Timescale- and Sensory Modality-Dependency of the Central Tendency of Time Perception.

PubMed

Murai, Yuki; Yotsumoto, Yuko

2016-01-01

When individuals are asked to reproduce intervals of stimuli that are intermixedly presented at various times, longer intervals are often underestimated and shorter intervals overestimated. This phenomenon may be attributed to the central tendency of time perception, and suggests that our brain optimally encodes a stimulus interval based on current stimulus input and prior knowledge of the distribution of stimulus intervals. Two distinct systems are thought to be recruited in the perception of sub- and supra-second intervals. Sub-second timing is subject to local sensory processing, whereas supra-second timing depends on more centralized mechanisms. To clarify the factors that influence time perception, the present study investigated how both sensory modality and timescale affect the central tendency. In Experiment 1, participants were asked to reproduce sub- or supra-second intervals, defined by visual or auditory stimuli. In the sub-second range, the magnitude of the central tendency was significantly larger for visual intervals compared to auditory intervals, while visual and auditory intervals exhibited a correlated and comparable central tendency in the supra-second range. In Experiment 2, the ability to discriminate sub-second intervals in the reproduction task was controlled across modalities by using an interval discrimination task. Even when the ability to discriminate intervals was controlled, visual intervals exhibited a larger central tendency than auditory intervals in the sub-second range. In addition, the magnitude of the central tendency for visual and auditory sub-second intervals was significantly correlated. These results suggest that a common modality-independent mechanism is responsible for the supra-second central tendency, and that both the modality-dependent and modality-independent components of the timing system contribute to the central tendency in the sub-second range.

Minimax confidence intervals in geomagnetism

NASA Technical Reports Server (NTRS)

Stark, Philip B.

1992-01-01

The present paper uses theory of Donoho (1989) to find lower bounds on the lengths of optimally short fixed-length confidence intervals (minimax confidence intervals) for Gauss coefficients of the field of degree 1-12 using the heat flow constraint. The bounds on optimal minimax intervals are about 40 percent shorter than Backus' intervals: no procedure for producing fixed-length confidence intervals, linear or nonlinear, can give intervals shorter than about 60 percent the length of Backus' in this problem. While both methods rigorously account for the fact that core field models are infinite-dimensional, the application of the techniques to the geomagnetic problem involves approximations and counterfactual assumptions about the data errors, and so these results are likely to be extremely optimistic estimates of the actual uncertainty in Gauss coefficients.

Effect of Age and Sex on the QTc Interval in Children and Adolescents With Type 1 and 2 Long-QT Syndrome.

PubMed

Vink, Arja S; Clur, Sally-Ann B; Geskus, Ronald B; Blank, Andreas C; De Kezel, Charlotte C A; Yoshinaga, Masao; Hofman, Nynke; Wilde, Arthur A M; Blom, Nico A

2017-04-01

In congenital long-QT syndrome, age, sex, and genotype have been associated with cardiac events, but their effect on the trend in QTc interval has never been established. We, therefore, aimed to assess the effect of age and sex on the QTc interval in children and adolescents with type 1 (LQT1) and type 2 (LQT2) long-QT syndrome. QTc intervals of 12-lead resting electrocardiograms were determined, and trends over time were analyzed using a linear mixed-effects model. The study included 278 patients with a median follow-up of 4 years (interquartile range, 1-9) and a median number of 6 (interquartile range, 2-10) electrocardiograms per patient. Both LQT1 and LQT2 male patients showed QTc interval shortening after the onset of puberty. In LQT2 male patients, this was preceded by a progressive QTc interval prolongation. In LQT1, after the age of 12 years, male patients had a significantly shorter QTc interval than female patients. In LQT2, during the first years of life and from 14 to 26 years, male patients had a significantly shorter QTc interval than female patients. On the contrary, between 5 and 14 years, LQT2 male patients had significantly longer QTc interval than LQT2 female patients. There is a significant effect of age and sex on the QTc interval in long-QT syndrome, with a unique pattern per genotype. The age of 12 to 14 years is an important transitional period. In the risk stratification and management of long-QT syndrome patients, clinicians should be aware of these age-, sex-, and genotype-related trends in QTc interval and especially the important role of the onset of puberty. © 2017 American Heart Association, Inc.

Do presenting symptoms explain sex differences in emergency department delays among patients with acute stroke?

PubMed

Gargano, Julia Warner; Wehner, Susan; Reeves, Mathew J

2009-04-01

Previous studies report that women with stroke may experience longer delays in diagnostic workup than men after arriving at the emergency department. We hypothesized that presenting symptom differences could explain these delays. Data were collected on 1922 acute stroke cases who presented to 15 hospitals participating in a statewide stroke registry. We evaluated 2 in-hospital time intervals: emergency department arrival to physician examination ("door-to-doctor") and emergency department arrival to brain imaging ("door-to-image"). We used parametric survival models to estimate time ratios, which represent the ratio of average times comparing women to men, after adjusting for symptom presentation and other confounders. Women were significantly less likely than men to present with any stroke warning sign or suspected stroke (87.5% versus 91.4%) or to report trouble with walking, balance, or dizziness (9.5% versus 13.7%). Difficulty speaking and loss of consciousness were associated with shorter door-to-doctor times. Weakness, facial droop, difficulty speaking, and loss of consciousness were associated with shorter door-to-image times, whereas difficulty with walking/balance was associated with longer door-to-image times. In adjusted analyses, women had 11% longer door-to-doctor intervals (time ratio, 1.11; 95%, CI 1.02 to 1.22) and 15% longer door-to-image intervals (time ratio, 1.15; 95% CI, 1.08 to 1.25) after accounting for presenting symptoms, age, and other confounders. Furthermore, these sex differences remained evident after restricting to patients who arrived within 6 or within 2 hours of symptom onset. Women with acute stroke experienced greater emergency department delays than men, which were not attributable to differences in presenting symptoms, time of arrival, age, or other confounders.

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.

[Association between oxytocin augmentation intervals and the risk of postpartum haemorrhage].

PubMed

Loscul, C; Chantry, A-A; Caubit, L; Deneux-Tharaux, C; Goffinet, F; Le Ray, C

2016-09-01

To study the association between the duration of oxytocin augmentation intervals and the risk of postpartum haemorrhage (PPH) among primiparous women in spontaneous labour. Retrospective cohort including primiparous women in spontaneous labour who received oxytocin during labour (n=454). Oxytocin augmentation intervals were dichotomized in intervals<20minutes and≥20minutes. Obstetrical and neonatal issues were analyzed according to the duration oxytocin augmentation intervals. The association between oxytocin augmentation intervals and PPH was analyzed using univariate and multivariate analysis. Oxytocin augmentation intervals were shorter than 20minutes for 43.8% of the study population. The rate of PPH was higher (9.1% vs 3.5%; P=0.014), and the use of sulprostone was more frequent (6.5% vs 3.5%; P=0.013) if oxytocin augmentation intervals were shorter than 20minutes in comparison with intervals≥20minutes. The association between oxytocin augmentation intervals and PPH remains significant after adjustment on other PPH risk factors (adjusted OR=3.48, 95% CI [1.45-8.34]). The rate of adverse neonatal issue, defined by arterial pH at birth≤7.10 and/or 5minutes score d'Apgar≤7, was higher if oxytocin augmentation intervals were<20minutes (12.1% vs 4.3%; P=0.002). Our study demonstrated an increased risk of PPH for primiparous women in spontaneous labour who received oxytocin with augmentation intervals shorter than 20minutes. Copyright © 2016. Published by Elsevier Masson SAS.

Red, orange and green Caesarean sections: a new communication tool for on-call obstetricians.

PubMed

Dupuis, Olivier; Sayegh, Isabelle; Decullier, Evelyne; Dupont, Corinne; Clément, Henri-Jacques; Berland, Michel; Rudigoz, René-Charles

2008-10-01

To evaluate the effect of a novel communication tool, related to the degree of urgency for Caesarean sections (CSs), on the decision-to-delivery interval for emergency CS. Red CS are very urgent cases corresponding to life-threatening maternal or foetal situations, orange CS are urgent cases and green CS are non-urgent intrapartum CS. We carried out this cohort study in a French maternity hospital. The study included all emergency Caesarean sections during two 6-month periods, before and after introduction of the code. We compared the decision-to-delivery interval of the two study periods. Our study included 174 emergency CS. The mean decision-to-delivery interval after introduction of the code was 31.7 min, significantly shorter (p=0.02) than the 39.6 min interval before introduction of the colour code. Except for the preparation time, each time interval decreased. This included transporting the patient into the operating theatre, and the incision-to-delivery time interval. This study suggests that the use of the three-colour code could significantly shorten the decision-to-delivery interval in emergency CS. Further prospective studies are needed to confirm this result.

Dyslexics’ faster decay of implicit memory for sounds and words is manifested in their shorter neural adaptation

PubMed Central

Jaffe-Dax, Sagi; Frenkel, Or; Ahissar, Merav

2017-01-01

Dyslexia is a prevalent reading disability whose underlying mechanisms are still disputed. We studied the neural mechanisms underlying dyslexia using a simple frequency-discrimination task. Though participants were asked to compare the two tones in each trial, implicit memory of previous trials affected their responses. We hypothesized that implicit memory decays faster among dyslexics. We tested this by increasing the temporal intervals between consecutive trials, and by measuring the behavioral impact and ERP responses from the auditory cortex. Dyslexics showed a faster decay of implicit memory effects on both measures, with similar time constants. Finally, faster decay of implicit memory also characterized the impact of sound regularities in benefitting dyslexics' oral reading rate. Their benefit decreased faster as a function of the time interval from the previous reading of the same non-word. We propose that dyslexics’ shorter neural adaptation paradoxically accounts for their longer reading times, since it reduces their temporal window of integration of past stimuli, resulting in noisier and less reliable predictions for both simple and complex stimuli. Less reliable predictions limit their acquisition of reading expertise. DOI: http://dx.doi.org/10.7554/eLife.20557.001 PMID:28115055

Divorce Stress and Adjustment Model: Locus of Control and Demographic Predictors.

ERIC Educational Resources Information Center

Barnet, Helen Smith

This study depicts the divorce process over three time periods: predivorce decision phase, divorce proper, and postdivorce. Research has suggested that persons with a more internal locus of control experience less intense and shorter intervals of stress during the divorce proper and better postdivorce adjustment than do persons with a more…

The effects of sampling frequency on the climate statistics of the European Centre for Medium-Range Weather Forecasts

NASA Astrophysics Data System (ADS)

Phillips, Thomas J.; Gates, W. Lawrence; Arpe, Klaus

1992-12-01

The effects of sampling frequency on the first- and second-moment statistics of selected European Centre for Medium-Range Weather Forecasts (ECMWF) model variables are investigated in a simulation of "perpetual July" with a diurnal cycle included and with surface and atmospheric fields saved at hourly intervals. The shortest characteristic time scales (as determined by the e-folding time of lagged autocorrelation functions) are those of ground heat fluxes and temperatures, precipitation and runoff, convective processes, cloud properties, and atmospheric vertical motion, while the longest time scales are exhibited by soil temperature and moisture, surface pressure, and atmospheric specific humidity, temperature, and wind. The time scales of surface heat and momentum fluxes and of convective processes are substantially shorter over land than over oceans. An appropriate sampling frequency for each model variable is obtained by comparing the estimates of first- and second-moment statistics determined at intervals ranging from 2 to 24 hours with the "best" estimates obtained from hourly sampling. Relatively accurate estimation of first- and second-moment climate statistics (10% errors in means, 20% errors in variances) can be achieved by sampling a model variable at intervals that usually are longer than the bandwidth of its time series but that often are shorter than its characteristic time scale. For the surface variables, sampling at intervals that are nonintegral divisors of a 24-hour day yields relatively more accurate time-mean statistics because of a reduction in errors associated with aliasing of the diurnal cycle and higher-frequency harmonics. The superior estimates of first-moment statistics are accompanied by inferior estimates of the variance of the daily means due to the presence of systematic biases, but these probably can be avoided by defining a different measure of low-frequency variability. Estimates of the intradiurnal variance of accumulated precipitation and surface runoff also are strongly impacted by the length of the storage interval. In light of these results, several alternative strategies for storage of the EMWF model variables are recommended.

Improving regression-model-based streamwater constituent load estimates derived from serially correlated data

USGS Publications Warehouse

Aulenbach, Brent T.

2013-01-01

A regression-model based approach is a commonly used, efficient method for estimating streamwater constituent load when there is a relationship between streamwater constituent concentration and continuous variables such as streamwater discharge, season and time. A subsetting experiment using a 30-year dataset of daily suspended sediment observations from the Mississippi River at Thebes, Illinois, was performed to determine optimal sampling frequency, model calibration period length, and regression model methodology, as well as to determine the effect of serial correlation of model residuals on load estimate precision. Two regression-based methods were used to estimate streamwater loads, the Adjusted Maximum Likelihood Estimator (AMLE), and the composite method, a hybrid load estimation approach. While both methods accurately and precisely estimated loads at the model’s calibration period time scale, precisions were progressively worse at shorter reporting periods, from annually to monthly. Serial correlation in model residuals resulted in observed AMLE precision to be significantly worse than the model calculated standard errors of prediction. The composite method effectively improved upon AMLE loads for shorter reporting periods, but required a sampling interval of at least 15-days or shorter, when the serial correlations in the observed load residuals were greater than 0.15. AMLE precision was better at shorter sampling intervals and when using the shortest model calibration periods, such that the regression models better fit the temporal changes in the concentration–discharge relationship. The models with the largest errors typically had poor high flow sampling coverage resulting in unrepresentative models. Increasing sampling frequency and/or targeted high flow sampling are more efficient approaches to ensure sufficient sampling and to avoid poorly performing models, than increasing calibration period length.

Time-measurement-regulating peptide PIN may alter a timer conformation of Time Interval Measuring Enzyme (TIME).

PubMed

Ti, Xiaonan; Tani, Naoki; Isobe, Minoru; Kai, Hidenori

2006-05-01

The TIME (Time Interval Measuring Enzyme) ATPase measures time intervals in accordance with diapause development, which indispensably requires cold for resumption of embryonic development in the silkworm (Bombyx mori). The PIN (Peptidyl Inhibitory Needle) peptide regulates the time measurement function of TIME. In the present study we investigated the interaction between TIME and PIN in order to address the mechanism of diapause development. When TIME was isolated from eggs later than 12 days after oviposition, transient bursts of ATPase activity occurred 18h after isolation of TIME, and the younger the eggs and pupal ovaries from which TIME was isolated, the earlier the bursts of ATPase activity appeared. However, no interval-timer activation of ATPase occurred in ovaries earlier than 6 days after pupation. Similar patterns of ATPase activity occurred in test tubes after mixing TIME with PIN. The shorter the time PIN was mixed with TIME, the earlier the ATPase activity appeared. The timer may be built into the protein conformation of TIME, and PIN (which is present in ovaries beginning 6 days after pupation) appears able to alter this timer conformation through pupal stages to laid eggs. We discuss the possible mechanism of diapause development in relation to the timer mechanism of TIME.

Effects of preparation time and trial type probability on performance of anti- and pro-saccades.

PubMed

Pierce, Jordan E; McDowell, Jennifer E

2016-02-01

Cognitive control optimizes responses to relevant task conditions by balancing bottom-up stimulus processing with top-down goal pursuit. It can be investigated using the ocular motor system by contrasting basic prosaccades (look toward a stimulus) with complex antisaccades (look away from a stimulus). Furthermore, the amount of time allotted between trials, the need to switch task sets, and the time allowed to prepare for an upcoming saccade all impact performance. In this study the relative probabilities of anti- and pro-saccades were manipulated across five blocks of interleaved trials, while the inter-trial interval and trial type cue duration were varied across subjects. Results indicated that inter-trial interval had no significant effect on error rates or reaction times (RTs), while a shorter trial type cue led to more antisaccade errors and faster overall RTs. Responses following a shorter cue duration also showed a stronger effect of trial type probability, with more antisaccade errors in blocks with a low antisaccade probability and slower RTs for each saccade task when its trial type was unlikely. A longer cue duration yielded fewer errors and slower RTs, with a larger switch cost for errors compared to a short cue duration. Findings demonstrated that when the trial type cue duration was shorter, visual motor responsiveness was faster and subjects relied upon the implicit trial probability context to improve performance. When the cue duration was longer, increased fixation-related activity may have delayed saccade motor preparation and slowed responses, guiding subjects to respond in a controlled manner regardless of trial type probability. Copyright © 2016 Elsevier B.V. All rights reserved.

Prospective and retrospective time perception are related to mental time travel: evidence from Alzheimer's disease.

PubMed

El Haj, Mohamad; Moroni, Christine; Samson, Séverine; Fasotti, Luciano; Allain, Philippe

2013-10-01

Unlike prospective time perception paradigms, in which participants are aware that they have to estimate forthcoming time, little is known about retrospective time perception in normal aging and Alzheimer's disease (AD). Our paper addresses this shortcoming by comparing prospective and retrospective time estimation in younger adults, older adults, and AD patients. In four prospective tasks (lasting 30s, 60s, 90s, or 120s) participants were asked to read a series of numbers and to provide a verbal estimation of the reading time. In four other retrospective tasks, they were not informed about time judgment until they were asked to provide a verbal estimation of four elapsed time intervals (lasting 30s, 60s, 90s, or 120s). AD participants gave shorter verbal time estimations than older adults and younger participants did, suggesting that time is perceived to pass quickly in these patients. For all participants, the duration of the retrospective tasks was underestimated as compared to the prospective tasks and both estimations were shorter than the real time interval. Prospective time estimation was further correlated with mental time travel, as measured with the Remember/Know paradigm. Mental time travel was even higher correlated with retrospective time estimation. Our findings shed light on the relationship between time perception and the ability to mentally project oneself into time, two skills contributing to human memory functioning. Finally, time perception deficits, as observed in AD patients, can be interpreted in terms of dramatic changes occurring in frontal lobes and hippocampus. Copyright © 2013 Elsevier Inc. All rights reserved.

Time perception and reproduction in young adults with attention deficit hyperactivity disorder.

PubMed

Barkley, R A; Murphy, K R; Bush, T

2001-07-01

Adults with attention deficit hyperactivity disorder (ADHD; n = 104) were compared with a control group (n = 64) on time estimation and reproduction tasks. Results were unaffected by ADHD subtype or gender. The ADHD group provided larger time estimations than the control group, particularly at long intervals. This became nonsignificant after controlling for IQ. The ADHD group made shorter reproductions than did the control group (15- and 60-s intervals) and greater reproduction errors (12-, 45-, 60-s durations). These differences remained after controlling for IQ and comorbid oppositional defiant disorder, depression, and anxiety. Only the level of anxiety contributed to errors (at 12-s duration) beyond the level of ADHD. Results extended findings on time perception in ADHD children to adults and ruled out comorbidity as the basis of the errors.

Exhibition of veiled features in diffusion bonding of titanium alloy and stainless steel via copper

NASA Astrophysics Data System (ADS)

Thirunavukarasu, Gopinath; Kundu, Sukumar; Laha, Tapas; Roy, Deb; Chatterjee, Subrata

2017-11-01

An investigation was carried out to know the extent of influence of bonding-time on the interface structure and mechanical properties of diffusion bonding (DB) of TiA|Cu|SS. DB of Ti6Al4V (TiA) and 304 stainless steel (SS) using pure copper (Cu) of 200-μm thickness were processed in vacuum using 4-MPa bonding-pressure at 1123 K from 15 to 120 min in steps of 15 min. Preparation of DB was not possible when bonding-time was less than 60 min as the bonding at Cu|SS interface was unsuccessful in spite of effective bonding at TiA|Cu interface; however, successful DB were produced when the bonding-time was 60 min and beyond. DB processed for 60 and 75 min (classified as shorter bonding-time interval) showed distinctive characteristics (structural, mechanical, and fractural) as compared to the DB processed for 90, 105, and 120 min (classified as longer bonding-time interval). DB processed for 60 and 75 min exhibited layer-wise Cu-Ti-based intermetallics at TiA|Cu interface, whereas Cu|SS interface was completely free from reaction products. The layer-wise structure of Cu-Ti-based intermetallics were not observed at TiA|Cu interface in the DB processed for longer bonding-time; however, the Cu|SS interface had layer-wise ternary intermetallic compounds (T1, T2, and T3) of Cu-Fe-Ti-based along with σ phase depending upon the bonding-time chosen. Diffusivity of Ti-atoms in Cu-layer (DTi in Cu-layer) was much greater than the diffusivity of Fe-atoms in Cu-layer (DFe in Cu-layer). Ti-atoms reached Cu|SS interface but Fe-atoms were unable to reach TiA|Cu interface. It was observed that DB fractured at Cu|SS interface when processed for shorter bonding-time interval, whereas the DB processed for longer bonding-time interval fractured apparently at the middle of Cu-foil region predominantly due to the existence of brittle Cu-Fe-Ti-based intermetallics.

Generalizing Over Conditions by Combining the Multitrait Multimethod Matrix and the Representative Design of Experiments,

DTIC Science & Technology

1986-01-01

by Anderson (1985) was reported in an article by Posner (1969) in which the difference in reaction time to an 1 "identity match" and a "name match...shorter reaction time) for the identity match but after a two-second [inter-stimulus) interval this * * advantage has almost completely disappeared. This...of critical sentences in a story. It is similar, however, in that reaction time was also used to evaluate differences between response categories that

Confidence intervals for the between-study variance in random-effects meta-analysis using generalised heterogeneity statistics: should we use unequal tails?

PubMed

Jackson, Dan; Bowden, Jack

2016-09-07

Confidence intervals for the between study variance are useful in random-effects meta-analyses because they quantify the uncertainty in the corresponding point estimates. Methods for calculating these confidence intervals have been developed that are based on inverting hypothesis tests using generalised heterogeneity statistics. Whilst, under the random effects model, these new methods furnish confidence intervals with the correct coverage, the resulting intervals are usually very wide, making them uninformative. We discuss a simple strategy for obtaining 95 % confidence intervals for the between-study variance with a markedly reduced width, whilst retaining the nominal coverage probability. Specifically, we consider the possibility of using methods based on generalised heterogeneity statistics with unequal tail probabilities, where the tail probability used to compute the upper bound is greater than 2.5 %. This idea is assessed using four real examples and a variety of simulation studies. Supporting analytical results are also obtained. Our results provide evidence that using unequal tail probabilities can result in shorter 95 % confidence intervals for the between-study variance. We also show some further results for a real example that illustrates how shorter confidence intervals for the between-study variance can be useful when performing sensitivity analyses for the average effect, which is usually the parameter of primary interest. We conclude that using unequal tail probabilities when computing 95 % confidence intervals for the between-study variance, when using methods based on generalised heterogeneity statistics, can result in shorter confidence intervals. We suggest that those who find the case for using unequal tail probabilities convincing should use the '1-4 % split', where greater tail probability is allocated to the upper confidence bound. The 'width-optimal' interval that we present deserves further investigation.

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.

Time between the first and second operations for staged total knee arthroplasties when the interval is determined by the patient.

PubMed

Ishii, Yoshinori; Noguchi, Hideo; Takeda, Mitsuhiro; Sato, Junko; Toyabe, Shin-Ichi

2014-01-01

The purpose of this study was to evaluate the interval between the first and second operations for staged total knee arthroplasties (TKAs) in patients with bilateral knee osteoarthritis. Depending on satisfactory preoperative health status, the patients determined the timing of the second operation. We also analysed correlations between the interval and patient characteristics. Eighty-six patients with bilateral knee osteoarthritis were analysed. The mean follow-up time from the first TKA was 96 months. The side of the first TKA was chosen by the patients. The timing of the second TKA was determined by the patients, depending on their perceived ability to tolerate the additional pain and limitations to activities of daily living. The median interval between the first and second operations was 12.5 months, with a range of 2 to 113 months. In 43 (50%) patients, the interval was <12 months. There was no difference in the interval between females and males (p=0.861), and no correlation between the interval and body mass index or age. There was weak correlation between the year of the first TKA and the interval (R=-0.251, p=0.020), with the interval getting significantly shorter as the years progressed (p=0.032). The median interval between the first and second operations in patients who underwent staged TKAs for bilateral knee osteoarthritis was about 1 year. The results of the current study may help patients and physicians to plan effective treatment strategies for staged TKAs. Level II. Copyright © 2013 Elsevier B.V. All rights reserved.

Prediction of mortality rates using a model with stochastic parameters

NASA Astrophysics Data System (ADS)

Tan, Chon Sern; Pooi, Ah Hin

2016-10-01

Prediction of future mortality rates is crucial to insurance companies because they face longevity risks while providing retirement benefits to a population whose life expectancy is increasing. In the past literature, a time series model based on multivariate power-normal distribution has been applied on mortality data from the United States for the years 1933 till 2000 to forecast the future mortality rates for the years 2001 till 2010. In this paper, a more dynamic approach based on the multivariate time series will be proposed where the model uses stochastic parameters that vary with time. The resulting prediction intervals obtained using the model with stochastic parameters perform better because apart from having good ability in covering the observed future mortality rates, they also tend to have distinctly shorter interval lengths.

Recognition of student names past: a longitudinal study with N = 1.

PubMed

Huang, I N

1997-01-01

Recognition of names of former students taught at different times by a middle-aged college professor was tested, to investigate recognition memory over a time span ranging from 6 months to 26.5 years. The relationship between the d', a measure of strength of memory, and the retention interval can be best described by a logarithmic function characterized by a rapid initial drop followed by a slow forgetting rate. The correct responses (hits and rejections) had higher confidence and shorter response time than did the incorrect responses (false alarms and misses). The results show that an ecologically realistic longitudinal study with N = 1 can provide a valuable means in the study of human memory with very long retention intervals, which have not yet been investigated in the laboratory.

Factors Associated With Shorter Colonoscopy Surveillance Intervals for Patients With Low-Risk Colorectal Adenomas and Effects on Outcome.

PubMed

Anderson, Joseph C; Baron, John A; Ahnen, Dennis J; Barry, Elizabeth L; Bostick, Roberd M; Burke, Carol A; Bresalier, Robert S; Church, Timothy R; Cole, Bernard F; Cruz-Correa, Marcia; Kim, Adam S; Mott, Leila A; Sandler, Robert S; Robertson, Douglas J

2017-06-01

Endoscopists do not routinely follow guidelines to survey individuals with low-risk adenomas (LRAs; 1-2 small tubular adenomas, < 1 cm) every 5-10 years for colorectal cancer; many recommend shorter surveillance intervals for these individuals. We aimed to identify the reasons that endoscopists recommend shorter surveillance intervals for some individuals with LRAs and determine whether timing affects outcomes at follow-up examinations. We collected data from 1560 individuals (45-75 years old) who participated in a prospective chemoprevention trial (of vitamin D and calcium) from 2004 through 2008. Participants in the trial had at least 1 adenoma, detected at their index colonoscopy, and were recommended to receive follow-up colonoscopy examinations at 3 or 5 years after adenoma identification, as recommended by the endoscopist. For this analysis we collected data from only participants with LRAs. These data included characteristics of participants and endoscopists and findings from index and follow-up colonoscopies. Primary endpoints were frequency of recommending shorter (3-year) vs longer (5-year) surveillance intervals, factors associated with these recommendations, and effect on outcome, determined at the follow-up colonoscopy. A 3-year surveillance interval was recommended for 594 of the subjects (38.1%). Factors most significantly associated with recommendation of 3-year vs a 5-year surveillance interval included African American race (relative risk [RR] to white, 1.41; 95% confidence interval [CI], 1.14-1.75), Asian/Pacific Islander ethnicity (RR to white, 1.7; 95% CI, 1.22-2.43), detection of 2 adenomas at the index examination (RR vs 1 adenoma, 1.47; 95% CI, 1.27-1.71), more than 3 serrated polyps at the index examination (RR=2.16, 95% CI, 1.59-2.93), or index examination with fair or poor quality bowel preparation (RR vs excellent quality, 2.16; 95% CI, 1.66-2.83). Other factors that had a significant association with recommendation for a 3-year surveillance interval included family history of colorectal cancer and detection of 1-2 serrated polyps at the index examination. In comparisons of outcomes, we found no significant differences between the 3-year vs 5-year recommendation groups in proportions of subjects found to have 1 or more adenomas (38.8% vs 41.7% respectively; P = .27), advanced adenomas (7.7% vs 8.2%; P = .73) or clinically significant serrated polyps (10.0% vs 10.3%; P = .82) at the follow-up colonoscopy. Possibly influenced by patients' family history, race, quality of bowel preparation, or number or size of polyps, endoscopists frequently recommend 3-year surveillance intervals instead of guideline-recommended intervals of 5 years or longer for individuals with LRAs. However, at the follow-up colonoscopy, similar proportions of participants have 1 or more adenomas, advanced adenomas, or serrated polyps. These findings support the current guideline recommendations of performing follow-up examinations of individuals with LRAs at least 5 years after the index colonoscopy. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Spatial and temporal variability in fire occurrence within the Las Bayas Forestry Reserve, Durango, Mexico

Treesearch

S. A. Drury; T. T. Veblen

2008-01-01

Patterns of fire occurrence within the Las Bayas Forestry Reserve, Mexico are analyzed in relation to variability in climate, topography, and human land-use. Significantly more fires with shorter fire return intervals occurred from 1900 to 1950 than from 1950 to 2001. However, the frequency of widespread fire years (25% filter) was unchanged over time, as widespread...

a New Approach to Physiologic Triggering in Medical Imaging Using Multiple Heart Sounds Alone.

NASA Astrophysics Data System (ADS)

Groch, Mark Walter

A new method for physiological synchronization of medical image acquisition using both the first and second heart sound has been developed. Heart sounds gating (HSG) circuitry has been developed which identifies, individually, both the first (S1) and second (S2) heart sounds from their timing relationship alone, and provides two synchronization points during the cardiac cycle. Identification of first and second heart sounds from their timing relationship alone and application to medical imaging has, heretofore, not been performed in radiology or nuclear medicine. The heart sounds are obtained as conditioned analog signals from a piezoelectric transducer microphone placed on the patient's chest. The timing relationships between the S1 to S2 pulses and the S2 to S1 pulses are determined using a logic scheme capable of distinguishing the S1 and S2 pulses from the heart sounds themselves, using their timing relationships, and the assumption that initially the S1-S2 interval will be shorter than the S2-S1 interval. Digital logic circuitry is utilized to continually track the timing intervals and extend the S1/S2 identification to heart rates up to 200 beats per minute (where the S1-S2 interval is not shorter than the S2-S1 interval). Clinically, first heart sound gating may be performed to assess the systolic ejection portion of the cardiac cycle, with S2 gating utilized for reproduction of the diastolic filling portion of the cycle. One application of HSG used for physiologic synchronization is in multigated blood pool (MGBP) imaging in nuclear medicine. Heart sounds gating has been applied to twenty patients who underwent analysis of ventricular function in Nuclear Medicine, and compared to conventional ECG gated MGBP. Left ventricular ejection fractions calculated from MGBP studies using a S1 and a S2 heart sound trigger correlated well with conventional ECG gated acquisitions in patients adequately gated by HSG and ECG. Heart sounds gating provided superior definition of the diastolic filling phase of the cardiac cycle by qualitative assessment of the left ventricular volume time -activity curves. Heart sounds physiological synchronization has potential to be used in other imaging modalities, such as magnetic resonance imaging, where the ECG is distorted due to the electromagnetic environment within the imager.

Echolocating Big Brown Bats, Eptesicus fuscus, Modulate Pulse Intervals to Overcome Range Ambiguity in Cluttered Surroundings

PubMed Central

Wheeler, Alyssa R.; Fulton, Kara A.; Gaudette, Jason E.; Simmons, Ryan A.; Matsuo, Ikuo; Simmons, James A.

2016-01-01

Big brown bats (Eptesicus fuscus) emit trains of brief, wideband frequency-modulated (FM) echolocation sounds and use echoes of these sounds to orient, find insects, and guide flight through vegetation. They are observed to emit sounds that alternate between short and long inter-pulse intervals (IPIs), forming sonar sound groups. The occurrence of these strobe groups has been linked to flight in cluttered acoustic environments, but how exactly bats use sonar sound groups to orient and navigate is still a mystery. Here, the production of sound groups during clutter navigation was examined. Controlled flight experiments were conducted where the proximity of the nearest obstacles was systematically decreased while the extended scene was kept constant. Four bats flew along a corridor of varying widths (100, 70, and 40 cm) bounded by rows of vertically hanging plastic chains while in-flight echolocation calls were recorded. Bats shortened their IPIs for more rapid spatial sampling and also grouped their sounds more tightly when flying in narrower corridors. Bats emitted echolocation calls with progressively shorter IPIs over the course of a flight, and began their flights by emitting shorter starting IPI calls when clutter was denser. The percentage of sound groups containing 3 or more calls increased with increasing clutter proximity. Moreover, IPI sequences having internal structure become more pronounced when corridor width narrows. A novel metric for analyzing the temporal organization of sound sequences was developed, and the results indicate that the time interval between echolocation calls depends heavily on the preceding time interval. The occurrence of specific IPI patterns were dependent upon clutter, which suggests that sonar sound grouping may be an adaptive strategy for coping with pulse-echo ambiguity in cluttered surroundings. PMID:27445723

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.

Development of visual field defect after first-detected optic disc hemorrhage in preperimetric open-angle glaucoma.

PubMed

Kim, Hae Jin; Song, Yong Ju; Kim, Young Kook; Jeoung, Jin Wook; Park, Ki Ho

2017-07-01

To evaluate functional progression in preperimetric glaucoma (PPG) with disc hemorrhage (DH) and to determine the time interval between the first-detected DH and development of glaucomatous visual field (VF) defect. A total of 87 patients who had been first diagnosed with PPG were enrolled. The medical records of PPG patients without DH (Group 1) and with DH (Group 2) were reviewed. When glaucomatous VF defect appeared, the time interval from the diagnosis of PPG to the development of VF defect was calculated and compared between the two groups. In group 2, the time intervals from the first-detected DH to VF defect of the single- and recurrent-DH were compared. Of the enrolled patients, 45 had DH in the preperimetric stage. The median time interval from the diagnosis of PPG to the development of VF defect was 73.3 months in Group 1, versus 45.4 months in Group 2 (P = 0.042). The cumulative probability of development of VF defect after diagnosis of PPG was significantly greater in Group 2 than in Group 1. The median time interval from first-detected DH to the development of VF defect was 37.8 months. The median time interval from DH to VF defect and cumulative probability of VF defect after DH did not show a statistical difference between single and recurrent-DH patients. The median time interval between the diagnosis of PPG and the development of VF defect was significantly shorter in PPG with DH. The VF defect appeared 37.8 months after the first-detected DH in PPG.

HIV testing, care referral and linkage to care intervals affect time to engagement in care for newly diagnosed HIV-infected adolescents in fifteen adolescent medicine clinics in the United States

PubMed Central

Philbin, Morgan M.; Tanner, Amanda E.; DuVal, Anna; Ellen, Jonathan M.; Xu, Jiahong; Kapogiannis, Bill; Bethel, Jim; Fortenberry, J. Dennis

2016-01-01

Objective To examine how the time from HIV testing to care referral and from referral to care linkage influenced time to care engagement for newly diagnosed HIV-infected adolescents. Methods We evaluated the Care Initiative, a care linkage and engagement program for HIV-infected adolescents in 15 U.S. clinics. We analyzed client-level factors, provider type and intervals from HIV testing to care referral and from referral to care linkage as predictors of care engagement. Engagement was defined as a second HIV-related medical visit within 16 weeks of initial HIV-related medical visit (linkage). Results At 32 months, 2,143 youth had been referred. Of these, 866 were linked to care through the Care Initiative within 42 days and thus eligible for study inclusion. Of the linked youth, 90.8% were ultimately engaged in care. Time from HIV testing to referral (e.g., ≤7 days versus >365 days) was associated with engagement (AOR=2.91; 95% CI: 1.43–5.94) and shorter time to engagement (Adjusted HR=1.41; 95% CI: 1.11–1.79). Individuals with shorter care referral to linkage intervals (e.g., ≤7 days versus 22–42 days) engaged in care faster (Adjusted HR=2.90; 95% CI: 2.34–3.60) and more successfully (AOR=2.01; 95% CI: 1.04–3.89). Conclusions These data address a critical piece of the care continuum, and can offer suggestions of where and with whom to intervene in order to best achieve the care engagement goals outlined in the U.S. National HIV/AIDS Strategy. These results may also inform programs and policies that set concrete milestones and strategies for optimal care linkage timing for newly diagnosed adolescents. PMID:26885804

The Pace of Cultural Evolution

PubMed Central

Perreault, Charles

2012-01-01

Today, humans inhabit most of the world’s terrestrial habitats. This observation has been explained by the fact that we possess a secondary inheritance mechanism, culture, in addition to a genetic system. Because it is assumed that cultural evolution occurs faster than biological evolution, humans can adapt to new ecosystems more rapidly than other animals. This assumption, however, has never been tested empirically. Here, I compare rates of change in human technologies to rates of change in animal morphologies. I find that rates of cultural evolution are inversely correlated with the time interval over which they are measured, which is similar to what is known for biological rates. This correlation explains why the pace of cultural evolution appears faster when measured over recent time periods, where time intervals are often shorter. Controlling for the correlation between rates and time intervals, I show that (1) cultural evolution is faster than biological evolution; (2) this effect holds true even when the generation time of species is controlled for; and (3) culture allows us to evolve over short time scales, which are normally accessible only to short-lived species, while at the same time allowing for us to enjoy the benefits of having a long life history. PMID:23024804

Human sinus arrhythmia as an index of vagal cardiac outflow

NASA Technical Reports Server (NTRS)

Eckberg, D. L.

1983-01-01

The human central vagal mechanisms were investigated by measuring the intervals between heartbeats during controlled breathing (at breathing intervals of 2.5-10 s and nominal tidal volumes of 1000 and 1500 ml) in six young men and women. It was found that as the breathing interval increased, the longest heart periods became longer, the shortest heart periods became shorter, and the peak-valley P-P intervals increased asymptotically. Peak-valley intervals also increased in proportion to tidal volume, although this influence was small. The phase angles between heart period changes and respiration were found to vary as linear functions of breathing interval. Heart period shortening began in inspiration at short breathing intervals and in expiration at long breathing intervals, while heart period lengthening began in early expiration at all breathing intervals studied. It is concluded that a close relationship exists between variations of respiratory depth and interval and the quantity, periodicity, and timing of vagal cardiac outflow in conscious humans. The results indicate that at usual breathing rates, phasic respiration-related changes of vagal motoneuron activity begin in expiration, progress slowly, and are incompletely expressed at fast breathing ratges.

Rats' Memory for Time and Relational Responding in the Duration-Comparison Procedure

ERIC Educational Resources Information Center

Santi, Angelo; Hoover, Claire; Simmons, Sabrina

2011-01-01

Rats were trained in a duration-comparison task to press one lever if the comparison duration ("c") was 1.2-s shorter than a standard duration ("s"), and another lever if c was 1.2-s longer than s. The interval between s and c duration was 1 s. The 10 duration pairs used during training controlled for the absolute duration of "c" and the total…

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

Differential Changes in Myocardial Performance Index and Its Time Intervals in Donors and Recipients of Twin-to-Twin Transfusion Syndrome before and after Laser Therapy.

PubMed

Ortiz, Javier U; Torres, Ximena; Eixarch, Elisenda; Bennasar, Mar; Cruz-Lemini, Monica; Gómez, Olga; Lobmaier, Silvia M; Martínez, Josep M; Gratacós, Eduard; Crispi, Fatima

2018-01-19

To evaluate left myocardial performance index (MPI) and time intervals in fetuses with twin-to-twin transfusion syndrome (TTTS) before and after laser surgery. Fifty-one fetal pairs with TTTS and 47 uncomplicated monochorionic twin pairs were included. Left ventricular isovolumetric contraction time (ICT), ejection time (ET), and isovolumetric relaxation time (IRT) were measured using conventional Doppler. Recipients showed prolonged ICT (46 ± 12 vs. 31 ± 8 vs. 30 ± 5 ms; p < 0.001) and IRT (51 ± 9 vs. 43 ± 8 vs. 43 ± 5 ms; p < 0.001) and higher MPI (0.57 ± 0.12 vs. 0.47 ± 0.09 vs. 0.44 ± 0.05; p < 0.001) than donors and controls. Donors showed shorter ET than recipients and controls (157 ± 12 vs. 169 ± 10 vs. 168 ± 10 ms; p < 0.001) and higher MPI than controls (0.47 ± 0.09 vs. 0.44 ± 0.05; p = 0.006). Preoperative MPI changes were observed in all TTTS stages. Time intervals partially improved after surgery. Donor and recipient twins had higher MPI due to different changes in the time intervals, possibly reflecting the state of hypovolemia in the donor and hypervolemia and pressure overload in the recipient. © 2018 S. Karger AG, Basel.

Polysomnographic Measurement of Sleep Duration and Bodily Pain Perception in the Sleep Heart Health Study.

PubMed

Weingarten, Jeremy A; Dubrovsky, Boris; Basner, Robert C; Redline, Susan; George, Liziamma; Lederer, David J

2016-08-01

To determine whether total sleep time (TST) and specific sleep stage duration are associated with bodily pain perception and whether sex, age, or subjective sleepiness modifies this relationship. Data from adults ages 39-90 y (n = 5,199) who took part in the Sleep Heart Health Study Exam 1 were analyzed. TST, rapid eye movement (REM) sleep time, and slow wave sleep (SWS) time were measured by unattended, in-home nocturnal polysomnography. Bodily pain perception was measured via the Short Form-36 questionnaire bodily pain component. We used logistic regression to examine associations between total and individual sleep stage durations and bodily pain perception controlling for age, sex, race, body mass index, apnea-hypopnea index, antidepressant use, and important cardiovascular conditions (smoking [pack-years], history of diabetes, and history of percutaneous coronary intervention and/or coronary artery bypass graft). In the fully adjusted model, REM sleep time and SWS time were not associated with "moderate to severe pain," whereas TST was: Each 1-h decrement in TST was associated with a 7% increased odds of "moderate to severe pain" (odds ratio 1.07, 95% confidence interval 1.002, 1.14). Due to modification of the association between SWS time and "moderate to severe pain" by sex (P for interaction = 0.01), we performed analyses stratified by sex: Each 1-h decrement in SWS time was associated with a 20% higher odds of "moderate to severe pain" among men (odds ratio 1.20, 95% confidence interval 1.03-1.42) whereas an association was not observed among women. Shorter TST among all subjects and shorter SWS time in men was associated with "moderate to severe pain." REM sleep time was not associated with bodily pain perception in this cohort. © 2016 Associated Professional Sleep Societies, LLC.

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.

Oncological strategies for locally advanced rectal cancer with synchronous liver metastases, interval strategy versus rectum first strategy: a comparison of short-term outcomes.

PubMed

Salvador-Rosés, H; López-Ben, S; Casellas-Robert, M; Planellas, P; Gómez-Romeu, N; Farrés, R; Ramos, E; Codina-Cazador, A; Figueras, J

2017-12-22

The goal of treatment for patients with synchronous liver metastases (SLM) from rectal cancer is to achieve a complete resection of both tumor locations. For patients with symptomatic locally advanced rectal cancer with resectable SLM at diagnosis, our usual strategy has been the rectum first approach (RF). However, since 2014, we advocate for the interval approach (IS) that involves the administration of chemo-radiotherapy followed by the resection of the SLM in the interval of time between rectal cancer radiation and rectal surgery. From 2010 to 2016, 16 patients were treated according to this new strategy and 19 were treated according RF strategy. Data were collected prospectively and analyzed with an intention-to-treat perspective. Complete resection rate, duration of the treatment and morbi-mortality were the main outcomes. The complete resection rate in the IS was higher (100%, n = 16) compared to the RF (74%, n = 14, p = 0.049) and the duration of the strategy was shorter (6 vs. 9 months, respectively, p = 0.006). The incidence of severe complications after liver surgery was 14% (n = 2) in the RF and 0% in the IS (p = 1.000), and after rectal surgery was 24% (n = 4) and 12% (n = 2), respectively (p = 1.000). The IS is a feasible and safe strategy that procures higher level of complete resection rate in a shorter period of time compared to RF strategy.

Care processes associated with quicker door-in-door-out times for patients with ST-elevation-myocardial infarction requiring transfer: results from a statewide regionalization program.

PubMed

Glickman, Seth W; Lytle, Barbara L; Ou, Fang-Shu; Mears, Greg; O'Brien, Sean; Cairns, Charles B; Garvey, J Lee; Bohle, David J; Peterson, Eric D; Jollis, James G; Granger, Christopher B

2011-07-01

The ability to rapidly identify patients with ST-segment elevation-myocardial infarction (STEMI) at hospitals without percutaneous coronary intervention (PCI) and transfer them to hospitals with PCI capability is critical to STEMI regionalization efforts. Our objective was to assess the association of prehospital, emergency department (ED), and hospital processes of care implemented as part of a statewide STEMI regionalization program with door-in-door-out times at non-PCI hospitals. Door-in-door-out times for 436 STEMI patients at 55 non-PCI hospitals were determined before (July 2005 to September 2005) and after (January 2007 to March 2007) a year-long implementation of standardized protocols as part of a statewide regionalization program (Reperfusion of Acute Myocardial Infarction in North Carolina Emergency Departments, RACE). The association of 8 system care processes (encompassing emergency medical services [EMS], ED, and hospital settings) with door-in-door-out times was determined using multivariable linear regression. Median door-in-door-out times improved significantly with the intervention (before: 97.0 minutes, interquartile range, 56.0 to 160.0 minutes; after: 58.0 minutes, interquartile range, 35.0 to 90.0 minutes; P<0.0001). Hospital, ED, and EMS care processes were each independently associated with shorter door-in-door-out times (-17.7 [95% confidence interval, -27.5 to -7.9]; -10.1 [95% confidence interval, -19.0 to -1.1], and -7.3 [95% confidence interval, -13.0 to -1.5] minutes for each additional hospital, ED, and EMS process, respectively). Combined, adoption of EMS processes was associated with the shortest median treatment times (44 versus 138 minutes for hospitals that adopted all EMS processes versus none). Prehospital, ED, and hospital processes of care were independently associated with shorter door-in-door-out times for STEMI patients requiring transfer. Adoption of several EMS processes was associated with the largest reduction in treatment times. These findings highlight the need for an integrated, system-based approach to improving STEMI care.

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.

The spatial return level of aggregated hourly extreme rainfall in Peninsular Malaysia

NASA Astrophysics Data System (ADS)

Shaffie, Mardhiyyah; Eli, Annazirin; Wan Zin, Wan Zawiah; Jemain, Abdul Aziz

2015-07-01

This paper is intended to ascertain the spatial pattern of extreme rainfall distribution in Peninsular Malaysia at several short time intervals, i.e., on hourly basis. Motivation of this research is due to historical records of extreme rainfall in Peninsular Malaysia, whereby many hydrological disasters at this region occur within a short time period. The hourly periods considered are 1, 2, 3, 6, 12, and 24 h. Many previous hydrological studies dealt with daily rainfall data; thus, this study enables comparison to be made on the estimated performances between daily and hourly rainfall data analyses so as to identify the impact of extreme rainfall at a shorter time scale. Return levels based on the time aggregate considered are also computed. Parameter estimation using L-moment method for four probability distributions, namely, the generalized extreme value (GEV), generalized logistic (GLO), generalized Pareto (GPA), and Pearson type III (PE3) distributions were conducted. Aided with the L-moment diagram test and mean square error (MSE) test, GLO was found to be the most appropriate distribution to represent the extreme rainfall data. At most time intervals (10, 50, and 100 years), the spatial patterns revealed that the rainfall distribution across the peninsula differ for 1- and 24-h extreme rainfalls. The outcomes of this study would provide additional information regarding patterns of extreme rainfall in Malaysia which may not be detected when considering only a higher time scale such as daily; thus, appropriate measures for shorter time scales of extreme rainfall can be planned. The implementation of such measures would be beneficial to the authorities to reduce the impact of any disastrous natural event.

Remote real-time monitoring of free flaps via smartphone photography and 3G wireless Internet: a prospective study evidencing diagnostic accuracy.

PubMed

Engel, Holger; Huang, Jung Ju; Tsao, Chung Kan; Lin, Chia-Yu; Chou, Pan-Yu; Brey, Eric M; Henry, Steven L; Cheng, Ming Huei

2011-11-01

This prospective study was designed to compare the accuracy rate between remote smartphone photographic assessments and in-person examinations for free flap monitoring. One hundred and three consecutive free flaps were monitored with in-person examinations and assessed remotely by three surgeons (Team A) via photographs transmitted over smartphone. Four other surgeons used the traditional in-person examinations as Team B. The response time to re-exploration was defined as the interval between when a flap was evaluated as compromised by the nurse/house officer and when the decision was made for re-exploration. The accuracy rate was 98.7% and 94.2% for in-person and smartphone photographic assessments, respectively. The response time of 8 ± 3 min in Team A was statistically shorter than the 180 ± 104 min in Team B (P = 0.01 by the Mann-Whitney test). The remote smartphone photography assessment has a comparable accuracy rate and shorter response time compared with in-person examination for free flap monitoring. Copyright © 2011 Wiley Periodicals, Inc.

Evidence for decay in verbal short-term memory: a commentary on Berman, Jonides, and Lewis (2009).

PubMed

Campoy, Guillermo

2012-07-01

M. G. Berman, J. Jonides, and R. L. Lewis (2009) adapted the recent-probes task to investigate the causes of forgetting in short-term memory. In 7 experiments, they studied the persistence of memory traces by assessing the level of proactive interference generated by previous-trial items over a range of intertrial intervals. None of the experiments found a reduction in proactive interference over time, which they interpreted as evidence against time-based decay. However, it is possible that decay actually occurred over a shorter time period than was tested in this study, wherein the shortest decay interval was 3,300 ms. By reducing the time scale, the 2 experiments reported in the current commentary revealed a sharp decrease in proactive interference over time, with this reduction reaching a plateau in less than 3 s. This pattern suggests that decay operates in the early stages, whereas subsequent forgetting is likely to be due to interference. 2012 APA, all rights reserved

Relationship of endogenous circadian melatonin and temperature rhythms to self-reported preference for morning or evening activity in young and older people

NASA Technical Reports Server (NTRS)

Duffy, J. F.; Dijk, D. J.; Hall, E. F.; Czeisler, C. A.

1999-01-01

BACKGROUND: Morningness-eveningness refers to interindividual differences in preferred timing of behavior (i.e., bed and wake times). Older people have earlier wake times and rate themselves as more morning-like than young adults. It has been reported that the phase of circadian rhythms is earlier in morning-types than in evening types, and that older people have earlier phases than young adults. These changes in phase have been considered to be the chronobiological basis of differences in preferred bed and wake times and age-related changes therein. Whether such differences in phase are associated with changes in the phase relationship between endogenous circadian rhythms and the sleep-wake cycle has not been investigated previously. METHODS: We investigated the association between circadian phase, the phase relationship between the sleep-wake cycle and circadian rhythms, and morningness-eveningness, and their interaction with aging. In this circadian rhythm study, 68 young and 40 older subjects participated. RESULTS: Among the young subjects, the phase of the melatonin and core temperature rhythms occurred earlier in morning than in evening types and the interval between circadian phase and usual wake time was longer in morning types. Thus, while evening types woke at a later clock hour than morning types, morning types actually woke at a later circadian phase. Comparing young and older morning types we found that older morning types had an earlier circadian phase and a shorter phase-wake time interval. The shorter phase-waketime interval in older "morning types" is opposite to the change associated with morningness in young people, and is more similar to young evening types. CONCLUSIONS: These findings demonstrate an association between circadian phase, the relationship between the sleep-wake cycle and circadian phase, and morningness-eveningness in young adults. Furthermore, they demonstrate that age-related changes in phase angle cannot be attributed fully to an age-related shift toward morningness. These findings have important implications for understanding individual preferences in sleep-wake timing and age-related changes in the timing of sleep.

Constraining response output on conjunctive fixed-ratio 1 fixed-time reinforcement schedules: Effects on the postreinforcement pause.

PubMed

Lopez, F; Pereira, C

1985-03-01

Two experiments used response-restriction procedures in order to test the independence of the factors determining response rate and the factors determining the size of the postreinforcement pause on interval schedules. Responding was restricted by response-produced blackout or by retracting the lever. In Experiment 1 with a Conjunctive FR 1 FT schedule, the blackout procedure reduced the postreinforcement pause more than the lever-retraction procedure did, and both procedures produced shorter pauses than did the schedule without response restriction. In Experiment 2 the interreinforcement interval was also manipulated, and the size of the pause was an increasing function of the interreinforcement interval, but the rate of increase was lower than that produced by fixed interval schedules of comparable interval durations. The assumption of functional independence of the postreinforcement pause and terminal rate in fixed interval schedules is questioned since data suggest that pause reductions resulted from constraining variation in response number compared to equivalent periodic schedules in which response number was allowed to vary. Copyright © 1985. Published by Elsevier B.V.

Shorter spontaneous fixation durations in infants with later emerging autism.

PubMed

Wass, Sam V; Jones, Emily J H; Gliga, Teodora; Smith, Tim J; Charman, Tony; Johnson, Mark H

2015-02-06

Little is known about how spontaneous attentional deployment differs on a millisecond-level scale in the early development of autism spectrum disorders (ASD). We measured fine-grained eye movement patterns in 6-to 9-month-old infants at high or low familial risk (HR/LR) of ASD while they viewed static images. We observed shorter fixation durations (i.e. the time interval between saccades) in HR than LR infants. Preliminary analyses indicate that these results were replicated in a second cohort of infants. Fixation durations were shortest in those infants who went on to receive an ASD diagnosis at 36 months. While these findings demonstrate early-developing atypicality in fine-grained measures of attentional deployment early in the etiology of ASD, the specificity of these effects to ASD remains to be determined.

Salutary effects of high-intensity interval training in persons with elevated cardiovascular risk.

PubMed

Fleg, Jerome L

2016-01-01

Although moderate-intensity continuous training (MICT) has been the traditional model for aerobic exercise training for over four decades, a growing body of literature has demonstrated equal if not greater improvement in aerobic capacity and similar beneficial effects on body composition, glucose metabolism, blood pressure, and quality of life from high-intensity interval training (HIIT). An advantage of HIIT over MICT is the shorter time required to perform the same amount of energy expenditure. The current brief review summarizes the effects of HIIT on peak aerobic capacity and cardiovascular risk factors in healthy adults and those with various cardiovascular diseases, including coronary artery disease, chronic heart failure, and post heart transplantation.

Salutary effects of high-intensity interval training in persons with elevated cardiovascular risk

PubMed Central

Fleg, Jerome L.

2016-01-01

Although moderate-intensity continuous training (MICT) has been the traditional model for aerobic exercise training for over four decades, a growing body of literature has demonstrated equal if not greater improvement in aerobic capacity and similar beneficial effects on body composition, glucose metabolism, blood pressure, and quality of life from high-intensity interval training (HIIT). An advantage of HIIT over MICT is the shorter time required to perform the same amount of energy expenditure. The current brief review summarizes the effects of HIIT on peak aerobic capacity and cardiovascular risk factors in healthy adults and those with various cardiovascular diseases, including coronary artery disease, chronic heart failure, and post heart transplantation. PMID:27635241

Behavioral regulation of gravity - Schedule effects under escape-avoidance procedures

NASA Technical Reports Server (NTRS)

Clark, F. C.; Lange, K. O.; Belleville, R. E.

1973-01-01

Squirrel monkeys were restrained in a centrifuge capsule and trained to escape and avoid increases in artificial gravity. During escape-avoidance, lever responses reduced centrifugally simulated gravity or postponed scheduled increases. The effect of variation in the interval of postponement (equal to the duration of decrease produced by escape responses) was studied under a multiple schedule of four components. Three components were gravity escape-avoidance with postponement times of 20, 40, and 60 sec. The fourth component was extinction. Each component was associated with a different auditory stimulus. Rate of responding decreased with increasing postponement time and higher mean g-levels occurred at shorter intervals of postponement. Effects of the schedule parameter on response rate and mean g-level were similar to effects of the schedule on free-operant avoidance and on titration behavior maintained by shock.

Trunk-arm coordination in reaching for moving targets in people with Parkinson's disease: comparison between virtual and physical reality.

PubMed

Ma, Hui-Ing; Hwang, Wen-Juh; Wang, Ching-Yi; Fang, Jing-Jing; Leong, Iat-Fai; Wang, Tsui-Ying

2012-10-01

We used a trunk-assisted prehension task to examine the effect of task (reaching for stationary vs. moving targets) and environmental constraints (virtual reality [VR] vs. physical reality) on the temporal control of trunk and arm motions in people with Parkinson's disease (PD). Twenty-four participants with PD and 24 age-matched controls reached for and grasped a ball that was either stationary or moving along a ramp 120% of arm length away. In a similar VR task, participants reached for a virtual ball that was either stationary or moving. Movement speed was measured as trunk and arm movement times (MTs); trunk-arm coordination was measured as onset interval and offset interval between trunk and arm motions, as well as a summarized index-desynchrony score. In both VR and physical reality, the PD group had longer trunk and arm MTs than the control group when reaching for stationary balls (p<.001). When reaching for moving balls in VR and physical reality, however, the PD group had lower trunk and arm MTs, onset intervals, and desynchrony scores (p<.001). For the PD group, VR induced shorter trunk MTs, shorter offset intervals, and lower desynchrony scores than did physical reality when reaching for moving balls (p<.001). These findings suggest that using real moving targets in trunk-assisted prehension tasks improves the speed and synchronization of trunk and arm motions in people with PD, and that using virtual moving targets may induce a movement termination strategy different from that used in physical reality. Copyright © 2012 Elsevier B.V. All rights reserved.

Atmospheric Fluctuation Measurements with the Palomar Testbed Interferometer

NASA Astrophysics Data System (ADS)

Linfield, R. P.; Lane, B. F.; Colavita, M. M.; PTI Collaboration

Observations of bright stars with the Palomar Testbed Interferometer, at a wavelength of 2.2 microns, have been used to measure atmospheric delay fluctuations. The delay structure function Dτ(Δ t) was calculated for 66 scans (each >= 120s in length) on seven nights in 1997 and one in 1998. For all except one scan, Dτ exhibited a clean power law shape over the time interval 50-500 msec. Over shorter time intervals, the effect of the delay line servo loop corrupts Dτ. Over longer time intervals (usually starting at > 1s), the slope of Dτ decreases, presumably due to some combination of saturation e.g. finite turbulent layer thickness) and the effect of the finite wind speed crossing time on our 110 m baseline. The mean power law slopes for the eight nights ranged from 1.16 to 1.36, substantially flatter than the value of 1.67 for three dimensional Kolmogorov turbulence. Such sub-Kolmogorov slopes will result in atmospheric seeling (θ) that improves rapidly with increasing wavelength: θ propto λ1-(2β), where β is the observed power law slope of Dτ. The atmospheric errors in astrometric measurements with an interferometer will average down more quickly than in the Kolmogorov case.

Association between Body Condition Score and Cancer Prognosis in Dogs with Lymphoma and Osteosarcoma.

PubMed

Romano, F R; Heinze, C R; Barber, L G; Mason, J B; Freeman, L M

2016-07-01

In humans and rodents obesity appears to promote some cancers by increasing incidence, tumor aggressiveness, recurrence, and fatality. However, the relationship between obesity and cancer in dogs has not been thoroughly evaluated. Whether body condition score (BCS) at the time of lymphoma (LSA) or osteosarcoma (OSA) diagnosis in dogs is predictive of survival time (ST) or progression-free interval (PFI). We hypothesized that an overweight body state at the time of cancer diagnosis would be associated with negative outcomes. Dogs with LSA (n = 270) and OSA (n = 54) diagnosed and treated between 2000 and 2010. Retrospective case review. Signalment, body weight, BCS, cancer diagnosis and treatment, relevant clinicopathologic values, and survival data were collected. Dogs were grouped by BCS (underweight, ideal, and overweight) and ST and PFI were compared. Overall, 5.5% of dogs were underweight, 54.0% were ideal weight, and 40.4% were overweight at diagnosis. Underweight dogs with LSA had shorter ST (P = .017) than ideal or overweight dogs. BCS was not associated with ST for OSA (P = .474). Progression-free interval did not differ among BCS categories for either cancer. Obesity was not associated with adverse outcomes among dogs with LSA or OSA in this retrospective study; however, being underweight at the time of diagnosis of LSA was associated with shorter survival. More research is needed to elucidate the relationship between excessive body weight and cancer development and progression in dogs. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

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.

Climate Simulation.

DTIC Science & Technology

1978-03-01

to each other in dimension- less-parameter space (RoT = 0.81 and Ro_, = 0.79, respectively), the transient is shorter in duration in the 5 - wave amplitude...9.8°C is traversed from the opposite direction (during the time interval 13,090 s t < 14,870 rot), the 5 - wave configuration remains during the...9.2°C produces a slight change in the 5 - wave amplitude vacillation pattern. In particular, the amplitude of wave number 5 decreases , ,^w

The effect of an osmotic contrast agent on complete meconium evacuation in preterm infants.

PubMed

Haiden, Nadja; Norooz, Florentine; Klebermass-Schrehof, Kathrin; Horak, Anna Sophie; Jilma, Bernd; Berger, Angelika; Repa, Andreas

2012-12-01

To determine whether enteral application of the osmotic contrast agent Gastrografin accelerates complete meconium excretion and improves feeding tolerance in very low birth weight infants. This study was a stratified, randomized, placebo-controlled trial in premature infants with a birth weight <1500 g and a gestational age <32 weeks who received 3 mL/kg Gastrografin diluted 1:3 with water within their first 24 hours of life, or placebo. Passage of last meconium occurred after a median of 7 days (95% confidence interval: 6-9 days, n = 39) in the intervention group and after 8 days (95% confidence interval: 7-10 days, n = 39) in the control group (P = .61); however, Gastrografin application was associated with a 7.5-day shorter time to full enteral feedings, a 24-day shorter stay in the NICU, and a 17-day reduction in the overall hospital stay in the intervention group compared with the control group. A numerically higher incidence of necrotizing enterocolitis (21%) was observed in the intervention group, however. Gastrografin application did not accelerate meconium evacuation, but the higher stool frequency during the first week of life had a beneficial effect on the time to full enteral feedings and later hospital stay; however, it may increase the necrotizing enterocolitis risk. Further investigations are needed with modified protocols, and the prophylactic use of Gastrografin cannot currently be recommended without further clinical trials.

Context and Time Matter: Effects of Emotion and Motivation on Episodic Memory Overtime

PubMed Central

Sun, Qing; Gu, Simeng

2018-01-01

Previous studies have shown that compared with neutral cues, stimuli with positive and negative/stressful contexts or reward and punishment cues are remembered better. However, it is unclear whether the enhanced effect differs in emotion or motivation dimensions and the passage of time. We addressed these issues by manipulating different contextual cues for neutral words at different time intervals. In experiment 1, subjects were asked to learn words with picture contexts in positive, negative/stressful, and neutral valences and were tested by old/new word recognition and contextual judgment 10 min, 1 day, and 1 week later. In experiment 2, the reward and punishment motivations were manipulated by monetary cues during learning. Word recognition and contextual judgment were assessed 10 min, 1 day, 1 week, and 1 month after the study. Compared with negative and punishment conditions, the words in positive and reward contexts were recognized better at shorter intervals, which was associated with recollection process. In contrast, the words in negative and punishment contexts were recognized better at longer intervals, which was mainly associated with familiarity process. These results clarified how different dimensions of emotional and motivational contexts influence memory at short and long intervals and highlighted the role of contextual features in memory formation and consolidation. PMID:29849564

Context and Time Matter: Effects of Emotion and Motivation on Episodic Memory Overtime.

PubMed

Sun, Qing; Gu, Simeng; Yang, Jiongjiong

2018-01-01

Previous studies have shown that compared with neutral cues, stimuli with positive and negative/stressful contexts or reward and punishment cues are remembered better. However, it is unclear whether the enhanced effect differs in emotion or motivation dimensions and the passage of time. We addressed these issues by manipulating different contextual cues for neutral words at different time intervals. In experiment 1, subjects were asked to learn words with picture contexts in positive, negative/stressful, and neutral valences and were tested by old/new word recognition and contextual judgment 10 min, 1 day, and 1 week later. In experiment 2, the reward and punishment motivations were manipulated by monetary cues during learning. Word recognition and contextual judgment were assessed 10 min, 1 day, 1 week, and 1 month after the study. Compared with negative and punishment conditions, the words in positive and reward contexts were recognized better at shorter intervals, which was associated with recollection process. In contrast, the words in negative and punishment contexts were recognized better at longer intervals, which was mainly associated with familiarity process. These results clarified how different dimensions of emotional and motivational contexts influence memory at short and long intervals and highlighted the role of contextual features in memory formation and consolidation.

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.

Frequency of depression in type 2 diabetes mellitus and an analysis of predictive factors.

PubMed

Arshad, Abdul Rehman; Alvi, Kamran Yousaf

2016-04-01

To determine frequency of depression in patients with diabetes mellitus type 2 and to identify predictive factors. The observational study was carried out at 1 Mountain Medical Battalion, Bagh, Azad Kashmir, Pakistan, from June 2013 to May 2014, and comprised type 2 diabetic patients who were not using anti-depressants and did not have history of other psychiatric illnesses. Demographic data, duration of diabetes, presence of hypertension and type of treatment were recorded and body mass index was calculated. Patient Health Questionnaire-9, translated into Urdu, was administered during face-to-face interviews. Scores >5 indicated depression, which was classified into different grades of severity using standard cut-off values. Of the 133 patients, 51(38.35%) were depressed. Depression was mild in 34(26%), moderate in 12(9.6%), moderately severe in 4(2.9%) and severe in 1(0.7%) patient. On univariate binary logistic regression, female gender (odds ratio=3.07; 95% confidence interval = 1.43, 6.59), lesser education (odds ratio = 0.90; 95% confidence interval 0.84, 0.97) shorter duration of diabetes (odds ratio=0.87; 95% confidence interval = 0.80, 0.96) and higher body mass index (odds ratio=1.41; 95% confidence interval = 1.05, 1.25) were significantly associated with depression. Only shorter duration of diabetes (odds ratio=0.90; 95% confidence interval = 0.82, 0.99) remained significant after adjustment for confounders. Age, level of education, glycaemic control and type of treatment did not predict depression. A significant proportion of type 2 diabetics were depressed. Shorter duration of diabetes reliably predicted depression in these patients.

The organizational pendulum--healthcare management in Sweden 1865-1998.

PubMed

Axelsson, R

2000-03-01

In recent years, there have been a number of large-scale changes in the organization of healthcare in Sweden, as in many other countries. From a longer time perspective, however, there has been a more or less permanent oscillation between centralization and decentralization, and also between competition and co-operation, in Swedish healthcare organizations. In fact, there seems to be something like a pendulum moving all the time between opposite forms of organization. The frequency of these changes has been increasing during the last fifteen years, as different organizational models have replaced each other at shorter and shorter intervals. This development is partly due to the increasing rate of change in modern society, but partly also due to an element of fashion in the area of management. There is, however, a growing change fatigue in many healthcare organizations, and also increasing demands for empirical evidence on the efficiency and effectiveness of different organizational models before they are introduced into the healthcare system.

Patterns of prospective memory impairment among individuals with depression: the influence of cue type and delay interval.

PubMed

Li, Yanqi Ryan; Weinborn, Michael; Loft, Shayne; Maybery, Murray

2013-07-01

The present study investigated the impact of cue type and delay interval on prospective memory performance in depressed, compared to non-depressed, individuals using a clinically relevant measure, the Memory for Intentions Screening Test. The depressed group demonstrated impaired performance on time-based, but not event-based, prospective memory tasks relative to the nondepressed group. The depressed group also demonstrated impaired prospective memory on tasks with longer delay intervals (15 min), but not on tasks with shorter delay intervals (2 min). These data support theoretical frameworks that posit that depression is associated with deficits in cognitive initiative (i.e., reduced ability to voluntarily direct attention to relevant tasks) and thus that depressed individuals are susceptible to poor performance on strategically demanding tasks. The results also raise multiple avenues for developing interventions (e.g., implementation intentions) to improve prospective memory performance among individuals with depression, with potential implications for medication and other treatment adherence.

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

Spatial memory during the tropism of maize (Zea mays L.) coleoptiles.

PubMed

Nick, P; Schafer, E

1988-09-01

Photo- or gravitropic stimulation of graminean coleoptiles involves the formation of putative tropistic transverse polarities. It had been postulated that these polarities can be extended by stabilization to developmentally active polarities. Such polarities are known from unicellular spores and zygotes of lower plants and regeneration experiments in dicotyledonous plants. In coleoptiles, photo- or gravitropic stimulation results in stability to counterstimulation of equal strength (with only transient bending in the direction of the second stimulus), as a result of a directional memory, if the time interval between both stimuli exceeds 90 min. This directional memory develops from a labile precursor, which is present from at least 20 min after induction. Once it is stable, spatial memory is conserved for many hours. The formation of spatial memory involves at least one step not present in the common tropistic transduction chain. The spatial expression of memory as curvature is restricted to three distinct responses: (i) curving in the direction of the first stimulus (for time intervals exceeding 90 min); (ii) curving in the direction of the second stimulus (for time intervals shorter than 65 min); and (iii) zero-curvature (for time intervals between 65 and 90 min). This can be interpreted in terms of a stable transverse polarity, which is not identical with the putative tropistic transverse polarity, but might be an extension of it.

Turn exchange rhythm in English dialogues

NASA Astrophysics Data System (ADS)

Fon, Janice

2005-09-01

This study looked at the relationship between rhythm and exchange type in British English, a stress-timed language, and Singaporean English, a syllable-timed language, using a spontaneous speech corpus. Exchange intervals (EIs), or the time difference between the end of one speaker and the beginning of another, were measured and exchanges of different types were labeled. Results showed that, in a dialogue, EIs were generally limited to a narrow range. However, within this range, EIs had at least four functions. First, EIs were reflective of the cognitive load and functioned as a way to differentiate various exchange types. Those requiring more cognitive resources, such as question-and-answer pairs, generally needed longer EIs than those not as cognitively loaded, such as backchanneling pairs. Second, EIs were indicative of linguistic rhythm. Singaporean English tended to have shorter EIs than British English. Third, EIs were reflective of politeness. The degree of politeness correlated negatively with EI. Shorter EIs showed a higher degree of respect. Finally, EIs were also indicative of the level of insecurity of a speaker, which was best reflected by gender differences. Females in general had longer EIs than males.

Adaptation of Timing Behavior to a Regular Change in Criterion

PubMed Central

Sanabria, Federico; Oldenburg, Liliana

2013-01-01

This study examined how operant behavior adapted to an abrupt but regular change in the timing of reinforcement. Pigeons were trained on a fixed interval (FI) 15-s schedule of reinforcement during half of each experimental session, and on an FI 45-s (Experiment 1), FI 60-s (Experiment 2), or extinction schedule (Experiment 3) during the other half. FI performance was well characterized by a mixture of two gamma-shaped distributions of responses. When a longer FI schedule was in effect in the first half of the session (Experiment 1), a constant interference by the shorter FI was observed. When a shorter FI schedule was in effect in the first half of the session (Experiments 1, 2, and 3), the transition between schedules involved a decline in responding and a progressive rightward shift in the mode of the response distribution initially centered around the short FI. These findings are discussed in terms of the constraints they impose to quantitative models of timing, and in relation to the implications for information-based models of associative learning. PMID:23962672

The effect of inter-set rest intervals on resistance exercise-induced muscle hypertrophy.

PubMed

Henselmans, Menno; Schoenfeld, Brad J

2014-12-01

Due to a scarcity of longitudinal trials directly measuring changes in muscle girth, previous recommendations for inter-set rest intervals in resistance training programs designed to stimulate muscular hypertrophy were primarily based on the post-exercise endocrinological response and other mechanisms theoretically related to muscle growth. New research regarding the effects of inter-set rest interval manipulation on resistance training-induced muscular hypertrophy is reviewed here to evaluate current practices and provide directions for future research. Of the studies measuring long-term muscle hypertrophy in groups employing different rest intervals, none have found superior muscle growth in the shorter compared with the longer rest interval group and one study has found the opposite. Rest intervals less than 1 minute can result in acute increases in serum growth hormone levels and these rest intervals also decrease the serum testosterone to cortisol ratio. Long-term adaptations may abate the post-exercise endocrinological response and the relationship between the transient change in hormonal production and chronic muscular hypertrophy is highly contentious and appears to be weak. The relationship between the rest interval-mediated effect on immune system response, muscle damage, metabolic stress, or energy production capacity and muscle hypertrophy is still ambiguous and largely theoretical. In conclusion, the literature does not support the hypothesis that training for muscle hypertrophy requires shorter rest intervals than training for strength development or that predetermined rest intervals are preferable to auto-regulated rest periods in this regard.

Shorter spontaneous fixation durations in infants with later emerging autism

PubMed Central

Wass, Sam V.; Jones, Emily J. H.; Gliga, Teodora; Smith, Tim J.; Charman, Tony; Johnson, Mark H.; Baron-Cohen, Simon; Bedford, Rachael; Bolton, Patrick; Chandler, Susie; Davies, Kim; Fernandes, Janice; Garwood, Holly; Hudry, Kristelle; Maris, Helen; Pasco, Greg; Pickles, Andrew; Ribiero, Helena; Tucker, Leslie; Volein, Agnes

2015-01-01

Little is known about how spontaneous attentional deployment differs on a millisecond-level scale in the early development of autism spectrum disorders (ASD). We measured fine-grained eye movement patterns in 6-to 9-month-old infants at high or low familial risk (HR/LR) of ASD while they viewed static images. We observed shorter fixation durations (i.e. the time interval between saccades) in HR than LR infants. Preliminary analyses indicate that these results were replicated in a second cohort of infants. Fixation durations were shortest in those infants who went on to receive an ASD diagnosis at 36 months. While these findings demonstrate early-developing atypicality in fine-grained measures of attentional deployment early in the etiology of ASD, the specificity of these effects to ASD remains to be determined. PMID:25655672

Associations of Accelerometer-Measured and Self-Reported Sedentary Time With Leukocyte Telomere Length in Older Women

PubMed Central

Shadyab, Aladdin H.; Macera, Caroline A.; Shaffer, Richard A.; Jain, Sonia; Gallo, Linda C.; LaMonte, Michael J.; Reiner, Alexander P.; Kooperberg, Charles; Carty, Cara L.; Di, Chongzhi; Manini, Todd M.; Hou, Lifang; LaCroix, Andrea Z.

2017-01-01

Abstract Few studies have assessed the association of sedentary time with leukocyte telomere length (LTL). In a cross-sectional study conducted in 2012–2013, we examined associations of accelerometer-measured and self-reported sedentary time with LTL in a sample of 1,481 older white and African-American women from the Women's Health Initiative and determined whether associations varied by level of moderate- to vigorous-intensity physical activity (MVPA). The association between sedentary time and LTL was evaluated using multiple linear regression models. Women were aged 79.2 (standard deviation, 6.7) years, on average. Self-reported sedentary time was not associated with LTL. In a model adjusting for demographic characteristics, lifestyle behaviors, and health-related factors, among women at or below the median level of accelerometer-measured MVPA, those in the highest quartile of accelerometer-measured sedentary time had significantly shorter LTL than those in the lowest quartile, with an average difference of 170 base pairs (95% confidence interval: 4, 340). Accelerometer-measured sedentary time was not associated with LTL in women above the median level of MVPA. Findings suggest that, on the basis of accelerometer measurements, higher sedentary time may be associated with shorter LTL among less physically active women. PMID:28100466

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.

Three Dimensional Structure and Time Development of Radio Emission from Solar Active Regions.

DTIC Science & Technology

1983-01-15

8217 surrounded by a weaker unpolarized halo whose angular extent ranges between 5’ and 9’. The bright (106K) sunspot-associated cores, which were intepreted in...shorter intervals. Examination of the He film indicates that the dominant He emission was stable for periods of at least six hours. Figure 8 and 9 also...the cool loops and may occupy a substantial fraction of the region above sunspots. This intepretation has, in fact, been supported by the model of

Behavioral regulation of gravity: schedule effects under escape-avoidance procedures1

PubMed Central

Clark, Fogle C.; Lange, Karl O.; Belleville, Richard E.

1973-01-01

Squirrel monkeys were restrained in a centrifuge capsule and trained to escape and avoid increases in artificial gravity. During escape-avoidance, lever responses reduced centrifugally simulated gravity or postponed scheduled increases. The effect of variation in the interval of postponement (equal to the duration of decrease produced by escape responses) was studied under a multiple schedule of four components. Three components were gravity escape-avoidance with postponement times of 20, 40, and 60 sec. The fourth component was extinction. Each component was associated with a different auditory stimulus. Rate of responding decreased with increasing postponement time and higher mean g-levels occurred at shorter intervals of postponement. Effects of the schedule parameter on response rate and mean g-level were similar to effects of the schedule on free-operant avoidance and on titration behavior maintained by shock. ImagesFig. 1. PMID:4202386

Heart retransplantation: a 23-year single-center clinical experience.

PubMed

Schnetzler, B; Pavie, A; Dorent, R; Camproux, A C; Leger, P; Delcourt, A; Gandjbakhch, I

1998-04-01

The main causes of allograft failure after cardiac transplantation are primary graft dysfunction, intractable acute rejection, and coronary graft disease. Despite the important progress in the last several years in graft preservation, surgical techniques, immunosuppression, and treatment of coronary graft disease, retransplantation in selected cases is the only way to achieve long-term recipient survival. We compare here in a case-control study 24 retransplantations with 47 first transplants in patients matched for date of transplantation. Between 1973 and 1996, 1,063 patients underwent cardiac transplantation in our institution. In this cohort, 22 patients had a total of 24 retransplantations (2 second-time retransplantations). The causes of retransplantations were primary graft failure (n=4), acute rejection (n=7), coronary graft disease (n=11), and miscellaneous (n=2). Survival at 1 and 5 years of patients with retransplantations is 45.5% and 31.2%, and survival of control patients is 59.4% and 38.8% (p=0.07). An interval between first transplantation and retransplantation shorter (n=11) or longer (n=13) than 1 year is associated with a 1-year survival of 27.3% and 61.5% and a 4-year survival of 27.3% and 46%, respectively (not significant). Intervals shorter than 1 year between first transplantation and retransplantation were exclusively secondary to primary graft failure or intractable acute rejection. In the face of lack of donor grafts, these and other data indicate that retransplantation should be considered cautiously, especially when the interval between the first transplantation and retransplantation is short.

Trading Speed and Accuracy by Coding Time: A Coupled-circuit Cortical Model

PubMed Central

Standage, Dominic; You, Hongzhi; Wang, Da-Hui; Dorris, Michael C.

2013-01-01

Our actions take place in space and time, but despite the role of time in decision theory and the growing acknowledgement that the encoding of time is crucial to behaviour, few studies have considered the interactions between neural codes for objects in space and for elapsed time during perceptual decisions. The speed-accuracy trade-off (SAT) provides a window into spatiotemporal interactions. Our hypothesis is that temporal coding determines the rate at which spatial evidence is integrated, controlling the SAT by gain modulation. Here, we propose that local cortical circuits are inherently suited to the relevant spatial and temporal coding. In simulations of an interval estimation task, we use a generic local-circuit model to encode time by ‘climbing’ activity, seen in cortex during tasks with a timing requirement. The model is a network of simulated pyramidal cells and inhibitory interneurons, connected by conductance synapses. A simple learning rule enables the network to quickly produce new interval estimates, which show signature characteristics of estimates by experimental subjects. Analysis of network dynamics formally characterizes this generic, local-circuit timing mechanism. In simulations of a perceptual decision task, we couple two such networks. Network function is determined only by spatial selectivity and NMDA receptor conductance strength; all other parameters are identical. To trade speed and accuracy, the timing network simply learns longer or shorter intervals, driving the rate of downstream decision processing by spatially non-selective input, an established form of gain modulation. Like the timing network's interval estimates, decision times show signature characteristics of those by experimental subjects. Overall, we propose, demonstrate and analyse a generic mechanism for timing, a generic mechanism for modulation of decision processing by temporal codes, and we make predictions for experimental verification. PMID:23592967

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

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

The steady part of the secular variation of the Earth's magnetic field

NASA Technical Reports Server (NTRS)

Bloxham, Jeremy

1992-01-01

The secular variation of the Earth's magnetic field results from the effects of magnetic induction in the fluid outer core and from the effects of magnetic diffusion in the core and the mantle. Adequate observations to map the magnetic field at the core-mantle boundary extend back over three centuries, providing a model of the secular variation at the core-mantle boundary. Here we consider how best to analyze this time-dependent part of the field. To calculate steady core flow over long time periods, we introduce an adaptation of our earlier method of calculating the flow in order to achieve greater numerical stability. We perform this procedure for the periods 1840-1990 and 1690-1840 and find that well over 90 percent of the variance of the time-dependent field can be explained by simple steady core flow. The core flows obtained for the two intervals are broadly similar to each other and to flows determined over much shorter recent intervals.

Association between gestational age and induction-to-abortion interval in mid-trimester pregnancy termination using misoprostol.

PubMed

Vitner, Dana; Deutsch, Michael; Paz, Yuri; Khatib, Nizar; Baltiter, Tania; Rosenberg, Shiran; Lowenstein, Lior

2011-06-01

The study was aimed to evaluate the effectiveness, outcome, and pain intensity of the vaginal administration of misoprostol for the induction of abortion between 13 and 24 gestational weeks. A retrospective study was conducted at our tertiary medical center from January 2006 to December 2009 on 122 consecutive women who underwent termination of pregnancy (TOP) in the mid-trimester. They were given 400 mcg of vaginal misoprostol every 6h, up to four doses. The induction-to-abortion interval and the level of pain experienced during the process were assessed. Success was defined by the fetus being expelled within 48 h. Vaginal misoprostol was effective in 84% (98/122) of patients. The median duration of the induction-to-abortion interval was 16 (5-48)h. The induction-to-abortion interval was correlated with gestational age, while inversely correlated with parity. A correlation was also found between gestational age and pain intensity at 12h from induction. Misoprostol is safe and effective in mid-trimester abortion induction. The induction-to-abortion interval is shorter and abortion less painful with lower gestational age. Higher parity is also associated with shorter induction to abortion interval. Copyright © 2011. Published by Elsevier Ireland Ltd.

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.

Analysis of the Factors Affecting the Interval between Blood Donations Using Log-Normal Hazard Model with Gamma Correlated Frailties.

PubMed

Tavakol, Najmeh; Kheiri, Soleiman; Sedehi, Morteza

2016-01-01

Time to donating blood plays a major role in a regular donor to becoming continues one. The aim of this study was to determine the effective factors on the interval between the blood donations. In a longitudinal study in 2008, 864 samples of first-time donors in Shahrekord Blood Transfusion Center,  capital city of Chaharmahal and Bakhtiari Province, Iran were selected by a systematic sampling and were followed up for five years. Among these samples, a subset of 424 donors who had at least two successful blood donations were chosen for this study and the time intervals between their donations were measured as response variable. Sex, body weight, age, marital status, education, stay and job were recorded as independent variables. Data analysis was performed based on log-normal hazard model with gamma correlated frailty. In this model, the frailties are sum of two independent components assumed a gamma distribution. The analysis was done via Bayesian approach using Markov Chain Monte Carlo algorithm by OpenBUGS. Convergence was checked via Gelman-Rubin criteria using BOA program in R. Age, job and education were significant on chance to donate blood (P<0.05). The chances of blood donation for the higher-aged donors, clericals, workers, free job, students and educated donors were higher and in return, time intervals between their blood donations were shorter. Due to the significance effect of some variables in the log-normal correlated frailty model, it is necessary to plan educational and cultural program to encourage the people with longer inter-donation intervals to donate more frequently.

Evaluation of timings and outcomes in category-one caesarean sections: A retrospective cohort study

PubMed Central

Dunn, Clare Newton; Zhang, Qianpian; Sia, Josh Tjunrong; Assam, Pryseley Nkouibert; Tagore, Shephali; Sng, Ban Leong

2016-01-01

Background and Aims: A decision-to-delivery interval (DDI) of 30 min for category-one caesarean section (CS) deliveries is the standard of practice recommended by clinical guidelines. Our institution established a protocol for category-one (‘crash’) CS to expedite deliveries. The aim of this study is to evaluate DDI, factors that affect DDI and the mode of anaesthesia for category-one CS. Methods: This retrospective cohort study evaluated 390 women who underwent category-one CS in a tertiary obstetric centre. We analysed the factors associated with DDI, mode of anaesthesia and perinatal outcomes. Summary statistics were performed for the outcomes. The association factors were considered significant at P < 0.05. Results: The mean (standard deviation) DDI was 9.4 (3.2) min with all deliveries achieved within 30 min. The longest factor in the DDI was time taken to transfer patients. A shorter DDI was not significantly associated with improved perinatal outcomes. The majority (88.9%) of women had general anaesthesia (GA) for category-one CS. Of those who had an epidural catheter already in situ (34.4%), 25.6% had successful epidural extension. GA was associated with shorter DDI, but worse perinatal outcomes than regional anaesthesia (RA). Conclusions: Our ‘crash’ CS protocol achieved 100% of deliveries within 30 min. The majority (88.9%) of the patients had GA for category-one CS. GA was found to be associated with shorter anaesthesia and operation times, but poorer perinatal outcomes compared to RA. PMID:27601736

Role of enamel deminerlization and remineralization on microtensile bond strength of resin composite.

PubMed

Rizvi, Abbas; Zafar, Muhammad S; Al-Wasifi, Yasser; Fareed, Wamiq; Khurshid, Zohaib

2016-01-01

This study is aimed to establish the microtensile bond strength of enamel following exposure to an aerated drink at various time intervals with/without application of remineralization agent. In addition, degree of remineralization and demineralization of tooth enamel has been assessed using polarized light microscopy. Seventy extracted human incisors split into two halves were immersed in aerated beverage (cola drink) for 5 min and stored in saliva until the time of microtensile bond testing. Prepared specimens were divided randomly into two study groups; remineralizing group (n = 70): specimens were treated for remineralization using casein phosphopeptides and amorphous calcium phosphate (CPP-ACP) remineralization agent (Recaldent™; GC Europe) and control group (n = 70): no remineralization treatment; specimens were kept in artificial saliva. All specimens were tested for microtensile bond strength at regular intervals (1 h, 1 days, 2 days, 1 week, and 2 weeks) using a universal testing machine. The results statistically analyzed (P = 0.05) using two-way ANOVA test. Results showed statistically significant increase in bond strength in CPP-ACP tested group (P < 0.05) at all-time intervals. The bond strength of remineralizing group samples at 2 days (~13.64 megapascals [MPa]) is comparable to that of control group after 1 week (~12.44 MPa). CPP-ACP treatment of teeth exposed to an aerated drink provided significant increase in bond strength at a shorter interval compared to teeth exposed to saliva alone.

Impact of a radio frequency management information system on the process and timing of providing respiratory care services.

PubMed

Stoller, James K; Kester, Lucy; Orens, Douglas K; McCarthy, Kevin

2002-08-01

Although radio frequency (RF) systems have proliferated and are designed to simplify care delivery in many clinical settings, little information is available on the impact of such RF systems on the delivery of patient care. Having used a hand-held-device-based management information system in our Respiratory Therapy Section for 16 years, we assessed the impact of an RF system on the delivery of respiratory therapy (RT) services. A single nursing unit dedicated to pulmonary and ear, nose, and throat care was selected for the RF system trial. Baseline (pre-RF) data were collected over 2 separate 1-month intervals (February 1999 and February 2000). The main outcome measures were (1) the amount of time needed at the beginning of the shift to organize and assign orders for RT services, (2) the time interval between notification of an RT consult order and completion of the RT consult, and (3) the time interval between notification of an RT treatment order and completion of the RT treatment. The activities required for organizing and assigning the orders were manually timed. Starting 6 weeks after therapists were trained to use the RF system, similar data were collected while using the RF system for two 1-month intervals (February and March 2001). The mean +/- SD time interval between receiving an RT consult order and completing the consult was reduced from 7.8 +/- 18.9 h to 2.8 +/- 2.4 h (p = 0.002). The percentage of patients who waited longer than 8 hours between receipt of a consult order and completion of the consult decreased from 18% to 4.7% (p = 0.026). The total time required for organizing and assigning RT work was reduced from 81.6 min to 43.6 min. The RF system had several advantages over the hand-held-device-based system: (1) shorter interval between the order for and completion of an RT consult, (2) lower percentage of patients for whom the interval between the order and the consult exceeded 8 hours, and (3) less time required to make shift assignments. These results invite assessment of whether accelerated delivery of RT services confers clinical benefits.

Association of time-to-surgery with outcomes in clinical stage I-II pancreatic adenocarcinoma treated with upfront surgery.

PubMed

Swords, Douglas S; Zhang, Chong; Presson, Angela P; Firpo, Matthew A; Mulvihill, Sean J; Scaife, Courtney L

2018-04-01

Time-to-surgery from cancer diagnosis has increased in the United States. We aimed to determine the association between time-to-surgery and oncologic outcomes in patients with resectable pancreatic ductal adenocarcinoma undergoing upfront surgery. The 2004-2012 National Cancer Database was reviewed for patients undergoing curative-intent surgery without neoadjuvant therapy for clinical stage I-II pancreatic ductal adenocarcinoma. A multivariable Cox model with restricted cubic splines was used to define time-to-surgery as short (1-14 days), medium (15-42), and long (43-120). Overall survival was examined using Cox shared frailty models. Secondary outcomes were examined using mixed-effects logistic regression models. Of 16,763 patients, time-to-surgery was short in 34.4%, medium in 51.6%, and long in 14.0%. More short time-to-surgery patients were young, privately insured, healthy, and treated at low-volume hospitals. Adjusted hazards of mortality were lower for medium (hazard ratio 0.94, 95% confidence interval, .90, 0.97) and long time-to-surgery (hazard ratio 0.91, 95% confidence interval, 0.86, 0.96) than short. There were no differences in adjusted odds of node positivity, clinical to pathologic upstaging, being unresectable or stage IV at exploration, and positive margins. Medium time-to-surgery patients had higher adjusted odds (odds ratio 1.11, 95% confidence interval, 1.03, 1.20) of receiving an adequate lymphadenectomy than short. Ninety-day mortality was lower in medium (odds ratio 0.75, 95% confidence interval, 0.65, 0.85) and long time-to-surgery (odds ratio 0.72, 95% confidence interval, 0.60, 0.88) than short. In this observational analysis, short time-to-surgery was associated with slightly shorter OS and higher perioperative mortality. These results may suggest that delays for medical optimization and referral to high volume surgeons are safe. Published by Elsevier Inc.

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.

Time from cervical conization to pregnancy and preterm birth.

PubMed

Himes, Katherine P; Simhan, Hyagriv N

2007-02-01

To estimate whether the time interval between cervical conization and subsequent pregnancy is associated with risk of preterm birth. Our study is a case control study nested in a retrospective cohort. Women who underwent colposcopic biopsy or conization with loop electrosurgical excision procedure, large loop excision of the transformation zone, or cold knife cone and subsequently delivered at our hospital were identified with electronic databases. Variables considered as possible confounders included maternal race, age, marital status, payor status, years of education, self-reported tobacco use, history of preterm delivery, and dimensions of cone specimen. Conization was not associated with preterm birth or any subtypes of preterm birth. Among women who underwent conization, those with a subsequent preterm birth had a shorter conization-to-pregnancy interval (337 days) than women with a subsequent term birth (581 days) (P=.004). The association between short conization-to-pregnancy interval and preterm birth remained significant when controlling for confounders including race and cone dimensions. The effect of short conization-to-pregnancy interval on subsequent preterm birth was more persistent among African Americans when compared with white women. Women with a short conization-to-pregnancy interval are at increased risk for preterm birth. Women of reproductive age who must have a conization procedure can be counseled that conceiving within 2 to 3 months of the procedure may be associated with an increased risk of preterm birth. II.

The effect of socio-economic status and food availability on first birth interval in a pre-industrial human population

PubMed Central

Nenko, Ilona; Hayward, Adam D.; Lummaa, Virpi

2014-01-01

Individual variation in nutritional status has direct implications for fitness and thus is crucial in shaping patterns of life-history variation. Nevertheless, it is difficult to measure in natural populations, especially in humans. Here, we used longitudinal data on individual life-histories and annual crop yield variation collected from pre-industrial Finnish populations experiencing natural mortality and fertility to test the validity of first birth interval (FBI; time between marriage and first birth) as a surrogate measure of nutritional status. We evaluated whether women with different socio-economic groups differ in length of FBI, whether women of poorer socio-economic status and experiencing lower crop yields conceive slower following marriage, and whether shorter FBI is associated with higher lifetime breeding success. We found that poorer women had longer FBI and reduced probability of giving birth in months with low food availability, while the FBI of richer women was not affected by variation in food availability. Women with shorter FBI achieved higher lifetime breeding success and a faster reproductive rate. This is, to our knowledge, the first study to show a direct relationship between environmental conditions and speed of childbirth following marriage, highlighting the value of FBI as an indicator of nutritional status when direct data are lacking. PMID:24285194

The effect of socio-economic status and food availability on first birth interval in a pre-industrial human population.

PubMed

Nenko, Ilona; Hayward, Adam D; Lummaa, Virpi

2014-01-22

Individual variation in nutritional status has direct implications for fitness and thus is crucial in shaping patterns of life-history variation. Nevertheless, it is difficult to measure in natural populations, especially in humans. Here, we used longitudinal data on individual life-histories and annual crop yield variation collected from pre-industrial Finnish populations experiencing natural mortality and fertility to test the validity of first birth interval (FBI; time between marriage and first birth) as a surrogate measure of nutritional status. We evaluated whether women with different socio-economic groups differ in length of FBI, whether women of poorer socio-economic status and experiencing lower crop yields conceive slower following marriage, and whether shorter FBI is associated with higher lifetime breeding success. We found that poorer women had longer FBI and reduced probability of giving birth in months with low food availability, while the FBI of richer women was not affected by variation in food availability. Women with shorter FBI achieved higher lifetime breeding success and a faster reproductive rate. This is, to our knowledge, the first study to show a direct relationship between environmental conditions and speed of childbirth following marriage, highlighting the value of FBI as an indicator of nutritional status when direct data are lacking.

Time frequency requirements for radio interferometric earth physics

NASA Technical Reports Server (NTRS)

Thomas, J. B.; Fliegel, H. F.

1973-01-01

Two systems of VLBI (Very Long Baseline Interferometry) are now applicable to earth physics: an intercontinental baseline system using antennas of the NASA Deep Space Network, now observing at one-month intervals to determine UTI for spacecraft navigation; and a shorter baseline system called ARIES (Astronomical Radio Interferometric Earth Surveying), to be used to measure crustal movement in California for earthquake hazards estimation. On the basis of experience with the existing DSN system, a careful study has been made to estimate the time and frequency requirements of both the improved intercontinental system and of ARIES. Requirements for the two systems are compared and contrasted.

Non-random temporary emigration and the robust design: Conditions for bias at the end of a time series: Section VIII

USGS Publications Warehouse

Langtimm, Catherine A.

2008-01-01

Knowing the extent and magnitude of the potential bias can help in making decisions as to what time frame provides the best estimates or the most reliable opportunity to model and test hypotheses about factors affecting survival probability. To assess bias, truncating the capture histories to shorter time frames and reanalyzing the data to compare time-specific estimates may help identify spurious effects. Running simulations that mimic the parameter values and movement conditions in the real situation can provide estimates of standardized bias that can be used to identify those annual estimates that are biased to the point where the 95% confidence intervals are inadequate in describing the uncertainty of the estimates.

A risk/cost analysis of alternative screening intervals for occupational tuberculosis infection.

PubMed

Nicas, M

1998-02-01

The Centers for Disease Control and Prevention (CDC) recommends that new health care employees receive a baseline skin test for Mycobacterium tuberculosis (M. tb) infection and that testing be repeated periodically. However, CDC does not explain the quantitative basis for its suggested screening intervals. This article examines the efficacy of alternative screening intervals for workers subject to different annual rates of M. tb infection and estimates the costs. An equation is developed for the cumulative risk of tuberculosis (TB) at 12 years given a specified annual rate of infection (ARI), screening interval, and a combined proportion (p) of successful skin testing and antibiotic prophylaxis. Equations for total cost of screening and cost per disease case prevented are provided. Results assume: (a) costs of $10 per skin test and $10,000 per TB disease case; (b) p = 0.88; and (c) and acceptable cumulative TB risk of 1 per 1000. For ARIs that might be deemed low (0.2% to 0.5%) and medium (1%), CDC screening intervals of 12 months and 6-12 months, respectively, minimize the cost per disease case prevented but permit residual disease risks greater than 1 per 1000. Recommended screening intervals are (i) 6 months for low-risk employee groups and (ii) 3 months for medium- and high-risk (e.g., ARIs of > or = 5%) groups. Interval (i) limits risk to 1 per 1000 and is approximately 50% shorter than the CDC interval for a low-risk group. Interval (ii), which is 67% shorter than the CDC interval for medium-risk groups but equal to that recommended for high-risk groups, permits a risk above 1 per 1000, but is likely the shortest feasible interval.

Infant Temperament: Stability by Age, Gender, Birth Order, Term Status, and SES

PubMed Central

Bornstein, Marc H.; Putnick, Diane L.; Gartstein, Maria A.; Hahn, Chun-Shin; Auestad, Nancy; O’Connor, Deborah L.

2015-01-01

Two complementary studies focused on stability of infant temperament across the first year and considered infant age, gender, birth order, term status, and socioeconomic status (SES) as moderators. Study 1 consisted of 73 mothers of firstborn term girls and boys queried at 2, 5, and 13 months of age. Study 2 consisted of 335 mothers of infants of different gender, birth order, term status, and SES queried at 6 and 12 months. Consistent positive and negative affectivity factors emerged at all time-points across both studies. Infant temperament proved stable and robust across gender, birth order, term status, and SES. Stability coefficients for temperament factors and scales were medium to large for shorter (<9 months) inter-assessment intervals and small to medium for longer (>10 months) intervals. PMID:25865034

Short-Duration Spaceflight Does Not Prolong QTc Intervals in Male Astronauts

NASA Technical Reports Server (NTRS)

Mitchell, Brett M.; Meck, Janice V.

2004-01-01

Although ventricular dysrhythmias are not increased during, and QTc intervals are not prolonged after, short-duration (5 to 16 days) spaceflights, QTc intervals have not previously been reported during these shorter flights. Holter monitor recordings, obtained in 11 male astronauts who flew on shuttle missions ranging from 5 to 10 days, showed that QTc intervals did not change significantly 10 days before launch, on 2 separate days of spaceflight, and 2 days after landing. Taken together, these data and our previous report show that QTc interval prolongation occurs sometime between the 9th and 30th days of spaceflight.

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

Response interval comparison between urban fire departments and ambulance services.

PubMed

Jermyn, B D

1999-01-01

To measure the response intervals of fire departments compared with ambulance services in three urban centers to determine whether defibrillators should be added to fire vehicles. A prospective sample of 1,882 code 4 (life-threatening) tiered calls were collected over a six-month period from March 1, 1994, to August 31, 1994. A matched pairs experimental design compared the response interval of the fire department with that of the ambulance service for each call. This emergency medical services (EMS) system encompasses three urban centers with populations of 80,000, 95,000, and 170,000. In two of three of the urban centers, the fire department arrived on scene more than a minute sooner than the ambulance service: Cambridge (n = 571, mean = 2.22 min, p < 0.0001); Kitchener (n = 1,011, mean = 1.24 min, p < 0.003); and Waterloo (n = 300, mean = 0.69 min, p < 0.98). The shorter response interval of fire departments suggests placing defibrillators on fire response vehicles in an effort to decrease the time to defibrillation for cardiac arrest victims in this EMS system.

Effect of Right Ventricular versus Biventricular Pacing on Electrical Remodeling in the Normal Heart

PubMed Central

Saba, Samir; Mehdi, Haider; Mathier, Michael A.; Islam, M. Zahadul; Salama, Guy; London, Barry

2010-01-01

Background Biventricular (BIV) pacing can improve cardiac function in heart failure by altering the mechanical and electrical substrates. We investigated the effect of BIV versus right ventricular (RV) pacing on the normal heart. Methods and Results Male New Zealand White rabbits (n=33) were divided into 3 groups: sham-operated (control), RV pacing, and BIV pacing groups. Four weeks after surgery, the native QT (p=0.004) interval was significantly shorter in the BIV group compared to the RV or sham-operated groups. Also, compared to rabbits in the RV group, rabbits in the BIV group had shorter RV ventricular effective refractory period (VERP) at all cycle lengths, and shorter LV paced QT interval during the drive train of stimuli and close to refractoriness (p<0.001 for all comparisons). Protein expression of the KVLQT1 was significantly increased in the BIV group compared to the RV and control groups, while protein expression of SCN5A and connexin43 was significantly decreased in the RV compared to the other study groups. Erg protein expression was significantly increased in both pacing groups compared to the controls. Conclusions In this rabbit model, we demonstrate a direct effect of BIV but not RV pacing on shortening the native QT interval as well as the paced QT interval during burst pacing and close to the VERP. These findings underscore the fact that the effect of BIV pacing is partially mediated through direct electrical remodeling and may have implications as to the effect of BIV pacing on arrhythmia incidence and burden. PMID:20042767

Modeling and quantification of repolarization feature dependency on heart rate.

PubMed

Minchole, A; Zacur, E; Pueyo, E; Laguna, P

2014-01-01

This article is part of the Focus Theme of Methods of Information in Medicine on "Biosignal Interpretation: Advanced Methods for Studying Cardiovascular and Respiratory Systems". This work aims at providing an efficient method to estimate the parameters of a non linear model including memory, previously proposed to characterize rate adaptation of repolarization indices. The physiological restrictions on the model parameters have been included in the cost function in such a way that unconstrained optimization techniques such as descent optimization methods can be used for parameter estimation. The proposed method has been evaluated on electrocardiogram (ECG) recordings of healthy subjects performing a tilt test, where rate adaptation of QT and Tpeak-to-Tend (Tpe) intervals has been characterized. The proposed strategy results in an efficient methodology to characterize rate adaptation of repolarization features, improving the convergence time with respect to previous strategies. Moreover, Tpe interval adapts faster to changes in heart rate than the QT interval. In this work an efficient estimation of the parameters of a model aimed at characterizing rate adaptation of repolarization features has been proposed. The Tpe interval has been shown to be rate related and with a shorter memory lag than the QT interval.

Assimilation and biological turnover of cesium-134, iodine-131, and chromium-51 in brown crickets, Acheta domesticus (L. )

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

Van Hook, R.I. Jr.; Crossley, D.A. Jr.

1969-01-01

Understanding of radionuclide accumulation by insects requires careful assessment of assimilation and turnover rates. In separate experiments, three radionuclides (/sup 134/Cs, /sup 131/I or /sup 51/Cr) were fed to adult brown crickets for a 24-hr period. The insects were then transferred to nonradioactive food and their whole-body retention measured at 1-hr intervals. The retention of each radionuclide can be described by a sum of two exponential functions, a shorter one related to loss of unassimilated radionuclide from the gut and a longer one describing excretion of assimilated radionuclide from tissues. The shorter components had similar rates (half-time = about 4more » hr) for all three radionuclides, indicating that they were a measure of gut clearance time. Chromium had the lowest assimilation (6%) and cesium the highest (65%). Assimilated /sup 134/Cs and /sup 51/Cr were eliminated at moderate rates (biological half-lives of 62 and 83 hr, respectively) but assimilated /sup 131/I was stored rather than excreted. 18 references, 2 figures, 1 table.« less

Neural substrates of time perception and impulsivity

PubMed Central

Wittmann, Marc; Simmons, Alan N.; Flagan, Taru; Lane, Scott D.; Wackermann, Jiří; Paulus, Martin P.

2011-01-01

Several studies provide empirical evidence for the association between impulsivity and time perception. However, little is known about the neural substrates underlying this function. This investigation examined the influence of impulsivity on neural activation patterns during the encoding and reproduction of intervals with durations of 3, 9 and 18 seconds using event-related functional magnetic resonance imaging (fMRI). Twenty-seven subjects participated in this study, including 15 high impulsive subjects that were classified based on their self-rating. FMRI activation during the duration reproduction task was correlated with measures of two self-report questionnaires related to the concept of impulsivity (Barratt Impulsiveness Scale, BIS; Zimbardo Time Perspective Inventory, ZTPI). Behaviorally, those individuals who under-reproduced temporal intervals also showed lower scores on the ZTPI future perspective subscale and higher scores on the BIS. FMRI activation revealed an accumulating pattern of neural activity peaking at the end of the 9- and 18-s interval within right posterior insula. Activations of brain regions during the reproduction phase of the timing task, such as those related to motor execution as well as to the ‘core control network’ – encompassing the inferior frontal and medial frontal cortex, the anterior insula as well as the inferior parietal cortex – were significantly correlated with reproduced duration, as well as with BIS and ZTPI subscales. In particular, the greater activation in these regions the shorter were the reproduced intervals, the more impulsive was an individual and the less pronounced the future perspective. Activation in the core control network, thus, may form a biological marker for cognitive time management and for impulsiveness. PMID:21763642

Comparison between the Effects of Rocuronium, Vecuronium, and Cisatracurium Using Train-of-Four and Clinical Tests in Elderly Patients

PubMed Central

Sagir, Ozlem; Yucesoy Noyan, Funda; Koroglu, Ahmet; Cicek, Muslum; Ilksen Toprak, Huseyin

2013-01-01

Background Postoperative residual blockade, longer duration of action for neuromuscular blockade, and slower recovery were relatively common in elderly patients. Objectives We aimed to investigate the safety of train-of-four ratio and clinical tests in the assessment of patient recovery, and to determine the effects of the rocuronium, vecuronium, and cisatracurium on intubation, extubation and recovery times in elderly patients undergoing abdominal surgery. Patients and Methods After obtaining institutional approval and informed consent, 60 patients over 60 years old and undergoing elective abdominal operations were included in this double-blind, randomized clinical trial. Following a standard anesthesia induction, 0.6mg kg-1 rocuronium, 0.1mg kg-1 vecuronium, and 0.1mg kg-1 cisatracurium were administered to the patients in Group R, Group V, and Group C, respectively. Train-of-four (TOF) ratios were recorded at 10-minute intervals during and after the operation. Modified Aldrete Score (MAS) and clinical tests were recorded in the recovery room at 10-minute intervals. In addition, intubation and extubation times, duration of recovery room stay, and any complications were recorded. Results Intubation time was found to be shorter in Group R than that in Groups V and C (P ˂ 0.001). Times to positive visual disturbances and grip strength tests were shorter in Group C than that in Group V (P = 0.016 and P = 0.011, respectively). In Group R and group C, time to TOF ≥ 0.9 was significantly longer than all positive clinical test times except grip strength (P < 0.05). Conclusions We hold the opinion that cisatracurium is safer in elderly patients compared to other drugs. We also concluded that the usage of TOF ratio together with clinical tests is suitable for assessment of neuromuscular recovery in these patients. PMID:24223350

An investigation of a hypothermic to ischemic ratio in patients following out-of-hospital cardiac arrest presenting with a shockable rhythm.

PubMed

Sawyer, Kelly N; Kurz, Michael C; Elswick, R K

2014-06-01

Targeted temperature management (TTM) improves outcome after out-of-hospital cardiac arrest (OHCA). We hypothesized that there may be a significant relationship between the dose of hypothermia, the time to return of spontaneous circulation (ROSC), and survival to discharge. Retrospective pilot investigation on 99 consecutive OHCA patients with initial shockable rhythm, surviving to admission, and undergoing TTM between 2008 and 2011. Dose of hypothermia was defined as the sum of the induction interval (time to target temperature [from ROSC to 33°C]); the controlled hypothermia interval (from reaching 33°C until rewarming); and the rewarming interval (from 33°C to 37°C). Time to ROSC was measured from pulselessness or 911 call time to ROSC. The ratio between the two was termed the hypothermic to ischemic ratio. Purposeful variable selection for logistic regression modeling was used to assess the influence of the hypothermic/ischemic ratio on survival. Odds ratios (OR) were used to examine the effects of predictor variables on survival. Of 99 patients, eight were excluded for deviation from protocol, death during protocol, or missing data. From the univariate models, survivors were more likely to be younger, have a shorter time to ROSC, and have a larger hypothermic/ischemic ratio. Survivors also had a nonsignificant trend toward a longer time to target temperature. In multivariable modeling, the hypothermic/ischemic ratio was the most significant predictor for survival (OR 2.161 [95% confidence interval 1.371, 3.404]). In this pilot study, the hypothermic to ischemic ratio was significantly associated with survival to discharge for patients with an initial shockable rhythm. Further investigation of the relationship between the dose of hypothermia and time to ROSC for postresuscitation TTM is needed.

HIV Intertest Interval among MSM in King County, Washington

PubMed Central

Katz, David A.; Dombrowski, Julia C.; Swanson, Fred; Buskin, Susan; Golden, Matthew R.; Stekler, Joanne D.

2012-01-01

OBJECTIVES We examined temporal trends and correlates of HIV testing frequency among men who have sex with men (MSM) in King County, WA. METHODS We evaluated data from MSM testing for HIV at the Public Health - Seattle & King County (PHSKC) STD Clinic and Gay City Health Project (GCHP) and testing history data from MSM in PHSKC HIV surveillance. The intertest interval (ITI) was defined as the number of days between the last negative HIV test and the current testing visit or first positive test. Correlates of the log10-transformed ITI were determined using GEE linear regression. RESULTS Between 2003 and 2010, the median ITI among MSM seeking HIV testing at the STD Clinic and GCHP were 215 (IQR: 124–409) and 257 (IQR: 148–503) days, respectively. In multivariate analyses, younger age, having only male partners, and reporting ≥10 male sex partners in the last year were associated with shorter ITIs at both testing sites (p<0.05). Among GCHP attendees, having a regular healthcare provider, seeking a test as part of a regular schedule, and inhaled nitrite use in the last year were also associated with shorter ITIs (p<0.001). Compared to MSM testing HIV-negative, MSM newly diagnosed with HIV had longer ITIs at the STD Clinic (median of 213 versus 278 days; p=0.01) and GCHP (median 255 versus 359 days; p=0.02). CONCLUSIONS Although MSM in King County appear to be testing at frequent intervals, further efforts are needed to reduce the time that HIV-infected persons are unaware of their status. PMID:22563016

HIV intertest interval among MSM in King County, Washington.

PubMed

Katz, David A; Dombrowski, Julia C; Swanson, Fred; Buskin, Susan E; Golden, Matthew R; Stekler, Joanne D

2013-02-01

The authors examined temporal trends and correlates of HIV testing frequency among men who have sex with men (MSM) in King County, Washington. The authors evaluated data from MSM testing for HIV at the Public Health-Seattle & King County (PHSKC) STD Clinic and Gay City Health Project (GCHP) and testing history data from MSM in PHSKC HIV surveillance. The intertest interval (ITI) was defined as the number of days between the last negative HIV test and the current testing visit or first positive test. Correlates of the log(10)-transformed ITI were determined using generalised estimating equations linear regression. Between 2003 and 2010, the median ITI among MSM seeking HIV testing at the STD Clinic and GCHP were 215 (IQR: 124-409) and 257 (IQR: 148-503) days, respectively. In multivariate analyses, younger age, having only male partners and reporting ≥10 male sex partners in the last year were associated with shorter ITIs at both testing sites (p<0.05). Among GCHP attendees, having a regular healthcare provider, seeking a test as part of a regular schedule and inhaled nitrite use in the last year were also associated with shorter ITIs (p<0.001). Compared with MSM testing HIV negative, MSM newly diagnosed with HIV had longer ITIs at the STD Clinic (median of 278 vs 213 days, p=0.01) and GCHP (median 359 vs 255 days, p=0.02). Although MSM in King County appear to be testing at frequent intervals, further efforts are needed to reduce the time that HIV-infected persons are unaware of their status.

Iron deficiency in blood donors: the REDS-II Donor Iron Status Evaluation (RISE) study.

PubMed

Cable, Ritchard G; Glynn, Simone A; Kiss, Joseph E; Mast, Alan E; Steele, Whitney R; Murphy, Edward L; Wright, David J; Sacher, Ronald A; Gottschall, Jerry L; Tobler, Leslie H; Simon, Toby L

2012-04-01

Blood donors are at risk of iron deficiency. We evaluated the effects of blood donation intensity on iron and hemoglobin (Hb) in a prospective study. Four cohorts of frequent and first-time or reactivated (FT/RA) blood donors (no donation in 2 years), female and male, totaling 2425, were characterized and followed as they donated blood frequently. At enrollment and the final visit, ferritin, soluble transferrin receptor (sTfR), and Hb were determined. Models to predict iron deficiency and Hb deferral were developed. Iron depletion was defined at two levels: iron deficiency erythropoiesis (IDE) [log(sTfR/ferritin) ≥ 2.07] and absent iron stores (AIS; ferritin < 12 ng/mL). Among returning female FT and RA donors, 20 and 51% had AIS and IDE at their final visit, respectively; corresponding proportions for males were 8 and 20%. Among female frequent donors who returned, 27 and 62% had AIS and IDE, respectively, while corresponding proportions for males were 18 and 47%. Predictors of IDE and/or AIS included a higher frequency of blood donation in the past 2 years, a shorter interdonation interval, and being female and young; conversely, taking iron supplements reduced the risk of iron depletion. Predictors of Hb deferral included female sex, black race, and a shorter interdonation interval. There is a high prevalence of iron depletion in frequent blood donors. Increasing the interdonation interval would reduce the prevalence of iron depletion and Hb deferral. Alternatively, replacement with iron supplements may allow frequent donation without the adverse outcome of iron depletion. © 2011 American Association of Blood Banks.

Faecal occult blood testing screening for colorectal cancer and 'missed' interval cancers: are we ignoring the elephant in the room? Results of a multicentre study.

PubMed

George, A T; Aggarwal, S; Dharmavaram, S; Menon, A; Dube, M; Vogler, M; Field, A

2017-05-01

Biennial faecal occult blood testing (FOBT) is used to screen for colorectal cancer throughout the UK. Interval cancers are tumours that develop in patients between screening rounds who have had a negative FOBT. Through a multicentre study, we compared the demographics of patients with interval cancers, FOBT screen detected cancers and cancers that developed in patients who chose not to participate in the screening programme. Five hundred and sixteen colorectal cancers were detected in the screening age group (60-74 years) population in three UK National Health Service hospitals over 2 years. One hundred and twenty seven (25%) were interval cancers, 161 (31%) were screen detected and 228 (44%) were cancers that developed in patients who had declined FOBT. The interval cancer group had a higher incidence of right-sided cancers (38% vs 29% and 24%), a higher proportion of high tumour stages (Dukes C and D) (70% vs 53% and 33%) and a shorter time from diagnosis to death (10 months vs 13 months and 24 months) compared to patients who had declined the FOBT and the FOBT screen detected cancers. Of all the patients studied, those with right-sided interval cancers had the worst outcome. A quarter of the colorectal cancers diagnosed in our study were interval cancers. Patients with right-sided interval cancers had the highest proportion of Dukes C and D tumours coupled with the shortest survival time after diagnosis compared with the other groups. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.

The interval between cancer diagnosis among mothers and offspring in a population-based cohort.

PubMed

Paltiel, Ora; Friedlander, Yehiel; Deutsch, Lisa; Yanetz, Rebecca; Calderon-Margalit, Ronit; Tiram, Efrat; Hochner, Hagit; Barchana, Micha; Harlap, Susan; Manor, Orly

2007-01-01

Familial cancers may be due to shared genes or environment, or chance aggregation. We explored the possibility that ascertainment bias influences cancer detection in families, bearing upon the time interval between diagnosis of affected mothers and offspring. The Jerusalem Perinatal Study (JPS) comprises all mothers (n = 39,734) from Western Jerusalem who gave birth 1964 -1976 and their offspring (n = 88,829). After linking identification numbers with Israel's Cancer Registry we measured the absolute time interval between initial cancer diagnoses in affected mother-offspring pairs. We tested the probability of obtaining intervals as short as those observed by chance alone, using a permutation test on the median interval. By June 2003 cancer had developed in 105 mother-offspring pairs within the cohort. Common sites among mothers were breast (47%), colorectal (9%), non-Hodgkin lymphoma (NHL) (8%) and cervix (7%), while for offspring in affected pairs common cancers were leukemia (12.4%), thyroid (13.3%), NHL (10.5%), breast (10.5%) and melanoma (7.6%). The median interval between diagnoses was 5.9 years, but for 33% of affected pairs the interval was < or =3 years. The probability of this occurring by chance alone was 0.03. This held true whether the offspring's or mother's diagnosis was first (P < 0.01). In a population-based cohort followed for three decades, the absolute interval between the diagnosis of cancer in mothers and their offspring is shorter than expected by chance. Explanations include shared environmental exposures or the possibility that cancer ascertainment in one pair member affects health behaviors in the other resulting in early diagnosis. The latter may bias the estimation of anticipation and survival in familial cancers.

Cascaded processing in written compound word production

PubMed Central

Bertram, Raymond; Tønnessen, Finn Egil; Strömqvist, Sven; Hyönä, Jukka; Niemi, Pekka

2015-01-01

In this study we investigated the intricate interplay between central linguistic processing and peripheral motor processes during typewriting. Participants had to typewrite two-constituent (noun-noun) Finnish compounds in response to picture presentation while their typing behavior was registered. As dependent measures we used writing onset time to assess what processes were completed before writing and inter-key intervals to assess what processes were going on during writing. It was found that writing onset time was determined by whole word frequency rather than constituent frequencies, indicating that compound words are retrieved as whole orthographic units before writing is initiated. In addition, we found that the length of the first syllable also affects writing onset time, indicating that the first syllable is fully prepared before writing commences. The inter-key interval results showed that linguistic planning is not fully ready before writing, but cascades into the motor execution phase. More specifically, inter-key intervals were largest at syllable and morpheme boundaries, supporting the view that additional linguistic planning takes place at these boundaries. Bigram and trigram frequency also affected inter-key intervals with shorter intervals corresponding to higher frequencies. This can be explained by stronger memory traces for frequently co-occurring letter sequences in the motor memory for typewriting. These frequency effects were even larger in the second than in the first constituent, indicating that low-level motor memory starts to become more important during the course of writing compound words. We discuss our results in the light of current models of morphological processing and written word production. PMID:25954182

Cascaded processing in written compound word production.

PubMed

Bertram, Raymond; Tønnessen, Finn Egil; Strömqvist, Sven; Hyönä, Jukka; Niemi, Pekka

2015-01-01

In this study we investigated the intricate interplay between central linguistic processing and peripheral motor processes during typewriting. Participants had to typewrite two-constituent (noun-noun) Finnish compounds in response to picture presentation while their typing behavior was registered. As dependent measures we used writing onset time to assess what processes were completed before writing and inter-key intervals to assess what processes were going on during writing. It was found that writing onset time was determined by whole word frequency rather than constituent frequencies, indicating that compound words are retrieved as whole orthographic units before writing is initiated. In addition, we found that the length of the first syllable also affects writing onset time, indicating that the first syllable is fully prepared before writing commences. The inter-key interval results showed that linguistic planning is not fully ready before writing, but cascades into the motor execution phase. More specifically, inter-key intervals were largest at syllable and morpheme boundaries, supporting the view that additional linguistic planning takes place at these boundaries. Bigram and trigram frequency also affected inter-key intervals with shorter intervals corresponding to higher frequencies. This can be explained by stronger memory traces for frequently co-occurring letter sequences in the motor memory for typewriting. These frequency effects were even larger in the second than in the first constituent, indicating that low-level motor memory starts to become more important during the course of writing compound words. We discuss our results in the light of current models of morphological processing and written word production.

Endocrine events during the periestrous period and the subsequent estrous cycle in ewes after estrus synchronization.

PubMed

Menegatos, J; Chadio, S; Kalogiannis, T; Kouskoura, T; Kouimtzis, S

2003-04-01

The aim of the present study was to investigate the endocrinology of the periestrus period and that of the subsequent estrous cycle in ewes synchronized during the breeding season. Animals were treated for 14 days with either MAP intravaginal sponges or subcutaneous progesterone implants, followed by administration of 500 IU PMSG at the time of withdrawal. The time to estrus occurrence following progestagen withdrawal differed significantly between groups (45.3+/-2.7h for the MAP and 21.5+/-1.2h for the implant group, P<0.001). Estradiol levels around estrus did not differ between groups, but a significant difference was detected for the interval from peak estradiol to estrus, with a shorter interval for the implant group (26.7+/-0.7 and 2.7+/-0.9h, P<0.001). Progesterone implants shortened the interval from removal to LH surge, compared to the MAP group (31.2+/-4.4 and 56.5+/-3.6h, respectively, P<0.05). An earlier response was also observed for the interval from estradiol peak to LH peak in the implant group (12.1+/-3.3 and 37+/-2h, respectively, P<0.005), but no difference was observed for the interval from estrus to LH surge. Progesterone levels, particularly during the Days 6 to 10 of the subsequent estrous cycle were significantly higher (P<0.05) in the implant group. It is concluded that the kind of progesterone treatment may affect the time of estrus and the LH peak as well as the progesterone levels of the subsequent cycle.

Prognostic role of the CDNK1B V109G polymorphism in multiple endocrine neoplasia type 1

PubMed Central

Circelli, Luisa; Ramundo, Valeria; Marotta, Vincenzo; Sciammarella, Concetta; Marciello, Francesca; Del Prete, Michela; Sabatino, Lina; Pasquali, Daniela; Izzo, Francesco; Scala, Stefania; Colao, Annamaria; Faggiano, Antongiulio; Colantuoni, Vittorio

2015-01-01

CDKN1B encodes the cyclin-dependent kinase inhibitor p27/Kip1. CDKN1B mutations and polymorphisms are involved in tumorigenesis; specifically, the V109G single nucleotide polymorphism has been linked to different tumours with controversial results. Multiple endocrine neoplasia type 1 (MEN1) is a rare autosomal dominant syndrome, characterized by the development of different types of neuroendocrine tumours and increased incidence of other malignancies. A clear genotype–phenotype correlation in MEN1 has not been established yet. In this study, we assessed whether the CDKN1B V109G polymorphism was associated with the development of aggressive tumours in 55 consecutive patients affected by MEN1. The polymorphism was investigated by PCR amplification of germline DNA followed by direct sequencing. Baseline and follow-up data of tumour types and their severity were collected and associated with the genetic data. MEN1-related aggressive and other malignant tumours of any origin were detected in 16.1% of wild-type and 33.3% of polymorphism allele-bearing patients (P = NS). The time interval between birth and the first aggressive tumour was significantly shorter in patients with the CDKN1B V109G polymorphism (median 46 years) than in those without (median not reached; P = 0.03). Similarly, shorter was the time interval between MEN1 diagnosis and age of the first aggressive tumour (P = 0.02). Overall survival could not be estimated as 96% patients were still alive at the time of the study. In conclusion, CDKN1B V109G polymorphism seems to play a role in the development of aggressive tumours in MEN1. PMID:25824098

The temporal relation between seizure onset and arousal-awakening in temporal lobe seizures.

PubMed

Gumusyayla, Sadiye; Erdal, Abidin; Tezer, F Irsel; Saygi, Serap

2016-07-01

Our main aim was to determine the time interval between the seizure onsets and arousal-awakening related to these seizures in patients with temporal lobe epilepsy (TLE) and to discuss the role of lateralization on arousal-awakening mechanisms. Thirty-three TLE patients who underwent video-EEG monitoring with simultaneous polysomnography (PSG) and had recorded nocturnal seizures were retrospectively examined. These TLE patients had 64 seizures during sleep. The onsets of seizures and arousal-awakening related to these seizures were marked according to clinical and electrophysiological features. The time interval between the seizure onset and arousal-awakening related to the seizure was compared in patients with right- or left-sided temporal lobe seizures. In our TLE patients nocturnal seizures mostly followed arousal-awakening (64%). The time interval between the seizure onset and arousal-awakening related to the seizure was significantly shorter in patients with left-sided temporal lobe seizures (p=0.01). Video-EEG monitoring and PSG with scalp electrodes in our TLE patients showed that nocturnal seizures mostly followed arousal-awakening, and it was more pronounced in those with left-sided seizures. Arousal-awakening might be a signal for subsequent seizures in patients with TLE. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Excess close burst pairs in FRB 121102

NASA Astrophysics Data System (ADS)

Katz, J. I.

2018-05-01

The repeating FRB 121102 emitted a pair of apparently discrete bursts separated by 37 ms and another pair, 131 d later, separated by 34 ms, during observations that detected bursts at a mean rate of ˜2 × 10-4 s-1. While FRB 121102 is known to produce multipeaked bursts, here I assume that these `burst pairs' are truly separate bursts and not multicomponent single bursts, and consider the implications of that assumption. Their statistics are then non-Poissonian. Assuming that the emission comes from a narrow range of rotational phase, then the measured burst intervals constrain any possible periodic modulation underlying the highly episodic emission. If more such short intervals are measured a period may be determined or periodicity may be excluded. The excess of burst intervals much shorter than their mean recurrence time may be explained if FRB emit steady but narrow beams that execute a random walk in direction, perhaps indicating origin in a black hole's accretion disc.

On the Theory of Type 1 X-Ray Bursts: The Energetics of Bursts and the Nuclear Fuel Reservoir in the Envelope

NASA Technical Reports Server (NTRS)

Fujimoto, Masayuki Y.; Sztajno, Mirek; Lewin, Walter H. G.; Vanparadijs, Jan

1986-01-01

The observed properties of type 1 X-ray bursts from 4U/MXB 1636-53 and those of models of thermonuclear flashes on accreting neutron stars are compared. Ways to explain variations in the burst recurrence properties without an apparent correlation with the accretion rate, including the rapid succession of bursts at intervals 10 min are discussed. The strongest X-ray bursts, which occur after a very long interval, are well described by thermonuclear flash models with simple accumulation of accreted fuel, and a spherically symmetric structure in the burning shell. The majority of observed bursts, however, occur after much shorter intervals, and radiate much smaller amounts of energy, by a factor of up to 10 times that predicted by the spherical models. An ignition mechanism of the bursts is proposed in terms of elemental mixing and dissipative heating associated with hydrodynamical instabilities in the neutron star envelope caused by angular momentum carried inward by accreted gas.

Evidence for impulsivity in the Spontaneously Hypertensive Rat drawn from complementary response-withholding tasks

PubMed Central

Sanabria, Federico; Killeen, Peter R

2008-01-01

Background The inability to inhibit reinforced responses is a defining feature of ADHD associated with impulsivity. The Spontaneously Hypertensive Rat (SHR) has been extolled as an animal model of ADHD, but there is no clear experimental evidence of inhibition deficits in SHR. Attempts to demonstrate these deficits may have suffered from methodological and analytical limitations. Methods We provide a rationale for using two complementary response-withholding tasks to doubly dissociate impulsivity from motivational and motor processes. In the lever-holding task (LHT), continual lever depression was required for a minimum interval. Under a differential reinforcement of low rates schedule (DRL), a minimum interval was required between lever presses. Both tasks were studied using SHR and two normotensive control strains, Wistar-Kyoto (WKY) and Long Evans (LE), over an overlapping range of intervals (1 – 5 s for LHT and 5 – 60 s for DRL). Lever-holding and DRL performance was characterized as the output of a mixture of two processes, timing and iterative random responding; we call this account of response inhibition the Temporal Regulation (TR) model. In the context of TR, impulsivity was defined as a bias toward premature termination of the timed intervals. Results The TR model provided an accurate description of LHT and DRL performance. On the basis of TR parameter estimates, SHRs were more impulsive than LE rats across tasks and target times. WKY rats produced substantially shorter timed responses in the lever-holding task than in DRL, suggesting a motivational or motor deficit. The precision of timing by SHR, as measured by the variance of their timed intervals, was excellent, flouting expectations from ADHD research. Conclusion This research validates the TR model of response inhibition and supports SHR as an animal model of ADHD-related impulsivity. It indicates, however, that SHR's impulse-control deficit is not caused by imprecise timing. The use of ad hoc impulsivity metrics and of WKY as control strain for SHR impulsivity are called into question. PMID:18261220

Low-temperature Ignition-delay Characteristics of Several Rocket Fuels with Mixed Acid in Modified Open-cup-type Apparatus

NASA Technical Reports Server (NTRS)

Miller, Riley O

1950-01-01

Summaries of low-temperature self-ignition data of various rocket fuels with mixed acid (nitric plus sulfuric) are presented. Several fuels are shown to have shorter ignition-delay intervals and less variation in delay intervals at moderate and sub-zero temperatures than crude N-ethylaniline (monoethylaniline),a rocket fuel in current use.

Contraception containing estradiol valerate and dienogest--advantages, adherence and user satisfaction.

PubMed

Graziottin, A

2014-10-01

The contraceptive pill containing estradiol valerate and dienogest meets women's requests for: a more natural contraceptive, that is reliable and easy to use, with positive cosmetic effects; less intense and shorter bleeding, reduced anaemia and increased vital energy; reduced dysmenorrhoea and all the specific cycle-related symptoms linked to a drop in oestrogen and the related systemic inflammation, the result of a hormone free interval (HFI) of just two days; with a good impact on sexuality and overall well-being, all associated with a high level of efficacy: (uncorrected Pearl Index: 0.79; corrected: 0.42). Women would prefer more natural hormonal contraception, with high reliability, good tolerability, a simple dosing schedule and possibly some health advantages. To evaluate what the pill containing estradiol valerate and dienogest can offer women and the best way to communicate this opportunity, after 4 years of growing clinical use. A review of literature plus the Author's clinical experience. The new pill containing estradiol valerate and dienogest may satisfy women's need for: a more natural hormonal contraceptive with a low hormone dosage, high reliability and good tolerability; a simple dosing schedule (one pill per day for 28 days); a positive cosmetic effect on the skin; lighter and shorter withdrawal bleeding, improved anaemia, less fatigue and higher vital energy; reduced dysmenorrhoea and a dramatic reduction in all symptoms thanks to a shorter Hormone Free Interval (HFI) of just two days. The new pill is an option for all women taking hormonal contraception who would like a more natural choice; for those who have never used hormonal contraception and may consider this new opportunity positively, for those who suffer from various menstrual symptoms, related inflammation ("a shorter HFI means much fewer or no symptoms") and, possibly for pre-menopausal women, an opportunity to combine excellent contraception with a definite improvement in their well-being. The pill containing estradiol valerate and dienogest is a contraceptive option that may satisfy women's demands for a more natural contraceptive while offering high reliability, good tolerability, a simple dosing schedule, lighter and shorter withdrawal bleeding, improved anaemia and a reduction in cycle-related symptoms thanks to a shorter Hormone Free Interval, and improved sexuality and general well-being. Communication should focus on women's priorities regarding contraception and their pursuit of a better quality of life while on OC.

The influence of pretreatment characteristics and radiotherapy parameters on time interval to development of radiation-associated meningioma.

PubMed

Paulino, Arnold C; Ahmed, Irfan M; Mai, Wei Y; Teh, Bin S

2009-12-01

To identify pretreatment characteristics and radiotherapy parameters which may influence time interval to development of radiation-associated meningioma (RAM). A Medline/PUBMED search of articles dealing with RAM yielded 66 studies between 1981 and 2006. Factors analyzed included patient age and gender, type of initial tumor treated, radiotherapy (RT) dose and volume, and time interval from RT to development of RAM. A total of 143 patients with a median age at RT of 12 years form the basis of this report. The most common initial tumors or conditions treated with RT were medulloblastoma (n = 27), pituitary adenoma (n = 20), acute lymphoblastic leukemia (n = 20), low-grade astrocytoma (n = 19), and tinea capitis (n = 14). In the 116 patients whose RT fields were known, 55 (47.4%) had a portion of the brain treated, whereas 32 (27.6%) and 29 (25.0%) had craniospinal and whole-brain fields. The median time from RT to develop a RAM or latent time (LT) was 19 years (range, 1-63 years). Male gender (p = 0.001), initial diagnosis of leukemia (p = 0.001), and use of whole brain or craniospinal field (p

The Influence of Pretreatment Characteristics and Radiotherapy Parameters on Time Interval to Development of Radiation-Associated Meningioma

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

Paulino, Arnold C., E-mail: apaulino@tmhs.or; Ahmed, Irfan M.; Mai, Wei Y.

2009-12-01

Purpose: To identify pretreatment characteristics and radiotherapy parameters which may influence time interval to development of radiation-associated meningioma (RAM). Methods and Materials: A Medline/PUBMED search of articles dealing with RAM yielded 66 studies between 1981 and 2006. Factors analyzed included patient age and gender, type of initial tumor treated, radiotherapy (RT) dose and volume, and time interval from RT to development of RAM. Results: A total of 143 patients with a median age at RT of 12 years form the basis of this report. The most common initial tumors or conditions treated with RT were medulloblastoma (n = 27), pituitarymore » adenoma (n = 20), acute lymphoblastic leukemia (n = 20), low-grade astrocytoma (n = 19), and tinea capitis (n = 14). In the 116 patients whose RT fields were known, 55 (47.4%) had a portion of the brain treated, whereas 32 (27.6%) and 29 (25.0%) had craniospinal and whole-brain fields. The median time from RT to develop a RAM or latent time (LT) was 19 years (range, 1-63 years). Male gender (p = 0.001), initial diagnosis of leukemia (p = 0.001), and use of whole brain or craniospinal field (p <= 0.0001) were associated with a shorter LT, whereas patients who received lower doses of RT had a longer LT (p < 0.0001). Conclusions: The latent time to develop a RAM was related to gender, initial tumor type, radiotherapy volume, and radiotherapy dose.« less

Intravenous Immunoglobulin Therapy in Pediatric Narcolepsy: A Nonrandomized, Open-Label, Controlled, Longitudinal Observational Study.

PubMed

Lecendreux, Michel; Berthier, Johanna; Corny, Jennifer; Bourdon, Olivier; Dossier, Claire; Delclaux, Christophe

2017-03-15

Previous case reports of intravenous immunoglobulins (IVIg) in pediatric narcolepsy have shown contradictory results. This was a nonrandomized, open-label, controlled, longitudinal observational study of IVIg use in pediatric narcolepsy with retrospective data collection from medical files obtained from a single pediatric national reference center for the treatment of narcolepsy in France. Of 56 consecutively referred patients with narcolepsy, 24 received IVIg (3 infusions administered at 1-mo intervals) in addition to standard care (psychostimulants and/or anticataplectic agents), and 32 continued on standard care alone (controls). For two patients in each group, medical files were unavailable. Of the 22 IVIg patients, all had cerebrospinal fluid (CSF) hypocretin ≤ 110 pg/mL and were HLA-DQB1*06:02 positive. Of the 30 control patients, 29 were HLA-DQB1*06:02 positive and of those with available CSF measurements, all 12 had hypocretin ≤ 110 pg/mL. Compared with control patients, IVIg patients had shorter disease duration, shorter latency to sleep onset, and more had received H1N1 vaccination. Mean (standard deviation) follow-up length was 2.4 (1.1) y in the IVIg group and 3.9 (1.7) y in controls. In multivariate-adjusted linear mixed-effects analyses of change from baseline in Ullanlinna Narcolepsy Scale (UNS) scores, high baseline UNS, but not IVIg treatment, was associated with a reduction in narcolepsy symptoms. On time-to-event analysis, among patients with high baseline UNS scores, control patients achieved a UNS score < 14 (indicating remission) less rapidly than IVIg patients (adjusted hazard ratio 0.18; 95% confidence interval: 95% confidence interval: 0.03, 0.95; p = 0.043). Shorter or longer disease duration did not influence treatment response in any analysis. Overall, narcolepsy symptoms were not significantly reduced by IVIg. However, in patients with high baseline symptoms, a subset of IVIg-treated patients achieved remission more rapidly than control patients. A commentary on this article appears in this issue on page 363. © 2017 American Academy of Sleep Medicine

The role of calling EMS versus using private transportation in improving the management of stroke in France.

PubMed

Gache, Kristel; Couralet, Melanie; Nitenberg, Gérard; Leleu, Henri; Minvielle, Etienne

2013-01-01

To compare the time from symptom onset to brain imaging between patients calling emergency medical services (EMS) and those using private means for transportation. We focused on symptom onset-to-brain imaging times of ≤2 hours and ≤3 hours 30 minutes, assuming a one-hour interval between imaging and thrombolysis. Other variables were the patient's age, gender, stroke type, National Institutes of Health Stroke Scale (NIHSS) score, presence of an on-site stroke unit, and period of symptom onset. Univariate analyses and a hierarchical linear regression model were used, as appropriate, and adjusted for these variables. A total of 1,105 stroke patients (28%) were included in the analyses, 40.6% of them transported by EMS. Patients using EMS were significantly older (72.8 vs. 70.5 years; p = 0.008), they had a higher NIHSS score (8 vs. 6.1; p = 0.0001), fewer were ischemic (85.1% vs. 90.6%; p = 0.005), and more of them reached hospitals with an on-site stroke unit (81.3% vs. 72.9%; p = 0.002). For the EMS-call patients, the median symptom onset-to-brain imaging time was significantly shorter (3 hours 21 minutes vs. 5 hours 57 minutes), and after adjustment, maximum delays of 2 hours and 3 hours 30 minutes were independently associated with EMS call: 28% vs. 18% (p = 0.015) and 66% vs. 45% (p < 0.0001) of patients, respectively, leading to an adjusted odds ratio of 2.77 (95% confidence interval, 2.007-3.828; p < 0.0001) for the threshold of 3 hours 30 minutes. The symptom onset-to-brain imaging time was significantly shorter in case of EMS transportation, but most patients did not reach the hospital in time to be eligible for thrombolysis. Efforts are still needed to reduce delays, especially public education and EMS activation. These efforts should be combined with new approaches for the quality management of stroke patients.

Role of enamel deminerlization and remineralization on microtensile bond strength of resin composite

PubMed Central

Rizvi, Abbas; Zafar, Muhammad S.; Al-Wasifi, Yasser; Fareed, Wamiq; Khurshid, Zohaib

2016-01-01

Objective: This study is aimed to establish the microtensile bond strength of enamel following exposure to an aerated drink at various time intervals with/without application of remineralization agent. In addition, degree of remineralization and demineralization of tooth enamel has been assessed using polarized light microscopy. Materials and Methods: Seventy extracted human incisors split into two halves were immersed in aerated beverage (cola drink) for 5 min and stored in saliva until the time of microtensile bond testing. Prepared specimens were divided randomly into two study groups; remineralizing group (n = 70): specimens were treated for remineralization using casein phosphopeptides and amorphous calcium phosphate (CPP-ACP) remineralization agent (Recaldent™; GC Europe) and control group (n = 70): no remineralization treatment; specimens were kept in artificial saliva. All specimens were tested for microtensile bond strength at regular intervals (1 h, 1 days, 2 days, 1 week, and 2 weeks) using a universal testing machine. The results statistically analyzed (P = 0.05) using two-way ANOVA test. Results: Results showed statistically significant increase in bond strength in CPP-ACP tested group (P < 0.05) at all-time intervals. The bond strength of remineralizing group samples at 2 days (~13.64 megapascals [MPa]) is comparable to that of control group after 1 week (~12.44 MPa). Conclusions: CPP-ACP treatment of teeth exposed to an aerated drink provided significant increase in bond strength at a shorter interval compared to teeth exposed to saliva alone. PMID:27403057

Investigation of kinetics and absorption isotherm models for hydroponic phytoremediation of waters contaminated with sulfate.

PubMed

Saber, Ali; Tafazzoli, Milad; Mortazavian, Soroosh; James, David E

2018-02-01

Two common wetland plants, Pampas Grass (Cortaderia selloana) and Lucky Bamboo (Dracaena sanderiana), were used in hydroponic cultivation systems for the treatment of simulated high-sulfate wastewaters. Plants in initial experiments at pH 7.0 removed sulfate more efficiently compared to the same experimental conditions at pH 6.0. Results at sulfate concentrations of 50, 200, 300, 600, 900, 1200, 1500 and 3000 mg/L during three consecutive 7-day treatment periods with 1-day rest intervals, showed decreasing trends of both removal efficiencies and uptake rates with increasing sulfate concentrations from the first to the second to the third 7-day treatment periods. Removed sulfate masses per unit dry plant mass, calculated after 23 days, showed highest removal capacity at 600 mg/L sulfate for both plants. A Langmuir-type isotherm best described sulfate uptake capacity of both plants. Kinetic studies showed that compared to pseudo first-order kinetics, pseudo-second order kinetic models slightly better described sulfate uptake rates by both plants. The Elovich kinetic model showed faster rates of attaining equilibrium at low sulfate concentrations for both plants. The dimensionless Elovich model showed that about 80% of sulfate uptake occurred during the first four days' contact time. Application of three 4-day contact times with 2-day rest intervals at high sulfate concentrations resulted in slightly higher uptakes compared to three 7-day contact times with 1-day rest intervals, indicating that pilot-plant scale treatment systems could be sized with shorter contact times and longer rest-intervals. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of low body temperature on associative interference in conditioned taste aversion.

PubMed

Christianson, John P; Anderson, Mathew J; Misanin, James R; Hinderliter, Charles F

2005-06-01

When two novel conditioned stimuli precede an unconditioned stimulus (US), the interval between the two conditioned stimuli (CS1 and CS2) influences the magnitude of the CS-US associability of each CS. As the interval between CS1 and CS2 increases, the associability of CS1 with the US decreases due to interference by CS2 and the associability of CS2 increases, given its temporal proximity to the US. Because hypothermia has been reported to increase the interval at which conditioned taste aversions can be formed, its influence was examined on the above relationship, i.e., how interference from CS2 affects the associability of CS1 with the US. Rats received a conditioned taste aversion procedure where CS1 and CS2 were presented either one after the other or separated by an 80-min. delay. For all subjects, the US or pseudo-US was presented immediately after CS2. When hypothermia was interpolated between the two flavor stimuli that were spaced 80 min. apart, CS2-interference with the CS1-US association was greatly attenuated. We propose that hypothermia modifies internal timing mechanisms such that the externally timed 80-min. CS1-CS2 interval was perceived as much shorter for rats made hypothermic. As a result of this perceived shortened inter-CS interval, CS2 produced less interference for the CS1-US association than would be expected for such a relatively long delay between CS1 and CS2.

Six Sessions of Sprint Interval Training Improves Running Performance in Trained Athletes.

PubMed

Koral, Jerome; Oranchuk, Dustin J; Herrera, Roberto; Millet, Guillaume Y

2018-03-01

Koral, J, Oranchuk, DJ, Herrera, R, and Millet, GY. Six sessions of sprint interval training improves running performance in trained athletes. J Strength Cond Res 32(3): 617-623, 2018-Sprint interval training (SIT) is gaining popularity with endurance athletes. Various studies have shown that SIT allows for similar or greater endurance, strength, and power performance improvements than traditional endurance training but demands less time and volume. One of the main limitations in SIT research is that most studies were performed in a laboratory using expensive treadmills or ergometers. The aim of this study was to assess the performance effects of a novel short-term and highly accessible training protocol based on maximal shuttle runs in the field (SIT-F). Sixteen (12 male, 4 female) trained trail runners completed a 2-week procedure consisting of 4-7 bouts of 30 seconds at maximal intensity interspersed by 4 minutes of recovery, 3 times a week. Maximal aerobic speed (MAS), time to exhaustion at 90% of MAS before test (Tmax at 90% MAS), and 3,000-m time trial (TT3000m) were evaluated before and after training. Data were analyzed using a paired samples t-test, and Cohen's (d) effect sizes were calculated. Maximal aerobic speed improved by 2.3% (p = 0.01, d = 0.22), whereas peak power (PP) and mean power (MP) increased by 2.4% (p = 0.009, d = 0.33) and 2.8% (p = 0.002, d = 0.41), respectively. TT3000m was 6% shorter (p < 0.001, d = 0.35), whereas Tmax at 90% MAS was 42% longer (p < 0.001, d = 0.74). Sprint interval training in the field significantly improved the 3,000-m run, time to exhaustion, PP, and MP in trained trail runners. Sprint interval training in the field is a time-efficient and cost-free means of improving both endurance and power performance in trained athletes.

Six Sessions of Sprint Interval Training Improves Running Performance in Trained Athletes

PubMed Central

Oranchuk, Dustin J.; Herrera, Roberto; Millet, Guillaume Y.

2018-01-01

Abstract Koral, J, Oranchuk, DJ, Herrera, R, and Millet, GY. Six sessions of sprint interval training improves running performance in trained athletes. J Strength Cond Res 32(3): 617–623, 2018—Sprint interval training (SIT) is gaining popularity with endurance athletes. Various studies have shown that SIT allows for similar or greater endurance, strength, and power performance improvements than traditional endurance training but demands less time and volume. One of the main limitations in SIT research is that most studies were performed in a laboratory using expensive treadmills or ergometers. The aim of this study was to assess the performance effects of a novel short-term and highly accessible training protocol based on maximal shuttle runs in the field (SIT-F). Sixteen (12 male, 4 female) trained trail runners completed a 2-week procedure consisting of 4–7 bouts of 30 seconds at maximal intensity interspersed by 4 minutes of recovery, 3 times a week. Maximal aerobic speed (MAS), time to exhaustion at 90% of MAS before test (Tmax at 90% MAS), and 3,000-m time trial (TT3000m) were evaluated before and after training. Data were analyzed using a paired samples t-test, and Cohen's (d) effect sizes were calculated. Maximal aerobic speed improved by 2.3% (p = 0.01, d = 0.22), whereas peak power (PP) and mean power (MP) increased by 2.4% (p = 0.009, d = 0.33) and 2.8% (p = 0.002, d = 0.41), respectively. TT3000m was 6% shorter (p < 0.001, d = 0.35), whereas Tmax at 90% MAS was 42% longer (p < 0.001, d = 0.74). Sprint interval training in the field significantly improved the 3,000-m run, time to exhaustion, PP, and MP in trained trail runners. Sprint interval training in the field is a time-efficient and cost-free means of improving both endurance and power performance in trained athletes. PMID:29076961

Effect of inter-train interval on the induction of repetition suppression of motor-evoked potentials using transcranial magnetic stimulation.

PubMed

Pitkänen, Minna; Kallioniemi, Elisa; Julkunen, Petro

2017-01-01

Repetition suppression (RS) is evident as a weakened response to repeated stimuli after the initial response. RS has been demonstrated in motor-evoked potentials (MEPs) induced with transcranial magnetic stimulation (TMS). Here, we investigated the effect of inter-train interval (ITI) on the induction of RS of MEPs with the attempt to optimize the investigative protocols. Trains of TMS pulses, targeted to the primary motor cortex by neuronavigation, were applied at a stimulation intensity of 120% of the resting motor threshold. The stimulus trains included either four or twenty pulses with an inter-stimulus interval (ISI) of 1 s. The ITI was here defined as the interval between the last pulse in a train and the first pulse in the next train; the ITIs used here were 1, 3, 4, 6, 7, 12, and 17 s. RS was observed with all ITIs except with the ITI of 1 s, in which the ITI was equal to ISI. RS was more pronounced with longer ITIs. Shorter ITIs may not allow sufficient time for a return to baseline. RS may reflect a startle-like response to the first pulse of a train followed by habituation. Longer ITIs may allow more recovery time and in turn demonstrate greater RS. Our results indicate that RS can be studied with confidence at relatively short ITIs of 6 s and above.

Effects of interstimulus intervals on behavioral, heart rate, and event-related potential indices of infant engagement and sustained attention

PubMed Central

Xie, Wanze; Richards, John E.

2016-01-01

Maximizing infant attention to stimulus presentation during an EEG or ERP experiment is important for making valid inferences about the neural correlates of infant cognition. The present study examined the effects of stimulus presentation interstimulus interval (ISI) on behavioral and physiological indices of infant attention including infants’ fixation to visual presentation, the amount of heart rate (HR) change during sustained attention, and ERP components. This study compared an ISI that is typically used in infant EEG/ERP studies (e.g., 1,500–2,000 ms) with two shorter durations (400–600 ms and 600–1,000 ms). Thirty-six infants were tested cross-sectionally at 3, 4.5, and 6 months. It was found that using the short (400–600 ms) and medium (600–1,000 ms) ISIs resulted in more visually fixated trials and reduced frequency of fixation disengagement per experimental block. We also found larger HR changes during sustained attention to both of the shorter ISIs compared with the long ISI, and larger ERP responses when using the medium ISI compared to using the short and long ISIs. These data suggest that utilizing an optimal ISI (e.g., 600– 1,000 ms), which increases the presentation complexity and provides sufficient time for information processing, can promote infant engagement and sustained attention during stimulus presentation. PMID:27159263

Time reproduction performance is associated with age and working memory in high-functioning youth with autism spectrum disorder.

PubMed

Brenner, Laurie A; Shih, Vivian H; Colich, Natalie L; Sugar, Catherine A; Bearden, Carrie E; Dapretto, Mirella

2015-02-01

Impaired temporal processing has historically been viewed as a hallmark feature of attention deficit hyperactivity disorder. Recent evidence suggests temporal processing deficits may also be characteristic of autism spectrum disorder (ASD). However, little is known about the factors that impact temporal processing in children with ASD. The purpose of this study was to assess the effects of co-morbid attention problems, working memory (WM), age, and their interactions, on time reproduction in youth with and without ASD. Twenty-seven high-functioning individuals with ASD and 25 demographically comparable typically developing individuals (ages 9-17; 85% male) were assessed on measures of time reproduction, auditory WM, and inattention/hyperactivity. The time reproduction task required depression of a computer key to mimic interval durations of 4, 8, 12, 16, or 20 sec. Mixed effects regression analyses were used to model accuracy and variability of time reproduction as functions of diagnostic group, interval duration, age, WM, and inattention/hyperactivity. A significant group by age interaction was detected for accuracy, with the deficit in the ASD group being greater in younger children. There was a significant group by WM interaction for consistency, with the effects of poor WM on performance consistency being more pronounced in youth with ASD. All participants tended to underestimate longer interval durations and to be less consistent for shorter interval durations; these effects appeared more pronounced in those who were younger or who had poorer WM performance. Inattention/hyperactivity symptoms in the ASD group were not related to either accuracy or consistency. This study highlights the potential value of temporal processing as an intermediate trait of relevance to multiple neurodevelopmental disorders. © 2014 International Society for Autism Research, Wiley Periodicals, Inc.

Electrophysiological markers predicting impeding AV-block during ablation of atrioventricular nodal reentry tachycardia.

PubMed

Fragakis, Nikolaos; Krexi, Lydia; Kyriakou, Panagiota; Sotiriadou, Melani; Lazaridis, Charalambos; Karamanolis, Athanasios; Dalampyras, Panagiotis; Tsakiroglou, Stelios; Skeberis, Vassilios; Tsalikakis, Dimitrios; Vassilikos, Vassilios

2018-01-01

Radiofrequency (RF) ablation of the slow pathway (SP) in atrioventricular nodal reentry tachycardia (AVNRT) is occasionally complicated with atrioventricular block (AVB) often predicted by junctional beats (JB) with loss of ventriculo-atrial (VA) conduction. We analyzed retrospectively 153 patients undergoing ablation of SP for typical AVNRT. Patients were divided into two age groups: 127 ≤ 70 years and 26 > 70 years. We analyzed the interval between the atrial electrogram in the His-bundle position and the distal ablation catheter [A(H)-A(RFd)] and between the distal ablation catheter and the proximal coronary sinus catheter [A(RFd)-A(CS)] before RF applications with and without JB. We evaluated if these intervals can be used as predictors of JB incidence and also of JB with loss of VA conduction. We also assessed if age influences the risk of loss of VA conduction. The A(H)-A(RFd) and A(RFd)-A(CS) intervals were significantly shorter in RF applications causing JB than those without JB (33 ± 11 ms vs 39 ± 9 ms, P < 0.001, 14 ± 9 ms vs 20 ± 7 ms, P < 0.001, respectively). The A(H)-A(RFd) and A(RFd)-A(CS) intervals were also significantly shorter in RFs causing JB with VA block than those with VA conduction (29 ± 11 ms vs 35 ± 11 ms, P < 0.001, 8 ± 8 ms vs 17 ± 8 ms, P < 0.001, respectively). Patients > 70 years had shorter intervals (36 ± 11 ms vs 29 ± 8 ms, P  =  0.012, 17 ± 8 ms vs 13 ± 7 ms, P  =  0.027, respectively), while VA block was more common in this age group. The A(H)-A(RFd) and A(RFd)-A(CS) intervals can be used as markers for predicting JB occurrence as well as impending AVB. JB with loss of VA conduction occur more often in older patients possibly due to a higher position of SP. © 2017 Wiley Periodicals, Inc.

Photoinduced diffusion molecular transport

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

Rozenbaum, Viktor M., E-mail: vik-roz@mail.ru, E-mail: litrakh@gmail.com; Dekhtyar, Marina L.; Lin, Sheng Hsien

2016-08-14

We consider a Brownian photomotor, namely, the directed motion of a nanoparticle in an asymmetric periodic potential under the action of periodic rectangular resonant laser pulses which cause charge redistribution in the particle. Based on the kinetics for the photoinduced electron redistribution between two or three energy levels of the particle, the time dependence of its potential energy is derived and the average directed velocity is calculated in the high-temperature approximation (when the spatial amplitude of potential energy fluctuations is small relative to the thermal energy). The thus developed theory of photoinduced molecular transport appears applicable not only to conventionalmore » dichotomous Brownian motors (with only two possible potential profiles) but also to a much wider variety of molecular nanomachines. The distinction between the realistic time dependence of the potential energy and that for a dichotomous process (a step function) is represented in terms of relaxation times (they can differ on the time intervals of the dichotomous process). As shown, a Brownian photomotor has the maximum average directed velocity at (i) large laser pulse intensities (resulting in short relaxation times on laser-on intervals) and (ii) excited state lifetimes long enough to permit efficient photoexcitation but still much shorter than laser-off intervals. A Brownian photomotor with optimized parameters is exemplified by a cylindrically shaped semiconductor nanocluster which moves directly along a polar substrate due to periodically photoinduced dipole moment (caused by the repetitive excited electron transitions to a non-resonant level of the nanocylinder surface impurity).« less

Two-step chlorination: A new approach to disinfection of a primary sewage effluent.

PubMed

Li, Yu; Yang, Mengting; Zhang, Xiangru; Jiang, Jingyi; Liu, Jiaqi; Yau, Cie Fu; Graham, Nigel J D; Li, Xiaoyan

2017-01-01

Sewage disinfection aims at inactivating pathogenic microorganisms and preventing the transmission of waterborne diseases. Chlorination is extensively applied for disinfecting sewage effluents. The objective of achieving a disinfection goal and reducing disinfectant consumption and operational costs remains a challenge in sewage treatment. In this study, we have demonstrated that, for the same chlorine dosage, a two-step addition of chlorine (two-step chlorination) was significantly more efficient in disinfecting a primary sewage effluent than a one-step addition of chlorine (one-step chlorination), and shown how the two-step chlorination was optimized with respect to time interval and dosage ratio. Two-step chlorination of the sewage effluent attained its highest disinfection efficiency at a time interval of 19 s and a dosage ratio of 5:1. Compared to one-step chlorination, two-step chlorination enhanced the disinfection efficiency by up to 0.81- or even 1.02-log for two different chlorine doses and contact times. An empirical relationship involving disinfection efficiency, time interval and dosage ratio was obtained by best fitting. Mechanisms (including a higher overall Ct value, an intensive synergistic effect, and a shorter recovery time) were proposed for the higher disinfection efficiency of two-step chlorination in the sewage effluent disinfection. Annual chlorine consumption costs in one-step and two-step chlorination of the primary sewage effluent were estimated. Compared to one-step chlorination, two-step chlorination reduced the cost by up to 16.7%. Copyright © 2016 Elsevier Ltd. All rights reserved.

Smoking Topography among Korean Smokers: Intensive Smoking Behavior with Larger Puff Volume and Shorter Interpuff Interval.

PubMed

Kim, Sungroul; Yu, Sol

2018-05-18

The difference of smoker's topography has been found to be a function many factors, including sex, personality, nicotine yield, cigarette type (i.e., flavored versus non-flavored) and ethnicity. We evaluated the puffing behaviors of Korean smokers and its association with smoking-related biomarker levels. A sample of 300 participants was randomly recruited from metropolitan areas in South Korea. Topography measures during a 24-hour period were obtained using a CReSS pocket device. Korean male smokers smoked two puffs less per cigarette compared to female smokers (15.0 (13.0⁻19.0) vs. 17.5 (15.0⁻21.0) as the median (Interquartile range)), but had a significantly larger puff volume (62.7 (52.7⁻75.5) mL vs. 53.5 (42.0⁻64.2) mL); p = 0.012). The interpuff interval was similar between men and women (8.9 (6.5⁻11.2) s vs. 8.3 (6.2⁻11.0) s; p = 0.122) but much shorter than other study results. A dose-response association ( p = 0.0011) was observed between daily total puff volumes and urinary cotinine concentrations, after controlling for sex, age, household income level and nicotine addiction level. An understanding of the difference of topography measures, particularly the larger puff volume and shorter interpuff interval of Korean smokers, may help to overcome a potential underestimation of internal doses of hazardous byproducts of smoking.

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.

Epidemiology, Seasonality, and Predictors of Outcome of AIDS-Associated Penicillium marneffei Infection in Ho Chi Minh City, Viet Nam

PubMed Central

Wolbers, Marcel; Quang, Vo Minh; Chinh, Nguyen Tran; Huong Lan, Nguyen Phu; Lam, Pham Si; Kozal, Michael J.; Shikuma, Cecilia M.; Day, Jeremy N.; Farrar, Jeremy

2011-01-01

Background. Penicillium marneffei is an important human immunodeficiency virus (HIV)–associated opportunistic pathogen in Southeast Asia. The epidemiology and the predictors of penicilliosis outcome are poorly understood. Methods. We performed a retrospective study of culture-confirmed incident penicilliosis admissions during 1996–2009 at the Hospital for Tropical Diseases in Ho Chi Minh City, Viet Nam. Seasonality of penicilliosis was assessed using cosinor models. Logistic regression was used to assess predictors of death or worsening disease based on 10 predefined covariates, and Cox regression was performed to model time-to-antifungal initiation. Results. A total of 795 patients were identified; hospital charts were obtainable for 513 patients (65%). Cases increased exponentially and peaked in 2007 (156 cases), mirroring the trends in AIDS admissions during the study period. A highly significant seasonality for penicilliosis (P < .001) but not for cryptococcosis (P = .63) or AIDS admissions (P = .83) was observed, with a 27% (95% confidence interval, 14%–41%) increase in incidence during rainy months. All patients were HIV infected; the median CD4 cell count (62 patients) was 7 cells/μL (interquartile range, 4–24 cells/μL). Hospital outcome was an improvement in 347 (68%), death in 101 (20%), worsening in 42 (8%), and nonassessable in 23 (5%) cases. Injection drug use, shorter history, absence of fever or skin lesions, elevated respiratory rates, higher lymphocyte count, and lower platelet count independently predicted poor outcome in both complete-case and multiple-imputation analyses. Time-to-treatment initiation was shorter for patients with skin lesions (hazard ratio, 3.78; 95% confidence interval, 2.96–4.84; P < .001). Conclusions. Penicilliosis incidence correlates with the HIV/AIDS epidemic in Viet nam. The number of cases increases during rainy months. Injection drug use, shorter history, absence of fever or skin lesions, respiratory difficulty, higher lymphocyte count, and lower platelet count predict poor in-hospital outcome. PMID:21427403

Absence of equifinality of hand position in a double-step unloading task.

PubMed

Norouzi-Gheidari, Nahid; Archambault, Philippe

2010-08-01

Equifinality, during arm reaching movements, relates to the capacity of the neuromuscular system to attain the same final position in the presence or absence of transient perturbations. There have been several controversies regarding equifinality in the literature. A brief elastic perturbation, applied during a fast arm movement or just before its initiation, typically does not affect final arm position. On the other hand, several experiments have shown that velocity-dependent perturbations, such as Coriolis force or negative damping, while transient in nature, have a significant effect on final arm position when compared to unperturbed movements. In this study, an unloading paradigm was used to study the role of reflexes with respect to equifinality. The effects on final arm position of suddenly decreasing a static load maintained by fourteen subjects were analyzed. Subjects maintained an initial load produced by a double-joint manipulandum moving in the horizontal plane. The load was suddenly decreased, either in one or in two successive steps with different time intervals, resulting in a rapid reflex-mediated change in arm position. Unloading led to short-latency changes in the activity of shoulder and elbow muscles and significant variations in tonic activity. It was found that the final hand position was shorter for double- versus single-step unloading if the time between two successive changes in load was greater than 100 ms. With a shorter time interval, the final hand positions were the same. This difference in final hand positions was inversely proportional to the hand velocity at the time of the second change in load. Further, agonist/antagonist co-activation increased in double-step unloading. Thus, the change in both the load and the movement velocity may influence the magnitude of the unloading reflex. This may be indicative of a dependence of stretch reflexes on velocity. Perturbation may cause a reflex-mediated increase in joint stiffness, which could explain why equifinality is not preserved after some perturbations, such as velocity-dependant external forces.

Odors Bias Time Perception in Visual and Auditory Modalities

PubMed Central

Yue, Zhenzhu; Gao, Tianyu; Chen, Lihan; Wu, Jiashuang

2016-01-01

Previous studies have shown that emotional states alter our perception of time. However, attention, which is modulated by a number of factors, such as emotional events, also influences time perception. To exclude potential attentional effects associated with emotional events, various types of odors (inducing different levels of emotional arousal) were used to explore whether olfactory events modulated time perception differently in visual and auditory modalities. Participants were shown either a visual dot or heard a continuous tone for 1000 or 4000 ms while they were exposed to odors of jasmine, lavender, or garlic. Participants then reproduced the temporal durations of the preceding visual or auditory stimuli by pressing the spacebar twice. Their reproduced durations were compared to those in the control condition (without odor). The results showed that participants produced significantly longer time intervals in the lavender condition than in the jasmine or garlic conditions. The overall influence of odor on time perception was equivalent for both visual and auditory modalities. The analysis of the interaction effect showed that participants produced longer durations than the actual duration in the short interval condition, but they produced shorter durations in the long interval condition. The effect sizes were larger for the auditory modality than those for the visual modality. Moreover, by comparing performance across the initial and the final blocks of the experiment, we found odor adaptation effects were mainly manifested as longer reproductions for the short time interval later in the adaptation phase, and there was a larger effect size in the auditory modality. In summary, the present results indicate that odors imposed differential impacts on reproduced time durations, and they were constrained by different sensory modalities, valence of the emotional events, and target durations. Biases in time perception could be accounted for by a framework of attentional deployment between the inducers (odors) and emotionally neutral stimuli (visual dots and sound beeps). PMID:27148143

A comparison of heart rate variability, n-3 PUFA status and lipid mediator profile in age- and BMI-matched middle-aged vegans and omnivores.

PubMed

Pinto, Ana M; Sanders, Thomas A B; Kendall, Alexandra C; Nicolaou, Anna; Gray, Robert; Al-Khatib, Haya; Hall, Wendy L

2017-03-01

Low heart rate variability (HRV) predicts sudden cardiac death. Long-chain (LC) n-3 PUFA (C20-C22) status is positively associated with HRV. This cross-sectional study investigated whether vegans aged 40-70 years (n 23), whose diets are naturally free from EPA (20 : 5n-3) and DHA (22 : 6n-3), have lower HRV compared with omnivores (n 24). Proportions of LC n-3 PUFA in erythrocyte membranes, plasma fatty acids and concentrations of plasma LC n-3 PUFA-derived lipid mediators were significantly lower in vegans. Day-time interbeat intervals (IBI), adjusted for physical activity, age, BMI and sex, were significantly shorter in vegans compared with omnivores (mean difference -67 ms; 95 % CI -130, -3·4, P50 % and high-frequency power) were similarly lower in vegans, with no differences during sleep. In conclusion, vegans have higher 24 h SDNN, but lower day-time HRV and shorter day-time IBI relative to comparable omnivores. Vegans may have reduced availability of precursor markers for pro-resolving lipid mediators; it remains to be determined whether there is a direct link with impaired cardiac function in populations with low-n-3 status.

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.

Tooth enamel mineralization in ungulates: implications for recovering a primary isotopic time-series

NASA Astrophysics Data System (ADS)

Passey, Benjamin H.; Cerling, Thure E.

2002-09-01

Temporal changes in the carbon and oxygen isotopic composition of an animal are an environmental and behavioral input signal that is recorded into the enamel of developing teeth. In this paper, we evaluate changes in phosphorus content and density along the axial lengths of three developing ungulate teeth to illustrate the protracted nature of mineral accumulation in a volume of developing enamel. The least mature enamel in these teeth contains by volume about 25% of the mineral mass of mature enamel, and the remaining 75% of the mineral accumulates during maturation. Using data from one of these teeth (a Hippopotamus amphibius canine), we develop a model for teeth growing at constant rate that describes how an input signal is recorded into tooth enamel. The model accounts for both the temporal and spatial patterns of amelogenesis (enamel formation) and the sampling geometry. The model shows that input signal attenuation occurs as a result of time-averaging during amelogenesis when the maturation interval is long compared to the duration of features in the input signal. Sampling does not induce significant attenuation, provided that the sampling interval is several times shorter than the maturation interval. We present a detailed δ 13C and δ 18O record for the H. amphibius canine and suggest possible input isotope signals that may have given rise to the measured isotope signal.

Decoupling the effects of primary production and residence time variation on nitrogen retention in a tidally-influenced spring run

NASA Astrophysics Data System (ADS)

Hensley, R. T.; Cohen, M. J.; Korhnak, L. V.

2013-12-01

Models of nitrogen (N) retention in river networks suggest biogeochemical as well as hydraulic properties exert considerable control on reach scale nutrient retention rates. Freshwater tidally influenced rivers provide a model system for decoupling metabolic vs. hydraulic controls on retention. The clear diurnal N retention signal in response to assimilatory uptake observed in other rivers becomes convoluted as the solar day moves in and out of phase with the semi-diurnal (~12.5 hr) tidal cycle. We used an upstream-downstream mass balance approach to estimate N retention at 15 minute intervals over an entire lunar month in Manatee Springs, a tidally varying, spring-fed stream in North Florida. Retention rates varied markedly with tidal forcing. Contrary to our expectations, higher retention rates and shorter uptake lengths were observed at low tide, corresponding to the shortest residence times, which varied between 22 and 71 minutes in this 350m reach. By profiling a continuously injected conservative tracer under both high and low tide conditions, we determined this was not the result of variation in lateral inflow (e.g., dilution from denitrified hyporheic porewater at lower channel stage). This increased retention at shorter residence times (and hence higher velocity) may be the result of greater turbulent mixing, which drives river water into the benthic reactive zone where the principal retention pathway, denitrification, occurs. After controlling for residence time effects, the residual retention signal exhibited a strong diel pattern. This assimilatory N retention was highly correlated with daily primary production (using the diel oxygen method), and estimated ecosystem molar C:N ratios (8.55×0.83:1) were comparable to observed tissue stoichiometry of the dominant autotrophs (9:1). N retention (blue) and residence time (red) calculated at 15 minute intervals. Note the inverse correlation; highest retention rates occur at the shortest residence times. N retention versus residence time separated into daytime (yellow) and nighttime (blue) data points. Note the daytime data points generally lie above the nighttime regression as a result of higher daytime retention due to assimilatory uptake.

Flame-spreading phenomena in the fin-slot region of a solid rocket motor

NASA Astrophysics Data System (ADS)

Kuo, K. K.; Kokal, R. A.; Paulauskas, M.; Alaksin, P.; Lee, L. S.

1993-06-01

Flame-spreading processes in the fin-slot regions of solid-propellant motor grains have the potential to influence the behavior of the overall ignition transient. The work being done on this project is aimed at obtaining a better understanding of the flame-spreading processes in rocket motors with aft-end fin slots. Non-intrusive optical diagnostic methods were employed to acquire flame-spreading measurements in the fin-slot region of a subscale rocket motor. Highly non-uniform flame-spreading processes were observed in both the deep and shallow fin regions of the test rig. The average flame-spreading rates in the fin-slot region were found to be two orders of magnitude less than those in the circular port region of a typical rocket motor. The flame-spreading interval was found to correlate well with the local pressurization rates. A higher pressurization rate produces a shorter flame-spreading time interval.

Infant temperament: stability by age, gender, birth order, term status, and socioeconomic status.

PubMed

Bornstein, Marc H; Putnick, Diane L; Gartstein, Maria A; Hahn, Chun-Shin; Auestad, Nancy; O'Connor, Deborah L

2015-01-01

Two complementary studies focused on stability of infant temperament across the 1st year and considered infant age, gender, birth order, term status, and socioeconomic status (SES) as moderators. Study 1 consisted of 73 mothers of firstborn term girls and boys queried at 2, 5, and 13 months of age. Study 2 consisted of 335 mothers of infants of different gender, birth order, term status, and SES queried at 6 and 12 months. Consistent positive and negative affectivity factors emerged at all time points across both studies. Infant temperament proved stable and robust across gender, birth order, term status, and SES. Stability coefficients for temperament factors and scales were medium to large for shorter (< 9 months) interassessment intervals and small to medium for longer (> 10 months) intervals. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

Early-stage chunking of finger tapping sequences by persons who stutter and fluent speakers.

PubMed

Smits-Bandstra, Sarah; De Nil, Luc F

2013-01-01

This research note explored the hypothesis that chunking differences underlie the slow finger-tap sequencing performance reported in the literature for persons who stutter (PWS) relative to fluent speakers (PNS). Early-stage chunking was defined as an immediate and spontaneous tendency to organize a long sequence into pauses, for motor planning, and chunks of fluent motor performance. A previously published study in which 12 PWS and 12 matched PNS practised a 10-item finger tapping sequence 30 times was examined. Both groups significantly decreased the duration of between-chunk intervals (BCIs) and within-chunk intervals (WCIs) over practice. PNS had significantly shorter WCIs relative to PWS, but minimal differences between groups were found for the number of, or duration of, BCI. Results imply that sequencing differences found between PNS and PWS may be due to differences in automatizing movements within chunks or retrieving chunks from memory rather than chunking per se.

Retinoblastoma Vitreous Seed Clouds (Class 3): A Comparison of Treatment with Ophthalmic Artery Chemosurgery with or without Intravitreous and Periocular Chemotherapy.

PubMed

Francis, Jasmine H; Iyer, Saipriya; Gobin, Y Pierre; Brodie, Scott E; Abramson, David H

2017-10-01

To compare the efficacy and toxicity of treating class 3 retinoblastoma vitreous seeds with ophthalmic artery chemosurgery (OAC) alone versus OAC with intravitreous chemotherapy. Retrospective cohort study. Forty eyes containing clouds (class 3 vitreous seeds) of 40 retinoblastoma patients (19 treated with OAC alone and 21 treated with OAC plus intravitreous and periocular chemotherapy). Ocular survival, disease-free survival and time to regression of seeds were estimated with Kaplan-Meier estimates. Ocular toxicity was evaluated by clinical findings and electroretinography: 30-Hz flicker responses were compared at baseline and last follow-up visit. Continuous variables were compared with Student t test, and categorical variables were compared with the Fisher exact test. Ocular survival, disease-free survival, and time to regression of seeds. There were no disease- or treatment-related deaths and no patient demonstrated externalization of tumor or metastatic disease. There was no significant difference in the age, laterality, disease, or disease status (treatment naïve vs. previously treated) between the 2 groups. The time to regression of seeds was significantly shorter for eyes treated with OAC plus intravitreous chemotherapy (5.7 months) compared with eyes treated with OAC alone (14.6 months; P < 0.001). The 18-month Kaplan-Meier estimates of disease-free survival were significantly worse for the OAC alone group: 67.1% (95% confidence interval, 40.9%-83.6%) versus 94.1% (95% confidence interval, 65%-99.1%) for the OAC plus intravitreous chemotherapy group (P = 0.05). The 36-month Kaplan-Meier estimates of ocular survival were 83.3% (95% confidence interval, 56.7%-94.3%) for the OAC alone group and 100% for the OAC plus intravitreous chemotherapy group (P = 0.16). The mean change in electroretinography responses was not significantly different between groups, decreasing by 11 μV for the OAC alone group and 22 μV for the OAC plus intravitreous chemotherapy group (P = 0.4). Treating vitreous seed clouds with OAC and intravitreous and periocular chemotherapy, compared with OAC alone, resulted in a shorter time to regression and was associated with fewer recurrences requiring additional treatment and fewer enucleations. The toxicity to the retina does not seem to be significantly worse in the OAC plus intravitreous chemotherapy group. Copyright © 2017 American Academy of Ophthalmology. Published by 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

Substorm occurrence rates, substorm recurrence times, and solar wind structure

NASA Astrophysics Data System (ADS)

Borovsky, Joseph E.; Yakymenko, Kateryna

2017-03-01

Two collections of substorms are created: 28,464 substorms identified with jumps in the SuperMAG AL index in the years 1979-2015 and 16,025 substorms identified with electron injections into geosynchronous orbit in the years 1989-2007. Substorm occurrence rates and substorm recurrence-time distributions are examined as functions of the phase of the solar cycle, the season of the year, the Russell-McPherron favorability, the type of solar wind plasma at Earth, the geomagnetic-activity level, and as functions of various solar and solar wind properties. Three populations of substorm occurrences are seen: (1) quasiperiodically occurring substorms with recurrence times (waiting times) of 2-4 h, (2) randomly occurring substorms with recurrence times of about 6-15 h, and (3) long intervals wherein no substorms occur. A working model is suggested wherein (1) the period of periodic substorms is set by the magnetosphere with variations in the actual recurrence times caused by the need for a solar wind driving interval to occur, (2) the mesoscale structure of the solar wind magnetic field triggers the occurrence of the random substorms, and (3) the large-scale structure of the solar wind plasma is responsible for the long intervals wherein no substorms occur. Statistically, the recurrence period of periodically occurring substorms is slightly shorter when the ram pressure of the solar wind is high, when the magnetic field strength of the solar wind is strong, when the Mach number of the solar wind is low, and when the polar-cap potential saturation parameter is high.

Cardiopulmonary resuscitation quality: Widespread variation in data intervals used for analysis.

PubMed

Talikowska, Milena; Tohira, Hideo; Bailey, Paul; Finn, Judith

2016-05-01

There is a growing body of evidence for the relationship between CPR quality and survival in cardiac arrest patients. We sought to describe the characteristics of the analysis intervals used across studies. Relevant papers were selected as described in our recent systematic review. From these papers we collected information about (1) the time interval used for analysis; (2) the event that marked the beginning of the analysis interval; and (3) the minimum amount of CPR quality data required for a case to be included in the analysed cohort. We then compared this data across papers. Twenty-one studies reported on the association between CPR quality and cardiac arrest patient survival. In two thirds of studies data from the start of the resuscitation episode was analysed, in particular the first 5min. Commencement of the analysis interval was marked by various events including ECG pad placement and first chest compression. Nine studies specified a minimum amount of data that had to have been collected for the individual case to be included in the analysis; most commonly 1min of data. The use of shorter intervals allowed for inclusion of more cases as it included cases that did not have a complete dataset. To facilitate comparisons across studies, a standardised definition of the data analysis interval should be developed; one that maximises the amount of cases available without compromising the data's representability of the resuscitation effort. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Self-induced laser line sweeping and self-pulsing in double-clad fiber lasers in Fabry-Perot and unidirectional ring cavities

NASA Astrophysics Data System (ADS)

Peterka, Pavel; Navrátil, Petr; Dussardier, Bernard; Slavík, Radan; Honzátko, Pavel; Kubecek, Václav

2012-06-01

Rare-earth doped fiber lasers are subject to instabilities and various self-pulsed regimes that can lead to catastrophic damage of their components. An interesting self-pulsing regime accompanied with laser wavelength drift with time is the so called self-induced laser line sweeping (SLLS). Despite the early observations of the SLLS in solid-state ruby lasers, in fiber lasers it was first time mentioned in literature only in 2009 where such a laser wavelength drift with time was observed in a relatively broad range of about 1076 -1084 nm in ring ytterbium-doped fiber laser (YDFL). The main characteristic of the SLLS is the scanning of the laser wavelength from shorter to longer wavelength, spanning over large interval of several nanometers, and instantaneous bounce backward. The period of this sweeping is usually quite long, of the order of seconds. This spectacular effect was attributed to spatial-hole burning caused by standing-wave in the laser cavity. In this paper we present experimental investigation of the SLLS in YDFLs in Fabry-Perot cavity and ring cavities. The SLLS was observed also in erbium-doped fiber laser around 1560 nm. We present for the first time observation of the laser wavelength sweep in reverse direction, i.e., from longer towards shorter wavelengths. It was observed in YDFL around 1080 nm.

Time and decision making: differential contribution of the posterior insular cortex and the striatum during a delay discounting task.

PubMed

Wittmann, Marc; Leland, David S; Paulus, Martin P

2007-06-01

Delay discounting refers to the fact that an immediate reward is valued more than the same reward if it occurs some time in the future. To examine the neural substrates underlying this process, we studied 13 healthy volunteers who repeatedly had to decide between an immediate and parametrically varied delayed hypothetical reward using a delay discounting task during event-related functional magnetic resonance imaging. Subject's preference judgments resulted in different discounting slopes for shorter (<1 year) and for longer (> or =1 year) delays. Neural activation associated with the shorter delays relative to the longer delays was associated with increased activation in the head of the left caudate nucleus and putamen. When individuals selected the delayed relative to the immediate reward, a strong activation was found in bilateral posterior insular cortex. Several brain areas including the left caudate nucleus showed a correlation between the behaviorally determined discounting and brain activation for the contrast of intervals with delays <1 and > or =1 year. These results suggest that (1) the posterior insula, which is a critical component of the decision-making neural network, is involved in delaying gratification and (2) the degree of neural activation in the striatum, which plays a fundamental role in reward prediction and in time estimation, may code for the time delay.

Randomized comparison of oral misoprostol and oxytocin for labor induction in term prelabor membrane rupture.

PubMed

Butt, K D; Bennett, K A; Crane, J M; Hutchens, D; Young, D C

1999-12-01

To compare labor induction intervals between oral misoprostol and intravenous oxytocin in women who present at term with premature rupture of membranes. One hundred eight women were randomly assigned to misoprostol 50 microg orally every 4 hours as needed or intravenous oxytocin. The primary outcome measure was time from induction to vaginal delivery. Sample size was calculated using a two-tailed alpha of 0.05 and power of 80%. Baseline demographic data, including maternal age, gestation, parity, Bishop score, birth weight, and group B streptococcal status, were similar. The mean time +/-standard deviation to vaginal birth with oral misoprostol was 720+/-382 minutes compared with 501+/-389 minutes with oxytocin (P = .007). The durations of the first, second, and third stages of labor were similar. There were no differences in maternal secondary outcomes, including cesarean birth (eight and seven, respectively), infection, maternal satisfaction with labor, epidural use, perineal trauma, manual placental removal, or gastrointestinal side effects. Neonatal outcomes including cord pH, Apgar scores, infection, and admission to neonatal intensive care unit were not different. Although labor induction with oral misoprostol was effective, oxytocin resulted in a shorter induction-to-delivery interval. Active labor intervals and other maternal and neonatal outcomes were similar.

Smoking and perceived stress in relation to short salivary telomere length among caregivers of children with disabilities

PubMed Central

Chen, Xiaoli; Velez, Juan Carlos; Barbosa, Clarita; Pepper, Micah; Andrade, Asterio; Stoner, Lee; De Vivo, Immaculata; Gelaye, Bizu; Williams, Michelle A.

2014-01-01

Telomere length (TL), the length of repeated DNA sequence that forms protective caps at the end of chromosomes, has emerged as a novel biomarker of cell aging and oxidative stress. There is increasing research exploring the associations of smoking and perceived stress with TL, and the results are inconsistent. This study aimed to examine whether smoking and perceived stress were associated with shortened salivary TL among primary caregivers of children with disabilities. Using a quantitative polymerase chain reaction method, salivary TL was assessed among 89 caregivers aged 19–69 years (87% were women) who took care of disabled children in the Patagonia Region, Chile. Interviewer-administered questionnaires were used to collect information on sociodemographic and lifestyle behaviors. The 14-item Perceived Stress Scale was used to assess perceived stress. Mean relative TL was 0.92 (standard error=0.03). Smokers had age-adjusted mean TL that was 0.07 units lower (beta=−0.07, standard error=0.03; p=0.012) than non-smokers. Smokers were 2.17 times more likely to have shorter TL (<0.73, the lowest quartile of TL) than non-smokers (odds ratio =3.17; 95% confidence interval=1.05–9.52) with adjustment for age and perceived stress. Caregivers with higher perceived stress were 2.13 times more likely to have shorter TL (odds ratio=3.13; 95% confidence interval=1.03–9.55) than caregivers with lower perceived stress after adjustment for age and smoking. This study provides the first evidence of strong associations between smoking and perceived stress and shortened salivary TL among caregivers of children with disabilities. Larger studies with detailed information on smoking status are warranted to confirm our findings. PMID:25256607

Telomere length in patients with pulmonary fibrosis associated with chronic lung allograft dysfunction and post-lung transplantation survival.

PubMed

Newton, Chad A; Kozlitina, Julia; Lines, Jefferson R; Kaza, Vaidehi; Torres, Fernando; Garcia, Christine Kim

2017-08-01

Prior studies have shown that patients with pulmonary fibrosis with mutations in the telomerase genes have a high rate of certain complications after lung transplantation. However, few studies have investigated clinical outcomes based on leukocyte telomere length. We conducted an observational cohort study of all patients with pulmonary fibrosis who underwent lung transplantation at a single center between January 1, 2007, and December 31, 2014. Leukocyte telomere length was measured from a blood sample collected before lung transplantation, and subjects were stratified into 2 groups (telomere length <10th percentile vs ≥10th percentile). Primary outcome was post-lung transplant survival. Secondary outcomes included incidence of allograft dysfunction, non-pulmonary organ dysfunction, and infection. Approximately 32% of subjects had a telomere length <10th percentile. Telomere length <10th percentile was independently associated with worse survival (hazard ratio 10.9, 95% confidence interval 2.7-44.8, p = 0.001). Telomere length <10th percentile was also independently associated with a shorter time to onset of chronic lung allograft dysfunction (hazard ratio 6.3, 95% confidence interval 2.0-20.0, p = 0.002). Grade 3 primary graft dysfunction occurred more frequently in the <10th percentile group compared with the ≥10th percentile group (28% vs 7%; p = 0.034). There was no difference between the 2 groups in incidence of acute cellular rejection, cytopenias, infection, or renal dysfunction. Telomere length <10th percentile was associated with worse survival and shorter time to onset of chronic lung allograft dysfunction and thus represents a biomarker that may aid in risk stratification of patients with pulmonary fibrosis before lung transplantation. Copyright © 2017 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Interval Between Hysterectomy and Start of Radiation Treatment Is Predictive of Recurrence in Patients With Endometrial Carcinoma

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

Cattaneo, Richard; Hanna, Rabbie K.; Jacobsen, Gordon

Purpose: Adjuvant radiation therapy (RT) has been shown to improve local control in patients with endometrial carcinoma. We analyzed the impact of the time interval between hysterectomy and RT initiation in patients with endometrial carcinoma. Methods and Materials: In this institutional review board-approved study, we identified 308 patients with endometrial carcinoma who received adjuvant RT after hysterectomy. All patients had undergone hysterectomy, oophorectomy, and pelvic and para-aortic lymph node evaluation from 1988 to 2010. Patients' demographics, pathologic features, and treatments were compared. The time interval between hysterectomy and the start of RT was calculated. The effects of time interval onmore » recurrence-free (RFS), disease-specific (DSS), and overall survival (OS) were calculated. Following univariate analysis, multivariate modeling was performed. Results: The median age and follow-up for the study cohort was 65 years and 72 months, respectively. Eighty-five percent of the patients had endometrioid carcinoma. RT was delivered with high-dose-rate brachytherapy alone (29%), pelvic RT alone (20%), or both (51%). Median time interval to start RT was 42 days (range, 21-130 days). A total of 269 patients (74%) started their RT <9 weeks after undergoing hysterectomy (group 1) and 26% started ≥9 weeks after surgery (group 2). There were a total of 43 recurrences. Tumor recurrence was significantly associated with treatment delay of ≥9 weeks, with 5-year RFS of 90% for group 1 compared to only 39% for group 2 (P<.001). On multivariate analysis, RT delay of ≥9 weeks (P<.001), presence of lymphovascular space involvement (P=.001), and higher International Federation of Gynecology and Obstetrics grade (P=.012) were independent predictors of recurrence. In addition, RT delay of ≥9 weeks was an independent significant predictor for worse DSS and OS (P=.001 and P=.01, respectively). Conclusions: Delay in administering adjuvant RT after hysterectomy was associated with worse survival endpoints. Our data suggest that shorter time interval between hysterectomy and start of RT may be beneficial.« less

Adherence to Guidelines for Oral Anticoagulation after Venous Thrombosis and Pulmonary Embolism

PubMed Central

Ganz, David A; Glynn, Robert J; Mogun, Helen; Knight, Eric L; Bohn, Rhonda L; Avorn, Jerry

2000-01-01

OBJECTIVE Guidelines for oral anticoagulation after deep venous thrombosis (DVT) or pulmonary embolism (PE) have recommended that patients be anticoagulated for at least 3 months after hospital discharge. We sought to determine whether this recommendation was being followed and what patient characteristics predict a shorter than recommended duration of therapy. DESIGN Retrospective cohort study using linked health care claims data. SETTING Routine clinical practice. PATIENTS Five hundred seventy-three members of New Jersey's Medicaid or Pharmacy Assistance for the Aged and Disabled programs aged 65 years and older who were hospitalized for DVT or PE between January 1, 1991 and June 30, 1994. RESULTS Of the 573 patients, 129 (23%) filled prescriptions covering less than 90 days of oral anticoagulant therapy. In multivariate models, African-American race was associated with an increased risk of a shorter than recommended duration of therapy (odds ratio [OR], 1.87; 95% confidence interval [CI], 1.14 to 3.08), but age and gender were not. Patients who used anticoagulants in the year prior to admission were less likely to have a short duration of therapy (OR, 0.30; 95% CI, 0.12 to 0.78), than were patients with PE (OR, 0.58; 95% CI, 0.38 to 0.88). CONCLUSIONS Nearly a quarter of those anticoagulated following DVT or PE received therapy for less than the recommended length of time after hospital discharge, with African Americans more likely to have a shorter than recommended course of treatment. Further research is needed to evaluate the causes of shorter than recommended duration of therapy and racial disparities in anticoagulant use. PMID:11119169

Effect of Prior Injury on Changes to Biceps Femoris Architecture across an Australian Football League Season.

PubMed

Timmins, Ryan G; Bourne, Matthew N; Hickey, Jack T; Maniar, Nirav; Tofari, Paul J; Williams, Morgan D; Opar, David A

2017-10-01

To assess in-season alterations of biceps femoris long head (BFlh) fascicle length in elite Australian footballers with and without a history of unilateral hamstring strain injury (HSI) in the past 12 months. Thirty elite Australian football players were recruited. Twelve had a history of unilateral HSI. Eighteen had no HSI history. All had their BFlh architecture assessed at approximately monthly intervals, six times across a competitive season. The previously injured limb's BFlh fascicles increased from the start of the season and peaked at week 5. Fascicle length gradually decreased until the end of the season, where they were shortest. The contralateral uninjured limb's fascicles were the longest when assessed at week 5 and showed a reduction in-season where weeks 17 and 23 were shorter than week 1. Control group fascicles were longest at week 5 and reduced in-season. The previously injured limb's BFlh fascicles were shorter than the control group at all weeks and the contralateral uninjured limb at week 5. Compared with the control group, the contralateral uninjured limb had shorter fascicles from weeks 9 to 23. Athletes with a history of HSI end the season with shorter fascicles than they start. Limbs without a history of HSI display similar BFlh fascicle lengths at the end of the season as they begin with. All athletes increase fascicle length at the beginning of the season; however, the extent of the increase differed based on history of HSI. These findings show that a HSI history may influence structural adaptation of the BFlh in-season.

Reliability of scoring arousals in normal children and children with obstructive sleep apnea syndrome.

PubMed

Wong, Tat Kong; Galster, Patricia; Lau, Tai Shing; Lutz, Janita M; Marcus, Carole L

2004-09-15

Scoring of arousals in children is based on an extension of adult criteria, as defined by the American Sleep Disorders Association (ASDA). By this, a minimum duration of 3 seconds is required. A few recent studies utilized modified criteria for the study of children, with durations as short as 1 second. However, the validity and reliability of scoring these shorter arousals have never been verified. Based on studies in adults, we hypothesized that interscorer agreement for scoring arousals shorter than 3 seconds was poor. Retrospective review of polysomnograms by 2 experienced sleep practitioners who independently scored arousals according to the ASDA 3-second criteria and modified duration criteria of 1 and 2 seconds. Academic hospital. 20 polysomnographic studies from children aged 3 to 8 years with mild to severe obstructive sleep apnea syndrome, and 16 polysomnographic studies from normal children. None. The intraclass correlation coefficient for scoring ASDA arousals was 0.90 (95% confidence interval: 0.81-0.95), indicating excellent interscorer agreement. The intraclass correlation coefficient for scoring modified 1-second and 2-second arousals were 0.35 (95% confidence interval: 0.02-0.61) and 0.42 (95% confidence interval: 0.12-0.65) respectively, indicating poor to fair interscorer agreement. Furthermore, modified 1-second and 2-second arousals accounted for less than 15% of all arousals scored. We conclude that there is much poorer interscorer agreement for scoring arousals shorter than 3 seconds, when compared to the standard ASDA criteria. We propose that scoring of arousals in children should follow the standard ASDA criteria.

Nutritive Value Response of Native Warm-Season Forage Grasses to Harvest Intervals and Durations in Mixed Stands

PubMed Central

Temu, Vitalis W.; Rude, Brian J.; Baldwin, Brian S.

2014-01-01

Interest in management of native warm-season grasses for multiple uses is growing in southeastern USA. Forage quality response of early-succession mixed stands of big bluestem (BB, Andropogon gerardii), indiangrass (IG, Sorghastrum nutans), and little bluestem (SG, Schizachyrium scoparium) to harvest intervals (30-, 40-, 60-, 90 or 120-d) and durations (one or two years) were assessed in crop-field buffers. Over three years, phased harvestings were initiated in May, on sets of randomized plots, ≥90 cm apart, in five replications (blocks) to produce one-, two-, and three-year-old stands, by the third year. Whole-plot regrowths were machine-harvested after collecting species (IG and LB) sample tillers for leafiness estimates. Species-specific leaf area (SLA) and leaf-to-stem ratio (LSR) were greater for early-season harvests and shorter intervals. In a similar pattern, whole-plot crude protein concentrations were greatest for the 30-d (74 g·kg−1 DM) and the least (40 g·kg−1 DM) for the 120-d interval. Corresponding neutral detergent fiber (NDF) values were the lowest (620 g·kg−1 DM) and highest (710 g·kg−1 DM), respectively. In vitro dry matter and NDF digestibility were greater for early-season harvests at shorter intervals (63 and 720 g·kg−1 DM). With strategic harvesting, similar stands may produce quality hay for beef cattle weight gain. PMID:27135504

Temporal slip-rate stability and variations on the Hope Fault, New Zealand, during the late Quaternary

NASA Astrophysics Data System (ADS)

Khajavi, Narges; Nicol, Andrew; Quigley, Mark C.; Langridge, Robert M.

2018-07-01

The Hope Fault transfers slip from Hikurangi subduction to the Alpine Fault in the northern South Island of New Zealand. It accommodates mainly dextral strike slip and currently carries the highest slip rate in the Marlborough Fault System. Displacements, displacement rates and earthquake recurrence intervals have been determined using a combination of high resolution LiDAR for 59 dextral displacements ( 2.5-200 m) together with calibrated radiocarbon ages ( 130 yr to 13,000 yr) for abandoned stream channels, terrace risers and alluvial fans. Mean single-event displacement (SED) of 3 ± 0.6 m (2.2 to 4.6 m for 21 measurements) and mean recurrence interval of 266 ± 100 yr (range 128 to 560 yr) have been determined for the five most recent surface-rupturing earthquakes. On time scales ≥2300 yr the dextral slip rate is uniform at 12.2 ± 2.4 mm/yr, however, when averaged over time intervals of 230 to 1700 yr slip rates range from 4 to 46.4 mm/yr. This order-of-magnitude variability in slip rate over shorter timescales cannot be fully attributed to errors in displacement and age data, and is at least partly due to variations in earthquake recurrence interval and inferred SED. Short-term non-characteristic earthquake behaviour may be due to changes in fault loading arising from stress interactions between different segments of the Hope Fault and nearby faults.

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.

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

PubMed Central

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

2015-01-01

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

Intravenous Immunoglobulin Therapy in Pediatric Narcolepsy: A Nonrandomized, Open-Label, Controlled, Longitudinal Observational Study

PubMed Central

Lecendreux, Michel; Berthier, Johanna; Corny, Jennifer; Bourdon, Olivier; Dossier, Claire; Delclaux, Christophe

2017-01-01

Study Objectives: Previous case reports of intravenous immunoglobulins (IVIg) in pediatric narcolepsy have shown contradictory results. Methods: This was a nonrandomized, open-label, controlled, longitudinal observational study of IVIg use in pediatric narcolepsy with retrospective data collection from medical files obtained from a single pediatric national reference center for the treatment of narcolepsy in France. Of 56 consecutively referred patients with narcolepsy, 24 received IVIg (3 infusions administered at 1-mo intervals) in addition to standard care (psychostimulants and/or anticataplectic agents), and 32 continued on standard care alone (controls). Results: For two patients in each group, medical files were unavailable. Of the 22 IVIg patients, all had cerebrospinal fluid (CSF) hypocretin ≤ 110 pg/mL and were HLA-DQB1*06:02 positive. Of the 30 control patients, 29 were HLA-DQB1*06:02 positive and of those with available CSF measurements, all 12 had hypocretin ≤ 110 pg/mL. Compared with control patients, IVIg patients had shorter disease duration, shorter latency to sleep onset, and more had received H1N1 vaccination. Mean (standard deviation) follow-up length was 2.4 (1.1) y in the IVIg group and 3.9 (1.7) y in controls. In multivariate-adjusted linear mixed-effects analyses of change from baseline in Ullanlinna Narcolepsy Scale (UNS) scores, high baseline UNS, but not IVIg treatment, was associated with a reduction in narcolepsy symptoms. On time-to-event analysis, among patients with high baseline UNS scores, control patients achieved a UNS score < 14 (indicating remission) less rapidly than IVIg patients (adjusted hazard ratio 0.18; 95% confidence interval: 95% confidence interval: 0.03, 0.95; p = 0.043). Shorter or longer disease duration did not influence treatment response in any analysis. Conclusions: Overall, narcolepsy symptoms were not significantly reduced by IVIg. However, in patients with high baseline symptoms, a subset of IVIg-treated patients achieved remission more rapidly than control patients. Commentary: A commentary on this article appears in this issue on page 363. Citation: Lecendreux M, Berthier J, Corny J, Bourdon O, Dossier C, Delclaux C. Intravenous immunoglobulin therapy in pediatric narcolepsy: a nonrandomized, open-label, controlled, longitudinal observational study. J Clin Sleep Med. 2017;13(3):441–453. PMID:28095967

Influence of gender and types of sports training on QT variables in young elite athletes.

PubMed

Omiya, Kazuto; Sekizuka, Hiromitsu; Kida, Keisuke; Suzuki, Kengo; Akashi, Yoshihiro J; Ohba, Haruo; Musha, Haruki

2014-01-01

Influence of gender and sports training on QT variables such as QT interval and dispersion (QT dispersion: QTD) in young elite athletes were evaluated. Subjects included 104 male and 97 female Japanese elite athletes (mean age 21.6 years). Sports included basketball, fencing, gymnastics, judo, swimming, tennis, track and field and volleyball. Age-matched healthy non-athletes (32 men and 20 women) were enrolled as controls. QT measurements were manually obtained from a 12-lead resting electrocardiogram and QTD was calculated as the difference between the longest and shortest QT intervals. A corrected QT interval (QTc) was obtained using Bazett's formula. Subjects were divided into two groups; an endurance training group and a static training group on the basis of their training types. Maximum and minimum QTc were significantly longer in female athletes than in male athletes (max: 414.2 vs. 404.5 ms, min: 375.1 vs. 359.2 ms, p<0.0001 respectively), whereas QTc dispersion (QTcD) was shorter in female athletes than in male athletes (39.2 vs. 45.3 ms, p<0.0001). QTcD was significantly shorter in female athletes than in the female control group (39.2 vs. 45.2 ms, p<0.05). However, no statistically significant difference was observed between male athletes and the male control group. Male gymnasts exhibited significantly longer QTcD than the control group (p<0.01), but female gymnasts had significantly shorter QTcD than the control group (p<0.05). Maximum QTc intervals were prolonged in the male static training group compared with non-athletes, and QTcDs in the static training group were prolonged compared with the endurance training group. However, no significant difference was observed in the female group. In conclusion, both gender and different characteristics of sports training may affect QT variables even in young elite athletes. Vigorous static exercise training may independently prolong QT variables.

Earth reencounter probabilities for aborted space disposal of hazardous nuclear waste

NASA Technical Reports Server (NTRS)

Friedlander, A. L.; Feingold, H.

1977-01-01

A quantitative assessment is made of the long-term risk of earth reencounter and reentry associated with aborted disposal of hazardous material in the space environment. Numerical results are presented for 10 candidate disposal options covering a broad spectrum of disposal destinations and deployment propulsion systems. Based on representative models of system failure, the probability that a single payload will return and collide with earth within a period of 250,000 years is found to lie in the range .0002-.006. Proportionately smaller risk attaches to shorter time intervals. Risk-critical factors related to trajectory geometry and system reliability are identified as possible mechanisms of hazard reduction.

Future directions for beam-foil spectroscopy

NASA Technical Reports Server (NTRS)

Bashkin, S.

1976-01-01

The beam-foil source has proved to be so useful for the study of atomic energy levels that it is almost trivial to propose a variety of new experiments involving new elements, higher energies, a broader wavelength range, shorter time intervals, pulsed beams, different targets, and new configurations in geometry or external fields. However, what is perhaps not so trivial is to propose experiments for which there is a specific purpose, experiments from which a novel kind of information might be expected. It is from this latter point of view that the author shall talk about experiments which seem to offer unusual opportunities to learn new things about atoms.

Outcomes of cats with oral tumors treated with mandibulectomy: 42 cases.

PubMed

Northrup, Nicole C; Selting, Kimberly A; Rassnick, Kenneth M; Kristal, Orna; O'Brien, Maura G; Dank, Gillian; Dhaliwal, Ravinder S; Jagannatha, Shyla; Cornell, Karen K; Gieger, Tracy L

2006-01-01

Medical records of 42 cats treated with mandibulectomy for oral neoplasia at eight institutions were reviewed to determine morbidity, progression-free interval, and survival time. Progression-free and survival rates at 1 and 2 years were 56% and 49%, and 60% and 57%, respectively. Cats with squamous cell carcinoma had significantly shorter survival than cats with fibrosarcoma or osteosarcoma. Seventy-two percent of cats were dysphagic or inappetent immediately postoperatively, and 12% never regained the ability to eat. Despite acute morbidity in 98% and long-term morbidity in 76% of cats, 83% of the 30 owners providing information were satisfied with the outcome of mandibulectomy.

Prognostic role of the CDNK1B V109G polymorphism in multiple endocrine neoplasia type 1.

PubMed

Circelli, Luisa; Ramundo, Valeria; Marotta, Vincenzo; Sciammarella, Concetta; Marciello, Francesca; Del Prete, Michela; Sabatino, Lina; Pasquali, Daniela; Izzo, Francesco; Scala, Stefania; Colao, Annamaria; Faggiano, Antongiulio; Colantuoni, Vittorio

2015-07-01

CDKN1B encodes the cyclin-dependent kinase inhibitor p27/Kip1. CDKN1B mutations and polymorphisms are involved in tumorigenesis; specifically, the V109G single nucleotide polymorphism has been linked to different tumours with controversial results. Multiple endocrine neoplasia type 1 (MEN1) is a rare autosomal dominant syndrome, characterized by the development of different types of neuroendocrine tumours and increased incidence of other malignancies. A clear genotype-phenotype correlation in MEN1 has not been established yet. In this study, we assessed whether the CDKN1B V109G polymorphism was associated with the development of aggressive tumours in 55 consecutive patients affected by MEN1. The polymorphism was investigated by PCR amplification of germline DNA followed by direct sequencing. Baseline and follow-up data of tumour types and their severity were collected and associated with the genetic data. MEN1-related aggressive and other malignant tumours of any origin were detected in 16.1% of wild-type and 33.3% of polymorphism allele-bearing patients (P = NS). The time interval between birth and the first aggressive tumour was significantly shorter in patients with the CDKN1B V109G polymorphism (median 46 years) than in those without (median not reached; P = 0.03). Similarly, shorter was the time interval between MEN1 diagnosis and age of the first aggressive tumour (P = 0.02). Overall survival could not be estimated as 96% patients were still alive at the time of the study. In conclusion, CDKN1B V109G polymorphism seems to play a role in the development of aggressive tumours in MEN1. © 2015 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

Seasonal change of residence time in spring water and groundwater at a mountainous headwater catchment

NASA Astrophysics Data System (ADS)

Nagano, Kosuke; Tsujimura, Maki; Onda, Yuichi; Iwagami, Sho; Sakakibara, Koichi; Sato, Yutaro

2017-04-01

Determination of water age in headwater is important to consider water pathway, source and storage in the catchment. Previous studies showed that groundwater residence time changes seasonally. These studies reported that mean residence time of water in dry season tends to be longer than that in rainy season, and it becomes shorter as precipitation and discharge amount increases. However, there are few studies to clarify factors causing seasonal change in mean residence time in spring water and groundwater based on observed data. Therefore, this study aims to reveal the relationship between mean residence time and groundwater flow system using SFconcentration in spring and 10 minutes interval hydrological data such as discharge volume, groundwater level and precipitation amount in a headwater catchment in Fukushima, Japan. The SF6 concentration data in spring water observed from April 2015 to November 2016 shows the mean residence time of springs ranged from zero to 14 years. We also observed a clear negative correlation between discharge rate and residence time in the spring. The residence time in shallow groundwater in rainy season was younger as compared with that in low rainfall period. Therefore, the shallow groundwater with young residence time seems to contribute to the spring in rainy season, causing shorter residence time. Additionally, the residence time of groundwater ranged from 3 to 5 years even in low rainfall period. The residence time in high groundwater table level in ridge was older as compared with that in low groundwater table level. These suggest that the contribution of groundwater with older age in the ridge becomes dominant in the low discharge.

Anatomy of Some Non-Heinrich Events During The Last Glacial Maximum on Laurentian Fan

NASA Astrophysics Data System (ADS)

Gil, I. M.; Keigwin, L. D.

2013-12-01

High-resolution diatom assemblage analyses coupled with oxygen and carbon isotopic records from a new 28 m piston core on Laurentian Fan reveal significant sedimentological and marine productivity changes related to variability of the nearby Laurentide Ice Sheet during the Last Glacial Maximum. Between 21.0 and 19.7 ka and between 18.8 and 18.6 ka, olive-grey clays intervals interrupt the usual glacial red-clays sedimentation. The timing of these two intervals corresponds to reported occurrence of layers low in detrital carbonate (LDC, considered as non-Heinrich events) that occurred between Heinrich Event 1 and 2. Diatoms are only abundant during those LDC - olive-grey clay intervals and suggest ice retreat (allowing light penetration necessary to diatoms). The species succession reveals also different environmental conditions. The 21.0 to 19.7 ka interval is divisible to two main periods: the first was characterized by environmental conditions dominated by ice, while the second period (starting at 20.2 ka) was warmer than the first. During the shorter 18.8 to 18.6 ka interval, conditions were even warmer than during the 20.2 to 19.7 ka sub-interval. Finally, the comparison of the interpreted oceanographic conditions with changes in Ice Rafted Debris and other records from the North Atlantic will bring a new insight into those episodes that precede the transition to deglaciation beginning ~18.2 ka on Laurentian Fan (based on δ18-O in N. pachyderma (s.)).

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.

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.

Reaching multi-nanosecond timescales in combined QM/MM molecular dynamics simulations through parallel horsetail sampling.

PubMed

Martins-Costa, Marilia T C; Ruiz-López, Manuel F

2017-04-15

We report an enhanced sampling technique that allows to reach the multi-nanosecond timescale in quantum mechanics/molecular mechanics molecular dynamics simulations. The proposed technique, called horsetail sampling, is a specific type of multiple molecular dynamics approach exhibiting high parallel efficiency. It couples a main simulation with a large number of shorter trajectories launched on independent processors at periodic time intervals. The technique is applied to study hydrogen peroxide at the water liquid-vapor interface, a system of considerable atmospheric relevance. A total simulation time of a little more than 6 ns has been attained for a total CPU time of 5.1 years representing only about 20 days of wall-clock time. The discussion of the results highlights the strong influence of the solvation effects at the interface on the structure and the electronic properties of the solute. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

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.

Comparison of maternal and neonatal outcomes for patients with placenta accreta spectrum between online-to-offline management model with standard care model.

PubMed

Sun, Wen; Yu, Lin; Liu, Shiliang; Chen, Yanhong; Chen, Juanjuan; Wen, Shi Wu; Chen, Dunjin

2018-03-01

Online-to-offline is a new model for emergent medical service with the ability to connect care providers with patients on instant basis. This study aims to evaluate maternal and neonatal outcomes in patients with placenta accreta spectrum managed by an online-to-offline care model. Starting from January 1, 2015, management of patients with placenta accreta spectrum was changed from standard care model into an online-to-offline care model through "Wechat" in Guangzhou Medical Centre for Critical Obstetrical Care. This study compared maternal and neonatal outcomes in patients affected by placenta accreta spectrum between 2015 (online-to-offline model) and 2014 (standard care model). A total of 209 cases of placenta accrete spectrum were treated in our center in 2015 and 218 such cases were treated in 2014. Patients treated in 2015 had lower rate of hysterectomy (14.83% versus 20.64%) and shorter hospital stay (7 days versus 8 days). The average interval from admission to emergency cesarean section for critically ill patients was 38.5 min in 2015 versus 50.7 min in 2014. Patients affected by placenta accreta spectrum managed by online-to-offline care model have reduced risk of hysterectomy, shorter hospital stay, and shorter response time from admission to emergency cesarean section. Copyright © 2018 Elsevier B.V. All rights reserved.

The associations of birth intervals with small-for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis

PubMed Central

2013-01-01

Background Short and long birth intervals have previously been linked to adverse neonatal outcomes. However, much of the existing literature uses cross-sectional studies, from which deriving causal inference is complex. We examine the association between short/long birth intervals and adverse neonatal outcomes by calculating and meta-analyzing associations using original data from cohort studies conducted in low-and middle-income countries (LMIC). Methods We identified five cohort studies. Adjusted odds ratios (aOR) were calculated for each study, with birth interval as the exposure and small-for-gestational-age (SGA) and/or preterm birth, and neonatal and infant mortality as outcomes. The associations were controlled for potential confounders and meta-analyzed. Results Birth interval of shorter than 18 months had statistically significant increased odds of SGA (pooled aOR: 1.51, 95% CI: 1.31-1.75), preterm (pooled aOR: 1.58, 95% CI: 1.19-2.10) and infant mortality (pooled aOR: 1.83, 95% CI: 1.19-2.81) after controlling for potential confounding factors (reference 36-<60 months). It was also significantly associated with term-SGA, preterm-appropriate-for-gestational-age, and preterm-SGA. Birth interval over 60 months had increased risk of SGA (pooled aOR: 1.22, 95% CI: 1.07-1.39) and term-SGA (pooled aOR: 1.14, 95% CI: 1.03-1.27), but was not associated with other outcomes. Conclusions Birth intervals shorter than 18 months are significantly associated with SGA, preterm birth and death in the first year of life. Lack of access to family planning interventions thus contributes to the burden of adverse birth outcomes and infant mortality in LMICs. Programs and policies must assess ways to provide equitable access to reproductive health interventions to mothers before or soon after delivering a child, but also address underlying socioeconomic factors that may modify and worsen the effect of short intervals. PMID:24564484

Low-Dose Involved-Field Radiation in the Treatment of Non-Hodgkin Lymphoma: Predictors of Response and Treatment Failure

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

Russo, Andrea L., E-mail: alrusso@partners.org; Chen, Yu-Hui; Martin, Neil E.

Purpose: To investigate clinical and pathologic factors significant in predicting local response and time to further treatment after low-dose involved-field radiation therapy (LD-IFRT) for non-Hodgkin lymphoma (NHL). Methods and Materials: Records of NHL patients treated at a single institution between April 2004 and September 2011 were retrospectively reviewed. Low-dose involved-field radiation therapy was given as 4 Gy in 2 fractions over 2 consecutive days. Treatment response and disease control were determined by radiographic studies and/or physical examination. A generalized estimating equation model was used to assess the effect of tumor and patient characteristics on disease response. A Cox proportional hazardsmore » regression model was used to assess time to further treatment. Results: We treated a total of 187 sites in 127 patients with LD-IFRT. Histologies included 66% follicular, 9% chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma, 10% marginal zone, 6% mantle cell lymphoma (MCL), and 8% other. Median follow-up time was 23.4 months (range, 0.03-92.2 months). The complete response, partial response, and overall response rates were 57%, 25%, and 82%, respectively. A CLL histology was associated with a lower response rate (odds ratio 0.2, 95% confidence interval 0.1-0.5, P=.02). Tumor size, site, age at diagnosis, and prior systemic therapy were not associated with response. The median time to first recurrence was 13.6 months. Those with CLL and age ≤50 years at diagnosis had a shorter time to further treatment for local failures (hazard ratio [HR] 3.63, P=.01 and HR 5.50, P=.02, respectively). Those with CLL and MCL had a shorter time to further treatment for distant failures (HR 11.1 and 16.3, respectively, P<.0001). Conclusions: High local response rates were achieved with LD-IFRT across most histologies. Chronic lymphocytic leukemia and MCL histologies and age ≤50 years at diagnosis had a shorter time to further treatment after LD-IFRT.« less

Ultra-short heart rate variability recording reliability: The effect of controlled paced breathing.

PubMed

Melo, Hiago M; Martins, Thiago C; Nascimento, Lucas M; Hoeller, Alexandre A; Walz, Roger; Takase, Emílio

2018-06-04

Recent studies have reported that Heart Rate Variability (HRV) indices remain reliable even during recordings shorter than 5 min, suggesting the ultra-short recording method as a valuable tool for autonomic assessment. However, the minimum time-epoch to obtain a reliable record for all HRV domains (time, frequency, and Poincare geometric measures), as well as the effect of respiratory rate on the reliability of these indices remains unknown. Twenty volunteers had their HRV recorded in a seated position during spontaneous and controlled respiratory rhythms. HRV intervals with 1, 2, and 3 min were correlated with the gold standard period (6-min duration) and the mean values of all indices were compared in the two respiratory rhythm conditions. rMSSD and SD1 were more reliable for recordings with ultra-short duration at all time intervals (r values from 0.764 to 0.950, p < 0.05) for spontaneous breathing condition, whereas the other indices require longer recording time to obtain reliable values. The controlled breathing rhythm evokes stronger r values for time domain indices (r values from 0.83 to 0.99, p < 0.05 for rMSSD), but impairs the mean values replicability of domains across most time intervals. Although the use of standardized breathing increases the correlations coefficients, all HRV indices showed an increase in mean values (t values from 3.79 to 14.94, p < 0.001) except the RR and HF that presented a decrease (t = 4.14 and 5.96, p < 0.0001). Our results indicate that proper ultra-short-term recording method can provide a quick and reliable source of cardiac autonomic nervous system assessment. © 2018 Wiley Periodicals, Inc.

Effect of specialized diagnostic assessment units on the time to diagnosis in screen-detected breast cancer patients.

PubMed

Jiang, L; Gilbert, J; Langley, H; Moineddin, R; Groome, P A

2015-05-26

The duration of the cancer diagnostic process has considerable influence on patients' psychosocial well-being. Breast diagnostic assessment units (DAUs) in Ontario, Canada are designed to improve the quality and timeliness of care during a breast cancer diagnosis. We compared the diagnostic duration of patients diagnosed through a DAU vs usual care (UC). Retrospective population-based cohort study of 2499 screen-detected breast cancers (2011) using administrative health-care databases linked to the Ontario Cancer Registry. The diagnostic interval was measured from the initial screen to cancer diagnosis. Diagnostic assessment unit use was based on the biopsy and/or surgery hospital. We compared the length of the diagnostic interval between the DAU groups using multivariable quantile regression. Diagnostic assessment units had a higher proportion of patients diagnosed within the 7-week target compared with UC (79.1% vs 70.2%, P<0.001). The median time to diagnosis at DAUs was 26 days, which was 9 days shorter compared with UC (95% CI: 6.4-11.6). This effect was reduced to 8.3 days after adjusting for all study covariates. Adjusted DAU differences were similar at the 75th and 90th percentiles of the diagnostic interval distribution. Diagnosis through an Ontario DAU was associated with a reduced time to diagnosis for screen-detected breast cancer patients, which likely reduces the anxiety and distress associated with waiting for a diagnosis.

SNF Interim Storage Canister Corrosion and Surface Environment Investigations

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

Bryan, Charles R.; Enos, David G.

2015-09-01

This progress report describes work being done at Sandia National Laboratories (SNL) to assess the localized corrosion performance of container/cask materials used in the interim storage of spent nuclear fuel (SNF). Of particular concern is stress corrosion cracking (SCC), by which a through-wall crack could potentially form in a canister outer wall over time intervals that are shorter than possible dry storage times. In order for SCC to occur, three criteria must be met. A corrosive environment must be present on the canister surface, the metal must susceptible to SCC, and sufficient tensile stress to support SCC must be presentmore » through the entire thickness of the canister wall. SNL is currently evaluating the potential for each of these criteria to be met.« less

Dose-time relationships for post-irradiation cutaneous telangiectasia

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

Cohen, L.; Ubaldi, S.E.

1977-01-01

Seventy-five patients who had received electron beam radiation a year or more previously were studied. The irradiated skin portals were photographed and late reactions graded in terms of the number and severity of telangiectatic lesions observed. The skin dose, number of fractions, overall treatment time and irradiated volume were recorded in each case. A Strandqvist-type iso-effect line was derived for this response. A multi-probit search program also was used to derive best-fitting cell population kinetic parameters for the same data. From these parameters a comprehensive iso-effect table could be computed for a wide range of treatment schedules including daily treatmentmore » as well as fractionation at shorter and longer intervals; this provided a useful set of normal tissue tolerance limits for late effects.« less

Mitigating the effects of in-vehicle distractions through use of the Psychological Refractory Period paradigm.

PubMed

Hibberd, Daryl L; Jamson, Samantha L; Carsten, Oliver M J

2013-01-01

Modern driving involves frequent and potentially detrimental interactions with distracting in-vehicle tasks. Distraction has been shown to slow brake reaction time and decrease lateral and longitudinal vehicle control. It is likely that these negative effects will become more prevalent in the future as advances are made in the functionality, availability, and number of in-vehicle systems. This paper addresses this problem by considering ways to manage in-vehicle task presentation to mitigate their distracting effects. A driving simulator experiment using 48 participants was performed to investigate the existence of the Psychological Refractory Period in the driving context and its effect on braking performance. Drivers were exposed to lead vehicle braking events in isolation (single-task) and with a preceding surrogate in-vehicle task (dual-task). In dual-task scenarios, the time interval between the in-vehicle and braking tasks was manipulated. Brake reaction time increased when drivers were distracted. The in-vehicle task interfered with the performance of the braking task in a manner that was dependent on the interval between the two tasks, with slower reactions following a shorter inter-task interval. This is the Psychological Refractory Period effect. These results have implications for driver safety during in-vehicle distraction. The findings are used to develop recommendations regarding the timing of in-vehicle task presentation so as to reduce their potentially damaging effects on braking performance. In future, these guidelines could be incorporated into a driver workload management system to minimise the opportunity for a driver to be distracted from the ongoing driving task. Copyright © 2012 Elsevier Ltd. All rights reserved.

Association of Aurora-A (STK15) Kinase Polymorphisms With Clinical Outcome of Esophageal Cancer Treated With Preoperative Chemoradiation

PubMed Central

Pan, Jennifer Y.; Ajani, Jaffer A.; Gu, Jian; Gong, Yubo; Quin, Angel; Hung, Maosheng; Wu, Xifeng; Izzo, Julie G.

2013-01-01

BACKGROUND: Aurora-A/STK15 is a serine/threonine kinase critical for regulated chromosome segregation and cytokinesis. We investigated the association between 2 nonsynonymous single nucleotide polymorphisms in the coding region of STK15, T91A (Phe31Ile) and G169A (Val57Ile), and clinical outcome of esophageal cancer treated with preoperative chemoradiation. METHODS: Genotypes at Phe31Ile and Val57Ile were assessed from peripheral blood lymphocytes of 190 esophageal cancer patients and were correlated to response to treatment, recurrence rate, risk of death, disease-free survival (DFS) and median survival time (MTS). RESULTS: All patients had resectable esophageal or gastroesophageal junction cancer and received preoperative chemoradiation followed by esophagectomy. The heterozygous variant Phe31/Ile variant was significantly associated with tumor recurrence (odds ratio [OR] = 4.39; 95% confidence interval [CI], 2.12-8.94; P < .001), shorter DFS (P = .0001), and shorter MTS (P = .012). For patients receiving cisplatin-based therapy, only the variant Phe31/Ile had an adverse effect on response (OR = 2.8; 95% CI, 1.01-5.17; P = .048) and MTS (P = .026). The variant 91A-169G haplotype carried a significant risk for lack of complete response (OR = 2.54; 95% CI, 1.15-5.54) and higher rate of recurrence (OR = 2.73; 95%CI, 1.00-7.29). The presence of at least 1 variant allele at each locus further increased the risk of recurrence (adjusted OR = 6.21; 95% CI, 2.28-17.11; P = <.001), and was associated significantly shorter DFS (P = .003). CONCLUSIONS: Our study shows that functional SNPs in the STK15 gene are associated with higher rate of recurrence, higher likelihood of chemoratiotherapy-resistance, shorter DFS, and shorter MTS. Confirmation of our data and understanding the mechanisms through which STK15 functional SNPs mediate resistance to chemoradiotherapy are warranted. PMID:22213102

Serum Phthalate Levels and Time to Pregnancy in Couples from Greenland, Poland and Ukraine

PubMed Central

Specht, Ina Olmer; Bonde, Jens Peter; Toft, Gunnar; Lindh, Christian H.; Jönsson, Bo A. G.; Jørgensen, Kristian T.

2015-01-01

Phthalates are ubiquitous industrial chemicals that have been associated with altered reproductive function in rodents. Several human studies have reported an inverse association between male testosterone and phthalate levels. Our aim was to investigate time to pregnancy (TTP) according to serum levels of diethylhexyl phthalate (DEHP) and diisononyl phthalate (DiNP) metabolites in both partners. In 2002-2004 we enrolled 938 pregnant women and 401 male spouses from Greenland, Poland and Ukraine. Six oxidized metabolites of DEHP and DiNP were summarized for each of the two parent compounds to provide proxies of the internal exposure. We used Cox discrete-time models to estimate fecundability ratios (FR) and 95% confidence intervals (95% CIs) for men and women according to their proxy-DEHP or -DiNP serum levels adjusted for a fixed set of covariates. The FR was slightly elevated among women with high levels of DEHP (FR=1.14, 95% CI 1.00;1.30) suggesting a shorter TTP in these women. The FR was unrelated to DiNP in women, whereas the results for men were inconsistent pointing in opposite directions. First-time pregnant women from Greenland with high serum DiNP levels had a longer TTP. This study spanning large contrast in environmental exposure does not indicate adverse effects of phthalates on couple fecundity. The shorter TTP in women with high levels of DEHP metabolites is unexplained and needs further investigation. PMID:25786246

Accelerated recovery from sevoflurane anesthesia with isocapnic hyperpnoea.

PubMed

Katznelson, Rita; Minkovich, Leonid; Friedman, Zeev; Fedorko, Ludvik; Beattie, W Scott; Fisher, Joseph A

2008-02-01

Isocapnic hyperpnoea (IH) reduces recovery time from isoflurane anesthesia in animals and humans. We studied the effect of IH on the emergence profile of sevoflurane-anesthetized patients by comparing postoperative recovery variables in patients administered IH (IH group) to those recovered in the customary fashion (control group). We enrolled 30 ASA I-III patients undergoing elective gynecological surgery. Induction and maintenance of anesthesia were standardized with a protocol consisting of fentanyl, propofol, rocuronium, and sevoflurane in air/O2. Patients were randomly assigned to control (C) or IH groups at the end of the surgery. We recorded time intervals from discontinuing sevoflurane to recovery milestones. Time to tracheal extubation was much shorter in the IH group compared with group C (6.2 +/- 2.1 vs 12.3 +/- 3.8 min, respectively, P < 0.01). The IH group also had shorter times to initiation of spontaneous ventilation (4.2 +/- 1.7 vs 6.5 +/- 3.8 min, P = 0.047), eye opening (5.5 +/- 1.4 vs 13.3 +/- 4.4 min, P < 0.01), bispectral index value >75 (3.9 +/- 1.1 vs 8.8 +/- 3.7 min, P < 0.01), leaving operating room (7.7 +/- 2.0 vs 15.3 +/- 3.4 min, P < 0.01), and eligibility for postanesthetic care unit discharge (67.2 +/- 19.3 vs 90.6 +/- 20.0 min, P < 0.01). IH accelerates recovery from sevoflurane anesthesia and shortens operating room and postanesthetic care unit stay.

Dynamics of Bottlebrush Networks

NASA Astrophysics Data System (ADS)

Cao, Zhen; Daniel, William; Vatankhah-Varnosfaderani, Mohammad; Sheiko, Sergei; Dobrynin, Andrey

The deformation dynamics of bottlebrush networks in a melt state is studied using a combination of theoretical, computational, and experimental techniques. Three main molecular relaxation processes are identified in these systems: (i) relaxation of the side chains, (ii) relaxation of the bottlebrush backbones on length scales shorter than the bottlebrush Kuhn length (bK) , and (iii) relaxation of the bottlebrush network strands between cross-links. The relaxation of side chains having a degree of polymerization (DP), nsc, dominates the network dynamics on the time scales τ0 < t <=τsc , where τ0 and τsc τ0 (nsc + 1)2 are the characteristic relaxation times of monomeric units and side chains, respectively. In this time interval, the shear modulus at small deformations decays with time as G0BB (t) t - 1 / 2. On time scales t >τsc, bottlebrush elastomers behave as networks of filaments with a shear modulus G0BB (t) (nsc + 1)- 1 / 4t - 1 / 2 . Finally, the response of the bottlebrush networks becomes time independent at times scales longer than the Rouse time of the bottlebrush network strands. In this time interval, the network shear modulus depends on the network molecular parameters as G0BB (t) (nsc + 1)-1N-1 . Analysis of the simulation data shows that the stress evolution in the bottlebrush networks during constant strain-rate deformation can be described by a universal function. NSF DMR-1409710, DMR-1407645, DMR-1624569, DMR-1436201.

Evaluation of an Automatic Registration-Based Algorithm for Direct Measurement of Volume Change in Tumors

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

Sarkar, Saradwata; Johnson, Timothy D.; Ma, Bing

2012-07-01

Purpose: Assuming that early tumor volume change is a biomarker for response to therapy, accurate quantification of early volume changes could aid in adapting an individual patient's therapy and lead to shorter clinical trials. We investigated an image registration-based approach for tumor volume change quantification that may more reliably detect smaller changes that occur in shorter intervals than can be detected by existing algorithms. Methods and Materials: Variance and bias of the registration-based approach were evaluated using retrospective, in vivo, very-short-interval diffusion magnetic resonance imaging scans where true zero tumor volume change is unequivocally known and synthetic data, respectively. Themore » interval scans were nonlinearly registered using two similarity measures: mutual information (MI) and normalized cross-correlation (NCC). Results: The 95% confidence interval of the percentage volume change error was (-8.93% to 10.49%) for MI-based and (-7.69%, 8.83%) for NCC-based registrations. Linear mixed-effects models demonstrated that error in measuring volume change increased with increase in tumor volume and decreased with the increase in the tumor's normalized mutual information, even when NCC was the similarity measure being optimized during registration. The 95% confidence interval of the relative volume change error for the synthetic examinations with known changes over {+-}80% of reference tumor volume was (-3.02% to 3.86%). Statistically significant bias was not demonstrated. Conclusion: A low-noise, low-bias tumor volume change measurement algorithm using nonlinear registration is described. Errors in change measurement were a function of tumor volume and the normalized mutual information content of the tumor.« less

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

PubMed

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

2009-06-01

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

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

PubMed Central

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

2010-01-01

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

Contraceptive confidence and timing of first birth in Moldova: an event history analysis of retrospective data.

PubMed

Lyons-Amos, Mark; Padmadas, Sabu S; Durrant, Gabriele B

2014-08-11

To test the contraceptive confidence hypothesis in a modern context. The hypothesis is that women using effective or modern contraceptive methods have increased contraceptive confidence and hence a shorter interval between marriage and first birth than users of ineffective or traditional methods. We extend the hypothesis to incorporate the role of abortion, arguing that it acts as a substitute for contraception in the study context. Moldova, a country in South-East Europe. Moldova exhibits high use of traditional contraceptive methods and abortion compared with other European countries. Data are from a secondary analysis of the 2005 Moldovan Demographic and Health Survey, a nationally representative sample survey. 5377 unmarried women were selected. The outcome measure was the interval between marriage and first birth. This was modelled using a piecewise-constant hazard regression, with abortion and contraceptive method types as primary variables along with relevant sociodemographic controls. Women with high contraceptive confidence (modern method users) have a higher cumulative hazard of first birth 36 months following marriage (0.88 (0.87 to 0.89)) compared with women with low contraceptive confidence (traditional method users, cumulative hazard: 0.85 (0.84 to 0.85)). This is consistent with the contraceptive confidence hypothesis. There is a higher cumulative hazard of first birth among women with low (0.80 (0.79 to 0.80)) and moderate abortion propensities (0.76 (0.75 to 0.77)) than women with no abortion propensity (0.73 (0.72 to 0.74)) 24 months after marriage. Effective contraceptive use tends to increase contraceptive confidence and is associated with a shorter interval between marriage and first birth. Increased use of abortion also tends to increase contraceptive confidence and shorten birth duration, although this effect is non-linear-women with a very high use of abortion tend to have lengthy intervals between marriage and first birth. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

ODP Site 1063 (Bermuda Rise) revisited: Oxygen isotopes, excursions and paleointensity in the Brunhes Chron

NASA Astrophysics Data System (ADS)

Channell, J. E. T.; Hodell, D. A.; Curtis, J. H.

2012-02-01

An age model for the Brunhes Chron of Ocean Drilling Program (ODP) Site 1063 (Bermuda Rise) is constructed by tandem correlation of oxygen isotope and relative paleointensity data to calibrated reference templates. Four intervals in the Brunhes Chron where paleomagnetic inclinations are negative for both u-channel samples and discrete samples are correlated to the following magnetic excursions with Site 1063 ages in brackets: Laschamp (41 ka), Blake (116 ka), Iceland Basin (190 ka), Pringle Falls (239 ka). These ages are consistent with current age estimates for three of these excursions, but not for "Pringle Falls" which has an apparent age older than a recently published estimate by ˜28 kyr. For each of these excursions (termed Category 1 excursions), virtual geomagnetic poles (VGPs) reach high southerly latitudes implying paired polarity reversals of the Earth's main dipole field, that apparently occurred in a brief time span (<2 kyr in each case), several times shorter than the apparent duration of regular polarity transitions. In addition, several intervals of low paleomagnetic inclination (low and negative in one case) are observed both in u-channel and discrete samples at ˜318 ka (MIS 9), ˜412 ka (MIS 11) and in the 500-600 ka interval (MIS 14-15). These "Category 2" excursions may constitute inadequately recorded (Category 1) excursions, or high amplitude secular variation.

Temporal dynamics underlying the modulation of social status on social attention.

PubMed

Dalmaso, Mario; Galfano, Giovanni; Coricelli, Carol; Castelli, Luigi

2014-01-01

Fixating someone suddenly moving the eyes is known to trigger a corresponding shift of attention in the observer. This phenomenon, known as gaze-cueing effect, can be modulated as a function of the social status of the individual depicted in the cueing face. Here, in two experiments, we investigated the temporal dynamics underlying this modulation. To this end, a gaze-cueing paradigm was implemented in which centrally-placed faces depicting high- and low-status individuals suddenly shifted the eyes towards a location either spatially congruent or incongruent with that occupied by a subsequent target stimulus. Social status was manipulated by presenting fictive Curriculum Vitae before the experimental phase. In Experiment 1, in which two temporal intervals (50 ms vs. 900 ms) occurred between the direct-gaze face and the averted-gaze face onsets, a stronger gaze-cueing effect in response to high-status faces than low-status faces was observed, irrespective of the time participants were allowed for extracting social information. In Experiment 2, in which two temporal intervals (200 ms vs. 1000 ms) occurred between the averted-gaze face and target onset, a stronger gaze cueing for high-status faces was observed at the shorter interval only. Taken together, these results suggest that information regarding social status is extracted from faces rapidly (Experiment 1), and that the tendency to selectively attend to the locations gazed by high-status individuals may decay with time (Experiment 2).

Discharge behavior of motor units in knee extensors during the initial stage of constant-force isometric contraction at low force level.

PubMed

Kamo, Mifuyu

2002-03-01

To elucidate the strategy of the activity of motor units (MUs) to maintain a constant-force isometric contraction, I examined the behavior of MUs in knee extensor muscles [(vastus medialis (VM), vastus lateralis (VL) and rectus femoris (RF)] during a sustained contraction at 5% of maximal voluntary contraction for 5 min. In all cases, the spike interval exhibited an elongating trend, and two discharge patterns were observed, continuous discharge and decruitment. In continuous-discharge MUs, the trend slope was steep immediately after the onset of constant force (steep phase), and then became gentle (gentle phase). Decruitments were observed frequently during each phase, and additional MU recruitment was observed throughout the contraction. The mean value of recruitment threshold force did not differ among the extensors. The mean spike interval at the onset of constant-force isometric contractions was shorter in RF than in VL. However, there were no differences in the duration and extent of the elongating trend, decruitment time and recruitment time among the extensors. The electromyogram of the antagonist biceps femoris muscle revealed no compensatory change for extensor activity. These results indicated that at a low force level, the strategy employed by the central nervous system to maintain constant force appears to involve cooperation among elongating trends in the spike interval, decruitment following elongation, and additional MU recruitment in synergistic muscles.

Periodic venting of MABR lumen allows high removal rates and high gas-transfer efficiencies.

PubMed

Perez-Calleja, P; Aybar, M; Picioreanu, C; Esteban-Garcia, A L; Martin, K J; Nerenberg, R

2017-09-15

The membrane-aerated biofilm reactor (MABR) is a novel treatment technology that employs gas-supplying membranes to deliver oxygen directly to a biofilm growing on the membrane surface. When operated with closed-end membranes, the MABR provides 100-percent oxygen transfer efficiencies (OTE), resulting in significant energy savings. However, closed-end MABRs are more sensitive to back-diffusion of inert gases, such as nitrogen. Back-diffusion reduces the average oxygen transfer rates (OTR), consequently decreasing the average contaminant removal fluxes (J). We hypothesized that venting the membrane lumen periodically would increase the OTR and J. Using an experimental flow cell and mathematical modeling, we showed that back-diffusion gas profiles developed over relatively long timescales. Thus, very short ventings could re-establish uniform gas profiles for relatively long time periods. Using modeling, we systematically explored the effect of the venting interval (time between ventings). At moderate venting intervals, opening the membrane for 20 s every 30 min, the venting significantly increased the average OTR and J without substantially impacting the OTEs. When the interval was short enough, in this case shorter than 20 min, the OTR was actually higher than for continuous open-end operation. Our results show that periodic venting is a promising strategy to combine the advantages of open-end and closed end operation, maximizing both the OTR and OTE. Copyright © 2017 Elsevier Ltd. All rights reserved.

'Stroke Room': Diagnosis and Treatment at a Single Location for Rapid Intraarterial Stroke Treatment.

PubMed

Ragoschke-Schumm, Andreas; Yilmaz, Umut; Kostopoulos, Panagiotis; Lesmeister, Martin; Manitz, Matthias; Walter, Silke; Helwig, Stefan; Schwindling, Lenka; Fousse, Mathias; Haass, Anton; Garner, Dominique; Körner, Heiko; Roumia, Safwan; Grunwald, Iris; Nasreldein, Ali; Halmer, Ramona; Liu, Yang; Schlechtriemen, Thomas; Reith, Wolfgang; Fassbender, Klaus

2015-01-01

For patients with acute ischemic stroke, intra-arterial treatment (IAT) is considered to be an effective strategy for removing the obstructing clot. Because outcome crucially depends on time to treatment ('time-is-brain' concept), we assessed the effects of an intervention based on performing all the time-sensitive diagnostic and therapeutic procedures at a single location on the delay before intra-arterial stroke treatment. Consecutive acute stroke patients with large vessel occlusion who obtained IAT were evaluated before and after implementation (April 26, 2010) of an intervention focused on performing all the diagnostic and therapeutic measures at a single site ('stroke room'). After implementation of the intervention, the median intervals between admission and first angiography series were significantly shorter for 174 intervention patients (102 min, interquartile range (IQR) 85-120 min) than for 81 control patients (117 min, IQR 89-150 min; p < 0.05), as were the intervals between admission and clot removal or end of angiography (152 min, IQR 123-185 min vs. 190 min, IQR 163-227 min; p < 0.001). However, no significant differences in clinical outcome were observed. This study shows for the, to our knowledge, first time that for patients with acute ischemic stroke, stroke diagnosis and treatment at a single location ('stroke room') saves crucial time until IAT. © 2015 S. Karger AG, Basel.

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.

Determinants of the relationship between cost and survival time after elective adult cardiac surgery.

PubMed

Ho, K M

2014-05-01

Cardiac surgery is increasingly performed on elderly patients with multiple comorbid conditions, but the determinants of the relationship between cost and survival time after cardiac surgery for patients with a serious cardiac condition remain uncertain. Using the long-term outcome data of a cohort study on adult cardiac surgical patients, the relationship between cost and survival time after cardiac surgery from a hospital service perspective was determined. The total cost for each patient was estimated by the costs of the surgical procedures, intra-aortic balloon pump utilisation, operating theatre utilisation, blood products, intensive care unit stay and cumulative hospital stay up to a median follow-up time of 30 months. Of the 2131 patients considered in this study, a total cost >A$100,000 per life-year after cardiac surgery was observed only in 171 patients (8.0%, 95% confidence interval 6.9 to 9.3%). Age, Charlson Comorbidity Index and EuroSCORE were all related to the cost per life-year after cardiac surgery, but EuroSCORE (odds ratio 1.26 per score increment, 95% confidence interval 1.18 to 1.35, P=0.001) was, by far, the most important determinant and explained 32% of the variability in cost per life-year after cardiac surgery. Patients with a high EuroSCORE were associated with a substantially longer length of intensive care unit stay and cumulative hospital stay, as well as a shorter survival time after cardiac surgery compared to patients with a lower EuroSCORE. Of all the subgroups of patients examined, only patients with a EuroSCORE >5 were consistently associated with a cost >A$100,000 per life-year (cost per life-year $183,148, 95% confidence interval 125, 394 to 240, 902).

Suggestion of an oral hygiene program for orthodontic patients with cleft lip and palate: findings of a pilot study.

PubMed

Brasil, Juliana Marcelina Plácido; de Almeida Pernambuco, Renata; da Silva Dalben, Gisele

2007-11-01

To evaluate the efficacy of an oral hygiene program for orthodontic patients with cleft lip and palate. Retrospective pilot study. Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, Brazil. One hundred twenty-two patients with complete cleft lip and palate undergoing orthodontic treatment. Orientation on toothbrushing and flossing, plaque disclosure, and scoring according to an especially designed index. Statistical comparison of variation in plaque index between sessions; correlation of intervals between sessions and variation in plaque index. Mean scores were reduced significantly, from 2.17 to 1.75 between first and second, 2.18 to 1.62 between first and third, and 1.93 to 1.62 between second and third sessions. Plaque reduction was inversely proportional to the time interval. The program demonstrated a significant plaque reduction. The highest reduction between the first and second sessions reveals the need to reinforce the initial instructions at all sessions. The greatest reduction observed at shorter intervals highlights the need for regular follow up. More controlled studies on larger samples should be encouraged to evaluate the validity of the index and the efficacy of similar programs worldwide.

Overuse of short-interval bone densitometry: assessing rates of low-value care.

PubMed

Morden, N E; Schpero, W L; Zaha, R; Sequist, T D; Colla, C H

2014-09-01

We evaluated the prevalence and geographic variation of short-interval (repeated in under 2 years) dual-energy X-ray absorptiometry tests (DXAs) among Medicare beneficiaries. Short-interval DXA use varied across regions (coefficient of variation = 0.64), and unlike other DXAs, rates decreased with payment cuts. The American College of Rheumatology, through the Choosing Wisely initiative, identified measuring bone density more often than every 2 years as care "physicians and patients should question." We measured the prevalence and described the geographic variation of short-interval (repeated in under 2 years) DXAs among Medicare beneficiaries and estimated the cost of this testing and its responsiveness to payment change. Using 100 % Medicare claims data, 2006-2011, we identified DXAs and short-interval DXAs for female Medicare beneficiaries over age 66. We determined the population rate of DXAs and short-interval DXAs, as well as Medicare spending on short-interval DXAs, nationally and by hospital referral region (HRR). DXA use was stable 2008-2011 (12.4 to 11.5 DXAs per 100 women). DXA use varied across HRRs: in 2011, overall DXA use ranged from 6.3 to 23.0 per 100 women (coefficient of variation = 0.18), and short-interval DXAs ranged from 0.3 to 8.0 per 100 women (coefficient of variation = 0.64). Short-interval DXA use fluctuated substantially with payment changes; other DXAs did not. Short-interval DXAs, which represented 10.1 % of all DXAs, cost Medicare approximately US$16 million in 2011. One out of ten DXAs was administered in a time frame shorter than recommended and at a substantial cost to Medicare. DXA use varied across regions. Short-interval DXA use was responsive to reimbursement changes, suggesting carefully designed policy and payment reform may reduce this care identified by rheumatologists as low value.

Response-food delay gradients for lever pressing and schedule-induced licking in rats.

PubMed

Pellón, Ricardo; Pérez-Padilla, Angeles

2013-06-01

Eight food-deprived Wistar rats developed stable patterns of lever pressing and licking when exposed to a fixed-time 30-s schedule of food pellet presentation. The rats were trained to lever press by presenting the lever 10 s before the programmed food delivery, with the food pellet being delivered immediately upon a lever press. The operant contingency was then removed and the lever was inserted through the entire interfood interval, being withdrawn with food delivery and reinserted 2 s later. On successive phases of the study, a protective contingency postponed food delivery if responses (lever presses or licks) occurred within the last 1, 2, 5, 10, 20, or 25 s of the interfood interval. Lever pressing was reduced at much shorter response-food delays than those that reduced licking. These results demonstrate that reinforcement contributes to the maintenance of different response patterns on periodic schedules, and that different responses are differentially sensitive to delays.

Long Term Follow-up of Botulinum Toxin Therapy for Focal Hand Dystonia: Outcome at 10 or More Years

PubMed Central

Lungu, Codrin; Karp, Barbara I; Alter, Katharine; Zolbrod, Regina; Hallett, Mark

2010-01-01

Background Prior studies have explored the efficacy and safety of BoNT treatment for FHD, but none have followed a large number of patients for 10 or more years. Methods Retrospective study, with benefit and weakness assessed on a 0-4 subjective scale. Demographic, clinical and treatment characteristics were analyzed using t-tests and Pearson correlations. Results 20 FHD patients had 10 years or longer treatment. Inter-injection intervals were variable. Musicians were more likely to wait longer between injections and had less complex dystonia. There was a trend for larger benefit in women and with shorter intervals. The dose increased over time. Dystonia characteristics did not predict response or side-effects, but benefit magnitude predicted longer compliance. No serious side-effects or antibody-mediated resistance occurred. Conclusion This is the longest reported period of BoNT treatment in the largest FHD cohort. BoNT therapy for FHD remains safe and effective after more than a decade of treatment. PMID:21506157

A prospective randomized trial comparing Foley catheter, oxytocin, and combination Foley catheter-oxytocin for labour induction with unfavourable cervix.

PubMed

El Khouly, Nabih I

2017-04-01

The purpose of this study was to evaluate the effectiveness and safety of transcervical Foley catheter with and without oxytocin versus oxytocin alone for labour induction with unfavourable cervix. This trial enrolled 108 women with singleton pregnancies presented for labour induction with unfavourable cervix. Patients were randomly assigned to receive Foley catheter alone (I), Foley catheter plus oxytocin (II) or oxytocin alone (III). Outcomes were analysed in terms of success of induction, induction delivery interval, route of delivery, dose and duration of oxytocin, and complications. Successful normal vaginal delivery was more common in group I (p = .02) compared to group III. Induction delivery time was statistically shorter in group II and group III (p < .001). Patients in group I required significantly less oxytocin dose and duration (p < .001). This led to our conclusion that induction of labour with Foley catheter without oxytocin increases success rate of normal vaginal delivery; however, it has a longer induction delivery interval with similar complications.

TH-A-9A-05: Initial Setup Accuracy Comparison Between Frame-Based and Frameless Stereotactic Radiosurgery

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

Tseng, T; Sheu, R; Todorov, B

2014-06-15

Purpose: To evaluate initial setup accuracy for stereotactic radiosurgery (SRS) between Brainlab frame-based and frameless immobilization system, also to discern the magnitude frameless system has on setup parameters. Methods: The correction shifts from the original setup were compared for total 157 SRS cranial treatments (69 frame-based vs. 88 frameless). All treatments were performed on a Novalis linac with ExacTrac positioning system. Localization box with isocenter overlay was used for initial setup and correction shift was determined by ExacTrac 6D auto-fusion to achieve submillimeter accuracy for treatment. For frameless treatments, mean time interval between simulation and treatment was 5.7 days (rangemore » 0–13). Pearson Chi-Square was used for univariate analysis. Results: The correctional radial shifts (mean±STD, median) for the frame and frameless system measured by ExacTrac were 1.2±1.2mm, 1.1mm and 3.1±3.3mm, 2.0mm, respectively. Treatments with frameless system had a radial shift >2mm more often than those with frames (51.1% vs. 2.9%; p<.0001). To achieve submillimeter accuracy, 85.5% frame-based treatments did not require shift and only 23.9% frameless treatment could succeed with initial setup. There was no statistical significant system offset observed in any direction for either system. For frameless treatments, those treated ≥ 3 days from simulation had statistically higher rates of radial shifts between 1–2mm and >2mm compared to patients treated in a shorter amount of time from simulation (34.3% and 56.7% vs. 28.6% and 33.3%, respectively; p=0.006). Conclusion: Although image-guided positioning system can also achieve submillimeter accuracy for frameless system, users should be cautious regarding the inherent uncertainty of its capability of immobilization. A proper quality assurance procedure for frameless mask manufacturing and a protocol for intra-fraction imaging verification will be crucial for frameless system. Time interval between simulation and treatment was influential to initial setup accuracy. A shorter time frame for frameless SRS treatment could be helpful in minimizing uncertainties in localization.« less

Non-Poissonian Quantum Jumps of a Fluxonium Qubit due to Quasiparticle Excitations

NASA Astrophysics Data System (ADS)

Vool, U.; Pop, I. M.; Sliwa, K.; Abdo, B.; Wang, C.; Brecht, T.; Gao, Y. Y.; Shankar, S.; Hatridge, M.; Catelani, G.; Mirrahimi, M.; Frunzio, L.; Schoelkopf, R. J.; Glazman, L. I.; Devoret, M. H.

2014-12-01

As the energy relaxation time of superconducting qubits steadily improves, nonequilibrium quasiparticle excitations above the superconducting gap emerge as an increasingly relevant limit for qubit coherence. We measure fluctuations in the number of quasiparticle excitations by continuously monitoring the spontaneous quantum jumps between the states of a fluxonium qubit, in conditions where relaxation is dominated by quasiparticle loss. Resolution on the scale of a single quasiparticle is obtained by performing quantum nondemolition projective measurements within a time interval much shorter than T1 , using a quantum-limited amplifier (Josephson parametric converter). The quantum jump statistics switches between the expected Poisson distribution and a non-Poissonian one, indicating large relative fluctuations in the quasiparticle population, on time scales varying from seconds to hours. This dynamics can be modified controllably by injecting quasiparticles or by seeding quasiparticle-trapping vortices by cooling down in a magnetic field.

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.

Non-Poissonian quantum jumps of a fluxonium qubit due to quasiparticle excitations.

PubMed

Vool, U; Pop, I M; Sliwa, K; Abdo, B; Wang, C; Brecht, T; Gao, Y Y; Shankar, S; Hatridge, M; Catelani, G; Mirrahimi, M; Frunzio, L; Schoelkopf, R J; Glazman, L I; Devoret, M H

2014-12-12

As the energy relaxation time of superconducting qubits steadily improves, nonequilibrium quasiparticle excitations above the superconducting gap emerge as an increasingly relevant limit for qubit coherence. We measure fluctuations in the number of quasiparticle excitations by continuously monitoring the spontaneous quantum jumps between the states of a fluxonium qubit, in conditions where relaxation is dominated by quasiparticle loss. Resolution on the scale of a single quasiparticle is obtained by performing quantum nondemolition projective measurements within a time interval much shorter than T₁, using a quantum-limited amplifier (Josephson parametric converter). The quantum jump statistics switches between the expected Poisson distribution and a non-Poissonian one, indicating large relative fluctuations in the quasiparticle population, on time scales varying from seconds to hours. This dynamics can be modified controllably by injecting quasiparticles or by seeding quasiparticle-trapping vortices by cooling down in a magnetic field.

Adult body height of twins compared with that of singletons: a register-based birth cohort study of Norwegian males.

PubMed

Eriksen, Willy; Sundet, Jon M; Tambs, Kristian

2013-05-01

In the present study, we evaluated whether childhood differences in body height between singletons and twins persist into adulthood. Data from the Medical Birth Register of Norway were linked with data from the Norwegian National Conscript Service. This study used data on the 457,999 males who were born alive and without physical anomalies in single or twin births in Norway during 1967-1984 and who were examined at the mandatory military conscription (age 18-20 years; 1985-2003). For sibling comparisons, the authors selected the 1,721 sibships of full brothers that included at least 1 male born in a single birth and at least 1 male born in a twin birth (4,520 persons, including 2,493 twins and 2,027 singletons). An analysis of the total study population using generalized estimating equations showed that the twins were 0.6 cm (95% confidence interval: 0.4, 0.7) shorter than were the singletons after adjustment for a series of background factors. The fixed-effects regression analysis of the sibships that included both twins and singletons showed that the twins were 0.9 cm (95% confidence interval: 0.6, 1.2) shorter than were their singleton brothers. The study suggests that male twins born in Norway during 1967-1984 were slightly shorter in early adulthood than were singletons.

The effect of congenital deafness on duration judgment.

PubMed

Kowalska, Joanna; Szelag, Elzbieta

2006-09-01

Congenital deafness provides the opportunity to study how atypical sensory and language experiences affect different aspects of information processing, e.g., time perception. Using two methods of temporal estimation, reproduction (Exp. 1) and production (Exp. 2), the effect of deafness on duration judgment was investigated within a time domain of a few seconds. We examined 16 congenitally deaf adolescents, aged between 16 and 19 years, and 16 normally hearing subjects, matched for gender and age. In Exp. 1 subjects were asked to reproduce durations from 1 to 5.5 s, whereas in Exp. 2 they produced durations from 1 to 6 s. The results showed that in both experiments, the region of accurate estimation was significantly limited in deaf individuals, compared to normal hearing ones. Deaf adolescents judged accurately only intervals around 3 s, whereas they overestimated standards shorter than 2 s and underestimated those above 3 s. In contrast, controls correctly estimated the majority of standards applied in both experiments, with the exception of underreproduction of intervals longer than 3 s (Exp. 1). The effect of deafness on the accuracy of duration judgment can be linked to differences in the use of conventional time units, applied strategy as well as cognitive processes such as attention or working memory.

[Influence of object material and inter-trial interval on novel object recognition test in mice].

PubMed

Li, Sheng-jian; Huang, Zhu-yan; Ye, Yi-lu; Yu, Yue-ping; Zhang, Wei-ping; Wei, Er-qing; Zhang, Qi

2014-05-01

To investigate the efficacy of novel object recognition (NOR) test in assessment of learning and memory ability in ICR mice in different experimental conditions. One hundred and thirty male ICR mice were randomly divided into 10 groups: 4 groups for different inter-trial intervals (ITI: 10 min, 90 min, 4 h, 24 h), 4 groups for different object materials (wood-wood, plastic-plastic, plastic-wood, wood-plastic) and 2 groups for repeated test (measured once a day or every 3 days, totally three times in each group). The locomotor tracks in the open field were recorded. The amount of time spent exploring the novel and familiar objects, the discrimination ratio (DR) and the discrimination index (DI) were analyzed. Compared with familiar object, DR and DI of novel object were both increased at ITI of 10 min and 90 min (P<0.01). Exploring time, DR and DI were greatly influenced by different object materials. DR and DI remained stable by using identical object material. NOR test could be done repeatedly in the same batch of mice. NOR test can be used to assess the learning and memory ability in mice at shorter ITI and with identical material. It can be done repeatedly.

Disparities in breast cancer surgery delay: the lingering effect of race.

PubMed

Sheppard, Vanessa B; Oppong, Bridget A; Hampton, Regina; Snead, Felicia; Horton, Sara; Hirpa, Fikru; Brathwaite, Echo J; Makambi, Kepher; Onyewu, S; Boisvert, Marc; Willey, Shawna

2015-09-01

Delays to surgical breast cancer treatment of 90 days or more may be associated with greater stage migration. We investigated racial disparities in time to receiving first surgical treatment in breast cancer patients. Insured black (56 %) and white (44 %) women with primary breast cancer completed telephone interviews regarding psychosocial (e.g., self-efficacy) and health care factors (e.g., communication). Clinical data were extracted from medical charts. Time to surgery was measured as the days between diagnosis and definitive surgical treatment. We also examined delays of more than 90 days. Unadjusted hazard ratios (HRs) examined univariate relationships between delay outcomes and covariates. Cox proportional hazard models were used for multivariate analyses. Mean time to surgery was higher in blacks (mean 47 days) than whites (mean 33 days; p = .001). Black women were less likely to receive therapy before 90 days compared to white women after adjustment for covariates (HR .58; 95 % confidence interval .44, .78). Health care process factors were nonsignificant in multivariate models. Women with shorter delay reported Internet use (vs. not) and underwent breast-conserving surgery (vs. mastectomy) (p < .01). Prolonged delays to definitive breast cancer surgery persist among black women. Because the 90-day interval has been associated with poorer outcomes, interventions to address delay are needed.

Impact of Hypokalemia on Electromechanical Window, Excitation Wavelength and Repolarization Gradients in Guinea-Pig and Rabbit Hearts

PubMed Central

Osadchii, Oleg E.

2014-01-01

Normal hearts exhibit a positive time difference between the end of ventricular contraction and the end of QT interval, which is referred to as the electromechanical (EM) window. Drug-induced prolongation of repolarization may lead to the negative EM window, which was proposed to be a novel proarrhythmic marker. This study examined whether abnormal changes in the EM window may account for arrhythmogenic effects produced by hypokalemia. Left ventricular pressure, electrocardiogram, and epicardial monophasic action potentials were recorded in perfused hearts from guinea-pig and rabbit. Hypokalemia (2.5 mM K+) was found to prolong repolarization, reduce the EM window, and promote tachyarrhythmia. Nevertheless, during both regular pacing and extrasystolic excitation, the increased QT interval invariably remained shorter than the duration of mechanical systole, thus yielding positive EM window values. Hypokalemia-induced arrhythmogenicity was associated with slowed ventricular conduction, and shortened effective refractory periods, which translated to a reduced excitation wavelength index. Hypokalemia also evoked non-uniform prolongation of action potential duration in distinct epicardial regions, which resulted in increased spatial variability in the repolarization time. These findings suggest that arrhythmogenic effects of hypokalemia are not accounted for by the negative EM window, and are rather attributed to abnormal changes in ventricular conduction times, refractoriness, excitation wavelength, and spatial repolarization gradients. PMID:25141124

Responses of heart rate and blood pressure to KC-135 hyper-gravity

NASA Technical Reports Server (NTRS)

Satake, Hirotaka; Matsunami, Ken'ichi; Reschke, Millard F.

1992-01-01

Many investigators have clarified the effects of hyper gravitational-inertial forces (G) upon the cardiovascular system, using the centrifugal apparatus with short rotating radius. We investigated the cardiovascular responses to KC-135 hyper-G flight with negligibly small angular velocity. Six normal, healthy subjects 29 to 40 years old (5 males and 1 female) took part in this experiment. Hyper gravitational-inertial force was generated by the KC-135 hyper-G flight, flown in a spiral path with a very long radius of 1.5 miles. Hyper-G was sustained for 3 minutes with 1.8 +Gz in each session and was repeatedly exposed to very subject sitting on a chair 5 times. The preliminary results of blood pressure and R-R interval are discussed. An exposure of 1.8 +Gz stress resulted in a remarkable increase of systolic and diastolic blood pressure, while the pulse pressure did not change and remained equal to the control level regardless of an exposure of hyper-G. These results in blood pressure indicate an increase of resistance in the peripheral vessels, when an exposure of hyper-G was applied. The R-R interval was calculated from ECG. R-R interval in all subjects was changed but not systematically, and R-R interval became obviously shorter during the hyper-G period than during the 1 +Gz control period although R-R interval varied widely in some cases. The coefficient of variation of R-R interval was estimated to determine the autonomic nerve activity, but no significant change was detectable.

Characterization of Myocardial Repolarization Reserve in Adolescent Females With Anorexia Nervosa.

PubMed

Padfield, Gareth J; Escudero, Carolina A; DeSouza, Astrid M; Steinberg, Christian; Gibbs, Karen; Puyat, Joseph H; Lam, Pei Yoong; Sanatani, Shubhayan; Sherwin, Elizabeth; Potts, James E; Sandor, George; Krahn, Andrew D

2016-02-09

Patients with anorexia nervosa exhibit abnormal myocardial repolarization and are susceptible to sudden cardiac death. Exercise testing is useful in unmasking QT prolongation in disorders associated with abnormal repolarization. We characterized QT adaptation during exercise in anorexia. Sixty-one adolescent female patients with anorexia nervosa and 45 age- and sex-matched healthy volunteers performed symptom-limited cycle ergometry during 12-lead ECG monitoring. Changes in the QT interval during exercise were measured, and QT/RR-interval slopes were determined by using mixed-effects regression modeling. Patients had significantly lower body mass index than controls; however, resting heart rates and QT/QTc intervals were similar at baseline. Patients had shorter exercise times (13.7±4.5 versus 20.6±4.5 minutes; P<0.001) and lower peak heart rates (159±20 versus 184±9 beats/min; P<0.001). The mean QTc intervals were longer at peak exercise in patients (442±29 versus 422±19 ms; P<0.001). During submaximal exertion at comparable heart rates (114±6 versus 115±11 beats/min; P=0.54), the QTc interval had prolonged significantly more in patients than controls (37±28 versus 24±25 ms; P<0.016). The RR/QT slope, best described by a curvilinear relationship, was more gradual in patients than in controls (13.4; 95% confidence interval, 12.8-13.9 versus 15.8; 95% confidence interval, 15.3-16.4 ms QT change per 10% change in RR interval; P<0.001) and steepest in patients within the highest body mass index tertile versus the lowest (13.9; 95% confidence interval, 12.9-14.9 versus 12.3; 95% confidence interval, 11.3-13.3; P=0.026). Despite the absence of manifest QT prolongation, adolescent anorexic females have impaired repolarization reserve in comparison with healthy controls. Further study may identify impaired QT dynamics as a risk factor for arrhythmias in anorexia nervosa. © 2016 American Heart Association, Inc.

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.

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.

Can interprofessional teamwork reduce patient throughput times? A longitudinal single-centre study of three different triage processes at a Swedish emergency department

PubMed Central

Masiello, Italo; Ponzer, Sari; Farrokhnia, Nasim

2018-01-01

Objective To determine the impact on emergency department (ED) throughput times and proportion of patients who leave without being seen by a physician (LWBS) of two triage interventions, where comprehensive nurse-led triage was first replaced by senior physician-led triage and then by interprofessional teamwork. Design Single-centre before-and-after study. Setting Adult ED of a Swedish urban hospital. Participants Patients arriving on weekdays 08:00 to 21:00 during three 1-year periods in the interval May 2012 to November 2015. A total of 185 806 arrivals were included. Interventions Senior physicians replaced triage nurses May 2013 to May 2014. Interprofessional teamwork replaced the triage process on weekdays 08:00 to 21:00 November 2014 to November 2015. Main outcome measures Primary outcomes were the median time to physician (TTP) and the median length of stay (LOS). Secondary outcome was the LWBS rate. Results The crude median LOS was shortest for teamwork, 228 min (95% CI 226.4 to 230.5) compared with 232 min (95% CI 230.8 to 233.9) for nurse-led and 250 min (95% CI 248.5 to 252.6) for physician-led triage. The adjusted LOS for the teamwork period was 16 min shorter than for nurse-led triage and 23 min shorter than for physician-led triage. The median TTP was shortest for physician-led triage, 56 min (95% CI 54.5 to 56.6) compared with 116 min (95% CI 114.4 to 117.5) for nurse-led triage and 74 min (95% CI 72.7 to 74.8) for teamwork. The LWBS rate was 1.9% for nurse-led triage, 1.2% for physician-led triage and 3.2% for teamwork. All outcome measure differences had two-tailed p values<0.01. Conclusions Interprofessional teamwork had the shortest length of stay, a shorter time to physician than nurse-led triage, but a higher LWBS rate. Interprofessional teamwork may be a useful approach to reducing ED throughput times. PMID:29674366

Increasing the interval between neoadjuvant chemoradiotherapy and surgery in esophageal cancer: a meta-analysis of published studies.

PubMed

Lin, G; Han, S-Y; Xu, Y-P; Mao, W-M

2016-11-01

The aim of this meta-analysis was to clarify whether a longer interval between the end of neoadjuvant chemoradiotherapy (nCRT) and surgery is associated with better outcomes in esophageal cancer. nCRT followed by surgery is the most common approach for patients with resectable esophageal cancer. Operations are performed within 2-8 weeks after nCRT; however, the optimal interval between nCRT and surgery for esophageal cancer is unknown. We performed a systematic literature search in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the Clinical Trials database for studies published between January 2000 and December 2014. Eligible studies were prospective or retrospective studies of esophageal cancer that assessed the effects of intervals longer or shorter than 7-8 weeks between the end of nCRT and surgery. The primary end-points were the overall survival (OS) and pathologic complete response (pCR). Secondary end-points were anastomotic leak, R0 resection, and postoperative mortality rate. A meta-analysis was performed to estimate odds ratios (ORs) using fixed-effect and random-effect models, with Review Manager 5.2. The five studies that met the eligibility requirements included 1,016 patients: 520 in the shorter interval group (≤7-8 weeks) and 496 in the longer interval group (>7-8 weeks). The results of our meta-analysis indicate that a longer interval between nCRT and surgery may be disadvantageous for 2-year OS (OR = 1.40, 95% confidence interval [CI]: 1.09-1.80, P = 0.010) and R0 resection rate (OR = 1.71, 95% CI: 1.14-2.22, P = 0.009). The pCR, anastomotic leak rate, and postoperative morbidity were similar in the two groups. A longer interval (more than the standard 7-8 weeks) from the end of preoperative nCRT to surgery did not increase the rate of pCR in esophageal cancer, and the different intervals had similar effects on anastomotic leak rate and postoperative mortality rates. However, the longer interval between nCRT and surgery may be disadvantageous for long-term OS. These results should be validated prospectively in a randomized trial. © 2015 International Society for Diseases of the Esophagus.

Dynamics of a bilayer membrane coupled to a two-dimensional cytoskeleton: Scale transfers of membrane deformations

NASA Astrophysics Data System (ADS)

Okamoto, Ryuichi; Komura, Shigeyuki; Fournier, Jean-Baptiste

2017-07-01

We theoretically investigate the dynamics of a floating lipid bilayer membrane coupled with a two-dimensional cytoskeleton network, taking into account explicitly the intermonolayer friction, the discrete lattice structure of the cytoskeleton, and its prestress. The lattice structure breaks lateral continuous translational symmetry and couples Fourier modes with different wave vectors. It is shown that within a short time interval a long-wavelength deformation excites a collection of modes with wavelengths shorter than the lattice spacing. These modes relax slowly with a common renormalized rate originating from the long-wavelength mode. As a result, and because of the prestress, the slowest relaxation is governed by the intermonolayer friction. Conversely, and most interestingly, forces applied at the scale of the cytoskeleton for a sufficiently long time can cooperatively excite large-scale modes.

78 FR 78779 - Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; Revisions to Headboat Reporting...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-27

... revisions require fishing records to be submitted electronically (via computer or internet) on a weekly basis or at intervals shorter than a week if notified by the NMFS' Southeast Fisheries Science Center (SEFSC) Science and Research Director (SRD), and prohibits [[Page 78780

Botulinum Toxin Dosing Trends in Spasmodic Dysphonia Over a 20-year Period.

PubMed

Namin, Arya W; Christopher, Kara M; Eisenbeis, John F

2017-01-01

The study aims to (1) identify the botulinum toxin (BTX) dosing trend in a cohort of patients who received at least 20 injections for the treatment of adductor spasmodic dysphonia (ADSD), (2) describe two distinct BTX dosing trends in treating ADSD (a "classic" dosing trend that initially decreases before stabilizing, and a "fluctuating" dosing trend), and (3) determine if patients with the "classic" dosing trend differed in age or in dosing intervals from those with the "fluctuating" dosing trend. This is a retrospective case series. Of 149 patients who received a total of 2484 BTX injections for the treatment of spasmodic dysphonia in 1993-2013, 49 patients received at least 20 injections. The BTX dose and the interval between doses were recorded. The mean dose of injections 1-20 was determined. The age at initial injection, initial dose, and interval in days between treatments were compared for the "fluctuating" and "classic" groups. The cohort exhibits a significant decrease in dose during the first 10-15 injections. The "fluctuating" group had a significantly shorter interval between injections (mean interval = 97.09 days, SD = 29.41; mean interval = 136.90 days, SD = 43.76, P = 0.002). The mean age at initial dose was not significantly different between the "classic" and "fluctuating" groups. The average BTX dose of patients with ADSD who receive long-term injections significantly decreases during the initial 10-15 injections before stabilizing. Patients who exhibit the "fluctuating" dosing pattern have a significantly shorter interval between injections than those with the "classic" dosing pattern. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Quantitative analysis of ventricular ectopic beats in short-term RR interval recordings to predict imminent ventricular tachyarrhythmia.

PubMed

Martínez-Alanis, Marisol; Ruiz-Velasco, Silvia; Lerma, Claudia

2016-12-15

Most approaches to predict ventricular tachyarrhythmias which are based on RR intervals consider only sinus beats, excluding premature ventricular complexes (PVCs). The method known as heartprint, which analyses PVCs and their characteristics, has prognostic value for fatal arrhythmias on long recordings of RR intervals (>70,000 beats). To evaluate characteristics of PVCs from short term recordings (around 1000 beats) and their prognostic value for imminent sustained tachyarrhythmia. We analyzed 132 pairs of short term RR interval recordings (one before tachyarrhythmia and one control) obtained from 78 patients. Patients were classified into two groups based on the history of accelerated heart rate (HR) (HR>90bpm) before a tachyarrhythmia episode. Heartprint indexes, such as mean coupling interval (meanCI) and the number of occurrences of the most prevalent form of PVCs (SNIB) were calculated. The predictive value of all the indexes and of the combination of different indexes was calculated. MeanCI shorter than 482ms and the occurrence of more repetitive arrhythmias (sNIB≥2.5), had a significant prognostic value for patients with accelerated heart rate: adjusted odds ratio of 2.63 (1.33-5.17) for meanCI and 2.28 (1.20-4.33) for sNIB. Combining these indexes increases the adjusted odds ratio: 10.94 (3.89-30.80). High prevalence of repeating forms of PVCs and shorter CI are potentially useful risk markers of imminent ventricular tachyarrhythmia. Knowing if a patient has history of VT/VF preceded by accelerated HR, improves the prognostic value of these risk markers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Impact of paliperidone palmitate one-month formulation on relapse prevention in patients with schizophrenia: A post-hoc analysis of a one-year, open-label study stratified by medication adherence.

PubMed

Si, Tianmei; Li, Nan; Lu, Huafei; Cai, Shangli; Zhuo, Jianmin; Correll, Christoph U; Zhang, Lili; Feng, Yu

2018-06-01

Limited data are available to help identify patients with schizophrenia who are most likely to benefit from long-acting injectable antipsychotics. To investigate the efficacy of long-acting injectable antipsychotic paliperidone palmitate one-month formulation for preventing relapses, factors influencing time to first relapse, and the effect of different antipsychotic adherence levels on time to first relapse in Chinese patients with schizophrenia. This was a post-hoc analysis from an open-label, single-arm study of stable patients (Positive and Negative Syndrome Scale total score <70; n=367) receiving paliperidone palmitate one-month formulation at the end of an acute 13-week treatment phase, who entered a naturalistic one-year follow-up period, either continuing with flexibly dosed paliperidone palmitate one-month formulation (75-150 mg eq.) or switching to another antipsychotic(s). There were 362/367 patients (age=31.4±10.75 years) included in the analysis of time to first relapse (primary outcome) and 327/362 patients (39/327, poor antipsychotic adherence (<80%)) willing to receive antipsychotics were included in the exposure/adherence analysis. Overall, 84.6% (95% confidence interval=79.2-88.7) patients remained relapse-free. Poor adherence during follow-up (hazard ratio=2.97, 95% confidence interval=1.48-5.98, p=0.002) and frequent hospitalizations in the previous year (hazard ratio=1.29, 95% confidence interval=1.02-1.62, p=0.03) were associated with a significant risk of shorter time to first relapse in the univariate analysis. In patients with poor adherence, 'no use' (hazard ratio=13.13, 95% confidence interval=1.33-129.96, p=0.03) and 'interrupted use' (hazard ratio=11.04, 95% confidence interval=1.03-118.60, p=0.047) of paliperidone palmitate one-month formulation (vs continued use) showed a significantly higher risk of relapse; this was not observed in patients with good (≥80%) antipsychotic adherence. No new safety concerns were identified. Continued use of paliperidone palmitate one-month formulation/long-acting injectable antipsychotic was effective in preventing schizophrenia relapses, especially in patients with suboptimal antipsychotic adherence.

On the Time Course of Vocal Emotion Recognition

PubMed Central

Pell, Marc D.; Kotz, Sonja A.

2011-01-01

How quickly do listeners recognize emotions from a speaker's voice, and does the time course for recognition vary by emotion type? To address these questions, we adapted the auditory gating paradigm to estimate how much vocal information is needed for listeners to categorize five basic emotions (anger, disgust, fear, sadness, happiness) and neutral utterances produced by male and female speakers of English. Semantically-anomalous pseudo-utterances (e.g., The rivix jolled the silling) conveying each emotion were divided into seven gate intervals according to the number of syllables that listeners heard from sentence onset. Participants (n = 48) judged the emotional meaning of stimuli presented at each gate duration interval, in a successive, blocked presentation format. Analyses looked at how recognition of each emotion evolves as an utterance unfolds and estimated the “identification point” for each emotion. Results showed that anger, sadness, fear, and neutral expressions are recognized more accurately at short gate intervals than happiness, and particularly disgust; however, as speech unfolds, recognition of happiness improves significantly towards the end of the utterance (and fear is recognized more accurately than other emotions). When the gate associated with the emotion identification point of each stimulus was calculated, data indicated that fear (M = 517 ms), sadness (M = 576 ms), and neutral (M = 510 ms) expressions were identified from shorter acoustic events than the other emotions. These data reveal differences in the underlying time course for conscious recognition of basic emotions from vocal expressions, which should be accounted for in studies of emotional speech processing. PMID:22087275

Palaeoflood records of the last three centuries from the Pyeongchang and Dong rivers, South Korea

NASA Astrophysics Data System (ADS)

Kim, Song-Hyun; Tanaka, Yukiya

2017-08-01

Slackwater deposits are paleostage indicators in paleoflood hydrology that have commonly been used in numerous studies to estimate the magnitude and frequency of flood events and to reconstruct paleoenvironments and paleohydrology. In this study, individual flood events along the Pyeongchang (PC) and Dong (D) rivers of South Korea were differentiated on the basis of changes in deposit color, grain size, organic content, and the existence of laminations. Based on 137Cs and 14C chronological data, 19 flood events have occurred at site PC since 1720, while 17 flood events have occurred at site D since 1815. At the PC study site, the average time interval between the flood events is 15.4 years and the average sediment accumulation rate is 9.7 mm/y. At study site D, the average time interval is 15 years and the average sediment accumulation rate is 11.6 mm/y. These high sediment accumulation rates are consistent with those in humid areas (e.g., Japan) and explain how slackwater deposits can be preserved despite erosion, bioturbation, and pedogenic processes. Based on the results, the study area was divided into three periods: (1) a relatively wet period (1720-1810 CE), (2) a dry period (1810-1960 CE), and (3) a wet period (1960 CE-present). The flood time intervals and average sediment accumulation rates of the eighteenth century were shorter and higher than those of the nineteenth century. This suggests that on the Korean Peninsula, the paleoclimate of the Little Ice Age (LIA) was wetter than that from the nineteenth century to the early twentieth century.

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.

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.

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.

Hospitalization, frequency of interventions, and quality of life after endoscopic, surgical, or conservative treatment in patients with chronic pancreatitis.

PubMed

Rutter, Karoline; Ferlitsch, A; Sautner, T; Püspök, A; Götzinger, P; Gangl, A; Schindl, M

2010-11-01

Patients with chronic pancreatitis usually have a long and debilitating history of disease with frequent hospital admissions, episodes of intractable pain and multiple interventions. The sequences of treatment at initial presentation, endoscopy, surgery, or conservative treatment may affect the time course and admissions needed for disease control, thereby determining quality of life and overall outcome. A total of 292 patients with initial endoscopic, surgical, or conservative pharmacological treatment were retrospectively analyzed regarding frequency of interventions, days in hospital, symptom-free intervals, morbidity, and mortality. Quality of life (QoL) at the latest follow-up was measured by two standardized quality of life questionnaires (EORTC C30 and PAN26). Endoscopic treatment was initially performed in 150 (51.4%) patients, whereas 99 (33.9%) underwent surgery and 43 (14.7%) patients were treated conservatively at their initial presentation. Patients who underwent surgery had a significantly shorter time in the hospital (25.3 ± 24.6, 34.4 ± 35.1, 61.1 ± 37.9; P < 0.001), fewer subsequent therapies (0.43 ± 1.0, 2.1 ± 2.4, 3.1 ± 3.0; P ≤ 0.001), and a longer relapse-free interval (P = 0.004) compared with endoscopically treated patients. The overall complication rate was 32% both after surgery and endoscopy. Infectious-related complications occurred more often after surgical treatment (P ≤ 0.001), whereas patients after endoscopic intervention developed acute or chronic pancreatitis or pseudocyst formation (P = 0.023). Patients who undergo surgery as their initial treatment for chronic pancreatitis require less consecutive interventions, a shorter hospital stay, and have a better quality of life compared with any other treatment. Surgery should therefore be considered early for the treatment of chronic pancreatitis, when endoscopic or conservative treatment fails and patients require further intervention.

The effect of atrial pacing site on electrophysiological properties of the atrioventricular junction and induction of atrioventricular nodal reentry in patients with typical atrioventricular nodal reentrant tachycardia.

PubMed

Kiedrowicz, Radosław M; Kaźmierczak, Jarosław; Wielusiński, Maciej

2017-01-01

Clinical studies in humans have shown the site of atrial stimulation to influence atrioventricular (AV) conduction times and refractory periods, the demonstration of dual AV nodal (AVN) pathways, and induction of AVN reentry. These studies often found conflicting results. Moreover, among enrolled patients a minority of them were found to have AVN reentrant tachycardia (AVNRT). The purpose of this study was to investigate the effect of right and left atrial pacing on the electrophysiological properties of the AV junction in the typical AVNRT population. Ninety-two consecutive patients with typical AVNRT were included. Atrial pacing was performed from the high right atrium (HRA) and the left atrium via the proximal coronary sinus (CS). Stimulation from either the HRA or the CS could result in dual AVN physiology and AVNRT. No site-dependent differences in the ease of induction of dual AVN pathways with variability of initiation from either site were found. However, AVNRT was easier to induce from the HRA. With CS pacing the leftward but not the rightward AVN approaches were the entry point to the AV node because of significantly shorter AH conduction times compared to HRA pacing. Conduction over the leftward AVN extensions could initiate the tachycardia with significantly shorter critical AH interval compared to conduction over the rightward AVN extensions; however, the AH interval during AVNRT and its cycle length were not significantly different. Rightward and leftward AVN extensions are regular features of the AV node. Their different electrophysiological properties lead to variation in the demonstration of discontinuous AVN conduction and AVNRT during right and left atrial pacing. Despite the observation that the left AVN extensions could compose the entry point to the reentrant circuit, there is no evidence that they constitute the critical component of sustained typical AVNRT.

Defining Incident Cases of Epilepsy in Administrative Data

PubMed Central

Bakaki, Paul M.; Koroukian, Siran M.; Jackson, Leila W.; Albert, Jeffrey M.; Kaiboriboon, Kitti

2013-01-01

Purpose To determine the minimum enrollment duration for identifying incident cases of epilepsy in administrative data. Methods We performed a retrospective dynamic cohort study using Ohio Medicaid data from 1992–2006 to identify a total of 5,037 incident epilepsy cases who had at least 1 year of follow-up prior to epilepsy diagnosis (epilepsy-free interval). The incidence for epilepsy-free intervals from 1 to 8 years, overall and stratified by pre-existing disability status, was examined. The graphical approach between the slopes of incidence estimates and the epilepsy-free intervals was used to identify the minimum epilepsy-free interval that minimized misclassification of prevalent as incident epilepsy cases. Results As the length of epilepsy-free interval increased, the incidence rates decreased. A graphical plot showed that the decline in incidence of epilepsy became nearly flat beyond the third epilepsy-free interval. Conclusion The minimum of 3-year epilepsy-free interval is needed to differentiate incident from prevalent cases in administrative data. Shorter or longer epilepsy-free intervals could result in over- or under-estimation of epilepsy incidence. PMID:23791310

Effects of intervals between jumps or bouts on osteogenic response to loading.

PubMed

Umemura, Yoshihisa; Sogo, Naota; Honda, Akiko

2002-10-01

Prolonged loading repetitions can diminish the mechanosensitivity of bones, and increased intervals between loading might restore sensitivity. This study was designed to investigate the effects of intervals between loadings or bouts on osteogenic response. Forty female Fisher 344 rats aged 5 wk were divided into a control group and three exercise groups: 20 jumps in a single bout with a 3-s (S3) or 30-s (S30) jump interval, or 20 jumps in 2 bouts (10 x 2) separated by a 6-h interval with a 3-s jump interval (D3). After 8 wk of training, the bone masses per body weight of the femur and tibia were significantly greater in the three exercise groups than in the control group, and these values were also greater in S30 than in S3, although they were at the same level in D3 and S3. These data suggest that a longer interval (30 s) between individual loading had more effective anabolic effects on bone than a shorter interval (3 s).

OK432 versus doxycycline for treatment of macrocystic lymphatic malformations.

PubMed

Motz, Kevin M; Nickley, Katherine B; Bedwell, Joshua R; Yadav, Bhupender; Guzzetta, Philip C; Oh, Albert K; Bauman, Nancy M

2014-02-01

A variety of sclerotherapy agents are used to treat macrocystic lymphatic malformations (LMs). This retrospective study at a single institution was performed to compare the outcomes of pediatric macrocystic LMs of the head and neck that were treated with doxycycline or with OK432. The outcomes measured included early response to therapy, number of treatments required, operating room time, and adverse events. The rates of clinical success for OK432 and doxycycline were similar (83% and 82%, respectively; p > 0.05), although OK432-treated patients required more treatments than did doxycycline-treated patients (1.9 versus 1.0 injections; p = 0.01; 95% confidence interval, 1.57 to 0.27). The average operating room time for a single OK432 injection was significantly shorter than that for doxycycline (53.2 versus 98.1 minutes; p < 0.001); however, when the total number of treatments administered was considered, the overall times in the operating room were similar. Adverse events in the early postoperative period were more common in OK432-treated patients, who experienced marked postoperative swelling compared to doxycycline-treated patients. OK432 and doxycycline are both effective sclerosants for the treatment of predominantly macrocystic LMs. The administration time for OK432 is shorter than that for doxycycline, but OK432 required more treatments overall to achieve clinical success. Early adverse events were more common in OK432-treated patients, but longer follow-up is necessary to determine whether rates of recurrence and adverse events are similar, particularly in light of the risk of tooth discoloration in doxycycline-treated patients.

The 3-Second Rule in Hereditary Pure Cerebellar Ataxia: A Synchronized Tapping Study

PubMed Central

Matsuda, Shunichi; Matsumoto, Hideyuki; Furubayashi, Toshiaki; Hanajima, Ritsuko; Tsuji, Shoji; Ugawa, Yoshikazu; Terao, Yasuo

2015-01-01

The ‘3-second rule’ has been proposed based on miscellaneous observations that a time period of around 3 seconds constitutes the fundamental unit of time related to the neuro-cognitive machinery in normal humans. The aim of paper was to investigate the temporal processing in patients with spinocerebellar ataxia type 6 (SCA6) and SCA31, pure cerebellar types of spinocerebellar degeneration, using a synchronized tapping task. Seventeen SCA patients (11 SCA6, 6 SCA31) and 17 normal age-matched volunteers participated. The task required subjects to tap a keyboard in synchrony with sequences of auditory stimuli presented at fixed interstimulus intervals (ISIs) between 200 and 4800 ms. In this task, the subjects required non-motor components to estimate the time of forthcoming tone in addition to motor components to tap. Normal subjects synchronized their taps to the presented tones at shorter ISIs, whereas as the ISI became longer, the normal subjects displayed greater latency between the tone and the tapping (transition zone). After the transition zone, normal subjects pressed the button delayed relative to the tone. On the other hand, SCA patients could not synchronize their tapping with the tone even at shorter ISIs, although they pressed the button delayed relative to the tone earlier than normal subjects did. The earliest time of delayed tapping appearance after the transition zone was 4800 ms in normal subjects but 1800 ms in SCA patients. The span of temporal integration in SCA patients is shortened compared to that in normal subjects. This could represent non-motor cerebellar dysfunction in SCA patients. PMID:25706752

A systematic review and meta-analysis of carbohydrate benefits associated with randomized controlled competition-based performance trials.

PubMed

Pöchmüller, Martin; Schwingshackl, Lukas; Colombani, Paolo C; Hoffmann, Georg

2016-01-01

Carbohydrate supplements are widely used by athletes as an ergogenic aid before and during sports events. The present systematic review and meta-analysis aimed at synthesizing all available data from randomized controlled trials performed under real-life conditions. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched systematically up to February 2015. Study groups were categorized according to test mode and type of performance measurement. Subgroup analyses were done with reference to exercise duration and range of carbohydrate concentration. Random effects and fixed effect meta-analyses were performed using the Software package by the Cochrane Collaboration Review Manager 5.3. Twenty-four randomized controlled trials met the objectives and were included in the present systematic review, 16 of which provided data for meta-analyses. Carbohydrate supplementations were associated with a significantly shorter exercise time in groups performing submaximal exercise followed by a time trial [mean difference -0.9 min (95 % confidence interval -1.7, -0.2), p = 0.02] as compared to controls. Subgroup analysis showed that improvements were specific for studies administering a concentration of carbohydrates between 6 and 8 % [mean difference -1.0 min (95 % confidence interval -1.9, -0.0), p = 0.04]. Concerning groups with submaximal exercise followed by a time trial measuring power accomplished within a fixed time or distance, mean power output was significantly higher following carbohydrate load (mean difference 20.2 W (95 % confidence interval 9.0, 31.5), p = 0.0004]. Likewise, mean power output was significantly increased following carbohydrate intervention in groups with time trial measuring power within a fixed time or distance (mean difference 8.1 W (95 % confidence interval 0.5, 15.7) p = 0.04]. Due to the limitations of this systematic review, results can only be applied to a subset of athletes (trained male cyclists). For those, we could observe a potential ergogenic benefit of carbohydrate supplementation especially in a concentration range between 6 and 8 % when exercising longer than 90 min.

The third-stimulus temporal discrimination threshold: focusing on the temporal processing of sensory input within primary somatosensory cortex.

PubMed

Leodori, Giorgio; Formica, Alessandra; Zhu, Xiaoying; Conte, Antonella; Belvisi, Daniele; Cruccu, Giorgio; Hallett, Mark; Berardelli, Alfredo

2017-10-01

The somatosensory temporal discrimination threshold (STDT) has been used in recent years to investigate time processing of sensory information, but little is known about the physiological correlates of somatosensory temporal discrimination. The objective of this study was to investigate whether the time interval required to discriminate between two stimuli varies according to the number of stimuli in the task. We used the third-stimulus temporal discrimination threshold (ThirdDT), defined as the shortest time interval at which an individual distinguishes a third stimulus following a pair of stimuli delivered at the STDT. The STDT and ThirdDT were assessed in 31 healthy subjects. In a subgroup of 10 subjects, we evaluated the effects of the stimuli intensity on the ThirdDT. In a subgroup of 16 subjects, we evaluated the effects of S1 continuous theta-burst stimulation (S1-cTBS) on the STDT and ThirdDT. Results show that ThirdDT is shorter than STDT. We found a positive correlation between STDT and ThirdDT values. As long as the stimulus intensity was within the perceivable and painless range, it did not affect ThirdDT values. S1-cTBS significantly affected both STDT and ThirdDT, although the latter was affected to a greater extent and for a longer period of time. We conclude that the interval needed to discriminate between time-separated tactile stimuli is related to the number of stimuli used in the task. STDT and ThirdDT are encoded in S1, probably by a shared tactile temporal encoding mechanism whose performance rapidly changes during the perception process. ThirdDT is a new method to measure somatosensory temporal discrimination. NEW & NOTEWORTHY To investigate whether the time interval required to discriminate between stimuli varies according to changes in the stimulation pattern, we used the third-stimulus temporal discrimination threshold (ThirdDT). We found that the somatosensory temporal discrimination acuity varies according to the number of stimuli in the task. The ThirdDT is a new method to measure somatosensory temporal discrimination and a possible index of inhibitory activity at the S1 level. Copyright © 2017 the American Physiological Society.

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

Caregiver Integration During Discharge Planning for Older Adults to Reduce Resource Use: A Metaanalysis.

PubMed

Rodakowski, Juleen; Rocco, Philip B; Ortiz, Maqui; Folb, Barbara; Schulz, Richard; Morton, Sally C; Leathers, Sally Caine; Hu, Lu; James, A Everette

2017-08-01

To determine the effect of integrating informal caregivers into discharge planning on postdischarge cost and resource use in older adults. A systematic review and metaanalysis of randomized controlled trials that examine the effect of discharge planning with caregiver integration begun before discharge on healthcare cost and resource use outcomes. MEDLINE, EMBASE, and the Cochrane Library databases were searched for all English-language articles published between 1990 and April 2016. Hospital or skilled nursing facility. Older adults with informal caregivers discharged to a community setting. Readmission rates, length of and time to post-discharge rehospitalizations, costs of postdischarge care. Of 10,715 abstracts identified, 15 studies met the inclusion criteria. Eleven studies provided sufficient detail to calculate readmission rates for treatment and control participants. Discharge planning interventions with caregiver integration were associated with a 25% fewer readmissions at 90 days (relative risk (RR) = 0.75, 95% confidence interval (CI) = 0.62-0.91) and 24% fewer readmissions at 180 days (RR = 0.76, 95% CI = 0.64-0.90). The majority of studies reported statistically significant shorter time to readmission, shorter rehospitalization, and lower costs of postdischarge care among discharge planning interventions with caregiver integration. For older adults discharged to a community setting, the integration of caregivers into the discharge planning process reduces the risk of hospital readmission. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Impact of robotics on the outcome of elderly patients with endometrial cancer.

PubMed

Lavoue, Vincent; Zeng, Xing; Lau, Susie; Press, Joshua Z; Abitbol, Jeremie; Gotlieb, Raphael; How, Jeffrey; Wang, Yifan; Gotlieb, Walter H

2014-06-01

To evaluate the impact of introducing a robotics program on clinical outcome of elderly patients with endometrial cancer. Evaluation and comparison of peri-operative morbidity and disease-free interval in 163 consecutive elderly patients (≥70years) with endometrial cancer undergoing staging procedure with traditional open surgery compared to robotic surgery. All consecutive patients ≥70years of age with endometrial cancer who underwent robotic surgery (n=113) were compared with all consecutive patients ≥70years of age (n=50) before the introduction of a robotic program in December 2007. Baseline patient characteristics were similar in both eras. Patients undergoing robotic surgery had longer mean operating times (244 compared with 217minutes, p=0.009) but fewer minor adverse events (17% compared with 60%, p<0.001). The robotics cohort had less estimated mean blood loss (75 vs 334mL, p<0.0001) and shorter mean hospital stay (3 vs 6days, p<0.0001). There was no difference in disease-free survival (p=0.61) during the mean follow-up time of 2years. Transitioning from open surgery to a robotics program for the treatment of endometrial cancer in the elderly has significant benefits, including lower minor complication rate, less operative blood loss and shorter hospitalization without compromising 2-year disease-free survival. Copyright © 2014 Elsevier Inc. All rights reserved.

Accelerated longitudinal designs: An overview of modelling, power, costs and handling missing data.

PubMed

Galbraith, Sally; Bowden, Jack; Mander, Adrian

2017-02-01

Longitudinal studies are often used to investigate age-related developmental change. Whereas a single cohort design takes a group of individuals at the same initial age and follows them over time, an accelerated longitudinal design takes multiple single cohorts, each one starting at a different age. The main advantage of an accelerated longitudinal design is its ability to span the age range of interest in a shorter period of time than would be possible with a single cohort longitudinal design. This paper considers design issues for accelerated longitudinal studies. A linear mixed effect model is considered to describe the responses over age with random effects for intercept and slope parameters. Random and fixed cohort effects are used to cope with the potential bias accelerated longitudinal designs have due to multiple cohorts. The impact of other factors such as costs and the impact of dropouts on the power of testing or the precision of estimating parameters are examined. As duration-related costs increase relative to recruitment costs the best designs shift towards shorter duration and eventually cross-sectional design being best. For designs with the same duration but differing interval between measurements, we found there was a cutoff point for measurement costs relative to recruitment costs relating to frequency of measurements. Under our model of 30% dropout there was a maximum power loss of 7%.

The effect of different foot and hand set-up positions on backstroke start performance.

PubMed

de Jesus, Karla; de Jesus, Kelly; Abraldes, J Arturo; Mourão, Luis; Borgonovo-Santos, Márcio; Medeiros, Alexandre I A; Gonçalves, Pedro; Chainok, Phornpot; Fernandes, Ricardo J; Vaz, Mário A P; Vilas-Boas, João Paulo

2016-11-01

Foot and hand set-up position effects were analysed on backstroke start performance. Ten swimmers randomly completed 27 starts grouped in trials (n = 3) of each variation, changing foot (totally immersed, partially and totally emerged) and hand (lowest, highest horizontal and vertical) positioning. Fifteen cameras recorded kinematics, and four force plates collected hands and feet kinetics. Standardised mean difference and 95% confidence intervals were used. Variations with feet immersed have shown lower vertical centre of mass (CM) set-up position (0.16 m), vertical impulse exerted at the hands, horizontal and vertical impulse exerted at the feet (0.28, 0.41, 0.16 N/BW.s, respectively) than feet emerged with hands horizontal and vertically positioned. Most variations with feet partially emerged exhibited higher and lesser vertical impulse exerted at hands than feet immersed and emerged (e.g. vertical handgrip, 0.13, 0.15 N/BW.s, respectively). Variation with feet emerged and hands on the lowest horizontal handgrip depicted shorter horizontal (0.23, 0.26 m) and vertical CM positioning at flight (0.16, 0.15 m) than the highest horizontal and vertical handgrip, respectively. Start variations have not affected 15-m time. Variations with feet partially or totally emerged depicted advantages, but focusing on the entry and underwater biomechanics is relevant for a shorter start time.

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.

Time-interval for integration of stabilizing haptic and visual information in subjects balancing under static and dynamic conditions

PubMed Central

Honeine, Jean-Louis; Schieppati, Marco

2014-01-01

Maintaining equilibrium is basically a sensorimotor integration task. The central nervous system (CNS) continually and selectively weights and rapidly integrates sensory inputs from multiple sources, and coordinates multiple outputs. The weighting process is based on the availability and accuracy of afferent signals at a given instant, on the time-period required to process each input, and possibly on the plasticity of the relevant pathways. The likelihood that sensory inflow changes while balancing under static or dynamic conditions is high, because subjects can pass from a dark to a well-lit environment or from a tactile-guided stabilization to loss of haptic inflow. This review article presents recent data on the temporal events accompanying sensory transition, on which basic information is fragmentary. The processing time from sensory shift to reaching a new steady state includes the time to (a) subtract or integrate sensory inputs; (b) move from allocentric to egocentric reference or vice versa; and (c) adjust the calibration of motor activity in time and amplitude to the new sensory set. We present examples of processes of integration of posture-stabilizing information, and of the respective sensorimotor time-intervals while allowing or occluding vision or adding or subtracting tactile information. These intervals are short, in the order of 1–2 s for different postural conditions, modalities and deliberate or passive shift. They are just longer for haptic than visual shift, just shorter on withdrawal than on addition of stabilizing input, and on deliberate than unexpected mode. The delays are the shortest (for haptic shift) in blind subjects. Since automatic balance stabilization may be vulnerable to sensory-integration delays and to interference from concurrent cognitive tasks in patients with sensorimotor problems, insight into the processing time for balance control represents a critical step in the design of new balance- and locomotion training devices. PMID:25339872

A Variable Oscillator Underlies the Measurement of Time Intervals in the Rostral Medial Prefrontal Cortex during Classical Eyeblink Conditioning in Rabbits.

PubMed

Caro-Martín, C Rocío; Leal-Campanario, Rocío; Sánchez-Campusano, Raudel; Delgado-García, José M; Gruart, Agnès

2015-11-04

We were interested in determining whether rostral medial prefrontal cortex (rmPFC) neurons participate in the measurement of conditioned stimulus-unconditioned stimulus (CS-US) time intervals during classical eyeblink conditioning. Rabbits were conditioned with a delay paradigm consisting of a tone as CS. The CS started 50, 250, 500, 1000, or 2000 ms before and coterminated with an air puff (100 ms) directed at the cornea as the US. Eyelid movements were recorded with the magnetic search coil technique and the EMG activity of the orbicularis oculi muscle. Firing activities of rmPFC neurons were recorded across conditioning sessions. Reflex and conditioned eyelid responses presented a dominant oscillatory frequency of ≈12 Hz. The firing rate of each recorded neuron presented a single peak of activity with a frequency dependent on the CS-US interval (i.e., ≈12 Hz for 250 ms, ≈6 Hz for 500 ms, and≈3 Hz for 1000 ms). Interestingly, rmPFC neurons presented their dominant firing peaks at three precise times evenly distributed with respect to CS start and also depending on the duration of the CS-US interval (only for intervals of 250, 500, and 1000 ms). No significant neural responses were recorded at very short (50 ms) or long (2000 ms) CS-US intervals. rmPFC neurons seem not to encode the oscillatory properties characterizing conditioned eyelid responses in rabbits, but are probably involved in the determination of CS-US intervals of an intermediate range (250-1000 ms). We propose that a variable oscillator underlies the generation of working memories in rabbits. The way in which brains generate working memories (those used for the transient processing and storage of newly acquired information) is still an intriguing question. Here, we report that the firing activities of neurons located in the rostromedial prefrontal cortex recorded in alert behaving rabbits are controlled by a dynamic oscillator. This oscillator generated firing frequencies in a variable band of 3-12 Hz depending on the conditioned stimulus-unconditioned stimulus intervals (1 s, 500 ms, 250 ms) selected for classical eyeblink conditioning of behaving rabbits. Shorter (50 ms) and longer (2 s) intervals failed to activate the oscillator and prevented the acquisition of conditioned eyelid responses. This is an unexpected mechanism to generate sustained firing activities in neural circuits generating working memories. Copyright © 2015 the authors 0270-6474/15/3514809-13$15.00/0.

High clearance phenotyping systems for season-long measurement of corn, sorghum and other row crops to complement unmanned aerial vehicle systems

NASA Astrophysics Data System (ADS)

Murray, Seth C.; Knox, Leighton; Hartley, Brandon; Méndez-Dorado, Mario A.; Richardson, Grant; Thomasson, J. Alex; Shi, Yeyin; Rajan, Nithya; Neely, Haly; Bagavathiannan, Muthukumar; Dong, Xuejun; Rooney, William L.

2016-05-01

The next generation of plant breeding progress requires accurately estimating plant growth and development parameters to be made over routine intervals within large field experiments. Hand measurements are laborious and time consuming and the most promising tools under development are sensors carried by ground vehicles or unmanned aerial vehicles, with each specific vehicle having unique limitations. Previously available ground vehicles have primarily been restricted to monitoring shorter crops or early growth in corn and sorghum, since plants taller than a meter could be damaged by a tractor or spray rig passing over them. Here we have designed two and already constructed one of these self-propelled ground vehicles with adjustable heights that can clear mature corn and sorghum without damage (over three meters of clearance), which will work for shorter row crops as well. In addition to regular RGB image capture, sensor suites are incorporated to estimate plant height, vegetation indices, canopy temperature and photosynthetically active solar radiation, all referenced using RTK GPS to individual plots. These ground vehicles will be useful to validate data collected from unmanned aerial vehicles and support hand measurements taken on plots.

Efficacy of clonidine versus phenobarbital in reducing neonatal morphine sulfate therapy days for neonatal abstinence syndrome. A prospective randomized clinical trial.

PubMed

Surran, B; Visintainer, P; Chamberlain, S; Kopcza, K; Shah, B; Singh, R

2013-12-01

To compare the efficacy of clonidine versus phenobarbital in reducing morphine sulfate treatment days for neonatal abstinence syndrome (NAS). Prospective, non-blinded, block randomized trial at a single level III NICU (Neonatal Intensive Care Unit). Eligible infants were treated with a combination of medications as per protocol. Primary outcome was treatment days with morphine sulfate. Secondary outcomes were the mean total morphine sulfate dose, outpatient phenobarbital days, adverse events and treatment failures. A total of 82 infants were eligible, of which 68 were randomized with 34 infants in each study group. Adjusting for covariates phenobarbital as compared with clonidine had shorter morphine sulfate treatment days (-4.6, 95% confidence interval (CI): -0.3, -8.9; P=0.037) with no difference in average morphine sulfate total dose (1.1 mg kg(-1), 95% CI: -0.1, 2.4; P=0.069). Post-discharge phenobarbital was continued for an average of 3.8 months (range 1 to 8 months). No other significant differences were noted. Phenobarbital as adjunct had clinically nonsignificant shorter inpatient but significant overall longer therapy time as compared with clonidine.

Ultrafast dynamic contrast-enhanced mri of the breast using compressed sensing: breast cancer diagnosis based on separate visualization of breast arteries and veins.

PubMed

Onishi, Natsuko; Kataoka, Masako; Kanao, Shotaro; Sagawa, Hajime; Iima, Mami; Nickel, Marcel Dominik; Toi, Masakazu; Togashi, Kaori

2018-01-01

To evaluate the feasibility of ultrafast dynamic contrast-enhanced (UF-DCE) magnetic resonance imaging (MRI) with compressed sensing (CS) for the separate identification of breast arteries/veins and perform temporal evaluations of breast arteries and veins with a focus on the association with ipsilateral cancers. Our Institutional Review Board approved this study with retrospective design. Twenty-five female patients who underwent UF-DCE MRI at 3T were included. UF-DCE MRI consisting of 20 continuous frames was acquired using a prototype 3D gradient-echo volumetric interpolated breath-hold sequence including a CS reconstruction: temporal resolution, 3.65 sec/frame; spatial resolution, 0.9 × 1.3 × 2.5 mm. Two readers analyzed 19 maximum intensity projection images reconstructed from subtracted images, separately identified breast arteries/veins and the earliest frame in which they were respectively visualized, and calculated the time interval between arterial and venous visualization (A-V interval) for each breast. In total, 49 breasts including 31 lesions (breast cancer, 16; benign lesion, 15) were identified. In 39 of the 49 breasts (breasts with cancers, 16; breasts with benign lesions, 10; breasts with no lesions, 13), both breast arteries and veins were separately identified. The A-V intervals for breasts with cancers were significantly shorter than those for breasts with benign lesions (P = 0.043) and no lesions (P = 0.007). UF-DCE MRI using CS enables the separate identification of breast arteries/veins. Temporal evaluations calculating the time interval between arterial and venous visualization might be helpful in the differentiation of ipsilateral breast cancers from benign lesions. 3 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:97-104. © 2017 International Society for Magnetic Resonance in Medicine.

Local quenches and quantum chaos from higher spin perturbations

NASA Astrophysics Data System (ADS)

David, Justin R.; Khetrapal, Surbhi; Kumar, S. Prem

2017-10-01

We study local quenches in 1+1 dimensional conformal field theories at large- c by operators carrying higher spin charge. Viewing such states as solutions in Chern-Simons theory, representing infalling massive particles with spin-three charge in the BTZ back-ground, we use the Wilson line prescription to compute the single-interval entanglement entropy (EE) and scrambling time following the quench. We find that the change in EE is finite (and real) only if the spin-three charge q is bounded by the energy of the perturbation E, as | q| /c < E 2 /c 2. We show that the Wilson line/EE correlator deep in the quenched regime and its expansion for small quench widths overlaps with the Regge limit for chaos of the out-of-time-ordered correlator. We further find that the scrambling time for the two-sided mutual information between two intervals in the thermofield double state increases with increasing spin-three charge, diverging when the bound is saturated. For larger values of the charge, the scrambling time is shorter than for pure gravity and controlled by the spin-three Lyapunov exponent 4 π/β. In a CFT with higher spin chemical potential, dual to a higher spin black hole, we find that the chemical potential must be bounded to ensure that the mutual information is a concave function of time and entanglement speed is less than the speed of light. In this case, a quench with zero higher spin charge yields the same Lyapunov exponent as pure Einstein gravity.

Identifying family members who may struggle in the role of surrogate decision maker.

PubMed

Majesko, Alyssa; Hong, Seo Yeon; Weissfeld, Lisa; White, Douglas B

2012-08-01

Although acting as a surrogate decision maker can be highly distressing for some family members of intensive care unit patients, little is known about whether there are modifiable risk factors for the occurrence of such difficulties. To identify: 1) factors associated with lower levels of confidence among family members to function as surrogates and 2) whether the quality of clinician-family communication is associated with the timing of decisions to forego life support. We conducted a prospective study of 230 surrogate decision makers for incapacitated, mechanically ventilated patients at high risk of death in four intensive care units at University of California San Francisco Medical Center from 2006 to 2007. Surrogates completed a questionnaire addressing their perceived ability to act as a surrogate and the quality of their communication with physicians. We used clustered multivariate logistic regression to identify predictors of low levels of perceived ability to act as a surrogate and a Cox proportional hazard model to determine whether quality of communication was associated with the timing of decisions to withdraw life support. There was substantial variability in family members' confidence to act as surrogate decision makers, with 27% rating their perceived ability as 7 or lower on a 10-point scale. Independent predictors of lower role confidence were the lack of prior experience as a surrogate (odds ratio 2.2, 95% confidence interval [1.04-4.46], p=.04), no prior discussions with the patient about treatment preferences (odds ratio 3.7, 95% confidence interval [1.79-7.76], p<.001), and poor quality of communication with the ICU physician (odds ratio 1.2, 95% confidence interval [1.09-1.35] p<.001). Higher quality physician-family communication was associated with a significantly shorter duration of life-sustaining treatment among patients who died (β=0.11, p=.001). Family members without prior experience as a surrogate and those who had not engaged in advanced discussions with the patient about treatment preferences were at higher risk to report less confidence in carrying out the surrogate role. Better-quality clinician-family communication was associated with both more confidence among family members to act as surrogates and a shorter duration of use of life support among patients who died.

Breath-hold imaging of the coronary arteries using Quiescent-Interval Slice-Selective (QISS) magnetic resonance angiography: pilot study at 1.5 Tesla and 3 Tesla.

PubMed

Edelman, Robert R; Giri, S; Pursnani, A; Botelho, M P F; Li, W; Koktzoglou, I

2015-11-23

Coronary magnetic resonance angiography (MRA) is usually obtained with a free-breathing navigator-gated 3D acquisition. Our aim was to develop an alternative breath-hold approach that would allow the coronary arteries to be evaluated in a much shorter time and without risk of degradation by respiratory motion artifacts. For this purpose, we implemented a breath-hold, non-contrast-enhanced, quiescent-interval slice-selective (QISS) 2D technique. Sequence performance was compared at 1.5 and 3 Tesla using both radial and Cartesian k-space trajectories. The left coronary circulation was imaged in six healthy subjects and two patients with coronary artery disease. Breath-hold QISS was compared with T2-prepared 2D balanced steady-state free-precession (bSSFP) and free-breathing, navigator-gated 3D bSSFP. Approximately 10 2.1-mm thick slices were acquired in a single ~20-s breath-hold using two-shot QISS. QISS contrast-to-noise ratio (CNR) was 1.5-fold higher at 3 Tesla than at 1.5 Tesla. Cartesian QISS provided the best coronary-to-myocardium CNR, whereas radial QISS provided the sharpest coronary images. QISS image quality exceeded that of free-breathing 3D coronary MRA with few artifacts at either field strength. Compared with T2-prepared 2D bSSFP, multi-slice capability was not restricted by the specific absorption rate at 3 Tesla and pericardial fluid signal was better suppressed. In addition to depicting the coronary arteries, QISS could image intra-cardiac structures, pericardium, and the aortic root in arbitrary slice orientations. Breath-hold QISS is a simple, versatile, and time-efficient method for coronary MRA that provides excellent image quality at both 1.5 and 3 Tesla. Image quality exceeded that of free-breathing, navigator-gated 3D MRA in a much shorter scan time. QISS also allowed rapid multi-slice bright-blood, diastolic phase imaging of the heart, which may have complementary value to multi-phase cine imaging. We conclude that, with further clinical validation, QISS might provide an efficient alternative to commonly used free-breathing coronary MRA techniques.

Estimating forest fuels in the Southwest using forest inventory data

Treesearch

Krista M. Gebert; Ervin G. Schuster; Sharon Woudenberg; Renee O' Brien

2008-01-01

Catastrophic wildfires occurring over the last several years have led land management agencies to focus on reducing hazardous fuels. These wildland fuel reduction projects will likely be concentrated in shorter interval, fire-adapted ecosystems that have been moderately or significantly altered from their historical range. But where are these situations located? What...

78 FR 63946 - Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; Revisions to Headboat Reporting...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-25

... electronically (via computer or internet) on a weekly basis or at intervals shorter than a week if notified by the NMFS' Southeast Fisheries Science Center (SEFSC) Science and Research Director (SRD), and would... regulations to explicitly require that headboats submit their fishing information electronically (via computer...

37 CFR 11.29 - Reciprocal transfer or initial transfer to disability inactive status.

Code of Federal Regulations, 2010 CFR

2010-07-01

... until reinstated to active status. (h) Confidentiality of proceeding; Orders to be public—(1... section may resume active status except by order of the OED Director. (2) Petition. A practitioner... Director for transfer to active status once a year, or at whatever shorter intervals the USPTO Director may...

Sonographical predictive markers of failure of induction of labour in term pregnancy.

PubMed

Brik, Maia; Mateos, Silvia; Fernandez-Buhigas, Irene; Garbayo, Paloma; Costa, Gloria; Santacruz, Belen

2017-02-01

Predictive markers of failure of induction of labour in term pregnancy were evaluated. A prospective study including 245 women attending induction of labour was performed. The inclusion criteria were singleton pregnancies, gestational age 37-42 weeks and the main outcomes were failure of induction, induction to delivery interval and mode of delivery. Women with a longer cervical length prior to induction (CLpi) had a higher rate of failure of induction (30.9 ± 6.8 vs. 23.9 ± 9.3, p < .001). BMI was higher and maternal height was lower in the group of caesarean section compared to vaginal delivery (33.1 ± 8 vs. 29.3 ± 4.6, 160 ± 5 vs. 164 ± 5, p < .001, respectively). A shorter CLpi correlated with a shorter induction to delivery interval (R Pearson .237, p < .001). In the regression analysis, for failure of induction the only independent predictor was the CL prior to induction. Therefore, the CLpi is an independent factor for prediction of failure of induction of labour.

Appendiceal mass: Is interval appendicectomy “something of the past”?

PubMed Central

Meshikhes, Abdul-Wahed Nasir

2011-01-01

The need for interval appendicectomy (I.A) after successful conservative management of appendiceal mass has recently been questioned. Furthermore, emergency appendicectomy for appendiceal mass is increasingly performed with equal success and safety to that performed in non-mass forming acute appendicitis. There is an increasing volume of evidence -although mostly retrospective- that if traditional conservative management is adopted, there is no need for routine I.A except for a small number of patients who continue to develop recurrent symptoms. On the other hand, the routine adoption of emergency laparoscopic appendicectomy (LA) in patients presenting with appendiceal mass obviates the need for a second admission and an operation for I.A with a considerable complication rate. It also abolishes misdiagnoses and deals promptly with any unexpected ileo-cecal pathology. Moreover, it may prove to be more cost-effective than conservative treatment even without I.A due to a much shorter hospital stay and a shorter period of intravenous antibiotic administration. If emergency LA is to become the standard of care for appendiceal mass, I.A will certainly become ‘something’ of the past. PMID:21799642

Abacavir–Lamivudine versus Tenofovir–Emtricitabine for Initial HIV-1 Therapy

PubMed Central

Sax, Paul E.; Tierney, Camlin; Collier, Ann C.; Fischl, Margaret A.; Mollan, Katie; Peeples, Lynne; Godfrey, Catherine; Jahed, Nasreen C.; Myers, Laurie; Katzenstein, David; Farajallah, Awny; Rooney, James F.; Ha, Belinda; Woodward, William C.; Koletar, Susan L.; Johnson, Victoria A.; Geiseler, P. Jan; Daar, Eric S.

2009-01-01

BACKGROUND The use of fixed-dose combination nucleoside reverse-transcriptase inhibitors (NRTIs) with a nonnucleoside reverse-transcriptase inhibitor or a ritonavir-boosted protease inhibitor is recommended as initial therapy in patients with human immunodeficiency virus type 1 (HIV-1) infection, but which NRTI combination has greater efficacy and safety is not known. METHODS In a randomized, blinded equivalence study involving 1858 eligible patients, we compared four once-daily anti retroviral regimens as initial therapy for HIV-1 infection: abacavir–lamivudine or tenofovir disoproxil fumarate (DF)–emtricitabine plus efavirenz or ritonavir-boosted atazanavir. The primary efficacy end point was the time from randomization to virologic failure (defined as a confirmed HIV-1 RNA level ≥1000 copies per milliliter at or after 16 weeks and before 24 weeks, or ≥200 copies per milliliter at or after 24 weeks). RESULTS A scheduled interim review by an independent data and safety monitoring board showed significant differences in virologic efficacy, according to the NRTI combination, among patients with screening HIV-1 RNA levels of 100,000 copies per milliliter or more. At a median follow-up of 60 weeks, among the 797 patients with screening HIV-1 RNA levels of 100,000 copies per milliliter or more, the time to virologic failure was significantly shorter in the abacavir–lamivudine group than in the tenofovir DF–emtricitabine group (hazard ratio, 2.33; 95% confidence interval, 1.46 to 3.72; P<0.001), with 57 virologic failures (14%) in the abacavir–lamivudine group versus 26 (7%) in the tenofovir DF–emtricitabine group. The time to the first adverse event was also shorter in the abacavir–lamivudine group (P<0.001). There was no significant difference between the study groups in the change from the baseline CD4 cell count at week 48. CONCLUSIONS In patients with screening HIV-1 RNA levels of 100,000 copies per milliliter or more, the times to virologic failure and the first adverse event were both significantly shorter in patients randomly assigned to abacavir–lamivudine than in those assigned to tenofovir DF–emtricitabine. (ClinicalTrials.gov number, NCT00118898.) PMID:19952143

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.

Relating seasonal patterns of the AVHRR vegetation index to simulated photosynthesis and transpiration of forests in different climates

NASA Technical Reports Server (NTRS)

Running, Steven W.; Nemani, Ramakrishna R.

1988-01-01

Weekly AVHRR Normalized Difference Vegetation Index (NDVI) values for 1983-1984 for seven sites of diverse climate in North America were correlated with results of an ecosystem simulation model of a hypothetical forest stand for the corresponding period at each site. The tendency of raw NDVI data to overpredict photosynthesis and transpiration on water limited sites was shown to be partially corrected by using an aridity index of annual radiation/annual precipitation. The results suggest that estimates of vegetation productivity using the global vegetation index are only accurate as annual integrations, unless unsubsampled local area coverage NDVI data can be tested against forest photosynthesis, transpiration and aboveground net primary production data measured at shorter time intervals.

Size Scales for Thermal Inhomogeneities in Mars' Atmosphere Surface Layer: Mars Pathfinder

NASA Technical Reports Server (NTRS)

Mihalov, John D.; Haberle, Robert M.; Seiff, Alvin; Murphy, James R.; Schofield, John T.; DeVincenzi, Donald L. (Technical Monitor)

2000-01-01

Atmospheric temperature measurement at three heights with thin wire thermocouples on the 1.1 m Mars Pathfinder meteorology must allow estimates of the integral scale of the atmospheric thermal turbulence during an 83 sol period that begins in the summer. The integral scale is a measure for regions of perturbations. In turbulent media that roughly characterizes locations where the perturbations are correlated. Excluding some to intervals with violent excursions of the mean temperatures, integral scale values are found that increase relatively rapidly from a few tenths meters or less near down to several meters by mid-morning. During mid-morning, the diurnal and shorter time scale wind direction variations often place the meteorology mast in the thermal wake of the Lander.

Efficacy and safety of bortezomib-based retreatment at the first relapse in multiple myeloma patients: A retrospective study.

PubMed

Oriol, Albert; Giraldo, Pilar; Kotsianidis, Ioannis; Couturier, Catherine; Olie, Robert; Angermund, Ralf; Corso, Alessandro

2015-08-01

Multiple myeloma remains incurable and retreatment with available therapies is of substantial interest. This retrospective observational study included data from 35 patients treated initially and at the first relapse with bortezomib-containing regimens. Bortezomib retreatment provided a similar depth and time to response as first-line therapy; however, as could be expected, the duration of response was shorter with retreatment. The tolerability profile was similar with bortezomib as the first- and second-line therapy, with no evidence of cumulative toxicity. These findings support bortezomib retreatment after a treatment-free interval of ≥6 months in patients who achieved at least a partial response to the first-line bortezomib-based therapy.

Characteristics of biosonar signals from the northern bottlenose whale, Hyperoodon ampullatus.

PubMed

Wahlberg, Magnus; Beedholm, Kristian; Heerfordt, Anders; Møhl, Bertel

2011-11-01

The biosonar pulses from free-ranging northern bottlenose whales (Hyperoodon ampullatus) were recorded with a linear hydrophone array. Signals fulfilling criteria for being recorded close to the acoustic axis of the animal (a total of 10 clicks) had a frequency upsweep from 20 to 55 kHz and durations of 207 to 377 μs (measured as the time interval containing 95% of the signal energy). The source level of these signals, denoted pulses, was 175-202 dB re 1 μPa rms at 1 m. The pulses had a directionality index of at least 18 dB. Interpulse intervals ranged from 73 to 949 ms (N = 856). Signals of higher repetition rates had interclick intervals of 5.8-13.1 ms (two sequences, made up of 59 and 410 clicks, respectively). These signals, denoted clicks, had a shorter duration (43-200 μs) and did not have the frequency upsweep characterizing the pulses of low repetition rates. The data show that the northern bottlenose whale emits signals similar to three other species of beaked whale. These signals are distinct from the three other types of biosonar signals of toothed whales. It remains unclear why the signals show this grouping, and what consequences it has on echolocation performance.

Long-term prediction of creep strains of mineral wool slabs under constant compressive stress

NASA Astrophysics Data System (ADS)

Gnip, Ivan; Vaitkus, Saulius; Keršulis, Vladislovas; Vėjelis, Sigitas

2012-02-01

The results obtained in determining the creep strain of mineral wool slabs under compressive stress, used for insulating flat roofs and facades, cast-in-place floors, curtain and external basement walls, as well as for sound insulation of floors, are presented. The creep strain tests were conducted under a compressive stress of σ c =0.35 σ 10%. Interval forecasting of creep strain was made by extrapolating the creep behaviour and approximated in accordance with EN 1606 by a power equation and reduced to a linear form using logarithms. This was performed for a lead time of 10 years. The extension of the range of the confidence interval due to discount of the prediction data, i.e. a decrease in their informativity was allowed for by an additional coefficient. Analysis of the experimental data obtained from the tests having 65 and 122 days duration showed that the prediction of creep strains for 10 years can be made based on data obtained in experiments with durations shorter than the 122 days as specified by EN 13162. Interval prediction of creep strains (with a confidence probability of 90%) was based on using the mean square deviation of the actual direct observations of creep strains in logarithmic form to have the linear trend in a retrospective area.

Time to Update and Quantitative Changes in the Results of Cochrane Pregnancy and Childbirth Reviews

PubMed Central

Jaidee, Wanlop; Moher, David; Laopaiboon, Malinee

2010-01-01

Background The recommended interval between updates for systematic reviews included in The Cochrane Library is 2 years. However, it is unclear whether this interval is always appropriate. Whereas excessive updating wastes time and resources, insufficient updating allows out-of-date or incomplete evidence to guide clinical decision-making. We set out to determine, for Cochrane pregnancy and childbirth reviews, the frequency of updates, factors associated with updating, and whether updating frequency was appropriate. Methodology/Principal Findings Cochrane pregnancy and childbirth reviews published in Issue 3, 2007 of the Cochrane Database of Systematic Reviews were retrieved, and data were collected from their original and updated versions. Quantitative changes were determined for one of the primary outcomes (mortality, or the outcome of greatest clinical significance). Potential factors associated with time to update were assessed using the Cox proportional hazard model. Among the 101 reviews in our final sample, the median time before the first update was 3.3 years (95% CI 2.7–3.8). Only 32.7% had been updated within the recommended interval of 2 years. In 75.3% (76/101), a median of 3 new trials with a median of 576 additional participants were included in the updated versions. There were quantitative changes in 71% of the reviews that included new trials (54/76): the median change in effect size was 18.2%, and the median change in 95% CI width was 30.8%. Statistical significance changed in 18.5% (10/54) of these reviews, but conclusions were revised in only 3.7% (2/54). A shorter time to update was associated with the same original review team at updating. Conclusions/Significance Most reviews were updated less frequently than recommended by Cochrane policy, but few updates had revised conclusions. Prescribed time to update should be reconsidered to support improved decision-making while making efficient use of limited resources. PMID:20644625

The impact of persistence with bisphosphonates on health resource utilization and fracture risk in the UK: a study of patient records from the UK Clinical Practice Research Datalink.

PubMed

Ferguson, Samara; Feudjo Tepie, Maurille; Taylor, Andrew; Roddam, Andrew; Critchlow, Cathy; Iqbal, Mazhar; Spangler, Leslie; Bayly, Jonathan

2016-02-01

Clinical trial data suggest that patients who have received bisphosphonates continue to benefit from them after discontinuation. However, data from real-world clinical practice are inconclusive. We assessed the impact of persistence and discontinuation on health resource utilization (HRU) and fracture rate in women who were prescribed oral bisphosphonates. The study used data from the UK Clinical Practice Research Datalink. Women aged 50 years or older with a first prescription of oral bisphosphonate therapy between January 2000 and December 2007 were included. Multivariate modelling compared rate ratios for fracture and HRU between patients who had discontinued medication (shorter persistence group) and patients who took their medication for longer (longer persistence group). The interactions of elapsed time (measured as 6-month intervals) with HRU and with fracture rate for all patients within paired groups were also assessed. Overall, 36 320 patients were included. Pairwise comparisons showed that HRU and fracture rates were lower in longer persistence groups than in shorter persistence groups. Analysis by 6-month interval showed that, across all patients in persistence group pairs, HRU significantly increased for each additional 6 months elapsed; trends towards increased risk of fracture were also seen. In contrast to results from clinical trials, in this patient population the protective effect of oral bisphosphonates after discontinuation was not sufficient to reduce HRU and fracture rates to the levels that would be seen if patients had continued on therapy. Reducing the rate of treatment discontinuation may decrease the burden that osteoporosis places on both patients and health care systems. © 2015 AMGEN Inc. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

Shortening the induction delivery interval with prostaglandins: a randomized controlled trial of solo or in combination

PubMed Central

Mahendru, Rajiv; Yadav, Shweta

2011-01-01

Objective To compare the efficacy and safety of misoprostol alone with dinoprostone followed by misoprostol, all inserted intravaginally in induction of labor at term and the obstetrical outcome. Material and Methods A pilot study comprising 111 primigravidae, >37 gestational weeks with singleton pregnancy in cephalic presentation having an unfavorable Bishop score admitted for labor induction, were considered and randomly allocated into two groups. In group I (n=55) with intravaginal 25mcg misoprostol 4 hourly (six doses at the most) and and group II (n=56), with dinoprostone 0.5mg followed eight hours later by 25mcg misoprostol induction to vaginal delivery time was found to be significantly different, being 14.8 h in group-I and shorter in group-II with a mean of 11.6 h. Vaginal delivery rates within 12 h (groups-I and −II: 47.2%, as compared to 60.7%, respectively) were found to be higher with dinoprostone-misoprostol induction, as well as vaginal delivery rates in 24 h, 80.0% and 91.1%. The need for oxytocin augmentation was more frequent in the misoprostol than in the dinoprostone-misoprostol group, (61.8%, and 39.3%), and all these observations were statistically significant. Abnormal foetal heart rate pattern occurred more frequently (18.2%) in group-I in contrast to 5.3% in group-II, as was the incidence rate of (18.2%) who had passage of meconium in group-I, this rate being significantly different from group-II having meconium passage in 3 cases, a rate of 5.3%. Conclusion Using dinoprostone followed by vaginal misoprostol is safe and effective for induction of labor with less need for oxytocin augmentation and shorter induction delivery interval. PMID:24591967

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.

Real-time processing for full-range Fourier-domain optical-coherence tomography with zero-filling interpolation using multiple graphic processing units.

PubMed

Watanabe, Yuuki; Maeno, Seiya; Aoshima, Kenji; Hasegawa, Haruyuki; Koseki, Hitoshi

2010-09-01

The real-time display of full-range, 2048?axial pixelx1024?lateral pixel, Fourier-domain optical-coherence tomography (FD-OCT) images is demonstrated. The required speed was achieved by using dual graphic processing units (GPUs) with many stream processors to realize highly parallel processing. We used a zero-filling technique, including a forward Fourier transform, a zero padding to increase the axial data-array size to 8192, an inverse-Fourier transform back to the spectral domain, a linear interpolation from wavelength to wavenumber, a lateral Hilbert transform to obtain the complex spectrum, a Fourier transform to obtain the axial profiles, and a log scaling. The data-transfer time of the frame grabber was 15.73?ms, and the processing time, which includes the data transfer between the GPU memory and the host computer, was 14.75?ms, for a total time shorter than the 36.70?ms frame-interval time using a line-scan CCD camera operated at 27.9?kHz. That is, our OCT system achieved a processed-image display rate of 27.23 frames/s.

Effect of Temperature on Feeding Period of Larval Blacklegged Ticks (Acari: Ixodidae) on Eastern Fence Lizards.

PubMed

Rulison, Eric L; Lebrun, Roger A; Ginsberg, Howard S

2014-11-01

Ambient temperature can influence tick development time, and can potentially affect tick interactions with pathogens and with vertebrate hosts. We studied the effect of ambient temperature on duration of attachment of larval blacklegged ticks, Ixodes scapularis Say, to eastern fence lizards, Sceloporus undulatus (Bosc & Daudin). Feeding periods of larvae that attached to lizards under preferred temperature conditions for the lizards (WARM treatment: temperatures averaged 36.6°C at the top of the cage and 25.8°C at the bottom, allowing behavioral thermoregulation) were shorter than for larvae on lizards held under cool conditions (COOL treatment temperatures averaged 28.4°C at top of cage and 24.9°C at the bottom). The lizards were infested with larvae four times at roughly monthly intervals. Larval numbers successfully engorging and dropping declined and feeding period was longer after the first infestation. © 2014 Entomological Society of America.

Effect of temperature on feeding period of larval blacklegged ticks (Acari: Ixodidae) on eastern fence lizards

USGS Publications Warehouse

Rulison, Eric L.; LeBrun, Roger A.; Ginsberg, Howard S.

2014-01-01

Ambient temperature can influence tick development time, and can potentially affect tick interactions with pathogens and with vertebrate hosts. We studied the effect of ambient temperature on duration of attachment of larval blacklegged ticks, Ixodes scapularis Say, to eastern fence lizards, Sceloporus undulatus (Bose & Daudin). Feeding periods of larvae that attached to lizards under preferred temperature conditions for the lizards (WARM treatment: temperatures averaged 36.6°C at the top of the cage and 25.8°C at the bottom, allowing behavioral thermoregulation) were shorter than for larvae on lizards held under cool conditions (COOL treatment temperatures averaged 28.4°C at top of cage and 24.9°C at the bottom). The lizards were infested with larvae four times at roughly monthly intervals. Larval numbers successfully engorging and dropping declined and feeding period was longer after the first infestation.

Determination of inadvertent atrial capture during para-Hisian pacing.

PubMed

Obeyesekere, Manoj; Leong-Sit, Peter; Skanes, Allan; Krahn, Andrew; Yee, Raymond; Gula, Lorne J; Bennett, Matthew; Klein, George J

2011-08-01

Inadvertent capture of the atrium will lead to spurious results during para-Hisian pacing. We sought to establish whether the stimulation-to-atrial electrogram interval at the proximal coronary sinus (stim-PCS) or high right atrium (stim-HRA) could signal inadvertent atrial capture. Para-Hisian pacing with and without intentional atrial capture was performed in 31 patients. Stim-HRA and stim-PCS intervals were measured with atrial capture, His plus para-Hisian ventricular (H+V) capture, and para-Hisian ventricular (V) capture alone. The mean stim-HRA interval was significantly shorter with atrial capture (66 ± 18 ms) than with H+V (121 ± 27 ms, P < 0.001) or V capture alone (174 ± 38 ms, P < 0.001). The mean stim-PCS interval was significantly shorter with atrial capture (51 ± 16 ms) than with H+V (92 ± 22 ms, P<0.001) or V capture alone (146 ± 33 ms, P < 0.001). A stim-PCS < 60 ms (stim-HRA < 70 ms) was observed only with atrial capture. A stim-PCS >90 ms (stim-HRA >100 ms) was observed only in the absence of atrial capture. A stim-HRA of < 85 ms was highly specific and stim-PCS of < 85 ms highly sensitive at identifying atrial capture. Stim-HRA intervals of 75 to 97 ms and stim-PCS intervals of 65 to 88 ms were observed with either atrial, His, or para-Hisian ventricular capture without atrial capture. In this overlap zone, all patients demonstrated a stim-PCS or stim-HRA interval prolongation of at least 20 ms when the catheter was advanced to avoid deliberate atrial pacing. The QRS morphology was of limited value in distinguishing atrial capture due to concurrent ventricular or H+V capture, as observed in 20 of 31 (65%) patients. Stim-PCS and stim-HRA intervals can be used to monitor for inadvertent atrial capture during para-Hisian pacing. A stim-PCS < 60 ms (or stim-HRA < 70 ms) and stim-PCS > 90 ms (or stim-HRA > 100 ms) were observed only with and without atrial capture, respectively, but there was significant overlap between these values. Deliberate atrial capture and loss of capture reliably identifies atrial capture regardless of intervals.

Symptomatic Versus Inapparent Outcome in Repeat Dengue Virus Infections Is Influenced by the Time Interval between Infections and Study Year

PubMed Central

Mercado, Juan Carlos; Williams, Katherine L.; Vargas, Maria José; Gutierrez, Gamaliel; Kuan, Guillermina; Gordon, Aubree; Balmaseda, Angel; Harris, Eva

2013-01-01

Four dengue virus serotypes (DENV1-4) circulate globally, causing more human illness than any other arthropod-borne virus. Dengue can present as a range of clinical manifestations from undifferentiated fever to Dengue Fever to severe, life-threatening syndromes. However, most DENV infections are inapparent. Yet, little is known about determinants of inapparent versus symptomatic DENV infection outcome. Here, we analyzed over 2,000 DENV infections from 2004 to 2011 in a prospective pediatric cohort study in Managua, Nicaragua. Symptomatic cases were captured at the study health center, and paired healthy annual samples were examined on a yearly basis using serological methods to identify inapparent DENV infections. Overall, inapparent and symptomatic DENV infections were equally distributed by sex. The mean age of infection was 1.2 years higher for symptomatic DENV infections as compared to inapparent infections. Although inapparent versus symptomatic outcome did not differ by infection number (first, second or third/post-second DENV infections), substantial variation in the proportion of symptomatic DENV infections among all DENV infections was observed across study years. In participants with repeat DENV infections, the time interval between a first inapparent DENV infection and a second inapparent infection was significantly shorter than the interval between a first inapparent and a second symptomatic infection. This difference was not observed in subsequent infections. This result was confirmed using two different serological techniques that measure total anti-DENV antibodies and serotype-specific neutralizing antibodies, respectively. Taken together, these findings show that, in this study, age, study year and time interval between consecutive DENV infections influence inapparent versus symptomatic infection outcome, while sex and infection number had no significant effect. Moreover, these results suggest that the window of cross-protection induced by a first infection with DENV against a second symptomatic infection is approximately 2 years. These findings are important for modeling dengue epidemics and development of vaccines. PMID:23951377

Short- or long-rest intervals during repeated-sprint training in soccer?

PubMed

Iaia, F Marcello; Fiorenza, Matteo; Larghi, Luca; Alberti, Giampietro; Millet, Grégoire P; Girard, Olivier

2017-01-01

The present study compared the effects of two repeated-sprint training (RST) programs, differing in duration of the between-sprint rest intervals, on various soccer-related exercise performances. For 5 weeks during the competitive season, twenty-nine young trained male soccer players either replaced two of their habitual fitness conditioning sessions with RST characterized by short (5-15; n = 9) or long (5-30; n = 10) rest intervals, or served as control (n = 10). The 5-15 and 5-30 protocols consisted of 6 repetitions of 30-m (~5 s) straight-line sprints interspersed with 15 s or 30 s of passive recovery, respectively. 5-15 improved 200-m sprint time (2.0±1.5%; p<0.05) and had a likely positive impact on 20-m sprint performance, whereas 5-30 lowered the 20-m sprint time (2.7±1.6%; p<0.05) but was only possibly effective for enhancing the 200-m sprint performance. The distance covered during the Yo-Yo Intermittent Recovery Test Level 2 increased following 5-15 (11.4±5.0%; p<0.05), which was possibly better than the non-significant 6.5% enhancement observed in 5-30. Improvements in the total time of a repeated-sprint ability test were possibly greater following 5-30 (3.6±0.9%; p<0.05) compared to 5-15 (2.6±1.1%; p<0.05). Both RST interventions led to similar beneficial (p<0.05) reductions in the percentage decrement score (~30%) of the repeated-sprint ability test as well as in blood lactate concentration during submaximal exercise (17-18%). No changes occurred in the control group. In soccer players, RST over a 5-week in-season period is an efficient means to simultaneously develop different components of fitness relevant to match performance, with different benefits induced by shorter compared to longer rest intervals.

Ground reaction forces and heart rate profile of aerobic dance instructors during a low and high impact exercise programme.

PubMed

Rousanoglou, E N; Boudolos, K D

2005-06-01

The magnitude of ground reaction forces (GRF) has been associated, although never verified, with the high incidence of lower extremities injuries in aerobic dance (AD) instructors. Moreover, during their working activities AD instructors have demonstrated HR levels, such as 70% HRmax, values, more in training rather in working status. This study was designed to investigate GRF and heart rate (HR) exhibited by AD instructors of both genders, during a simulated AD instruction, from the perspective of accepted occupational workloads. Fourteen females and 14 males instructors performed a 35 min AD exercise programme (warm up--low impact (LI) interval--in high impact (HI) interval--cool down). Four GRF measurements were taken during LI and HI time intervals, respectively. HR was recorded throughout the whole experimental procedure and was synchronised to GRF measurements. All GRF and HR values were significantly increased in HI exercise (p<0.05) with a non significant (p>0.05) time effect for GRF. In both LI and HI exercises, females demonstrated significantly higher vertical but lower lateral GRF (p<0.05) and significantly shorter cycles of movement (p<0.05) while in HI exercise they had significant longer flight times (p<0.05). For both genders, HR was kept at 70% and 80% of HR(max-calc) and RHR was 60% and 70%, during LI and HI intervals respectively, with females showing a trend, though non-significant, for higher HR values. The gender specificity of the significant vertical and lateral GRF pattern differences, may possibly be associated with the significant anthropometric differences of male and female AD instructors. HR(max-calc) and RHR exceeded the accepted occupational levels rising to training status levels. We suggest that AD instructors take up such instructing methods which allow them to minimize the magnitude or the rate of GRF, as well as HR levels, developed in the course of their working hour.

Short- or long-rest intervals during repeated-sprint training in soccer?

PubMed Central

Iaia, F. Marcello; Fiorenza, Matteo; Larghi, Luca; Alberti, Giampietro; Millet, Grégoire P.; Girard, Olivier

2017-01-01

The present study compared the effects of two repeated-sprint training (RST) programs, differing in duration of the between-sprint rest intervals, on various soccer-related exercise performances. For 5 weeks during the competitive season, twenty-nine young trained male soccer players either replaced two of their habitual fitness conditioning sessions with RST characterized by short (5–15; n = 9) or long (5–30; n = 10) rest intervals, or served as control (n = 10). The 5–15 and 5–30 protocols consisted of 6 repetitions of 30-m (~5 s) straight-line sprints interspersed with 15 s or 30 s of passive recovery, respectively. 5–15 improved 200-m sprint time (2.0±1.5%; p<0.05) and had a likely positive impact on 20-m sprint performance, whereas 5–30 lowered the 20-m sprint time (2.7±1.6%; p<0.05) but was only possibly effective for enhancing the 200-m sprint performance. The distance covered during the Yo-Yo Intermittent Recovery Test Level 2 increased following 5–15 (11.4±5.0%; p<0.05), which was possibly better than the non-significant 6.5% enhancement observed in 5–30. Improvements in the total time of a repeated-sprint ability test were possibly greater following 5–30 (3.6±0.9%; p<0.05) compared to 5–15 (2.6±1.1%; p<0.05). Both RST interventions led to similar beneficial (p<0.05) reductions in the percentage decrement score (~30%) of the repeated-sprint ability test as well as in blood lactate concentration during submaximal exercise (17–18%). No changes occurred in the control group. In soccer players, RST over a 5-week in-season period is an efficient means to simultaneously develop different components of fitness relevant to match performance, with different benefits induced by shorter compared to longer rest intervals. PMID:28199402

Symptomatic versus inapparent outcome in repeat dengue virus infections is influenced by the time interval between infections and study year.

PubMed

Montoya, Magelda; Gresh, Lionel; Mercado, Juan Carlos; Williams, Katherine L; Vargas, Maria José; Gutierrez, Gamaliel; Kuan, Guillermina; Gordon, Aubree; Balmaseda, Angel; Harris, Eva

2013-01-01

Four dengue virus serotypes (DENV1-4) circulate globally, causing more human illness than any other arthropod-borne virus. Dengue can present as a range of clinical manifestations from undifferentiated fever to Dengue Fever to severe, life-threatening syndromes. However, most DENV infections are inapparent. Yet, little is known about determinants of inapparent versus symptomatic DENV infection outcome. Here, we analyzed over 2,000 DENV infections from 2004 to 2011 in a prospective pediatric cohort study in Managua, Nicaragua. Symptomatic cases were captured at the study health center, and paired healthy annual samples were examined on a yearly basis using serological methods to identify inapparent DENV infections. Overall, inapparent and symptomatic DENV infections were equally distributed by sex. The mean age of infection was 1.2 years higher for symptomatic DENV infections as compared to inapparent infections. Although inapparent versus symptomatic outcome did not differ by infection number (first, second or third/post-second DENV infections), substantial variation in the proportion of symptomatic DENV infections among all DENV infections was observed across study years. In participants with repeat DENV infections, the time interval between a first inapparent DENV infection and a second inapparent infection was significantly shorter than the interval between a first inapparent and a second symptomatic infection. This difference was not observed in subsequent infections. This result was confirmed using two different serological techniques that measure total anti-DENV antibodies and serotype-specific neutralizing antibodies, respectively. Taken together, these findings show that, in this study, age, study year and time interval between consecutive DENV infections influence inapparent versus symptomatic infection outcome, while sex and infection number had no significant effect. Moreover, these results suggest that the window of cross-protection induced by a first infection with DENV against a second symptomatic infection is approximately 2 years. These findings are important for modeling dengue epidemics and development of vaccines.

Monovalent type-1 oral poliovirus vaccine given at short intervals in Pakistan: a randomised controlled, four-arm, open-label, non-inferiority trial.

PubMed

Mir, Fatima; Quadri, Farheen; Mach, Ondrej; Ahmed, Imran; Bhatti, Zaid; Khan, Asia; Rehman, Najeeb Ur; Durry, Elias; Salama, Maha; Oberste, Steven M; Weldon, William C; Sutter, Roland W; Zaidi, Anita K M

2015-08-01

Supplementary immunisation activities with oral poliovirus vaccines (OPVs) are usually separated by 4 week intervals; however, shorter intervals have been used in security-compromised areas and for rapid outbreak responses. We assessed the immunogenicity of monovalent type-1 oral poliovirus vaccine (mOPV1) given at shorter than usual intervals in Karachi, Pakistan. This was a multicentre, randomised, controlled, four-arm, open-label, non-inferiority trial done at five primary health-care centres in low-income communities in and around Karachi, Pakistan. Eligible participants were healthy newborn babies with a birthweight of at least 2·5 kg, for whom informed consent was provided by their parent or guardian, and lived less than 30 km from the study clinic. After receiving a birth dose of trivalent OPV, we enrolled and randomly assigned newborn babies (1:1:1:1) to receive two doses of mOPV1 with an interval of 1 week (mOPV1-1 week), 2 weeks (mOPV1-2 weeks), or 4 weeks (mOPV1-4 weeks) between doses, or two doses of bivalent OPV (bOPV) with an interval of 4 weeks between doses (bOPV-4 weeks). We gave the first study dose of OPV at age 6 weeks. We did the randomisation with a centrally generated, computerised allocation sequence with blocks of 16; participants' families and study physicians could not feasibly be masked to the allocations. Trial participants were excluded from local supplementary immunisation activities during the study period. The primary outcome was non-inferiority (within a 20% margin) between groups in seroconversion to type-1 poliovirus. The primary and safety analyses were done in the per-protocol population of infants who received all three doses of vaccine. This trial is registered with ClinicalTrials.gov, number NCT01586572, and is closed to new participants. Between March 1, 2012, and May 31, 2013, we enrolled 1009 newborn babies, and randomly assigned 829 (82%) to treatment. 554 (67%) of the 829 babies were included in the per-protocol analysis. Proportions of seroconversion to type-1 poliovirus were 107/135 (79%, 95% CI 72·4-86·1) with mOPV1-1 week, 108/135 (80%, 73·2-86·8) with mOPV1-2 weeks, 129/148 (87%, 80·9-92·0) with mOPV1-4 weeks, and 107/136 (79%, 71·8-85·6) with bOPV-4 weeks. Non-inferiority was shown between groups and no significant differences were noted. Ten participants died during the trial. Seven of these deaths occurred during the lead-in period before randomisation (two from diarrhoea, five from unknown causes). Three infants died from sepsis after random assignment. No deaths were attributed to the procedures or vaccines. Additionally, we noted no events of vaccine-associated paralysis. We identified no significant differences in responses to mOPV1 given with shorter intervals between doses than with the standard 4 week intervals. The short-interval strategy could be particularly beneficial when temporary windows of opportunity for safe access can be granted in areas of conflict--eg, during cease-fire periods. In such situations, we recommend shortening the interval between OPV doses to 7 days. World Health Organization. Copyright © 2015 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd.. All rights reserved.

Intraperitoneal chemotherapy for advanced ovarian and peritoneal cancers in patients following interval debulking surgery or primary cytoreductive surgery: Tom Baker Cancer Centre experience from 2006 to 2009.

PubMed

Nelson, Gregory; Lucero, Carlos Aspe; Chu, Pamela; Nation, Jill; Ghatage, Prafull

2010-03-01

To describe our experience with cisplatin- and paclitaxel-based IP chemotherapy in patients treated initially with either neoadjuvant chemotherapy and interval debulking surgery (IDS) or primary cytoreductive surgery (PCRS). We performed a retrospective review of the records of 67 patients (38 IDS, 29 PCRS) enrolled in the intraperitoneal (IP) chemotherapy program at the Tom Baker Cancer Centre between 2006 and 2009. Information pertaining to patient demographics, IP chemotherapy toxicity, and catheter complications was extracted, and the median time to recurrence was calculated. Most patients in the study were aged 50 to 70 years and had a diagnosis of stage III serous ovarian cancer. Overall, 295/393 IP cycles (75%) were successfully administered. The proportion of patients completing six cycles of chemotherapy in the IDS and PCRS groups was 53% and 59%, respectively. Frequent (> 25%) Grade 1 to 2 chemotherapy toxicities included fatigue, peripheral neuropathy, and nausea. Catheter complications were observed in 34% of patients (23/67). The recurrence rates for patients completing four or more cycles of IP chemotherapy in the IDS and PCRS groups were 58% and 35%, respectively, with the median time to recurrence approximately one year. Although IP chemotherapy is well tolerated in both IDS and PCRS patients, the median time to recurrence is shorter than expected.

Voiding diary might serve as a useful tool to understand differences between bladder pain syndrome/interstitial cystitis and overactive bladder.

PubMed

Kim, Sung Han; Oh, Shin Ah; Oh, Seung-June

2014-02-01

To identify the voiding characteristics of bladder pain syndrome/interstitial cystitis and overactive bladder. Between September 2005 and June 2010, 3-day voiding diaries of 49 consecutive bladder pain syndrome/interstitial cystitis patients and 301 overactive bladder patients were prospectively collected at an outpatient clinic and retrospectively analyzed. The characteristics of the two groups were not significantly different. However, all voiding variables including volume and frequency were significantly different except for the total voided volume: patients with bladder pain syndrome/interstitial cystitis showed significantly higher voiding frequencies, smaller maximal and mean voided volume, and more constant and narrower ranges of voided volume compared with overactive bladder patients (P < 0.005). Furthermore, mean intervals between voiding in bladder pain syndrome/interstitial cystitis were shorter and more consistent during the day and night (P < 0.001), although mean night-time variances were greater than daytime variances. Logistic regression analysis showed that total night-time frequency, maximal night-time voided volume and mean variance of daytime voiding intervals most significantly differentiated the two groups. Some voiding characteristics of bladder pain syndrome/interstitial cystitis and overactive bladder patients differ significantly according to 3-day voiding diary records. These findings provide additional information regarding the differences between these two diseases in the outpatient clinical setting. © 2013 The Japanese Urological Association.

Contribution of reactive and proactive control to children's working memory performance: Insight from item recall durations in response sequence planning.

PubMed

Chevalier, Nicolas; James, Tiffany D; Wiebe, Sandra A; Nelson, Jennifer Mize; Espy, Kimberly Andrews

2014-07-01

The present study addressed whether developmental improvement in working memory span task performance relies upon a growing ability to proactively plan response sequences during childhood. Two hundred thirteen children completed a working memory span task in which they used a touchscreen to reproduce orally presented sequences of animal names. Children were assessed longitudinally at 7 time points between 3 and 10 years of age. Twenty-one young adults also completed the same task. Proactive response sequence planning was assessed by comparing recall durations for the 1st item (preparatory interval) and subsequent items. At preschool age, the preparatory interval was generally shorter than subsequent item recall durations, whereas it was systematically longer during elementary school and in adults. Although children mostly approached the task reactively at preschool, they proactively planned response sequences with increasing efficiency from age 7 on, like adults. These findings clarify the nature of the changes in executive control that support working memory performance with age. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Long-term follow-up of botulinum toxin therapy for focal hand dystonia: outcome at 10 years or more.

PubMed

Lungu, Codrin; Karp, Barbara I; Alter, Katharine; Zolbrod, Regina; Hallett, Mark

2011-03-01

Previous studies have explored the efficacy and safety of botulinum neurotoxin (BoNT) treatment for Focal hand dystonia (FHD), but none have followed a large number of patients for 10 years or more. Retrospective study, with benefit and weakness assessed on a 0 to 4 subjective scale. Demographic, clinical and treatment characteristics were analyzed using t tests and Pearson correlations. Twenty FHD patients had 10 years or longer treatment. Interinjection intervals were variable. Musicians were more likely to wait longer between injections and had less complex dystonia. There was a trend for larger benefit in women and with shorter intervals. The dose increased over time. Dystonia characteristics did not predict response or side-effects, but benefit magnitude predicted longer compliance. No serious side-effects or antibody-mediated resistance occurred. This is the longest reported period of BoNT treatment in the largest FHD cohort. BoNT therapy for FHD remains safe and effective after more than a decade of treatment. Copyright © 2011 Movement Disorder Society.

Possible scenarios for occurrence of M ~ 7 interplate earthquakes prior to and following the 2011 Tohoku-Oki earthquake based on numerical simulation.

PubMed

Nakata, Ryoko; Hori, Takane; Hyodo, Mamoru; Ariyoshi, Keisuke

2016-05-10

We show possible scenarios for the occurrence of M ~ 7 interplate earthquakes prior to and following the M ~ 9 earthquake along the Japan Trench, such as the 2011 Tohoku-Oki earthquake. One such M ~ 7 earthquake is so-called the Miyagi-ken-Oki earthquake, for which we conducted numerical simulations of earthquake generation cycles by using realistic three-dimensional (3D) geometry of the subducting Pacific Plate. In a number of scenarios, the time interval between the M ~ 9 earthquake and the subsequent Miyagi-ken-Oki earthquake was equal to or shorter than the average recurrence interval during the later stage of the M ~ 9 earthquake cycle. The scenarios successfully reproduced important characteristics such as the recurrence of M ~ 7 earthquakes, coseismic slip distribution, afterslip distribution, the largest foreshock, and the largest aftershock of the 2011 earthquake. Thus, these results suggest that we should prepare for future M ~ 7 earthquakes in the Miyagi-ken-Oki segment even though this segment recently experienced large coseismic slip in 2011.

Possible scenarios for occurrence of M ~ 7 interplate earthquakes prior to and following the 2011 Tohoku-Oki earthquake based on numerical simulation

PubMed Central

Nakata, Ryoko; Hori, Takane; Hyodo, Mamoru; Ariyoshi, Keisuke

2016-01-01

We show possible scenarios for the occurrence of M ~ 7 interplate earthquakes prior to and following the M ~ 9 earthquake along the Japan Trench, such as the 2011 Tohoku-Oki earthquake. One such M ~ 7 earthquake is so-called the Miyagi-ken-Oki earthquake, for which we conducted numerical simulations of earthquake generation cycles by using realistic three-dimensional (3D) geometry of the subducting Pacific Plate. In a number of scenarios, the time interval between the M ~ 9 earthquake and the subsequent Miyagi-ken-Oki earthquake was equal to or shorter than the average recurrence interval during the later stage of the M ~ 9 earthquake cycle. The scenarios successfully reproduced important characteristics such as the recurrence of M ~ 7 earthquakes, coseismic slip distribution, afterslip distribution, the largest foreshock, and the largest aftershock of the 2011 earthquake. Thus, these results suggest that we should prepare for future M ~ 7 earthquakes in the Miyagi-ken-Oki segment even though this segment recently experienced large coseismic slip in 2011. PMID:27161897

An acoustic survey of beaked whales at Cross Seamount near Hawaii.

PubMed

McDonald, Mark A; Hildebrand, John A; Wiggins, Sean M; Johnston, David W; Polovina, Jeffrey J

2009-02-01

An acoustic record from Cross Seamount, southwest of Hawaii, revealed sounds characteristic of beaked whale echolocation at the same relative abundance year-around (270 of 356 days), occurring almost entirely at night. The most common sound had a linear frequency upsweep from 35 to 100 kHz (the bandwidth of recording), an interpulse interval of 0.11 s, and duration of at least 932 mus. A less common upsweep sound with shorter interpulse interval and slower sweep rate was also present. Sounds matching Cuvier's beaked whale were not detected, and Blainville's beaked whale sounds were detected on only one occasion.

Heinrich Events in the Southern Hemisphere: A Tropical Trigger?

NASA Astrophysics Data System (ADS)

Farmer, E. C.; Choi, W. S.; Quadri, M.

2006-12-01

Heinrich events, or periodic pulses of ice-rafted debris into the North Atlantic, have long been envisioned as having a high-latitude trigger. This trigger is most often cited as internal ice-sheet dynamics. McIntyre and Molfino (1996) proposed a tropical trigger for Heinrich Events: they suggested that precession-related strengthening of the North African monsoonal atmospheric circulation would alter oceanic circulation in such a way as to reduce heat transport to the high latitudes. Discovery of possible evidence (Mg/Ca ratios and faunal abundance) for Heinrich Event 1 (H1) in the Benguela upwelling region (Farmer et al. 2005) stimulated a search for a Heinrich Event 2 (H2) signal. From the review by Hemming (2004), we estimated the time horizon in which we would expect to find H2 as 22.4 - 26.8 ka. We extrapolated the published ODP1084B age model (Farmer et al. 2005) to estimate the depth interval of this time horizon, and counted the relative abundance of the four dominant species of planktonic foraminifera (G. inflata, G. bulloides, N. pachyderma right- and left-coiling) in each sample within this interval. We found an interval spanning five centimeters, or approximately 22.9 to 23.1 ka, in which the relative abundance of N. pachyderma (left-coiling) rose to a an average of 31.5%. Compared to the average level of 23.5% in the surrounding samples, and our pooled standard deviation of 3.4%, this shift appears significant. Increases in relative abundance of N. pachyderma (left-coiling) in earlier intervals are associated with decreased Mg/Ca-based sea surface temperatures (SSTs) and are inferred to be a likely result of increased upwelling (Farmer et al. 2005). Although this new interval is shorter than would be expected from Heinrich event studies elsewhere, the shift in relative abundance of N. pachyderma (left-coiling) is consistent with an H2 signal. Better age control is needed to constrain the timing of this event, however, and data from an additional proxy such as Mg/Ca is needed to confirm the signal.

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.

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

Risk factors of suicide mortality among multiple attempters: A national registry study in Taiwan.

PubMed

Chen, I-Ming; Liao, Shih-Cheng; Lee, Ming-Been; Wu, Chia-Yi; Lin, Po-Hsien; Chen, Wei J

2016-05-01

Little is known about the risk factors of suicide mortality among multiple attempters. This study aims to investigate the predictors of suicidal mortality in a prospective cohort of attempters in Taiwan, focusing on the time interval and suicide method change between the last two nonfatal attempts. The representative data retrieved from the National Suicide Surveillance System (NSSS) was linked with National Mortality Database to identify the causes of death in multiple attempters during 2006-2008. Cox-proportional hazard models were applied to calculate the hazard ratios for the predictors of suicide. Among the 55,560 attempters, 6485 (11.7%) had survived attempts ranging from one to 11 times; 861 (1.5%) eventually died by suicide. Multiple attempters were characterized by female (OR = 1.56, p < 0.0001), nonrecipient of national aftercare service (OR = 1.62, p < 0.0001), and current contact with mental health services (OR = 3.17, p < 0.0001). Most multiple attempters who survived from hanging (68.1%) and gas poisoning (61.9%) chose the same method in the following fatal episode. Predictors of suicidal death were identified as male, older age (≥ 45 years), shorter interval and not maintaining methods of low lethality in the last two nonfatal attempts. Receipt of nationwide aftercare was associated with lower risk of suicide but the effect was insignificant. The time interval of the last two nonfatal attempts and alteration in the lethality of suicide method were significant factors for completed suicide. Risk assessment involving these two factors may be necessary for multiple attempters in different clinical settings. Effective strategies for suicide prevention emphasizing this high risk population should be developed in the future. Copyright © 2015. Published by Elsevier B.V.

The association between calfhood bovine respiratory disease complex and subsequent departure from the herd, milk production, and reproduction in dairy cattle.

PubMed

Schaffer, Aaron P; Larson, Robert L; Cernicchiaro, Natalia; Hanzlicek, Gregg A; Bartle, Steven J; Thomson, Daniel U

2016-05-15

OBJECTIVE To describe the frequency of calfhood producer-identified bovine respiratory disease complex (BRDC) in Holstein replacement heifers on 1 large farm and determine associations between development of BRDC at ≤ 120 days of age (BRDC120) with milk production estimate, calving interval, and risk of departure from the herd (DFH). DESIGN Retrospective, observational study. ANIMALS 14,024 Holstein heifer calves born on 1 farm. PROCEDURES Data were obtained from herd management records. Cox proportional hazard and generalized linear mixed-effects models were used to assess associations for variables of interest (BRDC120 status, demographic data, and management factors) with DFH, milk production estimate, and calving interval. RESULTS Except for the year 2007, animals identified as having BRDC120 were 1.62 to 4.98 times as likely to leave the herd before first calving, compared with those that did not have this designation. Calves identified as having BRDC prior to weaning were 2.62 times as likely to have DFH before first calving as those classified as developing BRDC after weaning. Cows identified as having BRDC120 were 1.28 times as likely to have DFH between the first and second calving as were other cows. The BRDC120 designation was associated with a 233-kg (513-lb) lower 305-day mature equivalent value for first lactation milk production, but was not associated with longer or shorter calving intervals at maturity. CONCLUSIONS AND CLINICAL RELEVANCE Dairy cattle identified as having BRDC120 had increased risk of DFH before the first or second calving and lower first-lactation milk production estimates, compared with results for cattle without this finding. Further investigation of these associations is warranted.

Test-retest reliability of the prefrontal response to affective pictures based on functional near-infrared spectroscopy

NASA Astrophysics Data System (ADS)

Huang, Yuxia; Mao, Mengchai; Zhang, Zong; Zhou, Hui; Zhao, Yang; Duan, Lian; Kreplin, Ute; Xiao, Xiang; Zhu, Chaozhe

2017-01-01

Functional near-infrared spectroscopy (fNIRS) is being increasingly applied to affective and social neuroscience research; however, the reliability of this method is still unclear. This study aimed to evaluate the test-retest reliability of the fNIRS-based prefrontal response to emotional stimuli. Twenty-six participants viewed unpleasant and neutral pictures, and were simultaneously scanned by fNIRS in two sessions three weeks apart. The reproducibility of the prefrontal activation map was evaluated at three spatial scales (mapwise, clusterwise, and channelwise) at both the group and individual levels. The influence of the time interval was also explored and comparisons were made between longer (intersession) and shorter (intrasession) time intervals. The reliabilities of the activation map at the group level for the mapwise (up to 0.88, the highest value appeared in the intersession assessment) and clusterwise scales (up to 0.91, the highest appeared in the intrasession assessment) were acceptable, indicating that fNIRS may be a reliable tool for emotion studies, especially for a group analysis and under larger spatial scales. However, it should be noted that the individual-level and the channelwise fNIRS prefrontal responses were not sufficiently stable. Future studies should investigate which factors influence reliability, as well as the validity of fNIRS used in emotion studies.

Timing and context of dolphin clicks during and after mine simulator detection and marking in the open ocean

PubMed Central

Dibble, Dianna S.; Kennemer, Jaime A.

2018-01-01

ABSTRACT Two dolphins carrying cameras swam in the ocean as they searched for and marked mine simulators – buried, proud or moored. As the animals swam ahead of a boat they searched the ocean. Cameras on their harness recorded continuous sound and video. Once a target was detected, the dolphins received a marker to take to the simulator's location. During search and detection, dolphins made almost continuous trains of varying interval clicks. During the marking phase, shorter click trains were interrupted by periods of silence. As the dolphins marked simulators, they often produced victory squeals – pulse bursts that vary in duration, peak frequency and amplitude. Victory squeals were produced on 72% of marks. Sometimes after marking, or at other times during their long swims, the dolphins produced click packets. Packets typically consisted of two to 10 clicks with inter-click intervals of 7-117 ms followed by a silence of 223-983 ms. Click packets appeared unrelated with searching or marking. We suggest that the packets were used to improve signal to noise ratios for locating a boat or other distant object. Victory squeals produced when marking the targets suggest to us that the dolphins know when they have succeeded in this multipart task. PMID:29463515

Timing and context of dolphin clicks during and after mine simulator detection and marking in the open ocean.

PubMed

Ridgway, Sam H; Dibble, Dianna S; Kennemer, Jaime A

2018-02-20

Two dolphins carrying cameras swam in the ocean as they searched for and marked mine simulators - buried, proud or moored. As the animals swam ahead of a boat they searched the ocean. Cameras on their harness recorded continuous sound and video. Once a target was detected, the dolphins received a marker to take to the simulator's location. During search and detection, dolphins made almost continuous trains of varying interval clicks. During the marking phase, shorter click trains were interrupted by periods of silence. As the dolphins marked simulators, they often produced victory squeals - pulse bursts that vary in duration, peak frequency and amplitude. Victory squeals were produced on 72% of marks. Sometimes after marking, or at other times during their long swims, the dolphins produced click packets. Packets typically consisted of two to 10 clicks with inter-click intervals of 7-117 ms followed by a silence of 223-983 ms. Click packets appeared unrelated with searching or marking. We suggest that the packets were used to improve signal to noise ratios for locating a boat or other distant object. Victory squeals produced when marking the targets suggest to us that the dolphins know when they have succeeded in this multipart task. © 2018. Published by The Company of Biologists Ltd.

East Asian warm season temperature variations over the past two millennia.

PubMed

Zhang, Huan; Werner, Johannes P; García-Bustamante, Elena; González-Rouco, Fidel; Wagner, Sebastian; Zorita, Eduardo; Fraedrich, Klaus; Jungclaus, Johann H; Ljungqvist, Fredrik Charpentier; Zhu, Xiuhua; Xoplaki, Elena; Chen, Fahu; Duan, Jianping; Ge, Quansheng; Hao, Zhixin; Ivanov, Martin; Schneider, Lea; Talento, Stefanie; Wang, Jianglin; Yang, Bao; Luterbacher, Jürg

2018-05-16

East Asia has experienced strong warming since the 1960s accompanied by an increased frequency of heat waves and shrinking glaciers over the Tibetan Plateau and the Tien Shan. Here, we place the recent warmth in a long-term perspective by presenting a new spatially resolved warm-season (May-September) temperature reconstruction for the period 1-2000 CE using 59 multiproxy records from a wide range of East Asian regions. Our Bayesian Hierarchical Model (BHM) based reconstructions generally agree with earlier shorter regional temperature reconstructions but are more stable due to additional temperature sensitive proxies. We find a rather warm period during the first two centuries CE, followed by a multi-century long cooling period and again a warm interval covering the 900-1200 CE period (Medieval Climate Anomaly, MCA). The interval from 1450 to 1850 CE (Little Ice Age, LIA) was characterized by cooler conditions and the last 150 years are characterized by a continuous warming until recent times. Our results also suggest that the 1990s were likely the warmest decade in at least 1200 years. The comparison between an ensemble of climate model simulations and our summer reconstructions since 850 CE shows good agreement and an important role of internal variability and external forcing on multi-decadal time-scales.

Preventing tetanus, diphtheria, and pertussis among adults: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine recommendations of the Advisory Committee on Immunization Practices (ACIP) and recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for use of Tdap among health-care personnel.

PubMed

Kretsinger, Katrina; Broder, Karen R; Cortese, Margaret M; Joyce, M Patricia; Ortega-Sanchez, Ismael; Lee, Grace M; Tiwari, Tejpratap; Cohn, Amanda C; Slade, Barbara A; Iskander, John K; Mijalski, Christina M; Brown, Kristin H; Murphy, Trudy V

2006-12-15

On June 10, 2005, a tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) formulated for use in adults and adolescents was licensed in the United States for persons aged 11-64 years (ADACEL, manufactured by sanofi pasteur, Toronto, Ontario, Canada). Prelicensure studies demonstrated safety and efficacy, inferred through immunogenicity, against tetanus, diphtheria, and pertussis when Tdap was administered as a single booster dose to adults. To reduce pertussis morbidity among adults and maintain the standard of care for tetanus and diphtheria prevention and to reduce the transmission of pertussis to infants and in health-care settings, the Advisory Committee on Immunization Practices (ACIP) recommends that: 1) adults aged 19-64 years should receive a single dose of Tdap to replace tetanus and diphtheria toxoids vaccine (Td) for booster immunization against tetanus, diphtheria, and pertussis if they received their last dose of Td >or=10 years earlier and they have not previously received Tdap; 2) intervals shorter than 10 years since the last Td may be used for booster protection against pertussis; 3) adults who have or who anticipate having close contact with an infant aged <12 months (e.g., parents, grandparents aged <65 years, child-care providers, and health-care personnel) should receive a single dose of Tdap to reduce the risk for transmitting pertussis. An interval as short as 2 years from the last Td is suggested; shorter intervals can be used. When possible, women should receive Tdap before becoming pregnant. Women who have not previously received Tdap should receive a dose of Tdap in the immediate postpartum period; 4) health-care personnel who work in hospitals or ambulatory care settings and have direct patient contact should receive a single dose of Tdap as soon as feasible if they have not previously received Tdap. An interval as short as 2 years from the last dose of Td is recommended; shorter intervals may be used. These recommendations for use of Tdap in health-care personnel are supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC). This statement 1) reviews pertussis, tetanus and diphtheria vaccination policy in the United States; 2) describes the clinical features and epidemiology of pertussis among adults; 3) summarizes the immunogenicity, efficacy, and safety data of Tdap; and 4) presents recommendations for the use of Tdap among adults aged 19-64 years.

The electric field changes and UHF radiations caused by the triggered lightning in Japan

NASA Technical Reports Server (NTRS)

Kawasaki, Zen-Ichiro; Kanao, Tadashi; Matsuura, Kenji; Nakano, Minoru; Horii, Kenji; Nakamura, Koichi

1991-01-01

In the rocket triggered lightning experiment of fiscal 1989, researchers observed electromagnetic field changes and UHF electromagnetic radiation accompanying rocket triggered lightning. It was found that no rapid changes corresponding to the return stroke of natural lightning were observed in the electric field changes accompanying rocket triggered lightning. However, continuous currents were present. In the case of rocket triggered lightning to the tower, electromagnetic field changes corresponding to the initiation of triggered lightning showed a bipolar pulse of a relatively large amplitude. In contrast, the rocket triggered lightning to the ground did not have such a bipolar pulse. The UHF radiation accompanying the rocket triggered lightning preceded the waveform portions corresponding to the first changes in electromagnetic fields. The number of isolated pulses in the UHF radiation showed a correlation with the time duration from rocket launching up to triggered lightning. The time interval between consecutive isolated pulses tended to get shorter with the passage of time, just like the stepped leaders of natural lightning.

78 FR 59641 - Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; Revisions to Headboat Reporting...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-27

... revisions would require fishing records to be submitted electronically (via computer or Internet) on a weekly basis or at intervals shorter than a week if notified by the NMFS' Southeast Fisheries Science Center (SEFSC) Science and Research Director (SRD), and would prohibit headboats from continuing to fish...

78 FR 57339 - Fisheries of the Caribbean, Gulf of Mexico and South Atlantic; Revisions to Headboat Reporting...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-18

... approved, the For- Hire Reporting Amendment would amend the FMPs to modify data reporting for for-hire... would be required to submit electronic fishing records to the NMFS' Southeast Fisheries Science Center (SEFSC) Science and Research Director (SRD) weekly, or at intervals shorter than a week if notified by...

Evolutionary drivers of mast-seeding in a long-lived desert shrub

Treesearch

Susan E. Meyer; Burton K. Pendleton

2015-01-01

Patterns of reproductive output in blackbrush did not track current growing season precipitation, but instead were regulated by prior-year weather cues. The strength of the response to the masting cue depended on habitat quality, with higher mean reproductive output, shorter intervals between years of high seed production, and lower CVp at more favorable sites...

The temporal degradation of bone collagen: A histochemical approach.

PubMed

Boaks, Amelia; Siwek, Donald; Mortazavi, Farzad

2014-07-01

As forensic anthropologists are currently unable to estimate reliably and quantitatively the postmortem interval (PMI) of skeletonized remains, the current study was conducted to determine if degradation of bone collagen over time could be quantified using sirius red/fast green staining, and whether the degradation would occur at a predictive rate such that it may be used to estimate the PMI of skeletonized individuals. Resin embedded 200-300μm cross-sections of pig (Sus scrofa) long bones with known provenience and PMIs ranging from fresh to 12 months were stained using a histochemical reaction which differentially stains collagenous (Co) and non-collagenous (NCo) proteins. Spectrophotometry was used to determine the concentration of Co and NCo proteins in each bone section, after which the ratio of these proteins was calculated. The results of this study revealed a significant decline in the ratios of Co/NCo protein concentrations over the time period studied (p<0.001). Furthermore, a significant negative correlation between the ratios of Co/NCo protein concentrations and time (r=-0.563, p<0.0001) was observed. Despite a significant correlation, the moderate r-value obtained suggests that, at present, this method is useful primarily for detecting and quantifying the degradation of Co and NCo proteins in bones. Future studies that include shorter time intervals and environmental factors, such as soil pH, temperature, and hydrology may prove to be critical for using this method for PMI estimation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Long-term persistence of solar activity. [Abstract only

NASA Technical Reports Server (NTRS)

Ruzmaikin, Alexander; Feynman, Joan; Robinson, Paul

1994-01-01

The solar irradiance has been found to change by 0.1% over the recent solar cycle. A change of irradiance of about 0.5% is required to effect the Earth's climate. How frequently can a variation of this size be expected? We examine the question of the persistence of non-periodic variations in solar activity. The Huerst exponent, which characterizes the persistence of a time series (Mandelbrot and Wallis, 1969), is evaluated for the series of C-14 data for the time interval from about 6000 BC to 1950 AD (Stuiver and Pearson, 1986). We find a constant Huerst exponent, suggesting that solar activity in the frequency range of from 100 to 3000 years includes an important continuum component in addition to the well-known periodic variations. The value we calculate, H approximately equal to 0.8, is significantly larger than the value of 0.5 that would correspond to variations produced by a white-noise process. This value is in good agreement with the results for the monthly sunspot data reported elsewhere, indicating that the physics that produces the continuum is a correlated random process (Ruzmaikin et al., 1992), and that is is the same type of process over a wide range of time interval lengths. We conclude that the time period over which an irradiance change of 0.5% can be expected to occur is significantly shorter than that which would be expected for variations produced by a white-noise process.

Pharmacokinetic study of a new oral buffered acetylsalicylic acid (ASA) formulation in comparison with plain ASA in healthy volunteers.

PubMed

Viganò, G; Garagiola, U; Gaspari, F

1991-01-01

A single-blind, randomized, crossover pharmacokinetic study was carried out to investigate the bioavailability of a new oral buffered 325 mg acetylsalicylic acid (ASA) formulation (ASPIRINA 03) in comparison with a 325 mg plain tablet. Twelve healthy volunteers of both sexes, aged between 20 and 37 years, received buffered or plain ASA on two separate occasions with a wash-out interval of at least two weeks. ASA and salicylic acid (SA) plasma levels were determined by a chromatographic method. The results showed no difference between the area under concentration time curve (AUC0-infinity) ASA values of both formulations (p = 0.19), and buffered ASA relative bioavailability was 102.49% (= bioequivalence). A significant difference was found between the AUC0-30 min ASA values: 90.5 micrograms. min/ml with buffered and 67.7 micrograms. min/ml with the plain tablet (p less than 0.05). The buffered ASA time of maximum concentration was shorter (28 +/- 8 min) than the plain one (38 +/- 19 min, p less than 0.05). The plasma concentrations and pharmacokinetic parameters of SA were not significantly different after the administration of the two ASA formulations. The plain ASA tablet had a significantly lower (p less than 0.05) dissolution rate than buffered ASA tablet. Moreover, the buffered ASA tablet significantly (p less than 0.01) increased the pH by 0.5 units. In conclusion, the bioavailability of the new oral buffered ASA was equivalent to that of plain ASA, but the plasma concentration peak was reached in a shorter time.

Myocardial performance index in female rats with myocardial infarction: relationship with ventricular function parameters by Doppler echocardiography.

PubMed

Cury, Alexandre Ferreira; Bonilha, Andre; Saraiva, Roberto; Campos, Orlando; Carvalho, Antonio Carlos C; De Paola, Angelo Amato V; Fischer, Claudio; Tucci, Paulo Ferreira; Moises, Valdir Ambrosio

2005-05-01

The aim of the study was to analyze the myocardial performance index (MPI), its relationship with the standard variables of systolic and diastolic functions, and the influence of time intervals in an experimental model of female rats with myocardial infarction (MI). Forty-one Wistar female rats were submitted to surgery to induce MI. Six weeks later, Doppler echocardiography was performed to assess infarct size (IS,%), fractional area change (FAC,%), ejection fraction biplane Simpson (EF), E/A ratio of mitral inflow, MPI and its time intervals: isovolumetric contraction (IVCT, ms) and relaxation (IVRT, ms) times, and ejection time (ET, ms); MPI = IVCT + IVRT/ET. EF and FAC were progressively lower in rats with small, medium and large-size MI ( P < .001). E/A ratio was higher only in rats with large-size MI (6.25 +/- 2.69; P < .001). MPI was not different between control rats and small-size MI (0.37 +/- 0.03 vs 0.34 +/- 0.06, P = .87), but different between large and medium-size MI (0.69 +/- 0.08 vs 0.47 +/- 0.07; P < .001) and between these two compared to small-size MI. MPI correlated with IS (r = 0.85; P < .001), EF (r = -0.86; P < .001), FAC (r = -0.77; P < .001) and E/A ratio (r = 0.77; P < .001, non-linear). IVCT was longer in large size MI compared to medium-size MI (31.87 +/- 7.99 vs 15.92 +/- 5.88; P < .001) and correlated with IS (r = 0.85; P < .001) and MPI (r = 0.92; P < .001). ET was shorter only in large-size MI (81.07 +/- 7.23; P < .001), and correlated with IS (r = -0.70; P < .001) and MPI (r = -0.85; P < .001). IVRT was shorter only in large-size compared to medium-size MI (24.40 +/- 5.38 vs 29.69 +/- 5.92; P < .037), had borderline correlation with MPI (r = 0.34; P = .0534) and no correlation with IS (r = 0.26; p = 0.144). The MPI increased with IS, correlated inversely with systolic function parameters and had a non-linear relationship with diastolic function. These changes were due to the increase of IVCT and a decrease of ET, without significant influence of IVRT.

Setting the Revisit Interval in Primary Care

PubMed Central

Schwartz, Lisa M; Woloshin, Steven; Wasson, John H; Renfrew, Roger A; Welch, H Gilbert

1999-01-01

OBJECTIVE Although longitudinal care constitutes the bulk of primary care, physicians receive little guidance on the fundamental question of how to time follow-up visits. We sought to identify important predictors of the revisit interval and to describe the variability in how physicians set these intervals when caring for patients with common medical conditions. DESIGN Cross-sectional survey of physicians performed at the end of office visits for consecutive patients with hypertension, angina, diabetes, or musculoskeletal pain. PARTICIPANTS/SETTING One hundred sixty-four patients under the care of 11 primary care physicians in the Dartmouth Primary Care Cooperative Research Network. MEASUREMENTS The main outcome measures were the variability in mean revisit intervals across physicians and the proportion of explained variance by potential determinants of revisit intervals. We assessed the relation between the revisit interval (dependent variable) and three groups of independent variables, patient characteristics (e.g., age, physician perception of patient health), identification of individual physician, and physician characterization of the visit (e.g., routine visit, visit requiring a change in management, or visit occurring on a “hectic” day), using multiple regression that accounted for the natural grouping of patients within physician. MAIN RESULTS Revisit intervals ranged from 1 week to over 1 year. The most common intervals were 12 and 16 weeks. Physicians’ perception of fair-poor health status and visits involving a change in management were most strongly related to shorter revisit intervals. In multivariate analyses, patient characteristics explained about 18% of the variance in revisit intervals, and adding identification of the individual provider doubled the explained variance to about 40%. Physician characterization of the visit increased explained variance to 57%. The average revisit interval adjusted for patient characteristics for each of the 11 physicians varied from 4 to 20 weeks. Although all physicians lengthened revisit intervals for routine visits and shortened them when changing management, the relative ranking of mean revisit intervals for each physician changed little for different visit characterizations—some physicians were consistently long and others were consistently short. CONCLUSION Physicians vary widely in their recommendations for office revisits. Patient factors accounted for only a small part of this variation. Although physicians responded to visits in predictable ways, each physician appeared to have a unique set point for the length of the revisits interval. PMID:10203635

A cross-sectional study of hormone treatment and hippocampal volume in postmenopausal women: Evidence for a limited window of opportunity

PubMed Central

Erickson, Kirk I.; Voss, Michelle W.; Prakash, Ruchika S.; Chaddock, Laura; Kramer, Arthur F.

2010-01-01

The influence of hormone treatment on brain and cognition in postmenopausal women has been a controversial topic. Contradictory patterns of results have prompted speculation that a critical period, or a limited window of opportunity, exists for hormone treatment to protect against cognitive and neural decline in older women. Consistent with this hypothesis, studies in both humans and rodents indicate that the latency between the time of menopause and the initiation of hormone treatment is an important factor in determining whether hormone treatment will prevent or exacerbate cognitive impairment. In this cross-sectional study of 102 postmenopausal women, we examined whether hippocampal, amygdala, or caudate nucleus volumes and spatial memory performance were related to the interval between menopause and the initiation of hormone treatment. Consistent with a critical period hypothesis, we found that shorter intervals between menopause and the initiation of hormone treatment, as determined by self-report, were associated with larger hippocampal volumes compared with longer intervals between menopause and treatment initiation. Initiation of hormone treatment at the time of menopause was also associated with larger hippocampal volumes when compared to peers who had never used hormone treatment. Furthermore, these effects were independent from potentially confounding factors such as age, years of education, the duration of hormone treatment, current or past use of hormone therapy, the type of therapy, and the age at menopause. Larger hippocampal volumes in women who initiated hormone treatment at the time of menopause failed to translate to improved spatial memory performance. There was no relationship between the timing of hormone initiation, spatial memory performance, and amygdala or caudate nucleus volume. Our results provide support for the idea that there is a limited window of opportunity at the time of menopause for hormone treatment to influence hippocampal volume, yet the degree to which these effects translate to improved memory performance is uncertain. PMID:20063947

Boosting pitch encoding with audiovisual interactions in congenital amusia.

PubMed

Albouy, Philippe; Lévêque, Yohana; Hyde, Krista L; Bouchet, Patrick; Tillmann, Barbara; Caclin, Anne

2015-01-01

The combination of information across senses can enhance perception, as revealed for example by decreased reaction times or improved stimulus detection. Interestingly, these facilitatory effects have been shown to be maximal when responses to unisensory modalities are weak. The present study investigated whether audiovisual facilitation can be observed in congenital amusia, a music-specific disorder primarily ascribed to impairments of pitch processing. Amusic individuals and their matched controls performed two tasks. In Task 1, they were required to detect auditory, visual, or audiovisual stimuli as rapidly as possible. In Task 2, they were required to detect as accurately and as rapidly as possible a pitch change within an otherwise monotonic 5-tone sequence that was presented either only auditorily (A condition), or simultaneously with a temporally congruent, but otherwise uninformative visual stimulus (AV condition). Results of Task 1 showed that amusics exhibit typical auditory and visual detection, and typical audiovisual integration capacities: both amusics and controls exhibited shorter response times for audiovisual stimuli than for either auditory stimuli or visual stimuli. Results of Task 2 revealed that both groups benefited from simultaneous uninformative visual stimuli to detect pitch changes: accuracy was higher and response times shorter in the AV condition than in the A condition. The audiovisual improvements of response times were observed for different pitch interval sizes depending on the group. These results suggest that both typical listeners and amusic individuals can benefit from multisensory integration to improve their pitch processing abilities and that this benefit varies as a function of task difficulty. These findings constitute the first step towards the perspective to exploit multisensory paradigms to reduce pitch-related deficits in congenital amusia, notably by suggesting that audiovisual paradigms are effective in an appropriate range of unimodal performance. Copyright © 2014 Elsevier Ltd. All rights reserved.

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.

How one might miss early warning signals of critical transitions in time series data: A systematic study of two major currency pairs

PubMed Central

Ciamarra, Massimo Pica; Cheong, Siew Ann

2018-01-01

There is growing interest in the use of critical slowing down and critical fluctuations as early warning signals for critical transitions in different complex systems. However, while some studies found them effective, others found the opposite. In this paper, we investigated why this might be so, by testing three commonly used indicators: lag-1 autocorrelation, variance, and low-frequency power spectrum at anticipating critical transitions in the very-high-frequency time series data of the Australian Dollar-Japanese Yen and Swiss Franc-Japanese Yen exchange rates. Besides testing rising trends in these indicators at a strict level of confidence using the Kendall-tau test, we also required statistically significant early warning signals to be concurrent in the three indicators, which must rise to appreciable values. We then found for our data set the optimum parameters for discovering critical transitions, and showed that the set of critical transitions found is generally insensitive to variations in the parameters. Suspecting that negative results in the literature are the results of low data frequencies, we created time series with time intervals over three orders of magnitude from the raw data, and tested them for early warning signals. Early warning signals can be reliably found only if the time interval of the data is shorter than the time scale of critical transitions in our complex system of interest. Finally, we compared the set of time windows with statistically significant early warning signals with the set of time windows followed by large movements, to conclude that the early warning signals indeed provide reliable information on impending critical transitions. This reliability becomes more compelling statistically the more events we test. PMID:29538373

How one might miss early warning signals of critical transitions in time series data: A systematic study of two major currency pairs.

PubMed

Wen, Haoyu; Ciamarra, Massimo Pica; Cheong, Siew Ann

2018-01-01

There is growing interest in the use of critical slowing down and critical fluctuations as early warning signals for critical transitions in different complex systems. However, while some studies found them effective, others found the opposite. In this paper, we investigated why this might be so, by testing three commonly used indicators: lag-1 autocorrelation, variance, and low-frequency power spectrum at anticipating critical transitions in the very-high-frequency time series data of the Australian Dollar-Japanese Yen and Swiss Franc-Japanese Yen exchange rates. Besides testing rising trends in these indicators at a strict level of confidence using the Kendall-tau test, we also required statistically significant early warning signals to be concurrent in the three indicators, which must rise to appreciable values. We then found for our data set the optimum parameters for discovering critical transitions, and showed that the set of critical transitions found is generally insensitive to variations in the parameters. Suspecting that negative results in the literature are the results of low data frequencies, we created time series with time intervals over three orders of magnitude from the raw data, and tested them for early warning signals. Early warning signals can be reliably found only if the time interval of the data is shorter than the time scale of critical transitions in our complex system of interest. Finally, we compared the set of time windows with statistically significant early warning signals with the set of time windows followed by large movements, to conclude that the early warning signals indeed provide reliable information on impending critical transitions. This reliability becomes more compelling statistically the more events we test.

Can interprofessional teamwork reduce patient throughput times? A longitudinal single-centre study of three different triage processes at a Swedish emergency department.

PubMed

Liu, Jenny; Masiello, Italo; Ponzer, Sari; Farrokhnia, Nasim

2018-04-19

To determine the impact on emergency department (ED) throughput times and proportion of patients who leave without being seen by a physician (LWBS) of two triage interventions, where comprehensive nurse-led triage was first replaced by senior physician-led triage and then by interprofessional teamwork. Single-centre before-and-after study. Adult ED of a Swedish urban hospital. Patients arriving on weekdays 08:00 to 21:00 during three 1-year periods in the interval May 2012 to November 2015. A total of 185 806 arrivals were included. Senior physicians replaced triage nurses May 2013 to May 2014. Interprofessional teamwork replaced the triage process on weekdays 08:00 to 21:00 November 2014 to November 2015. Primary outcomes were the median time to physician (TTP) and the median length of stay (LOS). Secondary outcome was the LWBS rate. The crude median LOS was shortest for teamwork, 228 min (95% CI 226.4 to 230.5) compared with 232 min (95% CI 230.8 to 233.9) for nurse-led and 250 min (95% CI 248.5 to 252.6) for physician-led triage. The adjusted LOS for the teamwork period was 16 min shorter than for nurse-led triage and 23 min shorter than for physician-led triage. The median TTP was shortest for physician-led triage, 56 min (95% CI 54.5 to 56.6) compared with 116 min (95% CI 114.4 to 117.5) for nurse-led triage and 74 min (95% CI 72.7 to 74.8) for teamwork. The LWBS rate was 1.9% for nurse-led triage, 1.2% for physician-led triage and 3.2% for teamwork. All outcome measure differences had two-tailed p values<0.01. Interprofessional teamwork had the shortest length of stay, a shorter time to physician than nurse-led triage, but a higher LWBS rate. Interprofessional teamwork may be a useful approach to reducing ED throughput times. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effect of DA-9701 on gastric emptying in a mouse model: assessment by ¹³C-octanoic acid breath test.

PubMed

Lim, Chul-Hyun; Choi, Myung-Gyu; Park, Hyeyeon; Baeg, Myong Ki; Park, Jae Myung

2013-07-21

To evaluate the effects of DA-9701 on the gastric emptying of a solid meal using the ¹³C-octanoic acid breath test in a mouse model. Male C57BL/6 mice aged > 8 wk and with body weights of 20-25 g were used in this study. The solid test meal consisted of 200 mg of egg yolk labeled with 1.5 L/g ¹³C-octanoic acid. The mice were placed in a 130 mL chamber flushed with air at a flow speed of 200 mL/min. Breath samples were collected for 6 h. The half-emptying time and lag phase were calculated using a modified power exponential model. To assess the reproducibility of the ¹³C-octanoic acid breath test, the breath test was performed two times at intervals of one week in ten mice without drug treatment. To assess the gastrokinetic effects of DA-9701, the breath test was performed three times in another twelve mice, with a randomized crossover sequence of three drug treatments: DA-9701 3 mg/kg, erythromycin 6 mg/kg, or saline. Each breath test was performed at an interval of one week. Repeatedly measured half gastric emptying time of ten mice without drug treatment showed 0.856 of the intraclass correlation coefficient for the half gastric emptying time (P = 0.004). The mean cumulative excretion curve for the ¹³C-octanoic acid breath test showed accelerated gastric emptying after DA-9701 treatment compared with the saline control (P = 0.028). The median half gastric emptying time after the DA-9701 treatment was significantly shorter than after the saline treatment [122.4 min (109.0-137.9 min) vs 134.5 min (128.4-167.0 min), respectively; P = 0.028] and similar to that after the erythromycin treatment [123.3 min (112.9-138.2 min)]. The lag phase, which was defined as the period taken to empty 15% of a meal, was significantly shorter after the DA-9701 treatment than after the saline treatment [48.1 min (44.6-57.1 min) vs 52.6 min (49.45-57.4 min), respectively; P = 0.049]. The novel prokinetic agent DA-9701 accelerated gastric emptying, assessed with repeated measurements in the same mouse using the ¹³C-octanoic acid breath test. Our findings suggest that DA-9701 has therapeutic potential for the treatment of functional dyspepsia.

Rhopalium development in Aurelia aurita ephyrae

NASA Technical Reports Server (NTRS)

Spangenberg, D. B.

1991-01-01

Rhopalia of developing ephyrae were examined using the SEM and TEM at 24 h intervals following strobilation induction. Kinocilia are shorter in the ephyra stage than in polyps. A few ephyra-type kinocilia are found in rhopalia as early as 24 h after induction, before a distinct rhopalium is seen. By 72 h, the shorter kinocilia predominate and are almost as numerous as in ephyrae (120 h). Many of the kinocilia are associated with mechanoreceptor cells (MR) found in the rhopalia. These MR cells are compared to those reported for medusae. Although newly released ephyrae lack a touch plate, the MR cells in their rhopalia along with the statocyst and neuromuscular system apparently enable these organisms to detect and respond to gravity.

Predictors of hospital stay and home care services use: a population-based, retrospective cohort study in stage IV gastric cancer.

PubMed

Mahar, Alyson L; Coburn, Natalie G; Viola, Raymond; Johnson, Ana P

2015-02-01

Home care services use has been proposed as a means of reducing costs in palliative care by decreasing hospital stay without impacting quality of clinical care; however, little is known about utilization of these services in the time following a terminal cancer diagnosis. To examine disease, patient and healthcare system predictors of hospital stay, and home care services use in metastatic gastric cancer patients. This is a population-based, retrospective cohort study. Chart review and administrative data were linked, using a 26-month time horizon to collect health services data. All patients diagnosed with metastatic gastric cancer in the province of Ontario between 2005 and 2008 were included in the study (n = 1433). Age, comorbidity, tumor location, and burden of metastatic disease were identified as predictors of hospital stay and receipt of home care services. Individuals who received home care services spent fewer days in hospital than individuals who did not (relative risk: 0.44; 95% confidence interval: 0.38-0.51). Patients who interacted with a high-volume oncology specialist had shorter cumulative hospital stay (relative risk: 0.62; 95% confidence interval: 0.54-0.71) and were less likely to receive home care services (relative risk: 0.80; 95% confidence interval: 0.72-0.88) than those who did not. Examining how differences in hospital stay and home care services use impact clinical outcomes and how policies may reduce costs to the healthcare system is necessary. © The Author(s) 2014.

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.

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.

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.

Occupational Diesel Exposure, Duration of Employment, and Lung Cancer

PubMed Central

Picciotto, Sally; Costello, Sadie; Eisen, Ellen A.

2016-01-01

Background: If less healthy workers terminate employment earlier, thus accumulating less exposure, yet remain at greater risk of the health outcome, estimated health effects of cumulative exposure will be biased downward. If exposure also affects termination of employment, then the bias cannot be addressed using conventional methods. We examined these conditions as a prelude to a reanalysis of lung cancer mortality in the Diesel Exhaust in Miners Study. Methods: We applied an accelerated failure time model to assess the effect of exposures to respirable elemental carbon (a surrogate for diesel) on time to termination of employment among nonmetal miners who ever worked underground (n = 8,307). We then applied the parametric g-formula to assess how possible interventions setting respirable elemental carbon exposure limits would have changed lifetime risk of lung cancer, adjusting for time-varying employment status. Results: Median time to termination was 36% shorter (95% confidence interval = 33%, 39%), per interquartile range width increase in respirable elemental carbon exposure. Lung cancer risk decreased with more stringent interventions, with a risk ratio of 0.8 (95% confidence interval = 0.5, 1.1) comparing a limit of ≤25 µg/m3 respirable elemental carbon to no intervention. The fraction of cases attributable to diesel exposure was 27% in this population. Conclusions: The g-formula controlled for time-varying confounding by employment status, the signature of healthy worker survivor bias, which was also affected by diesel exposure. It also offers an alternative approach to risk assessment for estimating excess cumulative risk, and the impact of interventions based entirely on an observed population. PMID:26426944

Biosonar, diving and movements of two tagged white-beaked dolphin in Icelandic waters

NASA Astrophysics Data System (ADS)

Rasmussen, M. H.; Akamatsu, T.; Teilmann, J.; Vikingsson, G.; Miller, L. A.

2013-04-01

For the first time bio-logging tags were attached to free-ranging white-beaked dolphins, Lagenorhynchus albirostris. A satellite tag was attached to one animal while an acoustic A-tag, a time-depth recorder and a VHF transmitter complex was attached to a second dolphin with a suction cup. The satellite tag transmitted for 201 day, during which time the dolphin stayed in the coastal waters of western Iceland. The acoustic tag complex was on the second animal for 13 h and 40 min and provided the first insight into the echolocation behaviour of a free-ranging white-beaked dolphin. The tag registered 162 dives. The dolphin dove to a maximum depth of 45 m, which is about the depth of the bay in which the dolphin was swimming. Two basic types of dives were identified; U-shaped and V-shaped dives. The dolphin used more time in U-shaped dives, more clicks and sonar signals with shorter click intervals compared to those it used in V-shaped dives. The dolphin was in acoustic contact with other dolphins about five hours after it was released and stayed with these for the rest of the tagging time. Possible foraging attempts were found based on the reduction of click intervals from about 100 ms to 2-3 ms, which suggests a prey capture attempt. We found 19 punitive prey capture attempts and of these 53% occurred at the maximum dive depth. This suggests that more than half of the possible prey capture events occurred at or near the sea bed.

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

Observations on the behavior of bowhead whales (Balaena mysticetus) in the presence of operating seismic exploration vessels in the Alaskan Beaufort Sea

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

Ljungblad, D.K.; Wuersig, B.; Swartz, S.L.

1985-10-01

The response of bowhead whales to active geophysical vessels was observed during the course of 4 field experiments conducted in the Alaskan Beaufort Sea, September 1984. Conspicuous short-term behavioral changes were observed when active vessels approached to within 10km of bowheads, with the strongest responses occurring when whales were within 5km of active vessels. Behavioral responses included shorter surfacing and dive times, fewer blows per surfacing, and longer blow intervals. Total avoidance responses occured at vessel distances of 1.25km, 7.2km, 3.5km and 3.5km with associated measured sound levels from the seismic airgun arrays of 152dB, 164dB, 178dB and 163dB, respectively.

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.

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 Optimal Distribution of Practice for the Acquisition of L2 Morphology: A Conceptual Replication and Extension

ERIC Educational Resources Information Center

Suzuki, Yuichi

2017-01-01

This study examined optimal learning schedules for second language (L2) acquisition of a morphological structure. Sixty participants studied the simple and complex morphological rules of a novel miniature language system so as to use them for oral production. They engaged in four training sessions in either shorter spaced (3.3-day interval) or…

Productivity of Thai Brahman and Simmental-Brahman crossbred (Kabinburi) cattle in central Thailand

NASA Astrophysics Data System (ADS)

Boonprong, S.; Choothesa, A.; Sribhen, C.; Parvizi, N.; Vajrabukka, C.

2008-05-01

The productivity of the new crossbred cattle Kabinburi (K) was compared to that of Thai Brahman (TB) using 756 production records from K cattle and 1,316 production records from TB cattle kept at three locations in Thailand. The data were analyzed for the effect of breeds and locations. The ambient temperature, the humidity, the Temperature-Humidity Index (THI) and the rainfall of the three locations were different. Lamphayaklang Livestock Research and Breeding Center (LP) had the highest rainfall/year followed by Nongkwang Livestock Research and Breeding Center (NK), and Prachinburi Livestock Breeding Station (PC). Kabinburi cattle had a higher bodyweight at birth as well as at 200, 400 and 600 days of age than TB cattle. Furthermore, K heifers gave birth to their first calf at a younger age and had a shorter calving interval than TB cows. Thai Brahman cattle kept at LP had significantly higher bodyweight at 400 and 600 days than the animals kept at NK, but bodyweight at birth and 600 days of age were not significantly different. Thai Brahman cattle kept at LP were younger at first calving and had a shorter calving interval than the animals kept at NK. K cattle kept at NK were heavier at birth and at 200, 400 and 600 days of age than the animals kept at PC. Furthermore, Kabinburi cows kept at NK were younger at first calving ( P < 0.01), but the calving interval was not different between the two groups kept at NK or PC.

Two Hour Evaluation and Referral Model for Shorter Turnaround Times in the emergency department.

PubMed

Burke, John A; Greenslade, Jaimi; Chabrowska, Jadwiga; Greenslade, Katherine; Jones, Sally; Montana, Jacqueline; Bell, Anthony; O'Connor, Alan

2017-06-01

The objective of this study was to assess the implementation of a novel ED model of care, which combines clinical streaming, team-based assessment and early senior consultation to reduce length of stay. A pre-post-intervention study was used to compare ED performance following an extensive clinical redesign programme. Clinical teams and work sequences were reconfigured to promote the role of the staff specialist, with a focus on earlier decisions regarding disposition. Primary outcome measures were ED length of stay and National Emergency Access Target (NEAT) compliance. Secondary outcomes included referral and workup times, wait times by triage category, ambulance offload times, ward discharges and unit transfers within 24 h of admission, representation within 48 h, and Medical Emergency Response Team (MERT) calls within 24 h of admission. Two seasonally matched 26 week intervals were compared with adjustment for demographics, triage category and arrival by ambulance. Overall, there was an 18.4% rise in NEAT performance (95% confidence interval (CI): 17.7-19.1) while ED length of stay decreased by a total of 86.8 min (95% CI: 83.6-90.1). Time series analysis did not suggest any preexisting trends to explain these results. The average time to referral decreased by 74.7 min (95% CI: 69.8-79.6) and waiting times decreased across all triage categories. Rates of MERT activation and unplanned representation were unchanged. A facilitated team leader role for senior doctors can help to reduce length of stay by via early disposition, without significant risks to the patient. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

The Influence of Pituitary Size on Outcome After Transsphenoidal Hypophysectomy in a Large Cohort of Dogs with Pituitary-Dependent Hypercortisolism.

PubMed

van Rijn, S J; Galac, S; Tryfonidou, M A; Hesselink, J W; Penning, L C; Kooistra, H S; Meij, B P

2016-07-01

Transsphenoidal hypophysectomy is one of the treatment strategies in the comprehensive management of dogs with pituitary-dependent hypercortisolism (PDH). To describe the influence of pituitary size at time of pituitary gland surgery on long-term outcome. Three-hundred-and-six dogs with PDH. Survival and disease-free fractions were analyzed and related to pituitary size; dogs with and without recurrence were compared. Four weeks after surgery, 91% of dogs were alive and remission was confirmed in 92% of these dogs. The median survival time was 781 days, median disease-free interval was 951 days. Over time, 27% of dogs developed recurrence of hypercortisolism after a median period of 555 days. Dogs with recurrence had significantly higher pituitary height/brain area (P/B) ratio and pre-operative basal urinary corticoid-to-creatinine ratio (UCCR) than dogs without recurrence. Survival time and disease-free interval of dogs with enlarged pituitary glands was significantly shorter than that of dogs with a non-enlarged pituitary gland. Pituitary size at the time of surgery significantly increased over the 20-year period. Although larger tumors have a less favorable prognosis, outcome in larger tumors improved over time. Transsphenoidal hypophysectomy is an effective treatment for PDH in dogs, with an acceptable long-term outcome. Survival time and disease-free fractions are correlated negatively with pituitary gland size, making the P/B ratio an important pre-operative prognosticator. However, with increasing experience, and for large tumors, pituitary gland surgery remains an option to control the pituitary mass and hypercortisolism. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Racial and Ethnic Variation in Time to Prostate Biopsy After an Elevated Screening Level of Serum Prostate-specific Antigen.

PubMed

Reading, Stephanie R; Porter, Kimberly R; Hsu, Jin-Wen Y; Wallner, Lauren P; Loo, Ronald K; Jacobsen, Steven J

2016-10-01

To examine the racial and ethnic variation in time to prostate biopsy after an elevated screening level of serum prostate-specific antigen (PSA). Male members of the Kaiser Permanente of Southern California health plan, 45 years of age or older, with no history of prostate cancer or a prostate biopsy, and at least 1 elevated screening level of serum PSA between January 1, 1998 and December 31, 2007 were retrospectively identified (n = 59,506). All participants were passively followed via electronic health records until their time of prostate biopsy, death, membership disenrollment, or study conclusion (December 31, 2014), whichever was the initial event. Proportional hazard regression analyses were used to estimate the association between time from an elevated screening level of serum PSA to prostate biopsy, adjusting for age, benign prostatic hyperplasia, prostatitis, type 2 diabetes mellitus, hypertension, and Charlson Comorbidity Index score. Median time until biopsy was 0.6 years (214 days), with approximately 41% of participants receiving a prostate biopsy within the study period. Results from the fully adjusted analysis indicated that the non-Hispanic Asian or Pacific Islanders (hazard ratio: 1.10, 95% confidence interval: [1.04, 1.15]) and the non-Hispanic blacks (hazard ratio: 1.04, 95% confidence interval: [1.00, 1.08]) had a slightly shorter time to prostate biopsy after an elevated screening level of serum PSA compared to the non-Hispanic whites. These data suggest that, within an integrated healthcare organization, minimal differences exist between racial and ethnic subgroups in their time to prostate biopsy after an elevated screening level of serum PSA. Copyright © 2016. Published by Elsevier Inc.

Sex, timing, and depression among suicide victims with schizophrenia.

PubMed

Karvonen, Kaisa; Sammela, Hanna-Lena; Rahikkala, Heidi; Hakko, Helinä; Särkioja, Terttu; Meyer-Rochow, V Benno; Räsänen, Pirkko; Timonen, Markku

2007-01-01

Schizophrenia and depression by themselves and especially in combination with each other are known to be important risk factors of suicide. An increased risk of suicide has also been reported for the period immediately after a psychiatric patient's discharge from the hospital. However, to the best of our knowledge, it remains unknown whether survival times differ between suicide victims with schizophrenia concomitantly with and those without depression. This study aimed to examine survival times from the discharge of last hospital treatment (irrespective of the kind of illness) to the day of death in suicide victims with schizophrenia with or without concomitant depression. A 16-year database of all suicides (1535 males, 342 females) committed during the years 1988-2003 in the province of Oulu in northern Finland, and information available from the national hospital discharge registers formed the basis of this study. In male suicide victims with schizophrenia, the median survival time after final hospitalization was approximately 1 day in those with a history of depression and 90 days in those without depression (P = .005). The corresponding times for females were 50 and 24 days, respectively (P = .396). Using Cox regression analysis after adjusting for confounders, we noticed a statistically significant difference in survival times from last hospitalization to suicide between depressive and nondepressive male patients with schizophrenia (hazard ratio, 1.80; 95% confidence interval, 1.04-3.11), but not females (hazard ratio, 0.72; 95% confidence interval, 0.34-1.53). Concomitant depression was markedly linked with shorter survival time in male suicide victims with schizophrenia after last hospitalization. Psychiatric inpatient facilities appear to be in a key position to establish suicide prevention programs for patients with schizophrenia, especially those with depression.

Origin of the correlations between exit times in pedestrian flows through a bottleneck

NASA Astrophysics Data System (ADS)

Nicolas, Alexandre; Touloupas, Ioannis

2018-01-01

Robust statistical features have emerged from the microscopic analysis of dense pedestrian flows through a bottleneck, notably with respect to the time gaps between successive passages. We pinpoint the mechanisms at the origin of these features thanks to simple models that we develop and analyse quantitatively. We disprove the idea that anticorrelations between successive time gaps (i.e. an alternation between shorter ones and longer ones) are a hallmark of a zipper-like intercalation of pedestrian lines and show that they simply result from the possibility that pedestrians from distinct ‘lines’ or directions cross the bottleneck within a short time interval. A second feature concerns the bursts of escapes, i.e. egresses that come in fast succession. Despite the ubiquity of exponential distributions of burst sizes, entailed by a Poisson process, we argue that anomalous (power-law) statistics arise if the bottleneck is nearly congested, albeit only in a tiny portion of parameter space. The generality of the proposed mechanisms implies that similar statistical features should also be observed for other types of particulate flows.

Real-time vehicle emissions monitoring using a compact LiDAR system and conventional instruments: first results of an experimental campaign in a suburban area in southern Italy

NASA Astrophysics Data System (ADS)

Parracino, Stefano; Richetta, Maria; Gelfusa, Michela; Malizia, Andrea; Bellecci, Carlo; De Leo, Leonardo; Perrimezzi, Carlo; Fin, Alessandro; Forin, Marco; Giappicucci, Francesca; Grion, Massimo; Marchese, Giuseppe; Gaudio, Pasquale

2016-10-01

Urban air pollution causes deleterious effects on human health and the environment. To meet stringent standards imposed by the European Commission, advanced measurement methods are required. Remote sensing techniques, such as light detection and ranging (LiDAR), can be a valuable option for evaluating particulate matter (PM), emitted by vehicles in urban traffic, with high sensitivity and in shorter time intervals. Since air quality problems persist not only in large urban areas, a measuring campaign was specifically performed in a suburban area of Crotone, Italy, using both a compact LiDAR system and conventional instruments for real-time vehicle emissions monitoring along a congested road. First results reported in this paper show a strong dependence between variations of LiDAR backscattering signals and traffic-related air pollution levels. Moreover, time-resolved LiDAR data averaged in limited regions, directly above conventional monitoring stations at the border of an intersection, were found to be linearly correlated to the PM concentration levels with a correlation coefficient between 0.75 and 0.84.

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.

A window on perception: Response times of odontocete cetaceans in audiometric tests

NASA Astrophysics Data System (ADS)

Blackwood, Diane J.; Ridgway, Sam H.; Evans, William E.

2002-05-01

A standard psychometric measurement is response time, the interval elapsing between a stimulus and a response. While studies of response time have been published for humans and other terrestrial mammals, this study marks the first report of response times for odontocete cetaceans at threshold in an audiometric task. Two white whales (Delphinapterus leucas) and four Atlantic bottlenose dolphins (Tursiops truncatus) were given audiometric tests to determine masked hearing thresholds. Animals were tested at 26 frequencies over a range from 200 Hz to 100 kHz using pure tones. The test tone amplitudes covered a range of 20 dB re 1 microPascal including the hearing threshold of the animal at that frequency. Hearing thresholds varied from 87.5 dB to 125.5 dB depending on frequency, masking noise intensity and individual animal. Data was analyzed to determine characteristic relationships between response time and amplitude of test tone for each frequency and animal. The two whales responded significantly slower (640 ms, 0.001) than the four dolphins (430 ms). As in terrestrial animals, reaction time became shorter as stimulus strength increased. At threshold, median response time across frequencies within each animal varied about 150 ms.

Unintended pregnancy and interpregnancy interval by maternal age, National Survey of Family Growth.

PubMed

Ahrens, Katherine A; Thoma, Marie E; Copen, Casey E; Frederiksen, Brittni N; Decker, Emily J; Moskosky, Susan

2018-03-01

The relationship between unintended pregnancy and interpregnancy interval (IPI) across maternal age is not clear. Using data from the National Survey of Family Growth, we estimated the percentages of pregnancies that were unintended among IPI groups (<6, 6-11, 12-17, 18-23, 24+ months) by maternal age at last live birth (15-19, 20-24, 25-29, 30-44 years). Approximately 40% of pregnancies were unintended and 36% followed an IPI<18 months. Within each maternal age group, the percentage of pregnancies that were unintended decreased as IPI increased. Unintended pregnancies are associated with shorter IPI across the reproductive age spectrum. Published by Elsevier Inc.

From door-to-balloon time to contact-to-device time: predictors of achieving target times in patients with ST-elevation myocardial infarction.

PubMed

Roswell, Robert O; Greet, Brian; Parikh, Parin; Mignatti, Andrea; Freese, John; Lobach, Iryna; Guo, Yu; Keller, Norma; Radford, Martha; Bangalore, Sripal

2014-07-01

The 2013 American College of Cardiology Foundation/American Heart Association ST-segment elevation myocardial infarction (STEMI) guidelines have shifted focus from door-to-balloon (D2B) time to the time from first medical contact to device activation (contact-to-device time [C2D] ). This study investigates the impact of prehospital wireless electrocardiogram transmission (PHT) on reperfusion times to assess the impact of the new guidelines. From January 2009 to December 2012, data were collected on STEMI patients who received percutaneous coronary interventions; 245 patients were included for analysis. The primary outcome was median C2D time in the PHT group and the secondary outcome was D2B time. Prehospital wireless electrocardiogram transmission was associated with reduced C2D times vs no PHT: 80 minutes (interquartile range [IQR], 64-94) vs 96 minutes (IQR, 79-118), respectively, P < 0.0001. The median D2B time was lower in the PHT group vs the no-PHT group: 45 minutes (IQR, 34-56) vs 63 minutes (IQR, 49-81), respectively, P < 0.0001. Multivariate analysis showed PHT to be the strongest predictor of a C2D time of <90 minutes (odds ratio: 3.73, 95% confidence interval: 1.65-8.39, P = 0.002). Female sex was negatively predictive of achieving a C2D time <90 minutes (odds ratio: 0.23, 95% confidence interval: 0.07-0.73, P = 0.01). In STEMI patients, PHT was associated with significantly reduced C2D and D2B times and was an independent predictor of achieving a target C2D time. As centers adapt to the new guidelines emphasizing C2D time, targeting a shorter D2B time (<50 minutes) is ideal to achieve a C2D time of <90 minutes. © 2014 Wiley Periodicals, Inc.

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

Evaluating efficiency and statistical power of self-controlled case series and self-controlled risk interval designs in vaccine safety.

PubMed

Li, Rongxia; Stewart, Brock; Weintraub, Eric

2016-01-01

The self-controlled case series (SCCS) and self-controlled risk interval (SCRI) designs have recently become widely used in the field of post-licensure vaccine safety monitoring to detect potential elevated risks of adverse events following vaccinations. The SCRI design can be viewed as a subset of the SCCS method in that a reduced comparison time window is used for the analysis. Compared to the SCCS method, the SCRI design has less statistical power due to fewer events occurring in the shorter control interval. In this study, we derived the asymptotic relative efficiency (ARE) between these two methods to quantify this loss in power in the SCRI design. The equation is formulated as [Formula: see text] (a: control window-length ratio between SCRI and SCCS designs; b: ratio of risk window length and control window length in the SCCS design; and [Formula: see text]: relative risk of exposed window to control window). According to this equation, the relative efficiency declines as the ratio of control-period length between SCRI and SCCS methods decreases, or with an increase in the relative risk [Formula: see text]. We provide an example utilizing data from the Vaccine Safety Datalink (VSD) to study the potential elevated risk of febrile seizure following seasonal influenza vaccine in the 2010-2011 season.

Delay of Treatment Initiation Does Not Adversely Affect Survival Outcome in Breast Cancer.

PubMed

Yoo, Tae-Kyung; Han, Wonshik; Moon, Hyeong-Gon; Kim, Jisun; Lee, Jun Woo; Kim, Min Kyoon; Lee, Eunshin; Kim, Jongjin; Noh, Dong-Young

2016-07-01

Previous studies examining the relationship between time to treatment and survival outcome in breast cancer have shown inconsistent results. The aim of this study was to analyze the overall impact of delay of treatment initiation on patient survival and to determine whether certain subgroups require more prompt initiation of treatment. This study is a retrospective analysis of stage I-III patients who were treated in a single tertiary institution between 2005 and 2008. Kaplan-Meier survival analysis and Cox proportional hazards regression model were used to evaluate the impact of interval between diagnosis and treatment initiation in breast cancer and various subgroups. A total of 1,702 patients were included. Factors associated with longer delay of treatment initiation were diagnosis at another hospital, medical comorbidities, and procedures performed before admission for surgery. An interval between diagnosis and treatment initiation as a continuous variable or with a cutoff value of 15, 30, 45, and 60 days had no impact on disease-free survival (DFS). Subgroup analyses for hormone-responsiveness, triple-negative breast cancer, young age, clinical stage, and type of initial treatment showed no significant association between longer delay of treatment initiation and DFS. Our results show that an interval between diagnosis and treatment initiation of 60 days or shorter does not appear to adversely affect DFS in breast cancer.

Augmenting Plasticity Induction in Human Motor Cortex by Disinhibition Stimulation.

PubMed

Cash, Robin F H; Murakami, Takenobu; Chen, Robert; Thickbroom, Gary W; Ziemann, Ulf

2016-01-01

Cellular studies showed that disinhibition, evoked pharmacologically or by a suitably timed priming stimulus, can augment long-term plasticity (LTP) induction. We demonstrated previously that transcranial magnetic stimulation evokes a period of presumably GABA(B)ergic late cortical disinhibition (LCD) in human primary motor cortex (M1). Here, we hypothesized that, in keeping with cellular studies, LCD can augment LTP-like plasticity in humans. In Experiment 1, patterned repetitive TMS was applied to left M1, consisting of 6 trains (intertrain interval, 8 s) of 4 doublets (interpulse interval equal to individual peak I-wave facilitation, 1.3-1.5 ms) spaced by the individual peak LCD (interdoublet interval (IDI), 200-250 ms). This intervention (total of 48 pulses applied over ∼45 s) increased motor-evoked potential amplitude, a marker of corticospinal excitability, in a right hand muscle by 147% ± 4%. Control experiments showed that IDIs shorter or longer than LCD did not result in LTP-like plasticity. Experiment 2 indicated topographic specificity to the M1 hand region stimulated by TMS and duration of the LTP-like plasticity of 60 min. In conclusion, GABA(B)ergic LCD offers a powerful new approach for augmenting LTP-like plasticity induction in human cortex. We refer to this protocol as disinhibition stimulation (DIS). © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Recurrent craniopharyngioma after conformal radiation in children and the burden of treatment.

PubMed

Klimo, Paul; Venable, Garrett T; Boop, Frederick A; Merchant, Thomas E

2015-05-01

In this paper the authors present their experience treating children with recurrent craniopharyngioma who were initially managed with surgery followed by conformal radiation therapy (CRT). A departmental oncology information system was queried to identify all children (< 18 years old) who received CRT for a craniopharyngioma between 1998 and 2010 (inclusive) and specifically those who experienced tumor progression. For each patient, the authors recorded the type of recurrence (solid, cystic, or both), the time interval to first progression and each subsequent progression, the associated treatment complications, and disease status at last follow-up evaluation. Among the 97 patients that met criteria for entry into this study, 18 (18.6%) experienced tumor progression (9 cystic, 3 solid, 6 cystic and solid). The median time to first recurrence was 4.62 years (range 1.81-9.11 years). The subgroup included 6 female and 12 male patients with a median age of 7.54 years (range 3.61-13.83 years). Ten patients experienced first progression within 5 years of CRT. The 5- and 10-year treatment-free survival rates for the entire cohort were 89.0% (95% confidence interval [CI] 80.5%-93.9%) and 76.2% (95% CI 64%-85%), respectively. Seven patients had a single episode of progression and 11 had more than 1. The time interval between each subsequent progression was progressively shorter. The 18 patients underwent 38 procedures. The median follow-up duration for this group was 9.32 years (range 4.04-19.0 years). Three patients died, including 1 from perioperative complications. Craniopharyngioma progression after prior irradiation is exceedingly difficult to treat and local control is challenging despite repeated surgical procedures. Given our results, gross-total resection may need to be the surgical goal at the time of first recurrence, if possible. Decompressing new cyst formation alone has a low rate of long-term success.

In vivo real-time assessment of colorectal polyp histology using an optical biopsy forceps system based on laser-induced fluorescence spectroscopy.

PubMed

Rath, Timo; Tontini, Gian E; Vieth, Michael; Nägel, Andreas; Neurath, Markus F; Neumann, Helmut

2016-06-01

In order to reduce time, costs, and risks associated with resection of diminutive colorectal polyps, the American Society for Gastrointestinal Endoscopy (ASGE) recently proposed performance thresholds that new technologies should meet for the accurate real-time assessment of histology of colorectal polyps. In this study, we prospectively assessed whether laser-induced fluorescence spectroscopy (LIFS), using the new WavSTAT4 optical biopsy system, can meet the ASGE criteria. 27 patients undergoing screening or surveillance colonoscopy were included. The histology of 137 diminutive colorectal polyps was predicted in real time using LIFS and findings were compared with the results of conventional histopathological examination. The accuracy of predicting polyp histology with WavSTAT4 was assessed according to the ASGE criteria. The overall accuracy of LIFS using WavSTAT4 for predicting polyp histology was 84.7 % with sensitivity, specificity, and negative predictive value (NPV) of 81.8 %, 85.2 %, and 96.1 %. When only distal colorectal diminutive polyps were considered, the NPV for excluding adenomatous histology increased to 100 % (accuracy 82.4 %, sensitivity 100 %, specificity 80.6 %). On-site, LIFS correctly predicted the recommended surveillance intervals with an accuracy of 88.9 % (24/27 patients) when compared with histology-based United States guideline recommendations; in the 3 patients for whom LIFS- and histopathology-based recommended surveillance intervals differed, LIFS predicted shorter surveillance intervals. From the data of this pilot study, LIFS using the WavSTAT4 system appears accurate enough to allow distal colorectal polyps to be left in place and nearly reaches the threshold to "resect and discard" them without pathologic assessment. WavSTAT4 therefore has the potential to reduce costs and risks associated with the removal of diminutive colorectal polyps. © Georg Thieme Verlag KG Stuttgart · New York.

Reoperations on the pulmonary autograft and pulmonary homograft after the Ross procedure: An update on the German Dutch Ross Registry.

PubMed

Charitos, Efstratios I; Takkenberg, Johanna J M; Hanke, Thorsten; Gorski, Armin; Botha, Cornelius; Franke, Ulrich; Dodge-Khatami, Ali; Hoerer, Juergen; Lange, Rudiger; Moritz, Anton; Ferrari-Kuehne, Katharina; Hetzer, Roland; Huebler, Michael; Bogers, Ad J J C; Stierle, Ulrich; Sievers, Hans-Hinrich; Hemmer, Wolfgang

2012-10-01

Reinterventions after the Ross procedure are a concern for patients and treating physicians. The scope of the present report was to provide an update on the reinterventions observed in the large patient population of the German-Dutch Ross Registry. From 1988 to 2011, 2023 patients (age, 39.05 ± 16.5 years; male patients, 1502; adults, 1642) underwent a Ross procedure in 13 centers. The mean follow-up was 7.1 ± 4.6 years (range, 0-22 years; 13,168 patient-years). In the adult population, 120 autograft reinterventions in 113 patients (1.03%/patient-year) and 76 homograft reinterventions in 67 patients (0.65%/patient-year) and, in the pediatric population, 14 autograft reinterventions in 13 patients (0.91%/patient-year) and 42 homograft reinterventions in 31 patients (2.72%/patient-year) were observed. Of the autograft and homograft reinterventions, 17.9% and 21.2% were performed because of endocarditis, respectively. The subcoronary technique in the adult population resulted in significantly superior autograft durability (freedom from autograft reintervention: 97% at 10 years and 91% at 12 years; P < .001). The root replacement technique without root reinforcement (hazard ratio, 2.4; 95% confidence interval, 1.4-4.1) and the presence of pure aortic insufficiency preoperatively (hazard ratio, 2.3; 95% confidence interval, 1.5-3.5) were statistically significant predictors for a shorter time to reoperation. The center volume had a significant influence on the long-term results. The freedom from homograft reoperation for the adults and pediatric population was 97% and 87% at 5 years and 93% and 79% at 12 years, respectively (P < .001), with younger recipient and donor age being significant predictors of a shorter time to homograft reoperation. The autograft principle remains a valid option for young patients requiring aortic valve replacement. The risk of reoperation depends largely on the surgical technique used and the preoperative hemodynamics. Center experience and expertise also influence the long-term results. Adequate endocarditis prophylaxis might further reduce the need for reoperation. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Repeated measurements of mite and pet allergen levels in house dust over a time period of 8 years.

PubMed

Antens, C J M; Oldenwening, M; Wolse, A; Gehring, U; Smit, H A; Aalberse, R C; Kerkhof, M; Gerritsen, J; de Jongste, J C; Brunekreef, B

2006-12-01

Studies of the association between indoor allergen exposure and the development of allergic diseases have often measured allergen exposure at one point in time. We investigated the variability of house dust mite (Der p 1, Der f 1) and cat (Fel d 1) allergen in Dutch homes over a period of 8 years. Data were obtained in the Dutch PIAMA birth cohort study. Dust from the child's mattress, the parents' mattress and the living room floor was collected at four points in time, when the child was 3 months, 4, 6 and 8 years old. Dust samples were analysed for Der p 1, Der f 1 and Fel d 1 by sandwich enzyme immuno assay. Mite allergen concentrations for the child's mattress, the parents' mattress and the living room floor were moderately correlated between time-points. Agreement was better for cat allergen. For Der p 1 and Der f 1 on the child's mattress, the within-home variance was close to or smaller than the between-home variance in most cases. For Fel d 1, the within-home variance was almost always smaller than the between-home variance. Results were similar for allergen levels expressed per gram of dust and allergen levels expressed per square metre of the sampled surface. Variance ratios were smaller when samples were taken at shorter time intervals than at longer time intervals. Over a period of 4 years, mite and cat allergens measured in house dust are sufficiently stable to use single measurements with confidence in epidemiological studies. The within-home variance was larger when samples were taken 8 years apart so that over such long periods, repetition of sampling is recommended.

Optimal estimation of suspended-sediment concentrations in streams

USGS Publications Warehouse

Holtschlag, D.J.

2001-01-01

Optimal estimators are developed for computation of suspended-sediment concentrations in streams. The estimators are a function of parameters, computed by use of generalized least squares, which simultaneously account for effects of streamflow, seasonal variations in average sediment concentrations, a dynamic error component, and the uncertainty in concentration measurements. The parameters are used in a Kalman filter for on-line estimation and an associated smoother for off-line estimation of suspended-sediment concentrations. The accuracies of the optimal estimators are compared with alternative time-averaging interpolators and flow-weighting regression estimators by use of long-term daily-mean suspended-sediment concentration and streamflow data from 10 sites within the United States. For sampling intervals from 3 to 48 days, the standard errors of on-line and off-line optimal estimators ranged from 52.7 to 107%, and from 39.5 to 93.0%, respectively. The corresponding standard errors of linear and cubic-spline interpolators ranged from 48.8 to 158%, and from 50.6 to 176%, respectively. The standard errors of simple and multiple regression estimators, which did not vary with the sampling interval, were 124 and 105%, respectively. Thus, the optimal off-line estimator (Kalman smoother) had the lowest error characteristics of those evaluated. Because suspended-sediment concentrations are typically measured at less than 3-day intervals, use of optimal estimators will likely result in significant improvements in the accuracy of continuous suspended-sediment concentration records. Additional research on the integration of direct suspended-sediment concentration measurements and optimal estimators applied at hourly or shorter intervals is needed.

Genetic-economic evaluation of traits in a goose meat enterprise.

PubMed

Shalev, B A; Pasternak, H

1999-05-01

1. Goose can be considered as an additional and inexpensive meat source, provided that the marketing age does not exceed 8 weeks. Using the ability of geese to eat grass may reduce the intake of concentrated food up to 30%. 2. According to an equation developed, growth rate accounts for about 58% of the annual breeding gains, egg number 28%, feather yield 10%, fertility and mortality about 2%. These values are about the same for a wide range of food prices. 3. Employing realistic values for expected annual genetic gains reveals that the customary practice of keeping breeders for 5 to 6 years should be replaced by a much shorter cycle of 3 years because the economic gain from the shorter generation interval of selection exceeds the replacement costs.

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.

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.

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

Relative time sharing: new findings and an extension of the resource allocation model of temporal processing.

PubMed

Buhusi, Catalin V; Meck, Warren H

2009-07-12

Individuals time as if using a stopwatch that can be stopped or reset on command. Here, we review behavioural and neurobiological data supporting the time-sharing hypothesis that perceived time depends on the attentional and memory resources allocated to the timing process. Neuroimaging studies in humans suggest that timekeeping tasks engage brain circuits typically involved in attention and working memory. Behavioural, pharmacological, lesion and electrophysiological studies in lower animals support this time-sharing hypothesis. When subjects attend to a second task, or when intruder events are presented, estimated durations are shorter, presumably due to resources being taken away from timing. Here, we extend the time-sharing hypothesis by proposing that resource reallocation is proportional to the perceived contrast, both in temporal and non-temporal features, between intruders and the timed events. New findings support this extension by showing that the effect of an intruder event is dependent on the relative duration of the intruder to the intertrial interval. The conclusion is that the brain circuits engaged by timekeeping comprise not only those primarily involved in time accumulation, but also those involved in the maintenance of attentional and memory resources for timing, and in the monitoring and reallocation of those resources among tasks.

Shorter intervals between great earthquakes near Sendai: Scour ponds and a sand layer attributable to A.D. 1454 overwash

NASA Astrophysics Data System (ADS)

Sawai, Yuki; Namegaya, Yuichi; Tamura, Toru; Nakashima, Rei; Tanigawa, Koichiro

2015-06-01

A sparsely documented tsunami in 1454 may subdivide the recurrence interval between the 869 and 2011 tsunamis near Sendai, as judged from geomorphic, stratigraphic, and archival evidence. Pond-filled breaches cut across beach ridges on century-old topographic maps. The basal pond deposit in one of these breaches postdates 1454. Stratigraphy on Sendai Plain includes a sand sheet that contains marine and brackish diatoms. Radiocarbon ages suggest that the sheet dates to 1406-1615 (2σ), and written records for this interval in Tohoku mention a tsunami in 1454. The inferred inundation extended 1.0-2.5 km inland from an approximate medieval shoreline. Simulated tsunamis that best account for the sand sheet require a thrust earthquake of moment magnitude 8.4 or larger. If the sand sheet represents the 1454 tsunami, the two most recent intervals between great thrust earthquakes in Sendai region spanned 585 and 557 years.

Comparison of gamma-gamma Phase Coarsening Responses of Three Powder Metal Disk Superalloys

NASA Technical Reports Server (NTRS)

Gabb, T. P.; Gayda, J.; Johnson, D. F.; MacKay, R. A.; Rogers, R. B.; Sudbrack, C. K.; Garg, A.; Locci, I. E.; Semiatin, S. L.; Kang, E.

2016-01-01

The phase microstructures of several powder metal (PM) disk superalloys were quantitatively evaluated. Contents, chemistries, and lattice parameters of gamma and gamma strengthening phase were determined for conventionally heat treated Alloy 10, LSHR, and ME3 superalloys, after electrolytic phase extractions. Several of long term heat treatments were then performed, to allow quantification of the precipitation, content, and size distribution of gamma at a long time interval to approximate equilibrium conditions. Additional coarsening heat treatments were performed at multiple temperatures and shorter time intervals, to allow quantification of the precipitation, contents and size distributions of gamma at conditions diverging from equilibrium. Modest differences in gamma and gamma lattice parameters and their mismatch were observed among the alloys, which varied with heat treatment. Yet, gamma coarsening rates were very similar for all three alloys in the heat treatment conditions examined. Alloy 10 had higher gamma dissolution and formation temperatures than LSHR and ME3, but a lower lattice mismatch, which was slightly positive for all three alloys at room temperature. The gamma precipitates of Alloy 10 appeared to remain coherent at higher temperatures than for LSHR and ME3. Higher coarsening rates were observed for gamma precipitates residing along grain boundaries than for those within grains in all three alloys, during slow-moderate quenching from supersolvus solution heat treatments, and during aging at temperatures of 843 C and higher.

Change of short-term memory effect in acute ischemic ventricular myocardium: a computational study.

PubMed

Mei, Xi; Wang, Jing; Zhang, Hong; Liu, Zhi-cheng; Zhang, Zhen-xi

2014-02-01

The ionic mechanism of change in short-term memory (STM) during acute myocardial ischemia has not been well understood. In this paper, an advanced guinea pig ventricular model developed by Luo and Rudy was used to investigate STM property of ischemic ventricular myocardium. STM response was calculated by testing the time to reach steady-state action potential duration (APD) after an abrupt shortening of basic cycling length (BCL) in the pacing protocol. Electrical restitution curves (RCs), which can simultaneously visualize multiple aspects of APD restitution and STM, were obtained from dynamic and local S1S2 restitution portrait (RP), which consist of a longer interval stimulus (S1) and a shorter interval stimulus (S2). The angle between dynamic RC and local S1S2 RC reflects the amount of STM. Our results indicated that compared with control (normal) condition, time constant of STM response in the ischemic condition decreased significantly. Meanwhile the angle which reflects STM amount is less in ischemic model than that in control model. By tracking the effect of ischemia on intracellular ion concentration and membrane currents, we declared that changes in membrane currents caused by ischemia exert subtle influences on STM; it is only the decline of intracellular calcium concentration that give rise to the most decrement of STM. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Comparison of the acute effects of high-intensity interval training and continuous aerobic walking on inhibitory control.

PubMed

Kao, Shih-Chun; Westfall, Daniel R; Soneson, Jack; Gurd, Brendon; Hillman, Charles H

2017-09-01

The purpose of this study was to investigate the effects of a single bout of high-intensity interval training (HIIT) and continuous aerobic exercise (CAE) on inhibitory control. The P3 component of the stimulus-locked ERP was collected in 64 young adults during a modified flanker task following 20 min of seated rest, 20 min of CAE, and 9 min of HIIT on separate days in counterbalanced order. Participants exhibited shorter overall reaction time following CAE and HIIT compared to seated rest. Response accuracy improved following HIIT in the task condition requiring greater inhibitory control compared to seated rest and CAE. P3 amplitude was larger following CAE compared to seated rest and HIIT. Decreased P3 amplitude and latency were observed following HIIT compared to seated rest. The current results replicated previous findings indicating the beneficial effect of acute CAE on behavioral and neuroelectric indices of inhibitory control. With a smaller duration and volume of exercise, a single bout of HIIT resulted in additional improvements in inhibitory control, paralleled by a smaller and more efficient P3 component. In sum, the current study demonstrated that CAE and HIIT differentially facilitate inhibitory control and its underlying neuroelectric activation, and that HIIT may be a time-efficient approach for enhancing cognitive health. © 2017 Society for Psychophysiological Research.

The robustness of false memory for emotional pictures.

PubMed

Bessette-Symons, Brandy A

2018-02-01

Emotional material is commonly reported to be more accurately recognised; however, there is substantial evidence of increased false alarm rates (FAR) for emotional material and several reports of stronger influences on response bias than accuracy. This pattern is more frequently reported for words than pictures. Research on the mechanisms underlying bias differences has mostly focused on word lists under short retention intervals. This article presents four series of experiments examining recognition memory for emotional pictures while varying arousal and the control over the content of the pictures at two retention intervals, and one study measuring the relatedness of the series picture sets. Under the shorter retention interval, emotion increased false alarms and reduced accuracy. Under the longer retention interval emotion increased hit rates and FAR, resulting in reduced accuracy and/or bias. At both retention intervals, the pattern of valence effects differed based on the arousal associated with the picture sets. Emotional pictures were found to be more related than neutral pictures in each set; however, the influence of relatedness alone does not provide an adequate explanation for all emotional differences. The results demonstrate substantial emotional differences in picture recognition that vary based on valence, arousal and retention interval.

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.

Methodical aspects of rearing decapod larvae, Pagurus bernhardus (Paguridae) and Carcinus maenas (Portunidae)

NASA Astrophysics Data System (ADS)

Dawirs, R. R.

1982-12-01

Improved methods for experimental rearing of Pagurus bernhardus and Carcinus maenas larvae are presented. Isolated maintenance was found essential for reliable statistical evaluation of results obtained from stages older than zoea-1. Only by isolated rearing is it possible to calculate mean values ±95% confidence intervals of stage duration. Mean values (without confidence intervals) can only be given for group-reared larvae if mortality is zero. Compared to group rearing, isolated rearing led to better survival, shorter periods of development and stimulated growth. Due to different swimming behavior P. bernhardus zoeae needed larger water volumes than Carcinus maenas larvae. P. bernhardus zoeae were reared with best results when isolated in Petri dishes (ca. 50 ml). They fed on newly hatched brine shrimp nauplii ( Artemia spp.). P. bernhardus megalopa did not require any gastropod shell or substratum; it developed best in glass vials without any food. C. maenas larvae could be reared most sucessfully in glass vials (ca 20 ml) under a simulated day-night regime (LD 16:8); constant darkness had a detrimental effect on development, leading to prolonged stage-duration times. C. maenas larvae were fed a mixture of newly hatched brine shrimp naupli and rotifers ( Brachionus plicatilis).

Reconstruction of solar spectral irradiance since the Maunder minimum

NASA Astrophysics Data System (ADS)

Krivova, N. A.; Vieira, L. E. A.; Solanki, S. K.

2010-12-01

Solar irradiance is the main external driver of the Earth's climate. Whereas the total solar irradiance is the main source of energy input into the climate system, solar UV irradiance exerts control over chemical and physical processes in the Earth's upper atmosphere. The time series of accurate irradiance measurements are, however, relatively short and limit the assessment of the solar contribution to the climate change. Here we reconstruct solar total and spectral irradiance in the range 115-160,000 nm since 1610. The evolution of the solar photospheric magnetic flux, which is a central input to the model, is appraised from the historical record of the sunspot number using a simple but consistent physical model. The model predicts an increase of 1.25 W/m2, or about 0.09%, in the 11-year averaged solar total irradiance since the Maunder minimum. Also, irradiance in individual spectral intervals has generally increased during the past four centuries, the magnitude of the trend being higher toward shorter wavelengths. In particular, the 11-year averaged Ly-α irradiance has increased by almost 50%. An exception is the spectral interval between about 1500 and 2500 nm, where irradiance has slightly decreased (by about 0.02%).

Pitch discrimination as a function of the inter-stimulus interval: Evidence against a simple model of perceptual memory

NASA Astrophysics Data System (ADS)

Demany, Laurent; Montandon, Gaspard; Semal, Catherine

2003-04-01

A listener's ability to compare two sounds separated by a silent time interval T is limited by a sum of ``sensory noise'' and ``memory noise.'' The present work was intended to test a model according to which these two components of internal noise are independent and, for a given sensory continuum, the memory noise depends only on T. In three experiments using brief sounds (<80 ms), pitch discrimination performances were measured in terms of d' as a function of T (0.1-4 s) and a physical parameter affecting the amount of sensory noise (pitch salience). As T increased, d' first increased rapidly and then declined more slowly. According to the tested model, the relative decline of d' beyond the optimal value of T should have been slower when pitch salience was low (large amount of sensory noise) than when pitch salience was high (small amount of sensory noise). However, this prediction was disproved in each of the three experiments. It was also found, when a ``roving'' procedure was used, that the optimal value of T was markedly shorter for very brief tone bursts (6 sine cycles) than for longer tone bursts (30 sine cycles).

Quantifying Short-Term Dynamics of Parkinson’s Disease Using Self-Reported Symptom Data From an Internet Social Network

PubMed Central

Wicks, Paul; Vaughan, Timothy; Pentland, Alex

2013-01-01

Background Parkinson’s disease (PD) is an incurable neurological disease with approximately 0.3% prevalence. The hallmark symptom is gradual movement deterioration. Current scientific consensus about disease progression holds that symptoms will worsen smoothly over time unless treated. Accurate information about symptom dynamics is of critical importance to patients, caregivers, and the scientific community for the design of new treatments, clinical decision making, and individual disease management. Long-term studies characterize the typical time course of the disease as an early linear progression gradually reaching a plateau in later stages. However, symptom dynamics over durations of days to weeks remains unquantified. Currently, there is a scarcity of objective clinical information about symptom dynamics at intervals shorter than 3 months stretching over several years, but Internet-based patient self-report platforms may change this. Objective To assess the clinical value of online self-reported PD symptom data recorded by users of the health-focused Internet social research platform PatientsLikeMe (PLM), in which patients quantify their symptoms on a regular basis on a subset of the Unified Parkinson’s Disease Ratings Scale (UPDRS). By analyzing this data, we aim for a scientific window on the nature of symptom dynamics for assessment intervals shorter than 3 months over durations of several years. Methods Online self-reported data was validated against the gold standard Parkinson’s Disease Data and Organizing Center (PD-DOC) database, containing clinical symptom data at intervals greater than 3 months. The data were compared visually using quantile-quantile plots, and numerically using the Kolmogorov-Smirnov test. By using a simple piecewise linear trend estimation algorithm, the PLM data was smoothed to separate random fluctuations from continuous symptom dynamics. Subtracting the trends from the original data revealed random fluctuations in symptom severity. The average magnitude of fluctuations versus time since diagnosis was modeled by using a gamma generalized linear model. Results Distributions of ages at diagnosis and UPDRS in the PLM and PD-DOC databases were broadly consistent. The PLM patients were systematically younger than the PD-DOC patients and showed increased symptom severity in the PD off state. The average fluctuation in symptoms (UPDRS Parts I and II) was 2.6 points at the time of diagnosis, rising to 5.9 points 16 years after diagnosis. This fluctuation exceeds the estimated minimal and moderate clinically important differences, respectively. Not all patients conformed to the current clinical picture of gradual, smooth changes: many patients had regimes where symptom severity varied in an unpredictable manner, or underwent large rapid changes in an otherwise more stable progression. Conclusions This information about short-term PD symptom dynamics contributes new scientific understanding about the disease progression, currently very costly to obtain without self-administered Internet-based reporting. This understanding should have implications for the optimization of clinical trials into new treatments and for the choice of treatment decision timescales. PMID:23343503

Quantifying short-term dynamics of Parkinson's disease using self-reported symptom data from an Internet social network.

PubMed

Little, Max; Wicks, Paul; Vaughan, Timothy; Pentland, Alex

2013-01-24

Parkinson's disease (PD) is an incurable neurological disease with approximately 0.3% prevalence. The hallmark symptom is gradual movement deterioration. Current scientific consensus about disease progression holds that symptoms will worsen smoothly over time unless treated. Accurate information about symptom dynamics is of critical importance to patients, caregivers, and the scientific community for the design of new treatments, clinical decision making, and individual disease management. Long-term studies characterize the typical time course of the disease as an early linear progression gradually reaching a plateau in later stages. However, symptom dynamics over durations of days to weeks remains unquantified. Currently, there is a scarcity of objective clinical information about symptom dynamics at intervals shorter than 3 months stretching over several years, but Internet-based patient self-report platforms may change this. To assess the clinical value of online self-reported PD symptom data recorded by users of the health-focused Internet social research platform PatientsLikeMe (PLM), in which patients quantify their symptoms on a regular basis on a subset of the Unified Parkinson's Disease Ratings Scale (UPDRS). By analyzing this data, we aim for a scientific window on the nature of symptom dynamics for assessment intervals shorter than 3 months over durations of several years. Online self-reported data was validated against the gold standard Parkinson's Disease Data and Organizing Center (PD-DOC) database, containing clinical symptom data at intervals greater than 3 months. The data were compared visually using quantile-quantile plots, and numerically using the Kolmogorov-Smirnov test. By using a simple piecewise linear trend estimation algorithm, the PLM data was smoothed to separate random fluctuations from continuous symptom dynamics. Subtracting the trends from the original data revealed random fluctuations in symptom severity. The average magnitude of fluctuations versus time since diagnosis was modeled by using a gamma generalized linear model. Distributions of ages at diagnosis and UPDRS in the PLM and PD-DOC databases were broadly consistent. The PLM patients were systematically younger than the PD-DOC patients and showed increased symptom severity in the PD off state. The average fluctuation in symptoms (UPDRS Parts I and II) was 2.6 points at the time of diagnosis, rising to 5.9 points 16 years after diagnosis. This fluctuation exceeds the estimated minimal and moderate clinically important differences, respectively. Not all patients conformed to the current clinical picture of gradual, smooth changes: many patients had regimes where symptom severity varied in an unpredictable manner, or underwent large rapid changes in an otherwise more stable progression. This information about short-term PD symptom dynamics contributes new scientific understanding about the disease progression, currently very costly to obtain without self-administered Internet-based reporting. This understanding should have implications for the optimization of clinical trials into new treatments and for the choice of treatment decision timescales.

Electrophysiology of Memory-Updating Differs with Age

PubMed Central

Steiner, Genevieve Z.; Gonsalvez, Craig J.; De Blasio, Frances M.; Barry, Robert J.

2016-01-01

In oddball tasks, the P3 component of the event-related potential systematically varies with the time between target stimuli—the target-to-target interval (TTI). Longer TTIs result in larger P3 amplitudes and shorter latencies, and this pattern of results has been linked with working memory-updating processes. Given that working memory and the P3 have both been shown to diminish with age, the current study aimed to determine whether the linear relationship between P3 and TTI is compromised in healthy aging by comparing TTI effects on P3 amplitudes and latencies, and reaction time (RT), in young and older adults. Older adults were found to have an overall reduction in P3 amplitudes, longer latencies, an anterior shift in topography, a trend toward slower RTs, and a flatter linear relationship between P3 and TTI than young adults. Results suggest that the ability to maintain templates in working memory required for stimulus categorization decreases with age, and that as a result, neural compensatory mechanisms are employed. PMID:27378908

Electrophysiology of Memory-Updating Differs with Age.

PubMed

Steiner, Genevieve Z; Gonsalvez, Craig J; De Blasio, Frances M; Barry, Robert J

2016-01-01

In oddball tasks, the P3 component of the event-related potential systematically varies with the time between target stimuli-the target-to-target interval (TTI). Longer TTIs result in larger P3 amplitudes and shorter latencies, and this pattern of results has been linked with working memory-updating processes. Given that working memory and the P3 have both been shown to diminish with age, the current study aimed to determine whether the linear relationship between P3 and TTI is compromised in healthy aging by comparing TTI effects on P3 amplitudes and latencies, and reaction time (RT), in young and older adults. Older adults were found to have an overall reduction in P3 amplitudes, longer latencies, an anterior shift in topography, a trend toward slower RTs, and a flatter linear relationship between P3 and TTI than young adults. Results suggest that the ability to maintain templates in working memory required for stimulus categorization decreases with age, and that as a result, neural compensatory mechanisms are employed.

IGR J170626143 is an Accreting Millisecond X-Ray Pulsar

NASA Technical Reports Server (NTRS)

Strohmayer, Tod E.; Keek, Laurens

2017-01-01

We present the discovery of 163.65 Hz X-ray pulsations from IGR J17062-6143 in the only observation obtained from the source with the Rossi X-ray Timing Explorer. This detection makes IGR J17062-6143 the lowest frequency accreting millisecond X-ray pulsar presently known. The pulsations are detected in the 2-12 keV band with an overall significance of 4.3sigma and an observed pulsed amplitude of 5.54% +/-0.67% (in this band). Both dynamic power spectral and coherent phase timing analysis indicate that the pulsation frequency is decreasing during the approx. =1.2 ks observation in a manner consistent with orbital motion of the neutron star. Because the observation interval is short, we cannot precisely measure the orbital period; however, periods shorter than 17 minutes are excluded at 90% confidence. For the range of acceptable circular orbits the inferred binary mass function substantially overlaps the observed range for the AMXP population as a whole.

FY17 Status Report: Research on Stress Corrosion Cracking of SNF Interim Storage Canisters.

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

Schindelholz, Eric John; Bryan, Charles R.; Alexander, Christopher L.

This progress report describes work done in FY17 at Sandia National Laboratories (SNL) to assess the localized corrosion performance of container/cask materials used in the interim storage of spent nuclear fuel (SNF). Of particular concern is stress corrosion cracking (SCC), by which a through-wall crack could potentially form in a canister outer wall over time intervals that are shorter than possible dry storage times. Work in FY17 refined our understanding of the chemical and physical environment on canister surfaces, and evaluated the relationship between chemical and physical environment and the form and extent of corrosion that occurs. The SNL corrosionmore » work focused predominantly on pitting corrosion, a necessary precursor for SCC, and process of pit-to-crack transition; it has been carried out in collaboration with university partners. SNL is collaborating with several university partners to investigate SCC crack growth experimentally, providing guidance for design and interpretation of experiments.« less

Steady, modest slip over multiple earthquake cycles on the Owens Valley and Little Lake fault zones

NASA Astrophysics Data System (ADS)

Amos, C. B.; Haddon, E. K.; Burgmann, R.; Zielke, O.; Jayko, A. S.

2015-12-01

A comprehensive picture of current plate-boundary deformation requires integration of short-term geodetic records with longer-term geologic strain. Comparing rates of deformation across these time intervals highlights potential time-dependencies in both geodetic and geologic records and yields critical insight into the earthquake deformation process. The southern Walker Lane Belt in eastern California represents one location where short-term strain recorded by geodesy apparently outpaces longer-term geologic fault slip measured from displaced rocks and landforms. This discrepancy persists both for individual structures and across the width of the deforming zone, where ~1 cm/yr of current dextral shear exceeds Quaternary slip rates summed across individual faults. The Owens Valley and Little Lake fault systems form the western boundary of the southern Walker Lane and host a range of published slip rate estimates from ~1 - 7 mm/yr over varying time intervals based on both geodetic and geologic measurements. New analysis of offset geomorphic piercing lines from airborne lidar and field measurements along the Owens Valley fault provides a snapshot of deformation during individual earthquakes and over many seismic cycles. Viewed in context of previously reported ages from pluvial and other landforms in Owens Valley, these offsets suggest slip rates of ~0.6 - 1.6 mm/yr over the past 103 - 105 years. Such rates agree with similar estimates immediately to the south on the Little Lake fault, where lidar measurements indicate dextral slip averaging ~0.6 - 1.3 mm/yr over comparable time intervals. Taken together, these results suggest steady, modest slip in the absence of significant variations over the Mid-to-Late Quaternary for a ~200 km span of the southwestern Walker Lane. Our findings argue against the presence of long-range fault interactions and slip-rate variations for this portion of the larger, regional fault network. This result also suggests that faster slip-rate estimates from geodetic measurements reflect transients over much shorter time scales. Additionally, the persistence of relatively faster geodetic shear in comparison with time-averaged fault slip leaves open the possibility of significant off-fault deformation or slip on subsidiary structures across the Owens Valley.

Predicting drug hydrolysis based on moisture uptake in various packaging designs.

PubMed

Naversnik, Klemen; Bohanec, Simona

2008-12-18

An attempt was made to predict the stability of a moisture sensitive drug product based on the knowledge of the dependence of the degradation rate on tablet moisture. The moisture increase inside a HDPE bottle with the drug formulation was simulated with the sorption-desorption moisture transfer model, which, in turn, allowed an accurate prediction of the drug degradation kinetics. The stability prediction, obtained by computer simulation, was made in a considerably shorter time frame and required little resources compared to a conventional stability study. The prediction was finally upgraded to a stochastic Monte Carlo simulation, which allowed quantitative incorporation of uncertainty, stemming from various sources. The resulting distribution of the outcome of interest (amount of degradation product at expiry) is a comprehensive way of communicating the result along with its uncertainty, superior to single-value results or confidence intervals.

Rituximab as an immunosuppressant in antineutrophil cytoplasmic antibody-associated vasculitis

PubMed Central

McGregor, JulieAnne G.; Hogan, Susan L.; Kotzen, Elizabeth S.; Poulton, Caroline J.; Hu, Yichun; Negrete-Lopez, Roberto; Kidd, Jason M.; Katsanos, Suzanne L.; Bunch, Donna O.; Nachman, Patrick H.; Falk, Ronald J.

2015-01-01

Background Rituximab has been used in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) since 2003. Our objective was to describe outcomes and adverse events following rituximab since that time in an inception cohort. Methods Patients with AAV (diagnosed 1991–2012) who received rituximab (n = 120) were evaluated and incidence per person-year (PPY) with 95% confidence interval was calculated for relapse and infections. Time to remission and relapse by number of rituximab infusions given per treatment course (≤2 versus >2) and by ever having been exposed to cyclophosphamide were compared using Kaplan–Meier curves. Rituximab-treated patients were characterized in comparison with AAV patients treated with cyclophosphamide but not exposed to rituximab (n = 351) using Fisher's exact or rank tests. Results Rituximab resulted in 86% achieving remission and 41% having a subsequent relapse in a median of 19 months (range 9–29). Time to remission and relapse were similar between rituximab infusion courses (≤2 versus >2; remission P = 0.86 and relapse P = 0.78, respectively). Incidence of relapse was 0.22 PPY (0.14, 0.31) and of severe infection was 0.12 PPY (0.08, 0.24). Time to relapse was shorter in those never exposed to cyclophosphamide (n = 20): 50% by 8 months versus 50% by 24 and 30 months for those with prior or concurrent exposure to cyclophosphamide (n = 100). Compared with those who never received rituximab, rituximab-treated patients were younger (P < 0.001), more likely to have granulomatosis with polyangiitis (P = 0.001) and had more upper airway (P = 0.01) and less kidney involvement (P = 0.007). Conclusions Rituximab is beneficial when prescribed outside of a trial setting. Response to treatment and relapse is similar regardless of infusion number. Rituximab without cyclophosphamide may result in a shorter time to relapse supporting combination of these therapies. PMID:25805743

Delirium and coma evaluated in mechanically ventilated patients in the intensive care unit in Japan: a multi-institutional prospective observational study.

PubMed

Tsuruta, Ryosuke; Oda, Yasutaka; Shintani, Ayumi; Nunomiya, Shin; Hashimoto, Satoru; Nakagawa, Takashi; Oida, Yasuhisa; Miyazaki, Dai; Yabe, Shigemi

2014-06-01

The object of this study is to evaluate the prevalence and effects of delirium on 28-day mortality in critically ill patients on mechanical ventilation in Japan. Prospective cohort study was conducted in medical and surgical intensive care units (ICUs) of 24 medical centers. Patients were followed up daily for delirium during ICU stay after enrollment. Coma was defined with the Richmond Agitation Sedation Scale score of -4 or -5. Delirium was diagnosed using the Confusion Assessment Method for the ICU. The Cox proportional hazards regression model was used to assess the effects of delirium and coma on 28-day mortality, time to extubation, and time to ICU discharge; delirium and coma were included as time-varying covariates after controlling for age, Acute Physiology and Chronic Health Evaluation II score, ventilator-associated pneumonia, and the reason for intubation with infection. Of 180 patients, 115 patients (64%) developed delirium. Moreover, 15 patients (8%) died within 28 days after ICU admission, including 7 patients who experienced coma and 8 patients who experienced both coma and delirium. There were no deaths among patients who did not experience coma. Delirium was associated with a shorter time to extubation (hazard ratio [HR], 2.52; 95% confidence interval [CI], 1.65-3.85; P<.001) and a shorter ICU length of stay in comatose patients (HR, 1.59; 95% CI, 1.04-2.44; P=.034), whereas delirium appeared with prolonged time to ICU discharge among patients without coma, although statistical significance was not detected due to limited analytical power (HR, 0.62; 95% CI, 0.34-1.12; P=.114). Delirium during ICU stay was not associated with higher mortality. Further study is needed to investigate the discrepancy between these and previous data. Copyright © 2014 Elsevier Inc. All rights reserved.

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.

Estimation of Rainfall Erosivity via 1-Minute to Hourly Rainfall Data from Taipei, Taiwan

NASA Astrophysics Data System (ADS)

Huang, Ting-Yin; Yang, Ssu-Yao; Jan, Chyan-Deng

2017-04-01

Soil erosion is a natural process on hillslopes that threats people's life and properties, having a considerable environmental and economic implications for soil degradation, agricultural activity and water quality. The rainfall erosivity factor (R-factor) in the Universal Soil Loss Equation (USLE), composed of total kinetic energy (E) and the maximum 30-min rainfall intensity (I30), is widely used as an indicator to measure the potential risks of soil loss caused by rainfall at a regional scale. This R factor can represent the detachment and entrainment involved in climate conditions on hillslopes, but lack of 30-min rainfall intensity data usually lead to apply this factor more difficult in many regions. In recent years, fixed-interval, hourly rainfall data is readily available and widely used due to the development of automatic weather stations. Here we assess the estimations of R, E, and I30 based on 1-, 5-, 10-, 15-, 30-, 60-minute rainfall data, and hourly rainfall data obtained from Taipei weather station during 2004 to 2010. Results show that there is a strong correlation among R-factors estimated from different interval rainfall data. Moreover, the shorter time-interval rainfall data (e.g., 1-min) yields larger value of R-factor. The conversion factors of rainfall erosivity (ratio of values estimated from the resolution lower than 30-min rainfall data to those estimated from 60-min and hourly rainfall data, respectively) range from 1.85 to 1.40 (resp. from 1.89 to 1.02) for 60-min (resp. hourly) rainfall data as the time resolution increasing from 30-min to 1-min. This paper provides useful information on estimating R-factor when hourly rainfall data is only available.

How do season, on-farm fasting interval and lairage period affect swine welfare, carcass and meat quality traits?

NASA Astrophysics Data System (ADS)

Dalla Costa, Filipe Antonio; Dalla Costa, Osmar Antonio; Coldebella, Arlei; de Lima, Gustavo Júlio Mello Monteiro; Ferraudo, Antonio Sérgio

2018-03-01

This study was carried out in order to determine the effects of different combinations of on-farm fasting intervals (8, 12, 16, 20 h) and 1.5 h of transport plus lairage periods (1, 3, 6 h) at different seasons (summer/winter) on blood stress parameters (cortisol and lactate), stomach content and weight, skin lesion and meat quality in a total of 960 pigs from eight farms. Blood lactate levels were greater in the summer (P < 0.001) and stomach content was affected (P < 0.05) by season, on-farm fasting interval (P < 0.001), lairage time (P < 0.0001). Stomach content weight reduces as the total feed withdrawal time increases up to on-farm fasting of 17 and 1 h of lairage. Stomach content can be influenced by feed and water in different ways according to treatments. Only 8 h of on-farm fasting is not enough to empty stomachs from feed content. However, an on-farm fasting period of 16 h or longer can also increase the occurrence of more water in the stomachs. Carcass lesions caused by fighting were greater (P ≤ 0.005) in the winter, mainly after 3 and 6 h of lairage (P ≤ 0.005). Loin and ham pHu was lower (P ≤ 0.05) for pigs slaughtered after 6 h of lairage during the summer. The application of 12 h of on-farm fasting with 6 h of lairage seemed to be best combination to reduce stomach content weight (feed and water). In the winter, shorter lairage period can be used to reduce percentage of skin lesions and better pork quality traits in pigs.

The Safety and Efficacy of Approaches to Liver Resection: A Meta-Analysis

PubMed Central

Hauch, Adam; Hu, Tian; Buell, Joseph F.; Slakey, Douglas P.; Kandil, Emad

2015-01-01

Background: The aim of this study is to compare the safety and efficacy of conventional laparotomy with those of robotic and laparoscopic approaches to hepatectomy. Database: Independent reviewers conducted a systematic review of publications in PubMed and Embase, with searches limited to comparative articles of laparoscopic hepatectomy with either conventional or robotic liver approaches. Outcomes included total operative time, estimated blood loss, length of hospitalization, resection margins, postoperative complications, perioperative mortality rates, and cost measures. Outcome comparisons were calculated using random-effects models to pool estimates of mean net differences or of the relative risk between group outcomes. Forty-nine articles, representing 3702 patients, comprise this analysis: 1901 (51.35%) underwent a laparoscopic approach, 1741 (47.03%) underwent an open approach, and 60 (1.62%) underwent a robotic approach. There was no difference in total operative times, surgical margins, or perioperative mortality rates among groups. Across all outcome measures, laparoscopic and robotic approaches showed no difference. As compared with the minimally invasive groups, patients undergoing laparotomy had a greater estimated blood loss (pooled mean net change, 152.0 mL; 95% confidence interval, 103.3–200.8 mL), a longer length of hospital stay (pooled mean difference, 2.22 days; 95% confidence interval, 1.78–2.66 days), and a higher total complication rate (odds ratio, 0.5; 95% confidence interval, 0.42–0.57). Conclusion: Minimally invasive approaches to liver resection are as safe as conventional laparotomy, affording less estimated blood loss, shorter lengths of hospitalization, lower perioperative complication rates, and equitable oncologic integrity and postoperative mortality rates. There was no proven advantage of robotic approaches compared with laparoscopic approaches. PMID:25848191

Unipedal stance testing in the assessment of peripheral neuropathy.

PubMed

Hurvitz, E A; Richardson, J K; Werner, R A

2001-02-01

To define further the relation between unipedal stance testing and peripheral neuropathy. Prospective cohort. Electroneuromyography laboratory of a Veterans Affairs medical center and a university hospital. Ninety-two patients referred for lower extremity electrodiagnostic studies. A standardized history and physical examination designed to detect peripheral neuropathy, 3 trials of unipedal stance, and electrodiagnostic studies. Peripheral neuropathy was identified by electrodiagnostic testing in 32%. These subjects had a significantly shorter (p <.001) unipedal stance time (15.7s, longest of 3 trials) than the patients without peripheral neuropathy (37.1s). Abnormal unipedal stance time (<45s) identified peripheral neuropathy with a sensitivity of 83% and a specificity of 71%, whereas a normal unipedal stance time had a negative predictive value of 90%. Abnormal unipedal stance time was associated with an increased risk of having peripheral neuropathy on univariate analysis (odds ratio = 8.8, 95% confidence interval = 2.5--31), and was the only significant predictor of peripheral neuropathy in the regression model. Aspects of the neurologic examination did not add to the regression model compared with abnormal unipedal stance time. Unipedal stance testing is useful in the clinical setting both to identify and to exclude the presence of peripheral neuropathy.

Relative sensitivity of clinical tests to hydrophilic lens-induced corneal thickness changes.

PubMed

Elliott, D B; Fonn, D; Flanagan, J; Doughty, M

1993-12-01

The relative sensitivity of the van den Berg Straylightmeter, slitlamp biomicroscopy, a modified optical pachometer, Bailey-Lovie logMAR visual acuity (VA), and two glare tests (The Brightness Acuity Tester used with 10% contrast VA and Pelli-Robson contrast sensitivity) to hydrophilic contact lens-induced edema was assessed in 19 subjects (mean age 25.9 +/- 4.5 years). After baseline assessments, subjects wore thick hydrogel lenses on one eye which was patched tightly for 3 h. Assessments were repeated at frequent intervals after lens removal to assess recovery. None of the pachometer measurements returned to baseline within the 2-h monitoring period, although the majority were within 2% of baseline corneal thickness. The average time for the Straylightmeter scores to recover to baseline values after the lens removal was 90 min, which was similar to the time when visible edema at the slitlamp disappeared. The average time for return to baseline of logMAR VA and the two glare tests was consistently two to three times shorter than the time for the Straylightmeter score. The Straylightmeter therefore provided assessments of corneal edema similar to slitlamp examination and was more sensitive than VA or glare testing.

Comparison of Acute Ischemic Stroke Care and Outcomes Between Comprehensive Stroke Centers and Primary Stroke Centers in the United States.

PubMed

Man, Shumei; Zhao, Xin; Uchino, Ken; Hussain, M Shazam; Smith, Eric E; Bhatt, Deepak L; Xian, Ying; Schwamm, Lee H; Shah, Shreyansh; Khan, Yosef; Fonarow, Gregg C

2018-06-01

To improve stroke care, the Brain Attack Coalition recommended establishing primary stroke center (PSC) and comprehensive stroke center (CSC) certification. This study aimed to compare ischemic stroke care and in-hospital outcomes between CSCs and PSCs. We analyzed patients with acute ischemic stroke who were hospitalized at stroke centers participating in Get With The Guidelines-Stroke from 2013 to 2015. Multivariable logistic regression models were generated to examine the association between stroke center certification (CSC versus PSC) and performances and outcomes. This study included 722 941 patients who were admitted to 134 CSCs and 1047 PSCs. Both CSCs and PSCs had good conformity to 7 performance measures and the summary defect-free care measure. Among emergency department admissions, CSCs had higher intravenous tPA (tissue-type plasminogen activator) and endovascular thrombectomy rates than PSCs (14.3% versus 10.3%, 4.1% versus 1.0%, respectively). Door to intravenous tPA time was shorter at CSCs (median, 52 versus 61 minutes; adjusted risk ratio, 0.92; 95% confidence interval, 0.89-0.95). More patients at CSCs had door to intravenous tPA time ≤60 minutes (79.7% versus 65.1%; adjusted odds ratio, 1.48; 95% confidence interval, 1.25-1.75). For transferred patients, CSCs and PSCs had comparable overall performance in defect-free care, except higher endovascular thrombectomy therapy rates. The overall in-hospital mortality was higher at CSCs in both emergency department admissions (4.6% versus 3.8%; adjusted odds ratio, 1.14; 95% confidence interval, 1.01-1.29) and transferred patients (7.7% versus 6.8%; adjusted odds ratio, 1.17; 95% confidence interval, 1.05-1.32). In-hospital outcomes were comparable between CSCs and PSCs in patients who received intravenous tPA or endovascular thrombectomy. CSCs and PSCs achieved similar overall care quality for patients with acute ischemic stroke. CSCs exceeded PSCs in timely acute reperfusion therapy for emergency department admissions, whereas PSCs had lower risk-adjusted in-hospital mortality. This information may be important for acute stroke triage and targeted quality improvement. © 2018 American Heart Association, Inc.

Ionosonde observations of the northern magnetospheric cleft during December 1974 and January 1975

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

Stiles, G.S.; Hones Jr., E.W.; Lepping, R.P.

1977-01-01

During December 1974 and January 1975 the northern magnetospheric cleft was monitored by ionosondes at Cape Parry and Sachs Harbor, Northwest Territories, Canada, in support of rocket shots into the cleft. Ionograms were taken nominally at 15-min intervals but as rapidly as two per minute during times of particular interest. Analysis of 5 days of data shows the ionosphere at cleft latitudes to be very complex and dynamic. The ionograms often show considerable structure and can change appearance significantly in a minute or two. The cleft at times appears to move equatorward in response either to a southward turning ofmore » the interplanetary magnetic field or to the occurrence of geomagnetic disturbances. This response is in agreement with the conclusions of previous satellite studies. Behavior contrary to this generalization is not uncommon, however, and therefore it may not always hold on time scales considerably shorter than the satellite orbital period of approximately-greater-than 1 hour. The rate of the cleft's motion may vary from approx.0.05 to approx.0.5 deg/min. (AIP)« less

Outage maintenance checks on large generator windings

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

Nindra, B.; Jeney, S.I.; Slobodinsky, Y.

In the present days of austerity, more constraints and pressures are being brought on the maintenance engineers to certify the generators for their reliability and life extension. The outages are shorter and intervals between the outages are becoming longer. The annual outages were very common when utilities had no regulatory constraints and also had standby capacities. Furthermore, due to lean and mean budgets, outage maintenance programs are being pursued more aggressively, so that longer interval outages can be achieved to ensure peak generator performance. This paper will discuss various visual checks, electrical tests and recommended fixes to achieve the abovemore » mentioned objectives, in case any deficiencies are found.« less

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.

Short Stature and Access to Lung Transplantation in the United States. A Cohort Study

PubMed Central

Sell, Jessica L.; Bacchetta, Matthew; Goldfarb, Samuel B.; Park, Hanyoung; Heffernan, Priscilla V.; Robbins, Hilary A.; Shah, Lori; Raza, Kashif; D’Ovidio, Frank; Sonett, Joshua R.; Arcasoy, Selim M.

2016-01-01

Rationale: Anecdotally, short lung transplant candidates suffer from long waiting times and higher rates of death on the waiting list compared with taller candidates. Objectives: To examine the relationship between lung transplant candidate height and waiting list outcomes. Methods: We conducted a retrospective cohort study of 13,346 adults placed on the lung transplant waiting list in the United States between 2005 and 2011. Multivariable-adjusted competing risk survival models were used to examine associations between candidate height and outcomes of interest. The primary outcome was the time until lung transplantation censored at 1 year. Measurements and Main Results: The unadjusted rate of lung transplantation was 94.5 per 100 person-years among candidates of short stature (<162 cm) and 202.0 per 100 person-years among candidates of average stature (170–176.5 cm). After controlling for potential confounders, short stature was associated with a 34% (95% confidence interval [CI], 29–39%) lower rate of transplantation compared with average stature. Short stature was also associated with a 62% (95% CI, 24–96%) higher rate of death or removal because of clinical deterioration and a 42% (95% CI, 10–85%) higher rate of respiratory failure while awaiting lung transplantation. Conclusions: Short stature is associated with a lower rate of lung transplantation and higher rates of death and respiratory failure while awaiting transplantation. Efforts to ameliorate this disparity could include earlier referral and listing of shorter candidates, surgical downsizing of substantially oversized allografts for shorter candidates, and/or changes to allocation policy that account for candidate height. PMID:26554631

Retrieval practice in the form of online homework improved information retention more when spaced 5 days rather than 1 day after class in two physiology courses.

PubMed

Cadaret, Caitlin N; Yates, Dustin T

2018-06-01

Studies have shown that practicing temporally spaced retrieval of previously learned information via formal assessments increases student retention of the information. Our objective was to determine the impact of online homework administered as a first retrieval practice 1 or 5 days after introduction of physiology topics on long-term information retention. Students in two undergraduate courses, Anatomy and Physiology (ASCI 240) and Animal Physiological Systems (ASCI 340), were presented with information on a specific physiological system during each weekly laboratory and then completed an online homework assignment either 1 or 5 days later. Information retention was assessed via an in-class quiz the following week and by a comprehensive final exam at semester's end (4-13 wk later). Performance on homework assignments was generally similar between groups for both courses. Information retention at 1 wk did not differ due to timing of homework in either course. In both courses, however, students who received homework 5 days after class performed better on final exam questions relevant to that week's topic compared with their day 1 counterparts. These findings indicate that the longer period between introducing physiology information in class and assigning the first retrieval practice was more beneficial to long-term information retention than the shorter period, despite seemingly equivalent benefits in the shorter term. Since information is typically forgotten over time, we speculate that the longer interval necessitates greater retrieval effort in much the same way as built-in desirable difficulties, thus allowing for stronger conceptual connections and deeper comprehension.

Association of Biocompatible Peritoneal Dialysis Solutions with Peritonitis Risk, Treatment, and Outcomes

PubMed Central

Cho, Yeoungjee; Badve, Sunil V.; Hawley, Carmel M.; McDonald, Stephen P.; Brown, Fiona G.; Boudville, Neil; Bannister, Kym M.; Clayton, Philip A.

2013-01-01

Summary Background and objectives The effect of biocompatible peritoneal dialysis (PD) solutions on PD-related peritonitis is unclear. This study sought to evaluate the relationship between use of biocompatible solutions and the probability of occurrence or clinical outcomes of peritonitis. Design, setting, participants, & measurements The study included all incident Australian patients receiving PD between January 1, 2007, and December 31, 2010, using Australia and New Zealand Dialysis and Transplant Registry data. All multicompartment PD solutions of neutral pH were categorized as biocompatible solutions. The independent predictors of peritonitis and the use of biocompatible solutions were determined by multivariable, multilevel mixed-effects Poisson and logistic regression analysis, respectively. Sensitivity analyses, including propensity score matching, were performed. Results Use of biocompatible solutions gradually declined (from 7.5% in 2007 to 4.2% in 2010), with preferential use among smaller units and among younger patients without diabetes mellitus. Treatment with biocompatible solution was associated with significantly greater overall rate of peritonitis (0.67 versus 0.47 episode per patient-year; incidence rate ratio, 1.49; 95% confidence interval [CI], 1.19 to 1.89) and with shorter time to first peritonitis (hazard ratio [HR], 1.48; 95% CI, 1.17 to 1.87), a finding replicated in propensity score–matched cohorts (HR, 1.36; 95% CI, 1.09 to 1.71). Conclusions In an observational registry study, use of biocompatible PD solutions was associated with higher overall peritonitis rates and shorter time to first peritonitis. Further randomized studies adequately powered for a primary peritonitis outcome are warranted. PMID:23949232

The impact of the duration of an untreated episode on improvement of depression and somatic symptoms

PubMed Central

Hung, Ching-I; Yu, Nan-Wen; Liu, Chia-Yih; Wu, Kuan-Yi; Yang, Ching-Hui

2015-01-01

Purpose The aim of this study was to investigate the impact of the duration of an untreated episode (DUE) on the improvement of depression and somatic symptoms among patients with major depressive disorder (MDD), after the patients had received 4 weeks of pharmacotherapy. Methods In this open-label study, there were 155 participants with MDD who were treated daily with 75 mg of venlafaxine for 4 weeks. DUE was defined as the interval between the onset of the index major depressive episode and the start of pharmacotherapy. The Depression and Somatic Symptoms Scale (DSSS), composed of the depression subscale (DS) and the somatic subscale (SS), was used. The SS included the pain subscale (PS) and the nonpain somatic subscale (NPSS). Multiple linear regressions were used to test the impacts of DUE on the improvement percentages (IPs) of depression and somatic symptoms. Results Eighty-five subjects completed the 4-week treatment. The IPs of the DS, SS, and NPSS were significantly negatively correlated with DUE. A shorter DUE was related to higher IPs. DUE was an independent factor, predicting the IPs of the DS, SS, and NPSS. DUE <1 month was the most powerful time-point to predict the IPs of the DS, SS, and NPSS. However, DUE was unable to predict the IP of the PS at all time-points. Conclusion A shorter DUE might be one of the factors related to greater improvement of depression and somatic symptoms. DUE should be considered as an important factor when investigating the prognosis of depression and somatic symptoms. PMID:26346571

The impact of the duration of an untreated episode on improvement of depression and somatic symptoms.

PubMed

Hung, Ching-I; Yu, Nan-Wen; Liu, Chia-Yih; Wu, Kuan-Yi; Yang, Ching-Hui

2015-01-01

The aim of this study was to investigate the impact of the duration of an untreated episode (DUE) on the improvement of depression and somatic symptoms among patients with major depressive disorder (MDD), after the patients had received 4 weeks of pharmacotherapy. In this open-label study, there were 155 participants with MDD who were treated daily with 75 mg of venlafaxine for 4 weeks. DUE was defined as the interval between the onset of the index major depressive episode and the start of pharmacotherapy. The Depression and Somatic Symptoms Scale (DSSS), composed of the depression subscale (DS) and the somatic subscale (SS), was used. The SS included the pain subscale (PS) and the nonpain somatic subscale (NPSS). Multiple linear regressions were used to test the impacts of DUE on the improvement percentages (IPs) of depression and somatic symptoms. Eighty-five subjects completed the 4-week treatment. The IPs of the DS, SS, and NPSS were significantly negatively correlated with DUE. A shorter DUE was related to higher IPs. DUE was an independent factor, predicting the IPs of the DS, SS, and NPSS. DUE <1 month was the most powerful time-point to predict the IPs of the DS, SS, and NPSS. However, DUE was unable to predict the IP of the PS at all time-points. A shorter DUE might be one of the factors related to greater improvement of depression and somatic symptoms. DUE should be considered as an important factor when investigating the prognosis of depression and somatic symptoms.

A quantitative analysis of sensitivity to the conditioned reinforcing value of terminal-link stimuli in a concurrent-chains schedule.

PubMed Central

Omino, T

1993-01-01

Pigeons were exposed to a concurrent-chains schedule in which a single variable-interval 30-s schedule was used in the initial links and fixed-time schedules were used in the terminal links. Three types of keylight conditions were used in the terminal links. In the first condition, different delays were associated with different keylight stimuli (cued condition). In the second condition, different delays were associated with the same stimulus, either a blackout (uncued blackout condition) or a white key (uncued white condition). Paired values of terminal-link fixed-time schedules differed by a constant ratio of 3:1, while the absolute value of delays was varied from 3 s to 54 s. The results showed that choice proportions for the shorter of two delays increased when the absolute size of the delays was increased for all keylight conditions. Further, the choice proportions for the shorter delay increased from the uncued blackout condition, to the uncued white condition, to the cued condition. A modified version of Fantino's (1969) delay-reduction model (expressed as a function relating the response ratio to the delay-reduction ratio) can be applied to these data by showing that sensitivity to delay reduction increased from the uncued blackout condition, to the uncued white condition, to the cued condition. Thus, the present study demonstrated that a modified version of the delay-reduction model can be used to assess quantitative differences in the terminal-link keylight condition in terms of sensitivity to delay reduction (i.e., the conditioned reinforcing value of the terminal-link keylight stimuli). PMID:8283150

Accession medical waivers and deployment duration in the U.S. Army.

PubMed

Gubata, Marlene E; Oetting, Alexis A; Niebuhr, David W; Cowan, David N

2013-06-01

To examine the performance of active duty U.S. Army personnel with accession medical waivers during combat deployments, the deployment duration and likelihood of early return from theater for medically waived (n = 18,093) and medically qualified (n = 250,209) personnel deploying between September 2001 and March 2011 were determined. The mean and median deployment duration for waived men (309.4 ± 107.5 and 346) and for waived women (291.8 ± 115.3 and 341) was not shorter than for medically qualified men (304.6 ± 112.1 and 346) and women (289.5 ± 116.3 and 337). When adjusted for other accession factors in a multivariate linear regression model, neither waived men (p = 1.00) nor women (p = 0.7713) had significantly shorter deployments. In a case-control analysis, 24,369 men and 3,094 women were defined as having a short deployment. Multivariate logistic regression found that medically waived men (odds ratio [OR] = 0.87, 95% confidence interval [CI] = 0.82-0.92) and women (OR = 1.02, 95% CI = 0.87-1.19) were not more likely to have shorter deployments compared to medically qualified individuals. These findings show that those with an accession medical waiver were not more likely to have shorter deployments or more likely to return early from deployment than those without waivers. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

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...

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.

The Effects of Local Anaesthetics on QT Parameters during Thoracic Epidural Anaesthesia Combined with General Anaesthesia: Ropivacaine versus Bupivacaine

PubMed Central

Güven, Özlem; Sazak, Hilal; Alagöz, Ali; Şavkılıoğlu, Eser; Demirbaş, Çilsem Sevgen; Yıldız, Ali; Karabulut, Erdem

2013-01-01

Background: Many studies focusing on the effects of local anaesthetics on QT intervals have been performed, but the articles evaluating the relationship between thoracic epidural anaesthesia combined with general anaesthesia and QT parameters are very limited. Aims: We aimed to compare the effects of bupivacaine and ropivacaine on QT interval, corrected QT, dispersion of QT, and corrected dispersion of QT in patients undergoing lung resection under thoracic epidural anaesthesia combined with general anaesthesia. Study Design: Prospective clinical study. Methods: Thirty ASA physical status 1–3 patients requiring thoracic epidural anaesthesia combined with general anaesthesia for thoracic surgery. Patients were randomly assigned to two groups, which were allocated to receive either bupivacaine (Group B) or ropivacaine (Group R) during thoracic epidural anaesthesia. Following haemodynamic monitoring, a thoracic epidural catheter was inserted. Local anaesthetic at an average dose of 1.5 mL/ segment was given through an epidural catheter. The same general anaesthesia protocol was administered in both groups. Records and measurements were performed on 10 phases that were between the thoracic epidural catheter insertion to the 5th min of endobronchial intubation. In all phases, systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, heart rate, peripheral O2 saturation, and electrocardiogram monitoring were performed in patients. All QT parameters were recorded by 12-lead electrocardiogram and analysed manually by a cardiologist. Results: QT intervals were similar between two groups. In Group R, corrected QT values at the 20th min of local anaesthetic injection and the 5th min of endobronchial intubation were shorter than those in Group B (p<0.05). The basal dispersion of QT and dispersion of QT values at the 1st min of propofol injection were shorter than those in Group R (p<0.05). The corrected dispersion of QT value at the 1st min of propofol injection was shorter in Group R (p<0.05). In Group R, the decrease in mean arterial pressure at the 1st min of fentanyl injection was significant compared with Group B (p<0.05). There was no significant difference between the groups with respect to heart rate and complications. Conclusion: The corrected QT, dispersion of QT, and corrected dispersion of QT intervals were slightly longer in the patients receiving bupivacaine compared with those receiving ropivacaine in various phases of the present study. PMID:25207150

The modulation rate transfer function of a harbour porpoise (Phocoena phocoena).

PubMed

Linnenschmidt, Meike; Wahlberg, Magnus; Damsgaard Hansen, Janni

2013-02-01

During echolocation, toothed whales produce ultrasonic clicks at extremely rapid rates and listen for the returning echoes. The auditory brainstem response (ABR) duration was evaluated in terms of latency between single peaks: 5.5 ms (from peak I to VII), 3.4 ms (I-VI), and 1.4 ms (II-IV). In comparison to the killer whale and the bottlenose dolphin, the ABR of the harbour porpoise has shorter intervals between the peaks and consequently a shorter ABR duration. This indicates that the ABR duration and peak latencies are possibly related to the relative size of the auditory structures of the central nervous system and thus to the animal's size. The ABR to a sinusoidal amplitude modulated stimulus at 125 kHz (sensitivity threshold 63 dB re 1 μPa rms) was evaluated to determine the modulation rate transfer function of a harbour porpoise. The ABR showed distinct envelope following responses up to a modulation rate of 1,900 Hz. The corresponding calculated equivalent rectangular duration of 263 μs indicates a good temporal resolution in the harbour porpoise auditory system similar to the one for the bottlenose dolphin. The results explain how the harbour porpoise can follow clicks and echoes during echolocation with very short inter click intervals.

Dynamics of spallation during femtosecond laser ablation studied by time-resolved reflectivity with double pump pulses

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

Kumada, Takayuki, E-mail: kumada.takayuki@jaea.go.jp; Otobe, Tomohito; Nishikino, Masaharu

2016-01-04

The dynamics of photomechanical spallation during femtosecond laser ablation of fused silica was studied by time-resolved reflectivity with double pump pulses. Oscillation of reflectivity was caused by interference between the probe pulses reflected at the sample surface and the spallation layer, and was enhanced when the surface was irradiated with the second pump pulse within a time interval, Δτ, of several picoseconds after the first pump pulse. However, as Δτ was increased, the oscillation amplitude decreased with an exponential decay time of 10 ps. The oscillation disappeared when Δτ exceeded 20 ps. This result suggests that the formation time of the spallationmore » layer is approximately 10 ps. A second pump pulse with Δτ shorter than 10 ps excites the bulk sample. The spallation layer that is photo-excited by the first and second pump pulses is separated afterward. In contrast, a pulse with Δτ longer than the formation time excites and breaks up the spallation layer that has already been separated from the bulk. The formation time of the spallation layer, as determined in this experiment, is attributed to the characteristic time of the mechanical equilibration corresponding to the thickness divided by the sound velocity of the photo-excited layer.« less

Spatial distribution of temporal dynamics in anthropogenic fires in miombo savanna woodlands of Tanzania.

PubMed

Tarimo, Beatrice; Dick, Øystein B; Gobakken, Terje; Totland, Ørjan

2015-12-01

Anthropogenic uses of fire play a key role in regulating fire regimes in African savannas. These fires contribute the highest proportion of the globally burned area, substantial biomass burning emissions and threaten maintenance and enhancement of carbon stocks. An understanding of fire regimes at local scales is required for the estimation and prediction of the contribution of these fires to the global carbon cycle and for fire management. We assessed the spatio-temporal distribution of fires in miombo woodlands of Tanzania, utilizing the MODIS active fire product and Landsat satellite images for the past ~40 years. Our results show that up to 50.6% of the woodland area is affected by fire each year. An early and a late dry season peak in wetter and drier miombo, respectively, characterize the annual fire season. Wetter miombo areas have higher fire activity within a shorter annual fire season and have shorter return intervals. The fire regime is characterized by small-sized fires, with a higher ratio of small than large burned areas in the frequency-size distribution (β = 2.16 ± 0.04). Large-sized fires are rare, and occur more frequently in drier than in wetter miombo. Both fire prevalence and burned extents have decreased in the past decade. At a large scale, more than half of the woodland area has less than 2 years of fire return intervals, which prevent the occurrence of large intense fires. The sizes of fires, season of burning and spatial extent of occurrence are generally consistent across time, at the scale of the current analysis. Where traditional use of fire is restricted, a reassessment of fire management strategies may be required, if sustainability of tree cover is a priority. In such cases, there is a need to combine traditional and contemporary fire management practices.

Effect of posture on arterial baroreflex control of heart rate in humans

NASA Technical Reports Server (NTRS)

Harrison, M. H.; Rittenhouse, D.; Greenleaf, J. E.

1986-01-01

The effects of blood-volume redistribution induced by postural changes on baroreflex activity are investigated. The central blood volume and baroreceptor functions of ten males between 23-51 years old were examined while they were in the head-up tilt (HUT), head-down tilt (HDT), and supine positions. It is observed that during HDT at 15 deg the pulse interval over the first five cardiac cycles following neck suction onset is 51 + or - 18 ms longer, at 30 deg it is 61 + or - 20 ms longer, and at 45 deg it is 74 + or - 35 ms longer than at supine; during HUT at 15 deg the pulse interval is 25 + or - 9 ms shorter than when supine, but for the 30 and 45 deg there is no significant difference in pulse interval detected. The data reveal that posture does modify arterial baroreflex control of heart rate.

Apparatus and method for data communication in an energy distribution network

DOEpatents

Hussain, Mohsin; LaPorte, Brock; Uebel, Udo; Zia, Aftab

2014-07-08

A system for communicating information on an energy distribution network is disclosed. In one embodiment, the system includes a local supervisor on a communication network, wherein the local supervisor can collect data from one or more energy generation/monitoring devices. The system also includes a command center on the communication network, wherein the command center can generate one or more commands for controlling the one or more energy generation devices. The local supervisor can periodically transmit a data signal indicative of the data to the command center via a first channel of the communication network at a first interval. The local supervisor can also periodically transmit a request for a command to the command center via a second channel of the communication network at a second interval shorter than the first interval. This channel configuration provides effective data communication without a significant increase in the use of network resources.

How to Sync to the Beat of a Persistent Fractal Metronome without Falling Off the Treadmill?

PubMed Central

Roerdink, Melvyn; Daffertshofer, Andreas; Marmelat, Vivien; Beek, Peter J.

2015-01-01

In rehabilitation, rhythmic acoustic cues are often used to improve gait. However, stride-time fluctuations become anti-persistent with such pacing, thereby deviating from the characteristic persistent long-range correlations in stride times of self-paced walking healthy adults. Recent studies therefore experimented with metronomes with persistence in interbeat intervals and successfully evoked persistent stride-time fluctuations. The objective of this study was to examine how participants couple their gait to a persistent metronome, evoking persistently longer or shorter stride times over multiple consecutive strides, without wandering off the treadmill. Twelve healthy participants walked on a treadmill in self-paced, isochronously paced and non-isochronously paced conditions, the latter with anti-persistent, uncorrelated and persistent correlations in interbeat intervals. Stride-to-stride fluctuations of stride times, stride lengths and stride speeds were assessed with detrended fluctuation analysis, in conjunction with an examination of the coupling between stride times and stride lengths. Stride-speed fluctuations were anti-persistent for all conditions. Stride-time and stride-length fluctuations were persistent for self-paced walking and anti-persistent for isochronous pacing. Both stride times and stride lengths changed from anti-persistence to persistence over the four non-isochronous metronome conditions, accompanied by an increasingly stronger coupling between these gait parameters, with peak values for the persistent metronomes. These results revealed that participants were able to follow the beat of a persistent metronome without falling off the treadmill by strongly coupling stride-length fluctuations to the stride-time fluctuations elicited by persistent metronomes, so as to prevent large positional displacements along the treadmill. For self-paced walking, in contrast, this coupling was very weak. In combination, these results challenge the premise that persistent metronomes in gait rehabilitation would evoke stride-to-stride dynamics reminiscent of self-paced walking healthy adults. Future studies are recommended to include an analysis of the interrelation between stride times and stride lengths in addition to the correlational structure of either one in isolation. PMID:26230254

How to Sync to the Beat of a Persistent Fractal Metronome without Falling Off the Treadmill?

PubMed

Roerdink, Melvyn; Daffertshofer, Andreas; Marmelat, Vivien; Beek, Peter J

2015-01-01

In rehabilitation, rhythmic acoustic cues are often used to improve gait. However, stride-time fluctuations become anti-persistent with such pacing, thereby deviating from the characteristic persistent long-range correlations in stride times of self-paced walking healthy adults. Recent studies therefore experimented with metronomes with persistence in interbeat intervals and successfully evoked persistent stride-time fluctuations. The objective of this study was to examine how participants couple their gait to a persistent metronome, evoking persistently longer or shorter stride times over multiple consecutive strides, without wandering off the treadmill. Twelve healthy participants walked on a treadmill in self-paced, isochronously paced and non-isochronously paced conditions, the latter with anti-persistent, uncorrelated and persistent correlations in interbeat intervals. Stride-to-stride fluctuations of stride times, stride lengths and stride speeds were assessed with detrended fluctuation analysis, in conjunction with an examination of the coupling between stride times and stride lengths. Stride-speed fluctuations were anti-persistent for all conditions. Stride-time and stride-length fluctuations were persistent for self-paced walking and anti-persistent for isochronous pacing. Both stride times and stride lengths changed from anti-persistence to persistence over the four non-isochronous metronome conditions, accompanied by an increasingly stronger coupling between these gait parameters, with peak values for the persistent metronomes. These results revealed that participants were able to follow the beat of a persistent metronome without falling off the treadmill by strongly coupling stride-length fluctuations to the stride-time fluctuations elicited by persistent metronomes, so as to prevent large positional displacements along the treadmill. For self-paced walking, in contrast, this coupling was very weak. In combination, these results challenge the premise that persistent metronomes in gait rehabilitation would evoke stride-to-stride dynamics reminiscent of self-paced walking healthy adults. Future studies are recommended to include an analysis of the interrelation between stride times and stride lengths in addition to the correlational structure of either one in isolation.

Modeling water quality in an urban river using hydrological factors--data driven approaches.

PubMed

Chang, Fi-John; Tsai, Yu-Hsuan; Chen, Pin-An; Coynel, Alexandra; Vachaud, Georges

2015-03-15

Contrasting seasonal variations occur in river flow and water quality as a result of short duration, severe intensity storms and typhoons in Taiwan. Sudden changes in river flow caused by impending extreme events may impose serious degradation on river water quality and fateful impacts on ecosystems. Water quality is measured in a monthly/quarterly scale, and therefore an estimation of water quality in a daily scale would be of good help for timely river pollution management. This study proposes a systematic analysis scheme (SAS) to assess the spatio-temporal interrelation of water quality in an urban river and construct water quality estimation models using two static and one dynamic artificial neural networks (ANNs) coupled with the Gamma test (GT) based on water quality, hydrological and economic data. The Dahan River basin in Taiwan is the study area. Ammonia nitrogen (NH3-N) is considered as the representative parameter, a correlative indicator in judging the contamination level over the study. Key factors the most closely related to the representative parameter (NH3-N) are extracted by the Gamma test for modeling NH3-N concentration, and as a result, four hydrological factors (discharge, days w/o discharge, water temperature and rainfall) are identified as model inputs. The modeling results demonstrate that the nonlinear autoregressive with exogenous input (NARX) network furnished with recurrent connections can accurately estimate NH3-N concentration with a very high coefficient of efficiency value (0.926) and a low RMSE value (0.386 mg/l). Besides, the NARX network can suitably catch peak values that mainly occur in dry periods (September-April in the study area), which is particularly important to water pollution treatment. The proposed SAS suggests a promising approach to reliably modeling the spatio-temporal NH3-N concentration based solely on hydrological data, without using water quality sampling data. It is worth noticing that such estimation can be made in a much shorter time interval of interest (span from a monthly scale to a daily scale) because hydrological data are long-term collected in a daily scale. The proposed SAS favorably makes NH3-N concentration estimation much easier (with only hydrological field sampling) and more efficient (in shorter time intervals), which can substantially help river managers interpret and estimate water quality responses to natural and/or manmade pollution in a more effective and timely way for river pollution management. Copyright © 2014 Elsevier Ltd. All rights reserved.

Reproductive efficiency of captive Chinese- and Indian-origin rhesus macaque (Macaca mulatta) females

PubMed Central

Kubisch, H. Michael; Falkenstein, Kathrine P.; Deroche, Chelsea B.; Franke, Donald E.

2011-01-01

Reproductive and survival records (n = 2,913) from 313 Chinese-origin and 365 Indian-derived rhesus macaques at the Tulane National Primate Research Center spanning 3 generations were studied. Least-squares analysis of variance procedures were used to compare reproductive and infant survival traits while proportional hazards regression procedures were used to study female age at death, number of infants born per female and time from last birth to death. Chinese females were older at first parturition than Indian-females because they were older when placed with males, but the two subspecies had similar first and lifetime post-partum birth intervals. Females that gave birth to stillborn infants had shorter first post-partum birth intervals than females giving birth to live infants. Post-partum birth intervals decreased in females from 3 to 12 years of age but then increased again with advancing age. Chinese infants had a greater survival rate than Indian infants at 30 d, 6 mo and 1yr of age. Five hundred and forty-three females (80.01 %) had uncensored, or true records for age at death, number of infants born per female, and time from the birth until death whereas 135 females (19.91 %) had censored records for these traits. Low and high uncensored observations for age at death were 3 and 26 years of age for Chinese and 3 and 23 years of age for Indian females. Uncensored number of infants born per female ranged from 1 to 15 for Chinese females and 1 to 18 for Indian females. Each of these traits was significantly influenced by the origin × generation interaction in the proportional hazards regression analyses, indicating that probabilities associated with age at death, number of infants born per female and time from last birth to death for Chinese and Indian females did not rank the same across generations. PMID:22512021

Defining the Ideal Time Interval Between Planned Induction Therapy and Surgery for Stage IIIA Non-Small Cell Lung Cancer.

PubMed

Samson, Pamela; Crabtree, Traves D; Robinson, Cliff G; Morgensztern, Daniel; Broderick, Stephen; Krupnick, A Sasha; Kreisel, Daniel; Patterson, G Alexander; Meyers, Bryan; Puri, Varun

2017-04-01

Induction therapy leads to significant improvement in survival for selected patients with stage IIIA non-small cell lung cancer. The ideal time interval between induction therapy and surgery remains unknown. Clinical stage IIIA non-small cell lung cancer patients receiving induction therapy and surgery were identified in the National Cancer Database. Delayed surgery was defined as greater than or equal to 3 months after starting induction therapy. A logistic regression model identified variables associated with delayed surgery. Cox proportional hazards modeling and Kaplan-Meier analysis were performed to evaluate variables independently associated with overall survival. From 2006 to 2010, 1,529 of 2,380 (64.2%) received delayed surgery. Delayed surgery patients were older (61.2 ± 10.0 years versus 60.3 ± 9.2; p = 0.03), more likely to be non-white (12.4% versus 9.7%; p = 0.046), and less likely to have private insurance (50% versus 58.2%; p = 0.002). Delayed surgery patients were also more likely to have a sublobar resection (6.3% versus 2.9%). On multivariate analysis, age greater than 68 years (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.1 to 1.7) was associated with delayed surgery, whereas white race (OR, 0.75; 95% CI, 0.57 to 0.99) and private insurance status (OR, 0.82; 95% CI, 0.68 to 0.99) were associated with early surgery. Delayed surgery was associated with higher risk of long-term mortality (hazard ratio, 1.25; 95% CI, 1.07 to 1.47). Delayed surgery after induction therapy for stage IIIA lung cancer is associated with shorter survival, and is influenced by both social and physiologic factors. Prospective work is needed to further characterize the relationship between patient comorbidities and functional status with receipt of timely surgery. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Population Pharmacokinetic Model-Based Evaluation of Standard Dosing Regimens for Cefuroxime Used in Coronary Artery Bypass Graft Surgery with Cardiopulmonary Bypass.

PubMed

Alqahtani, Saeed A; Alsultan, Abdullah S; Alqattan, Hussain M; Eldemerdash, Ahmed; Albacker, Turki B

2018-04-01

The purpose of this study was to investigate the population pharmacokinetics (PK) of cefuroxime in patients undergoing coronary artery bypass graft (CABG) surgery. In this observational pharmacokinetic study, multiple blood samples were collected over a 48-h interval of intravenous cefuroxime administration. The samples were analyzed by using a validated high-performance liquid chromatography (HPLC) method. Population pharmacokinetic models were developed using Monolix (version 4.4) software. Pharmacokinetic-pharmacodynamic (PD) simulations were performed to explore the ability of different dosage regimens to achieve the pharmacodynamic targets. A total of 468 blood samples from 78 patients were analyzed. The PK for cefuroxime were best described by a two-compartment model with between-subject variability on clearance, the volume of distribution of the central compartment, and the volume of distribution of the peripheral compartment. The clearance of cefuroxime was related to creatinine clearance (CL CR ). Dosing simulations showed that standard dosing regimens of 1.5 g could achieve the PK-PD target of the percentage of the time that the free concentration is maintained above the MIC during a dosing interval ( fT MIC ) of 65% for an MIC of 8 mg/liter in patients with a CL CR of 30, 60, or 90 ml/min, whereas this dosing regimen failed to achieve the PK-PD target in patients with a CL CR of ≥125 ml/min. In conclusion, administration of standard doses of 1.5 g three times daily provided adequate antibiotic prophylaxis in patients undergoing CABG surgery. Lower doses failed to achieve the PK-PD target. Patients with high CL CR values required either higher doses or shorter intervals of cefuroxime dosing. On the other hand, lower doses (1 g three times daily) produced adequate target attainment for patients with low CL CR values (≤30 ml/min). Copyright © 2018 American Society for Microbiology.

On the relation between photo- and gravitropically induced spatial memory in maize coleoptiles.

PubMed

Nick, P; Sailer, H; Schafer, E

1990-06-01

The interaction of photo- and gravitropic stimulation was studied by analysing the curvature of maize (Zea mays L.) coleoptiles subjected to rotation on horizontal clinostats. Gravitropic curvature in different directions with respect to the stimulation plane was found to be transient. This instability was caused by an increasing deviation of response direction from the stimulation plane towards the caryopsis. The bending angle as such, however, increased steadily. This reorientation of the gravitropic response towards the caryopsis is thought to be caused by the clinostat-elicited nastic curvature found in maize coleoptiles. In contrast, the response to phototropic stimulation was stable, in both, orientation and curving. Although stimulation by gravity was not capable of inducing a stable tropistic response, it could inhibit the response to opposing phototropic stimulation, if the counterstimulation was given more than 90 min after the onset of gravistimulation. For shorter time intervals the influence of the phototropic stimulus obscured the response to the first, gravitropic stimulation. For time intervals exceeding 90 min, however, the phototropic effects disappeared and the response was identical to that for gravity stimulation alone. This gravity-induced inhibition of the phototropic response was confined to the plane of gravity stimulation, because a phototropic stimulation in the perpendicular direction remained unaffected, irrespective of the time interval between the stimulations. This concerned not only the stable phototropic curving, but also the capacity of the phototropic induction to elicit a stable directional memory as described earlier (P. Nick and F. Schafer, 1988b, Planta 175, 380-388). This was tested by a second blue-light pulse opposing the first. It is suggested that gravity, too, can induce a directional memory differing from the blue-light elicited memory. The mechanisms mediating gravi- and phototropic directional memories are thought to branch off the respective tropistic signal chain at a stage where photo- and gravitropic transduction are still separate.

Angiotensin-converting enzyme inhibitors delay the occurrence of renal involvement and are associated with a decreased risk of disease activity in patients with systemic lupus erythematosus--results from LUMINA (LIX): a multiethnic US cohort.

PubMed

Durán-Barragán, S; McGwin, G; Vilá, L M; Reveille, J D; Alarcón, G S

2008-07-01

To examine if angiotensin-converting enzyme (ACE) inhibitor use delays the occurrence of renal involvement and decreases the risk of disease activity in SLE patients. SLE patients (Hispanics, African Americans and Caucasians) from the lupus in minorities: nature vs nurture (LUMINA) cohort were studied. Renal involvement was defined as ACR criterion and/or biopsy-proven lupus nephritis. Time-to-renal involvement was examined by univariable and multivariable Cox proportional hazards regression analyses. Disease activity was examined with a case-crossover design and a conditional logistic regression model; in the case intervals, a decrease in the SLAM-R score >or=4 points occurred but not in the control intervals. Eighty of 378 patients (21%) were ACE inhibitor users; 298 (79%) were not. The probability of renal involvement free-survival at 10 yrs was 88.1% for users and 75.4% for non-users (P = 0.0099, log rank test). Users developed persistent proteinuria and/or biopsy-proven lupus nephritis (7.1%) less frequently than non-users (22.9%), P = 0.016. By multivariable Cox proportional hazards regression analyses, ACE inhibitors use [hazard ratio (HR) 0.27; 95% CI 0.09, 0.78] was associated with a longer time-to-renal involvement occurrence whereas African American ethnicity (HR 3.31; 95% CI 1.44, 7.61) was with a shorter time. ACE inhibitor use (54/288 case and 254/1148 control intervals) was also associated with a decreased risk of disease activity (HR 0.56; 95% CI 0.34, 0.94). ACE inhibitor use delays the development of renal involvement and associates with a decreased risk of disease activity in SLE; corroboration of these findings in other lupus cohorts is desirable before practice recommendations are formulated.

Inside anesthesia breathing circuits: time to reach a set sevoflurane concentration in toddlers and newborns: simulation using a test lung.

PubMed

Kern, Delphine; Larcher, Claire; Basset, Bertrand; Alacoque, Xavier; Fesseau, Rose; Samii, Kamran; Minville, Vincent; Fourcade, Olivier

2012-08-01

We measured the time it takes to reach the desired inspired anesthetic concentration using the Primus (Drägerwerk, AG, Lübeck, Germany) and the Avance (GE Datex-Ohmeda, Munich, Germany) anesthesia machines with toddler and newborn ventilation settings. The time to reach 95% of inspired target sevoflurane concentration was measured during wash-in from 0 to 6 vol% sevoflurane and during wash-out from 6 to 0 vol% with fresh gas flows equal to 1 and 2 times the minute ventilation. The Avance was faster than the Primus (65 seconds [95% confidence interval (CI): 55 to 78] vs 310 seconds [95% CI: 261 to 359]) at 1.5 L/min fresh gas flow, tidal volume of 50 mL, and 30 breaths/min. Times were shorter by the same magnitude at higher fresh gas flows and higher minute ventilation rates. The effect of doubling fresh gas flow was variable and less than expected. The Primus is slower during newborn than toddler ventilation, whereas the Avance's response time was the same for newborn and toddler ventilation. Our data confirm that the time to reach the target-inspired anesthetic concentration depends on breathing circuit volume, fresh gas flow, and minute ventilation.

What is the Relationship between the Solar Wind and Storms/Substorms?

NASA Technical Reports Server (NTRS)

Fairfield, D. H.; Burlaga, L. F.

1999-01-01

The interplanetary magnetic field (IMF) carried past the Earth by the solar wind has long been known to be the principal quantity that controls geomagnetic storms and substorms. Intervals of strong southward IMF with durations of at least a significant fraction of a day produce storms, while more typical, shorter intervals of less-intense southward fields produce substorms. The strong, long-duration southward fields are generally associated with coronal mass ejections and magnetic clouds or else they are produced by interplanetary dynamics initiated by fast solar wind flows that compress preexisting southward fields. Smaller, short-duration southward fields that occur on most days are related to long period waves, turbulence, or random variations in the IMF. Southward IMF enhances dayside reconnection between the IMF and the Earth's dipole with the reconnected field lines supplementing open field lines of the geomagnetic tail and producing an expanded polar cap and increased tail energy. Although the frequent storage of solar wind energy and its release during substorms is the most common mode of solar wind/magnetosphere interaction, under certain circumstances, steady southward IMF seems to produce intervals of relatively steady magnetosphere convection without substorms. During these latter times, the inner magnetosphere remains in a stressed tail-like state while the more distant magnetotail has larger northward field and more dipolar-like field lines. Recent evidence suggests that enhanced magnetosphere particle densities associated with enhanced solar wind densities allow more particles to be accelerated for the ring current, thus creating larger storms.

Monthly fluctuations of insomnia symptoms in a population-based sample.

PubMed

Morin, Charles M; Leblanc, M; Ivers, H; Bélanger, L; Mérette, Chantal; Savard, Josée; Jarrin, Denise C

2014-02-01

To document the monthly changes in sleep/insomnia status over a 12-month period; to determine the optimal time intervals to reliably capture new incident cases and recurrent episodes of insomnia and the likelihood of its persistence over time. Participants were 100 adults (mean age = 49.9 years; 66% women) randomly selected from a larger population-based sample enrolled in a longitudinal study of the natural history of insomnia. They completed 12 monthly telephone interviews assessing insomnia, use of sleep aids, stressful life events, and physical and mental health problems in the previous month. A total of 1,125 interviews of a potential 1,200 were completed. Based on data collected at each assessment, participants were classified into one of three subgroups: good sleepers, insomnia symptoms, and insomnia syndrome. At baseline, 42 participants were classified as good sleepers, 34 met criteria for insomnia symptoms, and 24 for an insomnia syndrome. There were significant fluctuations of insomnia over time, with 66% of the participants changing sleep status at least once over the 12 monthly assessments (51.5% for good sleepers, 59.5% for insomnia syndrome, and 93.4% for insomnia symptoms). Changes of status were more frequent among individuals with insomnia symptoms at baseline (mean = 3.46, SD = 2.36) than among those initially classified as good sleepers (mean = 2.12, SD = 2.70). Among the subgroup with insomnia symptoms at baseline, 88.3% reported improved sleep (i.e., became good sleepers) at least once over the 12 monthly assessments compared to 27.7% whose sleep worsened (i.e., met criteria for an insomnia syndrome) during the same period. Among individuals classified as good sleepers at baseline, risks of developing insomnia symptoms and syndrome over the subsequent months were, respectively, 48.6% and 14.5%. Monthly assessment over an interval of 6 months was found most reliable to estimate incidence rates, while an interval of 3 months proved the most reliable for defining chronic insomnia. Monthly assessment of insomnia and sleep patterns revealed significant variability over the course of a 12-month period. These findings highlight the importance for future epidemiological studies of conducting repeated assessment at shorter than the typical yearly interval in order to reliably capture the natural course of insomnia over time.

Validation of Heart Rate Monitor Polar RS800 for Heart Rate Variability Analysis During Exercise.

PubMed

Hernando, David; Garatachea, Nuria; Almeida, Rute; Casajús, Jose A; Bailón, Raquel

2018-03-01

Hernando, D, Garatachea, N, Almeida, R, Casajús, JA, and Bailón, R. Validation of heart rate monitor Polar RS800 for heart rate variability analysis during exercise. J Strength Cond Res 32(3): 716-725, 2018-Heart rate variability (HRV) analysis during exercise is an interesting noninvasive tool to measure the cardiovascular response to the stress of exercise. Wearable heart rate monitors are a comfortable option to measure interbeat (RR) intervals while doing physical activities. It is necessary to evaluate the agreement between HRV parameters derived from the RR series recorded by wearable devices and those derived from an electrocardiogram (ECG) during dynamic exercise of low to high intensity. Twenty-three male volunteers performed an exercise stress test on a cycle ergometer. Subjects wore a Polar RS800 device, whereas ECG was also recorded simultaneously to extract the reference RR intervals. A time-frequency spectral analysis was performed to extract the instantaneous mean heart rate (HRM), and the power of low-frequency (PLF) and high-frequency (PHF) components, the latter centered on the respiratory frequency. Analysis was done in intervals of different exercise intensity based on oxygen consumption. Linear correlation, reliability, and agreement were computed in each interval. The agreement between the RR series obtained from the Polar device and from the ECG is high throughout the whole test although the shorter the RR is, the more differences there are. Both methods are interchangeable when analyzing HRV at rest. At high exercise intensity, HRM and PLF still presented a high correlation (ρ > 0.8) and excellent reliability and agreement indices (above 0.9). However, the PHF measurements from the Polar showed reliability and agreement coefficients around 0.5 or lower when the level of the exercise increases (for levels of O2 above 60%).

[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.

Increasing synchrony of high temperature and low flow in western North American streams: double trouble for coldwater biota?

USGS Publications Warehouse

Arismendi, Ivan; Safeeq, Mohammad; Johnson, Sherri L.; Dunham, Jason B.; Haggerty, Roy

2013-01-01

Flow and temperature are strongly linked environmental factors driving ecosystem processes in streams. Stream temperature maxima (Tmax_w) and stream flow minima (Qmin) can create periods of stress for aquatic organisms. In mountainous areas, such as western North America, recent shifts toward an earlier spring peak flow and decreases in low flow during summer/fall have been reported. We hypothesized that an earlier peak flow could be shifting the timing of low flow and leading to a decrease in the interval between Tmax_w and Qmin. We also examined if years with extreme low Qmin were associated with years of extreme high Tmax_w. We tested these hypotheses using long32 term data from 22 minimally human-influenced streams for the period 1950-2010. We found trends toward a shorter time lag between Tmax_w and Qmin over time and a strong negative association between their magnitudes. Our findings show that aquatic biota may be increasingly experiencing narrower time windows to recover or adapt between these extreme events of low flow and high temperature. This study highlights the importance of evaluating multiple environmental drivers to better gauge the effects of the recent climate variability in freshwaters.

Improved central confidence intervals for the ratio of Poisson means

NASA Astrophysics Data System (ADS)

Cousins, R. D.

The problem of confidence intervals for the ratio of two unknown Poisson means was "solved" decades ago, but a closer examination reveals that the standard solution is far from optimal from the frequentist point of view. We construct a more powerful set of central confidence intervals, each of which is a (typically proper) subinterval of the corresponding standard interval. They also provide upper and lower confidence limits which are more restrictive than the standard limits. The construction follows Neyman's original prescription, though discreteness of the Poisson distribution and the presence of a nuisance parameter (one of the unknown means) lead to slightly conservative intervals. Philosophically, the issue of the appropriateness of the construction method is similar to the issue of conditioning on the margins in 2×2 contingency tables. From a frequentist point of view, the new set maintains (over) coverage of the unknown true value of the ratio of means at each stated confidence level, even though the new intervals are shorter than the old intervals by any measure (except for two cases where they are identical). As an example, when the number 2 is drawn from each Poisson population, the 90% CL central confidence interval on the ratio of means is (0.169, 5.196), rather than (0.108, 9.245). In the cited literature, such confidence intervals have applications in numerous branches of pure and applied science, including agriculture, wildlife studies, manufacturing, medicine, reliability theory, and elementary particle physics.

Free Interval Duration: Clinical Evidence of the Primary Role of Excitement in Bipolar Disorder.

PubMed

Sani, Gabriele; Simonetti, Alessio; Reginaldi, Daniela; Koukopoulos, Alexia E; Del Casale, Antonio; Manfredi, Giovanni; Kotzalidis, Georgios D; Girardi, Paolo

2017-04-01

Cyclicity is the essential feature of Bipolar disorder, but the effect of different cycle patterns on the clinical features is poorly understood. Moreover, no studies investigated the relationship between mania and depression inside the manic-depressive cycle. The aim of this study is to verify the presence of a relationship between the manic and the depressive phase during the course of bipolar disorder. 160 consecutive patients with BD type I were recruited and followed for a mean period of 10 years. During the follow-up period, four types of euthymic phases were collected: free intervals present between a depressive and a manic/hypomanic episode (D-M); free intervals present between a manic/hypomanic and a depressive episode (M-D); free intervals present between two depressive episodes (D-D); free intervals present between two manic/hypomanic episodes (M-M). One-way ANOVA using the groups as independent variable and the duration of the free intervals as dependent variables was used. Furthermore, ANOVA was followed by Fisher's Protected Least Significant Difference post-hoc test to measure between-group differences. M-D-free interval phases were shorter than D-M-free intervals. M-D intervals were the shortest ones, the D-D and D-M did not differ, and the M-M were the longest. The strict temporal link between manic and depressive phases supports the idea that the manic-depressive cycle usually begins with a manic episode, and that the subsequent depression is often the consequence of subsiding mania.

Effects of red-cell storage duration on patients undergoing cardiac surgery.

PubMed

Steiner, Marie E; Ness, Paul M; Assmann, Susan F; Triulzi, Darrell J; Sloan, Steven R; Delaney, Meghan; Granger, Suzanne; Bennett-Guerrero, Elliott; Blajchman, Morris A; Scavo, Vincent; Carson, Jeffrey L; Levy, Jerrold H; Whitman, Glenn; D'Andrea, Pamela; Pulkrabek, Shelley; Ortel, Thomas L; Bornikova, Larissa; Raife, Thomas; Puca, Kathleen E; Kaufman, Richard M; Nuttall, Gregory A; Young, Pampee P; Youssef, Samuel; Engelman, Richard; Greilich, Philip E; Miles, Ronald; Josephson, Cassandra D; Bracey, Arthur; Cooke, Rhonda; McCullough, Jeffrey; Hunsaker, Robert; Uhl, Lynne; McFarland, Janice G; Park, Yara; Cushing, Melissa M; Klodell, Charles T; Karanam, Ravindra; Roberts, Pamela R; Dyke, Cornelius; Hod, Eldad A; Stowell, Christopher P

2015-04-09

Some observational studies have reported that transfusion of red-cell units that have been stored for more than 2 to 3 weeks is associated with serious, even fatal, adverse events. Patients undergoing cardiac surgery may be especially vulnerable to the adverse effects of transfusion. We conducted a randomized trial at multiple sites from 2010 to 2014. Participants 12 years of age or older who were undergoing complex cardiac surgery and were likely to undergo transfusion of red cells were randomly assigned to receive leukocyte-reduced red cells stored for 10 days or less (shorter-term storage group) or for 21 days or more (longer-term storage group) for all intraoperative and postoperative transfusions. The primary outcome was the change in Multiple Organ Dysfunction Score (MODS; range, 0 to 24, with higher scores indicating more severe organ dysfunction) from the preoperative score to the highest composite score through day 7 or the time of death or discharge. The median storage time of red-cell units provided to the 1098 participants who received red-cell transfusion was 7 days in the shorter-term storage group and 28 days in the longer-term storage group. The mean change in MODS was an increase of 8.5 and 8.7 points, respectively (95% confidence interval for the difference, -0.6 to 0.3; P=0.44). The 7-day mortality was 2.8% in the shorter-term storage group and 2.0% in the longer-term storage group (P=0.43); 28-day mortality was 4.4% and 5.3%, respectively (P=0.57). Adverse events did not differ significantly between groups except that hyperbilirubinemia was more common in the longer-term storage group. The duration of red-cell storage was not associated with significant differences in the change in MODS. We did not find that the transfusion of red cells stored for 10 days or less was superior to the transfusion of red cells stored for 21 days or more among patients 12 years of age or older who were undergoing complex cardiac surgery. (Funded by the National Heart, Lung, and Blood Institute; RECESS ClinicalTrials.gov number, NCT00991341.).

Nocturnal heart rate variability in 1-year-old infants analyzed by using the Least Square Cosine Spectrum Method.

PubMed

Kochiya, Yuko; Hirabayashi, Akari; Ichimaru, Yuhei

2017-09-16

To evaluate the dynamic nature of nocturnal heart rate variability, RR intervals recorded with a wearable heart rate sensor were analyzed using the Least Square Cosine Spectrum Method. Six 1-year-old infants participated in the study. A wearable heart rate sensor was placed on their chest to measure RR intervals and 3-axis acceleration. Heartbeat time series were analyzed for every 30 s using the Least Square Cosine Spectrum Method, and an original parameter to quantify the regularity of respiratory-related heart rate rhythm was extracted and referred to as "RA (RA-COSPEC: Respiratory Area obtained by COSPEC)." The RA value is higher when a cosine curve is fitted to the original data series. The time sequential changes of RA showed cyclic changes with significant rhythm during the night. The mean cycle length of RA was 70 ± 15 min, which is shorter than young adult's cycle in our previous study. At the threshold level of RA greater than 3, the HR was significantly decreased compared with the RA value less than 3. The regularity of heart rate rhythm showed dynamic changes during the night in 1-year-old infants. Significant decrease of HR at the time of higher RA suggests the increase of parasympathetic activity. We suspect that the higher RA reflects the regular respiratory pattern during the night. This analysis system may be useful for quantitative assessment of regularity and dynamic changes of nocturnal heart rate variability in infants.

Common Genetic Variation in CYP17A1 and Response to Abiraterone Acetate in Patients with Metastatic Castration-Resistant Prostate Cancer

PubMed Central

Binder, Moritz; Zhang, Ben Y.; Hillman, David W.; Kohli, Rhea; Kohli, Tanvi; Lee, Adam; Kohli, Manish

2016-01-01

Treatment with abiraterone acetate and prednisone (AA/P) prolongs survival in metastatic castration-resistant prostate cancer (mCRPC) patients. We evaluated the genetic variation in CYP17A1 as predictive of response to AA/P. A prospective collection of germline DNA prior to AA/P initiation and follow-up of a mCRPC cohort was performed. Five common single-nucleotide polymorphisms (SNPs) in CYP17A1 identified using a haplotype-based tagging algorithm were genotyped. Clinical outcomes included biochemical response and time to biochemical progression on AA/P. Logistic regression was used to assess the association between tag SNPs and biochemical response. Proportional hazards regression was used to assess the association between tag SNPs and time to biochemical progression. Odds or hazard ratio per minor allele were estimated and p-values below 0.05 were considered statistically significant. Germline DNA was successfully genotyped for four tag SNPs in 87 patients. The median age was 73 years (54–90); the median prostate-specific antigen was 66 ng/dL (0.1–99.9). A single SNP, rs2486758, was associated with lower odds of experiencing a biochemical response (Odds ratio 0.22, 95% confidence interval 0.07–0.63, p = 0.005) and a shorter time to biochemical progression (Hazard ratio 2.23, 95% confidence interval 1.39–3.56, p < 0.001). This tag SNP located in the promoter region of CYP17A1 will need further validation as a predictive biomarker for AA/P therapy. PMID:27409606

Comparative study between atropine and hyoscine-N-butylbromide for reversal of detomidine induced bradycardia in horses.

PubMed

Pimenta, E L M; Teixeira Neto, F J; Sá, P A; Pignaton, W; Garofalo, N A

2011-05-01

Bradycardia may be implicated as a cause of cardiovascular instability during anaesthesia. Hyoscine would induce positive chronotropism of shorter duration than atropine, without adversely impairing intestinal motility in detomidine sedated horses. Ten minutes after detomidine (0.02 mg/kg bwt, i.v.), physiological saline (control), atropine (0.02 mg/kg bwt) or hyoscine (0.2 mg/kg bwt) were randomly administered i.v. to 6 horses, allowing one week intervals between treatments. Investigators blinded to the treatments monitored cardiopulmonary data and intestinal auscultation for 90 min and 24 h after detomidine, respectively. Gastrointestinal transit was assessed for 96 h via chromium detection in dry faeces. Detomidine significantly decreased heart rate (HR) and cardiac index (CI) from baseline for 30 and 60 min, respectively (control). Mean ± s.d. HR increased significantly 5 min after atropine (79 ± 5 beats/min) and hyoscine (75 ± 8 beats/min). After this time, HR was significantly higher after atropine in comparison to other treatments, while hyoscine resulted in intermediate values (lower than atropine but higher than controls). Hyoscine and atropine resulted in significantly higher CI than controls for 5 and 20 min, respectively; but this effect coincided with significant hypertension (mean arterial pressures >180 mmHg). Auscultation scores decreased from baseline in all treatments. Time to return to auscultation scores ≥12 (medians) did not differ between hyoscine (4 h) and controls (4 h) but atropine resulted in significantly longer time (10 h). Atropine induced colic in one horse. Gastrointestinal transit times did not differ between treatments. Hyoscine is a shorter acting positive chronotropic agent than atropine, but does not potentiate the impairment in intestinal motility induced by detomidine. Because of severe hypertension, routine use of anticholinergics combined with detomidine is not recommended. Hyoscine may represent an alternative to atropine for treating bradycardia. © 2010 EVJ Ltd.

A prospective, randomized, double-blind trial of intranasal dexmedetomidine and oral chloral hydrate for sedated auditory brainstem response (ABR) testing.

PubMed

Reynolds, Jason; Rogers, Amber; Medellin, Eduardo; Guzman, Jonathan A; Watcha, Mehernoor F

2016-03-01

Dexmedetomidine is increasingly used by various routes for pediatric sedation. However, there are few randomized controlled trials comparing the efficacy of dexmedetomidine to other commonly used sedatives. To compare the efficacy of sedation with intranasal dexmedetomidine to oral chloral hydrate for auditory brainstem response (ABR) testing. In this double-blind, double-dummy study, children undergoing ABR testing were randomized to receive intranasal dexmedetomidine 3 mcg · kg(-1) plus oral placebo (Group IN DEX) or oral chloral hydrate 50 mg · kg(-1) plus intranasal saline placebo (Group CH). We recorded demographic data, times from sedative administration to start and completion of testing, quality of sedation, occurrence of predefined adverse events, discharge times, and return to baseline activity on the day of testing. Testing completion rates with a single dose of medication were higher in the IN DEX group (89% vs 66% for CH, odds ratio with 95% confidence intervals 4.04 [1.3-12.6], P = 0.018). The median [95% CI)] time to successful testing start was shorter (25 [20-29] min vs 30 [20-49] min for IN DEX and CH, respectively, log rank test P = 0.02) and the proportion of children whose parents reported a return to baseline activity on the day of testing was greater for the IN DEX than the CH group (89% vs 64%, OR [95% CI] 4.71 [1.34-16.6], P = 0.02). There were no major adverse events in either group and no significant differences in the incidence of minor events. Intranasal dexmedetomidine is an effective alternative to oral chloral hydrate sedation for ABR testing, with the advantages of a higher incidence of testing completion with a single dose, shorter time to desired sedation level, and with significantly more patients reported to return to baseline activity on the same day. © 2016 John Wiley & Sons Ltd.

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

PubMed

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

2014-12-15

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

Epigallocatechin gallate enhances treatment efficacy of oral nifedipine against pregnancy-induced severe pre-eclampsia: A double-blind, randomized and placebo-controlled clinical study.

PubMed

Shi, D-D; Guo, J-J; Zhou, L; Wang, N

2018-02-01

Oral nifedipine is commonly used to treat pre-eclampsia, one of the most severe complications during pregnancy, but its clinical efficacy is less than ideal. Epigallocatechin gallate (EGCG), a natural compound from green tea, could benefit cardiovascular health especially hypertension. We investigated the clinical efficacy of EGCG, when complemented with oral nifedipine, in treating pre-eclampsia. A total of 350 pregnant women with severe pre-eclampsia were recruited and randomized to receive oral nifedipine, together with placebo (NIF+placebo) or EGCG (NIF+EGCG). The primary treatment outcome was the time needed to control blood pressure and interval time before a new hypertensive crisis, whereas the secondary treatment outcome was the number of treatment doses to effectively control blood pressure, maternal adverse effects and neonatal complications. Comparing NIF+EGCG group to NIF+placebo group, the time needed to control blood pressure was significantly shorter (NIF+EGCG 31.2±16.7 minutes, NIF+placebo 45.3±21.9 minutes; 95% CI 9.7-18.5 minutes), whereas interval time before a new hypertensive crisis was significantly prolonged (NIF+EGCG 7.2±2.9 hours, NIF+placebo 4.1±3.7 hours; 95% CI 2.3-3.9 hours), and the number of treatment dosages needed to effectively control blood pressure was also lower. Between the two treatment groups, no differences in incidence rates of maternal adverse effects or neonatal complications were observed. EGCG is both safe and effective in enhancing treatment efficacy of oral nifedipine against pregnancy-induced severe pre-eclampsia, but formal validation is required prior to its recommendation for use outside of clinical trials. © 2017 John Wiley & Sons Ltd.

Association between delay to coronary reperfusion and outcome in patients with acute coronary syndrome undergoing extracorporeal cardiopulmonary resuscitation.

PubMed

Kuroki, Norihiro; Abe, Daisuke; Iwama, Toru; Suzuki, Kou; Sugiyama, Kazuhiro; Akashi, Akiko; Hamabe, Yuichi; Aonuma, Kazutaka; Sato, Akira

2017-05-01

The prognostic effect of early coronary reperfusion therapy with extracorporeal cardiopulmonary resuscitation (ECPR) in patients with cardiac arrest due to acute coronary syndrome (ACS) has yet to be clarified. We investigated the relationship between time interval from collapse to start of ECPR (CtoE) and coronary reperfusion (CtoR) time and neurological outcome in patients with cardiac arrest due to ACS. A cohort of 119 consecutive patients (63±12 years old) with ACS who underwent ECPR and percutaneous coronary intervention(PCI) at our hospital was registered from January 2005 to June 2016. We analyzed patient clinical outcome, which was defined as survival with good neurological outcome at 30 days. We divided the patients into four groups according to CtoR time: Group 1 (time<60min: n=19), Group 2 (60≤time<90min: n=19), Group 3 (time≥90min: n=70) and Group 4 (unsuccessful coronary reperfusion: n=11). One hundred patients (84%) were successful of PCI. A Kaplan-Meier curve showed that Group 1 had the best outcome among the four groups (good neurological outcome at 30 days; 74% vs 37% vs 23% vs 9%, P<0.0001). In receiver operating characteristics analysis for good neurological outcome at 30 days, the cutoff values for CtoE was 40min. The delay CtoE and CtoR time were independent predictors of poor neurological outcome at 30 days after adjusting multiple confounders (CtoE time; Hazard ratio (HR):1.026, 95% confidential intervals(CI): 1.011-1.042, P=0.001), (CtoR time; HR: 1.004, 95% CI: 1.001-1.008, P=0.020). A shorter CtoE and CtoR predicts better clinical outcome in patients with ACS undergoing ECPR. Copyright © 2017 Elsevier B.V. All rights reserved.

Logistics of air medical transport: When and where does helicopter transport reduce prehospital time for trauma?

PubMed

Chen, Xilin; Gestring, Mark L; Rosengart, Matthew R; Peitzman, Andrew B; Billiar, Timothy R; Sperry, Jason L; Brown, Joshua B

2018-05-04

Trauma is a time sensitive disease. Helicopter emergency medical services (HEMS) have shown benefit over ground EMS (GEMS), which may be related to reduced prehospital time. The distance at which this time benefit emerges depends on many factors that can vary across regions. Our objective was to determine the threshold distance at which HEMS has shorter prehospital time than GEMS under different conditions. Patients in the PA trauma registry 2000-2013 were included. Distance between zip centroid and trauma center was calculated using straight-line distance for HEMS and driving distance from GIS network analysis for GEMS. Contrast margins from linear regression identified the threshold distance at which HEMS had a significantly lower prehospital time than GEMS, indicated by non-overlapping 95% confidence intervals. The effect of peak traffic times and adverse weather on the threshold distance was evaluated. Geographic effects across EMS regions were also evaluated. A total of 144,741 patients were included with 19% transported by HEMS. Overall, HEMS became faster than GEMS at 7.7miles from the trauma center (p=0.043). HEMS became faster at 6.5miles during peak traffic (p=0.025) compared to 7.9miles during off-peak traffic (p=0.048). Adverse weather increased the distance at which HEMS was faster to 17.1miles (p=0.046) from 7.3miles in clear weather (p=0.036). Significant variation occurred across EMS regions, with threshold distances ranging from 5.4miles to 35.3miles. There was an inverse but non-significant relationship between urban population and threshold distance across EMS regions (ρ -0.351, p=0.28). This is the first study to demonstrate that traffic, weather, and geographic region significantly impact the threshold distance at which HEMS is faster than GEMS. HEMS was faster at shorter distances during peak traffic while adverse weather increased this distance. The threshold distance varied widely across geographic region. These factors must be considered to guide appropriate HEMS triage protocols. III, Therapeutic.

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...

The effect of self-reported habitual sleep quality and sleep length on autobiographical memory.

PubMed

Murre, Jaap M J; Kristo, Gert; Janssen, Steve M J

2014-01-01

A large number of studies have recently shown effects of sleep on memory consolidation. In this study the effects of the sleep quality and sleep length on the retention of autobiographical memories are examined, using an Internet-based diary technique (Kristo, Janssen, & Murre, 2009). Each of over 600 participants recorded one recent personal event and was contacted after a retention interval that ranged from 2 to 46 days. Recall of the content, time, and details of the event were scored and related to sleep quality and sleep length as measured with the Pittsburgh Sleep Quality Index. Hierarchical regression analyses indicated that poor sleep quality, but not short sleep length, was associated with significantly lower recall at the longer retention periods (30-46 days), but not at the shorter ones (2-15 days), although the difference in recall between good and poor sleepers was small.

How does temporal preparation speed up response implementation in choice tasks? Evidence for an early cortical activation.

PubMed

Tandonnet, Christophe; Davranche, Karen; Meynier, Chloé; Burle, Borís; Vidal, Franck; Hasbroucq, Thierry

2012-02-01

We investigated the influence of temporal preparation on information processing. Single-pulse transcranial magnetic stimulation (TMS) of the primary motor cortex was delivered during a between-hand choice task. The time interval between the warning and the imperative stimulus varied across blocks of trials was either optimal (500 ms) or nonoptimal (2500 ms) for participants' performance. Silent period duration was shorter prior to the first evidence of response selection for the optimal condition. Amplitude of the motor evoked potential specific to the responding hand increased earlier for the optimal condition. These results revealed an early release of cortical inhibition and a faster integration of the response selection-related inputs to the corticospinal pathway when temporal preparation is better. Temporal preparation may induce cortical activation prior to response selection that speeds up the implementation of the selected response. Copyright © 2011 Society for Psychophysiological Research.

The Dynamics of Quantum Discord and Entanglement of Three Atoms Coupled to Three Spatially Separate Cavities

NASA Astrophysics Data System (ADS)

He, Juan; Wu, Tao; Ye, Liu

2013-10-01

In this paper, we study the dynamics of quantum discord and entanglement of three identical two-level atoms simultaneously resonantly interacting with three spatially separate single-mode of high- Q cavities respectively. Taking advantage of the depiction quantum discord and entanglement of formation (EoF), we conclude that the discord and entanglement of atoms and cavities can be mediated by changing some parameters and the maximum values of discord and entanglement are independent on the couplings of cavities and atoms. In particular, there also exists quantum discord sudden death as well as entanglement sudden death and the time interval of the former is shorter than that of the later in the proposed quantum system. It is shown that the discord and entanglement of any two atoms among three atoms can be transferred to the corresponding cavities, and there exists discord and entanglement exchanging between the atoms and the corresponding cavities.

Bottom-Water Conditions in a Marine Basin after the Cretaceous–Paleogene Impact Event: Timing the Recovery of Oxygen Levels and Productivity

PubMed Central

Sosa-Montes De Oca, Claudia; Martínez-Ruiz, Francisca; Rodríguez-Tovar, Francisco Javier

2013-01-01

An ultra-high-resolution analysis of major and trace element contents from the Cretaceous–Paleogene boundary interval in the Caravaca section, southeast Spain, reveals a quick recovery of depositional conditions after the impact event. Enrichment/depletion profiles of redox sensitive elements indicate significant geochemical anomalies just within the boundary ejecta layer, supporting an instantaneous recovery –some 102 years– of pre-impact conditions in terms of oxygenation. Geochemical redox proxies point to oxygen levels comparable to those at the end of the Cretaceous shortly after impact, which is further evidenced by the contemporary macrobenthic colonization of opportunistic tracemakers. Recovery of the oxygen conditions was therefore several orders shorter than traditional proposals (104–105 years), suggesting a probable rapid recovery of deep-sea ecosystems at bottom and in intermediate waters. PMID:24349232

Effects of Shuttle bay environment on UV sensitive photographic film - Instrumentation for Get-Away-Special

NASA Technical Reports Server (NTRS)

Kreplin, R. W.; Dohne, B.; Feldman, U.; Neupert, W. M.

1984-01-01

An account is given of a Get-Away-Special experiment flown on Space Shuttles 7 and 8 investigating the effect of the space environment on Shumann emulsions. Shumann emulsions, having low gelatin content and no protective gelatin overcoating, are useful detectors of ultraviolet radiation shorter than 2200 angstroms but are extremely sensitive to environmental conditions and handling. The instrument required no interface with the Shuttle. It was turned on by an aneroid switch at an altitude of 50,000 feet. After that, its operation was controlled completely by a CMOS digital controller. Each hour, two temperatures and one voltage were read and stored in a CMOS programmable read only memory. At intervals, valves were opened and closed to expose SO 652 film strips of three sensitivities to the cargo bay environment for various time periods. The design and operation of the instrument package is described.

Rate of Mass Loss Across the Instability Threshold for Thwaites Glacier Determines Rate of Mass Loss for Entire Basin

NASA Astrophysics Data System (ADS)

Waibel, M. S.; Hulbe, C. L.; Jackson, C. S.; Martin, D. F.

2018-01-01

Rapid change now underway on Thwaites Glacier (TG) raises concern that a threshold for unstoppable grounding line retreat has been or is about to be crossed. We use a high-resolution ice sheet model to examine the mechanics of TG self-sustained retreat by nudging the grounding line just past the point of instability. We find that by modifying surface slope in the region of the grounding line, the rate of the forcing dictates the rate of retreat, even after the external forcing is removed. Grounding line retreats that begin faster proceed more rapidly because the shorter time interval for the grounding line to erode into the grounded ice sheet means relatively thicker ice and larger driving stress upstream of the boundary. Retreat is sensitive to short-duration re-advances associated with reduced external forcing where the bathymetry allows regrounding, even when an instability is invoked.

Thermal loading of natural streams

USGS Publications Warehouse

Jackman, Alan P.; Yotsukura, Nobuhiro

1977-01-01

The impact of thermal loading on the temperature regime of natural streams is investigated by mathematical models, which describe both transport (convection-diffusion) and decay (surface dissipation) of waste heat over 1-hour or shorter time intervals. The models are derived from the principle of conservation of thermal energy for application to one- and two-dimensional spaces. The basic concept in these models is to separate water temperature into two parts, (1) excess temperature due to thermal loading and (2) natural (ambient) temperature. This separation allows excess temperature to be calculated from the models without incoming radiation data. Natural temperature may either be measured in prototypes or calculated from the model. If use is made of the model, however, incoming radiation is required as input data. Comparison of observed and calculated temperatures in seven natural streams shows that the models are capable of predicting transient temperature regimes satisfactorily in most cases. (Woodard-USGS)

Influence of resources on Hermetia illucens (Diptera: Stratiomyidae) larval development.

PubMed

Nguyen, Trinh T X; Tomberlin, Jeffery K; Vanlaerhoven, Sherah

2013-07-01

Arthropod development can be used to determine the time of colonization of human remains to infer a minimum postmortem interval. The black soldier fly, Hermetia illucens L. (Diptera. Stratiomyidae) is native to North America and is unique in that its larvae can consume a wide range of decomposing organic material, including carrion. Larvae development was observed on six resources: control poultry feed, liver, manure, kitchen waste, fruits and vegetables, and fish rendering. Larvae fed manure were shorter, weighed less, and took longer to develop. Kitchen waste produced longer and heavier larvae, whereas larvae fed fish had almost 100% mortality. Black soldier flies can colonize human remains, which in many instances can coincide with food and organic wastes. Therefore, it is necessary to understand black soldier fly development on different food resources other than carrion tissue to properly estimate their age when recovered from human remains.

Nosewitness Identification: Effects of Lineup Size and Retention Interval.

PubMed

Alho, Laura; Soares, Sandra C; Costa, Liliana P; Pinto, Elisa; Ferreira, Jacqueline H T; Sorjonen, Kimmo; Silva, Carlos F; Olsson, Mats J

2016-01-01

Although canine identification of body odor (BO) has been widely used as forensic evidence, the concept of nosewitness identification by human observers was only recently put to the test. The results indicated that BOs associated with male characters in authentic crime videos could later be identified in BO lineup tests well above chance. To further evaluate nosewitness memory, we assessed the effects of lineup size (Experiment 1) and retention interval (Experiment 2), using a forced-choice memory test. The results showed that nosewitness identification works for all lineup sizes (3, 5, and 8 BOs), but that larger lineups compromise identification performance in similarity to observations from eye- and earwitness studies. Also in line with previous eye- and earwitness studies, but in disagreement with some studies on odor memory, Experiment 2 showed significant forgetting between shorter retention intervals (15 min) and longer retention intervals (1-week) using lineups of five BOs. Altogether this study shows that identification of BO in a forensic setting is possible and has limits and characteristics in line with witness identification through other sensory modalities.

Nosewitness Identification: Effects of Lineup Size and Retention Interval

PubMed Central

Alho, Laura; Soares, Sandra C.; Costa, Liliana P.; Pinto, Elisa; Ferreira, Jacqueline H. T.; Sorjonen, Kimmo; Silva, Carlos F.; Olsson, Mats J.

2016-01-01

Although canine identification of body odor (BO) has been widely used as forensic evidence, the concept of nosewitness identification by human observers was only recently put to the test. The results indicated that BOs associated with male characters in authentic crime videos could later be identified in BO lineup tests well above chance. To further evaluate nosewitness memory, we assessed the effects of lineup size (Experiment 1) and retention interval (Experiment 2), using a forced-choice memory test. The results showed that nosewitness identification works for all lineup sizes (3, 5, and 8 BOs), but that larger lineups compromise identification performance in similarity to observations from eye- and earwitness studies. Also in line with previous eye- and earwitness studies, but in disagreement with some studies on odor memory, Experiment 2 showed significant forgetting between shorter retention intervals (15 min) and longer retention intervals (1-week) using lineups of five BOs. Altogether this study shows that identification of BO in a forensic setting is possible and has limits and characteristics in line with witness identification through other sensory modalities. PMID:27303317

Modeling bipolar stimulation of cardiac tissue

NASA Astrophysics Data System (ADS)

Galappaththige, Suran K.; Gray, Richard A.; Roth, Bradley J.

2017-09-01

Unipolar stimulation of cardiac tissue is often used in the design of cardiac pacemakers because of the low current required to depolarize the surrounding tissue at rest. However, the advantages of unipolar over bipolar stimulation are not obvious at shorter coupling intervals when the tissue near the pacing electrode is relatively refractory. Therefore, this paper analyzes bipolar stimulation of cardiac tissue. The strength-interval relationship for bipolar stimulation is calculated using the bidomain model and a recently developed parsimonious ionic current model. The strength-interval curves obtained using different electrode separations and arrangements (electrodes placed parallel to the fibers versus perpendicular to the fibers) indicate that bipolar stimulation results in more complex activation patterns compared to unipolar stimulation. An unusually low threshold stimulus current is observed when the electrodes are close to each other (a separation of 1 mm) because of break excitation. Unlike for unipolar stimulation, anode make excitation is not present during bipolar stimulation, and an abrupt switch from anode break to cathode make excitation can cause dramatic changes in threshold with very small changes in the interval. These results could impact the design of implantable pacemakers and defibrillators.

Paradoxical Tuberculosis Immune Reconstitution Inflammatory Syndrome (TB-IRIS) in HIV Patients with Culture Confirmed Pulmonary Tuberculosis in India and the Potential Role of IL-6 in Prediction

PubMed Central

Porter, Brian O.; Chandrasekhar, Chockalingam; Venkatesan, Perumal; Menon, Pradeep A.; Subramanian, Sudha; Anbalagan, Selvaraj; Bhavani, Kannabiran P.; Sekar, Sathiyavelu; Padmapriyadarshini, Chandrasekaran; Kumar, Satagopan; Ravichandran, Narayanan; Raja, Krishnaraj; Bhanu, Kesavamurthy; Mahilmaran, Ayyamperumal; Sekar, Lakshmanan; Sher, Alan; Sereti, Irini; Swaminathan, Soumya

2013-01-01

Background The incidence, manifestations, outcome and clinical predictors of paradoxical TB-IRIS in patients with HIV and culture confirmed pulmonary tuberculosis (PTB) in India have not been studied prospectively. Methods HIV+ patients with culture confirmed PTB started on anti-tuberculosis therapy (ATT) were followed prospectively after anti-retroviral therapy (ART) initiation. Established criteria for IRIS diagnosis were used including decline in plasma HIV RNA at IRIS event. Pre-ART plasma levels of interleukin (IL)-6 and C-reactive protein (CRP) were measured. Univariate and multivariate logistic regression models were used to evaluate associations between baseline variables and IRIS. Results Of 57 patients enrolled, 48 had complete follow up data. Median ATT-ART interval was 28 days (interquartile range, IQR 14–47). IRIS events occurred in 26 patients (54.2%) at a median of 11 days (IQR: 7–16) after ART initiation. Corticosteroids were required for treatment of most IRIS events that resolved within a median of 13 days (IQR: 9–23). Two patients died due to CNS TB-IRIS. Lower CD4+ T-cell counts, higher plasma HIV RNA levels, lower CD4/CD8 ratio, lower hemoglobin, shorter ATT to ART interval, extra-pulmonary or miliary TB and higher plasma IL-6 and CRP levels at baseline were associated with paradoxical TB-IRIS in the univariate analysis. Shorter ATT to ART interval, lower hemoglobin and higher IL-6 and CRP levels remained significant in the multivariate analysis. Conclusion Paradoxical TB–IRIS frequently complicates HIV-TB therapy in India. IL-6 and CRP may assist in predicting IRIS events and serve as potential targets for immune interventions. PMID:23691062

Examining Temporal Sample Scale and Model Choice with Spatial Capture-Recapture Models in the Common Leopard Panthera pardus.

PubMed

Goldberg, Joshua F; Tempa, Tshering; Norbu, Nawang; Hebblewhite, Mark; Mills, L Scott; Wangchuk, Tshewang R; Lukacs, Paul

2015-01-01

Many large carnivores occupy a wide geographic distribution, and face threats from habitat loss and fragmentation, poaching, prey depletion, and human wildlife-conflicts. Conservation requires robust techniques for estimating population densities and trends, but the elusive nature and low densities of many large carnivores make them difficult to detect. Spatial capture-recapture (SCR) models provide a means for handling imperfect detectability, while linking population estimates to individual movement patterns to provide more accurate estimates than standard approaches. Within this framework, we investigate the effect of different sample interval lengths on density estimates, using simulations and a common leopard (Panthera pardus) model system. We apply Bayesian SCR methods to 89 simulated datasets and camera-trapping data from 22 leopards captured 82 times during winter 2010-2011 in Royal Manas National Park, Bhutan. We show that sample interval length from daily, weekly, monthly or quarterly periods did not appreciably affect median abundance or density, but did influence precision. We observed the largest gains in precision when moving from quarterly to shorter intervals. We therefore recommend daily sampling intervals for monitoring rare or elusive species where practicable, but note that monthly or quarterly sample periods can have similar informative value. We further develop a novel application of Bayes factors to select models where multiple ecological factors are integrated into density estimation. Our simulations demonstrate that these methods can help identify the "true" explanatory mechanisms underlying the data. Using this method, we found strong evidence for sex-specific movement distributions in leopards, suggesting that sexual patterns of space-use influence density. This model estimated a density of 10.0 leopards/100 km2 (95% credibility interval: 6.25-15.93), comparable to contemporary estimates in Asia. These SCR methods provide a guide to monitor and observe the effect of management interventions on leopards and other species of conservation interest.

Examining Temporal Sample Scale and Model Choice with Spatial Capture-Recapture Models in the Common Leopard Panthera pardus

PubMed Central

Goldberg, Joshua F.; Tempa, Tshering; Norbu, Nawang; Hebblewhite, Mark; Mills, L. Scott; Wangchuk, Tshewang R.; Lukacs, Paul

2015-01-01

Many large carnivores occupy a wide geographic distribution, and face threats from habitat loss and fragmentation, poaching, prey depletion, and human wildlife-conflicts. Conservation requires robust techniques for estimating population densities and trends, but the elusive nature and low densities of many large carnivores make them difficult to detect. Spatial capture-recapture (SCR) models provide a means for handling imperfect detectability, while linking population estimates to individual movement patterns to provide more accurate estimates than standard approaches. Within this framework, we investigate the effect of different sample interval lengths on density estimates, using simulations and a common leopard (Panthera pardus) model system. We apply Bayesian SCR methods to 89 simulated datasets and camera-trapping data from 22 leopards captured 82 times during winter 2010–2011 in Royal Manas National Park, Bhutan. We show that sample interval length from daily, weekly, monthly or quarterly periods did not appreciably affect median abundance or density, but did influence precision. We observed the largest gains in precision when moving from quarterly to shorter intervals. We therefore recommend daily sampling intervals for monitoring rare or elusive species where practicable, but note that monthly or quarterly sample periods can have similar informative value. We further develop a novel application of Bayes factors to select models where multiple ecological factors are integrated into density estimation. Our simulations demonstrate that these methods can help identify the “true” explanatory mechanisms underlying the data. Using this method, we found strong evidence for sex-specific movement distributions in leopards, suggesting that sexual patterns of space-use influence density. This model estimated a density of 10.0 leopards/100 km2 (95% credibility interval: 6.25–15.93), comparable to contemporary estimates in Asia. These SCR methods provide a guide to monitor and observe the effect of management interventions on leopards and other species of conservation interest. PMID:26536231

The relationship between quality of sleep and night shift rotation interval.

PubMed

Kim, Jae Youn; Chae, Chang Ho; Kim, Young Ouk; Son, Jun Seok; Kim, Ja Hyun; Kim, Chan Woo; Park, Hyoung Ouk; Lee, Jun Ho; Kwon, Soon Il; Kwon, Sun Il

2015-01-01

Shift work is closely related with workers' health. In particular, sleep is thought to be affected by shift work. In addition, shift work has been reported to be associated with the type or direction of shift rotation, number of consecutive night shifts, and number of off-duty days. We aimed to analyze the association between the night shift rotation interval and the quality of sleep reported by Korean female shift workers. In total, 2,818 female shift workers from the manufacturing industry who received an employee physical examination at a single university hospital from January to August in 2014 were included. Subjects were classified into three groups (A, B, and C) by their night shift rotation interval. The quality of sleep was measured using the Korean version of the Pittsburgh Sleep Quality Index (PSQI). Descriptive analysis, univariate logistic regression, and multivariate logistic regression were performed. With group A as the reference, the odds ratio (OR) for having a seriously low quality of sleep was 1.456 (95% CI 1.171-1.811) and 2.348 (95% CI 1.852-2.977) for groups B and C, respectively. Thus, group C with the shortest night shift rotation interval was most likely to have a low quality of sleep. After adjustment for age, obesity, smoking status, alcohol consumption, exercise, being allowed to sleep during night shifts, work experience, and shift work experience, groups B and C had ORs of 1.419 (95% CI 1.134-1.777) and 2.238 (95% CI 1.737-2.882), respectively, compared to group A. Our data suggest that a shorter night shift rotation interval does not provide enough recovery time to adjust the circadian rhythm, resulting in a low quality of sleep. Because shift work is influenced by many different factors, future studies should aim to determine the most optimal shift work model and collect accurate, prospective data.

Conducting an acute intense interval exercise session during the Ramadan fasting month: what is the optimal time of the day?

PubMed

Aziz, Abdul Rashid; Chia, Michael Yong Hwa; Low, Chee Yong; Slater, Gary John; Png, Weileen; Teh, Kong Chuan

2012-10-01

This study examines the effects of Ramadan fasting on performance during an intense exercise session performed at three different times of the day, i.e., 08:00, 18:00, and 21:00 h. The purpose was to determine the optimal time of the day to perform an acute high-intensity interval exercise during the Ramadan fasting month. After familiarization, nine trained athletes performed six 30-s Wingate anaerobic test (WAnT) cycle bouts followed by a time-to-exhaustion (T(exh)) cycle on six separate randomized and counterbalanced occasions. The three time-of-day nonfasting (control, CON) exercise sessions were performed before the Ramadan month, and the three corresponding time-of-day Ramadan fasting (RAM) exercise sessions were performed during the Ramadan month. Note that the 21:00 h session during Ramadan month was conducted in the nonfasted state after the breaking of the day's fast. Total work (TW) completed during the six WAnT bouts was significantly lower during RAM compared to CON for the 08:00 and 18:00 h (p < .017; effect size [d] = .55 [small] and .39 [small], respectively) sessions, but not for the 21:00 h (p = .03, d = .18 [trivial]) session. The T(exh) cycle duration was significantly shorter during RAM than CON in the 18:00 (p < .017, d = .93 [moderate]) session, but not in the 08:00 (p = .03, d = .57 [small]) and 21:00 h (p = .96, d = .02 [trivial]) sessions. In conclusion, Ramadan fasting had a small to moderate, negative impact on quality of performance during an acute high-intensity exercise session, particularly during the period of the daytime fast. The optimal time to conduct an acute high-intensity exercise session during the Ramadan fasting month is in the evening, after the breaking of the day's fast.

Estimating the Seasonal Importance of Precipitation to Plant Source Water over Time and Space with Water Isotopes

NASA Astrophysics Data System (ADS)

Nelson, D. B.; Kahmen, A.

2017-12-01

The stable isotopic composition of hydrogen and oxygen are physical properties of water molecules that can carry information on their sources or transport histories. This provides a useful tool for assessing the importance of rainfall at different times of the year for plant growth, provided that rainwater values vary over time and that waters do not partially evaporate after deposition. We tested the viability of this approach using data from samples collected at nineteen sites throughout Europe at monthly intervals over two consecutive growing seasons in 2014 and 2015. We compared isotope measurements of plant xylem water with soil water from multiple depths, and measured and modeled precipitation isotope values. Paired analyses of oxygen and hydrogen isotope values were used to screen out a limited number of water samples that were influenced by evaporation, with the majority of all water samples indicating meteoric sources. The isotopic composition of soil and xylem waters varied over the course of an individual growing season, with many trending towards more enriched values, suggesting integration of the plant-relevant water pool at a timescale shorter than the annual mean. We then quantified how soil water residence times varied at each site by calculating the interval between measured xylem water and the most recently preceding match in modeled precipitation isotope values. Results suggest a generally increasing interval between rainfall and plant uptake throughout each year, with source water corresponding to dates in the spring, likely reflecting a combination of spring rain, and mixing with winter and summer precipitation. The seasonally evolving spatial distribution of source water-precipitation lag values was then modeled as a function of location and climatology to develop continental-scale predictions. This spatial portrait of the average date for filling the plant source water pool provides insights on the seasonal importance of rainfall for plant growth. It also permits continental scale predictions of monthly plant source water isotope values, with applications to improving isotopic paleoclimate proxies from plants such as tree rings or sedimentary leaf waxes, and for using oxygen and hydrogen isotopes to track the origins of agricultural products.

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...

Examining Delay Intervals in the Diagnosis and Treatment of Primary Open Angle Glaucoma in an Egyptian Population and Its Impact on Lifestyle

PubMed Central

Abu Hussein, Nahla B.; Habib, Ahmed E.; El Sayed, Yasmine M.

2016-01-01

Purpose. To examine causes as well as extent of delay in diagnosis and treatment of primary open angle glaucoma patients in a sample of Egyptians. Patients and Methods. 440 patients with primary open angle glaucoma were interviewed to evaluate delay in their diagnosis and treatment. The extent and cause of delay were investigated. The total delay interval, if any, was correlated with socioeconomic and other factors. Results. The median total delay was one year, with 50% of patients having a total delay of 1 year or less, of which 25% exhibited zero total delay. 25% of patients had a delay ranging from 1 to 3 years, and 25% had a total delay ranging from 3 to 27 years. Diagnostic delay accounted for 43.03% of cases. Longer delays were met in patients with certain socioeconomic factors. Patients with a positive family history of glaucoma displayed shorter delay periods. Conclusion. Significant delay in the diagnosis and treatment of glaucoma was found. Poor socioeconomic status seems to hinder timely diagnosis and treatment of POAG. Certain socioeconomic factors seem to correlate with the extent of delay. More effort is thus needed to subsidize the cost of investigations and treatment for glaucoma patients. PMID:28116140

Acidosis slows electrical conduction through the atrio-ventricular node

PubMed Central

Nisbet, Ashley M.; Burton, Francis L.; Walker, Nicola L.; Craig, Margaret A.; Cheng, Hongwei; Hancox, Jules C.; Orchard, Clive H.; Smith, Godfrey L.

2014-01-01

Acidosis affects the mechanical and electrical activity of mammalian hearts but comparatively little is known about its effects on the function of the atrio-ventricular node (AVN). In this study, the electrical activity of the epicardial surface of the left ventricle of isolated Langendorff-perfused rabbit hearts was examined using optical methods. Perfusion with hypercapnic Tyrode's solution (20% CO2, pH 6.7) increased the time of earliest activation (Tact) from 100.5 ± 7.9 to 166.1 ± 7.2 ms (n = 8) at a pacing cycle length (PCL) of 300 ms (37°C). Tact increased at shorter PCL, and the hypercapnic solution prolonged Tact further: at 150 ms PCL, Tact was prolonged from 131.0 ± 5.2 to 174.9 ± 16.3 ms. 2:1 AVN block was common at shorter cycle lengths. Atrial and ventricular conduction times were not significantly affected by the hypercapnic solution suggesting that the increased delay originated in the AVN. Isolated right atrial preparations were superfused with Tyrode's solutions at pH 7.4 (control), 6.8 and 6.3. Low pH prolonged the atrial-Hisian (AH) interval, the AVN effective and functional refractory periods and Wenckebach cycle length significantly. Complete AVN block occurred in 6 out of 9 preparations. Optical imaging of conduction at the AV junction revealed increased conduction delay in the region of the AVN, with less marked effects in atrial and ventricular tissue. Thus acidosis can dramatically prolong the AVN delay, and in combination with short cycle lengths, this can cause partial or complete AVN block and is therefore implicated in the development of brady-arrhythmias in conditions of local or systemic acidosis. PMID:25009505

Acidosis slows electrical conduction through the atrio-ventricular node.

PubMed

Nisbet, Ashley M; Burton, Francis L; Walker, Nicola L; Craig, Margaret A; Cheng, Hongwei; Hancox, Jules C; Orchard, Clive H; Smith, Godfrey L

2014-01-01

Acidosis affects the mechanical and electrical activity of mammalian hearts but comparatively little is known about its effects on the function of the atrio-ventricular node (AVN). In this study, the electrical activity of the epicardial surface of the left ventricle of isolated Langendorff-perfused rabbit hearts was examined using optical methods. Perfusion with hypercapnic Tyrode's solution (20% CO2, pH 6.7) increased the time of earliest activation (Tact) from 100.5 ± 7.9 to 166.1 ± 7.2 ms (n = 8) at a pacing cycle length (PCL) of 300 ms (37°C). Tact increased at shorter PCL, and the hypercapnic solution prolonged Tact further: at 150 ms PCL, Tact was prolonged from 131.0 ± 5.2 to 174.9 ± 16.3 ms. 2:1 AVN block was common at shorter cycle lengths. Atrial and ventricular conduction times were not significantly affected by the hypercapnic solution suggesting that the increased delay originated in the AVN. Isolated right atrial preparations were superfused with Tyrode's solutions at pH 7.4 (control), 6.8 and 6.3. Low pH prolonged the atrial-Hisian (AH) interval, the AVN effective and functional refractory periods and Wenckebach cycle length significantly. Complete AVN block occurred in 6 out of 9 preparations. Optical imaging of conduction at the AV junction revealed increased conduction delay in the region of the AVN, with less marked effects in atrial and ventricular tissue. Thus acidosis can dramatically prolong the AVN delay, and in combination with short cycle lengths, this can cause partial or complete AVN block and is therefore implicated in the development of brady-arrhythmias in conditions of local or systemic acidosis.

Life history of the Glanville fritillary butterfly in fragmented versus continuous landscapes

PubMed Central

Duplouy, Anne; Ikonen, Suvi; Hanski, Ilkka

2013-01-01

Habitat loss and fragmentation threaten the long-term viability of innumerable species of plants and animals. At the same time, habitat fragmentation may impose strong natural selection and lead to evolution of life histories with possible consequences for demographic dynamics. The Baltic populations of the Glanville fritillary butterfly (Melitaea cinxia) inhabit regions with highly fragmented habitat (networks of small dry meadows) as well as regions with extensive continuous habitat (calcareous alvar grasslands). Here, we report the results of common garden studies on butterflies originating from two highly fragmented landscapes (FL) in Finland and Sweden and from two continuous landscapes (CL) in Sweden and Estonia, conducted in a large outdoor cage (32 by 26 m) and in the laboratory. We investigated a comprehensive set of 51 life-history traits, including measures of larval growth and development, flight performance, and adult reproductive behavior. Seventeen of the 51 traits showed a significant difference between fragmented versus CL. Most notably, the growth rate of postdiapause larvae and several measures of flight capacity, including flight metabolic rate, were higher in butterflies from fragmented than CL. Females from CL had shorter intervals between consecutive egg clutches and somewhat higher life-time egg production, but shorter longevity, than females from FL. These results are likely to reflect the constant opportunities for oviposition in females living in continuous habitats, while the more dispersive females from FL allocate more resources to dispersal capacity at the cost of egg maturation rate. This study supports theoretical predictions about small population sizes and high rate of population turnover in fragmented habitats selecting for increased rate of dispersal, but the results also indicate that many other life-history traits apart from dispersal are affected by the degree of habitat fragmentation. PMID:24455144

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.

Effects of Climatic Region on Peritonitis Risk, Microbiology, Treatment, and Outcomes: a Multicenter Registry Study

PubMed Central

Cho, Yeoungjee; Badve, Sunil V.; Hawley, Carmel M.; McDonald, Stephen P.; Brown, Fiona G.; Boudville, Neil; Wiggins, Kathryn J.; Bannister, Kym M.; Clayton, Philip; Johnson, David W.

2013-01-01

♦ Background: The impact of climatic variations on peritoneal dialysis (PD)-related peritonitis has not been studied in detail. The aim of the current study was to determine whether various climatic zones influenced the probability of occurrence or the clinical outcomes of peritonitis. ♦ Methods: Using ANZDATA registry data, the study in cluded all Australian patients receiving PD between 1 October 2003 and 31 December 2008. Climatic regions were defined according to the Köppen classification. ♦ Results: The overall peritonitis rate was 0.59 episodes per patient-year. Most of the patients lived in Temperate regions (65%), with others residing in Subtropical (26%), Tropical (6%), and Other climatic regions (Desert, 0.6%; Grassland, 2.3%). Compared with patients in Temperate regions, those in Tropical regions demonstrated significantly higher overall peritonitis rates and a shorter time to a first peritonitis episode [adjusted hazard ratio: 1.15; 95% confidence interval (CI): 1.01 to 1.31]. Culture-negative peritonitis was significantly less likely in Tropical regions [adjusted odds ratio (OR): 0.42; 95% CI: 0.25 to 0.73]; its occurrence in Subtropical and Other regions was comparable to that in Temperate regions. Fungal peritonitis was independently associated with Tropical regions (OR: 2.18; 95% CI: 1.22 to 3.90) and Other regions (OR: 3.46; 95% CI: 1.73 to 6.91), where rates of antifungal prophylaxis were also lower. Outcomes after first peritonitis episodes were comparable in all groups. ♦ Conclusions: Tropical regions were associated with a higher overall peritonitis rate (including fungal peritonitis) and a shorter time to a first peritonitis episode. Augmented peritonitis prophylactic measures such as antifungal therapy and exit-site care should be considered in PD patients residing in Tropical climates. PMID:22942270

Minimally Invasive Surgical Staging in Early-stage Ovarian Carcinoma: A Systematic Review and Meta-analysis.

PubMed

Bogani, Giorgio; Borghi, Chiara; Leone Roberti Maggiore, Umberto; Ditto, Antonino; Signorelli, Mauro; Martinelli, Fabio; Chiappa, Valentina; Lopez, Carlos; Sabatucci, Ilaria; Scaffa, Cono; Indini, Alice; Ferrero, Simone; Lorusso, Domenica; Raspagliesi, Francesco

Few studies investigated the efficacy and safety of minimally invasive surgery for the treatment of early-stage epithelial ovarian cancer (eEOC). In this context, we aimed to review the current evidence comparing laparoscopy and the laparotomic approach for staging procedures in eEOC. This systematic review was registered in the International Prospective Register of Systematic Reviews. Overall, 3065 patients were included: 1450 undergoing laparoscopy and 1615 undergoing laparotomic staging. Patients undergoing laparoscopy experienced a longer (but not statistically significant) operative time (weighted mean difference [WMD] = 28.3 minutes; 95% confidence interval [CI], -2.59 to 59.2), a lower estimated blood loss (WMD = -156.5 mL; 95% CI, -216.4 to -96.5), a shorter length of hospital stay (WMD = -3.7 days; 95% CI, -5.2 to -2.1), and a lower postoperative complication rate (odds ratio [OR] = 0.48; 95% CI, 0.29-0.81) than patients undergoing laparotomy. The upstaging (OR = 0.81; 95% CI, 0.55-1.20) and cyst rupture (OR = 1.32; 95% CI, 0.52-3.38) rates were similar between groups. Laparoscopic staging is associated with a shorter time to chemotherapy than laparotomic procedures (WMD = -5.16 days; 95% CI, -8.68 to -1.64). Survival outcomes were not influenced by the route of surgery. Pooled data suggested that the minimally invasive surgical approach is equivalent to laparotomy for the treatment of eEOC and may be superior in terms of perioperative outcomes. However, because of the low level of evidence of the included studies, further randomized trials are warranted. Copyright © 2017 AAGL. Published by Elsevier Inc. All rights reserved.

Why Has the Number of Scientific Retractions Increased?

PubMed Central

Steen, R. Grant; Casadevall, Arturo; Fang, Ferric C.

2013-01-01

Background The number of retracted scientific publications has risen sharply, but it is unclear whether this reflects an increase in publication of flawed articles or an increase in the rate at which flawed articles are withdrawn. Methods and Findings We examined the interval between publication and retraction for 2,047 retracted articles indexed in PubMed. Time-to-retraction (from publication of article to publication of retraction) averaged 32.91 months. Among 714 retracted articles published in or before 2002, retraction required 49.82 months; among 1,333 retracted articles published after 2002, retraction required 23.82 months (p<0.0001). This suggests that journals are retracting papers more quickly than in the past, although recent articles requiring retraction may not have been recognized yet. To test the hypothesis that time-to-retraction is shorter for articles that receive careful scrutiny, time-to-retraction was correlated with journal impact factor (IF). Time-to-retraction was significantly shorter for high-IF journals, but only ∼1% of the variance in time-to-retraction was explained by increased scrutiny. The first article retracted for plagiarism was published in 1979 and the first for duplicate publication in 1990, showing that articles are now retracted for reasons not cited in the past. The proportional impact of authors with multiple retractions was greater in 1972–1992 than in the current era (p<0.001). From 1972–1992, 46.0% of retracted papers were written by authors with a single retraction; from 1993 to 2012, 63.1% of retracted papers were written by single-retraction authors (p<0.001). Conclusions The increase in retracted articles appears to reflect changes in the behavior of both authors and institutions. Lower barriers to publication of flawed articles are seen in the increase in number and proportion of retractions by authors with a single retraction. Lower barriers to retraction are apparent in an increase in retraction for “new” offenses such as plagiarism and a decrease in the time-to-retraction of flawed work. PMID:23861902

A randomized trial of misoprostol and oxytocin for induction of labor: safety and efficacy.

PubMed

Kramer, R L; Gilson, G J; Morrison, D S; Martin, D; Gonzales, J L; Qualls, C R

1997-03-01

To compare the safety and efficacy of misoprostol and oxytocin for induction of labor. One hundred thirty women requiring induction of labor were randomized to receive either intravenous oxytocin or 100 micrograms misoprostol, administered intravaginally every 4 hours until labor was established. Compared with women receiving oxytocin, a greater percentage of women in the misoprostol group had Bishop scores of 3 or less (58 versus 38%, P < .05). Nonetheless, the median induction-to-delivery interval was significantly shorter (585 versus 885 minutes, P < .001) in the misoprostol group. Women in the misoprostol group were more likely to deliver vaginally within 24 hours of the start of induction (77 versus 55%, P < .002). Epidural analgesia was used more frequently in women receiving oxytocin than in those receiving misoprostol (73 versus 50%, P = .025). The total percentage of cesarean deliveries was not significantly different, although the percentage of cesarean deliveries for dystocia was lower in the misoprostol group (8 versus 21%, P = .02). Uterine tachysystole was significantly more common (70 versus 11%, P < .001) and hospital charges significantly less with misoprostol. Compared with oxytocin for labor induction, misoprostol results in a shorter induction-to-delivery interval, a reduction in the rate of cesarean delivery for dystocia, and a decreased use of epidural analgesia. Uterine tachysystole is significantly more common with the use of misoprostol.

Childhood cancer and factors related to prolonged diagnostic intervals: a Danish population-based study

PubMed Central

Ahrensberg, J M; Olesen, F; Hansen, R P; Schrøder, H; Vedsted, P

2013-01-01

Background: Early diagnosis of childhood cancer provides hope for better prognoses. Shorter diagnostic intervals (DI) in primary care require better knowledge of the association between presenting symptoms, interpretation of symptoms and the wording of the referral letter. Methods: A Danish nationwide population-based study. Data on 550 children aged <15 years with an incident cancer diagnosis (January 2007–December 2010) were collected through questionnaires to parents (response rate=69%) and general practitioners (GPs) (response rate=87%). The DI from the first presentation in general practice until diagnosis was categorised as short or long based on quartiles. Associations between variables and long DIs were assessed using logistic regression. Results: The GPs interpreted symptoms as ‘vague' in 25.4%, ‘serious' in 50.0% and ‘alarm' in 19.0% of cases. Symptom interpretation varied by cancer type (P<0.001) and was associated with the DI (P<0.001). Vomiting was associated with a shorter DI for central nervous system (CNS) tumours, and pain with a longer DI for leukaemia. Referral letter wording was associated with DI (P<0.001); the shortest DIs were observed when cancer suspicion was raised in the letter. Conclusion: The GPs play an important role in recognising early signs of childhood cancer as their symptom interpretation and referral wording have a profound impact on the diagnostic process. PMID:23449354

Eye Movements in Darkness Modulate Self-Motion Perception.

PubMed

Clemens, Ivar Adrianus H; Selen, Luc P J; Pomante, Antonella; MacNeilage, Paul R; Medendorp, W Pieter

2017-01-01

During self-motion, humans typically move the eyes to maintain fixation on the stationary environment around them. These eye movements could in principle be used to estimate self-motion, but their impact on perception is unknown. We had participants judge self-motion during different eye-movement conditions in the absence of full-field optic flow. In a two-alternative forced choice task, participants indicated whether the second of two successive passive lateral whole-body translations was longer or shorter than the first. This task was used in two experiments. In the first ( n = 8), eye movements were constrained differently in the two translation intervals by presenting either a world-fixed or body-fixed fixation point or no fixation point at all (allowing free gaze). Results show that perceived translations were shorter with a body-fixed than a world-fixed fixation point. A linear model indicated that eye-movement signals received a weight of ∼25% for the self-motion percept. This model was independently validated in the trials without a fixation point (free gaze). In the second experiment ( n = 10), gaze was free during both translation intervals. Results show that the translation with the larger eye-movement excursion was judged more often to be larger than chance, based on an oculomotor choice probability analysis. We conclude that eye-movement signals influence self-motion perception, even in the absence of visual stimulation.

Eye Movements in Darkness Modulate Self-Motion Perception

PubMed Central

Pomante, Antonella

2017-01-01

Abstract During self-motion, humans typically move the eyes to maintain fixation on the stationary environment around them. These eye movements could in principle be used to estimate self-motion, but their impact on perception is unknown. We had participants judge self-motion during different eye-movement conditions in the absence of full-field optic flow. In a two-alternative forced choice task, participants indicated whether the second of two successive passive lateral whole-body translations was longer or shorter than the first. This task was used in two experiments. In the first (n = 8), eye movements were constrained differently in the two translation intervals by presenting either a world-fixed or body-fixed fixation point or no fixation point at all (allowing free gaze). Results show that perceived translations were shorter with a body-fixed than a world-fixed fixation point. A linear model indicated that eye-movement signals received a weight of ∼25% for the self-motion percept. This model was independently validated in the trials without a fixation point (free gaze). In the second experiment (n = 10), gaze was free during both translation intervals. Results show that the translation with the larger eye-movement excursion was judged more often to be larger than chance, based on an oculomotor choice probability analysis. We conclude that eye-movement signals influence self-motion perception, even in the absence of visual stimulation. PMID:28144623

An empirical study of race times in recreational endurance runners.

PubMed

Vickers, Andrew J; Vertosick, Emily A

2016-01-01

Studies of endurance running have typically involved elite athletes, small sample sizes and measures that require special expertise or equipment. We examined factors associated with race performance and explored methods for race time prediction using information routinely available to a recreational runner. An Internet survey was used to collect data from recreational endurance runners (N = 2303). The cohort was split 2:1 into a training set and validation set to create models to predict race time. Sex, age, BMI and race training were associated with mean race velocity for all race distances. The difference in velocity between males and females decreased with increasing distance. Tempo runs were more strongly associated with velocity for shorter distances, while typical weekly training mileage and interval training had similar associations with velocity for all race distances. The commonly used Riegel formula for race time prediction was well-calibrated for races up to a half-marathon, but dramatically underestimated marathon time, giving times at least 10 min too fast for half of runners. We built two models to predict marathon time. The mean squared error for Riegel was 381 compared to 228 (model based on one prior race) and 208 (model based on two prior races). Our findings can be used to inform race training and to provide more accurate race time predictions for better pacing.

Collective Attention and Stock Prices: Evidence from Google Trends Data on Standard and Poor's 100

PubMed Central

Heiberger, Raphael H.

2015-01-01

Today´s connected world allows people to gather information in shorter intervals than ever before, widely monitored by massive online data sources. As a dramatic economic event, recent financial crisis increased public interest for large companies considerably. In this paper, we exploit this change in information gathering behavior by utilizing Google query volumes as a "bad news" indicator for each corporation listed in the Standard and Poor´s 100 index. Our results provide not only an investment strategy that gains particularly in times of financial turmoil and extensive losses by other market participants, but reveal new sectoral patterns between mass online behavior and (bearish) stock market movements. Based on collective attention shifts in search queries for individual companies, hence, these findings can help to identify early warning signs of financial systemic risk. However, our disaggregated data also illustrate the need for further efforts to understand the influence of collective attention shifts on financial behavior in times of regular market activities with less tremendous changes in search volumes. PMID:26258498

CO 2 laser treatment system of tinea pedis

NASA Astrophysics Data System (ADS)

Ueda, Masahiro

The CO 2 laser treatment system 'Melase 1000' has been developed for the treatment of Tinea pedis and the efficacy of the treatment using the system and its optimum irradiation condition are studied. The present system enables us to make the healing time of Tinea pedis treatment far shorter than conventional pharmaceuticals. This is in spite of using heat levels low enough for patients not to feel discomfort. Features offered by the system are a safe-and-easy operation and a stable laser power for a prolonged use. The efficacy of the present therapy is excellent; only two treatments a week for three weeks, i.e. six consecutive treatments, attained an improvement rate of 71.8% in the skin findings and a 'usefulness' of 66.2% determined from cases rated as 'useful' or 'better'. The optimum laser irradiation condition for a single treatment found in this experiment is a light fluence of about 3 J/cm 2 and four laser pulses with a time interval between pulses of 1 s for a typical horny layer thinner than 0.5 mm.

Wildfires in Northern Siberian Larch Dominated Communities

NASA Technical Reports Server (NTRS)

Khaurk, Viacheslav I.; Ranson, Kenneth J.; Dvinskaya, Maria L.; Im, Sergey T.

2011-01-01

The fire history of the northern larch forests within the permafrost zone in a portion of northern Siberia (approx 66 deg N, 100 deg E) was studied. Since there is little to no human activities in this area fires within the study area were mostly caused by lightning. Fire return intervals (FRI) were estimated based on burn marks on tree stems and dates of tree natality. FRI values varied from 130 yr to 350 yr with 200 +/- 50 yr mean. In southerly larch dominated communities FRI was found to be shorter (77 +/- 20 yr at approx 61 deg. N, and 82 +/- 7 at 64 deg N), and longer at the northern boundary (approx 71 deg) of larch stands (320 +/- 50 yr). During the Little Ice Age period in the 16th to 18th centuries FRI was approximately twice as long as recorded in this study. Fire caused changes in the soil including increases in soil drainage and permafrost thawing depth and a radial growth increase of about 2 times (with more than 6 times observed). This effect may simulate the predicted warming impact on the larch growth in the permafrost zone.

Environmental cue saliency influences the vividness of a remote spatial memory in rats.

PubMed

Lopez, Joëlle; de Vasconcelos, Anne Pereira; Cassel, Jean-Christophe

2008-07-01

The Morris water maze is frequently used to evaluate the acquisition and retrieval of spatial memories. Few experiments, however, have investigated the effects of environmental cue saliency on the strength or persistence of such memories after a short vs. long post-acquisition interval. Using a Morris water maze, we therefore tested in rats the effect of the saliency of distal cues on the vividness of a recent (5 days) vs. remote (25 days) memory. Rats trained in a cue-enriched vs. a cue-impoverished context showed a better overall level of performance during acquisition. Furthermore, the probe trials revealed that the rats trained and tested in the cue-impoverished context (1) spent less time in the target quadrant at the 25-day delay, and (2) swam shorter distances in the target area, with fewer crossings at both 5- and 25-day delays, as compared to their counterparts trained and tested in the cue-enriched context. Thus, the memory trace formed in the cue-enriched context shows better resistance to time, suggesting an implication of cue saliency in the vividness of a spatial memory.

Collective attention and stock prices: evidence from Google Trends data on Standard and Poor's 100.

PubMed

Heiberger, Raphael H

2015-01-01

Today´s connected world allows people to gather information in shorter intervals than ever before, widely monitored by massive online data sources. As a dramatic economic event, recent financial crisis increased public interest for large companies considerably. In this paper, we exploit this change in information gathering behavior by utilizing Google query volumes as a "bad news" indicator for each corporation listed in the Standard and Poor´s 100 index. Our results provide not only an investment strategy that gains particularly in times of financial turmoil and extensive losses by other market participants, but reveal new sectoral patterns between mass online behavior and (bearish) stock market movements. Based on collective attention shifts in search queries for individual companies, hence, these findings can help to identify early warning signs of financial systemic risk. However, our disaggregated data also illustrate the need for further efforts to understand the influence of collective attention shifts on financial behavior in times of regular market activities with less tremendous changes in search volumes.

Infant Pupil Diameter Changes in Response to Others' Positive and Negative Emotions

PubMed Central

Geangu, Elena; Hauf, Petra; Bhardwaj, Rishi; Bentz, Wolfram

2011-01-01

It has been suggested that infants resonate emotionally to others' positive and negative affect displays, and that these responses become stronger towards emotions with negative valence around the age of 12-months. In this study we measured 6- and 12-month-old infants' changes in pupil diameter when presented with the image and sound of peers experiencing happiness, distress and an emotionally neutral state. For all participants the perception of another's distress triggered larger pupil diameters. Perceiving other's happiness also induced larger pupil diameters but for shorter time intervals. Importantly, we also found evidence for an asymmetry in autonomous arousal towards positive versus negative emotional displays. Larger pupil sizes for another's distress compared to another's happiness were recorded shortly after stimulus onset for the older infants, and in a later time window for the 6-month-olds. These findings suggest that arousal responses for negative as well as for positive emotions are present in the second half of the first postnatal year. Importantly, an asymmetry with stronger responses for negative emotions seems to be already present at this age. PMID:22110605

Spin-lattice relaxation of optically polarized nuclei in p -type GaAs

NASA Astrophysics Data System (ADS)

Kotur, M.; Dzhioev, R. I.; Vladimirova, M.; Cherbunin, R. V.; Sokolov, P. S.; Yakovlev, D. R.; Bayer, M.; Suter, D.; Kavokin, K. V.

2018-04-01

Spin-lattice relaxation of the nuclear spin system in p -type GaAs is studied using a three-stage experimental protocol including optical pumping and measuring the difference of the nuclear spin polarization before and after a dark interval of variable length. This method allows us to measure the spin-lattice relaxation time T1 of optically pumped nuclei "in the dark," that is, in the absence of illumination. The measured T1 values fall into the subsecond time range, being three orders of magnitude shorter than in earlier studied n -type GaAs. The drastic difference is further emphasized by magnetic-field and temperature dependencies of T1 in p -GaAs, showing no similarity to those in n -GaAs. This unexpected behavior finds its explanation in the spatial selectivity of the optical pumping in p -GaAs, that is only efficient in the vicinity of shallow donors, together with the quadrupole relaxation of nuclear spins, which is induced by electric fields within closely spaced donor-acceptor pairs. The developed theoretical model explains the whole set of experimental results.

Bedtime misalignment and progression of breast cancer.

PubMed

Hahm, Bong-Jin; Jo, Booil; Dhabhar, Firdaus S; Palesh, Oxana; Aldridge-Gerry, Arianna; Bajestan, Sepideh N; Neri, Eric; Nouriani, Bita; Spiegel, David; Zeitzer, Jamie M

2014-03-01

Disruption of circadian rhythms, which frequently occurs during night shift work, may be associated with cancer progression. The effect of chronotype (preference for behaviors such as sleep, work, or exercise to occur at particular times of day, with an associated difference in circadian physiology) and alignment of bedtime (preferred vs. habitual), however, have not yet been studied in the context of cancer progression in women with breast cancer. Chronotype and alignment of actual bedtime with preferred chronotype were examined using the Morningness-Eveningness Scale (MEQ) and sleep-wake log among 85 women with metastatic breast cancer. Their association with disease-free interval (DFI) was retrospectively examined using the Cox proportional hazards model. Median DFI was 81.9 months for women with aligned bedtimes ("going to bed at preferred bedtime") (n = 72), and 46.9 months for women with misaligned bedtimes ("going to bed later or earlier than the preferred bedtime") (n = 13) (log rank p = 0.001). In a multivariate Cox proportional hazard model, after controlling for other significant predictors of DFI, including chronotype (morning type/longer DFI; HR = 0.539, 95% CI = 0.320-0.906, p = 0.021), estrogen receptor (ER) status at initial diagnosis (negative/shorter DFI; HR = 2.169, 95% CI = 1.124-4.187, p = 0.028) and level of natural-killer cell count (lower levels/shorter DFI; HR = 1.641, 95% CI = 1.000-2.695, p = 0.050), misaligned bedtimes was associated with shorter DFI, compared to aligned bedtimes (HR = 3.180, 95% CI = 1.327-7.616, p = 0.018). Our data indicate that a misalignment of bedtime on a daily basis, an indication of circadian disruption, is associated with more rapid breast cancer progression as measured by DFI. Considering the limitations of small sample size and study design, a prospective study with a larger sample is necessary to explore their causal relationship and underlying mechanisms.

Termination of seizure clusters is related to the duration of focal seizures.

PubMed

Ferastraoaru, Victor; Schulze-Bonhage, Andreas; Lipton, Richard B; Dümpelmann, Matthias; Legatt, Alan D; Blumberg, Julie; Haut, Sheryl R

2016-06-01

Clustered seizures are characterized by shorter than usual interseizure intervals and pose increased morbidity risk. This study examines the characteristics of seizures that cluster, with special attention to the final seizure in a cluster. This is a retrospective analysis of long-term inpatient monitoring data from the EPILEPSIAE project. Patients underwent presurgical evaluation from 2002 to 2009. Seizure clusters were defined by the occurrence of at least two consecutive seizures with interseizure intervals of <4 h. Other definitions of seizure clustering were examined in a sensitivity analysis. Seizures were classified into three contextually defined groups: isolated seizures (not meeting clustering criteria), terminal seizure (last seizure in a cluster), and intracluster seizures (any other seizures within a cluster). Seizure characteristics were compared among the three groups in terms of duration, type (focal seizures remaining restricted to one hemisphere vs. evolving bilaterally), seizure origin, and localization concordance among pairs of consecutive seizures. Among 92 subjects, 77 (83%) had at least one seizure cluster. The intracluster seizures were significantly shorter than the last seizure in a cluster (p = 0.011), whereas the last seizure in a cluster resembled the isolated seizures in terms of duration. Although focal only (unilateral), seizures were shorter than seizures that evolved bilaterally and there was no correlation between the seizure type and the seizure position in relation to a cluster (p = 0.762). Frontal and temporal lobe seizures were more likely to cluster compared with other localizations (p = 0.009). Seizure pairs that are part of a cluster were more likely to have a concordant origin than were isolated seizures. Results were similar for the 2 h definition of clustering, but not for the 8 h definition of clustering. We demonstrated that intracluster seizures are short relative to isolated seizures and terminal seizures. Frontal and temporal lobe seizures are more likely to cluster. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

Surgeon-Performed Ultrasound-Guided Fine-Needle Aspiration Cytology (SP-US-FNAC) Shortens Time for Diagnosis of Thyroid Nodules.

PubMed

Gu, Wei Xiang; Tan, Chuen Seng; Ho, Thomas W T

2014-06-01

Ultrasound-guided fine-needle aspiration cytology (US-FNAC) of thyroid nodules is an important diagnostic procedure. In most hospitals, patients are referred to radiologists for US-FNAC, but this often results in a long waiting time before results are available. Surgeon-performed US-FNAC (SP-US-FNAC) during the initial patient consultation attempts to reduce the waiting time but it is not known whether this is as accurate as radiologist-performed US-FNAC (RP-US-FNAC). The aim of this study is to compare the clinical efficiency between SP-US-FNAC and RP-US-FNAC. A retrospective study was performed on patients from the Department of General Surgery, Tan Tock Seng Hospital (TTSH) who underwent an US-FNAC from August 2011 to May 2012. All cases of SP-US-FNAC were performed by a single surgeon. This study compared the rates of positive diagnoses achieved by SP-US-FNAC and RPUS- FNAC as well as the time interval to reach a cytological diagnosis by each group. A total of 40 cases of SP-US-FNAC and 72 cases of RP-US-FNAC were included in the study. SP-US-FNAC resulted in 28 (70%) positive diagnoses and 12 (30%) nondiagnoses while RP-US-FNAC resulted in 47 (65.3%) positive diagnoses and 25 (34.7%) non-diagnoses. These results were comparable (P=0.678). The median time taken to reach a cytological diagnosis was 1 working day for SP-US-FNAC and 29.5 working days for RP-US-FNAC resulting in a shorter interval to reaching a cytological diagnosis for SP-US-FNAC (P<0.001). In the workup of thyroid nodules, SP-US-FNAC is as accurate as RP-US-FNAC but significantly reduces the time taken to reach a cytological diagnosis. This leads to greater clinical efficiency in the management of patients with thyroid nodules, which in turn leads to other benefits such as decreased patient anxiety and increased patient satisfaction.

40-year trends in meal and snack eating behaviors of American adults.

PubMed

Kant, Ashima K; Graubard, Barry I

2015-01-01

Understanding changes in profiles of eating behaviors over time may provide insights into contributors to upward trajectories of obesity in the US population. Yet little is known about whether or not characteristics of meal and snack eating behaviors reported by adult Americans have changed over time. To examine time trends in the distribution of day's intake into individual meal and snack behaviors and related attributes in the US adult population. The study was observational with cross-sectional data from national surveys fielded over 40 years. Nationally representative dietary data from nine National Health and Nutrition Examination Surveys conducted from 1971-1974 to 2009-2010 (N=62,298 participants aged 20-74 years) were used to describe eating behaviors. The respondent-labeled eating behaviors examined included main meals (breakfast, lunch, and dinner), and snacks (before breakfast, between breakfast and lunch, between lunch and dinner, after dinner, or other). For each eating behavior, percent of reporters, relative contribution to 24-hour energy intake, the clock time of report, and intermeal/snack intervals were examined. Multivariable logistic and linear regression methods for analysis of complex survey data adjusted for characteristics of respondents in each survey. Over the 40-year span examined reports of each individual named main meal (or all three main meals) declined, but reports of only two out of three meals or the same meal more than once increased; the percentage of 24-hour energy from snacks reported between lunch and dinner or snacks that displaced meals increased; clock times of breakfast and lunch were later, and intervals between dinner and after-dinner snack were shorter. Changes in several snack reporting behaviors (eg, report of any snack or ≥2 snacks), were significant in women only. Several meal and snack eating behaviors of American adults changed over time, with a greater change in snack behaviors of women relative to men. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

40-year trends in meal and snack eating behaviors of American adults

PubMed Central

Kant, Ashima K.; Graubard, Barry I.

2014-01-01

Background Understanding of changes in profiles of eating behaviors over time may provide insights into contributors to upward trajectories of obesity in the United States population. Yet, little is known about whether characteristics of meal and snack eating behaviors reported by adult Americans have changed over time. Objective This study examined time trends in the distribution of day’s intake into individual meal and snack behaviors and related attributes in the United States adult population. Design The study was observational with cross-sectional data from national surveys fielded over 40 years. Participant/setting Nationally representative dietary data from nine National Health and Nutrition Examination Surveys conducted from 1971–74 to 2009–2010 (n=62298; age 20–74 years) were used to describe eating behaviors. Outcomes examined The respondent-labeled eating behaviors examined included main meals (breakfast, lunch, and dinner), and snacks (before breakfast, between breakfast and lunch, between lunch and dinner, after dinner, or other). For each eating behavior, percent of reporters; relative contribution to 24-hour energy intake; the clock time of report; and intermeal/snack intervals were examined. Statistical Analysis Multivariable logistic and linear regression methods for analysis of complex survey data adjusted for characteristics of respondents in each survey. Results Over the 40-year span examined: 1) reports of each individual named main meal (or all three main meals) declined, but reports of only two out of three meals or the same meal more than once increased; 2) the percentage of 24-hour energy from snacks reported between lunch and dinner or snacks that displaced meals increased; 3) clock times of breakfast and lunch were later, and intervals between dinner and after dinner snack were shorter. Changes in several snack reporting behaviors (e.g., report of any snack or ≥2 snacks), were significant in women only. Conclusions Several meal and snack eating behaviors of American adults changed over time, with a greater change in snack behaviors of women relative to men. PMID:25088521

Head or brain injuries and Alzheimer's disease: A nested case-control register study.

PubMed

Tolppanen, Anna-Maija; Taipale, Heidi; Hartikainen, Sirpa

2017-12-01

Many previous studies have been limited by self- or proxy-reported injury or short follow-up. We investigated whether head or brain injuries are associated with Alzheimer's disease (AD), possible modifying factors and dose-response relationship. Nested register-based case-control study of all community dwellers who received clinically verified AD diagnosis in Finland in 2005 to 2011 (n = 70,719) and one to four matched controls for each case (n of controls = 282,862). The magnitude of association between hospital-treated head and/or brain injuries was strongly dependent on the lag time between exposure and outcome. With a 5-year lag time, head injury (adjusted odds ratio; 95% confidence interval 1.19; 1.15-1.23) or brain injury (1.23; 1.18-1.29) was associated with higher risk of AD. Dose-response relationship with number and severity of injuries was observed. Associations were stronger in those with earlier onset of AD. Stronger associations with shorter lag times indicate that head and/or brain injuries may also reflect the ongoing AD disease process. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Daily Light Exposure Patterns Reveal Phase and Period of the Human Circadian Clock.

PubMed

Woelders, Tom; Beersma, Domien G M; Gordijn, Marijke C M; Hut, Roelof A; Wams, Emma J

2017-06-01

Light is the most potent time cue that synchronizes (entrains) the circadian pacemaker to the 24-h solar cycle. This entrainment process is an interplay between an individual's daily light perception and intrinsic pacemaker period under free-running conditions. Establishing individual estimates of circadian phase and period can be time-consuming. We show that circadian phase can be accurately predicted (SD = 1.1 h for dim light melatonin onset, DLMO) using 9 days of ambulatory light and activity data as an input to Kronauer's limit-cycle model for the human circadian system. This approach also yields an estimated circadian period of 24.2 h (SD = 0.2 h), with longer periods resulting in later DLMOs. A larger amount of daylight exposure resulted in an earlier DLMO. Individuals with a long circadian period also showed shorter intervals between DLMO and sleep timing. When a field-based estimation of tau can be validated under laboratory studies in a wide variety of individuals, the proposed methods may prove to be essential tools for individualized chronotherapy and light treatment for shift work and jetlag applications. These methods may improve our understanding of fundamental properties of human circadian rhythms under daily living conditions.

Daily Light Exposure Patterns Reveal Phase and Period of the Human Circadian Clock

PubMed Central

Woelders, Tom; Beersma, Domien G. M.; Gordijn, Marijke C. M.; Hut, Roelof A.; Wams, Emma J.

2017-01-01

Light is the most potent time cue that synchronizes (entrains) the circadian pacemaker to the 24-h solar cycle. This entrainment process is an interplay between an individual’s daily light perception and intrinsic pacemaker period under free-running conditions. Establishing individual estimates of circadian phase and period can be time-consuming. We show that circadian phase can be accurately predicted (SD = 1.1 h for dim light melatonin onset, DLMO) using 9 days of ambulatory light and activity data as an input to Kronauer’s limit-cycle model for the human circadian system. This approach also yields an estimated circadian period of 24.2 h (SD = 0.2 h), with longer periods resulting in later DLMOs. A larger amount of daylight exposure resulted in an earlier DLMO. Individuals with a long circadian period also showed shorter intervals between DLMO and sleep timing. When a field-based estimation of tau can be validated under laboratory studies in a wide variety of individuals, the proposed methods may prove to be essential tools for individualized chronotherapy and light treatment for shift work and jetlag applications. These methods may improve our understanding of fundamental properties of human circadian rhythms under daily living conditions. PMID:28452285

Electrocardiogram classification using delay differential equations

NASA Astrophysics Data System (ADS)

Lainscsek, Claudia; Sejnowski, Terrence J.

2013-06-01

Time series analysis with nonlinear delay differential equations (DDEs) reveals nonlinear as well as spectral properties of the underlying dynamical system. Here, global DDE models were used to analyze 5 min data segments of electrocardiographic (ECG) recordings in order to capture distinguishing features for different heart conditions such as normal heart beat, congestive heart failure, and atrial fibrillation. The number of terms and delays in the model as well as the order of nonlinearity of the model have to be selected that are the most discriminative. The DDE model form that best separates the three classes of data was chosen by exhaustive search up to third order polynomials. Such an approach can provide deep insight into the nature of the data since linear terms of a DDE correspond to the main time-scales in the signal and the nonlinear terms in the DDE are related to nonlinear couplings between the harmonic signal parts. The DDEs were able to detect atrial fibrillation with an accuracy of 72%, congestive heart failure with an accuracy of 88%, and normal heart beat with an accuracy of 97% from 5 min of ECG, a much shorter time interval than required to achieve comparable performance with other methods.

Dual-pulse laser ignition of ethylene-air mixtures in a supersonic combustor.

PubMed

Yang, Leichao; An, Bin; Liang, Jianhan; Li, Xipeng; Wang, Zhenguo

2018-04-02

To reduce the energy of an individual laser pulse, dual-pulse laser ignitions (LIs) at various pulse intervals were investigated in a Mach 2.92 scramjet engine fueled with ethylene. For comparison, experiments on a single-pulse LI were also performed. Schlieren visualization and high-speed photography were employed to observe the ignition processes simultaneously. The results indicate that the energy of an individual laser pulse can be reduced by half via a dual-pulse LI method as compared with a single-pulse LI with the same total energy. The reduction of the individual laser pulse energy degrades the requirements on the laser source and the beam delivery system, which facilitates the practical application of LI in hypersonic vehicles. A pulse interval shorter than 40 μs is suggested for dual-pulse LI in the present study. Because of the intense heat loss and radical dissipation in high-speed flows, the pulse interval for dual-pulse LI should be short enough to narrow the spatial distribution of the initial flame kernel.

Ageing airplane repair assessment program for Airbus A300

NASA Technical Reports Server (NTRS)

Gaillardon, J. M.; Schmidt, HANS-J.; Brandecker, B.

1992-01-01

This paper describes the current status of the repair categorization activities and includes all details about the methodologies developed for determination of the inspection program for the skin on pressurized fuselages. For inspection threshold determination two methods are defined based on fatigue life approach, a simplified and detailed method. The detailed method considers 15 different parameters to assess the influences of material, geometry, size location, aircraft usage, and workmanship on the fatigue life of the repair and the original structure. For definition of the inspection intervals a general method is developed which applies to all concerned repairs. For this the initial flaw concept is used by considering 6 parameters and the detectable flaw sizes depending on proposed nondestructive inspection methods. An alternative method is provided for small repairs allowing visual inspection with shorter intervals.

Synchronous Seasonal Change in Fin Whale Song in the North Pacific

PubMed Central

Oleson, Erin M.; Širović, Ana; Bayless, Alexandra R.; Hildebrand, John A.

2014-01-01

Fin whale (Balaenoptera physalus) song consists of down-swept pulses arranged into stereotypic sequences that can be characterized according to the interval between successive pulses. As in blue (B. musculus) and humpback whales (Megaptera novaeangliae), these song sequences may be geographically distinct and may correlate with population boundaries in some regions. We measured inter-pulse intervals of fin whale songs within year-round acoustic datasets collected between 2000 and 2006 in three regions of the eastern North Pacific: Southern California, the Bering Sea, and Hawaii. A distinctive song type that was recorded in all three regions is characterized by singlet and doublet inter-pulse intervals that increase seasonally, then annually reset to the same shorter intervals at the beginning of each season. This song type was recorded in the Bering Sea and off Southern California from September through May and off Hawaii from December through April, with the song interval generally synchronized across all monitoring locations. The broad geographic and seasonal occurrence of this particular fin whale song type may represent a single population broadly distributed throughout the eastern Pacific with no clear seasonal migratory pattern. Previous studies attempting to infer population structure of fin whales in the North Pacific using synchronous individual song samples have been unsuccessful, likely because they did not account for the seasonal lengthening in song intervals observed here. PMID:25521493

Synchronous seasonal change in fin whale song in the North Pacific.

PubMed

Oleson, Erin M; Širović, Ana; Bayless, Alexandra R; Hildebrand, John A

2014-01-01

Fin whale (Balaenoptera physalus) song consists of down-swept pulses arranged into stereotypic sequences that can be characterized according to the interval between successive pulses. As in blue (B. musculus) and humpback whales (Megaptera novaeangliae), these song sequences may be geographically distinct and may correlate with population boundaries in some regions. We measured inter-pulse intervals of fin whale songs within year-round acoustic datasets collected between 2000 and 2006 in three regions of the eastern North Pacific: Southern California, the Bering Sea, and Hawaii. A distinctive song type that was recorded in all three regions is characterized by singlet and doublet inter-pulse intervals that increase seasonally, then annually reset to the same shorter intervals at the beginning of each season. This song type was recorded in the Bering Sea and off Southern California from September through May and off Hawaii from December through April, with the song interval generally synchronized across all monitoring locations. The broad geographic and seasonal occurrence of this particular fin whale song type may represent a single population broadly distributed throughout the eastern Pacific with no clear seasonal migratory pattern. Previous studies attempting to infer population structure of fin whales in the North Pacific using synchronous individual song samples have been unsuccessful, likely because they did not account for the seasonal lengthening in song intervals observed here.

The Sleep-Time Cost of Parenting: Sleep Duration and Sleepiness Among Employed Parents in the Wisconsin Sleep Cohort Study

PubMed Central

Hagen, Erika W.; Mirer, Anna G.; Palta, Mari; Peppard, Paul E.

2013-01-01

Insufficient sleep is associated with poor health and increased mortality. Studies on whether parenthood (including consideration of number and ages of children) is associated with sleep duration or sleep problems are scant and inconclusive. Using data collected in the Wisconsin Sleep Cohort Study (n = 4,809) between 1989 and 2008, we examined cross-sectional associations of number and ages of children with self-reported parental sleep duration, daytime sleepiness, and dozing among employed adults. Longitudinal change in sleep duration over 19 years was examined to evaluate changes in parental sleep associated with children transitioning into adulthood (n = 833). Each child under age 2 years was associated with 13 fewer minutes of parental sleep per day (95% confidence interval (CI): 5, 21); each child aged 2–5 years was associated with 9 fewer minutes of sleep (95% CI: 5, 13); and each child aged 6–18 years was associated with 4 fewer minutes (95% CI: 2, 6). Adult children were not associated with shorter parental sleep duration. Parents of children over age 2 years were significantly more likely to experience daytime sleepiness and dozing during daytime activities. Parents of minor children at baseline had significantly greater increases in sleep duration over 19 years of follow-up. Parenting minor children is associated with shorter sleep duration. As children age into adulthood, the sleep duration of parents with more children approaches that of parents with fewer children. PMID:23378502

Mosaic Loss of Chromosome Y in Blood Is Associated with Alzheimer Disease.

PubMed

Dumanski, Jan P; Lambert, Jean-Charles; Rasi, Chiara; Giedraitis, Vilmantas; Davies, Hanna; Grenier-Boley, Benjamin; Lindgren, Cecilia M; Campion, Dominique; Dufouil, Carole; Pasquier, Florence; Amouyel, Philippe; Lannfelt, Lars; Ingelsson, Martin; Kilander, Lena; Lind, Lars; Forsberg, Lars A

2016-06-02

Men have a shorter life expectancy compared with women but the underlying factor(s) are not clear. Late-onset, sporadic Alzheimer disease (AD) is a common and lethal neurodegenerative disorder and many germline inherited variants have been found to influence the risk of developing AD. Our previous results show that a fundamentally different genetic variant, i.e., lifetime-acquired loss of chromosome Y (LOY) in blood cells, is associated with all-cause mortality and an increased risk of non-hematological tumors and that LOY could be induced by tobacco smoking. We tested here a hypothesis that men with LOY are more susceptible to AD and show that LOY is associated with AD in three independent studies of different types. In a case-control study, males with AD diagnosis had higher degree of LOY mosaicism (adjusted odds ratio = 2.80, p = 0.0184, AD events = 606). Furthermore, in two prospective studies, men with LOY at blood sampling had greater risk for incident AD diagnosis during follow-up time (hazard ratio [HR] = 6.80, 95% confidence interval [95% CI] = 2.16-21.43, AD events = 140, p = 0.0011). Thus, LOY in blood is associated with risks of both AD and cancer, suggesting a role of LOY in blood cells on disease processes in other tissues, possibly via defective immunosurveillance. As a male-specific risk factor, LOY might explain why males on average live shorter lives than females. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

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.

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.

Determinants of Short Interbirth Interval among Reproductive Age Mothers in Arba Minch District, Ethiopia

PubMed Central

Hailu, Desta; Gulte, Teklemariam

2016-01-01

Background. One of the key strategies to reduce fertility and promote the health status of mothers and their children is adhering to optimal birth spacing. However, women still have shorter birth intervals and studies addressing their determinants were scarce. The objective of this study, therefore, was to assess determinants of birth interval among women who had at least two consecutive live births. Methods. Case control study was conducted from February to April 2014. Cases were women with short birth intervals (<3 years), whereas controls were women having history of optimal birth intervals (3 to 5 years). Bivariate and multivariable analyses were performed. Result. Having no formal education (AOR = 2.36, 95% CL: [1.23–4.52]), duration of breast feeding for less than 24 months (AOR: 66.03, 95% CI; [34.60–126]), preceding child being female (AOR: 5.73, 95% CI; [3.18–10.310]), modern contraceptive use (AOR: 2.79, 95% CI: [1.58–4.940]), and poor wealth index (AOR: 4.89, 95% CI; [1.81–13.25]) of respondents were independent predictors of short birth interval. Conclusion. In equalities in education, duration of breast feeding, sex of the preceding child, contraceptive method use, and wealth index were markers of unequal distribution of inter birth intervals. Thus, to optimize birth spacing, strategies of providing information, education and communication targeting predictor variables should be improved. PMID:27239553

Sex-related differences in coronary revascularization practices: the perspective from a Canadian queue management project.

PubMed

Naylor, C D; Levinton, C M

1993-10-01

To assess sex-related differences in coronary revascularization practices in a Canadian setting. Prospective analytic cohort study. Regional referral office in Toronto. A selected but consecutive group of 131 women and 440 men referred by cardiologists for revascularization procedures between Jan. 3, 1989, and June 30, 1991. Coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA). Nurse-coordinators placed the referral with a surgeon or interventional cardiologist at one of three hospitals, who then communicated directly with the referring cardiologist. Symptom status at referral, procedures requested and performed, and time from referral to procedure. Although the women were more likely than the men to have unstable angina at the time of referral (odds ratio [OR] 2.28, 95% confidence interval [CI] 1.38 to 3.79, p = 0.0006), more women than men (16.8% v. 12.1%) were turned down for a procedure. Significant sex-related differences in practice patterns (p < 0.001) persisted after controlling for age or for the referring cardiologists' perception of expected procedural risk. A stepwise multivariate model showed that anatomy was the main determinant of case management; sex was the only other significant variable (p = 0.016). The referring physicians requested CABG more often for men than for women (p = 0.009), and the men accepted for a procedure were much more likely to undergo CABG than the women (OR 2.40, CI 1.47 to 3.93, p = 0.0002). Although the women undergoing CABG waited shorter periods than the men (p = 0.0035), this difference was attributable to their more severe symptoms. In this selected group women had more serious symptoms before referral but were turned down for revascularization more often than men. Reduced use of CABG rather than PTCA largely accounted for the sex-related differences in revascularization. Once accepted for a procedure women had shorter waiting times, which was appropriate given their more severe symptoms.

The effect of health insurance on childhood cancer survival in the United States.

PubMed

Lee, Jong Min; Wang, Xiaoyan; Ojha, Rohit P; Johnson, Kimberly J

2017-12-15

The effect of health insurance on childhood cancer survival has not been well studied. Using Surveillance, Epidemiology, and End Results (SEER) data, this study was designed to assess the association between health insurance status and childhood cancer survival. Data on cancers diagnosed among children less than 15 years old from 2007 to 2009 were obtained from the SEER 18 registries. The effect of health insurance at diagnosis on 5-year childhood cancer mortality was estimated with marginal survival probabilities, restricted mean survival times, and Cox proportional hazards (PH) regression analyses, which were adjusted for age, sex, race/ethnicity, and county-level poverty. Among 8219 childhood cancer cases, the mean survival time was 1.32 months shorter (95% confidence interval [CI], -4.31 to 1.66) after 5 years for uninsured children (n = 131) versus those with private insurance (n = 4297), whereas the mean survival time was 0.62 months shorter (95% CI, -1.46 to 0.22) for children with Medicaid at diagnosis (n = 2838). In Cox PH models, children who were uninsured had a 1.26-fold higher risk of cancer death (95% CI, 0.84-1.90) than those who were privately insured at diagnosis. The risk for those with Medicaid was similar to the risk for those with private insurance at diagnosis (hazard ratio, 1.06; 95% CI, 0.93-1.21). Overall, the results suggest that cancer survival is largely similar for children with Medicaid and those with private insurance at diagnosis. Slightly inferior survival was observed for those who were uninsured in comparison with those with private insurance at diagnosis. The latter result is based on a small number of uninsured children and should be interpreted cautiously. Further study is needed to confirm and clarify the reasons for these patterns. Cancer 2017;123:4878-85. © 2017 American Cancer Society. © 2017 American Cancer Society.

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.

Recognition of Modified Conditioning Sounds by Competitively Trained Guinea Pigs

PubMed Central

Ojima, Hisayuki; Horikawa, Junsei

2016-01-01

The guinea pig (GP) is an often-used species in hearing research. However, behavioral studies are rare, especially in the context of sound recognition, because of difficulties in training these animals. We examined sound recognition in a social competitive setting in order to examine whether this setting could be used as an easy model. Two starved GPs were placed in the same training arena and compelled to compete for food after hearing a conditioning sound (CS), which was a repeat of almost identical sound segments. Through a 2-week intensive training, animals were trained to demonstrate a set of distinct behaviors solely to the CS. Then, each of them was subjected to generalization tests for recognition of sounds that had been modified from the CS in spectral, fine temporal and tempo (i.e., intersegment interval, ISI) dimensions. Results showed that they discriminated between the CS and band-rejected test sounds but had no preference for a particular frequency range for the recognition. In contrast, sounds modified in the fine temporal domain were largely perceived to be in the same category as the CS, except for the test sound generated by fully reversing the CS in time. Animals also discriminated sounds played at different tempos. Test sounds with ISIs shorter than that of the multi-segment CS were discriminated from the CS, while test sounds with ISIs longer than that of the CS segments were not. For the shorter ISIs, most animals initiated apparently positive food-access behavior as they did in response to the CS, but discontinued it during the sound-on period probably because of later recognition of tempo. Interestingly, the population range and mean of the delay time before animals initiated the food-access behavior were very similar among different ISI test sounds. This study, for the first time, demonstrates a wide aspect of sound discrimination abilities of the GP and will provide a way to examine tempo perception mechanisms using this animal species. PMID:26858617

A Comparison of Outcomes Following Laparoscopic and Open Hysterectomy With or Without Lymphadenectomy for Presumed Early-Stage Endometrial Cancer: Results From the Medical Research Council ASTEC Trial.

PubMed

Kyrgiou, Maria; Swart, Anne-Marie; Qian, Wendi; Warwick, Jane

2015-10-01

Laparoscopic hysterectomy (LH) is increasingly used for the management of endometrial malignancy. Its benefits may be particularly pronounced as these women are more likely to be older or obese. The aim of this study was to determine whether outcomes for LH are comparable to the open hysterectomy (OH). This was a prospective cohort study nested within the multicenter ASTEC (A Study in the Treatment of Endometrial Cancer) randomized controlled trial (1998-2005). Women with presumed early endometrial cancer were included. Laparoscopic hysterectomy was compared with OH with or without systematic lymphadenectomy. Overall survival, time to first recurrence, complication rates, and surgical outcomes were the main outcome measures. Of 1408 women, 1309 (93%) received OH, and 99 (7%) had LH. LH was associated with longer operating time (median, LH 105 minutes [interquartile range (IQR), 60-150] vs OH 80 minutes [IQR, 60-95]; P < 0.001) but 50% shorter hospital stay (median, LH 4 days [IQR, 3-5] vs OH 6 days [IQR, 5-7]). The number of harvested lymph nodes was similar (median, LH 13 [IQR, 10-16] vs OH 12 [IQR, 11-13]; P = 0.67). LH had fewer intraoperative and postoperative adverse events (9% difference, LH 21% vs OH 30%; borderline significance; P = 0.07). The rate of conversion to laparotomy for the LH group was high (27%). The median follow-up was 37 months. After adjusting for significant prognostic factors, the hazard ratio for overall survival in those who underwent LH compared with those who underwent OH was 0.67 (95% confidence interval, 0.31-1.43) (P = 0.30). Laparoscopic hysterectomy for early endometrial cancer is safe. Although it requires longer operating time it is associated with shorter hospital stay and favorable morbidity profile. Further studies are required to assess the long-term safety.

Bioavailability of syrup and tablet formulations of cefetamet pivoxil.

PubMed

Ducharme, M P; Edwards, D J; McNamara, P J; Stoeckel, K

1993-12-01

Two studies examining the bioavailability of cefetamet pivoxil in healthy male subjects were conducted. In the first, the bioavailabilities of the 250-mg (M250) and M500 tablet formulations of cefetamet pivoxil to be marketed were compared with that of a tablet used in clinical trials. All products were given with food at a dose of 500 mg. In the second study, the bioavailability of the syrup formulation was evaluated under both fasting and nonfasting conditions and compared with that of the M500 tablet formulation given with food. The absolute bioavailabilities of the M500 and M250 tablets (55.0% +/- 8.0% and 55.7% +/- 7.0%, respectively) were not significantly different from that of the clinical-trial formulation (49.8% +/- 8.5%). The newer tablet formulations exhibited faster absorption as evidenced by higher peak concentrations (3.8 [M500] and 3.9 [M250] mg/liter compared with 3.2 mg/liter for the clinical-trial formulation), a shorter time to peak concentration, and a shorter mean absorption time. The syrup formulation was found to have significantly lower absolute bioavailability (37.9% +/- 6.0%) compared with that of the M500 tablet (58.4% +/- 9.0%) when both were given with food. Food had no significant effect on the bioavailability of the syrup, which averaged 34.0% +/- 8.6% under fasting conditions, although absorption was delayed by food (mean absorption time increased from 2.2 to 3.9 h). This contrasts with the results of previous studies documenting significant increases in tablet bioavailability with food. Despite the lower bioavailability of the syrup, unbound-cefetamet concentrations are expected to remain above the MICs for 90% of the strains tested for susceptible organisms for approximately 10 h of the usual 12-h dosing interval with both syrup and tablet formulations of cefetamet pivoxil given with food.

Bioavailability of syrup and tablet formulations of cefetamet pivoxil.

PubMed Central

Ducharme, M P; Edwards, D J; McNamara, P J; Stoeckel, K

1993-01-01

Two studies examining the bioavailability of cefetamet pivoxil in healthy male subjects were conducted. In the first, the bioavailabilities of the 250-mg (M250) and M500 tablet formulations of cefetamet pivoxil to be marketed were compared with that of a tablet used in clinical trials. All products were given with food at a dose of 500 mg. In the second study, the bioavailability of the syrup formulation was evaluated under both fasting and nonfasting conditions and compared with that of the M500 tablet formulation given with food. The absolute bioavailabilities of the M500 and M250 tablets (55.0% +/- 8.0% and 55.7% +/- 7.0%, respectively) were not significantly different from that of the clinical-trial formulation (49.8% +/- 8.5%). The newer tablet formulations exhibited faster absorption as evidenced by higher peak concentrations (3.8 [M500] and 3.9 [M250] mg/liter compared with 3.2 mg/liter for the clinical-trial formulation), a shorter time to peak concentration, and a shorter mean absorption time. The syrup formulation was found to have significantly lower absolute bioavailability (37.9% +/- 6.0%) compared with that of the M500 tablet (58.4% +/- 9.0%) when both were given with food. Food had no significant effect on the bioavailability of the syrup, which averaged 34.0% +/- 8.6% under fasting conditions, although absorption was delayed by food (mean absorption time increased from 2.2 to 3.9 h). This contrasts with the results of previous studies documenting significant increases in tablet bioavailability with food. Despite the lower bioavailability of the syrup, unbound-cefetamet concentrations are expected to remain above the MICs for 90% of the strains tested for susceptible organisms for approximately 10 h of the usual 12-h dosing interval with both syrup and tablet formulations of cefetamet pivoxil given with food. PMID:8109939

Burning phylogenies: fire, molecular evolutionary rates, and diversification.

PubMed

Verdú, Miguel; Pausas, Juli G; Segarra-Moragues, José Gabriel; Ojeda, Fernando

2007-09-01

Mediterranean-type ecosystems are among the most remarkable plant biodiversity "hot spots" on the earth, and fire has traditionally been invoked as one of the evolutionary forces explaining this exceptional diversity. In these ecosystems, adult plants of some species are able to survive after fire (resprouters), whereas in other species fire kills the adults and populations are only maintained by an effective post-fire recruitment (seeders). Seeders tend to have shorter generation times than resprouters, particularly under short fire return intervals, thus potentially increasing their molecular evolutionary rates and, ultimately, their diversification. We explored whether seeder lineages actually have higher rates of molecular evolution and diversification than resprouters. Molecular evolutionary rates in different DNA regions were compared in 45 phylogenetically paired congeneric taxa from fire-prone Mediterranean-type ecosystems with contrasting seeder and resprouter life histories. Differential diversification was analyzed with both topological and chronological approaches in five genera (Banksia, Daviesia, Lachnaea, Leucadendron, and Thamnochortus) from two fire-prone regions (Australia and South Africa). We found that seeders had neither higher molecular rates nor higher diversification than resprouters. Such lack of differences in molecular rates between seeders and resprouters-which did not agree with theoretical predictions-may occur if (1) the timing of the switch from seeding to resprouting (or vice versa) occurs near the branch tip, so that most of the branch length evolves under the opposite life-history form; (2) resprouters suffer more somatic mutations and therefore counterbalancing the replication-induced mutations of seeders; and (3) the rate of mutations is not related to shorter generation times because plants do not undergo determinate germ-line replication. The absence of differential diversification is to be expected if seeders and resprouters do not differ from each other in their molecular evolutionary rate, which is the fuel for speciation. Although other factors such as the formation of isolated populations may trigger diversification, we can conclude that fire acting as a throttle for diversification is by no means the rule in fire-prone ecosystems.

Cancer Recurrence After Esophagectomy: Impact of Postoperative Infection in Propensity-Matched Cohorts.

PubMed

Tam, Vernissia; Luketich, James D; Winger, Daniel G; Sarkaria, Inderpal S; Levy, Ryan M; Christie, Neil A; Awais, Omar; Shende, Manisha R; Nason, Katie S

2016-11-01

Postoperative infection increases cancer recurrence and worsens survival in colorectal cancer, but the relationship for esophagogastric adenocarcinoma after esophagectomy is not well defined. We aimed to determine whether recurrence and survival after minimally invasive esophagectomy for esophagogastric adenocarcinoma were influenced by postoperative infection using propensity-matched analysis. We abstracted data for 810 patients (1997-2010) and defined exposure as at least 1 in-hospital or 30-day infectious complication (n = 206 [25%]). Using 29 pretreatment/intraoperative variables, patients were propensity-score matched (caliper = 0.05). Time to cancer recurrence and survival (Kaplan-Meier curves and the Breslow test), and associated factors (Cox regression with shared frailty) were assessed. After propensity matching (n = 167 pairs), median bias across propensity-score variables was reduced from 12.9% (p < 0.001) to 4.4% (p = 1.000). Postoperative infection was not associated with rate (n = 60 versus 63; McNemar p = 0.736) or time to recurrence in those in whom disease recurred (median, 10.7 versus 11.1 months; Wilcoxon signed-rank p = 0.455) but was associated with shorter overall survival (n = 124 versus 102 deaths; median, 26 versus 41 months; Breslow p = 0.002). After adjusting for age, body mass index, neoadjuvant therapy, sex, comorbidity score, positive resection margins, pathologic stage, R0 resection, and recurrence, postoperative infection was associated with a 44% greater hazard for death (hazard ratio, 1.44; 95% confidence interval, 1.10-1.89). In patients with esophagogastric adenocarcinoma, infections after esophagectomy were not associated with an increased rate or earlier time to recurrence when baseline characteristics associated with infection risk were balanced using propensity-score matching. Despite this, overall survival was shorter in patients with infectious complications. After adjusting for other important survival predictors, infections after esophagectomy continued to be independently associated with worse survival. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Sequential Metabolic Phases as a Means to Optimize Cellular Output in a Constant Environment

PubMed Central

Bockmayr, Alexander; Holzhütter, Hermann-Georg

2015-01-01

Temporal changes of gene expression are a well-known regulatory feature of all cells, which is commonly perceived as a strategy to adapt the proteome to varying external conditions. However, temporal (rhythmic and non-rhythmic) changes of gene expression are also observed under virtually constant external conditions. Here we hypothesize that such changes are a means to render the synthesis of the metabolic output more efficient than under conditions of constant gene activities. In order to substantiate this hypothesis, we used a flux-balance model of the cellular metabolism. The total time span spent on the production of a given set of target metabolites was split into a series of shorter time intervals (metabolic phases) during which only selected groups of metabolic genes are active. The related flux distributions were calculated under the constraint that genes can be either active or inactive whereby the amount of protein related to an active gene is only controlled by the number of active genes: the lower the number of active genes the more protein can be allocated to the enzymes carrying non-zero fluxes. This concept of a predominantly protein-limited efficiency of gene expression clearly differs from other concepts resting on the assumption of an optimal gene regulation capable of allocating to all enzymes and transporters just that fraction of protein necessary to prevent rate limitation. Applying this concept to a simplified metabolic network of the central carbon metabolism with glucose or lactate as alternative substrates, we demonstrate that switching between optimally chosen stationary flux modes comprising different sets of active genes allows producing a demanded amount of target metabolites in a significantly shorter time than by a single optimal flux mode at fixed gene activities. Our model-based findings suggest that temporal expression of metabolic genes can be advantageous even under conditions of constant external substrate supply. PMID:25786979