Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Delay

  • activation delay
  • atrioventricular delay
  • av delay
  • average delay
  • average packet delay
  • cognitive delay
  • communication delay
  • conduction delay
  • constant delay
  • developmental delay
  • diagnostic delay
  • distributed delay
  • end-to-end delay
  • execution delay
  • global developmental delay
  • growth delay
  • ignition delay
  • initial delay
  • language delay
  • long delay
  • longer delay
  • mean delay
  • median delay
  • mild delay
  • mild developmental delay
  • min delay
  • motor delay
  • network delay
  • neurodevelopmental delay
  • packet delay
  • patient delay
  • phase delay
  • prehospital delay
  • processing delay
  • propagation delay
  • psychomotor delay
  • response delay
  • severe developmental delay
  • short delay
  • significant delay
  • speech delay
  • state delay
  • temporal delay
  • time delay
  • time-varying delay
  • transmission delay
  • treatment delay
  • trigger delay
  • tumor growth delay

  • Terms modified by Delay

  • delay differential equation
  • delay discounting
  • delay gastric emptying
  • delay interval
  • delay line
  • delay margin
  • delay model
  • delay performance
  • delay period
  • delay system
  • delay task
  • delay term
  • delay time
  • delay variation

  • Selected Abstracts


    F13; F34; 010 Empirical analyses attributing the 1980s' debt crisis to inconsistent stabilization policies rest on an inappropriate long-run approach. Revising this long-run approach yields opposite results: terms of trade shocks and foreign indebtedness explain this crisis, regardless of domestic stabilization policies. This prompts us to consider a new hypothesis, of delays in trade-policy reforms, with a model in which terms-of-trade variation (under shocks) is endogenous to export structure and efficiency of resource allocation. Evidence from the structural equations model shows that allocation distortions negatively affect changes in terms of trade, which then explain this crisis. A political economy extension demonstrates that income inequality and regional trade policy determine the distortions, which in turn leads to this crisis. [source]


    Yeong-Jeu Sun
    ABSTRACT In this paper, the instability for a class of singular systems with discrete and distributed time delays is investigated. Simple instability criterion, which is a delay-dependent criterion, is derived to guarantee the instability of such systems. Finally, a numerical example is given to illustrate the use of the main result. [source]


    Konstantin Yu.
    ABSTRACT The sampled-data H2 -optimization problem for plants with multiple input and output delays is considered. An equivalent discrete-time system is constructed and numerical algorithm for computing matrices of its state-space realization is presented. It is proved that stability of this system is equivalent to stability of original sampled-data system. The proposed method can be applied to a wide class of digital control problems for continuous-time plants with multiple input and output delays. [source]


    S. M. Saadni
    ABSTRACT This paper deals with the problem of robust stability and robust stabilization for uncertain continuous singular systems with multiple time-varying delays. The parametric uncertainty is assumed to be norm bounded. The purpose of the robust stability problem is to give conditions such that the uncertain singular system is regular, impulse free, and stable for all admissible uncertainties. The purpose of the robust stabilization problem is to design a feedback control law such that the resulting closed-loop system is robustly stable. This problem is solved via generalized quadratic stability approach. A strict linear matrix inequality (LMI) design approach is developed. Finally, a numerical example is provided to demonstrate the application of the proposed method. [source]


    Maiying Zhong
    ABSTRACT This paper deals with robust fault detection filter (RFDF) problem for a class of linear uncertain systems with time-varying delays and model uncertainties. The RFDF design problem is formulated as an optimization problem by using L2 -induced norm to represent the robustness of residual to unknown inputs and modelling errors, and the sensitivity to faults. A sufficient condition to the solvability of formulated problem is established in terms of certain matrix inequalities, which can be solved with the aid of an iterative linear matrix inequality (ILMI) algorithm. Finally, a numerical example is given to illustrate the effectiveness of the proposed method. [source]


    Jing Wu
    ABSTRACT In this paper, robust stochastic stabilization and H, control for a class of uncertain discrete-time linear systems with Markovian jumping parameters are considered. Based on a new bounded real lemma derived upon an inequality recently proposed, a new iterative state-feedback controller design procedure for discrete time-delay systems is presented. Sufficient conditions for stochastic stabilization are derived in the form of linear matrix inequalities (LMIs) based on an equivalent model transformation, and the corresponding H, control law is given. Finally, numerical examples are given to illustrate the solvability of the problems and effectiveness of the results. [source]

    Efficacy of the Flashlamp-Pumped Pulsed-Dye Laser in Nonsurgical Delay of Skin Flaps

    Ali Riza Erçöçen MD
    Objective. The purpose of this article was to determine the effectiveness of laser delay by use of the flashlamp-pumped pulsed-dye laser operating at a wavelength of 585 nm; to elucidate the comparable or dissimilar macroscopic, microscopic, and hemodynamic changes between laser and surgical delay methods; and to clarify the possible mechanisms underlying the delay effect of laser. Methods. A standardized caudally based random dorsal rat flap model was used in this study: Acute random skin flaps served as control subjects (group 1). Surgical delay was employed by incision of lateral longitudinal borders both without (group 2) and with (group 3) undermining, and laser delay methods were performed by laser irradiation of both lateral longitudinal borders (group 4) and the entire surface (group 5) of the proposed flap. Evaluation was done by histologic examination, India ink injection, laser Doppler perfusion imaging, and measurement of flap survival. Results. Histologically, dilation and hypertrophy of subpapillary and subdermal vessels were evident in groups 2, 3, and 4; on the other hand, degranulation of mast cells in the vicinity of occluded vessels at the 1st hour of laser delay and a striking mast cell proliferation and degranulation in association with newly formed vessels (angiogenesis) at the 14th day of laser delay were prominent in group 5. India ink injections revealed longitudinally arranged large-caliber vessels and cross-filling between the vessels of adjacent territories in groups, 2, 3, and 4, but only small-caliber vessels in group 5. Compared with the acute flaps, both surgical and laser delay significantly increased the mean flap perfusion to the maximal levels after a 14-day delay period, and all delay procedures improved flap survival; the most significant increase in surviving area was observed in group 3, whereas the less significant increase in surviving area was in group 5. Conclusion. This study demonstrates that laser delay is as effective as surgical delay and that laser delay by lasering lateral borders leads to dilation and longitudinal rearrangement of the existing vessels rather than angiogenesis, whereas laser delay by lasering the entire surface results in delay effect by inducing angiogenesis due to activation and degranulation of the mast cells. [source]

    Delay of myelin formation in arylsulphatase A-deficient mice

    Afshin Yaghootfam
    Abstract Metachromatic leukodystrophy (MLD) is a lysosomal storage disorder caused by the deficiency of arylsulphatase A (ASA). This leads to the accumulation of the sphingolipid 3-O-sulphogalactosylceramide (sulphatide) and progressive demyelination in the nervous system of MLD patients. The mechanisms and development of pathology in the disease are still largely unknown. In this study we investigate how the inability to degrade sulphatide affects the formation of myelin in ASA-deficient (ASA,/,) mice. In mice at 2 weeks of age there was a substantial reduction in myelin basic protein (MBP) mRNA and protein. This was confirmed by an immunohistochemical analysis. MBP mRNA and protein, however, reach normal levels at 3 weeks of age. Proteolipid protein (PLP) and MAL mRNA were also reduced in ASA,/, mice at 2 weeks of age; whereas the level of PLP mRNA was normal at 26 weeks of age, MAL mRNA expression remained reduced up to this age. In situ hybridization revealed no significant changes in the number of myelinating oligodendrocytes or oligodendrocyte precursor cells in ASA,/, mice. These results suggest that oligodendrocyte differentiation was normal in ASA,/, mice. No differences were found in the expression of the sulphatide synthesizing enzymes cerebroside sulphotransferase and UDP-galactose : ceramide galactosyltransferase. Our data demonstrate a delay in myelin formation in ASA,/, mice. This raises the possibility that similar alterations in MLD patients may contribute to the pathology of the disease. [source]

    Experimental Evidence of the Knowledge Gap: Message Arousal, Motivation, and Time Delay

    Maria Elizabeth Grabe
    This study experimentally tested the knowledge gap from an information processing perspective. Specifically, knowledge acquisition was investigated under conditions of medium and low news message arousal, with time delay. Results show the persistence of a knowledge gap, particularly for low arousing messages. In fact, at low levels of message arousal, the gap is larger than at medium levels of arousal. Some existing research suggests that message salience explains the knowledge gap. Findings from this study show that information processing aptitude may also be a significant factor. Measures of several dimensions of participant motivation to cognitively engage with news messages were added as covariates to statistical analyses. These were found not to affect the knowledge gap outcomes in this data set. Résumé Des preuves expérimentales de l,écart des savoirs : intérêt des messages, motivation et décalage de temps Cette étude a testé expérimentalement l'écart des savoirs à partir d,une perspective du traitement de l'information. En particulier, l,acquisition des connaissances fut étudiée dans des conditions d'intérêt moyen et faible des messages d,information, avec un décalage de temps. Les résultats démontrent la persistance d'un écart des savoirs, particulièrement pour les messages à faible intérêt. En fait, l,écart est plus large à de faibles niveaux d'intérêt qu,à des niveaux moyens. Des recherches préalables suggèrent que la prépondérance des messages explique l'écart des savoirs. Les résultats de cette étude démontrent que les aptitudes de traitement de l,information peuvent aussi être un facteur important. Les mesures de plusieurs dimensions de la motivation des participants à s'impliquer cognitivement avec les messages informatifs furent ajoutées comme covariables aux analyses statistiques. Elles n,ont pas paru avoir d'effets sur les résultats de l,écart des savoirs dans cet ensemble de données. Mots clés : écart des savoirs, modèle de capacité limitée du traitement motivé des messages médiatiques (limited capacity model of mediated motivated message processing), cognition, statut socioéconomique, éducation, intérêt des messages, mémoire, décalage de temps, motivation, prépondérange des messages, informations Abstract Ein experimenteller Nachweis der Wissenskluft: Botschaftserregung, Motivation und Zeitverzögerung Diese Studie testete die Wissensklufthypothese experimentell aus einer Informationsverarbeitungsperspektive. Insbesondere wurde die Wissensaneignung bei Nachrichten unter Bedingungen eines mittleren und niedrigen Botschaftserregungsniveaus mit Zeitverzögerung untersucht. Die Ergebnisse zeigen das Fortdauern einer Wissenskluft insbesondere bei wenig erregenden Botschaften. Tatsächlich ist die Kluft bei einem geringen Niveau der Botschaftserregung größer als bei mittleren Erregungsniveaus. Bestehende Forschung legt nahe, dass die Wissenskluft durch die Botschaftssalienz erklärt werden kann. Die Ergebnisse dieser Studie zeigen, dass die Informationsverarbeitungsfähigkeit ebenfalls ein signifikanter Faktor sein könnte. Messungen verschiedenen Dimensionen der Motivation der Teilnehmer, sich kognitiv mit den Nachrichtenbotschaften zu beschäftigen, wurden als Kovariate in die statistische Analyse einbezogen. Diese zeigten keine Auswirkungen auf die Wissenskluft in dieser Stichprobe. Resumen La Evidencia Experimental de la Brecha de Conocimiento: La Excitación del Mensaje, la Motivación, y la Demora de Tiempo Este estudio puso a prueba experimental la brecha de conocimiento desde la perspectiva del procesamiento de la información. Específicamente, la adquisición de conocimiento fue investigada bajo condiciones de excitación mediana y baja a los mensajes de noticias, con una demora de tiempo. Los resultados muestran la persistencia de la brecha de conocimiento, particularmente en los mensajes de excitación baja. De hecho, en los niveles de excitación de mensaje bajos la brecha fue mayor que en los niveles de excitación medianos. Algunas investigaciones existentes sugieren que la notabilidad del mensaje explica la brecha de conocimiento. Los hallazgos de este estudio muestran que la aptitud de procesamiento de información puede ser un factor significante también. Las medidas de varias dimensiones de la motivación del participante para involucrarse cognitivamente con los mensajes de noticias fueron agregadas como covarianzas a los análisis estadísticos. Se encontró que éstos no afectaron los resultados de la brecha de conocimiento en este grupo de datos. Palabras claves: brecha de conocimiento, modelo de capacidad limitada de procesamiento de mensajes motivadores mediatizados, cognición, estatus socioeconómico, educación, excitación del mensaje, memoria, demora de tiempo, motivación, notabilidad del mensaje, noticias. ZhaiYao Yo yak [source]

    The Causal Effect of Election Delay on Union Win Rates: Instrumental Variable Estimates from Two Natural Experiments

    The role of election delay in union organizing campaigns has become a key policy issue in several countries. Previous studies have documented a negative correlation between delay and union success. However, elections are generally not randomly delayed; in particular, election delay is correlated with various "hard-to-observe" union and employer strategies. This article exploits several exogenous sources of variation in election delay to estimate a causal model. The results indicate that two-stage least squares estimates of the causal effect of election delay on union success are twice the magnitude of standard OLS estimates. [source]

    The impact of the Occupation of Guernsey 1940,1945 on breast cancer risk factors and incidence

    I. S. Fentiman
    Summary To examine the impact of the German Occupation of Guernsey (1940,1945) on breast cancer risk factors and incidence. Under study were 1019 women who stayed, or whose mothers had stayed, in Guernsey, and 1358 women evacuated or born to evacuated mothers. Amongst those born 1926,1934 who remained in Guernsey, the secular trend of earlier menarche disappeared: menarche was delayed by 12 months for those born in 1930. By March 2006, 97 breast cancers had been diagnosed, 37 in the occupied group. Unusually, higher age at menarche appeared to be associated with increased risk of breast cancer (,14 years vs. ,13 years: HR = 1.52, 95% CI = 0.80,2.92). Separate analyses by birth cohort revealed a non-significantly higher incidence in the subgroup born from 1926 to 1934 (HR = 1.30, 95% CI = 0.62,2.76). Delay in menarche among women remaining in Guernsey during the Occupation, rather than being protective, was associated with an increased risk of breast cancer. [source]

    A perceptual quality model intended for adaptive VoIP applications,

    Christian Hoene
    Abstract Quality models predict the perceptual quality of services as they calculate subjective ratings from measured parameters. In this article, we present a new quality model that evaluates Voice over IP (VoIP) telephone calls. In addition to packet loss rate, coding mode and delay, it takes into account the impairments due to changes in the transmission configuration (e.g. switching the coding mode or re-scheduling the playout time). Moreover, this model can be used at run time to control the transmission of such calls. It is also computationally efficient and open source. To demonstrate the potential of our model, we apply it to select the ideal coding and packet rate in bandwidth-limited environments. Furthermore, we decide, based on model predictions, whether to delay the playout of speech frames after delay spikes. Delay spikes often occur after congestion and cause packets to arrive too late. We show a considerable improvement in perceptual speech quality if our model is applied to control VoIP transmissions. Copyright © 2005 John Wiley & Sons, Ltd. [source]

    Donepezil Delay to Nursing Home Placement Study is Flawed

    Jason H. T. Karlawish MD
    No abstract is available for this article. [source]

    Activation Delay and VT Parameters in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy: Toward Improvement of Diagnostic ECG Criteria

    Introduction: Desmosomal changes, electrical uncoupling, and surviving myocardial bundles embedded in fibrofatty tissue are hallmarks of activation delay in arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). Currently, generally accepted task force criteria (TFC) are used for clinical diagnosis. We propose additional criteria based on activation delay and ventricular tachycardia (VT) to improve identification of affected individuals. Methods and Results: Activation delay and VT-related 12-lead electrocardiographic (ECG) criteria were studied, while off drugs, in 42 patients with proven ARVD/C according to TFC, and 27 controls with idiopathic VT from the RV outflow tract. Two of three measured TFC could only be identified in a small minority of ARVD/C patients. Additional ECG criteria proposed in this study included (a) prolonged terminal activation duration, an indicator of activation delay; (b) VT with LBBB morphology and superior axis; and (c) multiple different VT morphologies. These criteria were met in 30 (71%), 28 (67%), and 37 (88%) ARVD/C patients, respectively, and in one control patient (P < 0.001). Electrophysiologic studies contributed importantly to yield different VT morphologies. Pathogenic plakophilin-2 mutations were identified in 25 (60%) of ARVD/C patients and in none of the controls. In ARVD/C patients, parameters measured were not significantly different between mutation carriers and noncarriers, except for negative T waves in V1,3, occurring more frequently in patients with mutation. Conclusions: The proposed additional criteria are specific for ARVD/C and more sensitive than the current TFC. Therefore, adding the newly proposed criteria to current TFC could improve ARVD/C diagnosis, independent of DNA analysis. [source]

    Phytanic Acid Accumulation Is Associated with Conduction Delay and Sudden Cardiac Death in Sterol Carrier Protein-2/Sterol Carrier Protein-x Deficient Mice

    Introduction: The sterol carrier protein-2 gene encodes two functionally distinct proteins: sterol carrier protein-2 (SCP2, a peroxisomal lipid carrier) and sterol carrier protein-x (SCPx, a peroxisomal thiolase known as peroxisomal thiolase-2), which is involved in peroxisomal metabolism of bile acids and branched-chain fatty acids. We show in this study that mice deficient in SCP2 and SCPx (SCP2null) develop a cardiac phenotype leading to a high sudden cardiac death rate if mice are maintained on diets enriched for phytol (a metabolic precursor of branched-chain fatty acids). Methods and Results: In 210 surface and 305 telemetric ECGs recorded in wild-type (C57BL/6; wt; n = 40) and SCP2 null mice (n = 40), no difference was observed at baseline. However, on diet, cycle lengths were prolonged in SCP2 null mice (262.9 ± 190 vs 146.3 ± 43 msec), AV conduction was prolonged (58.3 ± 17 vs 42.6 ± 4 ms), and QRS complexes were wider (19.1 ± 5 vs 14.0 ± 4 ms). In 11 gene-targeted Langendorff-perfused hearts isolated from SCP2 null mice after dietary challenge, complete AV blocks (n = 5/11) or impaired AV conduction (Wenckebach point 132 ± 27 vs 92 ± 10 msec; P < 0.05) could be confirmed. Monophasic action potentials were not different between the two genotypes. Left ventricular function studied by echocardiography was similar in both strains. Phytanic acid but not pristanic acid accumulated in the phospholipid fraction of myocardial membranes isolated from SCP2 null mice. Conclusion: Accumulation of phytanic acid in myocardial phospholipid membranes is associated with bradycardia and impaired AV nodal and intraventricular impulse conduction, which could provide an explanation for sudden cardiac death in this model. [source]

    Blood Pressure,The Better Biomarker: Delay in Clinical Application

    Thomas D. Giles MD
    "The truly great advances in our understanding of nature originated in a way almost diametrically opposed to induction. The intuitive grasp of the essentials of a large complex of facts leads the scientist to the postulation of a hypothetical law or laws. From these laws, he derives his conclusion.",Albert Einstein, "Induction and Deduction in Physics," Berliner Tageblatt, December 25, 1919, CPAE 7:28. [source]

    Control of Teleoperators with Communication Time Delay through State Convergence

    Jose M. Azorin
    This paper describes a new control method of teleoperation systems with communication time delay. This method models the teleoperation system in the state space, considering all the possible interactions that could appear in the operator-master-slave-environment set, and it uses the Taylor expansion to model the time delay. The control system allows that the slave manipulator follows the master in spite of the time delay in the communication channel. The tracking is achieved by state convergence between the master and the slave. The method is also able to establish the desired dynamics of this convergence and the dynamics of the slave manipulator. Furthermore, a simple design procedure is provided to obtain the control system gains. These control gains are calculated solving a set of seven equations. The control method is robust to the uncertainty of the design parameters, so it is not necessary to obtain good estimations of these parameters. Simulations and experiments with a one DOF teleoperation system are presented to verify the control method. © 2004 Wiley Periodicals, Inc. [source]

    Delay in blood glucose monitoring during an insulin infusion protocol is associated with increased risk of hypoglycemia in intensive care units,

    Rajesh Garg MD
    Abstract BACKGROUND: Hypoglycemia during insulin infusion therapy is a major problem. We investigated whether a delay in blood glucose (BG) monitoring during an insulin infusion protocol (IIP) in the intensive care unit (ICU) is associated with hypoglycemia. METHODS: Data were collected for 50 consecutive patients treated with Brigham and Women's Hospital's IIP. Point-of-care BG values were obtained from the bedside paper flow sheets and the exact times of individual measurements were ascertained from an internet-based glucose meter download program. Data were carefully studied for protocol time violations, defined as a delay of >10 minutes after the recommended time for BG measurement. RESULTS: A total of 2309 BG values were evaluated for time violation. A total of 1474 (63.9%) measurements had been obtained at the recommended time or earlier; 835 (36.1%) measurements had been obtained >10 minutes after the recommended time for measurement. There were a significantly higher proportion of BG values <80 mg/dL following the time violation as compared to no time violation (17.8% versus 11.6%; P < 0.001). CONCLUSION: We conclude that the risk of hypoglycemia during insulin infusion therapy is higher after a delay in BG measurement. Journal of Hospital Medicine 2009;4:E5,E7. © 2009 Society of Hospital Medicine. [source]

    Delivery of Medical Care for Migrants in Germany: Delay of Diagnosis and Treatment

    Katja Lenz MD
    Background Migrants form 9% of Germany's population and 13% of its capital Berlin. Only limited data are available regarding general health status and prevalence of tropical diseases among migrants in Germany. This study was conducted to investigate the spectrum and frequency of tropical diseases among migrants in Berlin and to evaluate the quality of the medical care provided. The necessity of a routine screening for tropical diseases among migrants was assessed. Methods Anonymized data of migrants presenting to the Berlin Institute of Tropical Medicine between 1999 and 2004 with a stay in Germany below 1 year (n= 153) were analyzed. Results Of all examined migrants, 48% needed immediate medical treatment and 38% carried an infectious disease, mainly nematodes and intestinal protozoa. 19% suffered from a noninfectious disease, mainly anemia, and 12% were transferred to other specialists for further investigation. These figures were similar among asymptomatic and symptomatic patients. The median duration of stay in Germany until presentation was 42 days. While 40% of the migrants were examined within the first 4 weeks of their stay, 20% had not received a medical examination after 6 months. Of this population, 50% required treatment upon presentation. Conclusions The high proportion of delayed diagnosis and treatment indicates a lack of medical service for migrants. While this clearly translates into increased health risks for the individual patient, it also indicates a potential risk for transmission of communicable diseases in the community. The lack of a correlation between symptoms and detected infectious disease indicates the need for a standardized routine screening examination in all migrants. [source]

    Delay in initiation and termination of muscle contraction, motor impairment, and physical disability in upper limb hemiparesis

    MUSCLE AND NERVE, Issue 4 2002
    John Chae MD
    Abstract The purpose of this study was to describe the relationship between the delay in initiation and termination of muscle contraction and clinical measures of motor impairment and physical disability in the affected upper limb of patients with hemiparesis. Electromyographic (EMG) activity of 26 long-term survivors of stroke was recorded during isometric wrist flexion and extension. Upper limb motor impairment and disability were assessed with the Fugl-Meyer motor assessment (FMA) and arm motor ability test (AMAT), respectively. Delay in initiation and termination of muscle contraction was significantly prolonged in the paretic arm. However, the delay was not significantly affected by stroke type, stroke level, side of hemiparesis, or presence of aphasia. Delay in initiation and termination of muscle contraction correlated significantly with FMA and AMAT. Abnormally delayed initiation and termination of muscle contraction may contribute to hemiparetic upper limb motor impairment and physical disability in hemiparetic patients. © 2002 Wiley Periodicals, Inc. 25: 000,000, 2002 [source]

    Programming Optimal Atrioventricular Delay in Dual Chamber Pacing Using Peak Endocardial Acceleration: Comparison with a Standard Echocardiographic Procedure

    DUPUIS, J.-M.,et al.: Programming Optimal Atrioventricular Delay in Dual Chamber Pacing Using Peak Endocardial Acceleration: Comparison with a Standard Echocardiographic Procedure.Optimization of programmed atrioventricular delay in dual chamber pacing is essential to the hemodynamic efficiency of the heart. Automatic AV delay optimization in an implanted pacemaker is highly desirable. Variations of peak endocardial acceleration (PEA) with AV delay at rest correlate well with echocardiography derived observations, particularly with end-diastolic filling and mitral valve closure timings. This suggests the possibility of devising a procedure for the automatic determination of the optimal AV delay. The aim of this study was to compare a proposed algorithm for optimal AV delay determination with an accepted echocardiographic method. Fifteen patients with high degree AV block received BEST-Living pacing systems. Automatic AV delay scans were performed at rest (60,300 ms in 20-ms steps with 60 beats per step) in DDD at 90 ppm, while simultaneously recording cycle-by-cycle PEA values, which were averaged for each AV delay to obtain a PEA versus AV delay curve. Nonlinear regression analysis based on a Boltzmann sigmoid curve was performed, and the optimal AV delay (OAVD) was chosen as the sigmoid inflection point of the regression curve. The OAVD was also evaluated for each patient using the Ritter echocardiographic method. Good sigmoid fit was obtained in 13 of 15 patients. The mean OAVD obtained by the PEA sigmoid algorithm was146.9 ± 32.1 ms, and the corresponding result obtained by echocardiography was156.4 ± 34.3 ms(range 31.8,39.7 ms). Correlation analysis yielded r = 0.79, P = 0.0012. In conclusion, OAVD estimates obtained by PEA analysis during automatic AV delay scanning are consistent with those obtained by echocardiography. The proposed algorithm can be used for automatic OAVD determination in an implanted pacemaker pulse generator. (PACE 2003; 26:[Pt. II]:210,213) [source]

    Delay of liver maturation as a cause of transient neonatal galactosemia

    Hiroaki Ono
    Abstract Background: Because a large amount of serum ,-fetoprotein (,-FP) is synthesized in the liver of the fetus or premature newborn, high concentrations or delayed degradation of serum ,-FP during the neonatal period may reflect hepatic immaturity. Methods: In order to evaluate the relationship between transient neonatal galactosemia and delay of liver maturation, the concentration and half-life of serum ,-FP during the neonatal period were measured in patients with transient galactosemia and in normal neonates. Results: No significant differences were observed in the serum concentration of ,-FP between normal and galactosemic patients less than 1 month of age. However, the half-life of serum ,-FP was significantly longer in galactosemic patients between 15 and 60 days of age compared with age-matched normal neonates. Conclusion: Based on these results, we hypothesize that delay of liver maturation during the neonatal period, especially during the first 2 months after birth, can be a cause of transient neonatal galactosemia. [source]

    Delay in seeking care for symptoms of acute myocardial infarction: Applying a theoretical model,

    Jill R. Quinn
    Abstract Thirty percent of people who experience symptoms of acute myocardial infarction (AMI) do not seek care until more than 2,6 hours after onset of symptoms, increasing their risk for morbidity and mortality. Using a model based on two frameworks, the common sense model of illness representation (CSM) and goal expectancy, variables associated with delay were examined to identify the most salient predictors of delay in seeking care for AMI. Hierarchical regression analysis revealed that the set of illness representation components from the CSM was a significant predictor of time to seek care, but individually, only recognition of symptoms as being caused by the heart was significant. Providing accurate information on symptoms of AMI may lead to early recognition, reduced delay, and reduced morbidity and mortality. © Wiley Periodicals, Inc. Res Nurs Health 28:283,294, 2005 [source]

    ORIGINAL RESEARCH,PEYRONIE'S DISEASE: Predicting Delay in Presentation in Men with Peyronie's Disease

    John P. Mulhall MD
    ABSTRACT Introduction., Many men with Peyronie's disease (PD) delay presentation to a urologist. The reasons for this are unclear. Aim., To define the differences in men who present early compared to those presenting in a delayed fashion and to determine predictors of delayed presentation. Methods., A retrospective analysis of all patients presenting for the first medical evaluation of PD. All patients underwent a standard history and physical examination and had a standardized deformity assessment. Demographic and PD parameters were recorded. Main Outcome Measures., Statistical comparison was used to define factors that were different between early and delayed presenters and multivariable analysis was used to define predictors of presentation >12 months. Results., 482 patients were analyzed, 61% presenting ,12 months, 39% >12 months. Mean patient age was 52 ± 13 years and mean duration of PD was 17 ± 30 months. Mean measured curvature was 42° ± 19°. Multivariable analysis revealed that delayed presentation patients were significantly more likely to be older (odds ratio [OR] = 4.0), to be in long-term relationships (OR = 3.6), to have dorsal curvature (OR = 2.5), to have curvature <45° (OR = 3.3), to be heterosexual (OR = 2.0), and to have simple deformity (OR = 1.5). Conclusions., One-third of men with PD presented in a delayed fashion and they tended to be older, to be in long-term relationships, to have dorsal curvature, or to have simple deformity. Mulhall JP, Alex B, and Choi JM. Predicting delay in presentation in men with Peyronie's disease. J Sex Med 2010;7:2226,2230. [source]

    Do Not Delay: Breast Cancer and Time, 1900,1970

    Robert A. Aronowitz
    Until the 1960s, the central public health message about breast cancer was that women should not delay seeking medical attention for breast problems. Epidemiological, pathological, public health, and clinical writings, movies, and doctor-patient correspondence are analyzed in order to understand the durability and centrality of this "do not delay" message. Problematic assumptions about the natural history of cancer, the efficacy of surgery, and individual responsibility for disease contributed to the durability of the "do not delay" message. More important, the message catalyzed or sustained changes in the routines of ordinary women, general practitioners, surgeons, and pathologists, which led to the perception that the campaign against cancer was working. Thus a powerful set of reinforcing perceptions and behaviors maintained the centrality of the "do not delay" campaign until the era of mammography. [source]

    The Future of Freedom of Information in the United Kingdom

    This article investigates the future of Britain's Freedom of Information Act [FOIA]. It argues that the UK FOI regime faces a set of unique opportunities and challenges that may decisively impact upon the shape of FOI policy in Britain. On the one hand, the increasingly assertive FOIA appeal bodies, constant pressure from requesters, alongside the more open habits practised within the Civil Service, may serve together to ,open up' government information access. This in turn may widen and strengthen the British FOI regime. On the other hand, a series of potential obstacles may inhibit or undermine the new FOI regime. Delay and inconsistency, potential record management problems and ,gaps' within the scope of the Act, all present possible barriers to further openness. Most of all, following the two recent attempts to limit the scope of the legislation, the intentions and actions of the government will be crucial in shaping the future of FOI policy. [source]

    Improving Distribution Efficiency of Hard-to-Place Deceased Donor Kidneys: Predicting Probability of Discard or Delay

    A. B. Massie
    We recently showed that DonorNet 2007 has reduced the efficiency of kidney distribution in the United States, particularly for those with prolonged cold ischemia time (CIT), by requiring systematic allocation of all kidneys regardless of quality. Reliable early identification of those most likely to be discarded or significantly delayed would enable assigning them to alternate, more efficient distribution strategies. Based on 39 035 adult kidneys recovered for possible transplantation between 2005 and 2008, we created a regression model that reliably (AUC 0.83) quantified the probability that a given kidney was either discarded or delayed beyond 36 h of CIT (Probability of Discard/Delay, PODD). We then analyzed two PODD cutoffs: a permissive cutoff that successfully flagged over half of those kidneys that were discarded/delayed, while only flagging 7% of kidneys that were not eventually discarded/delayed, and a more stringent cutoff that erroneously flagged only 3% but also correctly identified only 34%. Kidney transplants with high PODD were clustered in a minority of centers. Modifications of the kidney distribution system to more efficiently direct organs with high PODD to the centers that actually use them may result in reduced CIT and fewer discards. [source]

    Delay of Adequate Empiric Antibiotic Therapy Is Associated with Increased Mortality among Solid-Organ Transplant Patients

    B. Hamandi
    Empiric antibiotic therapy is often prescribed prior to the availability of bacterial culture results. In some cases, the organism isolated may not be susceptible to initial empiric therapy (inadequate empiric therapy or IET). In solid-organ transplant recipients, the overall incidence and clinical importance of IET is unknown. We performed a retrospective cohort study of patients admitted from 2002 to 2004. Multiple logistic regression analyses were conducted to determine associations between potential determinants and mortality. IET was administered in 169/312 (54%) patients, with a hospital mortality rate that was significantly greater than those receiving adequate therapy (24.9% vs. 7.0%; relative risk [RR] 3.55; 95% confidence interval [CI], 1.85,6.83; p < 0.001). Regression analysis demonstrated that an increasing duration of IET (adjusted odds ratio [OR] at 24 h: 1.33; 95% CI: 1.15,1.53; p < 0.001), ICU-associated infections (adjusted OR: 6.27; 95% CI: 2.79,14.09; p < 0.001), prior antibiotic use (adjusted OR: 3.56; 95% CI: 1.51,8.41; p = 0.004) and increasing APACHE-II scores (adjusted OR: 1.26; 95% CI: 1.16,1.34; p < 0.001) were independently correlated with hospital mortality. IET is common and appears to be associated with an increased hospital mortality rate in the solid-organ transplant population. [source]

    Assessment of Psychoeducational Outcomes After Pediatric Liver Transplant

    S. Gilmour
    Outcomes research in pediatric liver transplant (LT) has focused on mortality and morbidity but there is a need to also evaluate functional outcomes. Standardized cognitive testing was administered to a cohort of children with infantile chronic liver disease who were transplanted at the University of Alberta during their preschool years. Thirty children had comprehensive assessments with the Bayley Scales of Infant Development or Wechsler testing. Patient variables potentially associated with cognitive delay were analyzed with multiple regression analysis. The mean DQ/IQ score (developmental quotient/intelligence quotient) was 81 ± 17. Delay (DQ/IQ score < 70), and borderline delay (DQ/IQ 70,84) were each present in 27% of the cohort, with only 46% demonstrating normal cognition. Regression analysis demonstrated that the decreased IQ was associated with pretransplant growth retardation and elevated calcineurin inhibitor levels. Performance IQ had strong correlation with pretransplant growth retardation and elevated serum ammonia, R2= 45%, compared to verbal IQ that was associated was elevated calcineurin inhibitor levels, R2= 23%. Children post-LT are at high risk for cognitive delay or borderline delay. This is the first study to demonstrate the association calcineurin inhibitors with impaired IQ and also the unique finding of different variables predictive of impaired verbal intelligence quotient (VIQ) versus performance intelligence quotient (PIQ). [source]

    Primary hyperparathyroidism: Referral patterns and outcomes of surgery

    ANZ JOURNAL OF SURGERY, Issue 3 2002
    Richard S. Flint
    Background: Parathyroidectomy has long been established as an effective treatment for primary hyperparathyroidism (HPT). Methods: A 15-year retrospective audit was made by surgeons at North Shore Hospital, Auckland, of 33 patients with primary HPT who had parathyroidectomy. Results: There were 22 females and 11 males, ranging in age from 18 to 77 years (median 63 years). Initial diagnosis was predominantly by a general practitioner (72%), who invariably referred to a physician. Referral to surgery was made by general physicians (55%), endocrinologists (33%) and geriatricians (6%). Delay between diagnosis and referral for surgery ranged from 8 days to 10 years (median 7 months), and exceeded 2 years in 24% of patients. Twenty-eight (85%) were symptomatic: 13 (39%) had renal symptoms, 13 (39%) had bone disease, 10 (31%) had gastrointestinal complaints, seven (21%) had psychiatric illnesses and six (18%) had fatigue. The high incidence of symptoms was matched by high biochemical values (mean serum cal- cium level 2.97 mmol/L), and large parathyroid glands (mean weight 2001 mg). Twenty-nine patients (88%) had single adenomas, two (6%) had chief cell hyperplasia and two (6%) had carcinoma. Thirty-one (94%) were cured of their primary HPT. Conclusions: Parathyroidectomy is a safe and effective treatment for primary HPT but depends upon referral from non-surgical clinicians. A large proportion of patients have long delays before their surgery, and the group selected for surgery is referred with severe disease. [source]