without sacrificing exploration of the collective variable space in the early stages of simulations, unlike other convergent metadynamics (MetaD) methods. We have applied TTMetaD to study the permeation of drug-like molecules through a lipid bilayer to further investigate the usefulness of this method as applied to problems of relevance to medicinal chemistry. First, ethanol permeation through a lipid bilayer was studied to compare TTMetaD with nontempered metadynamics and well-tempered metadynamics. The bias energies computed from various metadynamics simulations were compared to the potential of mean force calculated from umbrella sampling. Though all of the MetaD simulations agree with one another asymptotically, TTMetaD is able to predict the most accurate and reliable estimate of the potential of mean force for permeation in the early stages of the simulations and is robust to the choice of required additional parameters. We also show that using multiple randomly initialized replicas allows convergence analysis and also provides an efficient means to converge the simulations in shorter wall times and, more unexpectedly, in shorter CPU times; splitting the CPU time between multiple replicas appears to lead to less overall error. After validating the method, we studied the permeation of a more complicated drug-like molecule, trimethoprim. Three sets of TTMetaD simulations with different choices of collective variables were carried out, and all converged within feasible simulation time. The minimum free energy paths showed that TTMetaD was able to predict almost identical permeation mechanisms in each case despite significantly different definitions of collective variables.

Effect of Daikenchuto, a Traditional Japanese Herbal Medicine, after Total Gastrectomy for Gastric Cancer: A Multicenter, Randomized, Double-Blind, Placebo-Controlled, Phase II Trial.

PubMed

Yoshikawa, Kozo; Shimada, Mitsuo; Wakabayashi, Go; Ishida, Koichiro; Kaiho, Takashi; Kitagawa, Yuko; Sakamoto, Junichi; Shiraishi, Norio; Koeda, Keisuke; Mochiki, Erito; Saikawa, Yoshiro; Yamaguchi, Kazuya; Watanabe, Masayuki; Morita, Satoshi; Kitano, Seigo; Saji, Shigetoyo; Kanematsu, Takashi; Kitajima, Masaki

2015-08-01

Daikenchuto (DKT) has widely been used to improve abdominal symptoms by being expected to accelerate bowel motility. The purpose of this study is to examine the efficacy and safety of DKT for prevention of ileus and associated gastrointestinal symptoms after total gastrectomy. Two hundred and forty-five gastric cancer patients who underwent total gastrectomy were enrolled. Patients received either DKT (15.0 g/d) or matching placebo from postoperative days 1 to 12. Primary end points were time to first flatus, time to first bowel movement (BM), and frequency of BM. Secondary end points included quality of life, C-reactive protein level, symptoms indicative of a severe gastrointestinal disorder, and incidence of postoperative ileus. A total of 195 patients (DKT, n = 96; placebo, n = 99) were included in the per-protocol set analysis. There were no significant differences between the groups in terms of patient background characteristics. Median time to first BM was shorter in the DKT group than in the placebo group (94.7 hours vs 113.9 hours; p = 0.051). In patients with high medication adherence, median time to first BM was significantly shorter in the DKT group than in the placebo group (93.8 hours vs 115.1 hours; p = 0.014). Significantly fewer patients in the DKT group had ≥2 symptoms of gastrointestinal dysfunction than those in the placebo group on postoperative day 12 (p = 0.026). Administration of DKT during the immediate postoperative period after total gastrectomy appears to promote early recovery of postoperative bowel function. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

From Laser Scanning to Finite Element Analysis of Complex Buildings by Using a Semi-Automatic Procedure.

PubMed

Castellazzi, Giovanni; D'Altri, Antonio Maria; Bitelli, Gabriele; Selvaggi, Ilenia; Lambertini, Alessandro

2015-07-28

In this paper, a new semi-automatic procedure to transform three-dimensional point clouds of complex objects to three-dimensional finite element models is presented and validated. The procedure conceives of the point cloud as a stacking of point sections. The complexity of the clouds is arbitrary, since the procedure is designed for terrestrial laser scanner surveys applied to buildings with irregular geometry, such as historical buildings. The procedure aims at solving the problems connected to the generation of finite element models of these complex structures by constructing a fine discretized geometry with a reduced amount of time and ready to be used with structural analysis. If the starting clouds represent the inner and outer surfaces of the structure, the resulting finite element model will accurately capture the whole three-dimensional structure, producing a complex solid made by voxel elements. A comparison analysis with a CAD-based model is carried out on a historical building damaged by a seismic event. The results indicate that the proposed procedure is effective and obtains comparable models in a shorter time, with an increased level of automation.

Formation of Minor Phases in a Nickel-Based Disk Superalloy

NASA Technical Reports Server (NTRS)

Gabb, T. P.; Garg, A.; Miller, D. R.; Sudbrack, C. K.; Hull, D. R.; Johnson, D.; Rogers, R. B.; Gayda, J.; Semiatin, S. L.

2012-01-01

The minor phases of powder metallurgy disk superalloy LSHR were studied. Samples were consistently heat treated at three different temperatures for long times to approximate equilibrium. Additional heat treatments were also performed for shorter times, to then assess non-equilibrium conditions. Minor phases including MC carbides, M23C6 carbides, M3B2 borides, and sigma were identified. Their transformation temperatures, lattice parameters, compositions, average sizes and total area fractions were determined, and compared to estimates of an existing phase prediction software package. Parameters measured at equilibrium sometimes agreed reasonably well with software model estimates, with potential for further improvements. Results for shorter times representing non-equilibrium indicated significant potential for further extension of the software to such conditions, which are more commonly observed during heat treatments and service at high temperatures for disk applications.

Comparison of Slab and Cylinder Expansion Test Geometries for PBX 9501

NASA Astrophysics Data System (ADS)

Jackson, Scott; Anderson, Eric; Aslam, Tariq; Whitley, Von

2017-06-01

The slab expansion test or ``sandwich test'' is the two-dimensional analog of the axisymmetric cylinder expansion test. The test consists of a high-aspect-ratio rectangular cuboid of high explosive with the two large sides confined by a thin metal confiner. Analysis of the confiner motion after the passage of the detonation yields the detonation product isentrope, which is a specialized form of the product equation of state. The slab expansion geometry inherently exhibits a lower product expansion rate and lower plastic work on the confiner than the cylinder expansion geometry. The slab geometry does, however, have a shorter test time. We review recent slab and cylinder expansion data with PBX 9501, the associated equation of state analysis, and the advantages of each geometry for different applications.

Defect and field-enhancement characterization through electron-beam-induced current analysis

NASA Astrophysics Data System (ADS)

Umezawa, Hitoshi; Gima, Hiroki; Driche, Khaled; Kato, Yukako; Yoshitake, Tsuyoshi; Mokuno, Yoshiaki; Gheeraert, Etienne

2017-05-01

To investigate the effects of defects and field enhancement in diamond power devices, a biased Schottky barrier diode was characterized by electron-beam-induced current (EBIC) analysis. The nonuniform distribution of the electrical field was revealed by bright spots on the laterally expanded depletion layer of the EBIC intensity map when the applied electrical field exceeded 0.95 MV/cm. The nonuniformity is partly due to a structural effect: the roughness at the edge of the Schottky electrode, induced by lithography and lift-off processes. A second family of spots was shown to increase the leakage current of the device. The time constant associated with this second spot family was 0.98 ms, which is three orders of magnitude shorter than that for defects previously characterized by deep-level transient spectroscopy.

Association between Recurrent Metastasis from Stage II and III Primary Colorectal Tumors and Moderate Microsatellite Instability

PubMed Central

Garcia, Melissa; Choi, Chan; Kim, Hyeong-Rok; Daoud, Yahya; Toiyama, Yuji; Takahashi, Masanobu; Goel, Ajay; Boland, C Richard; Koi, Minoru

2012-01-01

Colorectal cancer (CRC) cells frequently have low levels of microsatellite instability (MSI-L) and elevated microsatellite alterations at tetranucleotide repeats (EMAST), but little is known about the clinicopathological significance of these features. We observed that patients with stage II or III CRC with MSI-L and/or EMAST had a shorter times of recurrence-free survival than patients with high levels of MSI (MSI-H) (P=.0084) or with highly stable microsatellites (H-MSS) (P=.0415), based on Kaplan-Meier analysis. MSI-L and/or EMAST were independent predictors of recurrent distant metastasis from primary stage II or III colorectal tumors (Cox proportional hazard analysis hazard ratio, 1.83; 95% confidence interval, 1.06–3.15; P=.0301). PMID:22465427

Autoionizing states driven by stochastic electromagnetic fields

NASA Astrophysics Data System (ADS)

Mouloudakis, G.; Lambropoulos, P.

2018-01-01

We have examined the profile of an isolated autoionizing resonance driven by a pulse of short duration and moderately strong field. The analysis has been based on stochastic differential equations governing the time evolution of the density matrix under a stochastic field. Having focused our quantitative analysis on the 2{{s}}2{{p}}({}1{{P}}) resonance of helium, we have investigated the role of field fluctuations and of the duration of the pulse. We report surprisingly strong distortion of the profile, even for peak intensity below the strong field limit. Our results demonstrate the intricate connection between intensity and pulse duration, with the latter appearing to be the determining influence, even for a seemingly short pulse of 50 fs. Further effects that would arise under much shorter pulses are discussed.

40 CFR 79.33 - Motor vehicle diesel fuel.

Code of Federal Regulations, 2010 CFR

2010-07-01

... data may be for such shorter period. (1) Hydrocarbon composition (aromatic content, olefin content, saturate content), with the methods of analysis identified; (2) Polynuclear organic material content, sulfur content, and trace element content, with the methods of analysis identified; (3) Distillation...

Bar-spheroid interaction in galaxies

NASA Technical Reports Server (NTRS)

Hernquist, Lars; Weinberg, Martin D.

1992-01-01

N-body simulation and linear analysis is employed to investigate the secular evolution of barred galaxies, with emphasis on the interaction between bars and spheroidal components of galaxies. This interaction is argued to drive secular transfer of angular momentum from bars to spheroids, primarily through resonant coupling. A moderately strong bar, having mass within corotation about 0.3 times the enclosed spheroid mass, is predicted to shed all its angular momentum typically in less than about 10 exp 9 yr. Even shorter depletion time scales are found for relatively more massive bars. It is suggested either that spheroids around barred galaxies are structured so as to inhibit strong coupling with bars, or that bars can form by unknown processes long after disks are established. The present models reinforce the notion that bars can drive secular evolution in galaxies.

Comparing the demands of destination entry using Google Glass and the Samsung Galaxy S4 during simulated driving.

PubMed

Beckers, Niek; Schreiner, Sam; Bertrand, Pierre; Mehler, Bruce; Reimer, Bryan

2017-01-01

The relative impact of using a Google Glass based voice interface to enter a destination address compared to voice and touch-entry methods using a handheld Samsung Galaxy S4 smartphone was assessed in a driving simulator. Voice entry (Google Glass and Samsung) had lower subjective workload ratings, lower standard deviation of lateral lane position, shorter task durations, faster remote Detection Response Task (DRT) reaction times, lower DRT miss rates, and resulted in less time glancing off-road than the primary visual-manual interaction with the Samsung Touch interface. Comparing voice entry methods, using Google Glass took less time, while glance metrics and reaction time to DRT events responded to were similar. In contrast, DRT miss rate was higher for Google Glass, suggesting that drivers may be under increased distraction levels but for a shorter period of time; whether one or the other equates to an overall safer driving experience is an open question. Copyright © 2016 Elsevier Ltd. All rights reserved.

Patient navigation reduces time to care for patients with breast symptoms and abnormal screening mammograms.

PubMed

McKevitt, Elaine; Dingee, Carol; Warburton, Rebecca; Pao, Jin-Si; Brown, Carl J; Wilson, Christine; Kuusk, Urve

2018-05-01

Concern has been raised about delays for patients presenting with breast symptoms in Canada. Our objective was to determine if our Rapid Access Breast Clinic (RABC) improved care for patients presenting with breast symptoms compared to the traditional system (TS). A retrospective chart review tabulated demographic, surgical, pathology and radiologic information. Wait times to care were determined for patients presenting with symptomatic and screen detected breast problems. Time from presentation to surgeon evaluation was shorter in the RABC group for patients with breast symptoms (81 vs 35 days, p < .0001) and abnormal screens (72 vs 40 days, p = .092). Cancer patients with abnormal screens had shorter wait times than patients with breast symptoms in the TS (47 vs 70 days, p = .036). Coordination of imaging and clinical care reduces wait times in patients with both abnormal screening mammograms and symptomatic breast presentations and should be expanded in our province. Copyright © 2018 Elsevier Inc. All rights reserved.

The level and nature of autistic intelligence III: Inspection time.

PubMed

Barbeau, Elise B; Soulières, Isabelle; Dawson, Michelle; Zeffiro, Thomas A; Mottron, Laurent

2013-02-01

Across the autism spectrum, level of intelligence is highly dependent on the psychometric instrument used for assessment, and there are conflicting views concerning which measures best estimate autistic cognitive abilities. Inspection time is a processing speed measure associated with general intelligence in typical individuals. We therefore investigated autism spectrum performance on inspection time in relation to two different general intelligence tests. Autism spectrum individuals were divided into autistic and Asperger subgroups according to speech development history. Compared to a typical control group, mean inspection time for the autistic subgroup but not the Asperger subgroup was significantly shorter (by 31%). However, the shorter mean autistic inspection time was evident only when groups were matched on Wechsler IQ and disappeared when they were matched using Raven's Progressive Matrices. When autism spectrum abilities are compared to typical abilities, results may be influenced by speech development history as well as by the instrument used for intelligence matching. 2013 APA, all rights reserved

Point prevalence of access block and overcrowding in New Zealand emergency departments in 2010 and their relationship to the 'Shorter Stays in ED' target.

PubMed

Jones, Peter G; Olsen, Sarah

2011-10-01

To document the extent of access block and ED overcrowding in New Zealand in 2010 and to determine whether these were linked to the hospital's ability to meet the Shorter Stays in ED target. Surveys of all New Zealand EDs were undertaken at two points in time in 2010 to determine ED occupancy. Data on target achievement during corresponding time periods were obtained from the Ministry of Health. In tertiary and secondary hospitals, respectively, access block was seen in 64% versus 23% (P= 0.05) and overcrowding was seen in 57.1% versus 39% (P= 0.45). No hospital with access block met the 'Shorter Stays' target, compared with 60% without access block (P= 0.001). Twenty-three per cent of hospitals with ED overcrowding met the target compared with 43% without ED overcrowding (P= 0.42). The number of patients experiencing ≥8 h delay to admission were 25 in May and 59 in August (P= 0.04). This represented 45.5% and 79.7% of patients waiting for admission, respectively (P= 0.08). Hospital access block was seen more often in larger hospitals and significantly associated with failure to meet the 'Shorter Stays in ED' health target, whereas ED overcrowding was seen in both small and large hospitals, but not associated with failure to meet the target. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Shorter Ground Contact Time and Better Running Economy: Evidence From Female Kenyan Runners.

PubMed

Mooses, Martin; Haile, Diresibachew W; Ojiambo, Robert; Sang, Meshack; Mooses, Kerli; Lane, Amy R; Hackney, Anthony C

2018-06-25

Mooses, M, Haile, DW, Ojiambo, R, Sang, M, Mooses, K, Lane, AR, and Hackney, AC. Shorter ground contact time and better running economy: evidence from female Kenyan runners. J Strength Cond Res XX(X): 000-000, 2018-Previously, it has been concluded that the improvement in running economy (RE) might be considered as a key to the continued improvement in performance when no further increase in V[Combining Dot Above]O2max is observed. To date, RE has been extensively studied among male East African distance runners. By contrast, there is a paucity of data on the RE of female East African runners. A total of 10 female Kenyan runners performed 3 × 1,600-m steady-state run trials on a flat outdoor clay track (400-m lap) at the intensities that corresponded to their everyday training intensities for easy, moderate, and fast running. Running economy together with gait characteristics was determined. Participants showed moderate to very good RE at the first (202 ± 26 ml·kg·km) and second (188 ± 12 ml·kg·km) run trials, respectively. Correlation analysis revealed significant relationship between ground contact time (GCT) and RE at the second run (r = 0.782; p = 0.022), which represented the intensity of anaerobic threshold. This study is the first to report the RE and gait characteristics of East African female athletes measured under everyday training settings. We provided the evidence that GCT is associated with the superior RE of the female Kenyan runners.

The impact of therapeutic delay time on acute scintigraphic lesion and ultimate scar formation in children with first febrile UTI.

PubMed

Oh, Mi Mi; Kim, Jin Wook; Park, Min Gu; Kim, Je Jong; Yoo, Kee Hwan; Moon, Du Geon

2012-03-01

We assessed the role of therapeutic delay time (TDT) in acute renal cortical scintigraphic lesion (ASL) and ultimate scar formation (USF) in children with first febrile UTI and whether it is affected by the presence of vesico-ureteral reflux (VUR). 230 children, 90 girls and 140 boys with first febrile UTI were included. Radiologic (USG, DMSA, and VCUG), clinical (age, gender, peak fever, therapeutic delay time) and laboratory (CBC with differential count, ANC (absolute neutrophil count), BUN, Creatinine, urine analysis, gram stain, culture, CRP and ESR) variables were analysed. DMSA was performed within 5 days and after six months. VCUG was performed after acute phase of UTI. The differences in TDT according to the presence of ASL, USF and VUR were assessed. And the correlation between ASL or USF with the duration of TDT was assessed. Of 230 patients enrolled, 142 patients had refluxing UTI and 88 patients had non-refluxing UTI. TDT was the risk factor associated with ASL and USF along with presence of VUR. TDT was longer in ASL positive group compared with the ASL negative group. Also USF group showed longer TDT compared with those without USF in both refluxing UTI and non refluxing UTI. The TDT was significantly shorter in USF group with the presence of VUR. Positive linear association was noted between prevalence of ASL and USF and duration of TDT. In conclusion, the impact of UTI on formation of USF may be enhanced by the presence of VUR with shorter duration of TDT.

Histopathological and Postoperative Behavioral Comparison of Rodent Oral Tongue Resection: Fiber-Enabled CO2 Laser versus Electrocautery

PubMed Central

Shires, Courtney Brooke; Saputra, Jennifer Marie; King, Lauren; Thompson, Jerome W.; Heck, Detlef H.; Sebelik, Merry Ellen; Boughter, John Dudley

2015-01-01

Objective To compare operative time and hemostasis of fiber-enabled CO2 laser (FECL) energy to that of the electrocautery (EC) technique for oral tongue resection, to compare return to oral intake and preoperative weight after FECL and EC resection, and to compare histologic changes in adjacent tissue after FECL and EC resection. Study Design Prospective animal study. Setting Research laboratory. Subjects and Methods The CO2 laser fiber and the Bovie cautery were each used to resect the anterior tongue in 15 adult rats. Fixative perfusion and killing were performed on postoperative day 0 (n = 10), 3 (n = 10), or 7 (n = 10). Body weight, food intake, and water intake were recorded daily for 3- and 7-day survival rats. After preparation for histologic analysis, the tongue tissue was graded with a mucosal wound-healing scale (MWHS). Results A higher incidence of intraoperative bleeding and shorter operative times were noted in the EC group. No statistically significant difference in postoperative food or water intake between the EC and FECL groups was noted. The FECL group returned to baseline weight by postoperative day 6. MWHS scores were lower in the EC group by postoperative day 3 and lower in the FECL group by postoperative day 7. Conclusions Both EC and FECL are effective for resection of the tongue in rats. EC has the advantage of shorter operative time and lower MWHS scores by postoperative day 3; FECL has the advantages of less intraoperative bleeding, faster return to baseline body weight, and lower MWHS score by postoperative day 7. PMID:22535916

Hepatocellular Carcinoma in HIV-Infected Patients: Check Early, Treat Hard

PubMed Central

Garlassi, Elisa; Cacopardo, Bruno; Cappellani, Alessandro; Guaraldi, Giovanni; Cocchi, Stefania; De Paoli, Paolo; Lleshi, Arben; Izzi, Immacolata; Torresin, Augusta; Di Gangi, Pietro; Pietrangelo, Antonello; Ferrari, Mariachiara; Bearz, Alessandra; Berretta, Salvatore; Nasti, Guglielmo; Di Benedetto, Fabrizio; Balestreri, Luca; Tirelli, Umberto; Ventura, Paolo

2011-01-01

Purpose. Hepatocellular carcinoma (HCC) is an increasing cause of mortality in HIV-infected patients in the highly active antiretroviral therapy (HAART) era. The aims of this study were to describe HCC tumor characteristics and different therapeutic approaches, to evaluate patient survival time from HCC diagnosis, and to identify clinical prognostic predictors in patients with and without HIV infection. Patients and Methods. A multicenter observational retrospective comparison of 104 HIV-infected patients and 484 uninfected patients was performed in four Italian centers. HCC was staged according to the Barcelona Clinic Liver Cancer (BCLC) criteria. Results. Tumor characteristics of patients with and without HIV were significantly different for age, Eastern Cooperative Oncology Group performance status (PS) score ≤1, and etiology of chronic liver disease. Despite the similar potentially curative option rate and better BCLC stage at diagnosis, the median survival time was significantly shorter in HIV+ patients. HIV+ patients were less frequently retreated at relapse. Independent predictors of survival were: BCLC stage, potentially effective HCC therapy, tumor dimension ≤3 cm, HCC diagnosis under a screening program, HCC recurrence, and portal vein thrombosis. Restricting the analysis to HIV+ patients only, all positive prognostic factors were confirmed together with HAART exposure. Conclusion. This study confirms a significantly shorter survival time in HIV+ HCC patients. The less aggressive retreatment at recurrence approach does not balance the benefit of younger age and better BCLC stage and PS score of HIV+ patients. Thus, considering the prognosis of HIV+ HCC patients, effective screening techniques, programs, and specific management guidelines are urgently needed. PMID:21868692

Prostate cancer-related anxiety in long-term survivors after radical prostatectomy.

PubMed

Meissner, Valentin H; Herkommer, Kathleen; Marten-Mittag, Birgitt; Gschwend, Jürgen E; Dinkel, Andreas

2017-12-01

Knowledge of the psychological distress of long- and very long-term (>10 years) prostate cancer (PC) survivors is limited. This study intended to examine the parameters influencing anxiety related to prostate-specific antigen (PSA) and PC in long-term survivors after radical prostatectomy. We surveyed 4719 PC survivors from the German multicenter prospective database "Familial Prostate Cancer." We evaluated the association of PC-related anxiety (MAX-PC) with sociodemographic characteristics, family history of PC, global health status/quality of life (EORTC QLQ-C30), depression and anxiety (PHQ-2; GAD-2), latest PSA level, time since radical prostatectomy, and current therapy. The survey participants' mean age was 75.2 years (SD = 6.5). Median follow-up was 11.5 years, and 19.5% of participants had survived more than 15 years since the initial treatment. The final regression analysis found that younger age, lower global health status/quality of life, higher depression and anxiety scores, higher latest PSA level, and shorter time since radical prostatectomy predicted increased PSA-related anxiety and PC anxiety. Familial PC was predictive only of PSA anxiety (all p < 0.05). The final model explained 12% of the variance for PSA anxiety and 24% for PC anxiety. PC-related anxiety remained relevant many years after prostatectomy and was influenced by younger age, psychological status, rising PSA level, and shorter time since initial treatment. Survivors with these characteristics are at increased risk of PC-related anxieties, which should be considered by the treating physician during follow-up.

Effect of portal access system and surgery type on surgery times during laparoscopic ovariectomy and salpingectomy in captive African lions and cheetahs.

PubMed

Hartman, Marthinus Jacobus; Monnet, Eric; Kirberger, Robert Murco; Schoeman, Johan Petrus

2016-03-02

A prospective randomized study was used to compare surgery times for laparoscopic ovariectomy and salpingectomy in female African lion (Panthera leo) (n = 14) and cheetah (Acinonyx jubatus) (n = 20) and to compare the use of a multiple portal access system (MPAS) and single portal access system (SPAS) between groups. Two different portal techniques were used, namely MPAS (three separate ports) in lions and SPAS (SILS™ port) in cheetahs, using standard straight laparoscopic instruments. Portal access system and first ovary was not randomized. Five different surgery times were compared for the two different procedures as well as evaluating the use and application of MPAS and SPAS. Carbon dioxide volumes for lions were recorded. In adult lionesses operative time (OPT) (P = 0.016) and total surgical time (TST) (P = 0.032) were significantly shorter for salpingectomy compared to ovariectomy. Similarly in cheetahs OPT (P = 0.001) and TST (P = 0.005) were also shorter for salpingectomy compared to ovariectomy. In contrast, in lion cubs no difference was found in surgery times for ovariectomy and salpingectomy. Total unilateral procedure time was shorter than the respective bilateral time for both procedures (P = 0.019 and P = 0.001) respectively and unilateral salpingectomy was also faster than unilateral ovariectomy (P = 0.035) in cheetahs. Port placement time, suturing time and TST were significantly shorter for SPAS compared to MPAS (P = 0.008). There was, however, no difference in OPT between SPAS and MPAS. Instrument cluttering with SPAS was found to be negligible. There was no difference in mean volume CO2 required to complete ovariectomy in lions but the correlation between bodyweight and total volume of CO2 in lions was significant (rs = 0.867; P = 0.002). Laparoscopic salpingectomy was faster than ovariectomy in both adult lions and cheetahs. Using SPAS, both unilateral procedures were faster than bilateral procedures in cheetahs. Placement and suturing of SPAS in cheetahs was easier and faster compared to three separate ports in lions and lion cubs. The use of standard straight instruments during SPAS did not prolong surgery. Surgery was faster in cubs and CO2 required for laparoscopic sterilization in lions could be determined. Predictable surgery times and CO2 volumes will facilitate the accurate planning and execution of surgery in lions and cheetahs.

Improving Crotalidae polyvalent immune Fab reconstitution times.

PubMed

Quan, Asia N; Quan, Dan; Curry, Steven C

2010-06-01

Crotalidae polyvalent immune Fab (CroFab) is used to treat rattlesnake envenomations in the United States. Time to infusion may be a critical factor in the treatment of these bites. Per manufacturer's instructions, 10 mL of sterile water for injection (SWI) and hand swirling are recommended for reconstitution. We wondered whether completely filling vials with 25 mL of SWI would result in shorter reconstitution times than using 10-mL volumes and how hand mixing compared to mechanical agitation of vials or leaving vials undisturbed. Six sets of 5 vials were filled with either 10 mL or 25 mL. Three mixing techniques were used as follows: undisturbed; agitation with a mechanical agitator; and continuous hand rolling and inverting of vials. Dissolution was determined by observation and time to complete dissolution for each vial. Nonparametric 2-tailed P values were calculated. Filling vials completely with 25 mL resulted in quicker dissolution than using 10-mL volumes, regardless of mixing method (2-tailed P = .024). Mixing by hand was shorter than other methods (P < .001). Reconstitution with 25 mL and hand mixing resulted in the shortest dissolution times (median, 1.1 minutes; range, 0.9-1.3 minutes). This appeared clinically important because dissolution times using 10 mL and mechanical rocking of vials (median, 26.4 minutes) or leaving vials undisturbed (median, 33.6 minutes) was several-fold longer. Hand mixing after filling vials completely with 25 mL results in shorter dissolution times than using 10 mL or other methods of mixing and is recommended, especially when preparing initial doses of CroFab. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Patient navigation significantly reduces delays in breast cancer diagnosis in the District of Columbia.

PubMed

Hoffman, Heather J; LaVerda, Nancy L; Young, Heather A; Levine, Paul H; Alexander, Lisa M; Brem, Rachel; Caicedo, Larisa; Eng-Wong, Jennifer; Frederick, Wayne; Funderburk, William; Huerta, Elmer; Swain, Sandra; Patierno, Steven R

2012-10-01

Patient Navigation (PN) originated in Harlem as an intervention to help poor women overcome access barriers to timely breast cancer treatment. Despite rapid, nationally widespread adoption of PN, empirical evidence on its effectiveness is lacking. In 2005, National Cancer Institute initiated a multicenter PN Research Program (PNRP) to measure PN effectiveness for several cancers. The George Washington Cancer Institute, a project participant, established District of Columbia (DC)-PNRP to determine PN's ability to reduce breast cancer diagnostic time (number of days from abnormal screening to definitive diagnosis). A total of 2,601 women (1,047 navigated; 1,554 concurrent records-based nonnavigated) were examined for breast cancer from 2006 to 2010 at 9 hospitals/clinics in DC. Analyses included only women who reached complete diagnostic resolution. Differences in diagnostic time between navigation groups were tested with ANOVA models including categorical demographic and treatment variables. Log transformations normalized diagnostic time. Geometric means were estimated and compared using Tukey-Kramer P value adjustments. Average-geometric mean [95% confidence interval (CI)]-diagnostic time (days) was significantly shorter for navigated, 25.1 (21.7, 29.0), than nonnavigated women, 42.1 (35.8, 49.6). Subanalyses revealed significantly shorter average diagnostic time for biopsied navigated women, 26.6 (21.8, 32.5) than biopsied nonnavigated women, 57.5 (46.3, 71.5). Among nonbiopsied women, diagnostic time was shorter for navigated, 27.2 (22.8, 32.4), than nonnavigated women, 34.9 (29.2, 41.7), but not statistically significant. Navigated women, especially those requiring biopsy, reached their diagnostic resolution significantly faster than nonnavigated women. Results support previous findings of PN's positive influence on health care. PN should be a reimbursable expense to assure continuation of PN programs. 2012 AACR

Working Less and Enjoying It More: Alternative Work Schedules.

ERIC Educational Resources Information Center

Shanks, Katherine

1984-01-01

Explores three forms of alternative work schedules that research has shown improve job performance and decrease absenteeism: flextime (starting and stopping times vary within limits); permanent part-time employment (regular employment carried out during shorter working hours); and job sharing (two or more part-time employees share one full-time…

Sparse non-negative matrix factorizations via alternating non-negativity-constrained least squares for microarray data analysis.

PubMed

Kim, Hyunsoo; Park, Haesun

2007-06-15

Many practical pattern recognition problems require non-negativity constraints. For example, pixels in digital images and chemical concentrations in bioinformatics are non-negative. Sparse non-negative matrix factorizations (NMFs) are useful when the degree of sparseness in the non-negative basis matrix or the non-negative coefficient matrix in an NMF needs to be controlled in approximating high-dimensional data in a lower dimensional space. In this article, we introduce a novel formulation of sparse NMF and show how the new formulation leads to a convergent sparse NMF algorithm via alternating non-negativity-constrained least squares. We apply our sparse NMF algorithm to cancer-class discovery and gene expression data analysis and offer biological analysis of the results obtained. Our experimental results illustrate that the proposed sparse NMF algorithm often achieves better clustering performance with shorter computing time compared to other existing NMF algorithms. The software is available as supplementary material.

The impact of time of day on the gait and balance control of Alzheimer's patients.

PubMed

Paillard, Thierry; Noé, Frederic; Bru, Noëlle; Couderc, Martine; Debove, Lola

2016-01-01

Alzheimer's patients suffer from circadian dysregulation. The aim of this study was to examine the evolution of balance control and gait at different times of the day (11:00, 14:00, 18:00) in order to identify whether Alzheimer's patients were more likely to fall at certain periods of the day. Spatio-temporal parameters of centre of foot pressure displacements were measured with a force platform and spatio-temporal parameters of walking were evaluated with a gait analysis device. The results highlighted that balance control was worse in the evening and the afternoon than in the morning. Furthermore, the walking speed was faster and support duration, swing duration and cycle duration were shorter in the evening than in the morning and afternoon. The combined analysis of balance control and gait parameters revealed that balance control and walking are concomitantly altered in the evening which increases the fall risk in the evening, in comparison with the morning, for Alzheimer's patients.

The art of spacecraft design: A multidisciplinary challenge

NASA Technical Reports Server (NTRS)

Abdi, F.; Ide, H.; Levine, M.; Austel, L.

1989-01-01

Actual design turn-around time has become shorter due to the use of optimization techniques which have been introduced into the design process. It seems that what, how and when to use these optimization techniques may be the key factor for future aircraft engineering operations. Another important aspect of this technique is that complex physical phenomena can be modeled by a simple mathematical equation. The new powerful multilevel methodology reduces time-consuming analysis significantly while maintaining the coupling effects. This simultaneous analysis method stems from the implicit function theorem and system sensitivity derivatives of input variables. Use of the Taylor's series expansion and finite differencing technique for sensitivity derivatives in each discipline makes this approach unique for screening dominant variables from nondominant variables. In this study, the current Computational Fluid Dynamics (CFD) aerodynamic and sensitivity derivative/optimization techniques are applied for a simple cone-type forebody of a high-speed vehicle configuration to understand basic aerodynamic/structure interaction in a hypersonic flight condition.

NEW SUNS IN THE COSMOS. III. MULTIFRACTAL SIGNATURE ANALYSIS

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

Freitas, D. B. de; Nepomuceno, M. M. F.; Junior, P. R. V. de Moraes

2016-11-01

In the present paper, we investigate the multifractality signatures in hourly time series extracted from the CoRoT spacecraft database. Our analysis is intended to highlight the possibility that astrophysical time series can be members of a particular class of complex and dynamic processes, which require several photometric variability diagnostics to characterize their structural and topological properties. To achieve this goal, we search for contributions due to a nonlinear temporal correlation and effects caused by heavier tails than the Gaussian distribution, using a detrending moving average algorithm for one-dimensional multifractal signals (MFDMA). We observe that the correlation structure is the mainmore » source of multifractality, while heavy-tailed distribution plays a minor role in generating the multifractal effects. Our work also reveals that the rotation period of stars is inherently scaled by the degree of multifractality. As a result, analyzing the multifractal degree of the referred series, we uncover an evolution of multifractality from shorter to larger periods.« less

Tracker implementation for the orbiter Ku-band communications antenna

NASA Technical Reports Server (NTRS)

Rudnicki, J. F.; Lindsey, J. F.

1976-01-01

Possible implementations and recommendations for the Space Shuttle Ku-Band integrated communications/radar antenna tracking system were evaluated. Communication aspects involving the Tracking Data Relay Satellite (TDRS)/Orbiter Ku-Band link are emphasized. Detailed analysis of antenna sizes, gains and signal-to-noise ratios shows the desirability of using maximum size 36-inch diameter dish and a triple channel monopulse. The use of the original baselined 20 inch dish is found to result in excessive acquisition time since the despread signal would be used in the tracking loop. An evaluation of scan procedures which includes vehicle dynamics, designation error, time for acquisition and probability of acquisition shows that the conical scan is preferred since the time for lock-on for relatively slow look angle rates will be significantly shorter than the raster scan. Significant improvement in spherical coverage may be obtained by reorienting the antenna gimbal to obtain maximum blockage overlap.

Real-time mobile phone dialing system based on SSVEP

NASA Astrophysics Data System (ADS)

Wang, Dongsheng; Kobayashi, Toshiki; Cui, Gaochao; Watabe, Daishi; Cao, Jianting

2017-03-01

Brain computer interface (BCI) systems based on the steady state visual evoked potential (SSVEP) provide higher information transfer rates and require shorter training time than BCI systems using other brain signals. It has been widely used in brain science, rehabilitation engineering, biomedical engineering and intelligent information processing. In this paper, we present a real-time mobile phone dialing system based on SSVEP, and it is more portable than other dialing system because the flashing dial interface is set on a small tablet. With this online BCI system, we can take advantage of this system based on SSVEP to identify the specific frequency on behalf of a number using canonical correlation analysis (CCA) method and dialed out successfully without using any physical movements such as finger tapping. This phone dialing system will be promising to help disable patients to improve the quality of lives.

Simulation and analysis on ultrasonic testing for the cement grouting defects of the corrugated pipe

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

Qingbang, Han; Ling, Chen; Changping, Zhu

2014-02-18

The defects exist in the cement grouting process of prestressed corrugated pipe may directly impair the bridge safety. In this paper, sound fields propagation in concrete structures with corrugated pipes and the influence of various different defects are simulated and analyzed using finite element method. The simulation results demonstrate a much complex propagation characteristic due to multiple reflection, refraction and scattering, where the scattering signals caused by metal are very strong, while the signals scattered by an air bubble are weaker. The influence of defect both in time and frequency domain are found through deconvolution treatment. In the time domain,more » the deconvolution signals correspond to larger defect display a larger head wave amplitude and shorter arrive time than those of smaller defects; in the frequency domain, larger defect also shows a stronger amplitude, lower center frequency and lower cutoff frequency.« less

Virtual water trade and time scales for loss of water sustainability: a comparative regional analysis.

PubMed

Goswami, Prashant; Nishad, Shiv Narayan

2015-03-20

Assessment and policy design for sustainability in primary resources like arable land and water need to adopt long-term perspective; even small but persistent effects like net export of water may influence sustainability through irreversible losses. With growing consumption, this virtual water trade has become an important element in the water sustainability of a nation. We estimate and contrast the virtual (embedded) water trades of two populous nations, India and China, to present certain quantitative measures and time scales. Estimates show that export of embedded water alone can lead to loss of water sustainability. With the current rate of net export of water (embedded) in the end products, India is poised to lose its entire available water in less than 1000 years; much shorter time scales are implied in terms of water for production. The two cases contrast and exemplify sustainable and non-sustainable virtual water trade in long term perspective.

Virtual water trade and time scales for loss of water sustainability: A comparative regional analysis

NASA Astrophysics Data System (ADS)

Goswami, Prashant; Nishad, Shiv Narayan

2015-03-01

Assessment and policy design for sustainability in primary resources like arable land and water need to adopt long-term perspective; even small but persistent effects like net export of water may influence sustainability through irreversible losses. With growing consumption, this virtual water trade has become an important element in the water sustainability of a nation. We estimate and contrast the virtual (embedded) water trades of two populous nations, India and China, to present certain quantitative measures and time scales. Estimates show that export of embedded water alone can lead to loss of water sustainability. With the current rate of net export of water (embedded) in the end products, India is poised to lose its entire available water in less than 1000 years; much shorter time scales are implied in terms of water for production. The two cases contrast and exemplify sustainable and non-sustainable virtual water trade in long term perspective.

Classification of human pathogen bacteria for early screening using electronic nose

NASA Astrophysics Data System (ADS)

Zulkifli, Syahida Amani; Mohamad, Che Wan Syarifah Robiah; Abdullah, Abu Hassan

2017-10-01

This paper present human pathogen bacteria for early screening using electronic nose. Electronic nose (E-nose) known as gas sensor array is a device that analyze the odor measurement give the fast response and less time consuming for clinical diagnosis. Many bacterial pathogens could lead to life threatening infections. Accurate and rapid diagnosis is crucial for the successful management of these infections disease. The conventional method need more time to detect the growth of bacterial. Alternatively, the bacteria are Pseudomonas aeruginosa and Shigella cultured on different media agar can be detected and classifies according to the volatile compound in shorter time using electronic nose (E-nose). Then, the data from electronic nose (E-nose) is processed using statistical method which is principal component analysis (PCA). The study shows the capability of electronic nose (E-nose) for early screening for bacterial infection in human stomach.

Reducing trial length in force platform posturographic sleep deprivation measurements

NASA Astrophysics Data System (ADS)

Forsman, P.; Hæggström, E.; Wallin, A.

2007-09-01

Sleepiness correlates with sleep-related accidents, but convenient tests for sleepiness monitoring are scarce. The posturographic test is a method to assess balance, and this paper describes one phase of the development of a posturographic sleepiness monitoring method. We investigated the relationship between trial length and accuracy of the posturographic time-awake (TA) estimate. Twenty-one healthy adults were kept awake for 32 h and their balance was recorded, 16 times with 30 s trials, as a function of TA. The balance was analysed with regards to fractal dimension, most common sway amplitude and time interval for open-loop stance control. While a 30 s trial allows estimating the TA of individual subjects with better than 5 h accuracy, repeating the analysis using shorter trial lengths showed that 18 s sufficed to achieve the targeted 5 h accuracy. Moreover, it was found that with increasing TA, the posturographic parameters estimated the subjects' TA more accurately.

EAO Supplement Working Group 4 - EAO CC 2015 Short implants versus sinus lifting with longer implants to restore the posterior maxilla: a systematic review.

PubMed

Thoma, D S; Zeltner, M; Hüsler, J; Hämmerle, C H F; Jung, R E

2015-09-01

To compare short implants in the posterior maxilla to longer implants placed after or simultaneously with sinus floor elevation procedures. The focused question was as follows: Are short implants superior to longer implants in the augmented sinus in terms of survival and complication rates of implants and reconstructions, patient-reported outcome measures (PROMs) and costs? A MEDLINE search (1990-2014) was performed for randomized controlled clinical studies comparing short implants (≤8 mm) to longer implants (>8 mm) in augmented sinus. The search was complimented by an additional hand search of the selected papers and reviews published between 2011 and 2014. Eligible studies were selected based on the inclusion criteria, and quality assessments were conducted. Descriptive statistics were applied for a number of outcome measures. Survival rates of dental implants were pooled simply in case of comparable studies. Eight randomized controlled clinical trials (RCTs) comparing short implants versus longer implants in the augmented sinus derived from an initial search count of 851 titles were selected and data extracted. In general, all studies were well conducted with a low risk of bias for the majority of the analyzed parameters. Based on the pooled analyses of longer follow-ups (5 studies, 16-18 months), the survival rate of longer implants amounted to 99.5% (95% CI: 97.6-99.98%) and for shorter implants to 99.0% (95% CI: 96.4-99.8%). For shorter follow-ups (3 studies, 8-9 months), the survival rates of longer implants are 100% (95% CI: 97.1-100%) and for shorter implants 98.2% (95% CI: 93.9-99.7%). Complications were predominantly of biological origin, mainly occurred intraoperatively as membrane perforations, and were almost three times as higher for longer implant in the augmented sinus compared to shorter implants. PROMs, morbidity, surgical time and costs were generally in favor of shorter dental implants. All studies were performed by surgeons in specialized clinical settings. The outcomes of the survey analyses demonstrated predictably high implant survival rates for short implants and longer implants placed in augmented sinus and their respective reconstructions. Given the higher number of biological complications, increased morbidity, costs and surgical time of longer dental implants in the augmented sinus, shorter dental implants may represent the preferred treatment alternative. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Pilot production system cost/benefit analysis: Digital document storage project

NASA Technical Reports Server (NTRS)

1989-01-01

The Digital Document Storage (DDS)/Pilot Production System (PPS) will provide cost effective electronic document storage, retrieval, hard copy reproduction, and remote access for users of NASA Technical Reports. The DDS/PPS will result in major benefits, such as improved document reproduction quality within a shorter time frame than is currently possible. In addition, the DDS/PPS will provide an important strategic value through the construction of a digital document archive. It is highly recommended that NASA proceed with the DDS Prototype System and a rapid prototyping development methodology in order to validate recent working assumptions upon which the success of the DDS/PPS is dependent.

May radiofrequency be the best choice for III-IV degree hemorrhoids?

PubMed

Milito, Giovanni; Lisi, Giorgio; Aronadio, Elena; Campanelli, Michela; Venditti, Dario; Grande, Simona; Grande, Michele

2017-03-01

Hemorrhoidectomy is considered the most efficient method to treat hemorrhoids of III and IV grades. The aim of this study was to compare conventional diathermy hemorrhoidectomy and radiofrequency hemorrhoidectomy based on a large series of patients. Between June 2001 and June 2014, 1000 patients have been treated with radiofrequency hemorrhoidectomy (group A) and 500 patients have been treated with diathermy (group B) as a day-case procedure. Operating time, postoperative pain score, hospital stay, early and late postoperative complications, wound healing time and time to return to normal activities were assessed. The mean follow-up was seven years. The mean operating time for radiofrequency hemorrhoidectomy was shorter than diathermy but not significantly. Patients treated with radiofrequency had significantly less postoperative pain (measured on a Visual Analogue Scale; P=0.001), a shorter wound healing time, less time off work and postoperative complications (P=0.001) than patients who had diathermy. Neither wound healing nor mean hospital stay (day-case surgery) was significantly different. Radiofrequency hemorrhoidectomyis a valid alternative to the conventional diathermy technique, due to the reduction of operative time, postoperative pain, early and late complication rate.

Foot strike patterns and ground contact times during high-calibre middle-distance races.

PubMed

Hayes, Phil; Caplan, Nicholas

2012-01-01

The aims of this study were to examine ground contact characteristics, their relationship with race performance, and the time course of any changes in ground contact time during competitive 800 m and 1500 m races. Twenty-two seeded, single-sex middle-distance races totalling 181 runners were filmed at a competitive athletics meeting. Races were filmed at 100 Hz. Ground contact time was recorded one step for each athlete, on each lap of their race. Forefoot and midfoot strikers had significantly shorter ground contact times than heel strikers. Forefoot and midfoot strikers had significantly faster average race speed than heel strikers. There were strong large correlations between ground contact time and average race speed for the women's events and men's 1500 m (r = -0.521 to -0.623; P < 0.05), whereas the men's 800 m displayed only a moderate relationship (r = -0.361; P = 0.002). For each event, ground contact time for the first lap was significantly shorter than for the last lap, which might reflect runners becoming fatigued.

Longitudinal associations between time spent using technology and sleep duration among adolescents.

PubMed

Mazzer, K; Bauducco, S; Linton, S J; Boersma, K

2018-07-01

Technology use has been the focus of much concern for adolescents' sleep health. However, few studies have investigated the bidirectional association between sleep duration and time spent using technology. The aim of this study was to test whether time spent using technology predicted shorter sleep duration, and/or vice versa using cross-lagged analyses over one year. Participants were 1620 high school students in the 8th and 9th grade at baseline from 17 public schools in three middle Sweden communities. Students completed questionnaires at school during the spring of 2015 and 2016. Time spent using technology was self-reported and sleep duration was calculated from reported bed-times, wake-times and sleep onset latency. Time spent using technology significantly predicted shorter subsequent sleep duration and vice versa. Public health advocates educating others about the negative impacts of technology on sleep must also be mindful of the opposite, that many young people may turn to technological devices when experiencing difficulty sleeping. Copyright © 2018 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Quantification of cell cycle kinetics by EdU (5-ethynyl-2′-deoxyuridine)-coupled-fluorescence-intensity analysis

PubMed Central

Cabrita, Marisa; Bekman, Evguenia; Braga, José; Rino, José; Santus, Renè; Filipe, Paulo L.; Sousa, Ana E.; Ferreira, João A.

2017-01-01

We propose a novel single-deoxynucleoside-based assay that is easy to perform and provides accurate values for the absolute length (in units of time) of each of the cell cycle stages (G1, S and G2/M). This flow-cytometric assay takes advantage of the excellent stoichiometric properties of azide-fluorochrome detection of DNA substituted with 5-ethynyl-2′-deoxyuridine (EdU). We show that by pulsing cells with EdU for incremental periods of time maximal EdU-coupled fluorescence is reached when pulsing times match the length of S phase. These pulsing times, allowing labelling for a full S phase of a fraction of cells in asynchronous populations, provide accurate values for the absolute length of S phase. We characterized additional, lower intensity signals that allowed quantification of the absolute durations of G1 and G2 phases. Importantly, using this novel assay data on the lengths of G1, S and G2/M phases are obtained in parallel. Therefore, these parameters can be estimated within a time frame that is shorter than a full cell cycle. This method, which we designate as EdU-Coupled Fluorescence Intensity (E-CFI) analysis, was successfully applied to cell types with distinctive cell cycle features and shows excellent agreement with established methodologies for analysis of cell cycle kinetics. PMID:28465489

A prospective clinical study in humans of an endosseous dental implant partially covered with a powder-sintered porous coating: 3- to 4-year results.

PubMed

Deporter, D A; Watson, P A; Pilliar, R M; Pharoah, M; Smith, D C; Chipman, M; Locker, D; Rydall, A

1996-01-01

A dental implant covered partially with a porous coating (EndoPore) developed at the University of Toronto was tested. This new implant is a tapered, truncated-cone endosseous root-form implant fabricated from Ti-6Al-4V. It utilizes a powder-sintered porous surface geometry over most of its length to promote three-dimensional bone ingrowth and implant stabilization. In this trial, three implants were placed in the anterior mandibles of 52 patients and were used subsequently as free-standing units to support an overdenture. Much shorter implants, shorter initial healing periods, and simpler surgical techniques than are customary with other implant designs were used. At the time of this report, all patients with implants had passed 3 years of function, and the cumulative implant success rate was 94.8%. Analysis of carefully standardized radiographs revealed a pattern of crestal bone loss similar to earlier published dog data. On a yearly basis, the mean bone loss was 0.43 mm in year 1, 0.17 mm in year 2, and 0.13 mm in year 3.

Sleep and gravity.

PubMed

Gonfalone, Alain A

2018-04-01

What is known about sleep results from years of observation at the surface of the Earth. Since a few decade man has been able to reach space, escape from the earth attraction and spend days and nights in a weightless condition. Some major physiological changes have been observed during long stays and in particular the sleep duration in space is shorter than on ground. This paper reviews a novel hypothesis proposing that sleep is partly due to gravity. Gravity is a fundamental part of our environment, but is elusive and difficult to apprehend. At the same time, all creatures on Earth undergo cycles of activity and periods of rest (although not always sleep). Careful analysis of previous research on sleep, on Earth, in space and in water, shows that gravity differs in these three situations, and sleep also varies, at least in its duration. On Earth, Rapid Eye Movement (REM) sleep is conditioned by gravity; in space, astronauts have a shorter sleep duration and this is even more striking when a test subject is immersed in water for a week. In conclusion, sleep is partly due to gravity, which acts on our body and brain during the wake period. Copyright © 2018 The Author. Published by Elsevier Ltd.. All rights reserved.

Robotic assisted gastrectomy compared with open resection: a case-matched study.

PubMed

Caruso, Riccardo; Vicente, Emilio; Quijano, Yolanda; Ielpo, Benedetto; Duran, Hipolito; Diaz, Eduardo; Fabra, Isabel; Ferri, Valentina

2018-05-04

In recent years, increasingly sophisticated tools have allowed for more complex robotic surgery. Robotic gastrectomy, however, is adopted in only a few selected centers. The goals of this study were to examine the adoption of robotic gastrectomy and to compare outcomes between open and robotic gastric resections. This is a case-matched analysis of patients who underwent robotic and open gastric resection performed at Sanchinarro University Hospital, Madrid from November 2011 to February 2017. Patient data were obtained retrospectively. Clinicopathologic characteristics and perioperative and postoperative outcomes were recorded and analyzed. Two groups of demographically similar patients were analyzed: the robotic group (n = 20) and the open surgery group (n = 19). The patient characteristics of the two groups have been compared. Robotic resection resulted in less blood loss, shorter postoperative hospital stay, and a longer operating time. The two groups had similar complication rates. Pathological data were similar for both procedures. Robotic gastrectomy for locally advanced gastric carcinoma is safe, and long-term outcomes are comparable to those patients who underwent open resection. Robotic gastrectomy resulted in a shorter hospital stay, less blood loss and morbidity comparable with the outcomes of open gastrectomy.

Prognostic significance of specific magnetic resonance imaging features in canine nasal tumours treated by radiotherapy.

PubMed

Agthe, P; Caine, A R; Gear, R N A; Dobson, J M; Richardson, K J; Herrtage, M E

2009-12-01

To investigate the prognostic significance of the magnetic resonance (MR) findings of meningeal hyperintensity of the olfactory bulbs and tumour extension into the caudal nasal recess (CNR) in dogs with nasal tumours treated by radiotherapy. MR images of 41 dogs with nasal tumours treated with radiotherapy were reviewed. The occurrence of neurological signs and survival of patients with and without meningeal hyperintensity of the olfactory bulbs and tumour extension into the CNR were analysed together with possible confounding factors including intracranial extension and patient age. There was no significant association between the presence of meningeal hyperintensity or CNR involvement and the occurrence of neurological signs. Although there was a tendency towards shorter survival in dogs with tumour extension into the CNR, multivariable analysis showed no significant difference in survival between dogs with/without CNR involvement, meningeal hyperintensity or intracranial tumour extension (P=0.12, 0.50 and 0.57, respectively). In dogs with nasal tumours treated with radiotherapy, tumour extension into the cranium is not necessarily associated with shorter survival in patients without neurological signs at time of diagnosis. Although a definite influence of CNR involvement on case outcome could not be demonstrated, studies with a larger population are warranted.

Tuning surface grafting density of CeO2 nanocrystals with near- and supercritical solvent characteristics.

PubMed

Giroire, B; Slostowski, C; Marre, S; Aymonier, C; Aida, T; Hojo, D; Aoki, N; Takami, S; Adschiri, T

2016-01-21

In this work, the solvent effect on the synthesis of CeO2 nanocrystals synthesized in near- and supercritical alcohols is discussed. The materials prepared displayed a unique morphology of small nanocrystals (<10 nm) aggregated into larger nanospheres (∼100-200 nm). In such syntheses, alcohol molecules directly interact with the nanocrystal surface through alkoxide and carboxylate bondings. The grafting density was quantified from the weight loss measured using thermogravimetric analysis. A direct correlation between the grafting density and the alcohol chain length can be established. It was demonstrated that the shorter the alcohol chain length (i.e. methanol), the higher the surface coverage is. This trend is independent of the synthesis mode (batch or continuous). Additionally, an influence of the grafting density on the resulting nanocrystal size was established. It is suggested that the surface coverage has a high influence on the early stages of the nucleation and growth. Indeed, when high surface coverages are reached, all surface active sites are blocked, limiting the growth step and therefore leading to smaller particles. This effect was noticed with the materials prepared in the continuous mode where shorter reaction time was performed.

Design of a short nonuniform acquisition protocol for quantitative analysis in dynamic cardiac SPECT imaging - a retrospective 123 I-MIBG animal study.

PubMed

Zan, Yunlong; Long, Yong; Chen, Kewei; Li, Biao; Huang, Qiu; Gullberg, Grant T

2017-07-01

Our previous works have found that quantitative analysis of 123 I-MIBG kinetics in the rat heart with dynamic single-photon emission computed tomography (SPECT) offers the potential to quantify the innervation integrity at an early stage of left ventricular hypertrophy. However, conventional protocols involving a long acquisition time for dynamic imaging reduce the animal survival rate and thus make longitudinal analysis difficult. The goal of this work was to develop a procedure to reduce the total acquisition time by selecting nonuniform acquisition times for projection views while maintaining the accuracy and precision of estimated physiologic parameters. Taking dynamic cardiac imaging with 123 I-MIBG in rats as an example, we generated time activity curves (TACs) of regions of interest (ROIs) as ground truths based on a direct four-dimensional reconstruction of experimental data acquired from a rotating SPECT camera, where TACs represented as the coefficients of B-spline basis functions were used to estimate compartmental model parameters. By iteratively adjusting the knots (i.e., control points) of B-spline basis functions, new TACs were created according to two rules: accuracy and precision. The accuracy criterion allocates the knots to achieve low relative entropy between the estimated left ventricular blood pool TAC and its ground truth so that the estimated input function approximates its real value and thus the procedure yields an accurate estimate of model parameters. The precision criterion, via the D-optimal method, forces the estimated parameters to be as precise as possible, with minimum variances. Based on the final knots obtained, a new protocol of 30 min was built with a shorter acquisition time that maintained a 5% error in estimating rate constants of the compartment model. This was evaluated through digital simulations. The simulation results showed that our method was able to reduce the acquisition time from 100 to 30 min for the cardiac study of rats with 123 I-MIBG. Compared to a uniform interval dynamic SPECT protocol (1 s acquisition interval, 30 min acquisition time), the newly proposed protocol with nonuniform interval achieved comparable (K1 and k2, P = 0.5745 for K1 and P = 0.0604 for k2) or better (Distribution Volume, DV, P = 0.0004) performance for parameter estimates with less storage and shorter computational time. In this study, a procedure was devised to shorten the acquisition time while maintaining the accuracy and precision of estimated physiologic parameters in dynamic SPECT imaging. The procedure was designed for 123 I-MIBG cardiac imaging in rat studies; however, it has the potential to be extended to other applications, including patient studies involving the acquisition of dynamic SPECT data. © 2017 American Association of Physicists in Medicine.

Long pulse production from short pulses

DOEpatents

Toeppen, J.S.

1994-08-02

A method of producing a long output pulse from a short pump pulse is disclosed, using an elongated amplified fiber having a doped core that provides an amplifying medium for light of one color when driven into an excited state by light of a shorter wavelength and a surrounding cladding. A seed beam of the longer wavelength is injected into the core at one end of the fiber and a pump pulse of the shorter wavelength is injected into the cladding at the other end of the fiber. The counter-propagating seed beam and pump pulse will produce an amplified output pulse having a time duration equal to twice the transit time of the pump pulse through the fiber plus the length of the pump pulse. 3 figs.

[Analysis of breath hydrogen (H2) in diagnosis of gastrointestinal function: validation of a pocket breath H2 test analyzer].

PubMed

Braden, B; Braden, C P; Klutz, M; Lembcke, B

1993-04-01

Breath hydrogen (H2) analysis, as used in gastroenterologic function tests, requires a stationary analysis system equipped with a gaschromatograph or an electrochemical sensor cell. Now a portable breath H2-analyzer has been miniaturized to pocket size (104 mm x 62 mm x 29 mm). The application of this device in clinical practice has been assessed in comparison to the standard GMI-exhaled monitor. The pocket analyzer showed a linear response to standards with H2-concentrations ranging from 0-100 ppm (n = 7), which was not different from the GMI-apparatus. The correlation of both methods during clinical application (lactose tolerance tests, mouth-to-coecum transit time determined with lactulose) was excellent (Y = 1.08 X + 0.96; r = 0.959). Using the new device, both, analysis (3 s vs. 90 s) and the reset-time (43 s vs. 140 s) were shorter whereas calibration was more feasible with the GMI-apparatus. It is concluded, that the considerably cheaper pocket-sized breath H2-analyzer is as precise and sensitive as the GMI-exhaled monitor, and thus presents a valid alternative for H2-breath tests.

Optimization of BEV Charging Strategy

NASA Astrophysics Data System (ADS)

Ji, Wei

This paper presents different approaches to optimize fast charging and workplace charging strategy of battery electric vehicle (BEV) drivers. For the fast charging analysis, a rule-based model was built to simulate BEV charging behavior. Monte Carlo analysis was performed to explore to the potential range of congestion at fast charging stations which could be more than four hours at the most crowded stations. Genetic algorithm was performed to explore the theoretical minimum waiting time at fast charging stations, and it can decrease the waiting time at the most crowded stations to be shorter than one hour. A deterministic approach was proposed as a feasible suggestion that people should consider to take fast charging when the state of charge is approaching 40 miles. This suggestion is hoped to help to minimize potential congestion at fast charging stations. For the workplace charging analysis, scenario analysis was performed to simulate temporal distribution of charging demand under different workplace charging strategies. It was found that if BEV drivers charge as much as possible and as late as possible at workplace, it could increase the utility of solar-generated electricity while relieve grid stress of extra intensive electricity demand at night caused by charging electric vehicles at home.

Quantum mechanical expansion of variance of a particle in a weakly non-uniform electric and magnetic field

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

Chan, Poh Kam; Kosaka, Wataru; Oikawa, Shun-ichi

We have solved the Heisenberg equation of motion for the time evolution of the position and momentum operators for a non-relativistic spinless charged particle in the presence of a weakly non-uniform electric and magnetic field. It is shown that the drift velocity operator obtained in this study agrees with the classical counterpart, and that, using the time dependent operators, the variances in position and momentum grow with time. The expansion rate of variance in position and momentum are dependent on the magnetic gradient scale length, however, independent of the electric gradient scale length. In the presence of a weakly non-uniformmore » electric and magnetic field, the theoretical expansion rates of variance expansion are in good agreement with the numerical analysis. It is analytically shown that the variance in position reaches the square of the interparticle separation, which is the characteristic time much shorter than the proton collision time of plasma fusion. After this time, the wavefunctions of the neighboring particles would overlap, as a result, the conventional classical analysis may lose its validity. The broad distribution of individual particle in space means that their Coulomb interactions with other particles become weaker than that expected in classical mechanics.« less

Travel time and concurrent-schedule choice: retrospective versus prospective control.

PubMed

Davison, M; Elliffe, D

2000-01-01

Six pigeons were trained on concurrent variable-interval schedules in which two different travel times between alternatives, 4.5 and 0.5 s, were randomly arranged. In Part 1, the next travel time was signaled while the subjects were responding on each alternative. Generalized matching analyses of performance in the presence of the two travel-time signals showed significantly higher response and time sensitivity when the longer travel time was signaled compared to when the shorter time was signaled. When the data were analyzed as a function of the previous travel time, there were no differences in sensitivity. Dwell times on the alternatives were consistently longer in the presence of the stimulus that signaled the longer travel time than they were in the presence of the stimulus that signaled the shorter travel time. These results are in accord with a recent quantitative account of the effects of travel time. In Part 2, no signals indicating the next travel time were given. When these data were analyzed as a function of the previous travel time, time-allocation sensitivity after the 4.5-s travel time was significantly greater than that after the 0.5-s travel time, but no such difference was found for response allocation. Dwell times were also longer when the previous travel time had been longer.

Trades Between Opposition and Conjunction Class Trajectories for Early Human Missions to Mars

NASA Technical Reports Server (NTRS)

Mattfeld, Bryan; Stromgren, Chel; Shyface, Hilary; Komar, David R.; Cirillo, William; Goodliff, Kandyce

2014-01-01

Candidate human missions to Mars, including NASA's Design Reference Architecture 5.0, have focused on conjunction-class missions with long crewed durations and minimum energy trajectories to reduce total propellant requirements and total launch mass. However, in order to progressively reduce risk and gain experience in interplanetary mission operations, it may be desirable that initial human missions to Mars, whether to the surface or to Mars orbit, have shorter total crewed durations and minimal stay times at the destination. Opposition-class missions require larger total energy requirements relative to conjunction-class missions but offer the potential for much shorter mission durations, potentially reducing risk and overall systems performance requirements. This paper will present a detailed comparison of conjunction-class and opposition-class human missions to Mars vicinity with a focus on how such missions could be integrated into the initial phases of a Mars exploration campaign. The paper will present the results of a trade study that integrates trajectory/propellant analysis, element design, logistics and sparing analysis, and risk assessment to produce a comprehensive comparison of opposition and conjunction exploration mission constructs. Included in the trade study is an assessment of the risk to the crew and the trade offs between the mission duration and element, logistics, and spares mass. The analysis of the mission trade space was conducted using four simulation and analysis tools developed by NASA. Trajectory analyses for Mars destination missions were conducted using VISITOR (Versatile ImpulSive Interplanetary Trajectory OptimizeR), an in-house tool developed by NASA Langley Research Center. Architecture elements were evaluated using EXploration Architecture Model for IN-space and Earth-to-orbit (EXAMINE), a parametric modeling tool that generates exploration architectures through an integrated systems model. Logistics analysis was conducted using NASA's Human Exploration Logistics Model (HELM), and sparing allocation predictions were generated via the Exploration Maintainability Analysis Tool (EMAT), which is a probabilistic simulation engine that evaluates trades in spacecraft reliability and sparing requirements based on spacecraft system maintainability and reparability.

The advantage of short paper titles

PubMed Central

Letchford, Adrian; Moat, Helen Susannah; Preis, Tobias

2015-01-01

Vast numbers of scientific articles are published each year, some of which attract considerable attention, and some of which go almost unnoticed. Here, we investigate whether any of this variance can be explained by a simple metric of one aspect of the paper's presentation: the length of its title. Our analysis provides evidence that journals which publish papers with shorter titles receive more citations per paper. These results are consistent with the intriguing hypothesis that papers with shorter titles may be easier to understand, and hence attract more citations. PMID:26361556

Childhood sleep and adolescent chronic fatigue syndrome (CFS/ME): evidence of associations in a UK birth cohort.

PubMed

Collin, Simon M; Norris, Tom; Gringras, Paul; Blair, Peter S; Tilling, Kate; Crawley, Esther

2018-06-01

Sleep abnormalities are characteristic of chronic fatigue syndrome (CFS, also known as 'ME'), however it is unknown whether sleep might be a causal risk factor for CFS/ME. We analysed data from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. We describe sleep patterns of children aged 6 months to 11 years, who were subsequently classified as having (or not having) 'chronic disabling fatigue' (CDF, a proxy for CFS/ME) between the ages 13 and 18 years, and we investigated the associations of sleep duration at age nine years with CDF at age 13 years, as well as sleep duration at age 11 years with CDF at age 16 years. Children who had CDF during adolescence had shorter night-time sleep duration from 6 months to 11 years of age, and there was strong evidence that difficulties in going to sleep were more common in children who subsequently developed CDF. The odds of CDF at age 13 years were 39% lower (odds ratio (OR) = 0.61, 95% CI = 0.43, 0.88) for each additional hour of night-time sleep at age nine years, and the odds of CDF at age 16 years were 51% lower (OR = 0.49, 95% CI = 0.34, 0.70) for each additional hour of night-time sleep at age 11 years. Mean night-time sleep duration at age nine years was 13.9 (95% CI = 3.75, 24.0) minutes shorter among children who developed CDF at age 13 years, and sleep duration at age 11 years was 18.7 (95% CI = 9.08, 28.4) minutes shorter among children who developed CDF at age 16 (compared with children who did not develop CDF at 13 and 16 years, respectively). Children who develop chronic disabling fatigue in adolescence have shorter night-time sleep duration throughout early childhood, suggesting that sleep abnormalities may have a causal role in CFS/ME or that sleep abnormalities and CFS/ME are associated with a common pathophysiological cause. Copyright © 2018 The Author(s). Published by Elsevier B.V. All rights reserved.

Factors affecting breast cancer treatment delay in Turkey: a study from Turkish Federation of Breast Diseases Societies

PubMed Central

Boylu, Sukru; Ok, Engin; Canturk, Nuh Zafer; Celik, Varol; Kapkac, Murat; Girgin, Sadullah; Tireli, Mustafa; Ihtiyar, Enver; Demircan, Orhan; Baskan, Mazhar Semih; Koyuncu, Ayhan; Tasdelen, Ismet; Dumanli, Esra; Ozdener, Fatih; Zaborek, Piotr

2015-01-01

Background: One of the most important factors in breast cancer (BC) mortality is treatment delay. The primary goal of this survey was to identify factors affecting the total delay time (TDT) in Turkish BC patients. Methods: A total of 1031 patients with BC were surveyed using a uniform questionnaire. The time between discovering the first symptom and signing up for the first medical visit (patient delay time; PDT) and the time between the first medical visit and the start of therapy (system delay time; SDT) were modelled separately with multilevel regression. Results: The mean PDT, SDT and TDT were 4.8, 10.5 and 13.8 weeks, respectively. In all, 42% of the patients had a TDT >12 weeks. Longer PDT was significantly correlated with disregarding symptoms and having age of between 30 and 39 years. Shorter PDT was characteristic of patients who: had stronger self-examination habits, received more support from family and friends and had at least secondary education. Predictors of longer SDT included disregard of symptoms, distrust in success of therapy and medical system and having PDT in excess of 4 weeks. Shorter SDT was linked to the age of >60 years. Patients who were diagnosed during a periodic check-up or opportunistic mammography displayed shorter SDT compared with those who had symptomatic BC and their first medical examination was by a surgeon. Conclusion: TDT in Turkey is long and remains a major problem. Delays can be reduced by increasing BC awareness, implementing organized population-based screening programmes and founding cancer centres. PMID:25096257

Evaluation of Time Spent by Pharmacists and Nurses Based on the Location of Pharmacist Involvement in Medication History Collection.

PubMed

Chhabra, Anmol; Quinn, Andrea; Ries, Amanda

2018-01-01

Accurate history collection is integral to medication reconciliation. Studies support pharmacy involvement in the process, but assessment of global time spent is limited. The authors hypothesized the location of a medication-focused interview would impact time spent. The objective was to compare time spent by pharmacists and nurses based on the location of a medication-focused interview. Time spent by the interviewing pharmacist, admitting nurse, and centralized pharmacist verifying admission orders was collected. Patient groups were based on whether the interview was conducted in the emergency department (ED) or medical floor. The primary end point was a composite of the 3 time points. Secondary end points were individual time components and number and types of transcription discrepancies identified during medical floor interviews. Pharmacists and nurses spent an average of ten fewer minutes per ED patient versus a medical floor patient ( P = .028). Secondary end points were not statistically significant. Transcription discrepancies were identified at a rate of 1 in 4 medications. Post hoc analysis revealed the time spent by pharmacists and nurses was 2.4 minutes shorter per medication when interviewed in the ED ( P < .001). The primary outcome was statistically and clinically significant. Limitations included inability to blind and lack of cost-saving analysis. Pharmacist involvement in ED medication reconciliation leads to time savings during the admission process.

Changing community health service delivery in economically less-developed rural areas in China: impact on service use and satisfaction

PubMed Central

Liu, Yong; Yuan, Zhaokang; Liu, Yuxi; Jayasinghe, Upali W; Harris, Mark F

2014-01-01

Objective To evaluate the impact of a model of rural community health service (CHS) on the use and acceptability of primary healthcare services. Design Quasi-experimental. Setting Two adjacent rural counties in China. Participants 5842 residents in 2009 and 3807 in 2010 from 980 households in 7 intervention townships and 49 villages; 2232 residents in 2009 and 2315 in 2010 from 628 households in 3 comparison townships and 9 villages. All residents were approached to participate, with no significant differences in age or sex between groups. Intervention Multilevel intervention in 2009 including training rural practitioners, encouraging clinic improvements, providing clinical guidelines, standards and subsidies. Data collection Surveys of community members from randomly sampled households in 2009 and 2010. Primary outcome measures Satisfaction with and utilisation of outpatient and public health services. Analysis Factor analysis confirmed two components of satisfaction. Univariate and multilevel analysis was used. Results Satisfaction scores for intervention county respondents increased from 21.4 (95% CI 21.1 to 21.7) to 22.1 (95% CI 21.7 to 22.4) with no change in comparison area. In multilevel analysis, satisfaction with patient-centred care was associated with chronic disease, shorter waiting times and county. Satisfaction with clinic environment and cost was associated with female gender, shorter waiting times but not county. The proportion of children receiving immunisation in intervention village clinics increased from 42.5% (95% CI 27.9% to 47.1%) to 59.2% (95% CI 53.8% to 64.6%) whereas this decreased in comparison villages (16.5%; 95% CI 10.3% to 22.7% to 6.0%; 95% CI 1.3% to 10.7%). Antenatal visits increased in intervention villages (from 69.0%, 95% CI 65.8% to 73.1% to 75.8%, 95% CI 72.2% to 79.4%) with no change in comparison villages. Conclusions Introduction of a CHS model adapted to economically less-developed rural areas was associated with some improvements in satisfaction with care and use of some village-based public health services. Further research is needed to determine its public health impact and application to other areas. PMID:24583760

Balloon enteroscopy versus spiral enteroscopy for small-bowel disorders: a systematic review and meta-analysis.

PubMed

Baniya, Ramkaji; Upadhaya, Sunil; Subedi, Subash Chandra; Khan, Jahangir; Sharma, Prabin; Mohammed, Tabrez Shaik; Bachuwa, Ghassan; Jamil, Laith H

2017-12-01

Two novel enteroscopic procedures, balloon enteroscopy and spiral enteroscopy, have revolutionized the diagnostic and therapeutic approach to small-bowel disorders. These disorders that historically required surgical interventions are now investigated and managed nonsurgically. Only a few weakly powered studies have compared the outcomes of spiral enteroscopy and balloon enteroscopy. We conducted a systematic review and meta-analysis to compare the efficacy and safety of these 2 procedures. PubMed, Cochrane Library, Scopus, and clinicaltrials.gov databases were searched for all studies published up to January 12, 2017 comparing the efficacy and safety of balloon enteroscopy (single or double) and spiral enteroscopy. Primary outcomes of interest were diagnostic and therapeutic success rates. Other outcomes included procedure length, depth of maximal insertion (DMI), rate of complete enteroscopy, and adverse events. We calculated Odds ratios (ORs) for categorical variables and mean difference (MD) for continuous variables. The Mantel-Haenszel method was used to analyze the data. Fixed and random effect models were used for <50% heterogeneity and >50% heterogeneity, respectively. Eight studies met the inclusion criteria for this meta-analysis. A total of 615 procedures were analyzed, which included 394 balloon enteroscopy and 221 spiral enteroscopy procedures. There were no significant differences in diagnostic and therapeutic success rates (OR, 1.27; 95% confidence interval [CI], .86-1.88; P = .22; and OR, 1.23; 95% CI, .82-1.84; P = .32, respectively) between the 2 procedures. Similarly, DMI was not significantly different between the 2 groups (MD, 26.29; 95% CI, 20.92-73.49; P = .28). However, the procedure time was significantly shorter for the spiral enteroscopy group compared with the balloon enteroscopy group (MD, 11.26; 95% CI, 2.72-19.79; P = .010). A subgroup analysis comparing double balloon enteroscopy with spiral enteroscopy yielded similar results. Both procedures achieved similar diagnostic and therapeutic outcomes and with similar depth of insertion. Spiral enteroscopy has the benefit of shorter procedural time. Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Is local anesthesia the optimum strategy in retrograde transcatheter aortic valve implantation? A systematic review and meta-analysis.

PubMed

O' Sullivan, Katie E; Bracken-Clarke, Darragh; Segurado, Ricardo; Barry, Mitchel; Sugrue, Declan; Flood, Georgina; Hurley, John

2014-09-01

Retrograde transcatheter aortic valve implantation (TAVI) can be performed under local anesthesia (LA) or general anesthesia (GA); however, a wide variation in practice exists. PubMed was searched between 2009 and 2013. Data were extracted from eligible studies. Random-effects meta-analysis was performed using DerSimonian Laird between-study variance. There was no statistically significant difference identified between groups based on age or EuroSCORE. There was no statistically significant difference seen in all-cause mortality, or complication rates between groups. Mean procedural duration was 36 minutes shorter in the LA group (p = 0.001). There was increased vasopressor use in the GA group (odds ratio 3.92; p = 0.017). Mean hospital stay was 3.41 days shorter in the LA group (p = 0.018). Results suggest that the use of LA for retrograde TAVI is feasible. There are several potential benefits associated, shorter procedural duration, and hospital stay with lower vasopressor requirements. Further studies and randomized trials are mandatory to confirm the presented findings and to identify those patients for whom LA would be appropriate. Georg Thieme Verlag KG Stuttgart · New York.

Efficacy of Laparoscopic Nissen Fundoplication vs Transoral Incisionless Fundoplication or Proton Pump Inhibitors in Patients With Gastroesophageal Reflux Disease: A Systematic Review and Network Meta-analysis.

PubMed

Richter, Joel E; Kumar, Ambuj; Lipka, Seth; Miladinovic, Branko; Velanovich, Vic

2018-04-01

The effects of transoral incisionless fundoplication (TIF) and laparoscopic Nissen fundoplication (LNF) have been compared with those of proton pump inhibitors (PPIs) or a sham procedure in patients with gastroesophageal reflux disease (GERD), but there has been no direct comparison of TIF vs LNF. We performed a systematic review and network meta-analysis of randomized controlled trials to compare the relative efficacies of TIF vs LNF in patients with GERD. We searched publication databases and conference abstracts through May 10, 2017 for randomized controlled trials that compared the efficacy of TIF or LNF with that of a sham procedure or PPIs in patients with GERD. We performed a network meta-analysis using Bayesian methods under random-effects multiple treatment comparisons. We assessed ranking probability by surface under the cumulative ranking curve. Our search identified 7 trials comprising 1128 patients. Surface under the cumulative ranking curve ranking indicated TIF had highest probability of increasing patients' health-related quality of life (0.96), followed by LNF (0.66), a sham procedure (0.35), and PPIs (0.042). LNF had the highest probability of increasing percent time at pH <4 (0.99), followed by PPIs (0.64), TIF (0.32), and the sham procedure (0.05). LNF also had the highest probability of increasing LES pressure (0.78), followed by TIF (0.72) and PPIs (0.01). Patients who underwent the sham procedure had the highest probability for persistent esophagitis (0.74), followed by those receiving TIF (0.69), LNF (0.38), and PPIs (0.19). Meta-regression showed a shorter follow-up time as a significant confounder for the outcome of health-related quality of life in studies of TIF. In a systematic review and network meta-analysis of trials of patients with GERD, we found LNF to have the greatest ability to improve physiologic parameters of GERD, including increased LES pressure and decreased percent time pH <4. Although TIF produced the largest increase in health-related quality of life, this could be due to the shorter follow-up time of patients treated with TIF vs LNF or PPIs. TIF is a minimally invasive endoscopic procedure, yet based on evaluation of benefits vs risks, we do not recommend it as a long-term alternative to PPI or LNF treatment of GERD. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

Uniformity analysis for a direct-drive laser fusion reactor

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

Lund, L.D.; Skupsky, S.; Goldman, L.M.

1983-01-01

We show the results of an analysis of the uniformity for a direct-drive reactor using 20, 32, 60, or 96 beams. Several of these options achieve less than the 1% nonuniformity that is required. These options are considered for the cases where the solid angle fraction of the beam ports is 2% and 8%. The analysis is facilitated by separating the contributions due to the geometrical effects related to the number and orientation of the beams from those due to the spatial profile of the individual beams. Emphasis is placed on the wavelength of the nonuniformities, as the shorter wavelengthmore » nonuniformities are more easily smoothed by thermal conduction within the target. The analysis demonstrates that the longer wavelengths can be minimized by suitable choices of geometry and by maintaining beam balance, whereas the shorter wavelength nonuniformities can be reduced by optimizing parameters such as the focal position and the spatial intensity profile of each beam. The tolerances required for beam-to-beam energy balance will be discussed.« less

The timing of exposure in clinic-based treatment for childhood anxiety disorders.

PubMed

Gryczkowski, Michelle R; Tiede, Michael S; Dammann, Julie E; Jacobsen, Amy Brown; Hale, Lisa R; Whiteside, Stephen P H

2013-03-01

The present study examines treatment length and timing of exposure from two child anxiety disorders clinics. Data regarding symptoms and treatment characteristics for 28 youth were prospectively obtained through self, parent, and therapist report at each session. Information regarding length of treatment, timing of exposure initiation, and drop-out rates were compared with those obtained through efficacy and effectiveness trials of manualized treatment for anxious youth. Findings from the authors' clinical data revealed significantly shorter treatment duration with exposures implemented sooner than in the previous studies. Dropout rates were significantly higher than in the efficacy trial but comparable with the effectiveness trial. Outcome data from a subset of eight patients revealed large effect sizes. These findings suggest that effective treatment can be shorter and more focused on exposure than is often outlined in manuals and have important implications for outcome research and dissemination.

Planetary camera observations of the central parsec of M32

NASA Technical Reports Server (NTRS)

Lauer, Tod R.; Faber, S. M.; Currie, Douglas G.; Ewald, S. P.; Groth, Edward J.; Hester, J. J.; Holtzman, Jon A.; Light, Robert M.; O'Neil, Earl J., Jr.; Shaya, Edward J.

1992-01-01

New HST observations are reported which show that the M32 nucleus is extremely dense, with rho0 not less than 4 x 10 exp 6 solar masses/cu pc if M32 has a core with rc not greater than 0.37 pc, and rho0 greater than 3 x 10 exp 7 solar masses/cu pc if it instead has a central r exp -1/2 cusp. Limits on the M32 core radius are nearly three times smaller, and those on the central density at least four times greater, than values inferred from the best ground-based observations. A central relaxation that is almost an order of magnitude shorter than previous estimates is inferred from the new core parameters; a shorter stellar collision time is also inferred. It is argued that a starlight cusp surrounds the central black hole.

Planetary camera observations of the central parsec of M32

NASA Astrophysics Data System (ADS)

Lauer, Tod R.; Faber, S. M.; Currie, Douglas G.; Ewald, S. P.; Groth, Edward J.; Hester, J. Jeff; Holtzman, Jon A.; Light, Robert M.; O'Neil, Earl J., Jr.; Shaya, Edward J.; Westphal, James A.

1992-08-01

New HST observations are reported which show that the M32 nucleus is extremely dense, with rho0 not less than 4 x 10 exp 6 solar masses/cu pc if M32 has a core with rc not greater than 0.37 pc, and rho0 greater than 3 x 10 exp 7 solar masses/cu pc if it instead has a central r exp -1/2 cusp. Limits on the M32 core radius are nearly three times smaller, and those on the central density at least four times greater, than values inferred from the best ground-based observations. A central relaxation that is almost an order of magnitude shorter than previous estimates is inferred from the new core parameters; a shorter stellar collision time is also inferred. It is argued that a starlight cusp surrounds the central black hole.

RAPID SEPARATION METHOD FOR EMERGENCY WATER AND URINE SAMPLES

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

Maxwell, S.; Culligan, B.

2008-08-27

The Savannah River Site Environmental Bioassay Lab participated in the 2008 NRIP Emergency Response program administered by the National Institute for Standards and Technology (NIST) in May, 2008. A new rapid column separation method was used for analysis of actinides and {sup 90}Sr the NRIP 2008 emergency water and urine samples. Significant method improvements were applied to reduce analytical times. As a result, much faster analysis times were achieved, less than 3 hours for determination of {sup 90}Sr and 3-4 hours for actinides. This represents a 25%-33% improvement in analysis times from NRIP 2007 and a {approx}100% improvement compared tomore » NRIP 2006 report times. Column flow rates were increased by a factor of two, with no significant adverse impact on the method performance. Larger sample aliquots, shorter count times, faster cerium fluoride microprecipitation and streamlined calcium phosphate precipitation were also employed. Based on initial feedback from NIST, the SRS Environmental Bioassay Lab had the most rapid analysis times for actinides and {sup 90}Sr analyses for NRIP 2008 emergency urine samples. High levels of potential matrix interferences may be present in emergency samples and rugged methods are essential. Extremely high levels of {sup 210}Po were found to have an adverse effect on the uranium results for the NRIP-08 urine samples, while uranium results for NRIP-08 water samples were not affected. This problem, which was not observed for NRIP-06 or NRIP-07 urine samples, was resolved by using an enhanced {sup 210}Po removal step, which will be described.« less

Battery Lifespan | Transportation Research | NREL

Science.gov Websites

over time (ranging from 0 to 15 years) for three different climates (represented by Minneapolis . Trend lines from upper left to lower right reflect diminished capacity over time and shorter lifespan in Battery Life Model. Graph of relative capacity (ranging from .75 to 1) of battery in percent over time

Effects of processing parameters on immersion vacuum cooling time and physico-chemical properties of pork hams.

PubMed

Feng, Chao-Hui; Drummond, Liana; Zhang, Zhi-Hang; Sun, Da-Wen

2013-10-01

The effects of agitation (1002 rpm), different pressure reduction rates (60 and 100 mbar/min), as well as employing cold water with different initial temperatures (IWT: 7 and 20°C) on immersion vacuum cooling (IVC) of cooked pork hams were experimentally investigated. Final pork ham core temperature, cooling time, cooling loss, texture properties, colour and chemical composition were evaluated. The application for the first time of agitation during IVC substantially reduced the cooling time (47.39%) to 4.6°C, compared to IVC without agitation. For the different pressure drop rates, there was a trend that shorter IVC cooling times were achieved with lower cooling rate, although results were not statistically significant (P>0.05). For both IWTs tested, the same trend was observed: shorter cooling time and lower cooling loss were obtained under lower linear pressure drop rate of 60 mbar/min (not statistically significant, P>0.05). Compared to the reference cooling method (air blast cooling), IVC achieved higher cooling rates and better meat quality. Copyright © 2013 Elsevier Ltd. All rights reserved.

Thermal inactivation of Listeria innocua in salmon (Oncorhynchus keta) caviar using conventional glass and novel aluminum thermal-death-time tubes.

PubMed

Al-Holy, M; Quinde, Z; Guan, D; Tang, J; Rasco, B

2004-02-01

Differences in the come-up times and thermal inactivation parameters of Listeria innocua in salmon (Oncorhynchus keta) caviar containing 2.5% salt using conventional thermal-death-time (TDT) glass tubes and a novel aluminum tube were tested and compared. Generally, the come-up times and decimal reduction times (D-values) were shorter and the change in temperature required to change the D-value (z-value) was longer in the aluminum than in the glass tubes. The D-values at 60, 63, and 65 degrees C for the aluminum TDT tubes were 2.97, 0.77, and 0.40 min, respectively, and for the glass TDT tubes, these values were 3.55, 0.84, and 0.41 min. The z-values were 5.7 degrees C in the aluminum and 5.3 degrees C in the glass. Because of the shorter come-up time, the aluminum TDT tubes may provide a more precise measurement of microbial thermal inactivation than the glass TDT tubes, particularly for viscous materials, solid foods, and foods containing particulate matter.

Treatment of malignant gastric outlet obstruction with endoscopically placed self-expandable metal stents

PubMed Central

Gaidos, Jill KJ; Draganov, Peter V

2009-01-01

Malignant gastroduodenal obstruction can occur in up to 20% of patients with primary pancreatic, gastric or duodenal carcinomas. Presenting symptoms include nausea, vomiting, abdominal distention, pain and decreased oral intake which can lead to dehydration, malnutrition, and poor quality of life. Endoscopic stent placement has become the primary therapeutic modality because it is safe, minimally invasive, and a cost-effective option for palliation. Stents can be successfully deployed in the majority of patients. Stent placement appears to lead to a shorter time to symptomatic improvement, shorter time to resumption of an oral diet, and shorter hospital stays as compared with surgical options. Recurrence of the obstructive symptoms resulting from stent occlusion, due to tumor ingrowth or overgrowth, can be successfully treated with repeat endoscopic stent placement in the majority of the cases. Both endoscopic stenting and surgical bypass are considered palliative treatments and, to date, no improvement in survival with either modality has been demonstrated. A tailored therapeutic approach, taking into consideration patient preferences and involving a multidisciplinary team including the therapeutic endoscopist, surgeon, medical oncologist, radiation therapist, and interventional radiologist, should be considered in all cases. PMID:19764086

Robotic partial nephrectomy shortens warm ischemia time, reducing suturing time kinetics even for an experienced laparoscopic surgeon: a comparative analysis.

PubMed

Faria, Eliney F; Caputo, Peter A; Wood, Christopher G; Karam, Jose A; Nogueras-González, Graciela M; Matin, Surena F

2014-02-01

Laparoscopic and robotic partial nephrectomy (LPN and RPN) are strongly related to influence of tumor complexity and learning curve. We analyzed a consecutive experience between RPN and LPN to discern if warm ischemia time (WIT) is in fact improved while accounting for these two confounding variables and if so by which particular aspect of WIT. This is a retrospective analysis of consecutive procedures performed by a single surgeon between 2002-2008 (LPN) and 2008-2012 (RPN). Specifically, individual steps, including tumor excision, suturing of intrarenal defect, and parenchyma, were recorded at the time of surgery. Multivariate and univariate analyzes were used to evaluate influence of learning curve, tumor complexity, and time kinetics of individual steps during WIT, to determine their influence in WIT. Additionally, we considered the effect of RPN on the learning curve. A total of 146 LPNs and 137 RPNs were included. Considering renal function, WIT, suturing time, renorrhaphy time were found statistically significant differences in favor of RPN (p < 0.05). In the univariate analysis, surgical procedure, learning curve, clinical tumor size, and RENAL nephrometry score were statistically significant predictors for WIT (p < 0.05). RPN decreased the WIT on average by approximately 7 min compared to LPN even when adjusting for learning curve, tumor complexity, and both together (p < 0.001). We found RPN was associated with a shorter WIT when controlling for influence of the learning curve and tumor complexity. The time required for tumor excision was not shortened but the time required for suturing steps was significantly shortened.

Statistical analysis of hydrological response in urbanising catchments based on adaptive sampling using inter-amount times

NASA Astrophysics Data System (ADS)

ten Veldhuis, Marie-Claire; Schleiss, Marc

2017-04-01

In this study, we introduced an alternative approach for analysis of hydrological flow time series, using an adaptive sampling framework based on inter-amount times (IATs). The main difference with conventional flow time series is the rate at which low and high flows are sampled: the unit of analysis for IATs is a fixed flow amount, instead of a fixed time window. We analysed statistical distributions of flows and IATs across a wide range of sampling scales to investigate sensitivity of statistical properties such as quantiles, variance, skewness, scaling parameters and flashiness indicators to the sampling scale. We did this based on streamflow time series for 17 (semi)urbanised basins in North Carolina, US, ranging from 13 km2 to 238 km2 in size. Results showed that adaptive sampling of flow time series based on inter-amounts leads to a more balanced representation of low flow and peak flow values in the statistical distribution. While conventional sampling gives a lot of weight to low flows, as these are most ubiquitous in flow time series, IAT sampling gives relatively more weight to high flow values, when given flow amounts are accumulated in shorter time. As a consequence, IAT sampling gives more information about the tail of the distribution associated with high flows, while conventional sampling gives relatively more information about low flow periods. We will present results of statistical analyses across a range of subdaily to seasonal scales and will highlight some interesting insights that can be derived from IAT statistics with respect to basin flashiness and impact urbanisation on hydrological response.

Quantitative FE-EPMA measurement of formation and inhibition of carbon contamination on Fe for trace carbon analysis.

PubMed

Tanaka, Yuji; Yamashita, Takako; Nagoshi, Masayasu

2017-04-01

Hydrocarbon contamination introduced during point, line and map analyses in a field emission electron probe microanalysis (FE-EPMA) was investigated to enable reliable quantitative analysis of trace amounts of carbon in steels. The increment of contamination on pure iron in point analysis is proportional to the number of iterations of beam irradiation, but not to the accumulated irradiation time. A combination of a longer dwell time and single measurement with a liquid nitrogen (LN2) trap as an anti-contamination device (ACD) is sufficient for a quantitative point analysis. However, in line and map analyses, contamination increases with irradiation time in addition to the number of iterations, even though the LN2 trap and a plasma cleaner are used as ACDs. Thus, a shorter dwell time and single measurement are preferred for line and map analyses, although it is difficult to eliminate the influence of contamination. While ring-like contamination around the irradiation point grows during electron-beam irradiation, contamination at the irradiation point increases during blanking time after irradiation. This can explain the increment of contamination in iterative point analysis as well as in line and map analyses. Among the ACDs, which are tested in this study, specimen heating at 373 K has a significant contamination inhibition effect. This technique makes it possible to obtain line and map analysis data with minimum influence of contamination. The above-mentioned FE-EPMA data are presented and discussed in terms of the contamination-formation mechanisms and the preferable experimental conditions for the quantification of trace carbon in steels. © The Author 2016. Published by Oxford University Press on behalf of The Japanese Society of Microscopy. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Specification of matrix cleanup goals in fractured porous media.

PubMed

Rodríguez, David J; Kueper, Bernard H

2013-01-01

Semianalytical transient solutions have been developed to evaluate what level of fractured porous media (e.g., bedrock or clay) matrix cleanup must be achieved in order to achieve compliance of fracture pore water concentrations within a specified time at specified locations of interest. The developed mathematical solutions account for forward and backward diffusion in a fractured porous medium where the initial condition comprises a spatially uniform, nonzero matrix concentration throughout the domain. Illustrative simulations incorporating the properties of mudstone fractured bedrock demonstrate that the time required to reach a desired fracture pore water concentration is a function of the distance between the point of compliance and the upgradient face of the domain where clean groundwater is inflowing. Shorter distances correspond to reduced times required to reach compliance, implying that shorter treatment zones will respond more favorably to remediation than longer treatment zones in which back-diffusion dominates the fracture pore water response. For a specified matrix cleanup goal, compliance of fracture pore water concentrations will be reached sooner for decreased fracture spacing, increased fracture aperture, higher matrix fraction organic carbon, lower matrix porosity, shorter aqueous phase decay half-life, and a higher hydraulic gradient. The parameters dominating the response of the system can be measured using standard field and laboratory techniques. © 2012, The Author(s). Ground Water © 2012, National Ground Water Association.

Systematic Analysis of Long Non-Coding RNAs and mRNAs in the Ovaries of Duroc Pigs During Different Follicular Stages Using RNA Sequencing.

PubMed

Liu, Yi; Li, Mengxun; Bo, Xinwen; Li, Tao; Ma, Lipeng; Zhai, Tenjiao; Huang, Tao

2018-06-11

The dynamic process involving the selection and maturation of follicles is regulated and controlled by a highly synchronized and exquisitely timed cascade of gene expression. Studies have shown that long non-coding RNA (lncRNA) is essential for the normal maintenance of animal reproductive function and has an important regulatory function in ovarian development and hormone secretion. In this study, a total of 2076 lncRNAs (1362 known lncRNAs and 714 new lncRNAs) and 25,491 mRNAs were identified in libraries constructed from Duroc ovaries on days 0, 2 and 4 of follicle development. lncRNAs were shorter, had fewer exons, exhibited a shorter ORF (Open Reading Frame) length and lower expression levels, and were less conserved than mRNAs. Furthermore, 1694 transcripts (140 lncRNAs and 1554 mRNAs) were found to be differentially expressed in pairwise comparisons. A total of 6945 co-localized mRNAs were detected in cis in 2076 lncRNAs. The most enriched GO (Gene Ontology) terms were related to developmental processes. KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway analysis revealed that the differentially expressed lncRNAs targeted mRNAs, and the differentially expressed mRNAs were related to the TGF-β signaling pathway, the PI3K-Akt signaling pathway, the Retinol metabolic pathway and the Wnt signaling pathway. This study deepened our understanding of the genetic basis and molecular mechanisms of follicular development in pigs.

The significance of PIWI family expression in human lung embryogenesis and non-small cell lung cancer

PubMed Central

Navarro, Alfons; Tejero, Rut; Viñolas, Nuria; Cordeiro, Anna; Marrades, Ramon M.; Fuster, Dolors; Caritg, Oriol; Moises, Jorge; Muñoz, Carmen; Molins, Laureano; Ramirez, Josep; Monzo, Mariano

2015-01-01

The expression of Piwi-interacting RNAs, small RNAs that bind to PIWI proteins, was until recently believed to be limited to germinal stem cells. We have studied the expression of PIWI genes during human lung embryogenesis and in paired tumor and normal tissue prospectively collected from 71 resected non-small-cell lung cancer patients. The mRNA expression analysis showed that PIWIL1 was highly expressed in 7-week embryos and downregulated during the subsequent weeks of development. PIWIL1 was expressed in 11 of the tumor samples but in none of the normal tissue samples. These results were validated by immunohistochemistry, showing faint cytoplasmic reactivity in the PIWIL1-positive samples. Interestingly, the patients expressing PIWIL1 had a shorter time to relapse (TTR) (p = 0.006) and overall survival (OS) (p = 0.0076) than those without PIWIL1 expression. PIWIL2 and 4 were downregulated in tumor tissue in comparison to the normal tissue (p < 0.001) and the patients with lower levels of PIWIL4 had shorter TTR (p = 0.048) and OS (p = 0.033). In the multivariate analysis, PIWIL1 expression emerged as an independent prognostic marker. Using 5-Aza-dC treatment and bisulfite sequencing, we observed that PIWIL1 expression could be regulated in part by methylation. Finally, an in silico study identified a stem-cell expression signature associated with PIWIL1 expression. PMID:25742785

Development Roadmap of an Evolvable and Extensible Multi-Mission Telecom Planning and Analysis Framework

NASA Technical Reports Server (NTRS)

Cheung, Kar-Ming; Tung, Ramona H.; Lee, Charles H.

2003-01-01

In this paper, we describe the development roadmap and discuss the various challenges of an evolvable and extensible multi-mission telecom planning and analysis framework. Our long-term goal is to develop a set of powerful flexible telecommunications analysis tools that can be easily adapted to different missions while maintain the common Deep Space Communication requirements. The ability of re-using the DSN ground models and the common software utilities in our adaptations has contributed significantly to our development efforts measured in terms of consistency, accuracy, and minimal effort redundancy, which can translate into shorter development time and major cost savings for the individual missions. In our roadmap, we will address the design principles, technical achievements and the associated challenges for following telecom analysis tools (i) Telecom Forecaster Predictor - TFP (ii) Unified Telecom Predictor - UTP (iii) Generalized Telecom Predictor - GTP (iv) Generic TFP (v) Web-based TFP (vi) Application Program Interface - API (vii) Mars Relay Network Planning Tool - MRNPT.

Automated external defibrillators and simulated in-hospital cardiac arrests.

PubMed

Rossano, Joseph W; Jefferson, Larry S; Smith, E O'Brian; Ward, Mark A; Mott, Antonio R

2009-05-01

To test the hypothesis that pediatric residents would have shorter time to attempted defibrillation using automated external defibrillators (AEDs) compared with manual defibrillators (MDs). A prospective, randomized, controlled trial of AEDs versus MDs was performed. Pediatric residents responded to a simulated in-hospital ventricular fibrillation cardiac arrest and were randomized to using either an AED or MD. The primary end point was time to attempted defibrillation. Sixty residents, 21 (35%) interns, were randomized to 2 groups (AED = 30, MD = 30). Residents randomized to the AED group had a significantly shorter time to attempted defibrillation [median, 60 seconds (interquartile range, 53 to 71 seconds)] compared with those randomized to the MD group [median, 103 seconds (interquartile range, 68 to 288 seconds)] (P < .001). All residents in the AED group attempted defibrillation at <5 minutes compared with 23 (77%) in the MD group (P = .01). AEDs improve the time to attempted defibrillation by pediatric residents in simulated cardiac arrests. Further studies are needed to help determine the role of AEDs in pediatric in-hospital cardiac arrests.

Threshold units: A correct metric for reaction time?

PubMed Central

Zele, Andrew J.; Cao, Dingcai; Pokorny, Joel

2007-01-01

Purpose To compare reaction time (RT) to rod incremental and decremental stimuli expressed in physical contrast units or psychophysical threshold units. Methods Rod contrast detection thresholds and suprathreshold RTs were measured for Rapid-On and Rapid-Off ramp stimuli. Results Threshold sensitivity to Rapid-Off stimuli was higher than to Rapid-On stimuli. Suprathreshold RTs specified in Weber contrast for Rapid-Off stimuli were shorter than for Rapid-On stimuli. Reaction time data expressed in multiples of threshold reversed the outcomes: Reaction times for Rapid-On stimuli were shorter than those for Rapid-Off stimuli. The use of alternative contrast metrics also failed to equate RTs. Conclusions A case is made that the interpretation of RT data may be confounded when expressed in threshold units. Stimulus energy or contrast is the only metric common to the response characteristics of the cells underlying speeded responses. The use of threshold metrics for RT can confuse the interpretation of an underlying physiological process. PMID:17240416

Prospective Heart Tracking for Whole-heart Magnetic Resonance Angiography

PubMed Central

Moghari, Mehdi H.; Geva, Tal; Powell, Andrew J.

2015-01-01

Purpose To develop a prospective respiratory-gating technique (Heart-NAV) for use with contrast-enhanced 3D inversion recovery (IR) whole-heart magnetic resonance angiography (MRA) acquisitions that directly tracks heart motion without creating image inflow artifact. Methods With Heart-NAV, 1 of the startup pulses for the whole-heart steady-state free precession MRA sequence is used to collect the centerline of k-space, and its 1-dimensional reconstruction is fed into the standard diaphragm-navigator (NAV) signal analysis process to prospectively gate and track respiratory-induced heart displacement. Ten healthy volunteers underwent non-contrast whole-heart MRA acquisitions using the conventional diaphragm-NAV and Heart-NAV with 5 and 10 mm acceptance windows in a 1.5T scanner. Five patients underwent contrast-enhanced IR whole-heart MRA using a diaphragm-NAV and Heart-NAV with a 5 mm acceptance window. Results For non-contrast whole-heart MRA with both the 5 and 10 mm acceptance windows, Heart-NAV yielded coronary artery vessel sharpness and subjective visual scores that were not significantly different than those using a conventional diaphragm-NAV. Scan time for Heart-NAV was 10% shorter (p<0.05). In patients undergoing contrast-enhanced IR whole-heart MRA, inflow artifact was seen with the diaphragm-NAV but not with Heart-NAV. Conclusion Compared to a conventional diaphragm-NAV, Heart-NAV achieves similar image quality in a slightly shorter scan time and eliminates inflow artifact. PMID:26843458

Successful tocolysis: does cervical change affect time to delivery?

PubMed

Lewis, D F; Gallaspy, J W; Fontenot, M T; Burlison, R D; Imseis, J M; Edwards, M S

1997-11-01

Generally, it is preferable to tocolyze patients with idiopathic preterm labor (PTL). Little information is available about ultimate outcomes after successful tocolysis. Our objective is to evaluate the relationship between cervical change after the initiation of tocolysis and the delay in time to delivery in patients with preterm labor. A historical analysis of all patients with successful tocolysis after PTL between January 1992 and December 1993 was undertaken. The patients were then placed in one of three categories (regression, unchanged, or progression) based on cervical change after the initiation of tocolysis. Various demographic pregnancy characteristics and pregnancy outcome data were analyzed. One hundred and twenty-six patients had successful tocolysis and met the admission criteria. Patients who had cervical progression had shorter delay to delivery, delivered at an earlier gestational age (31.7 weeks compared to 34.0 and 34.1 weeks, respectively, p < 0.05), and were more likely to deliver before 35 weeks (88% compared to 50.0 and 55.0%, respectively, p < 0.05). Also, neonates remained in the hospital longer and were more likely to have respiratory distress syndrome when compared to the other two groups. Patients who had cervical progression after the initiation of tocolysis are more likely to deliver prematurely, had a shorter delay to delivery, and delivered lower birth weight infants than did patients whose cervix regressed or remained unchanged. In our population, patients who had successful tocolysis had a preterm delivery rate of 59.5% before the 35th week of gestation.

Homeobox B9 is overexpressed in hepatocellular carcinomas and promotes tumor cell proliferation both in vitro and in vivo

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

Li, Fangyi; Dong, Lei, E-mail: dlleidong@126.com; Xing, Rong

2014-02-07

Highlights: • HOXB9 is overexpressed in human HCC samples. • HOXB9 over expression had shorter survival time than down expression. • HOXB9 stimulated the proliferation of HCC cells. • Activation of TGF-β1 contributes to HOXB9-induced proliferation in HCC cells. - Abstract: HomeoboxB9 (HOXB9), a nontransforming transcription factor that is overexpressed in multiple tumor types, alters tumor cell fate and promotes tumor progression. However, the role of HOXB9 in hepatocellular carcinoma (HCC) development has not been well studied. In this paper, we found that HOXB9 is overexpressed in human HCC samples. We investigated HOXB9 expression and its prognostic value for HCC.more » HCC surgical tissue samples were taken from 89 HCC patients. HOXB9 overexpression was observed in 65.2% of the cases, and the survival analysis showed that the HOXB9 overexpression group had significantly shorter overall survival time than the HOXB9 downexpression group. The ectopic expression of HOXB9 stimulated the proliferation of HCC cells; whereas the knockdown of HOXB9 produced an opposite effect. HOXB9 also modulated the tumorigenicity of HCC cells in vivo. Moreover, we found that the activation of TGF-β1 contributes to HOXB9-induced proliferation activities. The results provide the first evidence that HOXB9 is a critical regulator of tumor growth factor in HCC.« less

Jupiter's Atmospheric Temperatures: From Voyager IRIS to Cassini CIRS

NASA Technical Reports Server (NTRS)

Simon-Miller, Amy A.; Conrath, Barney J.; Gierasch, Peter J.; Orton, Glenn S.; Achterberg, Richard K.; Flasar, F. Michael; Fisher, Brendan

2004-01-01

Retrievals run on Cassini Composite Infrared Spectrometer data obtained during the distant Jupiter flyby have been used to generate global temperature maps of the planet in the troposphere and stratosphere. Similar retrievals were performed on Voyager 1 IRIS data and have provided the first detailed IRIS map of the stratosphere. In both data sets, high latitude troposphere temperatures are presented for the first time, and the meridional gradients indicate the presence of circumpolar jets. Thermal winds were calculated for each data set and show strong vertical shears in the zonal winds at low latitudes. The temperatures retrieved from the two spacecraft were also compared with yearly ground-based data obtained over the intervening two decades. Tropospheric temperatures reveal gradual changes at low latitudes, with little obvious seasonal or short-term variation (Orton et al. 1994). Stratospheric temperatures show much more complicated behavior over short timescales, consistent with quasi-quadrennial oscillations at low latitudes, as suggested in prior analyses of shorter intervals of ground- based data (Orton et al. 1991, Friedson 1999). A scaling analysis indicates that meridional motions, mechanically forced by wave or eddy convergence, play an important role in modulating the temperatures and winds in the upper troposphere and stratosphere on seasonal and shorter time scales. At latitudes away from the equator, the mechanical forcing can be derived simply from a temporal record of temperature and its vertical derivative. Ground-based observations with improved vertical resolution and/or long-term monitoring from spacecraft are required for this purpose.

Optimizing time management after perforation by colonoscopy results in better outcome for the patients.

PubMed

Rumstadt, Bernhard; Schilling, Dieter

2008-01-01

Perforation during colonoscopy is a rare but severe complication. The aim of this study was to assess the time management and laparoscopic therapy of this complication and to evaluate patient outcomes. A retrospective analysis was done on 15 patients operated for a perforation from colonoscopy between January 2000 and December 2006. Three perforations occurred during diagnostic and 12 perforations during interventional colonoscopy. Two perforations occurred as transmural thermal injury to the colon wall. Peritonitis was found in 4 cases and significantly correlated with the mean time between perforation and operation. Twelve perforations were oversewn laparoscopically and 3 perforations were oversewn by laparotomy. After laparoscopic treatment, hospital stay was significantly shorter than after laparotomy. One patient had a postoperative wound infection, mortality was 0%. Laparoscopic oversewing is a safe and effective method in the treatment of perforation from colonoscopy. Optimizing the time range between perforation and laparoscopic therapy results in a better outcome for the patients.

Spectroscopic properties of triangular silver nanoplates immobilized on polyelectrolyte multilayer-modified glass substrates

NASA Astrophysics Data System (ADS)

Rabor, Janice B.; Kawamura, Koki; Muko, Daiki; Kurawaki, Junichi; Niidome, Yasuro

2017-07-01

Fabrication of surface-immobilized silver nanostructures with reproducible plasmonic properties by dip-coating technique is difficult due to shape alteration. To address this challenge, we used a polyelectrolyte multilayer to promote immobilization of as-received triangular silver nanoplates (TSNP) on a glass substrate through electrostatic interaction. The substrate-immobilized TSNP were characterized by absorption spectrophotometry and scanning electron microscopy. The bandwidth and peak position of localized surface plasmon resonance (LSPR) bands can be tuned by simply varying the concentration of the colloidal solution and immersion time. TSNP immobilized from a higher concentration of colloidal solution with longer immersion time produced broadened LSPR bands in the near-IR region, while a lower concentration with shorter immersion time produced narrower bands in the visible region. The shape of the nanoplates was retained even at long immersion time. Analysis of peak positions and bandwidths also revealed the point at which the main species of the immobilization had been changed from isolates to aggregates.

Effect of time and of precursor molecule on the deposition of hydrophobic nanolayers on ethyelene tetrafluoroethylene-silicon oxide substrates

NASA Astrophysics Data System (ADS)

Rossi, Gabriella; Castellano, Piera; Incarnato, Loredana

2016-10-01

A method was developed for generating transparent and hydrophobic nanolayers chemisorbed onto flexible substrates of ethylene tetrafluoroethylene-silicon oxide (ETFE-SiOx). In particular, the effect of the deposition time and of the precursor molecule on the nanocoating process was analyzed with the aim of pursuing an optimization of the above method in an industrial application perspective. It was found that precursor molecule of triethoxysilane allowed to obtain better hydrophobic properties on the SiOx surface in shorter times compared to trichlorosilane, reaching the 92 % of final contact angle (CA) value of 106° after only 1 h of deposition. The optical properties and surface morphology were also assessed in function of time, revealing that an initial transparency reduction is followed by a subsequent transmittance increase during the self assembly of fluoroalkylsilanes on the SiOx surface, coherently with the surface roughness analysis data. Encouraging results were also obtained in terms of oleophobic properties improvement of the nanocoated surfaces.

The Effect of Life History on Retroviral Genome Invasions

PubMed Central

Kanda, Ravinder K.; Coulson, Tim

2015-01-01

Endogenous retroviruses (ERV), or the remnants of past retroviral infections that are no longer active, are found in the genomes of most vertebrates, typically constituting approximately 10% of the genome. In some vertebrates, particularly in shorter-lived species like rodents, it is not unusual to find active endogenous retroviruses. In longer-lived species, including humans where substantial effort has been invested in searching for active ERVs, it is unusual to find them; to date none have been found in humans. Presumably the chance of detecting an active ERV infection is a function of the length of an ERV epidemic. Intuitively, given that ERVs or signatures of past ERV infections are passed from parents to offspring, we might expect to detect more active ERVs in species with longer generation times, as it should take more years for an infection to run its course in longer than in shorter lived species. This means the observation of more active ERV infections in shorter compared to longer-lived species is paradoxical. We explore this paradox using a modeling approach to investigate factors that influence ERV epidemic length. Our simple epidemiological model may explain why we find evidence of active ERV infections in shorter rather than longer-lived species. PMID:25692467

Independent influence of gait speed and step length on stability and fall risk.

PubMed

Espy, D D; Yang, F; Bhatt, T; Pai, Y-C

2010-07-01

With aging, individuals' gaits become slower and their steps shorter; both are thought to improve stability against balance threats. Recent studies have shown that shorter step lengths, which bring the center of mass (COM) closer to the leading foot, improve stability against slip-related falls. However, a slower gait, hence lower COM velocity, does the opposite. Due to the inherent coupling of step length and speed in spontaneous gait, the extent to which the benefit of shorter steps can offset the slower speed is unknown. The purpose of this study was to investigate, through decoupling, the independent effects of gait speed and step length on gait stability and the likelihood of slip-induced falls. Fifty-seven young adults walked at one of three target gait patterns, two of equal speed and two of equal step length; at a later trial, they encountered an unannounced slip. The results supported our hypotheses that faster gait as well as shorter steps each ameliorates fall risk when a slip is encountered. This appeared to be attributable to the maintenance of stability from slip initiation to liftoff of the recovery foot during the slip. Successful decoupling of gait speed from step length reveals for the first time that, although slow gait in itself leads to instability and falls (a one-standard-deviation decrease in gait speed increases the odds of fall by 4-fold), this effect is offset by the related decrease in step length (the same one-standard-deviation decrease in step length lowers fall risk by 6 times). Copyright © 2010 Elsevier B.V. All rights reserved.

Duration of Antimicrobial Treatment for Bacteremia in Canadian Critically Ill Patients.

PubMed

Daneman, Nick; Rishu, Asgar H; Xiong, Wei; Bagshaw, Sean M; Dodek, Peter; Hall, Richard; Kumar, Anand; Lamontagne, Francois; Lauzier, Francois; Marshall, John; Martin, Claudio M; McIntyre, Lauralyn; Muscedere, John; Reynolds, Steve; Stelfox, Henry T; Cook, Deborah J; Fowler, Robert A

2016-02-01

The optimum duration of antimicrobial treatment for patients with bacteremia is unknown. Our objectives were to determine duration of antimicrobial treatment provided to patients who have bacteremia in ICUs, to assess pathogen/patient factors related to treatment duration, and to assess the relationship between treatment duration and survival. Retrospective cohort study. Fourteen ICUs across Canada. Patients with bacteremia and were present in the ICU at the time culture reported positive. Duration of antimicrobial treatment for patients who had bacteremia in ICU. Among 1,202 ICU patients with bacteremia, the median duration of treatment was 14 days, but with wide variability (interquartile range, 9-17.5). Most patient characteristics were not associated with treatment duration. Coagulase-negative staphylococci were the only pathogens associated with shorter treatment (odds ratio, 2.82; 95% CI, 1.51-5.26). The urinary tract was the only source of infection associated with a trend toward lower likelihood of shorter treatment (odds ratio, 0.67; 95% CI, 0.42-1.08); an unknown source of infection was associated with a greater likelihood of shorter treatment (odds ratio, 2.14; 95% CI, 1.17-3.91). The association of treatment duration and survival was unstable when analyzed based on timing of death. Critically ill patients who have bacteremia typically receive long courses of antimicrobials. Most patient/pathogen characteristics are not associated with treatment duration; survivor bias precludes a valid assessment of the association between treatment duration and survival. A definitive randomized controlled trial is needed to compare shorter versus longer antimicrobial treatment in patients who have bacteremia.

Characteristic analysis of α-fetoprotein-producing gastric carcinoma in China

PubMed Central

2013-01-01

α-Fetoprotein-producing gastric cancer (AFPGC) is a rare type of gastric cancer. The largest population of patients with AFPGC is found in China. In the present study, a total of 4,779 GC patients, including 317 AFPGC patients, from 11 clinical studies in China with a general AFPGC/GC ratio of 6.63% were summarized and analyzed. On the basis of analysis of the clinical data, the patients with AFPGC had larger tumor size, weaker cell differentiation, worse histopathological types, deeper serosal infiltration, more lymph node and liver metastases, poorer stages, shorter survival time and more positive expression of vascular endothelial growth factors than the patients without AFPGC. Our observation is consistent with previous results reported in studies of AFPGC. Overall, AFPGC is a subtype of GC with a poor prognosis. PMID:24083471

[A study of the phenomenon of voice intonation: analysis, usage and diagnosis].

PubMed

Kazanecka, E; Pawłowski, Z; Zółtowski, M

1997-01-01

The aim of this work was to study the average rise time (RT) and average flow rate (MRT) in utterance. Data were collected from 48 singers and 44 patients. The group of patients included cases of modulus vocale, polypus laryngis, paresis bilateralis, hemiparesis, and CA laryngis. Various characteristics of utterance were recorded synchronously: the frequency and intensity of the fundamental laryngeal tone were measured with a laryngophone, a microphone was used to monitor acoustic radiation from the mouth, and a pneumotrachometer was applied for the measurement of flow rate. The data were stored and analysed with the use of a computer. Results show that the analysis carried out in the study describes the distinctive characteristics of normal and pathologic utterance. The main findings are as follows: a) rise time (RT) decreases with increasing loudness and pitch of the sound and is also shorter in staccato than inlegato sounds; b) during the initial transient of staccato sounds, the average flow rate in the glottis increases with intensity and pitch of the sound; c) pre-fonation time (TPP) and air volume do not differentiate normal and pathologic utterance; d) in cases of voice pathology, the analysis of utterance described in this study can be used for the evaluation of therapy and rehabilitation.

Chromosome aberrations detected by conventional karyotyping using novel mitogens in chronic lymphocytic leukemia: Clinical and biologic correlations.

PubMed

Rigolin, Gian Matteo; del Giudice, Ilaria; Formigaro, Luca; Saccenti, Elena; Martinelli, Sara; Cavallari, Maurizio; Lista, Enrico; Tammiso, Elisa; Volta, Eleonora; Lupini, Laura; Bassi, Cristian; Bardi, Antonella; Sofritti, Olga; Daghia, Giulia; Cavazzini, Francesco; Marinelli, Marilisa; Tavolaro, Simona; Guarini, Anna; Negrini, Massimo; Foà, Robin; Cuneo, Antonio

2015-12-01

To clarify whether karyotype aberrations (KA) involving regions not covered by the standard fluorescence in situ hybridization (FISH) panel have independent prognostic relevance, we evaluated KA by conventional cytogenetics in a learning cohort (LC; n = 166) and a validation cohort (VC; n = 250) of untreated chronic lymphocytic leukemia (CLL) patients. In the VC, novel mitogens were used to improve metaphase generation and TP53, NOTCH1, and SF3B1 mutations were assessed. KA undetected by FISH were found in 35 and 35% of the cases in the LC and VC, respectively. In addition to FISH, KA allowed reclassification of 23 and 26% of cases in the LC and VC, respectively, into a higher cytogenetic risk group. By multivariate analysis, both in the LC and VC, KA other than isolated 13q deletion correlated with a shorter time to first treatment (TFT; P < 0.001 and 0.003, respectively), while a complex karyotype predicted a worse overall survival (OS, P = 0.015 and 0.010, respectively). In the VC, where a comprehensive biologic assessment was performed, a shorter TFT was also predicted by stage (P < 0.001), IGHV mutational status (P = 0.05), and del(17p)/TP53 mutations (P = 0.033) while stage (P = 0.023) and del(17p)/TP53 mutations (P = 0.024) independently predicted a shorter OS. FISH results did not independently impact on TFT and OS, in the LC and VC cohorts; this was also the case for NOTCH1 and SF3B1 mutations in the VC. We suggest that in CLL, conventional karyotyping with novel mitogens could be more effective than FISH for the detection of KA allowing for a more precise refinement of prognosis. © 2015 Wiley Periodicals, Inc.

Factors Associated with Persistent Sputum Positivity at the End of the Second Month of Tuberculosis Treatment in Lithuania.

PubMed

Diktanas, Saulius; Vasiliauskiene, Edita; Polubenko, Katazyna; Danila, Edvardas; Celedinaite, Indre; Boreikaite, Evelina; Misiunas, Kipras

2018-06-19

Non-conversion of sputum smear and culture prolongs the infectivity of the patient and has been associated with unfavorable outcomes. We aimed to evaluate factors associated with persistent sputum positivity at the end of two months of treatment of new case pulmonary tuberculosis (TB). Data of 87 human immunodeficiency virus-negative patients with culture-positive drug-susceptible pulmonary TB admitted to local university hospital between September 2015 and September 2016 were reviewed. Factors associated with sputum smear and/or culture positivity at the end of the second month of treatment were analyzed. Twenty-two patients (25.3%) remained smear and/or culture-positive. Male sex, lower body mass index (BMI), unemployment, alcohol abuse, higher number of lobes involved and cavities on chest X-rays, shorter time to detection (TTD) on liquid cultures, higher respiratory sample smear grading and colony count in solid cultures, higher C-reactive protein, erythrocyte sedimentation rate, leukocytosis, thrombocytosis, and anemia were all significantly associated with persistent sputum positivity. However, in the logistic regression analysis only male sex, lower BMI, alcohol abuse, higher radiological involvement, cavitation, higher smear grading, higher colony count in solid cultures and shorter TTD were determined as independent factors associated with persistent sputum positivity at the end of 2 months of treatment. In conclusion, higher sputum smear and culture grading at diagnosis, shorter TTD, higher number of lobes involved, cavitation, male sex, alcohol abuse, and lower BMI were independently associated with persistent sputum positivity. These factors should be sought when distinguishing which patients will remain infectious longer and possibly have worse outcomes. Copyright©2018. The Korean Academy of Tuberculosis and Respiratory Diseases.

Comparing Outcomes and Cost of 3 Surgical Treatments for Sagittal Synostosis: A Retrospective Study Including Procedure-Related Cost Analysis.

PubMed

Garber, Sarah T; Karsy, Michael; Kestle, John R W; Siddiqi, Faizi; Spanos, Stephen P; Riva-Cambrin, Jay

2017-10-01

Neurosurgical techniques for repair of sagittal synostosis include total cranial vault (TCV) reconstruction, open sagittal strip (OSS) craniectomy, and endoscopic strip (ES) craniectomy. To evaluate outcomes and cost associated with these 3 techniques. Via retrospective chart review with waiver of informed consent, the last consecutive 100 patients with sagittal synostosis who underwent each of the 3 surgical correction techniques before June 30, 2013, were identified. Clinical, operative, and process of care variables and their associated specific charges were analyzed along with overall charge. The study included 300 total patients. ES patients had fewer transfusion requirements (13% vs 83%, P < .001) than TCV patients, fewer days in intensive care (0.3 vs 1.3, P < .001), and a shorter overall hospital stay (1.8 vs 4.2 d, P < .001), and they required fewer revisions (1% vs 6%, P = .05). The mean charge for the endoscopic procedure was $21 203, whereas the mean charge for the TCV reconstruction was $45 078 (P < .001). ES patients had more preoperative computed tomography scans (66% vs 44%, P = .003) than OSS patients, shorter operative times (68 vs 111 min, P < .001), and required fewer revision procedures (1% vs 8%, P < .001). The mean charge for the endoscopic procedure was $21 203 vs $20 535 for the OSS procedure (P = .62). The ES craniectomy for sagittal synostosis appeared to have less morbidity and a potential cost savings compared with the TCV reconstruction. The charges were similar to those incurred with OSS craniectomy, but patients had a shorter length of stay and fewer revisions. Copyright © 2017 by the Congress of Neurological Surgeons

Affiliation and aggression as related to gender in domestic chicks (Gallus gallus).

PubMed

Vallortigara, G

1992-03-01

Social discrimination in male and female domestic chicks (Gallus gallus) was investigated by using (a) latencies of approach response, (b) simultaneous free choice, and (c) intersubject aggressive-pecking tests. In approach-response tests, females showed shorter latencies when tested with cagemates than when tested with strangers, whereas males showed shorter latencies when tested with strangers than when tested with cagemates. In simultaneous-choice tests, females spent more time near a cagemate, whereas males spent more time near a strange chick. In aggressive-pecking tests, both sexes pecked more at strangers than at cagemates; aggressive pecking at strangers, however, was higher in males than in females. It is argued that gender effects in social discrimination can be accounted for in terms of stronger social attachment in females and aggressive responses in males.

Improved safety of retinal photocoagulation with a shaped beam and modulated pulse

NASA Astrophysics Data System (ADS)

Sramek, Christopher; Brown, Jefferson; Paulus, Yannis M.; Nomoto, Hiroyuki; Palanker, Daniel

2010-02-01

Shorter pulse durations help confine thermal damage during retinal photocoagulation, decrease treatment time and minimize pain. However, safe therapeutic window (the ratio of threshold powers for rupture and mild coagulation) decreases with shorter exposures. A ring-shaped beam enables safer photocoagulation than conventional beams by reducing the maximum temperature in the center of the spot. Similarly, a temporal pulse modulation decreasing its power over time improves safety by maintaining constant temperature for a significant portion of the pulse. Optimization of the beam and pulse shapes was performed using a computational model. In vivo experiments were performed to verify the predicted improvement. With each of these approaches, the pulse duration can be decreased by a factor of two, from 20 ms down to 10 ms while maintaining the same therapeutic window.

Extraordinary Activity in the BL Lac Object OJ 287

NASA Astrophysics Data System (ADS)

Hughes, P. A.; Aller, H. D.; Aller, M. F.

We present the results of a wavelet transform analysis of data for the BL Lac object OJ 287 acquired as part of the UMRAO variability program. We find clear evidence for a persistent modulation of the total flux and polarization with period 1.66 years, and for another signal that dominates activity in the 1980s with period 1.12 years. It appears that the longer time scale periodicity is associated with an otherwise quiescent jet, and the shorter time scale activity is associated with the passage of a shock, or shocks. The periodic behavior in polarization exhibits excursions in U which correspond to a direction 45circ from the VLBI jet axis. This behavior suggests a small amplitude, cyclic variation in the flow direction in that part of the flow that dominates cm-wavelength emission.

Acid--chlorite pretreatment and liquefaction of cornstalk in hot-compressed water for bio-oil production.

PubMed

Liu, Hua-Min; Feng, Bing; Sun, Run-Cang

2011-10-12

In this study, cornstalk was pretreated by an acid-chlorite delignification procedure to enhance the conversion of cornstalk to bio-oil in hot-compressed water liquefaction. The effects of the pretreatment conditions on the compositional and structural changes of the cornstalk and bio-oil yield were investigated. It was found that acid-chlorite pretreatment changed the main components and physical structures of cornstalk and effectively enhanced the bio-oil yield. Shorter residence time favored production of the total bio-oil products, whereas longer time led to cracking of the products. A high water loading was found to be favorable for high yields of total bio-oil and water-soluble oil. GC-MS analysis showed that the water-soluble oil and heavy oil were the complicated products of C(5-10) and C(8-11) organic compounds.

Solving the Software Legacy Problem with RISA

NASA Astrophysics Data System (ADS)

Ibarra, A.; Gabriel, C.

2012-09-01

Nowadays hardware and system infrastructure evolve on time scales much shorter than the typical duration of space astronomy missions. Data processing software capabilities have to evolve to preserve the scientific return during the entire experiment life time. Software preservation is a key issue that has to be tackled before the end of the project to keep the data usable over many years. We present RISA (Remote Interface to Science Analysis) as a solution to decouple data processing software and infrastructure life-cycles, using JAVA applications and web-services wrappers to existing software. This architecture employs embedded SAS in virtual machines assuring a homogeneous job execution environment. We will also present the first studies to reactivate the data processing software of the EXOSAT mission, the first ESA X-ray astronomy mission launched in 1983, using the generic RISA approach.

Predictive factors for postoperative visual function of primary chronic rhegmatogenous retinal detachment after scleral buckling.

PubMed

Fang, Wei; Li, Jiu-Ke; Jin, Xiao-Hong; Dai, Yuan-Min; Li, Yu-Min

2016-01-01

To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment (RRD) after sclera buckling (SB). Totally 48 patients (51 eyes) with primary chronic RRD were included in this prospective interventional clinical cases study, which underwent SB alone from June 2008 to December 2014. Age, sex, symptoms duration, detached extension, retinal hole position, size, type, fovea on/off, proliferative vitreoretinopathy (PVR), posterior vitreous detachment (PVD), baseline best corrected visual acuity (BCVA), operative duration, follow up duration, final BCVA were measured. Pearson correlation analysis, Spearman correlation analysis and multivariate linear stepwise regression were used to confirm predictive factors for better final visual acuity. Student's t-test, Wilcoxon two-sample test, Chi-square test and logistic stepwise regression were used to confirm predictive factors for better vision improvement. Baseline BCVA was 0.8313±0.6911 logMAR and final BCVA was 0.4761±0.4956 logMAR. Primary surgical success rate was 92.16% (47/51). Correlation analyses revealed shorter symptoms duration (r=0.3850, P=0.0053), less detached area (r=0.5489, P<0.0001), fovea (r=0.4605, P=0.0007), no PVR (r=0.3138, P=0.0250), better baseline BCVA (r=0.7291, P<0.0001), shorter operative duration (r=0.3233, P=0.0207) and longer follow up (r=-0.3358, P=0.0160) were related with better final BCVA, while independent predictive factors were better baseline BCVA [partial R-square (PR(2))=0.5316, P<0.0001], shorter symptoms duration (PR(2)=0.0609, P=0.0101), longer follow up duration (PR(2)=0.0278, P=0.0477) and shorter operative duration (PR(2)=0.0338, P=0.0350). Patients with vision improvement took up 49.02% (25/51). Univariate and multivariate analyses both revealed predictive factors for better vision improvement were better baseline vision [odds ratio (OR) =50.369, P=0.0041] and longer follow up duration (OR=1.144, P=0.0067). Independent predictive factors for better visual outcome of primary chronic RRD after SB are better baseline BCVA, shorter symptoms duration, shorter operative duration and longer follow up duration, while independent predictive factors for better vision improvement after operation are better baseline vision and longer follow up duration.

Microfluidic Devices for Forensic DNA Analysis: A Review.

PubMed

Bruijns, Brigitte; van Asten, Arian; Tiggelaar, Roald; Gardeniers, Han

2016-08-05

Microfluidic devices may offer various advantages for forensic DNA analysis, such as reduced risk of contamination, shorter analysis time and direct application at the crime scene. Microfluidic chip technology has already proven to be functional and effective within medical applications, such as for point-of-care use. In the forensic field, one may expect microfluidic technology to become particularly relevant for the analysis of biological traces containing human DNA. This would require a number of consecutive steps, including sample work up, DNA amplification and detection, as well as secure storage of the sample. This article provides an extensive overview of microfluidic devices for cell lysis, DNA extraction and purification, DNA amplification and detection and analysis techniques for DNA. Topics to be discussed are polymerase chain reaction (PCR) on-chip, digital PCR (dPCR), isothermal amplification on-chip, chip materials, integrated devices and commercially available techniques. A critical overview of the opportunities and challenges of the use of chips is discussed, and developments made in forensic DNA analysis over the past 10-20 years with microfluidic systems are described. Areas in which further research is needed are indicated in a future outlook.

Projected changes in Malawi's growing season

NASA Astrophysics Data System (ADS)

Vizy, Edward K.; Cook, Kerry H.; Chimphamba, James; McCusker, Brent

2015-09-01

Regional climate model projections at 30-km resolution are used to predict future mid-century and late-century growing season changes over Malawi due to global warming under the Representative Concentration Pathway 8.5 business-as-usual emissions forcing scenario. Three different methods for estimating growing season characteristics are applied and evaluated. All three methods yield reasonable growing season length, onset, and demise date estimates over Malawi given the wide range of uncertainty of the observations. The projections indicate the likelihood for a shorter growing season in the future over Malawi south of 13.5°S. At mid-century the growing season length is predicted to be 20-40 % (20-55 days) shorter over the southernmost districts and 5-20 % (5-30 days) shorter over the central districts. By late-century the length is predicted to be 25-55 % (20-70 days) shorter with significant differences extending into northern Malawi. The shorter growing season is primarily associated with an earlier demise date, as no significant change in the onset date is predicted. Analysis of the regional circulation and horizontal moisture flux transport indicates that the earlier demise is associated with an intensification of the thermal low over the Kalahari Desert to the south and west of Malawi and an expansion of the mid-tropospheric Kalahari anticyclone over southern Africa. The stronger thermal low/anticyclone enhances the moisture flux divergence over Malawi suppressing the convective activity at the end of the wet season.

Bladed wheels damage detection through Non-Harmonic Fourier Analysis improved algorithm

NASA Astrophysics Data System (ADS)

Neri, P.

2017-05-01

Recent papers introduced the Non-Harmonic Fourier Analysis for bladed wheels damage detection. This technique showed its potential in estimating the frequency of sinusoidal signals even when the acquisition time is short with respect to the vibration period, provided that some hypothesis are fulfilled. Anyway, previously proposed algorithms showed severe limitations in cracks detection at their early stage. The present paper proposes an improved algorithm which allows to detect a blade vibration frequency shift due to a crack whose size is really small compared to the blade width. Such a technique could be implemented for condition-based maintenance, allowing to use non-contact methods for vibration measurements. A stator-fixed laser sensor could monitor all the blades as they pass in front of the spot, giving precious information about the wheel health. This configuration determines an acquisition time for each blade which become shorter as the machine rotational speed increases. In this situation, traditional Discrete Fourier Transform analysis results in poor frequency resolution, being not suitable for small frequency shift detection. Non-Harmonic Fourier Analysis instead showed high reliability in vibration frequency estimation even with data samples collected in a short time range. A description of the improved algorithm is provided in the paper, along with a comparison with the previous one. Finally, a validation of the method is presented, based on finite element simulations results.

19 CFR 210.15 - Motions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... administrative law judge, all motions shall be addressed to the chief administrative law judge. During the time that an investigation or related proceeding is before an administrative law judge, all motions therein... written motions, or within such longer or shorter time as may be designated by the administrative law...

Cigarette smoking and telomere length: A systematic review of 84 studies and meta-analysis.

PubMed

Astuti, Yuliana; Wardhana, Ardyan; Watkins, Johnathan; Wulaningsih, Wahyu

2017-10-01

Cigarette smoking is a risk factor for ageing-related disease, but its association with biological ageing, indicated by telomere length, is unclear. We systematically reviewed evidence evaluating association between smoking status and telomere length. Searches were performed in MEDLINE (Ovid) and EMBASE (Ovid) databases, combining variation of keywords "smoking" and "telomere". Data was extracted for study characteristics and estimates for association between smoking and telomere length. Quality of studies was assessed with a risk of bias score, and publication bias was assessed with a funnel plot. I 2 test was used to observe heterogeneity. Meta-analysis was carried out to compare mean difference in telomere length by smoking status, and a dose-response approach was carried out for pack-years of smoking and telomere length. A sensitivity analysis was carried out to examine sources of heterogeneity. A total of 84 studies were included in the review, and 30 among them were included in our meta-analysis. Potential bias was addressed in half of included studies, and there was little evidence of small study bias. Telomere length was shorter among ever smokers compared to never smokers (summary standard mean difference [SMD]: -0.11 (95% CI -0.16 to -0.07)). Similarly, shorter telomere length was found among smokers compared to non-smokers, and among current smokers compared to never or former smokers. Dose-response meta-analysis suggested an inverse trend between pack-years of smoking and telomere length. However, heterogeneity among some analyses was observed. Shorter telomeres among ever smokers compared to those who never smoked may imply mechanisms linking tobacco smoke exposure to ageing-related disease. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

High-definition resolution three-dimensional imaging systems in laparoscopic radical prostatectomy: randomized comparative study with high-definition resolution two-dimensional systems.

PubMed

Kinoshita, Hidefumi; Nakagawa, Ken; Usui, Yukio; Iwamura, Masatsugu; Ito, Akihiro; Miyajima, Akira; Hoshi, Akio; Arai, Yoichi; Baba, Shiro; Matsuda, Tadashi

2015-08-01

Three-dimensional (3D) imaging systems have been introduced worldwide for surgical instrumentation. A difficulty of laparoscopic surgery involves converting two-dimensional (2D) images into 3D images and depth perception rearrangement. 3D imaging may remove the need for depth perception rearrangement and therefore have clinical benefits. We conducted a multicenter, open-label, randomized trial to compare the surgical outcome of 3D-high-definition (HD) resolution and 2D-HD imaging in laparoscopic radical prostatectomy (LRP), in order to determine whether an LRP under HD resolution 3D imaging is superior to that under HD resolution 2D imaging in perioperative outcome, feasibility, and fatigue. One-hundred twenty-two patients were randomly assigned to a 2D or 3D group. The primary outcome was time to perform vesicourethral anastomosis (VUA), which is technically demanding and may include a number of technical difficulties considered in laparoscopic surgeries. VUA time was not significantly shorter in the 3D group (26.7 min, mean) compared with the 2D group (30.1 min, mean) (p = 0.11, Student's t test). However, experienced surgeons and 3D-HD imaging were independent predictors for shorter VUA times (p = 0.000, p = 0.014, multivariate logistic regression analysis). Total pneumoperitoneum time was not different. No conversion case from 3D to 2D or LRP to open RP was observed. Fatigue was evaluated by a simulation sickness questionnaire and critical flicker frequency. Results were not different between the two groups. Subjective feasibility and satisfaction scores were significantly higher in the 3D group. Using a 3D imaging system in LRP may have only limited advantages in decreasing operation times over 2D imaging systems. However, the 3D system increased surgical feasibility and decreased surgeons' effort levels without inducing significant fatigue.

Carcinoma of the apocrine glands of the anal sac in dogs: 113 cases (1985-1995).

PubMed

Williams, Laurel E; Gliatto, John M; Dodge, Richard K; Johnson, Jeffrey L; Gamblin, Rance M; Thamm, Douglas H; Lana, Susan E; Szymkowski, Mary; Moore, Antony S

2003-09-15

To characterize the signalment, clinical signs, biological behavior, and response to treatment of carcinoma of the apocrine glands of the anal sac in dogs. Retrospective study. 113 dogs with histologically confirmed carcinoma of the apocrine glands of the anal sac. Data on signalment, clinical signs, and staging were reviewed and analyzed along with treatment modality for potential association with survival time. Sex distribution was approximately equal (54% female, 46% male). One hundred four dogs underwent treatment consisting of surgery, radiation therapy, chemotherapy, or multimodal treatment. Median survival for treated dogs was 544 days (range, 0 to 1,873 days). Dogs treated with chemotherapy alone had significantly shorter survival (median, 212 days) than those receiving other treatments (median, 584 days). Dogs not treated with surgery had significantly shorter survival (median, 402 days) than those that underwent surgery as part of their treatment (median, 548 days). Dogs with tumors > or = 10 cm2 had significantly shorter survival (median, 292 days) than dogs with tumors < 10 cm2 (median, 584 days). Hypercalcemia was identified in 27% (n = 29) of dogs, and those dogs had significantly shorter survival (median, 256 days), compared with those that were normocalcemic (median, 584 days). Dogs with pulmonary metastasis had significantly shorter survival (median, 219 days) than dogs without evidence of pulmonary metastasis (median, 548 days). Unlike most previous reports, this study revealed an approximately equal sex distribution, and results suggest a more favorable prognosis.

Poverty and mortality among the elderly: measurement of performance in 33 countries 1960-92.

PubMed

Wang, J; Jamison, D T; Bos, E; Vu, M T

1997-10-01

This paper analyses the effect of income and education on life expectancy and mortality rates among the elderly in 33 countries for the period 1960-92 and assesses how that relationship has changed over time as a result of technical progress. Our outcome variables are life expectancy at age 60 and the probability of dying between age 60 and age 80 for both males and females. The data are from vital-registration based life tables published by national statistical offices for several years during this period. We estimate regressions with determinants that include GDP per capita (adjusted for purchasing power), education and time (as a proxy for technical progress). As the available measure of education failed to account for variation in life expectancy or mortality at age 60, our reported analyses focus on a simplified model with only income and time as predictors. The results indicate that, controlling for income, mortality rates among the elderly have declined considerably over the past three decades. We also find that poverty (as measured by low average income levels) explains some of the variation in both life expectancy at age 60 and mortality rates among the elderly across the countries in the sample. The explained amount of variation is more substantial for females than for males. While poverty does adversely affect mortality rates among the elderly (and the strength of this effect is estimated to be increasing over time), technical progress appears far more important in the period following 1960. Predicted female life expectancy (at age 60) in 1960 at the mean income level in 1960 was, for example 18.8 years; income growth to 1992 increased this by an estimated 0.7 years, whereas technical progress increased it by 2.0 years. We then use the estimated regression results to compare country performance on life expectancy of the elderly, controlling for levels of poverty (or income), and to assess how performance has varied over time. High performing countries, on female life expectancy at age 60, for the period around 1990, included Chile (1.0 years longer life expectancy), China (1.7 years longer), France (2.0 years longer), Japan (1.9 years longer), and Switzerland (1.3 years longer). Poorly performing countries included Denmark (1.1 years shorter life expectancy than predicted from income), Hungary (1.4 years shorter), Iceland (1.2 years shorter), Malaysia (1.6 years shorter), and Trinidad and Tobago (3.9 years shorter). Chile and Switzerland registered major improvements in relative performance over this period; Norway, Taiwan and the USA, in contrast showed major declines in performance between 1980 and the early 1990s.

[Comparison of the application between circular stapler and linear stapler in Billroth II( anastomosis of distal gastrectomy].

PubMed

Zhang, Nan; Su, Xiangqian; Xu, Kai

2018-02-25

To compare the safety and effectiveness of circular stapler and linear stapler in Billroth II( anastomosis following distal gastrectomy for gastric cancer patients. Clinical data of gastric adenocarcinoma patients who received distal gastrectomy with Billroth II( anastomosis at Ward IIII( of Gastrointestinal Cancer Center of Peking University Cancer Hospital from January 2013 to April 2017 were collected retrospectively. (1) patients identified as stage IIII( gastric cancer by preoperative clinical and postoperative pathological staging. (2) patients undergoing emergency operation due to perforation, obstruction, or bleeding of digestive tract. (3) patients receiving chemotherapy before operation. (4) patients undergoing combined organ resection due to tumor involving other organs. (5) patients complicating with other malignancies. A total of 116 cases were enrolled and divided into circular stapler (CS, 61 cases) group and linear stapler (LS, 55 cases) group according to the application of mechanical stapler. Clinicopathological characteristics, operative conditions and postoperative recovery were compared between two groups. Differences in baseline data, such as tumor size, Lauren classification, differentiation grade, and pathologic stage, between two groups were not statistically significant (all P>0.05). The mean operative time (230 min vs. 234 min), median intra-operative blood loss (50.0 ml vs. 50.0 ml), median number of harvested lymph node (28.0 vs. 26.0) and median number of positive lymph node (1.0 vs. 2.0) between LS group and CS group were not significantly different (all P>0.05) As compared to CS group, LS group presented shorter median time to the first flatus (3.0 days vs. 4.0 days, P=0.038), shorter median time to the first liquid diet (7.0 days vs. 8.0 days, P=0.000), shorter median time to remove the first abdominal drainage tube (7.0 days vs. 9.0 days, P=0.000) and shorter median time of postoperative hospital stay (8.0 days vs. 10.0 days, P=0.000). The morbidity of postoperative complication was 11.5% and 1.8% in CS group and LS group respectively without significant difference (P=0.092). In CS group, 1 case (1.6%) developed anastomotic hemorrhage, 3 cases (4.9%) gastric emptying disorder and 3 cases (4.9%) abdominal infection after operation, who all were cured by conservative treatment without duodenal stump fistula and re-operation. In LS group, only 1 case (1.8%) developed duodenal stump fistula and was cured by re-operation. In distal gastrectomy with Billroth II( anastomosis for gastric cancer, the application of linear stapler results in faster recovery of gastrointestinal function and shorter hospital stay, indicating more advantages.

Significance of sarcopenia as a prognostic factor for metastatic urothelial carcinoma patients treated with systemic chemotherapy.

PubMed

Abe, Hideyuki; Takei, Kohei; Uematsu, Toshitaka; Tokura, Yuumi; Suzuki, Issei; Sakamoto, Kazumasa; Nishihara, Daisaku; Yamaguchi, Yoshiyuki; Mizuno, Tomoya; Nukui, Akinori; Kobayashi, Minoru; Kamai, Takao

2018-04-01

Recently, numerous studies have reported an association between sarcopenia and poor outcomes in various kinds of malignancies. We investigated whether sarcopenia predicts the survival of patients with metastatic urothelial carcinoma who underwent systemic chemotherapy. We reviewed 87 metastatic urothelial carcinoma patients who underwent chemotherapy (gemcitabine plus cisplatin or gemcitabine plus carboplatin for cisplatin-unfit patients) between 2007 and 2015. A computed tomography scan prior to chemotherapy was used for evaluating sarcopenia, and we measured three cross-sectional areas of skeletal muscle at the third lumbar vertebra and calculated the skeletal muscle index (SMI), the paraspinal muscle index (PSMI), and the total psoas area (TPA) of each patient. Predictive values of survival were assessed using Cox regression analysis. The median overall survival (OS) was 16 months (95% CI 13.5-18). Although SMI alone was not a significant predictor of shorter OS (P = 0.117) in univariate analysis, SMI stratified by the value of the body mass index (BMI) was a significant predictor of shorter OS in univariate analysis (P = 0.037) and was also an independent predictor of shorter OS in multivariate analysis (P = 0.026). PSMI and TPA were not significant prognostic factors even when stratified by BMI (P = 0.294 and 0.448), respectively. Neither PSMI nor TPA could substitute SMI as a predictor for poor outcomes in metastatic urothelial carcinoma patients treated with systemic chemotherapy in our study. SMI stratified by BMI is a useful predictor of prognosis in these patients.

Dynamic 18F-FET PET in newly diagnosed astrocytic low-grade glioma identifies high-risk patients.

PubMed

Jansen, Nathalie L; Suchorska, Bogdana; Wenter, Vera; Eigenbrod, Sabina; Schmid-Tannwald, Christine; Zwergal, Andreas; Niyazi, Maximilian; Drexler, Mark; Bartenstein, Peter; Schnell, Oliver; Tonn, Jörg-Christian; Thon, Niklas; Kreth, Friedrich-Wilhelm; la Fougère, Christian

2014-02-01

Because the clinical course of low-grade gliomas in the individual adult patient varies considerably and is unpredictable, we investigated the prognostic value of dynamic (18)F-fluorethyltyrosine ((18)F-FET) PET in the early diagnosis of astrocytic low-grade glioma (World Health Organization grade II). Fifty-nine patients with newly diagnosed low-grade glioma and dynamic (18)F-FET PET before histopathologic assessment were retrospectively investigated. (18)F-FET PET analysis comprised a qualitative visual classification of lesions; assessment of the semiquantitative parameters maximal, mean, and total standardized uptake value as ratio to background and biologic tumor volume; and dynamic analysis of intratumoral (18)F-FET uptake over time (increasing vs. decreasing time-activity curves). The correlation between PET parameters and progression-free survival, overall survival, and time to malignant transformation was investigated. (18)F-FET uptake greater than the background level was found in 34 of 59 tumors. Dynamic (18)F-FET uptake analysis was available for 30 of these 34 patients. Increasing and decreasing time-activity curves were found in 18 and 12 patients, respectively. Neither the qualitative factor presence or absence of (18)F-FET uptake nor any of the semiquantitative uptake parameters significantly influenced clinical outcome. In contrast, decreasing time-activity curves in the kinetic analysis were highly prognostic for shorter progression-free survival and time to malignant transformation (P < 0.001). Absence of (18)F-FET uptake in newly diagnosed astrocytic low-grade glioma does not generally indicate an indolent disease course. Among the (18)F-FET-positive gliomas, decreasing time-activity curves in dynamic (18)F-FET PET constitute an unfavorable prognostic factor in astrocytic low-grade glioma and, by identifying high-risk patients, may ease treatment decisions.

Determination of oligomeric chain length distributions at surfaces using ToF-SIMS: segregation effects and polymer properties

NASA Astrophysics Data System (ADS)

Gardella, Joseph A.; Mahoney, Christine M.

2004-06-01

While many XPS and SIMS studies of polymers have detected and quantified segregation of low surface energy blocks or components in copolymers and polymer blends [D. Briggs, in: D.R. Clarke, S. Suresh, I.M. Ward (Eds.), Surface Analysis of Polymers by XPS and Static SIMS, Cambridge University Press, Cambridge, 1998 (Chapter 5).], this paper reports ToF-SIMS studies of direct measurement of the segment length distribution at the surface of siloxane copolymers. These data allow insight into the segregation of particular portions of the oligomeric distribution; specifically, in this study, longer PDMS oligomers segregated at the expense of shorter PDMS chains. We have reported XPS analysis of competitive segregation effects for short PDMS chains [Macromolecules 35 (13) (2002) 5256]. In this study, a series of poly(ureaurethane)-poly(dimethylsiloxane) (PUU-PDMS) copolymers have been synthesized containing varying ratios of G-3 and G-9 (G- X describes the average segment length of the PDMS added), while maintaining a constant overall siloxane weight percentage (10, 30, and 60%). These copolymers were utilized as model systems to study the preferential segregation of certain siloxane segment lengths to the surface over others. ToF-SIMS analysis of PUU-PDMS copolymers has yielded high-mass range copolymer fragmentation patterns containing intact PDMS segments. For the first time, this information is utilized to determine PDMS segment length distributions at the copolymer surface as compared to the bulk. The results show that longer siloxane segment lengths are preferentially segregating to the surface over shorter chain lengths. These results also show the importance of ToF-SIMS and mass spectrometry in the development of new materials containing low molecular weight amino-propyl-terminated siloxanes.

Effects of autonomic ganglion blockade on fractal and spectral components of blood pressure and heart rate variability in free-moving rats.

PubMed

Castiglioni, Paolo; Di Rienzo, Marco; Radaelli, Alberto

2013-11-01

Fractal analysis is a promising tool for assessing autonomic influences on heart rate (HR) and blood pressure (BP) variability. The temporal spectrum of scale coefficients, α(t), was recently proposed to describe the cardiovascular fractal dynamics. Aim of our work is to evaluate sympathetic influences on cardiovascular variability analyzing α(t) and spectral powers of HR and BP after ganglionic blockade. BP was recorded in 11 rats before and after autonomic blockade by hexamethonium infusion (HEX). Systolic and diastolic BP, pulse pressure and pulse interval were derived beat-by-beat. Segments longer than 5 min were selected at baseline and HEX to estimate power spectra and α(t). Comparisons were made by paired t-test. HEX reduced all spectral components of systolic and diastolic BP, the reduction being particularly significant around the frequency of Mayer waves; it induced a reduction on α(t) coefficients at t<2s and an increase on coefficients at t>8s. HEX reduced only slower components of pulse interval power spectrum, but decreased significantly faster scale coefficients (t<8s). HEX only marginally affected pulse pressure variability. Results indicate that the sympathetic outflow contributes to BP fractal dynamics with fractional Gaussian noise (α<1) at longer scales and fractional Brownian motion (α>1) at shorter scales. Ganglionic blockade also removes a fractional Brownian motion component at shorter scales from HR dynamics. Results may be explained by the characteristic time constants between sympathetic efferent activity and cardiovascular effectors. Therefore fractal analysis may complete spectral analysis with information on the correlation structure of the data. Copyright © 2013 Elsevier B.V. All rights reserved.

Racial differences in dietary antioxidant intake and cardiac event-free survival in patients with heart failure.

PubMed

Wu, Jia-Rong; Song, Eun Kyeung; Moser, Debra K; Lennie, Terry A

2018-04-01

Heart failure is a chronic, burdensome condition with higher re-hospitalization rates in African Americans than Whites. Higher dietary antioxidant intake is associated with lower oxidative stress and improved endothelial function. Lower dietary antioxidant intake in African Americans may play a role in the re-hospitalization disparity between African American and White patients with heart failure. The objective of this study was to examine the associations among race, dietary antioxidant intake, and cardiac event-free survival in patients with heart failure. In a secondary analysis of 247 patients with heart failure who completed a four-day food diary, intake of alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein, zeaxanthin, lycopene, vitamins C and E, zinc, and selenium were assessed. Antioxidant deficiency was defined as intake below the estimated average requirement for antioxidants with an established estimated average requirement, or lower than the sample median for antioxidants without an established estimated average requirement. Patients were followed for a median of one year to determine time to first cardiac event (hospitalization or death). Survival analysis was used for data analysis. African American patients had more dietary antioxidant deficiencies and a shorter cardiac event-free survival compared with Whites ( p = .007 and p = .028, respectively). In Cox regression, race and antioxidant deficiency were associated with cardiac event-free survival before and after adjusting for covariates. African Americans with heart failure had more dietary antioxidant deficiencies and shorter cardiac event-free survival than Whites. This suggests that encouraging African American patients with heart failure to consume an antioxidant-rich diet may be beneficial in lengthening cardiac event-free survival.

Hyaluronidase as an adjunct in an immobilizing mixture for moose.

PubMed

Haigh, J C

1979-11-01

Hyaluronidase was put into immobilizing syringes for 58 of 104 moose captured with a fentanyl/xylazine mixture. Induction times were measured for both groups and were related to injection site as well as drug mixture. Hyaluronidase-treated moose had significantly shorter induction times than others. Injection site also had a significant effect on induction times.

Bacterial migration along solid surfaces.

PubMed Central

Harkes, G; Dankert, J; Feijen, J

1992-01-01

An in vitro system was developed to study the migration of uropathogenic Escherichia coli strains. In this system an aqueous agar gel is placed against a solid surface, allowing the bacteria to migrate along the gel/solid surface interface. Bacterial strains as well as solid surfaces were characterized by means of water contact angle and zeta potential measurements. When glass was used as the solid surface, significantly different migration times for the strains investigated were observed. Relationships among the observed migration times of six strains, their contact angles, and their zeta potentials were found. Relatively hydrophobic strains exhibited migration times shorter than those of hydrophilic strains. For highly negatively charged strains shorter migration times were found than were found for less negatively charged strains. When the fastest-migrating strain with respect to glass was allowed to migrate along solid surfaces differing in hydrophobicity and charge, no differences in migration times were found. Our findings indicate that strategies to prevent catheter-associated bacteriuria should be based on inhibition of bacterial growth rather than on modifying the physicochemical character of the catheter surface. PMID:1622217

Elimination of Perchlorate Oxidizers from Pyrotechnic Flare Compositions

DTIC Science & Technology

2007-03-09

in candelas ( cd ), where the candela is defined as, 1 cd = 1 lumen /steradian-1. DSC A thermal analysis technique known as Differential...Shorter Wavelength Infrared band routinely monitored in decoy flare performance tests. TGA A thermal analysis technique known as Thermogravimetric ...Scanning Calorimetry DTA A thermal analysis technique known as Differential Thermal Analysis GAP Glycidyl Azide Polymer used as a curable binder in some

Evaluation of Pictorial Dietary Assessment Tool for Hospitalized Patients with Diabetes: Cost, Accuracy, and User Satisfaction Analysis

PubMed Central

Shahar, Suzana; Abdul Manaf, Zahara; Mohd Nordin, Nor Azlin; Susetyowati, Susetyowati

2017-01-01

Although nutritional screening and dietary monitoring in clinical settings are important, studies on related user satisfaction and cost benefit are still lacking. This study aimed to: (1) elucidate the cost of implementing a newly developed dietary monitoring tool, the Pictorial Dietary Assessment Tool (PDAT); and (2) investigate the accuracy of estimation and satisfaction of healthcare staff after the use of the PDAT. A cross-over intervention study was conducted among 132 hospitalized patients with diabetes. Cost and time for the implementation of PDAT in comparison to modified Comstock was estimated using the activity-based costing approach. Accuracy was expressed as the percentages of energy and protein obtained by both methods, which were within 15% and 30%, respectively, of those obtained by the food weighing. Satisfaction of healthcare staff was measured using a standardized questionnaire. Time to complete the food intake recording of patients using PDAT (2.31 ± 0.70 min) was shorter than when modified Comstock (3.53 ± 1.27 min) was used (p < 0.001). Overall cost per patient was slightly higher for PDAT (United States Dollar 0.27 ± 0.02) than for modified Comstock (USD 0.26 ± 0.04 (p < 0.05)). The accuracy of energy intake estimated by modified Comstock was 10% lower than that of PDAT. There was poorer accuracy of protein intake estimated by modified Comstock (<40%) compared to that estimated by the PDAT (>71%) (p < 0.05). Mean user satisfaction of healthcare staff was significantly higher for PDAT than that for modified Comstock (p < 0.05). PDAT requires a shorter time to be completed and was rated better than modified Comstock. PMID:29283401

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

Thompson, Anna; Keyes, Mira, E-mail: mkeyes@bccancer.bc.c; Pickles, Tom

Purpose: To evaluate the prostate-specific antigen (PSA) kinetics of PSA failure (PSAf) and PSA bounce (PSAb) after permanent {sup 125}I prostate brachytherapy (PB). Methods and Materials: The study included 1,006 consecutive low and 'low tier' intermediate-risk patients treated with {sup 125}I PB, with a potential minimum follow-up of 4 years. Patients who met the Phoenix definition of biochemical failure (nadir + 2 ng/mL{sup -1}) were identified. If the PSA subsequently fell to {<=}0.5 ng/mL{sup -1}without intervention, this was considered a PSAb. All others were scored as true PSAf. Patient, tumor and dosimetric characteristics were compared between groups using the chi-squaremore » test and analysis of variance to evaluate factors associated with PSAf or PSAb. Results: Median follow-up was 54 months. Of the 1,006 men, 57 patients triggered the Phoenix definition of PSA failure, 32 (56%) were true PSAf, and 25 PSAb (44%). The median time to trigger nadir + 2 was 20.6 months (range, 6-36) vs. 49 mo (range, 12-83) for PSAb vs. PSAf groups (p < 0.001). The PSAb patients were significantly younger (p < 0.0001), had shorter time to reach the nadir (median 6 vs. 11.5 months, p = 0.001) and had a shorter PSA doubling time (p = 0.05). Men younger than age 70 who trigger nadir +2 PSA failure within 38 months of implant have an 80% likelihood of having PSAb and 20% chance of PSAf. Conclusions: With adequate follow-up, 44% of PSA failures by the Phoenix definition in our cohort were found to be benign PSA bounces. Our study reinforces the need for adequate follow-up when reporting PB PSA outcomes, to ensure accurate estimates of treatment efficacy and to avoid unnecessary secondary interventions.« less

Evaluation of the BD Vacutainer(®) RST blood collection tube for routine chemistry analytes: clinical significance of differences and stability study.

PubMed

Kocijancic, Marija; Cargonja, Jelena; Delic-Knezevic, Alma

2014-01-01

Preanalytical variables account for most of laboratory errors. There is a wide range of factors that affect the reliability of laboratory report. Most convenient sample type for routine laboratory analysis is serum. BD Vacutainer(®) Rapid Serum Tube (RST) (Becton, Dickinson and Company, Franklin Lakes, NJ, USA) blood collection tube provides rapid clotting time allowing fast serum separation. Our aim was to evaluate the comparability of routine chemistry parameters in BD Vacutainer(®) RST blood collection tube in reference with the BD Vacutainer(®) Serum Separating Tubes II Advance Tube (SST) (Becton, Dickinson and Company, Franklin Lakes, NJ, USA). Blood specimens were collected from 90 participants for evaluation on its results, clotting time and stability study of six routine biochemistry parameters: glucose (Glu), aspartate aminotransferase (AST), alanine aminotransferase (ALT), calcium (Ca), lactate dehidrogenase (LD) and potassium (K) measured with Olympus AU2700 analyzer (Beckman Coulter, Tokyo, Japan). The significance of the differences between samples was assessed by paired t-test or Wilcoxon Matched-Pairs Rank test after checking for normality. Clotting process was significantly shorter in the RSTs compared to SSTs (2.49 min vs. 19.47 min, respectively; P < 0.001). There was a statistically significant difference between the RST and SST II tubes for glucose, calcium and LD (P < 0.001). Differences for glucose and LD were also clinically significant. Analyte stability studies showed that all analytes were stable for 24 h at 4 °C. Most results (except LD and glucose) from RST are comparable with those from SST. In addition, RST tube provides shorter clotting time.

A quality improvement project sustainably decreased time to onset of active physical therapy intervention in patients with acute lung injury.

PubMed

Dinglas, Victor D; Parker, Ann M; Reddy, Dereddi Raja S; Colantuoni, Elizabeth; Zanni, Jennifer M; Turnbull, Alison E; Nelliot, Archana; Ciesla, Nancy; Needham, Dale M

2014-10-01

Rehabilitation started early during an intensive care unit (ICU) stay is associated with improved outcomes and is the basis for many quality improvement (QI) projects showing important changes in practice. However, little evidence exists regarding whether such changes are sustainable in real-world practice. To evaluate the sustained effect of a quality improvement project on the timing of initiation of active physical therapy intervention in patients with acute lung injury (ALI). This was a pre-post evaluation using prospectively collected data involving consecutive patients with ALI admitted pre-quality improvement (October 2004-April 2007, n = 120) versus post-quality improvement (July 2009-July 2012, n = 123) from a single medical ICU. The primary outcome was time to first active physical therapy intervention, defined as strengthening, mobility, or cycle ergometry exercises. Among ICU survivors, more patients in the post-quality improvement versus pre-quality improvement group received physical therapy in the ICU (89% vs. 24%, P < 0.001) and were able to stand, transfer, or ambulate during physical therapy in the ICU (64% vs. 7%, P < 0.001). Among all patients in the post-quality improvement versus pre-quality improvement group, there was a shorter median (interquartile range) time to first physical therapy (4 [2, 6] vs. 11 d [6, 29], P < 0.001) and a greater median (interquartile range) proportion of ICU days with physical therapy after initiation (50% [33, 67%] vs. 18% [4, 47%], P = 0.003). In multivariable regression analysis, the post-quality improvement period was associated with shorter time to physical therapy (adjusted hazard ratio [95% confidence interval], 8.38 [4.98, 14.11], P < 0.001), with this association significant for each of the 5 years during the post-quality improvement period. The following variables were independently associated with a longer time to physical therapy: higher Sequential Organ Failure Assessment score (0.93 [0.89, 0.97]), higher FiO2 (0.86 [0.75, 0.99] for each 10% increase), use of an opioid infusion (0.47 [0.25, 0.89]), and deep sedation (0.24 [0.12, 0.46]). In this single-site, pre-post analysis of patients with ALI, an early rehabilitation quality improvement project was independently associated with a substantial decrease in the time to initiation of active physical therapy intervention that was sustained over 5 years. Over the entire pre-post period, severity of illness and sedation were independently associated with a longer time to initiation of active physical therapy intervention in the ICU.

Estimated activity patterns in British 45 year olds: cross-sectional findings from the 1958 British birth cohort.

PubMed

Parsons, T J; Thomas, C; Power, C

2009-08-01

To investigate patterns of, and associations between, physical activity at work and in leisure time, television viewing and computer use. 4531 men and 4594 women with complete plausible data, age 44-45 years, participating in the 1958 British birth cohort study. Physical activity, television viewing and computer use (hours/week) were estimated using a self-complete questionnaire and intensity (MET hours/week) derived for physical activity. Relationships were investigated using linear regression and chi(2) tests. From a target sample of 11,971, 9223 provided information on physical activity, of whom 75 and 47% provided complete and plausible activity data on work and leisure time activity respectively. Men and women spent a median of 40.2 and 34.2 h/week, respectively in work activity, and 8.3 and 5.8 h/week in leisure activity. Half of all participants watched television for > or =2 h/day, and half used a computer for <1 h/day. Longer work hours were not associated with a shorter duration of leisure activity, but were associated with a shorter duration of computer use (men only). In men, higher work MET hours were associated with higher leisure-time MET hours, and shorter durations of television viewing and computer use. Watching more television was related to fewer hours or MET hours of leisure activity, as was longer computer use in men. Longer computer use was related to more hours (or MET hours) in leisure activities in women. Physical activity levels at work and in leisure time in mid-adulthood are low. Television viewing (and computer use in men) may compete with leisure activity for time, whereas longer duration of work hours is less influential. To change active and sedentary behaviours, better understanding of barriers and motivators is needed.

Factors affecting breast cancer treatment delay in Turkey: a study from Turkish Federation of Breast Diseases Societies.

PubMed

Ozmen, Vahit; Boylu, Sukru; Ok, Engin; Canturk, Nuh Zafer; Celik, Varol; Kapkac, Murat; Girgin, Sadullah; Tireli, Mustafa; Ihtiyar, Enver; Demircan, Orhan; Baskan, Mazhar Semih; Koyuncu, Ayhan; Tasdelen, Ismet; Dumanli, Esra; Ozdener, Fatih; Zaborek, Piotr

2015-02-01

One of the most important factors in breast cancer (BC) mortality is treatment delay. The primary goal of this survey was to identify factors affecting the total delay time (TDT) in Turkish BC patients. A total of 1031 patients with BC were surveyed using a uniform questionnaire. The time between discovering the first symptom and signing up for the first medical visit (patient delay time; PDT) and the time between the first medical visit and the start of therapy (system delay time; SDT) were modelled separately with multilevel regression. The mean PDT, SDT and TDT were 4.8, 10.5 and 13.8 weeks, respectively. In all, 42% of the patients had a TDT >12 weeks. Longer PDT was significantly correlated with disregarding symptoms and having age of between 30 and 39 years. Shorter PDT was characteristic of patients who: had stronger self-examination habits, received more support from family and friends and had at least secondary education. Predictors of longer SDT included disregard of symptoms, distrust in success of therapy and medical system and having PDT in excess of 4 weeks. Shorter SDT was linked to the age of >60 years. Patients who were diagnosed during a periodic check-up or opportunistic mammography displayed shorter SDT compared with those who had symptomatic BC and their first medical examination was by a surgeon. TDT in Turkey is long and remains a major problem. Delays can be reduced by increasing BC awareness, implementing organized population-based screening programmes and founding cancer centres. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association.

Association Between Elder Self-Neglect and Hospice Utilization in a Community Population

PubMed Central

Dong, XinQi; Simon, Melissa A.

2012-01-01

Elder self-neglect is associated with substantial 1-year mortality. However, hospice utilization among those with self-neglect remain unclear. The objective of this study is to quantify the prospective relation between self-neglect and risk for hospice utilization in a community population of older adults. Prospective population-based study in a geographically-defined community in Chicago of older adults who participated in the Chicago Health and Aging Project. Of the 8,669 participants in the Chicago Health and Aging Project, a subset of 1,438 participants was reported to social services agency for suspected elder self-neglect. Outcome of interest was the hospice utilization obtained from the Center for Medicare and Medicaid System. Cox proportional hazard models were used to assess independent association of self-neglect with risk of hospice utilization using time-varying covariate analyses. After adjusting for potential confounding factors, elders who self-neglect was associated with increased risk for hospice utilization (HR, 2.43, 95% CI, 2.10-2.81). Greater self-neglect severity (Mild: (HR, 2.12 (1.61-2.79); Moderate: (HR, 2.36 (1.95-2.84); Severe: (HR, 4.66 (2.98-7.30)) were associated with increased risk for hospice utilization. Interaction term analyses suggest that the significant relationship between self-neglect and hospice utilization was not mediated through medical conditions, cognitive impairment and physical disability. Moreover, self-neglect was associated with shorter length of stay in hospice (PE, −0.27, SE, 0.12, p<0.02) and shorter time from hospice admission to death (PE, −0.32, SE, 0.13, p<0.01). Elder self-neglect was associated with increased risk of hospice use in this community population. Elder self-neglect is associated with shorter length of stay in hospice care and shorter time from hospice admission to death. PMID:22770866

Simulation of time-dispersion spectral device with sample spectra accumulation

NASA Astrophysics Data System (ADS)

Zhdanov, Arseny; Khansuvarov, Ruslan; Korol, Georgy

2014-09-01

This research is conducted in order to design a spectral device for light sources power spectrum analysis. The spectral device should process radiation from sources, direct contact with radiation of which is either impossible or undesirable. Such sources include jet blast of an aircraft, optical radiation in metallurgy and textile industry. In proposed spectral device optical radiation is guided out of unfavorable environment via a piece of optical fiber with high dispersion. It is necessary for analysis to make samples of analyzed radiation as short pulses. Dispersion properties of such optical fiber cause spectral decomposition of input optical pulses. The faster time of group delay vary the stronger the spectral decomposition effect. This effect allows using optical fiber with high dispersion as a major element of proposed spectral device. Duration of sample must be much shorter than group delay time difference of a dispersive system. In the given frequency range this characteristic has to be linear. The frequency range is 400 … 500 THz for typical optical fiber. Using photonic-crystal fiber (PCF) gives much wider spectral range for analysis. In this paper we propose simulation of single pulse transmission through dispersive system with linear dispersion characteristic and quadratic-detected output responses accumulation. During simulation we propose studying influence of optical fiber dispersion characteristic angle on spectral measurement results. We also consider pulse duration and group delay time difference impact on output pulse shape and duration. Results show the most suitable dispersion characteristic that allow choosing the structure of PCF - major element of time-dispersion spectral analysis method and required number of samples for reliable assessment of measured spectrum.