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Sample records for bi-ventricular pacing system

  1. Pacing failure caused by automatic pacing threshold adjustment system

    Directory of Open Access Journals (Sweden)

    Jun Kishihara

    2017-12-01

    Full Text Available Ventricular capture management is an automatic pacing threshold adjustment algorithm that automatically measures pacing threshold through detection of the evoked response after a pacing stimulus. Although it is principally designed to save device battery under the maintenance of the patient׳s safety, we experienced a rare case with serious pacing failure due to a weakness of this algorithm. This pacing failure might be explained by a large variation in the ventricular pacing threshold depending on the atrioventricular interval and daily variation of pacing threshold and concomitant steroid use in this patient. Keywords: Automatic pacing threshold adjustment algorithm, Pacing failure

  2. A Leadless Intracardiac Transcatheter Pacing System

    NARCIS (Netherlands)

    Reynolds, Dwight; Duray, Gabor Z.; Omar, Razali; Soejima, Kyoko; Neuzil, Petr; Zhang, Shu; Narasimhan, Calambur; Steinwender, Clemens; Brugada, Josep; Lloyd, Michael; Roberts, Paul R.; Sagi, Venkata; Hummel, John; Bongiorni, Maria Grazia; Knops, Reinoud E.; Ellis, Christopher R.; Gornick, Charles C.; Bernabei, Matthew A.; Laager, Verla; Stromberg, Kurt; Williams, Eric R.; Hudnall, J. Harrison; Ritter, Philippe; Duray, Gabor Zoltan; Roberts, Paul; Gornick, Charles; Ellis, Christopher; Gonzalez, Efrain; Boersma, Lucas V. A.; Chinitz, Larry; Bernabei, Matthew; Shinn, Timothy; Jones, Randy; Schoenhard, John; Kusano, Kengo; Philippon, Francois; Atwater, Brett; Voigt, Andrew; Asano, Taku; Kowal, Robert; Simmers, Timothy Alexander; Milasinovic, Goran; Bahl, Vinay Kumar; Seger, John; Shehata, Michael; Thibault, Bernard T.; Ishikawa, Toshiyuki; Sra, Jasbir; Giocondo, Michael; Johnson, Eric; Wilkoff, Bruce; Collier, Jack; Hill, John; Vardas, Panos E.; Mittal, Suneet; Grubman, Eric; Ferguson, John; Svendsen, Jesper Hastrup; Chin, Ashley; Rogers, John; Jadonath, Ram; Tyagi, Sanjay; Ghali, Magdi; Coyne, Robert; Esberg, Douglas; Duray, Gabor

    2016-01-01

    A leadless intracardiac transcatheter pacing system has been designed to avoid the need for a pacemaker pocket and transvenous lead. In a prospective multicenter study without controls, a transcatheter pacemaker was implanted in patients who had guideline-based indications for ventricular pacing.

  3. Prediction of Procrastination in a Self-Pacing Instructional System.

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    Ely, Donald D.; Hampton, John D.

    The objective of the study was to predict potential procrastinators in a self-pacing instructional system. Seventy-five entering college freshmen were randomly selected to participate in a large scale individually-paced program. Those students (25) who procrastinated were classified as "no-start-procrastinators" (NSP); the remainder (52) were…

  4. Global Bi-ventricular endocardial distribution of activation rate during long duration ventricular fibrillation in normal and heart failure canines.

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    Luo, Qingzhi; Jin, Qi; Zhang, Ning; Han, Yanxin; Wang, Yilong; Huang, Shangwei; Lin, Changjian; Ling, Tianyou; Chen, Kang; Pan, Wenqi; Wu, Liqun

    2017-04-13

    The objective of this study was to detect differences in the distribution of the left and right ventricle (LV & RV) activation rate (AR) during short-duration ventricular fibrillation (SDVF, 1 min) in normal and heart failure (HF) canine hearts. Ventricular fibrillation (VF) was electrically induced in six healthy dogs (control group) and six dogs with right ventricular pacing-induced congestive HF (HF group). Two 64-electrode basket catheters deployed in the LV and RV were used for global endocardium electrical mapping. The AR of VF was estimated by fast Fourier transform analysis from each electrode. In the control group, the LV was activated faster than the RV in the first 20 s, after which there was no detectable difference in the AR between them. When analyzing the distribution of the AR within the bi-ventricles at 3 min of LDVF, the posterior LV was activated fastest, while the anterior was slowest. In the HF group, a detectable AR gradient existed between the two ventricles within 3 min of VF, with the LV activating more quickly than the RV. When analyzing the distribution of the AR within the bi-ventricles at 3 min of LDVF, the septum of the LV was activated fastest, while the anterior was activated slowest. A global bi-ventricular endocardial AR gradient existed within the first 20 s of VF but disappeared in the LDVF in healthy hearts. However, the AR gradient was always observed in both SDVF and LDVF in HF hearts. The findings of this study suggest that LDVF in HF hearts can be maintained differently from normal hearts, which accordingly should lead to the development of different management strategies for LDVF resuscitation.

  5. Unilateral Laryngeal Pacing System and Its Functional Evaluation

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    Taiping Zeng

    2017-01-01

    Full Text Available Goal. To establish a reliable instrumental system for synchronized reactivation of a unilaterally paralyzed vocal fold and evaluate its functional feasibility. Methods. Unilateral vocal fold paralysis model was induced by destruction of the left recurrent laryngeal nerve (RLN in anesthetized dogs. With a micro controller-based electronic system, electromyography (EMG signals from cricothyroid (CT muscle on the ipsilateral side were recorded and used to trigger pacing of paralyzed vocalis muscles. The dynamic movement of vocal folds was continuously monitored using an endoscope, and the opening and closing of the glottis were quantified with customized imaging processing software. Results. The recorded video images showed that left side vocal fold was obviously paralyzed after destructing the RLN. Using the pacing system with feedback triggering EMG signals from the ipsilateral CT muscle, the paralyzed vocal fold was successfully reactivated, and its movement was shown to be synchronized with the healthy side. Significance. The developed unilateral laryngeal pacing system triggered by EMG from the ipsilateral side CT muscle could be successfully used in unilateral vocal fold paralysis with the advantage of avoiding disturbance to the healthy side muscles.

  6. A Closer Look at Split Visual Attention in System- and Self-Paced Instruction in Multimedia Learning

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    Schmidt-Weigand, Florian; Kohnert, Alfred; Glowalla, Ulrich

    2010-01-01

    Two experiments examined visual attention distribution in learning from text and pictures. Participants watched a 16-step multimedia instruction on the formation of lightning. In Experiment 1 (N=90) the instruction was system-paced (fast, medium, slow pace), while it was self-paced in Experiment 2 (N=31). In both experiments the text modality was…

  7. Impact of pacing on systemic ventricular function in L-transposition of the great arteries.

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    Hofferberth, Sophie C; Alexander, Mark E; Mah, Douglas Y; Bautista-Hernandez, Victor; del Nido, Pedro J; Fynn-Thompson, Francis

    2016-01-01

    To assess the impact of univentricular versus biventricular pacing (BiVP) on systemic ventricular function in patients with congenitally corrected transposition of the great arteries (ccTGA). We performed a retrospective review of all patients with a diagnosis of ccTGA who underwent pacemaker insertion. From 1993 to 2014, 53 patients were identified from the cardiology database and surgical records. Overall mortality was 7.5% (n = 4). One patient required transplantation and 3 late deaths occurred secondary to end-stage heart failure. Median follow-up was 3.7 years (range, 4 days to 22.5 years). Twenty-five (47%) underwent univentricular pacing only, of these, 8 (32%) developed significant systemic ventricular dysfunction. Twenty-eight (53%) received BiVP, 17 (26%) were upgraded from a dual-chamber system, 11 (21%) received primary BiVP. Fourteen (82%) of the 17 undergoing secondary BiVP demonstrated systemic ventricular dysfunction at the time of pacer upgrade, with 7 (50%) demonstrating improved systemic ventricular function after pacemaker upgrade. Overall, 42 (79%) patients underwent univentricular pacing, with 22 (52%) developing significant systemic ventricular dysfunction. In contrast, the 11 (21%) who received primary BiVP had preserved systemic ventricular function at latest follow-up. Late-onset systemic ventricular dysfunction is a major complication associated with the use of univentricular pacing in patients with ccTGA. All patients with ccTGA who develop heart block should undergo primary biventricular pacing, as this prevents late systemic ventricular dysfunction. Preemptive placement of BiVP leads at the time of anatomical repair or other permanent palliative procedure will facilitate subsequent BiVP should heart block develop. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  8. A Review on Pacemakers: Device Types, Operating Modes and Pacing Pulses. Problems Related to the Pacing Pulses Detection

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    Valentin Tsibulko

    2014-06-01

    Full Text Available A pacemaker is a small battery-operated medical device that delivers electrical impulses to the heart in order to guarantee regular contractions. Depending on the number of active leads the pacemakers are single chamber, dual chamber and bi-ventricular. According to their programming the devices could be with fixed-rate, 'on demand' and rate-responsitive. The operating mode of the pacemaker depends on the paced chamber, the sensed chamber, the response to a sensed electrical signal and the rate modulation. Two types of pacing are recognized - unipolar and bipolar, represented with different pacing artifacts in the ECG signal. The pacing pulse on the skin surface usually have very fast rising edges of the order of 10 µs or less and could be as small as few hundreds µV. The pacing artifacts detection is important since they indicate the presence of a pacemaker and help to evaluate the reaction of the heart. All pertinent medical standards require the pacing artifacts to be captured and indicated on the screen of the device. This paper presents a short review on pacemakers - reasons for implementation, device types, different operation modes and pacing pulses. It reveals some common problems with the detection of pacemaker's artifacts.

  9. Uncovering the dynamics of cardiac systems using stochastic pacing and frequency domain analyses.

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    Mathieu Lemay

    Full Text Available Alternans of cardiac action potential duration (APD is a well-known arrhythmogenic mechanism which results from dynamical instabilities. The propensity to alternans is classically investigated by examining APD restitution and by deriving APD restitution slopes as predictive markers. However, experiments have shown that such markers are not always accurate for the prediction of alternans. Using a mathematical ventricular cell model known to exhibit unstable dynamics of both membrane potential and Ca²⁺ cycling, we demonstrate that an accurate marker can be obtained by pacing at cycle lengths (CLs varying randomly around a basic CL (BCL and by evaluating the transfer function between the time series of CLs and APDs using an autoregressive-moving-average (ARMA model. The first pole of this transfer function corresponds to the eigenvalue (λ(alt of the dominant eigenmode of the cardiac system, which predicts that alternans occurs when λ(alt ≤ -1. For different BCLs, control values of λ(alt were obtained using eigenmode analysis and compared to the first pole of the transfer function estimated using ARMA model fitting in simulations of random pacing protocols. In all versions of the cell model, this pole provided an accurate estimation of λ(alt. Furthermore, during slow ramp decreases of BCL or simulated drug application, this approach predicted the onset of alternans by extrapolating the time course of the estimated λ(alt. In conclusion, stochastic pacing and ARMA model identification represents a novel approach to predict alternans without making any assumptions about its ionic mechanisms. It should therefore be applicable experimentally for any type of myocardial cell.

  10. Diagnostic accuracy of pace spikes in the electrocardiogram to diagnose paced rhythm

    DEFF Research Database (Denmark)

    Andersson, Hedvig Bille; Hansen, Marco Bo; Thorsberger, Mads

    2015-01-01

    OBJECTIVE: To determine how often cardiac resynchronization therapy (CRT) pacing systems generate visible pace spikes in the electrocardiogram (ECG). METHODS: In 46 patients treated with CRT pacing systems, we recorded ECGs during intrinsic rhythm, atrial pacing and ventricular pacing. ECGs were...

  11. Temporary pacing

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    L.J. Workman

    1983-09-01

    Full Text Available Artificial cardiac pacing, the use of electrical stimuli to cause contraction of heart muscle, is a sophisticated therapeutic and diagnostic tool. Its rapid technologic improvement since first developed in the late 1930’s by Hyman, has made it possible not only to avoid certain cases of death due to heart block, but also to extend and improve the quality of life. Pacemaker therapy is generally used to treat heart rate or rhythm disturbances, being either tachy- or bradyarrhythmias that produce a detrimental drop in cardiac output. Of the many different types of pacemakers and electrodes currently available, ventricular demand pacing is the most commonly used.

  12. Tracking and data relay satellite fault isolation and correction using PACES: Power and attitude control expert system

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    Erikson, Carol-Lee; Hooker, Peggy

    1989-01-01

    The Power and Attitude Control Expert System (PACES) is an object oriented and rule based expert system which provides spacecraft engineers with assistance in isolating and correcting problems within the Power and Attitude Control Subsystems of the Tracking and Data Relay Satellites (TDRS). PACES is designed to act in a consultant role. It will not interface to telemetry data, thus preserving full operator control over spacecraft operations. The spacecraft engineer will input requested information. This information will include telemetry data, action being performed, problem characteristics, spectral characteristics, and judgments of spacecraft functioning. Questions are answered either by clicking on appropriate responses (for text), or entering numeric values. A context sensitive help facility allows access to additional information when the user has difficulty understanding a question or deciding on an answer. The major functionality of PACES is to act as a knowledge rich system which includes block diagrams, text, and graphics, linked using hypermedia techniques. This allows easy movement among pieces of the knowledge. Considerable documentation of the spacecraft Power and Attitude Control Subsystems is embedded within PACES. The development phase of TDRSS expert system technology is intended to provide NASA with the necessary expertise and capability to define requirements, evaluate proposals, and monitor the development progress of a highly competent expert system for NASA's Tracking and Data Relay Satellite Program.

  13. A bi-ventricular cardiac atlas built from 1000+ high resolution MR images of healthy subjects and an analysis of shape and motion.

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    Bai, Wenjia; Shi, Wenzhe; de Marvao, Antonio; Dawes, Timothy J W; O'Regan, Declan P; Cook, Stuart A; Rueckert, Daniel

    2015-12-01

    Atlases encode valuable anatomical and functional information from a population. In this work, a bi-ventricular cardiac atlas was built from a unique data set, which consists of high resolution cardiac MR images of 1000+ normal subjects. Based on the atlas, statistical methods were used to study the variation of cardiac shapes and the distribution of cardiac motion across the spatio-temporal domain. We have shown how statistical parametric mapping (SPM) can be combined with a general linear model to study the impact of gender and age on regional myocardial wall thickness. Finally, we have also investigated the influence of the population size on atlas construction and atlas-based analysis. The high resolution atlas, the statistical models and the SPM method will benefit more studies on cardiac anatomy and function analysis in the future. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Analysis of a Student-Centered, Self-Paced Pedagogy Style for Teaching Information Systems Courses

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    Sharon Paranto

    2006-12-01

    Full Text Available The entry-level skills for students enrolling in a college-level information systems course can vary widely. This paper analyzes the impact of a "student-centered" pedagogy model, in which students use a self-paced approach for learning the material in an introductory information systems course, with pre-assigned dates for lectures and for assignment/exam deadlines. This new paradigm was implemented in several sections of an introductory information systems course over a two-semester time span. Under the new model, tutorial-style textbooks were used to help students master the material, all other materials were available online, and all exams were given using a hands-on, task-oriented online testing package, which included a multiple-choice/true-false component to test student understanding of the conceptual portion of the course. An anonymous student survey was used to gain student perceptions of the level of learning that took place under the new paradigm, as well as to measure student satisfaction with the course design, and a pre-/post-test was used to provide a measure of student learning.

  15. An integrated optical coherence microscopy imaging and optical stimulation system for optogenetic pacing in Drosophila melanogaster (Conference Presentation)

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    Alex, Aneesh; Li, Airong; Men, Jing; Jerwick, Jason; Tanzi, Rudolph E.; Zhou, Chao

    2016-03-01

    Electrical stimulation is the clinical standard for cardiac pacing. Although highly effective in controlling cardiac rhythm, the invasive nature, non-specificity to cardiac tissues and possible tissue damage limits its applications. Optogenetic pacing of the heart is a promising alternative, which is non-invasive and more specific, has high spatial and temporal precision, and avoids the shortcomings in electrical stimulation. Drosophila melanogaster, which is a powerful model organism with orthologs of nearly 75% of human disease genes, has not been studied for optogenetic pacing in the heart. Here, we developed a non-invasive integrated optical pacing and optical coherence microscopy (OCM) imaging system to control the heart rhythm of Drosophila at different developmental stages using light. The OCM system is capable of providing high imaging speed (130 frames/s) and ultrahigh imaging resolutions (1.5 μm and 3.9 μm for axial and transverse resolutions, respectively). A light-sensitive pacemaker was developed in Drosophila by specifically expressing the light-gated cation channel, channelrhodopsin-2 (ChR2) in transgenic Drosophila heart. We achieved non-invasive and specific optical control of the Drosophila heart rhythm throughout the fly's life cycle (larva, pupa, and adult) by stimulating the heart with 475 nm pulsed laser light. Heart response to stimulation pulses was monitored non-invasively with OCM. This integrated non-invasive optogenetic control and in vivo imaging technique provides a novel platform for performing research studies in developmental cardiology.

  16. External electrical cardioversion of persistent atrial fibrillation in a patient with a Micra™ Transcatheter Pacing System.

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    Filipovic, K; Bellmann, B; Lüker, J; Steven, D; Sultan, A

    We report a case of a 85-year old woman with a preexisting Transcatheter Pacing System (TPS) (Micra™ VR, Fa. Medtronic, Inc., Minneapolis, MN, USA) undergoing several external electrical cardioversions (CV) for symptomatic persistent atrial fibrillation (persAF). Due to bradycardia in the setting of atrial fibrillation a right apical TPS implantation was performed earlier. Four weeks prior to presentation at our facility an unsuccessful CV with a maximum biphasic energy level of 360J was performed, after which amiodarone was initiated. At the time of presentation three shocks with 100 J, 200 J and 360 J were delivered without sustained restoration of a stable sinus rhythm. Patches were in an anterior-posterior position. No complications and no significant changes in device parameters in comparison to the pre-acquired values were observed. To our knowledge, this is the first case report of an external CV in a patient with a TPS. External CV in patients with a preexisting TPS seems to be safe and feasible. Copyright © 2017 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. All rights reserved.

  17. Implant Site Infection and Bone Flap Osteomyelitis Associated with the NeuroPace Responsive Neurostimulation System.

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    Wei, Zhikui; Gordon, Chad R; Bergey, Gregory K; Sacks, Justin M; Anderson, William S

    2016-04-01

    The NeuroPace RNS System is a method recently approved by the U.S. Food and Drug Administration for closed-loop direct brain stimulation in selected patients with drug-resistant partial seizures. The long-term risks of implant site infection and accompanying bone flap osteomyelitis associated with responsive neurostimulation (RNS) devices have not been fully appreciated. We report 3 cases of refractory partial epilepsy that were treated with RNS therapy in conjunction with antiepileptic drugs. Patients underwent invasive epilepsy monitoring and resection of seizure foci. All patients continued to have debilitating partial seizures and underwent implantation of the RNS device, which resulted in various degrees of symptomatic relief. On average, the battery of the implantable pulse generator was replaced every 2 years. All 3 patients developed implant site infection and bone flap osteomyelitis with multiple implantable pulse generator replacements, and the RNS devices were removed. Bone flaps were removed in 2 patients because of significant osteomyelitis and were reconstructed in a delayed fashion with customized cranial implants. No patient had evidence of meningitis or cerebritis. The patients were treated via a multidisciplinary approach, and all patients recovered well with satisfactory wound healing and seizure control. Implant site infection and bone flap osteomyelitis are significant adverse events associated with the RNS device. The incidence of infection in this series (10%) is comparable to the incidence reported in the long-term trial. The infection risk is mainly associated with reoperations and increases with multiple implantable pulse generator replacements. The RNS device may benefit from reducing technical risk factors that are associated with postoperative bone and soft tissue infections. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. An infrared optical pacing system for high-throughput screening of cardiac electrophysiology in human cardiomyocytes (Conference Presentation)

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    McPheeters, Matt T.; Wang, Yves T.; Laurita, Kenneth R.; Jenkins, Michael W.

    2017-02-01

    Cardiomyocytes derived from human induced pluripotent stem cells (hiPS-HCM) have the potential to provide individualized therapies for patients and to test drug candidates for cardiac toxicity. In order for hiPS-CM to be useful for such applications, there is a need for high-throughput technology to rapidly assess cardiac electrophysiology parameters. Here, we designed and tested a fully contactless optical mapping (OM) and optical pacing (OP) system capable of imaging and point stimulation of hiPS-CM in small wells. OM allowed us to characterize cardiac electrophysiological parameters (conduction velocity, action potential duration, etc.) using voltage-sensitive dyes with high temporal and spatial resolution over the entire well. To improve OM signal-to-noise ratio, we tested a new voltage-sensitive dye (Fluovolt) for accuracy and phototoxicity. Stimulation is essential because most electrophysiological parameters are rate dependent; however, traditional methods utilizing electrical stimulation is difficult in small wells. To overcome this limitation, we utilized OP (λ = 1464 nm) to precisely control heart rate with spatial precision without the addition of exogenous agents. We optimized OP parameters (e.g., well size, pulse width, spot size) to achieve robust pacing and minimize the threshold radiant exposure. Finally, we tested system sensitivity using Flecainide, a drug with well described action on multiple electrophysiological properties.

  19. Sensors for rate responsive pacing

    Directory of Open Access Journals (Sweden)

    Simonetta Dell’Orto

    2004-07-01

    Full Text Available Advances in pacemaker technology in the 1980s have generated a wide variety of complex multiprogrammable pacemakers and pacing modes. The aim of the present review is to address the different rate responsive pacing modalities presently available in respect to physiological situations and pathological conditions. Rate adaptive pacing has been shown to improve exercise capacity in patients with chronotropic incompetence. A number of activity and metabolic sensors have been proposed and used for rate control. However, all sensors used to optimize pacing rate metabolic demands show typical limitations. To overcome these weaknesses the use of two sensors has been proposed. Indeed an unspecific but fast reacting sensor is combined with a more specific but slower metabolic one. Clinical studies have demonstrated that this methodology is suitable to reproduce normal sinus behavior during different types and loads of exercise. Sensor combinations require adequate sensor blending and cross checking possibly controlled by automatic algorithms for sensors optimization and simplicity of programming. Assessment and possibly deactivation of some automatic functions should be also possible to maximize benefits from the dual sensor system in particular conditions. This is of special relevance in patient whose myocardial contractility is limited such as in subjects with implantable defibrillators and biventricular pacemakers. The concept of closed loop pacing, implementing a negative feedback relating pacing rate and the control signal, will provide new opportunities to optimize dual-sensors system and deserves further investigation. The integration of rate adaptive pacing into defibrillators is the natural consequence of technical evolution.

  20. [Change of quality of life and NYHA class in patients with advanced heart failure and permanent atrial fibrillation after 12-months period from upgrade of pacing system].

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    Małecka, Barbara; Zabek, Andrzej; Lelakowski, Jacek; Małecki, Janusz

    2012-01-01

    There is no research on the change of quality of life and NYHA classification after pacing system upgrade performed as a treatment of advanced heart failure during a long observation period in a particular population of patients with long-term apical right ventricular pacing, permanent atrial fibrillation and complete atrio-ventricular block. The aim of the study was evaluation of changes in quality of life and NYHA class in group of patients in which upgrade from right ventricular apical pacing to biventricular or bifocal right ventricular pacing was done. Evaluation of quality of life was performed in a chosen group of 27 patients (20 males, mean age 71.2) who completed the 12-month observation period. Quality of life was assessed by the Short Form-36 (SF-36) questionnaire. The first examination was carried out before the planned pacing system upgrade, that is, when advanced heart failure appeared in the course of permanent atrial fibrillation and right ventricular apical pacing present for a long time (on average 7.7 years). The change of quality of life after 12-month period of upgrade pacing system was analyzed. A comparison of patient's self assessment (as far as physical aspect of quality of life is concerned - Physical Component Summary - PCS) with doctor's interview concerning NYHA classification was performed. Additionally quality of life pointed out by a patient was analyzed in relation to the diseases most common in this population: hypertension, diabetes mellitus and renal failure. Because the questionnaires were completed by the patients personally without the third party, the assessment referred to mistakes in filling in the questionnaires (quantity of missed questions and incorrect marking the answers by adding individual comments) in relation to patients' age. In 12-month follow-up after pacing system upgrade, improvement of quality of life was found in 48.1% of patients. Assessment of physical aspect of quality of life was possible due to SF-36

  1. Ventricular resynchronization through biventricular cardiac pacing for the treatment of refractory heart failure in dilated cardiomyopathy

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    Silas S. Galvão Fº

    2002-01-01

    Full Text Available OBJECTIVE: The biventricular pacing (BVP approach has good results in the treatment of congestive heart failure (CHF in patients (pts with disorders of intraventricular conduction. METHODS: We have applied BVP to 28 pts, with left ventricular pacing using minitoracotomy in 3 pts and the transvenous aproach via coronary sinus in 25 pts. The mean duration of the QRS complexes was 187 ms, in the presence of the left branch block in 22 pts, and right branch block + divisional hemiblock in 6 pts. All pts had been considerated candidates to cardiac transplantation, and were under optimized drug therapy. Sixteen pts were in Functional Class (NYHA IV, and 12 in class III. The ejection fraction varied from 22 to 46% (average = 34%. The pacing mode employed was biventricular triple-chamber in 22 pts, and bi-ventricular dual-chamber in 6 pts (one with ICD. RESULTS: The pts were followed up for a period that ranged from 10 days to 14 months (mean 5 months. All pts presented clinical improvement after implant, chaging the NYHA Functional Class at the end of follow-up to Class I (9pts, Class II (10 pts and Class III (6 pts. The initial mean ejection fraction have-raised to 37%. Two pts died suddenly. One patient died due to a pulmonary fungal infection. CONCLUSION: Ventricular resynchronization through BVP, improved significantly the Functional Class and, therefore, the quality of life. Assessments of myocardial function acutely performed do not reflect the clinical improvement observed.

  2. Federal Government Information Systems Security Management and Governance Are Pacing Factors for Innovation

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    Edwards, Gregory

    2011-01-01

    Security incidents resulting from human error or subversive actions have caused major financial losses, reduced business productivity or efficiency, and threatened national security. Some research suggests that information system security frameworks lack emphasis on human involvement as a significant cause for security problems in a rapidly…

  3. Clinical validation of a real-time data processing system for cardiac output and arterial pressure measurement during intraoperative biventricular pacing optimization.

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    Johnson, Christopher K; Cabreriza, Santos E; Sahar, Rana L; Rusanov, Alexander; Wang, Daniel Y; Cheng, Bin; Gendy, Mira S; Quinn, T Alexander; Spotnitz, Henry Michael

    2012-01-01

    Biventricular pacing (BiVP) improves cardiac output (CO) and mean arterial pressure (MAP) after cardiopulmonary bypass (CPB) in selected patients at risk for acute left heart failure after cardiac surgery. Optimization of atrioventricular delay (AVD) and interventricular delay (VVD) to maximize the hemodynamic effect of pacing requires rapid and accurate data processing. Conventional post hoc data processing (PP) is accurate but time-consuming, and infeasible in the intraoperative setting. We created a customized, real-time data processing (RTP) system to improve data processing efficiency, while maintaining accuracy. Biventricular pacing optimization was performed within 1 hour of the conclusion of CPB in 10 patients enrolled in the Biventricular Pacing After Cardiac Surgery trial. Cardiac output, measured by an electromagnetic flow meter, and arterial pressure were recorded as AVD was randomly varied across seven settings and VVD across nine settings. Post hoc data processing values calculated by two observers were compared to RTP-generated outputs for CO and MAP. Interexaminer reliability coefficients were generated to access the dependability of RTP. Interexaminer reliability coefficient values ranged from 0.997 to 0.999, indicating RTP is as reliable as PP for optimization. Real-time data processing is instantaneous and therefore is more practical in a clinical setting than the PP method. Real-time data processing is useful for guiding intraoperative BiVP optimization and merits further development.

  4. Temporary internal pacing.

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    Ortiz Díaz-Miguel, R; Gómez Grande, M L

    2014-12-01

    Technology and insertion techniques for cardiac temporary internal pacing have experienced a remarkable development over the last few years. Despite this fact, the procedure continues to have potentially fatal associated complications. Temporary internal pacing is indicated for the treatment of bradyarrhythmias or tachyarrhythmias refractory to conventional treatment, or arrhythmias causing cardiovascular or clinical instability of the patient. On the other hand, the indications of temporary cardiac pacing are far less well defined than those of permanent pacing. Since the decision of implementing temporary pacing is complex and delicate, it should always be carefully considered, and over-indication should be avoided. We must base these decisions on robust knowledge of the arrhythmias that may benefit from temporary internal pacing, and should also acquire the habit of considering external temporary pacing among other less aggressive treatments, and to make the best use of new technologies such as echocardiography that add accuracy to the procedure. Copyright © 2013 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  5. Pacing stress echocardiography

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    Agrusta Marco

    2005-12-01

    Full Text Available Abstract Background High-rate pacing is a valid stress test to be used in conjunction with echocardiography; it is independent of physical exercise and does not require drug administration. There are two main applications of pacing stress in the echo lab: the noninvasive detection of coronary artery disease through induction of a regional transient dysfunction; and the assessment of contractile reserve through peak systolic pressure/ end-systolic volume relationship at increasing heart rates to assess global left ventricular contractility. Methods The pathophysiologic rationale of pacing stress for noninvasive detection of coronary artery disease is obvious, with the stress determined by a controlled increase in heart rate, which is a major determinant of myocardial oxygen demand, and thereby tachycardia may exceed a fixed coronary flow reserve in the presence of hemodynamically significant coronary artery disease. The use of pacing stress echo to assess left ventricular contractile reserve is less established, but promising. Positive inotropic interventions are mirrored by smaller end-systolic volumes and higher end-systolic pressures. An increased heart rate progressively increases the force of ventricular contraction (Bowditch treppe or staircase phenomenon. To build the force-frequency relationship, the force is determined at different heart rate steps as the ratio of the systolic pressure (cuff sphygmomanometer/end-systolic volume index (biplane Simpson rule. The heart rate is determined from ECG. Conclusion Two-dimensional echocardiography during pacing is a useful tool in the detection of coronary artery disease. Because of its safety and ease of repeatability noninvasive pacing stress echo can be the first-line stress test in patients with permanent pacemaker. The force-frequency can be defined as up- sloping (normal when the peak stress pacing systolic pressure/end-systolic volume index is higher than baseline and intermediate stress

  6. PACE Status Update

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    M., Zimring,; Hoffman, I.; Fuller, M.

    2010-08-11

    The Federal Housing Finance Agency (FHFA) regulates Fannie Mae, Freddie Mac, and the 12 Federal Home Loan Banks (the government-sponsored enterprises - GSEs). On July 6, 2010, FHFA and the Office of the Comptroller of the Currency (OCC) concluded that Property Assessed Clean Energy (PACE) programs 'present significant safety and soundness concerns' to the housing finance industry. This statement came after a year of discussions with state and federal agencies in which PACE, a novel mechanism for financing energy efficiency and renewable energy improvements, has gone from receiving support from the White House, canonization as one of Scientific American's 'World Changing Ideas' and legislative adoption in 24 states to questionable relevance, at least in the residential sector. Whether PACE resumes its expansion as an innovative tool for financing energy efficiency and clean generation depends on outcomes in each of the three branches of government - discussions on a PACE pilot phase among federal agencies, litigation in federal court, and legislation in Congress - all highly uncertain. This policy brief addresses the practical impacts of these possible outcomes on existing and emerging PACE programs across the United States and potential paths forward.

  7. [Right ventricular septal stimulation would produce similar bi-ventricular dyssynchrony as does apical stimulation in patients with normal ejection fraction].

    Science.gov (United States)

    Lange, Juan Manuel; Manzolillo, Hector; Parras, Jorge; Pozzer, Domingo; Reyes, Ignacio; Pantich, Rolando

    2014-01-01

    To determine in patients with normal ejection fraction, undergoing permanent VVI pacing, if medial septal stimulation has lower dyssynchrony than apical stimulation assessed by echocardiography. A prospective trial, 19 patients>70 years old, scheduled for VVI pacemaker implantation for complete degenerative atrioventricular block, ventricular frequency<50beat per minute and ejection fraction≥45%. Patients with atrial fibrillation, heart failure, left bundle branch block and QRS durations longer than 120milliseconds in surface electrocardiogram with sinus rhythm were excluded. Patients were randomized to apical implantation group A: 47% and septal implantation group B: 53%. Echocardiographic parameters were measured previous to the implant, 48h, 5 and 48 months after implantation. No patients had diagnosis of ischemic cardiomyopathy or heart failure. Echocardiographic parameters for interventricular dyssynchrony between groups were A: 14.44±19.76msec vs. B: 9±36.45msec; A: 6.11±62.11msec vs. B: 13±38.31msec; A: 77±53.51msec vs. B: 24.29±80.90msec, P=NS). For interventricular dyssynchrony were A: 46.44±19.76msec vs. B: 42.20±29.56msec; A: 45.33±45.67msec vs. B: 29.80±44.66msec; A: 46,38±20 msec vs. B: 21±27.20msec, P=NS) at 48h, 5 and 48 months, respectively. Apical site of stimulation does not increase ventricular dyssynchrony rate in patients with preserved ejection fraction. Septal stimulation showed decreased trend in interventricular dyssynchrony. Copyright © 2013 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  8. [Advances in cardiac pacing].

    Science.gov (United States)

    de Carranza, María-José Sancho-Tello; Fidalgo-Andrés, María Luisa; Ferrer, José Martínez; Mateas, Francisco Ruiz

    2012-01-01

    This article contains a review of the current status of remote monitoring and follow-up involving cardiac pacing devices and of the latest developments in cardiac resynchronization therapy. In addition, the most important articles published in the last year are discussed. Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  9. Recent developments in cardiac pacing.

    Science.gov (United States)

    Rodak, D J

    1995-10-01

    Indications for cardiac pacing continue to expand. Pacing to improve functional capacity, which is now common, relies on careful patient selection and technical improvements, such as complex software algorithms and diagnostic capabilities.

  10. Optogenetic pacing in Drosophila melanogaster (Conference Presentation)

    Science.gov (United States)

    Alex, Aneesh; Li, Airong; Men, Jing; Jerwick, Jason; Tanzi, Rudolph E.; Zhou, Chao

    2016-03-01

    A non-invasive, contact-less cardiac pacing technology can be a powerful tool in basic cardiac research and in clinics. Currently, electrical pacing is the gold standard for cardiac pacing. Although highly effective in controlling the cardiac function, the invasive nature, non-specificity to cardiac tissues and possible tissue damage limits its capabilities. Optical pacing of heart is a promising alternative, which is non-invasive and more specific, has high spatial and temporal precision, and avoids shortcomings in electrical stimulation. Optical coherence tomography has been proved to be an effective technique in non-invasive imaging in vivo with ultrahigh resolution and imaging speed. In the last several years, non-invasive specific optical pacing in animal hearts has been reported in quail, zebrafish, and rabbit models. However, Drosophila Melanogaster, which is a significant model with orthologs of 75% of human disease genes, has rarely been studied concerning their optical pacing in heart. Here, we combined optogenetic control of Drosophila heartbeat with optical coherence microscopy (OCM) technique for the first time. The light-gated cation channel, channelrhodopsin-2 (ChR2) was specifically expressed by transgene as a pacemaker in drosophila heart. By stimulating the pacemaker with 472 nm pulsed laser light at different frequencies, we achieved non-invasive and more specific optical control of the Drosophila heart rhythm, which demonstrates the wide potential of optical pacing for studying cardiac dynamics and development. Imaging capability of our customized OCM system was also involved to observe the pacing effect visually. No tissue damage was found after long exposure to laser pulses, which proved the safety of optogenetic control of Drosophila heart.

  11. A dual-chamber pacing mode to minimize ventricular pacing

    Directory of Open Access Journals (Sweden)

    Peter Rakovec

    2005-12-01

    Full Text Available Background: Though patients with sick sinus syndrome theoretically need an atrial pacemaker only, they usually receive a ventricular or a dual-chamber pacemaker because of possible developement of atrioventricular conduction abnormalities. Right ventricular pacing produces left bundle branch block (i.e. pacing-induced ventricular desynchronization, promoting heart failure and atrial fibrillation. This problem can be solved by a special pacing mode which on one hand preserves the safety of dual-chamber pacing and on the other hand minimizes right ventricular pacing.

  12. TCP Pacing Developed

    Science.gov (United States)

    Ivancic, William D.

    2002-01-01

    Transmission control protocol (TCP) was conceived and designed to run over a variety of communication links, including wireless and high-bandwidth links. However, with recent technological advances in satellite and fiber-optic networks, researchers are reevaluating the flexibility of TCP. The TCP pacing and packet pair probing implementation may help overcome two of the major obstacles identified for efficient bandwidth utilization over communication links with large delay-bandwidth products.

  13. Pacing for Vasovagal Syncope

    Directory of Open Access Journals (Sweden)

    Nevin T Wijesekera

    2002-10-01

    Full Text Available Vasovagal syncope is a common condition, usually associated with a benign prognosis. Most sufferers experience only occasional symptoms, and can be treated with reassurance and lifestyle advice. However, a minority of patients are debilitated by frequent fainting that can infringe on daily living, or even mimic sudden death. This has been termed "malignant" vasovagal syncope because of the associated falls and physical injury. In these cases, a more interventional approach may be appropriate. Pharmacological measures have been the mainstay of treatment for recurrent vasovagal syncope: beta-blockers (e.g. atenolol, serotonin reuptake inhibitors (e.g. paroxetine, certain vasoconstricting drugs (e.g. midodrine and fluid retaining agents (e.g. fludrocortisone have been of particular interest. However, there is only mixed support from randomised controlled trials for the efficacy of these agents in preventing vasovagal syncope. 1,2,3 In the last few years, cardiac pacing has been advocated for the treatment of some forms of vasovagal syncope. This article reviews the literature and discusses the indications for pacing in vasovagal syncope.

  14. Clock-dependent and system-driven oscillators interact in the suprachiasmatic nuclei to pace mammalian circadian rhythms.

    Directory of Open Access Journals (Sweden)

    Karine Abitbol

    Full Text Available Circadian clocks drive biological rhythms with a period of approximately 24 hours and keep in time with the outside world through daily resetting by environmental cues. While this external entrainment has been extensively investigated in the suprachiasmatic nuclei (SCN, the role of internal systemic rhythms, including daily fluctuations in core temperature or circulating hormones remains debated. Here, we show that lactating mice, which exhibit dampened systemic rhythms, possess normal molecular clockwork but impaired rhythms in both heat shock response gene expression and electrophysiological output in their SCN. This suggests that body rhythms regulate SCN activity downstream of the clock. Mathematical modeling predicts that systemic feedback upon the SCN functions as an internal oscillator that accounts for in vivo and ex vivo observations. Thus we are able to propose a new bottom-up hierarchical organization of circadian timekeeping in mammals, based on the interaction in the SCN between clock-dependent and system-driven oscillators.

  15. Pacing system malfunction is a rare cause of hospital admission for syncope in patients with a permanent pacemaker.

    Science.gov (United States)

    Ofman, Peter; Rahilly-Tierney, Catherine; Djousse, Luc; Peralta, Adelqui; Hoffmeister, Peter; Gaziano, J Michael; Weiss, Alexey; Lotan, Chaim; Rosenheck, Shimon

    2013-01-01

    Few studies have examined the prevalence of permanent pacemaker (PPM) malfunction among patients with a previously implanted pacemaker admitted to the hospital with syncope. This study sought to examine causes of syncope in patients with a previously implanted pacemaker admitted to our hospital with syncope. We retrospectively reviewed our hospital admission database for patients who had both keywords "syncope" and "pacemaker" as their diagnoses from January 1, 1995 until June 1, 2012. One hundred and sixty-two patients who were admitted to the hospital because of syncope and had a PPM implanted prior to the index syncopal episode were included. All patients had pacemakers interrogated during the admission. Two independent physicians examined the discharge summary of each patient and determined the cause of syncope in each case. Of the 162 patients studied, eight (4.9%) were found to have pacemaker system malfunction as a cause of syncope. In 96 patients (59.2%), the cause of syncope could not be determined prior to hospital discharge. Among the identifiable causes of syncope, orthostatic hypotension was most prevalent (16%) followed by vasovagal (6%), severe aortic stenosis (4.3%), atrial arrhythmia (3.1%), acute and subacute infection (3.1%), and other less prevalent causes (3.1%). In this study, PPM system malfunction was rarely a cause of syncope in patients admitted to the hospital with a previously implanted device. ©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.

  16. Towards a system-paced near-infrared spectroscopy brain-computer interface: differentiating prefrontal activity due to mental arithmetic and mental singing from the no-control state

    Science.gov (United States)

    Power, Sarah D.; Kushki, Azadeh; Chau, Tom

    2011-10-01

    Near-infrared spectroscopy (NIRS) has recently been investigated as a non-invasive brain-computer interface (BCI) for individuals with severe motor impairments. For the most part, previous research has investigated the development of NIRS-BCIs operating under synchronous control paradigms, which require the user to exert conscious control over their mental activity whenever the system is vigilant. Though functional, this is mentally demanding and an unnatural way to communicate. An attractive alternative to the synchronous control paradigm is system-paced control, in which users are required to consciously modify their brain activity only when they wish to affect the BCI output, and can remain in a more natural, 'no-control' state at all other times. In this study, we investigated the feasibility of a system-paced NIRS-BCI with one intentional control (IC) state corresponding to the performance of either mental arithmetic or mental singing. In particular, this involved determining if these tasks could be distinguished, individually, from the unconstrained 'no-control' state. Deploying a dual-wavelength frequency domain near-infrared spectrometer, we interrogated nine sites around the frontopolar locations (International 10-20 System) while eight able-bodied adults performed mental arithmetic and mental singing to answer multiple-choice questions within a system-paced paradigm. With a linear classifier trained on a six-dimensional feature set, an overall classification accuracy of 71.2% across participants was achieved for the mental arithmetic versus no-control classification problem. While the mental singing versus no-control classification was less successful across participants (62.7% on average), four participants did attain accuracies well in excess of chance, three of which were above 70%. Analyses were performed offline. Collectively, these results are encouraging, and demonstrate the potential of a system-paced NIRS-BCI with one IC state corresponding to

  17. Early performance of a miniaturized leadless cardiac pacemaker: the Micra Transcatheter Pacing Study

    NARCIS (Netherlands)

    Ritter, Philippe; Duray, Gabor Z.; Steinwender, Clemens; Soejima, Kyoko; Omar, Razali; Mont, Lluís; Boersma, Lucas V. A.; Knops, Reinoud E.; Chinitz, Larry; Zhang, Shu; Narasimhan, Calambur; Hummel, John; Lloyd, Michael; Simmers, Timothy Alexander; Voigt, Andrew; Laager, Verla; Stromberg, Kurt; Bonner, Matthew D.; Sheldon, Todd J.; Reynolds, Dwight; Kypta, Alexander; Vamos, Mate; Bordachar, Pierre; El Chami, Mikhael; Hussin, Azlan; Mont Girbau, Josep Lluís; Tolosana, José María; Morgan, John M.; Roberts, Paul; de Groot, Joris R.; Tjong, Fleur V. Y.; Sato, Toshiaki; Bongiorni, Maria Grazia; Soldati, Ezio; Augostini, Ralph; Love, Charles; Neuzil, Petr; Reddy, Vivek; Bracke, Frank A. L. E.; Sagi, Venkata; Lee, Scott; Gornick, Charles; Remole, Stephen; Sra, Jasbir; Nangia, Vikram; Shehata, Michael; Swerdlow, Charles; Schoenhard, John; Milstein, Simon; Saba, Samir; Bernabei, Matthew; Bansal, Sandeep; Stavrakis, Stavros

    2015-01-01

    Permanent cardiac pacing is the only effective treatment for symptomatic bradycardia, but complications associated with conventional transvenous pacing systems are commonly related to the pacing lead and pocket. We describe the early performance of a novel self-contained miniaturized pacemaker.

  18. Permanent pacing in infants and children: A single center experience in implantation and follow up

    Directory of Open Access Journals (Sweden)

    Rania Samir

    2011-09-01

    Conclusion: Permanent pacing in pediatric age group is relatively safe. However, there is substantial higher incidence of suboptimal pacing parameters and pacing system failures especially in younger and smaller children. Epicardial steroid eluting leads are comparable to endocardial steroid eluting leads in performance.

  19. Effects of Modality and Pace on Achievement, Mental Effort, and Positive Affect in Multimedia Learning Environments

    Science.gov (United States)

    Izmirli, Serkan; Kurt, Adile Askim

    2016-01-01

    The purpose of the study was to examine the effects of instruction given with different multimedia modalities (written text + animation or narration + animation) on the academic achievement, cognitive load, and positive affect in different paces (learner-paced or system-paced); 97 freshmen university students divided into four groups taught in…

  20. Leadless Pacing: Current State and Future Direction.

    Science.gov (United States)

    Merkel, Matthias; Grotherr, Philipp; Radzewitz, Andrea; Schmitt, Claus

    2017-12-01

    Leadless pacing is now an established alternative to conventional pacing with subcutaneous pocket and transvenous lead for patients with class I or II single-chamber pacing indication. Available 12-month follow-up data shows a 48% fewer major complication rate in patients with Micra™ compared to a historical control group in a nonrandomized study [1]. There is one system with Food and Drug Administration (FDA) approval and two with the Communauté Européenne (CE) mark. The OPS code for the implantation is 8-83d.3 and the procedure has recently been rated as a "new Examination and Treatment Method (NUB)" in the German DRG system, meaning adequate reimbursement is negotiable with health insurance providers. The systems offer similar generator longevity and programming possibilities as conventional pacemaker systems, including rate response, remote monitoring, and MRI safety. The biggest downsides to date are limitations to single-chamber stimulation, lack of long-time data, and concerns of handling of the system at the end of its life span. However, implant procedure complication rates and procedure times do not exceed conventional pacemaker operations, and proper training and patient selection is provided.

  1. Factors influencing pacing in triathlon

    Directory of Open Access Journals (Sweden)

    Wu SSX

    2014-09-01

    Full Text Available Sam SX Wu,1 Jeremiah J Peiffer,2 Jeanick Brisswalter,3 Kazunori Nosaka,1 Chris R Abbiss1 1Centre for Exercise and Sports Science Research, School of Exercise and Health Sciences, Edith Cowan University, Perth, WA, Australia; 2School of Psychology and Exercise Science, Murdoch University, Perth, WA, Australia; 3Laboratory of Human Motricity, Education Sport and Health, University of Nice Sophia Antipolis, Nice, France Abstract: Triathlon is a multisport event consisting of sequential swim, cycle, and run disciplines performed over a variety of distances. This complex and unique sport requires athletes to appropriately distribute their speed or energy expenditure (ie, pacing within each discipline as well as over the entire event. As with most physical activity, the regulation of pacing in triathlon may be influenced by a multitude of intrinsic and extrinsic factors. The majority of current research focuses mainly on the Olympic distance, whilst much less literature is available on other triathlon distances such as the sprint, half-Ironman, and Ironman distances. Furthermore, little is understood regarding the specific physiological, environmental, and interdisciplinary effects on pacing. Therefore, this article discusses the pacing strategies observed in triathlon across different distances, and elucidates the possible factors influencing pacing within the three specific disciplines of a triathlon. Keywords: cycle, endurance, multisport, pacing strategy, run, swim

  2. Haemodynamic effects of dual-chamber pacing versus ventricular pacing during a walk test in patients with depressed or normal left ventricular function

    Energy Technology Data Exchange (ETDEWEB)

    Ferro, Adele; Salvatore, Marco; Cuocolo, Alberto [University Federico II, Department of Biomorphological and Functional Sciences, Institute of Biostructure and Bioimages of the National Council of Research, Naples (Italy); Duilio, Carlo; Santomauro, Maurizio [University Federico II, Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Naples (Italy)

    2005-09-01

    Dual-chamber rate-modulated pacing provides haemodynamic benefits compared with ventricular pacing at rest, but it is unclear whether this also holds true during physical exercise in patients with heart failure. This study assessed the haemodynamic response to a walk test during dual-chamber pacing and ventricular pacing in patients with depressed or normal left ventricular (LV) function. Twelve patients with an LV ejection fraction <50% and 11 patients with an LV ejection fraction {>=}50% underwent two randomised 6-min walk tests under dual-chamber rate-modulated pacing and ventricular pacing at a fixed rate of 70 beats/min. All patients had a dual-chamber pacemaker implanted for complete heart block. LV function was monitored by a radionuclide ambulatory system. In patients with depressed LV function, the change from dual-chamber pacing to ventricular pacing induced a decrease in end-systolic volume at the peak of the walk test (P<0.05), with no difference in end-diastolic volume. As a consequence, higher increases in LV ejection fraction (P<0.0001) and stroke volume (P<0.01) were observed during ventricular pacing. No difference in cardiac output was found between the two pacing modes. In patients with normal LV function, the change from dual-chamber pacing to ventricular pacing induced a significant decrease in cardiac output (P<0.005 at rest and P<0.05 at the peak of the walk test). Compared with dual-chamber rate-modulated pacing, ventricular pacing improves cardiac function and does not affect cardiac output during physical activity in patients with depressed LV function, whereas it impairs cardiac output in those with normal function. (orig.)

  3. Haemodynamic effects of dual-chamber pacing versus ventricular pacing during a walk test in patients with depressed or normal left ventricular function

    International Nuclear Information System (INIS)

    Ferro, Adele; Salvatore, Marco; Cuocolo, Alberto; Duilio, Carlo; Santomauro, Maurizio

    2005-01-01

    Dual-chamber rate-modulated pacing provides haemodynamic benefits compared with ventricular pacing at rest, but it is unclear whether this also holds true during physical exercise in patients with heart failure. This study assessed the haemodynamic response to a walk test during dual-chamber pacing and ventricular pacing in patients with depressed or normal left ventricular (LV) function. Twelve patients with an LV ejection fraction <50% and 11 patients with an LV ejection fraction ≥50% underwent two randomised 6-min walk tests under dual-chamber rate-modulated pacing and ventricular pacing at a fixed rate of 70 beats/min. All patients had a dual-chamber pacemaker implanted for complete heart block. LV function was monitored by a radionuclide ambulatory system. In patients with depressed LV function, the change from dual-chamber pacing to ventricular pacing induced a decrease in end-systolic volume at the peak of the walk test (P<0.05), with no difference in end-diastolic volume. As a consequence, higher increases in LV ejection fraction (P<0.0001) and stroke volume (P<0.01) were observed during ventricular pacing. No difference in cardiac output was found between the two pacing modes. In patients with normal LV function, the change from dual-chamber pacing to ventricular pacing induced a significant decrease in cardiac output (P<0.005 at rest and P<0.05 at the peak of the walk test). Compared with dual-chamber rate-modulated pacing, ventricular pacing improves cardiac function and does not affect cardiac output during physical activity in patients with depressed LV function, whereas it impairs cardiac output in those with normal function. (orig.)

  4. Pace studying worldwide coke production

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    Pace Consultants Inc., Houston, has started a multiclient study of world-wide petroleum coke production, examining environmental initiatives and eventually forecasting prices of fuel grade coke. Pace expects coker expansions, increased operating severity, and reduced cycle times to boost coke supply to more than 50 million metric tons/year in 2000, compared with 39.7 million metric tons in 1992. Increased supply and tightened environmental rules in countries consuming large amounts of petroleum coke will be the main factors affecting coke markets. The paper discusses coke quality and the Japanese market

  5. Electrocardiographic features: Various atrial site pacing

    Directory of Open Access Journals (Sweden)

    Asit Das

    2017-09-01

    Full Text Available Atrial pacing is done for either symptomatic sinus node dysfunction (SND or for maintenance of atrio-ventricular synchrony in a dual chamber pacemaker. Conventionally, atrial lead is placed in the right atrial appendage. Atrial conduction disorder in patients with permanent pacing results in higher incidence of atrial fibrillation. Atrial septal pacing has emerged as a solution to this problem. So, it is extremely important to understand the different features of paced P wave from various atrial pacing sites. Conventional right atrial appendage pacing in presence of atrial conduction disorder results in marked latency with prolonged P wave duration with reduced amplitude. The morphology is similar to sinus rhythm. Atrial septal pacing causes short and sharp P wave with negative polarity in inferior leads and positive polarity in lead V1 in lower septal pacing, whereas positive polarity in inferior leads and negative polarity in lead V1 during pacing from upper septum.

  6. Science Unit Plans. PACE '94.

    Science.gov (United States)

    Schoon, Kenneth J., Ed.; Wiles, Clyde A., Ed.

    This booklet contains mathematics unit plans for Biology, Chemistry, and Physical Science developed by PACE (Promoting Academic Excellence In Mathematics, Science & Technology for Workers of the 21st Century). Each unit plan contains suggested timing, objectives, skills to be acquired, workplace relationships, learning activities with suggested…

  7. PACE and the Federal Housing Finance Agency (FHFA)

    Energy Technology Data Exchange (ETDEWEB)

    Zimring, Mark; Fuller, Merrian

    2010-03-17

    The FHFA regulates Fannie Mae, Freddie Mac, and the 12 Federal Home Loan Banks (the government-sponsored enterprises - GSEs). On June 18, 2009, James B. Lockhart III, then Director of FHFA, released a letter expressing concern about the negative impact of energy loan tax assessment programs (ELTAPs) - also known as Property Assessed Clean Energy (PACE) programs - on both the housing finance system and homeowner program participants. Subsequently, a number of PACE proponents responded to the concerns laid out in the FHFA letter. In early Fall 2009, word circulated that FHFA was planning to follow its June letter with guidance to other agencies, possibly including Fannie Mae and Freddie Mac, discouraging them from buying loans on properties subject to PACE-type assessment liens. This triggered a second round of stakeholder letters, several of which were addressed to President Obama. On October 18, 2009, the White House, in what some believe was an attempt to obviate the need for FHFA guidance, released a Policy Framework for PACE Financing Programs that outlined best practices guidance for homeowner and lender protection. As of February 2010, FHFA and the GSEs have agreed to monitor PACE programs and work with stakeholders and the Administration to consider additional guidance beyond the Policy Framework and to collect more information on PACE program efficacy and risks. A summary of the communications timeline and highlights of the communications are provided.

  8. The solarPACES strategy for the solar thermal breakthrough

    International Nuclear Information System (INIS)

    Burch, G.D.; Grasse, W.

    1997-01-01

    IEA(International Energy Agency)/SolarPACES(Solar Power and Chemical Energy systems)represents a world wide coalition for information sharing and collaboration on applications of concentrated solar energy. The current SolarPACES community has built up solar thermal system know-how over 15 years, is operating the three main solar test centres in the world. Its main activities are in the following four fields: solar thermal electric power systems, solar chemistry, solar technology and advanced applications and non-technical activities. The article presents the talk on the strategy of solarPACES given at the International Workshop on applied solar energy held in Tashkent(Uzbekistan) in June 1997. (A.A.D.)

  9. [Permanent cardiac pacing. Present possibilities and perspectives].

    Science.gov (United States)

    Novák, M

    1996-06-12

    Cardiac pacing is reckoned to be one of the most successful branches of medicine in the second half of the 20th century. Indications for single chamber ventricular pacing are getting gradually restricted. This early pacing mode, which was used in 1958 for the first time, has been recently replaced from modern modes: for atrial, dual chamber and rate adaptive ones. Not only these most recent methods prevent from bradycardia but they also meet demands of modern cardiac pacing, i.e. to restore the synchronization of the atriums and the ventricles and to restore the frequency response. So-called physiological pacing improves both the well-being and the survival of patients and it has also extended pacing indications to the non-arrhythmic ones: first and foremost to the cardiomyopathies. It is dual chamber pacing, the artificial biosensors, various kinds of counters and monitoring functions that enhance the energy consumption. Both low-threshold pacing leads and an automatic adjustment of the pulse energy are helpful in extending the longevity of tiny lithium-powered pacemakers of these days. Current dual chamber rate responsive devices represent an important first step towards a fully automatic smart pacemaker of the future. Such an intelligent pulse generator with several sensors will be operating in the DDDR mode checking automatically the pacing threshold and switching its pacing mode according to pathophysiological requirements.

  10. Pacing a data transfer operation between compute nodes on a parallel computer

    Science.gov (United States)

    Blocksome, Michael A [Rochester, MN

    2011-09-13

    Methods, systems, and products are disclosed for pacing a data transfer between compute nodes on a parallel computer that include: transferring, by an origin compute node, a chunk of an application message to a target compute node; sending, by the origin compute node, a pacing request to a target direct memory access (`DMA`) engine on the target compute node using a remote get DMA operation; determining, by the origin compute node, whether a pacing response to the pacing request has been received from the target DMA engine; and transferring, by the origin compute node, a next chunk of the application message if the pacing response to the pacing request has been received from the target DMA engine.

  11. Turbulence control with local pacing and its implication in cardiac defibrillation

    Science.gov (United States)

    Cao, Zhoujian; Li, Pengfei; Zhang, Hong; Xie, Fagen; Hu, Gang

    2007-03-01

    In this review article, we describe turbulence control in excitable systems by using a local periodic pacing method. The controllability conditions of turbulence suppression and the mechanisms underlying these conditions are analyzed. The local pacing method is applied to control Winfree turbulence (WT) and defect turbulence (DT) induced by spiral-wave breakup. It is shown that WT can always be suppressed by local pacing if the pacing amplitude and frequency are properly chosen. On the other hand, the pacing method can achieve suppression of DT induced by instabilities associated with the motions of spiral tips while failing to suppress DT induced by the instabilities of wave propagation far from tips. In the latter case, an auxiliary method of applying gradient field is suggested to improve the control effects. The implication of this local pacing method to realistic cardiac defibrillation is addressed.

  12. Pace: an advanced structure for handling multi-technique NDT

    International Nuclear Information System (INIS)

    Mayos, M.; Guisnel, F.

    1995-08-01

    The growing extent and complexity of NDT data analysis has reached a stage where dedicated systems are required. In the context of a European research program, EDF participated from 1992 to 1994 in one of the first international projects in this field, TRAPPIST and, in 1993, began developing An application for the electricity generating industry, giving rise to the PACE project. The prime objective specially targets the French electricity generating industry, where PACE was to be the reference system for analysis of NDE data concerning EdF power plants. The second objective is to promote the adoption of PACE by other industrial sectors and other countries. The analysis of needs shows that the required system must be designed to analyze data from widely different sources. The PACE entry point consequently has to be a standard format compatible with geometrical data as well as those provided by NDT. The TRAPPIST format constitutes the first version of this standard and is the first step towards European standardization in this respect. Consideration of the different user modes defined for PACE led to the design of a 2-part user structure comprising a database management system (Ingres/Windows 4GL) and a display/processing tool (AVS), also usable to construct analysis scenarios. The structure of PACE is defined nd seems well suited to industrial requirements, but before it is possible to proceed further towards its adoption for actual power plant inspections, it has to be validated on a more realistic application, the eddy current and ultrasonic testing of a full-scale T-joint. This is already under way, whilst work on format standardization and industrialization preparatory procedures are proceeding in parallel. (authors). 4 refs., 6 figs

  13. Self-Paced Physics, Segments 15-17.

    Science.gov (United States)

    New York Inst. of Tech., Old Westbury.

    Three review segments of the Self-Paced Physics Course materials are provided in this volume which is arranged to match study segments 1 through 14. Each of the three segments is composed of a set of problems and solutions, and accompanied by its own individual study guide. The problem set is designed as a back-referencing system, and the…

  14. Hardware packet pacing using a DMA in a parallel computer

    Science.gov (United States)

    Chen, Dong; Heidelberger, Phillip; Vranas, Pavlos

    2013-08-13

    Method and system for hardware packet pacing using a direct memory access controller in a parallel computer which, in one aspect, keeps track of a total number of bytes put on the network as a result of a remote get operation, using a hardware token counter.

  15. Low-cost implementation of a self-paced treadmill by using a commercial depth sensor.

    Science.gov (United States)

    Kim, Jonghyun; Gravunder, Andrew; Stanley, Christopher J; Park, Hyung-Soon

    2013-01-01

    A self-paced treadmill that can simulate overground walking has the potential to improve the effectiveness of treadmill training for gait rehabilitation. We have implemented a self-paced treadmill without the need for expensive equipment such as a motion capture system and an instrumented treadmill. For this, an inexpensive depth sensor, ASUS XtionTM, substitutes for the motion capture system, and a low-cost commercial treadmill is considered as the platform of the self-paced treadmill. The proposed self-paced treadmill is also convenient because the depth sensor does not require markers placed on user's body. Through pilot tests with two healthy subjects, it is quantitatively and qualitatively verified that the proposed self-paced treadmill achieves similar performance as one which utilizes a commercial motion capture system (VICON) as well as an instrumented treadmill.

  16. Hibernia field construction pace picks up speed

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    This paper reports that the pace of construction is increasing for the $5.2 billion (Canadian) Hibernia oil field development project off Newfoundland with a new partner close to signing on. Texaco, Inc. is reported ready to pick up a 25% interest in the project within a month. Construction activity for offshore systems was cut 50% last February when Gulf Canada Resources Inc. The it planned to withdraw from its 25% interest in Hibernia. Since then, remaining interest owners Mobil Oil Canada Ltd., Chevron Canada Resources Ltd., and Petro-Canada have been seeking new partners. The effort has focused on Texaco with Canadian Energy Minister Jake Epp playing a role in talks. Hibernia's construction work force has risen to 850 from a low of 600. A spokesman for Hibernia Management and Development Co., project manager, the a steady increase in the work force is planned

  17. Pacing during an ultramarathon running event in hilly terrain

    Directory of Open Access Journals (Sweden)

    Hugo A. Kerhervé

    2016-10-01

    Full Text Available Purpose The dynamics of speed selection as a function of distance, or pacing, are used in recreational, competitive, and scientific research situations as an indirect measure of the psycho-physiological status of an individual. The purpose of this study was to determine pacing on level, uphill and downhill sections of participants in a long (>80 km ultramarathon performed on trails in hilly terrain. Methods Fifteen ultramarathon runners competed in a  173 km event (five finished at  103 km carrying a Global-Positioning System (GPS device. Using the GPS data, we determined the speed, relative to average total speed, in level (LEV, uphill (UH and downhill (DH gradient categories as a function of total distance, as well as the correlation between overall performance and speed variability, speed loss, and total time stopped. Results There were no significant differences in normality, variances or means in the relative speed in 173-km and 103-km participants. Relative speed decreased in LEV, UH and DH. The main component of speed loss occurred between 5% and 50% of the event distance in LEV, and between 5% and 95% in UH and DH. There were no significant correlations between overall performance and speed loss, the variability of speed, or total time stopped. Conclusions Positive pacing was observed at all gradients, with the main component of speed loss occurring earlier (mixed pacing in LEV compared to UH and DH. A speed reserve (increased speed in the last section was observed in LEV and UH. The decrease in speed and variability of speed were more important in LEV and DH than in UH. The absence of a significant correlation between overall performance and descriptors of pacing is novel and indicates that pacing in ultramarathons in trails and hilly terrain differs to other types of running events.

  18. Web Tools: Keeping Learners on Pace

    Science.gov (United States)

    Kosloski, Mickey

    2016-01-01

    One of the greatest challenges in teaching technology and engineering is pacing. Some students grasp new technological concepts quickly, while others need repetition and may struggle to keep pace. This poses an obstacle for the technology and engineering teacher, and is particularly true when teaching students to build a website. However, there…

  19. 42 CFR 460.60 - PACE organizational structure.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false PACE organizational structure. 460.60 Section 460... ELDERLY (PACE) PACE Administrative Requirements § 460.60 PACE organizational structure. (a) A PACE... planning a change in organizational structure must notify CMS and the State administering agency, in...

  20. Optimal Implantation Depth and Adherence to Guidelines on Permanent Pacing to Improve the Results of Transcatheter Aortic Valve Replacement With the Medtronic CoreValve System: The CoreValve Prospective, International, Post-Market ADVANCE-II Study.

    Science.gov (United States)

    Petronio, Anna S; Sinning, Jan-Malte; Van Mieghem, Nicolas; Zucchelli, Giulio; Nickenig, Georg; Bekeredjian, Raffi; Bosmans, Johan; Bedogni, Francesco; Branny, Marian; Stangl, Karl; Kovac, Jan; Schiltgen, Molly; Kraus, Stacia; de Jaegere, Peter

    2015-05-01

    The aim of the CoreValve prospective, international, post-market ADVANCE-II study was to define the rates of conduction disturbances and permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement with the Medtronic CoreValve System (Minneapolis, Minnesota) using optimized implantation techniques and application of international guidelines on cardiac pacing. Conduction disturbances are a frequent complication of transcatheter aortic valve replacement. The rates of PPI in the published reports vary according to bioprosthesis type and the indications for PPI. The primary endpoint was the 30-day incidence of PPI with Class I/II indications when the Medtronic CoreValve System was implanted at an optimal depth (≤6 mm below the aortic annulus). The timing and resolution of all new-onset conduction disturbances were analyzed. A total of 194 patients were treated. The overall rate of PPI for Class I/II indications was 18.2%. An optimal depth was reached in 43.2% of patients, with a nonsignificantly lower incidence of PPI in patients with depths ≤6 mm, compared with those with deeper implants (13.3% vs. 21.1%; p = 0.14). In a paired analysis, new-onset left bundle branch block and first-degree atrioventricular block occurred in 45.4% and 39.0% of patients, respectively, and resolved spontaneously within 30 days in 43.2% and 73.9%, respectively. In patients with new PPI, the rate of intrinsic sinus rhythm increased from 25.9% at 7 days to 59.3% at 30 days (p = 0.004). Optimal Medtronic CoreValve System deployment and adherence to international guidelines on cardiac pacing are associated with a lower rate of new PPI after transcatheter aortic valve replacement, compared with results reported in previous studies. (CoreValve Advance-II Study: Prospective International Post-Market Study [ADVANCE II]; NCT01624870). Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  1. PACE: Power-Aware Computing Engines

    National Research Council Canada - National Science Library

    Asanovic, Krste

    2005-01-01

    This report describes the PACE project whose objective was to reduce the energy consumption of microprocessors by exploiting compile time knowledge to reduce run-time switching activity and to power down unneeded blocks...

  2. Outback is put through its paces.

    Science.gov (United States)

    2017-06-03

    Ashley Rubens, winner of the competition to find the BVA member facing the toughest driving conditions in the UK, has spent the past few months putting a Subaru Outback through its paces. British Veterinary Association.

  3. Cardiac pacing in pediatrics: Is still the right ventricle the optimal pacing site?

    Directory of Open Access Journals (Sweden)

    Michel Cabrera Ortega

    2015-10-01

    Full Text Available Permanent cardiac pacing is frequently indicated in pediatric patients due to atrioventricular block. Traditionally, the right ventricle has been the pacing site because it is readily accessible, and provides lead stability and optimal chronic pacing thresholds. However, it is associated with a dyssynchrony pattern of ventricular activation, that may cause remodeling and impairment of left ventricular function. In pediatric patients, paced from an early age and with a long life expectancy, the preservation of cardiac function is a premise. Therefore, the prevention of dyssynchrony, using possible alternative sites, is not just a priority, is a challenge. The aim of the article is to show the effects of chronic right ventricular pacing as well as the evidence of benefits provided by alternatives pacing sites in pediatric population and their clinical and practical implications.

  4. Utility of the surface electrocardiogram for confirming right ventricular septal pacing: validation using electroanatomical mapping.

    Science.gov (United States)

    Burri, Haran; Park, Chan-Il; Zimmermann, Marc; Gentil-Baron, Pascale; Stettler, Carine; Sunthorn, Henri; Domenichini, Giulia; Shah, Dipen

    2011-01-01

    When targeting the interventricular septum during pacemaker implantation, the lead may inadvertently be positioned on the anterior wall due to imprecise fluoroscopic landmarks. Surface electrocardiogram (ECG) criteria of the paced QRS complex (e.g. negativity in lead I) have been proposed to confirm a septal position, but these criteria have not been properly validated. Our aim was to investigate whether the paced QRS complex may be used to confirm septal lead position. Anatomical reconstruction of the right ventricle was performed using a NavX® system in 31 patients (70 ± 11 years, 26 males) to validate pacing sites. Surface 12-lead ECGs were analysed by digital callipers and compared while pacing from a para-Hissian position, from the mid-septum, and from the anterior free wall. Duration of the QRS complex was not significantly shorter when pacing from the mid-septum compared with the other sites. QRS axis was significantly less vertical during mid-septal pacing (18 ± 51°) compared with para-Hissian (38 ± 37°, P = 0.028) and anterior (53 ± 55°, P = 0.003) pacing, and QRS transition was intermediate (4.8 ± 1.3 vs. 3.8 ± 1.3, P < 0.001, and vs. 5.4 ± 0.9, P = 0.045, respectively), although no cut-offs could reliably distinguish sites. A negative QRS or the presence of a q-wave in lead I tended to be more frequent with anterior than with mid-septal pacing (9/31 vs. 3/31, P = 0.2 and 8/31 vs. 1/31, P = 1.0, respectively). No single ECG criterion could reliably distinguish pacing the mid-septum from the anterior wall. In particular, a negative QRS complex in lead I is an inaccurate criterion for validating septal pacing.

  5. Self-Paced Introductory Physics Course--An Eight-Year Progress Report

    Science.gov (United States)

    Brown, G. C.; And Others

    1977-01-01

    Describes a self-paced, mastery-oriented introductory physics course offered at Cornell University which incorporates aspects of audio-tutorial instruction and the Personalized System of Instruction (PSI). (SL)

  6. Cardiomyopathy induced by artificial cardiac pacing: myth or reality sustained by evidence?

    Science.gov (United States)

    Ferrari, Andrés Di Leoni; Borges, Anibal Pires; Albuquerque, Luciano Cabral; Sussenbach, Carolina Pelzer; da Rosa, Priscila Raupp; Piantá, Ricardo Medeiros; Wiehe, Mario; Goldani, Marco Antônio

    2014-01-01

    Implantable cardiac pacing systems are a safe and effective treatment for symptomatic irreversible bradycardia. Under the proper indications, cardiac pacing might bring significant clinical benefit. Evidences from literature state that the action of the artificial pacing system, mainly when the ventricular lead is located at the apex of the right ventricle, produces negative effects to cardiac structure (remodeling, dilatation) and function (dissinchrony). Patients with previously compromised left ventricular function would benefit the least with conventional right ventricle apical pacing, and are exposed to the risk of developing higher incidence of morbidity and mortality for heart failure. However, after almost 6 decades of cardiac pacing, just a reduced portion of patients in general would develop these alterations. In this context, there are not completely clear some issues related to cardiac pacing and the development of this cardiomyopathy. Causality relationships among QRS widening with a left bundle branch block morphology, contractility alterations within the left ventricle, and certain substrates or clinical (previous systolic dysfunction, structural heart disease, time from implant) or electrical conditions (QRS duration, percentage of ventricular stimulation) are still subjecte of debate. This review analyses contemporary data regarding this new entity, and discusses alternatives of how to use cardiac pacing in this context, emphasizing cardiac resynchronization therapy. PMID:25372916

  7. Cardiac optogenetic pacing in drosophila melanogaster using red-shifted opsins (Conference Presentation)

    Science.gov (United States)

    Men, Jing; Li, Airong; Jerwick, Jason; Tanzi, Rudolph E.; Zhou, Chao

    2017-02-01

    Electrical pacing is the current gold standard for investigation of mammalian cardiac electrical conduction systems as well as for treatment of certain cardiac pathologies. However, this method requires an invasive surgical procedure to implant the pacing electrodes. Recently, optogenetic pacing has been developed as an alternative, non-invasive method for heartbeat pacing in animals. It induces heartbeats by shining pulsed light on transgene-generated microbial opsins which in turn activate light gated ion channels in animal hearts. However, commonly used opsins, such as channelrhodopsin-2 (ChR2), require short light wavelength stimulation (475 nm), which is strongly absorbed and scattered by tissue. Here, we expressed recently engineered red-shifted opsins, ReaChR and CsChrimson, in the heart of a well-developed animal model, Drosophila melanogaster, for the first time. Optogenetic pacing was successfully conducted in both ReaChR and CsChrimson flies at their larval, pupal, and adult stages using 617 nm excitation light pulse, enabling a much deeper tissue penetration compared to blue stimulation light. A customized high speed and ultrahigh resolution OCM system was used to non-invasively monitor the heartbeat pacing in Drosophila. Compared to previous studies on optogenetic pacing of Drosophila, higher penetration depth of optogenetic excitation light was achieved in opaque late pupal flies. Lower stimulating power density is needed for excitation at each developmental stage of both groups, which improves the safety of this technique for heart rhythm studies.

  8. Optimal pacing for right ventricular and biventricular devices: minimizing, maximizing, and right ventricular/left ventricular site considerations.

    Science.gov (United States)

    Gillis, Anne M

    2014-10-01

    The results from numerous clinical studies provide guidance for optimizing outcomes related to RV or biventricular pacing in the pacemaker and ICD populations. (1) Programming algorithms to minimize RV pacing is imperative in patients with dual-chamber pacemakers who have intrinsic AV conduction or intermittent AV conduction block. (2) Dual-chamber ICDs should be avoided in candidates without an indication for bradycardia pacing. (3) Alternate RV septal pacing sites may be considered at the time of pacemaker implantation. (4) Biventricular pacing may be beneficial in some patients with mild LV dysfunction. (5) LV lead placement at the site of latest LV activation is desirable. (6) Programming CRT systems to achieve biventricular/LV pacing >98.5% is important. (7) Protocols for AV and VV optimization in patients with CRT are not recommended after device implantation but may be considered for CRT nonresponders. (8) Novel algorithms to maximize the benefit of CRT are in evolution further.

  9. Relative importance of pacing strategy and mean power output in 1500-m self-paced cycling

    NARCIS (Netherlands)

    Hettinga, F. J.; de Koning, J. J.; Hulleman, M.; Foster, C.

    Introduction Both mean power output (MPO) and the distribution of the available energy over the race, that is, pacing strategy, are critical factors in performance. The purpose of this study was to determine the relative importance of both pacing strategy and MPO to performance. Methods Six

  10. A Simulation Study of Paced TCP

    Science.gov (United States)

    Kulik, Joanna; Coulter, Robert; Rockwell, Dennis; Partridge, Craig

    2000-01-01

    In this paper, we study the performance of paced TCP, a modified version of TCP designed especially for high delay- bandwidth networks. In typical networks, TCP optimizes its send-rate by transmitting increasingly large bursts, or windows, of packets, one burst per round-trip time, until it reaches a maximum window-size, which corresponds to the full capacity of the network. In a network with a high delay-bandwidth product, however, Transmission Control Protocol's (TCPs) maximum window-size may be larger than the queue size of the intermediate routers, and routers will begin to drop packets as soon as the windows become too large for the router queues. The TCP sender then concludes that the bottleneck capacity of the network has been reached, and it limits its send-rate accordingly. Partridge proposed paced TCP as a means of solving the problem of queueing bottlenecks. A sender using paced TCP would release packets in multiple, small bursts during a round-trip time in which ordinary TCP would release a single, large burst of packets. This approach allows the sender to increase its send-rate to the maximum window size without encountering queueing bottlenecks. This paper describes the performance of paced TCP in a simulated network and discusses implementation details that can affect the performance of paced TCP.

  11. Update on arrhythmias and cardiac pacing 2013.

    Science.gov (United States)

    Almendral, Jesús; Pombo, Marta; Martínez-Alday, Jesús; González-Rebollo, José M; Rodríguez-Font, Enrique; Martínez-Ferrer, José; Castellanos, Eduardo; García-Fernández, F Javier; Ruiz-Mateas, Francisco

    2014-04-01

    This report discusses a selection of the most relevant articles on cardiac arrhythmias and pacing published in 2013. The first section discusses arrhythmias, classified as regular paroxysmal supraventricular tachyarrhythmias, atrial fibrillation, and ventricular arrhythmias, together with their treatment by means of an implantable cardioverter defibrillator. The next section reviews cardiac pacing, subdivided into resynchronization therapy, remote monitoring of implantable devices, and pacemakers. The final section discusses syncope. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  12. How do we perceive activity pacing in rheumatology care?

    DEFF Research Database (Denmark)

    Cuperus, N.; Vliet Vlieland, T.; Brodin, N.

    2015-01-01

    Background: Activity pacing is a recommended non-pharmacological intervention for the management of rheumatic and musculoskeletal diseases in international clinical guidelines. In clinical practice, activity pacing aims at adapting daily activities, and is often an important component of self......-management programs. However, despite its wide endorsement in clinical practice, to date activity pacing is still a poorly understood concept. Objectives: To achieve consensus by means of an international Delphi exercise on the most important aspects of activity pacing as an intervention within non...... goals of activity pacing, behaviours of activity pacing (the actions people take to meet the goal of activity pacing), strategies to change behaviour in activity pacing (for example goal setting) and contextual factors that should be acknowledged when instructing activity pacing. Besides, topics...

  13. Fast Paced, Low Cost Projects at MSFC

    Science.gov (United States)

    Watson-Morgan, Lisa; Clinton, Raymond

    2012-01-01

    What does an orbiting microsatellite, a robotic lander and a ruggedized camera and telescope have in common? They are all fast paced, low cost projects managed by Marshall Space Flight Center (MSFC) teamed with successful industry partners. MSFC has long been synonymous with human space flight large propulsion programs, engineering acumen and risk intolerance. However, there is a growing portfolio/product line within MSFC that focuses on these smaller, fast paced projects. While launching anything into space is expensive, using a managed risk posture, holding to schedule and keeping costs low by stopping at egood enough f were key elements to their success. Risk is defined as the possibility of loss or failure per Merriam Webster. The National Aeronautics and Space Administration (NASA) defines risk using procedural requirement 8705.4 and establishes eclasses f to discern the acceptable risk per a project. It states a Class D risk has a medium to significant risk of not achieving mission success. MSFC, along with industry partners, has created a niche in Class D efforts. How did the big, cautious MSFC succeed on these projects that embodied the antithesis of its heritage in human space flight? A key factor toward these successful projects was innovative industry partners such as Dynetics Corporation, University of Alabama in Huntsville (UAHuntsville), Johns Hopkins Applied Physics Laboratory (JHU APL), Teledyne Brown Engineering (TBE), Von Braun Center for Science and Innovation (VCSI), SAIC, and Jacobs. Fast Affordable Satellite Technology (FastSat HSV01) is a low earth orbit microsatellite that houses six instruments with the primary scientific objective of earth observation and technology demonstration. The team was comprised of Dynetics, UAHuntsvile, SAIC, Goddard Space Flight Center (GSFC) and VCSI with the United States Air Force Space Test Program as the customer. The team completed design, development, manufacturing, environmental test and integration in

  14. Potenzielle Einflussfaktoren auf Pacing im ausdauersportlichen Wettkampf

    NARCIS (Netherlands)

    Thiel, C.; de Koning, J.J.; Foster, C.

    2015-01-01

    In competitive endurance sport, athletes permanently regulate their performance to achieve the best result without threatening organismic integrity. This conscious and subconscious allocation of energy reserves in relation to an endpoint is termed pacing and depends on sport-specific experience as

  15. Self-Paced Instruction: Hello, Education

    Science.gov (United States)

    Leuba, Richard J.; Flammer, Gordon H.

    1975-01-01

    Answers criticisms of self-paced instruction (SPI) by citing advantages of SPI over lecture methods. Concludes that criticisms of SPI are useful since they indicate in which areas further research should be conducted to improve this method of instruction. (MLH)

  16. The pace and shape of ageing

    DEFF Research Database (Denmark)

    Baudisch, Annette

    2011-01-01

    exhibits negligible ageing - contrary to the commonly held view that long-lived species are good candidates for negligible ageing. 5.Analysis of species in pace-shape space provides a tool to identify key determinants of the evolution of ageing for species across the tree of life....

  17. Exercise performance in young patients with complete atrioventricular block: the relevance of synchronous atrioventricular pacing.

    Science.gov (United States)

    Gonzalez Corcia, M Cecilia; Remy, Lorraine Saint; Marchandise, Sebastien; Moniotte, Stephane

    2016-08-01

    At present, there are many pacing strategies for young patients with complete atrioventricular block. The most frequent policy is to attempt placing a dual-chamber system when possible; however, there is a group of patients that is functioning with a non-synchronous ventricular pacing, raising the question of the ideal timing to upgrade their systems. We investigated the exercise performance of a group of children and young adults with complete atrioventricular block and dual-chamber pacemakers in both single- and dual-chamber pacing modalities. A total of 15 patients performed maximal exercise stress testing after programming the VVIR or DDD modes with 2 hours of interval in a double-blind study protocol. Compared with VVIR pacing, DDD pacing resulted in increase in the peak VO2, longer test duration, major increase in the heart rate achieved during peak exercise, decreased systemic non-invasive arterial blood pressure measured at maximal exercise, higher maximal workload, prolongation of the anaerobic threshold timing, and better self-rated performance perception in all the patients. Synchronous atrioventricular pacing contributes to an increase in both the exercise performance and the performance perception in 100% of the patients. This difference contributes to create a sense of "fitness" with repercussions in the overall health, self-esteem, and life quality, as well as encourages youngster to practice sports. Our experience tends to favour upgrading patients' systems to dual-chamber systems before reaching the adolescent years, even if the centre policy is to prolong as long as possible the epicardial site in order to avoid long years of right ventricular pacing.

  18. Temporary emergency pacing-an orphan in district hospitals

    DEFF Research Database (Denmark)

    Gjesdal, Knut; Johansen, Jens Brock; Gadler, Fredrik

    2012-01-01

    This editorial discusses a report on the 1 year experience with temporary pacing, especially in the emergency setting, in several Norwegian district hospitals. The vast majority of the patients received transvenous temporary pacing, and the majority of leads were placed by noncardiologists. The p...... to a hospital with more available competence. Ideally, those who need pacing immediately, including those who need permanent pacing, should be offered permanent implantation on a 24 hours/7 days per week base....

  19. Pace of work stabilising, but not in all sectors

    NARCIS (Netherlands)

    Houtman, I.L.D.

    2003-01-01

    The Netherlands had the highest level of work pace in Europe but this position has levelled off in the last five years. There appears to be a general trend towards a decline in work pace. However, different sectors show varying trends, with work pace on the rise again in the education, health and

  20. Pajarito Aerosol Couplings to Ecosystems (PACE) Field Campaign Report

    Energy Technology Data Exchange (ETDEWEB)

    Dubey, M [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-03-01

    Laboratory (LANL) worked on the Pajarito Aerosol Couplings to Ecosystems (PACE) intensive operational period (IOP). PACE’s primary goal was to demonstrate routine Mobile Aerosol Observing System (MAOS) field operations and improve instrumental and operational performance. LANL operated the instruments efficiently and effectively with remote guidance by the instrument mentors. This was the first time a complex suite of instruments had been operated under the ARM model and it proved to be a very successful and cost-effective model to build upon.

  1. Visual aided pacing in respiratory maneuvers

    International Nuclear Information System (INIS)

    Rambaudi, L R; Rossi, E; Mantaras, M C; Perrone, M S; Siri, L Nicola

    2007-01-01

    A visual aid to pace self-controlled respiratory cycles in humans is presented. Respiratory manoeuvres need to be accomplished in several clinic and research procedures, among others, the studies on Heart Rate Variability. Free running respiration turns to be difficult to correlate with other physiologic variables. Because of this fact, voluntary self-control is asked from the individuals under study. Currently, an acoustic metronome is used to pace respiratory frequency, its main limitation being the impossibility to induce predetermined timing in the stages within the respiratory cycle. In the present work, visual driven self-control was provided, with separate timing for the four stages of a normal respiratory cycle. This visual metronome (ViMet) was based on a microcontroller which power-ON and -OFF an eight-LED bar, in a four-stage respiratory cycle time series handset by the operator. The precise timing is also exhibited on an alphanumeric display

  2. Phrenic pacing compared with mechanical ventilation

    DEFF Research Database (Denmark)

    Andersen, Morten Packert; Laub, Michael; Biering-Sørensen, Fin

    2017-01-01

    STUDY DESIGN: Comparable case series. OBJECTIVES: High-cervical spinal cord injury (SCI) may disrupt the ability to breathe sufficiently. To restore respiration a phrenic nerve pacer can be implanted. The aims of this study were to describe the use of phrenic nerve pacing in tetraplegics in Denmark...... mechanical ventilator dependent tetraplegics met the inclusion criteria. Data were retrieved from medical records and a structured follow-up interview with seven individuals from each group. RESULTS: No significant differences were found when comparing age at injury, time since injury, length...... of hospitalization, incidence of pneumonia, number of pneumonia hospitalizations, number of tracheal suctions, speech quality and activities of daily living or quality of life. On the Short Form Health Survey (SF36) mental health summary the median for both users of phrenic nerve pacing and users of mechanical...

  3. Reproducibility of pacing profiles in elite swimmers.

    Science.gov (United States)

    Skorski, Sabrina; Faude, Oliver; Caviezel, Seraina; Meyer, Tim

    2014-03-01

    To analyze the reproducibility of pacing in elite swimmers during competitions and to compare heats and finals within 1 event. Finals and heats of 158 male swimmers (age 22.8 ± 2.9 y) from 29 nations were analyzed in 2 competitions (downloaded from swimrankings.net). Of these, 134 were listed in the world's top 50 in 2010; the remaining 24 were finalists of the Pan Pacific Games or European Championships. The level of both competitions for the analysis had to be at least national championships (7.7 ± 5.4 wk apart). Standard error of measurement expressed as percentage of the subject's mean score (CV) with 90% confidence limits (CL) for each 50-m split time and for total times were calculated. In addition, mixed general modeling was used to determine standard deviations between and within swimmers. CV for total time in finals ranged between 0.8% and 1.3% (CL 0.6-2.2%). Regarding split times, 200-m freestyle showed a consistent pacing over all split times (CV 0.9-1.6%). During butterfly, backstroke, and 400-m freestyle, CVs were low in the first 3 and 7 sections, respectively (CV 0.9-1.7%), with greater variability in the last section (1.9-2.2%). In breaststroke, values were higher in all sections (CV 1.2-2.3%). Within-subject SDs for changes between laps were between 0.9% and 2.6% in all finals. Split-time variability for finals and heats ranged between 0.9% and 2.5% (CL 0.3-4.9%). Pacing profiles are consistent between different competitions. Variability of pacing seems to be a result of the within-subject variation rather than a result of different competitions.

  4. The Platform-Aware Compilation Environment (PACE)

    Science.gov (United States)

    2012-09-01

    HPCToolkit. PACE Compiler: • AAP: The code for the AAP is built on top of the open -source Xerces XML parser and the standard GNU utilities Bison and...Microsystems Technology Office (DARPA/MTO) 675 North Randolph Street Arlington, VA 22203‐2114 10. SPONSORING/MONITORING AGENCY ACRONYM...can be mapped efficiently onto the system’s hardware. To achieve a reasonably high fraction of available performance with existing tools, the

  5. Cardiac pacing in heart failure patients with left bundle branch block: impact of pacing site for optimizing left ventricular resynchronization.

    Science.gov (United States)

    Pappone, C; Rosanio, S; Oreto, G; Tocchi, M; Gulletta, S; Salvati, A; Dicandia, C; Santinelli, V; Mazzone, P; Veglia, F; Ding, J; Sallusti, L; Spinelli, J; Vicedomini, G

    2000-07-01

    Acute left ventricular pacing has been associated with hemodynamic improvement in patients with congestive heart failure and wide QRS complex. We hypothesized that pacing two left ventricular sites simultaneously would produce faster activation and better systolic function than single-site pacing. We selected 14 heart failure patients (NYHA functional class III or IV) in normal sinus rhythm with left bundle branch block and QRS > 150 ms. An 8F dual micromanometer catheter was placed in the aorta for measuring +dP/dt (mmHg/s), aortic pulse pressure (mmHg), and end-diastolic pressure (mmHg). Pacing leads were positioned via coronary veins at the posterior base and lateral wall. Patients were acutely paced VDD at the posterior base, lateral wall, and both sites (dual-site) with 5 atrioventricular delays (from 8 ms to PR -30 ms). Pacing sequences were executed in randomized order using a custom external computer (FlexStim, Guidant CRM). Dual-site pacing increased peak +dP/dt significantly more than posterior base and lateral wall pacing. Dual-site and posterior base pacing raised aortic pulse pressure significantly more than lateral wall pacing. Dual-site pacing shortened QRS duration by 22 %, whereas posterior base and lateral wall pacing increased it by 2 and 12%, respectively (p = 0.006). In heart failure patients with left bundle branch block, dual-site pacing improves systolic function more than single-site stimulation. Improved ventricular activation synchrony, expressed by paced QRS narrowing, may account for the additional benefit of dual- vs single-site pacing in enhancing contractility. This novel approach deserves consideration for future heart failure pacing studies.

  6. Impact of pacing modality and biventricular pacing on cardiac output and coronary conduit flow in the post-cardiotomy patient.

    LENUS (Irish Health Repository)

    Healy, David G

    2012-02-03

    We have previously demonstrated the role of univentricular pacing modalities in influencing coronary conduit flow in the immediate post-operative period in the cardiac surgery patient. We wanted to determine the mechanism of this improved coronary conduit and, in addition, to explore the possible benefits with biventricular pacing. Sixteen patients undergoing first time elective coronary artery bypass grafting who required pacing following surgery were recruited. Comparison of cardiac output and coronary conduit flow was performed between VVI and DDD pacing with a single right ventricular lead and biventricular pacing lead placement. Cardiac output was measured using arterial pulse waveform analysis while conduit flow was measured using ultrasonic transit time methodology. Cardiac output was greatest with DDD pacing using right ventricular lead placement only [DDD-univentricular 5.42 l (0.7), DDD-biventricular 5.33 l (0.8), VVI-univentricular 4.71 l (0.8), VVI-biventricular 4.68 l (0.6)]. DDD-univentricular pacing was significantly better than VVI-univentricular (P=0.023) and VVI-biventricular pacing (P=0.001) but there was no significant advantage to DDD-biventricular pacing (P=0.45). In relation to coronary conduit flow, DDD pacing again had the highest flow [DDD-univentricular 55 ml\\/min (24), DDD-biventricular 52 ml\\/min (25), VVI-univentricular 47 ml\\/min (23), VVI-biventricular 50 ml\\/min (26)]. DDD-univentricular pacing was significantly better than VVI-univentricular (P=0.006) pacing but not significantly different to VVI-biventricular pacing (P=0.109) or DDD-biventricular pacing (P=0.171). Pacing with a DDD modality offers the optimal coronary conduit flow by maximising cardiac output. Biventricular lead placement offered no significant benefit to coronary conduit flow or cardiac output.

  7. Non-invasive red light optogenetic pacing and optical coherence microscopy (OCM) imaging for drosophila melanogaster (Conference Presentation)

    Science.gov (United States)

    Men, Jing; Li, Airong; Jerwick, Jason; Tanzi, Rudolph E.; Zhou, Chao

    2017-02-01

    Cardiac pacing could be a powerful tool for investigating mammalian cardiac electrical conduction systems as well as for treatment of certain cardiac pathologies. However, traditional electrical pacing using pacemaker requires an invasive surgical procedure. Electrical currents from the implanted electrodes can also cause damage to heart tissue, further restricting its utility. Optogenetic pacing has been developed as a promising, non-invasive alternative to electrical stimulation for controlling animal heart rhythms. It induces heart contractions by shining pulsed light on transgene-generated microbial opsins, which in turn activate the light gated ion channels in animal hearts. However, commonly used opsins in optogenetic pacing, such as channelrhodopsin-2 (ChR2), require short light wavelength stimulation (475 nm), which is strongly absorbed and scattered by tissue. Here, we performed optogenetic pacing by expression of recently engineered red-shifted microbial opsins, ReaChR and CsChrimson, in a well-established animal model, Drosophila melanogaster, using the 617 nm stimulation light pulses. The OCM technique enables non-invasive optical imaging of animal hearts with high speed and ultrahigh axial and transverse resolutions. We integrated a customized OCM system with the optical stimulation system to monitor the optogenetic pacing noninvasively. The use of red-sifted opsins enabled deeper penetration of simulating light at lower power, which is promising for applications of optogenetic pacing in mammalian cardiac pathology studies or clinical treatments in the future.

  8. Unification of Frequency direction Pilot-symbol Aided Channel Estimation (PACE) for OFDM

    DEFF Research Database (Denmark)

    Rom, Christian; Manchón, Carles Navarro; Deneire, Luc

    2007-01-01

    Frequency direction Pilot-symbol Aided Channel Estimation (PACE) for Orthogonal Frequency Division Multiplexing (OFDM) is crucial in high-rate wireless systems. The choice of an estimator for upcoming standards, such as the Long Term Evolution (LTE) of UTRA, has to take into account their specifi......Frequency direction Pilot-symbol Aided Channel Estimation (PACE) for Orthogonal Frequency Division Multiplexing (OFDM) is crucial in high-rate wireless systems. The choice of an estimator for upcoming standards, such as the Long Term Evolution (LTE) of UTRA, has to take into account...

  9. The influence of collective behaviour on pacing in endurance competitions

    Directory of Open Access Journals (Sweden)

    Andrew eRenfree

    2015-12-01

    Full Text Available A number of theoretical models have been proposed to explain pacing strategies in individual competitive endurance events. These have typically related to internal regulatory processes informing the making of decisions relating to muscular work rate. Despite a substantial body of research investigating the influence of collective group dynamics on individual behaviours in various animal species, this issue has not been comprehensively studied in individual athletic events. This is surprising given that athletes directly compete in close proximity to one another, and that collective behaviour has also been observed in other human environments. Whilst reasons for adopting collective behaviour are not fully understood, it is thought to result from individual agents following simple local rules resulting in seemingly complex large systems acting to confer some biological advantage to the collective as a whole. Although such collective behaviours may generally be beneficial, endurance events are complicated by the fact that increasing levels of physiological disruption as activity progresses may compromise the ability of individuals to continue to interact with other group members. This could result in early fatigue and relative underperformance due to suboptimal utilisation of physiological resources by some athletes. Alternatively, engagement with a collective behaviour may benefit all due to a reduction in the complexity of decisions to be made and a subsequent reduction in cognitive loading and mental fatigue. This paper seeks evidence for collective behaviour in previously published analyses of pacing behaviour and proposes mechanisms through which it could potentially be either beneficial, or detrimental to individual performance.

  10. Application of PACE Principles for Population Health Management of Frail Older Adults.

    Science.gov (United States)

    Stefanacci, Richard G; Reich, Shelley; Casiano, Alex

    2015-10-01

    To determine which practices would have the most impact on reducing hospital and emergency department admissions and nursing home placement among older adults with multiple comorbid conditions, a literature search and survey were conducted to identify and prioritize comprehensive care principles as practiced in the Program of All-inclusive Care for the Elderly (PACE). PACE medical directors and members of the PACE interdisciplinary team (IDT) were surveyed to gain their insights on the most impactful practices, which were identified as: End-of-Life Management, Caregiver Support, Management of Red Flags, Medication Management, Participant and Caregiver Health Care System Literacy, and Care Coordination. In addition, this research evaluated measures that could be used to assess an organization's level of success with regard to each of the 6 PACE practices identified. The results reported in this article, found through a survey with PACE medical directors and IDT members concerning effective interventions, can be viewed as strategies to improve care for older adults, enabling them to maintain their independence in the community, avoid the expense of facility-based care, and enhance their quality of life.

  11. Fatigue and pacing in high-intensity intermittent team sport: an update.

    Science.gov (United States)

    Waldron, Mark; Highton, Jamie

    2014-12-01

    With the advancements in player tracking technology, the topic of fatigue and pacing in team sport has become increasingly popular in recent years. Initially based upon a pre-conceived pacing schema, a central metabolic control system is proposed to guide the movement of players during team sport matches, which can be consciously modified based on afferent signals from the various physiological systems and in response to environmental cues. On the basis of this theory, coupled with the collective findings from motion-analysis research, we sought to define the different pacing strategies employed by team sport players. Whole-match players adopt a 'slow-positive' pacing profile (gradual decline in total running intensity), which appears to be global across the different team sports. High-intensity movement also declines in a 'slow-positive' manner across most team sport matches. The duration of the exercise bout appears to be important for the selected exercise intensity, with the first introduction to a match as a substitute or interchange player resulting in a 'one bout, all out' strategy. In a limited interchange environment, a second introduction to the match results in a 'second-bout reserve' strategy; otherwise, the 'one bout, all out' strategy is likely to be adopted. These pacing profiles are proposed to reflect the presence of a central regulator that controls the movement intensity of the player to optimize performance, as well as avoiding the harmful failure of any physiological system. The presence of 'temporary fatigue' reflects this process, whereby exercise intensity is consciously modulated from within the framework of a global pacing schema.

  12. Interatrial septum pacing decreases atrial dyssynchrony on strain rate imaging compared with right atrial appendage pacing.

    Science.gov (United States)

    Yasuoka, Yoshinori; Abe, Haruhiko; Umekawa, Seiko; Katsuki, Keiko; Tanaka, Norio; Araki, Ryo; Imanaka, Takahiro; Matsutera, Ryo; Morisawa, Daisuke; Kitada, Hirokazu; Hattori, Susumu; Noda, Yoshiki; Adachi, Hidenori; Sasaki, Tatsuya; Miyatake, Kunio

    2011-03-01

    Interatrial septum pacing (IAS-P) decreases atrial conduction delay compared with right atrial appendage pacing (RAA-P). We evaluate the atrial contraction with strain rate of tissue Doppler imaging (TDI) during sinus activation or with IAS-P or RAA-P. Fifty-two patients with permanent pacemaker for sinus node disease were enrolled in the study. Twenty-three subjects were with IAS-P and 29 with RAA-P. The time from end-diastole to peak end-diastolic strain rate was measured and corrected with RR interval on electrocardiogram. It was defined as the time from end-diastole to peak end-diastolic strain rate (TSRc), and the balance between maximum and minimum TSRc at three sites (ΔTSRc) was compared during sinus activation and with pacing rhythm in each group. There were no significant differences observed in general characteristics and standard echocardiographic parameters except the duration of pacing P wave between the two groups. The duration was significantly shorter in the IAS-P group compared with the RAA-P group (95 ± 34 vs 138 ± 41; P = 0.001). TSRc was significantly different between sinus activation and pacing rhythm (36.3 ± 35.7 vs 61.6 ± 36.3; P = 0.003) in the RAA-P group, whereas no significant differences were observed in the IAS-P group (25.4 ± 12.1 vs 27.7 ± 14.7; NS). During the follow-up (mean 2.4 ± 0.7 years), the incidence of paroxysmal atrial fibrillation (AF) conversion to permanent AF was not significantly different between the two groups. IAS-P decreased the contraction delay on atrial TDI compared to RAA-P; however, it did not contribute to the reduction of AF incidence in the present study. ©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.

  13. Pacing and Defibrillators in Complex Congenital Heart Disease

    Science.gov (United States)

    Chubb, Henry; O’Neill, Mark; Rosenthal, Eric

    2016-01-01

    Device therapy in the complex congenital heart disease (CHD) population is a challenging field. There is a myriad of devices available, but none designed specifically for the CHD patient group, and a scarcity of prospective studies to guide best practice. Baseline cardiac anatomy, prior surgical and interventional procedures, existing tachyarrhythmias and the requirement for future intervention all play a substantial role in decision making. For both pacing systems and implantable cardioverter defibrillators, numerous factors impact on the merits of system location (endovascular versus non-endovascular), lead positioning, device selection and device programming. For those with Fontan circulation and following the atrial switch procedure there are also very specific considerations regarding access and potential complications. This review discusses the published guidelines, device indications and the best available evidence for guidance of device implantation in the complex CHD population. PMID:27403295

  14. Percutaneously injectable fetal pacemaker: electronics, pacing thresholds, and power budget.

    Science.gov (United States)

    Nicholson, Adriana; Chmait, Ramen; Bar-Cohen, Yaniv; Zheng, Kaihui; Loeb, Gerald E

    2012-01-01

    We are developing a cardiac pacemaker that is designed to be implanted percutaneously into a fetus to treat complete heart block and consequent hydrops fetalis, which is otherwise fatal. One of the most significant considerations for this device is the technical challenges presented by the battery and charging system. The size of the device is limited to about 3 mm in diameter; batteries on this scale have very small charge capacities. The smaller capacity means that the device needs to be designed so that it uses as little current as possible and so that its battery can be recharged wirelessly. We determined the pacing thresholds for a simple relaxation oscillator that can be assembled from discrete, surface mount components and analyzed the power consumption of the device given different electrode configurations and stimulus parameters. An inductive recharging system will be required for some patients; it is feasible within the package constraints and under development.

  15. Pacing Lead-Induced Granuloma in the Atrium: A Foreign Body Reaction to Polyurethane

    Directory of Open Access Journals (Sweden)

    Shinagawa Yoko

    2013-01-01

    Full Text Available We described a case of an 82-year-old male who presented with a granuloma entrapping the polyurethane-coated pacing lead at the site of contact on the atrium. He had been paced for 8 years without symptoms or signs suggestive of an allergic reaction to the pacemaker system and died from thrombosis of the superior mesenteric artery and heart failure. A histological examination of the nodule showed an incidental granuloma with multinucleated giant cells. No granuloma was found in the heart or the lung.

  16. Noninvasive external cardiac pacing for thallium-201 scintigraphy

    International Nuclear Information System (INIS)

    Feldman, M.D.; Warren, S.E.; Gervino, E.V.

    1988-01-01

    Improvements in noninvasive external cardiac pacing have led to a technique with reliable electrical capture and tolerable patient discomfort. To assess the use of this modality of pacing in combination with thallium scintigraphy as a noninvasive pacing stress test, we applied simultaneous noninvasive cardiac pacing, hemodynamic monitoring, and thallium-201 scintigraphy in 14 patients undergoing cardiac catheterization for chest pain syndromes. Two patients had normal coronary arteries, while the remaining 12 had significant coronary artery disease. Thallium scintigraphic responses to pacing were compared to routine exercise thallium stress testing in nine of these 14 patients. All patients were noninvasively paced to more than 85% of the age-predicted maximum heart rate. Twelve patients demonstrated reversible thallium defects, which corresponded in 11 cases to significant lesions seen on coronary angiography. Of nine patients who underwent both pacing and exercise thallium stress tests, comparable maximal rate-pressure products were achieved. Moreover, thallium imaging at peak pacing and during delayed views did not differ significantly from exercise thallium scintigraphy. A limiting factor associated with the technique was local patient discomfort, which occurred to some degree in all patients. We conclude that noninvasive external cardiac pacing together with thallium scintigraphy is capable of detecting significant coronary artery disease and may be comparable to routine exercise thallium stress testing. This new modality of stress testing could be useful in patients unable to undergo the exercise required for standard exercise tolerance testing, particularly if improvements in the technology can be found to reduce further the local discomfort

  17. The effects of presentation pace and modality on learning a multimedia science lesson

    Science.gov (United States)

    Chung, Wen-Hung

    Working memory is a system that consists of multiple components. The visuospatial sketchpad is the main entrance for visual and spatial information, whereas acoustic and verbal information is processed in the phonological loop. The central executive works as a coordinator of information from these two subsystems. Numerous studies have shown that working memory has a very limited capacity. Based on these characteristics of working memory, theories such as cognitive load theory and the cognitive theory of multimedia learning provide multimedia design principles. One of these principles is that when verbal information accompanying pictures is presented in audio mode instead of visually, learning can be more effective than if both text and pictures are presented visually. This is called the modality effect. However, some studies have found that the modality effect does not occur in some situations. In most experiments examining the modality effect, the multimedia is presented as system-paced. If learners are able to repeat listening as many times as they need, the superiority of spoken text over visual text seems lessened. One aim of this study was to examine the modality effect in a learner-controlled condition. This study also used the one-word-at-a-time technique to investigate whether the modality effect would still occur if both reading and listening rates were equal. There were 182 college students recruited for this study. Participants were randomly assigned to seven groups: a self-paced listening group, a self-paced reading group, a self text-block reading group, a general-paced listening group, a general-paced reading group, a fast-paced listening group, and a fast-paced reading group. The experimental material was a cardiovascular multimedia module. A three-by-two between-subjects design was used to test the main effect. Results showed that modality effect was still present but not between the self-paced listening group and the self text-block reading group

  18. Wind cooling during a self-paced cycling time trial

    NARCIS (Netherlands)

    Teunissen, L.P.J.; de Haan, A.; de Koning, J.J.; Daanen, H.A.M.

    2012-01-01

    Introduction Wind has been shown to be an effective cooling method during fixed-paced exercise in the heat, decreasing thermal strain and increasing time to fatigue. However, it has been scarcely investigated in what way these observations translate to self-paced performance. So the aim of this

  19. 77 FR 3958 - Mortgage Assets Affected by PACE Programs

    Science.gov (United States)

    2012-01-26

    ... collateral, and such liens ``run'' with the property. As a result, a mortgagee foreclosing on a property... (``ANPR'') concerning mortgage assets affected by Property Assessed Clean Energy (``PACE'') programs and... February 28, 2011, that deal with property assessed clean energy (PACE) programs.'' In response to and...

  20. PACE3 - front-end chip for the CMS Preshower

    CERN Multimedia

    Aspel, Paul

    2003-01-01

    This is PACE3 which is the front-end chip for the CMS Preshower. In fact PACE3 is the combination of two ASICs called Delta3 and PACEAM3. Delta3 is on the left and PACEAM3 is on the right. The two ASICs are bonded together and then packaged within a single 196 pin fpBGA package.

  1. Social Interaction in Self-Paced Distance Education

    Science.gov (United States)

    Anderson, Terry; Upton, Lorne; Dron, Jon; Malone, Judi; Poelhuber, Bruno

    2015-01-01

    In this paper we present a case study of a self-paced university course that was originally designed to support independent, self-paced study at distance. We developed a social media intervention, in design-based research terms, that allows these independent students to contribute archived content to enhance the course, to engage in discussions…

  2. Diaphragm Pacing as a Rehabilitative Tool for Patients With Pompe Disease Who Are Ventilator-Dependent: Case Series.

    Science.gov (United States)

    Smith, Barbara K; Fuller, David D; Martin, A Daniel; Lottenberg, Lawrence; Islam, Saleem; Lawson, Lee Ann; Onders, Raymond P; Byrne, Barry J

    2016-05-01

    Pompe disease is an inherited disorder notable for severe, progressive ventilatory compromise. Although ventilatory failure has been attributed to myofiber dysfunction secondary to diaphragmatic glycogen accumulation, neural involvement of the phrenic motor system is also a prominent feature. Direct diaphragm pacing supplements respiratory function in other disorders of the phrenic motor system. Accordingly, it is hypothesized that augmented neuromuscular activity via diaphragm pacing would promote weaning from mechanical ventilation in patients with Pompe disease who are unresponsive to conventional, muscle-directed treatments. Three patients with Pompe disease developed diaphragm paresis that resulted in chronic mechanical ventilation dependence. After preoperative inspiratory muscle strengthening exercises failed to improve function, fine-wire pacing electrodes were laparoscopically implanted into the diaphragm. Diaphragm conditioning was initiated the first postoperative week and consisted of gradual increases in stimulation parameters, lengthening of stimulation sessions, and ventilator weaning. Ventilation and intramuscular electromyographic activity were recorded periodically during conditioning to quantify diaphragm neuromuscular function. During paced breathing without mechanical ventilation, tidal volumes increased, and 2 patients were weaned from daytime ventilator dependence within the first 3 months of pacing, which has been sustained over the long-term. A third patient reduced reliance on daytime ventilation, but weaning was delayed by malacia of the large airways. In all patients, pacing appeared to facilitate spontaneous phrenic motor unit activity during independent breathing without ventilator or pacer support. The findings are consistent with the view that diaphragm pacing has potential rehabilitative value to reduce reliance on mechanical ventilation in people with Pompe disease, but further study is needed. Diaphragm pacing represents a

  3. Investigating the Effects of Concurrent Performance of Physical and Cognitive Demanding Task in Paced Assembly Lines

    Directory of Open Access Journals (Sweden)

    Shakil Ahmed Shaikh

    2013-07-01

    Full Text Available The study was undertaken to investigate the effects of pacing on aspects of performance at an assembly task and on the operators' responses related to work behaviour, perceived workload and perceived stress. A particular objective of the study was to investigate whether physical and cognitive demands may interact in their influences on these effects. An assembly task was simulated in the laboratory and the level of pacing imposed, work height and memory load within the task were all varied. The results showed that the type of pacing commonly imposed (as is common with a lean manufacturing Takt time system in industry can significantly affect both performance and perceived workload and stress. Physical demands (through work height affecting posture and mental demand (through memory load were also found to have significant effects, as would be expected from the many studies of these in the literature. More importantly, some interactions were found between pacing and work height in their effects on quality of assembly and the operator's own rating of performance, and between work height and memory load in their effects on errors. These findings will need to be taken into account by companies when implementing Takt time systems.

  4. A comparison of single-lead atrial pacing with dual-chamber pacing in sick sinus syndrome

    DEFF Research Database (Denmark)

    Nielsen, Jens Cosedis; Thomsen, Poul Erik B; Højberg, Søren

    2011-01-01

    In patients with sick sinus syndrome, bradycardia can be treated with a single-lead pacemaker or a dual-chamber pacemaker. Previous trials have revealed that pacing modes preserving atrio-ventricular synchrony are superior to single-lead ventricular pacing, but it remains unclear if there is any...

  5. The combined influence of task accuracy and pace on motor variability in a standardised repetitive precision task.

    Science.gov (United States)

    Srinivasan, Divya; Mathiassen, Svend Erik; Samani, Afshin; Madeleine, Pascal

    2015-01-01

    Thirty-five healthy women, experienced in pipetting, each performed four pipetting sessions at different pace and accuracy levels relevant to occupational tasks. The size and structure of motor variability of shoulder and elbow joint angles were quantified using cycle-to-cycle standard deviations of several kinematics properties, and indices based on sample entropy and recurrence quantification analysis. Decreasing accuracy demands increased both the size and structure of motor variability. However, when simultaneously lowering the accuracy demand and increasing pace, motor variability decreased to values comparable to those found when pace alone was increased without changing accuracy. Thus, motor variability showed some speed-accuracy trade-off, but the pace effect dominated the accuracy effect. Hence, this trade-off was different from that described for end-point performance by Fitts' law. The combined effect of accuracy and pace and the resultant decrease in motor variability are important to consider when designing sustainable work systems comprising repetitive precision tasks. Variability in movements and/or muscle activities between repeats of the same repetitive task is associated with important occupational outcomes, including fatigue, discomfort and pain. This study showed that simultaneously decreasing accuracy and increasing pace in short-cycle repetitive work led to decreased motor variability in arm movements, indicating less favourable ergonomics conditions.

  6. Pushing the pace of tree species migration.

    Directory of Open Access Journals (Sweden)

    Eli D Lazarus

    Full Text Available Plants and animals have responded to past climate changes by migrating with habitable environments, sometimes shifting the boundaries of their geographic ranges by tens of kilometers per year or more. Species migrating in response to present climate conditions, however, must contend with landscapes fragmented by anthropogenic disturbance. We consider this problem in the context of wind-dispersed tree species. Mechanisms of long-distance seed dispersal make these species capable of rapid migration rates. Models of species-front migration suggest that even tree species with the capacity for long-distance dispersal will be unable to keep pace with future spatial changes in temperature gradients, exclusive of habitat fragmentation effects. Here we present a numerical model that captures the salient dynamics of migration by long-distance dispersal for a generic tree species. We then use the model to explore the possible effects of assisted colonization within a fragmented landscape under a simulated tree-planting scheme. Our results suggest that an assisted-colonization program could accelerate species-front migration rates enough to match the speed of climate change, but such a program would involve an environmental-sustainability intervention at a massive scale.

  7. A section of a pacing mine timbering

    Energy Technology Data Exchange (ETDEWEB)

    Hodous, J.; Kubac, J.; Novak, Z.; Skrobalek, J.; Zajic, K.

    1982-04-15

    A section is proposed for a pacing mine support of the wall and supporting type, designed for reinforcing the operational space of a longwall. The support section differs from the known in that it has relatively large mobility with the use of single stage telescopic hydraulic uprights. The section has left and right skiis, to which the tunneling machine with an upper part is attached using a hinged link. One hydraulic upright is installed on each ski, while a device for advancing the support is installed between the skiis. It is linked using a trough with the longwall conveyor which is not shown in the figure. A complex shaped track is made on each ski with three support recesses located at a different height relative to the base of the ski. The hydraulic upright is linked by its fixed part with the upper part of with the heading machine. The support has controllable projections on two sides, each of which is inserted in a track. Moreover, the support is attached to a hydraulic power cylinder, which is hinged with one of the skiis.

  8. The pace of aging: Intrinsic time scales in demography

    Directory of Open Access Journals (Sweden)

    Tomasz Wrycza

    2014-05-01

    Full Text Available Background: The pace of aging is a concept that captures the time-related aspect of aging. It formalizesthe idea of a characteristic life span or intrinsic population time scale. In the rapidly developing field of comparative biodemography, measures that account for inter-speciesdifferences in life span are needed to compare how species age. Objective: We aim to provide a mathematical foundation for the concept of pace. We derive desiredmathematical properties of pace measures and suggest candidates which satisfy these properties. Subsequently, we introduce the concept of pace-standardization, which reveals differences in demographic quantities that are not due to pace. Examples and consequences are discussed. Conclusions: Mean life span (i.e., life expectancy from birth or from maturity is intuitively appealing,theoretically justified, and the most appropriate measure of pace. Pace-standardizationprovides a serviceable method for comparative aging studies to explore differences indemographic patterns of aging across species, and it may considerably alter conclusionsabout the strength of aging.

  9. A pilot study of cardiac electrophysiology catheters to map and pace bladder electrical activity.

    Science.gov (United States)

    Kelley, Robert S; Vardy, Michael D; Simons, Grant R; Chen, Henry; Ascher-Walsh, Charles; Brodman, Michael

    2017-04-01

    This is a pilot study to evaluate the feasibility of using diagnostic cardiac electrophysiology catheters for recording intrinsic urinary bladder electrical activity and for electrical pacing capture of bladder tissue. During cystoscopy, a curved quadripolar catheter was introduced and contact was made with the right and left halves of the dome and trigone in adult female patients undergoing cystoscopy. Electrical activity was recorded, using a commercially available cardiac electrophysiologic recording system, before and during pacing at 0.5-3.0 Hz. Apparent spontaneous electrical depolarizations were detected in both the trigone and the dome. The amplitude of these depolarizations was in the microVolt range. During pacing, local electrical capture was noted in the trigone, but not in the dome. Spontaneous low-amplitude electrical activity was detected in the bladder through the use of commercially available cardiac electrophysiology equipment. While these low-level signals could represent noise, the voltage, and morphology resemble detrusor muscle action potentials previously seen in animal studies. Pacing induced local electrical capture in the trigone but not the dome. © 2016 Wiley Periodicals, Inc.

  10. FITODEGRADASI DENGAN TANAMAN PACING (Speciosus Cheilocostus UNTUK MENURUNKAN KANDUNGAN Pb, Cd Dan Hg LIMBAH CAIR LABORATORIUM

    Directory of Open Access Journals (Sweden)

    Ni Nyoman Trisnawati

    2016-06-01

    Full Text Available ABSTRAK: UPT. Laboratorium Analitik Universitas Udayana menghasilkan limbah yang mengandung bahan-bahan kimia berbahaya. Sistem pengolahan air limbah yaitu fitodegradasi, menggunakan tanaman Pacing (Cheilocostus speciosus telah dicoba untuk mengolah limbah cair laboratorium. Konstruksi unit pengolahan terdiri dari sebuah bak terbuat dari beton dengan media  tanah berukuran 7 m x 1,2 m x 0,34 m yang ditumbuhi Pacing. Penelitian dilakukan selama dua minggu meliputi penelitian eksperimental, observasi pre dan post perlakuan. Efektivitas sistem  fitoremediasi dalam menurunkan kandungan Hg adalah 100% pada hari ketiga, Cd sebesar 77,17 % dan Pb sebesar 9,50 % pada hari keempat. Kandungan Pb, Cd dan Hg berkurang secara signifikan setelah fitoremediasi.   ABSTRACT: UPT Analytical Laboratory of Udayana University produced liquid waste which contained dangerous chemicals such as : lead (Pb, Cadmium (Cd, and Mercury (Hg. Processing system of liquid waste using phytodegradation of pacing plant (Cheilocostus speciosus has been studied to reduce the concentrations of heavy metals of laboratory liquid waste. The construction of the processing unit consisted of conerete tank filled with soil media grown over with pacing plant. The size of the tank was; 7 meters in length, 1.2 meters in width and 0.35 meters in depth. The duration  of the experiment was 2 weeks, by observation of pre and post treatment to record the effectivenesss of the pacing plants in reducing the concentrations of Pb, Cd and Hg in liquid waste. The results showed the effectiveness of the system in reducing the concentration of Pb, Cd and Hg were 9,50 %; 77,17 % and 100 % respectively.  The concentration of  Pb, Cd and Hg decreased significantly after treatment.

  11. “Add-on pacing lead”: An effective and safe alternative to lead replacement in ICD pacing failure

    Directory of Open Access Journals (Sweden)

    Sudeep Kumar

    2012-07-01

    Full Text Available Despite recent advances in implantable cardioverter defibrillator (ICD technology, the long-term reliability of ICD leads remains a significant problem. Lead failures constitute a major risk for patients with an implantable cardioverter defibrillator. There is no clear consensus on treatment strategy of ICD lead failure and decision should be individualized. We report a pacing-dependent elderly male with ICD lead pacing failure secondary to insulation break resulting in recurrent syncope. We emphasize the technique of “Add-on pacing lead implantation” could be an effective and alternative to ICD lead replacement.

  12. Factors explaining voluntary participation in PACE-Vaquita

    OpenAIRE

    Sara Avila

    2011-01-01

    Vaquita marina, a small species of porpoise endemic to the Northern Gulf of California in Mexico, is the world’s most endangered cetacean species. With the purpose of preserving vaquita, the Mexican government launched PACE-Vaquita in 2008. This voluntary program offers an innovative schedule of compensations: as in a payment for conservation program, PACE-Vaquita compensates for temporary reductions in fishing reductions in fishing effort; as in a program to accelerate technology adoption,PA...

  13. Reduced Lordosis and Enhanced Aggression in Paced and Non-Paced Mating in Diabetic Female Rats.

    Science.gov (United States)

    Hernández-Munive, Abigail K; Rebolledo-Solleiro, Daniela; Ventura-Aquino, Elisa; Fernández-Guasti, Alonso

    2018-02-01

    Clinical studies have shown altered sexual function in people with diabetes; basic science studies, using the streptozotocin (STZ)-induced animal model of type 1 diabetes mellitus (DM1), have consistently reported decreased sexual behavior in hyperglycemic female animals, but features of sexual motivation and aggressive behavior have not been explored in these animals. To study several parameters that denote sexual motivation in STZ-treated female rats and to compare behavioral features of sexual behavior and aggression in non-paced mating (NPM) and paced mating (PM) conditions. DM1 was induced by injecting STZ (diluted in citrate buffer) at a dose of 50 mg/kg intraperitoneally over 2 consecutive days into ovariectomized Wistar rats. 10 days later, female rats were treated with estradiol benzoate (10 μg, -24 hours) and progesterone (3 mg, -4 hours); their sexual behavior (including lordosis quotient, lordosis intensity, and proceptivity) and aggression were evaluated under NPM and PM conditions. Body weight, blood glucose levels, and spontaneous ambulatory activity also were measured. A group of STZ-treated animals was administered a long-acting insulin analogue (glargine) every 12 hours for 8 days, and their sexual and aggressive behaviors were evaluated in NPM. We quantified body weight, blood glucose level, spontaneous ambulatory activity, and sexual and aggressive behaviors in NPM and PM; the time the female rats spent interacting with the male rat or in the male rat's chamber also was registered in PM. Compared with controls, STZ-treated ovariectomized rats lost body weight, had increased blood glucose levels, and had unchanged spontaneous ambulatory activity. In the PM and NPM conditions, animals showed decreased lordosis quotient and lordosis intensity, increased aggression, and unaltered proceptivity, although in NPM the effects of STZ treatment on aggression were more drastic and were completely prevented by insulin. In PM no differences were found

  14. Multimedia Approach to Self-Paced Individualized Instruction in Automotive Mechanics and Other Vocational Programs. Final Report.

    Science.gov (United States)

    Ozarka Vocational Technical School, Melbourne, AR.

    A project developed, field tested, implemented, and disseminated a management system, support materials, and references for a self-paced individualized instructional program in automotive mechanics and food services. During the program, the Planwriter component of the SAGE/Compute-a-Match Assessment System was used to develop a management system…

  15. Cricket pace bowling: The trade-off between optimising knee angle ...

    African Journals Online (AJOL)

    benefits. At times this is done to the detriment of injury prevention. Objective. To investigate the relationship between three-dimensional (3D) knee kinematics during pace bowling action, injury incidence and bowling performance at .... medium pace (120 - 129 km/h); medium fast pace (130 - 139 km/h) and fast pace (≥140 ...

  16. Response of pulmonary vein potentials to burst pacing.

    Science.gov (United States)

    Vijayaraman, Pugazhendhi; Kok, Lai Chow; Shepard, Richard K; Wood, Mark A; Ellenbogen, Kenneth A

    2004-10-01

    Pulmonary vein potentials recorded at the ostia of pulmonary veins (PV) are a useful guide for segmental isolation of the PV in patients with atrial fibrillation (AF). Even during coronary sinus pacing at 600 ms, atrial (A) and PV potentials can overlap in 50-60% of patients making the accurate identification of PV potentials very difficult. Nineteen patients (M:F 15:4) with paroxysmal AF underwent segmental isolation of one or more PV. Coronary sinus (CS) pacing was performed at cycle lengths of 600/550/500/450/400/350/300 ms and bipolar electrograms were recorded from the 10 or 20 pole Lasso catheter placed at the atrial-PV junction in 27 pulmonary veins. Stimulus (S) to A, S-PVP and A-PVP intervals were measured during CS pacing at the different cycle lengths at sweep speed of 200 mm/sec. During CS pacing at 600 ms the A and PV potentials were significantly overlapped (A-PVP A-PVP > or = 25 ms) in 9 of the 15 veins where A and PV potentials overlapped and 21 of all 27 (78%) veins. In two patients pacing at 300 ms was associated with 2:1 conduction block from atrial to PV fascicle. Coronary sinus pacing at cycle length of 300 ms demonstrated better separation of A and PV potentials compared to pacing at 600 ms. This strategy is easier and less time consuming compared to extrastimuli testing. It also confirms that the electrophysiological properties of PV fascicles are different from that of the adjacent atrial musculature.

  17. Direct left ventricular endocardial pacing: an alternative when traditional resynchronization via coronary sinus is not feasible or effective.

    Science.gov (United States)

    Moriña-Vázquez, Pablo; Roa-Garrido, Jessica; Fernández-Gómez, Juan M; Venegas-Gamero, José; Pichardo, Rafael B; Carranza, Manuel H

    2013-06-01

    Biventricular pacing through the coronary sinus (CS) is effective for the treatment of patients with heart failure and left bundle-branch block. However, this approach is not always feasible. Although surgical epicardial lead implantation is an alternative, the technique may be deleterious in some patients. Thus, direct left ventricular (LV) endocardial pacing under local anesthesia may be an option. We describe our technique and analyze the results of direct LV endocardial pacing. Fourteen patients with failed resynchronization via CS (April 2006-September 2011) were selected. Using a femoral approach, we performed transseptal puncture and LV mapping, then fixed the active lead where the longest electrical delay was observed; the generator was placed in the anterior thigh. For resynchronization, eight patients with a device previously implanted through the upper veins received a single-chamber generator that was set to the VVT mode to sense the subclavian pacing spike. Six patients received a complete femoral resynchronization system with either a defibrillator or pacemaker. Patients were followed for 6-54 months. The LV lead was successfully implanted in all cases. Two patients experienced excessive bleeding and two died during follow-up. All except one improved at least one New York Heart Association class and experienced improved left ventricle ejection fraction. One patient with recurrent episodes of ventricular fibrillation was asymptomatic. Direct LV endocardial pacing is safe and may be a less risky, more efficient alternative than surgical epicardial lead implantation for resynchronization via CS. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.

  18. Short-term outcome of cardiac resynchronization therapy - a comparison between newly implanted and chronically right ventricle-paced patients.

    Science.gov (United States)

    Lipar, Luka; Srivathsan, Komandoor; Scott, Luis Roberto

    2016-09-15

    Cardiac resynchronization therapy (CRT) is considered as a standard adjunct therapy in symptomatic patients with congestive heart failure (CHF) who have a prolonged QRS. There is an increasing number of patients who do not receive de novo CRT devices but are upgraded from right ventricular (RV) pacing to biventricular stimulation. We wanted to evaluate the benefit of CRT in patients with chronic RV pacing in comparison to previously non-paced heart failure patients. One hundred and sixty-five patients who had their device newly implanted (group I) and 116 who were upgraded from previously implanted RV pacing systems (group II) at Mayo Clinic Hospital were retrospectively analyzed. Clinical and echocardiographic response to CRT was evaluated. Mean follow-up time was 290±250days. Baseline characteristics did not differ between the two groups of patients. Clinical response rate was identical in Groups I and II (65 vs. 65%, respectively; P=0.98) and echocardiographic response rate was similar in both groups of patients (64 vs. 62%; P=0.80). Post-implant QRS increased in group I and was reduced in group II (5 (27.4) vs. -20.0 (33.9) ms; PChronically RV-paced patients who receive CRT have similar short-term benefits when compared with patients with new CRT implantations. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Interaction Equivalency in Self-Paced Online Learning Environments: An Exploration of Learner Preferences

    Directory of Open Access Journals (Sweden)

    Jason F. Rhode

    2009-02-01

    Full Text Available This mixed methods study explored the dynamics of interaction within a self-paced online learning environment. It used rich media and a mix of traditional and emerging asynchronous computer-mediated communication tools to determine what forms of interaction learners in a self-paced online course value most and what impact they perceive interaction to have on their overall learning experience. This study demonstrated that depending on the specific circumstance, not all forms of interaction may be either equally valued by learners or effective. Participants differentiated among the various learning interactions available and indicated that informal interactions were as important as formal interactions in determining the quality of the online learning experience. Participants also reported the activity of blogging as being equally valued and in some ways superior to instructor-directed asynchronous discussion via the discussion board in a learning management system.

  20. Towards Development of a 3-State Self-Paced Brain-Computer Interface

    Directory of Open Access Journals (Sweden)

    Ali Bashashati

    2007-01-01

    the presence of a right- or a left-hand movement and the second classifies the detected movement as a right or a left one. In an offline analysis of the EEG data collected from four able-bodied individuals, the 3-state brain-computer interface shows a comparable performance with a 2-state system and significant performance improvement if used as a 2-state BCI, that is, in detecting the presence of a right- or a left-hand movement (regardless of the type of movement. It has an average true positive rate of 37.5% and 42.8% (at false positives rate of 1% in detecting right- and left-hand extensions, respectively, in the context of a 3-state self-paced BCI and average detection rate of 58.1% (at false positive rate of 1% in the context of a 2-state self-paced BCI.

  1. [Sinus node disease and atrio-ventricular disorders in pregnant women. When temporary or permanent pacing is necessary?].

    Science.gov (United States)

    Kutarski, Andrzej; Polewczyk, Anna

    2015-01-01

    Sinus node disease and atrioventricularis disorders are very rarely observed in women during pregnancy. Bradyarrhythmia in pregnant women is divided into mild bradycardia connected with pressure on venous cava inferior by growing fetus, new detected AV disorders and existing before pregnancy: AV Ill degree block congenital or after surgery, sinus node disease and channelopathies. Management in bradyarrhythmia in pregnancy is very difficult, despite guidelines. Whenever possible problem should be resolved before pregnancy. When symptomatic AV III degree block with wide QRS complex escape rhythm is observed--the permanent pacing should be considered with echocardiography or electro-anatomical system using. Another option is novel temporary, prolonged pacing.

  2. Cardiac Pacing and Defibrillation in Children and Young Adults

    Directory of Open Access Journals (Sweden)

    Harinder R. Singh, MD, CCDS

    2013-01-01

    Full Text Available The population of children and young adults requiring a cardiac pacing device has been consistently increasing. The current generation of devices are small with a longer battery life, programming capabilities that can cater to the demands of the young patients and ability to treat brady and tachyarrhythmias as well as heart failure. This has increased the scope and clinical indications of using these devices. As patients with congenital heart disease (CHD comprise majority of these patients requiring devices, the knowledge of indications, pacing leads and devices, anatomical variations and the technical skills required are different than that required in the adult population. In this review we attempt to discuss these specific points in detail to improve the understanding of cardiac pacing in children and young adults.

  3. Match intensity and pacing strategies in rugby league: an examination of whole-game and interchanged players, and winning and losing teams.

    Science.gov (United States)

    Black, Georgia M; Gabbett, Tim J

    2014-06-01

    There is currently limited information on whether pacing occurs during rugby league match play. In addition, to date no research has investigated whether pacing strategies differ between winning and losing teams. This study investigated the pacing strategies of whole-game and interchanged rugby league players. Furthermore, we investigated the pacing strategies of winning and losing teams. Fifty-two rugby league players, from a sample of 11 teams competing in a semi-elite competition, underwent global positioning system analysis. Performances were divided into match quartiles for whole-game and interchanged players. Total distance, including low- and high-speed distances, and repeated high-intensity effort bouts were recorded. The total distance and low-speed distance covered across all quartiles of the match, but specifically quartiles 1 and 8, were greater for interchanged players than whole-game players. The match outcome differentially affected the pacing strategies of whole-game and interchanged players. Whole-game players from winning teams set a higher pacing strategy than whole-game players from losing teams (effect size [ES] = 1.03 ± 0.77, 96%, very likely), whereas interchanged players from losing teams demonstrated a greater "end-spurt" than interchanged players from winning teams (ES = 0.60 ± 0.52, 96%, very likely). The pacing strategies of interchanged players were higher than whole-game players, irrespective of playing position. The results of this study suggest that pacing strategies differ between interchanged and whole-game rugby league players. Furthermore, our results demonstrate a different pacing strategy between winning and losing teams. These findings suggest that physical preparation for rugby league matches, and recovery from these matches, should be individualized for whole-game and interchanged players. Finally, performing physically intense training on a regular basis is likely to develop the physical and mental qualities required to

  4. Pattern and pace of dental eruption in Tarsius.

    Science.gov (United States)

    Guthrie, Emily H; Frost, Stephen R

    2011-07-01

    This article uses data on the dental eruption pattern and life history of Tarsius to test the utility of Schultz's rule. Schultz's rule claims a relationship between the relative pattern of eruption and the absolute pace of dental development and life history and may be useful in reconstructing life histories in extinct primates. Here, we document an unusual eruption pattern in Tarsius combining early eruption (relative to molars) of anterior replacement teeth (P2 and incisors) and relatively late eruption of the posterior replacement teeth (C, P3, and P4). This eruption pattern does not accurately predict the "slow" pace of life documented for Tarsius [Roberts: Int J Primatol 15 (1994) 1-28], nor aspects of life history directly associated with dental development as would be expected using Schultz's rule. In Tarsius, the anterior teeth and M1 erupt at an early age and therefore are not only fast in a relative sense but also fast in an absolute sense. This seems to be related to a developmental anomaly in the deciduous precursor teeth, which are essentially skipped. This decoupling among dental eruption pattern, dental eruption pace, and life history pace in Tarsius undermines the assumptions that life histories can accurately be described as "fast" or "slow" and that dental eruption pattern alone can be used to infer overall life history pace. The relatively and absolutely early eruption of the anterior dentition may be due to the utility of these front teeth in early food acquisition rather than with the pace of life history. Copyright © 2011 Wiley-Liss, Inc.

  5. Bike and run pacing on downhill segments predict Ironman triathlon relative success.

    Science.gov (United States)

    Johnson, Evan C; Pryor, J Luke; Casa, Douglas J; Belval, Luke N; Vance, James S; DeMartini, Julie K; Maresh, Carl M; Armstrong, Lawrence E

    2015-01-01

    Determine if performance and physiological based pacing characteristics over the varied terrain of a triathlon predicted relative bike, run, and/or overall success. Poor self-regulation of intensity during long distance (Full Iron) triathlon can manifest in adverse discontinuities in performance. Observational study of a random sample of Ironman World Championship athletes. High performing and low performing groups were established upon race completion. Participants wore global positioning system and heart rate enabled watches during the race. Percentage difference from pre-race disclosed goal pace (%off) and mean HR were calculated for nine segments of the bike and 11 segments of the run. Normalized graded running pace (accounting for changes in elevation) was computed via analysis software. Step-wise regression analyses identified segments predictive of relative success and HP and LP were compared at these segments to confirm importance. %Off of goal velocity during two downhill segments of the bike (HP: -6.8±3.2%, -14.2±2.6% versus LP: -1.2±4.2%, -5.1±11.5%; pbike component. Athletes who maintained faster relative speeds on downhill segments, and who had smaller changes in HR between consecutive up and downhill segments were more successful relative to their goal times. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  6. The impact of the perception of rhythmic music on oscillatory self-paced movements

    Directory of Open Access Journals (Sweden)

    Mathieu ePeckel

    2014-09-01

    Full Text Available Inspired by theories of perception-action coupling and embodied music cognition, we investigated how rhythmic music perception impacts self-paced oscillatory movements. In a pilot study, we examined the kinematic parameters of self-paced oscillatory movements, walking and finger tapping using optical motion capture. In accordance with biomechanical constraints accounts of motion, we found that movements followed a hierarchical organization depending on the proximal/distal characteristic of the limb used. Based on these findings, we were interested in knowing how and when the perception of rhythmic music could resonate with the motor system in the context of these constrained oscillatory movements. In order to test this, we conducted an experiment where participants performed four different effector-specific movements (lower leg, whole arm and forearm oscillation and finger tapping while rhythmic music was playing in the background. Musical stimuli consisted of computer-generated MIDI musical pieces with a 4/4 metrical structure. The musical tempo of each song increased from 60 BPM to 120 BPM by 6 BPM increments. A specific tempo was maintained for 20s before a 2s transition to the higher tempo. The task of the participant was to maintain a comfortable pace for the four movements (self-paced while not paying attention to the music. No instruction on whether to synchronize with the music was given. Results showed that participants were distinctively influenced by the background music depending on the movement used with the tapping task being consistently the most influenced. Furthermore, eight strategies put in place by participants to cope with task were unveiled. Despite not instructed to do so, participants also occasionally synchronized with music. Results are discussed in terms of the link between perception and action (i.e. motor/perceptual resonance. In general, our results give support to the notion that rhythmic music is processed in a

  7. The impact of the perception of rhythmic music on self-paced oscillatory movements.

    Science.gov (United States)

    Peckel, Mathieu; Pozzo, Thierry; Bigand, Emmanuel

    2014-01-01

    Inspired by theories of perception-action coupling and embodied music cognition, we investigated how rhythmic music perception impacts self-paced oscillatory movements. In a pilot study, we examined the kinematic parameters of self-paced oscillatory movements, walking and finger tapping using optical motion capture. In accordance with biomechanical constraints accounts of motion, we found that movements followed a hierarchical organization depending on the proximal/distal characteristic of the limb used. Based on these findings, we were interested in knowing how and when the perception of rhythmic music could resonate with the motor system in the context of these constrained oscillatory movements. In order to test this, we conducted an experiment where participants performed four different effector-specific movements (lower leg, whole arm and forearm oscillation and finger tapping) while rhythmic music was playing in the background. Musical stimuli consisted of computer-generated MIDI musical pieces with a 4/4 metrical structure. The musical tempo of each song increased from 60 BPM to 120 BPM by 6 BPM increments. A specific tempo was maintained for 20 s before a 2 s transition to the higher tempo. The task of the participant was to maintain a comfortable pace for the four movements (self-paced) while not paying attention to the music. No instruction on whether to synchronize with the music was given. Results showed that participants were distinctively influenced by the background music depending on the movement used with the tapping task being consistently the most influenced. Furthermore, eight strategies put in place by participants to cope with the task were unveiled. Despite not instructed to do so, participants also occasionally synchronized with music. Results are discussed in terms of the link between perception and action (i.e., motor/perceptual resonance). In general, our results give support to the notion that rhythmic music is processed in a motoric

  8. Optimal implantation depth and adherence to guidelines on permanent pacing to improve the results of transcatheter aortic valve replacement with the medtronic corevalve system: The CoreValve prospective, international, post-market ADVANCE-II study

    NARCIS (Netherlands)

    A.S. Petronio (Anna); J.-M. Sinning (Jan-Malte); N.M. van Mieghem (Nicolas); G. Zucchelli (Giulio); G. Nickenig (Georg); R. Bekeredjian (Raffi); J. Bosmans (Johan); F. Bedogni (Francesco); M. Branny (Marian); K. Stangl (Karl); J. Kovac (Jan); M. Schiltgen (Molly); S. Kraus (Stacia); P.P.T. de Jaegere (Peter)

    2015-01-01

    textabstractObjectives The aim of the CoreValve prospective, international, post-market ADVANCE-II study was to define the rates of conduction disturbances and permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement with the Medtronic CoreValve System (Minneapolis,

  9. Self-Paced Physics, Segment 41A-41E.

    Science.gov (United States)

    New York Inst. of Tech., Old Westbury.

    The second review segment of the Self-Paced Physics Course is presented in this volume and arranged to match study segments 19 through 40. The segment is divided into five subsegments, each of which is composed of a set of problems and solutions. A study guide is provided for each subsegment. The problem set is designed in a back-referencing…

  10. Self-Paced Physics, Segments 6-10.

    Science.gov (United States)

    New York Inst. of Tech., Old Westbury.

    Five segments of the Self-Paced Physics Course materials are presented in this problems and solutions book for use as the second part of student course work. The subject-matter topics are related to circular motion, work, power, kinetic energy, potential energy, conservative forces, conservation of energy, spring problems, center of mass, and…

  11. Self-Paced Physics, Segments 11-14.

    Science.gov (United States)

    New York Inst. of Tech., Old Westbury.

    Four segments of the Self-Paced Physics Course materials are presented in this problems and solutions book for use as the third part of student course work. The subject-matter topics are related to impulses, inelastic and elastic collisions, two-dimensional collision problems, universal constant of gravitation, gravitational acceleration and…

  12. Self-Paced Physics, Segments 28-31.

    Science.gov (United States)

    New York Inst. of Tech., Old Westbury.

    Four study segments of the Self-Paced Physics Course materials are presented in this sixth problems and solutions book used as a part of student course work. The subject matter is related to electric currents, current densities, resistances, Ohm's law, voltages, Joule heating, electromotive forces, single loop circuits, series and parallel…

  13. Individualized Self-Pacing (ISP)--A Success Story.

    Science.gov (United States)

    Collings, Melvin R.

    1979-01-01

    Examines Fullerton College's individualized self-pacing (ISP) program. Reviews twelve ISP objectives including provision of enrollment/scheduling flexibility; lists twenty-two class offerings, including basic business math, business English, and business machines. Compares costs, learning, and course completion in ISP and traditional programs.…

  14. Design Recommendations for Self-Paced Online Faculty Development Courses

    Science.gov (United States)

    Rizzuto, Melissa

    2017-01-01

    An increased need for self-paced, online professional development opportunities in higher education has emerged from a variety of factors including dispersed geographic locations of faculty, full teaching loads, and institutional evaluation requirements. This article is a report of the examination of the design and evaluation of a self-paced…

  15. "Set the Pace": Nutrition Education DVD for Head Start Parents

    Science.gov (United States)

    Adedze, Pascasie; Orr, Robin A.; Chapman-Novakofski, Karen; Donovan, Sharon M.

    2013-01-01

    Childhood overweight remains a major public health problem and innovative nutrition education programs are still needed. Thus, the "Set the Pace" is a nutrition education DVD for Head Start parents which provides visual nutrition education and physical activities to incorporate in their daily routines. (Contains 1 table.)

  16. The influence of pacing strategy on marathon world records.

    Science.gov (United States)

    Díaz, José Joaquín; Fernández-Ozcorta, Eduardo José; Santos-Concejero, Jordan

    2018-03-20

    The aim of this study was to analyse the influence of the pacing strategy adopted by elite marathon runners when setting every marathon world record in the last 50 years. We divided former marathon record holders into two groups: classic athletes (record holders between 1967 and 1988) and contemporaneous athletes (record holders between 1988 and 2018). The total distance of the marathon was divided into 8 sections of 5 km and 1 last section of 2.195 km, and the relative average speed of each section was calculated individually. On average athletes were slightly faster in the first half-marathon than in the second one, where they slowed down progressively (ES = 0.28, small effect). However, when comparing classic vs. contemporaneous athletes, we observed that classic athletes started significantly faster (p < .05, ES = 1.16, moderate effect), although after 25 km, their speed dropped dramatically and was significantly slower than in their contemporaneous counterparts (ES = 2.41, very large effect). This study shows that the pacing strategies of the best marathon runners in the world have changed over the last 50 years. Although a negative pace distribution has been proposed as the most efficient option, a pacing strategy characterised by very little speed changes across the whole race may be the way to go in the future.

  17. MFTF-B PACE tests and final cost report

    International Nuclear Information System (INIS)

    Krause, K.H.; Kozman, T.A.; Smith, J.L.; Horan, R.J.

    1986-10-01

    The Mirror Fusion Test Facility (MFTF-B) construction project was successfully completed in February 1986, with the conclusion of the Plant and Capital Equipment (PACE) Tests. This series of tests, starting in September 1985 and running through February 1986, demonstrated the overall machine capabilities and special facilities accomplishments for the Mirror Fusion Test Facility Project

  18. Pacing pattern in a 30-minute maximal cycling test.

    Science.gov (United States)

    Chaffin, Morgan E; Berg, Kris; Zuniga, Jorge; Hanumanthu, Vidya Sagar

    2008-11-01

    The purpose of this study was to investigate the pacing pattern and associated physiological effects in competitive cyclists who performed a 30-minute maximal cycling test. Measurements included oxygen uptake (V O2), heart rate (HR), blood lactate concentration (BLC), rating of perceived exertion (RPE), and work rate in watts. Twelve well-trained amateur cyclists (seven men and five women) whose mean age was 32.4 +/- 8.6 years participated in this study. They performed a 30-minute self-paced maximal cycling test using their own performance road bike attached to a CompuTrainer Pro, which allowed the assessment of work rate (W). During the test, work rate, V O2, and HR were measured every 30 seconds. Subjects' BLC and RPE were obtained every 5 minutes. Results indicate that no significant differences existed across three 10-minute periods for work rate, HR, or V O2. However, RPE at 30 minutes was significantly greater than RPE at 10 and 20 minutes (both p minutes was also greater than the RPE at 10 minutes (p 30 seconds of the test. The associated V O2 was fairly constant over time, whereas HR rose linearly and gradually. It was concluded that pacing in a 30-minute maximal exercise bout performed in the laboratory in experienced cyclists varies minimally until the last 30 seconds. Knowledge of pacing strategy and the linked physiological responses may be helpful to exercise scientists in optimizing performance in the endurance athlete.

  19. Optimizing Classroom Instruction through Self-Paced Learning Prototype

    Science.gov (United States)

    Bautista, Romiro G.

    2015-01-01

    This study investigated the learning impact of self-paced learning prototype in optimizing classroom instruction towards students' learning in Chemistry. Two sections of 64 Laboratory High School students in Chemistry were used as subjects of the study. The Quasi-Experimental and Correlation Research Design was used in the study: a pre-test was…

  20. Determination of myocardial energetic output for cardiac rhythm pacing

    Czech Academy of Sciences Publication Activity Database

    Heřman, D.; Převorovská, Světlana; Maršík, František

    2007-01-01

    Roč. 7, č. 4 (2007), s. 156-161 ISSN 1567-8822 R&D Projects: GA ČR GA106/03/1073 Institutional research plan: CEZ:AV0Z20760514 Keywords : heart arrhythmia * cardiac pacing modes * numerical simulation Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  1. The Pace and Shape of Senescence in Angiosperms

    DEFF Research Database (Denmark)

    Baudisch, Annette; Salguero-Gómez, Roberto; Jones, Owen

    2013-01-01

    not senesce. We find that growth form relates to differences in pace, that is, life span, as woody plants are typically longer lived than nonwoody plants, while differences in shape, that is, whether or not angiosperms senesce, are related to ancestral history. 5. Synthesis: The age trajectory of mortality...

  2. Self-Paced Physics, Segments 37-40.

    Science.gov (United States)

    New York Inst. of Tech., Old Westbury.

    Four study segments of the Self-Paced Physics Course materials are presented in this eighth problems and solutions book used as a part of course assignments. The content is related to magnetic induction, Faraday's law, induced currents, Lenz's law, induced electromotive forces, time-varying magnetic fields, self-inductance, inductors,…

  3. Keeping Pace with K-12 Online Learning, 2016

    Science.gov (United States)

    Gemin, Butch; Pape, Larry

    2017-01-01

    "Keeping Pace with K-12 Online Learning 2016" marks the thirteenth consecutive year Evergreen has published its annual research of the K-12 education online learning market. The thirteen years of researching, writing and publishing this report represents a time of remarkable change. There has been a constant presence that has become the…

  4. The Effects of Self-Paced Blended Learning of Mathematics

    Science.gov (United States)

    Balentyne, Phoebe; Varga, Mary Alice

    2016-01-01

    As online and blended learning gain more popularity in education, it becomes more important to understand their effects on student learning. The purpose of this study was to explore the effects of self-paced blended learning of mathematics on the attitudes and achievement of 26 high ability middle school students, and investigate the relationship…

  5. Gait Coordination After Stroke: Benefits of Acoustically Paced Treadmill Walking

    NARCIS (Netherlands)

    Roerdink, M.; Lamoth, C.J.C.; Kwakkel, G.; van Wieringen, P.C.W.; Beek, P.J.

    2007-01-01

    Background and Purpose: Gait coordination often is compromised after stroke. The purpose of this study was to evaluate the efficacy of acoustically paced treadmill walking as a method for improving gait coordination in people after stroke. Participants: Ten people after stroke volunteered for the

  6. Gait coordination after stroke: benefits of acoustically paced treadmill walking.

    NARCIS (Netherlands)

    Roerdink, M.; Lamoth, C.J.; Kwakkel, G.; Wieringen, P.C. van; Beek, P.J.

    2007-01-01

    BACKGROUND AND PURPOSE: Gait coordination often is compromised after stroke. The purpose of this study was to evaluate the efficacy of acoustically paced treadmill walking as a method for improving gait coordination in people after stroke. PARTICIPANTS: Ten people after stroke volunteered for the

  7. An Experiment in Self-Paced Study.

    Science.gov (United States)

    Brook, R.J.

    This monograph describes in detail how a Personalized System of Instruction (PSI), or Keller Plan, approach was implemented in a large statistics course at Massey University, New Zealand. Some of the strengths and weaknesses of the scheme are explored and possible extensions noted. Major areas covered are subject area (statistics), logistics,…

  8. Pacing, Pixels, and Paper: Flexibility in Learning Words from Flashcards

    Directory of Open Access Journals (Sweden)

    Kara Sage

    2016-08-01

    Full Text Available The present study focused on how self-control over pace might help learners successfully extract information from digital learning aids. Past research has indicated that too much control over pace can be overwhelming, but too little control over pace can be ineffective. Within the popular self-testing domain of flashcards, we sought to elucidate the optimal level of user control for digital learning and compare learning outcomes between paper and digital flashcards. College students learned vocabulary from paper flashcards or one of several digital flashcard versions and were scored on their memory recall and asked about their perceptions of the learning process. With digital flashcards, students were randomly assigned to an automatic slideshow of cards with no user control, automatic slideshow with pre-set pauses, automatic slideshow where users could press the spacebar to pause at any time, or a self-paced slideshow with complete user control. Users reported feeling more in control when indeed having some control, but ultimately memory recall, cognitive load, and satisfaction were similar across the five versions. However, memory recall was positively related to user satisfaction with their specific flashcard set, and negatively related to users’ perceived mental effort and difficulty. Notably, whether paper or digital, students showed individual variability in how they advanced through the words. This research adds to the educational literature by suggesting that paper and digital flashcards are equally viable options for students. Given differences between individual users and the connection between satisfaction and recall, individualistic options that offer, but do not force, some control over pace seem ideal. Paper flashcards may already include such options, and e-flashcards should offer similar adaptive features to appeal to a wide variety of users.

  9. Advances in Atmospheric Correction for NASA's PACE mission

    Science.gov (United States)

    Remer, L. A.; Franz, B. A.; Boss, E.

    2015-12-01

    The PACE (Pre- Aerosol, Clouds and ocean Ecosystem) mission is a strategic Climate Continuity mission, included in NASA's 2010 plan: "Responding to the Challenge of Climate and Environmental Change: NASA's Plan for a Climate-Centric Architecture for Earth Observations and Applications from Space". On a polar orbit, PACE will make climate-quality global measurements that are essential for understanding ocean biology, biogeochemistry, ecology, aerosol and cloud properties. These measurements will be used to help determine how the ocean and atmosphere are influencing and being influenced by a changing climate. At the heart of the PACE mission is a broad spectrum moderate resolution (~1 km nadir) radiometer, called the Ocean Color Instrument (OCI). OCI will provide high spectral resolution (5 nm) from the UV to NIR (350 - 800 nm), with additional spectral bands in the NIR and SWIR to support atmospheric correction, and aerosol and cloud science. Never before has a U.S. space borne instrument measured across such a broad spectral range at such a fine spectral and spatial resolutions on a global scale. The added capability of OCI presents unique new opportunities for oceanic and atmospheric retrievals, but also new challenges, especially for atmospheric correction. These challenges are being met in a variety of creative ways. In addition to OCI, PACE may include a multi-spectral, multi-angle polarimeter that will enhance aerosol and cloud characterization, aid significantly in atmospheric correction for oceanic retrievals, and may offer new insight into characterization of oceanic hydrosols. With these advanced global remote sensing capabilities PACE is expected to: (1) Provide high quality observations for both basic science research, as well as applications; and (2) Extend the current time-series of climate quality data to enable detection of long-term trends.

  10. The rationale and design of the Micra Transcatheter Pacing Study: safety and efficacy of a novel miniaturized pacemaker.

    Science.gov (United States)

    Ritter, Philippe; Duray, Gabor Z; Zhang, Shu; Narasimhan, Calambur; Soejima, Kyoko; Omar, Razali; Laager, Verla; Stromberg, Kurt; Williams, Eric; Reynolds, Dwight

    2015-05-01

    Recent advances in miniaturization technologies and battery chemistries have made it possible to develop a pacemaker small enough to implant within the heart while still aiming to provide similar battery longevity to conventional pacemakers. The Micra Transcatheter Pacing System is a miniaturized single-chamber pacemaker system that is delivered via catheter through the femoral vein. The pacemaker is implanted directly inside the right ventricle of the heart, eliminating the need for a device pocket and insertion of a pacing lead, thereby potentially avoiding some of the complications associated with traditional pacing systems. The Micra Transcatheter Pacing Study is currently undergoing evaluation in a prospective, multi-site, single-arm study. Approximately 720 patients will be implanted at up to 70 centres around the world. The study is designed to have a continuously growing body of evidence and data analyses are planned at various time points. The primary safety and efficacy objectives at 6-month post-implant are to demonstrate that (i) the percentage of Micra patients free from major complications related to the Micra system or implant procedure is significantly higher than 83% and (ii) the percentage of Micra patients with both low and stable thresholds is significantly higher than 80%. The safety performance benchmark is based on a reference dataset of 977 subjects from 6 recent pacemaker studies. The Micra Transcatheter Pacing Study will assess the safety and efficacy of a miniaturized, totally endocardial pacemaker in patients with an indication for implantation of a single-chamber ventricular pacemaker. NCT02004873. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  11. The impact of atrio-biventricular pacing on hemodynamics and left ventricular dyssynchrony compared with atrio-right ventricular pacing alone in the postoperative period after cardiac surgery.

    Science.gov (United States)

    Cannesson, Maxime; Farhat, Fadi; Scarlata, Maria; Cassar, Emmanuel; Lehot, Jean-Jacques

    2009-06-01

    The aims of this study were to test the hypotheses that in the postoperative period after coronary artery bypass graft surgery (1) atrio-right ventricular (RA-RV) pacing induces a decrease in cardiac output compared with RA pacing alone and (2) atrio-biventricular (RA-BiV) pacing improves CO compared with RA-RV pacing. A prospective observational study. A single-center university hospital. Patients referred for coronary artery bypass graft surgery. Patients were studied during atrial, RA-RV, and RA-BiV pacing. Cardiac output (echocardiography) and left ventricular dyssynchrony were assessed at each step. RA-RV pacing induced a significant decrease in cardiac output (4.3 +/- 1.0 to 3.7 +/- 0.8 L/min, p < 0.01) and a significant increase in left ventricular dyssynchrony (13 +/- 12 to 80 +/- 25 milliseconds, p < 0.01). Biventricular pacing induced a significant increase in cardiac output (3.7 +/- 0.8 to 4.5 +/- 1.0 L/min, p < 0.01) and a significant decrease in left ventricular dyssynchrony compared with right ventricular pacing (80 +/- 25 to 21 +/- 16 milliseconds, p < 0.05). RA-BiV pacing improves cardiac output compared with RA-RV pacing in the postoperative period after coronary artery bypass graft surgery. This improvement is related to an improvement in left ventricular synchronicity.

  12. Special Problems Of Pacing In Children

    Directory of Open Access Journals (Sweden)

    Herwig Antretter

    2003-01-01

    Full Text Available The number of children suffering from congenital or acquired rhythm disorders, and therefore being pacemaker dependent, is very small. This is one of the reasons why a special hardware has never been developed for this cohort. Pacemaker implantation into children does not differ substantially from operations in adults. But there are several important points which have to be fulfilled in these small patients in order to guarantee a complication free function. As most of these children remain pacemaker dependent a lifetime, it is of tremendous importance to minimize all revisions regarding the implanted systems and to enable our small patients a high and therefore nearly normal quality of life. Pros and cons of different surgical approaches, implantation sites and the problem of growth after pacemaker implantation in children are considered.

  13. Assessing the PACE of California residential solar deployment: Impacts of Property Assessed Clean Energy programs on residential solar photovoltaic deployment in California, 2010-2015

    Energy Technology Data Exchange (ETDEWEB)

    Deason, Jeff; Murphy, Sean

    2018-04-04

    A new study by Berkeley Lab found that residential Property Assessed Clean Energy (R-PACE) programs increased deployment of residential solar photovoltaic (PV) systems in California, raising it by about 7-12% in cities that adopt these programs. R-PACE is a financing mechanism that uses a voluntary property tax assessment, paid off over time, to facilitate energy improvements and, in some jurisdictions, water and resilience measures. While previous studies demonstrated that early, regional R-PACE programs increased solar PV deployment, this new analysis is the first to demonstrate these impacts from the large, statewide R-PACE programs dominating the California market today, which use private capital to fund the upfront costs of the improvements. Berkeley Lab estimated the impacts using econometric techniques on two samples: -Large cities only, allowing annual demographic and economic data as control variables -All California cities, without these annual data Analysis of both samples controls for several factors other than R-PACE that would be expected to drive solar PV deployment. We infer that on average, cities with R-PACE programs were associated with greater solar PV deployment in our study period (2010-2015). In the large cities sample, solar PV deployment in jurisdictions with R-PACE programs was higher by 1.1 watts per owner-occupied household per month, or 12%. Across all cities, solar PV deployment in jurisdictions with R-PACE programs was higher by 0.6 watts per owner-occupied household per month, or 7%. The large cities results are statistically significant at conventional levels; the all-cities results are not. The estimates imply that the majority of solar PV deployment financed by R-PACE programs would likely not have occurred in their absence. Results suggest that R-PACE programs have increased PV deployment in California even in relatively recent years, as R-PACE programs have grown in market share and as alternate approaches for financing solar PV

  14. Effect of age and performance on pacing of marathon runners

    Directory of Open Access Journals (Sweden)

    Nikolaidis PT

    2017-08-01

    Full Text Available Pantelis Theodoros Nikolaidis,1 Beat Knechtle2,3 1Exercise Physiology Laboratory, Attiki, Greece; 2Gesundheitszentrum St. Gallen, St. Gallen, 3Institute of Primary Care, University of Zurich, Zurich, Switzerland Abstract: Pacing strategies in marathon runners have previously been examined, especially with regard to age and performance level separately. However, less information about the age × performance interaction on pacing in age-group runners exists. The aim of the present study was to examine whether runners with similar race time and at different age differ for pacing. Data (women, n=117,595; men, n=180,487 from the “New York City Marathon” between 2006 and 2016 were analyzed. A between–within subjects analysis of variance showed a large main effect of split on race speed (p<0.001, η2=0.538 with the fastest speed in the 5–10 km split and the slowest in the 35–40 km. A small sex × split interaction on race speed was found (p<0.001, η2=0.035 with men showing larger increase in speed at 5 km and women at 25 km and 40 km (end spurt. An age-group × performance group interaction on Δspeed was shown for both sexes at 5 km, 10 km, 15 km, 20 km, 25 km, 30 km, 35 km, and 40 km (p<0.001, 0.001≤η2≤0.004, where athletes in older age-groups presented a relatively more even pace compared with athletes in younger age-groups, a trend that was more remarkable in the relatively slow performance groups. So far, the present study is the first one to observe an age × performance interaction on pacing; ie, older runners pace differently (smaller changes than younger runners with similar race time. These findings are of great practical interest for coaches working with marathon runners of different age, but similar race time. Keywords: running, master athlete, endurance, aerobic capacity, fatigue, gender, race time

  15. Passion and Pacing in Endurance Performance.

    Science.gov (United States)

    Schiphof-Godart, Lieke; Hettinga, Florentina J

    2017-01-01

    Endurance sports are booming, with sports passionates of varying skills and expertise battering city streets and back roads on their weekly or daily exercise rounds. The investments required for performing in endurance exercise are nevertheless considerable, and passion for their sport might explain the efforts endurance athletes are willing to make. Passion may be defined as a strong motivational force and as such might be related to the neurophysiological basis underlying the drive to exercise. A complex relationship between the brain and other systems is responsible for athletes' exercise behavior and thus performance in sports. We anticipate important consequences of athletes' short term choices, for example concerning risk taking actions, on long term outcomes, such as injuries, overtraining and burnout. We propose to consider athletes' type of passion, in combination with neurophysiological parameters, as an explanatory factor inunderstanding the apparent disparity in the regulation of exercise intensity during endurance sports. Previous research has demonstrated that athletes can be passionate toward their sport in either a harmonious or an obsessive way. Although both lead to considerable investments and therefore often to successful performances, obsessive passion may affect athlete well-being and performance on the long run, due to the corresponding inflexible exercise behavior. In this perspective we will thus examine the influence of passion in sport on athletes' short term and long term decision-making and exercise behavior, in particular related to the regulation of exercise intensity, and discuss the expected long term effects of both types of passion for sport.

  16. The accelerating pace of star formation

    Science.gov (United States)

    Caldwell, Spencer; Chang, Philip

    2018-03-01

    We study the temporal and spatial distribution of star formation rates in four well-studied star-forming regions in local molecular clouds (MCs): Taurus, Perseus, ρ Ophiuchi, and Orion A. Using published mass and age estimates for young stellar objects in each system, we show that the rate of star formation over the last 10 Myr has been accelerating and is (roughly) consistent with a t2 power law. This is in line with previous studies of the star formation history of MCs and with recent theoretical studies. We further study the clustering of star formation in the Orion nebula cluster. We examine the distribution of young stellar objects as a function of their age by computing an effective half-light radius for these young stars subdivided into age bins. We show that the distribution of young stellar objects is broadly consistent with the star formation being entirely localized within the central region. We also find a slow radial expansion of the newly formed stars at a velocity of v = 0.17 km s-1, which is roughly the sound speed of the cold molecular gas. This strongly suggests the dense structures that form stars persist much longer than the local dynamical time. We argue that this structure is quasi-static in nature and is likely the result of the density profile approaching an attractor solution as suggested by recent analytic and numerical analysis.

  17. What Pace Is Best? Assessing Adults' Learning from Slideshows and Video

    Science.gov (United States)

    Sage, Kara

    2014-01-01

    When acquiring information from a 2D platform, self-control and/or optimal pacing may help reduce cognitive load and enhance learning outcomes. In the present research, adults viewed novel action sequences via one of four learning media: (1) self-paced slideshows, where viewers advanced through slides at their own pace by clicking a mouse, (2)…

  18. Cardiac resynchronization as therapy for congestive cardiac failure in children dependent on chronic cardiac pacing.

    NARCIS (Netherlands)

    Beek, E. van; Backx, A.P.C.M.; Singh, S.K.

    2006-01-01

    Three patients with heart failure after chronic right ventricular apical pacing were treated with resynchronization. Biventricular pacing was used for two patients, and the other was treated with left univentricular pacing. In all patients, we observed a dramatic improvement of left ventricular

  19. Society for the Teaching of Psychology and the University of Wisconsin-Milwaukee: U-Pace

    Science.gov (United States)

    EDUCAUSE, 2014

    2014-01-01

    The Society for the Teaching of Psychology and the University of Wisconsin-Milwaukee (UWM) partnered to disseminate U-Pace, a technology-enabled instructional model that promotes student success through deeper learning. UWM developed U-Pace in 2006 for an Introduction to Psychology course and, over time, evidence indicates that U-Pace not only…

  20. Predicting Successful Completion Using Student Delay Indicators in Undergraduate Self-Paced Online Courses

    Science.gov (United States)

    Lim, Janine M.

    2016-01-01

    Self-paced online courses meet flexibility and learning needs of many students, but skepticism persists regarding the quality and the tendency for students to procrastinate in self-paced courses. Research is needed to understand procrastination and delay patterns of students in online self-paced courses to predict successful completion and…

  1. Optimal pacing strategy : from theoretical modelling to reality in 1500-m speed skating

    NARCIS (Netherlands)

    Hettinga, F. J.; De Koning, J. J.; Schmidt, L. J. I.; Wind, N. A. C.; MacIntosh, B. R.; Foster, C.

    Purpose Athletes are trained to choose the pace which is perceived to be correct during a specific effort, such as the 1500-m speed skating competition. The purpose of the present study was to "override" self-paced (SP) performance by instructing athletes to execute a theoretically optimal pacing

  2. The Pace and Shape of Senescence in Angiosperms

    DEFF Research Database (Denmark)

    Baudisch, Annette; Salguero-Gómez, Roberto; Jones, Owen

    2013-01-01

    1. Demographic senescence, the decay in fertility and increase in the risk of mortality with age, is one of the most striking phenomena in ecology and evolution. Comparative studies of senescence patterns of plants are scarce, and consequently, little is known about senescence and its determinants...... in the plant kingdom. 2. Senescence patterns of mortality can be classified by distinguishing between two metrics: pace and shape. The pace of mortality captures the speed at which life proceeds and can be measured by life expectancy, while the shape of mortality captures whether mortality increases...... (‘senescence’), decreases (‘negative senescence’) or remains constant over age (‘negligible senescence’). 3. We extract mortality trajectories from ComPADRe III, a data base that contains demographic information for several hundred plant species. We apply age-from-stage matrix decomposition methods to obtain...

  3. The pace of vocabulary growth helps predict later vocabulary skill

    Science.gov (United States)

    Rowe, Meredith L.; Raudenbush, Stephen W.; Goldin-Meadow, Susan

    2011-01-01

    Children vary widely in the rate at which they acquire words—some start slow and speed up, others start fast and continue at a steady pace. Do early developmental variations of this sort help predict vocabulary skill just prior to kindergarten entry? This longitudinal study starts by examining important predictors (SES, parent input, child gesture) of vocabulary growth between 14 and 46 months (n=62), and then uses growth estimates to predict children's vocabulary at 54 months. Velocity and acceleration in vocabulary development at 30 months predicted later vocabulary, particularly for children from low socioeconomic backgrounds. Understanding the pace of early vocabulary growth thus improves our ability to predict school readiness, and may help identify children at risk for starting behind. PMID:22235920

  4. ELM pacing and the ITER operating window: mutual constraints

    Science.gov (United States)

    Pacher, G. W.; Pacher, H. D.; Kukushkin, A. S.; Pitts, R. A.

    2011-08-01

    On ITER, one of the methods foreseen to reduce the energy loading due to edge localized modes (ELMs) on the divertor targets is the use of pellet injection to control the ELM frequency and amplitude of the energy losses at each ELM. However, the use of such pellet pacing introduces additional fuel throughput. This may constrict the burning plasma operating window through its influence on divertor plasma detachment, thus reducing the attainable alpha power. Consistent modelling of core, scrape-off layer, and divertor is used to document this effect. The result is a determination of the maximum attainable alpha power at the nominal pumping speed as a function of pacing pellet size and the maximum allowable pellet size as a function of ELM loss power fraction for which the reference operating window is not reduced.

  5. Organizational Learning: Keeping Pace with Change through Action Learning

    OpenAIRE

    Yeadon-Lee, Annie

    2015-01-01

    In the current climate of economic ‘austerity’, organisational learning has increasingly gained importance, and a need for new ways of transferring learning has been identified. Organisational learning is seen as key to organisational success, ensuring both competitive advantage and organisational longevity. However, in order for organisations to keep pace with change they must not only strive to learn but also pay attention to how they might learn. A dominant view within the field of organis...

  6. Determination of inadvertent atrial capture during para-Hisian pacing.

    Science.gov (United States)

    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 capture alone (174 ± 38 ms, P capture (51 ± 16 ms) than with H+V (92 ± 22 ms, Pcapture alone (146 ± 33 ms, P capture. A stim-PCS >90 ms (stim-HRA >100 ms) was observed only in the absence of atrial capture. A stim-HRA of 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 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.

  7. [Permanent cardiac pacing in vasovagal syncope and carotid sinus syndrome].

    Science.gov (United States)

    Dupliakov, D V; Golovina, G A; Zemlianova, M E; Khokhlunov, S M; Poliakov, V P

    2011-01-01

    Vasovagal syncope and carotid sinus syndrome are common conditions in young and elderly people, respectively, mostly with benign prognosis. Nevertheless, severe or "malignant" syncopal attacks in some patients may be associated with life-threatening injury. Unfortunately, up to now almost all drug trials have failed to demonstrate any benefit in preventing syncope and interventional approach (pacemaker) may be appropriate. This article contains literature review and discussion of indications for pacing in vasovagal syncope and carotid sinus syndrome.

  8. Optimizing classroom instruction through self-paced learning prototype

    Directory of Open Access Journals (Sweden)

    Romiro Gordo Bautista

    2015-09-01

    Full Text Available This study investigated the learning impact of self-paced learning prototype in optimizing classroom instruction towards students’ learning in Chemistry. Two sections of 64 Laboratory High School students in Chemistry were used as subjects of the study. The Quasi-Experimental and Correlation Research Design was used in the study: a pre-test was conducted, scored and analyzed which served as the basis in determining the initial learning schema of the respondents. A questionnaire was adopted to find the learning motivation of the students in science. Using Pearson-r correlation, it was found out that there is a highly significant relationship between their internal drive and their academic performance. Moreover, a post-test was conducted after self-paced learning prototype was used in the development of select topics in their curricular plot. It was found out that the students who experienced the self-paced learning prototype performed better in their academic performance as evidenced by the difference of their mean post-test results. ANCOVA results on the post-test mean scores of the respondents were utilized in establishing the causal-effect of the learning prototype to the academic performance of the students in Chemistry. A highly significant effect on their academic performance (R-square value of 70.7% and significant interaction of the models to the experimental grouping and mental abilities of the respondents are concluded in the study.

  9. Combined obliquity and precession pacing of late Pleistocene deglaciations.

    Science.gov (United States)

    Huybers, Peter

    2011-12-08

    Milankovitch proposed that Earth resides in an interglacial state when its spin axis both tilts to a high obliquity and precesses to align the Northern Hemisphere summer with Earth's nearest approach to the Sun. This general concept has been elaborated into hypotheses that precession, obliquity or combinations of both could pace deglaciations during the late Pleistocene. Earlier tests have shown that obliquity paces the late Pleistocene glacial cycles but have been inconclusive with regard to precession, whose shorter period of about 20,000 years makes phasing more sensitive to timing errors. No quantitative test has provided firm evidence for a dual effect. Here I show that both obliquity and precession pace late Pleistocene glacial cycles. Deficiencies in time control that have long stymied efforts to establish orbital effects on deglaciation are overcome using a new statistical test that focuses on maxima in orbital forcing. The results are fully consistent with Milankovitch's proposal but also admit the possibility that long Southern Hemisphere summers contribute to deglaciation.

  10. Factors affecting the regulation of pacing: current perspectives

    Directory of Open Access Journals (Sweden)

    Mauger AR

    2014-09-01

    Full Text Available Alexis R Mauger Endurance Research Group, School of Sport and Exercise Sciences, Faculty of Science, University of Kent, Chatham, UK Abstract: During prolonged dynamic and rhythmic exercise, muscular pain and discomfort arises as a result of an increased concentration of deleterious metabolites. Sensed by peripheral nociceptors and transmitted via afferent feedback to the brain, this provides important information regarding the physiological state of the muscle. These sensations ultimately contribute to what is termed "exercise-induced pain". Despite being well recognized by athletes and coaches, and suggested to be integral to exercise performance, this construct has largely escaped attention in experimental work. This perspective article highlights the current understanding of pacing in endurance performance, and the causes of exercise-induced pain. A new perspective is described, which proposes how exercise-induced pain may be a contributing factor in helping individuals to regulate their work rate during exercise and thus provides an important construct in pacing. Keywords: pain, exercise-induced pain, discomfort, exercise performance, self-paced

  11. Cardiac resynchronization therapy is appropriate for all patients requiring chronic right ventricular pacing: the con perspective.

    Science.gov (United States)

    Daoud, Emile G

    2015-09-01

    There has been compelling evidence for the use of biventricular (BiV) pacing to reduce mortality and heart failure (HF) hospitalization in patients with HF symptoms, depressed ejection fraction (EF), and a broad QRS. Cardiac resynchronization therapy (CRT) provides benefit for patients with depressed EF and minimal HF symptoms. Although data from CRT trials are compelling, clinical evidence to recommend BiV pacing to all patients who require a high degree of right ventricular (RV) pacing are lacking. This article summarizes the relevant studies demonstrating that BiV pacing is not appropriate therapy for all patients who require chronic RV pacing. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Cardiac resynchronization therapy is appropriate for all patients requiring chronic right ventricular pacing: the pro perspective.

    Science.gov (United States)

    Herweg, Bengt; Singh, Robin; Barold, S Serge

    2015-09-01

    Long-term right ventricular pacing has deleterious effects on the left ventricle (LV). The risk of pacemaker-induced cardiomyopathy (PICM) seems to be lower in patients with a normal LV ejection fraction (LVEF). Patients developing PICM respond favorably to a cardiac resynchronization therapy upgrade, suggesting that the dysfunction is partially reversible. Biventricular pacing has emerged as a treatment and/or prevention of PICM. Cumulative pacing greater than 40% of the time is considered the most important risk factor for PICM. No organizational guidelines exist for preventive biventricular pacing. The decision to pursue biventricular pacing should be individualized. Published by Elsevier Inc.

  13. Inspiratory muscle pacing in spinal cord injury: case report and clinical commentary.

    Science.gov (United States)

    DiMarco, Anthony F; Onders, Raymond P; Ignagni, Anthony; Kowalski, Krzysztof E

    2006-01-01

    A significant fraction of patients with cervical spinal cord injury suffer from respiratory muscle paralysis and dependence on chronic mechanical ventilation. In selected patients, diaphragm pacing (DP) through electrical stimulation of the phrenic nerves provides an alternative to mechanical ventilation with significant advantages in life quality. A case report of an individual who successfully underwent DP using intramuscular diaphragm electrodes. A brief review of the state of the art of DP including the clinical benefits of DP, patient selection and evaluation, description of equipment, methods of transition from mechanical ventilation to DP, potential complications and side effects, long-term outcome, and potential future developments in this field is included. Several available DP systems are available, including conventional ones in which electrodes are positioned directly on the phrenic nerves through thoracotomy and less invasive systems in which electrodes are placed within the diaphragm through laparoscopy. For patients with only unilateral phrenic nerve function, a combined intercostal and unilateral diaphragm pacing system is under development. In patients with ventilator-dependent tetraplegia, there are alternative methods of ventilatory support, which offer substantial benefits compared to mechanical ventilation.

  14. Self-paced intermittent-sprint performance and pacing strategies following respective pre-cooling and heating.

    Science.gov (United States)

    Skein, Melissa; Duffield, Rob; Cannon, Jack; Marino, Frank E

    2012-01-01

    This study examined the effects of pre-exercise cooling and heating on neuromuscular function, pacing and intermittent-sprint performance in the heat. Ten male, team sport athletes completed three randomized, counterbalanced conditions including a thermo-neutral environment (CONT), whole body submersion in an ice bath (ICE) and passive heating in a hot environment (HEAT) before 50 min of intermittent-sprint exercise (ISE) in the heat (31 + 1°C). Exercise involved repeated 15 m maximal sprints and self-paced exercise of varying intensities. Performance was measured by sprint times and distance covered during self-paced exercise. Maximal isometric contractions were performed to determine the maximal voluntary torque (MVT), activation (VA) and contractile properties. Physiological measures included heart rate (HR), core (T (core)) and skin (T (skin)) temperatures, capillary blood and perceptual ratings. Mean sprint times were slower during ICE compared to HEAT (P HEAT in 31-40 min compared to CONT, and 41-50 min compared to ICE (P HEAT. VA was reduced post-intervention in HEAT compared to CONT and ICE, and post-exercise compared to ICE (P HEAT (P HEAT conditions compared to CONT. However, initial sprint performance was slowed by pre-cooling, with improvements following passive heating possibly due to altered contractile properties. Conversely, pre-cooling improved exercise intensities, whilst HEAT resulted in greater declines in muscle recruitment and ensuing distance covered.

  15. Different training status may alter the continuous blood glucose kinetics in self-paced endurance running.

    Science.gov (United States)

    Suzuki, Yoshio; Shimizu, Tomomi; Ota, Makoto; Hirata, Ryuzo; Sato, Kenji; Tamura, Yoshifumi; Imanishi, Akio; Watanabe, Masayuki; Sakuraba, Keishoku

    2015-09-01

    The main purpose of the systemic energy metabolism is to provide a source of energy, mainly glucose, for the brain; therefore, blood glucose levels would be expected to correlate with exercise performance. The individual training status may also affect the blood glucose levels. The aim of the present study was to assess the association between blood glucose levels and running velocity during prolonged running in athletes with different training statuses. Two female college athletes, a triathlete and a tennis player, ran a course that was 247.4 m in circumference for 5 h while wearing a continuous glucose monitoring system. Blood was obtained at time-points of -1, 1, 3 and 5 h. The athletes had free access to food and fluids throughout the run. The athletes ran at almost the same pace without a sudden decrease in pace. The blood glucose levels increased and remained high in the triathlete, whereas the tennis player remained hypoglycemic throughout the run. Carbohydrate ingestion did not affect the blood glucose levels. The magnitude of hormonal changes, e.g. insulin, adrenaline and cortisol, was greater in the tennis player. The blood glucose concentration did not correlate with the running velocity or the carbohydrate ingestion; however, a discrepancy in blood glucose transition was observed between the triathlete and the tennis player, indicating a possible association between the adaptation to endurance exercise and the blood glucose kinetics during prolonged running.

  16. Successful pacing using a batteryless sunlight-powered pacemaker.

    Science.gov (United States)

    Haeberlin, Andreas; Zurbuchen, Adrian; Schaerer, Jakob; Wagner, Joerg; Walpen, Sébastien; Huber, Christoph; Haeberlin, Heinrich; Fuhrer, Juerg; Vogel, Rolf

    2014-10-01

    Today's cardiac pacemakers are powered by batteries with limited energy capacity. As the battery's lifetime ends, the pacemaker needs to be replaced. This surgical re-intervention is costly and bears the risk of complications. Thus, a pacemaker without primary batteries is desirable. The goal of this study was to test whether transcutaneous solar light could power a pacemaker. We used a three-step approach to investigate the feasibility of sunlight-powered cardiac pacing. First, the harvestable power was estimated. Theoretically, a subcutaneously implanted 1 cm(2) solar module may harvest ∼2500 µW from sunlight (3 mm implantation depth). Secondly, ex vivo measurements were performed with solar cells placed under pig skin flaps exposed to a solar simulator and real sunlight. Ex vivo measurements under real sunlight resulted in a median output power of 4941 µW/cm(2) [interquartile range (IQR) 3767-5598 µW/cm(2), median skin flap thickness 3.0 mm (IQR 2.7-3.3 mm)]. The output power strongly depended on implantation depth (ρSpearman = -0.86, P pacemaker powered by a 3.24 cm(2) solar module was implanted in vivo in a pig to measure output power and to pace. In vivo measurements showed a median output power of >3500 µW/cm(2) (skin flap thickness 2.8-3.84 mm). Successful batteryless VVI pacing using a subcutaneously implanted solar module was performed. Based on our results, we estimate that a few minutes of direct sunlight (irradiating an implanted solar module) allow powering a pacemaker for 24 h using a suitable energy storage. Thus, powering a pacemaker by sunlight is feasible and may be an alternative energy supply for tomorrow's pacemakers. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  17. Biventricular / Left Ventricular Pacing in Hypertrophic Obstructive Cardiomyopathy: An Overview

    Directory of Open Access Journals (Sweden)

    Radu Vatasescu, MD

    2012-05-01

    Full Text Available Hypertrophic cardiomyopathy (HCM is an autosomal dominant inherited genetic disease characterized by compensatory pathological left ventricle (LV hypertrophy due to sarcomere dysfunction. In an important proportion of patients with HCM, the site and extent of cardiac hypertrophy results in severe obstruction to LV outflow tract (LVOT, contributing to disabling symptoms and increasing the risk of sudden cardiac death (SCD. In patients with progressive and/or refractory symptoms despite optimal pharmacological treatment, invasive therapies that diminish or abolish LVOT obstruction relieve heart failure-related symptoms, improve quality of life and could be associated with long-term survival similar to that observed in the general population. The gold standard in this respect is surgical septal myectomy, which might be supplementary associated with a reduction in SCD. Percutaneous techniques, particularly alcohol septal ablation (ASA and more recently radiofrequency (RF septal ablation, can achieve LVOT gradient reduction and symptomatic benefit in a large proportion of HOCM patients at the cost of a supposedly limited septal myocardial necrosis and a 10-20% risk of chronic atrioventricular block. After an initial period of enthusiasm, standard DDD pacing failed to show in randomized trials significant LVOT gradient reductions and objective improvement in exercise capacity. However, case reports and recent small pilot studies suggested that atrial synchronous LV or biventricular (biV pacing significantly reduce LVOT obstruction and improve symptoms (acutely as well as long-term in a large proportion of severely symptomatic HOCM patients not suitable to other gradient reduction therapies. Moreover, biV/LV pacing in HOCM seems to be associated with significant LV reverse remodelling.

  18. Acute impact of pacing at different cardiac sites on left ventricular rotation and twist in dogs.

    Directory of Open Access Journals (Sweden)

    Zhi-Wen Zhou

    Full Text Available We evaluated the acute impact of different cardiac pacing sites on two-dimensional speckle-tracking echocardiography (STE derived left ventricular (LV rotation and twist in healthy dogs.Twelve dogs were used in this study. The steerable pacing electrodes were positioned into right heart through the superior or inferior vena cava, into LV through aorta across the aortic valve. The steerable pacing electrodes were positioned individually in the right atrium (RA, right ventricular apex (RVA, RV outflow tract (RVOT, His bundle (HB, LV apex (LVA and LV high septum (LVS, individual pacing mode was applied at 10 minutes interval for at least 5 minutes from each position under fluoroscopy and ultrasound guidance and at stabilized hemodynamic conditions. LV short-axis images at the apical and basal levels were obtained during sinus rhythm and pacing. Offline STE analysis was performed. Rotation, twist, time to peak rotation (TPR, time to peak twist (TPT, and apical-basal rotation delay (rotational synchronization index, RSI values were compared at various conditions. LV pressure was monitored simultaneously.Anesthetic death occurred in 1 dog, and another dog was excluded because of bad imaging quality. Data from 10 dogs were analyzed. RVA, RVOT, HB, LVA, LVS, RARV (RA+RVA pacing resulted in significantly reduced apical and basal rotation and twist, significantly prolonged apical TPR, TPT and RSI compared to pre-pacing and RA pacing (all P<0.05. The apical and basal rotation and twist values were significantly higher during HB pacing than during pacing at ventricular sites (all P<0.05, except basal rotation at RVA pacing. The apical TPR during HB pacing was significantly shorter than during RVOT and RVA pacing (both P<0.05. The LV end systolic pressure (LVESP was significantly lower during ventricular pacing than during pre-pacing and RA pacing.Our results show that RA and HB pacing results in less acute reduction on LV twist, rotation and LVESP compared

  19. Structural analysis of cell wall polysaccharides using PACE

    Energy Technology Data Exchange (ETDEWEB)

    Mortimer, Jennifer C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Joint BioEnergy Institute

    2017-01-01

    The plant cell wall is composed of many complex polysaccharides. The composition and structure of the polysaccharides affect various cell properties including cell shape, cell function and cell adhesion. Many techniques to characterize polysaccharide structure are complicated, requiring expensive equipment and specialized operators e.g. NMR, MALDI-MS. PACE (Polysaccharide Analysis using Carbohydrate gel Electrophoresis) uses a simple, rapid technique to analyze polysaccharide quantity and structure (Goubet et al. 2002). Whilst the method here describes xylan analysis, it can be applied (by use of the appropriate glycosyl hydrolase) to any cell wall polysaccharide.

  20. Ecuador steps up pace of oil development activity

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    This paper reports that oil companies operating in Ecuador plan to quicken the pace of oil development this year. After delays in 1991, companies plan a series of projects to develop reserves discovered the past 3 years estimated at more than 600 million bbl. Oil and Gas Journal estimated Ecuador's proved crude reserves at 1.55 billion bbl as of Jan. 1, 1992. The development push is part of a larger effort needed to ensure Ecuador's status as an oil exporter into the next century. Ecuador is the smallest crude oil producer and exporter in the Organization of Petroleum Exporting Countries

  1. Electrical Stimulation of the Heart: Pacing, Arrhythmias, and Defibrillation

    Science.gov (United States)

    Roth, Bradley J.

    2000-03-01

    Electrical stimulation of the heart underlies cardiac pacing and defibrillation. The "bidomain model" describes the anisotropic electrical properties of cardiac tissue. In particular, this model predicts mechanisms by which applied electric fields change the transmembrane potential of the myocardial cells. During unipolar stimulation, the bidomain model can explain "make" and "break" stimulation. Furthermore, it elucidates the cause of the "dip" in the anodal strength-interval curve, and predicts the initiation of novel quatrefoil reentry patterns. These results are beginning to shed light on the mechanisms of arrhythmia induction and defibrillation.

  2. Right Ventricular Versus Biventricular Pacing for Heart Failure and Atrioventricular Block.

    Science.gov (United States)

    Beck, Hiroko; Curtis, Anne B

    2016-10-01

    The use of cardiac resynchronization therapy (CRT) is well accepted as an important option for the treatment of patients with systolic heart failure and prolonged QRS duration. CRT for patients with narrow QRS complexes is reserved for patients who are undergoing implantation of new or replacement pacemakers or implantable cardioverter defibrillators with an anticipated significant requirement for ventricular pacing. The Biventricular versus Right Ventricular Pacing in Heart Failure Patients with Atrioventricular Block (BLOCK HF) Trial examined the role of CRT in heart failure patients with atrioventricular block and demonstrated significantly better outcomes with CRT compared to right ventricular pacing. On the other hand, conflicting preliminary data were reported by the Biventricular Pacing for Atrioventricular Block to Prevent Cardiac Desynchronization (BioPace) Trial investigators. In this review, we will discuss the adverse consequences of chronic right ventricular pacing, the options of alternate pacing sites in the right ventricle versus biventricular pacing, and the findings from the BLOCK HF Trial as well as the preliminary data from the BioPace Trial. Our goal is to explore the role of biventricular pacing in patients with atrioventricular block.

  3. Biventricular pacing with ventricular fusion by intrinsic activation in cardiac resynchronization therapy.

    Science.gov (United States)

    Guo, Tao; Li, Ruijie; Zhang, Limei; Luo, Zhiling; Zhao, Ling; Yang, Jun; Pu, Lijin; Hua, Baotong

    2015-05-13

    We sought to evaluate the impact of biventricular (BiV) pacing with ventricular fusion by intrinsic atrioventricular nodal (AVN) conduction (BiV + intrinsic pacing) on clinical outcomes in patients with chronic heart failure (CHF) receiving cardiac resynchronization therapy (CRT).A total of 44 patients were randomized to receive either BiV or BiV + intrinsic pacing for one month. Echocardiographic optimization was performed for the BiV pacing mode, while the BiV + intrinsic pacing mode was achieved by titrating AV delay under electrocardiography (ECG) monitoring. Symptoms, quality of life, ECG, echocardiography, and cardiovascular events were recorded at baseline and the end of the follow-up for each pacing mode.Patients undergoing BiV + intrinsic pacing mode had shorter QRS duration compared to those with conventional BiV pacing (118.4 ± 21.6 ms versus 146.4 ± 5.3 ms, P Heart Failure Questionnaire (MLHFQ) scores (12.5 ± 6.6 versus 18.2 ± 12.3, P = 0.0001).Treating CHF patients with BiV+intrinsic pacing resulted in improved cardiac function and quality of life. BiV + intrinsic pacing can be used in CHF patients with sinus rhythm and normal AV nodal conduction to improve CRT efficacy.

  4. The Influence of a Pacesetter on Psychological Responses and Pacing Behavior during a 1600 m Run

    Directory of Open Access Journals (Sweden)

    Christopher L. Fullerton, Andrew M. Lane, Tracey J. Devonport

    2017-12-01

    Full Text Available This study compared the effects of following a pacer versus following a self-paced plan on psychological responses and pacing behavior in well-trained distance runners. Pacing in the present study was individually tailored where each participant developed a personal strategy to ensure their goal time was achieved. We expected that following a pacer would associate with goal achievement, higher pre-run confidence, positive emotions and lower perceived exertion during performance. In a mixed-design repeated-measures study, nineteen well-trained runners completed two 1600m running time trials. Ten runners had a pacer (paced group who supported their individual pacing strategy, and nine participants self-paced running alone (control group. Both groups could check pace using their wrist watch. In contrast to our expectation, results indicated that the paced group reported higher pre-run anxiety with no significant differences in finish time, goal confidence, goal difficulty, perceived exertion, and self-rated performance between groups. We suggest that following a pacer is a skill that requires learning. Following a personalised pacer might associate with higher anxiety due to uncertainty in being able to keep up with the pacer and public visibility of dropping behind, something that is not so observable in a self-paced run completed alone. Future research should investigate mechanisms associated with effective pacing.

  5. Ischemic Stroke with Cardiac Pacemaker Implantation: Comparison of Physiological and Ventricular Pacing Modes.

    Science.gov (United States)

    Kato, Yuji; Hayashi, Takeshi; Kato, Ritsushi; Tanahashi, Norio; Takao, Masaki

    2017-09-01

    The clinical characteristics of ischemic stroke in patients with a pacemaker (PM) are not well understood. Forty-six ischemic stroke patients with a PM were investigated retrospectively, and the impact of different pacing modes was compared. The patients were divided into a physiological pacing group (n = 22) and a ventricular pacing group (n = 24). The prevalence of atrial fibrillation (AF) was significantly higher in the ventricular pacing group (36% versus 75%; P = .008). The mean left atrial dimension was relatively large in the ventricular pacing group than in the physiological pacing group (44.5 ± 6.7 mm versus 39.1 ± 8.5 mm, respectively; P = .071). Twenty-four percent of the patients were receiving anticoagulants, whereas 41% of the patients were receiving antiplatelet drugs. Cardioembolism was the most common stroke subtype in both groups. Although there was no statistically significant difference, neurological severity on admission was higher in the ventricular pacing group than in the physiological pacing group (P = .061). Functional outcomes, excluding patients with transient ischemic attack or prior stroke, significantly declined in the ventricular pacing group compared with the physiological pacing group (P = .044). The avoidance of the ventricular pacing mode may result in improved clinical outcomes. In patients without persistent AF, it may be important to select physiological pacing instead of ventricular pacing to decrease potential stroke severity. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  6. Partnerships for Active Children in Elementary Schools (PACES): First year process evaluation.

    Science.gov (United States)

    Egan, Cate A; Webster, Collin; Weaver, R Glenn; Brian, Ali; Stodden, David; Russ, Laura; Nesbitt, Danielle; Vazou, Spyridoula

    2018-04-01

    Movement integration (MI) is a strategy within comprehensive school physical activity programs (CSPAP). School-university partnerships are recommended to leverage teachers' capacity to use MI. A mixed method process evaluation was conducted of the first year of implementing Partnerships for Active Children in Elementary Schools (PACES). Classroom teachers (N=12) from four schools participated. Data were collected in Fall 2014 (baseline) and Spring 2015 (∼ four months of intervention) using the System for Observing Student Movement in Academic Routines and Transitions and semi-structured interviews. There were no significant differences between intervention classrooms and control classrooms MI promotion. Differences approaching significance (U=5, p=0.04, d=1.2) were observed when comparing classrooms that received two (community of practice, community-based participatory research) or three components (two components plus service learning) of the intervention and classrooms that received one (community of practice) or no components. Qualitative findings revealed that teachers in classrooms that were more successful responded more favorably to the intervention components than teachers in classrooms that were less successful. Quantitative and qualitative results supported the effectiveness of community-based participatory research as a component of PACES. This study provides information about MI process variables in the context of a CSPAP intervention. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. The Self-Paced Graz Brain-Computer Interface: Methods and Applications

    Directory of Open Access Journals (Sweden)

    Reinhold Scherer

    2007-01-01

    Full Text Available We present the self-paced 3-class Graz brain-computer interface (BCI which is based on the detection of sensorimotor electroencephalogram (EEG rhythms induced by motor imagery. Self-paced operation means that the BCI is able to determine whether the ongoing brain activity is intended as control signal (intentional control or not (non-control state. The presented system is able to automatically reduce electrooculogram (EOG artifacts, to detect electromyographic (EMG activity, and uses only three bipolar EEG channels. Two applications are presented: the freeSpace virtual environment (VE and the Brainloop interface. The freeSpace is a computer-game-like application where subjects have to navigate through the environment and collect coins by autonomously selecting navigation commands. Three subjects participated in these feedback experiments and each learned to navigate through the VE and collect coins. Two out of the three succeeded in collecting all three coins. The Brainloop interface provides an interface between the Graz-BCI and Google Earth.

  8. Pilot trial of an age-paced parenting newsletter.

    Science.gov (United States)

    Keane, Brigid; Waterston, Tony; McConachie, Helen; Towner, Elizabeth; Cook, Margaret; Birks, Eileen

    2005-10-01

    Supporting parents in the first three years of a child's life has the potential to produce successful outcomes. Present government initiatives such as Sure Start focus on this age group. An American educational intervention, in the style of a monthly newsletter, was adapted for use in the UK for parents of young children. Topics were presented in an easy-to-read format and focused on infant emotional development, parent interaction and play. Newsletters, called Baby Express were posted at monthly intervals to the family home providing age-paced information which could meet the specific needs of parents at that stage of their child's life. The aim of the study was to determine the applicability of the newsletter to UK parents and evaluate their satisfaction. Sixty home-based interviews were conducted and 95 per cent of mothers reported reading all or part of the newsletter. Changes in parenting style were spontaneously reported by 28 per cent of mothers. This study found that an aged-paced parenting newsletter was an acceptable and useful method of supporting parents in the early months of a child's life and promotes positive changes in parenting behaviour.

  9. Social Interaction in Self-paced Distance Education

    Directory of Open Access Journals (Sweden)

    Terry Anderson

    2015-02-01

    Full Text Available In this paper we present a case study of a self-paced university course that was originally designed to support independent, self-paced study at distance. We developed a social media intervention, in design-based research terms, that allows these independent students to contribute archived content to enhance the course, to engage in discussions with other students and to share as little or as much personal information with each other as they wished. We describe the learning design for the intervention and present survey data of student and tutor perception of value and content analysis of the archived contributions. The results indicate that the intervention was positively received by tutors and by the majority (but not all students and that the archive created by the students’ contributions was adding value to the course. We conclude that the intervention was a modest, yet manageable example of a learning enhancement to a traditional cognitive-behavioral, course that has positive impact and potential with little negative impact on workload.

  10. Data reproducibility of pace strategy in a laboratory test run.

    Science.gov (United States)

    de França, Elias; Xavier, Ana Paula; Hirota, Vinicius Barroso; Côrrea, Sônia Cavalcanti; Caperuto, Érico Chagas

    2016-06-01

    This data paper contains data related to a reproducibility test for running pacing strategy in an intermittent running test until exhaustion. Ten participants underwent a crossover study (test and retest) with an intermittent running test. The test was composed of three-minute sets (at 1 km/h above Onset Blood Lactate Accumulation) until volitional exhaustion. To assess pace strategy change, in the first test participants chose the rest time interval (RTI) between sets (ranging from 30 to 60 s) and in the second test the maximum RTI values were either the RTI chosen in the first test (maximum RTI value), or less if desired. To verify the reproducibility of the test, rating perceived exertion (RPE), heart rate (HR) and blood plasma lactate concentration ([La]p) were collected at rest, immediately after each set and at the end of the tests. As results, RTI, RPE, HR, [La]p and time to exhaustion were not statistically different (p>0.05) between test and retest, as well as they demonstrated good intraclass correlation.

  11. Data reproducibility of pace strategy in a laboratory test run

    Directory of Open Access Journals (Sweden)

    Elias de França

    2016-06-01

    Full Text Available This data paper contains data related to a reproducibility test for running pacing strategy in an intermittent running test until exhaustion. Ten participants underwent a crossover study (test and retest with an intermittent running test. The test was composed of three-minute sets (at 1 km/h above Onset Blood Lactate Accumulation until volitional exhaustion. To assess pace strategy change, in the first test participants chose the rest time interval (RTI between sets (ranging from 30 to 60 s and in the second test the maximum RTI values were either the RTI chosen in the first test (maximum RTI value, or less if desired. To verify the reproducibility of the test, rating perceived exertion (RPE, heart rate (HR and blood plasma lactate concentration ([La]p were collected at rest, immediately after each set and at the end of the tests. As results, RTI, RPE, HR, [La]p and time to exhaustion were not statistically different (p>0.05 between test and retest, as well as they demonstrated good intraclass correlation.

  12. Comparison of pacing algorithms to avoid unnecessary ventricular pacing in patients with sick sinus node syndrome: a single-centre, observational, parallel study.

    Science.gov (United States)

    Poghosyan, Hermine R; Jamalyan, Smbat V

    2012-10-01

    Reduction of unnecessary ventricular pacing (uVP) is an essential component in the treatment strategy in any pacing population in general. The aim of this study was to evaluate the efficacy of different algorithms to reduce uVP in an adult population with sick sinus syndrome (SSS) treated outside of clinical trials. Evaluation of the relationship between different types of pacing algorithms and clinical outcomes is also provided. This was a single-centre, observational, parallel study, based on retrospective analysis of the Arrhythmology Cardiology Center of Armenia electronic clinical database. This study evaluated atrial pacing percentage (AP%), ventricular pacing percentage (VP%), and the incidence of atrial high rate episodes in 56 patients with SSS using three different pacing strategies: managed VP, search atrioventricular (AV), and fixed long AV. We did not find statistically significant differences in the amount of VP between the groups. Although the atrial high rate percentage (AHR%) tended to be higher in the fixed long AV group, this difference was not statistically significant. Mean VP% and AP% were similar in all three groups. In our study, all three programmed strategies produced the same mean AP% and VP%, and were equally efficient in uVP reduction. There was no relationship between chosen algorithms and the incidence of pacemaker syndrome, hospitalizations, or change in New York Heart Association class. The percentage of AHR was not associated with pacing strategy or co-morbidities but showed borderline correlation with left atrial size.

  13. The pacing stress test: thallium-201 myocardial imaging after atrial pacing. Diagnostic value in detecting coronary artery disease compared with exercise testing

    International Nuclear Information System (INIS)

    Heller, G.V.; Aroesty, J.M.; Parker, J.A.; McKay, R.G.; Silverman, K.J.; Als, A.V.; Come, P.C.; Kolodny, G.M.; Grossman, W.

    1984-01-01

    Many patients suspected of having coronary artery disease are unable to undergo adequate exercise testing. An alternate stress, pacing tachycardia, has been shown to produce electrocardiographic changes that are as sensitive and specific as those observed during exercise testing. To compare thallium-201 imaging after atrial pacing stress with thallium imaging after exercise stress, 22 patients undergoing cardiac catheterization were studied with both standard exercise thallium imaging and pacing thallium imaging. Positive ischemic electrocardiographic changes (greater than 1 mm ST segment depression) were noted in 11 of 16 patients with coronary artery disease during exercise, and in 15 of the 16 patients during atrial pacing. One of six patients with normal or trivial coronary artery disease had a positive electrocardiogram with each test. Exercise thallium imaging was positive in 13 of 16 patients with coronary artery disease compared with 15 of 16 patients during atrial pacing. Three of six patients without coronary artery disease had a positive scan with exercise testing, and two of these same patients developed a positive scan with atrial pacing. Of those patients with coronary artery disease and an abnormal scan, 85% showed redistribution with exercise testing compared with 87% during atrial pacing. Segment by segment comparison of thallium imaging after either atrial pacing or exercise showed that there was a good correlation of the location and severity of the thallium defects (r . 0.83, p . 0.0001, Spearman rank correlation). It is concluded that the location and presence of both fixed and transient thallium defects after atrial pacing are closely correlated with the findings after exercise testing

  14. Elevational trends in life histories: revising the pace-of-life framework.

    Science.gov (United States)

    Hille, Sabine M; Cooper, Caren B

    2015-02-01

    Life-history traits in birds, such as lifespan, age at maturity, and rate of reproduction, vary across environments and in combinations imposed by trade-offs and limitations of physiological mechanisms. A plethora of studies have described the diversity of traits and hypothesized selection pressures shaping components of the survival-reproduction trade-off. Life-history variation appears to fall along a slow-fast continuum, with slow pace characterized by higher investment in survival over reproduction and fast pace characterized by higher investment in reproduction over survival. The Pace-of-Life Syndrome (POLS) is a framework to describe the slow-fast axis of variation in life-history traits and physiological traits. The POLS corresponds to latitudinal gradients, with tropical birds exhibiting a slow pace of life. We examined four possible ways that the traits of high-elevation birds might correspond to the POLS continuum: (i) rapid pace, (ii) tropical slow pace, (iii) novel elevational pace, or (iv) constrained pace. Recent studies reveal that birds breeding at high elevations in temperate zones exhibit a combination of traits creating a unique elevational pace of life with a central trade-off similar to a slow pace but physiological trade-offs more similar to a fast pace. A paucity of studies prevents consideration of the possibility of a constrained pace of life. We propose extending the POLS framework to include trait variation of elevational clines to help to investigate complexity in global geographic patterns. © 2014 The Authors. Biological Reviews © 2014 Cambridge Philosophical Society.

  15. Coronary grafts flow and cardiac pacing modalities: how to improve perioperative myocardial perfusion.

    LENUS (Irish Health Repository)

    D'Ancona, Giuseppe

    2012-02-03

    OBJECTIVE: Aim of this study was to investigate modifications of coronary grafts flow during different pacing modalities after CABG. MATERIALS AND METHODS: Two separate prospective studies were conducted in patients undergoing CABG and requiring intraoperative epicardial pacing. In a first study (22 patients) coronary grafts flows were measured during dual chamber pacing (DDD) and during ventricular pacing (VVI). In a second study (10 patients) flows were measured during DDD pacing at different atrio-ventricular (A-V) delay periods. A-V delay was adjusted in 25 ms increments from 25 to 250 ms and flow measurements were performed for each A-V delay increment. A transit time flowmeter was used for the measurements. RESULTS: An average of 3.4 grafts\\/patient were performed. In the first study, average coronary graft flow was 47.4+\\/-20.8 ml\\/min during DDD pacing and 41.8+\\/-18.2 ml\\/min during VVI pacing (P = 0.0004). Furthermore average systolic pressure was 94.3+\\/-10.1 mmHg during DDD pacing and 89.6+\\/-12.2 mmHg during VVV pacing (P = 0.0007). No significant differences in diastolic pressure were recorded during the two different pacing modalities. In the second study, maximal flows were achieved during DDD pacing with an A-V delay of 175 ms (54+\\/-9.6 ml\\/min) and minimal flows were detected at 25 ms A-V delay (38.1+\\/-4.7 ml\\/min) (P=ns). No significant differences in systolic or diastolic blood pressure were noticed during the different A-V delays. CONCLUSION: Grafts flowmetry provides an extra tool to direct supportive measures such as cardiac pacing after CABG. DDD mode with A-V delay around 175 ms. should be preferred to allow for maximal myocardial perfusion via the grafts.

  16. Meta-Analysis of Single-Case Research Design Studies on Instructional Pacing.

    Science.gov (United States)

    Tincani, Matt; De Mers, Marilyn

    2016-11-01

    More than four decades of research on instructional pacing has yielded varying and, in some cases, conflicting findings. The purpose of this meta-analysis was to synthesize single-case research design (SCRD) studies on instructional pacing to determine the relative benefits of brisker or slower pacing. Participants were children and youth with and without disabilities in educational settings, excluding higher education. Tau-U, a non-parametric statistic for analyzing data in SCRD studies, was used to determine effect size estimates. The article extraction yielded 13 instructional pacing studies meeting contemporary standards for high quality SCRD research. Eleven of the 13 studies reported small to large magnitude effects when two or more pacing parameters were compared, suggesting that instructional pacing is a robust instructional variable. Brisker instructional pacing with brief inter-trial interval (ITI) produced small increases in correct responding and medium to large reductions in challenging behavior compared with extended ITI. Slower instructional pacing with extended wait-time produced small increases in correct responding, but also produced small increases in challenging behavior compared with brief wait-time. Neither brief ITI nor extended wait-time meets recently established thresholds for evidence-based practice, highlighting the need for further instructional pacing research. © The Author(s) 2016.

  17. Pacing and Self-regulation: Important Skills for Talent Development in Endurance Sports.

    Science.gov (United States)

    Elferink-Gemser, Marije T; Hettinga, Florentina J

    2017-07-01

    Pacing has been characterized as a multifaceted goal-directed process of decision making in which athletes need to decide how and when to invest their energy during the race, a process essential for optimal performance. Both physiological and psychological characteristics associated with adequate pacing and performance are known to develop with age. Consequently, the multifaceted skill of pacing might be under construction throughout adolescence, as well. Therefore, the authors propose that the complex skill of pacing is a potential important performance characteristic for talented youth athletes that needs to be developed throughout adolescence. To explore whether pacing is a marker for talent and how talented athletes develop this skill in middle-distance and endurance sports, they aim to bring together literature on pacing and literature on talent development and self-regulation of learning. Subsequently, by applying the cyclical process of self-regulation to pacing, they propose a practical model for the development of performance in endurance sports in youth athletes. Not only is self-regulation essential throughout the process of reaching the long-term goal of athletic excellence, but it also seems crucial for the development of pacing skills within a race and the development of a refined performance template based on previous experiences. Coaches and trainers are advised to incorporate pacing as a performance characteristic in their talent-development programs by stimulating their athletes to reflect, plan, monitor, and evaluate their races on a regular basis to build performance templates and, as such, improve their performance.

  18. Ventricular Pacing via the Coronary Sinus in a Patient with a Mechanical Tricuspid Valve Prosthesis

    Directory of Open Access Journals (Sweden)

    Janice Swampillai, MD

    2011-01-01

    Full Text Available Implantation of a transvenous endocardial pacing lead in the right ventricle is contra-indicated after mechanical tricuspid valve replacement; therefore a surgical approach to the epicardium is usually required. This case report describes ventricular pacing via a branch of the coronary sinus in a patient with mechanical mitral, aortic and tricuspid valve replacements. In conclusion, this approach is minimally invasive, provides effective ventricular stimulation with low pacing threshold and stable lead position, and is a feasible option when transvenous right ventricular pacing is not possible.

  19. PACING DEVICE FOR SWIMMING. MECHANICAL CONSTRUCTION OF CONSTANT SPEED

    Directory of Open Access Journals (Sweden)

    MESSINIS S.

    2010-04-01

    Full Text Available The pace in swimming is very important because it allows swimmers to allocate their forces accordingly, and therefore a distance to travel as quickly as possible. The training pace at different swimmingspeeds and combinations thereof, is an important part of training before the competitions.The definition and maintenance of the stable and swimmer specific speed is difficult to achieve and requires considerable effort and experience. To determine the desired rate of accuracy by the researchers and their coaches used till now, various audio and visual media.However, some of these institutions did not very accurately measure the rate and not all styles of swimming, while other aspects affect the proper swimming. In this construction, a key objective is to solve the problems occurring in the previous constructions, the modern technological development of them and the adaption of the specificities of different swimming styles.This device consists of an electro 3 / 8 of the horse, a flange, a single inverter from 3 / 8 to ½ of the horse, pulleys with taper Bush, flange axle, pulleys, platforms and a 52 meters cable. The assembly and operation is as follows: At the edge of the pool next to the platform is placed the base of pulleys, the electro setis connected to the inverter and the axle flange.Precisely opposite is positioned the other base. Along the pool «moves» the cable that connects the two bases, located 150 cm above the water. A fixed point on the cable is marked with paint in order to be visible to the swimmer during backstroke swimming while for other styles we adapt a lamination at the cable vertically inthe pool, above the surface a sheet of 15 cm which is painted with strong color that is visible from the athlete and will precede him. Setting the speed with inverter it starts from one end of the tank leading to the other, doing a circular motion.The swimmer is required to follow the marked point of the cable in the backstroke or

  20. Understanding immune function as a pace of life trait requires environmental context.

    Science.gov (United States)

    Tieleman, B Irene

    2018-01-01

    This article provides a brief historical perspective on the integration of physiology into the concept of the pace of life of birds, evaluates the fit of immune function into this framework, and asks what it will take to fruitfully understand immune functioning of birds in pace of life studies in the future. In the late 1970s, physiology started to seriously enter avian life history ecology, with energy as the main currency of interest, inspired by David Lack's work in the preceding decades emphasizing how food availability explained life history variation. In an effort to understand the trade-off between survival and reproduction, and specifically the mortality costs associated with hard work, in the 1980s and 1990s, other physiological phenomena entered the realm of animal ecologists, including endocrinology, oxidative stress, and immunology. Reviewing studies thus far to evaluate the role of immune function in a life history context and particularly to address the questions whether immune function (1) consistently varies with life history variation among free-living bird species and (2) mediates life history trade-offs in experiments with free-living bird species; I conclude that, unlike energy metabolism, the immune system does not closely covary with life history among species nor mediates the classical trade-offs within individuals. Instead, I propose that understanding the tremendous immunological variation uncovered among free-living birds over the past 25 years requires a paradigm shift. The paradigm should shift from viewing immune function as a costly trait involved in life history trade-offs to explicitly including the benefits of the immune system and placing it firmly in an environmental and ecological context. A first step forward will be to quantify the immunobiotic pressures presented by diverse environmental circumstances that both shape and challenge the immune system of free-living animals. Current developments in the fields of infectious

  1. Quick pace of property acquisitions requires two-stage evaluations

    International Nuclear Information System (INIS)

    Hollo, R.; Lockwood, S.

    1994-01-01

    The traditional method of evaluating oil and gas reserves may be too cumbersome for the quick pace of oil and gas property acquisition. An acquisition evaluator must decide quickly if a property meets basic purchase criteria. The current business climate requires a two-stage approach. First, the evaluator makes a quick assessment of the property and submits a bid. If the bid is accepted then the evaluator goes on with a detailed analysis, which represents the second stage. Acquisition of producing properties has become an important activity for many independent oil and gas producers, who must be able to evaluate reserves quickly enough to make effective business decisions yet accurately enough to avoid costly mistakes. Independent thus must be familiar with how transactions usually progress as well as with the basic methods of property evaluation. The paper discusses acquisition activity, the initial offer, the final offer, property evaluation, and fair market value

  2. The pace of shifting climate in marine and terrestrial ecosystems

    DEFF Research Database (Denmark)

    Burrows, Michael T.; Schoeman, David S.; Buckley, Lauren B.

    2011-01-01

    Climate change challenges organisms to adapt or move to track changes in environments in space and time. We used two measures of thermal shifts from analyses of global temperatures over the past 50 years to describe the pace of climate change that species should track: the velocity of climate...... change (geographic shifts of isotherms over time) and the shift in seasonal timing of temperatures. Both measures are higher in the ocean than on land at some latitudes, despite slower ocean warming. These indices give a complex mosaic of predicted range shifts and phenology changes that deviate from...... simple poleward migration and earlier springs or later falls. They also emphasize potential conservation concerns, because areas of high marine biodiversity often have greater velocities of climate change and seasonal shifts....

  3. Trotting, pacing and bounding by a quadruped robot.

    Science.gov (United States)

    Raibert, M H

    1990-01-01

    This paper explores the quadruped running gaits that use the legs in pairs: the trot (diagonal pairs), the pace (lateral pairs), and the bound (front and rear pairs). Rather than study these gaits in quadruped animals, we studied them in a quadruped robot. We found that each of the gaits that use the legs in pairs can be transformed into a common underlying gait, a virtual biped gait. Once transformed, a single set of control algorithms produce all three gaits, with modest parameter variations between them. The control algorithms manipulated rebound height, running speed, and body attitude, while a low-level mechanism coordinated the behavior of the legs in each pair. The approach was tested with laboratory experiments on a four-legged robot. Data are presented that show the details of the running motion for the three gaits and for transitions from one gait to another.

  4. Mathematically modelling the effects of pacing, finger strategies and urgency on numerical typing performance with queuing network model human processor.

    Science.gov (United States)

    Lin, Cheng-Jhe; Wu, Changxu

    2012-01-01

    Numerical typing is an important perceptual-motor task whose performance may vary with different pacing, finger strategies and urgency of situations. Queuing network-model human processor (QN-MHP), a computational architecture, allows performance of perceptual-motor tasks to be modelled mathematically. The current study enhanced QN-MHP with a top-down control mechanism, a close-loop movement control and a finger-related motor control mechanism to account for task interference, endpoint reduction, and force deficit, respectively. The model also incorporated neuromotor noise theory to quantify endpoint variability in typing. The model predictions of typing speed and accuracy were validated with Lin and Wu's (2011) experimental results. The resultant root-mean-squared errors were 3.68% with a correlation of 95.55% for response time, and 35.10% with a correlation of 96.52% for typing accuracy. The model can be applied to provide optimal speech rates for voice synthesis and keyboard designs in different numerical typing situations. An enhanced QN-MHP model was proposed in the study to mathematically account for the effects of pacing, finger strategies and internalised urgency on numerical typing performance. The model can be used to provide optimal pacing for voice synthesise systems and suggested optimal numerical keyboard designs under urgency.

  5. Corticosterone and pace of life in two life-history ecotypes of the garter snake Thamnophis elegans.

    Science.gov (United States)

    Palacios, Maria G; Sparkman, Amanda M; Bronikowski, Anne M

    2012-02-01

    Glucocorticoids are main candidates for mediating life-history trade-offs by regulating the balance between current reproduction and survival. It has been proposed that slow-living organisms should show higher stress-induced glucocorticoid levels that favor self-maintenance rather than current reproduction when compared to fast-living organisms. We tested this hypothesis in replicate populations of two ecotypes of the garter snake (Thamnophis elegans) that exhibit slow and fast pace of life strategies. We subjected free-ranging snakes to a capture-restraint protocol and compared the stress-induced corticosterone levels between slow- and fast-living snakes. We also used a five-year dataset to assess whether baseline corticosterone levels followed the same pattern as stress-induced levels in relation to pace of life. In accordance with the hypothesis, slow-living snakes showed higher stress-induced corticosterone levels than fast-living snakes. Baseline corticosterone levels showed a similar pattern with ecotype, although differences depended on the year of study. Overall, however, levels of glucocorticoids are higher in slow-living than fast-living snakes, which should favor self-maintenance and survival at the expense of current reproduction. The results of the present study are the first to relate glucocorticoid levels and pace of life in a reptilian system and contribute to our understanding of the physiological mechanisms involved in life-history evolution. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Spanish Pacemaker Registry. Twelfth Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2014).

    Science.gov (United States)

    Cano Pérez, Óscar; Pombo Jiménez, Marta; Coma Samartín, Raúl

    2015-12-01

    This report describes the results of the analysis of pacemaker implant and replacement data submitted to the Spanish Pacemaker Registry in 2014, with special reference to pacing mode selection. The report is based on the processing of information provided by the European Pacemaker Patient Identification Card. Information was received from 117 hospitals, with a total of 12 358 cards, representing 34% of estimated activity. Use of conventional generators and resynchronization devices was 784 and 64.4 units per million population, respectively. The mean age of patients receiving an implant was 77.3 years. Men received 59% of implants and 56.4% of replacements. Most patients receiving generator implants and replacements were in the age range 80 to 89 years. Most endocardial leads used were bipolar, and 84.2% had an active fixation system. Pacing was in VVI/R mode despite being in sinus rhythm in 24.7% of patients with sick sinus syndrome and 24% of those with atrioventricular block. The use of pacemaker generators and resynchronization devices per million population continued to increase. Most implanted leads had active fixation and approximately 20% had magnetic resonance imaging protection. Age and sex directly influenced pacing mode selection, which could have been improved in more than 20% of cases. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  7. The Influence of Physical Fitness and Playing Standard on Pacing Strategies During a Team-Sport Tournament.

    Science.gov (United States)

    Johnston, Rich D; Gabbett, Tim J; Jenkins, David G

    2015-11-01

    To assess the influence of playing standard and physical fitness on pacing strategies during a junior team-sport tournament. A between-groups, repeated-measures design was used. Twenty-eight junior team-sport players (age 16.6 ± 0.5 y, body mass 79.9 ± 12.0 kg) from a high-standard and low-standard team participated in a junior rugby league tournament, competing in 5 games over 4 d (4 × 40-min and 1 × 50-min game). Players wore global positioning system (GPS) microtechnology during each game to provide information on match activity profiles. The Yo-Yo Intermittent Recovery Test (level 1) was used to assess physical fitness before the competition. High-standard players had an initially higher pacing strategy than the low-standard players, covering greater distances at high (ES = 1.32) and moderate speed (ES = 1.41) in game 1 and moderate speed (ES = 1.55) in game 2. However, low-standard players increased their playing intensity across the competition (ES = 0.57-2.04). High-standard/high-fitness players maintained a similar playing intensity, whereas high-standard/low-fitness players reduced their playing intensities across the competition. Well-developed physical fitness allows for a higher-intensity pacing strategy that can be maintained throughout a tournament. High-standard/low-fitness players reduce playing intensity, most likely due to increased levels of fatigue as the competition progresses. Low-standard players adopt a pacing strategy that allows them to conserve energy to produce an "end spurt" in the latter games. Maximizing endurance fitness across an entire playing group will maximize playing intensity and minimize performance reductions during the latter stages of a tournament.

  8. Spanish Pacemaker Registry. Thirteenth Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2015).

    Science.gov (United States)

    Pombo Jiménez, Marta; Cano Pérez, Óscar; Fidalgo Andrés, María Luisa; Lorente Carreño, Diego; Coma Samartín, Raúl

    2016-12-01

    We describe the results of the analysis of the devices implanted and conveyed to the Spanish Pacemaker Registry in 2015. The report is based on the processing of information provided by the European Pacemaker Patient Identification Card. We received information from 111 hospitals, with a total of 12 555 cards, representing 32.1% of all the estimated activity. The use of conventional generators and resynchronization devices was 820 and 73 units per million population, respectively. The mean age of the patients receiving an implantation was 77.7 years, and more than 50% of the devices were implanted in patients over 80 years of age. Overall, 58.6% of the implants and 58.8% of the replacements were performed in men. All of the endocardial leads employed were bipolar, 81.5% had an active fixation system, and 16.5% were compatible with magnetic resonance. Although dual chamber sequential pacing continues to be more widespread, pacing with VVI/R mode is used because up to 23.8% of the patients with sinus node disease are in sinus rhythm, as are 24.1% of those with atrioventricular block. The total use of pacemaker generators in Spain has increased by about 5% with respect to 2014. The majority of the leads implanted are of active fixation, and less than 20% are protected from magnetic resonance. The factors directly related to the selection of pacing mode are age and sex. In around 20% of patients, the choice of the pacing mode could be improved. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  9. CHADS2 and CHA2DS2-VASc score to assess risk of stroke and death in patients paced for sick sinus syndrome

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Nielsen, Jens Cosedis; Darkner, Stine

    2013-01-01

    The risk of stroke in patients with atrial fibrillation (AF) can be assessed by use of the CHADS2 and the CHA2DS2-VASc score system. We hypothesised that these risk scores and their individual components could also be applied to patients paced for sick sinus syndrome (SSS) to evaluate risk of str...

  10. Can Aquatic Plants Keep Pace with Climate Change?

    Directory of Open Access Journals (Sweden)

    Duarte S. Viana

    2017-11-01

    Full Text Available The persistence of species may depend upon their capacity to keep pace with climate change. However, dispersal has been ignored in the vast majority of studies that aimed at estimating and predicting range shifts as a response to climate change. Long distance dispersal (LDD in particular might promote rapid range shifts and allow species to track suitable habitat. Many aquatic plant species are dispersed by birds and have the potential to be dispersed over hundreds of kilometers during the bird migration seasons. I argue that such dispersal potential might be critical to allow species to track climate change happening at unprecedented high rates. As a case study, I used dispersal data from three aquatic plant species dispersed by migratory birds to model range shifts in response to climate change projections. By comparing four dispersal scenarios – (1 no dispersal, (2 unlimited dispersal, (3 LDD < 100 km, and (4 LDD mediated by bird migratory movements –, it was shown that, for bird-mediated dispersal, the rate of colonization is sufficient to counterbalance the rate of habitat loss. The estimated rates of colonization (3.2–31.5 km⋅year-1 are higher than, for example, the rate of global warming (previously estimated at 0.42 km⋅year-1. Although further studies are needed, the results suggest that these aquatic plant species can adjust their ranges under a severe climate change scenario. Therefore, investigating the dispersal capacity of species, namely their LDD potential, may contribute to estimate the likelihood of species to keep pace with climate change.

  11. A Multi-Usable Cloud Service Platform: A Case Study on Improved Development Pace and Efficiency

    Directory of Open Access Journals (Sweden)

    John Lindström

    2018-02-01

    Full Text Available The case study, spanning three contexts, concerns a multi-usable cloud service platform for big data collection and analytics and how the development pace and efficiency of it has been improved by 50–75% by using the Arrowhead framework and changing development processes/practices. Furthermore, additional results captured during the case study are related to technology, competencies and skills, organization, management, infrastructure, and service and support. A conclusion is that when offering a complex offer such as an Industrial Product-Service System, comprising sensors, hardware, communications, software, cloud service platform, etc., it is necessary that the technology, business model, business setup, and organization all go hand in hand during the development and later operation, as all ‘components’ are required for a successful result.

  12. The corticospinal responses of metronome-paced, but not self-paced strength training are similar to motor skill training.

    Science.gov (United States)

    Leung, Michael; Rantalainen, Timo; Teo, Wei-Peng; Kidgell, Dawson

    2017-12-01

    The corticospinal responses to skill training may be different to strength training, depending on how the strength training is performed. It was hypothesised that the corticospinal responses would not be different following skill training and metronome-paced strength training (MPST), but would differ when compared with self-paced strength training (SPST). Corticospinal excitability, short-interval intra-cortical inhibition (SICI) and strength and tracking error were measured at baseline and 2 and 4 weeks. Participants (n = 44) were randomly allocated to visuomotor tracking, MPST, SPST or a control group. MPST increased strength by 7 and 18%, whilst SPST increased strength by 12 and 26% following 2 and 4 weeks of strength training. There were no changes in strength following skill training. Skill training reduced tracking error by 47 and 58% at 2 and 4 weeks. There were no changes in tracking error following SPST; however, tracking error reduced by 24% following 4 weeks of MPST. Corticospinal excitability increased by 40% following MPST and by 29% following skill training. There was no change in corticospinal excitability following 4 weeks of SPST. Importantly, the magnitude of change between skill training and MPST was not different. SICI decreased by 41 and 61% following 2 and 4 weeks of MPST, whilst SICI decreased by 41 and 33% following 2 and 4 weeks of skill training. Again, SPST had no effect on SICI at 2 and 4 weeks. There was no difference in the magnitude of SICI reduction between skill training and MPST. This study adds new knowledge regarding the corticospinal responses to skill and MPST, showing they are similar but different when compared with SPST.

  13. Program of all-inclusive care (PACE): past, present, and future.

    Science.gov (United States)

    Hirth, Victor; Baskins, Judith; Dever-Bumba, Maureen

    2009-03-01

    From modest beginnings in 1973 to over 60 programs nationwide, the PACE concept has proven the value of integrated, interdisciplinary-based care for frail older adults. The evolution of PACE and its regulatory and reimbursement model have changed over time, but the principals of care have remained unchanged. Nationally PACE programs are dealing with some of the same challenges they had 30 years ago and yet PACE programs continue to expand and provide care to an ever wider distribution of populations. The looming issue of ever-growing health care expenditures represents another opportunity for PACE to demonstrate its value while providing a level of quality beyond what could normally be provided by typical Medicare and Medicaid payments for similar conditions and patient characteristics. The future for PACE includes a number of possibilities including flexibility in financing and reimbursement, design changes to work with community-based physicians, potential eligibility adjustments, and growth of rural PACE. The PACE model has clearly demonstrated that in a debilitated, frail population in whom health care expenses would be expect to be high, a combination of team care, managed health care services, and care coordination can lead to both improved health outcomes and reduced expenses over time.

  14. Effects of permanent dual chamber pacing on myocardial perfusion in symptomatic hypertrophic cardiomyopathy

    NARCIS (Netherlands)

    Posma, JL; Blanksma, PK; VanderWall, EE; Vaalburg, W; Crijns, HJGM; Lie, KI

    1996-01-01

    Objective-Angina and the presence of myocardial ischaemia are common in hypertrophic cardiomyopathy. Dual chamber pacing results in clinical improvement in these patients. This study evaluates the effects of permanent dual chamber pacing on absolute regional myocardial perfusion and perfusion

  15. Beneficial effects of biventricular pacing in a patient with hypertrophic cardiomyopathy and intraventricular conduction delay

    OpenAIRE

    Rinaldi, C A; Bucknall, C A; Gill, J S

    2002-01-01

    The beneficial use of biventricular pacing is reported in a patient with hypertrophic cardiomyopathy and intraventricular conduction delay. This resulted in improvements in symptomatic status and exercise tolerance that may be related to cardiac resynchronisation. The improvement in symptoms by biventricular pacing in a patient with hypertrophic cardiomyopathy and intraventricular conduction delay is previously undocumented and requires further investigation.

  16. Cricket pace bowling: The trade-off between optimising knee angle ...

    African Journals Online (AJOL)

    Objective. To investigate the relationship between three-dimensional (3D) knee kinematics during pace bowling action, injury incidence and bowling performance at the start and end of a cricket season. Methods. Knee angle and ball release (BR) speed of injury-free premier league (club level) cricket pace bowlers over the ...

  17. Achievement of Women in a Self-paced Earth Science Course

    Science.gov (United States)

    Mott, Charles J.

    1978-01-01

    Performance differences were not significant between men and women in Earth Science classes with fixed assignment deadlines, nor were achievement differences significant for women in self-paced sections compared to fixed deadline men or women. Men performed higher than women in self-paced groups, and higher than men or women in other learning…

  18. Atrioventricular Cross-Talk Leading to Ventricular Pacing Inhibition in a Dual-Chamber ICD

    Directory of Open Access Journals (Sweden)

    Luuk Debie

    2011-01-01

    Full Text Available We report atrio-ventricular cross talk in a patient with a dual chamber ICD leading to ventricular pacing inhibition. This was observed in an ICD without the ventricular safety pace option, which normally is a sufficient protection against this phenomenon. Cross talk could be prevented effectively by reprogramming ventricular sensitivity to a less sensitive setting.

  19. The Relationship between Right Ventricular Pacing Voltage and QRS Complex Duration

    Czech Academy of Sciences Publication Activity Database

    Vančura, V.; Wichterle, D.; Brabec, Marek; Bytešník, J.; Lefflerová, K.; Kautzner, J.

    2009-01-01

    Roč. 30, č. 5 (2009), s. 517-527 ISSN 0967-3334 Institutional research plan: CEZ:AV0Z10300504 Keywords : cardiac pacing * QRS complex duration * pacing voltag * vectorcardiography * nonlinear regression analysis Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 1.430, year: 2009

  20. Integrating Self-Paced Mobile Learning into Language Instruction: Impact on Reading Comprehension and Learner Satisfaction

    Science.gov (United States)

    Wang, Yen-Hui

    2017-01-01

    The study integrated self-paced mobile learning (m-learning) into a language course, and examined what impacts were being produced on learners' reading comprehension and student satisfaction resulting from the instruction with m-learning integration. The self-paced, learner-centered mobile learning integration instruction (MLI) was compared with…

  1. Improvement of pacing induced regional myocardial ischemia by Solcoseryl in conscious dogs with coronary stenosis.

    Science.gov (United States)

    Shimada, T; Sasayama, S; Takahashi, M; Osakada, G; Kawai, C

    1984-02-01

    The effects of Solcoseryl on regional myocardial function were studied in 5 conscious dogs with partial coronary constriction, in which temporary ischemia was induced by rapid cardiac pacing. During the coronary artery constriction, the percent shortening of the ischemic segment decreased by 9%. When the heart rate was increased by pacing, the percent shortening of the ischemic segments was further reduced by 57%. On cessation of cardiac pacing, the early potentiation of dP/dt and of control segment shortening became evident and was followed by exponential decay in the subsequent several beats. In the ischemic segment, the percent shortening was significantly improved in the first post-pacing beat but was more severely depressed at five seconds. Thirty minutes after administration of Solcoseryl, the cardiac pacing was repeated in the same manner but the pacing-induced hypokinesia of the ischemic segment were less marked, the percent shortening being at an average of 9.1% during control pacing and 12.7% during the second pacing after Solcoseryl (p less than 0.05). Postpacing deterioration of the ischemic segment shortening was also significantly improved from 9.8 to 11.8% at 5 seconds (p less than 0.05). These findings indicate that Solcoseryl exerts protective effects on the ischemic myocardium by promoting a rapid recovery from ischemia, probably due to the improvement of oxygen utility through activated cellular respiration.

  2. New method for cardiac resynchronization therapy: Transapical endocardial lead implantation for left ventricular free wall pacing

    NARCIS (Netherlands)

    I. Kassai (Imre); C. Foldesi (Csaba); A. Szekely (Andrea); T. Szili-Torok (Tamas)

    2008-01-01

    textabstractCoronary sinus lead placement for transvenous left ventricular (LV) pacing in cardiac resynchronization therapy (CRT) has a significant failure rate at implant and a significant dislocation rate during follow-up. For these patients, epicardial pacing lead implantation is the most

  3. Right ventricular pacing and the risk of heart failure in implantable cardioverter-defibrillator patients

    NARCIS (Netherlands)

    Smit, Marcelle D.; Van Dessel, Pascal F. H. M.; Nieuwland, Wybe; Wiesfeld, Ans C. P.; Tan, Eng S.; Anthonio, Rutger L.; Van Erven, Lieselot; Van Veldhuisen, Dirk J.; Van Gelder, Isabelle C.

    2006-01-01

    BACKGROUND Right ventricular (RV) pacing in implantable cardioverter-defibrillator (ICD) patients may have detrimental effects on morbidity and mortality, in particular by inducing heart failure (HF). OBJECTIVE We investigated whether RV pacing increases the risk of HF in an asymptomatic ICD

  4. Keeping Pace with K-12 Online & Blended Learning: An Annual Review of Policy and Practice, 2013

    Science.gov (United States)

    Watson, John; Murin, Amy; Vashaw, Lauren; Gemin, Butch; Rapp, Chris

    2013-01-01

    This is the 10th annual "Keeping Pace" report. "Keeping Pace" has several goals: (1) add to the body of knowledge about online education policy and practice, and make recommendations for advances; (2) serve as a reference source for information about programs and policies across the country, both for policymakers and…

  5. METODE FUTURE PACING HYPNOTHERAPY UNTUK MENURUNKAN TINGKAT KECEMASAN PADA MAHASISWA BARU

    Directory of Open Access Journals (Sweden)

    Zahro Varisna Rohmadani

    2017-09-01

    Full Text Available Penelitian ini bertujuan untuk mengetahui efektivitas metode future pacing hypnotherapy dalam menurunkan tingkat kecemasan pada mahasiswa baru. Subjek penelitian adalah 20 mahasiswa/i baru, 10 mahasiswa di kelompok eksperimen dan 10 mahasiswa di kelompok kontrol. Peserta mendapatkan penanganan untuk penurunan kecemasan dengan metode berupa future pacing hypnotherapy. Metode analisis data yang digunakan adalah statistik nonparametrik teknik Wilcoxon Signed Rank Test untuk menguji perbedaan skor cemas kelompok subjek saat pretest dan posttest serta Mann Whitney U untuk melihat perbedaan penurunan kecemasan pada kelompok eksperimen dan kelompok kontrol. Hasil Wilcoxon Signed Rank Test menunjukkan bahwa future pacing hypnotherapy efektif dalam menurunkan kecemasan dengan p=0,012. Sedangkan hasil Mann Whitney U menunjukkan bahwa future pacing hypnotherapy efektif dalam menurunkan kecemasan dengan p=0,003 dan kelompok eksperimen mengalami penurunan kecemasan yang lebih besar dengan mean rank = 14,25.Kata kunci : future pacing hypnotherapy, kecemasan, mahasiswa baru

  6. The utility of atrial pacing for identifying the electrical breakthrough sites between the left atrium and pulmonary veins

    Directory of Open Access Journals (Sweden)

    Shinya Sugiura, MD

    2017-04-01

    Conclusions: This pacing method may help to identify whether EBSs are located in the anterior Lt.PVs. Improved recognition of EBSs through pacing from different sites would be helpful for achieving PV isolation.

  7. Antitachycardia pacing programming in implantable cardioverter defibrillator: A systematic review.

    Science.gov (United States)

    De Maria, Elia; Giacopelli, Daniele; Borghi, Ambra; Modonesi, Letizia; Cappelli, Stefano

    2017-05-26

    Implantable cardioverter defibrillator (ICD) programming involves several parameters. In recent years antitachycardia pacing (ATP) has gained an increasing importance in the treatment of ventricular arrhythmias, whether slow or fast. It reduces the number of unnecessary and inappropriate shocks and improves both patient's quality of life and device longevity. There is no clear indication regarding the type of ATP to be used, except for the treatment of fast ventricular tachycardias (188 bpm-250 bpm) where it has been shown a greater efficacy and safety of burst compared to ramp; 8 impulses in each sequence of ATP appears to be the best programming option in this setting. Beyond ATP use, excellent clinical results were obtained with programming standardization following these principles: extended detection time in ventricular fibrillation (VF) zone; supraventricular discrimination criteria up to 200 bpm; first shock in VF zone at the maximum energy in order to reduce the risk of multiple shocks. The MADIT-RIT trial and some observational registries have also recently demonstrated that programming with a widespread use of ATP, higher cut-off rates or delayed intervention reduces the number of inappropriate and unnecessary therapies and improves the survival of patients during mid-term follow-up.

  8. The role of temporary biventricular pacing in the cardiac surgical patient with severely reduced left ventricular systolic function.

    Science.gov (United States)

    Evonich, Rudolph F; Stephens, John C; Merhi, William; Dukkipati, Srinivas; Tepe, Nicholas; Shannon, Francis; Altshuler, Jeffrey; Sakwa, Marc; Bassett, Joseph; Hanson, Eric; Boura, Judy; O'Neill, William W; Haines, David E

    2008-10-01

    The objective was to evaluate the effects of atrial synchronous biventricular pacing in postoperative patients with severe cardiomyopathy. Atrial synchronous biventricular pacing epicardial leads were placed during cardiac surgery in patients with an ejection fraction of 30% or less. Patients were randomized to usual care pacing, the mode determined by the surgeon (excluding atrial synchronous biventricular pacing) with a preference for no pacing or atrial pacing (atrial inhibited pacing); atrial synchronous right ventricular pacing; or atrial synchronous biventricular pacing. Pacing was continued until cessation of hemodynamic support. At 12 hours postoperatively, patients were randomly tested in each mode (atrial inhibited, atrial synchronous right ventricular, and atrial synchronous biventricular pacing), and thermodilution outputs were measured. Forty subjects were randomized. Groups were similar in age (66 +/- 11 years), gender (85% were male), ejection fraction (23% +/- 6%), QRS duration (111 +/- 30 ms), and surgical indication. There was no difference in stroke index or cardiac index at 12 hours, duration of inotropic or intra-aortic balloon pump support, intensive care unit, or hospital length of stay. On comparative crossover testing, stroke volume was similar with atrial inhibited pacing and atrial synchronous biventricular pacing (59.3 +/- 13.4 vs 57 +/- 12.1, respectively, P = not significant); however, atrial synchronous right ventricular pacing was inferior (56 +/- 12.9, P or= 5%), whereas 41% had a 5% or greater decrease in stroke volume. Pacing mode affects stroke volume in patients with severe cardiomyopathy. Atrial synchronous biventricular pacing was helpful in a minority, but in 41% it compromised stroke volume.

  9. Echocardiographic estimation of acute haemodynamic response during optimization of multisite pace-maker using different pacing modalities and atrioventricular delays

    Directory of Open Access Journals (Sweden)

    Šalinger-Martinović Sonja

    2009-01-01

    Full Text Available Background/Aim. Cardiac resynchronization therapy (CRT improves ventricular dyssynchrony and is associated with an improvement in symptoms, quality of life and prognosis in patients with severe heart failure and intraventricular conduction delay. Different pacing modalities produce variable activation patterns and may be a cause of different haemodynamic changes. The aim of our study was to investigate acute haemodynamic changes with different CRT configurations during optimization procedure. Methods. This study included 30 patients with severe left ventricular systolic dysfunction and left bundle branch block with wide QRS (EF 24.33 ± 3.7%, QRS 159 ± 17.3 ms, New York Heart Association III/IV 25/5 with implanted CRT device. The whole group of patients had severe mitral regurgitation in order to measure dP/dt. After implantation and before discharge all the patients underwent optimization procedure guided by Doppler echocardiography. Left and right ventricular pre-ejection intervals (LVPEI and RVPEI, interventricular mechanical delay (IVD and the maximal rate of ventricular pressure rise during early systole (max dP/dt were measured during left and biventricular pacing with three different atrioventricular (AV delays. Results. After CRT device optimization, optimal AV delay and CRT mode were defined. Left ventricular pre-ejection intervals changed from 170.5 ± 24.6 to 145.9 ± 9.5 (p < 0.001, RVPEI from 102.4 ± 15.9 to 119.8 ± 10.9 (p < 0.001, IVD from 68.1 ± 18.3 to 26.5 ± 8.2 (p < 0.001 and dP/dt from 524.2 ± 67 to 678.2 ± 88.5 (p < 0.01. Conclusion. In patients receiving CRT echocardiographic assessment of the acute haemodynamic response to CRT is a useful tool in optimization procedure. The variability of Doppler parameters with different CRT modalities emphasizes the necessity of individualized approach in optimization procedure.

  10. Pacing-induced congenital heart defects assessed by OCT (Conference Presentation)

    Science.gov (United States)

    Ford, Stephanie M.; McPheeters, Matt T.; Wang, Yves T.; Gu, Shi; Doughman, Yong Qiu; Strainic, James P.; Rollins, Andrew M.; Watanabe, Michiko; Jenkins, Michael W.

    2016-03-01

    The role of hemodynamics in early heart development is poorly understood. In order to successfully assess the impact of hemodynamics on development, we need to monitor and perturb blood flow, and quantify the resultant effects on morphology. Here, we have utilized cardiac optical pacing to create regurgitant flow in embryonic hearts and OCT to quantify regurgitation percentage and resultant morphology. Embryonic quail in a shell-less culture were optically paced at 3 Hz (well above the intrinsic rate or 1.33-1.67 Hz) on day 2 of development (3-4 weeks human) for 5 minutes. The pacing fatigued the heart and led to a prolonged period (> 1 hour) of increased regurgitant flow. Embryos were kept alive until day 3 (cardiac looping - 4-5 weeks human) or day 8 (4 chambered heart - 8 weeks human) to quantify resultant morphologic changes with OCT. All paced embryos imaged at day 3 displayed cardiac defects. The extent of regurgitant flow immediately after pacing was correlated with cardiac cushion size 24-hours post pacing (p-value cardio-facial/DiGeorge syndrome models suggesting that hemodynamics plays a role in these syndromes as well. Utilizing OCT and optical pacing to understand hemodynamics in development is an important step towards determining CHD mechanisms and ultimately developing earlier treatments.

  11. Improvement of Sprint Triathlon Performance in Trained Athletes With Positive Swim Pacing.

    Science.gov (United States)

    Wu, Sam S X; Peiffer, Jeremiah J; Peeling, Peter; Brisswalter, Jeanick; Lau, Wing Y; Nosaka, Kazunori; Abbiss, Chris R

    2016-11-01

    To investigate the effect of 3 swim-pacing profiles on subsequent performance during a sprint-distance triathlon (SDT). Nine competitive/trained male triathletes completed 5 experimental sessions including a graded running exhaustion test, a 750-m swim time trial (STT), and 3 SDTs. The swim times of the 3 SDTs were matched, but pacing was manipulated to induce positive (ie, speed gradually decreasing from 92% to 73% STT), negative (ie, speed gradually increasing from 73% to 92% STT), or even pacing (constant 82.5% STT). The remaining disciplines were completed at a self-selected maximal pace. Speed over the entire triathlon, power output during the cycle discipline, rating of perceived exertion (RPE) for each discipline, and heart rate during the cycle and run were determined. Faster cycle and overall triathlon times were achieved with positive swim pacing (30.5 ± 1.8 and 65.9 ± 4.0 min, respectively), as compared with the even (31.4 ± 1.0 min, P = .018 and 67.7 ± 3.9 min, P = .034, effect size [ES] = 0.46, respectively) and negative (31.8 ± 1.6 min, P = .011 and 67.3 ± 3.7 min, P = .041, ES = 0.36, respectively) pacing. Positive swim pacing elicited a lower RPE (9 ± 2) than negative swim pacing (11 ± 2, P = .014). No differences were observed in the other measured variables. A positive swim pacing may improve overall SDT performance and should be considered by both elite and age-group athletes during racing.

  12. An Analysis of the Pacing Strategies Adopted by Elite Cross-Country Skiers.

    Science.gov (United States)

    Losnegard, Thomas; Kjeldsen, Kasper; Skattebo, Øyvind

    2016-11-01

    Losnegard, T, Kjeldsen, K, and Skattebo, Ø. An analysis of the pacing strategies adopted by elite cross-country skiers. J Strength Cond Res 30(11): 3256-3260, 2016-Understanding the pacing strategies used by the most successful skiers may provide insight into the most desirable pacing approach in cross-country (XC) skiing. This study examined the pacing strategies adopted by male and female XC skiers of different performance standards during 10 and 15 km races in World Cup, World Championships, and Olympic events. Analyses were performed on races involving 5 km laps in the men's 15 km (number of races = 22) and the women's 10 km (n = 14) individual start races (classic and freestyle) from season 2002/2003 to season 2013/2014. Final rank and lap times for the 40 top finishers in each race were analyzed. Both sexes demonstrated a positive pacing pattern shown by a decline in velocity from the first to the last lap (men: 6.76 ± 0.43 m·s vs. 6.47 ± 0.46 m·s; p < 0.001; women: 6.0 ± 0.47 m·s vs. 5.87 ± 0.53 m·s; p < 0.001). For the men, slower skiers (final ranking 21st-30th and 31st-40th) were characterized by a quick start relative to their average velocity, with a greater decrease during the race compared with the fastest skiers (1st-10th) (p = 0.007 and p < 0.001, respectively). For the women, no group differences in pacing strategy were found. In conclusion, this study shows that the pacing strategy indicates the standard of elite male XC skiers. Examining the pacing strategies of the best male performers suggests that lower-performing male skiers should consider a more even pacing strategy to improve their performance.

  13. Attenuation of Post-Shock Increases in Brain Natriuretic Peptide with Post Shock Overdrive Pacing

    Directory of Open Access Journals (Sweden)

    Marco Budeus

    2010-03-01

    Full Text Available Background: Predischarge defibrillation threshold testing is often performed a few days after ICD implantation in order to validate defibrillation thresholds obtained at the time of implant. Ventricular fibrillation is induced with such testing and causes an increase in serum Brain Natriuretic Peptide (BNP levels. BNP is an indicator for cardiac stress. We wanted to examine the feasibility to alter the trend of BNP after predischarge testing in VVI, DDD and CRT ICD´s.Methods: We measured BNP before predischarge testing and 5, 10, 20 and 40 minutes after predischarge testing in 13 groups with each 20 patients. We evaluated patients without post shock pacing and patients with a post shock pacing frequency of 60, 70, 80, 90 and 100 bpm and a duration of 30 and 60 sec as well as a post shock pacing frequency of 80 and 90 bpm and a duration of 120 sec post shock pacing. Results: Patients without post shock pacing showed the highest BNP during the follow-up. The percentage values of BNP increased consistent significantly after 5 minutes compared with BNP before predischarge testing. The percentage values of BNP trend was significantly lower with a post shock pacing of 90 bpm and duration of 60 sec. In addition, we excluded a cardiac necrosis by predischarge testing because of similar values of myoglobin, cardiac troponin I and creatine kinase during the follow-up.Conclusions: Our results suggested that post shock pacing with 90 bpm and duration of 60 sec as the best optimized post shock pacing frequency and duration for VVI, DDD and CRT ICD´s. A reduction of cardiac stress is going to be achieved with the optimization of the post shock pacing frequency and duration.

  14. Comparison of two strategies to reduce ventricular pacing in pacemaker patients.

    Science.gov (United States)

    Pürerfellner, Helmut; Brandt, Johan; Israel, Carsten; Sheldon, Todd; Johnson, James; Tscheliessnigg, Karlheinz; Sperzel, Johannes; Boriani, Giuseppe; Puglisi, Andrea; Milasinovic, Goran

    2008-02-01

    Managed Ventricular Pacing (MVP) and Search AV+ (SAV+) are two pacing algorithms designed to reduce ventricular pacing. MVP promotes conduction by operating in AAI/R mode with backup ventricular pacing during atrioventricular block (AVB). SAV+ operates in DDD/R mode with a nominal AV extension of 290 ms during atrial sensing and 320 ms during atrial pacing. The reduction in ventricular pacing was compared with these two algorithms in pacemaker patients. The EnRhythm and EnPulse clinical studies assessed the percentage of ventricular pacing (%VP) after 1 month. Each patient's AVB status was assigned using the following hierarchical categories: persistent third-degree AVB (p3AVB), episodic third-degree AVB (e3AVB), second-degree AVB (2AVB), first-degree AVB (1AVB), and no AVB (nAVB). The%VP was tabulated for each AVB status category. Data were available from 322 patients of whom 129 received DDD(R) pacing with the MVP algorithm activated and 193 patients with DDD(R) pacing and the SAV+ function activated, each for a month period. MVP resulted in a significantly lower median%VP than SAV+ in all AVB categories except for p3AVB: nAVB (0.3 vs 2.9, P < 0.0001), 1AVB (0.9% vs 80.6%, P < 0.0001), 2AVB (37.6 vs 99.3, P< 0.002), e3AVB (1.2 vs 42.2, P = 0.02), p3AVB (98.9 vs 100, P = 1.00). MVP resulted in a greater reduction in%VP than SAV+ across all patient groups except persistent third-degree AV block. The greatest reduction in%VP was observed in patients with mildly impaired AV conduction.

  15. Rationale and design of a randomized trial to assess the safety and efficacy of MultiPoint Pacing (MPP) in cardiac resynchronization therapy: The MPP Trial.

    Science.gov (United States)

    Tomassoni, Gery; Baker, James; Corbisiero, Raffaele; Love, Charles; Martin, David; Sheppard, Robert; Worley, Seth J; Lee, Kwangdeok; Niazi, Imran

    2017-11-01

    Although the majority of Class III congestive heart failure (HF) patients treated with cardiac resynchronization therapy (CRT) show a clinical benefit, up to 40% of patients do not respond to CRT. This paper reports the design of the MultiPoint Pacing (MPP) trial, a prospective, randomized, double-blind, controlled study to evaluate the safety and efficacy of CRT using MPP compared to standard biventricular (Bi-V) pacing. A maximum of 506 patients with a standard CRT-D indication will be enrolled at up to 50 US centers. All patients will be implanted with a CRT-D system (Quartet LV lead Model 1458Q with a Quadra CRT-D, Abbott) that can deliver both MPP and Bi-V pacing. Standard Bi-V pacing will be activated at implant. At 3 months postimplant, patients in whom the echocardiographic parameters during MPP are equal or better than during Bi-V pacing are randomized (1:1) to either an MPP or Bi-V arm. The primary safety endpoint is freedom from system-related complications at 9 months. Each patient's response to CRT will be evaluated using a heart-failure clinical composite score, consisting of a change in NYHA functional class, patient global assessment score, HF events, and cardiovascular death. The primary efficacy endpoint is the proportion of responders in the MPP arm compared with the Bi-V arm between 3 and 9 months. This trial seeks to evaluate whether MPP via a single quadripolar LV lead improves hemodynamic and clinical responses to CRT, both in clinical responders and nonresponders. © 2017 Wiley Periodicals, Inc.

  16. Earlier Right Ventricular Pacing in Cardiac Resynchronization Therapy for a Patient with Right Axis Deviation.

    Science.gov (United States)

    Hattori, Yusuke; Ishibashi, Kohei; Noda, Takashi; Okamura, Hideo; Kanzaki, Hideaki; Anzai, Toshihisa; Yasuda, Satoshi; Kusano, Kengo

    2017-09-01

    We describe the case of a 37-year-old woman who presented with complete right bundle branch block and right axis deviation. She was admitted to our hospital due to severe heart failure and was dependent on inotropic agents. Cardiac resynchronization therapy was initiated but did not improve her condition. After the optimization of the pacing timing, we performed earlier right ventricular pacing, which led to an improvement of her heart failure. Earlier right ventricular pacing should be considered in patients with complete right bundle branch block and right axis deviation when cardiac resynchronization therapy is not effective.

  17. Earlier Right Ventricular Pacing in Cardiac Resynchronization Therapy for a Patient with Right Axis Deviation

    Science.gov (United States)

    Hattori, Yusuke; Ishibashi, Kohei; Noda, Takashi; Okamura, Hideo; Kanzaki, Hideaki; Anzai, Toshihisa; Yasuda, Satoshi; Kusano, Kengo

    2017-01-01

    We describe the case of a 37-year-old woman who presented with complete right bundle branch block and right axis deviation. She was admitted to our hospital due to severe heart failure and was dependent on inotropic agents. Cardiac resynchronization therapy was initiated but did not improve her condition. After the optimization of the pacing timing, we performed earlier right ventricular pacing, which led to an improvement of her heart failure. Earlier right ventricular pacing should be considered in patients with complete right bundle branch block and right axis deviation when cardiac resynchronization therapy is not effective. PMID:28794367

  18. Optimal Cardiac Resynchronization Therapy Pacing Rate in Non-Ischemic Heart Failure Patients

    DEFF Research Database (Denmark)

    Ghotbi, Adam Ali; Sander, Mikael; Køber, Lars

    2015-01-01

    BACKGROUND: The optimal pacing rate during cardiac resynchronization therapy (CRT) is unknown. Therefore, we investigated the impact of changing basal pacing frequencies on autonomic nerve function, cardiopulmonary exercise capacity and self-perceived quality of life (QoL). METHODS: Twelve CRT...... by microneurography (MSNA), peak oxygen consumption (pVO2), N-terminal pro-brain natriuretic peptide (p-NT-proBNP), echocardiography and QoL. RESULTS: DDD-80 pacing for 3 months increased the mean heart rate from 77.3 to 86.1 (p = 0.001) and reduced sympathetic activity compared to DDD-60 (51±14 bursts/100 cardiac...

  19. Using the Surface ECG to Identify Right Ventricular Pacing Lead Position: A Cautionary Tale.

    Science.gov (United States)

    Kaye, Gerald C; Rowe, Matthew K; Gould, Paul A

    2017-09-01

    Chronic right ventricular (RV) apical pacing may lead to the development of heart failure in some patients. Although pacing of the RV septum has been proposed as an alternative, positioning a lead in the true septum has proven challenging. In addition to fluoroscopy at implant, it has been suggested that 12-lead surface electrocardiogram (ECG) can be used to determine septal lead position; however, studies show this may be inaccurate. We present a case where a change in the ECG QRS axis late after pacemaker insertion with an active fixation lead highlights the difficulties of ECG localization of pacing leads. © 2017 Wiley Periodicals, Inc.

  20. Long-term outcome of physiologic VDD pacing versus non-physiologic VVI pacing in dogs with high-grade atrioventricular block.

    Science.gov (United States)

    Lichtenberger, Jonathan; Scollan, Katherine F; Bulmer, Barret J; Sisson, D David

    2015-03-01

    To compare the long-term outcome associated with physiologic VDD and non-physiologic VVI or VVIR pacing in dogs with high-grade atrioventricular block. Forty-nine paced dogs with high-grade atrioventricular block were included. Retrospective review of medical records, thoracic radiographs and echocardiograms for all dogs. Patient owners and referring veterinarians were contacted for survival times and a satisfaction questionnaire was submitted to the owners. Survival times, complication rates, resolution of clinical signs, and owner satisfaction were compared between the pacing modalities. A single lead VDD pacemaker was implanted in 19 dogs (39%) whereas 30 dogs (61%) were treated with VVI pacing. The median survival time for all dogs post-pacemaker implantation was 24.5 months. Survival time was significantly decreased in dogs that were older at the time of presentation or that presented with ventricular tachycardia or reduced left ventricular fractional shortening. Median survival times after implantation were not significantly different between pacing modalities (P = 0.29). Major complication rates were 11% within the VDD group and 20% within the VVI group and were not significantly different (P = 0.46). Minor complications were significantly higher within the VDD group than within the VVI group (47% versus 7% respectively; P dogs in the VDD group experiencing transient ventricular premature contractions in the immediate post-implantation time period. Resolution of clinical signs, owner satisfaction, and quality of life perception were considered excellent in both groups. No long-term clinical benefit of VDD over VVI pacing could be identified in the present study. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Fast self paced listening times in syntactic comprehension is aphasia -- implications for deficits

    Directory of Open Access Journals (Sweden)

    Jennifer Michaud

    2015-04-01

    Full Text Available Sixty one people with aphasia (pwa and forty one matched controls were tested for the ability to understand sentences that required the ability to assign particular syntactic structures. Participants paced themselves word-by-word through twenty examples of eleven spoken sentence types and indicated which of two pictures corresponded to the meaning of each sentence. Sentences were developed in pairs such that comprehension of the experimental version of a pair required an aspect of syntactic processing not required in the corresponding baseline sentence. The need for the syntactic operations required only in the experimental version was triggered at a “critical word” in the experimental sentence. Listening times for critical words in experimental sentences were compared to those for corresponding words in the corresponding baseline sentences. We adjusted self paced listening times for word duration by subtracting word durations from tag-to-tag self paced listening times to correct for word duration, yielding what we have previously called “corrected listening times.” Corrected listening times above ceiling (10,000 msec for sentence-final words and 5,000 msec for all other words were discarded. For controls, this led to 0.2% of data being discarded and for PWAs 2.2% were discarded. Corrected listening times that were more than 3 standard deviations above or below the mean for that sentence type for each subject were adjusted either down to the upper limit or up to the lower limit of the 3SD range (not discarded. For accurate sentences, 1.7% of the control data were adjusted and 1.8% of the aphasic data were adjusted. For inaccurate sentences, 10% of the corrected listening times were adjusted for controls and 3.3% for aphasics. Our interest is in incremental parsing and interpretation. The measure we used of this process was the residual of a regression of corrected self paced listening times for critical words in experimental sentences

  2. An Approach to Endovascular Ventricular Pacing in a Patient with Ebstein Anomaly and a Mechanical Tricuspid Valve.

    Science.gov (United States)

    Zipse, Matthew M; Groves, Daniel W; Khanna, Amber D; Nguyen, Duy Thai

    2016-03-01

    In the presence of a mechanical tricuspid valve, endocardial right ventricular pacing is contraindicated, and permanent pacing is usually achieved via a surgically implanted epicardial lead. In a patient with Ebstein anomaly, a mechanical tricuspid valve, and complete heart block, transvenous pacing was achieved by implantation of a pace-sense lead in a coronary sinus ventricular branch. Noninvasive cardiac imaging can provide information regarding anatomic variation in patients with congenital heart disease or when there are challenges to lead placement. With careful planning and execution, endovascular pacing in patients with a mechanical tricuspid valve is feasible and can safely be performed. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Characteristics of a large sample of candidates for permanent ventricular pacing included in the Biventricular Pacing for Atrio-ventricular Block to Prevent Cardiac Desynchronization Study (BioPace).

    Science.gov (United States)

    Funck, Reinhard C; Mueller, Hans-Helge; Lunati, Maurizio; Piorkowski, Christopher; De Roy, Luc; Paul, Vince; Wittenberg, Michael; Wuensch, David; Blanc, Jean-Jacques

    2014-03-01

    The general clinical profile of European pacemaker recipients who require predominant ventricular pacing (VP) is scarcely known. We examined the demographic and clinical characteristics of the 1808 participants (out of 1833 randomized patients) of the ongoing Biventricular Pacing for Atrio-ventricular Block to Prevent Cardiac Desynchronization (BioPace) study. BioPace recruited patients between May 2003 and September 2007 predominantly in European medical centres. We analysed demographic data and described clinical characteristics and electrophysiological parameters prior to device implantation in 1808 enrolled patients. The mean age ± standard deviation (SD) of the 1808 patients was 73.5 ± 9.2 years, 1235 (68%) were men, 654 (36%) presented without structural heart disease, 547 (30%) had ischemic, 355 (20%) hypertensive, 146 (8%) valvular, and 102 (6%) non-ischemic dilated cardiomyopathy. Mean left ventricular ejection fraction was 55.4 ± 12.3%. The main pacing indications were (a) permanent and intermittent atrioventricular (AV) block in 973 (54%), (b) atrial fibrillation with slow ventricular rate in 313 (17%), and (c) miscellaneous bradyarrhythmias in 522 (29%) patients. Mean QRS duration was 118.5 ± 30.5 ms, left bundle branch block was present in 316 (17%), and atrial tachyarrhythmias in 426 (24%) patients. To the best of our knowledge, this sample is a representative source of description of the general profile of European pacemaker recipients who require predominant VP. Patients' characteristics included advanced age, predominantly male gender, preserved left ventricular systolic function, high-grade AV block, narrow QRS complex, and atrial tachyarrhythmias, the latter being present in nearly one-fourth of the cohort.

  4. Infrared-based blink-detecting glasses for facial pacing: toward a bionic blink.

    Science.gov (United States)

    Frigerio, Alice; Hadlock, Tessa A; Murray, Elizabeth H; Heaton, James T

    2014-01-01

    IMPORTANCE Facial paralysis remains one of the most challenging conditions to effectively manage, often causing life-altering deficits in both function and appearance. Facial rehabilitation via pacing and robotic technology has great yet unmet potential. A critical first step toward reanimating symmetrical facial movement in cases of unilateral paralysis is the detection of healthy movement to use as a trigger for stimulated movement. OBJECTIVE To test a blink detection system that can be attached to standard eyeglasses and used as part of a closed-loop facial pacing system. DESIGN, SETTING, AND PARTICIPANTS Standard safety glasses were equipped with an infrared (IR) emitter-detector unit, oriented horizontally across the palpebral fissure, creating a monitored IR beam that became interrupted when the eyelids closed, and were tested in 24 healthy volunteers from a tertiary care facial nerve center community. MAIN OUTCOMES AND MEASURES Video-quantified blinking was compared with both IR sensor signal magnitude and rate of change in healthy participants with their gaze in repose, while they shifted their gaze from central to far-peripheral positions, and during the production of particular facial expressions. RESULTS Blink detection based on signal magnitude achieved 100% sensitivity in forward gaze but generated false detections on downward gaze. Calculations of peak rate of signal change (first derivative) typically distinguished blinks from gaze-related eyelid movements. During forward gaze, 87% of detected blink events were true positives, 11% were false positives, and 2% were false negatives. Of the 11% false positives, 6% were associated with partial eyelid closures. During gaze changes, false blink detection occurred 6% of the time during lateral eye movements, 10% of the time during upward movements, 47% of the time during downward movements, and 6% of the time for movements from an upward or downward gaze back to the primary gaze. Facial expressions

  5. Photovoltaics (PV) as an Eligible Measure in Residential PACE Programs: Benefits and Challenges (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    Coughlin, J.

    2010-06-01

    Property Assessed Clean Energy (PACE) financing is one of several new financial models broadening access to clean energy by addressing the barrier of initial capital cost. The majority of the PACE programs in the market today include PV as an eligible measure. PV appeals to homeowners as a way to reduce utility bills, self-generate sustainable power, increase energy independence and demonstrate a commitment to the environment. If substantial state incentives for PV exist, PV projects can be economic under PACE, especially when partnered with good net metering policies. At the same time, PV is expensive relative to other eligible measures with a return on investment horizon that might exceed program targets. This fact sheet reviews the benefits and potential challenges of including PV in PACE programs.

  6. Effects of Bepridil on Atrial Electrical Remodeling in Short-Term Rapid Pacing

    Directory of Open Access Journals (Sweden)

    Hiroto Tsuchiya, MD

    2009-01-01

    Conclusions: Bepridil prevented the shortening of the ERP and MAPD90 induced by rapid atrial pacing in the acute phase. The results of this study might explain the efficacy of bepridil for preventing the recurrence of paroxysmal AF.

  7. Effects of postshock atrial pacing on atrial defibrillation outcome in the isolated sheep heart

    NARCIS (Netherlands)

    Skanes, A. C.; Gray, R. A.; Zuur, C. L.; Jalife, J.

    1998-01-01

    BACKGROUND: Failed atrial defibrillation shocks are associated with organization of postshock activity and a substantial postshock electrical quiescence. We investigated the ability of a train of pacing stimuli to capture or locally entrain atrial myocardium during the quiescent period after

  8. Research and Its Implications for Secondary School Mathematics Instruction Via Self-Pacing

    Science.gov (United States)

    Schoen, Harold L.

    1977-01-01

    Provides a summary of the findings of nearly one hundred-fifty studies dealing with self-paced instruction S(PI) mathematics programs that involved students at the secondary level with some implications for practice. (Author/RK)

  9. Synchronous intra-myocardial ventricular pacing without crossing the tricuspid valve or entering the coronary sinus

    Energy Technology Data Exchange (ETDEWEB)

    Konecny, Tomas; DeSimone, Christopher V.; Friedman, Paul A.; Bruce, Charles [Department of Medicine, Cardiovascular Diseases, Mayo Clinic, Rochester, MN (United States); Asirvatham, Samuel J., E-mail: asirvatham.samuel@mayo.edu [Department of Medicine, Cardiovascular Diseases, Mayo Clinic, Rochester, MN (United States); Department of Pediatric and Adolescent Medicine, Pediatric Cardiology, Mayo Clinic, Rochester, MN (United States)

    2013-05-15

    Ventricular pacing is most commonly performed at the right ventricular (RV) apex. This is not without risk as placement requires crossing the tricuspid valve (TV) and may cause valvular dysfunction and dyssynchronous activation of the ventricles. The fact that the tricuspid valve lies more apically than the mitral valve allows for the possibility of pacing the ventricles from the right atrium (RA) via the “atrio-ventricular septum” without crossing the TV or entering the coronary sinus (CS). In order to mitigate far field activation inherent to current pacing technology, we constructed a novel lead in which the cathode and anode are both intra-myocardial. We demonstrate safety and efficacy of this novel lead for ventricular pacing at the atrio-ventricular septum in canines, including improved synchronous activation of both ventricles, improved differentiation in ventricular versus atrial sensing, while providing reliable ventricular capture, opening novel and a potentially safer alternative to human cardiac resynchronization therapy.

  10. EFFECT OF ADAPTIVE PACED CARDIOLOCOMOTOR SYNCHRONIZATION DURING RUNNING: A PRELIMINARY STUDY

    Directory of Open Access Journals (Sweden)

    Bill Phillips

    2013-09-01

    Full Text Available Cardiolocomotor synchronization (CLS has been well established for individuals engaged in rhythmic activity, such as walking, running, or cycling. When frequency of the activity is at or near the heart rate, entrainment occurs. CLS has been shown in many cases to improve the efficiency of locomotor activity, improving stroke volume, reducing blood pressure variability, and lowering the oxygen uptake (VO2. Instead of a 1:1 frequency ratio of activity to heart rate, an investigation was performed to determine if different harmonic coupling at other simple integer ratios (e.g. 1:2, 2:3, 3:2 could achieve any performance benefits. CLS was ensured by pacing the stride rate according to the measured heartbeat (i.e., adaptive paced CLS, or forced CLS. An algorithm was designed that determined the simplest ratio (lowest denominator that, when multiplied by the heart rate will fall within an individualized, predetermined comfortable pacing range for the user. The algorithm was implemented on an iPhone 4, which generated a 'tick-tock' sound through the iPhone's headphones. A sham-controlled crossover study was performed with 15 volunteers of various fitness levels. Subjects ran a 3 mile (4.83 km simulated training run at their normal pace on two consecutive days (randomized one adaptive pacing, one sham. Adaptive pacing resulted in faster runs run times, with subjects running an average of 26:03 ± 3:23 for adaptive pacing and 26:38 ± 3:31 for sham (F = 5.46, p < 0.05. The increase in heart rate from the start of the race as estimated by an exponential time constant was significantly longer during adaptive pacing, τ = 0.99 ± 0.30, compared to sham, τ = 1.53 ± 0.34 (t = -6.62, p < 0.01. Eighty-seven percent of runners found it easy to adjust their stride length to match the pacing signal with seventy-nine percent reporting that pacing helped their performance. These results suggest that adaptive paced CLS may have a beneficial effect on running

  11. Tailoring device settings in cardiac resynchronization therapy using electrograms from pacing electrodes.

    Science.gov (United States)

    Engels, Elien B; Mafi-Rad, Masih; Hermans, Ben J M; Aranda, Alfonso; van Stipdonk, Antonius M W; Rienstra, Michiel; Scheerder, Coert O S; Maass, Alexander H; Prinzen, Frits W; Vernooy, Kevin

    2017-06-30

    Left ventricular (LV) fusion pacing appears to be at least as beneficial as biventricular pacing in cardiac resynchronization therapy (CRT). Optimal LV fusion pacing critically requires adjusting the atrioventricular (AV)-delay to the delay between atrial pacing and intrinsic right ventricular (RV) activation (Ap-RV). We explored the use of electrogram (EGM)-based vectorloop (EGMV) derived from EGMs of implanted pacing leads to achieve optimal LV fusion pacing and to compare it with conventional approaches. During CRT-device implantation, 28 patients were prospectively studied. During atrial-LV pacing (Ap-LVp) at various AV-delays, LV dP/dtmax, 12-lead electrocardiogram (ECG), and unipolar EGMs were recorded. Electrocardiogram and electrogram were used to reconstruct a vectorcardiogram (VCG) and EGMV, respectively, from which the maximum QRS amplitude (QRSampl), was extracted. Ap-RV was determined: (i) conventionally as the longest AV-delay at which QRS morphology was visually unaltered during RV pacing at increasing AV-delays(Ap-RVvis; reference-method); (ii) 70% of delay between atrial pacing and RV sensing (Ap-RVaCRT); and (iii) the delay between atrial pacing and onset of QRS (Ap-QRSonset). In both the EGMV and VCG, the longest AV-delay showing an unaltered QRSampl as compared with Ap-LVp with a short AV-delay, corresponded to Ap-RVvis. In contrast, Ap-QRSonset and Ap-RVaCRT were larger. The Ap-LVp induced increase in LV dP/dtmax was larger at Ap-RVvis, Ap-RVEGMV, and Ap-RVVCG than at Ap-QRSonset (all P < 0.05) and Ap-RVaCRT (P = 0.02, P = 0.13, and P = 0.03, respectively). In this acute study, it is shown that the EGMV QRSampl can be used to determine optimal and individual CRT-device settings for LV fusion pacing, possibly improving long-term CRT response. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  12. Interatrial septum versus right atrial appendage pacing for prevention of atrial fibrillation : A meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Zhang, L; Jiang, H; Wang, W; Bai, J; Liang, Y; Su, Y; Ge, J

    2017-07-28

    Interatrial septum (IAS) pacing seems to be a promising strategy for the prevention of atrial fibrillation (AF); however, studies have yielded conflicting results. This meta-analysis was to compare IAS with right atrial appendage (RAA) pacing on the prevention of postpacing AF occurrence. Pubmed, MEDLINE, EMBASE and Web of Science databases were searched through October 2016 for randomized controlled trials comparing IAS with RAA pacing on the prevention of AF. Data concerning study design, patient characteristics and outcomes were extracted. Risk ratio (RR), weighted mean differences (WMD) or standardized mean differences (SMD) were calculated using fixed or random effects models. A total of 12 trials involving 1146 patients with dual-chamber pacing were included. Although IAS was superior to RAA pacing in terms of reducing the number of AF episodes (SMD = -0.29, P = 0.05), AF burden (SMD = -0.41, P = 0.008) and P -wave duration (WMD = -34.45 ms, P IAS pacing. Nevertheless, no differences were observed concerning all-cause death (RR = 1.04, P = 0.88), procedure-related events (RR = 1.17, P = 0.69) and pacing parameters between IAS and RAA pacing in the follow-up period. IAS pacing is safe and as well tolerated as RAA pacing. Although IAS pacing may fail to prevent permanent AF occurrence and recurrences of AF, it is able to not only improve interatrial conduction, but also reduce AF burden.

  13. Underestimation of pacing threshold as determined by an automatic ventricular threshold testing algorithm.

    Science.gov (United States)

    Sauer, William H; Cooper, Joshua M; Lai, Rebecca W; Verdino, Ralph J

    2006-09-01

    In this case report, we describe markedly different pacing thresholds determined by a manual threshold test and the automatic Ventricular Capture Management algorithm. The discrepancy in pacing threshold values reported was due to the difference in the AV intervals used with the different testing methods. We propose that the differences in right ventricular dimensions with altered diastolic filling periods affected the threshold in this patient with a new passive fixation lead in the right ventricular apex.

  14. Utility of transesophageal electrocardiography to guide optimal placement of a transesophageal pacing catheter in dogs.

    Science.gov (United States)

    Sanders, Robert A; Chapel, Emily; Garcia-Pereira, Fernando L; Venet, Katherine E

    2015-01-01

    To determine if the transesophageal atrial (A) wave amplitude or ventricular (V) wave amplitude can be used to guide optimal positioning of a transesophageal pacing catheter in dogs. Prospective clinical study. Fourteen client owned healthy dogs with a median weight of 15.4 kg (IQR = 10.6-22.4) and a median age of 12 months (IQR = 6-12). Transesophageal atrial pacing (TAP) using a 6 Fr pacing catheter was attempted in dogs under general anesthesia. The pacing catheter was inserted orally into the esophagus to a position caudal to the heart. With the pulse generator set at a rate 20 beats/minute(-1) above the intrinsic sinus rate, the catheter was slowly withdrawn until atrial pacing was noted on a surface electrocardiogram (ECG). Then the catheter was withdrawn in 1 cm increments until atrial capture was lost. Minimum pacing threshold (MPT) and transesophageal ECG were recorded at each site. Amplitudes of the A and V waves on transesophageal ECG were then measured and their relationship to MPT was evaluated. TAP was achieved in all dogs. In 9/14 dogs the site of lowest overall MPT was the same as the site of maximal A wave deflection. In dogs with at least three data points, linear regression analysis of the relationship between the estimated site of the lowest overall MPT compared to estimated site of the maximal A and V waveform amplitudes demonstrated a strong correlation (R(2) = 0.99). Transesophageal ECG A and V waveforms were correlated to MPT and could be used to direct the placement of a pacing catheter. However, the technique was technically challenging and was not considered to be clinically useful to guide the placement of a pacing catheter. © 2014 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

  15. On the pace of fertility decline in sub-Saharan Africa

    OpenAIRE

    David Shapiro; Andrew Hinde

    2017-01-01

    Background: This descriptive finding examines the comparative pace of fertility decline in sub-Saharan Africa, relative to Asia, Latin America and the Caribbean, and Northern Africa.Objective: We seek to determine if fertility decline has been slower in sub-Saharan Africa than elsewhere in the developing world.Methods: United Nations 2017 estimates of national fertility are used in assessing the comparative pace of fertility decline, and the four regions are compared in terms of how far they ...

  16. Right bundle branch block pattern during right ventricular permanent pacing: Is it safe or not?

    OpenAIRE

    Erdogan, Okan; Aksu, Feyza

    2007-01-01

    The present case report describes a patient with dual chamber pacemaker whose surface ECG demonstrated paced right bundle branch block pattern suggesting a malpositioned ventricular lead in the left ventricle. However, diagnostic work-up revealed that the lead was appropriately located in the right ventricular apex. Diagnostic maneuvers and clues for differentiating safe right bundle branch block pattern during permanent pacing are thoroughly revisited and discussed within the article.

  17. Ventricular defibrillation combining DC electrical field and electrical pacing: an optical mapping study

    Science.gov (United States)

    Musunuri, Sai Shruthi; Tang, Liang; Joung, Boyoung; Berbari, Edward J.; Lin, Shien-Fong

    2009-02-01

    Although high voltage direct current (DC) shock is a standard technique to terminate ventricular fibrillation (VF), it can cause severe pain and tissue damage. The exact effect of the DC electric field, which can depolarize the heart during VF is still unknown. We hypothesized that low-energy DC field in combination with pacing (pacing+DC) could terminate VF by affecting the ventricular propagation pattern. In six Langendorff-perfused isolated rabbit hearts with the ablated sinoatrial (SA) node, the DC field was delivered to the left ventricle (cathode) and right ventricle (anode). We designed a timed protocol using LabVIEW programming that delivers pacing, DC and pacing+DC stimuli for two seconds time intervals each. The pacing pulse (with varying pacing cycle length: 300ms-30ms) was delivered to the apex. Transmembrane voltage was recorded with optical mapping technique for 16 seconds at a sampling rate of 2ms/frame. We crushed the sinoatrial node to reduce the heart rate. The baseline activation appeared to have endocardial origins with a mean escape ventricular rate of 60 +/- 5bpm at baseline. The DC field (30mA-60mA) alone increased the mean heart rate to 120+/-5bpm. Although DC alone terminated VF in a few cases, the rate of termination was very low (6.2%). However, when pacing+DC was applied, it was possible to terminate VF in 34 of 130 episodes in six rabbits. The rate of successful defibrillation of VF with pacing+DC was significantly higher than that with DC alone (20% vs 6.2%, pdefibrillation with lower energy requirements.

  18. The effect of visitor number and spice provisioning in pacing expression by jaguars evaluated through a case study

    Directory of Open Access Journals (Sweden)

    L. S. Vidal

    Full Text Available Abstract Captive animals exhibit stereotypic pacing in response to multiple causes, including the inability to escape from human contact. Environmental enrichment techniques can minimize pacing expression. By using an individual-based approach, we addressed whether the amount of time two males and a female jaguar (Panthera onca devote to pacing varied with the number of visitors and tested the effectiveness of cinnamon and black pepper in reducing pacing. The amount of time that all jaguars engaged in pacing increased significantly with the number of visitors. Despite the difference between the males regarding age and housing conditions, both devoted significantly less time to pacing following the addition of both spices, which indicates their suitability as enrichment techniques. Mean time devoted to pacing among the treatments did not differ for the female. Our findings pointed out to the validity of individual-based approaches, as they can reveal how suitable olfactory stimuli are to minimizing stereotypies irrespective of particular traits.

  19. Peak fat oxidation during self-paced activities of daily life: influence of sex and body composition.

    Science.gov (United States)

    Grams, Lena; Kück, Momme; Haufe, Sven; Tegtbur, Uwe; Nelius, Anne-Katrin; Kerling, Arno

    2017-05-01

    Increasing physical activity is a cornerstone in the treatment of overweight individuals and self-selected exercise intensity leads to higher adherence to physical activity. However, information on differences in energy expenditure and fat oxidation between sexes regarding common self-paced activities of daily living are rare. We divided 33 subjects into normal weight (NW, N.=21) and overweight (OW, N.=12). Energy expenditure and substrate oxidation was measured during six self-paced physical activities of daily living using a portable spirometric system. We also determined maximum aerobic capacity (VO2max) and estimated free-living physical activity with a multi-sensor device. For all six activities, total energy expenditure was not different between NW and OW subjects in both sexes. The peak fat oxidation during physical activities was reached at higher intensities for women (NW 57±15%; OW 53±8% of VO2max) compared to men (NW 41±8%; OW 42±9% of VO2max) with no differences between NW and OW subjects. The majority of OW (92%) but not NW (42%) subjects reached their highest fat oxidation during walking. The self-selected walking speed was not significantly different between NW and OW men (NW 5.25±0.48 km/h, OW 5.52±0.42 km/h) and NW and OW women (NW 5.16±0.89 km/h, OW 5.01±0.42 km/h). When physical activity aims to maximizing fat oxidation, women should exercise at higher relative intensities than men, regardless of being normal weight or overweight. Self-paced walking is a suitable activity for overweight subjects to achieve high rates of both total energy expenditure and fat oxidation.

  20. Rate responsive pacing using cardiac resynchronization therapy in patients with chronotropic incompetence and chronic heart failure.

    Science.gov (United States)

    Sims, Daniel B; Mignatti, Andrea; Colombo, Paolo C; Uriel, Nir; Garcia, Luis I; Ehlert, Frederick A; Jorde, Ulrich P

    2011-10-01

    Chronotropic incompetence (CI) is a common finding in patients with advanced chronic heart failure (CHF) and is associated with a worse functional capacity. Whether rate responsive pacing with cardiac resynchronization therapy (CRT) would acutely improve exercise performance in patients with advanced CHF and severe CI (heart rate) is unknown. Patients (n = 13) with CHF, a CRT device, and severe CI were randomized in a double-blind crossover pilot study to either DDD (control) or DDDR (rate responsive) pacing. Six minutes walk test (6MWT) distance, oxygen consumption at anaerobic threshold (VO(2) @ AT), and maximal oxygen consumption (VO(2) max) were measured. One week later, testing was repeated in the alternate pacing mode. Rate responsive pacing commenced with standard settings in only 9 of 13 (69%) patients. In these 9 subjects, 6MWT distance improved acutely from 358.5 ± 40.7 to 376.8 ± 24.5 m with DDDR pacing (Pheart rate at minute 3 during rate responsive pacing and improvement in VO(2) @ AT (r = 0.83, Pheart rate response may be beneficial to optimize CRT settings in this patient population.

  1. A Pilot Study on the Effects of Slow Paced Breathing on Current Food Craving.

    Science.gov (United States)

    Meule, Adrian; Kübler, Andrea

    2017-03-01

    Heart rate variability biofeedback (HRV-BF) involves slow paced breathing (approximately six breaths per minute), thereby maximizing low-frequent heart rate oscillations and baroreflex gain. Mounting evidence suggests that HRV-BF promotes symptom reductions in a variety of physical and mental disorders. It may also positively affect eating behavior by reducing food cravings. The aim of the current study was to investigate if slow paced breathing can be useful for attenuating momentary food craving. Female students performed paced breathing either at six breaths per minute (n = 32) or at nine breaths per minute (n = 33) while watching their favorite food on the computer screen. Current food craving decreased during a first resting period, increased during paced breathing, and decreased during a second resting period in both conditions. Although current hunger increased in both conditions during paced breathing as well, it remained elevated after the second resting period in the nine breaths condition only. Thus, breathing rate did not influence specific food craving, but slow paced breathing appeared to have a delayed influence on state hunger. Future avenues are suggested for the study of HRV-BF in the context of eating behavior.

  2. Integrating palliative care in long-term care facilities across Europe (PACE): protocol of a cluster randomized controlled trial of the 'PACE Steps to Success' intervention in seven countries.

    Science.gov (United States)

    Smets, Tinne; Onwuteaka-Philipsen, Bregje B D; Miranda, Rose; Pivodic, Lara; Tanghe, Marc; van Hout, Hein; Pasman, Roeline H R W; Oosterveld-Vlug, Mariska; Piers, Ruth; Van Den Noortgate, Nele; Wichmann, Anne B; Engels, Yvonne; Vernooij-Dassen, Myrra; Hockley, Jo; Froggatt, Katherine; Payne, Sheila; Szczerbińska, Katarzyna; Kylänen, Marika; Leppäaho, Suvi; Barańska, Ilona; Gambassi, Giovanni; Pautex, Sophie; Bassal, Catherine; Deliens, Luc; Van den Block, Lieve

    2018-03-12

    palliative care intervention for long-term care facilities 'PACE Steps to Success' in seven countries, will provide important evidence concerning the effectiveness as well as the preconditions for optimal implementation of palliative care in nursing homes, and this within different health care systems. The study is registered at www.isrctn.com - ISRCTN14741671 (FP7-HEALTH-2013-INNOVATION-1 603111) Registration date: July 30, 2015.

  3. Obliquity-paced Pliocene West Antarctic ice sheet oscillations

    Science.gov (United States)

    Naish, T.; Powell, R.; Levy, R.; Wilson, G.; Scherer, R.; Talarico, F.; Krissek, L.; Niessen, F.; Pompilio, M.; Wilson, T.; Carter, L.; DeConto, R.; Huybers, P.; McKay, R.; Pollard, D.; Ross, J.; Winter, D.; Barrett, P.; Browne, G.; Cody, R.; Cowan, E.; Crampton, J.; Dunbar, G.; Dunbar, N.; Florindo, F.; Gebhardt, C.; Graham, I.; Hannah, M.; Hansaraj, D.; Harwood, D.; Helling, D.; Henrys, S.; Hinnov, L.; Kuhn, G.; Kyle, P.; Laufer, A.; Maffioli, P.; Magens, D.; Mandernack, K.; McIntosh, W.; Millan, C.; Morin, R.; Ohneiser, C.; Paulsen, T.; Persico, D.; Raine, I.; Reed, J.; Riesselman, C.; Sagnotti, L.; Schmitt, D.; Sjunneskog, C.; Strong, P.; Taviani, M.; Vogel, S.; Wilch, T.; Williams, T.

    2009-01-01

    Thirty years after oxygen isotope records from microfossils deposited in ocean sediments confirmed the hypothesis that variations in the Earth's orbital geometry control the ice ages1, fundamental questions remain over the response of the Antarctic ice sheets to orbital cycles2. Furthermore, an understanding of the behaviour of the marine-based West Antarctic ice sheet (WAIS) during the 'warmer-than-present' early-Pliocene epoch (5–3 Myr ago) is needed to better constrain the possible range of ice-sheet behaviour in the context of future global warming3. Here we present a marine glacial record from the upper 600 m of the AND-1B sediment core recovered from beneath the northwest part of the Ross ice shelf by the ANDRILL programme and demonstrate well-dated, 40-kyr cyclic variations in ice-sheet extent linked to cycles in insolation influenced by changes in the Earth's axial tilt (obliquity) during the Pliocene. Our data provide direct evidence for orbitally induced oscillations in the WAIS, which periodically collapsed, resulting in a switch from grounded ice, or ice shelves, to open waters in the Ross embayment when planetary temperatures were up to 3 °C warmer than today4 and atmospheric CO2 concentration was as high as 400 p.p.m.v. (refs 5, 6). The evidence is consistent with a new ice-sheet/ice-shelf model7 that simulates fluctuations in Antarctic ice volume of up to +7 m in equivalent sea level associated with the loss of the WAIS and up to +3 m in equivalent sea level from the East Antarctic ice sheet, in response to ocean-induced melting paced by obliquity. During interglacial times, diatomaceous sediments indicate high surface-water productivity, minimal summer sea ice and air temperatures above freezing, suggesting an additional influence of surface melt8 under conditions of elevated CO2.

  4. Diaphragmatic pacing stimulation in spinal cord injury: anesthetic and perioperative management

    Directory of Open Access Journals (Sweden)

    Miguel L. Tedde

    2012-11-01

    Full Text Available OBJECTIVE: The standard therapy for patients with high-level spinal cord injury is long-term mechanical ventilation through a tracheostomy. However, in some cases, this approach results in death or disability. The aim of this study is to highlight the anesthetics and perioperative aspects of patients undergoing insertion of a diaphragmatic pacemaker. METHODS: Five patients with quadriplegia following high cervical traumatic spinal cord injury and ventilator-dependent chronic respiratory failure were implanted with a laparoscopic diaphragmatic pacemaker after preoperative assessments of their phrenic nerve function and diaphragm contractility through transcutaneous nerve stimulation. ClinicalTrials.gov: NCT01385384. RESULTS: The diaphragmatic pacemaker placement was successful in all of the patients. Two patients presented with capnothorax during the perioperative period, which resolved without consequences. After six months, three patients achieved continuous use of the diaphragm pacing system, and one patient could be removed from mechanical ventilation for more than 4 hours per day. CONCLUSIONS: The implantation of a diaphragmatic phrenic system is a new and safe technique with potential to improve the quality of life of patients who are dependent on mechanical ventilation because of spinal cord injuries. Appropriate indication and adequate perioperative care are fundamental to achieving better results.

  5. Self-paced brain-computer interface control of ambulation in a virtual reality environment

    Science.gov (United States)

    Wang, Po T.; King, Christine E.; Chui, Luis A.; Do, An H.; Nenadic, Zoran

    2012-10-01

    Objective. Spinal cord injury (SCI) often leaves affected individuals unable to ambulate. Electroencephalogram (EEG) based brain-computer interface (BCI) controlled lower extremity prostheses may restore intuitive and able-body-like ambulation after SCI. To test its feasibility, the authors developed and tested a novel EEG-based, data-driven BCI system for intuitive and self-paced control of the ambulation of an avatar within a virtual reality environment (VRE). Approach. Eight able-bodied subjects and one with SCI underwent the following 10-min training session: subjects alternated between idling and walking kinaesthetic motor imageries (KMI) while their EEG were recorded and analysed to generate subject-specific decoding models. Subjects then performed a goal-oriented online task, repeated over five sessions, in which they utilized the KMI to control the linear ambulation of an avatar and make ten sequential stops at designated points within the VRE. Main results. The average offline training performance across subjects was 77.2±11.0%, ranging from 64.3% (p = 0.001 76) to 94.5% (p = 6.26×10-23), with chance performance being 50%. The average online performance was 8.5±1.1 (out of 10) successful stops and 303±53 s completion time (perfect = 211 s). All subjects achieved performances significantly different than those of random walk (p prosthesis systems may be feasible.

  6. Life after PACE (Program of All-Inclusive Care for the Elderly): A retrospective/prospective, qualitative analysis of the impact of closing a nurse practitioner centered PACE site.

    Science.gov (United States)

    Meunier, Miranda J; Brant, Jeannine M; Audet, Simmy; Dickerson, Dustin; Gransbery, Karen; Ciemins, Elizabeth L

    2016-11-01

    Caring for frail older adults is a significant healthcare concern as the frailest 10% of the population account for over 70% of healthcare expenditures. Research reveals the use of comprehensive models, such as Program of All-Inclusive Care for the Elderly (PACE), leads to improved functional outcomes for participants and cost savings through decreased utilization. This study examines how closing a PACE program impacts health outcomes of previously enrolled participants. Data were collected every 6 months for 2 years via phone surveys on 34 former participants enrolled in the program at the time of the closure. The survey included questions regarding satisfaction with care, activities of daily living (ADLs), instrumental ADLs (IADLs), emergency department (ED) visits, hospitalizations, and use of home health services. Deaths and nursing home placements were monitored. Outcomes were compared during and post-PACE. Higher numbers of ED visits, hospitalizations, and nursing home placements occurred post-PACE. PACE/post-PACE differences in ADL and IADL scores were not significant, nor were death rates. Higher satisfaction existed with PACE versus non-PACE care. Comprehensive care programs such as PACE are effective in reducing healthcare utilization, thus limiting costs. Further work is required to maintain, develop, and support comprehensive models similar to PACE. ©2016 American Association of Nurse Practitioners.

  7. Variables affecting the manifestation of and intensity of pacing behavior: A preliminary case study in zoo-housed polar bears.

    Science.gov (United States)

    Cless, Isabelle T; Lukas, Kristen E

    2017-09-01

    High-speed video analysis was used to quantify two aspects of gait in 10 zoo-housed polar bears. These two variables were then examined as to how they differed in the conditions of pacing versus locomoting for each bear. Percent difference calculations measured the difference between pacing and locomoting data for each bear. We inferred that the higher the percent difference between pacing and locomoting in a given subject, the more intense the pacing may be. The percent difference values were analyzed alongside caregiver survey data defining the locations, frequency, and anticipatory nature of pacing in each bear, as well as each bear's age and sex, to determine whether any variables were correlated. The frequency and intensity of pacing behavior were not correlated. However, location of pacing was significantly correlated both with the subjects' age and whether or not the subject was classified as an anticipatory pacer. Bears appeared to select specific spots within their exhibits to pace, and the location therefore seemed tied to underlying motivation for the behavior. Additionally, bears that were classified in the survey as pacing anticipatorily displayed significantly more intense pacing behavior as quantified by gait analysis. © 2017 Wiley Periodicals, Inc.

  8. Relation of pace mapping QRS configuration and conduction delay to ventricular tachycardia reentry circuits in human infarct scars.

    Science.gov (United States)

    Stevenson, W G; Sager, P T; Natterson, P D; Saxon, L A; Middlekauff, H R; Wiener, I

    1995-08-01

    This study sought to determine the relation of the paced QRS configuration and conduction delay during pace mapping to reentry circuit sites in patients with ventricular tachycardia late after myocardial infarction. The QRS configuration produced by ventricular pacing during sinus rhythm (pace mapping) can locate focal idiopathic ventricular tachycardias during catheter mapping, but postinfarction reentry circuits may be relatively large and contain regions of slow conduction. We hypothesized that for postinfarction ventricular tachycardia, 1) pacing during sinus rhythm at reentry circuit sites distant from the exit from the scar would produce a QRS configuration different from the tachycardia; and 2) a stimulus to QRS delay during pace mapping may be a useful guide to reentry circuit slow conduction zones. Catheter mapping and ablation were performed in 18 consecutive patients with ventricular tachycardia after myocardial infarction. At 85 endocardial sites in 13 patients, 12-lead electrocardiograms (ECGs) were recorded during pace mapping, and participation of each site in a reentry circuit was then evaluated by entrainment techniques during induced ventricular tachycardia or by application of radiofrequency current. Pace maps resembled tachycardia at 40 ms was observed at > or = 70% of reentry circuit sites. At many sites in postinfarction ventricular reentry circuits, the QRS configuration during pace mapping does not resemble the ventricular tachycardia QRS complex, consistent with relatively large reentry circuits or regions of functional conduction block during ventricular tachycardia. A stimulus to QRS delay during pace mapping is consistent with slow conduction and may aid in targeting endocardial sites for further evaluation during tachycardia.

  9. A fast-start pacing strategy speeds pulmonary oxygen uptake kinetics and improves supramaximal running performance.

    Directory of Open Access Journals (Sweden)

    Tiago Turnes

    Full Text Available The focus of the present study was to investigate the effects of a fast-start pacing strategy on running performance and pulmonary oxygen uptake (VO2 kinetics at the upper boundary of the severe-intensity domain. Eleven active male participants (28±10 years, 70±5 kg, 176±6 cm, 57±4 mL/kg/min visited the laboratory for a series of tests that were performed until exhaustion: 1 an incremental test; 2 three laboratory test sessions performed at 95, 100 and 110% of the maximal aerobic speed; 3 two to four constant speed tests for the determination of the highest constant speed (HS that still allowed achieving maximal oxygen uptake; and 4 an exercise based on the HS using a higher initial speed followed by a subsequent decrease. To predict equalized performance values for the constant pace, the relationship between time and distance/speed through log-log modelling was used. When a fast-start was utilized, subjects were able to cover a greater distance in a performance of similar duration in comparison with a constant-pace performance (constant pace: 670 m±22%; fast-start: 683 m±22%; P = 0.029; subjects also demonstrated a higher exercise tolerance at a similar average speed when compared with constant-pace performance (constant pace: 114 s±30%; fast-start: 125 s±26%; P = 0.037. Moreover, the mean VO2 response time was reduced after a fast start (constant pace: 22.2 s±28%; fast-start: 19.3 s±29%; P = 0.025. In conclusion, middle-distance running performances with a duration of 2-3 min are improved and VO2 response time is faster when a fast-start is adopted.

  10. Virtual reality paced serial assessment test for neuropsychological assessment of a military cohort.

    Science.gov (United States)

    Parsons, Thomas D; Courtney, Christopher; Rizzo, Albert A; Armstrong, Christina; Edwards, Joseph; Reger, Gregory

    2012-01-01

    The assessment and treatment of traumatic brain injury (TBI) has become a difficult challenge for the DoD medical health system. Clinical neuropsychologists are being asked to make statements regarding a soldier's functional skills, ability to return to active duty, and competence in tasks of community living. Given the increasing prevalence of blast injuries to the head, and the fact that many brain injuries may have no external marker of injury, there is need for researching innovative assessment methods in detecting blast-related brain injury. To address these issues, two virtual reality-based Paced Auditory/Visual Serial Addition Tests (PA/VSAT) were developed that involve the participant being immersed in a Virtual Middle Eastern City as serial addition stimuli are presented. This study is an initial validation of the VRPASAT and VRPVSAT as assessments of neurocognitive functioning. When compared to the paper-and-pencil version of the test, as well as the Automated Neuropsychological Assessment Metrics, the VRPASAT and VRPVSAT appear to have enhanced capacity for providing an indication of a participant's performance while immersed in a military relevant simulation.

  11. Relationships between triathlon performance and pacing strategy during the run in an international competition.

    Science.gov (United States)

    Le Meur, Yann; Bernard, Thierry; Dorel, Sylvain; Abbiss, Chris R; Honnorat, Gérard; Brisswalter, Jeanick; Hausswirth, Christophe

    2011-06-01

    The purpose of the present study was to examine relationships between athlete's pacing strategies and running performance during an international triathlon competition. Running split times for each of the 107 finishers of the 2009 European Triathlon Championships (42 females and 65 males) were determined with the use of a digital synchronized video analysis system. Five cameras were placed at various positions of the running circuit (4 laps of 2.42 km). Running speed and an index of running speed variability (IRSVrace) were subsequently calculated over each section or running split. Mean running speed over the first 1272 m of lap 1 was 0.76 km·h-1 (+4.4%) and 1.00 km·h-1 (+5.6%) faster than the mean running speed over the same section during the three last laps, for females and males, respectively (P international competitions, even if high levels of motivation and direct opponents lead them to adopt an aggressive strategy.

  12. Astronomical pacing of the global silica cycle recorded in Mesozoic bedded cherts

    Science.gov (United States)

    Ikeda, Masayuki; Tada, Ryuji; Ozaki, Kazumi

    2017-06-01

    The global silica cycle is an important component of the long-term climate system, yet its controlling factors are largely uncertain due to poorly constrained proxy records. Here we present a ~70 Myr-long record of early Mesozoic biogenic silica (BSi) flux from radiolarian chert in Japan. Average low-mid-latitude BSi burial flux in the superocean Panthalassa is ~90% of that of the modern global ocean and relative amplitude varied by ~20-50% over the 100 kyr to 30 Myr orbital cycles during the early Mesozoic. We hypothesize that BSi in chert was a major sink for oceanic dissolved silica (DSi), with fluctuations proportional to DSi input from chemical weathering on timescales longer than the residence time of DSi (<~100 Kyr). Chemical weathering rates estimated by the GEOCARBSULFvolc model support these hypotheses, excluding the volcanism-driven oceanic anoxic events of the Early-Middle Triassic and Toarcian that exceed model limits. We propose that the Mega monsoon of the supercontinent Pangea nonlinearly amplified the orbitally paced chemical weathering that drove BSi burial during the early Mesozoic greenhouse world.

  13. Distractor Effect of Auditory Rhythms on Self-Paced Tapping in Chimpanzees and Humans.

    Science.gov (United States)

    Hattori, Yuko; Tomonaga, Masaki; Matsuzawa, Tetsuro

    2015-01-01

    Humans tend to spontaneously align their movements in response to visual (e.g., swinging pendulum) and auditory rhythms (e.g., hearing music while walking). Particularly in the case of the response to auditory rhythms, neuroscientific research has indicated that motor resources are also recruited while perceiving an auditory rhythm (or regular pulse), suggesting a tight link between the auditory and motor systems in the human brain. However, the evolutionary origin of spontaneous responses to auditory rhythms is unclear. Here, we report that chimpanzees and humans show a similar distractor effect in perceiving isochronous rhythms during rhythmic movement. We used isochronous auditory rhythms as distractor stimuli during self-paced alternate tapping of two keys of an electronic keyboard by humans and chimpanzees. When the tempo was similar to their spontaneous motor tempo, tapping onset was influenced by intermittent entrainment to auditory rhythms. Although this effect itself is not an advanced rhythmic ability such as dancing or singing, our results suggest that, to some extent, the biological foundation for spontaneous responses to auditory rhythms was already deeply rooted in the common ancestor of chimpanzees and humans, 6 million years ago. This also suggests the possibility of a common attentional mechanism, as proposed by the dynamic attending theory, underlying the effect of perceiving external rhythms on motor movement.

  14. Distractor Effect of Auditory Rhythms on Self-Paced Tapping in Chimpanzees and Humans.

    Directory of Open Access Journals (Sweden)

    Yuko Hattori

    Full Text Available Humans tend to spontaneously align their movements in response to visual (e.g., swinging pendulum and auditory rhythms (e.g., hearing music while walking. Particularly in the case of the response to auditory rhythms, neuroscientific research has indicated that motor resources are also recruited while perceiving an auditory rhythm (or regular pulse, suggesting a tight link between the auditory and motor systems in the human brain. However, the evolutionary origin of spontaneous responses to auditory rhythms is unclear. Here, we report that chimpanzees and humans show a similar distractor effect in perceiving isochronous rhythms during rhythmic movement. We used isochronous auditory rhythms as distractor stimuli during self-paced alternate tapping of two keys of an electronic keyboard by humans and chimpanzees. When the tempo was similar to their spontaneous motor tempo, tapping onset was influenced by intermittent entrainment to auditory rhythms. Although this effect itself is not an advanced rhythmic ability such as dancing or singing, our results suggest that, to some extent, the biological foundation for spontaneous responses to auditory rhythms was already deeply rooted in the common ancestor of chimpanzees and humans, 6 million years ago. This also suggests the possibility of a common attentional mechanism, as proposed by the dynamic attending theory, underlying the effect of perceiving external rhythms on motor movement.

  15. Left ventricular-only pacing in heart failure patients with normal atrioventricular conduction improves global function and left ventricular regional mechanics compared with biventricular pacing: an adaptive cardiac resynchronization therapy sub-study.

    Science.gov (United States)

    Burns, Kevin V; Gage, Ryan M; Curtin, Antonia E; Gorcsan, John; Bank, Alan J

    2017-10-01

    Right ventricular (RV) pacing can impair left ventricular (LV) function. When timed with native RV activation, LV-only pacing may cause greater improvements in LV function than biventricular pacing. This study compared the chronic effects of cardiac resynchronization therapy (CRT) on LV mechanics between biventricular pacing and LV-only pacing in patients with normal atrioventricular (AV) conduction. The Adaptive CRT (aCRT) algorithm provides LV-only pacing timed with native RV activation when the AV interval is normal (≤200 ms during sinus rhythm). We studied patients from the aCRT trial with normal AV conduction at their baseline visit and compared changes in cardiac function after 12 months of treatment with conventional biventricular or mostly (≥80%) LV-only pacing. Speckle tracking echocardiography was used to assess LV myocardial strain before and after treatment. Despite similar improvements in Packer's clinical composite scores and LV volumes, LV-only paced patients (n = 70) had a greater improvement in LV ejection fraction (8.5 ± 11.3% vs. 5.5 ± 10.3%, P = 0.038) and global LV radial strain (6.3 ± 8.6% vs. 4.0 ± 10.1%, P = 0.046) than those randomized to biventricular pacing (n = 91). Strain was improved to a greater extent near the RV pacing lead, in septal and apical regions (P heart failure patients with normal AV conduction, LV-only pacing timed with native RV activation may result in greater improvements in LV ejection fraction and myocardial strain compared with biventricular pacing due to better apical and septal function. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

  16. Ventricular evoked response in patients with hypertrophic obstructive cardiomyopathy treated with DDD pacing

    Directory of Open Access Journals (Sweden)

    João Ricardo M. Sant'Anna

    1999-08-01

    Full Text Available OBJECTIVE: To assess the changes in ventricular evoked responses (VER produced by the decrease in left ventricular outflow tract gradient (LVOTG in patients with hypertrophic obstructive cardiomyopathy (HOCM treated with dual-chamber (DDD pacing. METHODS: A pulse generator Physios CTM (Biotronik, Germany was implanted in 9 patients with severe drug-refractory HOCM. After implantation, the following conditions were assessed: 1 Baseline evaluation: different AV delay (ranging from 150ms to 50 ms were sequentially programmed during 5 to 10 minutes, and the LVOTG (as determined by Doppler echocardiography and VER recorded; 2 standard evaluation, when the best AV delay (resulting in the lowest LVOTG programmed at the initial evaluation was maintained so that its effect on VER and LVOTG could be assessed during each chronic pacing evaluation. RESULTS: LVOTG decreased after DDD pacing, with a mean value of 59 ± 24 mmHg after dual chamber pacemaker, which was significantly less than the gradient before pacing (98 + 22mmHg. An AV delay >100ms produced a significantly lower decrease in VER depolarization duration (VER DD when compared to an AV delay <=100ms. Linear regression analyses showed a significant correlation between the LVOTG values and the magnitude of VER (r=0.69; p<0.05 in the 9 studied patients. CONCLUSION: The telemetry obtained intramyocardial electrogram is a sensitive means to assess left ventricular dynamics in patients with HOCM treated with DDD pacing.

  17. Efficacy of Precordial Percussion Pacing Assessed in a Cardiac Standstill Microminipig Model.

    Science.gov (United States)

    Wada, Takeshi; Ohara, Hiroshi; Nakamura, Yuji; Cao, Xin; Izumi-Nakaseko, Hiroko; Ando, Kentaro; Honda, Mitsuru; Yoshihara, Katsunori; Nakazato, Yuji; Lurie, Keith G; Sugiyama, Atsushi

    2017-07-25

    Potential cardiovascular benefits of precordial percussion pacing (PPP) during cardiac standstill are unknown.Methods and Results:A cardiac standstill model in amicrominipigwas created by inducing complete atrioventricular block with a catheter ablation technique (n=7). Next, the efficacy of cardiopulmonary resuscitation by standard chest compressions (S-CPR), PPP and ventricular electrical pacing in this model were analyzed in series (n=4). To assess the mechanism of PPP, a non-selective, stretch-activated channel blocker, amiloride, was administered during PPP (n=3). Peak systolic and diastolic arterial pressures during S-CPR, PPP and ventricular electrical pacing were statistically similar. However, the duration of developed arterial pressure with PPP was comparable to that with ventricular electrical pacing, and significantly greater than that with S-CPR. Amiloride decreased the induction rate of ventricular electrical activity by PPP in a dose-related manner. Each animal survived without any neurological deficit at 24, 48 h and 1 week, even with up to 2 h of continuous PPP. In amicrominipigmodel of cardiac standstill, PPP can become a novel means to significantly improve physiological outcomes after cardiac standstill or symptomatic bradyarrhythmias in the absence of cardiac pacing. Activation of the non-selective stretch-activated channels may mediate some of the mechanophysiological effects of PPP. Further study of PPP by itself and together with S-CPR is warranted using cardiac arrest models of atrioventricular block and asystole.

  18. Atrial pacing and thallium 201 scintigraphy: combined use for diagnosis of coronary artery disease

    International Nuclear Information System (INIS)

    Stratmann, H.G.; Mark, A.L.; Walter, K.E.; Fletcher, J.W.; Williams, G.A.

    1987-01-01

    To evaluate the presence of coronary artery disease (CAD), atrial pacing and thallium 201 scintigraphy were performed in 36 patients with stable angina pectoris who were unable to perform an adequate exercise stress test. All patients underwent cardiac catheterization. Nine patients had previously undergone coronary artery bypass surgery. Significant CAD (one or more lesions greater than or equal to 50%) was present in 33 patients. Atrial pacing produced ischemic ST segment depression (greater than or equal to 1 mm) in 18 (55%) patients with CAD, and angina in 20 patients (61%). As the number of vessels with CAD increased, there was no significant change in the sensitivities of pacing-induced angina or ST segment depression for detecting CAD. In the 3 patients without CAD, ST segment depression occurred in 1 patient and angina in none. Thallium 201 scintigraphy demonstrated perfusion defects in 27 (82%) patients with CAD, with fixed defects seen in 13 studies (39%) and reversible defects in 15 (45%). In the 3 patients without CAD, no perfusion defects were seen. The thallium 201 scan successfully predicted the presence of CAD in patients with single-vessel disease but usually underestimated the number of vessels involved in patients with multivessel disease. Combined sensitivity of pacing-induced ST segment depression and an abnormal thallium 201 scan finding for detecting CAD was 91%. The authors conclude that combined atrial pacing and thallium 201 scintigraphy is a useful test for detecting CAD in patients unable to perform an adequate exercise stress test

  19. Cardiac resynchronization therapy or atrio-biventricular pacing-what should it be called?

    Science.gov (United States)

    Cleland, John G F; Nasir, Mansour; Tageldien, Ahmed

    2007-02-01

    Reduced cardiac efficiency caused by suboptimal synchronization of the heart's normal contraction might contribute to the development of or exacerbate heart failure. Conceptually and in practice cardiac dyssynchrony is complex. Recent studies have shown that atrio-biventricular pacing can improve cardiac synchrony in many patients and improve cardiac function, symptoms and exercise capacity, and reduce morbidity and mortality substantially. Randomized controlled trials, however, indicate that the severity of cardiac dyssynchrony, as conventionally measured, is a poor guide to treatment benefit and that correction of dyssynchrony accounts for only part of the benefit of atrio-biventricular pacing. Although some of the benefits of atrio-biventricular pacing might be mediated by cardiac resynchronization, much of the benefit could be mediated by mechanisms that are as yet unknown. Withholding atrio-biventricular pacing in patients who do not exhibit cardiac dyssynchrony on imaging but otherwise fulfil the entry criteria used in randomized controlled trials of this therapy could be unwise. Here, we examine the evidence that cardiac resynchronization is indeed the mechanism by which atrio-biventricular pacing exerts its effects.

  20. High Frequency ELM Pacing by Lithium Pellet Injection on DIII-D

    Science.gov (United States)

    Bortolon, A.; Maingi, R.; Mansfield, D. K.; Nagy, A.; Roquemore, A. L.; Lunsford, R.; Jackson, G. L.; Osborne, T. H.; Parks, P. B.

    2015-11-01

    Full-shot, high-frequency pacing of edge localized modes (ELM) by lithium pellet injection has been demonstrated in DIII-D. A Lithium Granule Injector (LGI), recently installed on DIII-D to study pacing efficiency dependence on granule size and velocity, was tested in different ELMy scenarios (βN = 1.2-2.0) injecting granules of nominal diameter 0.3-0.9 mm, with injection speed 50-120 m/s and injection rates up to 500 Hz. Robust ELM pacing was documented on time windows up to 3.5 s, with triggering efficiency close to 100% obtained with 0.9 mm diameter granules, lower with smaller sizes and weakly dependent on granule velocity. Paced ELM frequencies up to 100 Hz were achieved, with a 2-5 fold increase over the natural ELM frequency and a consequent reduction of divertor peak heat flux. Overall, LGI high frequency pacing appeared to be compatible with high plasma performance, in terms of global confinement and pedestal characteristics. Work supported by the US Department of Energy under DE-AC02-09CH11466, DE-FC02-04ER54698.

  1. Effect of Psychological Intervention on Marital Satisfaction of Mothers with Slow Pace Under 5 Years Children

    Directory of Open Access Journals (Sweden)

    Mehran Soleymani

    2012-04-01

    Full Text Available Objectives: Objective of this study was investigating impact of early psychological interventions on marital satisfaction of mothers with slow pace under 5 years children. Considering variables of the research, that is, early psychological interventions and marital satisfaction, research hypotheses was as follows: "early psychological interventions affect marital satisfaction of mothers with slow pace under 5 years children" and it was examined. Methods: This research is of experimental type and pretest-posttest plan with control groups was used. Statistical population included all mothers with slow pace under 5 years children in Urmia. To this end, 40 mothers with slow pace children were selected as the sample in a non-random manner by convenience sampling. They were assigned randomly into two groups of 20 (20 test group and 20 control group, and finally psychological interventions were conducted on one of groups randomly. In order to evaluate marital satisfaction, Enrich marital satisfaction questionnaire with 47 items was used. Data were analyzed by univariate analysis of covariance. Results: findings showed that there is significant difference between two groups in posttest in overall score of marital satisfaction as well as in some elements such as conventional responses, marital satisfaction, personality issues, marital relationships, conflict resolution, leisure, parenting, family and friends, and ideological orientation and sexual relations (P<0.005, and no significant difference was observed in financial supervision and roles related to gender equality. Discusion: Psychological interventions were effective in promoting marital satisfaction in mothers with slow pace under 5 years children.

  2. Deviation from goal pace, body temperature and body mass loss as predictors of road race performance.

    Science.gov (United States)

    Adams, William M; Hosokawa, Yuri; Belval, Luke N; Huggins, Robert A; Stearns, Rebecca L; Casa, Douglas J

    2017-03-01

    The purpose of this study was to examine the relationship between pacing, gastrointestinal temperature (T GI ), and percent body mass loss (%BML) on relative race performance during a warm weather 11.3km road race. Observational study of a sample of active runners competing in the 2014 Falmouth Road Race. Participants ingested a T GI pill and donned a GPS enabled watch with heart rate monitoring capabilities prior to the start of the race. Percent off predicted pace (% OFF ) was calculated for seven segments of the race. Separate linear regression analyses were used to assess the relationship between pace, T ​GI , and %BML on relative race performance. One-way ANOVA was used to analyse post race T GI (≥40°C vs Body temperature (pre race T GI and post race T GI ) was not predictive of overall finish time (p>0.05). There was a trend in a slower pace (p=0.055) and greater % OFF (p=0.056) in runners finishing the race with a T GI >40°C. Overall, finish time was influenced by greater variations in pace during the first two miles of the race. In addition, runners who minimized fluid losses and had lower T GI were associated with meeting self-predicted goals. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  3. Changes of Sympathetic Activity in Patient with Chronic Atrial Fibrillation and Severe Congestive Heart Failure Treated with Biventricular Pacing

    Directory of Open Access Journals (Sweden)

    Kohei Matsushita, MD

    2006-01-01

    Full Text Available The patient was a 64-year-old man with chronic atrial fibrillation with bradycardia. Left ventricular ejection fraction was 34%. He was treated with biventricular pacing. Heart failure improved from NYHA class III to II. Sympathetic nerve activity (SNA. was recorded during 6 minutes of biventricular (BV, right ventricular apical (RVA. and left ventricular (LV. pacing. SNA was significantly lower during biventricular pacing (49.5 ± 4.0/min. compared with RVA (58.8 ±6:9/min, p = 0.016. and LV (63.3 ± 4.3/min, p = 0.002. pacing. BV pacing improves hemodynamics and decreases SNA compared with RVA or LV pacing.

  4. Pacemaker prevention therapy in drug-refractory paroxysmal atrial fibrillation: reliability of diagnostics and effectiveness of prevention pacing therapy in Vitatron selection device.

    Science.gov (United States)

    Terranova, Paolo; Valli, Paolo; Terranova, Peppino; Dell'Orto, Simonetta; Greco, Enrico Maria

    2006-04-01

    Atrial fibrillation (AF), the most common and rising disorder of cardiac rhythm, is quite difficult to control and/or to treat. Non pharmacological therapies for AF may involve the use of dedicated pacing algorithms to detect and prevent atrial arrhythmia that could be a trigger for AF onset. Selection 900E/AF2.0 Vitatron DDDRP pacemaker (1) keeps an atrial arrhythmia diary thus providing detailed onset reports of arrhythmias of interest, (2) provides us data about the number of premature atrial contractions (PACs) and (3) plots heart rate in the 5 minutes preceding the detection of an atrial arrhythmia. Moreover, this device applies four dedicated pacing therapies to reduce the incidence of atrial arrhythmia and AF events. To analyze the reliability to record atrial arrhythmias and evaluate effectiveness of its AF preventive pacing therapies. We enrolled 15 patients (9 males and 6 females, mean age of 71+/-5 years, NYHA class I-II), with a DDDRP pacemaker implanted for a "bradycardia-tachycardia" syndrome, with advanced atrioventricular conduction disturbances. We compared the number and duration of AF episodes' stored in the device with a contemporaneous 24h Holter monitoring. After that, we switched on the atrial arrhythmias detecting algorithms, starting from an atrial rate over 180 beats per minute for at least 6 ventricular cycles, and ending with at least 10 ventricular cycles in sinus rhythm. Thereafter, in order to evaluate the possible reduction in PACs number and in number and duration of AF episodes, we tailored all the four pacing preventive algorithms. Patients were followed for 24+/-8 months (from 20 to 32 months). All 59 atrial arrhythmia episodes occurred in the first part of this trial, were correctly recorded by both systems, with a correlation coefficient (r) of 0.96. During the follow-up, we observed a significant reduction not only in PACs number (from 83+/-12/day to 2.3+/-0.8/day) but also in AF episodes (from 46+/-7/day to 0.12+/-0.03/day

  5. Pacemaker Prevention Therapy in Drug–refractory Paroxysmal Atrial Fibrillation: Reliability of Diagnostics and Effectiveness of Prevention Pacing Therapy in Vitatron™ Selection® device

    Directory of Open Access Journals (Sweden)

    Paolo Terranova

    2006-04-01

    Full Text Available Introduction. Atrial fibrillation (AF, the most common and rising disorder of cardiac rhythm, is quite difficult to control and/or to treat. Non pharmacological therapies for AF may involve the use of dedicated pacing algorithms to detect and prevent atrial arrhythmia that could be a trigger for AF onset. Selection 900E/AF2.0 Vitatron DDDRP pacemaker (1 keeps an atrial arrhythmia diary thus providing detailed onset reports of arrhythmias of interest, (2 provides us data about the number of premature atrial contractions (PACs and (3 plots heart rate in the 5 minutes preceding the detection of an atrial arrhythmia. Moreover, this device applies four dedicated pacing therapies to reduce the incidence of atrial arrhythmia and AF events. Aim of the Study. To analyze the reliability to record atrial arrhythmias and evaluate effectiveness of its AF preventive pacing therapies. Material and Methods. We enrolled 15 patients (9 males and 6 females, mean age of 71±5 years, NYHA class I–II, with a DDDRP pacemaker implanted for a “bradycardia–tachycardia” syndrome, with advanced atrioventricular conduction disturbances. We compared the number and duration of AF episodes’ stored in the device with a contemporaneous 24h Holter monitoring. After that, we switched on the atrial arrhythmias detecting algorithms, starting from an atrial rate over 180 beats per minute for at least 6 ventricular cycles, and ending with at least 10 ventricular cycles in sinus rhythm. Thereafter, in order to evaluate the possible reduction in PACs number and in number and duration of AF episodes, we tailored all the four pacing preventive algorithms. Patients were followed for 24±8 months (from 20 to 32 months. Results. All 59 atrial arrhythmia episodes occurred in the first part of this trial, were correctly recorded by both systems, with a correlation coefficient (r of 0.96. During the follow–up, we observed a significant reduction not only in PACs number (from 83±12

  6. Impact of early personal-history characteristics on the Pace of Aging: implications for clinical trials of therapies to slow aging and extend healthspan.

    Science.gov (United States)

    Belsky, Daniel W; Caspi, Avshalom; Cohen, Harvey J; Kraus, William E; Ramrakha, Sandhya; Poulton, Richie; Moffitt, Terrie E

    2017-08-01

    Therapies to extend healthspan are poised to move from laboratory animal models to human clinical trials. Translation from mouse to human will entail challenges, among them the multifactorial heterogeneity of human aging. To inform clinical trials about this heterogeneity, we report how humans' pace of biological aging relates to personal-history characteristics. Because geroprotective therapies must be delivered by midlife to prevent age-related disease onset, we studied young-adult members of the Dunedin Study 1972-73 birth cohort (n = 954). Cohort members' Pace of Aging was measured as coordinated decline in the integrity of multiple organ systems, by quantifying rate of decline across repeated measurements of 18 biomarkers assayed when cohort members were ages 26, 32, and 38 years. The childhood personal-history characteristics studied were known predictors of age-related disease and mortality, and were measured prospectively during childhood. Personal-history characteristics of familial longevity, childhood social class, adverse childhood experiences, and childhood health, intelligence, and self-control all predicted differences in cohort members' adulthood Pace of Aging. Accumulation of more personal-history risks predicted faster Pace of Aging. Because trials of anti-aging therapies will need to ascertain personal histories retrospectively, we replicated results using cohort members' retrospective personal-history reports made in adulthood. Because many trials recruit participants from clinical settings, we replicated results in the cohort subset who had recent health system contact according to electronic medical records. Quick, inexpensive measures of trial participants' early personal histories can enable clinical trials to study who volunteers for trials, who adheres to treatment, and who responds to anti-aging therapies. © 2017 The Authors. Aging Cell published by the Anatomical Society and John Wiley & Sons Ltd.

  7. An Appropriate Compression Pace is Important for Securing the Quality of Hands-only CPR : A manikin study

    OpenAIRE

    Shimizu, Yoshitaka; Tanigawa, Koichi; Ishikawa, Masami; Ouhara, Kazuhisa; Oue, Kana; Yoshinaka, Taiga; Kurihara, Hidemi; Irifune, Masahiro

    2014-01-01

    It is important to implement good quality chest compressions for cardiopulmonary resuscitation (CPR). This manikin study examined the effects of different compression rates on chest compression depth variables using a metronome sound guide. Fifty sixth-year dentistry students participated in the study. Each participant performed CPR at 3 different compression rates, 110, 100, and 90 compressions per min (pace-110-g, pace-100-g, and pace-90-g) for 2 consecutive one-minute sets with a ten-secon...

  8. Effect of atrial pacing on phase analysis in patients with the Wolff-Parkinson-White syndrome

    International Nuclear Information System (INIS)

    Magosaki, Nobuhisa; Hiroe, Michiaki; Kasanuki, Hiroshi; Ohnishi, Satoshi; Tanaka, Etsuko; Horie, Toshinobu; Kusakabe, Kiyoko; Kondo, Mizuka; Hirosawa, Koshichiro

    1984-01-01

    Phase analysis of ECG-gated radionuclide ventriculography was performed during sinus rhythm and atrial pacing for 11 patients with the Wolff-Parkinson-White (WPW) syndrome. During sinus rhythm, phase analysis demonstrated abnormal early-emptying segments reflecting preexcitation in six of the 11 patients. In the remaining five patients, the precise site of abnormal early-emptying could not be detected. Atrial pacing increased the degree of pre-exicitation, and abnormal early-emptying segments became clear in all patients. Our study demonstrated the utility of atrial pacing in performing phase analysis for patients with the WPW syndrome. Seven patients had abnormal early-emptying segments; four of them with ECG type A, in the left ventricle, and three of them with ECG type B, in the right ventricle. These results were consistent with results of the body surface and electrophysiologic mapping. In patients with posterior septal accessory pathways, phase analysis suggested probable laterality of the accessory pathway. (author)

  9. Three-Dimensional Printing for In Vivo Visualization of His Bundle Pacing Leads.

    Science.gov (United States)

    Bauch, Terry; Vijayaraman, Pugazhendhi; Dandamudi, Gopi; Ellenbogen, Kenneth

    2015-08-01

    Transvenous pacing leads have been implicated in tricuspid valve dysfunction, and our group has adopted routine use of His bundle pacing to mitigate this effect. Three-dimensional (3D) printing technology holds great promise for advancing medicine, but the high start-up costs can be a deterrent. Seeking confirmation of optimal lead placement relative to the tricuspid annulus, we used low-cost commercial and public domain technologies to generate 3D-printed hearts from selected patients with His bundle pacing leads. Our models successfully demonstrated that such lead placements avoided interference with the tricuspid valve apparatus in these cases. Future applications of 3D printing include facilitating research to minimize lead-valve interactions, understand complex cardiac anatomy, and plan complex surgical procedures. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Successful percutaneous retrieval of a leadless pacemaker due to an acute rise in pacing threshold

    Directory of Open Access Journals (Sweden)

    Ngai-yin Chan

    2017-11-01

    Full Text Available Leadless cardiac pacemakers (LCP have become available recently. Both its acute and long-term performance in a large population of patients remain to be tested. Subacute rise in pacing threshold has been reported as an uncommon complication. On the other hand, the retrieval technique for LCP with passive fixation mechanism has not been previously described in details. Herein we report a newly recognized complication of an acute rise in pacing threshold very soon after implantation of an LCP without radiographic dislodgement. Percutaneous retrieval of this LCP with passive fixation mechanism was successful using a novel technique with the cryoballoon steerable sheath and a snare. Keywords: Leadless pacemaker, Percutaneous retrieval, Pacing threshold, Bradycardia, Dislodgement

  11. Endocardial left ventricular pacing improves cardiac resynchronization therapy in chronic asynchronous infarction and heart failure models.

    Science.gov (United States)

    Strik, Marc; Rademakers, Leonard M; van Deursen, Caroline J M; van Hunnik, Arne; Kuiper, Marion; Klersy, Catherine; Auricchio, Angelo; Prinzen, Frits W

    2012-02-01

    Studies in canine hearts with acute left bundle branch block (LBBB) showed that endocardial left ventricular (LV) pacing improves the efficacy of cardiac resynchronization therapy (CRT) compared with conventional epicardial LV pacing. The present study explores the efficacy of endocardial CRT in more compromised hearts and the mechanisms of such beneficial effects. Measurements were performed in 22 dogs, 9 with acute LBBB, 7 with chronic LBBB combined with infarction (embolization; LBBB plus myocardial infarction, and concentric remodeling), and 6 with chronic LBBB and heart failure (rapid pacing, LBBB+HF, and eccentric remodeling). A head-to-head comparison was performed of the effects of endocardial and epicardial LV pacing at 8 sites. LV activation times were measured using ≈100 endocardial and epicardial electrodes and noncontact mapping. Pump function was assessed from right ventricular and LV pressures. Endocardial CRT resulted in better electric resynchronization than epicardial CRT in all models, although the benefit was larger in concentrically remodeled LBBB plus myocardial infarction than in eccentrically remodeled LBBB+HF hearts (19% versus 10%). In LBBB and LBBB+HF animals, endocardial conduction was ≈50% faster than epicardial conduction; in all models, transmural impulse conduction was ≈25% faster when pacing from the endocardium than from the epicardium. Hemodynamic effects were congruent with electric effects. Endocardial CRT improves electric synchrony of activation and LV pump function compared with conventional epicardial CRT in compromised canine LBBB hearts. This benefit can be explained by a shorter path length along the endocardium and by faster circumferential and transmural impulse conduction during endocardial LV pacing.

  12. Long-Term Outcome of Patients with Bifascicular Block and Unexplained Syncope Following Cardiac Pacing.

    Science.gov (United States)

    Kalscheur, Matthew M; Donateo, Paolo; Wenzke, Kevin E; Aste, Milena; Oddone, Daniele; Solano, Alberto; Maggi, Roberto; Croci, Francesco; Page, Richard L; Brignole, Michele; Hamdan, Mohamed H

    2016-10-01

    According to the ACC/AHA/HRS guidelines, cardiac pacing is reasonable in patients with bifascicular block (BF-B) and syncope when other causes have been excluded. The purpose of this study was to assess the long-term outcome of patients with BF-B and unexplained syncope following cardiac pacing. Between 2009 and 2015, we identified 43 consecutive patients (mean age of 78 ± 12 years, 64% males) who presented with syncope and BF-B and had received a pacemaker (PM). During a mean follow-up period of 31 ± 21 months, syncope recurred in seven patients (16%): 7% (95% standard error [SE] ± 3%) at 1 year and 18% (95% SE ± 7%) at 5 years. At univariable analysis, the only predictor of syncope recurrence was empiric pacing (P = 0.03). There were no syncope recurrences in the 12 patients who received a PM following a positive electrophysiological study (EPS) and the five patients with documentation of paroxysmal atrioventricular block (AVB) during cardiac monitoring (insertable loop recorder [ILR]), (EPS/ILR Group, n = 17) compared to seven of 26 (27%) patients who received empiric pacing (Empiric Group, n = 26; P = 0.02). Progression to high-degree AVB was documented during follow-up in 16 (37%) patients: nine of 17 (53%) patients in the EPS/ILR Group and seven of 26 (27%) patients in the Empiric Group (P = 0.11). There were no injuries reported during ILR monitoring. We have shown that syncope recurs not infrequently in patients with BF-B who received pacing for syncope. Nearly one in four patients who had empiric pacing suffered syncope recurrence compared to no recurrences in patients who received a PM following a positive EPS or documentation of transient AVB. © 2016 Wiley Periodicals, Inc.

  13. Pulsed acoustic cellular expression (PACE) reduces capsule formation around silicone implants.

    Science.gov (United States)

    Reichenberger, Matthias A; Heimer, Sina; Lass, Ulrike; Germann, Günter; Köllensperger, Eva; Mueller, Wolf; Hirsch, Tobias; Fischer, Sebastian

    2014-02-01

    Capsular contracture remains a major complication after reconstructive or aesthetic breast augmentation. Formation of capsular fibrosis is a multifactorial process. An initial inflammatory reaction appears to be key to the development of capsular contracture. Recent studies have shown that pulsed acoustic cellular expression (PACE) has significant antiinflammatory effects. Thus, this study aimed to determine the potential of PACE to prevent or attenuate capsular contracture around silicone implants in a rodent model. For this study, 36 Lewis rats were divided into two groups, and a textured silicone implant was placed in a dorsal submuscular pocket. One group received PACE treatment, whereas the other group served as the control group and received no treatment. Follow-up evaluations were performed after 10, 35, and 100 days. Capsule thickness, collagen density, myofibroblasts, vascular density, and a semiquantitative real-time polymerase chain reaction that addressed differential gene expression were assessed. The PACE treatment significantly reduced capsule thickness on days 10, 35, and 100 compared with the control group (day 10: 632.9 ± 164.5 vs 932.6 ± 160.8, p silicone implants. A decrease in capsular thickness after PACE treatment seems to be associated with a downregulation of proinflammatory genes and proteins. The study identifies PACE technology as a potential low-cost technique that is easy to use for reduction of capsular contracture after augmentation using silicone implants. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

  14. MCTS self-paced training kit (exam 70-680) configuring Windows 7

    CERN Document Server

    McLean, Ian

    2010-01-01

    NOTE: The most recent printings of this title incorporate corrections to errors found in the earlier printings. This Self-Paced Training Kit is designed to help maximize your performance on 70-680, the required exam for the Microsoft® Certified Technology Specialist (MCTS): Windows 7, Configuration certification.This 2-in-1 kit includes the official Microsoft study guide, plus practice tests on CD to help you assess your skills. It comes packed with the tools and features exam candidates want most-including in-depth, self-paced training based on final exam content; rigorous, objective-by-obj

  15. First observation of ELM pacing with vertical jogs in a spherical torus

    Science.gov (United States)

    Gerhardt, S. P.; Ahn, J.-W.; Canik, J. M.; Maingi, R.; Bell, R.; Gates, D.; Goldston, R.; Hawryluk, R.; Le Blanc, B. P.; Menard, J.; Sontag, A. C.; Sabbagh, S.; Tritz, K.

    2010-06-01

    Experiments in a number of conventional aspect ratio tokamaks have been successful in pacing edge localized modes (ELMs) by rapid vertical jogging of the plasma. This paper demonstrates the first pacing of ELMs in a spherical torus plasma. Applied 30 Hz vertical jogs synchronized the ELMs with the upward motion of the plasma. 45 Hz jogs also lead to an increase in the ELM frequency, though the synchronization of the ELMs and jogs was unclear. A reduction in the ELM energy was observed at the higher driven ELM frequencies.

  16. Metabolic Responses and Pacing Strategies during Successive Sprint Skiing Time Trials

    DEFF Research Database (Denmark)

    Andersson, Erik; Holmberg, Hans-Christer; Ørtenblad, Niels

    2016-01-01

    PURPOSE: To examine the metabolic responses and pacing strategies during the performance of successive sprint time trials (STTs) in cross-country skiing. METHODS: Ten well-trained male cross-country skiers performed four self-paced 1300-m STTs on a treadmill, each separated by 45 min of recovery....... The simulated STT course was divided into three flat (1°) sections (S1, S3 and S5) involving the double poling sub-technique interspersed with two uphill (7°) sections (S2 and S4) involving the diagonal stride sub-technique. Treadmill velocity and V˙O2 were monitored continuously and gross efficiency was used...

  17. Time perception, pacing and exercise intensity: maximal exercise distorts the perception of time

    OpenAIRE

    Edwards, A. M.; McCormick, A.

    2017-01-01

    Introduction\\ud \\ud Currently there are no data examining the impact of exercise on the perception of time, which is surprising as optimal competitive performance is dependent on accurate pacing using knowledge of time elapsed.\\ud \\ud \\ud Methods\\ud \\ud With institutional ethics approval, 12 recreationally active adult participants (f = 7, m = 5) undertook both 30 s Wingate cycles and 20 min (1200 s) rowing ergometer bouts as short and long duration self-paced exercise trials, in each of thre...

  18. Pacing in a 94-year-old runner during a 6-hour run

    OpenAIRE

    Knechtle,Beat; Nikolaidis,Pantelis T

    2018-01-01

    Beat Knechtle,1,2 Pantelis T Nikolaidis3 1Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland; 2Institute of Primary Care, University of Zurich, Zurich, Switzerland; 3Exercise Physiology Laboratory, Nikaia, Greece Abstract: It is well known that elderly people up to 90 years of age are able to finish a marathon. We have no knowledge, however, how runners at the age of 90 years or older pace during a long run. In this case report, we describe the pacing of a 94-year-old man competing in...

  19. Pacing the Cell: Walking and Productivity in the Work of Bruce Nauman

    Directory of Open Access Journals (Sweden)

    Ruth Burgon

    2016-12-01

    Full Text Available After graduating from art school in the late 1960s Bruce Nauman found himself pacing his studio, unsure how to produce work as a professional artist. Out of this practice arose several films and videos recording these performances of studio pacing. This paper draws upon Michel Foucault’s Discipline and Punish (1975, translated into English 1977 to shed light upon the aesthetic of confinement and incarceration found in Nauman’s use of the walking body in this early work.

  20. Constant DI pacing suppresses cardiac alternans formation in numerical cable models

    Science.gov (United States)

    Zlochiver, S.; Johnson, C.; Tolkacheva, E. G.

    2017-09-01

    Cardiac repolarization alternans describe the sequential alternation of the action potential duration (APD) and can develop during rapid pacing. In the ventricles, such alternans may rapidly turn into life risking arrhythmias under conditions of spatial heterogeneity. Thus, suppression of alternans by artificial pacing protocols, or alternans control, has been the subject of numerous theoretical, numerical, and experimental studies. Yet, previous attempts that were inspired by chaos control theories were successful only for a short spatial extent (implanted pacemakers, in order to reduce the risk of life-threatening arrhythmias. Future research should be conducted in order to experimentally validate these promising results.

  1. Human activities and climate variability drive fast-paced change across the world's estuarine-coastal ecosystems.

    Science.gov (United States)

    Cloern, James E; Abreu, Paulo C; Carstensen, Jacob; Chauvaud, Laurent; Elmgren, Ragnar; Grall, Jacques; Greening, Holly; Johansson, John Olov Roger; Kahru, Mati; Sherwood, Edward T; Xu, Jie; Yin, Kedong

    2016-02-01

    Time series of environmental measurements are essential for detecting, measuring and understanding changes in the Earth system and its biological communities. Observational series have accumulated over the past 2-5 decades from measurements across the world's estuaries, bays, lagoons, inland seas and shelf waters influenced by runoff. We synthesize information contained in these time series to develop a global view of changes occurring in marine systems influenced by connectivity to land. Our review is organized around four themes: (i) human activities as drivers of change; (ii) variability of the climate system as a driver of change; (iii) successes, disappointments and challenges of managing change at the sea-land interface; and (iv) discoveries made from observations over time. Multidecadal time series reveal that many of the world's estuarine-coastal ecosystems are in a continuing state of change, and the pace of change is faster than we could have imagined a decade ago. Some have been transformed into novel ecosystems with habitats, biogeochemistry and biological communities outside the natural range of variability. Change takes many forms including linear and nonlinear trends, abrupt state changes and oscillations. The challenge of managing change is daunting in the coastal zone where diverse human pressures are concentrated and intersect with different responses to climate variability over land and over ocean basins. The pace of change in estuarine-coastal ecosystems will likely accelerate as the human population and economies continue to grow and as global climate change accelerates. Wise stewardship of the resources upon which we depend is critically dependent upon a continuing flow of information from observations to measure, understand and anticipate future changes along the world's coastlines. © 2015 The Authors. Global Change Biology Published by John Wiley & Sons Ltd.

  2. Human activities and climate variability drive fast-paced change across the world's estuarine-coastal ecosystems

    Science.gov (United States)

    Cloern, James E.; Abreu, Paulo C.; Carstensen, Jacob; Chauvaud, Laurent; Elmgren, Ragnar; Grall, Jacques; Greening, Holly; Johansson, John O.R.; Kahru, Mati; Sherwood, Edward T.; Xu, Jie; Yin, Kedong

    2016-01-01

    Time series of environmental measurements are essential for detecting, measuring and understanding changes in the Earth system and its biological communities. Observational series have accumulated over the past 2–5 decades from measurements across the world's estuaries, bays, lagoons, inland seas and shelf waters influenced by runoff. We synthesize information contained in these time series to develop a global view of changes occurring in marine systems influenced by connectivity to land. Our review is organized around four themes: (i) human activities as drivers of change; (ii) variability of the climate system as a driver of change; (iii) successes, disappointments and challenges of managing change at the sea-land interface; and (iv) discoveries made from observations over time. Multidecadal time series reveal that many of the world's estuarine–coastal ecosystems are in a continuing state of change, and the pace of change is faster than we could have imagined a decade ago. Some have been transformed into novel ecosystems with habitats, biogeochemistry and biological communities outside the natural range of variability. Change takes many forms including linear and nonlinear trends, abrupt state changes and oscillations. The challenge of managing change is daunting in the coastal zone where diverse human pressures are concentrated and intersect with different responses to climate variability over land and over ocean basins. The pace of change in estuarine–coastal ecosystems will likely accelerate as the human population and economies continue to grow and as global climate change accelerates. Wise stewardship of the resources upon which we depend is critically dependent upon a continuing flow of information from observations to measure, understand and anticipate future changes along the world's coastlines.

  3. Atrial overexpression of angiotensin-converting enzyme 2 improves the canine rapid atrial pacing-induced structural and electrical remodeling. Fan, ACE2 improves atrial substrate remodeling.

    Science.gov (United States)

    Fan, Jinqi; Zou, Lili; Cui, Kun; Woo, Kamsang; Du, Huaan; Chen, Shaojie; Ling, Zhiyu; Zhang, Quanjun; Zhang, Bo; Lan, Xianbin; Su, Li; Zrenner, Bernhard; Yin, Yuehui

    2015-01-01

    The purpose of this study was to investigate whether atrial overexpression of angiotensin-converting enzyme 2 (ACE2) by homogeneous transmural atrial gene transfer can reverse atrial remodeling and its mechanisms in a canine atrial-pacing model. Twenty-eight mongrel dogs were randomly divided into four groups: Sham-operated, AF-control, gene therapy with adenovirus-enhanced green fluorescent protein (Ad-EGFP) and gene therapy with Ad-ACE2 (Ad-ACE2) (n = 7 per subgroup). AF was induced in all dogs except the Sham-operated group by rapid atrial pacing at 450 beats/min for 2 weeks. Ad-EGFP and Ad-ACE2 group then received epicardial gene painting. Three weeks after gene transfer, all animals except the Sham group underwent rapid atrial pacing for another 3 weeks and then invasive electrophysiological, histological and molecular studies. The Ad-ACE2 group showed an increased ACE2 and Angiotensin-(1-7) expression, and decreased Angiotensin II expression in comparison with Ad-EGFP and AF-control group. ACE2 overexpression attenuated rapid atrial pacing-induced increase in activated extracellular signal-regulated kinases and mitogen-activated protein kinases (MAPKs) levels, and decrease in MAPK phosphatase 1(MKP-1) level, resulting in attenuation of atrial fibrosis collagen protein markers and transforming growth factor-β1. Additionally, ACE2 overexpression also modulated the tachypacing-induced up-regulation of connexin 40, down-regulation of connexin 43 and Kv4.2, and significantly decreased the inducibility and duration of AF. ACE2 overexpression could shift the renin-angiotensin system balance towards the protective axis, attenuate cardiac fibrosis remodeling associated with up-regulation of MKP-1 and reduction of MAPKs activities, modulate tachypacing-induced ion channels and connexin remodeling, and subsequently reduce the inducibility and duration of AF.

  4. Randomized crossover comparison of right atrial appendage pacing versus interatrial septum pacing for prevention of paroxysmal atrial fibrillation in patients with sinus bradycardia.

    Science.gov (United States)

    Padeletti, L; Pieragnoli, P; Ciapetti, C; Colella, A; Musilli, N; Porciani, M C; Ricci, R; Pignalberi, C; Santini, M; Puglisi, A; Azzolini, P; Spampinato, A; Martelli, M; Capucci, A; Boriani, G; Botto, G; Proclemer, A

    2001-12-01

    New atrial pacing techniques and overdrive pacing algorithms have been introduced to prevent atrial fibrillation. This study was designed to test the hypotheses that (1) interatrial septum pacing (IASP) at the triangle of Koch would be more effective than right atrial appendage pacing (RAAP) in preventing paroxysmal atrial fibrillation (PAF) in patients with sinus bradycardia and (2) an algorithm (CAP) designed to achieve constant atrial capture would increase the efficacy of rate-responsive atrial pacing. We studied 46 patients with PAF and sinus bradycardia implanted with a DDD(R) (Medtronic Thera) pacemaker. Twenty-four patients (6.0 +/- 10.1 PAF episodes/month within 3 months before study) were randomized to RAAP and 22 patients (5.4 +/- 7.1, not significant) to IASP. Within each arm 2 randomized crossover periods of CAP-OFF and CAP-ON function were programed. The PAF episodes per month significantly decreased in the RAAP (CAP-OFF: 2.1 +/- 4.2, P <.05; CAP-ON: 1.9 +/- 3.8, P <.05) and in the IASP group (CAP-OFF: 0.2 +/- 0.5, P <.05; CAP-ON: 0.2 +/- 0.5, P <.05). Values were significantly lower in the IASP group than in the RAAP group in both CAP-OFF (0.2 +/- 0.5 vs 2.1 +/- 4.2, P <.05) and CAP-ON (0.2 +/- 0.5 vs 1.9 +/- 3.8, P <.05) conditions. PAF burden was significantly lower in the IASP than in the RAAP group in CAP-OFF (47 +/- 84 min/d vs 140 +/- 217, P <.05) and in CAP-ON (41 +/- 72 vs 193 +/- 266, P <.05) conditions. No differences were observed within each arm in PAF burden between the 2 crossover CAP programing periods. Rate-adaptive IASP at the triangle of Koch is more effective than RAAP in preventing PAF in patients with sinus bradycardia. In our sample of patients no additional clinical benefit is furnished by the CAP algorithm.

  5. Mastery-Based, Self-Paced Instruction in Foreign Languages at Ohio State University: A Report to the Profession on a Four Year Experiment in Individualized Instruction in Six Foreign Languages.

    Science.gov (United States)

    Twarog, Leon I.; Walters, E. Garrison

    1981-01-01

    Describes development and implementation of system of individualized instruction at Ohio State University at elementary level in Arabic, French, German, Latin, Russian, and Spanish. Funded by National Endowment for the Humanities, the project involved three components--teacher-assisted, mastery-based, and self-paced instruction (TAMBSPI).…

  6. The effect of uphill and downhill walking on gait parameters: A self-paced treadmill study.

    Science.gov (United States)

    Kimel-Naor, Shani; Gottlieb, Amihai; Plotnik, Meir

    2017-07-26

    It has been shown that gait parameters vary systematically with the slope of the surface when walking uphill (UH) or downhill (DH) (Andriacchi et al., 1977; Crowe et al., 1996; Kawamura et al., 1991; Kirtley et al., 1985; McIntosh et al., 2006; Sun et al., 1996). However, gait trials performed on inclined surfaces have been subject to certain technical limitations including using fixed speed treadmills (TMs) or, alternatively, sampling only a few gait cycles on inclined ramps. Further, prior work has not analyzed upper body kinematics. This study aims to investigate effects of slope on gait parameters using a self-paced TM (SPTM) which facilitates more natural walking, including measuring upper body kinematics and gait coordination parameters. Gait of 11 young healthy participants was sampled during walking in steady state speed. Measurements were made at slopes of +10°, 0° and -10°. Force plates and a motion capture system were used to reconstruct twenty spatiotemporal gait parameters. For validation, previously described parameters were compared with the literature, and novel parameters measuring upper body kinematics and bilateral gait coordination were also analyzed. Results showed that most lower and upper body gait parameters were affected by walking slope angle. Specifically, UH walking had a higher impact on gait kinematics than DH walking. However, gait coordination parameters were not affected by walking slope, suggesting that gait asymmetry, left-right coordination and gait variability are robust characteristics of walking. The findings of the study are discussed in reference to a potential combined effect of slope and gait speed. Follow-up studies are needed to explore the relative effects of each of these factors. Copyright © 2017. Published by Elsevier Ltd.

  7. Increased Complexities in Visual Search Behavior in Skilled Players for a Self-Paced Aiming Task

    Directory of Open Access Journals (Sweden)

    Jingyi S. Chia

    2017-06-01

    Full Text Available The badminton serve is an important shot for winning a rally in a match. It combines good technique with the ability to accurately integrate visual information from the shuttle, racket, opponent, and intended landing point. Despite its importance and repercussive nature, to date no study has looked at the visual search behaviors during badminton service in the singles discipline. Unlike anticipatory tasks (e.g., shot returns, the serve presents an opportunity to explore the role of visual search behaviors in movement control for self-paced tasks. Accordingly, this study examined skill-related differences in visual behavior during the badminton singles serve. Skilled (n = 12 and less skilled (n = 12 participants performed 30 serves to a live opponent, while real-time eye movements were captured using a mobile gaze registration system. Frame-by-frame analyses of 662 serves were made and the skilled players took a longer preparatory time before serving. Visual behavior of the skilled players was characterized by significantly greater number of fixations on more areas of interest per trial than the less skilled. In addition, the skilled players spent a significantly longer time fixating on the court and net, whereas the less skilled players found the shuttle to be more informative. Quiet eye (QE duration (indicative of superior sports performance however, did not differ significantly between groups which has implications on the perceived importance of QE in the badminton serve. Moreover, while visual behavior differed by skill level, considerable individual differences were also observed especially within the skilled players. This augments the need for not just group-level analyses, but individualized analysis for a more accurate representation of visual behavior. Findings from this study thus provide an insight to the possible visual search strategies as players serve in net-barrier games. Moreover, this study highlighted an important aspect of

  8. Automated Electrophysiology Makes the Pace for Cardiac Ion Channel Safety Screening

    Directory of Open Access Journals (Sweden)

    Clemens eMoeller

    2011-11-01

    Full Text Available The field of automated patch-clamp electrophysiology has emerged from the tension between the pharmaceutical industry’s need for high-throughput compound screening versus its need to be conservative due to regulatory requirements. On the one hand, hERG channel screening was increasingly requested for new chemical entities, as the correlation between blockade of the ion channel coded by hERG and Torsades de Pointes cardiac arrhythmia gained increasing attention. On the other hand, manual patch-clamping, typically quoted as the gold-standard for understanding ion channel function and modulation, was far too slow (and, consequently, too expensive for keeping pace with the numbers of compounds submitted for hERG channel investigations from pharmaceutical R&D departments. In consequence it became more common for some pharmaceutical companies to outsource safety pharmacological investigations, with a focus on hERG channel interactions. This outsourcing has allowed those pharmaceutical companies to build up operational flexibility and greater independence from internal resources, and allowed them to obtain access to the latest technological developments that emerged in automated patch-clamp electrophysiology – much of which arose in specialized biotech companies. Assays for nearly all major cardiac ion channels are now available by automated patch-clamping using heterologous expression systems, and recently, automated action potential recordings from stem-cell derived cardiomyocytes have been demonstrated. Today, most of the large pharmaceutical companies have acquired automated electrophysiology robots and have established various automated cardiac ion channel safety screening assays on these, in addition to outsourcing parts of their needs for safety screening.

  9. Effects of radiant heat exposure on pacing pattern during a 15-km cycling time trial

    NARCIS (Netherlands)

    Levels, K.; de Koning, J.J.; Broekhuijzen, I.; Zwaan, T.; Foster Jr., C.C.; Daanen, H.A.M.

    2014-01-01

    The goal of this study was to investigate the effects of different durations of skin temperature manipulation on pacing patterns and performance during a 15-km cycling time trial. Nineteen well-trained men completed three 15-km cycling time trials in 18°C and 50% relative humidity with 4.5-km

  10. Self-Paced Physics, Documentation Report, Test Item Bank 5.3.

    Science.gov (United States)

    New York Inst. of Tech., Old Westbury.

    As a supplement to the principal reports, a compilation of criterion check items and diagnostic test items identified by terminal objectives is presented in this document relating to the U. S. Naval Academy Self-Paced Physics Course. Included are a progress check item bank, student terminal objective key sheets, quarterly diagnostic tests and…

  11. Atrial electromechanical cycle length mapping in paced canine hearts in vivo.

    Science.gov (United States)

    Costet, Alexandre; Bunting, Ethan; Grondin, Julien; Gambhir, Alok; Konofagou, Elisa E

    2015-07-01

    Atrial arrhythmias affect millions of people worldwide. Characterization and study of arrhythmias in the atria in the clinic is currently performed point by point using mapping catheters capable of generating maps of the electrical activation rate or cycle length. In this paper, we describe a new ultrasound-based mapping technique called electromechanical cycle length mapping (ECLM) capable of estimating the electromechanical activation rate, or cycle length, i.e., the rate of the mechanical activation of the myocardium which follows the electrical activation. ECLM relies on frequency analysis of the incremental strain within the atria and can be performed in a single acquisition. ECLM was validated in a canine model paced from the left atrial appendage, against pacing rates within the reported range of cycle lengths previously measured during atrial arrhythmias such as atrial fibrillation. Correlation between the global estimated electromechanical cycle lengths and pacing rates was shown to be excellent (slope = 0.983, intercept = 3.91, r(2) = 0.9999). The effect of the number of cardiac cycles on the performance of ECLM was also investigated and the reproducibility of ECLM was demonstrated (error between consecutive acquisitions for all pacing rates: 6.3 ± 4.3%). These findings indicate the potential of ECLM for noninvasively characterizing atrial arrhythmias and provide feedback on the treatment planning of catheter ablation procedures in the clinic.

  12. Managing after-work stress: paced breathing while watching video content (abstract)

    NARCIS (Netherlands)

    Tijs, T.J.W.; Weda, J.; Weffers-Albu, M.A.; Hoogenstraaten, W.

    2011-01-01

    Objectives. After a hard day’s work, we need to recover from work stress. Two frequently reported activities to relieve stress are television (TV) watching and paced breathing exercises. We investigated the potential of combining these techniques. Method. Two explorativeexperiments were conducted.

  13. Pacing Strategy, Muscle Fatigue and Technique in 1500m Speed Skating and Cycling Time-Trials

    NARCIS (Netherlands)

    Stoter, Inge K; MacIntosh, Brian R; Fletcher, Jared R; Pootz, Spencer; Zijdewind, Inge; Hettinga, Florentina J

    2016-01-01

    PURPOSE: To evaluate pacing behavior and peripheral and central contributions to muscle fatigue in 1500m speed skating and cycling time-trials, when a faster or slower start is instructed. METHODS: Nine speed skaters and nine cyclists, all competing at regional or national level, performed two 1500m

  14. Percutaneous Retrieval of a Pulmonary Artery Catheter Knot in Pacing Electrodes

    International Nuclear Information System (INIS)

    Valenzuela-Garcia, Luis Felipe; Almendro-Delia, Manuel; Gonzalez-Valdayo, Miguel; Munoz-Campos, Juan; Dorado-Garcia, Jose C.; Gomez-Rosa, Francisco; Vazquez-Garcia, Rafael; Calderon-Leal, Jose M.

    2007-01-01

    To illustrate a successful approach to resolving a pulmonary artery catheter knot in the pacing leads of a cardiac resynchronization device. When planning invasive monitoring for patients having right chamber electrodes, fluoroscopic-guided catheter insertion and extraction is advisable. In the event of coiling or knotting, an interventional radiologist should be contacted as soon as possible to avoid serious complications

  15. Sequential Atrioventricular Pacing in Patients With Hypertrophic Cardiomyopathy: An 18-year Experience.

    Science.gov (United States)

    Jurado Román, Alfonso; Montero Cabezas, José M; Rubio Alonso, Belén; García Tejada, Julio; Hernández Hernández, Felipe; Albarrán González-Trevilla, Agustín; Velázquez Martín, María T; Coma Samartín, Raúl; Rodríguez García, Jesús; Tascón Pérez, Juan C

    2016-04-01

    Controversy persists regarding the role of sequential atrioventricular pacing in patients with obstructive hypertrophic cardiomyopathy and disabling symptoms. The aim of this study was to evaluate the effect of pacing on symptoms, dynamic gradient, and left ventricular function in patients with hypertrophic cardiomyopathy. From 1991 to 2009, dual-chamber pacemakers were implanted in 82 patients with obstructive hypertrophic cardiomyopathy and disabling symptoms despite optimal medical therapy. Sequential pacing was performed with a short atrioventricular delay. Clinical and echocardiographic parameters were measured before and immediately after implantation and after a long follow-up (median, 8.5 years [range, 1-18 years]). The New York Heart Association functional class was immediately reduced after pacemaker implantation in 95% of patients (P hypertrophic cardiomyopathy improves functional class and reduces dynamic gradient and mitral regurgitation immediately after pacemaker implantation and at final follow-up. Prolonged ventricular pacing has no negative effects on systolic or diastolic function in these patients. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  16. The effect of work pace on workload, motor variability and fatigue during simulated light assembly work

    NARCIS (Netherlands)

    Bosch, T.; Mathiassen, S.E.; Visser, B.; Looze, M.D. de; Dieën, J.V. van

    2011-01-01

    This study investigated the effect of work pace on workload, motor variability and fatigue during light assembly work. Upper extremity kinematics and electromyography (EMG) were obtained on a cycle-to-cycle basis for eight participants during two conditions, corresponding to "normal" and "high" work

  17. Risk of heart failure- and cardiac death gradually increases with more right ventricular pacing

    NARCIS (Netherlands)

    Udo, Erik O.; van Hemel, Norbert M.; Zuithoff, Nicolaas P. A.; Doevendans, Pieter A.; Moons, Karel G. M.

    2015-01-01

    Background: Right ventricular pacing (RVP) is associated with an increased risk of heart failure (HF) events. However, the extent and shape of this association is hardly assessed. Objective: We quantified whether the undesired effects of RVP are confirmed in an unselected population of first

  18. Effects of wind application on thermal perception and self-paced performance

    NARCIS (Netherlands)

    Teunissen, L.P.J.; Haan, A. de; Koning, J.J. de; Daanen, H.A.M.

    2013-01-01

    Physiological and perceptual effects of wind cooling are often intertwined and have scarcely been studied in self-paced exercise. Therefore, we aimed to investigate (1) the independent perceptual effect of wind cooling and its impact on performance and (2) the responses to temporary wind cooling

  19. Mobitz type I atrio-ventricular block in dengue myocarditis, requiring temporary pacing

    Directory of Open Access Journals (Sweden)

    S. de Mel

    2015-01-01

    Full Text Available We present a case of dengue myocarditis related Mobitz type I atrio-ventricular (A-V block. To our knowledge, this is the first report of such a patient requiring pacing. An early response to methylprednisolone suggests the possibility of a therapeutic role for steroids in these patients.

  20. Mobitz type I atrio-ventricular block in dengue myocarditis, requiring temporary pacing.

    Science.gov (United States)

    de Mel, S; Mowjood, R; Kapuruge, L; de Mel, C; Path, D

    2015-01-01

    We present a case of dengue myocarditis related Mobitz type I atrio-ventricular (A-V) block. To our knowledge, this is the first report of such a patient requiring pacing. An early response to methylprednisolone suggests the possibility of a therapeutic role for steroids in these patients.

  1. Increased diagnostic contribution of heart rate variability at 0.1Hz paced breathing

    Czech Academy of Sciences Publication Activity Database

    Jurák, Pavel; Halámek, Josef; Somers, V. K.; Nykodým, J.; Leinveber, P.; Fráňa, P.; Eisenberger, M.; Kára, T.

    2005-01-01

    Roč. 4, č. 1 (2005), s. 95 [World Congress on Heart Disease - New Trends in Research, Diagnosis and Treatment /12./. 16.07.2005-19.07.2005, Vancouver] R&D Projects: GA ČR(CZ) GA102/05/0402 Keywords : paced breathing * HRV * ICD Subject RIV: FS - Medical Facilities ; Equipment

  2. Trasformare luoghi di guerra in luoghi di pace: Appeace: War Places/Peace Citizens

    Directory of Open Access Journals (Sweden)

    Elisa Gardini

    2015-07-01

    Full Text Available Il progetto triennale Appeace: War Places/Peace Citizens è partito da Montescudo, nell'entroterra riminese, con l’intento di trasformare una rete europea di luoghi di guerra, feriti dal passaggio dei conflitti bellici del Novecento, in una memoria condivisa e improntata a una cultura di pace.

  3. Language switch costs in sentence comprehension depend on language dominance: Evidence from self-paced reading

    NARCIS (Netherlands)

    Bultena, S.S.; Dijkstra, A.F.J.; Hell, J.G. van

    2015-01-01

    This study investigated two prominent issues in the comprehension of language switches. First, how does language switching direction affect switch costs in sentence context? Second, are switch costs modulated by L2 proficiency and cross-linguistic activation? We conducted a self-paced reading task

  4. On the pace of fertility decline in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    David Shapiro

    2017-10-01

    Full Text Available Background: This descriptive finding examines the comparative pace of fertility decline in sub-Saharan Africa, relative to Asia, Latin America and the Caribbean, and Northern Africa. Objective: We seek to determine if fertility decline has been slower in sub-Saharan Africa than elsewhere in the developing world. Methods: United Nations 2017 estimates of national fertility are used in assessing the comparative pace of fertility decline, and the four regions are compared in terms of how far they are into their fertility transition. Results: The data shows clearly that fertility decline in sub-Saharan Africa, still at a comparatively early stage, has been considerably slower than the earlier declines in Asia, Latin America and the Caribbean, and Northern Africa at comparable stages of the transition, and displays less within-region heterogeneity than the transitions in these other regions. Conclusions: The slower pace of fertility decline in sub-Saharan Africa, in conjunction with the high current fertility levels in the region, means that in the absence of policies seeking to accelerate fertility decline, sub-Saharan Africa will continue to experience rapid population growth that in turn will constrain its development. Contribution: Presentation of data in a novel way (Figures 2‒4, and associated calculations unambiguously demonstrates the slow pace of fertility decline in sub-Saharan Africa compared with other regions of the world.

  5. Determination of optimal pacing strategy in track cycling with an energy flow model

    NARCIS (Netherlands)

    de Koning, J.J.; Bobbert, M.F.; Foster, C.

    1999-01-01

    The purpose of this study was to investigate the effect of pacing strategies on performance times in the 1000 m time trial event and the 4000 m pursuit event in track cycling. For this purpose, we simulated these events with a model based on the flow of energy in cycling. Different strategies in

  6. Causes and implications of the slow pace of technology transfer and ...

    African Journals Online (AJOL)

    The study was set up to examine the causes and implication of slow pace of technology transfer and adoption in rural agriculture. Based on this major objective, the paper among other specific objectives, examines the role of extension agent in technology transfer and adoption, identify factor militating against technology ...

  7. VDDR pacing after His-bundle ablation for paroxysmal atrial fibrillation : A pilot study

    NARCIS (Netherlands)

    Buys, EM; van Hemel, NM; Jessurun, ER; Bakema, L; Kingma, JH

    1998-01-01

    His-bundle ablation followed by pacemaker implantation is today a widely accepted therapeutic choice when drug refractoriness of symptomatic AF is evident. The selection of pacing mode in patients suffering from paroxysmal AF is still controversial. Preservation of AV synchrony is an attractive

  8. PACE VII. Curriculum Counts: Planning for Success through Developmentally Appropriate Movement Activities.

    Science.gov (United States)

    Indiana State Dept. of Education, Indianapolis.

    This volume contains summaries of 13 presentations at the PACE (Positive Approaches to Children's Education) conference. The titles are: "Fabulous Fitness Fun" (Deborah L. Arfman); "Manipulative Equipment Modified for Success" (Noel Bewley); "Fitness Play-Focus on Fun" (Noel Bewley); "Keeping Them All Moving:…

  9. Constitutive innate immunity is a component of the pace-of-life syndrome in tropical birds

    NARCIS (Netherlands)

    Tieleman, BI; Williams, JB; Ricklefs, RE; Klasing, KC; Williams, Joseph B.; Ricklefs, Robert E.; Klasing, Kirk C.

    2005-01-01

    We studied the relationship between one component of immune function and basal metabolic rate (BMR), an indicator of the 'pace-of-life syndrome', among 12 tropical bird species and among individuals of the tropical house wren (Troglodytes aedon), to gain insights into functional connections between

  10. The effect of slow-paced breathing on stress management in adolescents with intellectual disability.

    Science.gov (United States)

    Laborde, S; Allen, M S; Göhring, N; Dosseville, F

    2017-06-01

    Intellectual disabilities often create a state of chronic stress for both the person concerned and their significant others (family, caregivers). The development of stress management methods is therefore important for the reduction of stress in persons with intellectual disability. The aim of this experiment was to investigate the effect of slow-paced breathing on stress symptoms experienced by adolescents with intellectual disabilities during a cognitive task under time pressure. Fourteen adolescents with intellectual disabilities (M age  = 17.39 years, range 15-19 years) took part in two laboratory sessions - a slow-paced breathing session (experimental condition) and an audiobook session (control condition) - the order of which was counterbalanced across participants. Vagal tone was measured through heart rate variability to index stress management. No difference in vagal tone was observed at baseline between experimental and control conditions. Compared with the control condition, vagal tone was significantly higher during the experimental condition. The slow-paced breathing task enhanced stress management to a greater extent than did listening to an audiobook. Slow-paced breathing seems to be an easy to learn stress management technique that appears as an effective auxiliary method of lowering stress in adolescents with intellectual disabilities. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  11. Pacing and Self-regulation : Important Skills for Talent Development in Endurance Sports

    NARCIS (Netherlands)

    Elferink-Gemser, Marije T.; Hettinga, Florentine J.

    Pacing has been characterized as a multifaceted goal-directed process of decision making in which athletes need to decide how and when to invest their energy during the race, a process essential for optimal performance. Both physiological and psychological characteristics associated with adequate

  12. 1998 survey of cardiac pacing in South Africa report of the working ...

    African Journals Online (AJOL)

    1998 survey of cardiac pacing in South Africa report of the working group on registries of the Cardiac Arrhythmia Society of South Africa (CASSA). RN Scott Millar. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals ...

  13. Keeping Pace with K-12 Digital Learning: An Annual Review of Policy and Practice. Eleventh Edition

    Science.gov (United States)

    Watson, John; Pape, Larry; Murin, Amy; Gemin, Butch; Vashaw, Lauren

    2014-01-01

    "Keeping Pace with K-12 Digital Learning" (2014) is the 11th in a series of annual reports that began in 2004 that examine the status of K-12 online education across the country. The report provides an overview of the latest policies, practices, and trends affecting online learning programs across all 50 states. It summarizes that at a…

  14. The pace of vocabulary growth during preschool predicts cortical structure at school age.

    Science.gov (United States)

    Asaridou, Salomi S; Demir-Lira, Özlem Ece; Goldin-Meadow, Susan; Small, Steven L

    2017-04-01

    Children vary greatly in their vocabulary development during preschool years. Importantly, the pace of this early vocabulary growth predicts vocabulary size at school entrance. Despite its importance for later academic success, not much is known about the relation between individual differences in early vocabulary development and later brain structure and function. Here we examined the association between vocabulary growth in children, as estimated from longitudinal measurements from 14 to 58 months, and individual differences in brain structure measured in 3rd and 4th grade (8-10 years old). Our results show that the pace of vocabulary growth uniquely predicts cortical thickness in the left supramarginal gyrus. Probabilistic tractography revealed that this region is directly connected to the inferior frontal gyrus (pars opercularis) and the ventral premotor cortex, via what is most probably the superior longitudinal fasciculus III. Our findings demonstrate, for the first time, the relation between the pace of vocabulary learning in children and a specific change in the structure of the cerebral cortex, specifically, cortical thickness in the left supramarginal gyrus. They also highlight the fact that differences in the pace of vocabulary growth are associated with the dorsal language stream, which is thought to support speech perception and articulation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Freely-Paced Walking In Healthy Adults Does Not Meet Minimum ...

    African Journals Online (AJOL)

    Walking is a very popular form of physical activity and a brisk walking pace is often advised as a form of exercise. However, in order for exercise to enhance fitness it should be of sufficient intensity to elicit at least 50% of maximal oxygen consumption (VO2max) and it is not known if a brisk walk in healthy adults elicits this ...

  16. Causes and implications of the slow pace of technology transfer and ...

    African Journals Online (AJOL)

    The slow pace of technology transfer and adoption were also found to have negative implication in rural agriculture and the nation's economy as a whole because of the resultant low agricultural productivity. Based on these, the paper therefore concluded by recommending that Agricultural Extension Research Liaison ...

  17. The Post-Myocardial Infarction Pacing Remodeling Prevention Therapy (PRomPT) Trial

    DEFF Research Database (Denmark)

    Chung, Eugene S; Fischer, Trent M; Kueffer, Fred

    2015-01-01

    adverse post-MI remodeling. Up to 120 subjects with peak creatine phosphokinase >3,000 U/L (or troponin T >10 μg/L) at time of MI will be randomized to either dual-site or single-site biventricular pacing with the left ventricular lead implanted in a peri-infarct region or to a nonimplanted control group...

  18. Lessons in Commercial PACE Leadership: The Path from Legislation to Launch

    Energy Technology Data Exchange (ETDEWEB)

    Leventis, G; Schwartz, LC; Kramer, C; Deason, J

    2018-02-27

    Nonresidential buildings are responsible for over a quarter of primary energy consumption in the United States. Efficiency improvements in these buildings could result in significant energy and utility bill savings. To unlock those potential savings, a number of market barriers to energy efficiency must be addressed. Commercial Property Assessed Clean Energy (C-PACE) financing programs can help overcome several of these barriers with minimal investment from state and local governments. With programs established or under development in 22 states, and at least $521 million in investments so far, other state and local governments are interested in bringing the benefits of C-PACE to their jurisdictions. Lessons in Commercial PACE Leadership: The Path from Legislation to Launch, aims to fast track the set-up of C-PACE programs for state and local governments by capturing the lessons learned from leaders. The report examines the list of potential program design options and important decision points in setting up a C-PACE program, tradeoffs for available options, and experiences of stakeholders that have gone through (or are going through) the process. C-PACE uses a voluntary special property assessment to facilitate energy and other improvements in commercial buildings. For example: - Long financing terms under C-PACE can produce cash flow-positive -- projects to help overcome a focus on short paybacks. - Payment obligations can transfer to subsequent owners, mitigating concern about investing in improvements for a building that may be sold before the return on the investment is fully realized. - 100% of both hard and soft costs can be financed. To capture the benefits of C-PACE financing, state and local governments must navigate numerous decision points and engage with stakeholders to set-up or join a program. Researchers interviewed experts (including state and local sponsors, program administrators, capital providers and industry experts) on their lessons learned and

  19. PACE: A dynamic programming algorithm for hardware/software partitioning

    DEFF Research Database (Denmark)

    Knudsen, Peter Voigt; Madsen, Jan

    1996-01-01

    with a hardware area constraint and the problem of minimizing hardware area with a system execution time constraint. The target architecture consists of a single microprocessor and a single hardware chip (ASIC, FPGA, etc.) which are connected by a communication channel. The algorithm incorporates a realistic...

  20. Estimation of the effects of multipoint pacing on battery longevity in routine clinical practice.

    Science.gov (United States)

    Akerström, Finn; Narváez, Irene; Puchol, Alberto; Pachón, Marta; Martín-Sierra, Cristina; Rodríguez-Mañero, Moisés; Rodríguez-Padial, Luis; Arias, Miguel A

    2017-09-23

    Multipoint pacing (MPP) permits simultaneous multisite pacing of the left ventricle (LV); initial studies suggest haemodynamic and clinical benefits over conventional (single LV site) cardiac resynchronization therapy (CRT). The aim of this study was to estimate the impact of MPP activation on battery longevity in routine clinical practice. Patient (n = 46) and device data were collected from two centres at least 3 months after MPP-CRT device implantation. Multipoint pacing programming was based on the maximal possible anatomical LV1/LV2 separation according to three predefined LV pacing capture threshold (PCT) cut-offs (≤1.5 V; ≤4.0 V; and ≤6.5 V). Estimated battery longevity was calculated using the programmed lower rate limit, lead impedances, outputs, and pacing percentages. Relative to the longevity for conventional CRT using the lowest PCT (8.9 ± 1.2 years), MPP activation significantly shortened battery longevity for all three PCT cut-offs (≤1.5 V, -5.6%; ≤4.0 V, -16.9%; ≤6.5 V, -21.3%; P's battery longevity was significantly shortened for the MPP ≤ 4.0 V and ≤6.5 V cut-offs (-10.8 and -15.7%, respectively; P's battery longevity compared with that for conventional CRT configuration. When reasonable MPP LV vector PCTs (≤4.0 V) are achieved, the decrease in battery longevity is relatively small which may prompt the clinician to activate MPP.

  1. The Downside of Downtime: The Prevalence and Work Pacing Consequences of Idle Time at Work.

    Science.gov (United States)

    Brodsky, Andrew; Amabile, Teresa M

    2018-01-22

    Although both media commentary and academic research have focused much attention on the dilemma of employees being too busy, this paper presents evidence of the opposite phenomenon, in which employees do not have enough work to fill their time and are left with hours of meaningless idle time each week. We conducted six studies that examine the prevalence and work pacing consequences of involuntary idle time. In a nationally representative cross-occupational survey (Study 1), we found that idle time occurs frequently across all occupational categories; we estimate that employers in the United States pay roughly $100 billion in wages for time that employees spend idle. Studies 2a-3b experimentally demonstrate that there are also collateral consequences of idle time; when workers expect idle time following a task, their work pace declines and their task completion time increases. This decline reverses the well-documented deadline effect, producing a deadtime effect, whereby workers slow down as a task progresses. Our analyses of work pace patterns provide evidence for a time discounting mechanism: workers discount idle time when it is relatively distant, but act to avoid it increasingly as it becomes more proximate. Finally, Study 4 demonstrates that the expectation of being able to engage in leisure activities during posttask free time (e.g., surfing the Internet) can mitigate the collateral work pace losses due to idle time. Through examination and discussion of the effects of idle time at work, we broaden theory on work pacing. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  2. Remote Sensing Ocean Color Observations from NASA's PACE Mission: Applications and Societal Benefits

    Science.gov (United States)

    Tzortziou, M.; Omar, A. H.; Turner, W.

    2014-12-01

    The PACE (Pre- Aerosol, Clouds and ocean Ecosystems) mission is a strategic Climate Continuity mission, included in NASA's 2010 plan: "Responding to the Challenge of Climate and Environmental Change: NASA's Plan for a Climate-Centric Architecture for Earth Observations and Applications from Space". On a polar orbit, PACE will make climate-quality global measurements that are essential for understanding ocean biology, biogeochemistry and ecology, and determining how the ocean's role in global biogeochemical cycling and ocean ecology both affects and is affected by climate change. With advanced global remote sensing capabilities that include high spectral-resolution imaging, extended spectral coverage to the UV and SWIR, improved spatial resolution in inland, estuarine and coastal waters, enhanced atmospheric correction and higher signal-to-noise, PACE is expected to provide high quality observations that, over the long-term, will contribute to an extended time series of records on inland, coastal, and ocean ecosystems—all of which have substantial value beyond basic science and research. The combination of climate-quality, global atmospheric and oceanic observations provided by the PACE mission will provide a unique capability to help understand changes that affect our ecosystem services, implement science-based management strategies of coastal, marine and inland aquatic resources, and support assessments, policy analyses, and design approaches to plan adaptation and responses to impacts of climate change. Here we discuss the PACE applications program, the new capabilities afforded by this future satellite mission, and how they could potentially advance applications across a range of areas, including Oceans, Climate, Water Resources, Ecological Forecasting, Disasters, Human Health and Air Quality.

  3. Prevalence of conduction delay of the right atrium in patients with SSS: implications for pacing site selection.

    Science.gov (United States)

    Verlato, Roberto; Zanon, Francesco; Bertaglia, Emanuele; Turrini, Pietro; Baccillieri, Maria Stella; Baracca, Enrico; Bongiorni, Maria Grazia; Zampiero, Aldo; Zonzin, Pietro; Pascotto, Pietro; Venturini, Diego; Corbucci, Giorgio

    2007-09-01

    To evaluate the prevalence of severe right atrial conduction delay in patients with sinus node dysfunction (SND) and atrial fibrillation (AF) and the effects of pacing in the right atrial appendage (RAA) and in the inter-atrial septum (IAS). Forty-two patients (15 male, 72 +/- 7 years) underwent electrophysiologic study to measure the difference between the conduction time from RAA to coronary sinus ostium during stimulation at 600 ms and after extrastimulus (DeltaCTos). Patients were classified as group A if DeltaCTos > 60 ms and group B if IAS pacing and algorithms ON/OFF. Fifteen patients (36%, group A) had DeltaCTos = 76 +/- 11 ms and 27 patients (64%, group B) had DeltaCTos = 36 +/- 20 ms. Twenty-two patients were paced at the RAA and 20 at the IAS. During the study, no AF recurrences were reported in 11 of 42 (26%) patients, independently of RAA or IAS pacing. Patients from group A and RAA pacing had 0.79 +/- 0.81 episodes of AF/day during DDD, which increased to 1.52 +/- 1.41 episodes of AF/day during DDDR + Alg (P = 0.046). Those with IAS pacing had 0.5 +/- 0.24 episodes of AF/day during DDD, which decreased to 0.06 +/- 0.08 episodes of AF/day during DDDR + Alg (P = 0.06). In group B, no differences were reported between pacing sites and pacing modes. Severe right atrial conduction delay is present in one-third of patients with SND and AF: continuous pacing at the IAS is superior to RAA for AF recurrences. In patients without severe conduction delay, no differences between pacing site or mode were observed.

  4. Is right ventricular mid-septal pacing superior to apical pacing in patients with high degree atrio-ventricular block and moderately depressed left ventricular function?*

    Science.gov (United States)

    Chen, Kang; Mao, Ye; Liu, Shao-hua; Wu, Qiong; Luo, Qing-zhi; Pan, Wen-qi; Jin, Qi; Zhang, Ning; Ling, Tian-you; Chen, Ying; Gu, Gang; Shen, Wei-feng; Wu, Li-qun

    2014-01-01

    Objective: We are aimed to investigate whether right ventricular mid-septal pacing (RVMSP) is superior to conventional right ventricular apical pacing (RVAP) in improving clinical functional capacity and left ventricular ejection fraction (LVEF) for patients with high-degree atrio-ventricular block and moderately depressed left ventricle (LV) function. Methods: Ninety-two patients with high-degree atrio-ventricular block and moderately reduced LVEF (ranging from 35% to 50%) were randomly allocated to RVMSP (n=45) and RVAP (n=47). New York Heart Association (NYHA) functional class, echocardiographic LVEF, and distance during a 6-min walk test (6MWT) were determined at 18 months after pacemaker implantation. Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured using an enzyme-linked immunosorbent assay (ELISA) kit. Results: Compared with baseline, NYHA functional class remained unchanged at 18 months, distance during 6MWT (485 m vs. 517 m) and LVEF (36.7% vs. 41.8%) were increased, but BNP levels were reduced (2352 pg/ml vs. 710 pg/ml) in the RVMSP group compared with those in the RVAP group, especially in patients with LVEF 35%–40% (for all comparisons, P<0.05). However, clinical function capacity and LV function measurements were not significantly changed in patients with RVAP, despite the pacing measurements being similar in both groups, such as R-wave amplitude and capture threshold. Conclusions: RVMSP provides a better clinical utility, compared with RVAP, in patients with high-degree atrioventricular block and moderately depressed LV function whose LVEF levels ranged from 35% to 40%. PMID:24903987

  5. Is right ventricular mid-septal pacing superior to apical pacing in patients with high degree atrio-ventricular block and moderately depressed left ventricular function?

    Science.gov (United States)

    Chen, Kang; Mao, Ye; Liu, Shao-hua; Wu, Qiong; Luo, Qing-zhi; Pan, Wen-qi; Jin, Qi; Zhang, Ning; Ling, Tian-you; Chen, Ying; Gu, Gang; Shen, Wei-feng; Wu, Li-qun

    2014-06-01

    We are aimed to investigate whether right ventricular mid-septal pacing (RVMSP) is superior to conventional right ventricular apical pacing (RVAP) in improving clinical functional capacity and left ventricular ejection fraction (LVEF) for patients with high-degree atrio-ventricular block and moderately depressed left ventricle (LV) function. Ninety-two patients with high-degree atrio-ventricular block and moderately reduced LVEF (ranging from 35% to 50%) were randomly allocated to RVMSP (n=45) and RVAP (n=47). New York Heart Association (NYHA) functional class, echocardiographic LVEF, and distance during a 6-min walk test (6MWT) were determined at 18 months after pacemaker implantation. Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured using an enzyme-linked immunosorbent assay (ELISA) kit. Compared with baseline, NYHA functional class remained unchanged at 18 months, distance during 6MWT (485 m vs. 517 m) and LVEF (36.7% vs. 41.8%) were increased, but BNP levels were reduced (2352 pg/ml vs. 710 pg/ml) in the RVMSP group compared with those in the RVAP group, especially in patients with LVEF 35%-40% (for all comparisons, P<0.05). However, clinical function capacity and LV function measurements were not significantly changed in patients with RVAP, despite the pacing measurements being similar in both groups, such as R-wave amplitude and capture threshold. RVMSP provides a better clinical utility, compared with RVAP, in patients with high-degree atrioventricular block and moderately depressed LV function whose LVEF levels ranged from 35% to 40%.

  6. The pace of past climate change vs. potential bird distributions and land use in the United States.

    Science.gov (United States)

    Bateman, Brooke L; Pidgeon, Anna M; Radeloff, Volker C; VanDerWal, Jeremy; Thogmartin, Wayne E; Vavrus, Stephen J; Heglund, Patricia J

    2016-03-01

    Climate change may drastically alter patterns of species distributions and richness, but predicting future species patterns in occurrence is challenging. Significant shifts in distributions have already been observed, and understanding these recent changes can improve our understanding of potential future changes. We assessed how past climate change affected potential breeding distributions for landbird species in the conterminous United States. We quantified the bioclimatic velocity of potential breeding distributions, that is, the pace and direction of change for each species' suitable climate space over the past 60 years. We found that potential breeding distributions for landbirds have shifted substantially with an average velocity of 1.27 km yr(-1) , about double the pace of prior distribution shift estimates across terrestrial systems globally (0.61 km yr(-1) ). The direction of shifts was not uniform. The majority of species' distributions shifted west, northwest, and north. Multidirectional shifts suggest that changes in climate conditions beyond mean temperature were influencing distributional changes. Indeed, precipitation variables that were proxies for extreme conditions were important variables across all models. There were winners and losers in terms of the area of distributions; many species experienced contractions along west and east distribution edges, and expansions along northern distribution edges. Changes were also reflected in the potential species richness, with some regions potentially gaining species (Midwest, East) and other areas potentially losing species (Southwest). However, the degree to which changes in potential breeding distributions are manifested in actual species richness depends on landcover. Areas that have become increasingly suitable for breeding birds due to changing climate are often those attractive to humans for agriculture and development. This suggests that many areas might have supported more breeding bird

  7. Redistribution of myocardial perfusion during permanent dual chamber pacing in symptomatic non-obstructive hypertrophic cardiomyopathy : A quantitative positron emission tomography study

    NARCIS (Netherlands)

    Posma, JL; Blanksma, PK; vanderWall, EE

    Dual chamber pacing causes significant symptomatic improvement in many patients with hypertrophic cardiomyopathy. The mechanism behind this beneficial response is not fully understood. Positron emission tomography showed a redistribution of myocardial flow during pacing in a patient with

  8. Challenge of engaging all students via self-paced interactive electronic learning tutorials for introductory physics

    Directory of Open Access Journals (Sweden)

    Seth DeVore

    2017-05-01

    Full Text Available As research-based, self-paced electronic learning tools become increasingly available, a critical issue educators encounter is implementing strategies to ensure that all students engage with them as intended. Here, we first discuss the effectiveness of electronic learning tutorials as self-paced learning tools in large enrollment brick and mortar introductory physics courses and then propose a framework for helping students engage effectively with the learning tools. The tutorials were developed via research in physics education and were found to be effective for a diverse group of introductory physics students in one-on-one implementation. Instructors encouraged the use of these tools in a self-paced learning environment by telling students that they would be helpful for solving the assigned homework problems and that the underlying physics principles in the tutorial problems would be similar to those in the in-class quizzes (which we call paired problems. We find that many students in the courses in which these interactive electronic learning tutorials were assigned as a self-study tool performed poorly on the paired problems. In contrast, a majority of student volunteers in one-on-one implementation greatly benefited from the tutorials and performed well on the paired problems. The significantly lower overall performance on paired problems administered as an in-class quiz compared to the performance of student volunteers who used the research-based tutorials in one-on-one implementation suggests that many students enrolled in introductory physics courses did not effectively engage with the tutorials outside of class and may have only used them superficially. The findings suggest that many students in need of out-of-class remediation via self-paced learning tools may have difficulty motivating themselves and may lack the self-regulation and time-management skills to engage effectively with tools specially designed to help them learn at their

  9. Challenge of engaging all students via self-paced interactive electronic learning tutorials for introductory physics

    Science.gov (United States)

    DeVore, Seth; Marshman, Emily; Singh, Chandralekha

    2017-06-01

    As research-based, self-paced electronic learning tools become increasingly available, a critical issue educators encounter is implementing strategies to ensure that all students engage with them as intended. Here, we first discuss the effectiveness of electronic learning tutorials as self-paced learning tools in large enrollment brick and mortar introductory physics courses and then propose a framework for helping students engage effectively with the learning tools. The tutorials were developed via research in physics education and were found to be effective for a diverse group of introductory physics students in one-on-one implementation. Instructors encouraged the use of these tools in a self-paced learning environment by telling students that they would be helpful for solving the assigned homework problems and that the underlying physics principles in the tutorial problems would be similar to those in the in-class quizzes (which we call paired problems). We find that many students in the courses in which these interactive electronic learning tutorials were assigned as a self-study tool performed poorly on the paired problems. In contrast, a majority of student volunteers in one-on-one implementation greatly benefited from the tutorials and performed well on the paired problems. The significantly lower overall performance on paired problems administered as an in-class quiz compared to the performance of student volunteers who used the research-based tutorials in one-on-one implementation suggests that many students enrolled in introductory physics courses did not effectively engage with the tutorials outside of class and may have only used them superficially. The findings suggest that many students in need of out-of-class remediation via self-paced learning tools may have difficulty motivating themselves and may lack the self-regulation and time-management skills to engage effectively with tools specially designed to help them learn at their own pace. We

  10. Single-site ventricular pacing via the coronary sinus in patients with tricuspid valve disease.

    Science.gov (United States)

    Noheria, Amit; van Zyl, Martin; Scott, Luis R; Srivathsan, Komandoor; Madhavan, Malini; Asirvatham, Samuel J; McLeod, Christopher J

    2017-03-01

    To evaluate coronary sinus single-site (CSSS) left ventricular pacing in adult patients with normal left ventricular ejection fraction (LVEF) when traditional right ventricular lead implantation is not feasible or is contraindicated. We performed a retrospective analysis of 23 patients with tricuspid valve surgery/disease who received a CSSS ventricular pacing lead to avoid crossing the tricuspid valve. Two matched control populations were obtained from patients receiving (i) conventional right ventricular single-site (RVSS) leads and (ii) coronary sinus leads for cardiac resynchronization therapy (CSCRT). Main outcomes of interest were lead stability, electrical lead parameters and change in LVEF during long-term follow-up. Successful CSSS pacing was accomplished in all 23 patients without any procedural complications. During the 5.3 ± 2.8-year follow-up 22/23 (95.7%) leads were functional with stable pacing and sensing parameters, and 1/23 (4.3%) was extracted for unrelated reasons. Compared to CSSS leads, the lead revision/abandonment was similar with RVSS leads (Hazard ratio (HR) 0.87, 95% confidence interval (CI) 0.03, 22.0), but was higher with CSCRT leads (HR 7.41, 95% CI 1.30, 139.0). There was no difference in change in LVEF between CSSS and RVSS groups (-2.4 ± 11.0 vs. 1.5 ± 12.8, P = 0.76), but LVEF improved in CSCRT group (11.2 ± 16.5%, P = 0.002). Fluoroscopy times were longer during implantation of CSSS compared to RVSS leads (25.6 ± 24.6 min vs. 12.3 ± 18.6 min, P = 0.049). In patients with normal LVEF, single-site ventricular pacing via the coronary sinus is a feasible, safe and reliable alternative to right ventricular pacing. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  11. From generic to biosimilar drugs: why take an innovative pace?

    Directory of Open Access Journals (Sweden)

    Fereshteh Barei

    2012-12-01

    Full Text Available BACKGROUND: The transition of the generic/biotechnology industry to innovation by investing in innovative R&D will enhance business expertise in biopharmaceutical development and manufacturing. The major impact of this evolution is on patient access to treatment and savings for the health care systems. OBJECTIVES: The aim of this paper is to investigate the innovative aspect of biosimilar and biobetter products, manufactured by some big generic companies. We will also try to explore the innovative business strategy, implementing this high risk product differentiation policy. METHODS: This qualitative research is conducted by a series of interviews with CEOs, physicians, and academics in different countries. The qualitative data obtained were analyzed by Nvivo9.2 software. A literature review has also contributed to our key findings. RESULTS: The results show that switching into biosimilars/biobetters is an innovative strategic choice, approved by some big generic pharmaceutical companies. The biosimilar/biobetter products can be considered innovative because of their value added quality. CONCLUSION: Expanding the product portfolio to biosimilars/biobetter can be considered as a long run strategy in the innovative business plans aiming to ensure the market access. Patients and their access to better treatments are major components of these innovative business models.

  12. Growth, innovation, scaling, and the pace of life in cities.

    Science.gov (United States)

    Bettencourt, Luís M A; Lobo, José; Helbing, Dirk; Kühnert, Christian; West, Geoffrey B

    2007-04-24

    Humanity has just crossed a major landmark in its history with the majority of people now living in cities. Cities have long been known to be society's predominant engine of innovation and wealth creation, yet they are also its main source of crime, pollution, and disease. The inexorable trend toward urbanization worldwide presents an urgent challenge for developing a predictive, quantitative theory of urban organization and sustainable development. Here we present empirical evidence indicating that the processes relating urbanization to economic development and knowledge creation are very general, being shared by all cities belonging to the same urban system and sustained across different nations and times. Many diverse properties of cities from patent production and personal income to electrical cable length are shown to be power law functions of population size with scaling exponents, beta, that fall into distinct universality classes. Quantities reflecting wealth creation and innovation have beta approximately 1.2 >1 (increasing returns), whereas those accounting for infrastructure display beta approximately 0.8 cities are similar to, and differ from, biological organisms, for which betasustain growth and avoid stagnation or collapse.

  13. Reduction of unnecessary right ventricular pacing by managed ventricular pacing and search AV+ algorithms in pacemaker patients: 12-month follow-up results of a randomized study.

    Science.gov (United States)

    Chen, Silin; Chen, Keping; Tao, Qianmin; Zheng, Liangrong; Shen, Farong; Wu, Shulin; Fan, Jie; Xu, Geng; Wang, Li; Zhou, Xiaohong; Zhang, Shu

    2014-11-01

    The present study was to assess the reduction of right ventricular pacing (RVP) by pacemaker algorithms of Managed Ventricular Pacing (MVP) and Search AV+ (SAV+) interval over a period of 12 months. A total of 385 patients indicated for a dual-chamber pacemaker (DC-PM) were enrolled in the prospective, randomized COMPARE study at 29 centres in China between June 2009 and April 2011. Patients implanted with DC-PMs were randomized in a 1 : 1 ratio to the MVP group or the SAV+ group. The percentage of VP (%VP) was obtained from the device diagnostic data at 1-, 6-, and 12-month follow-ups and was expressed as the median %VP over all beats in patients with sinus node dysfunction (SND) and atrioventricular block (AVB) excluding persistent third-degree AVB. Of 385 enrolled patients, 253 had SND and 72 had AVB. The %VP in the MVP group was significantly lower than that in the SAV+ group at 1-, 6-, and 12-month follow-ups, respectively. At 12-month follow-up, the median %VP in SND patients was 0.20% in the MVP group and 1.4% in the SAV+ group (P sustainable %VP reduction has potential implications in reducing the development of heart failure and/or atrial arrhythmia morbidity. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  14. Sequential biventricular pacing improves regional contractility, longitudinal function and dyssynchrony in patients with heart failure and prolonged QRS

    Directory of Open Access Journals (Sweden)

    Ring Margareta

    2010-04-01

    Full Text Available Abstract Aims Biventricular pacing (BiP is an effective treatment in systolic heart failure (HF patients with prolonged QRS. However, approximately 35% of the patients receiving BiP are classified as non-responders. The aim of this study is to evaluate the acute effects of VV-optimization on systolic heart function. Methods Twenty-one HF patients aged 72 (46-88 years, QRS 154 (120-190 ms, were studied with echocardiography, Tissue Doppler Imaging (TDI and 3D-echo the first day after receiving a BiP device. TDI was performed; during simultaneous pacing (LV-lead pacing 4 ms before the RV-lead and during sequential pacing (LV 20 and 40 ms before RV and RV 20 and 40 ms before LV-lead pacing. Systolic heart function was studied by tissue tracking (TT for longitudinal function and systolic maximal velocity (SMV for regional contractility and signs of dyssynchrony assessed by time-delays standard deviation of aortic valve opening to SMV, AVO-SMV/SD and tissue synchronization imaging (TSI. Results The TT mean value preoperatively was 4,2 ± 1,5 and increased at simultaneous pacing to 5,0 ± 1,2 mm (p Conclusions VV-optimization in the acute phase improves systolic heart function more than simultaneous BiP pacing. Long-term effects should be evaluated in prospective randomized trials.

  15. Diritto internazionale umanitario, guerra e pace, diritti delle persone

    Directory of Open Access Journals (Sweden)

    Giovanni Barberini

    2011-11-01

    every military operation. The rules of engagement substantially have an operational content and the busy soldiers on the field set their attention on these rules more and more that in practice they represent a daily vademecum, not only because they individualize the chain of command. Their juridical value depends on the single arrangements that of it therefore responsible. The word "war" in the contemporary age it doesn't boast an uncontested right of citizen anymore in the international relationships. Our constitution in art. 11 among the fundamental principles enact that Italy repudiates the war as an instrument of offense against the freedom of other peoples and as a means of resolving international disputes. The war, as an instrument normally used in the past in the relationships among States, it is not in our juridical arrangement anymore. In 1948 started a very strong commitment to the universal level and at regional level; so much so that today we can count at least 130 Conventions and agreements for the protection of human rights, in various respects, for different situations. The reference to the international obligations placed to protection of the people led us to remember what has been written recently, i.e the two systems, the traditional humanitarian law and the recent human rights, with different historical training and technical configuration, based on a common philosophical basis, the affirmation of the value of the person, and tend toward the common goal of ensuring a stable and effective protection in every circumstance, that is then condition of world peace (U. Genesio, Le leggi dell’umanità, Nagard, Milano, 2009, p. 31.

  16. Classifying running-related injuries based upon etiology, with emphasis on volume and pace

    DEFF Research Database (Denmark)

    Nielsen, Rasmus Oestergaard; Nohr, Ellen Aagaard; Rasmussen, Sten

    2013-01-01

    BACKGROUND AND PURPOSE: Many researchers acknowledge the importance of "training errors" as the main cause of running-related injuries. The purpose of this clinical commentary is to present a theoretical framework for the assumption that some running-related injuries among rear-foot strikers...... of patellofemoral pain syndrome, iliotibial band syndrome, and patellar tendinopathy, while change in running pace may be associated with the development of achilles tendinopathy, gastrocnemius injuries, and plantar fasciitis. DISCUSSIONRELATION TO CLINICAL PRACTICE: If this assertion is correct, bias may...... be prevented in future studies by categorizing injuries into volume or pacing injuries. However, more work is needed to provide further evidence in support of this approach. Future investigations of the link between training patterns and injury development should be designed as large-scale prospective studies...

  17. Memory effects, transient growth, and wave breakup in a model of paced atrium

    Science.gov (United States)

    Garzón, Alejandro; Grigoriev, Roman O.

    2017-09-01

    The mechanisms underlying cardiac fibrillation have been investigated for over a century, but we are still finding surprising results that change our view of this phenomenon. The present study focuses on the transition from normal rhythm to spiral wave chaos associated with a gradual increase in the pacing rate. While some of our findings are consistent with existing experimental, numerical, and theoretical studies of this problem, one result appears to contradict the accepted picture. Specifically we show that, in a two-dimensional model of paced homogeneous atrial tissue, transition from discordant alternans to conduction block, wave breakup, reentry, and spiral wave chaos is associated with the transient growth of finite amplitude disturbances rather than a conventional instability. It is mathematically very similar to subcritical, or bypass, transition from laminar fluid flow to turbulence, which allows many of the tools developed in the context of fluid turbulence to be used for improving our understanding of cardiac arrhythmias.

  18. Effects of self-paced interval and continuous training on health markers in women

    DEFF Research Database (Denmark)

    Connolly, Luke J; Bailey, Stephen J; Krustrup, Peter

    2017-01-01

    PURPOSE: To compare the effects of self-paced high-intensity interval and continuous cycle training on health markers in premenopausal women. METHODS: Forty-five inactive females were randomised to a high-intensity interval training (HIIT; n = 15), continuous training (CT; n = 15) or an inactive...... control (CON; n = 15) group. HIIT performed 5 × 5 min sets comprising repetitions of 30-s low-, 20-s moderate- and 10-s high-intensity cycling with 2 min rest between sets. CT completed 50 min of continuous cycling. Training was completed self-paced, 3 times weekly for 12 weeks. RESULTS: Peak oxygen......, whereas blood pressure, submaximal HR, well-being and body mass adaptations were training-type-specific. Both training methods improved established health markers, but the adaptations to HIIT were evoked for a lower time commitment....

  19. Aerosol Absorption Retrievals from the PACE Broad Spectrum Ocean Color Instrument (OCI)

    Science.gov (United States)

    Mattoo, Shana; Remer, Lorraine A.; Levy, Robert C.; Gupta, Pawan; Ahmad, Ziauddin; Martins, J. Vanderlei; Lima, Adriana Rocha; Torres, Omar

    2016-01-01

    The PACE (Pre-­Aerosol, Clouds and ocean Ecosystem) mission, anticipated for launch in the early 2020s, is designed to characterize oceanic and atmospheric properties. The primary instrument on-­-board will be a moderate resolution (approximately 1 km nadir) radiometer, called the Ocean Color Instrument (OCI). OCI will provide high spectral resolution (5 nm) from the UV to NIR (350 - 800 nm), with additional spectral bands in the NIR and SWIR. The OCI itself is an excellent instrument for atmospheric objectives, providing measurements across a broad spectral range that in essence combines the capabilities of MODIS and OMI, but with the UV channels from OMI to be available at moderate resolution. (Image credit: PACE Science Definition Team Report). Objective: Can we make use of the UV-­SWIR measurements to derive information about aerosol absorption when aerosol loading is high?

  20. Classification of PolSAR Images Using Multilayer Autoencoders and a Self-Paced Learning Approach

    Directory of Open Access Journals (Sweden)

    Wenshuai Chen

    2018-01-01

    Full Text Available In this paper, a novel polarimetric synthetic aperture radar (PolSAR image classification method based on multilayer autoencoders and self-paced learning (SPL is proposed. The multilayer autoencoders network is used to learn the features, which convert raw data into more abstract expressions. Then, softmax regression is applied to produce the predicted probability distributions over all the classes of each pixel. When we optimize the multilayer autoencoders network, self-paced learning is used to accelerate the learning convergence and achieve a stronger generalization capability. Under this learning paradigm, the network learns the easier samples first and gradually involves more difficult samples in the training process. The proposed method achieves the overall classification accuracies of 94.73%, 94.82% and 78.12% on the Flevoland dataset from AIRSAR, Flevoland dataset from RADARSAT-2 and Yellow River delta dataset, respectively. Such results are comparable with other state-of-the-art methods.

  1. Temporary epicardial cardiac resynchronisation versus conventional right ventricular pacing after cardiac surgery: study protocol for a randomised control trial

    Directory of Open Access Journals (Sweden)

    Russell Stuart J

    2012-02-01

    Full Text Available Abstract Background Heart failure patients with stable angina, acute coronary syndromes and valvular heart disease may benefit from revascularisation and/or valve surgery. However, the mortality rate is increased- 5-30%. Biventricular pacing using temporary epicardial wires after surgery is a potential mechanism to improve cardiac function and clinical endpoints. Method/design A multi-centred, prospective, randomised, single-blinded, intervention-control trial of temporary biventricular pacing versus standard pacing. Patients with ischaemic cardiomyopathy, valvular heart disease or both, an ejection fraction ≤ 35% and a conventional indication for cardiac surgery will be recruited from 2 cardiac centres. Baseline investigations will include: an electrocardiogram to confirm sinus rhythm and measure QRS duration; echocardiogram to evaluate left ventricular function and markers of mechanical dyssynchrony; dobutamine echocardiogram for viability and blood tests for renal function and biomarkers of myocardial injury- troponin T and brain naturetic peptide. Blood tests will be repeated at 18, 48 and 72 hours. The principal exclusions will be subjects with permanent atrial arrhythmias, permanent pacemakers, infective endocarditis or end-stage renal disease. After surgery, temporary pacing wires will be attached to the postero-lateral wall of the left ventricle, the right atrium and right ventricle and connected to a triple chamber temporary pacemaker. Subjects will be randomised to receive either temporary biventricular pacing or standard pacing (atrial inhibited pacing or atrial-synchronous right ventricular pacing for 48 hours. The primary endpoint will be the duration of level 3 care. In brief, this is the requirement for invasive ventilation, multi-organ support or more than one inotrope/vasoconstrictor. Haemodynamic studies will be performed at baseline, 6, 18 and 24 hours after surgery using a pulmonary arterial catheter. Measurements will be

  2. The impact of mental processing and pacing on spine loading: 2002 Volvo Award in biomechanics.

    Science.gov (United States)

    Davis, Kermit G; Marras, William S; Heaney, Catherine A; Waters, Thomas R; Gupta, Purnendu

    2002-12-01

    The impact of various levels of mental processing and pacing (during lifting) on spine loading was monitored under laboratory conditions. To explore how mental demands and pacing influence the biomechanical response and subsequent spine loading and, to determine whether individual characteristics have a modifying role in the responses. Modern work often requires rapid physical exertions along with demands of mental processing (both psychosocial stressors). While the effect of physical workplace factors on spine loading has been widely documented, few studies have investigated the impact that interaction of psychosocial factors and individual factors has on spine loads. For this study, 60 subjects lifted boxes while completing two types of mental processing tasks: 1) series tasks with decisions occurring before the act of lifting, and 2) simultaneous tasks with decisions occurring concurrently with the lift. For both of these mental processing conditions, two intensities of mental load were evaluated: simple and complex. Task pacing was also adjusted under slow and fast conditions. Finally, individual characteristics (personality and gender) were evaluated as potential modifiers. An electromyographically assisted model evaluated the three-dimensional spine loads under the experimental conditions. Simultaneous mental processing had the largest impact on the spine loads, with the complex intensity resulting in increases of 160 N with lateral shear, 80 N with anteroposterior shear, and 700 N with compression. Increased task pace produced greater lateral shear (by 20 N), anteroposterior shear (by 60 N), and compression loads (by 410 N). Gender and personality also influenced loadings by as much as 17%. Mental processing stress acted as a catalyst for the biomechanical responses, leading to intensified spine loading. Mental stress appeared to occur as a function of time pressures on task performance and resulted in less controlled movements and increases in trunk muscle

  3. Effect of cardiac pacing on sleep-related breathing disorders: a systematic review.

    Science.gov (United States)

    Anastasopoulos, Dimitrios L; Chalkias, Athanasios; Iakovidou, Nicoletta; Xanthos, Theodoros

    2016-09-01

    Sleep-related breathing disorders are commonly encountered in the middle-aged population, negatively affecting quality of life. Central sleep apnea is associated with congestive heart failure, whereas obstructive sleep apnea is related to different pathophysiologic mechanisms, such as the total or partial occlusion of upper airway tract. Both sleep-related disorders have been associated with increased morbidity, and hence, they have been a target of several treatment strategies. The aim of this systematic review is to evaluate the effect of different types of cardiac pacing on sleep-related breathing disorders in patients with or without heart failure. The PubMed and Cochrane Central Register of Controlled Trials were examined from April 2015 to January 2016. Of the initial 360 studies, 22 eligible trials were analyzed. The included studies were classified according to the type of sleep disorder and the intervention undertaken. The evidence shows that cardiac resynchronization therapy but not atrial overdrive pacing can reduce apneic events in central sleep apnea patients. However, their effect on obstructive sleep apnea is controversial. It can be assumed that pacing cannot be used alone as treatment of sleep-related breathing disorders. Further research is needed in order to elucidate the effect of these interventions in sleep apnea patients.

  4. Evolution of sex-specific pace-of-life syndromes: genetic architecture and physiological mechanisms.

    Science.gov (United States)

    Immonen, Elina; Hämäläinen, Anni; Schuett, Wiebke; Tarka, Maja

    2018-01-01

    Sex differences in life history, physiology, and behavior are nearly ubiquitous across taxa, owing to sex-specific selection that arises from different reproductive strategies of the sexes. The pace-of-life syndrome (POLS) hypothesis predicts that most variation in such traits among individuals, populations, and species falls along a slow-fast pace-of-life continuum. As a result of their different reproductive roles and environment, the sexes also commonly differ in pace-of-life, with important consequences for the evolution of POLS. Here, we outline mechanisms for how males and females can evolve differences in POLS traits and in how such traits can covary differently despite constraints resulting from a shared genome. We review the current knowledge of the genetic basis of POLS traits and suggest candidate genes and pathways for future studies. Pleiotropic effects may govern many of the genetic correlations, but little is still known about the mechanisms involved in trade-offs between current and future reproduction and their integration with behavioral variation. We highlight the importance of metabolic and hormonal pathways in mediating sex differences in POLS traits; however, there is still a shortage of studies that test for sex specificity in molecular effects and their evolutionary causes. Considering whether and how sexual dimorphism evolves in POLS traits provides a more holistic framework to understand how behavioral variation is integrated with life histories and physiology, and we call for studies that focus on examining the sex-specific genetic architecture of this integration.

  5. Non-invasive cardiac pacing with image-guided focused ultrasound

    Science.gov (United States)

    Marquet, Fabrice; Bour, Pierre; Vaillant, Fanny; Amraoui, Sana; Dubois, Rémi; Ritter, Philippe; Haïssaguerre, Michel; Hocini, Mélèze; Bernus, Olivier; Quesson, Bruno

    2016-11-01

    Currently, no non-invasive cardiac pacing device acceptable for prolonged use in conscious patients exists. High Intensity Focused Ultrasound (HIFU) can be used to perform remote pacing using reversibility of electromechanical coupling of cardiomyocytes. Here we described an extracorporeal cardiac stimulation device and study its efficacy and safety. We conducted experiments ex vivo and in vivo in a large animal model (pig) to evaluate clinical potential of such a technique. The stimulation threshold was determined in 10 different ex vivo hearts and different clinically relevant electrical effects such as consecutive stimulations of different heart chambers with a single ultrasonic probe, continuous pacing or the inducibility of ventricular tachycardia were shown. Using ultrasonic contrast agent, consistent cardiac stimulation was achievable in vivo for up to 1 hour sessions in 4 different animals. No damage was observed in inversion-recovery MR sequences performed in vivo in the 4 animals. Histological analysis revealed no differences between stimulated and control regions, for all ex vivo and in vivo cases.

  6. Effects of self-paced interval and continuous training on health markers in women.

    Science.gov (United States)

    Connolly, Luke J; Bailey, Stephen J; Krustrup, Peter; Fulford, Jonathan; Smietanka, Chris; Jones, Andrew M

    2017-11-01

    To compare the effects of self-paced high-intensity interval and continuous cycle training on health markers in premenopausal women. Forty-five inactive females were randomised to a high-intensity interval training (HIIT; n = 15), continuous training (CT; n = 15) or an inactive control (CON; n = 15) group. HIIT performed 5 × 5 min sets comprising repetitions of 30-s low-, 20-s moderate- and 10-s high-intensity cycling with 2 min rest between sets. CT completed 50 min of continuous cycling. Training was completed self-paced, 3 times weekly for 12 weeks. Peak oxygen uptake (16 ± 8 and 21 ± 12%), resting heart rate (HR) (-5 ± 9 and -4 ± 7 bpm) and visual and verbal learning improved following HIIT and CT compared to CON (P  0.05). No outcome variable changed in the CON group (P > 0.05). Twelve weeks of self-paced HIIT and CT were similarly effective at improving cardiorespiratory fitness, resting HR and cognitive function in inactive premenopausal women, whereas blood pressure, submaximal HR, well-being and body mass adaptations were training-type-specific. Both training methods improved established health markers, but the adaptations to HIIT were evoked for a lower time commitment.

  7. Spontaneous Velocity Effect of Musical Expression on Self-Paced Walking.

    Directory of Open Access Journals (Sweden)

    Jeska Buhmann

    Full Text Available The expressive features of music can influence the velocity of walking. So far, studies used instructed (and intended synchronization. But is this velocity effect still present with non-instructed (spontaneous synchronization? To figure that out, participants were instructed to walk in their own comfort tempo on an indoor track, first in silence and then with tempo-matched music. We compared velocities of silence and music conditions. The results show that some music has an activating influence, increasing velocity and motivation, while other music has a relaxing influence, decreasing velocity and motivation. The influence of musical expression on the velocity of self-paced walking can be predicted with a regression model using only three sonic features explaining 56% of the variance. Phase-coherence between footfall and beat did not contribute to the velocity effect, due to its implied fixed pacing. The findings suggest that the velocity effect depends on vigor entrainment that influences both stride length and pacing. Our findings are relevant for preventing injuries, for gait improvement in walking rehabilitation, and for improving performance in sports activities.

  8. First reported experience with intramuscular diaphragm pacing in replacing positive pressure mechanical ventilators in children.

    Science.gov (United States)

    Onders, Raymond P; Ponsky, Todd A; Elmo, MaryJo; Lidsky, Karen; Barksdale, Edward

    2011-01-01

    Diaphragm pacing (DP) has been shown to successfully replace mechanical ventilators for adult tetraplegic patients with chronic respiratory insufficiency. This is the first report of DP in ventilator-dependent children. This was a prospective interventional experience under institutional review board approval. Diaphragm pacing involves outpatient laparoscopic diaphragm motor point mapping to identify the site where stimulation causes maximum diaphragm contraction with implantation of 4 percutaneous intramuscular electrodes. Diaphragm conditioning ensues to wean the child from the ventilator. Six children were successfully implanted ranging from 5 to 17 years old with the smallest 15 kg in weight. Length of time on mechanical ventilation ranged from 11 days to 7.6 years with an average of 3.2 years. In all patients, DP provided tidal volumes above basal needs. Five of the patients underwent a home-based weaning program, whereas one patient who was implanted only 11 days post spinal cord injury never returned to the ventilator with DP use. Another patient was weaned from the ventilator full time but died of complications of his underlying brain stem tumor. The remaining patients weaned from the ventilator for over 14 hours a day and/or are actively conditioning their diaphragms. Diaphragm pacing successfully replaced mechanical ventilators, which improves quality of life. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Large animal model of functional tricuspid regurgitation in pacing induced end-stage heart failure.

    Science.gov (United States)

    Malinowski, Marcin; Proudfoot, Alistair G; Langholz, David; Eberhart, Lenora; Brown, Michael; Schubert, Hans; Wodarek, Jeremy; Timek, Tomasz A

    2017-06-01

    Functional tricuspid regurgitation (FTR) is common in patients with advanced heart failure and frequently complicates left ventricular assist device implantation yet remains poorly understood. We set out to establish large animal model of FTR that could serve as a research platform to investigate the pathogenesis of FTR associated with end-stage heart failure. : Through right thoracotomy, ten adult sheep underwent implantation of pacemaker with epicardial LV lead, five sonomicrometry crystals on the right ventricle, and left and right ventricular telemetry pressure sensors during a beating heart off-pump procedure. After 5 ± 1 days of recovery, baseline haemodynamic, echocardiographic and sonomicrometry data were collected. Animals were paced thereafter at a rate of 220-240 beats/min until the development of heart failure and concomitant tricuspid regurgitation. : Three animals died during early recovery period and one during the pacing phase. Six surviving animals were paced for a mean of 14 ± 5 days. Cardiac function was significantly depressed compared to baseline, with LV ejection fraction falling from 69 ± 2% to 22 ± 4% ( P  heart failure patients presenting for mechanical support. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  10. The distribution of pace adopted by cyclists during a cross-country mountain bike World Championships.

    Science.gov (United States)

    Abbiss, Chris R; Ross, Megan L R; Garvican, Laura A; Ross, Neil; Pottgiesser, Torben; Gregory, John; Martin, David T

    2013-01-01

    The purpose of this study was to examine the distribution of pace self-selected by cyclists of varying ability, biological age and sex performing in a mountain bike World Championship event. Data were collected on cyclists performing in the Elite Male (ELITEmale; n = 75), Elite Female (ELITEfemale; n = 50), Under 23 Male (U23male; n = 62), Under 23 Female (U23female; n = 34), Junior Male (JNRmale; n = 71) and Junior Female (JNRfemale; n = 30) categories of the 2009 UCI Cross-Country Mountain Bike World Championships. Split times were recorded for the top, middle and bottom 20% of all finishers of each category. Timing splits were positioned to separate the course into technical and non-technical, uphill, downhill and rolling/flat sections. Compared with bottom performers, top performers in all male categories (ELITEmale, U23male, JNRmale) maintained a more even pace over the event as evidenced by a significantly lower standard deviation and range in average lap speed. Top performers, males, and ELITEmale athletes spent a lower percentage of overall race time on technical uphill sections of the course, compared with middle and bottom placed finishers, females, and JNRmale athletes, respectively. Better male performers adopt a more even distribution of pace throughout cross-country mountain events. Performance of lower placed finishers, females and JNRmale athletes may be improved by enhancing technical uphill cycling ability.

  11. A positron emission tomography study of self-paced finger movements at different frequencies

    International Nuclear Information System (INIS)

    Kawashima, R.; Inoue, K.; Sugiura, M.; Okada, K.; Ogawa, A.; Fukuda, H.

    1999-01-01

    Regional cerebral blood flow was measured in six right-handed volunteers using positron emission tomography during tasks involving repetitive self-paced finger tapping at five different frequencies. The contralateral primary sensorimotor cortex, the pre-supplementary motor area and the cingulate motor area showed significant activation during self-paced finger tapping tasks, compared with the resting state. A positive correlation between the regional cerebral blood flow and the movement frequency was found only in the primary sensorimotor cortex. In the pre-supplementary motor area and the cingulate motor area, however, activity increased when the subject employed movement frequencies faster or slower than his own pace. The same tendency was noted with respect to the relative variability of the inter-tapping interval.The results therefore indicate that the activity of the pre-supplementary motor area and the cingulate motor area may well be related to the increased difficulty in motor control rather than to the execution of the movement itself. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)

  12. Spontaneous Velocity Effect of Musical Expression on Self-Paced Walking.

    Science.gov (United States)

    Buhmann, Jeska; Desmet, Frank; Moens, Bart; Van Dyck, Edith; Leman, Marc

    2016-01-01

    The expressive features of music can influence the velocity of walking. So far, studies used instructed (and intended) synchronization. But is this velocity effect still present with non-instructed (spontaneous) synchronization? To figure that out, participants were instructed to walk in their own comfort tempo on an indoor track, first in silence and then with tempo-matched music. We compared velocities of silence and music conditions. The results show that some music has an activating influence, increasing velocity and motivation, while other music has a relaxing influence, decreasing velocity and motivation. The influence of musical expression on the velocity of self-paced walking can be predicted with a regression model using only three sonic features explaining 56% of the variance. Phase-coherence between footfall and beat did not contribute to the velocity effect, due to its implied fixed pacing. The findings suggest that the velocity effect depends on vigor entrainment that influences both stride length and pacing. Our findings are relevant for preventing injuries, for gait improvement in walking rehabilitation, and for improving performance in sports activities.

  13. Theory of the development of alternans in the heart during controlled diastolic interval pacing

    Science.gov (United States)

    Otani, Niels F.

    2017-09-01

    The beat-to-beat alternation in action potential durations (APDs) in the heart, called APD alternans, has been linked to the development of serious cardiac rhythm disorders, including ventricular tachycardia and fibrillation. The length of the period between action potentials, called the diastolic interval (DI), is a key dynamical variable in the standard theory of alternans development. Thus, methods that control the DI may be useful in preventing dangerous cardiac rhythms. In this study, we examine the dynamics of alternans during controlled-DI pacing using a series of single-cell and one-dimensional (1D) fiber models of alternans dynamics. We find that a model that combines a so-called memory model with a calcium cycling model can reasonably explain two key experimental results: the possibility of alternans during constant-DI pacing and the phase lag of APDs behind DIs during sinusoidal-DI pacing. We also find that these results can be replicated by incorporating the memory model into an amplitude equation description of a 1D fiber. The 1D fiber result is potentially concerning because it seems to suggest that constant-DI control of alternans can only be effective over only a limited region in space.

  14. Spontaneous Velocity Effect of Musical Expression on Self-Paced Walking

    Science.gov (United States)

    Buhmann, Jeska; Desmet, Frank; Moens, Bart; Van Dyck, Edith; Leman, Marc

    2016-01-01

    The expressive features of music can influence the velocity of walking. So far, studies used instructed (and intended) synchronization. But is this velocity effect still present with non-instructed (spontaneous) synchronization? To figure that out, participants were instructed to walk in their own comfort tempo on an indoor track, first in silence and then with tempo-matched music. We compared velocities of silence and music conditions. The results show that some music has an activating influence, increasing velocity and motivation, while other music has a relaxing influence, decreasing velocity and motivation. The influence of musical expression on the velocity of self-paced walking can be predicted with a regression model using only three sonic features explaining 56% of the variance. Phase-coherence between footfall and beat did not contribute to the velocity effect, due to its implied fixed pacing. The findings suggest that the velocity effect depends on vigor entrainment that influences both stride length and pacing. Our findings are relevant for preventing injuries, for gait improvement in walking rehabilitation, and for improving performance in sports activities. PMID:27167064

  15. Running pace decrease during a marathon is positively related to blood markers of muscle damage.

    Directory of Open Access Journals (Sweden)

    Juan Del Coso

    Full Text Available BACKGROUND: Completing a marathon is one of the most challenging sports activities, yet the source of running fatigue during this event is not completely understood. The aim of this investigation was to determine the cause(s of running fatigue during a marathon in warm weather. METHODOLOGY/PRINCIPAL FINDINGS: We recruited 40 amateur runners (34 men and 6 women for the study. Before the race, body core temperature, body mass, leg muscle power output during a countermovement jump, and blood samples were obtained. During the marathon (27 °C; 27% relative humidity running fatigue was measured as the pace reduction from the first 5-km to the end of the race. Within 3 min after the marathon, the same pre-exercise variables were obtained. RESULTS: Marathoners reduced their running pace from 3.5 ± 0.4 m/s after 5-km to 2.9 ± 0.6 m/s at the end of the race (P 15% pace reduction had elevated post-race myoglobin (1318 ± 1411 v 623 ± 391 µg L(-1; P<0.05, lactate dehydrogenase (687 ± 151 v 583 ± 117 U L(-1; P<0.05, and creatine kinase (564 ± 469 v 363 ± 158 U L(-1; P = 0.07 in comparison with marathoners that preserved their running pace reasonably well throughout the race. However, they did not differ in their body mass change (-3.1 ± 1.0 v -3.0 ± 1.0%; P = 0.60 or post-race body temperature (38.7 ± 0.7 v 38.9 ± 0.9 °C; P = 0.35. CONCLUSIONS/SIGNIFICANCE: Running pace decline during a marathon was positively related with muscle breakdown blood markers. To elucidate if muscle damage during a marathon is related to mechanistic or metabolic factors requires further investigation.

  16. An appropriate compression pace is important for securing the quality of hands-only CPR--a manikin study.

    Science.gov (United States)

    Shimizu, Yoshitaka; Tanigawa, Koichi; Ishikawa, Masami; Ouhara, Kazuhisa; Oue, Kana; Yoshinaka, Taiga; Kurihara, Hidemi; Irifune, Masahiro

    2014-09-01

    It is important to implement good quality chest compressions for cardiopulmonary resuscitation (CPR). This manikin study examined the effects of different compression rates on chest compression depth variables using a metronome sound guide. Fifty sixth-year dentistry students participated in the study. Each participant performed CPR at 3 different compression rates, 110, 100, and 90 compressions per min (pace-110-g, pace-100-g, and pace-90-g) for 2 consecutive one-minute sets with a ten-second break between the sets. The percentage of compressions deeper than 5 cm at pace-110-g decreased significantly from 22.1 ± 4.7% in the first set to 16.7 ± 4.4%* in the second set (*p CPR.

  17. Atrial fibrillation in patients with sick sinus syndrome: the association with PQ-interval and percentage of ventricular pacing

    DEFF Research Database (Denmark)

    Nielsen, Jens Cosedis; Thomsen, Poul Erik B; Højberg, Søren

    2012-01-01

    AimsIn the recently published DANPACE trial, incidence of atrial fibrillation (AF) was significantly higher with single-lead atrial (AAIR) pacing than with dual-chamber (DDDR) pacing. The present analysis aimed to evaluate the importance of baseline PQ-interval and percentage of ventricular pacing...... (VP) on AF.Methods and resultsWe analysed data on AF during follow-up in 1415 patients included in the DANPACE trial. In a subgroup of 650 patients with DDDR pacemaker, we studied whether %VP, baseline PQ-interval, and programmed atrio-ventricular interval (AVI) was associated with AF burden measured...... between minimal-paced programmed AVI = 100 and >100 ms (median value), respectively (P= 0.60).ConclusionsThe present study indicates that a longer baseline PQ-interval is associated with an increased risk of AF in patients with sick sinus syndrome. Atrial fibrillation burden is not associated...

  18. The size and structure of arm movement variability decreased with work pace in a standardised repetitive precision task.

    Science.gov (United States)

    Srinivasan, Divya; Samani, Afshin; Mathiassen, Svend Erik; Madeleine, Pascal

    2015-01-01

    Increased movement variability has been suggested to reduce the risk of developing musculoskeletal disorders caused by repetitive work. This study investigated the effects of work pace on arm movement variability in a standardised repetitive pipetting task performed by 35 healthy women. During pipetting at slow and fast paces differing by 15%, movements of arm, hand and pipette were tracked in 3D, and used to derive shoulder and elbow joint angles. The size of cycle-to-cycle motor variability was quantified using standard deviations of several kinematics properties, while the structure of variability was quantified using indices of sample entropy and recurrence quantification analysis. When pace increased, both the size and structure of motor variability in the shoulder and elbow decreased. These results suggest that motor variability drops when repetitive movements are performed at increased paces, which may in the long run lead to undesirable outcomes such as muscle fatigue or overuse.

  19. Acquired tricuspid valve stenosis due to intentionally redundant transvenous lead placement for VDD pacing in two small dogs.

    Science.gov (United States)

    Gunther-Harrington, Catherine T; Michel, Adam O; Stern, Joshua A

    2015-12-01

    Placement of an endocardial VDD pacing lead in small dogs (dogs between 8 months and 4 years after VDD pacemaker placement for third-degree atrioventricular block. Echocardiography and Doppler echocardiography identified elevated transtricuspid flow velocities, prolonged pressure half-times, decreased valve leaflet excursions, and tricuspid regurgitation in both cases. Both cases were euthanized secondary to this pacing complication. Necropsy was performed in one case and confirmed adherence between the redundant lead loop, atrial and valve tissue. While VDD pacing in dogs has proven hemodynamic benefits, these benefits have not been demonstrated in terms of survival benefit or clinical signs. The requirement of redundant lead placement in small dogs for appropriate VDD lead function creates potential deleterious effects that should be weighed against the possible clinical value of VDD pacing in these patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Understanding the pace of deinstitutionalisation: the role and nature of cumulative actions in the case of asbestos in France

    OpenAIRE

    Peton, Hélène; Blanc, Antoine

    2015-01-01

    Even when accelerated by a jolt, deinstitutionalisation is most often a long process constituted by short timestep and long timestep periods. Little has been said however to explain the pace of deinstitutionalisation and the factors that may accelerate or slow down this process. Not only strategic actions contribute to deinstitutionalisation. Multiple actions are involved and have an impact on the pace of deinstitutionalisation, depending on efforts of maintenance and disruption which may be ...

  1. Pacing and decision making in sport and exercise: the roles of perception and action in the regulation of exercise intensity.

    Science.gov (United States)

    Smits, Benjamin L M; Pepping, Gert-Jan; Hettinga, Florentina J

    2014-06-01

    In pursuit of optimal performance, athletes and physical exercisers alike have to make decisions about how and when to invest their energy. The process of pacing has been associated with the goal-directed regulation of exercise intensity across an exercise bout. The current review explores divergent views on understanding underlying mechanisms of decision making in pacing. Current pacing literature provides a wide range of aspects that might be involved in the determination of an athlete's pacing strategy, but lacks in explaining how perception and action are coupled in establishing behaviour. In contrast, decision-making literature rooted in the understanding that perception and action are coupled provides refreshing perspectives on explaining the mechanisms that underlie natural interactive behaviour. Contrary to the assumption of behaviour that is managed by a higher-order governor that passively constructs internal representations of the world, an ecological approach is considered. According to this approach, knowledge is rooted in the direct experience of meaningful environmental objects and events in individual environmental processes. To assist a neuropsychological explanation of decision making in exercise regulation, the relevance of the affordance competition hypothesis is explored. By considering pacing as a behavioural expression of continuous decision making, new insights on underlying mechanisms in pacing and optimal performance can be developed.

  2. Effect of the pacing strategy during half-duration resistance test on the mechanic, metabolic and cardio-respiratory response

    Directory of Open Access Journals (Sweden)

    A. Pérez-Guerra

    2017-12-01

    Full Text Available Objective: Changes in pacing rhythm are translated into functional and metabolic changes that can be significantly reflected in the final results of an athlete. Method: Ten male subjects, with moderate performance level (age: 25.2 ± 2.2 years; VO2max: 56.9 ± 5.7 ml kg−1 min−1, performed four 5-min races with different pacing strategies: constant-pace (CP, record-pace (RP, kicker-pace (KP, incremental-pace (IP. Results: The cardio-respiratory response did not show statistically significant. There were statistically significant differences (p ≤ 0.05 in the energetic efficiency among the protocols CP vs. RP, CP vs. KP and RP vs. IP. When results were analyzed by partials (1-min duration phases, significant differences were observed in the energetic efficiency during the 3rd-min among CP vs. KP, RP vs. KP and KP vs. IP. These significant differences were extended to the 4th-min when comparing CP vs. IP, CP vs. KP, KP vs. RP and KP vs. IP. In the last minute of the test, there were significant differences among CP vs. KP. No significant differences were found in any of the variables assessing anaerobic metabolism (accumulated oxygen deficit, oxygen debt, oxygen uptake kinetics and blood lactate between both protocols. Conclusions: Results suggest that the main functional systems response are significantly affected by the pacing strategy used by middle-level subjects during middle-distance running. Resumen: Objetivo: Los cambios en el ritmo de carrera se traducen en cambios funcionales y metabólicos que pueden reflejarse significativamente en los resultados finales de un atleta. Método: Diez sujetos varones, con un nivel medio (edad: 25.2 ± 2.2 años; VO2max: 56.9 ± 5.7 mlkg−1min−1, llevaron a cabo carreras de 5 minutos con diferentes estrategias: ritmo constante (RC, ritmo récord (RR, ritmo kicker (RK y ritmo incremental (RI. Resultados: La respuesta

  3. Marcapasso com sensor de contratilidade regulado pelas variações do sistema nervoso autônomo na miocardiopatia chagásica crônica Chagas heart disease and contractility rate responsive pacing controlled by autonomic nervous system variations

    Directory of Open Access Journals (Sweden)

    Oswaldo Tadeu Greco

    1998-12-01

    Full Text Available OBJETIVO: Analisar o desempenho da estimulação cardíaca artificial com marcapasso do tipo VVIR cujo sensor é regulado pelas variações do sistema nervoso autônomo em pacientes chagásicos com distúrbio no sistema de condução. MÉTODOS: Estudados 47 chagásicos, 28 do sexo masculino, com idades entre 24 e 68 anos, 36 tinham bloqueio atrioventricular (AV total; 8, bloqueio AV de 2º grau 2; e 3 doença do nódulo sinusal, e encontravam-se, de acordo com a NYHA, em classe I (4, II (15, III (16 e IV (12. Após o implante de marcapasso do tipo VVIR os pacientes foram acompanhados durante 12 meses. A resposta de freqüência foi registrada em gravações de Holter de 24h e divididos em dois grupos de acordo com a FC em repouso - grupo 1: >65bpm e grupo 2: PURPOSE: To analyse the performance of the artificial cardiac stimulation with the VVIR pacemaker whose sensor is adjusted by the variations of the autonomic nervous system in Chagas disease patients with deficiency of the conduction system. METHODS: Forty-seven Chagas disease patients have been studied, 28 male between 24 and 68 years old, 36 patients had complete AV block, 8 had 2nd degree AV block and the other 3 had sinus node disease. The patients were in class I (4, II (15, III (16 and IV (12 according to the NYHA. A 12-month-follow-up with constant clinical evaluations was carried out after pacemaker implantation. Patients were divided in 2 different groups according to the HR at rest - group 1: >65 beats per minute (bpm and group 2: <=65bpm, for a comparative study considering: 1 HR at stress test after the implantation; 2 arterial blood pressure at rest after the implantation and, 3 evaluation of the identified electrodes such as TIR-60-UP and others. RESULTS: The group 1 had greater HR at rest, and a smaller variation of values at stress than group 2. This shows that with this type of stimulation system it is possible to control each patient separately. The values of blood pressure

  4. Astronomically paced changes in deep-water circulation in the western North Atlantic during the middle Eocene

    Science.gov (United States)

    Vahlenkamp, Maximilian; Niezgodzki, Igor; De Vleeschouwer, David; Bickert, Torsten; Harper, Dustin; Kirtland Turner, Sandra; Lohmann, Gerrit; Sexton, Philip; Zachos, James; Pälike, Heiko

    2018-02-01

    North Atlantic Deep Water (NADW) currently redistributes heat and salt between Earth's ocean basins, and plays a vital role in the ocean-atmosphere CO2 exchange. Despite its crucial role in today's climate system, vigorous debate remains as to when deep-water formation in the North Atlantic started. Here, we present datasets from carbonate-rich middle Eocene sediments from the Newfoundland Ridge, revealing a unique archive of paleoceanographic change from the progressively cooling climate of the middle Eocene. Well-defined lithologic alternations between calcareous ooze and clay-rich intervals occur at the ∼41-kyr beat of axial obliquity. Hence, we identify obliquity as the driver of middle Eocene (43.5-46 Ma) Northern Component Water (NCW, the predecessor of modern NADW) variability. High-resolution benthic foraminiferal δ18O and δ13C suggest that obliquity minima correspond to cold, nutrient-depleted, western North Atlantic deep waters. We thus link stronger NCW formation with obliquity minima. In contrast, during obliquity maxima, Deep Western Boundary Currents were weaker and warmer, while abyssal nutrients were more abundant. These aspects reflect a more sluggish NCW formation. This obliquity-paced paleoceanographic regime is in excellent agreement with results from an Earth system model, in which obliquity minima configurations enhance NCW formation.

  5. Intra-rater repeatability of gait parameters in healthy adults during self-paced treadmill-based virtual reality walking.

    Science.gov (United States)

    Al-Amri, Mohammad; Al Balushi, Hilal; Mashabi, Abdulrhman

    2017-12-01

    Self-paced treadmill walking is becoming increasingly popular for the gait assessment and re-education, in both research and clinical settings. Its day-to-day repeatability is yet to be established. This study scrutinised the test-retest repeatability of key gait parameters, obtained from the Gait Real-time Analysis Interactive Lab (GRAIL) system. Twenty-three male able-bodied adults (age: 34.56 ± 5.12 years) completed two separate gait assessments on the GRAIL system, separated by 5 ± 3 days. Key gait kinematic, kinetic, and spatial-temporal parameters were analysed. The Intraclass-Correlation Coefficients (ICC), Standard Error Measurement (SEM), Minimum Detectable Change (MDC), and the 95% limits of agreements were calculated to evaluate the repeatability of these gait parameters. Day-to-day agreements were excellent (ICCs > 0.87) for spatial-temporal parameters with low MDC and SEM values, gait performance over time.

  6. Triassic-Jurassic climate in continental high-latitude Asia was dominated by obliquity-paced variations (Junggar Basin, Ürümqi, China).

    Science.gov (United States)

    Sha, Jingeng; Olsen, Paul E; Pan, Yanhong; Xu, Daoyi; Wang, Yaqiang; Zhang, Xiaolin; Yao, Xiaogang; Vajda, Vivi

    2015-03-24

    Empirical constraints on orbital gravitational solutions for the Solar System can be derived from the Earth's geological record of past climates. Lithologically based paleoclimate data from the thick, coal-bearing, fluvial-lacustrine sequences of the Junggar Basin of Northwestern China (paleolatitude ∼60°) show that climate variability of the warm and glacier-free high latitudes of the latest Triassic-Early Jurassic (∼198-202 Ma) Pangea was strongly paced by obliquity-dominated (∼40 ky) orbital cyclicity, based on an age model using the 405-ky cycle of eccentricity. In contrast, coeval low-latitude continental climate was much more strongly paced by climatic precession, with virtually no hint of obliquity. Although this previously unknown obliquity dominance at high latitude is not necessarily unexpected in a high CO2 world, these data deviate substantially from published orbital solutions in period and amplitude for eccentricity cycles greater than 405 ky, consistent with chaotic diffusion of the Solar System. In contrast, there are indications that the Earth-Mars orbital resonance was in today's 2-to-1 ratio of eccentricity to inclination. These empirical data underscore the need for temporally comprehensive, highly reliable data, as well as new gravitational solutions fitting those data.

  7. Triassic–Jurassic climate in continental high-latitude Asia was dominated by obliquity-paced variations (Junggar Basin, Ürümqi, China)

    Science.gov (United States)

    Sha, Jingeng; Olsen, Paul E.; Pan, Yanhong; Xu, Daoyi; Wang, Yaqiang; Zhang, Xiaolin; Yao, Xiaogang; Vajda, Vivi

    2015-01-01

    Empirical constraints on orbital gravitational solutions for the Solar System can be derived from the Earth’s geological record of past climates. Lithologically based paleoclimate data from the thick, coal-bearing, fluvial-lacustrine sequences of the Junggar Basin of Northwestern China (paleolatitude ∼60°) show that climate variability of the warm and glacier-free high latitudes of the latest Triassic–Early Jurassic (∼198–202 Ma) Pangea was strongly paced by obliquity-dominated (∼40 ky) orbital cyclicity, based on an age model using the 405-ky cycle of eccentricity. In contrast, coeval low-latitude continental climate was much more strongly paced by climatic precession, with virtually no hint of obliquity. Although this previously unknown obliquity dominance at high latitude is not necessarily unexpected in a high CO2 world, these data deviate substantially from published orbital solutions in period and amplitude for eccentricity cycles greater than 405 ky, consistent with chaotic diffusion of the Solar System. In contrast, there are indications that the Earth–Mars orbital resonance was in today’s 2-to-1 ratio of eccentricity to inclination. These empirical data underscore the need for temporally comprehensive, highly reliable data, as well as new gravitational solutions fitting those data. PMID:25759439

  8. Issues of work intensity, pace, and sustainability in relation to work context and nutritional status.

    Science.gov (United States)

    Panter-Brick, Catherine

    2003-01-01

    This article raises issues about work intensity, pace, and sustainability during physical activity, focusing attention on the nature of work in labor-intensive societies, the management of exertion in habitual tasks, and the health and broad socioeconomic correlates of alternative ways to regulate work patterns. At the heart of this review are concerns to document human adaptability (in terms of the physical and behavioral management of heavy work) and to renew debate regarding the conceptualization and measurement of work intensity (variously evaluated in absolute or relative terms, as indexed by oxygen consumption, energy expenditure, percentage maximal work capacity, heart rate elevation, time and motion indicators, or physiological cost). Three questions are examined: Is heavy work primarily a matter of time or energy intensity? How is heavy work habitually sustained? What is the bigger picture relating work performance to work context and to nutritional or health status? It is argued that many arduous activities, such as carrying loads, demand endurance over time rather than intensive effort per unit time, and that work pace management lies in regulating both the rate of work and the time in rest during physical activity. Furthermore, strategies that maximize long-term endurance (adopted by "tortoises") and those that maximize short-term productivity (adopted by "hares") are appropriate to different work contexts (e.g., a subsistence or wage-labor economy) and suit individuals with different health status and ability. Thus, work intensity is an important aspect of the links between physical activity, health, productivity, and society, as noted in literature reviewing objectives for sustainable development and public health messages for disease risk management. These areas of scholarship are underresearched, partly because consensus has been slow in agreeing on which are the best measures of work pace and work intensity for use in field situations, and which

  9. Effects of radiant heat exposure on pacing pattern during a 15-km cycling time trial.

    Science.gov (United States)

    Levels, Koen; de Koning, Jos; Broekhuijzen, Iris; Zwaan, Tamara; Foster, Carl; Daanen, Hein

    2014-01-01

    The goal of this study was to investigate the effects of different durations of skin temperature manipulation on pacing patterns and performance during a 15-km cycling time trial. Nineteen well-trained men completed three 15-km cycling time trials in 18 °C and 50% relative humidity with 4.5-km (short-heat), 9.0-km (long-heat) or without (control) radiant heat exposure applied by infrared heaters after 1.5 km in the time trial. During the time trials, power output, mean skin temperature, rectal temperature, heart rate and rating of perceived exertion were assessed. The radiant heat exposure resulted in higher mean skin temperature during the time trial for short-heat (35.0 ± 0.6 °C) and long-heat (35.3 ± 0.5 °C) than for control (32.5 ± 1.0 °C; P temperature was similar (P = 0.55). The mean power output was less for short-heat (273 ± 8 W; P = 0.001) and long-heat (271 ± 9 W; P = 0.02) than for control (287 ± 7 W), but pacing patterns did not differ (P = 0.55). Heart rate was greatest in control (177 ± 9 beats · min(-1); P radiant heat exposure and associated higher skin temperature reduced overall performance, but did not modify pacing pattern during a 15-km cycling time trial, regardless of the duration of the exposure.

  10. Work Rate during Self-paced Exercise is not Mediated by the Rate of Heat Storage.

    Science.gov (United States)

    Friesen, Brian J; Périard, Julien D; Poirier, Martin P; Lauzon, Martin; Blondin, Denis P; Haman, Francois; Kenny, Glen P

    2018-01-01

    To date, there have been mixed findings on whether greater anticipatory reductions in self-paced exercise intensity in the heat are mediated by early differences in rate of body heat storage. The disparity may be due to an inability to accurately measure minute-to-minute changes in whole-body heat loss. Thus, we evaluated whether early differences in rate of heat storage can mediate exercise intensity during self-paced cycling at a fixed rate of perceived exertion (RPE of 16; hard-to-very-hard work effort) in COOL (15°C), NORMAL (25°C), and HOT (35°C) ambient conditions. On separate days, nine endurance-trained cyclists exercised in COOL, NORMAL, and HOT conditions at a fixed RPE until work rate (measured after first 5 min of exercise) decreased to 70% of starting values. Whole-body heat loss and metabolic heat production were measured by direct and indirect calorimetry, respectively. Total exercise time was shorter in HOT (57 ± 20 min) relative to both NORMAL (72 ± 23 min, P = 0.004) and COOL (70 ± 26 min, P = 0.045). Starting work rate was lower in HOT (153 ± 31 W) compared with NORMAL (166 ± 27 W, P = 0.024) and COOL (170 ± 33 W, P = 0.037). Rate of heat storage was similar between conditions during the first 4 min of exercise (all P > 0.05). Thereafter, rate of heat storage was lower in HOT relative to NORMAL and COOL until 30 min of exercise (last common time-point between conditions; all P exercise. No differences were measured at end exercise. We show that rate of heat storage does not mediate exercise intensity during self-paced exercise at a fixed RPE in cool to hot ambient conditions.

  11. Effectiveness of paced walking to music at home for patients with COPD.

    Science.gov (United States)

    Ho, Chiung-Fang; Maa, Suh-Hwa; Shyu, Yea-Ing Lotus; Lai, Yu-Te; Hung, Tsung-Chieh; Chen, Hao-Cheng

    2012-08-01

    The use of rhythmic music is beneficial in assisting with the exercise intensity at home. This paper investigated the effects of paced walking to music at home with an 80% VO(2) peak for patients with COPD. A prospective randomized clinical trial consisting of a treatment group (n = 20) assigned to a 12-week period of paced walking to music at home, while the patients in the control group (n = 21) were only given educational information. The treatment response was measured based on the patient's score in the maximal exercise capacity test using the incremental shuttle walking test (ISWT), lung function, health- related quality of life (HRQOL) using the Saint George Respiratory Questionnaire (SGRQ) and their health care utilization during baseline, 4, 8, 12 and 16 weeks. The treatment group increased their distance in the ISWT from 243.5 ± 135.4 at baseline to 16 weeks (306.0 ± 107.3, p < 0.001), Borg RPE-D decreased from 2.2 ± 1.3 at baseline to 0.8 ± 1.1 (p < 0.001) at 16 weeks, and Borg RPE-L decreased from 1.2 ± 1.4 at baseline to 0.3 ± 0.7 (p < 0.05) at 16 weeks, and improved all of the domains of the SGRQ, compared to the control group. The paced walking to music at home program helps patients to achieve a higher-intensity exercise. It is easily incorporated into the care of COPD patients, providing them with a convenient, safe and enjoyable exercise.

  12. Indicators of a poor outcome after temporary pacing in patients with complete atrioventricular block

    International Nuclear Information System (INIS)

    Kazmi, U.; Hyder, S.N.; Sheikh, A.M.

    2013-01-01

    Background: Temporary pace maker (tpm) implantation is an emergency procedure, performed in symptomatic patients with AV block We report our experience of temporary pacing at a tertiary care center. It is the first study of its type from a local center. Objectives: To study the clinical course of patients after tpm implantation and to determine indicators of a poor outcome after tpm implantation. Methods: This was descriptive retrospective study. Data of all tpm procedures performed at Children Hospital from 2006 to 2012 was retrieved. We excluded patients with surgically placed tpm leads. All patients receiving transvenous tpm were included in our study. Results: Total of 12 patients received tpm, 8 were male (66.6%) and 4 were female (33.3%). Median age was 6 years ( range 1.4 -13 year ). Mean weight was 30kg, (range 8.7 - 50kg). All of them presented with complete heart block.One patient each had post diphtheria cardiomyopathy, unknown poisoning. The rest had congenital heart block. The mean period between tpm to ppm implantation was 5 days, (range 1 - 30 days). One patient spontaneously reverted to sinus rhythm(8.3%), 6 had ppm implantation (58.3%), 5 patients expired (33.3%). A low Ejection Fraction was found to be associated with a poor outcome (p<0.01). Variables that were associated with a poor outcome(mortality), were SOB (p<0.015), weak pulses (p<0.015), and hepatomegaly (p<0.01). Conclusion: Low Ejection Fraction and Heart failure is associated with a poor outcome and increased mortality in patients with complete AV block. We suggest that pacing should be considered in patients earlier, before they develop signs or symptoms of cardiac dysfunction. (author)

  13. Early change in thermal perception is not a driver of anticipatory exercise pacing in the heat.

    Science.gov (United States)

    Barwood, Martin James; Corbett, Jo; White, Danny; James, Jason

    2012-10-01

    Initial power output declines significantly during exercise in hot conditions on attaining a rapid increase in skin temperature when exercise commences. It is unclear whether this initial reduced power is mediated consciously, through thermal perceptual cues, or is a subconscious process. The authors tested the hypothesis that improved thermal perception (feeling cooler and more comfortable) in the absence of a change in thermal state (ie, similar deep-body and skin temperatures between spray conditions) would alter pacing and 40 km cycling time trial (TT) performance. Eleven trained participants (mean (SD): age 30 (8.1) years; height 1.78 (0.06) m; mass 76.0 (8.3) kg) completed three 40 km cycling TTs in standardised conditions (32°C, 50% RH) with thermal perception altered prior to exercise by application of cold-receptor-activating menthol spray (MENTHOL SPRAY), in contrast to a separate control spray (CONTROL SPRAY) and no spray control (CON). Thermal perception, perceived exertion, thermal responses and cycling TT performance were measured. MENTHOL SPRAY induced feelings of coolness and improved thermal comfort before and during exercise. Skin temperature profile at the start of exercise was similar between sprays (CON-SPRAY 33.3 (1.1)°C and MENTHOL SPRAY 33.4 (0.4)°C, but different to CON 34.5 (0.5)°C), but there was no difference in the pacing strategy adopted. There was no performance benefit using MENTHOL SPRAY; cycling TT completion time for CON is 71.58 (6.21) min, for CON-SPRAY is 70.94 (6.06) min and for MENTHOL SPRAY is 71.04 (5.47) min. The hypothesis is rejected. Thermal perception is not a primary driver of early pacing during 40 km cycling TT in hot conditions in trained participants.

  14. Static stretching alters neuromuscular function and pacing strategy, but not performance during a 3-km running time-trial.

    Directory of Open Access Journals (Sweden)

    Mayara V Damasceno

    Full Text Available Previous studies report that static stretching (SS impairs running economy. Assuming that pacing strategy relies on rate of energy use, this study aimed to determine whether SS would modify pacing strategy and performance in a 3-km running time-trial.Eleven recreational distance runners performed a a constant-speed running test without previous SS and a maximal incremental treadmill test; b an anthropometric assessment and a constant-speed running test with previous SS; c a 3-km time-trial familiarization on an outdoor 400-m track; d and e two 3-km time-trials, one with SS (experimental situation and another without (control situation previous static stretching. The order of the sessions d and e were randomized in a counterbalanced fashion. Sit-and-reach and drop jump tests were performed before the 3-km running time-trial in the control situation and before and after stretching exercises in the SS. Running economy, stride parameters, and electromyographic activity (EMG of vastus medialis (VM, biceps femoris (BF and gastrocnemius medialis (GA were measured during the constant-speed tests.The overall running time did not change with condition (SS 11:35±00:31 s; control 11:28±00:41 s, p = 0.304, but the first 100 m was completed at a significantly lower velocity after SS. Surprisingly, SS did not modify the running economy, but the iEMG for the BF (+22.6%, p = 0.031, stride duration (+2.1%, p = 0.053 and range of motion (+11.1%, p = 0.0001 were significantly modified. Drop jump height decreased following SS (-9.2%, p = 0.001.Static stretch impaired neuromuscular function, resulting in a slow start during a 3-km running time-trial, thus demonstrating the fundamental role of the neuromuscular system in the self-selected speed during the initial phase of the race.

  15. Ice slurry ingestion does not enhance self-paced intermittent exercise in the heat.

    Science.gov (United States)

    Gerrett, N; Jackson, S; Yates, J; Thomas, G

    2017-11-01

    This study aimed to determine if ice slurry ingestion improved self-paced intermittent exercise in the heat. After a familiarisation session, 12 moderately trained males (30.4 ± 3.4 year, 1.8 ± 0.1 cm, 73.5 ± 14.3 kg, V˙O 2max 58.5 ± 8.1 mL/kg/min) completed two separate 31 min self-paced intermittent protocols on a non-motorised treadmill in 30.9 ± 0.9 °C, 41.1 ± 4.0% RH. Thirty minutes prior to exercise, participants consumed either 7.5 g/kg ice slurry (0.1 ± 0.1 °C) (ICE) or 7.5 g/kg water (23.4 ± 0.9 °C) (CONTROL). Despite reductions in T c (ΔT c : -0.51 ± 0.3 °C, P exercise, ICE did not enhance self-paced intermittent exercise compared to CONTROL. The average speed during the walk (CONTROL: 5.90 ± 1.0 km, ICE: 5.90 ± 1.0 km), jog (CONTROL: 8.89 ± 1.7 km, ICE: 9.11 ± 1.5 km), run (CONTROL: 12.15 ± 1.7 km, ICE: 12.54 ± 1.5 km) and sprint (CONTROL: 17.32 ± 1.3 km, ICE: 17.18 ± 1.4 km) was similar between conditions (P > 0.05). Mean T sk , T b , blood lactate, heart rate and RPE were similar between conditions (P > 0.05). The findings suggest that lowering T c prior to self-paced intermittent exercise does not translate into an improved performance. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Operational Evaluation of Self-Paced Instruction in U.S. Army Training.

    Science.gov (United States)

    1979-01-01

    particularly Dr. John E. Taylor, Mr. John Joyner and Mr. Michael McCluskey, without whose support and encouragement the study would not have been...approach, although it m.ay seem modern, was propounded by Comenius in the 17th Century (Sae~tler, 1968). It is on this same set of instructional...Mark F., and John E. Tavlcr. Seli-Pacing a Gross Motor Skills Course: Crawler Tractor O.er1tor, MUS 62E20. Alexandria, Virginia: Human Resources

  17. Pacing and time allocation at the micro- and meso-level within the class hour: Why pacing is important, how to study it, and what it implies for individual lesson planning

    Directory of Open Access Journals (Sweden)

    Joshua Goldsmith

    2009-11-01

    Full Text Available The topic of pacing at the level of the individual class hour has received relatively little coverage in research literature. In order to provide a research-based take on the issue, the current work surveys the existing literature, develops terminology and draws a key distinction between macro-, meso-, and micro-levels of pacing, sequencing, grading, and transitioning. In order to focus on one of pacing’s constituent sub-topics—the allocation of classroom time—this article presents a case study of a first semester college-level introductory German class at a top-tier American university. The data come from two hours of class, one each from the beginning and end of the semester, in an attempt to discover not only how pacing affects teaching synchronically but also how it might change diachronically. Utterances and gestures were transcribed in order to segment the class into activities and sub-activities, and a model for using verbal and gestural cues to perform this kind of segmentation is proposed. The paper also discusses how the teacher allocates time to different kinds of activities, considering pacing strategies that help keep students focused and “on plan” and how these pacing strategies can allow for more time and activities spent on communicative, pair-based work. It is argued that because of the case study teacher’s focus on pacing and use of various strategies to pace the class, not only researchers but also teachers might be able to generalize the micro- and meso-pacing model described in this study to the pacing of individual lessons in their own classrooms.-------------------------------------------------------------------- L’anàlisi detallada del pacing en una hora de classe és un aspecte poc tractat en la literatura científica. Per garantir una perspectiva basada en resultats empírics, aquest estudi es proposa fer un repàs a la literatura ja publicada sobre el tema, desenvolupar-ne la terminologia i distingir

  18. Non-physiological increase of AV conduction time in sinus disease patients programmed in AAIR-based pacing mode.

    Science.gov (United States)

    Mabo, Philippe; Cebron, Jean-Pierre; Solnon, Aude; Tassin, Aude; Graindorge, Laurence; Gras, Daniel

    2012-11-01

    The EVOCAV(DS) trial aimed to quantify the paradoxal atrioventricular (AV) conduction time lengthening in sinus node (SD) patients (pts) paced in AAIR-based pacing mode. SD pts, implanted with dual-chamber pacemaker programmed in AAIR-based pacing mode, were randomized in two arms for a 1-month period: the low atrial pacing (LAP; basic rate at 60 bpm, dual sensor with minimal slope) and the high atrial pacing (HAP; basic rate at 70 bpm, dual sensor with optimized slope, overdrive pacing) arm. At 1 month, crossover was performed for an additional 1-month period. AV conduction time, AV block occurrence and AV conduction time adaptation during exercise were ascertained from device memories at each follow-up. Seventy-nine pts participated to the analysis (75 ± 8 years; 32 male; PR = 184 ± 38 ms; bundle branch block n = 12; AF history n = 36; antiarrhythmic treatment n = 53; beta-blockers n = 27; class III/Ic n = 18; both n = 8). The mean AV conduction time was significantly greater during the HAP (275 ± 51 ms) vs. LAP (263 ± 49 ms) period (p AV blocks occurred in 49 % of pts in the HAP vs. 19 % in the LAP period (p AV conduction time during exercise. AAIR-based pacing in SD pts may induce a significant lengthening of pts' AV conduction time, including frequent abnormal adaptation of AV conduction time during exercise.

  19. IMPLEMENTATION OF BIOFEEDBACK IN A CLOSED LOOP OF HEART RATE VARIABILITY AND PACED BREATHING IN PATIENTS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    O. L. Kulik

    2014-06-01

    Full Text Available The effectiveness of biofeedback in a closed loop of heart rate variability (HRV and paced breathing in patients with arterial hypertension was studied. 61 subjects with arterial hypertension (31 females and 30 males, mean age 56.8 ± 6.2 years were examined. In accordance with the objective of the study all subjects were divided into 2 groups: 1 – biofeedback group (34 subjects and 2 – the comparison group (27 subjects. 5 biofeedback sessions were performed in biofeedback group. In the comparison group only two biofeedback sessions were performed – at admission and before discharge from the hospital. Efficacy of biofeedback was evaluated by comparing the values of systolic and diastolic blood pressure (SBP and DBP, respectively, heart rate (HR, HRV indices, indicators of optimality (O, sensitivity (S and efficiency (E and BQI index at admission and discharge in both groups of patients. The use of biofeedback in arterial hypertension subjects allowed to achieve better control of heart rate, systolic and diastolic blood pressure and improves HRV indices. The positive dynamics of optimality and the integral BQI values indicated a training effect of regulation systems.

  20. Detection of Self-Paced Reaching Movement Intention from EEG Signals

    Directory of Open Access Journals (Sweden)

    Eileen eLew

    2012-07-01

    Full Text Available Future neuroprosthetic devices, in particular upper limb, will require decoding and executing not only the user’s intended movement type, but also when the user intends to execute the movement. This work investigates the potential use of brain signals recorded non-invasively for detecting the time before a self-paced reaching movement is initiated which could contribute to the design of practical upper limb neuroprosthetics. In particular, we show the detection of self-paced reaching movement intention in single trials using the readiness potential, an EEG slow cortical potential computed in a narrow frequency range (0.1 to 1 Hz. Our experiments with 12 human volunteers, two of them stroke subjects, yield high detection rates prior to the movement onset and low detection rates during the non-movement intention period. With the proposed approach, movement intention was detected around 500 ms before actual onset, which clearly matches previous literature on readiness potentials. Interestingly, the result obtained with one of the stroke subjects is coherent with those achieved in healthy subjects, with single-trial performance of up to 92% for the paretic arm. These results suggest that, apart from contributing to our understanding of voluntary motor control for designing more advanced neuroprostheses, our work could also have a direct impact on advancing robot-assisted neurorehabilitation.

  1. Utilizing solid impurity granules for ELM pacing in NSTX-U

    Science.gov (United States)

    Lunsford, Robert; Roquemore, L.; Jaworski, M. A.; Kaita, R.; Maingi, R.; NSTX-U Team

    2015-11-01

    Periodic edge localized modes (ELMs) rapidly transport stored energy from the edge plasma to the divertor. These events result in abrupt heating of the plasma facing components (PFCs) which reduces their effective lifetime as well as generating a strong impurity influx. If the frequency of these ELMs can be increased through controlled triggering, also known as pacing, then the inverse relationship between the peak heat flux and the frequency of the ELMs can be utilized to prevent material damage that could result from otherwise unmitigated ELMs. At NSTX, the ability of small (300 - 1000 micron) impurity granules to trigger and pace these ELMs is being explored. In these experiments, ELMs are triggered by seeding a density perturbation within the edge-pedestal region through low speed injection and ablation of impurity granules, thus generating a localized instability. Granules are dropped from a reservoir and transit a vertical flight tube at which point a rotating impeller imparts horizontal momentum into the falling granules. This drives them into the edge of the discharge at speeds ranging from 50-150 m/s and average injection frequencies of up to 200 Hz depending upon the settings of the injector. Results from the initial laboratory injection tests of lithium, boron carbide (B4C) and vitreous carbon granules and their subsequent implementation in NSTX-U experiments will be discussed. Work supported by DOE Contract No. DE-AC02-09CH11466.

  2. Novel Insights into Structure-Activity Relationships of N-Terminally Modified PACE4 Inhibitors.

    Science.gov (United States)

    Kwiatkowska, Anna; Couture, Frédéric; Levesque, Christine; Ly, Kévin; Beauchemin, Sophie; Desjardins, Roxane; Neugebauer, Witold; Dory, Yves L; Day, Robert

    2016-02-04

    PACE4 plays important roles in prostate cancer cell proliferation. The inhibition of this enzyme has been shown to slow prostate cancer progression and is emerging as a promising therapeutic strategy. In previous work, we developed a highly potent and selective PACE4 inhibitor, the multi-Leu (ML) peptide, an octapeptide with the sequence Ac-LLLLRVKR-NH2 . Here, with the objective of developing a useful compound for in vivo administration, we investigate the effect of N-terminal modifications. The inhibitory activity, toxicity, stability, and cell penetration properties of the resulting analogues were studied and compared to the unmodified inhibitor. Our results show that the incorporation of a polyethylene glycol (PEG) moiety leads to a loss of antiproliferative activity, whereas the attachment of a lipid chain preserves or improves it. However, the lipidated peptides are significantly more toxic when compared with their unmodified counterparts. Therefore, the best results were achieved not by the N-terminal extension but by the protection of both ends with the d-Leu residue and 4-amidinobenzylamide, which yielded the most stable inhibitor, with an excellent activity and toxicity profile. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. Characterizing Spatial Dynamics of Bifurcation to Alternans in Isolated Whole Rabbit Hearts Based on Alternate Pacing

    Directory of Open Access Journals (Sweden)

    Kanchan Kulkarni

    2015-01-01

    Full Text Available Sudden cardiac death instigated by ventricular fibrillation (VF is the largest cause of natural death in the USA. Alternans, a beat-to-beat alternation in the action potential duration, has been implicated as being proarrhythmic. The onset of alternans is mediated via a bifurcation, which may occur through either a smooth or a border-collision mechanism. The objective of this study was to characterize the mechanism of bifurcation to alternans based on experiments in isolated whole rabbit hearts. High resolution optical mapping was performed and the electrical activity was recorded from the left ventricle (LV epicardial surface of the heart. Each heart was paced using an “alternate pacing protocol,” where the basic cycle length (BCL was alternatively perturbed by ±δ. Local onset of alternans in the heart, BCLstart, was measured in the absence of perturbations (δ=0 and was defined as the BCL at which 10% of LV exhibited alternans. The influences of perturbation size were investigated at two BCLs: one prior to BCLstart (BCLprior=BCLstart+20 ms and one preceding BCLprior (BCLfar=BCLstart+40 ms. Our results demonstrate significant spatial correlation of the region exhibiting alternans with smooth bifurcation characteristics, indicating that transition to alternans in isolated rabbit hearts occurs predominantly through smooth bifurcation.

  4. Timing and pacing of the Late Devonian mass extinction event regulated by eccentricity and obliquity.

    Science.gov (United States)

    De Vleeschouwer, David; Da Silva, Anne-Christine; Sinnesael, Matthias; Chen, Daizhao; Day, James E; Whalen, Michael T; Guo, Zenghui; Claeys, Philippe

    2017-12-22

    The Late Devonian envelops one of Earth's big five mass extinction events at the Frasnian-Famennian boundary (374 Ma). Environmental change across the extinction severely affected Devonian reef-builders, besides many other forms of marine life. Yet, cause-and-effect chains leading to the extinction remain poorly constrained as Late Devonian stratigraphy is poorly resolved, compared to younger cataclysmic intervals. In this study we present a global orbitally calibrated chronology across this momentous interval, applying cyclostratigraphic techniques. Our timescale stipulates that 600 kyr separate the lower and upper Kellwasser positive δ 13 C excursions. The latter excursion is paced by obliquity and is therein similar to Mesozoic intervals of environmental upheaval, like the Cretaceous Ocean-Anoxic-Event-2 (OAE-2). This obliquity signature implies coincidence with a minimum of the 2.4 Myr eccentricity cycle, during which obliquity prevails over precession, and highlights the decisive role of astronomically forced "Milankovitch" climate change in timing and pacing the Late Devonian mass extinction.

  5. COHERENT HEMODYNAMICS SPECTROSCOPY BASED ON A PACED BREATHING PARADIGM — REVISITED

    Directory of Open Access Journals (Sweden)

    JANA M. KAINERSTORFER

    2014-01-01

    Full Text Available A novel hemodynamic model has been recently introduced, which provides analytical relationships between the changes in cerebral blood volume (CBV, cerebral blood flow (CBF, and cerebral metabolic rate of oxygen (CMRO2, and associated changes in the tissue concentrations of oxy- and deoxy-hemoglobin (ΔO and ΔD measured with near-infrared spectroscopy (NIRS [S. Fantini, Neuroimage85, 202–221 (2014]. This novel model can be applied to measurements of the amplitude and phase of induced hemodynamic oscillations as a function of the frequency of oscillation, realizing the novel technique of coherent hemodynamics spectroscopy (CHS [S. Fantini, Neuroimage85, 202–221 (2014; M. L. Pierro et al., Neuroimage85, 222–233 (2014]. In a previous work, we have demonstrated an in vivo application of CHS on human subjects during paced breathing [M. L. Pierro et al., Neuroimage85, 222–233 (2014]. In this work, we present a new analysis of the collected data during paced breathing based on a slightly revised formulation of the hemodynamic model and an efficient fitting procedure. While we have initially treated all 12 model parameters as independent, we have found that, in this new implementation of CHS, the number of independent parameters is eight. In this article, we identify the eight independent model parameters and we show that our previous results are consistent with the new formulation, once the individual parameters of the earlier analysis are combined into the new set of independent parameters.

  6. Dual chamber pacing with optimal AV delay in congestive heart failure: a randomized study.

    Science.gov (United States)

    Capucci, A; Romano, S; Puglisi, A; Santini, M; Pagani, M; Cazzin, R; Zanuttini, D; Mangiameli, S; Moracchini, P V; Neri, R; De Ciuceis, P; Circo, A; Cavaglià, S; De Seta, F

    1999-07-01

    A prospective randomized trial was set up to evaluate contractile parameters and quality of life in patients with congestive heart failure. We describe the results from 38 patients in sinus rhythm and with chronic heart failure due to congestive cardiomyopathy, prospectively randomized to optimal medical therapy (Group 1, 19 patients) or optimal medical therapy plus dual chamber pacemaker programmed to optimal AV delay (Group 2, 19 patients). At a 6 month follow-up, 7/19 patients in Group 1 had died compared with 5/19 patients in Group 2. During follow-up, there were few significant changes in evaluated parameters except for mitral regurgitation time, which was prolonged in Group 1 and shortened in Group 2. The systolic left ventricular diameter shortened significantly only in Group 2. An energy and activity questionnaire showed that the effect of DDD pacing in the latter patient population was beneficial. From these results we may conclude that at the 6 month follow-up DDD pacing with echo-optimized AV interval programming can improve quality of life without affecting survival.

  7. Inspiratory muscle fatigue after race-paced swimming is not restricted to the front crawl stroke.

    Science.gov (United States)

    Lomax, Mitch; Iggleden, Colin; Tourell, Alice; Castle, Sophie; Honey, Jo

    2012-10-01

    The occurrence of inspiratory muscle fatigue (IMF) has been documented after front crawl (FC) swimming of various distances. Whether IMF occurs after other competitive swimming strokes is not known. The aim of the present study was to assess the impact of all 4 competitive swimming strokes on the occurrence of IMF after race-paced swimming and to determine whether the magnitude of IMF was related to the breathing pattern adopted and hence breathing frequency (f(b)). Eleven, nationally ranked, youth swimmers completed four 200-m swims (one in each competitive stroke) on separate occasions. The order of the swims, which consisted of FC, backstroke (BK), breaststroke (BR), and butterfly (FLY), was randomized. Maximal inspiratory mouth pressure (MIP) was assessed before (after a swimming and inspiratory muscle warm-up) and after each swim with f(b) calculated post swim from recorded data. Inspiratory muscle fatigue was evident after each 200-m swim (p 0.05) was observed between f(b) and the change in MIP (FC: r = -0.456; BK: r = 0.218; BR: r = 0.218; and FLY: r = 0.312). These results demonstrate that IMF occurs in response to 200-m race-paced swimming in all strokes and that the magnitude of IMF is similar between strokes when breathing is ad libitum occurring no less than 1 breath (inhalation) every third stroke.

  8. Distinguishing mechanisms for alternans in cardiac cells using constant-diastolic-interval pacing.

    Science.gov (United States)

    Cherry, Elizabeth M

    2017-09-01

    Alternans, a proarrhythmic dynamical state in which cardiac action potentials alternate between long and short durations despite a constant pacing period, traditionally has been explained at the cellular level using nonlinear dynamics principles under the assumption that the action potential duration (APD) is determined solely by the time elapsed since the end of the previous action potential, called the diastolic interval (DI). In this scenario, APDs at a steady state should be the same provided that the preceding DIs are the same. Nevertheless, experiments attempting to eliminate alternans by dynamically adjusting the timing of pacing stimuli to keep the DI constant showed that alternans persisted, contradicting the traditional theory. It is now widely known that alternans also can arise from a different mechanism associated with intracellular calcium cycling. Our goal is to determine whether intracellular calcium dynamics can explain the experimental findings regarding the persistence of alternans despite a constant DI. For this, we use mathematical models capable of producing alternans through both voltage- and calcium-mediated mechanisms. We show that for voltage-driven alternans, action potentials elicited from a constant-DI protocol are always the same. However, in the case of calcium-driven alternans, the constant-DI protocol can result in alternans. Reducing the strength of the calcium instability progressively reduces and finally eliminates constant-DI alternans. Our findings suggest that screening for the presence of alternans using a constant-DI protocol has the potential for differentiating between voltage-driven and calcium-driven alternans.

  9. Distinguishing mechanisms for alternans in cardiac cells using constant-diastolic-interval pacing

    Science.gov (United States)

    Cherry, Elizabeth M.

    2017-09-01

    Alternans, a proarrhythmic dynamical state in which cardiac action potentials alternate between long and short durations despite a constant pacing period, traditionally has been explained at the cellular level using nonlinear dynamics principles under the assumption that the action potential duration (APD) is determined solely by the time elapsed since the end of the previous action potential, called the diastolic interval (DI). In this scenario, APDs at a steady state should be the same provided that the preceding DIs are the same. Nevertheless, experiments attempting to eliminate alternans by dynamically adjusting the timing of pacing stimuli to keep the DI constant showed that alternans persisted, contradicting the traditional theory. It is now widely known that alternans also can arise from a different mechanism associated with intracellular calcium cycling. Our goal is to determine whether intracellular calcium dynamics can explain the experimental findings regarding the persistence of alternans despite a constant DI. For this, we use mathematical models capable of producing alternans through both voltage- and calcium-mediated mechanisms. We show that for voltage-driven alternans, action potentials elicited from a constant-DI protocol are always the same. However, in the case of calcium-driven alternans, the constant-DI protocol can result in alternans. Reducing the strength of the calcium instability progressively reduces and finally eliminates constant-DI alternans. Our findings suggest that screening for the presence of alternans using a constant-DI protocol has the potential for differentiating between voltage-driven and calcium-driven alternans.

  10. Effect of Music Tempo on Attentional Focus and Perceived Exertion during Self-selected Paced Walking.

    Science.gov (United States)

    Silva, Aldo Coelho; Dos Santos Ferreira, Sandro; Alves, Ragami Chaves; Follador, Lucio; DA Silva, Sergio Gregorio

    2016-01-01

    This study investigated the influence of music on the rating of perceived exertion (RPE) and attentional focus during walking at a self-selected pace. Fifteen overweight and obese women volunteered to participate in the study. They underwent four sessions: the first for incremental maximal test and anthropometric measurement followed by three experimental sessions. After the first session, they were exposed to three 30-minute walking sessions at a self-selected pace in a counterbalanced order: fast-tempo music (FT), medium-tempo music (MT) and no-music control (NM). Borg's RPE Scale and an Attentional Focus Questionnaire were used to measure the perceptual response and attentional focus, respectively. Results showed that the RPE was higher in the no-music control than in the medium-tempo music (12.05 ± 0.6 vs. 10.5 ± 0.5). Furthermore, dissociative attentional focus was greater for both conditions with music in comparison with the no-music control (NM= 39.0 ± 4.1; MT= 48.4 ± 4.1 and FT= 47.9 ± 4.5). The results indicated that the use of music during walking can modulate attentional focus, increasing dissociative thought, and medium-tempo music can reduce the RPE.

  11. VARIABILITY OF COORDINATION PARAMETERS AT 400-M FRONT CRAWL SWIMMING PACE

    Directory of Open Access Journals (Sweden)

    Christophe Schnitzler

    2009-06-01

    Full Text Available This study examined the variability of physiological, perceptual, stroke and coordination parameters in both genders during several swim trials at the 400-m pace speed. Twelve national level competitors (6 men, 6 women swam 400-m at maximal speed. They then swam three additional trials (100, 200 and 300-m at the pace (speed of the previous 400-m. Three cameras were used to determine stroke cycle [speed (V, stroke length (SL, stroke rate (SR] and coordination [index of coordination (IdC, stroke phases] parameters. Physiological [heart rate (HR and lactate [La-] and perceptual [subjective workload (TWL] parameters were assessed after each swim trial. Inter-trial data indicated that HR, [La-] and TWL increased significantly with the distance swum (p 0.05. Thus, despite changes in both physiological and perceptual responses consecutive to increasing fatigue, coordination parameters remained stable during an all-out 400-m freestyle swim. The examination of these parameters based on short-distance trials appears then to be valid, which offers interesting perspectives for swim testing.

  12. The slow pace of institutional change in the Italian food system.

    Science.gov (United States)

    Ferretti, Maria Paola; Magaudda, Paolo

    2006-09-01

    Recent surveys show that Italians have little trust in the food they eat. This seems at odds with the world-wide popularity of Italian food, and the very prominent role that the agro-food sector has in the national economy and culture. This paper aims to explain this apparent contradiction by examining recent political and economic changes in the food sector. From the analysis it emerges that, facing institutional crises and food scandals, Italian politicians have left the task of reassuring consumers to the market. However, the market actors' strategy has been to prioritise the discourse of food quality, but give little weight to some other important preoccupation of consumers, such as safety. To address these concerns a more proactive role of the State would be required. An actual concern of public institutions with consumer needs, institutional efficiency, transparency and accountability emerges as a crucial factor in restoring and maintaining trust.

  13. Acute electrical and hemodynamic effects of multisite left ventricular pacing for cardiac resynchronization therapy in the dyssynchronous canine heart.

    Science.gov (United States)

    Ploux, Sylvain; Strik, Marc; van Hunnik, Arne; van Middendorp, Lars; Kuiper, Marion; Prinzen, Frits W

    2014-01-01

    Multisite left ventricular (multi-LV) epicardial pacing has been proposed as an alternative to conventional single-site LV (single-LV) pacing to increase the efficacy of cardiac resynchronization therapy. To compare the effects of multi-LV versus single-LV pacing in dogs with left bundle branch block (LBBB). Studies were performed in 9 anaesthetized dogs with chronic LBBB using 7 LV epicardial electrodes. Each electrode was tested alone and in combination with 1, 2, 3, and 6 other electrodes, the sequence of which was chosen on the basis of practical real-time electrical mapping to determine the site of the latest activation. LV total activation time (LVTAT) and dispersion of repolarization (DRep) were measured by using approximately 100 electrodes around the ventricles. LV contractility was assessed as the maximum derivative of left ventricular pressure (LVdP/dtmax ). Single-LV pacing provided, on average, a -4.0% ± 9.3% change in LVTAT and 0.2% ± 13.7% change in DRep. Multi-LV pacing markedly decreased both LVTAT and DRep in a stepwise fashion to reach -41.3% ± 5% (P Heart Rhythm Society Published by Heart Rhythm Society All rights reserved.

  14. A Pilot Study on the Effects of Transcranial Direct Current Stimulation on Brain Rhythms and Entropy during Self-Paced Finger Movement using the Epoc Helmet.

    Science.gov (United States)

    Bodranghien, Florian C A A; Langlois Mahe, Margot; Clément, Serge; Manto, Mario U

    2017-01-01

    Transcranial direct current stimulation (tDCS) of the cerebellum is emerging as a novel non-invasive tool to modulate the activity of the cerebellar circuitry. In a single blinded study, we applied anodal tDCS (atDCS) of the cerebellum to assess its effects on brain entropy and brain rhythms during self-paced sequential finger movements in a group of healthy volunteers. Although wearable electroencephalogram (EEG) systems cannot compete with traditional clinical/laboratory set-ups in terms of accuracy and channel density, they have now reached a sufficient maturity to envision daily life applications. Therefore, the EEG was recorded with a comfortable and easy to wear 14 channels wireless helmet (Epoc headset; electrode location was based on the 10-20 system). Cerebellar neurostimulation modified brain rhythmicity with a decrease in the delta band (electrode F3 and T8, p Epoc headset.

  15. Increased heart rate caused by atrial pacing with the closed-loop stimulation function prevented micturition syncope

    Directory of Open Access Journals (Sweden)

    Tatsuo Haraki, MD,PhD

    2013-10-01

    Full Text Available A 70-year-old man had been experiencing syncope several times a year. We implanted a DDD pacemaker with closed-loop stimulation (CLS function. When he urinated early in the morning, his increased atrial pacing rates elevated his heart rate (HR during and after micturition. After implantation of the DDD-CLS mode, he did not experience symptoms. In contrast, in the DDD-R mode, his intrinsic HR changed to atrial pacing after micturition but decreased to the basal rate within 2 min, and he experienced a sense of cold perspiration and presyncope. Increased HRs caused by atrial pacing with the CLS function were useful in the prevention of micturition syncope.

  16. Left ventricular performance during triggered left ventricular pacing in patients with cardiac resynchronization therapy and left bundle branch block

    DEFF Research Database (Denmark)

    Witt, Christoffer Tobias; Kronborg, Mads Brix; Nohr, Ellen Aagaard

    2016-01-01

    PURPOSE: To assess the acute effect of triggered left ventricular pacing (tLVp) on left ventricular performance and contraction pattern in patients with heart failure, left bundle branch block (LBBB), and cardiac resynchronization therapy (CRT). METHODS: Twenty-three patients with pre-implant QRS...... complex >150 ms, QRS complex narrowing under CRT, and sinus rhythm were included ≥3 months after CRT implantation. Echocardiographic assessment of left ventricular ejection fraction (LVEF), global peak systolic longitudinal strain (GLS), and contraction pattern by 2D strain was performed during intrinsic......V pacing. CONCLUSIONS: The acute effect of tLVp on LV systolic function and contraction pattern is significantly lower than the effect of BiV pacing and not different from intrinsic conduction in patients with LBBB and CRT....

  17. Human radiation studies: Remembering the early years. Oral history of physiologist Nello Pace, Ph.D., August 16, 1994

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-06-01

    Dr. Nello Pace was interviewed by representatives of the US DOE Office of Human Radiation Experiments (OHRE). Dr. Pace was selected fro the interview because of the positions he held with the US Navy, at the University of California, Berkeley, and as Director of the White Mountain Research Station near Bishop, California. Following a brief biographical sketch, Dr. Pace related his remembrances concerning tritium injections experiments in animals and humans during World War II, the development of Medical Physics Degree Programs at UC Berkeley, conducting the first radiation survey at Nagasaki after the bomb, and the establishment of a research laboratory at White Mountain. He also offers reflections on Shields Warren and comments on the public`s attitudes towards radiation both then and now.

  18. Peri-infarct zone pacing to prevent adverse left ventricular remodelling in patients with large myocardial infarction

    DEFF Research Database (Denmark)

    Stone, Gregg W; Chung, Eugene S; Stancak, Branislav

    2016-01-01

    -diastolic volume (ΔLVEDV) from baseline to 18 months between the pooled pacing therapy groups and the control group. ΔLVEDV increased by 15.3 ± 28.6 mL in the control group and by 16.7 ± 30.5 mL in the pooled pacing groups during follow-up (adjusted mean difference (95% CI) = 0.6 (-12.3, 13.5) mL, P = 0......AIMS: We sought to determine whether peri-infarct pacing prevents left ventricular (LV) remodelling and improves functional and clinical outcomes in patients with large first myocardial infarction (MI). METHODS AND RESULTS: A total of 126 patients at 27 international sites within 10 days of onset...

  19. Human radiation studies: Remembering the early years. Oral history of physiologist Nello Pace, Ph.D., August 16, 1994

    International Nuclear Information System (INIS)

    1995-06-01

    Dr. Nello Pace was interviewed by representatives of the US DOE Office of Human Radiation Experiments (OHRE). Dr. Pace was selected fro the interview because of the positions he held with the US Navy, at the University of California, Berkeley, and as Director of the White Mountain Research Station near Bishop, California. Following a brief biographical sketch, Dr. Pace related his remembrances concerning tritium injections experiments in animals and humans during World War II, the development of Medical Physics Degree Programs at UC Berkeley, conducting the first radiation survey at Nagasaki after the bomb, and the establishment of a research laboratory at White Mountain. He also offers reflections on Shields Warren and comments on the public's attitudes towards radiation both then and now

  20. Environmental effects on the behavior of zoo-housed lions and tigers, with a case study of the effects of a visual barrier on pacing.

    Science.gov (United States)

    Bashaw, Meredith J; Kelling, Angela S; Bloomsmith, Mollie A; Maple, Terry L

    2007-01-01

    Tigers and lions in the wild are nocturnal nonhuman animals who may hunt and mate opportunistically during daylight hours. In captivity, they spend most time on exhibit sleeping or pacing. To better understand their activity budget, this study examined the daily behavior patterns of 2 Sumatran tigers and 3 African lions in different housings. The proportion of scans the large felids spent engaged in stereotypic pacing varied by time of day and environment. The tigers spent different amounts of time pacing when housed in different exhibits; the lions paced more in off-exhibit housing than when on exhibit. These differences suggest changes to the cats' immediate housing environment may decrease pacing but provide little insight into altering specifics. Carnivores' pacing relates to their inability to control sensory access to social partners. Both environments with increased pacing contained chain-link fencing. allowing uncontrolled sensory contact. Where the tigers paced, the study placed a visual barrier between one female and keepers' or conspecifics' cues. This did not significantly decrease pacing. However, the study suggests considering sensory access and environmental variables when designing environments for captive carnivores.

  1. A case of hypertrophic obstructive cardiomyopathy in which left ventricular remodeling and reverse remodeling were seen with pacing on and off

    Directory of Open Access Journals (Sweden)

    Taiju Matsui, MD

    2014-04-01

    Full Text Available A 77-year-old woman with hypertrophic obstructive cardiomyopathy was admitted to the hospital in March 2005 with a chief complaint of chest discomfort, and a left ventricular outflow tract (LVOT gradient was seen. After starting apical dual chamber (DDD pacing and oral cibenzoline 300 mg/day to relieve the stenosis, the pressure gradient and subjective symptoms disappeared. The patient was then followed as an outpatient. In January 2008, cibenzoline was discontinued because the patient experienced a hypoglycemic attack. Plain chest radiographs showed an increased cardiothoracic ratio from May 2009 and ventricular remodeling was suspected, although there were no changes in chest symptoms. Therefore, pacing off was considered. Acute changes in the LVOT gradient were evaluated with echocardiography before and after pacing on–off, but no changes were seen, so the course was observed in the pacing-off state. The LVOT gradient gradually increased again from 7 months after pacing off, and the pressure gradient decreased again after pacing was restarted. On the electrocardiogram, a deep negative T wave was seen in V4–6 immediately after pacing off, but with time, it became positive, similar to before an implantable cardioverter defibrillator was inserted. Reverse remodeling was judged to occur after pacing off, and pacing therapy was restarted. The patient is currently under observation.

  2. Immune investment is explained by sexual selection and pace-of-life, but not longevity in parrots (Psittaciformes.

    Directory of Open Access Journals (Sweden)

    Darryl B Edwards

    Full Text Available Investment in current reproduction should come at the expense of traits promoting future reproduction, such as immunity and longevity. To date, comparative studies of pace-of-life traits have provided some support for this, with slower paced species having greater immune function. Another means of investment in current reproduction is through secondary sexual characters (SSC. Investment in SSC's is considered costly, both in terms of immunity and longevity, with greater costs being borne by species with more elaborate traits. Yet within species, females prefer more ornate males and those males are typically immunologically superior. Because of this, predictions about the relationship between immunity and SSC's across species are not clear. If traits are costly, brighter species should have reduced immune function, but the opposite is true if SSC's arise from selection for more immunocompetent individuals. My approach was to investigate immune investment in relation to SSC's, pace-of-life and longevity while considering potentially confounding ecological factors. To do so I assessed leukocyte counts from in a novel group, the Psittaciformes. Investment in SSC's best explained investment in immunity: species with brighter plumage had higher leukocyte counts and those with a greater degree of sexual dichromatism had fewer. Ecological variables and pace-of-life models tended to be poor predictors of immune investment. However, shorter incubation periods were associated with lower leukocyte counts supporting the notion that species with a fast pace-of-life invest less in immunity. These results suggest that investment in reproduction in terms of fast pace-of-life and sexual dichromatism results in reduced immunity; however, investment in plumage colour per se does not impose a cost on immunity across species.

  3. Immune investment is explained by sexual selection and pace-of-life, but not longevity in parrots (Psittaciformes).

    Science.gov (United States)

    Edwards, Darryl B

    2012-01-01

    Investment in current reproduction should come at the expense of traits promoting future reproduction, such as immunity and longevity. To date, comparative studies of pace-of-life traits have provided some support for this, with slower paced species having greater immune function. Another means of investment in current reproduction is through secondary sexual characters (SSC). Investment in SSC's is considered costly, both in terms of immunity and longevity, with greater costs being borne by species with more elaborate traits. Yet within species, females prefer more ornate males and those males are typically immunologically superior. Because of this, predictions about the relationship between immunity and SSC's across species are not clear. If traits are costly, brighter species should have reduced immune function, but the opposite is true if SSC's arise from selection for more immunocompetent individuals. My approach was to investigate immune investment in relation to SSC's, pace-of-life and longevity while considering potentially confounding ecological factors. To do so I assessed leukocyte counts from in a novel group, the Psittaciformes. Investment in SSC's best explained investment in immunity: species with brighter plumage had higher leukocyte counts and those with a greater degree of sexual dichromatism had fewer. Ecological variables and pace-of-life models tended to be poor predictors of immune investment. However, shorter incubation periods were associated with lower leukocyte counts supporting the notion that species with a fast pace-of-life invest less in immunity. These results suggest that investment in reproduction in terms of fast pace-of-life and sexual dichromatism results in reduced immunity; however, investment in plumage colour per se does not impose a cost on immunity across species.

  4. Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing.

    Science.gov (United States)

    Wang, Jingfeng; Nie, Zhenning; Chen, Haiyan; Shu, Xianhong; Yang, Zhaohua; Yao, Ruiming; Su, Yangang; Ge, Junbo

    2017-12-11

    It is now well recognized that heart failure (HF) patients with left bundle branch block (LBBB) derive substantial clinical benefits from cardiac resynchronization therapy (CRT), and LBBB has become one of the important predictors for CRT response. The conventional tachypacing-induced HF model has several major limitations, including absence of stable LBBB and rapid reversal of left ventricular (LV) dysfunction after cessation of pacing. Hence, it is essential to establish an optimal model of chronic HF with isolated LBBB for studying CRT benefits. In the present study, a canine model of asynchronous HF induced by left bundle branch (LBB) ablation and 4 weeks of rapid right ventricular (RV) pacing is established. The RV and right atrial (RA) pacing electrodes via the jugular vein approach, together with an epicardial LV pacing electrode, were implanted for CRT performance. Presented here are the detailed protocols of radiofrequency (RF) catheter ablation, pacing leads implantation, and rapid pacing strategy. Intracardiac and surface electrograms during operation were also provided for a better understanding of LBB ablation. Two-dimensional speckle tracking imaging and aortic velocity time integral (aVTI) were acquired to validate the chronic stable HF model with LV asynchrony and CRT benefits. By coordinating ventricular activation and contraction, CRT uniformed the LV mechanical work and restored LV pump function, which was followed by reversal of LV dilation. Moreover, the histopathological study revealed a significant restoration of cardiomyocyte diameter and collagen volume fraction (CVF) after CRT performance, indicating a histologic and cellular reverse remodeling elicited by CRT. In this report, we described a feasible and valid method to develop a chronic asynchronous HF model, which was suitable for studying structural and biologic reverse remodeling following CRT.

  5. Antifibrillatory effects of renal denervation on ventricular fibrillation in a canine model of pacing-induced heart failure.

    Science.gov (United States)

    Luo, Qingzhi; Jin, Qi; Zhang, Ning; Huang, Shangwei; Han, Yanxin; Lin, Changjian; Ling, Tianyou; Chen, Kang; Pan, Wenqi; Wu, Liqun

    2018-01-01

    What is the central question of this study? In the present study, we investigated the effects of renal denervation on the vulnerability to ventricular fibrillation and the ventricular electrical properties in a rapid pacing-induced heart failure canine model. What is the main finding and its importance? Renal denervation significantly attenuated the process of heart failure and improved left ventricular systolic dysfunction, stabilized ventricular electrophysiological properties and decreased the vulnerability of the heart to ventricular fibrillation during heart failure. Thus, renal denervation can attenuate ventricular electrical remodelling and exert a potential antifibrillatory action in a pacing-induced heart failure canine model. In this study, we investigated the effects of renal denervation (RDN) on the vulnerability to ventricular fibrillation (VF) and the ventricular electrical properties in a canine model of pacing-induced heart failure (HF). Eighteen beagles were divided into the following three groups: control (n = 6), HF (n = 6) and HF+RDN (n = 6). Heart failure was induced by rapid right ventricular pacing. Renal denervation was performed simultaneously with the pacemaker implantation in the HF+RDN group. A 64-unipolar basket catheter was used to perform global endocardial mapping of the left ventricle. The restitution properties and dispersion of refractoriness were estimated from the activation recovery intervals (ARIs) by a pacing protocol. The VF threshold (VFT) was defined as the maximal pacing cycle length required to induce VF using a specific pacing protocol. The defibrillation threshold (DFT) was measured by an up-down algorithm. Renal denervation partly restored left ventricular systolic function and attenuated the process of HF. Compared with the control group, the VFT in the HF group was decreased by 27% (106 ± 8.0 versus 135 ± 10 ms, P Renal denervation significantly flattened the ventricular ARI restitution curve by 15% (1

  6. Atrium-driven mitral annulus motion velocity reflects global left ventricular function and pulmonary congestion during acute biventricular pacing.

    Science.gov (United States)

    Frielingsdorf, Jürgen; Schmidt, Christoph; Debrunner, Marianne; Tavakoli, Reza; Genoni, Michele; Straumann, Edwin; Bertel, Osmund; Naegeli, Barbara

    2008-03-01

    The short-term effect of acute biventricular pacing on cardiac function in patients with chronic heart failure undergoing heart surgery is widely unknown. The present study was designed to determine whether mitral annular tissue Doppler imaging (TDI) is useful to predict acute changes in global systolic function determined by the continuous cardiac output method that was measured postoperatively during various pacing configurations in patients with depressed left ventricular (LV) function. TDI peak velocities of systolic (Sm), early diastolic (Em), and late diastolic (Am) mitral annular motion waves were measured in 17 patients (age 67 +/- 8 years, 10 male) with depressed LV systolic function (LV ejection fraction 120 ms undergoing temporary epicardial biventricular pacing after aortocoronary bypass and valve surgery. TDI velocities, QRS duration on surface electrocardiogram, cardiac index (CI), right atrial pressure, pulmonary artery pressure, and pulmonary capillary wedge (PCW) pressure were measured simultaneously during various pacing configurations (right atrial-biventricular, right atrial-LV, right atrial-right ventricular, atrial inhibited, and no pacing). Univariate linear regression analysis showed a good correlation between Am and CI (r = 0.53, P = .0001) determined in all pacing modes, a weak correlation between Sm and CI (r = 0.31, P = .017), and no correlation between Em and CI (r = 0.21, P = .074). Am > 6 cm/s predicted a CI of 2.5 L/min/m(2) or more with a sensitivity of 95% and a specificity of 30%. All TDI values correlated negatively with PCW (r = -0.53, P = .0001 for Sm; r = -0.34, P = .01 for Em; r = -0.50, P = .0001 for Am). Am greater than 6 cm/s predicted a PCW of 16 mm Hg or less with a specificity of 100% and a sensitivity of 34%. Mean values of TDI velocities and hemodynamic parameters were not significantly different between each pacing configuration. Peak Am mitral annular velocity correlates well with CI and PCW, respectively, thus

  7. Left ventricular endocardial or triventricular pacing to optimize cardiac resynchronization therapy in a chronic canine model of ischemic heart failure.

    Science.gov (United States)

    Bordachar, Pierre; Grenz, Nathan; Jais, Pierre; Ritter, Philippe; Leclercq, Christophe; Morgan, John M; Gras, Daniel; Yang, Ping

    2012-07-15

    Cardiac resynchronization therapy (CRT) is a proven treatment for heart failure but ~30% of patients appear to not benefit from the therapy. Left ventricular (LV) endocardial and multisite epicardial [triventricular (TriV)] pacing have been proposed as alternatives to traditional LV transvenous epicardial pacing, but no study has directly compared the hemodynamic effects of these approaches. Left bundle branch block ablation and repeated microembolizations were performed in dogs to induce electrical dysynchrony and to reduce LV ejection fraction to chronic benefit of this approach in humans.

  8. Challenge of Helping Introductory Physics Students Transfer Their Learning by Engaging with a Self-Paced Learning Tutorial

    Directory of Open Access Journals (Sweden)

    Emily Megan Marshman

    2018-03-01

    Full Text Available With advances in digital technology, research-validated self-paced learning tools can play an increasingly important role in helping students with diverse backgrounds become good problem solvers and independent learners. Thus, it is important to ensure that all students engage with self-paced learning tools effectively in order to learn the content deeply, develop good problem-solving skills, and transfer their learning from one context to another. Here, we first provide an overview of a holistic framework for engaging students with self-paced learning tools so that they can transfer their learning to solve novel problems. The framework not only takes into account the features of the self-paced learning tools but also how those tools are implemented, the extent to which the tools take into account student characteristics, and whether factors related to students’ social environments are accounted for appropriately in the implementation of those tools. We then describe an investigation in which we interpret the findings using the framework. In this study, a research-validated self-paced physics tutorial was implemented in both controlled one-on-one interviews and in large enrollment, introductory calculus-based physics courses as a self-paced learning tool. We find that students who used the tutorial in a controlled one-on-one interview situation performed significantly better on transfer problems than those who used it as a self-paced learning tool in the large-scale implementation. The findings suggest that critically examining and taking into account how the self-paced tools are implemented and incentivized, student characteristics including their self-regulation and time-management skills, and social and environmental factors can greatly impact the extent and manner in which students engage with these learning tools. Getting buy in from students about the value of these tools and providing appropriate support while implementing them is

  9. Heart failure in patients with sick sinus syndrome treated with single lead atrial or dual-chamber pacing

    DEFF Research Database (Denmark)

    Riahi, Sam; Nielsen, Jens Cosedis; Hjortshøj, Søren

    2012-01-01

    AIMS: Previous studies indicate that ventricular pacing may precipitate heart failure (HF). We investigated occurrence of HF during long-term follow-up among patients with sick sinus syndrome (SSS) randomized to AAIR or DDDR pacing. Furthermore, we investigated effects of percentage of ventricular...... during follow-up. Patients were classified with new HF, if in New York Heart Association (NYHA) functional class IV or if presence of ≥2 of: oedema; dyspnoea; NYHA functional class III. Mean follow-up was 5.4 ± 2.4 years. Heart failure hospitalizations did not differ between groups. In the AAIR group...

  10. Multi-site multi-polar left ventricular pacing through persistent left superior vena cava in tricuspid valve disease

    Directory of Open Access Journals (Sweden)

    Ernest W. Lau

    2017-09-01

    Full Text Available Multi-site multi-polar left ventricular pacing through the coronary sinus (CS may be preferred over endocardial right ventricular or surgical epicardial pacing in the presence of tricuspid valve disease. However, the required lead placement can be difficult through a persistent left superior vena cava (PLSVC, as the CS tends to be hugely dilated and side branches tend to have sharp angulations (>90° when approached from the PLSVC. Pre-shaped angiography catheters and techniques used for finding venous grafts from the ascending aorta post coronary bypass surgery may help with lead placement in such a situation.

  11. Long-term clinical effects of ventricular pacing reduction with a changeover mode to minimize ventricular pacing in a general pacemaker population.

    Science.gov (United States)

    Stockburger, Martin; Boveda, Serge; Moreno, Javier; Da Costa, Antoine; Hatala, Robert; Brachmann, Johannes; Butter, Christian; Garcia Seara, Javier; Rolando, Mara; Defaye, Pascal

    2015-01-14

    Right ventricular pacing (VP) has been hypothesized to increase the risk in heart failure (HF) and atrial fibrillation (AF). The ANSWER study evaluated, whether an AAI-DDD changeover mode to minimize VP (SafeR) improves outcome compared with DDD in a general dual-chamber pacemaker population. ANSWER was a randomized controlled multicentre trial assessing SafeR vs. standard DDD in sinus node disease (SND) or AV block (AVB) patients. After a 1-month run-in period, they were randomized (1 : 1) and followed for 3 years. Pre-specified co-primary end-points were VP and the composite of hospitalization for HF, AF, or cardioversion. Pre-specified secondary end-points were cardiac death or HF hospitalizations and cardiovascular hospitalizations. ANSWER enrolled 650 patients (52.0% SND, 48% AVB) at 43 European centres and randomized in SafeR (n = 314) or DDD (n = 318). The SafeR mode showed a significant decrease in VP compared with DDD (11.5 vs. 93.6%, P hospitalization for HF, AF, or cardioversion, nor in the individual components. SafeR showed a 51% risk reduction (RR) in experiencing cardiac death or HF hospitalization [HR = 0.49; 95% CI (0.27-0.90); P = 0.02] and 30% RR in experiencing cardiovascular hospitalizations [HR = 0.70; 95% CI (0.49-1.00); P = 0.05]. SafeR safely and significantly reduced VP in a general pacemaker population though had no effect on hospitalization for HF, AF, or cardioversion, when compared with DDD. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Cardiology.

  12. Toward a semi-self-paced EEG brain computer interface: decoding initiation state from non-initiation state in dedicated time slots.

    Directory of Open Access Journals (Sweden)

    Lingling Yang

    Full Text Available Brain computer interfaces (BCIs offer a broad class of neurologically impaired individuals an alternative means to interact with the environment. Many BCIs are "synchronous" systems, in which the system sets the timing of the interaction and tries to infer what control command the subject is issuing at each prompting. In contrast, in "asynchronous" BCIs subjects pace the interaction and the system must determine when the subject's control command occurs. In this paper we propose a new idea for BCI which draws upon the strengths of both approaches. The subjects are externally paced and the BCI is able to determine when control commands are issued by decoding the subject's intention for initiating control in dedicated time slots. A single task with randomly interleaved trials was designed to test whether it can be used as stimulus for inducing initiation and non-initiation states when the sensory and motor requirements for the two types of trials are very nearly identical. Further, the essential problem on the discrimination between initiation state and non-initiation state was studied. We tested the ability of EEG spectral power to distinguish between these two states. Among the four standard EEG frequency bands, beta band power recorded over parietal-occipital cortices provided the best performance, achieving an average accuracy of 86% for the correct classification of initiation and non-initiation states. Moreover, delta band power recorded over parietal and motor areas yielded a good performance and thus could also be used as an alternative feature to discriminate these two mental states. The results demonstrate the viability of our proposed idea for a BCI design based on conventional EEG features. Our proposal offers the potential to mitigate the signal detection challenges of fully asynchronous BCIs, while providing greater flexibility to the subject than traditional synchronous BCIs.

  13. Promotion of Adequate Exercise for Chronic Disorders' Elderly Through Paced Music.

    Science.gov (United States)

    Kang, Gi-Ryong; Kim, Il Kon; Kim, Woo Jin; Lee, Do-Youn

    2017-01-01

    South Korean population has been aging at an accelerated rate in recent years and the country will be a hyper-aging nation at 2020. One important issue in an aged society is higher rates of chronic disorders among the population. One of the best means to prevent an increase in severity of chronic disease is making patients exercise regularly. In this paper, we present a mobile app for senior citizens that provides daily exercise recommendations an receive tailored service related to a chronic disorder. In this app, pace (BPM) of played music is regulated to encourage patients to fulfill their daily exercise goal. The combination was constructed by using suggestions of World Health Organization and Korea Sports Promotion Foundation. Through our app, users are guided to exercise daily and regularly with appropriate exercise intensity. Patients can deal with their chronic disorders via our mobile application with increased physical activities.

  14. Prolonged self-paced exercise in the heat - environmental factors affecting performance

    DEFF Research Database (Denmark)

    Junge, Nicklas; Jørgensen, Rasmus; Flouris, Andreas D

    2016-01-01

    metabolic rate, it appears that endurance is affected even at much lower ambient temperatures. On this basis we conclude that environmental heat stress impacts self-paced endurance performance. However, the effect is markedly modified by acclimatization status and exercise mode, as the wind generated......) was on average reduced by 15% in the 14 studies that fulfilled the inclusion criteria. Ambient temperature per se was a poor predictor of the integrated environmental heat stress and 2 of the prevailing heat stress indices (WBGT and UTCI) failed to predict the environmental influence on performance. The weighing...... of wind speed appears to be too low for predicting the effect for cycling in trained acclimatized subjects, where performance may be maintained in outdoor time trials at ambient temperatures as high as 36°C (36°C UTCI; 28°C WBGT). Power output during indoor trials may also be maintained with temperatures...

  15. Los bonos educativos en el programa Paces en Colombia, 1992-1998: una experiencia fallida

    Directory of Open Access Journals (Sweden)

    Piedad Patricia Restrepo

    2004-07-01

    Full Text Available Esta investigación muestra que, a través de un análisis del diseño institucional e implementación, el programa de bonos educativos Paces en Colombia, en el periodo 1992-1998, estuvo lejos de cumplir sus objetivos de corto y largo plazo. La no inclusión dentro del valor del bono del costo de oportunidad por los ingresos laborales perdidos, la escasa regulación y monitoreo de los colegios participantes, en especial de aquellos que surgieron a raíz del programa, son algunos de los factores que incidieron en sus resultados. Al final, se presentan algunas propuestas para mejorar el diseño de este tipo de programas que permitan alcanzar los objetivos planteados en cuanto a cobertura, calidad y equidad.

  16. Self-pacing direct memory access data transfer operations for compute nodes in a parallel computer

    Science.gov (United States)

    Blocksome, Michael A

    2015-02-17

    Methods, apparatus, and products are disclosed for self-pacing DMA data transfer operations for nodes in a parallel computer that include: transferring, by an origin DMA on an origin node, a RTS message to a target node, the RTS message specifying an message on the origin node for transfer to the target node; receiving, in an origin injection FIFO for the origin DMA from a target DMA on the target node in response to transferring the RTS message, a target RGET descriptor followed by a DMA transfer operation descriptor, the DMA descriptor for transmitting a message portion to the target node, the target RGET descriptor specifying an origin RGET descriptor on the origin node that specifies an additional DMA descriptor for transmitting an additional message portion to the target node; processing, by the origin DMA, the target RGET descriptor; and processing, by the origin DMA, the DMA transfer operation descriptor.

  17. Cardiac response to low-energy field pacing challenges the standard theory of defibrillation.

    Science.gov (United States)

    Caldwell, Bryan J; Trew, Mark L; Pertsov, Arkady M

    2015-06-01

    The electric response of myocardial tissue to periodic field stimuli has attracted significant attention as the basis for low-energy antifibrillation pacing, potentially more effective than traditional single high-energy shocks. In conventional models, an electric field produces a highly nonuniform response of the myocardial wall, with discrete excitations, or hot spots (HS), occurring at cathodal tissue surfaces or large coronary vessels. We test this prediction using novel 3-dimensional tomographic optical imaging. Experiments were performed in isolated coronary perfused pig ventricular wall preparations stained with near-infrared voltage-sensitive fluorescent dye DI-4-ANBDQBS. The 3-dimensional coordinates of HS were determined using alternating transillumination. To relate HS formation with myocardial structures, we used ultradeep confocal imaging (interrogation depths, >4 mm). The peak HS distribution is located deep inside the heart wall, and the depth is not significantly affected by field polarity. We did not observe the strong colocalization of HS with major coronary vessels anticipated from theory. Yet, we observed considerable lateral displacement of HS with field polarity reversal. Models that de-emphasized lateral intracellular coupling and accounted for resistive heterogeneity in the extracellular space showed similar HS distributions to the experimental observations. The HS distributions within the myocardial wall and the significant lateral displacements with field polarity reversal are inconsistent with standard theories of defibrillation. Extended theories based on enhanced descriptions of cellular scale electric mechanisms may be necessary. The considerable lateral displacement of HS with field polarity reversal supports the hypothesis of biphasic stimuli in low-energy antifibrillation pacing being advantageous. © 2015 American Heart Association, Inc.

  18. Influence of Knowledge of Task Endpoint on Pacing and Performance During Simulated Rugby League Match Play.

    Science.gov (United States)

    Highton, Jamie; Mullen, Thomas; Twist, Craig

    2017-10-01

    To examine the influence of knowledge of exercise duration on pacing and performance during simulated rugby league match play. Thirteen male university rugby players completed 3 simulated rugby league matches (RLMSP-i) on separate days in a random order. In a control trial, participants were informed that they would be performing 2 × 23-min bouts (separated by 20 min) of the RLMSP-i (CON). In a second trial, participants were informed that they would be performing 1 × 23-min bout of the protocol but were then asked to perform another 23-min bout (DEC). In a third trial, participants were not informed of the exercise duration and performed 2 × 23-min bouts (UN). Distance covered and high-intensity running were higher in CON (4813 ± 167 m, 26 ± 4.1 m/min) than DEC (4764 ± 112 m, 25.2 ± 2.8 m/min) and UN (4744 ± 131 m, 24.4 m/min). Compared with CON, high-intensity running and peak speed were typically higher for DEC in bout 1 and lower in bout 2 of the RLMSP-i, while UN was generally lower throughout. Similarly, DEC resulted in an increased heart rate, blood lactate, and rating of perceived exertion than CON in bout 1, whereas these variables were lower throughout the protocol in UN. Pacing and performance during simulated rugby league match play depend on an accurate understanding of the exercise endpoint. Applied practitioners should consider informing players of their likely exercise duration to maximize running.

  19. [The role of cardiac pacing therapy in the management of carotid sinus syndrome].

    Science.gov (United States)

    2015-01-01

    Carotid sinus syndrome is characterized by a hypersensitive carotid sinus and syncope. Although we have clear guidelines for the diagnosis and treatment of carotid sinus syndrome, the efficacy of pacing therapy with this indication has not been the subject of many studies. This study aimed to assess the efficacy and safety of pacing therapy in the treatment of patients with carotid sinus syndrome and to determine the factors contributing to symp- toms recurrence after pacemaker implantation. This study was retrospective and included 32 patients in whom a pacemaker was implanted due to carotid sinus syn- drome at the Pacemaker Center, Clinical Center of Serbia, be- tween April 2005 and April 2012. Carotid sinus massage and head-up tilt test (HUTT) were performed to select patients with cardioinhibitory and mixed type carotid sinus syndrome, who were enrolled to the study. The mean age of patients was 65.6 ± 11.5 years and 20 (62.5%) were men. The mean follow-up period was 4.3 ± 1.9 years. HUTT was performed in 3 (9.4%) patients. Twenty-seven (84.4%) patients presented with cardioinhibitory and 5 (15.6%) with mixed type of carotid sinus syndrome. After pacemaker implantation, 22 (68.7%) patients had no further symptoms, 8 (25.0%) had syncope and 2 (6.3%) presyncope.The mixed type of the disease (HR 3.1; 95% CI 1.4-5.1; p = 0.021) and implanta- tion of pacemaker in WI mode (HR 1.8; 95% CI 1.1-3.2; p = 0.034) were independent predictors of symptoms recurrence. There were 3 (9.4%) perioperative surgical complications. Pacemaker therapy is an effective and safe treat- ment for patients with carotid sinus syndrome. As predictors of symptoms persistence after pacemaker implantation in our population, we identified the implantation of pacemaker in WI mode and the mixed type of carotid sinus syndrome.

  20. Orbitally paced phosphogenesis in Mediterranean shallow marine carbonates during the middle Miocene Monterey event.

    Science.gov (United States)

    Auer, Gerald; Hauzenberger, Christoph A; Reuter, Markus; Piller, Werner E

    2016-04-01

    During the Oligo-Miocene, major phases of phosphogenesis occurred in the Earth's oceans. However, most phosphate deposits represent condensed or allochthonous hemipelagic deposits, formed by complex physical and chemical enrichment processes, limiting their applicability for the study regarding the temporal pacing of Miocene phosphogenesis. The Oligo-Miocene Decontra section located on the Maiella Platform (central Apennines, Italy) is a widely continuous carbonate succession deposited in a mostly middle to outer neritic setting. Of particular interest are the well-winnowed grain to packstones of the middle Miocene Bryozoan Limestone, where occurrences of authigenic phosphate grains coincide with the prominent carbon isotope excursion of the Monterey event. This unique setting allows the analysis of orbital forcing on phosphogenesis, within a bio, chemo, and cyclostratigraphically constrained age-model. LA-ICP-MS analyses revealed a significant enrichment of uranium in the studied authigenic phosphates compared to the surrounding carbonates, allowing natural gamma-radiation (GR) to be used as a qualitative proxy for autochthonous phosphate content. Time series analyses indicate a strong 405 kyr eccentricity forcing of GR in the Bryozoan Limestone. These results link maxima in the GR record and thus phosphate content to orbitally paced increases in the burial of organic carbon, particularly during the carbon isotope maxima of the Monterey event. Thus, phosphogenesis during the middle Miocene in the Mediterranean was controlled by the 405 kyr eccentricity and its influence on large-scale paleoproductivity patterns. Rare earth element data were used as a tool to reconstruct the formation conditions of the investigated phosphates, indicating generally oxic formation conditions, which are consistent with microbially mediated phosphogenesis.

  1. Influence of prior knowledge of exercise duration on pacing strategies during game-based activities.

    Science.gov (United States)

    Gabbett, Tim J; Walker, Ben; Walker, Shane

    2015-04-01

    To investigate the influence of prior knowledge of exercise duration on the pacing strategies employed during game-based activities. Twelve semiprofessional team-sport athletes (mean ± SD age 22.8 ± 2.1 y) participated in this study. Players performed 3 small-sided games in random order. In one condition (Control), players were informed that they would play the small-sided game for 12 min and then completed the 12-min game. In a 2nd condition (Deception), players were told that they would play the small-sided game for 6 minutes, but after completing the 6-min game, they were asked to complete another 6 min. In a 3rd condition (Unknown), players were not told how long they would be required to play the small-sided game, but the activity was terminated after 12 min. Movement was recorded using a GPS unit sampling at 10 Hz. Post hoc inspection of video footage was undertaken to count the number of possessions and the number and quality of disposals. Higher initial intensities were observed in the Deception (130.6 ± 3.3 m/min) and Unknown (129.3 ± 2.4 m/min) conditions than the Control condition (123.3 ± 3.4 m/min). Greater amounts of high-speed running occurred during the initial phases of the Deception condition, and more low-speed activity occurred during the Unknown condition. A moderately greater number of total skill involvements occurred in the Unknown condition than the Control condition. These findings suggest that during game-based activities, players alter their pacing strategy based on the anticipated endpoint of the exercise bout.

  2. Faster self-paced rate of drinking for alcohol mixed with energy drinks versus alcohol alone.

    Science.gov (United States)

    Marczinski, Cecile A; Fillmore, Mark T; Maloney, Sarah F; Stamates, Amy L

    2017-03-01

    The consumption of alcohol mixed with energy drinks (AmED) has been associated with higher rates of binge drinking and impaired driving when compared with alcohol alone. However, it remains unclear why the risks of use of AmED are heightened compared with alcohol alone even when the doses of alcohol consumed are similar. Therefore, the purpose of this laboratory study was to investigate if the rate of self-paced beverage consumption was faster for a dose of AmED versus alcohol alone using a double-blind, within-subjects, placebo-controlled study design. Participants (n = 16) of equal gender who were social drinkers attended 4 separate test sessions that involved consumption of alcohol (1.97 ml/kg vodka) and energy drinks, alone and in combination. On each test day, the dose assigned was divided into 10 cups. Participants were informed that they would have a 2-h period to consume the 10 drinks. After the self-paced drinking period, participants completed a cued go/no-go reaction time (RT) task and subjective ratings of stimulation and sedation. The results indicated that participants consumed the AmED dose significantly faster (by ∼16 min) than the alcohol dose. For the performance task, participants' mean RTs were slower in the alcohol conditions and faster in the energy-drink conditions. In conclusion, alcohol consumers should be made aware that rapid drinking might occur for AmED beverages, thus heightening alcohol-related safety risks. The fast rate of drinking may be related to the generalized speeding of responses after energy-drink consumption. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  3. Effects of resistance training on neuromuscular characteristics and pacing during 10-km running time trial.

    Science.gov (United States)

    Damasceno, Mayara V; Lima-Silva, Adriano E; Pasqua, Leonardo A; Tricoli, Valmor; Duarte, Marcos; Bishop, David J; Bertuzzi, Rômulo

    2015-07-01

    The purpose of this study was to analyze the impact of an 8-week strength training program on the neuromuscular characteristics and pacing adopted by runners during a self-paced endurance running. Eighteen endurance runners were allocated into either strength training group (STG, n = 9) or control group (CG, n = 9) and performed the following tests before and after the training period: (a) incremental test, (b) running speed-constant test, (c) 10-km running time trial, (d) drop jump test, (e) 30-s Wingate anaerobic test, (f) maximum dynamic strength test (1RM). During 1RM, the electromyographic activity was measured. In the STG, the magnitude of improvement for 1RM (23.0 ± 4.2 %, P = 0.001), drop jump (12.7 ± 4.6 %, P = 0.039), and peak treadmill speed (2.9 ± 0.8 %, P = 0.013) was significantly higher compared to CG. This increase in the 1RM for STG was accompanied by a tendency to a higher electromyographic activity (P = 0.080). The magnitude of improvement for 10-km running performance was higher (2.5 %) for STG than for CG (-0.7 %, P = 0.039). Performance was improved mainly due to higher speeds during the last seven laps (last 2800 m) of the 10-km running trial. There were no significant differences between before and after training period for maximal oxygen uptake, respiratory compensation point, running economy, and anaerobic performance for both groups (P > 0.05). These findings suggest that a strength training program offers a potent stimulus to counteract fatigue during the last parts of a 10-km running race, resulting in an improved overall running performance.

  4. Integrating mobile technology with routine dietetic practice: the case of myPace for weight management.

    Science.gov (United States)

    Harricharan, Michelle; Gemen, Raymond; Celemín, Laura Fernández; Fletcher, David; de Looy, Anne E; Wills, Josephine; Barnett, Julie

    2015-05-01

    The field of Mobile health (mHealth), which includes mobile phone applications (apps), is growing rapidly and has the potential to transform healthcare by increasing its quality and efficiency. The present paper focuses particularly on mobile technology for body weight management, including mobile phone apps for weight loss and the available evidence on their effectiveness. Translation of behaviour change theory into weight management strategies, including integration in mobile technology is also discussed. Moreover, the paper presents and discusses the myPace platform as a case in point. There is little clinical evidence on the effectiveness of currently available mobile phone apps in enabling behaviour change and improving health-related outcomes, including sustained body weight loss. Moreover, it is unclear to what extent these apps have been developed in collaboration with health professionals, such as dietitians, and the extent to which apps draw on and operationalise behaviour change techniques has not been explored. Furthermore, presently weight management apps are not built for use as part of dietetic practice, or indeed healthcare more widely, where face-to-face engagement is fundamental for instituting the building blocks for sustained lifestyle change. myPace is an innovative mobile technology for weight management meant to be embedded into and to enhance dietetic practice. Developed out of systematic, iterative stages of engagement with dietitians and consumers, it is uniquely designed to complement and support the trusted health practitioner-patient relationship. Future mHealth technology would benefit if engagement with health professionals and/or targeted patient groups, and behaviour change theory stood as the basis for technology development. Particularly, integrating technology into routine health care practice, rather than replacing one with the other, could be the way forward.

  5. PACE Continuous Innovation Indicators—a novel tool to measure progress in cancer treatments

    Science.gov (United States)

    Paddock, Silvia; Brum, Lauren; Sorrow, Kathleen; Thomas, Samuel; Spence, Susan; Maulbecker-Armstrong, Catharina; Goodman, Clifford; Peake, Michael; McVie, Gordon; Geipel, Gary; Li, Rose

    2015-01-01

    Concerns about rising health care costs and the often incremental nature of improvements in health outcomes continue to fuel intense debates about ‘progress’ and ‘value’ in cancer research. In times of tightening fiscal constraints, it is increasingly important for patients and their representatives to define what constitutes ’value’ to them. It is clear that diverse stakeholders have different priorities. Harmonisation of values may be neither possible nor desirable. Stakeholders lack tools to visualise or otherwise express these differences and to track progress in cancer treatments based on variable sets of values. The Patient Access to Cancer care Excellence (PACE) Continuous Innovation Indicators are novel, scientifically rigorous progress trackers that employ a three-step process to quantify progress in cancer treatments: 1) mine the literature to determine the strength of the evidence supporting each treatment; 2) allow users to weight the analysis according to their priorities and values; and 3) calculate Evidence Scores (E-Scores), a novel measure to track progress, based on the strength of the evidence weighted by the assigned value. We herein introduce a novel, flexible value model, show how the values from the model can be used to weight the evidence from the scientific literature to obtain E-Scores, and illustrate how assigning different values to new treatments influences the E-Scores. The Indicators allow users to learn how differing values lead to differing assessments of progress in cancer research and to check whether current incentives for innovation are aligned with their value model. By comparing E-Scores generated by this tool, users are able to visualise the relative pace of innovation across areas of cancer research and how stepwise innovation can contribute to substantial progress against cancer over time. Learning from experience and mapping current unmet needs will help to support a broad audience of stakeholders in their

  6. PACE Continuous Innovation Indicators-a novel tool to measure progress in cancer treatments.

    Science.gov (United States)

    Paddock, Silvia; Brum, Lauren; Sorrow, Kathleen; Thomas, Samuel; Spence, Susan; Maulbecker-Armstrong, Catharina; Goodman, Clifford; Peake, Michael; McVie, Gordon; Geipel, Gary; Li, Rose

    2015-01-01

    Concerns about rising health care costs and the often incremental nature of improvements in health outcomes continue to fuel intense debates about 'progress' and 'value' in cancer research. In times of tightening fiscal constraints, it is increasingly important for patients and their representatives to define what constitutes 'value' to them. It is clear that diverse stakeholders have different priorities. Harmonisation of values may be neither possible nor desirable. Stakeholders lack tools to visualise or otherwise express these differences and to track progress in cancer treatments based on variable sets of values. The Patient Access to Cancer care Excellence (PACE) Continuous Innovation Indicators are novel, scientifically rigorous progress trackers that employ a three-step process to quantify progress in cancer treatments: 1) mine the literature to determine the strength of the evidence supporting each treatment; 2) allow users to weight the analysis according to their priorities and values; and 3) calculate Evidence Scores (E-Scores), a novel measure to track progress, based on the strength of the evidence weighted by the assigned value. We herein introduce a novel, flexible value model, show how the values from the model can be used to weight the evidence from the scientific literature to obtain E-Scores, and illustrate how assigning different values to new treatments influences the E-Scores. The Indicators allow users to learn how differing values lead to differing assessments of progress in cancer research and to check whether current incentives for innovation are aligned with their value model. By comparing E-Scores generated by this tool, users are able to visualise the relative pace of innovation across areas of cancer research and how stepwise innovation can contribute to substantial progress against cancer over time. Learning from experience and mapping current unmet needs will help to support a broad audience of stakeholders in their efforts to

  7. System upgrade and its complications in patients with a single lead atrial pacemaker

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Andersen, Henning Rud; Nielsen, Jens Cosedis

    2013-01-01

    To investigate the indications for system upgrade with single lead atrial pacing (AAIR), complications associated with these re-interventions, and possible predictors for system upgrade among patients included in the Danish Multicenter Randomized Trial on AAIR vs. dual-chamber pacing (DDDR) in si...

  8. Orbital pacing and ocean circulation-induced collapses of the Mesoamerican monsoon over the past 22,000 y.

    Science.gov (United States)

    Lachniet, Matthew S; Asmerom, Yemane; Bernal, Juan Pablo; Polyak, Victor J; Vazquez-Selem, Lorenzo

    2013-06-04

    The dominant controls on global paleomonsoon strength include summer insolation driven by precession cycles, ocean circulation through its influence on atmospheric circulation, and sea-surface temperatures. However, few records from the summer North American Monsoon system are available to test for a synchronous response with other global monsoons to shared forcings. In particular, the monsoon response to widespread atmospheric reorganizations associated with disruptions of the Atlantic Meridional Overturning Circulation (AMOC) during the deglacial period remains unconstrained. Here, we present a high-resolution and radiometrically dated monsoon rainfall reconstruction over the past 22,000 y from speleothems of tropical southwestern Mexico. The data document an active Last Glacial Maximum (18-24 cal ka B.P.) monsoon with similar δ(18)O values to the modern, and that the monsoon collapsed during periods of weakened AMOC during Heinrich stadial 1 (ca. 17 ka) and the Younger Dryas (12.9-11.5 ka). The Holocene was marked by a trend to a weaker monsoon that was paced by orbital insolation. We conclude that the Mesoamerican monsoon responded in concert with other global monsoon regions, and that monsoon strength was driven by variations in the strength and latitudinal position of the Intertropical Convergence Zone, which was forced by AMOC variations in the North Atlantic Ocean. The surprising observation of an active Last Glacial Maximum monsoon is attributed to an active but shallow AMOC and proximity to the Intertropical Convergence Zone. The emergence of agriculture in southwestern Mexico was likely only possible after monsoon strengthening in the Early Holocene at ca. 11 ka.

  9. Representing number in the real-time processing of agreement: Self-paced reading evidence from Arabic

    Directory of Open Access Journals (Sweden)

    Matthew A. Tucker

    2015-04-01

    Full Text Available In the processing of subject-verb agreement, non-subject plural nouns following a singular subject sometimes attract the agreement with the verb, despite not being grammatically licensed to do so. This phenomenon generates agreement errors in production and an increased tendency to fail to notice such errors in comprehension, thereby providing a window into the representation of grammatical number in working memory during sentence processing. Research in this topic, however, is primarily done in related languages with similar agreement systems. In order to increase the cross-linguistic coverage of the processing of agreement, we conducted a self-paced reading study in Modern Standard Arabic. We report robust agreement attraction errors in relative clauses, a configuration not particularly conducive to the generation of such errors for all possible lexicalizations. In particular, we examined the speed with which readers retrieve a subject controller for both grammatical and ungrammatical agreeing verbs in sentences where verbs are preceded by two NPs, one of which is a local non-subject NP that can act as a distractor for the successful resolution of subject-verb agreement. Our results suggest that the frequency of errors is modulated by the kind of plural formation strategy used on the attractor noun: nouns which form plurals by suffixation condition high rates of attraction, whereas nouns which form their plurals by internal vowel change (ablaut generate lower rates of errors and reading-time attraction effects of smaller magnitudes. Furthermore, we show some evidence that these agreement attraction effects are mostly contained in the right tail of reaction time distributions. We also present modeling data in the ACT-R framework which supports a view of these ablauting patterns wherein they are differentially specified for number and evaluate the consequences of possible representations for theories of grammar and parsing.

  10. Crawling to the finish line-why do endurance runners collapse? Implications for understanding the mechanisms underlying fatigue and pacing.

    NARCIS (Netherlands)

    St Clair Gibson, A; de Koning, J.J.; Thompson, K.G.; Roberts, W.O.; Micklewright, D.; Raglin, J.; Foster, C.

    2013-01-01

    Effective regulation of pace enables the majority of runners to complete competitive endurance events without mishap. However, some runners do experience exercise-induced collapse associated with postural hypotension, which in rare cases results from life-threatening conditions such as cardiac

  11. The role of the entry-and-stretch phase at the different paces of race in front crawl swimming.

    Science.gov (United States)

    Samson, Mathias; Monnet, Tony; Bernard, Anthony; Lacouture, Patrick; David, Laurent

    2015-01-01

    The aim of this study was to determine the role played by the entry-and-stretch phase in the coordination of swimming, at the different paces of race. Three national level swimmers (two men and one woman) were recorded, in lateral and bottom views, in three swimming paces: sprint (50 m and 100 m), middle-distance (200 m and 400 m) and long-distance (800 m and 1500 m). Anatomical landmark positions were obtained by manual digitalisation of the videos. Computational fluid dynamics and experimental studies (with a strain gauge balance and particle image velocimetry method) were used to measure and to calculate the external forces applied to the hand and to the forearm and to visualise the flow around the profile. Entry-and-stretch is the phase which varies the most according to the swimming pace. This phase can be decomposed into two sub-phases: one, the extension forward coordinated with the insweep of the opposite arm, and another one, the rotation downward coordinated with the upsweep. Results show that, at the three paces, this phase is not propulsive and could contribute essentially to maintain the horizontal balance of the body.

  12. How Adults Learn from Self-Paced, Technology-Based Corporate Training: New Focus for Learners, New Focus for Designers

    Science.gov (United States)

    Dobrovolny, Jackie

    2006-01-01

    "How" do adults learn from self-paced, technology-based corporate training, which they select based on its relevance to their current employment responsibilities? Specifically, "how" do adults use the following learning strategies: prior experience, reflection, metacognition, conversations, generative learning strategies, and authentic…

  13. How disturbance, competition, and dispersal interact to prevent tree range boundaries from keeping pace with climate change

    Science.gov (United States)

    Yu Liang; Matthew J. Duveneck; Eric J. Gustafson; Josep M. Serra-Diaz; Jonathan R. Thompson

    2018-01-01

    Climate change is expected to cause geographic shifts in tree species' ranges, but such shifts may not keep pace with climate changes because seed dispersal distances are often limited and competition-induced changes in community composition can be relatively slow. Disturbances may speed changes in community composition, but the interactions among climate change,...

  14. Major League Baseball pace-of-play rules and their influence on predicted muscle fatigue during simulated baseball games.

    Science.gov (United States)

    Sonne, Michael W L; Keir, Peter J

    2016-11-01

    Major League Baseball (MLB) has proposed rule changes to speed up baseball games. Reducing the time between pitches may impair recovery from fatigue. Fatigue is a known precursor to injury and may jeopardise joint stability. This study examined how fatigue accumulated during baseball games and how different pace of play initiatives may influence fatigue. Pitcher data were retrieved from a public database. A predictive model of muscle fatigue estimated muscle fatigue in 8 arm muscles. A self-selected pace (22.7 s), 12 s pace (Rule 8.04 from the MLB) and a 20 s rest (a pitch clock examined in the 2014 Arizona Fall League (AFL)) were examined. Significantly more muscle fatigue existed in both the AFL and Rule 8.04 conditions, when compared to the self-selected pace condition (5.01 ± 1.73%, 3.95 ± 1.20% and 3.70 ± 1.10% MVC force lost, respectively). Elevated levels of muscle fatigue are predicted in the flexor-pronator mass, which is responsible for providing elbow stability. Reduced effectiveness of the flexor-pronator mass may reduce the active contributions to joint rotational stiffness, increasing strain on the ulnar collateral ligament (UCL) and possibly increasing injury risk.

  15. Efficacy of walking aids on self-paced outdoor walking in individuals with COPD: A randomized cross-over trial.

    Science.gov (United States)

    Vaes, Anouk W; Meijer, Kenneth; Delbressine, Jeannet M; Wiechert, Jozé; Willems, Paul; Wouters, Emiel F M; Franssen, Frits M E; Spruit, Martijn A

    2015-08-01

    Walking aids, such as rollator or draisine, improve mobility and functional exercise performance in individuals with chronic obstructive pulmonary disease (COPD) during an indoor 6-min walk test. However, this test does not reflect everyday walking, which is the most frequently reported problematic activity of daily life in individuals with COPD. To date, efficacy of walking aids during self-paced outdoor walking remains unknown. Therefore, we aimed to determine the efficacy of a rollator and draisine on self-paced outdoor walking in individuals with COPD. Fifteen individuals with COPD (68% men; age: 63 ± 8 years; forced expiratory volume in 1 s: 40 ± 14% predicted) performed three self-paced outdoor walking tests on two consecutive days: test 1 unaided, and tests 2 and 3 with rollator or draisine in random order. Participants had to walk as long as possible at their own pace. The test ended when participants needed to stop, with a maximum duration of 30 min. The use of rollator resulted in the highest walk distance and time (P walked significantly further and longer during an unaided test compared with a draisine aided test (P walking speed, fewer strides, greater stride length, and higher step and stride variability (P walk distance and time in individuals with moderate and advanced COPD and a poor functional exercise capacity, whereas the use of a draisine had a detrimental effect compared with unaided walking. © 2015 Asian Pacific Society of Respirology.

  16. Biventricular pacing-induced acute response in baroreflex sensitivity has predictive value for midterm response to cardiac resynchronization therapy

    NARCIS (Netherlands)

    Gademan, Maaike G. J.; van Bommel, Rutger J.; Borleffs, C. Jan Willem; Man, Sumche; Haest, Joris C. W.; Schalij, Martin J.; van der Wall, Ernst E.; Bax, Jeroen J.; Swenne, Cees A.

    2009-01-01

    In a previous study we demonstrated that the institution of biventricular pacing in chronic heart failure (CHF) acutely facilitates the arterial baroreflex. The arterial baroreflex has important prognostic value in CHF. We hypothesized that the acute response in baroreflex sensitivity (BRS) after

  17. Optimizing Cardiac Resynchronization Therapy in Heart Failure Patients by Measuring Transient Changes in Sinus Rate During Pacing

    Science.gov (United States)

    2001-10-25

    cardiac resynchronization therapy (CRT) for chronic heart failure (CHF) patients, acute studies show that left ventricular... Cardiac pacing, chronic heart failure , baroreceptor reflex, hemodynamics, left ventricular function, cycle length, cardiac resynchronization ... chronic heart failure (CHF) and ventricular conduction delay [1,2]. In these studies, Cardiac Resynchronization Therapy (CRT) has been

  18. Examining the Effectiveness of a Semi-Self-Paced Flipped Learning Format in a College General Chemistry Sequence

    Science.gov (United States)

    Hibbard, Lisa; Sung, Shannon; Wells, Breche´

    2016-01-01

    Flipped learning has come to the forefront in education. It maximizes learning by moving content delivery online, where learning can be self-paced, allowing for class time to focus on student-centered active learning. This five-year cross-sectional study assessed student performance in a college general chemistry for majors sequence taught by a…

  19. Environmental proxies of antigen exposure explain variation in immune investment better than indices of pace of life

    NARCIS (Netherlands)

    Horrocks, N.P.C.; Hegemann, A.; Ostrowski, S.; Ndithia, H.; Shobrak, M.; Williams, J.B.; Matson, K.D.; Tieleman, B.I.

    2015-01-01

    Investment in immune defences is predicted to covary with a variety of ecologically and evolutionarily relevant axes, with pace of life and environmental antigen exposure being two examples. These axes may themselves covary directly or inversely, and such relationships can lead to conflicting

  20. Pacing and decision making in sport and exercise : The roles of perception and action in the regulation of exercise intensity

    NARCIS (Netherlands)

    Smits, Benjamin L. M.; Pepping, Gert-Jan; Hettinga, Florentina J.

    In pursuit of optimal performance, athletes and physical exercisers alike have to make decisions about how and when to invest their energy. The process of pacing has been associated with the goal-directed regulation of exercise intensity across an exercise bout. The current review explores divergent

  1. Recruitment and Retention Strategies among Older African American Women Enrolled in an Exercise Study at a PACE Program

    Science.gov (United States)

    Sullivan-Marx, Eileen M.; Mangione, Kathleen K.; Ackerson, Theimann; Sidorov, Ingrid; Maislin, Greg; Volpe, Stella L.; Craik, Rebecca

    2011-01-01

    Purpose: This study examined employment of specific recruitment and retention strategies in a study evaluating outcomes of a moderate activity exercise program for older African American women with functional impairments attending a Program for All-Inclusive Care of Elders (PACE). Design and Methods: Recruitment and retention strategies focused on…

  2. Creatine kinase and creatine kinase subunit-B in coronary sinus blood in pacing-induced angina pectoris

    DEFF Research Database (Denmark)

    Bagger, J P; Ingerslev, J; Heinsvig, E M

    1982-01-01

    In nine out of 10 patients with angiographic documented coronary artery disease, pacing-induced angina pectoris provoked myocardial production of lactate, whereas no significant release of either creatine kinase or creatine kinase subunit-B to coronary sinus and peripheral venous blood could...

  3. Corrective effect of diaphragm pacing on the decrease in cardiac output induced by positive pressure mechanical ventilation in anesthetized sheep.

    Science.gov (United States)

    Masmoudi, Hicham; Persichini, Romain; Cecchini, Jérôme; Delemazure, Julie; Dres, Martin; Mayaux, Julien; Demoule, Alexandre; Assouad, Jalal; Similowski, Thomas

    2017-02-01

    Positive pressure ventilation (PPV) is a fundamental life support measure, but it decreases cardiac output (CO). Diaphragmatic contractions produce negative intrathoracic and positive abdominal pressures, promoting splanchnic venous return. We hypothesized that: 1) diaphragm pacing alone could produce adequate ventilation without decreasing CO; 2) diaphragm pacing on top of PPV could improve CO. Of 11 anesthetized and mechanically ventilated ewes (39.6±5.9kg), 3 were discarded from analysis because of hemodynamic instability during the experiment, and 8 retained for analysis. Phrenic stimulation electrodes were inserted in the diaphragm (implanted phrenic nerve stimulation, iPS). CO was measured by the thermodilution technique (pulmonary artery catheter). CO during end-expiratory apnea served as reference. Median CO was 9.77 [6.25-11.25] lmin -1 during end-expiratory apnea, 8.25 [5.06-9.25] lmin -1 during "PPV" (-15%) (pventilation was comparable to its PPV counterpart (median 92% [74-97], NS). Diaphragm pacing alone can produce adequate ventilation without reducing CO. Superimposed onto PPV, diaphragm pacing can reduce the PPV-induced decrease in CO. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. 77 FR 60732 - PACE Select Advisors Trust and UBS Global Asset Management (Americas) Inc.; Notice of Application

    Science.gov (United States)

    2012-10-04

    ... Select Advisors Trust and UBS Global Asset Management (Americas) Inc.; Notice of Application September 27... Hutchins Asset Management, Inc., Investment Company Act Release Nos. 24823 (Jan. 11, 2001) (notice) and...) (order). Applicants: PACE Select Advisors Trust (the ``Trust'') and UBS Global Asset Management (Americas...

  5. The influence of right ventricular apical pacing on left atrial volume in patients with normal left ventricular function

    Directory of Open Access Journals (Sweden)

    AR Moaref1

    2008-03-01

    Full Text Available Background: Right ventricular apical (RVA pacing has been reported to induce several deleterious effects particularly in the presence of structural heart disease but can also involve patients with normal left ventricular (LV function. Left atrial (LA enlargement is one of these effects, but the majority of studies have measured LA dimension rather than volume.Objective: The present prospective study was designed to assess the effect of RVA pacing on LA volume in patients with normal LV function.Patients and Methods: The study comprised 41 consecutive patients with LV ejection fraction ≥ 45% and LV end diastolic dimension ≤ 56 mm who underwent single-or dual- chamber pacemaker implantation in RVA and followed for LA volume measurement and pacemaker analysis at least during the ensuing 4.2 months. Results: In all, 21 patients were excluded from the study due to five spontaneous wide QRS complex (≥120msec, one recent acute coronary syndrome,one significant valvular heart disease, three pacing frequency <90%, eight death or losing follow up in three cases. In remaining 20 patients, LA volume ragned from 21 to 54 mm3 with mean of 37.3±9.7 mm3 prior to pacemaker implantation that increased to 31 to 103 mm3 (54.3±17.0 during follow-up (P<0.001.Conclusion: RVA pacing might lead to an increase in LA volume even in patients with normal LV function.

  6. Parahippocampal activation during successful recognition of words: a self-paced event-related fMRI study

    NARCIS (Netherlands)

    Daselaar, S. M.; Rombouts, S. A.; Veltman, D. J.; Raaijmakers, J. G.; Lazeron, R. H.; Jonker, C.

    2001-01-01

    In this study, we investigated retrieval from verbal episodic memory using a self-paced event-related fMRI paradigm, similar to the designs typically used in behavioral studies of memory function. We tested the hypothesis that the medial temporal lobe (MTL) is involved in the actual recovery of

  7. High-Rate Pacing Reduces Variability of Repolarization and Prevents Repolarization-Dependent Arrhythmias in Dogs With Chronic AV Block

    DEFF Research Database (Denmark)

    Oosterhoff, Peter; Thomsen, Morten Bækgaard; Maas, Joep N

    2010-01-01

    -term variability of repolarization (STV) as a feedback parameter of arrhythmic risk. Methods and Results: The minimal signal sampling frequency required for measuring STV was determined through computer simulation. Arrhythmogenic response to dofetilide (25 µg/kg/5minutes) was tested at two different paced heart...

  8. Self-paced versus fixed speed walking and the effect of virtual reality in children with cerebral palsy

    NARCIS (Netherlands)

    Sloot, L.H.; Harlaar, J.; van der Krogt, M.M.

    2015-01-01

    While feedback-controlled treadmills with a virtual reality could potentially offer advantages for clinical gait analysis and training, the effect of self-paced walking and the virtual environment on the gait pattern of children and different patient groups remains unknown. This study examined the

  9. Right Ventricular Pacing and Sensing Function in High Posterior Septal and Apical Lead Placement in Cardiac Resynchronization Therapy

    Directory of Open Access Journals (Sweden)

    H.M. Kristiansen, MD

    2012-01-01

    Conclusions: The RV-HS lead position demonstrated stable and acceptable long-term pacing and sensing function, with rates of complications comparable to conventional RV-A lead position in CRT. The RV-HS lead position is feasible in CRT-P.

  10. Keeping Pace with K-12 Online & Blended Learning: An Annual Review of Policy and Practice. 10 Year Anniversary Issue

    Science.gov (United States)

    Watson, John; Murin, Amy; Vashaw, Lauren; Gemin, Butch; Rapp, Chris

    2013-01-01

    "Keeping Pace with K-12 Online & Blended Learning" (2013), the 10th in a series of annual reports that began in 2004, examines the status of K-12 online education across the country. The report provides an overview of the latest policies, practices, and trends affecting online learning programs across all 50 states. In this 10th…

  11. Self-Paced Tutorial Courses for Mineral Science - Metallurgy Departments. Final Progress Report (July 1975-August 1980).

    Science.gov (United States)

    Twidwell, L. G.

    Four courses in extractive metallurgy (Pyrometallurgy, Hydrometallurgy, Electrometallurgy; and Physical Chemistry of Iron and Steel) were prepared in a modular, self-paced format. Development of the course materials included: (1) preparation of course outlines by unit coordinators and advisory committees; (2) approval of course outlines (included…

  12. Impact of right-ventricular apical pacing on the optimal left-ventricular lead positions measured by phase analysis of SPECT myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Hung, Guang-Uei; Huang, Jin-Long; Lin, Wan-Yu; Tsai, Shih-Chung; Wang, Kuo-Yang; Chen, Shih-Ann; Lloyd, Michael S.; Chen, Ji

    2014-01-01

    The use of SPECT phase analysis to optimize left-ventricular (LV) lead positions for cardiac resynchronization therapy (CRT) was performed at baseline, but CRT works as simultaneous right ventricular (RV) and LV pacing. The aim of this study was to assess the impact of RV apical (RVA) pacing on optimal LV lead positions measured by SPECT phase analysis. This study prospectively enrolled 46 patients. Two SPECT myocardial perfusion scans were acquired under sinus rhythm with complete left bundle branch block and RVA pacing, respectively, following a single injection of 99m Tc-sestamibi. LV dyssynchrony parameters and optimal LV lead positions were measured by the phase analysis technique and then compared between the two scans. The LV dyssynchrony parameters were significantly larger with RVA pacing than with sinus rhythm (p ∝0.01). In 39 of the 46 patients, the optimal LV lead positions were the same between RVA pacing and sinus rhythm (kappa = 0.861). In 6 of the remaining 7 patients, the optimal LV lead positions were along the same radial direction, but RVA pacing shifted the optimal LV lead positions toward the base. The optimal LV lead positions measured by SPECT phase analysis were consistent, no matter whether the SPECT images were acquired under sinus rhythm or RVA pacing. In some patients, RVA pacing shifted the optimal LV lead positions toward the base. This study supports the use of baseline SPECT myocardial perfusion imaging to optimize LV lead positions to increase CRT efficacy. (orig.)

  13. Association between frequency of atrial and ventricular ectopic beats and biventricular pacing percentage and outcomes in patients with cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Ruwald, Martin H; Mittal, Suneet; Ruwald, Anne-Christine

    2014-01-01

    -defibrillator device with data available on biventricular pacing percentage and pre-implantation 24-h Holter recordings were included. Using logistic regression, we estimated the influence of ectopic beats on the percentage of biventricular pacing. Reverse remodeling was measured as reductions in atrial and left...

  14. The association between biventricular pacing and cardiac resynchronization therapy-defibrillator efficacy when compared with implantable cardioverter defibrillator on outcomes and reverse remodelling

    DEFF Research Database (Denmark)

    Ruwald, Anne-Christine; Kutyifa, Valentina; Ruwald, Martin H

    2015-01-01

    AIMS: Previous studies on biventricular (BIV) pacing and cardiac resynchronization therapy-defibrillator (CRT-D) efficacy have used arbitrarily chosen BIV pacing percentages, and no study has employed implantable cardioverter defibrillator (ICD) patients as a control group. METHODS AND RESULTS...

  15. The coordination of shoulder girdle muscles during repetitive arm movements at either slow or fast pace among women with or without neck-shoulder pain.

    Science.gov (United States)

    Januario, Leticia Bergamin; Oliveira, Ana Beatriz; Cid, Marina Machado; Madeleine, Pascal; Samani, Afshin

    2017-10-01

    The aim of this study was to evaluate the coordination of the shoulder girdle muscles among subjects with or without neck-shoulder pain performing repetitive arm movement at either a slow or fast pace. Thirty female adults were allocated to one of two groups-healthy controls or cases with neck-shoulder pain. Surface electromyography (sEMG) signals from the clavicular, acromial, middle and lower trapezius portions and the serratus anterior muscles were recorded during a task performed for 20min at a slow pace and 20min at a fast pace. The root mean square (RMS), relative rest time (RRT) and normalised mutual information (NMI, an index of functional connectivity between two muscles in a pair) were computed. No significant differences on RMS, RRT and NMI were found between groups. For both groups, the fast movement pace resulted in increased levels of RMS, lower degrees of RRT and higher NMI compared to the slow pace. No interaction between group and movement pace was found. This study highlights the change in sEMG activity of muscles to meet the demands of performing a task at fast movement pace. The fast pace imposed a higher muscle demand evidenced by increased sEMG amplitude, low degree of muscle rest and increased functional connectivity for subjects in both the case and control groups. No indication of impaired sEMG activity was found in individuals with neck-shoulder pain. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Protocol for diaphragm pacing in patients with respiratory muscle weakness due to motor neurone disease (DiPALS: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    McDermott Christopher J

    2012-08-01

    Full Text Available Abstract Background Motor neurone disease (MND is a devastating illness which leads to muscle weakness and death, usually within 2-3 years of symptom onset. Respiratory insufficiency is a common cause of morbidity, particularly in later stages of MND and respiratory complications are the leading cause of mortality in MND patients. Non Invasive Ventilation (NIV is the current standard therapy to manage respiratory insufficiency. Some MND patients however do not tolerate NIV due to a number of issues including mask interface problems and claustrophobia. In those that do tolerate NIV, eventually respiratory muscle weakness will progress to a point at which intermittent/overnight NIV is ineffective. The NeuRx RA/4 Diaphragm Pacing System was originally developed for patients with respiratory insufficiency and diaphragm paralysis secondary to stable high spinal cord injuries. The DiPALS study will assess the effect of diaphragm pacing (DP when used to treat patients with MND and respiratory insufficiency. Method/Design 108 patients will be recruited to the study at 5 sites in the UK. Patients will be randomised to either receive NIV (current standard care or receive DP in addition to NIV. Study participants will be required to complete outcome measures at 5 follow up time points (2, 3, 6, 9 and 12 months plus an additional surgery and 1 week post operative visit for those in the DP group. 12 patients (and their carers from the DP group will also be asked to complete 2 qualitative interviews. Discussion The primary objective of this trial will be to evaluate the effect of Diaphragm Pacing (DP on survival over the study duration in patients with MND with respiratory muscle weakness. The project is funded by the National Institute for Health Research, Health Technology Assessment (HTA Programme (project number 09/55/33 and the Motor Neurone Disease Association and the Henry Smith Charity. Trial Registration: Current controlled trials ISRCTN53817913. The

  17. The specialized role of the RN in the Program of All-inclusive Care for the Elderly (PACE) interdisciplinary care team.

    Science.gov (United States)

    Madden, Karen A; Waldo, Mary; Cleeter, Deborah

    2014-01-01

    There is an increasing volume of literature supporting the Program of All-inclusive Care for the Elderly (PACE) as an innovative model of health care delivery for frail seniors. Registered Nurses (RN) hold an essential position among the PACE interdisciplinary teams (IDT) which serve as the foundational practice approach to patient care. There are currently 97 PACE programs in 31 states. Federal and respective state laws provide comprehensive specifications for IDT composition, minimum qualification of team members and services provided. The role of the RN is not fully defined beyond the requirement of periodic assessments. The intent of this study was to explore and describe the role of the nurse in PACE and to compare nursing care delivery models. Focused interviews and survey results show great variation in nursing roles as well as some common themes among nursing leaders for the vision of PACE nurses. Copyright © 2014 Mosby, Inc. All rights reserved.

  18. [The influence of stress hyperglycemia on the prognosis of patients with acute myocardial infarction and temporary electrical cardiac pacing].

    Science.gov (United States)

    Stojković, Aleksandar; Koracević, Goran; Perisić, Zoran; Krstić, Nebojsa; Pavlović, Milan; Todorović, Lazar; Glasnović, Jozef; Burazor, Ivana; Apostolović, Svetlana; Nikolić, Gordana; Kostić, Tomislav; Branković, Natasa

    2010-01-01

    Elevated glucose levels on admission in many emergency conditions, including acute myocardial infarction (AMI), have been identified as a predictor of hospital mortality. Since there are no data in the literature related to stress hyperglycaemia (SH) in patients with both AIM and temporary electrical cardiac pacing, we aimed to investigate the influence of stress hyperglycaemia on the prognosis of patients with AMI and temporary electrical cardiac pacing. The prospective study included 79 patients with diagnosed AMI with ST-segment elevation (STEMI), admitted to the Coronary Care Unit of the Clinic for Cardiovascular Diseases, Clinical Centre Nis, from 2004 to 2007, who were indicated for temporary electrical cardiac pacing. The blood was sampled on admission for lab analysis, glucose levels were determined (as well as markers of myocardial necrosis troponin I, CK-MB). Echocardiographic study was performed and ejection fraction was evaluated by using area length method. The ROC analysis indicated that the best glycaemic level on admission, which could be used as a predictor of mortality, was 10.00 mmol/l, and the area under the curve was 0.82. In the group without SH, hospital mortality was 3-fold lower 11/48 (22.91%) compared to the group with SH 19/31 (61.29%), p 1, lower ejection fraction and heart rate, as well as systolic blood pressure. The best cut-off value for SH in patients with AMI (STEMI) and temporary electrical cardiac pacing is 10 mmol/l (determined by ROC curve) and may be used in risk stratification; patients with glucose levels 10 mml/l. Our results suggest that SH is a more reliable marker of poor outcome in AMI patients with temporary pace maker, without previously diagnosed DM.

  19. Pacing strategy in male elite and age group 100 km ultra-marathoners

    Directory of Open Access Journals (Sweden)

    Knechtle B

    2015-03-01

    Full Text Available Beat Knechtle,1,2 Thomas Rosemann,1 Matthias A Zingg,1 Michael Stiefel,1 Christoph A Rüst11Institute of Primary Care, University of Zurich, Zurich, 2Gesundheitszentrum St Gallen, St Gallen, SwitzerlandAbstract: Pacing strategy has been investigated in elite 100 km and elite 161 km (100 mile ultra-marathoners, but not in age group ultra-marathoners. This study investigated changes in running speed over segments in male elite and age group 100 km ultra-marathoners with the assumption that running speed would decrease over segments with increasing age of the athlete. Running speed during segments in male elite and age group finishers for 5-year age groups (ie, 18–24 to 65–69 years in the 100 km Lauf Biel in Switzerland was investigated during the 2000–2009 period. Average running speed over segment time station (TS TS1–TS2 (56.1 km was compared with running speed Start–TS1 (38 km and Start–TS3 (76.7 km and running speed TS2–TS3 was compared with running speed Start–Finish. For the top ten athletes in each edition, running speed decreased from 2000 to 2009 for TS1–TS2 and TS2–TS3 (P<0.0001 but not in TS3–Finish (P>0.05. During TS1–TS2, athletes were running at 98.0%±2.1% of the running speed of Start–TS1. In TS2–TS3, they were running at 94.6%±3.4% of the running speed of TS1–TS2. In TS3–Finish, they were running at 95.5%±3.8% of running speed in TS2–TS3. For age group athletes, running speed decreased in TS1–TS2 and TS2–TS3. In TS3–Finish, running speed remained unchanged with the exception of the age group 40–44 years for which running speed increased. Running speed showed the largest decrease in the age group 18–24 years. To summarize, the top ten athletes in each edition maintained their running speed in the last segment (TS3–Finish although running speed decreased over the first two segments (TS1–TS2 and TS2–TS3. The best pacers were athletes in the age group 40–44 years, who were able to

  20. Design of ProjectRun21: a 14-week prospective cohort study of the influence of running experience and running pace on running-related injury in half-marathoners.

    Science.gov (United States)

    Damsted, Camma; Parner, Erik Thorlund; Sørensen, Henrik; Malisoux, Laurent; Nielsen, Rasmus Oestergaard

    2017-11-06

    Participation in half-marathon has been steeply increasing during the past decade. In line, a vast number of half-marathon running schedules has surfaced. Unfortunately, the injury incidence proportion for half-marathoners has been found to exceed 30% during 1-year follow-up. The majority of running-related injuries are suggested to develop as overuse injuries, which leads to injury if the cumulative training load over one or more training sessions exceeds the runners' load capacity for adaptive tissue repair. Owing to an increase of load capacity along with adaptive running training, the runners' running experience and pace abilities can be used as estimates for load capacity. Since no evidence-based knowledge exist of how to plan appropriate half-marathon running schedules considering the level of running experience and running pace, the aim of ProjectRun21 is to investigate the association between running experience or running pace and the risk of running-related injury. Healthy runners using Global Positioning System (GPS) watch between 18 and 65 years will be invited to participate in this 14-week prospective cohort study. Runners will be allowed to self-select one of three half-marathon running schedules developed for the study. Running data will be collected objectively by GPS. Injury will be based on the consensus-based time loss definition by Yamato et al.: "Running-related (training or competition) musculoskeletal pain in the lower limbs that causes a restriction on or stoppage of running (distance, speed, duration, or training) for at least 7 days or 3 consecutive scheduled training sessions, or that requires the runner to consult a physician or other health professional". Running experience and running pace will be included as primary exposures, while the exposure to running is pre-fixed in the running schedules and thereby conditioned by design. Time-to-event models will be used for analytical purposes. ProjectRun21 will examine if particular

  1. The role of cardiac pacing therapy in the management of carotid sinus syndrome

    Directory of Open Access Journals (Sweden)

    Radovanović Nikola

    2015-01-01

    Full Text Available Introduction. Carotid sinus syndrome is characterized by a hypersensitive carotid sinus and syncope. Although we have clear guidelines for the diagnosis and treatment of carotid sinus syndrome, the efficacy of pacing therapy with this indication has not been the subject of many studies. Objective. This study aimed to assess the efficacy and safety of pacing therapy in the treatment of patients with carotid sinus syndrome and to determine the factors contributing to symptoms recurrence after pacemaker implantation. Methods. This study was retrospective and included 32 patients in whom a pacemaker was implanted due to carotid sinus syndrome at the Pacemaker Center, Clinical Center of Serbia, between April 2005 and April 2012. Carotid sinus massage and head-up tilt test (HUTT were performed to select patients with cardioinhibitory and mixed type carotid sinus syndrome, who were enrolled to the study. Results. The mean age of patients was 65.6±11.5 years and 20 (62.5% were men. The mean follow-up period was 4.3±1.9 years. HUTT was performed in 3 (9.4% patients. Twenty-seven (84.4% patients presented with cardioinhibitory and 5 (15.6% with mixed type of carotid sinus syndrome. After pacemaker implantation, 22 (68.7% patients had no further symptoms, 8 (25.0% had syncope and 2 (6.3% presyncope. The mixed type of the disease (HR 3.1; 95% CI 1.4-5.1; p=0.021 and implantation of pacemaker in VVI mode (HR 1.8; 95%CI 1.1-3.2; p=0.034 were independent predictors of symptoms recurrence. There were 3 (9.4% perioperative surgical complications. Conclusion. Pacemaker therapy is an effective and safe treatment for patients with carotid sinus syndrome. As predictors of symptoms persistence after pacemaker implantation in our population, we identified the implantation of pacemaker in VVI mode and the mixed type of carotid sinus syndrome.

  2. Rehabilitative therapies for chronic fatigue syndrome: a secondary mediation analysis of the PACE trial.

    Science.gov (United States)

    Chalder, Trudie; Goldsmith, Kimberley A; White, Peter D; Sharpe, Michael; Pickles, Andrew R

    2015-02-01

    Cognitive behaviour therapy (CBT) added to specialist medical care (SMC), or graded exercise therapy (GET) added to SMC, are more effective in reducing fatigue and improving physical function than both adaptive pacing therapy (APT) plus SMC and SMC alone for chronic fatigue syndrome. We investigate putative treatment mechanisms. We did a planned secondary mediation analysis of the PACE trial comparing SMC alone or SMC plus APT with SMC plus CBT and SMC plus GET for patients with chronic fatigue syndrome. 641 participants were recruited from six specialist chronic fatigue syndrome clinics in the UK National Health Service between March 18, 2005, and Nov 28, 2008. We assessed mediation using the product of coefficients method with the 12 week measure of the mediators and the 52 week measure of the outcomes. The primary outcomes were fatigue measured by the Chalder fatigue scale and physical function measured by the physical function subscale of the SF-36. We included confounder covariates and used treatment by mediator interaction terms to examine differences in mediator-outcome relations by treatment group. The largest mediated effect for both CBT and GET and both primary outcomes was through fear avoidance beliefs with an effect of larger magnitude for GET (standardised effects ×10, CBT vs APT, fatigue -1.22, 95% CI -0.52 to -1.97, physical function 1.54, 0.86 to 2.31; GET vs APT, fatigue -1.86, -0.80 to -2.89, physical function 2.35, 1.35 to 3.39). Increase in exercise tolerance (6 min walk distance) was a potent mediator of the effect of GET (vs APT, fatigue -1.37, 95% CI -0.76 to -2.21, physical function 1.90, 1.10 to 2.91), but not CBT. Our main finding was that fear avoidance beliefs were the strongest mediator for both CBT and GET. Changes in both beliefs and behaviour mediated the effects of both CBT and GET, but more so for GET. The results support a treatment model in which both beliefs and behaviour play a part in perpetuating fatigue and disability in

  3. Long-term prognostic value of transesophageal atrial pacing stress echocardiography.

    Science.gov (United States)

    Płońska, Edyta; Kasprzak, Jarosław D; Kornacewicz-Jach, Zdzisława

    2005-07-01

    The aim of our study was to evaluate the long-term prognostic value of transesophageal atrial pacing stress echocardiography (TAPSE) for the prediction of cardiovascular events (myocardial infarction) and mortality at 10-year follow-up. TAPSE was applied as a diagnostic modality in 93 consecutive patients (mean age 45 +/- 8 years) who were diagnosed for the cause of chest pain. Long-term follow-up data were obtained from 87 (94%) patients with a mean duration of follow-up of 92 +/- 4 months. Stress echocardiography was performed using TAPSE with a mean pacing rate of 142 +/- 18/min. Predefined cardiac events occurred during the follow-up period in 45 (52%) patients, including 24 (28%) with hard end points: 10 (12%) with nonfatal myocardial infarction and 17 who died (events overlap). Positive result of TAPSE was found in 47 (54%) patients and among those with positive TAPSE result, 16 died (94% of total mortality) and 21 had a hard event (death or infarction-88% of total prevalence). Survival free from hard events was noted in 37 (92%) patients with negative TAPSE and only in 26 (55%) of those with positive TAPSE ( P = .001). Independent predictive factors for mortality were TAPSE positivity (relative risk with 95% confidence interval [RR/CI] = 39.6 [36.3-42.9], P = .0006) and diabetes (RR/CI = 10.2 [8.6-11.8], P = .0026). Independent predictive factors for myocardial infarction were diabetes (RR/CI = 8.1 [6.3-9.9], P = .0186) and significant coronary stenosis in angiography (RR/CI = 9.0 [6.8-11.2], P = .0479). Independent predictive factors for death or nonfatal myocardial infarction were TAPSE positivity (RR/CI = 12.3 [11.1-13.3], P = .0001) and diabetes (RR/CI = 7.0 [5.8-8.2], P = .0018). Positive TAPSE result carries long-term prognostic information regarding mortality and risk of myocardial infarction that can be used to identify patients requiring more aggressive treatment. Negative TAPSE allows highly accurate definition of low-risk population with

  4. Urbanization Is Associated with Divergence in Pace-of-Life in Great Tits

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    Anne Charmantier

    2017-05-01

    Full Text Available As an extension of the classic life history theory, the recently highlighted pace-of-life syndrome hypothesis predicts the coevolution of behavioral, physiological and life-history traits. For instance, bolder and shyer individuals do not only differ in personality profiles, but also in neuro-endocrinology and breeding patterns. While theory predicts that bolder (i.e., proactive, more aggressive individuals should colonize more rapidly urbanized habitats than shyer (i.e., reactive, less aggressive individuals, it is also predicted that across generations, adaptive selection processes could favor shyer individuals that are more sensitive to novel environmental cues. Here we compared two personality traits (handling aggression, exploration score in a novel environment, one physiological trait related to stress response (breath rate and four breeding traits (lay date, clutch size, hatching success and fledging success in a rural and an urban study population of Mediterranean great tits Parus major. Mixed models revealed strong phenotypic divergence between forest and city in most traits explored, in particular in personality, whereby urban great tits were more reactive to stress and faster explorers compared to rural birds (yet not more aggressive. Urban birds also laid smaller broods earlier in spring compared to their rural conspecifics, and city broods resulted in lower hatching success yet interestingly fledging success was similar. Nest-box centered measures of anthropogenic (artificial light, pedestrians, and cars perturbation and resource abundance allowed us to go beyond the classical forest/city comparison by exploring the phenotypic variation across an urbanization gradient. This revealed that high urbanization in nest-box surroundings was associated overall with earlier breeding and smaller clutches, but also with faster breath rate, although these trends showed strong annual variation. Ongoing rapid urbanization and non-random gene flow

  5. Pretreatment of BAPTA-AM suppresses the genesis of repetitive endocardial focal discharges and pacing-induced ventricular arrhythmia during global ischemia.

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    Wu, Tsu-Juey; Lin, Shien-Fong; Hsieh, Yu-Cheng; Lin, Tung-Chao; Lin, Jiunn-Cherng; Ting, Chih-Tai

    2011-10-01

    In isolated rabbit hearts, repetitive endocardial focal discharges (REFDs) were consistently observed during ventricular fibrillation (VF) with prolonged (>5 minutes) global ischemia (GI). We hypothesized that BAPTA-AM, a calcium chelator, can suppress these REFDs. Using a two-camera optical mapping system, we simultaneously mapped endocardial (left ventricle, LV) and epicardial (both ventricles) activations during ventricular arrhythmia with GI. In 5 hearts (protocol I), we infused Tyrode's solution (no BAPTA-AM) for ≥30 minutes before the onset of no-flow GI. In 7 additional hearts (protocol II), BAPTA-AM (20 μmol/L) was infused for ≥30 minutes before the initiation of GI. In protocol I, sustained VF (>30 seconds) was successfully induced in all 5 hearts with prolonged GI. REFDs were present in >85 % of recording time. In protocol II, however, ventricular arrhythmia was not inducible and REFDs were not observed after 5-minute GI in 5 hearts. Effects of BAPTA-AM on intracellular calcium (Ca(i) ) at the LV endocardium were also evaluated in 5 hearts (protocol III) using dual Ca(i) /membrane potential mapping. GI, both without and with BAPTA-AM pretreatment, caused a decrease of Ca(i) amplitude during S(1) pacing. However, this effect was more pronounced in the hearts with BAPTA-AM pretreatment (P AM pretreatment, caused broadening of Ca(i) transient. In contrast, GI, with BAPTA-AM pretreatment, caused narrowing of Ca(i) transient. BAPTA-AM pretreatment attenuates Ca(i) transient, suppressing the genesis of REFDs and pacing-induced ventricular arrhythmia during GI. These findings support the notion that Ca(i) dynamics is important in the maintenance of REFDs.  © 2011 Wiley Periodicals, Inc.

  6. The role of pCO2 in astronomically-paced climate and carbon cycle variations in the Middle Miocene

    Science.gov (United States)

    Penman, D. E.; Hull, P. M.; Scher, H.; Kirtland Turner, S.; Ridgwell, A.

    2017-12-01

    The pace of Earth's background climate variability is known to be driven by the Milankovitch cycles, variations in Earth's orbital parameters and axial tilt. While the Milankovitch (orbital) theory of climate change is very nearly universally accepted, the climate system mechanisms and feedbacks responsible for amplifying orbital cycles preserved in the geologic record remain uncertain. For the late Pleistocene, the ice core-derived record of atmospheric carbon dioxide (pCO2) is strongly coupled with global temperature on orbital time scales, indicating that internal feedbacks involving the carbon cycle amplify or even cause the large changes in global temperature during orbitally driven glacial-interglacial cycles. However, for earlier time periods beyond the range of ice cores (the last 800 kyr), it is not possible to directly compare records of pCO2 to orbital climate cycles because there are no high-resolution (orbitally resolved) records of pCO2 before the Pliocene. We address this deficiency with a high-resolution ( 5-10 kyr spacing) record of planktonic foraminiferal d11B-derived surface seawater pH (as well as d13C and trace metal analyses) over a 500 kyr time window in a sedimentary record with known Milankovitch-scale climate and carbon cycle oscillations: the Middle Miocene (14.0 - 14.5 Ma) at ODP Site 926 (subtropical North Atlantic). The resulting pH record can be used to constrain atmospheric pCO2, allowing comparison of the timescale and magnitude of carbon cycle changes during a period of eccentricity-dominated variability in the response of the global climate system (the Late Pleistocene) with a period of obliquity-dominance (the middle Miocene). These new records of planktic d11B and d13C will then be used to guide simulations of astronomical climate forcing in Earth System models, resulting in refined estimates of pCO2 changes over orbital cycles and providing quantitative constraints on the mechanisms and feedbacks responsible for the

  7. Aircraft Environmental System Mechanic, 2-9. Block IV--Utility Systems and Flight Line Maintenance. Military Curriculum Materials for Vocational and Technical Education.

    Science.gov (United States)

    Ohio State Univ., Columbus. National Center for Research in Vocational Education.

    This publication contains a teaching guide and student instructional materials for conducting a high school or adult vocational education course to train persons to perform duties as an aircraft environmental systems mechanic. The instructional design for this course is self-paced and/or small group-paced. Instructor materials contained in the…

  8. Advanced Traveler Information Systems (ATIS) 2.0 Precursor System: Final Report

    Science.gov (United States)

    2018-03-01

    Advanced Traveler Information Systems (ATIS) have experienced significant growth since their initial inception in the 1990s. Technologies have continued to evolve at a rapid pace, enabling the integration of advanced solutions for traveler informatio...

  9. Keeping pace with the science: Seismic hazard analysis in the western United States

    International Nuclear Information System (INIS)

    Youngs, R.R.; Coppersmith, K.J.

    1989-01-01

    Recent years have witnessed rapid advances in the understanding of the earthquake generation process in the western US, with particular emphasis on geologic studies of fault behavior and seismologic studies of the rupture process. The authors discuss how probabilistic seismic hazard analysis (PSHA) methodologies have been refined to keep pace with scientific understanding. Identified active faults are modeled as three-dimensional surfaces with the rupture shape and distribution of nucleation points estimated from physical constraints and seismicity. Active blind thrust ramps at depth and sources associated with subduction zones such as the Cascadia zone off Oregon and Washington can also be modeled. Maximum magnitudes are typically estimated from evaluations of possible rupture dimensions and empirical relations between these dimensions and earthquake magnitude. A rapidly evolving technique for estimating the length of future ruptures on a fault is termed segmentation, and incorporates behavior and geometric fault characteristics. To extend the short historical record, fault slip rate is now commonly used to constrain earthquake recurrence. Paleoseismic studies of fault behavior have led to the characteristic earthquake recurrence model specifying the relative frequency of earthquakes of various sizes. Recent studies have indicated the importance of faulting style and crustal structure on earthquake ground motions. For site-specific applications, empirical estimation techniques are being supplemented with numerical modeling approaches

  10. Acute neuromuscular responses to short and long roundhouse kick striking paces in professional Muay Thai fighters.

    Science.gov (United States)

    Cimadoro, Giuseppe; Mahaffey, Ryan; Babault, Nicolas

    2018-04-04

    Muay Thai fighters strongly rely on the use of the roundhouse kick due to its effectiveness (i.e. power) and implications on the final score. Therefore, different striking tempos at full power are used during training as a method to enhance kicking power. However, the neuromuscular responses are unknown. Thus, the goal of this study was to investigate neuromuscular responses to a single bout of shorter (every second = H1) and longer (every 3s = H3) kick striking time intervals, measured with the countermovement jump (CMJ). Nine professional Muay Thai fighters participated in this randomized, cross-over trial. CMJs were measured on force plates before and after (post 0min, post 5min, post 10min, post 20min and post 30min) two striking (1set x 20reps) conditions (H1; H3). Although no difference was observed between H1 and H3 values, neuromuscular fatigue parameters displayed different patterns over time. CMJ height decreased immediately after H3 striking (PMuay Thai and conditioning coaches should focus on hard striking with both long and slow pacing during specific heavy bag or pad work.

  11. Evolutionary traces decode molecular mechanism behind fast pace of myosin XI

    Directory of Open Access Journals (Sweden)

    Syamaladevi Divya P

    2011-09-01

    Full Text Available Abstract Background Cytoplasmic class XI myosins are the fastest processive motors known. This class functions in high-velocity cytoplasmic streaming in various plant cells from algae to angiosperms. The velocities at which they process are ten times faster than its closest class V homologues. Results To provide sequence determinants and structural rationale for the molecular mechanism of this fast pace myosin, we have compared the sequences from myosin class V and XI through Evolutionary Trace (ET analysis. The current study identifies class-specific residues of myosin XI spread over the actin binding site, ATP binding site and light chain binding neck region. Sequences for ET analysis were accumulated from six plant genomes, using literature based text search and sequence searches, followed by triple validation viz. CDD search, string-based searches and phylogenetic clustering. We have identified nine myosin XI genes in sorghum and seven in grape by sequence searches. Both the plants possess one gene product each belonging to myosin type VIII as well. During this process, we have re-defined the gene boundaries for three sorghum myosin XI genes using fgenesh program. Conclusion Molecular modelling and subsequent analysis of putative interactions involving these class-specific residues suggest a structural basis for the molecular mechanism behind high velocity of plant myosin XI. We propose a model of a more flexible switch I region that contributes to faster ADP release leading to high velocity movement of the algal myosin XI.

  12. The effects of block training on pacing during 20-km cycling time trial.

    Science.gov (United States)

    Costa, Vitor Pereira; Guglielmo, Luiz Guilherme Antonacci; Paton, Carl David

    2017-04-01

    The aim of this study was to determine the effects of block training (BL) on pacing during a 20-km hilly cycling time trial (TT) in trained cyclists. Twenty male cyclists were separated into 2 groups: control and BL. The training of each cyclist was monitored during a period of 3 weeks. In the first week cyclists performed an overload period of 7 consecutive days of high-intensity interval training followed by 2 weeks of normal training. Cyclists performed 1 TT before intervention and 2 TT after 7 and 14 days at the end of training. Each training session consisted of 10 sets of 3 repeated maximal-effort sprints (15, 30, and 45 s) with an effort/recovery duration ratio of 1:5. The main finding of this study was that the power output displayed a significantly higher start from the start until the halfway point of the TT (p power output was characterized by a significant higher end spurt in the final 2 km in the BL after 2 weeks at the end of training (p power output in the beginning and final part of the TT in trained cyclists.

  13. Cardiorespiratory and metabolic responses associated with children's physical activity during self-paced games.

    Science.gov (United States)

    Belcastro, Angelo N; Morrison, Katherine S; Hicks, Emma; Matta, Helin

    2012-09-01

    The aim of this study was to explore the possibility of identifying clusters of children's games based on estimated energy expenditures and (or) intensity when performed in a guided active play format. The study also investigated whether the identified active play game clusters were repeatable when the games were performed on different days. Children (9.7 ± 1.1 years; n = 12) were assessed for oxygen consumption, heart rate, energy expenditure (EE), and metabolic equivalent (MET) on a treadmill (at 4, 6, and 8 km·h(-1) (0% grade)). HR and ActiGraph GT1M accelerometer (ACC) generated linear regression equations were used to estimate EE. The ACC (3 s epochs) were used for estimating METs in assigning percent time at medium-vigorous physical activity (%MVPA) of 10 self-paced games. The results showed a consistent range of EEs (ACC-equation) from 13.57 kcal·(5 min)(-1) to 25.00 kcal·(5 min)(-1) (p games. These were reproducible from day to day (p > 0.05). This study confirms the existence of active play children's game clusters that might be useful in formatting guided active play in a dose-response manner for children.

  14. Comparing electro- and mechano-myographic muscle activation patterns in self-paced pediatric gait.

    Science.gov (United States)

    Plewa, Katherine; Samadani, Ali; Chau, Tom

    2017-10-01

    Electromyography (EMG) is the standard modality for measuring muscle activity. However, the convenience and availability of low-cost accelerometer-based wearables makes mechanomyography (MMG) an increasingly attractive alternative modality for clinical applications. Literature to date has demonstrated a strong association between EMG and MMG temporal alignment in isometric and isokinetic contractions. However, the EMG-MMG relationship has not been studied in gait. In this study, the concurrence of EMG- and MMG-detected contractions in the tibialis anterior, lateral gastrocnemius, vastus lateralis, and biceps femoris muscles were investigated in children during self-paced gait. Furthermore, the distribution of signal power over the gait cycle was statistically compared between EMG-MMG modalities. With EMG as the reference, muscular contractions were detected based on MMG with balanced accuracies between 88 and 94% for all muscles except the gastrocnemius. MMG signal power differed from that of EMG during certain phases of the gait cycle in all muscles except the biceps femoris. These timing and power distribution differences between the two modalities may in part be related to muscle fascicle length changes that are unique to muscle motion during gait. Our findings suggest that the relationship between EMG and MMG appears to be more complex during gait than in isometric and isokinetic contractions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Updates in Cardiac Resynchronization Therapy for Chronic Heart Failure: Review of Multisite Pacing.

    Science.gov (United States)

    Antoniadis, Antonios P; Sieniewicz, Ben; Gould, Justin; Porter, Bradley; Webb, Jessica; Claridge, Simon; Behar, Jonathan M; Rinaldi, Christopher Aldo

    2017-10-01

    Cardiac resynchronization therapy (CRT) reduces the morbidity and mortality of patients with left ventricular (LV) systolic dysfunction and intra-ventricular conduction delay. However, its clinical outcomes are heterogeneous and not all patients show a beneficial response. Multisite pacing (MSP), by stimulating the myocardium from more than one locations, is a potential therapeutic option in patients requiring CRT. This article provides a current update in the methods and outcomes of MSP, as well as in challenges in this field and opportunities for further research and development. MSP can be delivered either with multiple leads or with quadripolar LV leads which can stimulate the LV from two separate sites. Initial results are promising but not always consistent across studies. Larger patient subgroups and longer follow-up duration are required for more conclusive evaluation of MSP. Routine use of MSP in clinical practice cannot be advocated at present. In selected patient subgroups, however, MSP could be considered. Newer devices and expanding knowledge are expected to facilitate the more widespread implementation of MSP and the assessment of its effects in the clinical outcomes of CRT.

  16. Modelling far field pacing for terminating spiral waves pinned to ischaemic heterogeneities in cardiac tissue

    Science.gov (United States)

    Boccia, E.; Luther, S.; Parlitz, U.

    2017-05-01

    In cardiac tissue, electrical spiral waves pinned to a heterogeneity can be unpinned (and eventually terminated) using electric far field pulses and recruiting the heterogeneity as a virtual electrode. While for isotropic media the process of unpinning is much better understood, the case of an anisotropic substrate with different conductivities in different directions still needs intensive investigation. To study the impact of anisotropy on the unpinning process, we present numerical simulations based on the bidomain formulation of the phase I of the Luo and Rudy action potential model modified due to the occurrence of acute myocardial ischaemia. Simulating a rotating spiral wave pinned to an ischaemic heterogeneity, we compare the success of sequences of far field pulses in the isotropic and the anisotropic case for spirals still in transient or in steady rotation states. Our results clearly indicate that the range of pacing parameters resulting in successful termination of pinned spiral waves is larger in anisotropic tissue than in an isotropic medium. This article is part of the themed issue `Mathematical methods in medicine: neuroscience, cardiology and pathology'.

  17. SELF-PACED READING AND THE ACHIEVEMENT OF PERSIAN EFL LEARNERS

    Directory of Open Access Journals (Sweden)

    Amir Toghyani Khorasgani

    2013-12-01

    Full Text Available This study aimed at investigating the effects of reading goals on L2 reading comprehension in a computer-mediated environment when reading is self-paced by the learners and students are responsible for their own comprehension. Sixty participants (30 males & 30 females in three groups of 20 were involved. A computer program, written in C#.NET program, presented the text on the screen four lines at a time, and measured the amount of time students would spend on each page initially, how many times students re-read pages, and how much time students would spend re-reading pages. L2 learners’ comprehension and learning strategies were measured in three ways: recall of materials, time spent reading each page of the text and time spent re-reading pages, and the number of times pages were re-read. Finally, after one month from the first test a posttest was administered to determine which group could remember materials better. The results revealed that recall of materials was significantly greater for the teaching-goal group than the other two groups in both first and second tests. Time spent re-reading was significantly greater for the teaching-goal group as well. These findings suggest that reading goals do have an effect on comprehension and recalling in a computer-mediated environment and students with a different reading goal performed differently while reading passages.

  18. Synchronization as a mechanism for low-energy anti-fibrillation pacing.

    Science.gov (United States)

    Ji, Yanyan Claire; Uzelac, Ilija; Otani, Niels; Luther, Stefan; Gilmour, Robert F; Cherry, Elizabeth M; Fenton, Flavio H

    2017-08-01

    Low-energy anti-fibrillation pacing (LEAP) has been suggested as an alternative treatment in symptomatic fibrillation patients. It significantly lowers the energy required compared with standard 1-shock defibrillation. In this study, we investigated the mechanism of arrhythmia termination by LEAP and systematically analyzed the influence of shock period and timing on the success rate of LEAP. We induced atrial and ventricular fibrillation in isolated canine hearts and applied LEAP and standard 1-shock defibrillation to terminate the arrhythmia. We simulated the arrhythmia and LEAP using a 2-dimensional bidomain human atrial model. The ex vivo experiments showed successful termination of atrial fibrillation and ventricular fibrillation using LEAP, with an average 88% and 81% energy reduction, respectively, and both experiments and simulations verified that synchronization from virtual electrodes is the key mechanism for termination of arrhythmia by LEAP using modified Kuramoto phase plots and fraction of tissue excited (FTE) plots. We also observed in simulations that LEAP is more effective when the shock period is close to the dominant period and the first shock is delivered when FTE is decreasing. Our results support synchronization as the mechanism for arrhythmia termination by LEAP, and its effectiveness can be improved by adjusting shock period and timing. Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  19. Task-Difficulty Homeostasis in Car Following Models: Experimental Validation Using Self-Paced Visual Occlusion.

    Directory of Open Access Journals (Sweden)

    Jami Pekkanen

    Full Text Available Car following (CF models used in traffic engineering are often criticized for not incorporating "human factors" well known to affect driving. Some recent work has addressed this by augmenting the CF models with the Task-Capability Interface (TCI model, by dynamically changing driving parameters as function of driver capability. We examined assumptions of these models experimentally using a self-paced visual occlusion paradigm in a simulated car following task. The results show strong, approximately one-to-one, correspondence between occlusion duration and increase in time headway. The correspondence was found between subjects and within subjects, on aggregate and individual sample level. The long time scale aggregate results support TCI-CF models that assume a linear increase in time headway in response to increased distraction. The short time scale individual sample level results suggest that drivers also adapt their visual sampling in response to transient changes in time headway, a mechanism which isn't incorporated in the current models.

  20. From Oedipus to PACE, using the concepts of shame and guilt as golden thread.

    Science.gov (United States)

    Beckmann, Klaus Martin

    2016-02-01

    To demonstrate that antiquity's concepts of shame and guilt developed in their meaning over the centuries and can still have practical applicability in psychological therapies these days. To review shame and guilt in philosophy, history, ethics and psychiatry contexts. Within limitations, a narrative is presented, starting with Oedipus in antiquity, visiting several important philosophical theories and ending in the present time with, for example, Dan Hughes' PACE model for therapy. The first part expands on selected ideas presented in Melvyn Bragg's 2007 BBC radio programme entitled 'Guilt'; the second part adds selected therapeutic models where concepts of shame and guilt play a role. Shame and guilt are archaic but quintessential concepts that already occupied thinkers in antiquity. Shame and guilt are concepts that preoccupied science and art over the millennia and continue as useful concepts to the present day. Moreover, shame and guilt, as concepts, continue to play a salient role in recent and contemporary psychiatry. © The Royal Australian and New Zealand College of Psychiatrists 2015.