Factors that influence treatment delay in patients with colorectal cancer

Science.gov (United States)

Zarcos-Pedrinaci, Irene; Fernández-López, Alberto; Téllez, Teresa; Rivas-Ruiz, Francisco; Rueda A, Antonio; Suarez-Varela, María Manuela Morales; Briones, Eduardo; Baré, Marisa; Escobar, Antonio; Sarasqueta, Cristina; de Larrea, Nerea Fernández; Aguirre, Urko; Quintana, José María; Redondo, Maximino

2017-01-01

A prospective study was performed of patients diagnosed with colorectal cancer (CRC), distinguishing between colonic and rectal location, to determine the factors that may provoke a delay in the first treatment (DFT) provided. 2749 patients diagnosed with CRC were studied. The study population was recruited between June 2010 and December 2012. DFT is defined as time elapsed between diagnosis and first treatment exceeding 30 days. Excessive treatment delay was recorded in 65.5% of the cases, and was more prevalent among rectal cancer patients. Independent predictor variables of DFT in colon cancer patients were a low level of education, small tumour, ex-smoker, asymptomatic at diagnosis and following the application of screening. Among rectal cancer patients, the corresponding factors were primary school education and being asymptomatic. We conclude that treatment delay in CRC patients is affected not only by clinicopathological factors, but also by sociocultural ones. Greater attention should be paid by the healthcare provider to social groups with less formal education, in order to optimise treatment attention. PMID:27888636

A novel design for randomized immuno-oncology clinical trials with potentially delayed treatment effects

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Pei He

2015-10-01

Full Text Available The semi-parametric proportional hazards model is widely adopted in randomized clinical trials with time-to-event outcomes, and the log-rank test is frequently used to detect a potential treatment effect. Immuno-oncology therapies pose unique challenges to the design of a trial as the treatment effect may be delayed, which violates the proportional hazards assumption, and the log-rank test has been shown to markedly lose power under the non-proportional hazards setting. A novel design and analysis approach for immuno-oncology trials is proposed through a piecewise treatment effect function, which is capable of detecting a potentially delayed treatment effect. The number of events required for the trial will be determined to ensure sufficient power for both the overall log-rank test without a delayed effect and the test beyond the delayed period when such a delay exists. The existence of a treatment delay is determined by a likelihood ratio test with resampling. Numerical results show that the proposed design adequately controls the Type I error rate, has a minimal loss in power under the proportional hazards setting and is markedly more powerful than the log-rank test with a delayed treatment effect.

Necessary and sufficient conditions for Hopf bifurcation in tri-neuron equation with a delay

International Nuclear Information System (INIS)

Liu Xiaoming; Liao Xiaofeng

2009-01-01

In this paper, we consider the delayed differential equations modeling three-neuron equations with only a time delay. Using the time delay as a bifurcation parameter, necessary and sufficient conditions for Hopf bifurcation to occur are derived. Numerical results indicate that for this model, Hopf bifurcation is likely to occur at suitable delay parameter values.

PEMF as treatment for delayed healing of foot and ankle arthrodesis.

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Saltzman, Charles; Lightfoot, Andrew; Amendola, Annunziato

2004-11-01

Arthrodesis is the most common surgical treatment for foot and ankle arthritis. In adults, these procedures are associated with a 5% to 10% rate of nonunion. Pulsed electromagnetic field (PEMF) stimulation was approved by the Federal Drug Administration (FDA) for treatment of delayed unions after long-bone fractures and joint arthrodesis. The purpose of this study was to examine the results of PEMF treatment for delayed healing after foot and ankle arthrodesis. Three hundred and thirty-four foot and ankle arthrodeses were done. Nineteen resulted in delayed unions that were treated with a protocol of immobilization, limited weightbearing, and PEMF stimulation for a median of 7 (range 5 to 27) months. All patients were followed clinically and radiographically. The use of PEMF, immobilization, and limited weightbearing to treat delayed union after foot and ankle arthrodesis was successful in 5 of 19 (26%) patients. Of the other 14 patients with nonunions, nine had revision surgery with autogenous grafting, continued immobilization, and PEMF stimulation. Seven of these eventually healed at a median of 5.5 (range 2 to 26) months and two did not heal. One patient had a below-knee amputation, and four refused further treatment. The protocol of PEMF, immobilization, and limited weightbearing had a relatively low success rate in this group of patients. We no longer use this protocol alone to treat delayed union after foot and ankle arthrodesis.

Delays in presentation and treatment of breast cancer in Enugu ...

African Journals Online (AJOL)

To assess the delays and define the causes of delay in presentation and treatment of breast cancer patients inEnugu,Nigeria. Across-sectional survey of breast cancer patients using a semi structured questionnaire. SurgicalOncology unit,University ofNigeriaTeachingHospitalEnugu, (UNTH-E),Nigeria. 164 consecutively ...

Global exponential stability and periodicity of reaction-diffusion delayed recurrent neural networks with Dirichlet boundary conditions

International Nuclear Information System (INIS)

Lu Junguo

2008-01-01

In this paper, the global exponential stability and periodicity for a class of reaction-diffusion delayed recurrent neural networks with Dirichlet boundary conditions are addressed by constructing suitable Lyapunov functionals and utilizing some inequality techniques. We first prove global exponential converge to 0 of the difference between any two solutions of the original reaction-diffusion delayed recurrent neural networks with Dirichlet boundary conditions, the existence and uniqueness of equilibrium is the direct results of this procedure. This approach is different from the usually used one where the existence, uniqueness of equilibrium and stability are proved in two separate steps. Furthermore, we prove periodicity of the reaction-diffusion delayed recurrent neural networks with Dirichlet boundary conditions. Sufficient conditions ensuring the global exponential stability and the existence of periodic oscillatory solutions for the reaction-diffusion delayed recurrent neural networks with Dirichlet boundary conditions are given. These conditions are easy to check and have important leading significance in the design and application of reaction-diffusion recurrent neural networks with delays. Finally, two numerical examples are given to show the effectiveness of the obtained results

Delayed unpaired extinction as a treatment for hyperarousal of the rabbit nictitating membrane response and its implications for treating PTSD.

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Schreurs, Bernard G; Smith-Bell, Carrie A; Burhans, Lauren B

2018-04-01

Treatment for PTSD (Post-traumatic stress disorder) is rarely available immediately after trauma and often delayed for weeks or months after an event. In a rabbit eyeblink conditioning model of PTSD, we have previously shown that presentations of a tone conditioned stimulus (CS) and shock unconditioned stimulus (US) in an explicitly unpaired manner known as unpaired extinction is effective in reducing CS responding and US hyperarousal even if shock intensity is reduced eight-fold and elicits only minimal responding. Here we determined if delayed delivery of unpaired extinction would still be effective in extinguishing hyperarousal. Rabbits were tested for sensitivity to shock before CS-US pairings and after six days of unpaired extinction presented a day, a week or a month after CS-US pairings. Hyperarousal was extinguished a day and a week after conditioning but not after a month suggesting a significant delay in "treatment" can make hyperarousal persist. We next assessed if this persistence of hyperarousal was associative by comparing rabbits given CS-US pairings to those given explicitly unpaired CS and US presentations, measuring hyperarousal a day and a month later, followed by unpaired extinction and hyperarousal assessment. After four weeks, there was an increase in responding for all rabbits but only rabbits receiving CS-US pairings showed a significant increase in associatively-mediated hyperarousal. Importantly, both paired and unpaired groups showed increased levels of responding after unpaired extinction suggesting treatment delayed for too long may no longer be effective and could cause generalized hyperarousal. Copyright © 2018 Elsevier Ltd. All rights reserved.

Impact of delay to treatment upon survival in 1067 patients with breast-cancer.

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Rabinovich, M; Vallejo, C; Perez, J; Rodriguez, R; Cuevas, M; Machiavelli, M; Lacava, J; Leone, B; Romero, A; Mickiewicz, E; Chacon, R; Estevez, R

1993-02-01

The medical records of 1067 patients with breast cancer were reviewed to evaluate the influence of delay between first symptom and first treatment upon survival. Three delay intervals were considered: 6 months. At a follow-up of 120 months, survival analyses identified a statistically significant difference (p=0.029) favoring patients with 3 months delay between first symptom and first treatment. Better survival rate for patients with a short delay would obey to a greater number of patients in favorable stages and a higher proportion of women aged 50 or older in this group.

The Amygdala Is Critical for Trace, Delay, and Contextual Fear Conditioning

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Kochli, Daniel E.; Thompson, Elaine C.; Fricke, Elizabeth A.; Postle, Abagail F.; Quinn, Jennifer J.

2015-01-01

Numerous investigations have definitively shown amygdalar involvement in delay and contextual fear conditioning. However, much less is known about amygdala contributions to trace fear conditioning, and what little evidence exists is conflicting as noted in previous studies. This discrepancy may result from selective targeting of individual nuclei…

Factors associated with delays in treatment initiation after tuberculosis diagnosis in two districts of India.

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Durba Paul

Full Text Available BACKGROUND: Excessive time between diagnosis and initiation of tuberculosis (TB treatment contributes to ongoing TB transmission and should be minimized. In India, Revised National TB Control Programme (RNTCP focuses on indicator start of treatment within 7 days of diagnosis for patients with sputum smear-positive PTB for monitoring DOTS implementation. OBJECTIVES: To determine length of time between diagnosis and initiation of treatment and factors associated with delays of more than 7 days in smear-positive pulmonary TB. METHODS: Using existing programme records such as the TB Register, treatment cards, and the laboratory register, we conducted a retrospective cohort study of all patients with smear-positive pulmonary TB registered from July-September 2010 in two districts in India. A random sample of patients with pulmonary TB who experienced treatment delay of more than 7 days was interviewed using structured questionnaire. RESULTS: 2027 of 3411 patients registered with pulmonary TB were smear-positive. 711(35% patients had >7 days between diagnosis and treatment and 262(13% had delays >15 days. Mean duration between TB diagnosis and treatment initiation was 8 days (range = 0-128 days. Odds of treatment delay >7 days was 1.8 times more likely among those who had been previously treated (95% confidence interval [CI] 1.5-2.3 and 1.6 (95% CI 1.3-1.8 times more likely among those diagnosed in health facilities without microscopy centers. The main factors associated with a delay >7 days were: patient reluctance to start a re-treatment regimen, patients seeking second opinions, delay in transportation of drugs to the DOT centers and delay in initial home visits. To conclude, treatment delay >7 days was associated with a number of factors that included history of previous treatment and absence of TB diagnostic services in the local health facility. Decentralized diagnostic facilities and improved referral procedures may reduce such treatment

A new delay-independent condition for global robust stability of neural networks with time delays.

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Samli, Ruya

2015-06-01

This paper studies the problem of robust stability of dynamical neural networks with discrete time delays under the assumptions that the network parameters of the neural system are uncertain and norm-bounded, and the activation functions are slope-bounded. By employing the results of Lyapunov stability theory and matrix theory, new sufficient conditions for the existence, uniqueness and global asymptotic stability of the equilibrium point for delayed neural networks are presented. The results reported in this paper can be easily tested by checking some special properties of symmetric matrices associated with the parameter uncertainties of neural networks. We also present a numerical example to show the effectiveness of the proposed theoretical results. Copyright © 2015 Elsevier Ltd. All rights reserved.

Short-term total sleep deprivation alters delay-conditioned memory in the rat.

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Tripathi, Shweta; Jha, Sushil K

2016-06-01

Short-term sleep deprivation soon after training may impair memory consolidation. Also, a particular sleep stage or its components increase after learning some tasks, such as negative and positive reinforcement tasks, avoidance tasks, and spatial learning tasks, and so forth. It suggests that discrete memory types may require specific sleep stage or its components for their optimal processing. The classical conditioning paradigms are widely used to study learning and memory but the role of sleep in a complex conditioned learning is unclear. Here, we have investigated the effects of short-term sleep deprivation on the consolidation of delay-conditioned memory and the changes in sleep architecture after conditioning. Rats were trained for the delay-conditioned task (for conditioning, house-light [conditioned stimulus] was paired with fruit juice [unconditioned stimulus]). Animals were divided into 3 groups: (a) sleep deprived (SD); (b) nonsleep deprived (NSD); and (c) stress control (SC) groups. Two-way ANOVA revealed a significant interaction between groups and days (training and testing) during the conditioned stimulus-unconditioned stimulus presentation. Further, Tukey post hoc comparison revealed that the NSD and SC animals exhibited significant increase in performances during testing. The SD animals, however, performed significantly less during testing. Further, we observed that wakefulness and NREM sleep did not change after training and testing. Interestingly, REM sleep increased significantly on both days compared to baseline more specifically during the initial 4-hr time window after conditioning. Our results suggest that the consolidation of delay-conditioned memory is sleep-dependent and requires augmented REM sleep during an explicit time window soon after training. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Sharp conditions for global stability of Lotka-Volterra systems with distributed delays

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Faria, Teresa

We give a criterion for the global attractivity of a positive equilibrium of n-dimensional non-autonomous Lotka-Volterra systems with distributed delays. For a class of autonomous Lotka-Volterra systems, we show that such a criterion is sharp, in the sense that it provides necessary and sufficient conditions for the global asymptotic stability independently of the choice of the delay functions. The global attractivity of positive equilibria is established by imposing a diagonal dominance of the instantaneous negative feedback terms, and relies on auxiliary results showing the boundedness of all positive solutions. The paper improves and generalizes known results in the literature, namely by considering systems with distributed delays rather than discrete delays.

Delays in the diagnosis and treatment of tuberculosis patients in Vietnam: a cross-sectional study

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Khanh Vu T

2007-06-01

Full Text Available Abstract Background Treatment delay is an important indicator of access to tuberculosis diagnosis and treatment. Analyses of patient delay (i.e. time interval between onset of symptoms and first consultation of a health care provider and health care delay (i.e. time interval between first consultation and start of treatment can inform policies to improve access. This study assesses the patient, health care provider and total delay in diagnosis and treatment of new smear-positive pulmonary tuberculosis patients, and the risk factors for long delay, in Vietnam. Methods A cross-sectional survey of new patients treated by the National Tuberculosis Control Programme was conducted in 70 randomly selected districts in Vietnam. All consecutively registered patients in one quarter of 2002 were interviewed using a pre-coded structured questionnaire. Results Median (range delay was 4 weeks (1–48 for total, 3 (1–48 weeks for patient and 1 (0–25 week for health care delay. Patients with long total delay (≥ 12 weeks, 15% accounted for 49% of the cumulative number of delay-weeks. Independent risk factors (p 5 km distance from a health facility or in the northern area. For long health care delay (≥ 6 weeks this was urban setting, residence in the central area and initial visit to a communal health post, TB hospital or the private sector. Conclusion Analyses of patient and treatment delays can indicate target groups and areas for health education and strengthening of the referral system, in particular between the private sector and the NTP.

Children with autism spectrum disorders show abnormal conditioned response timing on delay, but not trace, eyeblink conditioning

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Oristaglio, Jeff; West, Susan Hyman; Ghaffari, Manely; Lech, Melissa S.; Verma, Beeta R.; Harvey, John A.; Welsh, John P.; Malone, Richard P.

2013-01-01

Children with autism spectrum disorder (ASD) and age-matched typically-developing (TD) peers were tested on two forms of eyeblink conditioning (EBC), a Pavlovian associative learning paradigm where subjects learn to execute an appropriately-timed eyeblink in response to a previously neutral conditioning stimulus (CS). One version of the task, trace EBC, interposes a stimulus-free interval between the presentation of the CS and the unconditioned stimulus (US), a puff of air to the eye which causes subjects to blink. In delay EBC, the CS overlaps in time with the delivery of the US, usually with both stimuli terminating simultaneously. ASD children performed normally during trace EBC, exhibiting no differences from typically-developing (TD) subjects with regard to learning rate or the timing of the CR. However, when subsequently tested on delay EBC, subjects with ASD displayed abnormally-timed conditioned eye blinks that began earlier and peaked sooner than those of TD subjects, consistent with previous findings. The results suggest an impaired ability of children with ASD to properly time conditioned eye blinks which appears to be specific to delay EBC. We suggest that this deficit may reflect a dysfunction of cerebellar cortex in which increases in the intensity or duration of sensory input can temporarily disrupt the accuracy of motor timing over short temporal intervals. PMID:23769889

High mortality during tuberculosis treatment does not indicate long diagnostic delays in Vietnam: a cohort study

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Sy Dinh N

2007-08-01

Full Text Available Abstract Background Delay in tuberculosis diagnosis and treatment initiation may increase disease severity and mortality. In evaluations of tuberculosis control programmes high fatality rates during tuberculosis treatment, are used as an indicator of long delays in low HIV-prevalence settings. However, data for this presumed association between delay and fatality are lacking. We assessed the association between diagnostic delay and mortality of new smear-positive pulmonary tuberculosis patients in Vietnam. Methods Follow-up of a patient cohort included in a survey of diagnostic delay in 70 randomly selected districts. Data on diagnosis and treatment were extracted from routine registers. Patients who had died during the course of treatment were compared to those with reported cure, completed treatment or failure (survivors. Results Complete data were available for 1881/2093 (89.9% patients, of whom 82 (4.4% had died. Fatality was 4.5% for patients with ≤ 4 weeks delay, 5.0% for 5- ≤ 8 weeks delay (aOR 1.11, 95%CI 0.67–1.84 and 3.2% for > 9 weeks delay (aOR 0.69, 95%CI 0.37–1.30. Fatality tended to decline with increasing delay but this was not significant. Fatality was not associated with median diagnostic delay at district level (Spearman's rho = -0.08, P = 0.5. Conclusion Diagnostic delay is not associated with treatment mortality in Vietnam at individual nor district level, suggesting that high case fatality should not be used as an indicator of long diagnostic delay in national tuberculosis programmes.

Local Stability of AIDS Epidemic Model Through Treatment and Vertical Transmission with Time Delay

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Novi W, Cascarilla; Lestari, Dwi

2016-02-01

This study aims to explain stability of the spread of AIDS through treatment and vertical transmission model. Human with HIV need a time to positively suffer AIDS. The existence of a time, human with HIV until positively suffer AIDS can be delayed for a time so that the model acquired is the model with time delay. The model form is a nonlinear differential equation with time delay, SIPTA (susceptible-infected-pre AIDS-treatment-AIDS). Based on SIPTA model analysis results the disease free equilibrium point and the endemic equilibrium point. The disease free equilibrium point with and without time delay are local asymptotically stable if the basic reproduction number is less than one. The endemic equilibrium point will be local asymptotically stable if the time delay is less than the critical value of delay, unstable if the time delay is more than the critical value of delay, and bifurcation occurs if the time delay is equal to the critical value of delay.

Delay in the diagnosis and treatment of pulmonary tuberculosis in Uzbekistan: a cross-sectional study.

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Belkina, Tatiana V; Khojiev, Doniyor S; Tillyashaykhov, Mirzagaleb N; Tigay, Zinaida N; Kudenov, Marat U; Tebbens, Jurjen Duintjer; Vlcek, Jiri

2014-11-25

Early diagnosis and prompt effective therapy are crucial for the prevention of tuberculosis (TB) transmission, particularly in regions with high levels of multi-drug resistant TB. This study aimed to evaluate the extent of delay in diagnosis and treatment of TB in Uzbekistan and identify associated risk factors. A cross-sectional study was performed on hospital patients with newly diagnosed TB. The time between the onset of respiratory symptoms and initiation of anti-TB treatment was assessed and delays were divided into patient, health system and total delays. Univariable and multivariable logistic regression analysis was used to evaluate determinants of diagnostic and treatment delay. Among 538 patients enrolled, the median delay from onset of symptoms until treatment with anti-TB drugs was 50 days. Analysis of the factors affecting health-seeking behaviour and timely treatment showed the presence of the patient factor. Self-medication was the first health-seeking action for 231 (43%) patients and proved to be a significant predictor of delay (p = 0.005), as well as coughing (p = 0.009), loss of weight (p = 0.001), and visiting private and primary healthcare facilities (p = 0.03 and p = 0.02, respectively). TB diagnostic and treatment delay was mainly contributed to by patient delay and should be reduced through increasing public awareness of TB symptoms and improving public health-seeking behaviour for timely initiation of anti-TB treatment. Efforts should be made to minimise irrational use of antibiotics and support interventions to restrict over-the-counter availability of antibiotics.

Karrikins delay soybean seed germination by mediating abscisic acid and gibberellin biogenesis under shaded conditions

Science.gov (United States)

Meng, Yongjie; Chen, Feng; Shuai, Haiwei; Luo, Xiaofeng; Ding, Jun; Tang, Shengwen; Xu, Shuanshuan; Liu, Jianwei; Liu, Weiguo; Du, Junbo; Liu, Jiang; Yang, Feng; Sun, Xin; Yong, Taiwen; Wang, Xiaochun; Feng, Yuqi; Shu, Kai; Yang, Wenyu

2016-01-01

Karrikins (KAR) are a class of signal compounds, discovered in wildfire smoke, which affect seed germination. Currently, numerous studies have focused on the model plant Arabidopsis in the KAR research field, rather than on crops. Thus the regulatory mechanisms underlying KAR regulation of crop seed germination are largely unknown. Here, we report that KAR delayed soybean seed germination through enhancing abscisic acid (ABA) biosynthesis, while impairing gibberellin (GA) biogenesis. Interestingly, KAR only retarded soybean seed germination under shaded conditions, rather than under dark and white light conditions, which differs from in Arabidopsis. Phytohormone quantification showed that KAR enhanced ABA biogenesis while impairing GA biosynthesis during the seed imbibition process, and subsequently, the ratio of active GA4 to ABA was significantly reduced. Further qRT-PCR analysis showed that the transcription pattern of genes involved in ABA and GA metabolic pathways are consistent with the hormonal measurements. Finally, fluridone, an ABA biogenesis inhibitor, remarkably rescued the delayed-germination phenotype of KAR-treatment; and paclobutrazol, a GA biosynthesis inhibitor, inhibited soybean seed germination. Taken together, these evidences suggest that KAR inhibit soybean seed germination by mediating the ratio between GA and ABA biogenesis. PMID:26902640

Karrikins delay soybean seed germination by mediating abscisic acid and gibberellin biogenesis under shaded conditions.

Science.gov (United States)

Meng, Yongjie; Chen, Feng; Shuai, Haiwei; Luo, Xiaofeng; Ding, Jun; Tang, Shengwen; Xu, Shuanshuan; Liu, Jianwei; Liu, Weiguo; Du, Junbo; Liu, Jiang; Yang, Feng; Sun, Xin; Yong, Taiwen; Wang, Xiaochun; Feng, Yuqi; Shu, Kai; Yang, Wenyu

2016-02-23

Karrikins (KAR) are a class of signal compounds, discovered in wildfire smoke, which affect seed germination. Currently, numerous studies have focused on the model plant Arabidopsis in the KAR research field, rather than on crops. Thus the regulatory mechanisms underlying KAR regulation of crop seed germination are largely unknown. Here, we report that KAR delayed soybean seed germination through enhancing abscisic acid (ABA) biosynthesis, while impairing gibberellin (GA) biogenesis. Interestingly, KAR only retarded soybean seed germination under shaded conditions, rather than under dark and white light conditions, which differs from in Arabidopsis. Phytohormone quantification showed that KAR enhanced ABA biogenesis while impairing GA biosynthesis during the seed imbibition process, and subsequently, the ratio of active GA4 to ABA was significantly reduced. Further qRT-PCR analysis showed that the transcription pattern of genes involved in ABA and GA metabolic pathways are consistent with the hormonal measurements. Finally, fluridone, an ABA biogenesis inhibitor, remarkably rescued the delayed-germination phenotype of KAR-treatment; and paclobutrazol, a GA biosynthesis inhibitor, inhibited soybean seed germination. Taken together, these evidences suggest that KAR inhibit soybean seed germination by mediating the ratio between GA and ABA biogenesis.

Predicting memory performance under conditions of proactive interference: immediate and delayed judgments of learning.

Science.gov (United States)

Wahlheim, Christopher N

2011-07-01

Four experiments examined the monitoring accuracy of immediate and delayed judgments of learning (JOLs) under conditions of proactive interference (PI). PI was produced using paired-associate learning tasks that conformed to variations of classic A-B, A-D paradigms. Results revealed that the relative monitoring accuracy of interference items was better for delayed than for immediate JOLs. However, delayed JOLs were overconfident for interference items, but not for items devoid of interference. Intrusions retrieved prior to delayed JOLs produced inflated predictions of performance. These results show that delayed JOLs enhance monitoring accuracy in PI situations, except when intrusions are mistaken for target responses.

The impact of 5-hydroxytryptamine-receptor antagonists on chemotherapy treatment adherence, treatment delay, and nausea and vomiting.

Science.gov (United States)

Palli, Swetha Rao; Grabner, Michael; Quimbo, Ralph A; Rugo, Hope S

2015-01-01

To determine the incidence of chemotherapy-induced nausea/vomiting (CINV) and chemotherapy treatment delay and adherence among patients receiving palonosetron versus other 5-hydroxytryptamine receptor antagonist (5-HT3 RA) antiemetics. This retrospective claims analysis included adults with primary malignancies who initiated treatment consisting of single-day intravenous highly emetogenic chemotherapy (HEC) or moderately EC (MEC) regimens. Treatment delay was defined as a gap in treatment at least twice the National Comprehensive Cancer Network-specified cycle length, specific to each chemotherapy regimen. Treatment adherence was determined by the percentage of patients who received the regimen-specific recommended number of chemotherapy cycles within the recommended time frame. We identified 1,832 palonosetron and 2,387 other 5-HT3 RA ("other") patients who initiated HEC therapy, and 1,350 palonosetron users and 1,379 patients on other antiemetics who initiated MEC therapy. Fewer patients receiving palonosetron experienced CINV versus other (HEC, 27.5% versus 32.2%, P=0.0011; MEC, 36.1% versus 41.7%, P=0.0026), and fewer treatment delays occurred among patients receiving palonosetron versus other (HEC, 3.2% versus 6.0%, PHEC, 74.7% versus 69.7%, P=0.0004; MEC, 43.1% versus 37.3%, P=0.0019) and dosage (HEC, 27.3% versus 25.8%, P=0.0004; MEC, 15.0% versus 12.6%, P=0.0019). Palonosetron more effectively reduced occurrence of CINV in patients receiving HEC or MEC compared with other agents in this real-world setting. Additionally, patients receiving palonosetron had better adherence and fewer treatment delays than patients receiving other 5-HT3 RAs.

Treatment delay among pulmonary tuberculosis patients in pastoralist communities in Bale Zone, Southeast Ethiopia

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Hussen Awol

2012-06-01

Full Text Available Abstract Background Tuberculosis (TB is a major public health problem in Africa with Ethiopia being the most affected. Treatment delay is an important indicator of access to TB diagnosis and treatment. However, little is known about factors associated with treatment delay of pulmonary TB among pastoralists. Health facility based cross sectional study was conducted on 129 pulmonary TB patients in pastoralist community. The study was conducted in three health centers and a hospital. Time between onset of TB symptoms and first visit to a professional health care provider (patient delay, and the time between first visits to the professional health care provider to the date of diagnosis (provider's delay were analyzed using SPSS 16.0 statistical software. Findings A total of 129 new smear positive pulmonary TB patients participated in the study. The median total delay was 97 days. The median patient and health provider delays were 63 and 34 days, respectively. Ninety six percent of the patients were delayed for more than the twenty one days cutoff point. Patient delay was positively associated with first visit to traditional healer/private clinic/drug shop, rural residence, being illiterate, living in more than 10 kilometers from health facility; severity of illness at first presentation to health facility. Provider delay was positively associated with rural residence, being illiterate, patient with good functional status, patients in contact with more than two health providers, and place of first visit being traditional healer/private clinic/drug shop. Conclusions This study showed that majority of smear positive patients delayed either for diagnosis or treatment, thus continue to serve as reservoirs of infection. This indicates that there is a need for intervention to decrease patient and provider delays. Effort to reduce delays in pastoralist communities should focus on improving access to services in rural communities, engaging traditional and

Determinants of patient delay in seeking treatment among ...

African Journals Online (AJOL)

lmboera

A descriptive cross sectional study was employed. A face to .... Face validation of the instrument was done through peer review and pretesting. In this ..... patient delay for Christians was about 3.3 fold higher compared with Muslims. ... Grover, A., Kumar, R. & Jindal, K. (2006) Socio-demographic determinants of treatment.

Delay discounting, treatment motivation and treatment retention among substance-dependent individuals attending an in inpatient detoxification program

NARCIS (Netherlands)

Stevens, Laura; Verdejo-García, Antonio; Roeyers, Herbert; Goudriaan, Anna E.; Vanderplasschen, Wouter

2015-01-01

Recent studies consistently indicate high rates of delay discounting in drug users, which refers to a strong tendency to devaluate delayed rewards. Many addiction treatment programs however, place high demands on the ability to postpone immediate gratification. Therefore, these programs may be

Globally exponential stability condition of a class of neural networks with time-varying delays

International Nuclear Information System (INIS)

Liao, T.-L.; Yan, J.-J.; Cheng, C.-J.; Hwang, C.-C.

2005-01-01

In this Letter, the globally exponential stability for a class of neural networks including Hopfield neural networks and cellular neural networks with time-varying delays is investigated. Based on the Lyapunov stability method, a novel and less conservative exponential stability condition is derived. The condition is delay-dependent and easily applied only by checking the Hamiltonian matrix with no eigenvalues on the imaginary axis instead of directly solving an algebraic Riccati equation. Furthermore, the exponential stability degree is more easily assigned than those reported in the literature. Some examples are given to demonstrate validity and excellence of the presented stability condition herein

HAMLET treatment delays bladder cancer development.

Science.gov (United States)

Mossberg, Ann-Kristin; Hou, Yuchuan; Svensson, Majlis; Holmqvist, Bo; Svanborg, Catharina

2010-04-01

HAMLET is a protein-lipid complex that kills different types of cancer cells. Recently we observed a rapid reduction in human bladder cancer size after intravesical HAMLET treatment. In this study we evaluated the therapeutic effect of HAMLET in the mouse MB49 bladder carcinoma model. Bladder tumors were established by intravesical injection of MB49 cells into poly L-lysine treated bladders of C57BL/6 mice. Treatment groups received repeat intravesical HAMLET instillations and controls received alpha-lactalbumin or phosphate buffer. Effects of HAMLET on tumor size and putative apoptotic effects were analyzed in bladder tissue sections. Whole body imaging was used to study HAMLET distribution in tumor bearing mice compared to healthy bladder tissue. HAMLET caused a dose dependent decrease in MB49 cell viability in vitro. Five intravesical HAMLET instillations significantly decreased tumor size and delayed development in vivo compared to controls. TUNEL staining revealed selective apoptotic effects in tumor areas but not in adjacent healthy bladder tissue. On in vivo imaging Alexa-HAMLET was retained for more than 24 hours in the bladder of tumor bearing mice but not in tumor-free bladders or in tumor bearing mice that received Alexa-alpha-lactalbumin. Results show that HAMLET is active as a tumoricidal agent and suggest that topical HAMLET administration may delay bladder cancer development. Copyright (c) 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Delays before Diagnosis and Initiation of Treatment in Patients Presenting to Mental Health Services with Bipolar Disorder.

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Rashmi Patel

Full Text Available Bipolar disorder is a significant cause of morbidity and mortality. Although existing treatments are effective, there is often a substantial delay before diagnosis and treatment initiation. We sought to investigate factors associated with the delay before diagnosis of bipolar disorder and the onset of treatment in secondary mental healthcare.Retrospective cohort study using anonymised electronic mental health record data from the South London and Maudsley NHS Foundation Trust (SLaM Biomedical Research Centre (BRC Case Register on 1364 adults diagnosed with bipolar disorder between 2007 and 2012. The following predictor variables were analysed in a multivariable Cox regression analysis: age, gender, ethnicity, compulsory admission to hospital under the UK Mental Health Act, marital status and other diagnoses prior to bipolar disorder. The outcomes were time to recorded diagnosis from first presentation to specialist mental health services (the diagnostic delay, and time to the start of appropriate therapy (treatment delay.The median diagnostic delay was 62 days (interquartile range: 17-243 and median treatment delay was 31 days (4-122. Compulsory hospital admission was associated with a significant reduction in both diagnostic delay (hazard ratio 2.58, 95% CI 2.18-3.06 and treatment delay (4.40, 3.63-5.62. Prior diagnoses of other psychiatric disorders were associated with increased diagnostic delay, particularly alcohol (0.48, 0.33-0.41 and substance misuse disorders (0.44, 0.31-0.61. Prior diagnosis of schizophrenia and psychotic depression were associated with reduced treatment delay.Some individuals experience a significant delay in diagnosis and treatment of bipolar disorder after initiation of specialist mental healthcare, particularly those who have prior diagnoses of alcohol and substance misuse disorders. These findings highlight a need for further study on strategies to better identify underlying symptoms and offer appropriate treatment

Delays before Diagnosis and Initiation of Treatment in Patients Presenting to Mental Health Services with Bipolar Disorder.

Science.gov (United States)

Patel, Rashmi; Shetty, Hitesh; Jackson, Richard; Broadbent, Matthew; Stewart, Robert; Boydell, Jane; McGuire, Philip; Taylor, Matthew

2015-01-01

Bipolar disorder is a significant cause of morbidity and mortality. Although existing treatments are effective, there is often a substantial delay before diagnosis and treatment initiation. We sought to investigate factors associated with the delay before diagnosis of bipolar disorder and the onset of treatment in secondary mental healthcare. Retrospective cohort study using anonymised electronic mental health record data from the South London and Maudsley NHS Foundation Trust (SLaM) Biomedical Research Centre (BRC) Case Register on 1364 adults diagnosed with bipolar disorder between 2007 and 2012. The following predictor variables were analysed in a multivariable Cox regression analysis: age, gender, ethnicity, compulsory admission to hospital under the UK Mental Health Act, marital status and other diagnoses prior to bipolar disorder. The outcomes were time to recorded diagnosis from first presentation to specialist mental health services (the diagnostic delay), and time to the start of appropriate therapy (treatment delay). The median diagnostic delay was 62 days (interquartile range: 17-243) and median treatment delay was 31 days (4-122). Compulsory hospital admission was associated with a significant reduction in both diagnostic delay (hazard ratio 2.58, 95% CI 2.18-3.06) and treatment delay (4.40, 3.63-5.62). Prior diagnoses of other psychiatric disorders were associated with increased diagnostic delay, particularly alcohol (0.48, 0.33-0.41) and substance misuse disorders (0.44, 0.31-0.61). Prior diagnosis of schizophrenia and psychotic depression were associated with reduced treatment delay. Some individuals experience a significant delay in diagnosis and treatment of bipolar disorder after initiation of specialist mental healthcare, particularly those who have prior diagnoses of alcohol and substance misuse disorders. These findings highlight a need for further study on strategies to better identify underlying symptoms and offer appropriate treatment sooner

The impact of 5-hydroxytryptamine-receptor antagonists on chemotherapy treatment adherence, treatment delay, and nausea and vomiting

International Nuclear Information System (INIS)

Palli, Swetha Rao; Grabner, Michael; Quimbo, Ralph A; Rugo, Hope S

2015-01-01

To determine the incidence of chemotherapy-induced nausea/vomiting (CINV) and chemotherapy treatment delay and adherence among patients receiving palonosetron versus other 5-hydroxytryptamine receptor antagonist (5-HT 3 RA) antiemetics. This retrospective claims analysis included adults with primary malignancies who initiated treatment consisting of single-day intravenous highly emetogenic chemotherapy (HEC) or moderately EC (MEC) regimens. Treatment delay was defined as a gap in treatment at least twice the National Comprehensive Cancer Network-specified cycle length, specific to each chemotherapy regimen. Treatment adherence was determined by the percentage of patients who received the regimen-specific recommended number of chemotherapy cycles within the recommended time frame. We identified 1,832 palonosetron and 2,387 other 5-HT 3 RA (“other”) patients who initiated HEC therapy, and 1,350 palonosetron users and 1,379 patients on other antiemetics who initiated MEC therapy. Fewer patients receiving palonosetron experienced CINV versus other (HEC, 27.5% versus 32.2%, P=0.0011; MEC, 36.1% versus 41.7%, P=0.0026), and fewer treatment delays occurred among patients receiving palonosetron versus other (HEC, 3.2% versus 6.0%, P<0.0001; MEC, 17.0% versus 26.8%, P<0.0001). Compared with the other cohort, patients receiving palonosetron were significantly more adherent to the index chemotherapy regimen with respect to the recommended time frame (HEC, 74.7% versus 69.7%, P=0.0004; MEC, 43.1% versus 37.3%, P=0.0019) and dosage (HEC, 27.3% versus 25.8%, P=0.0004; MEC, 15.0% versus 12.6%, P=0.0019). Palonosetron more effectively reduced occurrence of CINV in patients receiving HEC or MEC compared with other agents in this real-world setting. Additionally, patients receiving palonosetron had better adherence and fewer treatment delays than patients receiving other 5-HT 3 RAs

Retention and Extinction of Delay Eyeblink Conditioning Are Modulated by Central Cannabinoids

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Steinmetz, Adam B.; Freeman, John H.

2011-01-01

Rats administered the cannabinoid agonist WIN55,212-2 or the antagonist SR141716A exhibit marked deficits during acquisition of delay eyeblink conditioning, as noted by Steinmetz and Freeman in an earlier study. However, the effects of these drugs on retention and extinction of eyeblink conditioning have not been assessed. The present study…

The impact of 5-hydroxytryptamine-receptor antagonists on chemotherapy treatment adherence, treatment delay, and nausea and vomiting

Directory of Open Access Journals (Sweden)

Palli SR

2015-06-01

Full Text Available Swetha Rao Palli,1 Michael Grabner,1 Ralph A Quimbo,1 Hope S Rugo2 1HealthCore, Wilmington, DE, 2University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA Purpose: To determine the incidence of chemotherapy-induced nausea/vomiting (CINV and chemotherapy treatment delay and adherence among patients receiving palonosetron versus other 5-hydroxytryptamine receptor antagonist (5-HT3 RA antiemetics. Materials and methods: This retrospective claims analysis included adults with primary malignancies who initiated treatment consisting of single-day intravenous highly emetogenic chemotherapy (HEC or moderately EC (MEC regimens. Treatment delay was defined as a gap in treatment at least twice the National Comprehensive Cancer Network-specified cycle length, specific to each chemotherapy regimen. Treatment adherence was determined by the percentage of patients who received the regimen-specific recommended number of chemotherapy cycles within the recommended time frame. Results: We identified 1,832 palonosetron and 2,387 other 5-HT3 RA (“other” patients who initiated HEC therapy, and 1,350 palonosetron users and 1,379 patients on other antiemetics who initiated MEC therapy. Fewer patients receiving palonosetron experienced CINV versus other (HEC, 27.5% versus 32.2%, P=0.0011; MEC, 36.1% versus 41.7%, P=0.0026, and fewer treatment delays occurred among patients receiving palonosetron versus other (HEC, 3.2% versus 6.0%, P<0.0001; MEC, 17.0% versus 26.8%, P<0.0001. Compared with the other cohort, patients receiving palonosetron were significantly more adherent to the index chemotherapy regimen with respect to the recommended time frame (HEC, 74.7% versus 69.7%, P=0.0004; MEC, 43.1% versus 37.3%, P=0.0019 and dosage (HEC, 27.3% versus 25.8%, P=0.0004; MEC, 15.0% versus 12.6%, P=0.0019. Conclusion: Palonosetron more effectively reduced occurrence of CINV in patients receiving HEC or MEC compared with

Synchronization of Reaction-Diffusion Neural Networks With Dirichlet Boundary Conditions and Infinite Delays.

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Sheng, Yin; Zhang, Hao; Zeng, Zhigang

2017-10-01

This paper is concerned with synchronization for a class of reaction-diffusion neural networks with Dirichlet boundary conditions and infinite discrete time-varying delays. By utilizing theories of partial differential equations, Green's formula, inequality techniques, and the concept of comparison, algebraic criteria are presented to guarantee master-slave synchronization of the underlying reaction-diffusion neural networks via a designed controller. Additionally, sufficient conditions on exponential synchronization of reaction-diffusion neural networks with finite time-varying delays are established. The proposed criteria herein enhance and generalize some published ones. Three numerical examples are presented to substantiate the validity and merits of the obtained theoretical results.

Why trace and delay conditioning are sometimes (but not always) hippocampal dependent: A computational model

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Moustafa, Ahmed A.; Wufong, Ella; Servatius, Richard J.; Pang, Kevin C. H.; Gluck, Mark A.; Myers, Catherine E.

2013-01-01

A recurrent-network model provides a unified account of the hippocampal region in mediating the representation of temporal information in classical eyeblink conditioning. Much empirical research is consistent with a general conclusion that delay conditioning (in which the conditioned stimulus CS and unconditioned stimulus US overlap and co-terminate) is independent of the hippocampal system, while trace conditioning (in which the CS terminates before US onset) depends on the hippocampus. However, recent studies show that, under some circumstances, delay conditioning can be hippocampal-dependent and trace conditioning can be spared following hippocampal lesion. Here, we present an extension of our prior trial-level models of hippocampal function and stimulus representation that can explain these findings within a unified framework. Specifically, the current model includes adaptive recurrent collateral connections that aid in the representation of intra-trial temporal information. With this model, as in our prior models, we argue that the hippocampus is not specialized for conditioned response timing, but rather is a general-purpose system that learns to predict the next state of all stimuli given the current state of variables encoded by activity in recurrent collaterals. As such, the model correctly predicts that hippocampal involvement in classical conditioning should be critical not only when there is an intervening trace interval, but also when there is a long delay between CS onset and US onset. Our model simulates empirical data from many variants of classical conditioning, including delay and trace paradigms in which the length of the CS, the inter-stimulus interval, or the trace interval is varied. Finally, we discuss model limitations, future directions, and several novel empirical predictions of this temporal processing model of hippocampal function and learning. PMID:23178699

Choice between delayed food and immediate oxycodone in rats.

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Secci, Maria E; Factor, Julie A; Schindler, Charles W; Panlilio, Leigh V

2016-12-01

The choice to seek immediate drug effects instead of more meaningful but delayed rewards is a defining feature of addiction. To develop a rodent model of this behavior, we allowed rats to choose between immediate intravenous delivery of the prescription opioid oxycodone (50 μg/kg) and delayed delivery of palatable food pellets. Rats preferred food at delays up to 30 s, but they chose oxycodone and food equally at 60-s delay and preferred oxycodone over food at 120-s delay. Comparison of food-drug choice, food-only, and drug-only conditions indicated that food availability decreased drug intake, but drug availability increased food intake. In the food-only condition, food was effective as a reinforcer even when delayed by 120 s. Pre-session feeding with chow slowed acquisition of food and drug self-administration, but did not affect choice. To establish procedures for testing potential anti-addiction medications, noncontingent pre-treatment with oxycodone or naltrexone (analogous to substitution and antagonist therapies, respectively) were tested on a baseline in which oxycodone was preferred over delayed food. Naltrexone pre-treatment decreased drug intake and increased food intake. Oxycodone pre-treatment decreased drug intake, but also produced extended periods with no food or drug responding. These findings show that the contingencies that induce preference for drugs over more meaningful but less immediate rewards in humans can be modeled in rodents, and they suggest that the model could be useful for assessing the therapeutic potential of treatments and exploring the underlying behavioral and neural mechanisms involved in addiction.

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

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

2016-07-01

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

Barriers and Delays in Tuberculosis Diagnosis and Treatment Services: Does Gender Matter?

Directory of Open Access Journals (Sweden)

Wei-Teng Yang

2014-01-01

Full Text Available Background. Tuberculosis (TB remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation. Methods. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined barriers and delays at the individual and provider/system levels using a conceptual framework of the TB care continuum and examined gender-related differences. Results. Among 13,448 articles, 137 were included: many assessed individual-level barriers (52% and delays (42%, 76% surveyed persons presenting for care with diagnosed or suspected TB, 24% surveyed community members, and two-thirds were from African and Asian regions. Many studies reported no gender differences. Among studies reporting disparities, women faced greater barriers (financial: 64% versus 36%; physical: 100% versus 0%; stigma: 85% versus 15%; health literacy: 67% versus 33%; and provider-/system-level: 100% versus 0% and longer delays (presentation to diagnosis: 45% versus 0% than men. Conclusions. Many studies found no quantitative gender-related differences in barriers and delays limiting access to TB services. When differences were identified, women experienced greater barriers and longer delays than men.

Barriers and delays in tuberculosis diagnosis and treatment services: does gender matter?

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Yang, Wei-Teng; Gounder, Celine R; Akande, Tokunbo; De Neve, Jan-Walter; McIntire, Katherine N; Chandrasekhar, Aditya; de Lima Pereira, Alan; Gummadi, Naveen; Samanta, Santanu; Gupta, Amita

2014-01-01

Background. Tuberculosis (TB) remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation. Methods. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined barriers and delays at the individual and provider/system levels using a conceptual framework of the TB care continuum and examined gender-related differences. Results. Among 13,448 articles, 137 were included: many assessed individual-level barriers (52%) and delays (42%), 76% surveyed persons presenting for care with diagnosed or suspected TB, 24% surveyed community members, and two-thirds were from African and Asian regions. Many studies reported no gender differences. Among studies reporting disparities, women faced greater barriers (financial: 64% versus 36%; physical: 100% versus 0%; stigma: 85% versus 15%; health literacy: 67% versus 33%; and provider-/system-level: 100% versus 0%) and longer delays (presentation to diagnosis: 45% versus 0%) than men. Conclusions. Many studies found no quantitative gender-related differences in barriers and delays limiting access to TB services. When differences were identified, women experienced greater barriers and longer delays than men.

On-demand SSRI treatment of premature ejaculation: pharmacodynamic limitations for relevant ejaculation delay and consequent solutions.

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Waldinger, Marcel D; Schweitzer, Dave H; Olivier, Berend

2005-01-01

Recently, the idea has emerged that on-demand use of serotonin reuptake inhibitors (SSRIs), particularly short half-life, should be equally effective in delaying ejaculation as daily SSRI treatment of premature ejaculation. To provide evidence that SSRI-induced ejaculation delay is mainly dependent on pharmacodynamic properties of the drug and hardly on pharmacokinetic factors, and that combined SSRI administration with specific 5-hydroxytryptamine (5-HT) receptor antagonism leads acutely to stronger ejaculation delay than acute SSRI monoadministration. We performed a detailed analysis of serotonin neurotransmission and reviewed animal studies with 5-HT(1A) receptor antagonists. In addition, we critically reviewed existing on-demand SSRI treatments publications and the current debate on a definition of premature ejaculation. Intravaginal ejaculation latency time (IELT). Acute SSRI administration leads to only a mild or no increase of 5-HT neurotransmission and concomitant stimulation of postsynaptic 5-HT receptors. Existing on-demand SSRI treatment studies suffer from methodological insufficiencies, and the reported high-fold increases of ejaculation time contradict with neuropharmacological insights from serotonin metabolism. Animal studies show that SSRI coadministration with 5-HT(1A) receptor antagonists significantly increases the ejaculation time acutely compared to acute SSRI monoadministration. On-demand SSRI treatment has less ejaculation-delaying effects than daily SSRI treatment. SSRIs with a short half-life are likely leading to much less ejaculation delay than current registered SSRIs. Combined use of SSRIs with 5-HT(1A) receptor antagonists increases the likelihood of clinically relevant ejaculation delay after on-demand treatment. On-demand SSRIs with short half-life that insufficiently delay ejaculation in men with IELTs less than 1 minute should be called ejaculation-delaying drugs rather than drugs against premature ejaculation.

Why Irish women delay seeking treatment for urinary incontinence : a focus group study

OpenAIRE

Ni Aileasa, Mairead

2011-01-01

non-peer-reviewed Background: Urinary Incontinence is defined as "any involuntary leakage of urine" (Abrams et al, 2002). Living with incontinence can effect one's life greatly. Many women delay seeking treatment and often do not seek any help (Dolan et al, 1999), despite physiotherapy being an effective treatment (Neumann et al, 2005). Therefore, there is a need to discover why women delay seeking help, such as physiotherapy and continue to live with incontinence. Objectives: To establ...

Delays in switching patients onto second-line antiretroviral treatment ...

African Journals Online (AJOL)

Background: South Africa has one of the largest antiretroviral treatment (ART) programmes globally. In addition to increasing access to ART, it is important that the health system also focuses on the appropriate management of patients who fail first-line ART. Delays in switching patients onto second-line ART can adversely ...

Role of surgery in delayed local treatment for INSS 4 neuroblastoma.

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Uehara, Shuichiro; Yoneda, Akihiro; Oue, Takaharu; Nakahata, Kengo; Zenitani, Masahiro; Miyamura, Takako; Hashii, Yoshiko; Fukuzawa, Masahiro; Okuyama, Hiroomi

2017-09-01

The aim of the present study was to compare the efficacy, complications and outcomes of the following two surgical strategies for delayed local treatment for International Neuroblastoma Staging System (INSS) 4 neuroblastoma (NB): complete resection (CR; period A); and gross total resection/subtotal resection (GTR/STR) with local irradiation (period B). We retrospectively analyzed 17 patients with INSS 4 NB who received delayed local treatment (period A, n = 11; period B, n = 6). Eleven patients in period A received CR. Two patients underwent GTR and four patients underwent STR in period B. The amount of blood loss in period A was significantly greater than that in period B. Postoperative complications were observed in eight patients in period A (73%), but in only one patient in period B (17%; P < 0.01). Recurrence was observed in five patients in period A and in one patient in period B (45.4% vs 16.6%; P = n.s.). Distant metastasis at recurrence was observed in four patients in period A and in one patient in period B. Gross total resection/subtotal resection with local irradiation may be a safe and effective delayed local treatment for INSS 4 NB. © 2017 Japan Pediatric Society.

Division delay after low x-ray doses and treatment with cyclohexionide

International Nuclear Information System (INIS)

Schneiderman, M.H.; Braby, L.A.; Roesch, W.C.

1977-01-01

Radiation-induced division delay of Chinese hamster ovary cells located in G 2 , and in G 2 between the cycloheximide and x-ray transition points, was measured by the mitotic cell selection technique. The mitotic yield (number of mitotic cells after treatment expressed as a fraction of the control) decreased with increasing radiation dose (4.5 to 34 rad). However, either because some cells were not delayed or because delayed cells recovered rapidly, the mitotic yield did not fall to zero. When cycloheximide was combined with radiation to prevent repair of the radiation damage, only cells which were past the cycloheximide transition point and not delayed by the radiation were selected. The location of the transition points determined from the combined drug plus low-dose radiation (4.5 to 34 rad) experiments indicate a dose-dependent relationship, with more cells delayed as the dose was increased. In addition, the transition point for cells treated with cycloheximide plus 150 rad of x rays was closer to division than the 150 rad of x rays alone. These results are discussed in light of a recent model for radiation-induced division delay proposed by Dewey and Highfield

Delayed versus immediate treatment for patients with acute hepatitis C: a randomised controlled non-inferiority trial.

Science.gov (United States)

Deterding, Katja; Grüner, Norbert; Buggisch, Peter; Wiegand, Johannes; Galle, Peter R; Spengler, Ulrich; Hinrichsen, Holger; Berg, Thomas; Potthoff, Andrej; Malek, Nisar; Großhennig, Anika; Koch, Armin; Diepolder, Helmut; Lüth, Stefan; Feyerabend, Sandra; Jung, Maria Christina; Rogalska-Taranta, Magdalena; Schlaphoff, Verena; Cornberg, Markus; Manns, Michael P; Wedemeyer, Heiner

2013-06-01

Early treatment of acute hepatitis C virus (HCV) infection with interferon alfa monotherapy is very effective, with cure rates of greater than 85%. However, spontaneous clearance of HCV occurs in 10-50% of cases. We aimed to assess an alternative treatment strategy of delayed antiviral therapy in patients who do not eliminate the virus spontaneously compared with immediate treatment. In our open-label phase 3 non-inferiority trial, we enrolled adults (≥18 years) with acute hepatitis C but no HIV or hepatitis B co-infection at 72 centres in Germany. We randomly allocated patients with symptomatic acute hepatitis C (1:1) to receive immediate pegylated interferon alfa-2b treatment for 24 weeks or delayed treatment with pegylated interferon alfa-2b plus ribavirin (for 24 weeks) starting 12 weeks after randomisation if HCV RNA remained positive. We used a computer-generated randomisation sequence and block sizes of eight, stratified by bilirubin concentration. We assigned all asymptomatic patients to immediate treatment with pegylated interferon alfa-2b for 24 weeks. The primary endpoint was sustained HCV RNA negativity in all randomly allocated participants who completed screening (intention-to-treat analysis), with a non-inferiority margin of 10%. For the primary analysis, we calculated the virological response of patients in the immediate and delayed treatment groups and an absolute risk difference stratified by bilirubin status. The trial was stopped early on advice from the study advisory committee because of slow recruitment of participants. This study is registered, number ISRCTN88729946. Between April, 2004, and February, 2010, we recruited 107 symptomatic and 25 asymptomatic patients. 37 (67%) of 55 symptomatic patients randomly allocated to receive immediate treatment and 28 (54%) of 52 symptomatic patients randomly allocated to receive delayed treatment had a sustained virological response (difference 13·7%, 95% CI -4·6 to 32·0; p=0·071). 18 (72%) of 25

A favorable outcome despite a 39-hour treatment delay for arterial gas embolism: case report.

Science.gov (United States)

Covington, Derek; Bielawski, Anthony; Sadler, Charlotte; Latham, Emi

2016-01-01

Cerebral arterial gas embolism (CAGE) occurs when gas enters the cerebral arterial vasculature. CAGE can occur during sitting craniotomies, cranial trauma or secondary to gas embolism from the heart. A far less common cause of CAGE is vascular entrainment of gas during endoscopic procedures. We present the case of a 49-year-old male who developed a CAGE following an esophagoduodenoscopy (EGD) biopsy. Due to a delay in diagnosis, the patient was not treated with hyperbaric oxygen (HBO₂) therapy until 39 hours after the inciting event. Despite presenting to our institution non-responsive and with decorticate posturing, the patient was eventually discharged to a rehabilitation facility, with only mild left upper extremity weakness. This delay in HBO₂ treatment represents the longest delay in treatment to our knowledge for a patient suffering from CAGE secondary to EGD. In addition to the clinical case report, we discuss the etiology of CAGE and the evidence supporting early HBO₂ treatment, as well as the data demonstrating efficacy even after considerable treatment delay. Copyright© Undersea and Hyperbaric Medical Society.

Variation formulae for the solutions of delay differential equations with discontinuous initial conditions

International Nuclear Information System (INIS)

Kharatishvili, G L; Tadumadze, T A

2005-01-01

Variation formulae are proved for solutions of non-linear differential equations with variable delays and discontinuous initial conditions. The discontinuity of the initial condition means that at the initial moment of time the values of the initial function and the trajectory, generally speaking, do not coincide. The formulae obtained contain a new summand connected with the discontinuity of the initial condition and the variation of the initial moment.

[Impact of care pathway on the delay for initiation of antituberculosis treatment in Conakry, Guinea].

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Camara, A; Bah-Sow, O Y; Baldé, N M; Camara, L M; Barry, I S; Bah, B; Diallo, M; Chaperon, J; Riou, F

2009-06-01

Complex care pathways can result in detrimental treatment delay particularly in tuberculosis patients. The purpose of this retrospective study was to assess the care pathways followed by tuberculosis patients prior to diagnosis and to assess impact on the delay for initiation of treatment in Conakry, Guinea. A total of 112 patients were interviewed at the time of first admission for pulmonary tuberculosis with positive bacilloscopy. Based on interview data, pathways were classified as conventional (use of health care facilities only) and mixed (use of health care facilities, self-medication, and traditional medicine). The correlation between patient characteristics and type of pathway was assessed by univariate and multivariate analysis and the two groups, i.e., conventional vs. mixed, were compared with regard to delay for initiation of treatment. The care pathway was classified as mixed in two out of three patients. Multivariate analysis showed that this type of pathway was only correlated with schooling (p=0.02). The mean delay for treatment was similar, i.e., 13.4 and 12.8 weeks for conventional and mixed pathways respectively (p<0.68). The percentage of pathways including three consultations at health care facilities was significantly higher in the conventional than mixed group (72% vs. 30%, p<0.001). The main reasons given for delayed use of health care facilities were poor knowledge of tuberculosis symptoms (26%) and high cost of care (12%). The findings of this study indicate that tuberculosis patients follow a variety of care pathways that can lead to delayed treatment. An information campaign is needed to increase awareness among the population and care providers.

Oxytocin versus no treatment or delayed treatment for slow progress in the first stage of spontaneous labour.

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Bugg, George J; Siddiqui, Farah; Thornton, Jim G

2013-06-23

Slow progress in the first stage of spontaneous labour is associated with an increased caesarean section rate and fetal and maternal morbidity. Oxytocin has long been advocated as a treatment for slow progress in labour but it is unclear to what extent it improves the outcomes for that labour and whether it actually reduces the caesarean section rate or maternal and fetal morbidity. This review will address the use of oxytocin and whether it improves the outcomes for women who are progressing slowly in labour compared to situations where it is not used or where its administration is delayed. To determine if the use of oxytocin for the treatment of slow progress in the first stage of spontaneous labour is associated with a reduction in the incidence of caesarean sections, or maternal and fetal morbidity compared to situations where it is not used or where its administration is delayed. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (23 February 2013) and bibliographies of relevant papers. Randomised controlled trials which compared oxytocin with either placebo, no treatment or delayed oxytocin in the active stage of spontaneous labour in low-risk women at term. Two authors independently assessed studies for inclusion, assessed risk of bias and extracted data. We sought additional information from trial authors. We included eight studies in the review involving a total of 1338 low-risk women in the first stage of spontaneous labour at term. Two comparisons were made; 1) the use of oxytocin versus placebo or no treatment (three trials); 2) the early use of oxytocin versus its delayed use (five trials). There were no significant differences in the rates of caesarean section or instrumental vaginal delivery in either comparison. Early use of oxytocin resulted in an increase in uterine hyperstimulation associated with fetal heart changes. However, the early use of oxytocin versus its delayed use resulted in no significant differences in a range

Factors contributing to delay in diagnosis and start of treatment of leprosy

DEFF Research Database (Denmark)

Nicholls, P.G.; Chhina, N; Aaen, Karen Bro

2005-01-01

The objective of our research was to identify factors contributing to delay in diagnosis and start of treatment in leprosy, focussing on patients' narratives of help-seeking behaviour. Our research took place in Purulia, West Bengal, India and in Nilphamari, northern Bangladesh. Between January...... and August 2000, we conducted semi-structured interviews with 104 patients that explored each individual's narrative of help-seeking behaviour and the context of beliefs and attitudes towards leprosy. Subsequently we surveyed 356 patients currently receiving treatment for leprosy and recorded specific...... aspects of each help-seeking action and their reports of local beliefs and attitudes towards leprosy. Delay was estimated from time of first symptoms through to start of effective treatment (mean 18 months, median 9 months in Purulia and mean 20 months, median 12 months in Nilphamari). The number of help...

Somaclonal variation and irradiation in sugarcane calli for selection against red rot, water-logged conditions and delayed or non-flowering characters

International Nuclear Information System (INIS)

Samad, M.A.; Begum, S.; Majid, M.A.

2001-01-01

A protocol for callus induction and plant regeneration from primordial leaf culture was established in sugarcane cv. 'Isd-16'. The regenerated (R 1 ) plants were grown in field, and the subsequent propagations (R 2 -R 4 ) were screened for resistance to red rot disease and waterlogged conditions. Three clones showed moderate resistance (MR) to red rot and 3 clones were tolerant to water-logging in R 4 . In another experiment, callus cultures were irradiated with 2 to 10 Gy gamma rays. The maximum regeneration was obtained from 3 Gy treatment. Of the 768 R 1 plants, 50 survived to maturity. R 2 and R 3 populations were selected for delayed or non-flowering types. Five R 3 canes showed delayed flowering. (author)

Effects of early versus delayed initiation of antiretroviral treatment on clinical outcomes of HIV-1 infection: results from the phase 3 HPTN 052 randomised controlled trial

Science.gov (United States)

Grinsztejn, Beatriz; Hosseinipour, Mina C; Ribaudo, Heather J; Swindells, Susan; Eron, Joseph; Chen, Ying Q; Wang, Lei; Ou, San-San; Anderson, Maija; McCauley, Marybeth; Gamble, Theresa; Kumarasamy, Nagalingeshwaran; Hakim, James G; Kumwenda, Johnstone; Pilotto, Jose H S; Godbole, Sheela V; Chariyalertsak, Suwat; de Melo, Marineide Gonçalves; Mayer, Kenneth H; Eshleman, Susan H; Piwowar-Manning, Estelle; Makhema, Joseph; Mills, Lisa A; Panchia, Ravindre; Sanne, Ian; Gallant, Joel; Hoffman, Irving; Taha, Taha E; Nielsen-Saines, Karin; Celentano, David; Essex, Max; Havlir, Diane; Cohen, Myron S

2014-01-01

Summary Background Use of antiretroviral treatment for HIV-1 infection has decreased AIDS-related morbidity and mortality and prevents sexual transmission of HIV-1. However, the best time to initiate antiretroviral treatment to reduce progression of HIV-1 infection or non-AIDS clinical events is unknown. We reported previously that early antiretroviral treatment reduced HIV-1 transmission by 96%. We aimed to compare the effects of early and delayed initiation of antiretroviral treatment on clinical outcomes. Methods The HPTN 052 trial is a randomised controlled trial done at 13 sites in nine countries. We enrolled HIV-1-serodiscordant couples to the study and randomly allocated them to either early or delayed antiretroviral treatment by use of permuted block randomisation, stratified by site. Random assignment was unblinded. The HIV-1-infected member of every couple initiated antiretroviral treatment either on entry into the study (early treatment group) or after a decline in CD4 count or with onset of an AIDS-related illness (delayed treatment group). Primary events were AIDS clinical events (WHO stage 4 HIV-1 disease, tuberculosis, and severe bacterial infections) and the following serious medical conditions unrelated to AIDS: serious cardiovascular or vascular disease, serious liver disease, end-stage renal disease, new-onset diabetes mellitus, and non-AIDS malignant disease. Analysis was by intention-to-treat. This trial is registered with ClinicalTrials.gov, number NCT00074581. Findings 1763 people with HIV-1 infection and a serodiscordant partner were enrolled in the study; 886 were assigned early antiretroviral treatment and 877 to the delayed treatment group (two individuals were excluded from this group after randomisation). Median CD4 counts at randomisation were 442 (IQR 373–522) cells per μL in patients assigned to the early treatment group and 428 (357–522) cells per μL in those allocated delayed antiretroviral treatment. In the delayed group

A novel stabilization condition for T-S polynomial fuzzy system with time-delay:A sum-of-squares approach

OpenAIRE

Tsai, Shun Hung; Chen, Yu-An; Chen, Yu-Wen; Lo, Ji-Chang; Lam, Hak-Keung

2017-01-01

A novel stabilization problem for T-S polynomial fuzzy system with time-delay is investigated in this paper. Firstly, a polynomial fuzzy controller for T-S polynomial fuzzy system with time-delay is proposed. In addition, based on polynomial Lyapunov-Krasovskii function and the developed polynomial slack variable matrices, a novel stabilization condition for T-S polynomial fuzzy system with time-delay is presented in terms of sum-of-square (SOS) form. Lastly, nonlinear system with time-delay ...

A simple model of carcinogenic mutations with time delay and diffusion.

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Piotrowska, Monika Joanna; Foryś, Urszula; Bodnar, Marek; Poleszczuk, Jan

2013-06-01

In the paper we consider a system of delay differential equations (DDEs) of Lotka-Volterra type with diffusion reflecting mutations from normal to malignant cells. The model essentially follows the idea of Ahangar and Lin (2003) where mutations in three different environmental conditions, namely favorable, competitive and unfavorable, were considered. We focus on the unfavorable conditions that can result from a given treatment, e.g. chemotherapy. Included delay stands for the interactions between benign and other cells. We compare the dynamics of ODEs system, the system with delay and the system with delay and diffusion. We mainly focus on the dynamics when a positive steady state exists. The system which is globally stable in the case without the delay and diffusion is destabilized by increasing delay, and therefore the underlying kinetic dynamics becomes oscillatory due to a Hopf bifurcation for appropriate values of the delay. This suggests the occurrence of spatially non-homogeneous periodic solutions for the system with the delay and diffusion.

An improved condition for master-slave synchronization of Lur'e systems with time delay

International Nuclear Information System (INIS)

Xiang, Ji; Li, Yanjun; Wei, Wei

2007-01-01

In this Letter, a new sufficient condition is proposed for master-slave synchronization of Lur'e system with time delay. This condition is constructed on the new integral inequality method such that the obtained result is much sharper than that in [M.E.Y. Yalcin, J.A.K. Suykens, J. Vandewalle, Int. J. Bifur. Chaos 11 (2001) 1707

Impact of fluoroquinolone treatment on delay of tuberculosis diagnosis: A systematic review and meta-analysis

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Catherine A Hogan

2017-01-01

Full Text Available Background: Fluoroquinolones are among the most commonly used antibiotics for the treatment of respiratory infections. Because fluoroquinolones show bactericidal activity against Mycobacterium tuberculosis, there is concern that their use can delay the diagnosis of tuberculosis. We conducted a systematic review and meta-analysis to assess whether empiric treatment with fluoroquinolones delays the diagnosis and treatment of tuberculosis in patients with respiratory tract infections. Objectives: The primary objective was to assess the delay in days in the diagnosis and treatment of tuberculosis, among patients who received quinolones, compared to those who received non-fluoroquinolone antibiotics. Methods: We included studies of adult patients treated with fluoroquinolones prior to a confirmed diagnosis of tuberculosis. We performed a literature search of 7 databases (including PubMed, Embase and Cochrane Library with no language restrictions. We calculated an unweighted mean of estimate of difference in delay across all studies. For the studies for which the estimate was available as a mean with standard deviation, a weighted average using a random effects meta-analysis model was estimated. Results: A total of 3983 citations were identified from the literature search; of these, 17 articles were selected for full-text review. A total of 10 studies were retained for the synthesis. These included 7 retrospective cohort studies and 3 case-control studies. Only one of these studies was from a high TB burden country, South Africa. The most commonly used fluoroquinolones were levofloxacin, gemifloxacin and moxifloxacin. The unweighted average of difference in delay between the fluoroquinolone group and non-fluoroquinolone group was 12.9 days (95% CI 6.1–19.7. When these differences were pooled using a random effects model, the weighted estimate was 10.9 days (95% CI 4.2–17.6. When stratified by acid-fast smear status, the delay was

Systemic 5-fluorouracil treatment causes a syndrome of delayed myelin destruction in the central nervous system

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Han Ruolan

2008-04-01

Full Text Available Abstract Background Cancer treatment with a variety of chemotherapeutic agents often is associated with delayed adverse neurological consequences. Despite their clinical importance, almost nothing is known about the basis for such effects. It is not even known whether the occurrence of delayed adverse effects requires exposure to multiple chemotherapeutic agents, the presence of both chemotherapeutic agents and the body's own response to cancer, prolonged damage to the blood-brain barrier, inflammation or other such changes. Nor are there any animal models that could enable the study of this important problem. Results We found that clinically relevant concentrations of 5-fluorouracil (5-FU; a widely used chemotherapeutic agent were toxic for both central nervous system (CNS progenitor cells and non-dividing oligodendrocytes in vitro and in vivo. Short-term systemic administration of 5-FU caused both acute CNS damage and a syndrome of progressively worsening delayed damage to myelinated tracts of the CNS associated with altered transcriptional regulation in oligodendrocytes and extensive myelin pathology. Functional analysis also provided the first demonstration of delayed effects of chemotherapy on the latency of impulse conduction in the auditory system, offering the possibility of non-invasive analysis of myelin damage associated with cancer treatment. Conclusions Our studies demonstrate that systemic treatment with a single chemotherapeutic agent, 5-FU, is sufficient to cause a syndrome of delayed CNS damage and provide the first animal model of delayed damage to white-matter tracts of individuals treated with systemic chemotherapy. Unlike that caused by local irradiation, the degeneration caused by 5-FU treatment did not correlate with either chronic inflammation or extensive vascular damage and appears to represent a new class of delayed degenerative damage in the CNS.

[Delayed reactions of active avoidance in white rats under conditions of an alternative choice].

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Ioseliani, T K; Sikharulidze, N I; Kadagishvili, A Ia; Mitashvili, E G

1995-01-01

It was shown that if the rats had been learned and then tested using conventional pain punishment of erroneous choice they were able to solve the problem of alternative choice only in the period of immediate action of conditioned stimuli. If the pain punishment for erroneously chosen compartment had not been applied in animal learning and testing, rats successfully solved the problem of alternative choice even after 5-second delay. Introduction of pain punishment led to the frustration of earlier elaborated delayed avoidance reactions. Analysis of the obtained results allows us to argue that the apparent incapability of white rats for solving the problems of delayed avoidance is caused by simultaneous action of two different mechanisms, i.e., those of the active and passive avoidance rather than short-term memory deficit.

Efficacy of a store-based environmental change intervention compared with a delayed treatment control condition on store customers' intake of fruits and vegetables.

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Ayala, Guadalupe X; Baquero, Barbara; Laraia, Barbara A; Ji, Ming; Linnan, Laura

2013-11-01

The present store-based intervention was designed to promote sales of fruits and vegetables (F&V) to increase intake among store customers--specifically customers of tiendas, small-to-medium-sized Latino food stores. Four tiendas were randomized to a 2-month environmental change intervention or a delayed treatment control condition. Employees and managers were trained to promote F&V sales, including how to implement a food marketing campaign and installing store equipment to promote fresh fruits and vegetables. The primary outcome was self-reported daily intake of F&V among a convenience sample of customers (at least forty per store) collected at baseline prior to randomization and then 4 months later. In addition, changes in availability of F&V in the tiendas, using unobtrusive observational methods, provided evidence of intervention fidelity. Tiendas in central North Carolina. Participants included 179 customers who were recent immigrants from Mexico and Central America. A group-by-time interaction approached significance on daily servings of F&V; intervention customers reported an increase in F&V intake over time and as a function of the intervention (P customers’ reported F&V intake. Such strategies can have a public health impact on underserved populations.

Healthcare-seeking behavior, treatment delays and its determinants among pulmonary tuberculosis patients in rural Nigeria: a cross-sectional study

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Ukwaja Kingsley N

2013-01-01

Full Text Available Abstract Background Nigeria ranks fourth among 22 high tuberculosis (TB burden countries. Although it reached 99% DOTS coverage in 2008, current case detection rate is 40%. Little is known about delays before the start of TB therapy and health-seeking behaviour of TB patients in rural resource-limited settings. We aimed to: 1 assess healthcare-seeking behaviour and delay in treatment of pulmonary TB patients, 2 identify the determinants of the delay in treatment of pulmonary TB. Methods We conducted a cross-sectional study of adult new pulmonary TB patients notified to the National Tuberculosis Control Programme (NTP by three rural (two mission/one public hospitals. Data on health-seeking and delays were collected using a standardised questionnaire. We defined patient delay as the interval (weeks between the onset of cough and the first visit to any health provider, and health system delay as the time interval (weeks between patient's first attendance to any health provider, and the onset of treatment. Total delay is the sum of both delays. Multiple linear regression models using nine exposure variables were built to identify determinants of delays. Results Of 450 patients (median age 30 years enrolled, most were males (55%, subsistent farmers (49%, rural residents (78%; and 39% had no formal education. About 84% of patients reported first consulting a non-NTP provider. For such patients, the first facilities visited after onset of symptoms were drug shops (79%, traditional healers (10%, and private hospitals (10%. The median total delay was 11 (IQR 9–16 weeks, patient delay 8 (IQR 8–12 and health system (HS delay 3 (IQR 1–4 weeks. Factors associated with increased patient delay were older age (P Conclusion Overall, TB treatment delays were high; and needs to be reduced in Nigeria. This may be achieved through improved access to care, further education of patients, engagement of informal care providers, and strengthening of existing public

Total Delay Is Associated with Unfavorable Treatment Outcome among Pulmonary Tuberculosis Patients in West Gojjam Zone, Northwest Ethiopia: A Prospective Cohort Study.

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Senedu Bekele Gebreegziabher

Full Text Available delay in diagnosis and treatment of tuberculosis (TB may worsen the disease, increase mortality and enhance transmission in the community. This study aimed at assessing the association between total delay and unfavorable treatment outcome among newly diagnosed pulmonary TB (PTB patients.A prospective cohort study was conducted in West Gojjam Zone, Amhara Region of Ethiopia from October 2013 to May 2015. Newly diagnosed PTB patients who were ≥15 years of age were consecutively enrolled in the study from 30 randomly selected public health facilities. Total delay (the time period from onset of TB symptoms to first start of anti-TB treatment was measured. Median total delay was calculated. Mixed effect logistics regression was used to analyze factors associated with unfavorable treatment outcome.Seven hundred six patients were enrolled in the study. The median total delay was 60 days. Patients with total delay of > 60 days were more likely to have unfavorable TB treatment outcome than patients with total delay of ≤ 60 days (adjusted odds ratio [AOR], 2.33; 95% confidence interval [CI], 1.04-5.26. Human immunodeficiency virus (HIV positive TB patients were 8.46 times more likely to experience unfavorable treatment outcome than HIV negative TB patients (AOR, 8.46; 95% CI, 3.14-22.79.Long total delay and TB/HIV coinfection were associated with unfavorable treatment outcome. Targeted interventions that can reduce delay in diagnosis and treatment of TB, and early comprehensive management of TB/HIV coinfection are needed to reduce increased risk of unfavorable treatment outcome.

ATFM airborne delays without extra fuel consumption in wind conditions

OpenAIRE

Delgado, L.; Prats, X.

2012-01-01

Air Traffic Flow Management (ATFM) regulations, such as ground holdings, are often canceled before their initially planned ending time. The ground delays impact on the cost of recovering part of the delay if the regulation is canceled, as aircraft are still at the origin airport. In previous publications, the authors have suggested a speed reduction strategy to split the assigned ATFM delay between ground delay and airborne delay. By flying at the the minimum speed that g...

Pseudotumoral delayed cerebral radionecrosis

International Nuclear Information System (INIS)

Ciaudo-Lacroix, C.; Lapresle, J.

1985-01-01

A 60 year-old woman with a scalp epithelioma underwent radiotherapy, the dose being 57 Gray. A first epileptic seizure occurred twenty months later. Neurological examination revealed signs of left hemisphere involvement. γEG, angiography, CT scans, demonstrated a pseudotumoral avascular process. On account of the localisation, the patient being right-handed, no surgical procedure was performed. In spite of corticotherapy and anticonvulsive treatment, seizures recurred and neurological signs slowly progressed. The patient died, 22 months after the first seizure, of an associated disseminated carcinoma with cachexia. Neuropathological examination showed a massive lesion presenting all the features of delayed radionecrosis in the left hemisphere: situated mainly in the white matter; numerous vascular abnormalities; wide-spread demyelination; disappearance of oligoglial cells. The Authors recall the clinical and anatomical aspects of this condition for which the only successful treatment is surgical removal when location and size of the lesion permit. Finally, the mechanisms which have been proposed to explain this delayed cerebral radionecrosis are discussed [fr

Pseudotumoral delayed cerebral radionecrosis

Energy Technology Data Exchange (ETDEWEB)

Ciaudo-Lacroix, C; Lapresle, J [Centre Hospitalier de Bicetre, 94 - Le Kremlin-Bicetre (France)

1985-01-01

A 60 year-old woman with a scalp epithelioma underwent radiotherapy, the dose being 57 Gray. A first epileptic seizure occurred twenty months later. Neurological examination revealed signs of left hemisphere involvement. ..gamma..EG, angiography, CT scans, demonstrated a pseudotumoral avascular process. On account of the localisation, the patient being right-handed, no surgical procedure was performed. In spite of corticotherapy and anticonvulsive treatment, seizures recurred and neurological signs slowly progressed. The patient died, 22 months after the first seizure, of an associated disseminated carcinoma with cachexia. Neuropathological examination showed a massive lesion presenting all the features of delayed radionecrosis in the left hemisphere: situated mainly in the white matter; numerous vascular abnormalities; wide-spread demyelination; disappearance of oligoglial cells. The Authors recall the clinical and anatomical aspects of this condition for which the only successful treatment is surgical removal when location and size of the lesion permit. Finally, the mechanisms which have been proposed to explain this delayed cerebral radionecrosis are discussed.

Delay-dependent exponential stability of cellular neural networks with time-varying delays

International Nuclear Information System (INIS)

Zhang Qiang; Wei Xiaopeng; Xu Jin

2005-01-01

The global exponential stability of cellular neural networks (CNNs) with time-varying delays is analyzed. Two new sufficient conditions ensuring global exponential stability for delayed CNNs are obtained. The conditions presented here are related to the size of delay. The stability results improve the earlier publications. Two examples are given to demonstrate the effectiveness of the obtained results

Delay in Diagnosis and Treatment of Breast Cancer among Women Attending a Reference Service in Brazil

Science.gov (United States)

Romeiro Lopes, Tiara Cristina; Gravena, Angela Andréia França; Demitto, Marcela de Oliveira; Borghesan, Deise Helena Pelloso; Dell`Agnolo, Cátia Millene; Brischiliari, Sheila Cristina Rocha; Carvalho, Maria Dalva de Barros; Pelloso, Sandra Marisa

2017-11-26

Background: Cancer is a major public health problem. Early diagnosis and treatment are essential for reducing mortality. This study aimed to analyze factors associated with delay in breast cancer diagnosis and treatment among women attending a reference cancer service. Methods: This retrospective, cross-sectional study was performed with data collected from medical records and interviews conducted with women diagnosed with breast cancer and treated from October 2013 to October 2014 at a cancer reference hospital in Paraná, Southern Brazil. Results: A total of 82 participants were enrolled during the study period; their average age was 58.2 ± 11.5 years. The average time taken for final diagnosis of breast cancer was 102.5 ± 165.5 days. Treatment onset was delayed in the majority of cases, and the average time elapsing from diagnostic biopsy to onset of primary treatment was 72.3 ± 54.0 days. The odds of treatment delay were higher among the women with a low educational level. Conclusions: The results underline the need for proposals aimed at early detection, identification of risk factors and timely provision of treatment by health managers that focus on this group. Creative Commons Attribution License

Self-regulation strategies may enhance the acute effect of exercise on smoking delay.

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Hatzigeorgiadis, Antonis; Pappa, Vassiliki; Tsiami, Anastasia; Tzatzaki, Theodora; Georgakouli, Kalliopi; Zourbanos, Nikos; Goudas, Marios; Chatzisarantis, Nikos; Theodorakis, Yannis

2016-06-01

The present study examined the acute effect of a moderate intensity aerobic exercise session combined with self-regulation on smoking delay in physically inactive smokers. Participants were 11 adults (5 males and 6 females) that completed three experimental conditions: control, exercise, and exercise using self-regulation strategies (SR). Following the experimental treatment smoking for the two exercise conditions delayed significantly more than for the control condition; in addition exercise SR delayed smoking marginally more that the plain exercise condition. Findings supported previous research that acute exercise reduces cravings to smoke, and suggests that the use of self-regulation strategies may strengthen exercise for smoking cessation interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Delayed access to treatments for rare diseases: who's to blame?

Science.gov (United States)

Feltmate, Karen; Janiszewski, Peter M; Gingerich, Sheena; Cloutier, Michael

2015-04-01

The development and commercialization of drugs for rare diseases, termed 'orphan drugs', has historically been economically unattractive. However, because of the introduction of legislation that provides financial and regulatory incentives for the development of orphan drugs, new developments are making their way through the regulatory approval processes. Unfortunately, delays in availability of new drugs for treating rare disease continue to persist. This paper reviews the approach of several regulatory jurisdictions to orphan drugs in an effort to determine their relative effectiveness in providing patient access. Generally speaking, regulatory authorities across jurisdictions have recognized the need to enhance timely access to safe, effective treatment for patients with rare diseases and have been able to shift the approval timelines for access to new care. The greater impediment to orphan drug access appears to be funding, particularly in publicly sponsored health-care systems. Redundancies in federal and provincial reviews of orphan drugs can result in significant delays in access to new drugs. Clearly, more must be done to accelerate access to the treatments so desperately needed by patients. Public payers must be held accountable for their process and decisions--especially for rare disease therapies. © 2015 Asian Pacific Society of Respirology.

On the form of the forgetting function: the effects of arithmetic and logarithmic distributions of delays.

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Sargisson, Rebecca J; White, K Geoffrey

2003-11-01

Forgetting functions with 18 delay intervals were generated for delayed matching-to-sample performance in pigeons. Delay interval variation was achieved by arranging five different sets of five delays across daily sessions. In different conditions, the delays were distributed in arithmetic or logarithmic series. There was no convincing evidence for different effects on discriminability of the distributions of different delays. The mean data were better fitted by some mathematical functions than by others, but the best-fitting functions depended on the distribution of delays. In further conditions with a fixed set of five delays, discriminability was higher with a logarithmic distribution of delays than with an arithmetic distribution. This result is consistent with the treatment of the forgetting function in terms of generalization decrement.

Open lung ventilation preserves the response to delayed surfactant treatment in surfactant-deficient newborn piglets

NARCIS (Netherlands)

van Veenendaal, Mariëtte B.; van Kaam, Anton H.; Haitsma, Jack J.; Lutter, René; Lachmann, Burkhard

2006-01-01

OBJECTIVE: Delayed surfactant treatment (>2 hrs after birth) is less effective than early treatment in conventionally ventilated preterm infants with respiratory distress syndrome. The objective of this study was to evaluate if this time-dependent efficacy of surfactant treatment is also present

Delayed treatment of decompression sickness with short, no-air-break tables: review of 140 cases.

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Cianci, Paul; Slade, John B

2006-10-01

Most cases of decompression sickness (DCS) in the U.S. are treated with hyperbaric oxygen using U.S. Navy Treatment Tables 5 and 6, although detailed analysis shows that those tables were based on limited data. We reviewed the development of these protocols and offer an alternative treatment table more suitable for monoplace chambers that has proven effective in the treatment of DCS in patients presenting to our facility. We reviewed the outcomes for 140 cases of DCS in civilian divers treated with the shorter tables at our facility from January 1983 through December 2002. Onset of symptoms averaged 9.3 h after surfacing. At presentation, 44% of the patients demonstrated mental aberration. The average delay from onset of symptoms to treatment was 93.5 h; median delay was 48 h. Complete recovery in the total group of 140 patients was 87%. When 30 patients with low probability of DCS were excluded, the recovery rate was 98%. All patients with cerebral symptoms recovered. Patients with the highest severity scores showed a high rate of complete recovery (97.5%). Short oxygen treatment tables as originally described by Hart are effective in the treatment of DCS, even with long delays to definitive recompression that often occur among civilian divers presenting to a major Divers Alert Network referral center.

Factors affecting professional delay in diagnosis and treatment of oral cancer in Iran.

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Esmaelbeigi, Farhad; Hadji, Maryam; Harirchi, Iraj; Omranipour, Ramesh; vand Rajabpour, Mojtaba; Zendehdel, Kazem

2014-04-01

Oral cancer is the most common malignant tumor among head and neck cancers. Delay in diagnosis affects the treatment and prognosis of oral cancer. We measured the professional delay in the diagnosis and its attributes in the Cancer Institute of Iran, the largest referral center for oral cancer patients in the country.  We interviewed oral cancer patients to measure the delay and used case-control approach to study association of various prognostic factors with professional delay and tumor stage. Out of 206 patients, 71.4% were diagnosed at the advanced stage. The median of the patient, professional and total delays were 45, 86 and 140 day, receptively. In the univariate model, prescription of medicines like analgesics (OR = 5.3, 95% CI 2.2-12.9) and history of dental procedure (OR=6.8, 95% CI 1.7-26.9) were associated with higher risk of delay compared to patient who were biopsied from the beginning. History of loose teeth increased risk of delay 4 times (OR = 4.0, 95% CI 1.6-9.8). Patients with primary education had 70% lower risk of delay compared to the illiterate patients (OR = 0.3, 95% CI 0.1-0.7) and the risk was lower among patients who had diploma (OR = 0.04, 95% CI 0-0.7) and college education (OR = 0.1, 95% CI 0-0.4). The delayed patients were diagnosed in more advanced stage compared to the patients without delay (OR = 2.1, 95% CI 1.0-4.4). Development of a national guideline for follow-up of oral lesions, training and awareness of health care professionals about oral cancer diagnosis may decrease the delay and improve the oral cancer outcome in Iran.

Early versus delayed hormonal treatment in locally advanced or asymptomatic metastatic prostatic cancer patient dilemma.

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Prezioso, Domenico; Iacono, Fabrizio; Romeo, Giuseppe; Ruffo, Antonio; Russo, Nicola; Illiano, Ester

2014-06-01

The objective of this work is to compare the effectiveness of hormonal treatment (luteinizing hormone-releasing hormone agonists and/or antiandrogens) as an early or as a deferred intervention for patients with locally advanced prostate cancer (LAPC) and/or asymptomatic metastasis. Systematic review of trials published in 1950-2007. Sources included MEDLINE and bibliographies of retrieved articles. Eligible trials included adults with a history of LAPC who are not suitable for curative local treatment of prostate cancer. We retrieved 22 articles for detailed review, of which 8 met inclusion criteria. The Veterans Administration Cooperative Urological Research Group suggested that delaying hormonal therapy did not compromise overall survival and that many of the patients died of causes other than prostate cancer. In European Organisation for Research and Treatment of Cancer (EORTC) 30846 trial, the median survival for delayed endocrine treatment was 6.1 year, and for immediate treatment 7.6 year, the HR for survival on delayed versus immediate treatment was 1.23 (95 % CI 0.88-1.71), indicating a 23 % nonsignificant trend in favour of early treatment. In EORTC 30891, the immediate androgen deprivation resulted in a modest but statistically significant increase in overall survival. The protocol SAKK 08/88 showed the lack of any major advantage of immediate compared with deferred hormonal treatment regarding quality of life or overall survival. The early intervention with hormonal treatment for patients with LAPC provides important reductions in all-cause mortality, prostate cancer-specific mortality, overall progression, and distant progression compared with deferring their use until standard care has failed to halt the disease.

Acute and delayed deferoxamine treatment attenuates long-term sequelae after germinal matrix hemorrhage in neonatal rats.

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Klebe, Damon; Krafft, Paul R; Hoffmann, Clotilde; Lekic, Tim; Flores, Jerry J; Rolland, William; Zhang, John H

2014-08-01

This study investigated if acute and delayed deferoxamine treatment attenuates long-term sequelae after germinal matrix hemorrhage (GMH). Bacterial collagenase (0.3 U) was infused intraparenchymally into the right hemispheric ganglionic eminence in P7 rat pups to induce GMH. GMH animals received either deferoxamine or vehicle twice a day for 7 consecutive days. Deferoxamine administration was initiated at either 1 hour or 72 hours post-GMH. Long-term neurocognitive deficits and motor coordination were assessed using Morris water maze, rotarod, and foot fault tests between day 21 to 28 post-GMH. At 28 days post-GMH, brain morphology was assessed and extracellular matrix protein (fibronectin and vitronectin) expression was determined. Acute and delayed deferoxamine treatment improved long-term motor and cognitive function at 21 to 28 days post-GMH. Attenuated neurofunction was paralleled with improved overall brain morphology at 28 days post-GMH, reducing white matter loss, basal ganglia loss, posthemorrhagic ventricular dilation, and cortical loss. GMH resulted in significantly increased expression of fibronectin and vitronectin, which was reversed by acute and delayed deferoxamine treatment. Acute and delayed deferoxamine administration ameliorated long-term sequelae after GMH. © 2014 American Heart Association, Inc.

Posterior treatment of delayed traumatic atlantoaxial joint dislocation with apofix internal fixation

International Nuclear Information System (INIS)

Qing Wei; Jiang Weimin; Shi Jinhui; Li Xuefeng; Yang Huilin; Tang Tiansi

2010-01-01

Objective: To assess the effect of posterior fixation and fusion with Apofix device for the treatment of delayed traumatic atlantoaxial joint dislocation. Methods: Eighteen patients with delayed traumatic atlantoaxial joint dislocation were included. Posterior fixation and fusion with Apofix device were performed. First step was one or two week skull traction. After the atlantoaxial joint dislocation had been reduced, the posterior fixation and fusion with Apofix was performed. Using local anaesthesia, atlantoaxial interval and posterior structure of atlas and dentata were exposed by midline operative approach. Apofix interlaminar clamps were placed at posterior arch of atlas and odontoid vertebral laminae, autologous iliac bone graft was placed for fusion. Then the device to proper position was pressurized and items locked. Results: All of the patients were followed up, the mean follow-up period was 38 months (13 ∼ 84 months). Fifteen patients obtained complete reduction, the others were partial reduction. Seventeen patients had successful fusion after 3 or 4 months, only 1 patient who had partial reduction had internal fixation loose and nonfusion, leading to recurrence of atlantoaxial joint dislocation. An occipitocervical fusion surgery was performed on this patient. As to neurological assessment, 16 patients had neurological deficit before operation, while 6 of them recovered completely after operation, another 10 patients' neurological status improved significantly. JOA score was improved from 9.5 pre-operative to 15.8 post-operative. Conclusion: Apofix internal fixation and fusion seems to be feasible in treatment of delayed traumatic atlantoaxial joint dislocation. Successful reduction before operation and proper treatment after operation is also important. (authors)

Emergency or Delayed Surgical Treatment of Unstable Supracondylar Humeral Fractures in Children?

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Stefanovic Branko

2017-06-01

Full Text Available Supracondylar humeral fractures (SCHF are the most common elbow fractures in children, representing 3% of all paediatric fractures. Treatment options for SCHF in children are based on the Gartland classification. Treatment of non-displaced fractures (type I is non-operative. Plaster immobilization for 3 to 4 weeks is recommended, depending on the age of the child and fracture healing. Treatments of displaced supracondylar fractures (type II and III of the humerus in children are still undefined in clinical practice. Because of divided opinions, the aim of this study was to evaluate whether delayed or immediate surgical treatment has an advantage in the treatment of supracondylar fractures in children. This is a prospective – retrospective clinical study. This study included 64 patients from 5 to 15 years old; 47 (73.4% were boys and 17 (26.6% were girls. The most common age range (59.4% in this study was 5-8 years old. All patients were diagnosed with supracondylar fractures at the Institute for Orthopaedic Surgery “Banjica”. We analysed 17 parameters, which were obtained either from direct patient interviews or from their medical history. All patients were divided into two groups with matched characteristics. Group I consisted of 26 patients who had immediate operations. Group II consisted of 38 patients who had delayed operations.

AD/HD and the Capture of Attention by Briefly Exposed Delay-Related Cues: Evidence from a Conditioning Paradigm

Science.gov (United States)

Sonuga-Barke, Edmund J. S.; De Houwer, Jan; De Ruiter, Karen; Ajzenstzen, Michal; Holland, Sarah

2004-01-01

Background: The selective attention of children with attention deficit/hyperactivity disorder (AD/HD) to briefly exposed delay-related cues was examined in two experiments using a dot-probe conditioning paradigm. Method: Colour cues were paired with negatively (i.e., imposition of delay) and positively valenced cues (i.e., escape from or avoidance…

Binge-Eating Disorder and Comorbid Conditions: Differential Diagnosis and Implications for Treatment.

Science.gov (United States)

Citrome, Leslie

2017-01-01

Many patients with symptoms of binge-eating disorder (BED) are not diagnosed. Perhaps the biggest obstacles are the failure of physicians to recognize BED as a distinct disorder and the lack of awareness among patients that binge-eating is a well-studied abnormal behavior that is amenable to treatment. In addition, patients may avoid seeking treatment because they feel a general sense of shame over their eating habits and do not want to bring up these symptoms during visits with their physicians. In general, negative attitudes and biases regarding overweight and obesity are common. The presence of medical and psychiatric comorbidities also contributes to the challenge of diagnosis, as many doctors focus on treating those comorbidities, thereby delaying treatment for the BED and leading to suboptimal care. Once BED is diagnosed along with any comorbid conditions, medications for the treatment of the comorbidities must be carefully considered so that BED symptoms are not exacerbated. © Copyright 2017 Physicians Postgraduate Press, Inc.

Chaos synchronization in time-delayed systems with parameter mismatches and variable delay times

International Nuclear Information System (INIS)

Shahverdiev, E.M.; Nuriev, R.A.; Hashimov, R.H.; Shore, K.A.

2004-06-01

We investigate synchronization between two undirectionally linearly coupled chaotic nonidentical time-delayed systems and show that parameter mismatches are of crucial importance to achieve synchronization. We establish that independent of the relation between the delay time in the coupled systems and the coupling delay time, only retarded synchronization with the coupling delay time is obtained. We show that with parameter mismatch or without it neither complete nor anticipating synchronization occurs. We derive existence and stability conditions for the retarded synchronization manifold. We demonstrate our approach using examples of the Ikeda and Mackey Glass models. Also for the first time we investigate chaos synchronization in time-delayed systems with variable delay time and find both existence and sufficient stability conditions for the retarded synchronization manifold with the coupling-delay lag time. (author)

Improved Stabilization Conditions for Nonlinear Systems with Input and State Delays via T-S Fuzzy Model

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Chang Che

2018-01-01

Full Text Available This paper focuses on the problem of nonlinear systems with input and state delays. The considered nonlinear systems are represented by Takagi-Sugeno (T-S fuzzy model. A new state feedback control approach is introduced for T-S fuzzy systems with input delay and state delays. A new Lyapunov-Krasovskii functional is employed to derive less conservative stability conditions by incorporating a recently developed Wirtinger-based integral inequality. Based on the Lyapunov stability criterion, a series of linear matrix inequalities (LMIs are obtained by using the slack variables and integral inequality, which guarantees the asymptotic stability of the closed-loop system. Several numerical examples are given to show the advantages of the proposed results.

Rare Neural Correlations Implement Robotic Conditioning with Delayed Rewards and Disturbances

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Soltoggio, Andrea; Lemme, Andre; Reinhart, Felix; Steil, Jochen J.

2013-01-01

Neural conditioning associates cues and actions with following rewards. The environments in which robots operate, however, are pervaded by a variety of disturbing stimuli and uncertain timing. In particular, variable reward delays make it difficult to reconstruct which previous actions are responsible for following rewards. Such an uncertainty is handled by biological neural networks, but represents a challenge for computational models, suggesting the lack of a satisfactory theory for robotic neural conditioning. The present study demonstrates the use of rare neural correlations in making correct associations between rewards and previous cues or actions. Rare correlations are functional in selecting sparse synapses to be eligible for later weight updates if a reward occurs. The repetition of this process singles out the associating and reward-triggering pathways, and thereby copes with distal rewards. The neural network displays macro-level classical and operant conditioning, which is demonstrated in an interactive real-life human-robot interaction. The proposed mechanism models realistic conditioning in humans and animals and implements similar behaviors in neuro-robotic platforms. PMID:23565092

Predictors of delay in starting radiation treatment for patients with early stage breast cancer

International Nuclear Information System (INIS)

Benk, Veronique; Ho, Vivian; Fortin, Paul R.; Zhang, G.; Levinton, Carey; Freeman, C.R.

1998-01-01

Purpose: To describe the factors predicting waiting time for radiation treatment in early breast cancer. Materials and Methods: Between January 1992 and December 1993, 739 patients with Stage I and II breast cancer were treated with conservative treatment at three McGill University Hospitals. Waiting time was defined as the interval between the date of surgery and the date of the first radiation treatment. Delay was defined as a waiting time of more than 7 weeks for women who did not receive chemotherapy (Group NC, n 478), and as a waiting time of more than 24 weeks for those who received chemotherapy (Group C, n = 261). We analyzed predictive factors related to the patient (age, stage, treatment on protocol, income by postal code) and to the referring hospital (university or community hospital). Results: For the entire population, 54% of patients were delayed, 72% in Group NC and 21.4% in Group C. Univariate analysis showed an impact of referring hospital in both groups, and of stage and treatment on protocol in Group C (all p = 0.001). Multivariate analysis showed that delays were significantly less in Group NC for women referred from a community hospital (p = 0.001) and in Group C for women with Stage I disease (p = 0.06), those treated on protocol, and those referred from a university hospital (p = 0.001). Conclusion: More than half of patients with early breast cancer waited more than the recommended intervals for radiation therapy. However, lower income breast cancer patients did not wait longer for treatment than higher income patients, possibly a result of the Canadian Medicare system which provides universal access to health care

REASONS FOR PATIENT DELAYS & HEALTH SYSTEM DELAYS FOR TUBERCULOSIS IN SOUTH INDIA

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Kapil Goel

2011-12-01

Full Text Available Background: Globally, the burden of Tuberculosis is escalating. Early diagnosis and prompt initiation of tuberculosis treatment is essential for an effective tuberculosis control programme. Objectives: To study the self reported reasons for patient and health system (diagnosis & treatment delays in Tuberculosis patients. Methods: A community based cross sectional study was conducted among 98 new sputum positive TB cases aged > 15 years registered under RNTCP from Oct 2006 to June 2007 & receiving treatment under DOTS in Udupi taluk by interviewing them. Results: Total 98 patients were recruited and 68% were males. Out of 17 patients with patient delays, 82% felt that their symptoms were not severe, 71% felt that patient delay was due to lack of awareness and 71% did not take it seriously. Out of 86 patients with health system delays, 82.6% of patients mentioned that doctor has not advised for sputum examination, 76.7% of patients told that they first consulted a private doctor, 21% of them mentioned that doctor was unaware to diagnose TB. Conclusion: Symptoms not severe is the main reason for the patient delay and doctor didn’t advise for sputum examination is the main reason for health system delays.

Delayed complications of radiotherapy treatment for nasopharyngeal carcinoma: imaging findings

International Nuclear Information System (INIS)

King, A.D.; Ahuja, A.T.; Yeung, D.K.; Wong, J.K.T.; Lee, Y.Y.P.; Lam, W.W.M.; Ho, S.S.M.; Yu, S.C.H.; Leung, S.-F.

2007-01-01

Radiotherapy is used to treat a wide variety of head and neck tumours that arise in and around the skull base. The delayed effects of radiation damages a range of structures, including the nervous system, bone, major vessels, mucus membranes, pituitary and salivary glands, as well as increasing the risk of radiation-induced neoplasms. In this review the complications resulting from radiation treatment for nasopharyngeal carcinoma (NPC), a cancer treated with a high dose of radiation to a fairly large region, are illustrated. Many patients with NPC have a long-term survival, so are at risk of developing delayed radiation effects, and hence may demonstrate a wide range of complications on imaging. Other tumours around the skull base treated with radiotherapy include meningiomas, chordomas, chondrosarcomas, pituitary adenomas, paranasal sinus and nasal cavity tumours. In these cases similar complications may be encountered on imaging, although the severity, incidence and location will vary

Durations and Delays in Care Seeking, Diagnosis and Treatment Initiation in Uncomplicated Pulmonary Tuberculosis Patients in Mumbai, India.

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Nerges Mistry

Full Text Available Timely diagnosis and treatment initiation are critical to reduce the chain of transmission of Tuberculosis (TB in places like Mumbai, where almost 60% of the inhabitants reside in overcrowded slums. This study documents the pathway from the onset of symptoms suggestive of TB to initiation of TB treatment and examines factors responsible for delay among uncomplicated pulmonary TB patients in Mumbai.A population-based retrospective survey was conducted in the slums of 15 high TB burden administrative wards to identify 153 self-reported TB patients. Subsequently in-depth interviews of 76 consenting patients that fit the inclusion criteria were undertaken using an open-ended interview schedule. Mean total, first care seeking, diagnosis and treatment initiation duration and delays were computed for new and retreatment patients. Patients showing defined delays were divided into outliers and non-outliers for all three delays using the median values.The mean duration for the total pathway was 65 days with 29% of patients being outliers. Importantly the mean duration of first care seeking was similar in new (24 days and retreatment patients (25 days. Diagnostic duration contributed to 55% of the total pathway largely in new patients. Treatment initiation was noted to be the least among the three durations with mean duration in retreatment patients twice that of new patients. Significantly more female patients experienced diagnostic delay. Major shift of patients from the private to public sector and non-allopaths to allopaths was observed, particularly for treatment initiation.Achieving positive behavioural changes in providers (especially non-allopaths and patients needs to be considered in TB control strategies. Specific attention is required in counselling of TB patients so that timely care seeking is effected at the time of relapse. Prioritizing improvement of environmental health in vulnerable locations and provision of point of care diagnostics

Durations and Delays in Care Seeking, Diagnosis and Treatment Initiation in Uncomplicated Pulmonary Tuberculosis Patients in Mumbai, India.

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Mistry, Nerges; Rangan, Sheela; Dholakia, Yatin; Lobo, Eunice; Shah, Shimoni; Patil, Akshaya

2016-01-01

Timely diagnosis and treatment initiation are critical to reduce the chain of transmission of Tuberculosis (TB) in places like Mumbai, where almost 60% of the inhabitants reside in overcrowded slums. This study documents the pathway from the onset of symptoms suggestive of TB to initiation of TB treatment and examines factors responsible for delay among uncomplicated pulmonary TB patients in Mumbai. A population-based retrospective survey was conducted in the slums of 15 high TB burden administrative wards to identify 153 self-reported TB patients. Subsequently in-depth interviews of 76 consenting patients that fit the inclusion criteria were undertaken using an open-ended interview schedule. Mean total, first care seeking, diagnosis and treatment initiation duration and delays were computed for new and retreatment patients. Patients showing defined delays were divided into outliers and non-outliers for all three delays using the median values. The mean duration for the total pathway was 65 days with 29% of patients being outliers. Importantly the mean duration of first care seeking was similar in new (24 days) and retreatment patients (25 days). Diagnostic duration contributed to 55% of the total pathway largely in new patients. Treatment initiation was noted to be the least among the three durations with mean duration in retreatment patients twice that of new patients. Significantly more female patients experienced diagnostic delay. Major shift of patients from the private to public sector and non-allopaths to allopaths was observed, particularly for treatment initiation. Achieving positive behavioural changes in providers (especially non-allopaths) and patients needs to be considered in TB control strategies. Specific attention is required in counselling of TB patients so that timely care seeking is effected at the time of relapse. Prioritizing improvement of environmental health in vulnerable locations and provision of point of care diagnostics would be

Immediate Extinction Causes a Less Durable Loss of Performance than Delayed Extinction following Either Fear or Appetitive Conditioning

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Woods, Amanda M.; Bouton, Mark E.

2008-01-01

Five experiments with rat subjects compared the effects of immediate and delayed extinction on the durability of extinction learning. Three experiments examined extinction of fear conditioning (using the conditioned emotional response method), and two experiments examined extinction of appetitive conditioning (using the food-cup entry method). In…

Remote ischemic conditioning: A treatment for vascular cognitive impairment

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David C Hess

2015-01-01

Full Text Available There is a strong link between hypoperfusion and white matter (WM damage in patients with leukoaraiosis and vascular cognitive impairment (VCI. Other than management of vascular risk factors, there is no treatment for WM damage and VCI that delays progression of the disease process to dementia. Observational studies suggest that exercise may prevent or slow down the progression of Alzheimer′s disease (AD and VCI. However, getting patients to exercise is challenging, especially with advancing age and disability. Remote ischemic conditioning, an "exercise equivalent," allows exercise to be given with a "device" at home for long periods of time. Since remote ischemic conditioning (RIC increases cerebral blood flow (CBF in preclinical studies and in humans, RIC may be an ideal therapy to treat VCI and WM disease and perhaps even sporadic AD. By using magnetic resonance imaging (MRI imaging of WM progression, a sample size in the range of about 100 subjects per group could determine if RIC has activity in WM disease and VCI.

Gender differences in reasons patients delay in seeking treatment for acute myocardial infarction symptoms.

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Moser, Debra K; McKinley, Sharon; Dracup, Kathleen; Chung, Misook L

2005-01-01

Patients (n = 194) with confirmed acute myocardial infarction (AMI) were interviewed to determine sociodemographic, clinical, social, behavioral, cognitive and emotional factors that contribute to delay in seeking treatment for their symptoms. Initial symptom experience was similar for men and women: both were most commonly at home when symptoms began; both were most commonly in the presence of their spouse or other family member; few patients (trouble others, and prior knowledge of thrombolytics. There was no difference in delay between men and women (median 3.08 versus 3.10 h), but there are important gender differences in the reasons patients delay and in their patterns of decision-making that may assist clinicians trying to tailor interventions.

Neurodevelopmental delay in children exposed in utero to hyperemesis gravidarum.

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Fejzo, Marlena S; Magtira, Aromalyn; Schoenberg, Frederic Paik; Macgibbon, Kimber; Mullin, Patrick M

2015-06-01

The purpose of this study is to determine the frequency of emotional, behavioral, and learning disorders in children exposed in utero to hyperemesis gravidarum (HG) and to identify prognostic factors for these disorders. Neurodevelopmental outcomes of 312 children from 203 mothers with HG were compared to neurodevelopmental outcomes from 169 children from 89 unaffected mothers. Then the clinical profiles of patients with HG and a normal child outcome were compared to the clinical profiles of patients with HG and a child with neurodevelopmental delay to identify prognostic factors. Binary responses were analyzed using either a Chi-square or Fisher Exact test and continuous responses were analyzed using a t-test. Children exposed in utero to HG have a 3.28-fold increase in odds of a neurodevelopmental diagnosis including attention disorders, learning delay, sensory disorders, and speech and language delay (Pneurodevelopmental delay. We found no evidence for increased risk of 13 emotional, behavioral, and learning disorders, including autism, intellectual impairment, and obsessive-compulsive disorder. However, the study was not sufficiently powered to detect rare conditions. Medications, treatments, and preterm birth were not associated with an increased risk for neurodevelopmental delay. Women with HG are at a significantly increased risk of having a child with neurodevelopmental delay. Common antiemetic treatments were not linked to neurodevelopmental delay, but early symptoms may play a role. There is an urgent need to address whether aggressive treatment that includes vitamin and nutrient supplementation in women with early symptoms of severe nausea of pregnancy decreases the risk of neurodevelopmental delay. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Treatment for delayed brain injury after pituitary irradiation

International Nuclear Information System (INIS)

Fujii, Takashi; Misumi, Shuzoh; Shibasaki, Takashi; Tamura, Masaru; Kunimine, Hideo; Hayakawa, Kazushige; Niibe, Hideo; Miyazaki, Mizuho; Miyagi, Osamu.

1988-01-01

Treatment for delayed brain injury after pituitary irradiation is discussed. Six cases with delayed brain injury were treated with a combination of dexamethasone or betamethasone, with heparin, glycerol, dextran 40 and some vasodilators. Two cases with temporal lobe syndrome were treated in the early stages of brain injury for a period of over 12 months were almost completely cured, another two cases with chiasma syndrome were treated in the relatively late stages, showed a partial improvement. One case which was irradiated 120 GY during 13 years did not improve. The final case treated with steroids for a short period also resulted in failure and the patient underwent an operation for the removal of the necrotic mass three years after the radiotherapy. Steroid therapy started in the early stages of brain injury after irradiation for over the 12 months is thought to be effective. Heparin therapy was also effective in one out of three cases, but in one of the cases subarachnoid hemorrhage from a traumatic aneurysm occurred during the therapy. In an acute phase, showing edematous change of the injured brain, the administration of glycerol is also thought to be useful. But the effectiveness of the other medicines containing some vasodilators was obscure or doubtful. We propose the following : (1) A meticulous observation is essential for the patients who received high doses of irradiation to diagnose brain injury in the early reversible stage. (2) Steroids should be given immediately in this reversible stage of brain injury before the irreversible ''necrosis'' occurs. (3) Steroids should be maintained for a long period over 12 months. (4) Heparin therapy is also thought to be effective, but careful precautions to avoid hemorrhagic complications before the therapy should be scheduled. This recommended plan may also be used for the treatment of brain injuries after cranial irradiation for other intracranial tumors. (author)

Early versus delayed postoperative radiotherapy for treatment of low-grade gliomas

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Sarmiento, J Manuel; Venteicher, Andrew S; Patil, Chirag G

2015-01-01

Background In most people with low-grade gliomas (LGG), the primary treatment regimen remains a combination of surgery followed by postoperative radiotherapy. However, the optimal timing of radiotherapy is controversial. It is unclear whether to use radiotherapy in the early postoperative period, or whether radiotherapy should be delayed until tumour progression occurs. Objectives To assess the effects of early postoperative radiotherapy versus radiotherapy delayed until tumour progression for low-grade intracranial gliomas in people who had initial biopsy or surgical resection. Search methods We searched up to September 2014 the following electronic databases: the Cochrane Register of Controlled Trials (CENTRAL, Issue 8, 2014), MEDLINE (1948 to Aug week 3, 2014), and EMBASE (1980 to Aug week 3, 2014) to identify trials for inclusion in this Cochrane review. Selection criteria We included randomised controlled trials (RCTs) that compared early versus delayed radiotherapy following biopsy or surgical resection for the treatment of people with newly diagnosed intracranial LGG (astrocytoma, oligodendroglioma, mixed oligoastrocytoma, astroblastoma, xanthoastrocytoma, or ganglioglioma). Radiotherapy may include conformal external beam radiotherapy (EBRT) with linear accelerator or cobalt-60 sources, intensity-modulated radiotherapy (IMRT), or stereotactic radiosurgery (SRS). Data collection and analysis Three review authors independently assessed the trials for inclusion and risk of bias, and extracted study data. We resolved any differences between review authors by discussion. Adverse effects were also extracted from the study report. We performed meta-analyses using a random-effects model with inverse variance weighting. Main results We included one large, multi-institutional, prospective RCT, involving 311 participants; the risk of bias in this study was unclear. This study found that early postoperative radiotherapy is associated with an increase in time to

Qualitative study of men's perceptions of why treatment delays occur in the UK for those with testicular cancer.

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Chapple, Alison; Ziebland, Sue; McPherson, Ann

2004-01-01

Many studies (but not all) have shown that for men with testicular cancer a longer treatment delay is associated with additional treatments, greater morbidity, and shorter survival. This paper explores patients' perspectives on why treatment delays occur. Qualitative study using narrative interviews Interviews in patient's homes throughout the United Kingdom (UK). Interviews with a maximum variation sample of 45 men with testicular cancer, recruited through general practitioners (GPs), urologists, support groups, and charities. Those who sought help relatively quickly responded to symptoms, had heard about testicular cancer in the media, had seen leaflets in GPs' surgeries, or knew others with this disease. Men delayed because they did not recognise signs and symptoms; feared appearing weak, a hypochondriac, or lacking in masculinity; recalled past illness or painful examinations; were embarrassed; feared the consequences of treatment; or lacked time to consult their doctors. Beliefs about symptoms and pessimistic associations with cancer also led to delay. Treatment delays also resulted from misdiagnosis or waiting lists. Whether or not men should be taught to examine themselves routinely to check for testicular cancer is much debated. This study suggests that it is important that men are aware of the normal shape and feel of their testicles, and may benefit from information about signs and symptoms of testicular cancer and the excellent cure rate. Information, provided in surgeries where men feel welcome, might encourage men to seek help promptly when a problem arises. Our study also suggests that GPs may need to accept a low threshold for ultrasound investigation of testicular symptoms and that the ultrasound service needs to be improved. These measures may further reduce mortality and morbidity.

Toxicity profile and treatment delays in NOPHO ALL2008-comparing adults and children with Philadelphia chromosome-negative acute lymphoblastic leukemia

DEFF Research Database (Denmark)

Toft, Nina; Birgens, Henrik; Abrahamsson, Jonas

2016-01-01

OBJECTIVES: Cure rates improve when adolescents and young adults with acute lymphoblastic leukemia (ALL) are treated according to pediatric protocols. Assumed risks of toxicities and associated delays in treatment have played a role in setting upper age limits. The aim of this study was to examine...... the toxicity profile and treatment delays in NOPHO ALL2008 comparing children and adults. METHODS: We collected information on 19 treatment-related toxicities, systematically captured at 3-month intervals throughout therapy, and time intervals between 12 consecutive treatment phases for 1076 patients aged 1......-45 yrs treated according to the Nordic/Baltic ALL2008 protocol. RESULTS: No adults died during induction. The duration of induction therapy and postinduction treatment phases did not differ between children and adults, except for patients 18-45 yrs being significantly delayed during two of nine high...

Time Delay and Associated Factors in Diagnosis and Treatment of Pulmonary Tuberculosis in Markazi Province

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Aliasghar Farazi

2012-07-01

Full Text Available Introduction: Delay in the diagnosis of tuberculosis increases the risk of death and enhances the transmission of disease in the community. This study aims to determine the patient and health service delay and factors affecting it in tuberculosis diagnosis. Materials & Methods: A cross-sectional survey that included all the public health centers was conducted in Markazi province from March 2009 till June 2011. Patients were interviewed after diagnosis by using a structured questionnaire. Results: One hundred and sixty-six patients aged between 9 and 87 (median; 66 years were included in the study. They comprised 87 (52.4% females and 79 (47.6% males. The median and mean of patient delay was 35 and 62 days, respectively; the median and mean of health system diagnosis delay was 34 and 53 days, respectively; the median and mean of health system treatment delay was 5 and 6 days, respectively; The median and mean of total delays were 86 and 121 days, respectively for all patients. The main determinants of delay were non education, poor economic, private sector, female gender and age≥55. Conclusion: The results of this review suggest that there is a need for revising case-finding strategies and reduction of infectious cases for better control of tuberculosis.

A general formula considering one group delayed neutron under nonequilibrium condition

International Nuclear Information System (INIS)

Li Haofeng; Chen Wenzhen; Zhu Qian; Luo Lei

2008-01-01

A general neutron breeder formula is developed when the reactor does not reach the steady state and the reactivity changes in phase. This formula can be used to calculate the results of six groups delayed neutron model through a way of amending λ in one group delayed neutron model. The analysis shows that the solution of amended single group delayed neutron model is approximately equal to that of six-group delayed neutron model, and the amended model meets the engineering accuracy. (authors)

Hippocampal lesions impair performance on a conditional delayed matching and non-matching to position task in the rat.

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Sloan, Hazel L; Döbrössy, Màtè; Dunnett, Stephen B

2006-08-10

The hippocampus is thought to be involved in a range of cognitive processes, from the ability to acquire new memories, to the ability to learn about spatial relationships. Humans and monkeys with damage to the hippocampus are typically impaired on delayed matching to sample tasks, of which the operant delayed matching to position task (DMTP) is a rat analogue. The reported effects of hippocampal damage on DMTP vary, ranging from delay-dependent deficits to no deficit whatsoever. The present study investigates a novel memory task; the conditional delayed matching/non-matching to position task (CDM/NMTP) in the Skinner box. CDM/NMTP uses the presence of specific stimulus cues to signify whether a particular trial is matching or non-matching in nature. Thus, it incorporates both the task contingencies within one session, and supplements the requirement for remembering the side of the lever in the sample phase with attending to the stimulus and remembering the conditional discrimination for the rule. Rats were trained preoperatively and the effects of bilateral excitotoxic lesions of the hippocampus were examined on postoperative retention of the task. Rats with lesions of the hippocampus incurred a significant impairment on the task that was manifest at all delays intervals. Despite a bias towards matching during training, trials of either type were performed with equivalent accuracy and neither rule was affected differentially by the lesion. This task may prove useful in determining the cognitive roles of a range of brain areas.

Diagnosis and treatment delays among elderly breast cancer patients with pre-existing mental illness.

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Iglay, Kristy; Santorelli, Melissa L; Hirshfield, Kim M; Williams, Jill M; Rhoads, George G; Lin, Yong; Demissie, Kitaw

2017-11-01

This study aimed to compare diagnosis and treatment delays in elderly breast cancer patients with and without pre-existing mental illness. A retrospective cohort study was conducted using the Surveillance, Epidemiology and End Results-Medicare data including 16,636 women 68+ years, who were diagnosed with stage I-IIIa breast cancer in the United States from 2005 to 2007. Mental illness was identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes recorded on inpatient and outpatient claims during the 3 years prior to breast cancer diagnosis. Patients were classified as having no mental illness, anxiety, depression, anxiety and depression, or severe mental illness (bipolar disorder, schizophrenia, and other psychotic disorder). Multivariable binomial regression was used to assess the association between mental illness and delays of ≥60 and ≥90 days after adjustment for confounders. Patients with comorbid anxiety and depression had an increased risk for diagnosis delay of ≥90 days from symptom recognition (RR 1.11; 95% CI 1.00, 1.23), and those with severe mental illness had an increased risk for initial treatment delay of ≥60 days from diagnosis (RR 1.36; 95% CI 1.06, 1.74). Patients with any mental illness experienced an increased risk for adjuvant chemotherapy delay of ≥90 days from last operation (RR 1.13; 95% CI 1.01, 1.26) and each category of mental illness, except depression, showed a non-significant trend for this association. Breast cancer patients with mental illness should be closely managed by a cross-functional care team, including a psychiatrist, a primary care physician, and an oncologist, to ensure adequate care is received within an appropriate timeframe.

Delayed xenon post-conditioning mitigates spinal cord ischemia/reperfusion injury in rabbits by regulating microglial activation and inflammatory factors.

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Yang, Yan-Wei; Wang, Yun-Lu; Lu, Jia-Kai; Tian, Lei; Jin, Mu; Cheng, Wei-Ping

2018-03-01

The neuroprotective effect against spinal cord ischemia/reperfusion injury in rats exerted by delayed xenon post-conditioning is stronger than that produced by immediate xenon post-conditioning. However, the mechanisms underlying this process remain unclear. Activated microglia are the main inflammatory cell type in the nervous system. The release of pro-inflammatory factors following microglial activation can lead to spinal cord damage, and inhibition of microglial activation can relieve spinal cord ischemia/reperfusion injury. To investigate how xenon regulates microglial activation and the release of inflammatory factors, a rabbit model of spinal cord ischemia/reperfusion injury was induced by balloon occlusion of the infrarenal aorta. After establishment of the model, two interventions were given: (1) immediate xenon post-conditioning-after reperfusion, inhalation of 50% xenon for 1 hour, 50% N 2 /50%O 2 for 2 hours; (2) delayed xenon post-conditioning-after reperfusion, inhalation of 50% N 2 /50%O 2 for 2 hours, 50% xenon for 1 hour. At 4, 8, 24, 48 and 72 hours after reperfusion, hindlimb locomotor function was scored using the Jacobs locomotor scale. At 72 hours after reperfusion, interleukin 6 and interleukin 10 levels in the spinal cord of each group were measured using western blot assays. Iba1 levels were determined using immunohistochemistry and a western blot assay. The number of normal neurons at the injury site was quantified using hematoxylin-eosin staining. At 72 hours after reperfusion, delayed xenon post-conditioning remarkably enhanced hindlimb motor function, increased the number of normal neurons at the injury site, decreased Iba1 levels, and inhibited interleukin-6 and interleukin-10 levels in the spinal cord. Immediate xenon post-conditioning did not noticeably affect the above-mentioned indexes. These findings indicate that delayed xenon post-conditioning after spinal cord injury improves the recovery of neurological function by reducing

Predicting delay to treatment of urinary incontinence among urban community-dwelling women in China

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Chen Wu

2015-03-01

Conclusion: Women who were older, had lower subjective UI severity, and who reported only stress or urgency UI tended to delay treatment longer; such patients should be targeted for health education and intervention regarding UI in urban communities.

Immediate extinction causes a less durable loss of performance than delayed extinction following either fear or appetitive conditioning

OpenAIRE

Woods, Amanda M.; Bouton, Mark E.

2008-01-01

Five experiments with rat subjects compared the effects of immediate and delayed extinction on the durability of extinction learning. Three experiments examined extinction of fear conditioning (using the conditioned emotional response method), and two experiments examined extinction of appetitive conditioning (using the food-cup entry method). In all experiments, conditioning and extinction were accomplished in single sessions, and retention testing took place 24 h after extinction. In both f...

Delays in diagnosis and treatment of extrapulmonary tuberculosis in Guatemala.

Science.gov (United States)

Shah, Pooja Ajay; Coj, Merida; Rohloff, Peter

2017-10-09

A 23-year-old indigenous Guatemalan man presented in 2016 to our clinic in Sololá, Guatemala, with 10 months of recurrent neck swelling, fevers, night sweats and weight loss. Previously, he had sought care in three different medical settings, including a private physician-run clinic, a tertiary private cancer treatment centre and, finally, a rural government health post. With assistance from our institution's accompaniment staff, the patient was admitted to a public tertiary care hospital for work-up. Rifampin-susceptible tuberculosis was diagnosed, and appropriate treatment was begun. The case illustrates how low tuberculosis recognition among community health workers and health system segmentation creates obstacles to appropriate care, especially for patients with limited means. As a result, significant diagnostic and treatment delays can occur, increasing the public health burden of tuberculosis. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Delay-independent stability of genetic regulatory networks.

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Wu, Fang-Xiang

2011-11-01

Genetic regulatory networks can be described by nonlinear differential equations with time delays. In this paper, we study both locally and globally delay-independent stability of genetic regulatory networks, taking messenger ribonucleic acid alternative splicing into consideration. Based on nonnegative matrix theory, we first develop necessary and sufficient conditions for locally delay-independent stability of genetic regulatory networks with multiple time delays. Compared to the previous results, these conditions are easy to verify. Then we develop sufficient conditions for global delay-independent stability for genetic regulatory networks. Compared to the previous results, this sufficient condition is less conservative. To illustrate theorems developed in this paper, we analyze delay-independent stability of two genetic regulatory networks: a real-life repressilatory network with three genes and three proteins, and a synthetic gene regulatory network with five genes and seven proteins. The simulation results show that the theorems developed in this paper can effectively determine the delay-independent stability of genetic regulatory networks.

A novel approach to delayed-start analyses for demonstrating disease-modifying effects in Alzheimer's disease.

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Hong Liu-Seifert

Full Text Available One method for demonstrating disease modification is a delayed-start design, consisting of a placebo-controlled period followed by a delayed-start period wherein all patients receive active treatment. To address methodological issues in previous delayed-start approaches, we propose a new method that is robust across conditions of drug effect, discontinuation rates, and missing data mechanisms. We propose a modeling approach and test procedure to test the hypothesis of noninferiority, comparing the treatment difference at the end of the delayed-start period with that at the end of the placebo-controlled period. We conducted simulations to identify the optimal noninferiority testing procedure to ensure the method was robust across scenarios and assumptions, and to evaluate the appropriate modeling approach for analyzing the delayed-start period. We then applied this methodology to Phase 3 solanezumab clinical trial data for mild Alzheimer's disease patients. Simulation results showed a testing procedure using a proportional noninferiority margin was robust for detecting disease-modifying effects; conditions of high and moderate discontinuations; and with various missing data mechanisms. Using all data from all randomized patients in a single model over both the placebo-controlled and delayed-start study periods demonstrated good statistical performance. In analysis of solanezumab data using this methodology, the noninferiority criterion was met, indicating the treatment difference at the end of the placebo-controlled studies was preserved at the end of the delayed-start period within a pre-defined margin. The proposed noninferiority method for delayed-start analysis controls Type I error rate well and addresses many challenges posed by previous approaches. Delayed-start studies employing the proposed analysis approach could be used to provide evidence of a disease-modifying effect. This method has been communicated with FDA and has been

Well-posedness and exponential stability for a wave equation with nonlocal time-delay condition

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Carlos Alberto Raposo

2017-11-01

Full Text Available Well-posedness and exponential stability of nonlocal time-delayed of a wave equation with a integral conditions of the 1st kind forms the center of this work. Through semigroup theory we prove the well-posedness by the Hille-Yosida theorem and the exponential stability exploring the dissipative properties of the linear operator associated to damped model using the Gearhart-Huang-Pruss theorem.

Extracorporeal shock wave treatment of non- or delayed union of proximal metatarsal fractures.

Science.gov (United States)

Alvarez, Richard G; Cincere, Brandon; Channappa, Chandra; Langerman, Richard; Schulte, Robert; Jaakkola, Juha; Melancon, Keith; Shereff, Michael; Cross, G Lee

2011-08-01

Nonunion or delayed union of fractures in the proximal aspect of metatarsals 1 to 4 and Zone 2 of the fifth metatarsal were treated by high energy extracorporeal shock wave treatment (ESWT) to study the safety and efficacy of this method of treatment in a FDA study of the Ossatron device. In a prospective single-arm, multi-center study, 34 fractures were treated in 32 patients (two subjects had two independent fractures) with ESWT. All fractures were at least 10 (range, 10 to 833) weeks after injury, with a median of 23 weeks. ESWT application was conducted using a protocol totaling 2,000 shocks for a total energy application of approximately 0.22 to 0.51 mJ/mm2 per treatment. The mean ESWT application time for each of the treatments was 24.6 +/- 16.6 minutes, and anesthesia time averaged 27.1 +/- 10.4 minutes. All subjects were followed for 1 year after treatment at intervals of 12 weeks, 6, 9, and 12 months. The overall success rate at the 12-week visit was 71% with low complications, significant pain improvement as well as improvement on the SF-36. The success/fail criteria was evaluated again at the 6- and 12-month followup, showing treatment success rates of 89% (23/26) and 90% (18/20), respectively. The most common adverse event was swelling in the foot, reported by five subjects (15.6%). High-energy ESWT appears to be effective and safe in patients for treatment of nonunion or a delayed healing of a proximal metatarsal, and in fifth metatarsal fractures in Zone 2.

Delay-dependent stability of neural networks of neutral type with time delay in the leakage term

International Nuclear Information System (INIS)

Li, Xiaodi; Cao, Jinde

2010-01-01

This paper studies the global asymptotic stability of neural networks of neutral type with mixed delays. The mixed delays include constant delay in the leakage term (i.e. 'leakage delay'), time-varying delays and continuously distributed delays. Based on the topological degree theory, Lyapunov method and linear matrix inequality (LMI) approach, some sufficient conditions are derived ensuring the existence, uniqueness and global asymptotic stability of the equilibrium point, which are dependent on both the discrete and distributed time delays. These conditions are expressed in terms of LMI and can be easily checked by the MATLAB LMI toolbox. Even if there is no leakage delay, the obtained results are less restrictive than some recent works. It can be applied to neural networks of neutral type with activation functions without assuming their boundedness, monotonicity or differentiability. Moreover, the differentiability of the time-varying delay in the non-neutral term is removed. Finally, two numerical examples are given to show the effectiveness of the proposed method

Delayed treatment of basilar thrombosis in a patient with a basilar aneurysm: a case report

Directory of Open Access Journals (Sweden)

Fakhouri T

2008-11-01

Full Text Available Abstract Introduction Acute occlusion of the basilar artery is a neurological emergency that has a high risk of severe disability and mortality. Delayed thrombolysis or endovascular therapy has been performed with some success in patients who present after 3 hours of symptom onset. Here we present the first case of delayed intra-arterial thrombolysis of a basilar artery thrombosis associated with a large saccular aneurysm. Case presentation A 73-year-old Caucasian man with a history of smoking and alcohol abuse presented to the Emergency Department complaining of diplopia and mild slurred speech and who progressed over 12 hours to coma and quadriparesis. He was found to have a large basilar tip aneurysm putting him at high risk for hemorrhage with lytic treatment. Conclusion The treatment options for basilar thrombosis are discussed. Aggressive treatment options should be considered despite long durations of clinical symptoms in basilar thrombosis, even in extremely high risk patients.

Enhancement of delay eyelid conditioning by microcurrent electrical stimulation of the medial prefrontal cortex is triggered by the expression of Fos protein in guinea pigs

OpenAIRE

ZHENG, YA-JUAN; DONG, YU-CHEN; ZHU, CHAO; ZHAO, MEI-SHENG

2016-01-01

Eyelid conditioning, including delay eyelid conditioning and trace eyelid conditioning, has been used extensively to study neural structures and mechanisms of learning and memory as a form of associative learning. In the present study, microcurrent electrical stimulation was used to stimulate the medial prefrontal cortex (mPFC) to induce delay eyelid conditioning in guinea pigs. The acquisition rate and relative latency of the conditioned eyelid response (CR) and the startle eyelid response (...

THE TREATMENT OF INTERSEX AND THE PROBLEM OF DELAY: THE AUSTRALIAN SENATE INQUIRY INTO INTERSEX SURGERY AND CONFLICTING HUMAN RIGHTS FOR CHILDREN.

Science.gov (United States)

O'Connor, Mike

2016-03-01

When a child is born with indeterminate genitalia (so-called intersex or disordered sex development), it becomes very difficult to balance the child's right to determine their own sexual future against the problems of living as a child with an indeterminate gender. Moreover, the initial assignment of gender may prove to be inappropriate and major psychological disturbances in the recipient can arise during adolescence and adult life. The problems of these children were explained to the Australian Senate Committee during its inquiry into intersex surgery in 2013. As a result, the Committee made a number of recommendations, including a proposal that all surgery be deferred until the child is able to consent to treatment. The author argues that the Committee's proposal to delay all modifications of indeterminate genitalia is impractical. The inclusion in the definition of intersex of common conditions (such as hypospadias in genetic male infants) means that necessary and uncontroversial surgery will be delayed until after puberty. This delay may be harmful and adverse to some children's best interests.

Delay-range-dependent exponential H∞ synchronization of a class of delayed neural networks

International Nuclear Information System (INIS)

Karimi, Hamid Reza; Maass, Peter

2009-01-01

This article aims to present a multiple delayed state-feedback control design for exponential H ∞ synchronization problem of a class of delayed neural networks with multiple time-varying discrete delays. On the basis of the drive-response concept and by introducing a descriptor technique and using Lyapunov-Krasovskii functional, new delay-range-dependent sufficient conditions for exponential H ∞ synchronization of the drive-response structure of neural networks are driven in terms of linear matrix inequalities (LMIs). The explicit expression of the controller gain matrices are parameterized based on the solvability conditions such that the drive system and the response system can be exponentially synchronized. A numerical example is included to illustrate the applicability of the proposed design method.

Global synchronization criteria with channel time-delay for chaotic time-delay system

International Nuclear Information System (INIS)

Sun Jitao

2004-01-01

Based on the Lyapunov stabilization theory, matrix measure, and linear matrix inequality (LMIs), this paper studies the chaos synchronization of time-delay system using the unidirectional linear error feedback coupling with time-delay. Some generic conditions of chaos synchronization with time-delay in the transmission channel is established. The chaotic Chua's circuit is used for illustration, where the coupling parameters are determined according to the criteria under which the global chaos synchronization of the time-delay coupled systems is achieved

Effect of Delayed Reinforcement on Skill Acquisition during Discrete-Trial Instruction: Implications for Treatment-Integrity Errors in Academic Settings

Science.gov (United States)

Carroll, Regina A.; Kodak, Tiffany; Adolf, Kari J.

2016-01-01

We used an adapted alternating treatments design to compare skill acquisition during discrete-trial instruction using immediate reinforcement, delayed reinforcement with immediate praise, and delayed reinforcement for 2 children with autism spectrum disorder. Participants acquired the skills taught with immediate reinforcement; however, delayed…

Necessary optimality conditions of the second oder in a stochastic optimal control problem with delay argument

Directory of Open Access Journals (Sweden)

Rashad O. Mastaliev

2016-12-01

Full Text Available The optimal control problem of nonlinear stochastic systems which mathematical model is given by Ito stochastic differential equation with delay argument is considered. Assuming that the concerned region is open for the control by the first and the second variation (classical sense of the quality functional we obtain the necessary optimality condition of the first and the second order. In the particular case we receive the stochastic analog of the Legendre—Clebsch condition and some constructively verified conclusions from the second order necessary condition. We investigate the Legendre–Clebsch conditions for the degeneration case and obtain the necessary conditions of optimality for a special control, in the classical sense.

Exponential synchronization of delayed neutral-type neural networks with Lévy noise under non-Lipschitz condition

Science.gov (United States)

Ma, Shuo; Kang, Yanmei

2018-04-01

In this paper, the exponential synchronization of stochastic neutral-type neural networks with time-varying delay and Lévy noise under non-Lipschitz condition is investigated for the first time. Using the general Itô's formula and the nonnegative semi-martingale convergence theorem, we derive general sufficient conditions of two kinds of exponential synchronization for the drive system and the response system with adaptive control. Numerical examples are presented to verify the effectiveness of the proposed criteria.

Delayed conifer mortality after fuel reduction treatments: Interactive effects of fuel, fire intensity, and bark beetles

Science.gov (United States)

Youngblood, A.; Grace, J.B.; Mciver, J.D.

2009-01-01

Many low-elevation dry forests of the western United States contain more small trees and fewer large trees, more down woody debris, and less diverse and vigorous understory plant communities compared to conditions under historical fire regimes. These altered structural conditions may contribute to increased probability of unnaturally severe wildfires, susceptibility to uncharacteristic insect outbreaks, and drought-related mortality. Broad-scale fuel reduction and restoration treatments are proposed to promote stand development on trajectories toward more sustainable structures. Little research to date, however, has quantified the effects of these treatments on the ecosystem, especially delayed and latent tree mortality resulting directly or indirectly from treatments. In this paper, we explore complex hypotheses relating to the cascade of effects that influence ponderosa pine (Pinus ponderosa) and Douglas-fir (Pseudotsuga menziesii) mortality using structural equation modeling (SEM). We used annual census and plot data through six growing seasons after thinning and four growing seasons after burning from a replicated, operational-scale, completely randomized experiment conducted in northeastern Oregon, USA, as part of the national Fire and Fire Surrogate study. Treatments included thin, burn, thin followed by burn (thin+burn), and control. Burn and thin+burn treatments increased the proportion of dead trees while the proportion of dead trees declined or remained constant in thin and control units, although the density of dead trees was essentially unchanged with treatment. Most of the new mortality (96%) occurred within two years of treatment and was attributed to bark beetles. Bark beetle-caused tree mortality, while low overall, was greatest in thin + burn treatments. SEM results indicate that the probability of mortality of large-diameter ponderosa pine from bark beetles and wood borers was directly related to surface fire severity and bole charring, which in

Delay in treatment seeking of smear positive tuberculous patients

International Nuclear Information System (INIS)

Bhatti, A.T.; Zahid, M.

2010-01-01

To assess and identify the causes and circumstances leading to delays in health seeking and diagnosis of tuberculosis patients as they often present with advance disease resulting in increased morbidity and mortality. Settings Department of Tuberculosis, DOTS clinic DHQ Hospital, Vehari. Methodology One (author) inspiration diagnosed smear positive pulmonary tuberculosis patients were included. Information was gathered through interviews and from TB-01 card. Results Maximum patients were in age group of 16-40 years. Median patient delay was 4-6 months; jobless, homeless personnel had longer delay. The main reason for delay was that the symptoms were not considered serious enough. Delay in presentation of smear positive cases may be due to the lack of awareness of patients and the incompetence of some health workers. Training and supervision of staff and awareness campaigns targeted at the population and involvement of private sector will improve TB control in Vehari. (author)

Effects of OEF/OIF-Related Physical and Emotional Co-Morbidities on Associative Learning: Concurrent Delay and Trace Eyeblink Classical Conditioning

Directory of Open Access Journals (Sweden)

Regina E. McGlinchey

2014-03-01

Full Text Available This study examined the performance of veterans and active duty personnel who served in Operation Enduring Freedom and/or Operation Iraqi Freedom (OEF/OIF on a basic associative learning task. Eighty-eight individuals participated in this study. All received a comprehensive clinical evaluation to determine the presence and severity of posttraumatic stress disorder (PTSD and traumatic brain injury (TBI. The eyeblink conditioning task was composed of randomly intermixed delay and trace conditioned stimulus (CS and unconditioned stimulus (US pairs (acquisition followed by a series of CS only trials (extinction. Results revealed that those with a clinical diagnosis of PTSD or a diagnosis of PTSD with comorbid mTBI acquired delay and trace conditioned responses (CRs to levels and at rates similar to a deployed control group, thus suggesting intact basic associative learning. Differential extinction impairment was observed in the two clinical groups. Acquisition of CRs for both delay and trace conditioning, as well as extinction of trace CRs, was associated with alcoholic behavior across all participants. These findings help characterize the learning and memory function of individuals with PTSD and mTBI from OEF/OIF and raise the alarming possibility that the use of alcohol in this group may lead to more significant cognitive dysfunction.

Delayed brain radiation necrosis: pathological review and new molecular targets for treatment.

Science.gov (United States)

Furuse, Motomasa; Nonoguchi, Naosuke; Kawabata, Shinji; Miyatake, Shin-Ichi; Kuroiwa, Toshihiko

2015-12-01

Delayed radiation necrosis is a well-known adverse event following radiotherapy for brain diseases and has been studied since the 1930s. The primary pathogenesis is thought to be the direct damage to endothelial and glial cells, particularly oligodendrocytes, which causes vascular hyalinization and demyelination. This primary pathology leads to tissue inflammation and ischemia, inducing various tissue protective responses including angiogenesis. Macrophages and lymphocytes then infiltrate the surrounding areas of necrosis, releasing inflammatory cytokines such as interleukin (IL)-1α, IL-6, and tumor necrosis factor (TNF)-α. Microglia also express these inflammatory cytokines. Reactive astrocytes play an important role in angiogenesis, expressing vascular endothelial growth factor (VEGF). Some chemokine networks, like the CXCL12/CXCR4 axis, are upregulated by tissue inflammation. Hypoxia may mediate the cell-cell interactions among reactive astrocytes, macrophages, and microglial cells around the necrotic core. Recently, bevacizumab, an anti-VEGF antibody, has demonstrated promising results as an alternative treatment for radiation necrosis. The importance of VEGF in the pathophysiology of brain radiation necrosis is being recognized. The discovery of new molecular targets could facilitate novel treatments for radiation necrosis. This literature review will focus on recent work characterizing delayed radiation necrosis in the brain.

Immediate versus delayed treatment for recently symptomatic carotid artery stenosis

Directory of Open Access Journals (Sweden)

Vladimir Vasconcelos

Full Text Available ABSTRACT BACKGROUND: The timing of surgery for recently symptomatic carotid artery stenosis remains controversial. Early cerebral revascularization may prevent a disabling or fatal ischemic recurrence, but it may also increase the risk of hemorrhagic transformation, or of dislodging a thrombus. This review examined the randomized controlled evidence that addressed whether the increased risk of recurrent events outweighed the increased benefit of an earlier intervention. OBJECTIVES: To assess the risks and benefits of performing very early cerebral revascularization (within two days compared with delayed treatment (after two days for people with recently symptomatic carotid artery stenosis. METHODS: Search methods: We searched the Cochrane Stroke Group Trials Register in January 2016, the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library 2016, issue 1, MEDLINE (1948 to 26 January 2016, EMBASE (1974 to 26 January 2016, LILACS (1982 to 26 January 2016, and trial registers (from inception to 26 January 2016. We also handsearched conference proceedings and journals, and searched reference lists. There were no language restrictions. We contacted colleagues and pharmaceutical companies to identify further studies and unpublished trials Selection criteria: All completed, truly randomized trials (RCT that compared very early cerebral revascularization (within two days with delayed treatment (after two days for people with recently symptomatic carotid artery stenosis. Data collection and analysis: We independently selected trials for inclusion according to the above criteria, assessed risk of bias for each trial, and performed data extraction. We utilized an intention-to-treat analysis strategy. MAIN RESULTS: We identified one RCT that involved 40 participants, and addressed the timing of surgery for people with recently symptomatic carotid artery stenosis. It compared very early surgery with surgery performed after 14 days of

Controllability of nonlinear delay oscillating systems

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Chengbin Liang

2017-05-01

Full Text Available In this paper, we study the controllability of a system governed by second order delay differential equations. We introduce a delay Gramian matrix involving the delayed matrix sine, which is used to establish sufficient and necessary conditions of controllability for the linear problem. In addition, we also construct a specific control function for controllability. For the nonlinear problem, we construct a control function and transfer the controllability problem to a fixed point problem for a suitable operator. We give a sufficient condition to guarantee the nonlinear delay system is controllable. Two examples are given to illustrate our theoretical results by calculating a specific control function and inverse of a delay Gramian matrix.

Delayed orgasm and anorgasmia.

Science.gov (United States)

Jenkins, Lawrence C; Mulhall, John P

2015-11-01

Delayed orgasm/anorgasmia defined as the persistent or recurrent difficulty, delay in, or absence of attaining orgasm after sufficient sexual stimulation, which causes personal distress. Delayed orgasm and anorgasmia are associated with significant sexual dissatisfaction. A focused medical history can shed light on the potential etiologies, which include medications, penile sensation loss, endocrinopathies, penile hyperstimulation, and psychological etiologies. Unfortunately, there are no excellent pharmacotherapies for delayed orgasm/anorgasmia, and treatment revolves largely around addressing potential causative factors and psychotherapy. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Antibiotic treatment delay and outcome in acute bacterial meningitis

DEFF Research Database (Denmark)

Køster-Rasmussen, Rasmus; Korshin, André; Meyer, Christian N

2008-01-01

OBJECTIVES: To identify to what degree in-hospital delay of antibiotic therapy correlated to outcome in community acquired bacterial meningitis. METHODS: All cases of culture-positive cerebrospinal fluids in east Denmark from 2002 to 2004 were included. Medical records were collected retrospectiv......OBJECTIVES: To identify to what degree in-hospital delay of antibiotic therapy correlated to outcome in community acquired bacterial meningitis. METHODS: All cases of culture-positive cerebrospinal fluids in east Denmark from 2002 to 2004 were included. Medical records were collected......=1.30/h, CI: 1.08-1.57). The median delay to the first dose of adequate antibiotics was 1h and 39min (1h and 14min in children vs. 2h in adults, pmeningitis. CONCLUSION: The delay in antibiotic therapy correlated...

G-CSF in solid tumor chemotherapy: a tailored regimen reduces febrile neutropenia, treatment delays and direct costs.

Science.gov (United States)

Tsavaris, Nicolas; Kosmas, Christos; Gouveris, Panagiotis; Vadiak, Maria; Dimitrakopoulos, Antonis; Karadima, Dimitra; Pagouni, Efterpi; Panagiotakopoulos, George; Tzima, Evanthia; Ispoglou, Sevasti; Sakelariou, Dimitris; Koufos, Christos

2004-02-01

Current guidelines do not recommend G-CSF for patients with risk factors for neutropenia. One-hundred patients undergoing chemotherapy were randomized to treatment with G-CSF at 5 Kg/kg for established febrile neutropenia (ANC <1000/microl) (Group A) or G-CSF at 263 Kg/day if ANC was 1500/microl or less on the day of the expected nadir, with the duration of treatment determined by the severity of neutropenia (Group B). The number of doses of G-CSF was similar in the two groups. There were 34 cases of febrile neutropenia in Group A, but none in Group B (p=0.0001). Hospital admission for febrile neutropenia, antibiotic use and delays in chemotherapy were all significantly more common in Group A. Total direct costs were estimated to be 66, 646 for Group A and 47, 119 for Group B. Tailoring treatment does not increase G-CSF use, but significantly reduces febrile neutropenia and treatment delays and lowers direct costs.

Determinants of delay in malaria treatment-seeking behaviour for under-five children in south-west Ethiopia: a case control study

Directory of Open Access Journals (Sweden)

Deribew Amare

2010-11-01

Full Text Available Abstract Background Prompt diagnosis and timely treatment of malaria within 24 hours after onset of first symptoms can reduce illness progression to severe stages and therefore, decrease mortality. The reason why mothers/caretakers delay in malaria diagnosis and treatment for under-five children is not well studied in Ethiopia. The objective of this study was to assess determinants of malaria treatment delay in under-five children in three districts of south-west Ethiopia. Methods A case control study was conducted from March 15 to April 20, 2010. Cases were under-five children who had clinical malaria and sought treatment after 24 hours of developing sign and symptom, and controls were under-five children who had clinical malaria and sought treatment within 24 hours of developing sign and symptom of malaria. Data were collected by trained enumerators using structured questionnaire. Data were entered in to Epi Info version 6.04 and analyzed using SPSS version 16.0. To identify determinants, multiple logistic regression was done. Results A total of 155 mothers of cases and 155 mothers of controls were interviewed. Mothers of children who were in a monogamous marriage (OR = 3.41, 95% CI: 1.39, 8.34, who complained about the side effects of anti-malarial drugs (OR = 4.96, 95% CI: 1.21, 20.36, who had no history of child death (OR = 3.50, 95% CI: 1.82, 6.42 and who complained about the higher cost of transportation to reach the health institutions (OR = 2.01, 95% CI: 1.17, 3.45 were more likely to be late for the treatment of malaria in under-five children. Conclusion Effective malaria control programmes should address reducing delayed presentation of children for treatment. Efforts to reduce delay should address transport cost, decentralization of services and increasing awareness of the community on early diagnosis and treatment.

Survival of Primates in Lethal Septic Shock Following Delayed Treatment with Steroid.

Science.gov (United States)

1981-02-26

TECHNICAL REPORT NO. 142 SURVIVAL OF PRIMATES IN LETHAL SEPTIC SHOCK FOLLOWING DELAYED TREAMENT WIn STEROID L. B. Hinshaw, L. T. Archer, B. K. Belier ...2. Schumer W: Steroids in the treatment of clinical septic shock. Ann Surg 184:333-341, 1976. 3. Hinshaw LB, Belier PK, Archer LT, Flournoy DJ, White...not preventable by antibiotic alone. Infect Immun ZS:538-5)7, 1979. 6. Hinshaw LB, Archer LT, Belier -Todd BK, Coalson .JJ, Flournoy DL, Passey R

Delays and Refusal in Treatment for Breast Cancer Among Native American and Hispanic Women with Breast Cancer

National Research Council Canada - National Science Library

Saavedra, Elba

2000-01-01

..., attitudinal, spiritual and demographic variables associated with delays and refusals in breast cancer treatment The focus of the semi-structured interview is to encourage the women in story-telling...

Delayed puberty and hypogonadotropic hypogonadism. Differential diagnosis and treatment

NARCIS (Netherlands)

Snoep, Marinus Cornelis

1978-01-01

This thesis describes a method enabling a prospecrive differential diagnosis to be made berween delayed puberty (DP) and hypogonadotropic hypogonadism (HH). The influence of androgen administration on the gonadal feedback sysrem of patients with delayed puberty was also studied. ... Zie: Summary

Operative treatment of the midshaft fractures of the clavicle – does delay matter?

Directory of Open Access Journals (Sweden)

Matej Andoljšek

2007-11-01

Full Text Available Background: Fractures of the clavicle are common injuries and mostly treated non-operatively. Nearly always the fracture is clinically united within three to four weeks and functional recovery should be completed within two months. Traditionally thinking has been that operative treatment is indicated exceptionaly and that delayed surgery is less successful. In retrospective comparative study authors have asked – whether delay of surgery in middle-third clavicular fractures negatively affects functional results and – whether after delayed surgery complications are more frequent.Patients and methods: Thirty-seven of 733 fractures of the clavicle were treated operatively. Among these, 11 were fresh Allman Type I fractures (early procedure, 9 delayed- or non-unions and one malunion (late procedure. All fractures were fixed with plates and screws. In none of the reconstructive procedures composite bone grafting was performed, twice spongiotic bone graft and twice morsilized calus grafts were used. DASH and Constant scores were used for outcome evaluation.Results: Twenty-one of 22 patients were evaluated (one foreign turist missed on average 21 month after surgery. Average DASH scores for early operated patients were 14.4 and for late operated 18.5; an average Quich DASH were 16.4 and 20.5 respectively. Average Constant scores were 85.6 and 76.0. Statistically differences are not important. Three patients had early complications (two from early, one from late group. Five patients had late complications (four skin paresthesias, one non-union.Conclusions: In retrospective study, functional results of surgically treated fresh Type I fractures and after reconstructive surgery for delayed-, non- and mal-union of the midshaft of the clavicle were comparable. No significant differences in complication rates were confirmed.

Time-delayed contrast-enhanced MRI improves detection of brain metastases and apparent treatment volumes.

Science.gov (United States)

Kushnirsky, Marina; Nguyen, Vinh; Katz, Joel S; Steinklein, Jared; Rosen, Lisa; Warshall, Craig; Schulder, Michael; Knisely, Jonathan P S

2016-02-01

Contrast-enhanced MRI is the preeminent diagnostic test for brain metastasis (BM). Detection of BMs for stereotactic radiosurgery (SRS) planning may improve with a time delay following administration of a high-relaxivity agent for 1.5-T and 3-T imaging systems. Metastasis detection with time-delayed MRI was evaluated in this study. Fifty-three volumetric MRI studies from 38 patients undergoing SRS for BMs were evaluated. All studies used 0.1-mmol/kg gadobenate dimeglumine (MultiHance; Bracco Diagnostics) immediately after injection, followed by 2 more axial T1-weighted sequences after 5-minute intervals (final image acquisition commenced 15 minutes after contrast injection). Two studies were motion limited and excluded. Two hundred eighty-seven BMs were identified. The studies were randomized and examined separately by 3 radiologists, who were blinded to the temporal sequence. Each radiologist recorded the number of BMs detected per scan. A Wilcoxon signed-rank test compared BM numbers between scans. One radiologist determined the scan on which BMs were best defined. All confirmed, visible tumors were contoured using iPlan RT treatment planning software on each of the 3 MRI data sets. A linear mixed model was used to analyze volume changes. The interclass correlations for Scans 1, 2, and 3 were 0.7392, 0.7951, and 0.7290, respectively, demonstrating excellent interrater reliability. At least 1 new lesion was detected in the second scan as compared with the first in 35.3% of subjects (95% CI 22.4%-49.9%). The increase in BM numbers between Scans 1 and 2 ranged from 1 to 10. At least 1 new lesion was detected in the third scan as compared with the second in 21.6% of subjects (95% CI 11.3%-35.3%). The increase in BM numbers between Scans 2 and 3 ranged from 1 to 9. Between Scans 1 and 3, additional tumors were seen on 43.1% of scans (increase ranged from 1 to 14). The median increase in tumor number for all comparisons was 1. There was a significant increase in number

Delayed Ejaculation

Science.gov (United States)

... cases, it is due to a combination of physical and psychological concerns. Psychological causes of delayed ejaculation include: Depression, anxiety or other mental health conditions Relationship problems due to stress, poor communication ...

Methyl bromide fumigation and delayed mortality: safe trade of live pests?

Science.gov (United States)

Phillips, C B; Iline, I I; Novoselov, M; McNeill, M R; Richards, N K; van Koten, C; Stephenson, B P

Live organisms intercepted from treated commodities during phytosanitary inspections usually arouse suspicions of treatment failure, sub-standard treatment application, or post-treatment infestation. The additional possibility that some treatments could kill slowly, meaning commodities might be inspected before pests have succumbed, is seldom considered for treatments other than irradiation. We used a novel biochemical viability assay to measure delays between methyl bromide fumigation and mortality of dipteran eggs, and evaluated the correspondence between egg viability and egg morphological features. Our experimental conditions simulated shipping of rock melons from Australia to New Zealand by sea and air. No eggs survived fumigation, but they took 3-20 days to die, whereas phytosanitary inspections of rock melons occur within 2-7 days. Delays were not influenced by methyl bromide concentration, but were significantly lengthened by cooler storage temperatures. Methyl bromide's preservative effects delayed degradation of egg morphology, so the biochemical assay detected mortality long before morphological signs of egg death appeared. The results show that commodities subjected to effective methyl bromide treatments are at risk of being inspected before all pests have either died, or started to exhibit morphological signs of death. This could cause commodities to be unnecessarily rejected by quarantine authorities. Better methods than inspection for live pests are needed to assist authorities to gain assurance that treated commodities have been effectively disinfested. These could be developed by exploiting biochemical responses of pests and commodities to treatments.

Perceived Discrimination and Reported Delay of Pharmacy Prescriptions and Medical Tests

Science.gov (United States)

Van Houtven, Courtney Harold; Voils, Corrine I; Oddone, Eugene Z; Weinfurt, Kevin P; Friedman, Joëlle Y; Schulman, Kevin A; Bosworth, Hayden B

2005-01-01

BACKGROUND Access to health care varies according to a person's race and ethnicity. Delaying treatment is one measure of access with important health consequences. OBJECTIVE Determine whether perceptions of unfair treatment because of race or ethnicity are associated with reported treatment delays, controlling for economic constraints, self-reported health, depression, and demographics. DESIGN Cross-sectional, observational study. PARTICIPANTS A randomly selected community sample of 181 blacks, 148 Latinos, and 193 whites in Durham County, NC. MEASUREMENTS A phone survey conducted in 2002 to assess discrimination, trust in medical care, quality of care, and access to care. Treatment delays were measured by whether or not a person reported delaying or forgoing filling a prescription and delaying or forgoing having a medical test/treatment in the past 12 months. Perceived discrimination was measured as unfair treatment in health care and as racism in local health care institutions. RESULTS The odds of delaying filling prescriptions were significantly higher (odds ratio (OR)=2.02) for persons who perceived unfair treatment, whereas the odds of delaying tests or treatments were significantly higher (OR=2.42) for persons who thought racism was a problem in health care locally. People with self-reported depression and people who reported not working had greater odds of delaying both types of care. CONCLUSIONS A prospective cohort study with both personal and macro measures of discrimination, as well as more refined measures of treatment delays, would help us better understand the relationship between perceived discrimination and treatment delays. PMID:16050850

Rapid Disease Progression With Delay in Treatment of Non-Small-Cell Lung Cancer

International Nuclear Information System (INIS)

Mohammed, Nasiruddin; Kestin, Larry Llyn; Grills, Inga Siiner; Battu, Madhu; Fitch, Dwight Lamar; Wong, Ching-yee Oliver; Margolis, Jeffrey Harold; Chmielewski, Gary William; Welsh, Robert James

2011-01-01

Purpose: To assess rate of disease progression from diagnosis to initiation of treatment for Stage I-IIIB non-small-cell lung cancer (NSCLC). Methods and Materials: Forty patients with NSCLC underwent at least two sets of computed tomography (CT) and 18-fluorodeoxyglucose positron emission tomography (PET) scans at various time intervals before treatment. Progression was defined as development of any new lymph node involvement, site of disease, or stage change. Results: Median time interval between first and second CT scans was 13.4 weeks, and between first and second PET scans was 9.0 weeks. Median initial primary maximum tumor dimension (MTD) was 3.5 cm (0.6-8.5 cm) with a median standardized uptake value (SUV) of 13.0 (1.7-38.5). The median MTD increased by a median of 1.0 cm (mean, 1.6 cm) between scans for a median relative MTD increase of 35% (mean, 59%). Nineteen patients (48%) progressed between scans. Rate of any progression was 13%, 31%, and 46% at 4, 8, and 16 weeks, respectively. Upstaging occurred in 3%, 13%, and 21% at these intervals. Distant metastasis became evident in 3%, 13%, and 13% after 4, 8, and 16 weeks, respectively. T and N stage were associated with progression, whereas histology, grade, sex, age, and maximum SUV were not. At 3 years, overall survival for Stage III patients with vs. without progression was 18% vs. 67%, p = 0.05. Conclusions: With NSCLC, treatment delay can lead to disease progression. Diagnosis, staging, and treatment initiation should be expedited. After 4-8 weeks of delay, complete restaging should be strongly considered.

Effect of Temperature, Pressure and Equivalence Ratio on Ignition Delay in Ignition Quality Tester (IQT): Diesel,n-Heptane, andiso-Octane Fuels under Low Temperature Conditions

KAUST Repository

Yang, Seung Yeon

2015-11-02

Effects of temperature, pressure and global equivalence ratio on total ignition delay time in a constant volume spray combustion chamber were investigated for diesel fuel along with the primary reference fuels (PRFs) of n-heptane and iso-octane in relatively low temperature conditions to simulate unsteady spray ignition behavior. A KAUST Research ignition quality tester (KR-IQT) was utilized, which has a feature of varying temperature, pressure and equivalence ratio using a variable displacement fuel pump. A gradient method was adopted in determining the start of ignition in order to compensate pressure increase induced by low temperature heat release. Comparison of this method with other existing methods was discussed. Ignition delay times were measured at various equivalence ratios (0.5-1.7) with the temperatures of initial charge air in the range from 698 to 860 K and the pressures in the range of 1.5 to 2.1 MPa, pertinent to low temperature combustion (LTC) conditions. An attempt to scale the effect of pressure on total ignition delay was undertaken and the equivalence ratio exponent and activation energy in the Arrhenius expression of total ignition delay were determined. Ignition delay results indicated that there were strong correlations of pressure, temperature, and equivalence ratio under most conditions studied except at relatively low pressures. Diesel (DCN 52.5) and n-heptane (DCN 54) fuels exhibited reasonably similar ignition delay characteristics, while iso-octane showed a distinct behavior under low temperature regime having a two-stage ignition, which substantiate the adoption of the gradient method in determining ignition delay.

Transfer between hospitals as a predictor of delay in diagnosis and treatment of patients with Non-Small Cell Lung Cancer

DEFF Research Database (Denmark)

Iachina, Maria; Jakobsen, Erik; Fallesen, Anne Kudsk

2017-01-01

with treatment facilities during the care pathway. We wanted to investigate whether this organizational set-up influenced the time that patients wait for the diagnosis and treatment. Therefore, the objective of this study was to uncover the impact of transfer between hospitals on the delay in the diagnosis......BACKGROUND: Lung cancer is the second most frequent cancer diagnosis in Denmark. Although improved during the last decade, the prognosis of lung cancer is still poor with an overall 5-year survival rate of approximately 12%. Delay in diagnosis and treatment of lung cancer has been suggested...... and incomplete data on the dates of referral, diagnosis and treatment were excluded. RESULTS: A total of 11 273 patients were included for further analyses. Transfer patients waited longer for treatment after the diagnosis, (Hazard ratio (HR) 0.81 (0.68-0.96)) and in total time from referral to treatment (HR 0...

Early-Onset Bipolar Disorder and Treatment Delay Are Risk Factors for Poor Outcome in Adulthood

NARCIS (Netherlands)

Post, Robert M.; Leverich, Gabriele S.; Kupka, Ralph W.; Keck, Paul E.; McElroy, Susan L.; Altshuler, Lori L.; Frye, Mark A.; Luckenbaugh, David A.; Rowe, Michael; Grunze, Heinz; Suppes, Trisha; Nolen, Willem A.

Objective: We examined the influence of age at onset of illness and the delay in time to first treatment on morbidity in adulthood. Method: 529 adult outpatients with a mean age of 42 years, who entered our research network from 1996 through 2001 and who were diagnosed with bipolar disorder

Prehospital delay in acute coronary syndrome--an analysis of the components of delay

DEFF Research Database (Denmark)

Ottesen, Michael Mundt; Dixen, Ulrik; Torp-Pedersen, Christian

2004-01-01

BACKGROUND: Prompt hospital admission is essential when treating acute coronary syndrome. Delay prior to admission is unnecessarily long. Therefore, a thorough scrutiny of the influence of characteristics, circumstantial and subjective variables on elements of prehospital delay among patients...... admitted with acute coronary syndrome is warranted. METHODS: A structured interview was conducted on 250 consecutive patients admitted alive with acute coronary syndrome. RESULTS: Median prehospital, decision, physician and transportation delays were 107, 74, 25 and 22 min, respectively. Women (n=77) had...... of acute coronary syndrome among women, and thereby contributes to unnecessary long delay to treatment. The patient's prior experience and interpretation has a significant influence on behaviour....

Patient characteristics associated with self-presentation, treatment delay and survival following primary percutaneous coronary intervention.

Science.gov (United States)

Austin, David; Yan, Andrew T; Spratt, James C; Kunadian, Vijay; Edwards, Richard J; Egred, Mohaned; Bagnall, Alan J

2014-09-01

Delayed arrival to a primary percutaneous coronary intervention (PPCI)-capable hospital following ST-elevation myocardial infarction (STEMI) is associated with poorer outcome. The influence of patient characteristics on delayed presentation during STEMI is unknown. This was a retrospective observational study. Patients presenting for PPCI from March 2008 to November 2011 in the north of England (Northumbria, Tyne and Wear) were included. The outcomes were self-presentation to a non-PPCI-capable hospital, symptom to first medical contact (STFMC) time, total ischaemic time and mortality during follow-up. STEMI patients included numbered 2297; 619 (26.9%) patients self-presented to a non-PPCI-capable hospital. STFMC of >30 min and total ischaemic time of >180 min was present in 1521 (70.7%) and 999 (44.9%) cases, respectively. Self-presentation was the strongest predictor of prolonged total ischaemic time (odds ratio, OR (95% confidence interval, CI): 5.05 (3.99-6.39)). Married patients (OR 1.38 (1.10-1.74)) and patients living closest to an Emergency Room self-presented more commonly (driving time (vs. ≤10 min) 11-20 min OR 0.66 (0.52-0.83), >20 minutes OR 0.46 (0.33-0.64). Unmarried females waited longest to call for help (OR vs. married males 1.89 (1.29-2.78) and experienced longer total ischaemic times (OR 1.51 (1.10-2.07)). Married patients had a borderline association with lower mortality (hazard ratio 0.75 (0.53-1.05), p=0.09). Unmarried female patients had the longest treatment delays. Married patients and those living closer to an Emergency Room self-present more frequently. Early and exclusive use of the ambulance service may reduce treatment delay and improve STEMI outcome. © The European Society of Cardiology 2014.

New Delay-Dependent Stability Criteria for Uncertain Neutral Systems with Mixed Time-Varying Delays and Nonlinear Perturbations

Directory of Open Access Journals (Sweden)

Hamid Reza Karimi

2009-01-01

Full Text Available The problem of stability analysis for a class of neutral systems with mixed time-varying neutral, discrete and distributed delays and nonlinear parameter perturbations is addressed. By introducing a novel Lyapunov-Krasovskii functional and combining the descriptor model transformation, the Leibniz-Newton formula, some free-weighting matrices, and a suitable change of variables, new sufficient conditions are established for the stability of the considered system, which are neutral-delay-dependent, discrete-delay-range-dependent, and distributed-delay-dependent. The conditions are presented in terms of linear matrix inequalities (LMIs and can be efficiently solved using convex programming techniques. Two numerical examples are given to illustrate the efficiency of the proposed method.

Treatment and conditioning of metallic intermediate level waste

International Nuclear Information System (INIS)

Lidar, Per; Larsson, Arne; Huutoniemi, Tommi; Blank, Eva; Elfwing, Mattias

2014-01-01

In 2011 SKB started an R and D program for evaluating different disposal concepts for LL-LILW. The purpose was to develop alternative repository concepts and conditioning methods for LL-LILW and to evaluate and compare them from a range of parameters. The goal is to present a comparison between identified repository concepts by 2013. The material should be of such a quality that SKB can make decisions of which concepts that are to be further investigated in a safety analysis. As a part of the R and D program for the LL-LILW disposal facility, Studsvik was assigned to investigate whether melting of metallic LL-LILW is technically feasible and, if so, what the requirements are to build and operate such a facility. Specific concern was given to the following metallic components: - Core components and reactor internals from both boiling water reactors (BWRs) and pressurized water reactors (PWRs). - Reactor pressure vessels from PWRs. The paper presents a feasibility study of a melting facility for core components and reactor internals. An overview is given of how such a facility for treatment of intermediate level waste might be designed, constructed and operated and highlights both the possibilities and challenges. A cost estimate and a risk analysis are presented in order to make a conclusion of the technical feasibility of such a facility. Based on the Studsvik authors' experience in operating a low level waste melting facility, their conclusion is presented in the paper, considering cost of constructing and operating such a facility, in conjunction with the radio-logical risks associated with operation and the benefits to disposal and long term safety. Studsvik also investigated alternative techniques for embedding of metallic ILW components. Embedding of radioactive metallic ILW components protects the component from corrosion and leakage of radionuclides from repository to biosphere can thereby be both delayed and decreased. Conditioning by embedding has

When the Battle is Lost and Won: Delayed Chest Closure After Bilateral Lung Transplantation.

Science.gov (United States)

Soresi, Simona; Sabashnikov, Anton; Weymann, Alexander; Zeriouh, Mohamed; Simon, André R; Popov, Aron-Frederik

2015-10-12

In this article we summarize benefits of delayed chest closure strategy in lung transplantation, addressing indications, different surgical techniques, and additional perioperative treatment. Delayed chest closure seems to be a valuable and safe strategy in managing patients with various conditions after lung transplantation, such as instable hemodynamics, need for high respiratory pressures, coagulopathy, and size mismatch. Therefore, this approach should be considered in lung transplant centers to give patients time to recover before the chest is closed.

The Long-Term Outcome Comparison of Different Time-Delayed Kallikrein Treatments in a Mouse Cerebral Ischemic Model

Directory of Open Access Journals (Sweden)

Yaohui Ni

2018-01-01

Full Text Available Delayed administration of kallikrein after cerebral infarction can improve neurological function. However, the appropriate kallkrein treatment time after ischemic stroke has not been illuminated. In this study, we compared the long-term outcome among three kallikrein therapeutic regimens starting at different time points following mouse cerebral ischemia. Furthermore, the protective mechanisms involving neurogenesis, angiogenesis, and AKT-GSK3β-VEGF signaling pathway were analyzed. Human tissue kallikrein was injected through the tail vein daily starting at 8 h, 24 h, or 36 h after right middle cerebral artery occlusion (MCAO until the 28th day. Three therapeutic regimens all protected against neurological dysfunction, but kallikrein treatment starting at 8 h after MCAO had the best efficacy. Additionally, kallikrein treatment at 8 h after MCAO significantly enhanced cell proliferation including neural stem cell and induced differentiation of neural stem cell into mature neuron. Kallikrein treatment starting at 8 h also promoted more angiogenesis than other two treatment regimens, which was associated with AKT-GSK3β-VEGF signaling pathway. Thus, we confirm that three delayed kallikrein treatments provide protection against cerebral infarction and furthermore suggest that kallikrein treatment starting at 8 h had a better effect than that at 24 h and 36 h. These findings provide the experimental data contributing to better clinical application of exogenous kallikrein.

Global exponential convergence of neutral-type Hopfield neural networks with multi-proportional delays and leakage delays

International Nuclear Information System (INIS)

Xu, Changjin; Li, Peiluan

2017-01-01

This paper is concerned with a class of neutral-type Hopfield neural networks with multi-proportional delays and leakage delays. Using the differential inequality theory, a set of sufficient conditions which guarantee that all solutions of neutral-type Hopfield neural networks with multi-proportional delays and leakage delays converge exponentially to zero vector are derived. Computer simulations are carried out to verify our theoretical findings. The obtained results of this paper are new and complement some previous studies.

Stressful life events predict delayed functional recovery following treatment for mania in bipolar disorder.

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Yan-Meier, Leslie; Eberhart, Nicole K; Hammen, Constance L; Gitlin, Michael; Sokolski, Kenneth; Altshuler, Lori

2011-04-30

Identifying predictors of functional recovery in bipolar disorder is critical to treatment efforts to help patients re-establish premorbid levels of role adjustment following an acute manic episode. The current study examined the role of stressful life events as potential obstacles to recovery of functioning in various roles. 65 patients with bipolar I disorder participated in a longitudinal study of functional recovery following clinical recovery from a manic episode. Stressful life events were assessed as predictors of concurrent vs. delayed recovery of role functioning in 4 domains (friends, family, home duties, work/school). Despite clinical recovery, a subset of patients experienced delayed functional recovery in various role domains. Moreover, delayed functional recovery was significantly associated with presence of one or more stressors in the prior 3 months, even after controlling for mood symptoms. Presence of a stressor predicted longer time to functional recovery in life domains, up to 112 days in work/school. Interventions that provide monitoring, support, and problem-solving may be needed to help prevent or mitigate the effects of stress on functional recovery. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Robust Moving Horizon H∞ Control of Discrete Time-Delayed Systems with Interval Time-Varying Delays

Directory of Open Access Journals (Sweden)

F. Yıldız Tascikaraoglu

2014-01-01

Full Text Available In this study, design of a delay-dependent type moving horizon state-feedback control (MHHC is considered for a class of linear discrete-time system subject to time-varying state delays, norm-bounded uncertainties, and disturbances with bounded energies. The closed-loop robust stability and robust performance problems are considered to overcome the instability and poor disturbance rejection performance due to the existence of parametric uncertainties and time-delay appeared in the system dynamics. Utilizing a discrete-time Lyapunov-Krasovskii functional, some delay-dependent linear matrix inequality (LMI based conditions are provided. It is shown that if one can find a feasible solution set for these LMI conditions iteratively at each step of run-time, then we can construct a control law which guarantees the closed-loop asymptotic stability, maximum disturbance rejection performance, and closed-loop dissipativity in view of the actuator limitations. Two numerical examples with simulations on a nominal and uncertain discrete-time, time-delayed systems, are presented at the end, in order to demonstrate the efficiency of the proposed method.

Exponential synchronization of two nonlinearly non-delayed and delayed coupled complex dynamical networks

International Nuclear Information System (INIS)

Zheng Song

2012-01-01

In this paper, the exponential synchronization between two nonlinearly coupled complex networks with non-delayed and delayed coupling is investigated with Lyapunov-Krasovskii-type functionals. Based on the stability analysis of the impulsive differential equation and the linear matrix inequality, sufficient delay-dependent conditions for exponential synchronization are derived, and a linear impulsive controller and simple updated laws are also designed. Furthermore, the coupling matrices need not be symmetric or irreducible. Numerical examples are presented to verify the effectiveness and correctness of the synchronization criteria obtained.

Novel delay-distribution-dependent stability analysis for continuous-time recurrent neural networks with stochastic delay

International Nuclear Information System (INIS)

Wang Shen-Quan; Feng Jian; Zhao Qing

2012-01-01

In this paper, the problem of delay-distribution-dependent stability is investigated for continuous-time recurrent neural networks (CRNNs) with stochastic delay. Different from the common assumptions on time delays, it is assumed that the probability distribution of the delay taking values in some intervals is known a priori. By making full use of the information concerning the probability distribution of the delay and by using a tighter bounding technique (the reciprocally convex combination method), less conservative asymptotic mean-square stable sufficient conditions are derived in terms of linear matrix inequalities (LMIs). Two numerical examples show that our results are better than the existing ones. (general)

Precision medicine of aneurysmal subarachnoid hemorrhage, vasospasm and delayed cerebral ischemia.

Science.gov (United States)

Burrell, Christian; Avalon, Nicole E; Siegel, Jason; Pizzi, Michael; Dutta, Tumpa; Charlesworth, M Cristine; Freeman, William D

2016-11-01

Precision medicine provides individualized treatment of diseases through leveraging patient-to-patient variation. Aneurysmal subarachnoid hemorrhage carries tremendous morbidity and mortality with cerebral vasospasm and delayed cerebral ischemia proving devastating and unpredictable. Lack of treatment measures for these conditions could be improved through precision medicine. Areas covered: Discussed are the pathophysiology of CV and DCI, treatment guidelines, and evidence for precision medicine used for prediction and prevention of poor outcomes following aSAH. A PubMed search was performed using keywords cerebral vasospasm or delayed cerebral ischemia and either biomarkers, precision medicine, metabolomics, proteomics, or genomics. Over 200 peer-reviewed articles were evaluated. The studies presented cover biomarkers identified as predictive markers or therapeutic targets following aSAH. Expert commentary: The biomarkers reviewed here correlate with CV, DCI, and neurologic outcomes after aSAH. Though practical use in clinical management of aSAH is not well established, using these biomarkers as predictive tools or therapeutic targets demonstrates the potential of precision medicine.

[Hyperthyroidism in the elderly: aspecific signs may cause a delay in diagnosis].

Science.gov (United States)

Rozendaal, F P

2005-05-01

The clinical manifestations of thyroid diseases in the elderly are often atypical and can easily be attributed to other medical conditions or 'normal aging'. Two nursing home patients with hyperthyroidism are described. Due to the atypical presentation of the thyroid disease their complaints were attributed to other conditions. In both patients there was a significant delay in diagnosis and treatment of hyperthyroidism. In elder patients signs and symptoms of thyreotoxicosis are frequently related to cardiovascular, gastrointestinal and neuropsychiatric disorders. Most often occur atrial fibrillation, worsening of cardiac failure and angina pectoris, weight loss, anorexia, constipation, cognitive impairment and delirium. Delay of diagnosis and treatment of hyperthyroidism may be potentially harmful to the patient. Untreated thyreotoxicosis may lead to serious cardiovasculair complications (particularly cardiac failure and cerebrovascular accidents), mental deterioration and osteoporosis. In elder people with unexplained and vague signs and symptoms thyroid function should always be checked. The TSH assay is a very accurate diagnostic test for screening thyroid function. A normal TSH indicates euthyroidism with an accuracy of almost 100%. The medical treatment for hyperthyreoidism in the elderly are antithyroid drugs. When an euthyroid state is rendered, suppletion with L-thyroxine may be nessecary. Radioactive iodine treatment is preferred in some cases though there may be practical difficulties with the application of this treatment in nursing home patients because temporary isolation is necessary.

Delayed Toxicity Associated with Soluble Anthrax Toxin Receptor Decoy-Ig Fusion Protein Treatment

Science.gov (United States)

Cote, Christopher; Welkos, Susan; Manchester, Marianne; Young, John A. T.

2012-01-01

Soluble receptor decoy inhibitors, including receptor-immunogloubulin (Ig) fusion proteins, have shown promise as candidate anthrax toxin therapeutics. These agents act by binding to the receptor-interaction site on the protective antigen (PA) toxin subunit, thereby blocking toxin binding to cell surface receptors. Here we have made the surprising observation that co-administration of receptor decoy-Ig fusion proteins significantly delayed, but did not protect, rats challenged with anthrax lethal toxin. The delayed toxicity was associated with the in vivo assembly of a long-lived complex comprised of anthrax lethal toxin and the receptor decoy-Ig inhibitor. Intoxication in this system presumably results from the slow dissociation of the toxin complex from the inhibitor following their prolonged circulation. We conclude that while receptor decoy-Ig proteins represent promising candidates for the early treatment of B. anthracis infection, they may not be suitable for therapeutic use at later stages when fatal levels of toxin have already accumulated in the bloodstream. PMID:22511955

Pinning synchronization of the complex networks with non-delayed and delayed coupling

International Nuclear Information System (INIS)

Guo Wanli; Austin, Francis; Chen Shihua; Sun Wen

2009-01-01

In this Letter, without assuming the symmetry of the coupling matrix, we investigate the global synchronization of the complex networks with non-delayed and delayed coupling based on the pinning controllers. Some sufficient conditions for the global synchronization by adding linear and adaptive feedback controllers to a part of nodes are obtained. Numerical examples are also provided to demonstrate the effectiveness of the theory.

[Re-bleeding predictors in patients with aneurysmal subarachnoid haemorrhage and delayed neurosurgical treatment].

Science.gov (United States)

Rivero Rodríguez, Dannys; Scherle Matamoros, Claudio; Fernández Cúe, Leda; Miranda Hernández, José Luis; Pernas Sánchez, Yanelis; Pérez Nellar, Jesús

2016-01-01

To evaluate the re-bleeding predictors in patients with delayed treatment of aneurysmal subarachnoid hemorrhage. A prospective cohort study enrolled 261 patients with aneurysmal subarachnoid hemorrhage, attending in Hermanos Ameijeiras Hospital from October 2005, and June 2014. An increased re-bleeding risk in the multivariate analysis was associated with grade III (OR 2.01; 95% CI; 1.06-3.84) and grade IV (OR 3.84; 95% CI; 2.06-7.31) on World Federation Neurological Surgeon (WFNS) scale; grade III (OR 2.04; 95% CI; 1.01-4.13) and grade IV (OR 2.12, 95% CI; 1.05-4.28) on the Fischer scale, aneurism location in posterior circulation (OR 2.45, 95% CI; 1.33-4.44), and anterior communicant artery (OR 1.57, 95% CI;1.00-2.46). Hypertension history was present in 60.9% (159 patients) and was also associated with risk of re-bleeding (OR 2.70, 95% CI; 1.00-7.30). Blood pressure, haematocrit, glycemic, aneurysm size, multiple aneurysms, and location in the middle cerebral artery, do not show any relationship. Hypertension history, poor grade (III and IV) on WFNS and Fisher scale and aneurysm location were independent risks factors of re-bleeding in patients with delayed aneurysmal treatment. Copyright © 2014 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

The neurobiology of thalamic amnesia: Contributions of medial thalamus and prefrontal cortex to delayed conditional discrimination.

Science.gov (United States)

Mair, Robert G; Miller, Rikki L A; Wormwood, Benjamin A; Francoeur, Miranda J; Onos, Kristen D; Gibson, Brett M

2015-07-01

Although medial thalamus is well established as a site of pathology associated with global amnesia, there is uncertainty about which structures are critical and how they affect memory function. Evidence from human and animal research suggests that damage to the mammillothalamic tract and the anterior, mediodorsal (MD), midline (M), and intralaminar (IL) nuclei contribute to different signs of thalamic amnesia. Here we focus on MD and the adjacent M and IL nuclei, structures identified in animal studies as critical nodes in prefrontal cortex (PFC)-related pathways that are necessary for delayed conditional discrimination. Recordings of PFC neurons in rats performing a dynamic delayed non-matching-to position (DNMTP) task revealed discrete populations encoding information related to planning, execution, and outcome of DNMTP-related actions and delay-related activity signaling previous reinforcement. Parallel studies recording the activity of MD and IL neurons and examining the effects of unilateral thalamic inactivation on the responses of PFC neurons demonstrated a close coupling of central thalamic and PFC neurons responding to diverse aspects of DNMTP and provide evidence that thalamus interacts with PFC neurons to give rise to complex goal-directed behavior exemplified by the DNMTP task. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effect of magnesium treatment and glucose levels on delayed cerebral ischemia in patients with subarachnoid hemorrhage: a substudy of the Magnesium in Aneurysmal Subarachnoid Haemorrhage trial (MASH-II).

Science.gov (United States)

Leijenaar, Jolien F; Dorhout Mees, Sanne M; Algra, Ale; van den Bergh, Walter M; Rinkel, Gabriel J E

2015-10-01

Magnesium treatment did not improve outcome in patients with aneurysmal subarachnoid haemorrhage in the Magnesium in Aneurysmal Subarachnoid Haemorrhage II trial. We hypothesized that high glucose levels may have offset a potential beneficial effect to prevent delayed cerebral ischemia. We investigated if magnesium treatment led to less delayed cerebral ischemia and if glucose levels interacted with magnesium treatment in the Magnesium in Aneurysmal Subarachnoid Haemorrhage II trial. To investigate the effect of magnesium treatment on occurrence of delayed cerebral ischemia and the interaction between glucose levels and magnesium treatment in subarachnoid hemorrhage patients. The Magnesium in Aneurysmal Subarachnoid Haemorrhage was a phase III randomized placebo-controlled trial assessing the effect of magnesium sulphate on clinical outcome in aneurysmal subarachnoid hemorrhage patients. For the current study, we included only the patients admitted to the University Medical Centre-Utrecht. We calculated hazard ratios for occurrence of delayed cerebral ischemia in patients treated with magnesium vs. placebo for the entire study population, and separately in the subgroups of patients with high and low mean fasting and mean daily glucose levels until onset of delayed cerebral ischemia. We used the cross-product of magnesium and glucose in the regression analysis to evaluate whether an interaction between magnesium and glucose existed. We included 616 patients: 307 received magnesium and 309 placebo; 156 patients had delayed cerebral ischemia. Hazard ratio for magnesium on occurrence of delayed cerebral ischemia was 1·0 (95% confidence interval: 0·7-1·4). Results were similar in patients with low or high fasting or daily glucose levels. We found no interactions between magnesium treatment and high fasting (P = 0·54) and daily glucose (P = 0·60). Magnesium treatment did not reduce the risk of delayed cerebral ischemia in patients with aneurysmal

Diagnosis delay in tuberculosis and its consequences

International Nuclear Information System (INIS)

Habibullah, S.; Sheikh, M.A.; Sadiq, A.; Anwar, T.

2004-01-01

Objective: To find out the average duration from onset of symptoms to the diagnosis and treatment of tuberculosis, reasons for diagnostic delay, its consequences, association of variables and formulation of recommendations. Results: In this study it was found that average time from onset of initial symptoms to diagnosis and treatment of tuberculosis was 120 days. In 64% of the patients medical practitioners were responsible for delaying the diagnosis of tuberculosis. Loss of weight in 40% and haemoptysis is 21% were the consequences of diagnostic delay of tuberculosis. Delay in the diagnosis of tuberculosis was statistically significant in those patients who consulted private practitioners, and consequences of tuberculosis were severe in those patients who consulted late. (author)

Effects of music therapy in the treatment of children with delayed speech development - results of a pilot study

Science.gov (United States)

2010-01-01

Background Language development is one of the most significant processes of early childhood development. Children with delayed speech development are more at risk of acquiring other cognitive, social-emotional, and school-related problems. Music therapy appears to facilitate speech development in children, even within a short period of time. The aim of this pilot study is to explore the effects of music therapy in children with delayed speech development. Methods A total of 18 children aged 3.5 to 6 years with delayed speech development took part in this observational study in which music therapy and no treatment were compared to demonstrate effectiveness. Individual music therapy was provided on an outpatient basis. An ABAB reversal design with alternations between music therapy and no treatment with an interval of approximately eight weeks between the blocks was chosen. Before and after each study period, a speech development test, a non-verbal intelligence test for children, and music therapy assessment scales were used to evaluate the speech development of the children. Results Compared to the baseline, we found a positive development in the study group after receiving music therapy. Both phonological capacity and the children's understanding of speech increased under treatment, as well as their cognitive structures, action patterns, and level of intelligence. Throughout the study period, developmental age converged with their biological age. Ratings according to the Nordoff-Robbins scales showed clinically significant changes in the children, namely in the areas of client-therapist relationship and communication. Conclusions This study suggests that music therapy may have a measurable effect on the speech development of children through the treatment's interactions with fundamental aspects of speech development, including the ability to form and maintain relationships and prosodic abilities. Thus, music therapy may provide a basic and supportive therapy for

Effects of music therapy in the treatment of children with delayed speech development - results of a pilot study

Directory of Open Access Journals (Sweden)

Linden Ulrike

2010-07-01

Full Text Available Abstract Background Language development is one of the most significant processes of early childhood development. Children with delayed speech development are more at risk of acquiring other cognitive, social-emotional, and school-related problems. Music therapy appears to facilitate speech development in children, even within a short period of time. The aim of this pilot study is to explore the effects of music therapy in children with delayed speech development. Methods A total of 18 children aged 3.5 to 6 years with delayed speech development took part in this observational study in which music therapy and no treatment were compared to demonstrate effectiveness. Individual music therapy was provided on an outpatient basis. An ABAB reversal design with alternations between music therapy and no treatment with an interval of approximately eight weeks between the blocks was chosen. Before and after each study period, a speech development test, a non-verbal intelligence test for children, and music therapy assessment scales were used to evaluate the speech development of the children. Results Compared to the baseline, we found a positive development in the study group after receiving music therapy. Both phonological capacity and the children's understanding of speech increased under treatment, as well as their cognitive structures, action patterns, and level of intelligence. Throughout the study period, developmental age converged with their biological age. Ratings according to the Nordoff-Robbins scales showed clinically significant changes in the children, namely in the areas of client-therapist relationship and communication. Conclusions This study suggests that music therapy may have a measurable effect on the speech development of children through the treatment's interactions with fundamental aspects of speech development, including the ability to form and maintain relationships and prosodic abilities. Thus, music therapy may provide a basic

Effects of music therapy in the treatment of children with delayed speech development - results of a pilot study.

Science.gov (United States)

Gross, Wibke; Linden, Ulrike; Ostermann, Thomas

2010-07-21

Language development is one of the most significant processes of early childhood development. Children with delayed speech development are more at risk of acquiring other cognitive, social-emotional, and school-related problems. Music therapy appears to facilitate speech development in children, even within a short period of time. The aim of this pilot study is to explore the effects of music therapy in children with delayed speech development. A total of 18 children aged 3.5 to 6 years with delayed speech development took part in this observational study in which music therapy and no treatment were compared to demonstrate effectiveness. Individual music therapy was provided on an outpatient basis. An ABAB reversal design with alternations between music therapy and no treatment with an interval of approximately eight weeks between the blocks was chosen. Before and after each study period, a speech development test, a non-verbal intelligence test for children, and music therapy assessment scales were used to evaluate the speech development of the children. Compared to the baseline, we found a positive development in the study group after receiving music therapy. Both phonological capacity and the children's understanding of speech increased under treatment, as well as their cognitive structures, action patterns, and level of intelligence. Throughout the study period, developmental age converged with their biological age. Ratings according to the Nordoff-Robbins scales showed clinically significant changes in the children, namely in the areas of client-therapist relationship and communication. This study suggests that music therapy may have a measurable effect on the speech development of children through the treatment's interactions with fundamental aspects of speech development, including the ability to form and maintain relationships and prosodic abilities. Thus, music therapy may provide a basic and supportive therapy for children with delayed speech development

Selective attention affects implicit and explicit memory for familiar pictures at different delay conditions.

Science.gov (United States)

Ballesteros, Soledad; Reales, José M; García, Eulalio; Carrasco, Marisa

2006-02-01

Three experiments investigated the effects of two variables -selective attention during encoding and delay between study and test- on implicit (picture fragment completion and object naming) and explicit (free recall and recognition) memory tests. Experiments 1 and 2 consistently indicated that (a) at all delays (immediate to 1 month), picture-fragment identification threshold was lower for the attended than the unattended pictures; (b) the attended pictures were recalled and recognized better than the unattended; and (c) attention and delay interacted in both memory tests. For implicit memory, performance decreased as delay increased for both attended and unattended pictures, but priming was more pronounced and lasted longer for the attended pictures; it was still present after a 1-month delay. For explicit memory, performance decreased as delay increased for attended pictures, but for unattended pictures performance was consistent throughout delay. By using a perceptual object naming task, Experiment 3 showed reliable implicit and explicit memory for attended but not for unattended pictures. This study indicates that picture repetition priming requires attention at the time of study and that neither delay nor attention dissociate performance in explicit and implicit memory tests; both types of memory require attention, but explicit memory does so to a larger degree.

Developmental delay

Science.gov (United States)

Nutrition support is essential for the care of the child with developmental delay. After a thorough evaluation, an individualized intervention plan that accounts for the child’s nutrition status, feeding ability, and medical condition may be determined. Nutrition assessments may be performed at leas...

A delay fractioning approach to global synchronization of delayed complex networks with stochastic disturbances

International Nuclear Information System (INIS)

Wang Yao; Wang Zidong; Liang Jinling

2008-01-01

In this Letter, the synchronization problem is investigated for a class of stochastic complex networks with time delays. By utilizing a new Lyapunov functional form based on the idea of 'delay fractioning', we employ the stochastic analysis techniques and the properties of Kronecker product to establish delay-dependent synchronization criteria that guarantee the globally asymptotically mean-square synchronization of the addressed delayed networks with stochastic disturbances. These sufficient conditions, which are formulated in terms of linear matrix inequalities (LMIs), can be solved efficiently by the LMI toolbox in Matlab. The main results are proved to be much less conservative and the conservatism could be reduced further as the number of delay fractioning gets bigger. A simulation example is exploited to demonstrate the advantage and applicability of the proposed result

Conditioned Side Effects Induced by Cancer Chemotherapy: Prevention Through Behavioral Treatment.

Science.gov (United States)

Burish, Thomas G.; And Others

1987-01-01

Studied cancer patients (N=24) in order to determine whether conditioned nausea and vomiting could be delayed or prevented. Indicated that patients receiving progressive muscle relaxation training and guided imagery had significantly less nausea and vomiting and significanty lower blood pressures, pulse rates, and dysphoria, especially anxiety,…

Effect of Processing Delay and Storage Conditions on Urine Albumin-to-Creatinine Ratio.

Science.gov (United States)

Herrington, William; Illingworth, Nicola; Staplin, Natalie; Kumar, Aishwarya; Storey, Ben; Hrusecka, Renata; Judge, Parminder; Mahmood, Maria; Parish, Sarah; Landray, Martin; Haynes, Richard; Baigent, Colin; Hill, Michael; Clark, Sarah

2016-10-07

Because there is substantial biologic intraindividual variation in albumin excretion, randomized trials of albuminuria-reducing therapies may need multiple urine samples to estimate daily urinary albumin excretion. Mailing spot urine samples could offer a convenient and cost-effective method to collect multiple samples, but urine albumin-to-creatinine ratio stability in samples stored at ambient temperatures for several days is unknown. Patients with kidney disease provided fresh urine samples in two tubes (with and without boric acid preservative). Reference aliquots from each participant were analyzed immediately, whereas remaining aliquots were subject to different handling/storage conditions before analysis, including delayed processing for up to 7 days at three different storage temperatures (4°C, 18°C, and 30°C), multiple freeze-thaw cycles, and long-term frozen storage at -80°C, -40°C, and -20°C. We calculated the mean percentage change in urine albumin-to-creatinine ratio for each condition, and we considered samples stable if the 95% confidence interval was within a ±5% threshold. Ninety-three patients provided samples with detectable albuminuria in the reference aliquot. Median (interquartile range) urine albumin-to-creatinine ratio was 87 (20-499) mg/g. The inclusion of preservative had minimal effect on fresh urine albumin-to-creatinine ratio measurements but reduced the changes in albumin and creatinine in samples subject to processing delay and storage conditions. The urine albumin-to-creatinine ratio was stable for 7 days in samples containing preservative at 4°C and 18°C and 2 days when stored at 30°C. It was also stable in samples with preservative after three freeze-thaw cycles and in frozen storage for 6 months at -80°C or -40°C but not at -20°C. Mailed urine samples collected with preservative and received within 7 days if ambient temperature is ≤18°C, or within 2 days if the temperature is higher but does not exceed 30°C, are

New Results on Passivity Analysis of Stochastic Neural Networks with Time-Varying Delay and Leakage Delay

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YaJun Li

2015-01-01

Full Text Available The passivity problem for a class of stochastic neural networks systems (SNNs with varying delay and leakage delay has been further studied in this paper. By constructing a more effective Lyapunov functional, employing the free-weighting matrix approach, and combining with integral inequality technic and stochastic analysis theory, the delay-dependent conditions have been proposed such that SNNs are asymptotically stable with guaranteed performance. The time-varying delay is divided into several subintervals and two adjustable parameters are introduced; more information about time delay is utilised and less conservative results have been obtained. Examples are provided to illustrate the less conservatism of the proposed method and simulations are given to show the impact of leakage delay on stability of SNNs.

Profitless delays for extinction in nonautonomous Lotka-Volterra system

Science.gov (United States)

Liu, Shengqiang; Chen, Lansun

2001-12-01

We study the delayed periodic n-species Lotka-Voterra systems where the growth rate of each species is not always positive. The sufficient conditions for the extinction that are independent of the delays are obtained. Some known results are improved and generalized. Our results suggest that under some conditions, the introduction and the variance of the time delays can be both harmless and profitless. Discussion about the effect of time delays on the extinction of the system is also advanced.

First treatment contact for ADHD: predictors of and gender differences in treatment seeking.

Science.gov (United States)

Dakwar, Elias; Levin, Frances R; Olfson, Mark; Wang, Shuai; Kerridge, Bradley; Blanco, Carlos

2014-12-01

For attention-deficit hyperactivity disorder (ADHD), treatment seeking is a critical first step in treatment initiation and remains insufficiently understood. The aims of this study were to estimate ADHD treatment-seeking probabilities over the lifetime and to identify predictors of treatment seeking for ADHD separately for males and females. Data were drawn from 2001 to 2005 as part of the National Epidemiologic Survey on Alcohol and Related Conditions, a two-wave face-to-face survey conducted by the National Institute on Alcohol Abuse and Alcoholism (N=34,653). The lifetime cumulative probability of ADHD treatment seeking was estimated at 55%. Males identifying as African American, with less than 12 years of education, or paranoid personality disorder or in an older cohort (>30 years old) at the time of interview were more likely to experience delays, whereas males with comorbid alcohol dependence, dysthymic disorder, borderline personality disorder, or histrionic personality disorder were less likely. Among females, older age (>44 years) was the only predictor of a delay to first treatment seeking, whereas bipolar disorder was associated with more rapid treatment seeking. Age of onset had opposite effects on treatment-seeking delays by gender; males but not females with early-onset ADHD were more likely to experience treatment-seeking delays. A large proportion of persons with ADHD do not seek treatment. Furthermore, treatment seeking by males was affected by a greater number of identifiable characteristics, suggesting that males might be more responsive to efforts directed toward expediting treatment entry. Future research should explore how to facilitate early access to treatment for individuals with ADHD.

A STUDY OF IMPACT OF DETERMINANTS OF PATIENTS AND HEALTH SYSTEM DELAY ON TUBERCULOSIS DIAGNOSIS AND TREATMENT IN BANGALORE

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Jagadish Siddalinga Devaru

2013-01-01

Full Text Available Setting: TU/DMCs of Bangalore city. India. All new sputum positive patients registered to the selected TU/DMCs were interviewed. A total of 468 patients aged above 20 years were enrolled. The study period was from January to June 2009. Objectives: To track the delay in diagnosis and treatment of patients reporting to tuberculosis units and microscopy centers. Design: A cross sectional study. TU/DMCs were randomly selected. A pretested questionnaire was administered to collect data. Results: The study population had 326 (69.7% males. The mean age of study population was 38.5 years. 74.4% were married, 20.7% were illiterates, 27.8% were daily wagers, 10.5% were unemployed. The median and mean total delays from development of cough to diagnosis were 41 days and 36.04 days; the median and mean patient delay was 24 days and 20.7 days, and health system delay was 18 and 15.31 days respectively. There was a significant difference among the different age group of patients with older people having longer patient delay (p<0.0001. Lower income, illiteracy, unemployment, showed significant association with patients delay (p<0.0001. Alcohol intake and smoking habit among the male patients had significant association for longer patient delay (p=0.00004. Health seeking behavior like self medication, also had longer patient delay. Other socio demographic factors had no significant influence on the patient delay. Longer health system delay was found among patients who visited general practitioners and Ayurvedic medicine. Conclusion: More specific and effective health education of the general public on tuberculosis and seeking of appropriate medical consultation are likely to improve case detection.

A STUDY OF IMPACT OF DETERMINANTS OF PATIENTS AND HEALTH SYSTEM DELAY ON TUBERCULOSIS DIAGNOSIS AND TREATMENT IN BANGALORE

Directory of Open Access Journals (Sweden)

Jagadish Siddalinga Devaru

2012-12-01

Full Text Available Setting: TU/DMCs of Bangalore city. India. All new sputum positive patients registered to the selected TU/DMCs were interviewed. A total of 468 patients aged above 20 years were enrolled. The study period was from January to June 2009. Objectives: To track the delay in diagnosis and treatment of patients reporting to tuberculosis units and microscopy centers. Design: A cross sectional study. TU/DMCs were randomly selected. A pretested questionnaire was administered to collect data. Results: The study population had 326 (69.7% males. The mean age of study population was 38.5 years. 74.4% were married, 20.7% were illiterates, 27.8% were daily wagers, 10.5% were unemployed. The median and mean total delays from development of cough to diagnosis were 41 days and 36.04 days; the median and mean patient delay was 24 days and 20.7 days, and health system delay was 18 and 15.31 days respectively. There was a significant difference among the different age group of patients with older people having longer patient delay (p<0.0001. Lower income, illiteracy, unemployment, showed significant association with patients delay (p<0.0001. Alcohol intake and smoking habit among the male patients had significant association for longer patient delay (p=0.00004. Health seeking behavior like self medication, also had longer patient delay. Other socio demographic factors had no significant influence on the patient delay. Longer health system delay was found among patients who visited general practitioners and Ayurvedic medicine. Conclusion: More specific and effective health education of the general public on tuberculosis and seeking of appropriate medical consultation are likely to improve case detection.

The effect of duration of untreated psychosis and treatment delay on the outcomes of prolonged early intervention in psychotic disorders.

Science.gov (United States)

Albert, Nikolai; Melau, Marianne; Jensen, Heidi; Hastrup, Lene Halling; Hjorthøj, Carsten; Nordentoft, Merete

2017-09-26

The duration of untreated psychosis (DUP) has been shown to have an effect on outcome after first-episode psychosis. The premise of specialized early intervention (SEI) services is that intervention in the early years of illness can affect long-term outcomes. In this study, we investigate whether DUP affects treatment response after 5 years of SEI treatment compared to 2 years of SEI treatment. As part of a randomized controlled trial testing the effect of prolonged SEI treatment 400 participants diagnosed within the schizophrenia spectrum were recruited. For this specific study participants were dichotomized based on DUP, treatment delay, and time from first symptom until start of SEI treatment. The groups were analyzed with regard to treatment response on psychopathology, level of functioning, and cognitive functioning. The participants with a short DUP had a tendency to respond better to the prolonged treatment with regards to disorganized and negative dimension. For participants with short duration from first symptom until start of SEI treatment there was a significant difference on the negative dimension favoring the prolonged OPUS treatment. The finding of an effect of prolonged treatment for participants with a short total treatment delay could mean that prolonged SEI treatment is more beneficial than treatment as usual (TAU) so long as it is provided in the early years of illness and not just in the early years after diagnosis. THE EARLIER THE BETTER: The duration of untreated psychosis influences the long-term outcomes of treatment. Nikolai Albert, at the Copenhagen Mental Health Centre, and a team of Danish researchers have investigated the effects of a specialized early intervention program (OPUS) in 400 patients diagnosed with schizophrenia spectrum disorders and compared the effects of OPUS after two and five years. Their findings suggest that five years of specialized early intervention was most beneficial when the total duration from symptom start to

Variables influencing delay in antenatal clinic attendance among ...

African Journals Online (AJOL)

A delay in deciding to seek antenatal care is predominant among pregnant teenagers in Lesotho. This subsequently leads to delay in reaching treatment and in receiving adequate treatment. Early antenatal care attendance plays a major role in detecting and treating complications of pregnancy and forms a good basis for ...

Surgical treatment of delayed radiation effects in the skin and its indication

International Nuclear Information System (INIS)

Tilkorn, H.; Drepper, H.

1987-01-01

Since 1960 a total of 1200 patients with skin disease as delayed radiation effects were treated at the Hornheide special clinic, 40% of whom received plastic surgery. This requires knowledge of the type of radiation applied and when it was applied, additional harmful influences, exposure, differentiation in cases of ulcers between primary, cumulative, and combination effect, early radiation effects, and late radiation effects. Secondary factors leading possibly to necrosis may be: recidivation of the primary tumours, benign or malignant neoplasms, traumatic injuries such as injections, sampling, tight clothing, chemical factors like therapeuticals for local application, allergies, infections of the skin with bacteria or fungi, osteomyelitis, non-infections skin disease, and internal disease. A precondition for successful dermatological and surgical treatment are a careful review of the previous case history and exact diagnosis. Some clinical cases serve to illustrate the theoretical explanations and point out possibilities for surgical treatment. (TRV) [de

Effect of Aegle marmelos and Murraya koenigii in treatment of delayed pubertal buffaloes heifers

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Mohan M. Baitule

2016-12-01

Full Text Available Aim: This study aims to study the estrus induction, ovulation, and conception rate of delayed puberty in buffaloes heifers by feeding a herbal plants Aegle marmelos (bael/bili/bhel leaf and Murraya koenigii (Curry leaf. Materials and Methods: Totally, 24 buffalo heifers with delayed puberty were selected for the present study and divided randomly in four equal groups (n=6. Before experiment, all animals were dewormed with albendazole at 10 mg/kg body weight to prevent them from the stress of parasitism. In the present experiment, four group taken and Group I (n=6 treated with A. marmelos, Group II (n=6 treated with M. koenigii, Group III (n=6 treated with mixture of A. marmelos and M. koenigii and fed for 9 days. Group IV (n=6 considered as control and fed with concentrate only. The blood samples were collected from all the animals on day 0 (before treatment, 4, 9 (during treatment, on the day of estrus and day 8 after the onset of estrus. The 10 ml blood was collected from the jugular vein of all the experimental animals for estimation of serum calcium, inorganic phosphorus, and progesterone (P4. The estrus response, ovulation, conception rate along with serum calcium, inorganic phosphorus, and progesterone level were determined by the standard protocol. Results: From Group III 4 heifers, from Group II 3 heifers, and from Group I and IV (Control 2 heifers each, exhibited the estrus. The estrus response was recorded as 33.33%, 50.00%, 75.00%, and 33.33% in Group I, Group II, Group III, and Group IV, respectively. In treatment Group III, serum calcium found significantly more (p<0.05 on day 8 post-estrus as compared to other groups at a similar interval. Inorganic phosphorus and progesterone show no significant difference between groups. The ovulation and conception rates are comparatively better in Group III (75% buffalo heifers than other groups. Conclusion: Herbal supplementation of A. marmelos and M. koenigii in combination, as well as M

Classical conditioning in the treatment of psoriasis.

Science.gov (United States)

Ader, R

2000-11-01

It has been argued that the placebo effect represents a learned response. Research is suggested to address the utility of applying principles derived from classical (Pavlovian) conditioning to the design of drug treatment protocols. In the present instance, it is hypothesized that, by capitalizing on conditioned pharmacotherapeutic responses, it may be possible to reduce the cumulative amount of corticosteroid medication used in the treatment of psoriasis.

An experimental field study of delayed density dependence in natural populations of Aedes albopictus.

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Rachael K Walsh

Full Text Available Aedes albopictus, a species known to transmit dengue and chikungunya viruses, is primarily a container-inhabiting mosquito. The potential for pathogen transmission by Ae. albopictus has increased our need to understand its ecology and population dynamics. Two parameters that we know little about are the impact of direct density-dependence and delayed density-dependence in the larval stage. The present study uses a manipulative experimental design, under field conditions, to understand the impact of delayed density dependence in a natural population of Ae. albopictus in Raleigh, North Carolina. Twenty liter buckets, divided in half prior to experimentation, placed in the field accumulated rainwater and detritus, providing oviposition and larval production sites for natural populations of Ae. albopictus. Two treatments, a larvae present and larvae absent treatment, were produced in each bucket. After five weeks all larvae were removed from both treatments and the buckets were covered with fine mesh cloth. Equal numbers of first instars were added to both treatments in every bucket. Pupae were collected daily and adults were frozen as they emerged. We found a significant impact of delayed density-dependence on larval survival, development time and adult body size in containers with high larval densities. Our results indicate that delayed density-dependence will have negative impacts on the mosquito population when larval densities are high enough to deplete accessible nutrients faster than the rate of natural food accumulation.

Delay-Range-Dependent H∞ Control for Automatic Mooring Positioning System with Time-Varying Input Delay

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Xiaoyu Su

2014-01-01

Full Text Available Aiming at the economy and security of the positioning system in semi-submersible platform, the paper presents a new scheme based on the mooring line switching strategy. Considering the input delay in switching process, H∞ control with time-varying input delay is designed to calculate the control forces to resist disturbing forces. In order to reduce the conservativeness, the information of the lower bound of delay is taken into account, and a Lyapunov function which contains the range of delay is constructed. Besides, the input constraint is considered to avoid breakage of mooring lines. The sufficient conditions for delay-range-dependent stabilization are derived in terms of LMI, and the controller is also obtained. The effectiveness of the proposed approach is illustrated by a realistic design example.

Toxicity profile and treatment delays in NOPHO ALL2008-comparing adults and children with Philadelphia chromosome-negative acute lymphoblastic leukemia.

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Toft, Nina; Birgens, Henrik; Abrahamsson, Jonas; Griškevičius, Laimonas; Hallböök, Helene; Heyman, Mats; Klausen, Tobias Wirenfeldt; Jónsson, Ólafur Gísli; Palk, Katrin; Pruunsild, Kaie; Quist-Paulsen, Petter; Vaitkeviciene, Goda; Vettenranta, Kim; Asberg, Ann; Helt, Louise Rold; Frandsen, Thomas; Schmiegelow, Kjeld

2016-02-01

Cure rates improve when adolescents and young adults with acute lymphoblastic leukemia (ALL) are treated according to pediatric protocols. Assumed risks of toxicities and associated delays in treatment have played a role in setting upper age limits. The aim of this study was to examine the toxicity profile and treatment delays in NOPHO ALL2008 comparing children and adults. We collected information on 19 treatment-related toxicities, systematically captured at 3-month intervals throughout therapy, and time intervals between 12 consecutive treatment phases for 1076 patients aged 1-45 yrs treated according to the Nordic/Baltic ALL2008 protocol. No adults died during induction. The duration of induction therapy and postinduction treatment phases did not differ between children and adults, except for patients 18-45 yrs being significantly delayed during two of nine high-risk blocks (median number of days for patients 1-9, 10-17, and 18-45 yrs; the glucocorticosteroid/antimetabolite-based block B1: 24, 26, and 29 d, respectively, P = 0.001, and Block 5 (in most cases also a B block): 29, 29, and 37 d, respectively, P = 0.02). A higher incidence of thrombosis with increasing age was found; highest odds ratio 5.4 (95% CI: (2.6;11.0)) for patients 15-17 yrs compared with children 1-9 yrs (P children, although thrombosis and avascular osteonecrosis was most common among adolescents. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Deep cerebellar nuclei play an important role in two-tone discrimination on delay eyeblink conditioning in C57BL/6 mice.

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Toshiro Sakamoto

Full Text Available Previous studies have shown that deep cerebellar nuclei (DCN-lesioned mice develop conditioned responses (CR on delay eyeblink conditioning when a salient tone conditioned stimulus (CS is used, which suggests that the cerebellum potentially plays a role in more complicated cognitive functions. In the present study, we examined the role of DCN in tone frequency discrimination in the delay eyeblink-conditioning paradigm. In the first experiment, DCN-lesioned and sham-operated mice were subjected to standard simple eyeblink conditioning under low-frequency tone CS (LCS: 1 kHz, 80 dB or high-frequency tone CS (HCS: 10 kHz, 70 dB conditions. DCN-lesioned mice developed CR in both CS conditions as well as sham-operated mice. In the second experiment, DCN-lesioned and sham-operated mice were subjected to two-tone discrimination tasks, with LCS+ (or HCS+ paired with unconditioned stimulus (US, and HCS- (or LCS- without US. CR% in sham-operated mice increased in LCS+ (or HCS+ trials, regardless of tone frequency of CS, but not in HCS- (or LCS- trials. The results indicate that sham-operated mice can discriminate between LCS+ and HCS- (or HCS+ and LCS-. In contrast, DCN-lesioned mice showed high CR% in not only LCS+ (or HCS+ trials but also HCS- (or LCS- trials. The results indicate that DCN lesions impair the discrimination between tone frequency in eyeblink conditioning. Our results suggest that the cerebellum plays a pivotal role in the discrimination of tone frequency.

Lag synchronization of chaotic systems with time-delayed linear ...

Indian Academy of Sciences (India)

delayed linear terms via impulsive control is investigated. Based on the stability theory of impulsive delayed differen- tial equations, some sufficient conditions are obtained guaranteeing the synchronized behaviours between two delayed chaotic ...

Treatment and conditioning of solid and liquid raw

International Nuclear Information System (INIS)

Jakubec, R.

2015-01-01

Jadrova a vyradovacia spolocnost, a.s. (JAVYS) implements activities within the processes of treatment and conditioning of radioactive waste (RAW) at two nuclear facilities, one of them located in Bohunice - Technologies for treatment and conditioning of RAW. This nuclear facility includes: Bohunice RAW treatment centre, bituminization lines, waste water purification station and technologies for sorting, fragmentation and decontamination of metallic RAW. The Bohunice RAW treatment centre (BRTC) in Bohunice processes and conditions liquid and solid radioactive waste produced during the A1 NPP and V1 NPP decommissioning, waste from the operation of V2 NPP in Bohunice as well as from the operation of NPP EMO 1,2 in Mochovce. The BRTC includes the following technological facilities: sorting, high-pressure compaction, incineration, concentration and cementation. Treatment of radioactive wastes in the BRTC is described. (authors)

Power conditioning accessories. Construction of a delayed drop-out relay and test of constant voltage transformers

International Nuclear Information System (INIS)

Keroe, E.; Kaufmann, H.; Koeck, J.; Scarpatetti, R.; Vuister, P.

1983-10-01

A delayed drop-out relay aimed to protect electronic measuring equipment during voltage fluctuations and power failures and transients is described. The results of a test on the performance of three resonant voltage transformers (GOULD GT 3000, CVT Isoreg 15-025 and Philips 1412/00) coupled with this relay, are presented. It is found that with this set-up, instrument malfunction and breakdown can be effectively prevented under the normal power conditions met in European countries or the USA. Under more severe conditions, usually met in the developing countries, a more careful selection has to be made; the test recommends the Philips transformer. It is also recommended that for best results the constant voltage transformers should be used at 75-80% of their rated power

The identification of risk factors associated with patient and healthcare system delays in the treatment of tuberculosis in Tabriz, Iran.

Science.gov (United States)

Ebrahimi Kalan, Mohammad; Yekrang Sis, Hassan; Kelkar, Vinaya; Harrison, Scott H; Goins, Gregory D; Asghari Jafarabadi, Mohammad; Han, Jian

2018-01-24

Tuberculosis (TB) is a serious health concern, particularly in developing countries. Various delays, such as patient delay (PD) and healthcare system delay (HSD) in the TB process, are exacerbating the disease burden and increasing the rates of transmission and mortality in various global communities. Therefore, the aim of this study is to identify risk factors associated with PD and HSD in TB patients in Tabriz, Iran. A cross-sectional study was conducted on 173 TB patients in Tabriz, Iran from 2012 to 2014. Patients were interviewed with a semi-structured questionnaire. Frequencies and percentages were reported for patient categories of sex, age, and education. The median and interquartile range (IQR) were reported for the time intervals of delays. Univariate and multivariate logistic regressions of delay in respect to socio-demographic and clinical variables were performed. Statistical significance was set at p patients during their initial visit to the health care facilities. The knowledge generated from this study will be helpful for prioritizing and developing strategies for minimizing delays, initiating early treatment to TB patients, and improving TB-related training programs and healthcare systems in Tabriz, Iran.

Robust Synchronization of Delayed Chaotic FitzHugh-Nagumo Neurons under External Electrical Stimulation

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Muhammad Rehan

2012-01-01

Full Text Available Synchronization of chaotic neurons under external electrical stimulation (EES is studied in order to understand information processing in the brain and to improve the methodologies employed in the treatment of cognitive diseases. This paper investigates the dynamics of uncertain coupled chaotic delayed FitzHugh-Nagumo (FHN neurons under EES for incorporated parametric variations. A global nonlinear control law for synchronization of delayed neurons with known parameters is developed. Based on local and global Lipschitz conditions, knowledge of the bounds on the neuronal states, the Lyapunov-Krasovskii functional, and the L2 gain reduction, a less conservative local robust nonlinear control law is formulated to address the problem of robust asymptotic synchronization of delayed FHN neurons under parametric uncertainties. The proposed local control law guarantees both robust stability and robust performance and provides the L2 bound for uncertainty rejection in the synchronization error dynamics. Separate conditions for single-input and multiple-input control schemes for synchronization of a wide class of FHN systems are provided. The results of the proposed techniques are verified through numerical simulations.

Delay-Dependent Asymptotic Stability of Cohen-Grossberg Models with Multiple Time-Varying Delays

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Xiaofeng Liao

2007-01-01

Full Text Available Dynamical behavior of a class of Cohen-Grossberg models with multiple time-varying delays is studied in detail. Sufficient delay-dependent criteria to ensure local and global asymptotic stabilities of the equilibrium of this network are derived by constructing suitable Lyapunov functionals. The obtained conditions are shown to be less conservative and restrictive than those reported in the known literature. Some numerical examples are included to demonstrate our results.

Maternal prepregnancy obesity and insulin treatment during pregnancy are independently associated with delayed lactogenesis in women with recent gestational diabetes mellitus.

Science.gov (United States)

Matias, Susana L; Dewey, Kathryn G; Quesenberry, Charles P; Gunderson, Erica P

2014-01-01

The timely onset of stage II lactogenesis (OL) is important for successful breastfeeding and newborn health. Several risk factors for delayed OL are common in women with a history of gestational diabetes mellitus (GDM), which may affect their chances for successful breastfeeding outcomes. We investigated the prevalence and risk factors associated with delayed OL in a racially and ethnically diverse cohort of postpartum women with recent GDM. We analyzed data collected in the Study of Women, Infant Feeding and Type 2 Diabetes After GDM Pregnancy (SWIFT), which is a prospective cohort of women diagnosed with GDM who delivered at Kaiser Permanente Northern California hospitals from 2008 to 2011. At 6-9 wk postpartum, delayed OL was assessed by maternal report of breast fullness and defined as occurring after 72 h postpartum. We obtained data on prenatal course and postdelivery infant feeding practices from electronic medical records and in-person surveys. We used multivariable logistic regression models to estimate associations of delayed OL with prenatal, delivery, and postnatal characteristics. The analysis included 883 SWIFT participants who initiated breastfeeding and did not have diabetes at 6-9 wk postpartum. Delayed OL was reported by 33% of women and was associated with prepregnancy obesity (OR: 1.56; 95% CI: 1.07, 2.29), older maternal age (OR: 1.05; 95% CI: 1.01, 1.08), insulin GDM treatment (OR: 3.11; 95% CI: 1.37, 7.05), and suboptimal in-hospital breastfeeding (OR: 1.65; 95% CI: 1.20, 2.26). A higher gestational age was associated with decreased odds of delayed OL but only in multiparous mothers (OR: 0.79; 95% CI: 0.67, 0.94). One-third of women with recent GDM experienced delayed OL. Maternal obesity, insulin treatment, and suboptimal in-hospital breastfeeding were key risk factors for delayed OL. Early breastfeeding support for GDM women with these risk factors may be needed to ensure successful lactation. This trial was registered at clinicaltrials

Delay-dependent exponential stability for neural networks with discrete and distributed time-varying delays

International Nuclear Information System (INIS)

Zhu Xunlin; Wang Youyi

2009-01-01

This Letter studies the exponential stability for a class of neural networks (NNs) with both discrete and distributed time-varying delays. Under weaker assumptions on the activation functions, by defining a more general type of Lyapunov functionals and developing a new convex combination technique, new less conservative and less complex stability criteria are established to guarantee the global exponential stability of the discussed NNs. The obtained conditions are dependent on both discrete and distributed delays, are expressed in terms of linear matrix inequalities (LMIs), and contain fewer decision variables. Numerical examples are given to illustrate the effectiveness and the less conservatism of the proposed conditions.

Adaptive control of chaotic continuous-time systems with delay

Science.gov (United States)

Tian, Yu-Chu; Gao, Furong

1998-06-01

A simple delay system governed by a first-order differential-delay equation may behave chaotically, but the conditions for the system to have such behaviors have not been well recognized. In this paper, a set of rules is postulated first for the conditions for the delay system to display chaos. A model-reference adaptive control scheme is then proposed to control the chaotic system state to converge to an arbitrarily given reference trajectory with certain and uncertain system parameters. Numerical examples are given to analyze the chaotic behaviors of the delay system and to demonstrate the effectiveness of the proposed adaptive control scheme.

Enhancement of delay eyelid conditioning by microcurrent electrical stimulation of the medial prefrontal cortex is triggered by the expression of Fos protein in guinea pigs.

Science.gov (United States)

Zheng, Ya-Juan; Dong, Yu-Chen; Zhu, Chao; Zhao, Mei-Sheng

2016-03-01

Eyelid conditioning, including delay eyelid conditioning and trace eyelid conditioning, has been used extensively to study neural structures and mechanisms of learning and memory as a form of associative learning. In the present study, microcurrent electrical stimulation was used to stimulate the medial prefrontal cortex (mPFC) to induce delay eyelid conditioning in guinea pigs. The acquisition rate and relative latency of the conditioned eyelid response (CR) and the startle eyelid response (SR) were analyzed. The mPFC sites in the guinea pigs were examined under a light microscope following Nissl staining. In addition, the expression of Fos protein in neurons was detected using immunohistochemistry and western blot analysis. The results indicated that the acquisition rates of CR and SR were increased significantly (Pmicrocurrent electrical stimulation of the mPFC in guinea pigs was triggered by the expression of Fos protein. The observations of the present study further expand the understanding of conditioned reflexes and may aid future investigations into the formation of eyelid conditioning and the mechanisms underlying the circuit in various conditions.

Effect of Processing Delay and Storage Conditions on Urine Albumin-to-Creatinine Ratio

Science.gov (United States)

Illingworth, Nicola; Staplin, Natalie; Kumar, Aishwarya; Storey, Ben; Hrusecka, Renata; Judge, Parminder; Mahmood, Maria; Parish, Sarah; Landray, Martin; Haynes, Richard; Baigent, Colin; Hill, Michael; Clark, Sarah

2016-01-01

Background and objectives Because there is substantial biologic intraindividual variation in albumin excretion, randomized trials of albuminuria-reducing therapies may need multiple urine samples to estimate daily urinary albumin excretion. Mailing spot urine samples could offer a convenient and cost-effective method to collect multiple samples, but urine albumin-to-creatinine ratio stability in samples stored at ambient temperatures for several days is unknown. Design, setting, participants, & measurements Patients with kidney disease provided fresh urine samples in two tubes (with and without boric acid preservative). Reference aliquots from each participant were analyzed immediately, whereas remaining aliquots were subject to different handling/storage conditions before analysis, including delayed processing for up to 7 days at three different storage temperatures (4°C, 18°C, and 30°C), multiple freeze-thaw cycles, and long–term frozen storage at −80°C, −40°C, and −20°C. We calculated the mean percentage change in urine albumin-to-creatinine ratio for each condition, and we considered samples stable if the 95% confidence interval was within a ±5% threshold. Results Ninety-three patients provided samples with detectable albuminuria in the reference aliquot. Median (interquartile range) urine albumin-to-creatinine ratio was 87 (20–499) mg/g. The inclusion of preservative had minimal effect on fresh urine albumin-to-creatinine ratio measurements but reduced the changes in albumin and creatinine in samples subject to processing delay and storage conditions. The urine albumin-to-creatinine ratio was stable for 7 days in samples containing preservative at 4°C and 18°C and 2 days when stored at 30°C. It was also stable in samples with preservative after three freeze-thaw cycles and in frozen storage for 6 months at −80°C or −40°C but not at −20°C. Conclusions Mailed urine samples collected with preservative and received within 7 days if

Synchronization of nonidentical chaotic neural networks with leakage delay and mixed time-varying delays

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Cao Jinde

2011-01-01

Full Text Available Abstract In this paper, an integral sliding mode control approach is presented to investigate synchronization of nonidentical chaotic neural networks with discrete and distributed time-varying delays as well as leakage delay. By considering a proper sliding surface and constructing Lyapunov-Krasovskii functional, as well as employing a combination of the free-weighting matrix method, Newton-Leibniz formulation and inequality technique, a sliding mode controller is designed to achieve the asymptotical synchronization of the addressed nonidentical neural networks. Moreover, a sliding mode control law is also synthesized to guarantee the reachability of the specified sliding surface. The provided conditions are expressed in terms of linear matrix inequalities, and are dependent on the discrete and distributed time delays as well as leakage delay. A simulation example is given to verify the theoretical results.

Heroin delay discounting: Modulation by pharmacological state, drug-use impulsivity, and intelligence.

Science.gov (United States)

Stoltman, Jonathan J K; Woodcock, Eric A; Lister, Jamey J; Lundahl, Leslie H; Greenwald, Mark K

2015-12-01

Delay discounting (DD) refers to how rapidly an individual devalues goods based on delays to receipt. DD usually is considered a trait variable but can be state dependent, yet few studies have assessed commodity valuation at short, naturalistically relevant time intervals that might enable state-dependent analysis. This study aimed to determine whether drug-use impulsivity and intelligence influence heroin DD at short (ecologically relevant) delays during two pharmacological states (heroin satiation and withdrawal). Out-of-treatment, intensive heroin users (n = 170; 53.5% African American; 66.7% male) provided complete DD data during imagined heroin satiation and withdrawal. Delays were 3, 6, 12, 24, 48, 72, and 96 hours; maximum delayed heroin amount was thirty $10 bags. Indifference points were used to calculate area under the curve (AUC). We also assessed drug-use impulsivity (subscales from the Impulsive Relapse Questionnaire [IRQ]) and estimated intelligence (Shipley IQ) as predictors of DD. Heroin discounting was greater (smaller AUC) during withdrawal than satiation. In regression analyses, lower intelligence and IRQ Capacity for Delay as well as higher IRQ Speed (to return to drug use) predicted greater heroin discounting in the satiation condition. Lower intelligence and higher IRQ Speed predicted greater discounting in the withdrawal condition. Sex, race, substance use variables, and other IRQ subscales were not significantly related to the withdrawal or satiation DD behavior. In summary, heroin discounting was temporally rapid, pharmacologically state dependent, and predicted by drug-use impulsivity and estimated intelligence. These findings highlight a novel and sensitive measure of acute DD that is easy to administer. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Hyperactivity and frustration: the influence of control over and size of rewards in delaying gratification.

Science.gov (United States)

Rapport, M D; Tucker, S B; DuPaul, G J; Merlo, M; Stoner, G

1986-06-01

This study examined the differential effects of frustration on normal children and those diagnosed as having Attention Deficit Disorder with Hyperactivity. Each group consisted of 16 boys between the ages of 6 and 8 years who were prematched for age, grade, and classroom placement. All children completed a series of arithmetic problems in order to earn toy rewards. Using a variant of Mischel's (1974) delay-of-gratification paradigm, children were presented with two choice-of-delay conditions in a randomly assigned, counterbalanced sequence: a free-choice conflict situation involving a long-passive or short-active reward delay, and a short-active delay. Results showed that a significantly greater proportion of hyperactive children chose to complete problems for an immediate reward compared to their normal control counterparts (p less than .01). Group differences were no longer apparent in the short-active delay trial. The results are discussed in terms of frustration tolerance and contributing factors such as cognitive-attentional style. Implications for treatment and future directions are delineated.

Exponential Antisynchronization Control of Stochastic Memristive Neural Networks with Mixed Time-Varying Delays Based on Novel Delay-Dependent or Delay-Independent Adaptive Controller

Directory of Open Access Journals (Sweden)

Minghui Yu

2017-01-01

Full Text Available The global exponential antisynchronization in mean square of memristive neural networks with stochastic perturbation and mixed time-varying delays is studied in this paper. Then, two kinds of novel delay-dependent and delay-independent adaptive controllers are designed. With the ability of adapting to environment changes, the proposed controllers can modify their behaviors to achieve the best performance. In particular, on the basis of the differential inclusions theory, inequality theory, and stochastic analysis techniques, several sufficient conditions are obtained to guarantee the exponential antisynchronization between the drive system and response system. Furthermore, two numerical simulation examples are provided to the validity of the derived criteria.

Delayed Face Recognition in Children and Adolescents with Autism Spectrum Disorders

Directory of Open Access Journals (Sweden)

Zahra Shahrivar

2012-06-01

Full Text Available Objective: Children with autism spectrum disorders (ASDs have great problems in social interactions including face recognition. There are many studies reporting deficits in face memory in individuals with ASDs. On the other hand, some studies indicate that this kind of memory is intact in this group. In the present study, delayed face recognition has been investigated in children and adolescents with ASDs compared to the age and sex matched typically developing group.Methods: In two sessions, Benton Facial Recognition Test was administered to 15 children and adolescents with ASDs (high functioning autism and Asperger syndrome and to 15 normal participants, ages 8-17 years. In the first condition, the long form of Benton Facial Recognition Test was used without any delay. In the second session, this test was administered with 15 seconds delay after one week. The reaction times and correct responses were measured in both conditions as the dependent variables.Results: Comparison of the reaction times and correct responses in the two groups revealed no significant difference in delayed and non-delayed conditions. Furthermore, no significant difference was observed between the two conditions in ASDs patients when comparing the variables. Although a significant correlation (p<0.05 was found between delayed and non-delayed conditions, it was not significant in the normal group. Moreover, data analysis revealed no significant difference between the two groups in the two conditions when the IQ was considered as covariate. Conclusion: In this study, it was found that the ability to recognize faces in simultaneous and delayed conditions is similar between adolescents with ASDs and their normal counterparts.

Passivity analysis and synthesis for uncertain time-delay systems

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Magdi S. Mahmoud

2001-01-01

Full Text Available In this paper, we investigate the robust passivity analysis and synthesis problems for a class of uncertain time-delay systems. This class of systems arises in the modelling effort of studying water quality constituents in fresh stream. For the analysis problem, we derive a sufficient condition for which the uncertain time-delay system is robustly stable and strictly passive for all admissible uncertainties. The condition is given in terms of a linear matrix inequality. Both the delay-independent and delay-dependent cases are considered. For the synthesis problem, we propose an observer-based design method which guarantees that the closed-loop uncertain time-delay system is stable and strictly passive for all admissible uncertainties. Several examples are worked out to illustrate the developed theory.

Beta delayed particle emission in light nuclei

International Nuclear Information System (INIS)

Riisager, K.; Gabelmann, H.

1991-01-01

A short discussion of theoretical treatments of beta delayed particle emission is followed by a presentation of data on the newly found beta delayed deuteron decay of 6 He. This decay cannot be described properly with existing theories. (author) 8 refs.; 3 figs

Delay and reward choice in ADHD: an experimental test of the role of delay aversion.

Science.gov (United States)

Marco, Rafaela; Miranda, Ana; Schlotz, Wolff; Melia, Amanda; Mulligan, Aisling; Müller, Ueli; Andreou, Penny; Butler, Louise; Christiansen, Hanna; Gabriels, Isabel; Medad, Sheera; Albrecht, Bjorn; Uebel, Henrik; Asherson, Phillip; Banaschewski, Tobias; Gill, Michael; Kuntsi, Jonna; Mulas, Fernando; Oades, Robert; Roeyers, Herbert; Steinhausen, Hans-Christoph; Rothenberger, Aribert; Faraone, Stephen V; Sonuga-Barke, Edmund J S

2009-05-01

Children with attention deficit/hyperactivity disorder (ADHD) choose smaller sooner (SS) over larger later (LL) rewards more than controls. Here we assess the contributions of impulsive drive for immediate rewards (IDIR) and delay aversion (DAv) to this pattern. We also explore the characteristics of, and the degree of familiality in, ADHD SS responders. We had 360 ADHD probands; 349 siblings and 112 controls (aged between 6 to 17 years) chose between SS (1 point after 2 s) and LL reward (2 points after 30 s) outcomes on the Maudsley Index of Delay Aversion (Kuntsi, Oosterlaan, & Stevenson, 2001): Under one condition SS choice led to less overall trial delay under another it did not. ADHD participants chose SS more than controls under both conditions. This effect was larger when SS choice reduced trial delay. ADHD SS responders were younger, had lower IQ, more conduct disorder and had siblings who were more likely to be SS responders themselves. The results support a dual component model in which both IDIR and DAv contribute to SS choice in ADHD. SS choice may be a marker of an ADHD motivational subtype.

'Lost to follow up': rethinking delayed and interrupted HIV treatment among married Swazi women.

Science.gov (United States)

Dlamini-Simelane, Thandeka T T; Moyer, Eileen

2017-03-01

Through various campaigns and strategies, more women are being tested for HIV in countries with a high prevalence of the virus. Despite the ready availability of treatment at government clinics in sub-Saharan African countries like Swaziland, women consistently report difficulty in maintaining access to treatment. Drawing on two individual case studies selected from a larger study of the so-called leaky cascade in Swaziland, we illustrate the protracted journeys married women undertake to initiate treatment. We demonstrate how women manoeuvre tactically after diagnosis, highlight factors that influence their decisions related to initiating treatment, and detail the actors involved in the decision-making process. Our research shows the persistence of structural factors that inhibit access, including economic constraints, gender inequality and patriarchal social norms. Patients referred as ‘lost to follow up’ are in many cases actively pursuing treatment within a context that includes the biomedical health system, but also extends well beyond it. We argue that the phrase ‘lost to follow up’ conceals the complex social navigation required by women to initiate and maintain access to treatment. Further, we suggest that many of the logistical challenges of monitoring and tracking people with HIV can be better addressed by taking into account the structural and social aspects of delayed treatment initiative.

Delayed pan-hypopituitarism as a complication following endovascular treatment of bilateral internal carotid artery aneurysms. A case report and review.

Science.gov (United States)

Hall, Jonathan; Caputo, Carmela; Chung, Carlos; Holt, Michael; Wang, Yi Yuen

2015-04-01

Pan-hypopituitarism has been reported in patients who are subsequently found to have a cerebral aneurysm and there have been reports of pituitary dysfunction immediately following both surgical and endovascular treatment. The authors report a rare case of delayed pan-hypopituitarism following endovascular treatment of bilateral internal carotid artery aneurysms with coil embolisation and flow-diverting stents.

Radiation treatment of painful degenerative skeletal conditions

International Nuclear Information System (INIS)

Schaefer, U.; Micke, O.; Willich, N.

1996-01-01

The study reported was intended to present own experience with irradiation for treatment of painful degenerative skeletal conditions and examine the long-term effects of this treatment. A retrospective study was performed covering the period from 1985 until 1991, examining 157 patients suffering from painful degenerative skeletal conditions who entered information on the success of their radiation treatment in a questionnaire. 94 of the questionnaires could be used for evaluation. Pain anamnesis revealed periods of more than one year in 45% of the cases. 74% of the patients had been treated without success with drug or orthopedic therapy. Immediately after termination of the radiotherapy, 38% of the patients said to be free of pain or to feel essentially relieved, while at the time the questionnaire was distributed, the percentage was 76%. Thus in our patient material, radiotherapy for treatment of painful degenerative skeletal lesions was successful in 76% of the cases and for long post-treatment periods, including those cases whith long pain anamnesis and unsuccessful conventional pre-treatment. (orig./MG) [de

Acetylcholinesterase inhibitor treatment alleviated cognitive impairment caused by delayed encephalopathy due to carbon monoxide poisoning: Two case reports and a review of the literature.

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Yanagiha, Kumi; Ishii, Kazuhiro; Tamaoka, Akira

2017-02-01

Delayed encephalopathy due to carbon monoxide (CO) poisoning can even occur in patients with mild symptoms of acute CO poisoning. Some cases taking conventional hyperbaric oxygen (HBO) therapy or steroid-pulse therapy may be insufficient, and AchEI may be effective. We report two cases of delayed encephalopathy after acute CO poisoning involving two women aged 69 (Case 1) and 60 years (Case 2) whose cognitive function improved with acetylcholinesterase inhibitor (AchEI) treatment. Delayed encephalopathy occurred 25 and 35 days after acute CO poisoning in Case 1 and Case 2, respectively. Both patients demonstrated cognitive impairment, apathy, and hypokinesia on admission. Although hyperbaric oxygen therapy did not yield any significant improvements, cognitive dysfunction improved substantially. This was evidenced by an improved Mini-Mental State Examination score ffom 9 to 28 points in Case 1 and an improved Hasegawa's dementia rating scale score from 4 to 25 points in Case 2 after administration of an AchEI. In Case 1, we administered galantamine hydrobromide, which was related with improved white matter lesions initially detected on brain magnetic resonance imaging. However, in Case 2 white matter lesions persisted despite AchEI treatment. AchEI treatment may result in improved cognitive and frontal lobe function by increasing low acetylcholine concentrations in the hippocampus and frontal lobe caused by decreased nicotinic acetylcholine receptor levels in delayed encephalopathy after CO poisoning. Physicians should consider AchEIs for patients demonstrating delayed encephalopathy due to CO poisoning.

Herbs and natural supplements in the prevention and treatment of delayed-onset muscle soreness

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Abbas Meamarbashi

2017-01-01

Full Text Available Objective:  Unaccustomed and intense eccentric exercise is a common cause of delayed-onset muscle soreness (DOMS. There are multiple remedies for the treatment of DOMS, but its clinical and laboratory pieces of evidence are scarce. Currently, the treatments proposed for DOMS are numerous and include pharmaceuticals, herbal remedies, stretching, massage, nutritional supplements, and other alternatives. To find a holistic treatment with effective pain relief and minimum side effects, complementary and alternative medicine, including herbal therapies, plays a main role.Methods: In this review, the existing published studies investigating the efficacy of herbal and natural supplementation therapies for the prevention or treatment of side effects, symptoms, and signs of DOMS are summarized.Results: Previous studies have documented the efficacy of herbal therapies to treat pain, inflammation, as well as laboratory and clinical side effects of DOMS.Conclusion: The use of herbs in DOMS seems safer and has lower side effects than pharmacotherapy. However, the potential for side effects and drug interactions should be considered.

Outcome measures in studies on the use of oxytocin for the treatment of delay in labour: A systematic review.

LENUS (Irish Health Repository)

Begley, Cecily M

2014-07-01

to identify primary and secondary outcome measures in randomised trials, and systematic reviews of randomised trials, measuring effectiveness of oxytocin for treatment of delay in the first and second stages of labour, and to identify any positive health-focussed outcomes used.

Lag synchronization of chaotic systems with time-delayed linear

Indian Academy of Sciences (India)

In this paper, the lag synchronization of chaotic systems with time-delayed linear terms via impulsive control is investigated. Based on the stability theory of impulsive delayed differential equations, some sufficient conditions are obtained guaranteeing the synchronized behaviours between two delayed chaotic systems.

Delayed radiation necrosis in the optochiasmatic region

International Nuclear Information System (INIS)

Andoh, Takashi; Yokoyama, Kazutoshi; Kumagai, Morio

1984-01-01

Two cases with delayed radiation necrosis of the chiasmatic region following irradiation of the hypophysis for treatment of Cushing's disease were presented. Case 1 was a 36-year-old female who had reduction of visual acuity and bitemporal hemianopsia 2 years after 60 Co-irradiation therapy (total 8000 rads) for Cushing's disease. CT scans showed low density in the pituitary fossa and irregular contrast-enhanced suprasellar mass, and metrizamide CT cisternography revealed the pituitary fossa filled with contrast medium. From those findings, secondary empty sella syndrome was suspicious. Case 2 was a 35-year-old male who had progressive visual disturbance 3 years after 60 Co-irradiation therapy (total 9050 rads) for Cushing's disease. The right visual acuity was 0.05 and the left one was 0.1. Examination of visual field showed left homonymous hemianopsia. CT scans showed the contrast enhanced suprasellar mass extending to the right anterior thalamic region, and metrizamide CT cisternography detected secondary empty sella as same as that of Case 1. Authors reviewed and analyzed literatures of delayed radiation necrosis. The incidence of this condition was 4% to 9% and onset of the symptoms occured approximately 2 years after irradiation to hypophysis. Administration of steroid hormone and surgical treatment for the radiation necrosis involving the chiasmatic region were almost ineffective and also the prognosis of radionecrotic lesions involving the hypothalamus was very poor. Therefore, radiotherapy for hypophyseal region must be carried out by means of a rotation or arching technique in order to avoid this condition and further total dosage and its fractionation in radiation therapy should not exceed 6000 rads and 200 rads a day. (J.P.N.)

Effect of caffeine on radiation-induced mitotic delay: delayed expression of G2 arrest

International Nuclear Information System (INIS)

Rowley, R.; Zorch, M.; Leeper, D.B.

1984-01-01

In the presence of 5 mM caffeine, irradiated (1.5 Gy) S and G 2 cells progressed to mitosis in register and without arrest in G 2 . Caffeine (5 mM) markedly reduced mitotic delay even after radiation doses up to 20 Gy. When caffeine was removed from irradiated (1.5 Gy) and caffeine-treated cells, a period of G 2 arrest followed, similar in length to that produced by radiation alone. The arrest expressed was independent of the duration of the caffeine treatment for exposures up to 3 hr. The similarity of the response to the cited effects of caffeine on S-phase delay suggests a common basis for delay induction in S and G 2 phases

Stability analysis of fractional-order Hopfield neural networks with time delays.

Science.gov (United States)

Wang, Hu; Yu, Yongguang; Wen, Guoguang

2014-07-01

This paper investigates the stability for fractional-order Hopfield neural networks with time delays. Firstly, the fractional-order Hopfield neural networks with hub structure and time delays are studied. Some sufficient conditions for stability of the systems are obtained. Next, two fractional-order Hopfield neural networks with different ring structures and time delays are developed. By studying the developed neural networks, the corresponding sufficient conditions for stability of the systems are also derived. It is shown that the stability conditions are independent of time delays. Finally, numerical simulations are given to illustrate the effectiveness of the theoretical results obtained in this paper. Copyright © 2014 Elsevier Ltd. All rights reserved.

Global synchronization in arrays of delayed neural networks with constant and delayed coupling

International Nuclear Information System (INIS)

Cao Jinde; Li Ping; Wang Weiwei

2006-01-01

This Letter investigates the global exponential synchronization in arrays of coupled identical delayed neural networks (DNNs) with constant and delayed coupling. By referring to Lyapunov functional method and Kronecker product technique, some sufficient conditions are derived for global synchronization of such systems. These new synchronization criteria offer some adjustable matrix parameters, which is of important significance in the design and applications of such coupled DNNs, and the results improve and extend the earlier works. Finally, an example is given to illustrate the theoretical results

Single-subject withdrawal designs in delayed matching-to-sample procedures

OpenAIRE

Eilifsen, Christoffer; Arntzen, Erik

2011-01-01

In most studies of delayed matching-to-sample (DMTS) and stimulus equivalence, the delay has remained fixed throughout a single experimental condition. We wanted to expand on the DMTS and stimulus equivalence literature by examining the effects of using titrating delays with different starting points during the establishment of conditional discriminations prerequisite for stimulus equivalence. In Experiment 1, a variation of a single-subject withdrawal design was used. Ten adults were exposed...

Maternal Immune-Mediated Conditions, Autism Spectrum Disorders, and Developmental Delay

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Lyall, Kristen; Ashwood, Paul; Van de Water, Judy; Hertz-Picciotto, Irva

2014-01-01

The maternal immune system may play a role in offspring neurodevelopment. We examined whether maternal autoimmune disease, asthma, and allergy were associated with child autism spectrum disorder (ASD) and developmental delay without autism (DD) using 560 ASD cases, 391 typically developing controls, and 168 DD cases from the CHildhood Autism Risk…

Improved Criteria on Delay-Dependent Stability for Discrete-Time Neural Networks with Interval Time-Varying Delays

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O. M. Kwon

2012-01-01

Full Text Available The purpose of this paper is to investigate the delay-dependent stability analysis for discrete-time neural networks with interval time-varying delays. Based on Lyapunov method, improved delay-dependent criteria for the stability of the networks are derived in terms of linear matrix inequalities (LMIs by constructing a suitable Lyapunov-Krasovskii functional and utilizing reciprocally convex approach. Also, a new activation condition which has not been considered in the literature is proposed and utilized for derivation of stability criteria. Two numerical examples are given to illustrate the effectiveness of the proposed method.

Synchronization of Markovian jumping stochastic complex networks with distributed time delays and probabilistic interval discrete time-varying delays

International Nuclear Information System (INIS)

Li Hongjie; Yue Dong

2010-01-01

The paper investigates the synchronization stability problem for a class of complex dynamical networks with Markovian jumping parameters and mixed time delays. The complex networks consist of m modes and the networks switch from one mode to another according to a Markovian chain with known transition probability. The mixed time delays are composed of discrete and distributed delays, the discrete time delay is assumed to be random and its probability distribution is known a priori. In terms of the probability distribution of the delays, the new type of system model with probability-distribution-dependent parameter matrices is proposed. Based on the stochastic analysis techniques and the properties of the Kronecker product, delay-dependent synchronization stability criteria in the mean square are derived in the form of linear matrix inequalities which can be readily solved by using the LMI toolbox in MATLAB, the solvability of derived conditions depends on not only the size of the delay, but also the probability of the delay-taking values in some intervals. Finally, a numerical example is given to illustrate the feasibility and effectiveness of the proposed method.

Euclidean null controllability of nonlinear infinite delay systems with ...

African Journals Online (AJOL)

Sufficient conditions for the Euclidean null controllability of non-linear delay systems with time varying multiple delays in the control and implicit derivative are derived. If the uncontrolled system is uniformly asymptotically stable and if the control system is controllable, then the non-linear infinite delay system is Euclidean null ...

Stability of Neutral Fractional Neural Networks with Delay

Institute of Scientific and Technical Information of China (English)

LI Yan; JIANG Wei; HU Bei-bei

2016-01-01

This paper studies stability of neutral fractional neural networks with delay. By introducing the definition of norm and using the uniform stability, the sufficient condition for uniform stability of neutral fractional neural networks with delay is obtained.

Stability results for stochastic delayed recurrent neural networks with discrete and distributed delays

Science.gov (United States)

Chen, Guiling; Li, Dingshi; Shi, Lin; van Gaans, Onno; Verduyn Lunel, Sjoerd

2018-03-01

We present new conditions for asymptotic stability and exponential stability of a class of stochastic recurrent neural networks with discrete and distributed time varying delays. Our approach is based on the method using fixed point theory, which do not resort to any Liapunov function or Liapunov functional. Our results neither require the boundedness, monotonicity and differentiability of the activation functions nor differentiability of the time varying delays. In particular, a class of neural networks without stochastic perturbations is also considered. Examples are given to illustrate our main results.

Ovarian reaction and estrus manifestation in delayed puberty gilts after treatment with equine chorionic gonadotropin

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Stančić Ivan B

2012-08-01

Full Text Available Abstract Background Prolonged pre-insemination anestrus (i.e. delayed puberty is a major contributing factor for culling up to 30% of the replacement gilts at large breeding farm units in Vojvodina. It is imperative to determine if these gilts are acyclic (prepubertal or cyclic, but just fail to exhibit behavioural estrus. Recent investigations demonstrate that treatment with equine chorionic gonadotropin (eCG can increase the diestrous phase duration in sexually mature gilts. Based on these finding, the aim of the present studies was to determine the reproductive status of delayed puberty gilts following injection with eCG. Methods Two experiments were conducted on a swine breeding farm in Vojvodina. In Exp. 1, 20 prepubertal (acyclic gilts, and 120 sexually mature (cyclic gilts were injected with a single injection of 400 IU eCG + 200 IU human chorionic gonadotropin (hCG or with 1000 IU eCG (cyclic gilts, at d5, d11 or d17 after spontaneous estrus detection, to determine their ovarian reaction and induced estrus manifestation. In Exp. 2, sixty delayed puberty gilts (estrus not detected until 8 month of age, av. 258 days were culled from breeding herd and slaughtered to determine their reproductive status based on ovarian anatomical features. The second group of gilts (n = 60 was treated with a single 1000 IU eCG injection to determine their reproductive status, based on the interval between eCG injection to estrus detection and duration. The data were analyzed by descriptive statistics, t-test, analysis of variance and Duncan’s test in the software package Statistics 10th. Results Ovulations were induced in 90% of acyclic (sexually immature and, on average, 93.3% of cyclic (sexually mature gilts after the eCG injection. On average, 4 days after the eCG injection, estrus was detected in 85% of the treated acyclic (sexually immature gilts and in 95% (19/20 of the cyclic (sexually mature gilts, treated with eCG on day 17

Robustness of delayed multistable systems with application to droop-controlled inverter-based microgrids

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Efimov, Denis; Schiffer, Johannes; Ortega, Romeo

2016-05-01

Motivated by the problem of phase-locking in droop-controlled inverter-based microgrids with delays, the recently developed theory of input-to-state stability (ISS) for multistable systems is extended to the case of multistable systems with delayed dynamics. Sufficient conditions for ISS of delayed systems are presented using Lyapunov-Razumikhin functions. It is shown that ISS multistable systems are robust with respect to delays in a feedback. The derived theory is applied to two examples. First, the ISS property is established for the model of a nonlinear pendulum and delay-dependent robustness conditions are derived. Second, it is shown that, under certain assumptions, the problem of phase-locking analysis in droop-controlled inverter-based microgrids with delays can be reduced to the stability investigation of the nonlinear pendulum. For this case, corresponding delay-dependent conditions for asymptotic phase-locking are given.

[Usefulness of endovascular treatment for delayed massive epistaxis following endoscopic endonasal transsphenoidal surgery: a case report].

Science.gov (United States)

Oka, Tetsuo; Sugiu, Kenji; Ishida, Joji; Hishikawa, Tomohito; Ono, Shigeki; Tokunaga, Koji; Date, Isao

2012-01-01

We report here a case of massive nasal bleeding from the sphenopalatine artery three weeks after endonasal transsphenoidal surgery. This 66-year-old male suffered from massive nasal bleeding with the status of hypovolemic shock. Under general anesthesia, an emergent angiography revealed an extravasation from the sphenopalatine artery. Trans-arterial embolization using coil and n-butyl-cyanoacrylate (NBCA) was performed following the diagnostic angiography. Complete occlusion of the injured artery was achieved. The patient showed good recovery from general anesthesia. Delayed nasal bleeding after endonasal transsphenoidal surgery is a rare but important complication. The sphenopalatine artery and its branch are located in the hidden inferior lateral corner of the sphenoid sinus and may be injured during enlargement of the sphenoid opening. When massive delayed nasal bleeding follows transsphenoidal surgery and damage of the internal carotid artery has been ruled out, endovascular treatment of the external carotid artery should be considered.

Growth of meromorphic solutions of delay differential equations

OpenAIRE

Halburd, Rod; Korhonen, Risto

2016-01-01

Necessary conditions are obtained for certain types of rational delay differential equations to admit a non-rational meromorphic solution of hyper-order less than one. The equations obtained include delay Painlev\\'e equations and equations solved by elliptic functions.

Behavior Problems in Toddlers with and without Developmental Delays: Comparison of Treatment Outcomes

Science.gov (United States)

Holtz, Casey A.; Carrasco, Jennifer M.; Mattek, Ryan J.; Fox, Robert A.

2009-01-01

The purpose of this study is to examine the effectiveness of an in-home parent management program for toddlers with behavior problems and developmental delays by comparing outcomes for a group of toddlers with developmental delays (n = 27) and a group of toddlers without developmental delays (n = 27). The majority of children lived in single…

Global exponential stability and periodicity of reaction-diffusion recurrent neural networks with distributed delays and Dirichlet boundary conditions

International Nuclear Information System (INIS)

Lu Junguo; Lu Linji

2009-01-01

In this paper, global exponential stability and periodicity of a class of reaction-diffusion recurrent neural networks with distributed delays and Dirichlet boundary conditions are studied by constructing suitable Lyapunov functionals and utilizing some inequality techniques. We first prove global exponential convergence to 0 of the difference between any two solutions of the original neural networks, the existence and uniqueness of equilibrium is the direct results of this procedure. This approach is different from the usually used one where the existence, uniqueness of equilibrium and stability are proved in two separate steps. Secondly, we prove periodicity. Sufficient conditions ensuring the existence, uniqueness, and global exponential stability of the equilibrium and periodic solution are given. These conditions are easy to verify and our results play an important role in the design and application of globally exponentially stable neural circuits and periodic oscillatory neural circuits.

Global synchronization of a class of delayed complex networks

International Nuclear Information System (INIS)

Li Ping; Yi Zhang; Zhang Lei

2006-01-01

Global synchronization of a class of complex networks with time-varying delays is investigated in this paper. Some sufficient conditions are derived. These conditions show that the synchronization of delayed complex networks can be determined by their topologies. In addition, these conditions are simply represented in terms of the networks coupling matrix and are easy to be checked. A typical example of complex networks with chaotic nodes is employed to illustrate the obtained global synchronization results

The Oscillation of a Class of the Fractional-Order Delay Differential Equations

Directory of Open Access Journals (Sweden)

Qianli Lu

2014-01-01

Full Text Available Several oscillation results are proposed including necessary and sufficient conditions for the oscillation of fractional-order delay differential equations with constant coefficients, the sufficient or necessary and sufficient conditions for the oscillation of fractional-order delay differential equations by analysis method, and the sufficient or necessary and sufficient conditions for the oscillation of delay partial differential equation with three different boundary conditions. For this, α-exponential function which is a kind of functions that play the same role of the classical exponential functions of fractional-order derivatives is used.

Behavioral effects of delayed timeouts from reinforcement.

Science.gov (United States)

Byrne, Tom; Poling, Alan

2017-03-01

Timeouts are sometimes used in applied settings to reduce target responses, and in some circumstances delays are unavoidably imposed between the onset of a timeout and the offset of the response that produces it. The present study examined the effects of signaled and unsignaled timeouts in rats exposed to concurrent fixed-ratio 1 fixed-ratio 1 schedules of food delivery, where each response on one lever, the location of which changed across conditions, produced both food and a delayed 10-s timeout. Delays of 0 to 38 s were examined. Delayed timeouts often, but not always, substantially reduced the number of responses emitted on the lever that produced timeouts relative to the number emitted on the lever that did not produce timeouts. In general, greater sensitivity was observed to delayed timeouts when they were signaled. These results demonstrate that delayed timeouts, like other delayed consequences, can affect behavior, albeit less strongly than immediate consequences. © 2017 Society for the Experimental Analysis of Behavior.

Stability of Nonlinear Systems with Unknown Time-varying Feedback Delay

Science.gov (United States)

Chunodkar, Apurva A.; Akella, Maruthi R.

2013-12-01

This paper considers the problem of stabilizing a class of nonlinear systems with unknown bounded delayed feedback wherein the time-varying delay is 1) piecewise constant 2) continuous with a bounded rate. We also consider application of these results to the stabilization of rigid-body attitude dynamics. In the first case, the time-delay in feedback is modeled specifically as a switch among an arbitrarily large set of unknown constant values with a known strict upper bound. The feedback is a linear function of the delayed states. In the case of linear systems with switched delay feedback, a new sufficiency condition for average dwell time result is presented using a complete type Lyapunov-Krasovskii (L-K) functional approach. Further, the corresponding switched system with nonlinear perturbations is proven to be exponentially stable inside a well characterized region of attraction for an appropriately chosen average dwell time. In the second case, the concept of the complete type L-K functional is extended to a class of nonlinear time-delay systems with unknown time-varying time-delay. This extension ensures stability robustness to time-delay in the control design for all values of time-delay less than the known upper bound. Model-transformation is used in order to partition the nonlinear system into a nominal linear part that is exponentially stable with a bounded perturbation. We obtain sufficient conditions which ensure exponential stability inside a region of attraction estimate. A constructive method to evaluate the sufficient conditions is presented together with comparison with the corresponding constant and piecewise constant delay. Numerical simulations are performed to illustrate the theoretical results of this paper.

The Effects of Four-Hour Delay of PUnishment under Two Conditions of Verbal Instruction

Science.gov (United States)

Verna, Gary B.

1977-01-01

The effects of 4-hour delay of punishment (withdrawal of reward) on response inhibition was studied with 24 fourth-grade children. Results showed that verbal expression of the punishment contingency allows the 10-year-old child to profit from 4-hour delayed punishment as much as immediate punishment. (Author/JMB)

Delays in the management of retroperitoneal sarcomas

DEFF Research Database (Denmark)

Seinen, Jojanneke; Almquist, Martin; Styring, Emelie

2010-01-01

Retroperitoneal sarcomas are rare and treatment should optimally be centralized. Despite successful centralization with 90% of the patients referred prior to surgery, delays occur, which led us to assess lead times in a population-based series. Method. Patients diagnosed with retroperitoneal...... sarcoma in the southern Sweden health care region 2003-2009 were eligible for the study. Data on referrals and diagnostic investigations were collected from clinical files from primary health care, local hospitals, and from the sarcoma centre. Lead times were divided into patient delays and health care...... delays caused by primary health care, local hospitals, or procedures at the sarcoma centre. Results. Complete data were available from 33 patients and demonstrated a median patient delay of 23¿days (0-17¿months) and median health care delay of 94¿days (1-40¿months) with delays of median 15¿days...

What role do traditional beliefs play in treatment seeking and delay for Buruli ulcer disease?--insights from a mixed methods study in Cameroon.

Directory of Open Access Journals (Sweden)

Koen Peeters Grietens

Full Text Available Victims of Buruli ulcer disease (BUD frequently report to specialized units at a late stage of the disease. This delay has been associated with local beliefs and a preference for traditional healing linked to a reportedly mystical origin of the disease. We assessed the role beliefs play in determining BUD sufferers' choice between traditional and biomedical treatments.Anthropological fieldwork was conducted in community and clinical settings in the region of Ayos and Akonolinga in Central Cameroon. The research design consisted of a mixed methods study, triangulating a qualitative strand based on ethnographic research and quantitative data obtained through a survey presented to all patients at the Ayos and Akonolinga hospitals (N = 79 at the time of study and in four endemic communities (N = 73 belonging to the hospitals' catchment area.The analysis of BUD sufferers' health-seeking behaviour showed extremely complex therapeutic itineraries, including various attempts and failures both in the biomedical and traditional fields. Contrary to expectations, nearly half of all hospital patients attributed their illness to mystical causes, while traditional healers admitted patients they perceived to be infected by natural causes. Moreover, both patients in hospitals and in communities often combined elements of both types of treatments. Ultimately, perceptions regarding the effectiveness of the treatment, the option for local treatment as a cost prevention strategy and the characteristics of the doctor-patient relationship were more determinant for treatment choice than beliefs.The ascription of delay and treatment choice to beliefs constitutes an over-simplification of BUD health-seeking behaviour and places the responsibility directly on the shoulders of BUD sufferers while potentially neglecting other structural elements. While more efficacious treatment in the biomedical sector is likely to reduce perceived mystical involvement in the

Termination of short term melatonin treatment in children with delayed Dim Light Melatonin Onset: effects on sleep, health, behavior problems, and parenting stress

NARCIS (Netherlands)

van Maanen, Annette; Meijer, Anne Marie; Smits, Marcel G.; Oort, Frans J.

2011-01-01

To investigate the effects of termination of short term melatonin treatment on sleep, health, behavior, and parenting stress in children with delayed Dim Light Melatonin Onset. Forty-one children (24 boys, 17 girls; mean age=9.43 years) entered melatonin treatment for 3 weeks and then discontinued

[Mental health of children, adolescents and young adults--part 1: prevalence, illness persistence, adversities, service use, treatment delay and consequences].

Science.gov (United States)

Lambert, M; Bock, T; Naber, D; Löwe, B; Schulte-Markwort, M; Schäfer, I; Gumz, A; Degkwitz, P; Schulte, B; König, H H; Konnopka, A; Bauer, M; Bechdolf, A; Correll, C; Juckel, G; Klosterkötter, J; Leopold, K; Pfennig, A; Karow, A

2013-11-01

Numerous birth-control studies, epidemiological studies, and observational studies have investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use by children, adolescents and young adults is low, even lower than for adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for a poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called "early intervention services" at the interface of child and adolescent and adult psychiatry. Emerging studies show that these health-care structures are effective and efficient. Part 1 of the present review summarises the current state of mental health in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, and treatment delay with consequences. © Georg Thieme Verlag KG Stuttgart · New York.

An investigation into factors causing delays in highway construction projects in iraq

Directory of Open Access Journals (Sweden)

Al Hadithi Bevian I.

2018-01-01

Full Text Available The highways sector is a prominent sector in any country’s economy because of its impact on the well-being and safety of its citizens. The transport sector has an impact on social improvement and investment in the nation on the illustration that allows access to markets, production, jobs, health and other social services.This study investigates the causes of delay of highway construction projects in Iraq, which is frequent occurrence. Data was collected using questionnaires which were distributed to the key project participants; contractors, owners and consultants. The data were analyzed using the Frequency index and Spearman‟s rank correlation. The top seven causes of project delays were observed to be political decisions and political realities, the economic crisis of the country, delays in materials test of and obtaining the results, delay in monthly payments of contractor, failure treatment of the delays when implementing the project, the effects of weather, rain and high temperatures, delay in activities during implementation. It is recommended to establish an appropriate number of laboratories and adopt the field laboratory mechanism for the external and remote screens. Owners should give special attention to pay progress payment to contractors on time. The competent contractor who has prior experience in implementing the high projects should be selected. The contractor must take into consideration the weather conditions when preparing the time plan necessary to implement the project. The project management should identify these reasons and deal with them quickly in order to reduce the total delay of the project.

Sodium butyrate into the insular cortex during conditioned taste-aversion acquisition delays aversive taste memory extinction.

Science.gov (United States)

Núñez-Jaramillo, Luis; Reyes-López, Julian; Miranda, María Isabel

2014-04-16

Histone acetylation is one mechanism that promotes gene expression, and it increases during learning of various tasks. Specifically, novel taste consumption produces an increased acetylation of histone lysine residues in the insular cortex (IC), where protein synthesis is crucial during memory consolidation of conditioned taste aversion (CTA). However, the role of this elevated histone acetylation during CTA learning has not been examined directly. Thus, the present study investigated the effects of sodium butyrate (NaBu), a histone deacetylase inhibitor, injected into the IC during CTA acquisition. Male Wistar rats, IC bilaterally implanted, were injected 60 min before saccharine presentation, with a total volume of 0.5 µl of NaBu solution (100, 500, and 10 µg/0.5 µl) or saline; 30 min later animals were injected intraperitoneally with lithium chloride, a malaise-inducing drug. The next day, CTA retrieval was tested. No effects of NaBu were observed during acquisition or retrieval, but during extinction trials, a significant delay in aversive memory extinction was observed in the group injected with the lowest NaBu dose. This result indicates that NaBu in the IC strengthens CTA and delays aversive memory extinction, and suggests that histone acetylation could increase long-term taste-aversive memory strength.

Mothers' perception of recovery and satisfaction with patent medicine dealers' treatment of childhood febrile conditions in rural communities.

Science.gov (United States)

Ibeneme, Georgian Chiaka; Nwaneri, Ada Caroline; Ibeneme, Sam Chidi; Ezenduka, Pauline; Strüver, Vanessa; Fortwengel, Gehard; Okoye, Ifeoma Joy

2016-06-28

Infant mortality in rural areas of Nigeria can be minimized if childhood febrile conditions are treated by trained health personnel, deployed to primary healthcare centres (PHCs) rather than the observed preference of mothers for patent medicine dealers (PMDs). However, health service utilization/patronage is driven by consumer satisfaction and perception of services/product value. The objective of this study was to determine 'mothers' perception of recovery' and 'mothers' satisfaction' after PMD treatment of childhood febrile conditions, as likely drivers of mothers' health-seeking behaviour, which must be targeted to reverse the trend. Ugwuogo-Nike, in Enugu, Nigeria, has many PMDs/PHCs, and was selected based on high prevalence of childhood febrile conditions. In total, 385 consenting mothers (aged 15-45 years) were consecutively recruited at PMD shops, after purchasing drugs for childhood febrile conditions, in a cross-sectional observational study using a pre-tested instrument; 33 of them (aged 21-47 years) participated in focus group discussions (FGDs). Qualitative data were thematically analysed while a quantitative study was analysed with Z score and Chi square statistics, at p perceived that their child had delayed recovery, but were satisfied with PMDs' treatment of childhood febrile conditions, for reasons that included politeness, caring attitude, drug availability, easy accessibility, flexibility in pricing, shorter waiting time, their God-fearing nature, and disposition as good listeners. Mothers' satisfaction with PMDs' treatment is significantly (p satisfaction with PMDs' treatment from a knowledge of mothers' perception of recovery shows a high accord (lambda[A from B] = 0.8727), unlike when predicting mothers' perception of recovery based on knowledge of mothers' satisfaction with PMDs' treatment (lambda[A from B] = 0.4727). Mothers' satisfaction could be the key 'driver' of mothers' health-seeking behaviour and is less likely to be

Motor skill delays in pre-school children with leukemia one year after treatment: Hematopoietic stem cell transplantation therapy as an important risk factor.

Science.gov (United States)

Taverna, Livia; Tremolada, Marta; Bonichini, Sabrina; Tosetto, Barbara; Basso, Giuseppe; Messina, Chiara; Pillon, Marta

2017-01-01

CNS-directed therapies for the treatment of leukemia can adversely affect the acquisition of new skills, such as reading/writing and math. Two years after the end of treatments, children show gross and fine motor skill delays that may persist even when patients are considered healed. The goal of the present study was to assess motor skills difficulties in pre-school children with leukemia one year after treatment. Particular attention has been paid to those patients who had undergone Hematopoietic Stem Cell Transplantation (HSCT) and to the relationship between motor delays and age bands. Participants were 60 children (median age of 5; inter quartile range: 3.07-5.76), including 31 females and 29 males, 91.7% of them were affected by acute lymphoblastic leukemia (ALL), and 8.3% by acute myeloid leukemia (AML). Five children had undergone HCST. Parents were interviewed by Vineland Adaptive Behavior Scales (VABS) on children's motor skills and filled in the Italian Temperament Questionnaire (QUIT). VABS's total scores were converted into equivalent mental age scores (EMA). A score difference of at least three months between current age and equivalent mental age was considered a developmental delay. Non-parametric analyses were run to understand if HSCT treatment and a specific age band influence children's motor skills. Significant delays were found in global motor skills (56.7%) as well as in fine and gross motor domains. Mann Whitney U tests showed that children with HSCT were reported to have lower gross motor mean ranks (U = 62; p = 0.004; Mean rank = 15.40) than peers without HSCT (Mean rank = 31.87) and lower mean rank values on motor temperament scale (U = 9; p = 0.003; HSCT Mean rank = 4.75 versus no HSCT Mean rank = 27.81). Kruskal Wallis' tests identified the high risk treatment showing that HSCT experience negatively impacted the motor skills and temperamental motor activity of pre-school children one year after the diagnosis of leukemia.

Motor skill delays in pre-school children with leukemia one year after treatment: Hematopoietic stem cell transplantation therapy as an important risk factor.

Directory of Open Access Journals (Sweden)

Livia Taverna

Full Text Available CNS-directed therapies for the treatment of leukemia can adversely affect the acquisition of new skills, such as reading/writing and math. Two years after the end of treatments, children show gross and fine motor skill delays that may persist even when patients are considered healed. The goal of the present study was to assess motor skills difficulties in pre-school children with leukemia one year after treatment. Particular attention has been paid to those patients who had undergone Hematopoietic Stem Cell Transplantation (HSCT and to the relationship between motor delays and age bands. Participants were 60 children (median age of 5; inter quartile range: 3.07-5.76, including 31 females and 29 males, 91.7% of them were affected by acute lymphoblastic leukemia (ALL, and 8.3% by acute myeloid leukemia (AML. Five children had undergone HCST. Parents were interviewed by Vineland Adaptive Behavior Scales (VABS on children's motor skills and filled in the Italian Temperament Questionnaire (QUIT. VABS's total scores were converted into equivalent mental age scores (EMA. A score difference of at least three months between current age and equivalent mental age was considered a developmental delay. Non-parametric analyses were run to understand if HSCT treatment and a specific age band influence children's motor skills. Significant delays were found in global motor skills (56.7% as well as in fine and gross motor domains. Mann Whitney U tests showed that children with HSCT were reported to have lower gross motor mean ranks (U = 62; p = 0.004; Mean rank = 15.40 than peers without HSCT (Mean rank = 31.87 and lower mean rank values on motor temperament scale (U = 9; p = 0.003; HSCT Mean rank = 4.75 versus no HSCT Mean rank = 27.81. Kruskal Wallis' tests identified the high risk treatment showing that HSCT experience negatively impacted the motor skills and temperamental motor activity of pre-school children one year after the diagnosis of leukemia.

Motor skill delays in pre-school children with leukemia one year after treatment: Hematopoietic stem cell transplantation therapy as an important risk factor

Science.gov (United States)

Bonichini, Sabrina; Tosetto, Barbara; Basso, Giuseppe; Messina, Chiara; Pillon, Marta

2017-01-01

CNS-directed therapies for the treatment of leukemia can adversely affect the acquisition of new skills, such as reading/writing and math. Two years after the end of treatments, children show gross and fine motor skill delays that may persist even when patients are considered healed. The goal of the present study was to assess motor skills difficulties in pre-school children with leukemia one year after treatment. Particular attention has been paid to those patients who had undergone Hematopoietic Stem Cell Transplantation (HSCT) and to the relationship between motor delays and age bands. Participants were 60 children (median age of 5; inter quartile range: 3.07–5.76), including 31 females and 29 males, 91.7% of them were affected by acute lymphoblastic leukemia (ALL), and 8.3% by acute myeloid leukemia (AML). Five children had undergone HCST. Parents were interviewed by Vineland Adaptive Behavior Scales (VABS) on children’s motor skills and filled in the Italian Temperament Questionnaire (QUIT). VABS’s total scores were converted into equivalent mental age scores (EMA). A score difference of at least three months between current age and equivalent mental age was considered a developmental delay. Non-parametric analyses were run to understand if HSCT treatment and a specific age band influence children’s motor skills. Significant delays were found in global motor skills (56.7%) as well as in fine and gross motor domains. Mann Whitney U tests showed that children with HSCT were reported to have lower gross motor mean ranks (U = 62; p = 0.004; Mean rank = 15.40) than peers without HSCT (Mean rank = 31.87) and lower mean rank values on motor temperament scale (U = 9; p = 0.003; HSCT Mean rank = 4.75 versus no HSCT Mean rank = 27.81). Kruskal Wallis’ tests identified the high risk treatment showing that HSCT experience negatively impacted the motor skills and temperamental motor activity of pre-school children one year after the diagnosis of leukemia. PMID

Retailer’s replenishment policies under conditions of permissible delay in payments

Directory of Open Access Journals (Sweden)

Huang Yung-Fu

2004-01-01

Full Text Available Goyal (1985 is frequently cited when the inventory systems under conditions of permissible delay in payments are discussed. Goyal implicitly assumed that: 1. The unit selling price and the unit purchasing price are equal; 2. At the end of the credit period, the account is settled. The retailer starts paying for higher interest charges on the items in stock and returns money of the remaining balance immediately when the items are sold. But these assumptions are debatable in real-life situations. The main purpose of this paper is to modify Goyal’s model to allow the unit selling price and the unit purchasing price not necessarily be equal to reflect the real-life situations. Furthermore, this paper will adopt different payment rule. We assume that the retailer uses sales revenue during the permissible credit period to make payment to the supplier at the end of the credit period. If it is not enough to pay off the purchasing cost of all items, the retailer will pay off the remaining balance by taking loan from the bank. So, the retailer starts paying for the interest charges on the amount of loan from the bank after the account is settled. Then the retailer will return money to the bank at the end of the inventory cycle. Under these conditions, we model the retailer’s inventory system as a cost minimization problem to determine the retailer’s optimal cycle time and optimal order quantity. Four cases are developed to efficiently determine the optimal cycle time and the optimal order quantity. Numerical examples are given to illustrate these cases. Comparing with Goyal’s model, we also find that the optimal cycle times in this paper are not longer than those of Goyal’s model.

Routine delayed voiding cystourethography after initial successful endoscopic treatment with Dextranomer/Hialuronic Acid Copolimer (Dx/HA) of vesicoureteral reflux (VUR). Is it necessary?

Science.gov (United States)

García-Aparicio, L; Blázquez-Gómez, E; Vila Santandreu, A; Camacho Diaz, J A; Vila-Cots, J; Ramos Cebrian, M; de Haro, I; Martin, O; Tarrado, X

2016-12-01

Some guidelines recommend an early voiding cystourethrography (VCUG) after endoscopic treatment of vesicoureteral reflux (VUR), but there's no consensus if it's necessary a long-term follow-up in these patients. The aim of our study is analyze if it's necessary a delayed VCUG after initial successful treatment with Dx/HA. We have reviewed all medical charts of patients that underwent Dx/HA treatment from 2006 to 2010. We have selected patients with initial successful treatment and more than 3 years of radiological and clinical follow-up. We have analyzed late clinical and radiological outcomes. One hundred and sixty children with 228 refluxing ureters underwent Dx/HA endoscopic treatment with a mean follow-up of 52.13 months. Early VCUG was performed in 215 ureters with an initial successful rate of 84.1%. The group of study was 94/215 ureters with more than 3 years of follow-up with a delayed VCUG. VUR was still resolved in 79,8% of the ureters. Clinical success rate was 91.7%. The incidence of febrile urinary tract infection in those patients with cured VUR and those with a relapsed VUR was 8 and 15%, respectively; but there were no significant differences. We have not found any variable related with relapsed VUR except those ureters that initially received 2 injections (P<.05). If our objective in the treatment of VUR is to reduce the incidence of febrile urinary tract infection it is not necessary to perform a delayed VCUG even though the long-term radiological outcomes is worse than clinical outcome. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Patient and health system delay among patients with pulmonary tuberculosis in Beira city, Mozambique.

Science.gov (United States)

Saifodine, Abuchahama; Gudo, Paula Samo; Sidat, Mohsin; Black, James

2013-06-07

TB control is based on the rapid identification of cases and their effective treatment. However, many studies have shown that there are important delays in diagnosis and treatment of patients with TB. The purpose of this study was to assess the prevalence of and identify risk factors associated with patient delay and health system delay among newly diagnosed patients with pulmonary TB. A cross sectional study was carried out in Beira city, Mozambique between September 2009 and February 2010. Patients in the first month of treatment were consecutively selected to this study if they had a diagnosis of pulmonary TB, had no history of previous TB treatment, and were 18 years or older and provided informed consent. Data was obtained through a questionnaire administered to the patients and from patients' files. Among the 622 patients included in the study the median age was 32 years (interquartile range, 26-40) and 272 (43.7%) were females. The median total delay, patient delay and health system delay was 150 days (interquartile range, 91-240), 61 days (28-113) and 62 days (37-120), respectively. The contribution of patient delay and health system delay to total delay was similar. Farming, visiting first a traditional healer, low TB knowledge and coexistence of a chronic disease were associated with increased patient delay. More than two visits to a health facility, farming and coexistence of a chronic disease were associated with increased health system delay. This study revealed a long total delay with a similar contribution of patient delay and health system delay. To reduce the total delay in this setting we need a combination of interventions to encourage patients to seek appropriate health care earlier and to expedite TB diagnosis within the health care system.

Optimal control problems with delay, the maximum principle and necessary conditions

NARCIS (Netherlands)

Frankena, J.F.

1975-01-01

In this paper we consider a rather general optimal control problem involving ordinary differential equations with delayed arguments and a set of equality and inequality restrictions on state- and control variables. For this problem a maximum principle is given in pointwise form, using variational

Elite athletes and pubertal delay.

Science.gov (United States)

Kapczuk, Karina

2017-10-01

Intensive physical training and participation in competitive sports during childhood and early adolescence may affect athletes' pubertal development. On the other hand, pubertal timing, early or late, may impact on an athlete selection for a particular sport. Genetic predisposition, training load, nutritional status and psychological stress determine athletes' pubertal timing. Athletes that practice esthetic sports, especially gymnasts, are predisposed to a delay in pubertal development. The growing evidence indicates that energy deficiency, not a systemic training per se, plays a crucial role in the pathogenesis of functional hypothalamic hypogonadism in female athletes. Metabolic and psychologic stress activate hypothalamic-pituitary-adrenal axis and suppress hypothalamic-pituitary-ovarian axis. Female athletes who do not begin secondary sexual development by the age of 14 or menstruation by the age of 16 warrant a comprehensive evaluation and a targeted treatment. Somatic growth and sexual maturation of elite female athletes are largely sport-specific since each sport favors a particular somatotype and requires a specific training. Chronic negative energy balance resulting from a systemic physical training and inadequate energy intake may delay pubertal development in elite athletes. Youth athletes, especially those engaged in competitive sports that emphasize prepubertal or lean appearance, are at risk of developing relative energy deficiency in sport associated with disordered eating or eating disorders. Management strategies should address the complex conditions underlying functional hypothalamic hypogonadism.

Delayed traumatic intracranial hematoma

International Nuclear Information System (INIS)

Tomita, Hiroki

1984-01-01

CT was performed serially within 24 hours after head injury in 64 patients having Glasgow Coma Scale of 14 or less or cranial fracture shown on roentgenogram. Delayed traumatic extradural hematoma was observed within 7-12 hours after head injury in 6 cases (9.4%). This was prominent in the frontal and occipital regions (67%). Good recovery was seen in 83.3%. Delayed traumatic intracerebral hematoma was observed within 6-24 hours after head injury in 17 cases (26.6%). This higher incidence was related to contre coup injury. Conservative treatment was possible in 14 of the 17 patients (82.4%), showing good recovery in 70%. (Namekawa, K.)

Epidemiology, diagnostic delay and outcome of tuberculosis in North Jutland, Denmark

DEFF Research Database (Denmark)

Andersen, Rosa M Ø; Bjørn-Præst, Simon O; Oren Gradel, Kim

2011-01-01

The objective of this study was to evaluate the clinical outcome of tuberculosis (TB) with regards to epidemiology, symptoms, delay, diagnostics, use of HIV-test, treatment, treatment outcome and mortality in the North Jutland Region from 2000 through 2008.......The objective of this study was to evaluate the clinical outcome of tuberculosis (TB) with regards to epidemiology, symptoms, delay, diagnostics, use of HIV-test, treatment, treatment outcome and mortality in the North Jutland Region from 2000 through 2008....

A stability criterion for HNFDE with non-uniform delays

International Nuclear Information System (INIS)

Liu Xingwen; Zhong Shouming; Zhang Fengli

2005-01-01

Stability of functional differential equations (FDE) is an increasingly important problem in both science and engineering. Delays, whether uniform or non-uniform, play an important role in the dynamics of a system. Since non-uniform delay is more general and less focused than uniform delay, this paper concentrates on the stability of high-order neutral functional differential equations (HNFDE) with non-uniform delay, and proposes a sufficient condition for it. This result may be widely helpful, thanks to the frequent emergence of a HNFDE with non-uniform delay in various fields. Its effectiveness is illustrated by some examples

Permissible Delay in Payments

Directory of Open Access Journals (Sweden)

Yung-Fu Huang

2007-01-01

Full Text Available The main purpose of this paper wants to investigate the optimal retailer's lot-sizing policy with two warehouses under partially permissible delay in payments within the economic order quantity (EOQ framework. In this paper, we want to extend that fully permissible delay in payments to the supplier would offer the retailer partially permissible delay in payments. That is, the retailer must make a partial payment to the supplier when the order is received. Then the retailer must pay off the remaining balance at the end of the permissible delay period. In addition, we want to add the assumption that the retailer's storage space is limited. That is, the retailer will rent the warehouse to store these exceeding items when the order quantity is larger than retailer's storage space. Under these conditions, we model the retailer's inventory system as a cost minimization problem to determine the retailer's optimal cycle time and optimal order quantity. Three theorems are developed to efficiently determine the optimal replenishment policy for the retailer. Finally, numerical examples are given to illustrate these theorems and obtained a lot of managerial insights.

Duration reproduction with sensory feedback delay: Differential involvement of perception and action time

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Stephanie eGanzenmüller

2012-10-01

Full Text Available Previous research has shown that voluntary action can attract subsequent, delayed feedback events towards the action, and adaptation to the sensorimotor delay can even reverse motor-sensory temporal-order judgments. However, whether and how sensorimotor delay affects duration reproduction is still unclear. To investigate this, we injected an onset- or offset-delay to the sensory feedback signal from a duration reproduction task. We compared duration reproductions within (visual, auditory modality and across audiovisual modalities with feedback signal onset- and offset-delay manipulations. We found that the reproduced duration was lengthened in both visual and auditory feedback signal onset-delay conditions. The lengthening effect was evident immediately, on the first trial with the onset delay. However, when the onset of the feedback signal was prior to the action, the lengthening effect was diminished. In contrast, a shortening effect was found with feedback signal offset-delay, though the effect was weaker and manifested only in the auditory offset-delay condition. These findings indicate that participants tend to mix the onset of action and the feedback signal more when the feedback is delayed, and they heavily rely on motor-stop signals for the duration reproduction. Furthermore, auditory duration was overestimated compared to visual duration in crossmodal feedback conditions, and the overestimation of auditory duration (or the underestimation of visual duration was independent of the delay manipulation.

Infertility, infertility treatment and psychomotor development: the Danish National Birth Cohort.

Science.gov (United States)

Zhu, Jin Liang; Basso, Olga; Obel, Carsten; Hvidtjørn, Dorte; Olsen, Jørn

2009-03-01

Babies born of infertile couples, regardless of treatment, have a higher risk of preterm birth and low birthweight, conditions associated with delayed development. We examined developmental milestones in singletons as a function of parental infertility [time to pregnancy (TTP) > 12 months] and infertility treatment. From the Danish National Birth Cohort (1997-2003), we identified 37 897 singletons born of fertile couples (TTP 12 months), and 3309 born after infertility treatment. When the children were about 18 months old, mothers reported 12 developmental milestones by responding to structured questions. We defined a failure to achieve the assessed milestone or the minimal numbers of milestones in a summary (motor, or cognitive/language skills) as delay. Naturally conceived children born of infertile couples had a pattern of psychomotor development similar to that of children born of fertile couples, but increasing TTP correlated with a modest delay. When the analysis was restricted to infertile couples (treated and untreated), children born after treatment showed a slight delay in cognitive/language development (odds ratio 1.24, [95% confidence interval 1.01, 1.53]) for not meeting at least three out of six cognitive/language milestones); children born after intracytoplasmic sperm injection (ICSI) had the highest estimated relative risk of delay for most milestones, especially motor milestones. These results suggest that a long TTP may be associated with a modest developmental delay. Infertility treatment, especially ICSI, may be associated with a slight delay for some of these early milestones.

Global exponential stability of octonion-valued neural networks with leakage delay and mixed delays.

Science.gov (United States)

Popa, Călin-Adrian

2018-06-08

This paper discusses octonion-valued neural networks (OVNNs) with leakage delay, time-varying delays, and distributed delays, for which the states, weights, and activation functions belong to the normed division algebra of octonions. The octonion algebra is a nonassociative and noncommutative generalization of the complex and quaternion algebras, but does not belong to the category of Clifford algebras, which are associative. In order to avoid the nonassociativity of the octonion algebra and also the noncommutativity of the quaternion algebra, the Cayley-Dickson construction is used to decompose the OVNNs into 4 complex-valued systems. By using appropriate Lyapunov-Krasovskii functionals, with double and triple integral terms, the free weighting matrix method, and simple and double integral Jensen inequalities, delay-dependent criteria are established for the exponential stability of the considered OVNNs. The criteria are given in terms of complex-valued linear matrix inequalities, for two types of Lipschitz conditions which are assumed to be satisfied by the octonion-valued activation functions. Finally, two numerical examples illustrate the feasibility, effectiveness, and correctness of the theoretical results. Copyright © 2018 Elsevier Ltd. All rights reserved.

ALMOST PERIODIC SOLUTIONS TO SOME NONLINEAR DELAY DIFFERENTIAL EQUATION

Institute of Scientific and Technical Information of China (English)

无

2009-01-01

The existence of an almost periodic solutions to a nonlinear delay diffierential equation is considered in this paper. A set of sufficient conditions for the existence and uniqueness of almost periodic solutions to some delay diffierential equations is obtained.

Stability analysis of delayed genetic regulatory networks with stochastic disturbances

Energy Technology Data Exchange (ETDEWEB)

Zhou Qi, E-mail: zhouqilhy@yahoo.com.c [School of Automation, Nanjing University of Science and Technology, Nanjing 210094, Jiangsu (China); Xu Shengyuan [School of Automation, Nanjing University of Science and Technology, Nanjing 210094, Jiangsu (China); Chen Bing [Institute of Complexity Science, Qingdao University, Qingdao 266071, Shandong (China); Li Hongyi [Space Control and Inertial Technology Research Center, Harbin Institute of Technology, Harbin 150001 (China); Chu Yuming [Department of Mathematics, Huzhou Teacher' s College, Huzhou 313000, Zhejiang (China)

2009-10-05

This Letter considers the problem of stability analysis of a class of delayed genetic regulatory networks with stochastic disturbances. The delays are assumed to be time-varying and bounded. By utilizing Ito's differential formula and Lyapunov-Krasovskii functionals, delay-range-dependent and rate-dependent (rate-independent) stability criteria are proposed in terms of linear matrices inequalities. An important feature of the proposed results is that all the stability conditions are dependent on the upper and lower bounds of the delays. Another important feature is that the obtained stability conditions are less conservative than certain existing ones in the literature due to introducing some appropriate free-weighting matrices. A simulation example is employed to illustrate the applicability and effectiveness of the proposed methods.

Local and global stability for Lotka-Volterra systems with distributed delays and instantaneous negative feedbacks

Science.gov (United States)

Faria, Teresa; Oliveira, José J.

This paper addresses the local and global stability of n-dimensional Lotka-Volterra systems with distributed delays and instantaneous negative feedbacks. Necessary and sufficient conditions for local stability independent of the choice of the delay functions are given, by imposing a weak nondelayed diagonal dominance which cancels the delayed competition effect. The global asymptotic stability of positive equilibria is established under conditions slightly stronger than the ones required for the linear stability. For the case of monotone interactions, however, sharper conditions are presented. This paper generalizes known results for discrete delays to systems with distributed delays. Several applications illustrate the results.

Stability analysis for cellular neural networks with variable delays

International Nuclear Information System (INIS)

Zhang Qiang; Wei Xiaopeng; Xu Jin

2006-01-01

Some sufficient conditions for the global exponential stability of cellular neural networks with variable delay are obtained by means of a method based on delay differential inequality. The method, which does not make use of Lyapunov functionals, is simple and effective for the stability analysis of neural networks with delay. Some previously established results in the literature are shown to be special cases of the presented result

Delay to Reconstruction of the Adolescent Anterior Cruciate Ligament: The Socioeconomic Impact on Treatment.

Science.gov (United States)

Newman, Justin T; Carry, Patrick M; Terhune, Elizabeth B; Spruiell, Murray; Heare, Austin; Mayo, Meredith; Vidal, Armando F

2014-08-01

A delay in pediatric and adolescent anterior cruciate ligament (ACL) reconstruction is associated with an increase in the number of concomitant meniscal and chondral injuries. Factors that contribute to this delay have not been well described. Socioeconomic and demographic factors are related to ACL surgery timing. Cohort study; Level of evidence, 3. All subjects who underwent primary ACL reconstruction at a single tertiary pediatric hospital between 2005 and 2012 were retrospectively reviewed. Variables included concomitant knee injuries (cartilage or meniscus injuries requiring additional operative treatment) and chronologic, demographic, and socioeconomic factors. Multivariable Cox proportional-hazards analyses were used to identify factors related to ACL surgery timing. The mean age of the 272 subjects was 15.2 ± 2.12 years. Time to surgery was significantly different among subjects who required multiple additional surgical procedures at time of ACL reconstruction (median, 3.3 months) compared with subjects with 1 (median, 2.0 months) or no additional injuries (median, 1.6 months). Subjects underwent ACL reconstruction significantly sooner if they were older at the time of injury (hazard ratio [HR], 1.2 per 1 year; 95% CI, 1.1-1.2; P socioeconomic and demographic factors and ACL surgery timing to optimize outcomes.

Global robust stability of neural networks with multiple discrete delays and distributed delays

International Nuclear Information System (INIS)

Gao Ming; Cui Baotong

2009-01-01

The problem of global robust stability is investigated for a class of uncertain neural networks with both multiple discrete time-varying delays and distributed time-varying delays. The uncertainties are assumed to be of norm-bounded form and the activation functions are supposed to be bounded and globally Lipschitz continuous. Based on the Lyapunov stability theory and linear matrix inequality technique, some robust stability conditions guaranteeing the global robust convergence of the equilibrium point are derived. The proposed LMI-based criteria are computationally efficient as they can be easily checked by using recently developed algorithms in solving LMIs. Two examples are given to show the effectiveness of the proposed results.

The delaying effect of stigma on mental health help-seeking in Sri Lanka.

Science.gov (United States)

Fernando, Sunera M; Deane, Frank P; McLeod, Hamish J

2017-03-01

Mental health stigma has been associated with delays in seeking treatment. To describe perceived stigma experienced by patients and carers in Sri Lanka and to determine the effects of stigma on help-seeking delay. Survey of outpatients and family carers (n = 118 dyads) attending two psychiatric hospitals in Sri Lanka, using the Disclosure and Discrimination subscales of the Stigma Scale. Stigma was positively related to help-seeking delay for carers but not patients. Public stigma experienced by carers accounted for 23% of the variance in help-seeking delay. Reducing stigma may reduce help-seeking delays during the course of treatment. © 2016 John Wiley & Sons Australia, Ltd.

Factors influencing diagnosis delay of advanced breast cancer in Moroccan women.

Science.gov (United States)

Maghous, A; Rais, F; Ahid, S; Benhmidou, N; Bellahamou, K; Loughlimi, H; Marnouche, E; Elmajjaoui, S; Elkacemi, H; Kebdani, T; Benjaafar, N

2016-06-07

Delay in the diagnosis of breast cancer in symptomatic women of 3 months or more is associated with advanced stage and low survival. We conducted this study to learn more about the extent and reasons behind diagnosis delay of advanced breast cancer in Moroccan women. A group of patients with advanced breast cancer were interviewed at the National Institute of Oncology in Rabat during the period from February to December 2014. Diagnosis delay was devised into patient delay and system delay. Patient delay was defined as time from first symptoms until first medical consultation. System delay was defined as time from first presentation to a health care provider until definite diagnosis or treatment. Prospective information and clinical data were collected on a form during an interview with each patient and from medical records. In all, 137 patients were interviewed. The mean age of women was 48.3 ± 10.4 years. The median of consultation time was 6[4,12] months and the median of diagnosis time was 1[1,3] months. Diagnosis delay was associated to a personal reason in 96 (70.1 %) patients and to a medical reason in 19 (13.9 %) patients. A number of factors predicted diagnosis delay: symptoms were not considered serious in 66 (55.9 %) patients; traditional therapy was applied in 15 (12.7 %) patients and fear of cancer diagnosis and/or treatment in 14 (11.9 %) patients. A use of traditional methods was significantly associated with rural residence and far away from basic health center (p = 0.000). Paradoxically, a family history of breast cancer was significantly higher in who report a fear of cancer diagnosis and/or treatment to diagnosis delay (p Diagnosis delay is very serious problem in Morocco. Diagnosis delay was associated with complex interactions between several factors and with advanced stages. There is a need for improving breast cancer information in our populations and training of general practitioners to reduce advanced breast cancer by

Noise-sustained fluctuations in stochastic dynamics with a delay.

Science.gov (United States)

D'Odorico, Paolo; Laio, Francesco; Ridolfi, Luca

2012-04-01

Delayed responses to external drivers are ubiquitous in environmental, social, and biological processes. Delays may induce oscillations, Hopf bifurcations, and instabilities in deterministic systems even in the absence of nonlinearities. Despite recent advances in the study of delayed stochastic differential equations, the interaction of random drivers with delays remains poorly understood. In particular, it is unclear whether noise-induced behaviors may emerge from these interactions. Here we show that noise may enhance and sustain transient periodic oscillations inherent to deterministic delayed systems. We investigate the conditions conducive to the emergence and disappearance of these dynamics in a linear system in the presence of both additive and multiplicative noise.

Using Video to Bridge the Gap Between Problem Behavior and a Delayed Time-out Procedure.

Science.gov (United States)

Coppage, Sara; Meindl, James N

2017-09-01

Treatment plans focused on problem behavior often include punishment contingencies to decrease problem behavior. Immediate punishers are typically more effective than delayed punishers, but immediate delivery of a punisher is not always possible. Strategies need to be developed to increase the suppressive effects of delayed punishers. This study demonstrated the effectiveness of a treatment package involving replaying a video recording of problem behavior immediately before delivering a 15 min delayed time-out. This treatment package may prove to be an accessible and inexpensive strategy when using delayed punishers.

Stability analysis of linear switching systems with time delays

International Nuclear Information System (INIS)

Li Ping; Zhong Shouming; Cui Jinzhong

2009-01-01

The issue of stability analysis of linear switching system with discrete and distributed time delays is studied in this paper. An appropriate switching rule is applied to guarantee the stability of the whole switching system. Our results use a Riccati-type Lyapunov functional under a condition on the time delay. So, switching systems with mixed delays are developed. A numerical example is given to illustrate the effectiveness of our results.

Finite-Dimensional Representations for Controlled Diffusions with Delay

Energy Technology Data Exchange (ETDEWEB)

Federico, Salvatore, E-mail: salvatore.federico@unimi.it [Università di Milano, Dipartimento di Economia, Management e Metodi Quantitativi (Italy); Tankov, Peter, E-mail: tankov@math.univ-paris-diderot.fr [Université Paris Diderot, Laboratoire de Probabilités et Modèles Aléatoires (France)

2015-02-15

We study stochastic delay differential equations (SDDE) where the coefficients depend on the moving averages of the state process. As a first contribution, we provide sufficient conditions under which the solution of the SDDE and a linear path functional of it admit a finite-dimensional Markovian representation. As a second contribution, we show how approximate finite-dimensional Markovian representations may be constructed when these conditions are not satisfied, and provide an estimate of the error corresponding to these approximations. These results are applied to optimal control and optimal stopping problems for stochastic systems with delay.

Global robust exponential stability for interval neural networks with delay

International Nuclear Information System (INIS)

Cui Shihua; Zhao Tao; Guo Jie

2009-01-01

In this paper, new sufficient conditions for globally robust exponential stability of neural networks with either constant delays or time-varying delays are given. We show the sufficient conditions for the existence, uniqueness and global robust exponential stability of the equilibrium point by employing Lyapunov stability theory and linear matrix inequality (LMI) technique. Numerical examples are given to show the approval of our results.

No Evidence of Delayed Parasite Clearance after Oral Artesunate Treatment of Uncomplicated Falciparum Malaria in Mali

Science.gov (United States)

Maiga, Amelia W.; Fofana, Bakary; Sagara, Issaka; Dembele, Demba; Dara, Antoine; Traore, Oumar Bila; Toure, Sekou; Sanogo, Kassim; Dama, Souleymane; Sidibe, Bakary; Kone, Aminatou; Thera, Mahamadou A.; Plowe, Christopher V.; Doumbo, Ogobara K.; Djimde, Abdoulaye A.

2012-01-01

Plasmodium falciparum resistance to artemisinins by delayed parasite clearance is present in Southeast Asia. Scant data on parasite clearance after artemisinins are available from Africa, where transmission is high, burden is greatest, and artemisinin use is being scaled up. Children 1–10 years of age with uncomplicated malaria were treated with 7 days of artesunate and followed for 28 days. Blood smears were done every 8 hours until negative by light microscopy. Results were compared with a similar study conducted in the same village in 2002–2004. The polymerase chain reaction-corrected cure rate was 100%, identical to 2002–2004. By 24 hours after treatment initiation, 37.0% of participants had cleared parasitemia, compared with 31.9% in 2002–2004 (P = 0.5). The median parasite clearance time was 32 hours. Only one participant still had parasites at 48 hours and no participant presented parasitemia at 72 hours. Artesunate was highly efficacious, with no evidence of delayed parasite clearance. We provide baseline surveillance data for the emergence or dissemination of P. falciparum resistance in sub-Saharan Africa. PMID:22764287

[Early versus delayed physiotherapy in the treatment of post-prostatectomy male urinary incontinence].

Science.gov (United States)

Tarcía Kahihara, Carina; Ferreira, Ubirajora; Nardi Pedro, Renato; Matheus, Wagner Eduardo; Rodrigues Netto, Nelson

2006-10-01

To analyze the importance of the starting time for pelvic floor physiotherapy in patients with post radical prostatectomy urinary incontinence. Between May 2003 and February 2004 18 patients with the diagnosis of post radical prostatectomy urinary incontinence underwent physiotherapy of the pelvic floor. Each patient received 12 sessions using kinesotherapy and electric stimulation on a weekly basis. Patients were divided into two groups: Group 1 included eight patients that started therapy within the first six months after surgery; Group 2 included 10 patients starting therapy after the sixth post operative month. All patients were evaluated by the pad test and number of incontinence pads per day. Evaluating pad tests before and after treatment, six patients in group 1 had a reduction of the amount of urine leak in comparison to seven patients in group 2. The statistical analysis showed significant differences before and after treatment for both groups (group 1: p = 0.028; group 2: p = 0.018). The evaluation of the number of pads showed: Group 1: all eight patients using pods had a reduction in the number of pads. Group 2: 5 of the eight patients using pads had a reduction and the other three continued using the same number. Statistical analysis comparing the number of pads per day before and after treatment showed a significant difference in group 1 (p = 0.004). There was no statistically significant difference in the number of pads per day before and after physiotherapy in group 2, although half of the patients showed a diminishment in the number of pads required after treatment. Results demonstrate that early indication of physiotherapy for the treatment of post radical prostatectomy urinary incontinence is better than delayed treatment. New works may be developed in the future to confirm our results.

Anoxia Treatment for Delaying Skin Browning, Inhibiting Disease Development and Maintaining the Quality of Litchi Fruit

Directory of Open Access Journals (Sweden)

Yueming Jiang

2004-01-01

Full Text Available Litchi fruit has a very short shelf life after harvest, so marketers and consumers alike desire longer periods of storage, transportation and distribution. To extend shelf life, anoxia treatments were used for the fruit. Litchi fruit were exposed to pure N2 for 0, 3, 6, 12 or 24 h. They were then kept individually in closed but vented containers for 6 days in the dark at 20 °C and 95–100 % relative humidity. Exposure of litchi fruit to N2 for 3 or 6 h markedly delayed skin browning, reduced rot development and maintained higher concentrations of total soluble solids, titratable acidity and ascorbic acid after 6 days of storage. Anoxia treatment for 24 h reduced browning index, but it accelerated disease development, compared to the control. Thus, a pre-storage pure N2 treatment for 3 or 6 h can be an effective means of reducing rotting while maintaining the physical quality of the fruit.

Assessment of Confounding in Studies of Delay and Survival

DEFF Research Database (Denmark)

Tørring, Marie Louise; Vedsted, Peter; Frydenberg, Morten

BACKGROUND: Whether longer time to diagnosis (diagnostic delay) in patients with cancer symptoms is directly and independently associated with poor prognosis cannot be determined in randomised controlled trials. Analysis of observational data is therefore necessary. Many previous studies of the i......BACKGROUND: Whether longer time to diagnosis (diagnostic delay) in patients with cancer symptoms is directly and independently associated with poor prognosis cannot be determined in randomised controlled trials. Analysis of observational data is therefore necessary. Many previous studies......) Clarify which factors are considered confounders or intermediate variables in the literature. 2) Assess how and to what extent these factors bias survival estimates. CONSIDERATIONS: As illustrated in Figure 1, symptoms of cancer may alert patients, GP's, and hospital doctors differently and influence both...... delay and survival time in different ways. We therefore assume that the impact of confounding factors depends on the type of delay studied (e.g., patient delay, GP delay, referral delay, or treatment delay). MATERIALS & METHODS: The project includes systematic review and methodological developments...

A note on exponential convergence of neural networks with unbounded distributed delays

Energy Technology Data Exchange (ETDEWEB)

Chu Tianguang [Intelligent Control Laboratory, Center for Systems and Control, Department of Mechanics and Engineering Science, Peking University, Beijing 100871 (China)]. E-mail: chutg@pku.edu.cn; Yang Haifeng [Intelligent Control Laboratory, Center for Systems and Control, Department of Mechanics and Engineering Science, Peking University, Beijing 100871 (China)

2007-12-15

This note examines issues concerning global exponential convergence of neural networks with unbounded distributed delays. Sufficient conditions are derived by exploiting exponentially fading memory property of delay kernel functions. The method is based on comparison principle of delay differential equations and does not need the construction of any Lyapunov functionals. It is simple yet effective in deriving less conservative exponential convergence conditions and more detailed componentwise decay estimates. The results of this note and [Chu T. An exponential convergence estimate for analog neural networks with delay. Phys Lett A 2001;283:113-8] suggest a class of neural networks whose globally exponentially convergent dynamics is completely insensitive to a wide range of time delays from arbitrary bounded discrete type to certain unbounded distributed type. This is of practical interest in designing fast and reliable neural circuits. Finally, an open question is raised on the nature of delay kernels for attaining exponential convergence in an unbounded distributed delayed neural network.

A note on exponential convergence of neural networks with unbounded distributed delays

International Nuclear Information System (INIS)

Chu Tianguang; Yang Haifeng

2007-01-01

This note examines issues concerning global exponential convergence of neural networks with unbounded distributed delays. Sufficient conditions are derived by exploiting exponentially fading memory property of delay kernel functions. The method is based on comparison principle of delay differential equations and does not need the construction of any Lyapunov functionals. It is simple yet effective in deriving less conservative exponential convergence conditions and more detailed componentwise decay estimates. The results of this note and [Chu T. An exponential convergence estimate for analog neural networks with delay. Phys Lett A 2001;283:113-8] suggest a class of neural networks whose globally exponentially convergent dynamics is completely insensitive to a wide range of time delays from arbitrary bounded discrete type to certain unbounded distributed type. This is of practical interest in designing fast and reliable neural circuits. Finally, an open question is raised on the nature of delay kernels for attaining exponential convergence in an unbounded distributed delayed neural network

Modeling delay in genetic networks: from delay birth-death processes to delay stochastic differential equations.

Science.gov (United States)

Gupta, Chinmaya; López, José Manuel; Azencott, Robert; Bennett, Matthew R; Josić, Krešimir; Ott, William

2014-05-28

Delay is an important and ubiquitous aspect of many biochemical processes. For example, delay plays a central role in the dynamics of genetic regulatory networks as it stems from the sequential assembly of first mRNA and then protein. Genetic regulatory networks are therefore frequently modeled as stochastic birth-death processes with delay. Here, we examine the relationship between delay birth-death processes and their appropriate approximating delay chemical Langevin equations. We prove a quantitative bound on the error between the pathwise realizations of these two processes. Our results hold for both fixed delay and distributed delay. Simulations demonstrate that the delay chemical Langevin approximation is accurate even at moderate system sizes. It captures dynamical features such as the oscillatory behavior in negative feedback circuits, cross-correlations between nodes in a network, and spatial and temporal information in two commonly studied motifs of metastability in biochemical systems. Overall, these results provide a foundation for using delay stochastic differential equations to approximate the dynamics of birth-death processes with delay.

Modeling delay in genetic networks: From delay birth-death processes to delay stochastic differential equations

Energy Technology Data Exchange (ETDEWEB)

Gupta, Chinmaya; López, José Manuel; Azencott, Robert; Ott, William [Department of Mathematics, University of Houston, Houston, Texas 77004 (United States); Bennett, Matthew R. [Department of Biochemistry and Cell Biology, Rice University, Houston, Texas 77204, USA and Institute of Biosciences and Bioengineering, Rice University, Houston, Texas 77005 (United States); Josić, Krešimir [Department of Mathematics, University of Houston, Houston, Texas 77004 (United States); Department of Biology and Biochemistry, University of Houston, Houston, Texas 77204 (United States)

2014-05-28

Delay is an important and ubiquitous aspect of many biochemical processes. For example, delay plays a central role in the dynamics of genetic regulatory networks as it stems from the sequential assembly of first mRNA and then protein. Genetic regulatory networks are therefore frequently modeled as stochastic birth-death processes with delay. Here, we examine the relationship between delay birth-death processes and their appropriate approximating delay chemical Langevin equations. We prove a quantitative bound on the error between the pathwise realizations of these two processes. Our results hold for both fixed delay and distributed delay. Simulations demonstrate that the delay chemical Langevin approximation is accurate even at moderate system sizes. It captures dynamical features such as the oscillatory behavior in negative feedback circuits, cross-correlations between nodes in a network, and spatial and temporal information in two commonly studied motifs of metastability in biochemical systems. Overall, these results provide a foundation for using delay stochastic differential equations to approximate the dynamics of birth-death processes with delay.

Modeling delay in genetic networks: From delay birth-death processes to delay stochastic differential equations

International Nuclear Information System (INIS)

Gupta, Chinmaya; López, José Manuel; Azencott, Robert; Ott, William; Bennett, Matthew R.; Josić, Krešimir

2014-01-01

Delay is an important and ubiquitous aspect of many biochemical processes. For example, delay plays a central role in the dynamics of genetic regulatory networks as it stems from the sequential assembly of first mRNA and then protein. Genetic regulatory networks are therefore frequently modeled as stochastic birth-death processes with delay. Here, we examine the relationship between delay birth-death processes and their appropriate approximating delay chemical Langevin equations. We prove a quantitative bound on the error between the pathwise realizations of these two processes. Our results hold for both fixed delay and distributed delay. Simulations demonstrate that the delay chemical Langevin approximation is accurate even at moderate system sizes. It captures dynamical features such as the oscillatory behavior in negative feedback circuits, cross-correlations between nodes in a network, and spatial and temporal information in two commonly studied motifs of metastability in biochemical systems. Overall, these results provide a foundation for using delay stochastic differential equations to approximate the dynamics of birth-death processes with delay

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

Science.gov (United States)

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

2015-09-01

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

Is immediate adjunctive CBT more beneficial than delayed CBT in treating depression?: A Pilot Study.

Science.gov (United States)

Rizvi, Sakina J; Zaretsky, Ari; Schaffer, Ayal; Levitt, Anthony

2015-03-01

Cognitive-behavioral therapy (CBT) is an efficacious first-line therapy for patients with major depressive disorder (MDD). Due to the limited accessibility of CBT, long wait lists result in delayed treatment, which may affect treatment outcomes. The goal of this pilot study was to obtain preliminary data from a randomized controlled trial to determine whether delayed CBT reduces the effectiveness of the therapy compared to immediate CBT in patients with MDD receiving pharmacotherapy. Patients were randomized to receive immediate CBT (n=18) or to begin CBT after 6 months (n=20) and received 14 weekly sessions, followed by two additional booster sessions. During the active treatment months, patients in the immediate group demonstrated reductions in scores on the Beck Depression Inventory II (BDI-II) that were similar to those in the delayed CBT group. However, when the analysis was performed using only data from patients in the delayed group who were still in a depressive episode, there was an overall greater decrease in BDI-II scores in the immediate group vs. the delayed group over the active treatment months, but not specifically at the 6-month endpoint. These findings suggest delays in depression treatment, similar to what occurs with real-world wait list times, may not have a significant impact on the effectiveness of CBT in patients who are already receiving treatment as usual. However, such delays may affect the effectiveness of CBT in those patients who remain depressed during the time delay. A larger trial is necessary to confirm these findings. (Journal of Psychiatric Practice 2015;21:107-113).

A comparison of pecking generated by serial, delay, and trace autoshaping procedures1

Science.gov (United States)

Newlin, Robert J.; LoLordo, Vincent M.

1976-01-01

Pigeons were exposed to serial, delay, and trace autoshaping procedures. In Experiment I, all conditioned stimuli (CSs) were changes in illumination of the response key. The number of trials to acquisition of the keypeck increased from serial, to 4-sec delay, 8-sec delay, and 8-sec trace procedures, in that order. In Experiment II, which used a longer intertrial interval, trials to criterion increased from 8-sec delay, to 28-sec delay, 8-sec trace, and 28-sec trace procedures, in that order. In Experiment III, two groups received serial procedures in which the first CS was either a tone or a houselight, and the second was a keylight. The tone group acquired the key peck more rapidly than the houselight group. Early in conditioning in these experiments, and when the conditioned stimulus was a change in the keylight, there was a short latency to the onset of pecking and pecking was directed at the CS. After extensive conditioning, or when the CS was relatively diffuse, pecking still occurred, but had a longer latency and was not reliably directed toward the conditioned stimulus. PMID:16811907

Delayed encephalopathy after acute carbon monoxide poisoning

Directory of Open Access Journals (Sweden)

Mehmet İbrahim Turan

2014-03-01

Full Text Available Carbon monoxide poisoning is a major cause of death following attempted suicide and accidental exposures. Although clinical presentation depends on the duration and the intensity of exposure, the assessment of the severity of intoxication is difficult. A small percentage of patients who show complete initial recovery may develop delayed neurological deficits. Delayed encephalopathy after acute carbon monoxide poisoning is a rare and poor prognosis neurologic disorders and there is no specific treatment. We present a case with early onset of delayed encephalopathy after acute carbon monoxide poisoning with typical cranial imaging findings in a child with atypical history and clinical presentation.

Stability Tests of Positive Fractional Continuous-time Linear Systems with Delays

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Tadeusz Kaczorek

2013-06-01

Full Text Available Necessary and sufficient conditions for the asymptotic stability of positive fractional continuous-time linear systems with many delays are established. It is shown that: 1 the asymptotic stability of the positive fractional system is independent of their delays, 2 the checking of the asymptotic stability of the positive fractional systems with delays can be reduced to checking of the asymptotic stability of positive standard linear systems without delays.

Exponential stability of delayed fuzzy cellular neural networks with diffusion

International Nuclear Information System (INIS)

Huang Tingwen

2007-01-01

The exponential stability of delayed fuzzy cellular neural networks (FCNN) with diffusion is investigated. Exponential stability, significant for applications of neural networks, is obtained under conditions that are easily verified by a new approach. Earlier results on the exponential stability of FCNN with time-dependent delay, a special case of the model studied in this paper, are improved without using the time-varying term condition: dτ(t)/dt < μ

Delayed tooth replantation after root surface treatment with sodium hypochlorite and sodium fluoride: histomorphometric analysis in rats.

Science.gov (United States)

Sottovia, André Dotto; Sonoda, Celso Koogi; Poi, Wilson Roberto; Panzarini, Sônia Regina; Lauris, José Roberto Pereira

2006-04-01

In cases of delayed tooth replantation, non-vital periodontal ligament remnants have been removed with sodium hypochlorite in an attempt to control root resorption. Nevertheless, reports of its irritating potential in contact with the alveolar connective tissue have been described. Therefore, this study evaluated the healing process on delayed replantation of rat teeth, after periodontal ligament removal by different treatment modalities. Twenty-four rats, assigned to 3 groups (n=8), had their upper right incisor extracted and left on the workbench for desiccation during 60 min. Afterwards, the teeth in group I were immersed in saline for 2 min. In group II, root surfaces were scrubbed with gauze soaked in saline for 2 min; and in group III, scrubbing was done with gauze soaked in 1% sodium hypochlorite solution. Thereafter, root surfaces were etched with 37% phosphoric acid and immersed in 2% acidulate-phosphate sodium fluoride solution, at pH 5.5. Root canals were filled with a calcium hydroxide-based paste and the teeth were replanted. The animals were sacrificed 60 days postoperatively and the pieces containing the replanted teeth were processed and paraffin- embedded. Semi-serial transversally sections were obtained from the middle third of the root and stained with hematoxylin and eosin for histomorphometric analysis. Data were analyzed statistically using Kruskal-Wallis and Dunn's tests. The results showed that root structure and cementum extension were more affected by resorption in group III (p<0.05). All groups were affected by root resorption but the treatment performed in group III was the least effective for its control. The treatment accomplished in groups I and II yielded similar results to each other.

Understanding the delayed-keyword effect on metacomprehension accuracy.

Science.gov (United States)

Thiede, Keith W; Dunlosky, John; Griffin, Thomas D; Wiley, Jennifer

2005-11-01

The typical finding from research on metacomprehension is that accuracy is quite low. However, recent studies have shown robust accuracy improvements when judgments follow certain generation tasks (summarizing or keyword listing) but only when these tasks are performed at a delay rather than immediately after reading (K. W. Thiede & M. C. M. Anderson, 2003; K. W. Thiede, M. C. M. Anderson, & D. Therriault, 2003). The delayed and immediate conditions in these studies confounded the delay between reading and generation tasks with other task lags, including the lag between multiple generation tasks and the lag between generation tasks and judgments. The first 2 experiments disentangle these confounded manipulations and provide clear evidence that the delay between reading and keyword generation is the only lag critical to improving metacomprehension accuracy. The 3rd and 4th experiments show that not all delayed tasks produce improvements and suggest that delayed generative tasks provide necessary diagnostic cues about comprehension for improving metacomprehension accuracy.

Between two beds: inappropriately delayed discharges from hospitals.

Science.gov (United States)

Holmås, Tor Helge; Islam, Mohammad Kamrul; Kjerstad, Egil

2013-12-01

Acknowledging the necessity of a division of labour between hospitals and social care services regarding treatment and care of patients with chronic and complex conditions, is to acknowledge the potential conflict of interests between health care providers. A potentially important conflict is that hospitals prefer comparatively short length of stay (LOS) at hospital, while social care services prefer longer LOS all else equal. Furthermore, inappropriately delayed discharges from hospital, i.e. bed blocking, is costly for society. Our aim is to discuss which factors that may influence bed blocking and to quantify bed blocking costs using individual Norwegian patient data, merged with social care and hospital data. The data allow us to divide hospital LOS into length of appropriate stay (LAS) and length of delay (LOD), the bed blocking period. We find that additional resources allocated to social care services contribute to shorten LOD indicating that social care services may exploit hospital resources as a buffer for insufficient capacity. LAS increases as medical complexity increases indicating hospitals incentives to reduce LOS are softened by considerations related to patients’ medical needs. Bed blocking costs constitute a relatively large share of the total costs of inpatient care.

Factors contributing to delay in parasite clearance in uncomplicated falciparum malaria in children

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Sijuade Abayomi

2010-02-01

Full Text Available Abstract Background Drug resistance in Plasmodium falciparum is common in many endemic and other settings but there is no clear recommendation on when to change therapy when there is delay in parasite clearance after initiation of therapy in African children. Methods The factors contributing to delay in parasite clearance, defined as a clearance time > 2 d, in falciparum malaria were characterized in 2,752 prospectively studied children treated with anti-malarial drugs between 1996 and 2008. Results 1,237 of 2,752 children (45% had delay in parasite clearance. Overall 211 children (17% with delay in clearance subsequently failed therapy and they constituted 72% of those who had drug failure, i.e., 211 of 291 children. The following were independent risk factors for delay in parasite clearance at enrolment: age less than or equal to 2 years (Adjusted odds ratio [AOR] = 2.13, 95% confidence interval [CI]1.44-3.15, P 50,000/ul (AOR = 2.21, 95% CI = 1.77-2.75, P 20000/μl a day after treatment began, were independent risk factors for delay in clearance. Non-artemisinin monotherapies were associated with delay in clearance and treatment failures, and in those treated with chloroquine or amodiaquine, with pfmdr 1/pfcrt mutants. Delay in clearance significantly increased gametocyte carriage (P Conclusion Delay in parasite clearance is multifactorial, is related to drug resistance and treatment failure in uncomplicated malaria and has implications for malaria control efforts in sub-Saharan Africa.

Stability Analysis for Fractional-Order Linear Singular Delay Differential Systems

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Hai Zhang

2014-01-01

Full Text Available We investigate the delay-independently asymptotic stability of fractional-order linear singular delay differential systems. Based on the algebraic approach, the sufficient conditions are presented to ensure the asymptotic stability for any delay parameter. By applying the stability criteria, one can avoid solving the roots of transcendental equations. An example is also provided to illustrate the effectiveness and applicability of the theoretical results.

Treatment with 24 h-delayed normo- and hyperbaric oxygenation in severe sepsis induced by cecal ligation and puncture in rats

DEFF Research Database (Denmark)

Bærnthsen, Nina Falcon; Hansen, Marco Bo; Wahl, Anna Mygind

2017-01-01

uncertain. We investigated the effects of 24 h delayed normobaric oxygen (NBO2) and HBO2treatment on the endogenous production of the inflammatory markers interleukin (IL)-6, tumor necrosis factor (TNF)-α and IL-10, and on mortality in rats with cecal ligation and puncture (CLP) induced sepsis. Method...

A delay-dependent approach to robust control for neutral uncertain neural networks with mixed interval time-varying delays

International Nuclear Information System (INIS)

Lu, Chien-Yu

2011-01-01

This paper considers the problem of delay-dependent global robust stabilization for discrete, distributed and neutral interval time-varying delayed neural networks described by nonlinear delay differential equations of the neutral type. The parameter uncertainties are norm bounded. The activation functions are assumed to be bounded and globally Lipschitz continuous. Using a Lyapunov functional approach and linear matrix inequality (LMI) techniques, the stability criteria for the uncertain neutral neural networks with interval time-varying delays are established in the form of LMIs, which can be readily verified using the standard numerical software. An important feature of the result reported is that all the stability conditions are dependent on the upper and lower bounds of the delays. Another feature of the results lies in that it involves fewer free weighting matrix strategy, and upper bounds of the inner product between two vectors are not introduced to reduce the conservatism of the criteria. Two illustrative examples are provided to demonstrate the effectiveness and the reduced conservatism of the proposed method

Psychosocial and cultural reasons for delay in seeking help and nonadherence to treatment in Indonesian women with breast cancer: A qualitative study.

NARCIS (Netherlands)

Iskandarsyah, A.; Klerk, C.D.; Suardi, D.R.; Soemitro, M.P.; Sadarjoen, S.S.; Passchier, J.

2014-01-01

Objective: The aim of this study was to explore reasons for delay in seeking medical help and nonadherence to treatment in Indonesian women with breast cancer. Method: Semistructured interviews were conducted by purposive sampling, using a consecutive sample of 50 breast cancer patients who were

The 808 nm Laser-Assisted Surgery as an Adjunct to Orthodontic Treatment of Delayed Tooth Eruption.

Science.gov (United States)

Seifi, Massoud; Vahid-Dastjerdi, Elahe; Ameli, Nazila; Badiee, Mohammad-Reza; Younessian, Farnaz; Amdjadi, Parisa

2013-01-01

Failure of teeth to erupt from gingival tissues at usual developmental time is called delayed tooth eruption (DTE). Delayed tooth eruption lead to prolonged fixed orthodontic treatment and its eventual complications. The purpose of the present study was to evaluate the effect of laser-assisted (808 nm) surgical uncovering, on the tooth emergence and orthodontic treatment of DTE. A total of 16 orthodontic patients were included in this study and were equally assigned to an experimental and a control group. Subjects for experiment consisted of eight patients (6 girls and 2 boys) with a mean age of 14±0.9 years. All patients exhibited delayed second premolar eruption. The laser wavelength was 810 nm and it was set in a continuous wave mode at a power output of 1.6 watt with a 0.3-mm diameter fiber tip. When the target tissue was sufficiently anesthetized, the tip was directed at an angle of 10 to 20 degrees to the tissue (light contact mode); and was applied continuously for approximately 12 Seconds until an acceptable tooth exposure area was visible. The facial axis of the clinical crown (FACC) line represents the most prominent portion of the facial central lobe for premolars. All orthodontic brackets are aligned along this reference and are located on FA (Facial Axis) point. The standard for adequate tooth eruption was the accessibility of facial axis of the clinical crown (FACC) for bonding the brackets. Data gathered from the patients were statistically surveyed and compared by means of Tukey's Test and Analysis of Variance (ANOVA). All patients showed good gingival status, no significant bleeding during or immediately after the surgery, and acceptable level of healing after laser surgery. The biologic width of the teeth was preserved and no violation of this important periodontal parameter was observed. The average time for accessing the FA point in experimental group was 11±1.1 weeks and the mentioned period was increased to 25±1.8 weeks in control group

Delay time and tunneling transient phenomena

International Nuclear Information System (INIS)

Garcia-Calderon, Gaston; Villavicencio, Jorge

2002-01-01

Analytic solutions to the time-dependent Schroedinger equation for cutoff wave initial conditions are used to investigate the time evolution of the transmitted probability density for tunneling. For a broad range of values of the potential barrier opacity α, we find that the probability density exhibits two evolving structures. One refers to the propagation of a forerunner related to a time domain resonance [Phys. Rev. A 64, 0121907 (2001)], while the other consists of a semiclassical propagating wave front. We find a regime where the forerunners are absent, corresponding to positive time delays, and show that this regime is characterized by opacities α c . The critical opacity α c is derived from the analytical expression for the delay time, which reflects a link between transient effects in tunneling and the delay time

Robust and global delay-dependent stability for genetic regulatory networks with parameter uncertainties.

Science.gov (United States)

Tian, Li-Ping; Wang, Jianxin; Wu, Fang-Xiang

2012-09-01

The study of stability is essential for designing or controlling genetic regulatory networks, which can be described by nonlinear differential equations with time delays. Much attention has been paid to the study of delay-independent stability of genetic regulatory networks and as a result, many sufficient conditions have been derived for delay-independent stability. Although it might be more interesting in practice, delay-dependent stability of genetic regulatory networks has been studied insufficiently. Based on the linear matrix inequality (LMI) approach, in this study we will present some delay-dependent stability conditions for genetic regulatory networks. Then we extend these results to genetic regulatory networks with parameter uncertainties. To illustrate the effectiveness of our theoretical results, gene repressilatory networks are analyzed .

Probing the limits of delay intolerance: preliminary young adult data from the Delay Frustration Task (DeFT).

Science.gov (United States)

Bitsakou, Paraskevi; Antrop, Inge; Wiersema, Jan Roelf; Sonuga-Barke, Edmund J S

2006-02-15

Delay intolerance/aversion is one amongst a number of candidate neuropsychological endophenotypes for ADHD. Pilot data suggest that, because of potential ceiling effects, simple choice measures of delay tolerance used for children are probably not appropriate for adolescents and adults. The Delay Frustration Task (DeFT) is a new measure of delay intolerance, designed to be used in a similar form with adolescents and adults as well as children. In it delay frustration is indexed as the number and duration of responses made on a response key during a series of unpredictable and unsignalled delay periods, which interrupt the completion of a simple computer-based tests. The aim of this study was to provide preliminary data on the applicability of the task in a sample of young adults. The DeFT was administered to 49 male and female undergraduate students selected from a normal population-base. Their mean age was 23.14 (S.D.=1.54). Three measures of delay frustration were recorded across time intervals during the response window; the number of responses, their duration and their combined product (total time button was pressed) was calculated for each second interval bin during the post-response delay period. The AARS and HADS were used as screening questionnaires for ADHD and anxiety behaviour, respectively. The results indicated that young adults with high-ADHD symptoms scores pressed the button more than those with low ADHD scores during the post-response delay condition. While both groups increased responding across time within intervals this was significantly more marked in the high-ADHD symptom group. These effects became more pronounced when anxiety was controlled. Young adults with high-ADHD symptoms appear to be more sensitive to the imposition of unscheduled and unsignalled delay during a simple maths test. DeFT may provide a useful index of delay tolerance in young adults with ADHD. Future research needs to examine DeFT performance in different age groups and

Patient reported delays in seeking treatment for Tuberculosis (TB among adult and pediatric TB patients and TB patients co-infected with HIV in Lima, Peru: a qualitative study

Directory of Open Access Journals (Sweden)

Valerie A Paz-Soldan

2014-12-01

Full Text Available Abstract: Tuberculosis (TB remains a significant public health challenge worldwide, and particularly in Peru with one of the highest incidence rates in Latin America. TB patient behavior has a direct influence on whether a patient will receive timely diagnosis and successful treatment of their illness. Objectives: The objective was to understand the complex factors that can impact TB patient health seeking behavior. Methods: In-depth interviews were conducted with adult and parents of pediatric patients receiving TB treatment (n=43, within that group a sub-group was also co-infected with HIV (n=11. Results: Almost all of the study participants recognized delays in seeking either their child’s or their own diagnosis of their TB symptoms. The principal reasons for treatment-seeking delays were lack of knowledge and confusion of tuberculosis symptoms, fear and embarrassment of receiving a TB diagnosis, and a patient tendency to self-medicate prior to seeking formal medical attention.Conclusions: Health promotion activities that target patient delays have the potential to improve individual patient outcomes and mitigate the spread of TB at a community level.

Heteroclinic Bifurcation Behaviors of a Duffing Oscillator with Delayed Feedback

Directory of Open Access Journals (Sweden)

Shao-Fang Wen

2018-01-01

Full Text Available The heteroclinic bifurcation and chaos of a Duffing oscillator with forcing excitation under both delayed displacement feedback and delayed velocity feedback are studied by Melnikov method. The Melnikov function is analytically established to detect the necessary conditions for generating chaos. Through the analysis of the analytical necessary conditions, we find that the influences of the delayed displacement feedback and delayed velocity feedback are separable. Then the influences of the displacement and velocity feedback parameters on heteroclinic bifurcation and threshold value of chaotic motion are investigated individually. In order to verify the correctness of the analytical conditions, the Duffing oscillator is also investigated by numerical iterative method. The bifurcation curves and the largest Lyapunov exponents are provided and compared. From the analysis of the numerical simulation results, it could be found that two types of period-doubling bifurcations occur in the Duffing oscillator, so that there are two paths leading to the chaos in this oscillator. The typical dynamical responses, including time histories, phase portraits, and Poincare maps, are all carried out to verify the conclusions. The results reveal some new phenomena, which is useful to design or control this kind of system.

Delay in the Diagnosis of Stable Slipped Capital Femoral Epiphysis.

Science.gov (United States)

Hosseinzadeh, Pooya; Iwinski, Henry J; Salava, Jonathon; Oeffinger, Donna

2017-01-01

Delays in the diagnosis of stable slipped capital femoral epiphysis (SCFE) is common due to the vague symptomatology and the lack of awareness of this entity by healthcare providers. Delays in the diagnosis of this condition can lead to poor outcomes for the patients. This study was designed to identify factors that contributed to delays in the diagnosis or the treatment of patients with SCFE seen at our institution. A retrospective chart review of patients with the diagnosis of a stable SCFE who had undergone screw stabilization between 1989 and 2010 at our hospital was performed. For each patient, demographic data, the date of initial onset of symptoms, the date of the first visit to the medical provider, the type of provider seen initially (orthopaedic surgeon or not), the date of diagnosis of SCFE, the type of physician who made the diagnosis (orthopaedic surgeon or not), and the date of surgery were recorded. For each patient, the presenting symptom was recorded as hip, thigh, or knee pain. The effect of demographic data, presenting symptoms, and the type of initial provider seen on the delay to diagnosis was studied using 2 Cox models. A total of 149 patients with 196 stable SCFE were included. The average time from the first physician visit to diagnosis was 94 days in the group seen by a nonorthopaedic provider compared with an average of 2.9 days in the group seen by an orthopaedist (Pprovider versus 97% in the group seen by orthopaedic surgeons. It took significantly longer to be diagnosed with SCFE in patients who presented with initial knee pain (P=0.0097) compared with those who presented with hip pain at the initial visit. This study shows a significant delay in the diagnosis of SCFE in the United States, particularly in patients seen by nonorthopaedic providers initially. Level III-prognostic.

"What time is my next meal?" delay-discounting individuals choose smaller portions under conditions of uncertainty.

Science.gov (United States)

Zimmerman, Annie R; Ferriday, Danielle; Davies, Sarah R; Martin, Ashley A; Rogers, Peter J; Mason, Alice; Brunstrom, Jeffrey M

2017-09-01

'Dietary' delay discounting is typically framed as a trade-off between immediate rewards and long-term health concerns. Our contention is that prospective thinking also occurs over shorter periods, and is engaged to select portion sizes based on the interval between meals (inter-meal interval; IMI). We sought to assess the extent to which the length of an IMI influences portion-size selection. We predicted that delay discounters would show 'IMI insensitivity' (relative lack of concern about hunger or fullness between meals). In particular, we were interested in participants' sensitivity to an uncertain IMI. We hypothesized that when meal times were uncertain, delay discounters would be less responsive and select smaller portion sizes. Participants (N = 90) selected portion sizes for lunch. In different trials, they were told to expect dinner at 5pm, 9pm, and either 5pm or 9pm (uncertain IMI). Individual differences in future-orientation were measured using a monetary delay-discounting task. Participants chose larger portions when the IMI was longer (p relationship between BMI and smaller portion selection in uncertainty (p < 0.05). This is the first study to report an association between delay discounting and IMI insensitivity. We reason that delay discounters selected smaller portions because they were less sensitive to the uncertain IMI, and overlooked concerns about potential future hunger. These findings are important because they illustrate that differences in discounting are expressed in short-term portion-size decisions and suggest that IMI insensitivity increases when meal timings are uncertain. Further research is needed to confirm whether these findings generalise to other populations. Copyright © 2017. Published by Elsevier Ltd.

A delay-dependent LMI approach to dynamics analysis of discrete-time recurrent neural networks with time-varying delays

International Nuclear Information System (INIS)

Song, Qiankun; Wang, Zidong

2007-01-01

In this Letter, the analysis problem for the existence and stability of periodic solutions is investigated for a class of general discrete-time recurrent neural networks with time-varying delays. For the neural networks under study, a generalized activation function is considered, and the traditional assumptions on the boundedness, monotony and differentiability of the activation functions are removed. By employing the latest free-weighting matrix method, an appropriate Lyapunov-Krasovskii functional is constructed and several sufficient conditions are established to ensure the existence, uniqueness, and globally exponential stability of the periodic solution for the addressed neural network. The conditions are dependent on both the lower bound and upper bound of the time-varying time delays. Furthermore, the conditions are expressed in terms of the linear matrix inequalities (LMIs), which can be checked numerically using the effective LMI toolbox in MATLAB. Two simulation examples are given to show the effectiveness and less conservatism of the proposed criteria

Delay-distribution-dependent H∞ state estimation for delayed neural networks with (x,v)-dependent noises and fading channels.

Science.gov (United States)

Sheng, Li; Wang, Zidong; Tian, Engang; Alsaadi, Fuad E

2016-12-01

This paper deals with the H ∞ state estimation problem for a class of discrete-time neural networks with stochastic delays subject to state- and disturbance-dependent noises (also called (x,v)-dependent noises) and fading channels. The time-varying stochastic delay takes values on certain intervals with known probability distributions. The system measurement is transmitted through fading channels described by the Rice fading model. The aim of the addressed problem is to design a state estimator such that the estimation performance is guaranteed in the mean-square sense against admissible stochastic time-delays, stochastic noises as well as stochastic fading signals. By employing the stochastic analysis approach combined with the Kronecker product, several delay-distribution-dependent conditions are derived to ensure that the error dynamics of the neuron states is stochastically stable with prescribed H ∞ performance. Finally, a numerical example is provided to illustrate the effectiveness of the obtained results. Copyright © 2016 Elsevier Ltd. All rights reserved.

Optimal Joint Expected Delay Forwarding in Delay Tolerant Networks

OpenAIRE

Jia Xu; Xin Feng; Wen Jun Yang; Ru Chuan Wang; Bing Qing Han

2013-01-01

Multicopy forwarding schemes have been employed in delay tolerant network (DTN) to improve the delivery delay and delivery rate. Much effort has been focused on reducing the routing cost while retaining high performance. This paper aims to provide an optimal joint expected delay forwarding (OJEDF) protocol which minimizes the expected delay while satisfying a certain constant on the number of forwardings per message. We propose a comprehensive forwarding metric called joint expected delay (JE...

Learning monopolies with delayed feedback on price expectations

Science.gov (United States)

Matsumoto, Akio; Szidarovszky, Ferenc

2015-11-01

We call the intercept of the price function with the vertical axis the maximum price and the slope of the price function the marginal price. In this paper it is assumed that a monopolistic firm has full information about the marginal price and its own cost function but is uncertain on the maximum price. However, by repeated interaction with the market, the obtained price observations give a basis for an adaptive learning process of the maximum price. It is also assumed that the price observations have fixed delays, so the learning process can be described by a delayed differential equation. In the cases of one or two delays, the asymptotic behavior of the resulting dynamic process is examined, stability conditions are derived. Three main results are demonstrated in the two delay learning processes. First, it is possible to stabilize the equilibrium which is unstable in the one delay model. Second, complex dynamics involving chaos, which is impossible in the one delay model, can emerge. Third, alternations of stability and instability (i.e., stability switches) occur repeatedly.

Absolute stability of nonlinear systems with time delays and applications to neural networks

Directory of Open Access Journals (Sweden)

Xinzhi Liu

2001-01-01

Full Text Available In this paper, absolute stability of nonlinear systems with time delays is investigated. Sufficient conditions on absolute stability are derived by using the comparison principle and differential inequalities. These conditions are simple and easy to check. In addition, exponential stability conditions for some special cases of nonlinear delay systems are discussed. Applications of those results to cellular neural networks are presented.

Maximal monotone model with delay term of convolution

Directory of Open Access Journals (Sweden)

Claude-Henri Lamarque

2005-01-01

Full Text Available Mechanical models are governed either by partial differential equations with boundary conditions and initial conditions (e.g., in the frame of continuum mechanics or by ordinary differential equations (e.g., after discretization via Galerkin procedure or directly from the model description with the initial conditions. In order to study dynamical behavior of mechanical systems with a finite number of degrees of freedom including nonsmooth terms (e.g., friction, we consider here problems governed by differential inclusions. To describe effects of particular constitutive laws, we add a delay term. In contrast to previous papers, we introduce delay via a Volterra kernel. We provide existence and uniqueness results by using an Euler implicit numerical scheme; then convergence with its order is established. A few numerical examples are given.

Stability of formation control using a consensus protocol under directed communications with two time delays and delay scheduling

Science.gov (United States)

Cepeda-Gomez, Rudy; Olgac, Nejat

2016-01-01

We consider a linear algorithm to achieve formation control in a group of agents which are driven by second-order dynamics and affected by two rationally independent delays. One of the delays is in the position and the other in the velocity information channels. These delays are taken as constant and uniform throughout the system. The communication topology is assumed to be directed and fixed. The formation is attained by adding a supplementary control term to the stabilising consensus protocol. In preparation for the formation control logic, we first study the stability of the consensus, using the recent cluster treatment of characteristic roots (CTCR) paradigm. This effort results in a unique depiction of the non-conservative stability boundaries in the domain of the delays. However, CTCR requires the knowledge of the potential stability switching loci exhaustively within this domain. The creation of these loci is done in a new surrogate coordinate system, called the 'spectral delay space (SDS)'. The relative stability is also investigated, which has to do with the speed of reaching consensus. This step leads to a paradoxical control design concept, called the 'delay scheduling', which highlights the fact that the group behaviour may be enhanced by increasing the delays. These steps lead to a control strategy to establish a desired group formation that guarantees spacing among the agents. Example case studies are presented to validate the underlying analytical derivations.

Decentralized H∞ Control of Interconnected Systems with Time-varying Delays

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Amal Zouhri

2017-01-01

Full Text Available This paper focuses on the problem of delay dependent stability/stabilization of interconnected systems with time-varying delays. The approach is based on a new Lyapunov-Krasovskii functional. A decentralized delay-dependent stability analysis is performed to characterize linear matrix inequalities (LMIs based on the conditions under which every local subsystem of the linear interconnected delay system is asymptotically stable. Then we design a decentralized state-feedback stabilization scheme such that the family of closedloop feedback subsystems enjoys the delay-dependent asymptotic stability for each subsystem. The decentralized feedback gains are determined by convex optimization over LMIs. All the developed results are tested on a representative example and compared with some recent previous ones.

The Effect of D-Cycloserine on Immediate vs. Delayed Extinction of Learned Fear

Science.gov (United States)

Langton, Julia M.; Richardson, Rick

2010-01-01

We compared the effect of D-cycloserine (DCS) on immediate (10 min after conditioning) and delayed (24 h after conditioning) extinction of learned fear in rats. DCS facilitated both immediate and delayed extinction when the drug was administered after extinction training. However, DCS did not facilitate immediate extinction when administered prior…

Two-actor conflict with time delay: A dynamical model

Science.gov (United States)

Qubbaj, Murad R.; Muneepeerakul, Rachata

2012-11-01

Recent mathematical dynamical models of the conflict between two different actors, be they nations, groups, or individuals, have been developed that are capable of predicting various outcomes depending on the chosen feedback strategies, initial conditions, and the previous states of the actors. In addition to these factors, this paper examines the effect of time delayed feedback on the conflict dynamics. Our analysis shows that under certain initial and feedback conditions, a stable neutral equilibrium of conflict may destabilize for some critical values of time delay, and the two actors may evolve to new emotional states. We investigate the results by constructing critical delay surfaces for different sets of parameters and analyzing results from numerical simulations. These results provide new insights regarding conflict and conflict resolution and may help planners in adjusting and assessing their strategic decisions.

Adverse events in diabetic foot infections: a case control study comparing early versus delayed medical treatment after home remedies

Directory of Open Access Journals (Sweden)

Cawich SO

2014-11-01

outcomes when patients delay conventional medical therapy in favour of home remedies to treat diabetic foot infections. These treatments need not be mutually exclusive. We encourage persons with diabetes who wish to try home remedies to seek medical advice in addition as a part of holistic care. Keywords: diabetic foot infections, adverse events, medical treatment, home remedies

Delayed Radiation-Induced Vasculitic Leukoencephalopathy

Energy Technology Data Exchange (ETDEWEB)

Rauch, Philipp J. [Departments of Pathology and Neurosurgery, Yale University School of Medicine, New Haven, Connecticut (United States); Faculty of Medicine, University of Heidelberg, Heidelberg (Germany); Park, Henry S. [Departments of Pathology and Neurosurgery, Yale University School of Medicine, New Haven, Connecticut (United States); Knisely, Jonathan P.S. [Department of Radiation Medicine, North Shore University Hospital, Manhasset, New York (United States); Chiang, Veronica L. [Departments of Pathology and Neurosurgery, Yale University School of Medicine, New Haven, Connecticut (United States); Vortmeyer, Alexander O., E-mail: alexander.vortmeyer@yale.edu [Departments of Pathology and Neurosurgery, Yale University School of Medicine, New Haven, Connecticut (United States)

2012-05-01

Purpose: Recently, single-fraction, high-dosed focused radiation therapy such as that administered by Gamma Knife radiosurgery has been used increasingly for the treatment of metastatic brain cancer. Radiation therapy to the brain can cause delayed leukoencephalopathy, which carries its own significant morbidity and mortality. While radiosurgery-induced leukoencephalopathy is known to be clinically different from that following fractionated radiation, pathological differences are not well characterized. In this study, we aimed to integrate novel radiographic and histopathologic observations to gain a conceptual understanding of radiosurgery-induced leukoencephalopathy. Methods and Materials: We examined resected tissues of 10 patients treated at Yale New Haven Hospital between January 1, 2009, and June 30, 2010, for brain metastases that had been previously treated with Gamma Knife radiosurgery, who subsequently required surgical management of a symptomatic regrowing lesion. None of the patients showed pathological evidence of tumor recurrence. Clinical and magnetic resonance imaging data for each of the 10 patients were then studied retrospectively. Results: We provide evidence to show that radiosurgery-induced leukoencephalopathy may present as an advancing process that extends beyond the original high-dose radiation field. Neuropathologic examination of the resected tissue revealed traditionally known leukoencephalopathic changes including demyelination, coagulation necrosis, and vascular sclerosis. Unexpectedly, small and medium-sized vessels revealed transmural T-cell infiltration indicative of active vasculitis. Conclusions: We propose that the presence of a vasculitic component in association with radiation-induced leukoencephalopathy may facilitate the progressive nature of the condition. It may also explain the resemblance of delayed leukoencephalopathy with recurring tumor on virtually all imaging modalities used for posttreatment follow-up.

Treatment-time-dependence models of early and delayed radiation injury in rat small intestine

International Nuclear Information System (INIS)

Denham, James W.; Hauer-Jensen, Martin; Kron, Tomas; Langberg, Carl W.

2000-01-01

Background: The present study modeled data from a large series of experiments originally designed to investigate the influence of time, dose, and fractionation on early and late pathologic endpoints in rat small intestine after localized irradiation. The objective was to obtain satisfactory descriptions of the regenerative response to injury together with the possible relationships between early and late endpoints. Methods: Two- and 26-week pathologic radiation injury data in groups of Sprague-Dawley rats irradiated with 27 different fractionation schedules were modeled using the incomplete repair (IR) version of the linear-quadratic model with or without various time correction models. The following time correction models were tested: (1) No time correction; (2) A simple exponential (SE) regenerative response beginning at an arbitrary time after starting treatment; and (3) A bi-exponential response with its commencement linked to accumulated cellular depletion and fraction size (the 'intelligent response model' [INTR]). Goodness of fit of the various models was assessed by correlating the predicted biological effective dose for each dose group with the observed radiation injury score. Results: (1) The incomplete repair model without time correction did not provide a satisfactory description of either the 2- or 26-week data. (2) The models using SE time correction performed better, providing modest descriptions of the data. (3) The INTR model provided reasonable descriptions of both the 2- and 26-week data, confirming a treatment time dependence of both early and late pathological endpoints. (4) The most satisfactory descriptions of the data by the INTR model were obtained when the regenerative response was assumed to cease 2 weeks after irradiation rather than at the end of irradiation. A fraction-size-dependent delay of the regenerative response was also suggested in the best fitting models. (5) Late endpoints were associated with low-fractionation sensitivity

Relative controllability of nonlinear systems with delays in state and ...

African Journals Online (AJOL)

In this work, sufficient conditions are developed for the relative controllability of perturbed nonlinear systems with time varying multiple delays in control with the perturbation function having implicit derivative with delays depending on both state and control variable, using Darbo's fixed points theorem. Journal of the Nigerian ...

An integrated supply chain model for deteriorating items considering delay in payments, imperfect quality and inspection errors under inflationary conditions

DEFF Research Database (Denmark)

Mahmoudinezhad, Mahvash; Mirzazadeh, Abolfazl; Ghoreishi, Maryam

2017-01-01

of the manufacturer is not perfect and makes inspection errors of Type 1 and Type 2. The second-stage inspection of the manufacturer is at the end of production period without inspection errors. Also, the demand is linear function of time. Once the retailer receives the lot, a 100% screening process of the lot......In this article, an integrated production–distribution model is presented for a manufacturer and retailer supply chain under inflationary conditions, permissible delay in payments, deterioration, imperfect production process and inspection errors. We assume that the first-stage inspection...

Delayed Complications After Transsphenoidal Surgery for Pituitary Adenomas.

Science.gov (United States)

Alzhrani, Gmaan; Sivakumar, Walavan; Park, Min S; Taussky, Philipp; Couldwell, William T

2018-01-01

Perioperative complications after transsphenoidal surgery for pituitary adenomas have been well documented in the literature; however, some complications can occur in a delayed fashion postoperatively, and reports are sparse about their occurrence, management, and outcome. Here, we describe delayed complications after transsphenoidal surgery and discuss the incidence, temporality from the surgery, and management of these complications based on the findings of studies that reported delayed postoperative epistaxis, delayed postoperative cavernous carotid pseudoaneurysm formation and rupture, vasospasm, delayed symptomatic hyponatremia, hypopituitarism, hydrocephalus, and sinonasal complications. Our findings from this review revealed an incidence of 0.6%-3.3% for delayed postoperative epistaxis at 1-3 weeks postoperatively, 18 reported cases of delayed carotid artery pseudoaneurysm formation at 2 days to 10 years postoperatively, 30 reported cases of postoperative vasospasm occurring 8 days postoperatively, a 3.6%-19.8% rate of delayed symptomatic hyponatremia at 4-7 days postoperatively, a 3.1% rate of new-onset hypopituitarism at 2 months postoperatively, and a 0.4%-5.8% rate of hydrocephalus within 2.2 months postoperatively. Sinonasal complications are commonly reported after transsphenoidal surgery, but spontaneous resolutions within 3-12 months have been reported. Although the incidence of some of these complications is low, providing preoperative counseling to patients with pituitary tumors regarding these delayed complications and proper postoperative follow-up planning is an important part of treatment planning. Copyright © 2017 Elsevier Inc. All rights reserved.

Health system delay and its effect on clinical stage of breast cancer: Multicenter study.

Science.gov (United States)

Unger-Saldaña, Karla; Miranda, Alfonso; Zarco-Espinosa, Gelasio; Mainero-Ratchelous, Fernando; Bargalló-Rocha, Enrique; Miguel Lázaro-León, Jesús

2015-07-01

The objective of this study was to determine the correlation between health system delay and clinical disease stage in patients with breast cancer. This was a cross-sectional study of 886 patients who were referred to 4 of the largest public cancer hospitals in Mexico City for the evaluation of a probable breast cancer. Data on time intervals, sociodemographic factors, and clinical stage at diagnosis were retrieved. A logistic regression model was used to estimate the average marginal effects of delay on the probability of being diagnosed with advanced breast cancer (stages III and IV). The median time between problem identification and the beginning of treatment was 7 months. The subinterval with the largest delay was that between the first medical consultation and diagnosis (median, 4 months). Only 15% of the patients who had cancer were diagnosed with stage 0 and I disease, and 48% were diagnosed with stage III and IV disease. Multivariate analyses confirmed independent correlations for the means of problem identification, patient delay, health system delay, and age with a higher probability that patients would begin cancer treatment in an advanced stage. In the sample studied, the majority of patients with breast cancer began treatment after a delay. Both patient delays and provider delays were associated with advanced disease. Research aimed at identifying specific access barriers to medical services is much needed to guide the design of tailored health policies that go beyond the promotion of breast care awareness and screening participation to include improvements in health services that facilitate access to timely diagnosis and treatment. © 2015 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

Prefrontocortical dopamine loss in rats delays long-term extinction of contextual conditioned fear, and reduces social interaction without affecting short-term social interaction memory.

Science.gov (United States)

Fernandez Espejo, Emilio

2003-03-01

Prefrontal dopamine loss delays extinction of cued fear conditioning responses, but its role in contextual fear conditioning has not been explored. Medial prefrontal lesions also enhance social interaction in rats, but the role of prefrontal dopamine loss on social interaction memory is not known. Besides, a role for subcortical accumbal dopamine on mnesic changes after prefrontal dopamine manipulation has been proposed but not explored. The objective was to study the involvement of dopaminergic neurotransmission in the medial prefrontal cortex (mPFC) and nucleus accumbens in two mnesic tasks: contextual fear conditioning and social interaction memory. For contextual fear conditioning, short- and long-term freezing responses after an electric shock were studied, as well as extinction retention. Regarding social interaction memory, the recognition of a juvenile, a very sensitive short-term memory test, was used. Dopamine loss was carried out by injection of 6-hydroxydopamine, and postmortem catecholamine levels were analyzed by high-performance liquid chromatography. Prefrontocortical dopamine loss (>76%) led to a reactive enhancement of accumbal dopamine content (ploss. In lesioned rats, long-term extinction of contextual fear conditioning was significantly delayed and extinction retention was impaired without changes in acquisition and short-term contextual fear conditioning and, on the other hand, acquisition and short-term social interaction memory were not affected, although time spent on social interaction was significantly reduced. Added dopamine loss in the nucleus accumbens (>76%) did not alter these behavioral changes. In summary, the results of the present study indicate that the dopaminergic network in the mPFC (but not in the nucleus accumbens) coordinates the normal long-term extinction of contextual fear conditioning responses without affecting their acquisition, and it is involved in time spent on social interaction, but not acquisition and short

Heterogeneous delay-induced asynchrony and resonance in a small-world neuronal network system

Science.gov (United States)

Yu, Wen-Ting; Tang, Jun; Ma, Jun; Yang, Xianqing

2016-06-01

A neuronal network often involves time delay caused by the finite signal propagation time in a given biological network. This time delay is not a homogenous fluctuation in a biological system. The heterogeneous delay-induced asynchrony and resonance in a noisy small-world neuronal network system are numerically studied in this work by calculating synchronization measure and spike interval distribution. We focus on three different delay conditions: double-values delay, triple-values delay, and Gaussian-distributed delay. Our results show the following: 1) the heterogeneity in delay results in asynchronous firing in the neuronal network, and 2) maximum synchronization could be achieved through resonance given that the delay values are integer or half-integer times of each other.

Delayed-Start Analyses in the Phase 3 Solanezumab EXPEDITION3 Study in Mild Alzheimer's Disease.

Science.gov (United States)

Liu-Seifert, H; Case, M G; Andersen, S W; Holdridge, K C; Aisen, P S; Kollack-Walker, S; Siemers, E

2018-01-01

A delayed-start design has been proposed to assess a potential disease-modifying effect in investigational drugs for Alzheimer's disease that target the underlying disease process. We extended this methodology to recently obtained data from the EXPEDITION3. EXPEDITION3 was a Phase 3, double-blind study with participants randomized to solanezumab (400 mg) or placebo every 4 weeks for 80 weeks, with an optional extension of active treatment. The delayed-start analysis was designed to determine if a statistically significant treatment difference established during the placebo-controlled period is maintained (at predefined level) during the delayed-start period, which would suggest the active drug has a disease-modifying effect. The delayed-start analysis was assessed across multiple efficacy measures, and includes data from baseline in the placebo-controlled period and up to 9 months in the delayed-start period. No significant difference was observed between the placebo and solanezumab treatment groups at the end of the placebo-controlled period for the Alzheimer's Disease Assessment Scale-Cognitive 14-item subscale. A significant treatment difference was observed at the end of the placebo-controlled period for the Alzheimer's Disease Cooperative Study-Activities of Daily Living instrumental items, an effect also seen at 6 months in the delayed-start period, and the noninferiority criterion was met. No other efficacy measures met these criteria. Delayed-start statistical methodology was used to understand the longitudinal outcomes in EXPEDITION3 and its extension. The small treatment differences observed at the end of the placebo-controlled phase prevented adequate assessment of any putative disease modifying effect.

Optimal Control for Stochastic Delay Evolution Equations

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Meng, Qingxin, E-mail: mqx@hutc.zj.cn [Huzhou University, Department of Mathematical Sciences (China); Shen, Yang, E-mail: skyshen87@gmail.com [York University, Department of Mathematics and Statistics (Canada)

2016-08-15

In this paper, we investigate a class of infinite-dimensional optimal control problems, where the state equation is given by a stochastic delay evolution equation with random coefficients, and the corresponding adjoint equation is given by an anticipated backward stochastic evolution equation. We first prove the continuous dependence theorems for stochastic delay evolution equations and anticipated backward stochastic evolution equations, and show the existence and uniqueness of solutions to anticipated backward stochastic evolution equations. Then we establish necessary and sufficient conditions for optimality of the control problem in the form of Pontryagin’s maximum principles. To illustrate the theoretical results, we apply stochastic maximum principles to study two examples, an infinite-dimensional linear-quadratic control problem with delay and an optimal control of a Dirichlet problem for a stochastic partial differential equation with delay. Further applications of the two examples to a Cauchy problem for a controlled linear stochastic partial differential equation and an optimal harvesting problem are also considered.

New exponential stability conditions for linear delayed systems of differential equations

Directory of Open Access Journals (Sweden)

Leonid Berezansky

2016-08-01

where $t\\ge 0$, $m$ and $r_{ij}$, $i,j=1,\\dots,m$ are natural numbers, $a_{ij}^{k}\\colon [0,\\infty\\to\\mathbb{R}$ are measurable coefficients, and $h_{ij}^{k}\\colon [0,\\infty\\to\\mathbb{R}$ are measurable delays. The progress was achieved by using a new technique making it possible to replace the constant $1$ by the constant $1+{1}/{\\mathrm{e}}$ on the right-hand sides of crucial inequalities ensuring exponential stability.

Trace conditioning in insects-keep the trace!

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Dylla, Kristina V; Galili, Dana S; Szyszka, Paul; Lüdke, Alja

2013-01-01

Trace conditioning is a form of associative learning that can be induced by presenting a conditioned stimulus (CS) and an unconditioned stimulus (US) following each other, but separated by a temporal gap. This gap distinguishes trace conditioning from classical delay conditioning, where the CS and US overlap. To bridge the temporal gap between both stimuli and to form an association between CS and US in trace conditioning, the brain must keep a neural representation of the CS after its termination-a stimulus trace. Behavioral and physiological studies on trace and delay conditioning revealed similarities between the two forms of learning, like similar memory decay and similar odor identity perception in invertebrates. On the other hand differences were reported also, like the requirement of distinct brain structures in vertebrates or disparities in molecular mechanisms in both vertebrates and invertebrates. For example, in commonly used vertebrate conditioning paradigms the hippocampus is necessary for trace but not for delay conditioning, and Drosophila delay conditioning requires the Rutabaga adenylyl cyclase (Rut-AC), which is dispensable in trace conditioning. It is still unknown how the brain encodes CS traces and how they are associated with a US in trace conditioning. Insects serve as powerful models to address the mechanisms underlying trace conditioning, due to their simple brain anatomy, behavioral accessibility and established methods of genetic interference. In this review we summarize the recent progress in insect trace conditioning on the behavioral and physiological level and emphasize similarities and differences compared to delay conditioning. Moreover, we examine proposed molecular and computational models and reassess different experimental approaches used for trace conditioning.

Early versus delayed initiation of antiretroviral therapy for Indian HIV-Infected individuals with tuberculosis on antituberculosis treatment.

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Sinha, Sanjeev; Shekhar, Rahul C; Singh, Gurjeet; Shah, Nipam; Ahmad, Hafiz; Kumar, Narendra; Sharma, Surendra K; Samantaray, J C; Ranjan, Sanjai; Ekka, Meera; Sreenivas, Vishnu; Mitsuyasu, Ronald T

2012-07-31

For antiretroviral therapy (ART) naive human immunodeficiency virus (HIV) infected adults suffering from tuberculosis (TB), there is uncertainty about the optimal time to initiate highly active antiretroviral therapy (HAART) after starting antituberculosis treatment (ATT), in order to minimize mortality, HIV disease progression, and adverse events. In a randomized, open label trial at All India Institute of Medical Sciences, New Delhi, India, eligible HIV positive individuals with a diagnosis of TB were randomly assigned to receive HAART after 2-4 or 8-12 weeks of starting ATT, and were followed for 12 months after HAART initiation. Participants received directly observed therapy short course (DOTS) for TB, and an antiretroviral regimen comprising stavudine or zidovudine, lamivudine, and efavirenz. Primary end points were death from any cause, and progression of HIV disease marked by failure of ART. A total of 150 patients with HIV and TB were initiated on HAART: 88 received it after 2-4 weeks (early ART) and 62 after 8-12 weeks (delayed ART) of starting ATT. There was no significant difference in mortality between the groups after the introduction of HAART. However, incidence of ART failure was 31% in delayed versus 16% in early ART arm (p = 0.045). Kaplan Meier disease progression free survival at 12 months was 79% for early versus 64% for the delayed ART arm (p = 0.05). Rates of adverse events were similar. Early initiation of HAART for patients with HIV and TB significantly decreases incidence of HIV disease progression and has good tolerability. CTRI/2011/12/002260.

Generalized synchronization-based multiparameter estimation in modulated time-delayed systems

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Ghosh, Dibakar; Bhattacharyya, Bidyut K.

2011-09-01

We propose a nonlinear active observer based generalized synchronization scheme for multiparameter estimation in time-delayed systems with periodic time delay. A sufficient condition for parameter estimation is derived using Krasovskii-Lyapunov theory. The suggested tool proves to be globally and asymptotically stable by means of Krasovskii-Lyapunov method. With this effective method, parameter identification and generalized synchronization of modulated time-delayed systems with all the system parameters unknown, can be achieved simultaneously. We restrict our study for multiple parameter estimation in modulated time-delayed systems with single state variable only. Theoretical proof and numerical simulation demonstrate the effectiveness and feasibility of the proposed technique. The block diagram of electronic circuit for multiple time delay system shows that the method is easily applicable in practical communication problems.

BDNFval66met affects neural activation pattern during fear conditioning and 24 h delayed fear recall.

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Lonsdorf, Tina B; Golkar, Armita; Lindström, Kara M; Haaker, Jan; Öhman, Arne; Schalling, Martin; Ingvar, Martin

2015-05-01

Brain-derived neurotrophic factor (BDNF), the most abundant neutrophin in the mammalian central nervous system, is critically involved in synaptic plasticity. In both rodents and humans, BDNF has been implicated in hippocampus- and amygdala-dependent learning and memory and has more recently been linked to fear extinction processes. Fifty-nine healthy participants, genotyped for the functional BDNFval66met polymorphism, underwent a fear conditioning and 24h-delayed extinction protocol while skin conductance and blood oxygenation level dependent (BOLD) responses (functional magnetic resonance imaging) were acquired. We present the first report of neural activation pattern during fear acquisition 'and' extinction for the BDNFval66met polymorphism using a differential conditioned stimulus (CS)+ > CS- comparison. During conditioning, we observed heightened allele dose-dependent responses in the amygdala and reduced responses in the subgenual anterior cingulate cortex in BDNFval66met met-carriers. During early extinction, 24h later, we again observed heightened responses in several regions ascribed to the fear network in met-carriers as opposed to val-carriers (insula, amygdala, hippocampus), which likely reflects fear memory recall. No differences were observed during late extinction, which likely reflects learned extinction. Our data thus support previous associations of the BDNFval66met polymorphism with neural activation in the fear and extinction network, but speak against a specific association with fear extinction processes. © The Author (2014). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Delay-dependent asymptotic stability of a two-neuron system with different time delays

International Nuclear Information System (INIS)

Tu Fenghua; Liao Xiaofeng; Zhang Wei

2006-01-01

In this paper, we consider a two-neuron system with time-delayed connections between neurons. Based on the construction of Lyapunov functionals, we obtain sufficient criteria to ensure local and global asymptotic stability of the equilibrium of the neural network. The obtained conditions are shown to be less conservative and restrictive than those reported in the literature. Some examples are included to illustrate our results

Exploration of the Reasons for Delays in Construction

DEFF Research Database (Denmark)

Lindhard, Søren Munch; Wandahl, Søren

2014-01-01

Construction sites are dominated by chaos and complexity, enforcing challenging conditions for establishing reliable and robust schedules that are easy to observe. The consequence is a large amount of delayed activities that again results in an unreliable schedule. Last planner system (LPS...... used in the LPS theory. Therefore, the results can directly be applied to the making-ready process and used as guidance of where to intervene in attempt to reduce future delay....

Delayed diagnosis of sarcoidosis is common in Brazil

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Mauri Monteiro Rodrigues

2013-09-01

Full Text Available OBJECTIVE: To determine the frequency of and the factors related to delayed diagnosis of sarcoidosis in Brazil. METHODS: We evaluated patients with a biopsy-proven diagnosis of sarcoidosis, using a questionnaire that addressed the following: time since symptom onset and since the first medical visit; and the number and specialty of the physicians visited. We divided the patients by the timeliness of the diagnosis-timely (< 6 months and delayed (≥ 6 months-comparing the two groups in terms of systemic and pulmonary symptoms; extrathoracic involvement; spirometric data; radiological staging; level of education; income; and tuberculosis (diagnosis and treatment. RESULTS: We evaluated 100 patients. The median number of physicians consulted was 3 (range, 1-14. In 11 cases, sarcoidosis was diagnosed at the first visit. In 54, the first physician seen was a general practitioner. The diagnosis of sarcoidosis was timely in 41 patients and delayed in 59. The groups did not differ in terms of gender; race; type of health insurance; level of education; income; respiratory/systemic symptoms; extrathoracic involvement; and radiological staging. In the delayed diagnosis group, FVC was lower (80.3 ± 20.4% vs. 90.5 ± 17.1%; p = 0.010, as was FEV1 (77.3 ± 19.9% vs. 86.4 ± 19.5%; p = 0.024, misdiagnosis with and treatment for tuberculosis (≥ 3 months also being more common (24% vs. 7%, p = 0.032, and 20% vs. 0%; p = 0.002, respectively. CONCLUSIONS: The diagnosis of sarcoidosis is often delayed, even when the imaging is suggestive of sarcoidosis. Delayed diagnosis is associated with impaired lung function at the time of diagnosis. Many sarcoidosis patients are misdiagnosed with and treated for tuberculosis.

The effect of response-delay on estimating reachability.

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Gabbard, Carl; Ammar, Diala

2008-11-01

The experiment was conducted to compare visual imagery (VI) and motor imagery (MI) reaching tasks in a response-delay paradigm designed to explore the hypothesized dissociation between vision for perception and vision for action. Although the visual systems work cooperatively in motor control, theory suggests that they operate under different temporal constraints. From this perspective, we expected that delay would affect MI but not VI because MI operates in real time and VI is postulated to be memory-driven. Following measurement of actual reach, right-handers were presented seven (imagery) targets at midline in eight conditions: MI and VI with 0-, 1-, 2-, and 4-s delays. Results indicted that delay affected the ability to estimate reachability with MI but not with VI. These results are supportive of a general distinction between vision for perception and vision for action.

Exponential stability of switched linear systems with time-varying delay

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Satiracoo Pairote

2007-11-01

Full Text Available We use a Lyapunov-Krasovskii functional approach to establish the exponential stability of linear systems with time-varying delay. Our delay-dependent condition allows to compute simultaneously the two bounds that characterize the exponential stability rate of the solution. A simple procedure for constructing switching rule is also presented.

Overview of treatment and conditioning of low-level wastes

International Nuclear Information System (INIS)

Trevorrow, L.

1986-01-01

The consideration of alternative technologies in low-level waste management is assumed to be partly a response to current demands for lower risk in waste disposal. One of the determinants of risk in waste disposal is the set of characteristics of the materials placed into disposal cells, i.e., the products of treatment and conditioning operations. The treatment and conditioning operations that have been applied to waste streams are briefly examined. Three operations are the most important determinants of the stability that will contribute to reducing risk at the disposal cell: compaction, high-integrity containers, and solidification. The status of these three operations is reviewed

Apomorphine conditioning and sensitization: the paired/unpaired treatment order as a new major determinant of drug conditioned and sensitization effects.

Science.gov (United States)

de Matos, Liana Wermelinger; Carey, Robert J; Carrera, Marinete Pinheiro

2010-09-01

Repeated treatments with psychostimulant drugs generate behavioral sensitization. In the present study we employed a paired/unpaired protocol to assess the effects of repeated apomorphine (2.0 mg/kg) treatments upon locomotion behavior. In the first experiment we assessed the effects of conditioning upon apomorphine sensitization. Neither the extinction of the conditioned response nor a counter-conditioning procedure in which we paired an inhibitory treatment (apomorphine 0.05 mg/kg) with the previously established conditioned stimulus modified the sensitization response. In the second experiment, we administered the paired/unpaired protocol in two phases. In the second phase, we reversed the paired/unpaired protocol. Following the first phase, the paired group alone exhibited conditioned locomotion in the vehicle test and a sensitization response. In the second phase, the initial unpaired group which received 5 paired apomorphine trials during the reversal phase did not develop a conditioned response but developed a potentiated sensitization response. This disassociation of the conditioned response from the sensitization response is attributed to an apomorphine anti-habituation effect that can generate a false positive Pavlovian conditioned response effect. The potentiated sensitization response induced by the treatment reversal protocol points to an important role for the sequential experience of the paired/unpaired protocol in behavioral sensitization. 2010 Elsevier Inc. All rights reserved.

Thalidomide for control delayed vomiting in cancer patients receiving chemotherapy

International Nuclear Information System (INIS)

Han, Z.; Sun, X.; Du, X.

2016-01-01

To explore the efficacy and safety of thalidomide for the treatment of delayed vomiting, induced by chemotherapy in cancer patients. Study Design: Randomized, double-blind controlled study. Place and Duration of Study: The Oncology Department of Affiliated Hospital of Xuzhou Medical University, Jiangsu Xuzhou, China, from January 2012 to January 2014. Methodology: A total of 78 cancer patients, who had delayed vomiting observed from 24 hours to 1 week after chemotherapy, were included in the study. Patients were divided in a treatment group (40 patients, 51.28%) and a control group (38 patients, 48.71%). The treatment group received thalidomide at an oral dose of 100 mg per night; 50 mg was added daily up to a dose of 200 mg per night, if the curative effect was suboptimal and the medicine was tolerated. Both the treatment and the control groups received a drip of 10 mg azasetron 30 minutes before chemotherapy. The control group only proportions of antiemetic effects and adverse reactions were compared using the ?2 test. Antiemetic effects and adverse reactions were assessed from Odds Ratios (OR) with 95% Confidence Intervals(95% CI). Results: The effective control rate of delayed vomiting in the treatment group was significantly higher than that in the control group (?2=5.174, p=0.023). No significant difference was found between the two groups in other adverse effects of chemotherapy. Karnofsky scores or the overall self-evaluation of the patients (p>0.05). Conclusion: Thalidomide can effectively control the delayed vomiting of cancer patients receiving chemotherapy and the adverse reactions of the agent can be tolerated.

Moments of the Wigner delay times

International Nuclear Information System (INIS)

Berkolaiko, Gregory; Kuipers, Jack

2010-01-01

The Wigner time delay is a measure of the time spent by a particle inside the scattering region of an open system. For chaotic systems, the statistics of the individual delay times (whose average is the Wigner time delay) are thought to be well described by random matrix theory. Here we present a semiclassical derivation showing the validity of random matrix results. In order to simplify the semiclassical treatment, we express the moments of the delay times in terms of correlation functions of scattering matrices at different energies. In the semiclassical approximation, the elements of the scattering matrix are given in terms of the classical scattering trajectories, requiring one to study correlations between sets of such trajectories. We describe the structure of correlated sets of trajectories and formulate the rules for their evaluation to the leading order in inverse channel number. This allows us to derive a polynomial equation satisfied by the generating function of the moments. Along with showing the agreement of our semiclassical results with the moments predicted by random matrix theory, we infer that the scattering matrix is unitary to all orders in the semiclassical approximation.

Treatment with Docosahexaenoic Acid, but Not Eicosapentaenoic Acid, Delays Ca2+-Induced Mitochondria Permeability Transition in Normal and Hypertrophied Myocardium

OpenAIRE

Khairallah, Ramzi J.; O'Shea, Karen M.; Brown, Bethany H.; Khanna, Nishanth; Des Rosiers, Christine; Stanley, William C.

2010-01-01

Intake of fish oil containing docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) prevents heart failure; however, the mechanisms are unclear. Mitochondrial permeability transition pore (MPTP) opening contributes to myocardial pathology in cardiac hypertrophy and heart failure, and treatment with DHA + EPA delays MPTP opening. Here, we assessed: 1) whether supplementation with both DHA and EPA is needed for optimal prevention of MPTP opening, and 2) whether this benefit occurs in hyper...

Delayed bracket placement in orthodontic treatment

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Chandra Wigati

2008-12-01

Full Text Available Background: Beside bracket position, the timing of bracket placement is one of the most essential in orthodontic treatment with fixed appliances. Even it seems simple the timing of bracket placement can be crucial and significantly influence the result of orthodontic treatment. However it is often found brackets are placed without complete understanding of its purpose and effects, which could be useless and even detrimental for the case. Purpose: The aim of this case report is to show that the timing of bracket placement could be different depending on the cases. Case: Five different cases are presented here with different timing of bracket placement. Case management: On these cases, brackets were placed on the upper arch first, on the lower arch first, or even only on some teeth first. Good and efficient orthodontic treatment results were achieved. Conclusion: For every orthodontic case, from the very beginning of treatment, bracket should be placed with the end result in mind. If brackets are correctly placed at a correct time, better treatment result could be achieved without unnecessary round tripping tooth movement.

Stability and delay sensitivity of neutral fractional-delay systems.

Science.gov (United States)

Xu, Qi; Shi, Min; Wang, Zaihua

2016-08-01

This paper generalizes the stability test method via integral estimation for integer-order neutral time-delay systems to neutral fractional-delay systems. The key step in stability test is the calculation of the number of unstable characteristic roots that is described by a definite integral over an interval from zero to a sufficient large upper limit. Algorithms for correctly estimating the upper limits of the integral are given in two concise ways, parameter dependent or independent. A special feature of the proposed method is that it judges the stability of fractional-delay systems simply by using rough integral estimation. Meanwhile, the paper shows that for some neutral fractional-delay systems, the stability is extremely sensitive to the change of time delays. Examples are given for demonstrating the proposed method as well as the delay sensitivity.

Ignition Delay of Combustible Materials in Normoxic Equivalent Environments

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McAllister, Sara; Fernandez-Pello, Carlos; Ruff, Gary; Urban, David

2009-01-01

Material flammability is an important factor in determining the pressure and composition (fraction of oxygen and nitrogen) of the atmosphere in the habitable volume of exploration vehicles and habitats. The method chosen in this work to quantify the flammability of a material is by its ease of ignition. The ignition delay time was defined as the time it takes a combustible material to ignite after it has been exposed to an external heat flux. Previous work in the Forced Ignition and Spread Test (FIST) apparatus has shown that the ignition delay in the currently proposed space exploration atmosphere (approximately 58.6 kPa and32% oxygen concentration) is reduced by 27% compared to the standard atmosphere used in the Space Shuttle and Space Station. In order to determine whether there is a safer environment in terms of material flammability, a series of piloted ignition delay tests using polymethylmethacrylate (PMMA) was conducted in the FIST apparatus to extend the work over a range of possible exploration atmospheres. The exploration atmospheres considered were the normoxic equivalents, i.e. reduced pressure conditions with a constant partial pressure of oxygen. The ignition delay time was seen to decrease as the pressure was reduced along the normoxic curve. The minimum ignition delay observed in the normoxic equivalent environments was nearly 30% lower than in standard atmospheric conditions. The ignition delay in the proposed exploration atmosphere is only slightly larger than this minimum. Interms of material flammability, normoxic environments with a higher pressure relative to the proposed pressure would be desired.

Globally exponential stability of neural network with constant and variable delays

International Nuclear Information System (INIS)

Zhao Weirui; Zhang Huanshui

2006-01-01

This Letter presents new sufficient conditions of globally exponential stability of neural networks with delays. We show that these results generalize recently published globally exponential stability results. In particular, several different globally exponential stability conditions in the literatures which were proved using different Lyapunov functionals are generalized and unified by using the same Lyapunov functional and the technique of inequality of integral. A comparison between our results and the previous results admits that our results establish a new set of stability criteria for delayed neural networks. Those conditions are less restrictive than those given in the earlier references

On the delay effects of different channels in Internet-based networked control systems

Science.gov (United States)

Zhao, Yun-Bo; Kim, Jongrae; Sun, Xi-Ming; Liu, Guo-Ping

2013-11-01

The sensor-to-controller and the controller-to-actuator delays in networked control systems (NCSs) are investigated for the first time with respect to their different effects on the system performance. This study starts with identifying the delay-independent and delay-dependent control laws in NCSs, and confirms that only two delay-dependent control laws can cause different delay effects in different channels. The conditions under which the different delays in different channels can cause different effects are then given for both delay-dependent control laws. The results are verified by numerical examples. Potentially, these results can be regarded as important design principles in the practical implementation of NCSs.

Passivity of memristive BAM neural networks with leakage and additive time-varying delays

Science.gov (United States)

Wang, Weiping; Wang, Meiqi; Luo, Xiong; Li, Lixiang; Zhao, Wenbing; Liu, Linlin; Ping, Yuan

2018-02-01

This paper investigates the passivity of memristive bidirectional associate memory neural networks (MBAMNNs) with leakage and additive time-varying delays. Based on some useful inequalities and appropriate Lyapunov-Krasovskii functionals (LKFs), several delay-dependent conditions for passivity performance are obtained in linear matrix inequalities (LMIs). Moreover, the leakage delays as well as additive delays are considered separately. Finally, numerical simulations are provided to demonstrate the feasibility of the theoretical results.

Introduction to Focus Issue: Time-delay dynamics

Science.gov (United States)

Erneux, Thomas; Javaloyes, Julien; Wolfrum, Matthias; Yanchuk, Serhiy

2017-11-01

The field of dynamical systems with time delay is an active research area that connects practically all scientific disciplines including mathematics, physics, engineering, biology, neuroscience, physiology, economics, and many others. This Focus Issue brings together contributions from both experimental and theoretical groups and emphasizes a large variety of applications. In particular, lasers and optoelectronic oscillators subject to time-delayed feedbacks have been explored by several authors for their specific dynamical output, but also because they are ideal test-beds for experimental studies of delay induced phenomena. Topics include the control of cavity solitons, as light spots in spatially extended systems, new devices for chaos communication or random number generation, higher order locking phenomena between delay and laser oscillation period, and systematic bifurcation studies of mode-locked laser systems. Moreover, two original theoretical approaches are explored for the so-called Low Frequency Fluctuations, a particular chaotical regime in laser output which has attracted a lot of interest for more than 30 years. Current hot problems such as the synchronization properties of networks of delay-coupled units, novel stabilization techniques, and the large delay limit of a delay differential equation are also addressed in this special issue. In addition, analytical and numerical tools for bifurcation problems with or without noise and two reviews on concrete questions are proposed. The first review deals with the rich dynamics of simple delay climate models for El Nino Southern Oscillations, and the second review concentrates on neuromorphic photonic circuits where optical elements are used to emulate spiking neurons. Finally, two interesting biological problems are considered in this Focus Issue, namely, multi-strain epidemic models and the interaction of glucose and insulin for more effective treatment.

Stability Analysis of Fractional-Order Nonlinear Systems with Delay

Directory of Open Access Journals (Sweden)

Yu Wang

2014-01-01

Full Text Available Stability analysis of fractional-order nonlinear systems with delay is studied. We propose the definition of Mittag-Leffler stability of time-delay system and introduce the fractional Lyapunov direct method by using properties of Mittag-Leffler function and Laplace transform. Then some new sufficient conditions ensuring asymptotical stability of fractional-order nonlinear system with delay are proposed firstly. And the application of Riemann-Liouville fractional-order systems is extended by the fractional comparison principle and the Caputo fractional-order systems. Numerical simulations of an example demonstrate the universality and the effectiveness of the proposed method.

Projective synchronization of time-varying delayed neural network with adaptive scaling factors

International Nuclear Information System (INIS)

Ghosh, Dibakar; Banerjee, Santo

2013-01-01

Highlights: • Projective synchronization in coupled delayed neural chaotic systems with modulated delay time is introduced. • An adaptive rule for the scaling factors is introduced. • This scheme is highly applicable in secure communication. -- Abstract: In this work, the projective synchronization between two continuous time delayed neural systems with time varying delay is investigated. A sufficient condition for synchronization for the coupled systems with modulated delay is presented analytically with the help of the Krasovskii–Lyapunov approach. The effect of adaptive scaling factors on synchronization are also studied in details. Numerical simulations verify the effectiveness of the analytic results

A Potential Animal Model of Maladaptive Palatable Food Consumption Followed by Delayed Discomfort

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Lital Moshe

2017-07-01

Full Text Available Introduction: Binging is the consumption of larger amounts of food in a briefer period of time than would normally be consumed under similar circumstances. Binging requires palatable food (PF to trigger abnormal eating, probably reflecting gene × environment interactions. In this study we examined the impact of trait binge eating (BE and its compulsive nature on the conflict between hedonic eating of PF and anticipation of a delayed aversive effect. We used female rats as an animal model similar to other models of BE. A novel aspect of this model in this paper is the use of a delayed internal aversive effect produced by lactose ingestion. Establishing this model will allow us to better understand the nature of the conflict between immediate reward and its delayed aversive implications. We hypothesized that BE prone (BEP rats will demonstrate maladaptive decision making, presenting higher motivation toward PF even when this is associated with delayed discomfort.Method: (Phase 1 52 female adult Wistar rats were divided to two eating profiles: resistant and prone binge eaters (BER/BEP based on intake of liquid PF (Ensure. Next, all subjects underwent a Lactose Conditioning Protocol (LCP that included 4 h tests, one baseline and 3 conditioning days (Phase 2, in which solid PF (Oreo cookies was paired with glucose (control-no internal aversive effect or lactose, dissolved in liquid PF. Index for PF motivation was PF consumption during the 4 h LCP. To test for memory of lactose conditioning, we performed another LCP with glucose only (anticipation, but no actual lactose-induced discomfort, a week after the last conditioning session.Results: Lactose conditioned BEP showed higher motivation toward PF compared to lactose conditioned BER faced with delayed aversive effects. Only lactose conditioned BER rats devaluated the PF over LCP days, indicating an association between PF and abdominal discomfort. In addition, only lactose conditioned BER presented

Hydrogen effect on tendency to delayed brittle fracture in titanium alloys

International Nuclear Information System (INIS)

Nazimov, O.P.; Bunin, L.A.; Il'in, A.A.; Ponomareva, N.A.

1979-01-01

The results of investigating hydrogen effetc on the tendency to delayed fracture of the titanium alloys of VT1-0, VT5, VT5-1, OT4, VT6S and VT14 are given. The delayed fracture test data have been compared with the results of fractographic investigations. The notion of structural instability in the initial condition during the tests was suggested as a criterion for evaluating the tendency of metal to delayed fracture

Osteoarthritis treatment using autologous conditioned serum after placebo

NARCIS (Netherlands)

Rutgers, Marijn; Creemers, Laura B; Auw Yang, Kiem Gie; Raijmakers, Natasja J H; Dhert, Wouter J A; Saris, Daniel B F

BACKGROUND AND PURPOSE: Autologous conditioned serum (ACS) is a disease-modifying drug for treatment of knee osteoarthritis, and modest superiority over placebo was reported in an earlier randomized controlled trial (RCT). We hypothesized that when given the opportunity, placebo-treated patients

Asymptotic Behavior of Solutions of Delayed Difference Equations

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J. Diblík

2011-01-01

Full Text Available This contribution is devoted to the investigation of the asymptotic behavior of delayed difference equations with an integer delay. We prove that under appropriate conditions there exists at least one solution with its graph staying in a prescribed domain. This is achieved by the application of a more general theorem which deals with systems of first-order difference equations. In the proof of this theorem we show that a good way is to connect two techniques—the so-called retract-type technique and Liapunov-type approach. In the end, we study a special class of delayed discrete equations and we show that there exists a positive and vanishing solution of such equations.

Discrete-time recurrent neural networks with time-varying delays: Exponential stability analysis

International Nuclear Information System (INIS)

Liu, Yurong; Wang, Zidong; Serrano, Alan; Liu, Xiaohui

2007-01-01

This Letter is concerned with the analysis problem of exponential stability for a class of discrete-time recurrent neural networks (DRNNs) with time delays. The delay is of the time-varying nature, and the activation functions are assumed to be neither differentiable nor strict monotonic. Furthermore, the description of the activation functions is more general than the recently commonly used Lipschitz conditions. Under such mild conditions, we first prove the existence of the equilibrium point. Then, by employing a Lyapunov-Krasovskii functional, a unified linear matrix inequality (LMI) approach is developed to establish sufficient conditions for the DRNNs to be globally exponentially stable. It is shown that the delayed DRNNs are globally exponentially stable if a certain LMI is solvable, where the feasibility of such an LMI can be easily checked by using the numerically efficient Matlab LMI Toolbox. A simulation example is presented to show the usefulness of the derived LMI-based stability condition

Magnetic Resonance Imaging (MRI) Evaluation of Developmental Delay in Pediatric Patients

OpenAIRE

Ali, Althaf S.; Syed, Naziya P.; Murthy, G.S.N.; Nori, Madhavi; Abkari, Anand; Pooja, B.K.; Venkateswarlu, J.

2015-01-01

Introduction: Developmental delay is defined as significant delay in one or more developmental domains. Magnetic Resonance Imaging (MRI) is the best modality to investigate such patients. Evaluation of a child with developmental delay is important not only because it allows early diagnosis and treatment but also helpful for parental counseling regarding the outcome of their child and to identify any possible risk of recurrence in the siblings. Thus this study was undertaken to evaluate the de...

Loss-to-follow-up and delay to treatment initiation in Pakistan's national tuberculosis control programme.

Science.gov (United States)

Ali, Syed Mustafa; Naureen, Farah; Noor, Arif; Fatima, Irum; Viney, Kerri; Ishaq, Muhammad; Anjum, Naveed; Rashid, Aamna; Haider, Ghulam Rasool; Khan, Muhammad Aamir; Aamir, Javariya

2018-03-09

Researchers and policy-makers have identified loss to follow-up as a major programmatic problem. Therefore, the objective of this study is to quantify TB related pre-treatment loss to follow up and treatment delay in private sector health care facilities in Pakistan. This was a retrospective, descriptive cohort study using routinely collected programmatic data from TB referral, diagnosis and treatment registers. Data from 48 private healthcare facilities were collected using an online questionnaire prepared in ODK Collect, for the period October 2015 to March 2016. Data were analysed using SPSS. We calculated the: (1) number and proportion of patients who were lost to follow-up during the diagnostic period, (2) number and proportion of patients with pre-treatment loss to follow-up, and (3) the number of days between diagnosis and initiation of treatment. One thousand five hundred ninety-six persons with presumptive TB were referred to the laboratory. Of these, 96% (n = 1538) submitted an on-the-spot sputum sample. Of the 1538 people, 1462 (95%) people subsequently visited the laboratory to submit the early morning (i.e. the second) sample. Hence, loss to follow-up during the diagnostic process was 8% overall (n = 134). Of the 1462 people who submitted both sputum samples, 243 (17%) were diagnosed with sputum smear-positive pulmonary TB and 231 were registered for anti-TB treatment, hence, loss in the pre-treatment phase was 4.9% (n = 12). 152 persons with TB (66%) initiated TB treatment either on the day of TB diagnosis or the next day. A further 79 persons with TB (34%) commenced TB treatment within a mean time of 7 days (range 2 to 64 days). Concentrated efforts should be made by the National TB Control Programme to retain TB patients and innovative methods such as text reminders and behavior change communication may need to be used and tested.

State estimation for discrete-time Markovian jumping neural networks with mixed mode-dependent delays

International Nuclear Information System (INIS)

Liu Yurong; Wang Zidong; Liu Xiaohui

2008-01-01

In this Letter, we investigate the state estimation problem for a new class of discrete-time neural networks with Markovian jumping parameters as well as mode-dependent mixed time-delays. The parameters of the discrete-time neural networks are subject to the switching from one mode to another at different times according to a Markov chain, and the mixed time-delays consist of both discrete and distributed delays that are dependent on the Markovian jumping mode. New techniques are developed to deal with the mixed time-delays in the discrete-time setting, and a novel Lyapunov-Krasovskii functional is put forward to reflect the mode-dependent time-delays. Sufficient conditions are established in terms of linear matrix inequalities (LMIs) that guarantee the existence of the state estimators. We show that both the existence conditions and the explicit expression of the desired estimator can be characterized in terms of the solution to an LMI. A numerical example is exploited to show the usefulness of the derived LMI-based conditions

Exponential stability of delayed recurrent neural networks with Markovian jumping parameters

International Nuclear Information System (INIS)

Wang Zidong; Liu Yurong; Yu Li; Liu Xiaohui

2006-01-01

In this Letter, the global exponential stability analysis problem is considered for a class of recurrent neural networks (RNNs) with time delays and Markovian jumping parameters. The jumping parameters considered here are generated from a continuous-time discrete-state homogeneous Markov process, which are governed by a Markov process with discrete and finite state space. The purpose of the problem addressed is to derive some easy-to-test conditions such that the dynamics of the neural network is stochastically exponentially stable in the mean square, independent of the time delay. By employing a new Lyapunov-Krasovskii functional, a linear matrix inequality (LMI) approach is developed to establish the desired sufficient conditions, and therefore the global exponential stability in the mean square for the delayed RNNs can be easily checked by utilizing the numerically efficient Matlab LMI toolbox, and no tuning of parameters is required. A numerical example is exploited to show the usefulness of the derived LMI-based stability conditions

Early versus delayed initiation of antiretroviral therapy for Indian HIV-Infected individuals with tuberculosis on antituberculosis treatment

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Sinha Sanjeev

2012-07-01

Full Text Available Abstract Background For antiretroviral therapy (ART naive human immunodeficiency virus (HIV infected adults suffering from tuberculosis (TB, there is uncertainty about the optimal time to initiate highly active antiretroviral therapy (HAART after starting antituberculosis treatment (ATT, in order to minimize mortality, HIV disease progression, and adverse events. Methods In a randomized, open label trial at All India Institute of Medical Sciences, New Delhi, India, eligible HIV positive individuals with a diagnosis of TB were randomly assigned to receive HAART after 2-4 or 8-12 weeks of starting ATT, and were followed for 12 months after HAART initiation. Participants received directly observed therapy short course (DOTS for TB, and an antiretroviral regimen comprising stavudine or zidovudine, lamivudine, and efavirenz. Primary end points were death from any cause, and progression of HIV disease marked by failure of ART. Findings A total of 150 patients with HIV and TB were initiated on HAART: 88 received it after 2-4 weeks (early ART and 62 after 8-12 weeks (delayed ART of starting ATT. There was no significant difference in mortality between the groups after the introduction of HAART. However, incidence of ART failure was 31% in delayed versus 16% in early ART arm (p = 0.045. Kaplan Meier disease progression free survival at 12 months was 79% for early versus 64% for the delayed ART arm (p = 0.05. Rates of adverse events were similar. Interpretation Early initiation of HAART for patients with HIV and TB significantly decreases incidence of HIV disease progression and has good tolerability. Trial registration CTRI/2011/12/002260

Delays in the management of retroperitoneal sarcomas

DEFF Research Database (Denmark)

Seinen, Jojanneke; Almquist, Martin; Styring, Emelie

2010-01-01

Retroperitoneal sarcomas are rare and treatment should optimally be centralized. Despite successful centralization with 90% of the patients referred prior to surgery, delays occur, which led us to assess lead times in a population-based series. Method. Patients diagnosed with retroperitoneal...... sarcoma in the southern Sweden health care region 2003-2009 were eligible for the study. Data on referrals and diagnostic investigations were collected from clinical files from primary health care, local hospitals, and from the sarcoma centre. Lead times were divided into patient delays and health care...... at the general practitioner, 36 days at local hospitals, and 55 days at the sarcoma centre. Conclusion. Centralization per se is not sufficient for optimized and efficient management. Our findings suggest that delays can be minimized by direct referral of patients from primary health care to sarcoma centers...

Stabilizing embedology: Geometry-preserving delay-coordinate maps

Science.gov (United States)

Eftekhari, Armin; Yap, Han Lun; Wakin, Michael B.; Rozell, Christopher J.

2018-02-01

Delay-coordinate mapping is an effective and widely used technique for reconstructing and analyzing the dynamics of a nonlinear system based on time-series outputs. The efficacy of delay-coordinate mapping has long been supported by Takens' embedding theorem, which guarantees that delay-coordinate maps use the time-series output to provide a reconstruction of the hidden state space that is a one-to-one embedding of the system's attractor. While this topological guarantee ensures that distinct points in the reconstruction correspond to distinct points in the original state space, it does not characterize the quality of this embedding or illuminate how the specific parameters affect the reconstruction. In this paper, we extend Takens' result by establishing conditions under which delay-coordinate mapping is guaranteed to provide a stable embedding of a system's attractor. Beyond only preserving the attractor topology, a stable embedding preserves the attractor geometry by ensuring that distances between points in the state space are approximately preserved. In particular, we find that delay-coordinate mapping stably embeds an attractor of a dynamical system if the stable rank of the system is large enough to be proportional to the dimension of the attractor. The stable rank reflects the relation between the sampling interval and the number of delays in delay-coordinate mapping. Our theoretical findings give guidance to choosing system parameters, echoing the tradeoff between irrelevancy and redundancy that has been heuristically investigated in the literature. Our initial result is stated for attractors that are smooth submanifolds of Euclidean space, with extensions provided for the case of strange attractors.

Improved delayed signal cancellation-based SRF-PLL for unbalanced grid

DEFF Research Database (Denmark)

Messo, Tuomas; Sihvo, Jussi; Yang, Dongsheng

2017-01-01

Problems with power quality in the grid have gained a lot of attention recently due to rapid increase in the amount of grid-connected power converters. The converter should produce sinusoidal currents also during abnormal conditions, such as unbalanced grid voltages. Several methods, like...... the delayed signal cancellation-based method (DSC), have been proposed to alleviate the detrimental effect of unbalance. This paper proposes an improvement to a delayed signal cancellation based synchronization algorithm for unbalanced grids. The proposed PLL structure employs only half of the delay required...

Discrete-time bidirectional associative memory neural networks with variable delays

International Nuclear Information System (INIS)

Liang Jinling; Cao Jinde; Ho, Daniel W.C.

2005-01-01

Based on the linear matrix inequality (LMI), some sufficient conditions are presented in this Letter for the existence, uniqueness and global exponential stability of the equilibrium point of discrete-time bidirectional associative memory (BAM) neural networks with variable delays. Some of the stability criteria obtained in this Letter are delay-dependent, and some of them are delay-independent, they are less conservative than the ones reported so far in the literature. Furthermore, the results provide one more set of easily verified criteria for determining the exponential stability of discrete-time BAM neural networks

Discrete-time bidirectional associative memory neural networks with variable delays

Science.gov (United States)

Liang, variable delays [rapid communication] J.; Cao, J.; Ho, D. W. C.

2005-02-01

Based on the linear matrix inequality (LMI), some sufficient conditions are presented in this Letter for the existence, uniqueness and global exponential stability of the equilibrium point of discrete-time bidirectional associative memory (BAM) neural networks with variable delays. Some of the stability criteria obtained in this Letter are delay-dependent, and some of them are delay-independent, they are less conservative than the ones reported so far in the literature. Furthermore, the results provide one more set of easily verified criteria for determining the exponential stability of discrete-time BAM neural networks.

Prevalence and determinants of delay in diagnosis of pulmonary tuberculosis in Darjeeling district of West Bengal

Directory of Open Access Journals (Sweden)

Sibasis Das

2017-01-01

Full Text Available Background: Delayed diagnosis of tuberculosis (TB is a significant problem both in individual as well as community level. Different studies around globe revealed that these diagnostic delays are attributed to both patient delay and health system-related delay. Aims: This study aims to assess the magnitude of delay in diagnosis and the association with sociodemographic profile among new sputum-positive pulmonary TB patients in Darjeeling district. Materials and Methods: A cross-sectional study was conducted among 374 TB patients from October 2011 to March 2012 using a predesigned pretested schedule by face-to-face interview. Statistical Analysis: Logistic regression analysis, odds ratios (OR, adjusted ORs. Results: Patient delay, health system delay and total diagnostic delay were 27 days, 20.1 days, and 20.6 days; mean delays were 23.64, 5.71, and 29.46 days, and median delays were 25, 5, and 32 days, respectively. Risk factors associated with patient delay were female gender, rural residence, illiteracy, smoking, alcohol consumption, taking two, or more alternate treatments; for health system delay were female sex, rural residence, time to reach health facility, time spent per visit; and for total diagnostic delay were female sex, alcoholism, and seeking more than two alternate treatment. Conclusions: The risk factors for delay identified may be the subject of future interventions.

Distributed optimisation problem with communication delay and external disturbance

Science.gov (United States)

Tran, Ngoc-Tu; Xiao, Jiang-Wen; Wang, Yan-Wu; Yang, Wu

2017-12-01

This paper investigates the distributed optimisation problem for the multi-agent systems (MASs) with the simultaneous presence of external disturbance and the communication delay. To solve this problem, a two-step design scheme is introduced. In the first step, based on the internal model principle, the internal model term is constructed to compensate the disturbance asymptotically. In the second step, a distributed optimisation algorithm is designed to solve the distributed optimisation problem based on the MASs with the simultaneous presence of disturbance and communication delay. Moreover, in the proposed algorithm, each agent interacts with its neighbours through the connected topology and the delay occurs during the information exchange. By utilising Lyapunov-Krasovskii functional, the delay-dependent conditions are derived for both slowly and fast time-varying delay, respectively, to ensure the convergence of the algorithm to the optimal solution of the optimisation problem. Several numerical simulation examples are provided to illustrate the effectiveness of the theoretical results.

Delayed discounting of pain with and without monetary reward

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Kicman Paweł

2017-12-01

Full Text Available We investigated the effect of monetary rewards on the rate of pain discounting. Our aim, also, was to understand the effect of previous painful dental experiences on the rate of discounting pain. Two groups (N = 148 completed a discounting task. In the first group, delayed pain was weaker than immediate pain, and in the second group delayed pain was stronger than immediate pain. Two conditions were studied: pain was either accompanied by a monetary reward or not. We found that people preferred immediate pain when it was weaker than delayed pain; however, when delayed pain was stronger than immediate pain, there was no clear preference. In both groups the preference for immediate pain was higher when pain was accompanied by a monetary reward. Previous painful experiences were not related to the rate of discounting. It was concluded that the preference for delayed pain depends on the intensity of pain, and it can be modified by rewards that accompany pain.

Robust filtering and fault detection of switched delay systems

CERN Document Server

Wang, Dong; Wang, Wei

2013-01-01

Switched delay systems appear in a wide field of applications including networked control systems, power systems, memristive systems. Though the large amount of ideas with respect to such systems have generated, until now, it still lacks a framework to focus on filter design and fault detection issues which are relevant to life safety and property loss. Beginning with the comprehensive coverage of the new developments in the analysis and control synthesis for switched delay systems, the monograph not only provides a systematic approach to designing the filter and detecting the fault of switched delay systems, but it also covers the model reduction issues. Specific topics covered include: (1) Arbitrary switching signal where delay-independent and delay-dependent conditions are presented by proposing a linearization technique. (2) Average dwell time where a weighted Lyapunov function is come up with dealing with filter design and fault detection issues beside taking model reduction problems. The monograph is in...

Delay differential systems for tick population dynamics.

Science.gov (United States)

Fan, Guihong; Thieme, Horst R; Zhu, Huaiping

2015-11-01

Ticks play a critical role as vectors in the transmission and spread of Lyme disease, an emerging infectious disease which can cause severe illness in humans or animals. To understand the transmission dynamics of Lyme disease and other tick-borne diseases, it is necessary to investigate the population dynamics of ticks. Here, we formulate a system of delay differential equations which models the stage structure of the tick population. Temperature can alter the length of time delays in each developmental stage, and so the time delays can vary geographically (and seasonally which we do not consider). We define the basic reproduction number [Formula: see text] of stage structured tick populations. The tick population is uniformly persistent if [Formula: see text] and dies out if [Formula: see text]. We present sufficient conditions under which the unique positive equilibrium point is globally asymptotically stable. In general, the positive equilibrium can be unstable and the system show oscillatory behavior. These oscillations are primarily due to negative feedback within the tick system, but can be enhanced by the time delays of the different developmental stages.

Relation between delay and survival in 596 patients with breast cancer.

Science.gov (United States)

Machiavelli, M; Leone, B; Romero, A; Perez, J; Vallejo, C; Bianco, A; Rodriguez, R; Estevez, R; Chacon, R; Dansky, C

1989-01-01

To evaluate the influence of delay between first symptom and first treatment upon survival the medical records of 596 patients with breast cancer were reviewed. The following intervals were considered: less than 3 months; 3-6 months and greater than 6 months. Patients in the less than 3 months delay group had a better distribution by clinical stages and a 10-year survival rate higher than those in the longer delay groups (p = 0.034). However, within each stage no statistically significant difference in survival according to delay was observed. A Cox multivariate analysis revealed that performance status and stage of disease were independent predictors of survival, but not delay. Assuming the best prognosis for patients with clinical stages I and II and less than 3 months delay, the group with longer delay times had 15 deaths over what would have been predicted. This adverse effect was observed almost exclusively among patients over age 50 (14/15).

Delayed consequences of biological action of electromagnetic fields

International Nuclear Information System (INIS)

Grigor'ev, Yu.G.

2000-01-01

Based on available data the real possibility of development of delayed effects in people of long-term electromagnetic fields (EMF) exposure is considered. It is shown that is a relation between long-term EMF-exposure and development of the breast cancer, brain tumors, leukemia and neurodegenerative diseases (Alzheimer's and Parkinson's diseases, amyotrophic lateral sclerosis). Analysis of up-to-date publications permit to conclude that this problem is urgent and further researches of the conditions promoting the development of delayed effects are required [ru

Recurrent meningitis and frontal encephalocele as delayed complications of craniofacial trauma.

Science.gov (United States)

Gumussoy, Murat; Ugur, Omer; Cukurova, Ibrahim; Uluyol, Sinan

2014-03-01

Frontal sinus back table fractures are seen rarely; also, typical presentation of frontal sinus encephalocele as a delayed complication of frontal sinus fracture is seen more rarely. We present a case of frontal encephalocele and recurrent meningitis as delayed complications of craniofacial trauma. Diagnosis, management, and treatment approaches of these complications are discussed.

Trace conditioning in insects – Keep the trace!

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Kristina V Dylla

2013-08-01

Full Text Available Trace conditioning is a form of associative learning that can be induced by presenting a conditioned stimulus (CS and an unconditioned stimulus (US following each other, but separated by a temporal gap. This gap distinguishes trace conditioning from classical delay conditioning, where the CS and US overlap. To bridge the temporal gap between both stimuli and to form an association between CS and US in trace conditioning, the brain must keep a neural representation of the CS after its termination – a stimulus trace. Behavioral and physiological studies on trace and delay conditioning revealed similarities between the two forms of learning, like similar memory decay and similar odor identity perception in invertebrates. On the other hand differences were reported also, like the requirement of distinct brain structures in vertebrates or disparities in molecular mechanisms in both vertebrates and invertebrates. For example, in commonly used vertebrate conditioning paradigms the hippocampus is necessary for trace but not for delay conditioning, and Drosophila delay conditioning requires the Rutabaga adenylyl cyclase, which is dispensable in trace conditioning. It is still unknown how the brain encodes CS traces and how they are associated with a US in trace conditioning. Insects serve as powerful models to address the mechanisms underlying trace conditioning, due to their simple brain anatomy, behavioral accessibility and established methods of genetic interference. In this review we summarize the recent progress in insect trace conditioning on the behavioral and physiological level and emphasize similarities and differences compared to delay conditioning. Moreover, we examine proposed molecular and computational models and reassess different experimental approaches used for trace conditioning.

Response Surface Methodology: An Extensive Potential to Optimize in vivo Photodynamic Therapy Conditions

International Nuclear Information System (INIS)

Tirand, Loraine; Bastogne, Thierry; Bechet, Denise M.Sc.; Linder, Michel; Thomas, Noemie; Frochot, Celine; Guillemin, Francois; Barberi-Heyob, Muriel

2009-01-01

Purpose: Photodynamic therapy (PDT) is based on the interaction of a photosensitizing (PS) agent, light, and oxygen. Few new PS agents are being developed to the in vivo stage, partly because of the difficulty in finding the right treatment conditions. Response surface methodology, an empirical modeling approach based on data resulting from a set of designed experiments, was suggested as a rational solution with which to select in vivo PDT conditions by using a new peptide-conjugated PS targeting agent, neuropilin-1. Methods and Materials: A Doehlert experimental design was selected to model effects and interactions of the PS dose, fluence, and fluence rate on the growth of U87 human malignant glioma cell xenografts in nude mice, using a fixed drug-light interval. All experimental results were computed by Nemrod-W software and Matlab. Results: Intrinsic diameter growth rate, a tumor growth parameter independent of the initial volume of the tumor, was selected as the response variable and was compared to tumor growth delay and relative tumor volumes. With only 13 experimental conditions tested, an optimal PDT condition was selected (PS agent dose, 2.80 mg/kg; fluence, 120 J/cm 2 ; fluence rate, 85 mW/cm 2 ). Treatment of glioma-bearing mice with the peptide-conjugated PS agent, followed by the optimized PDT condition showed a statistically significant improvement in delaying tumor growth compared with animals who received the PDT with the nonconjugated PS agent. Conclusions: Response surface methodology appears to be a useful experimental approach for rapid testing of different treatment conditions and determination of optimal values of PDT factors for any PS agent.

Mitotic delay of irradiated cells and its connection with quantity of radiation injuries

International Nuclear Information System (INIS)

Lobachevskij, P.N.; Fominykh, E.V.

1989-01-01

The study is dedicated to development of mathematical approach to interpret radiation-induced mitosic delay. An assumption is made that mitotic delay is conditioned by discrete injuries distributed in cells according to stochasticity of interaction of radiation and target substance. It is supposed to consider the problem on injuries nature causing mitotic delay and to use the developed method for accounting the effect of radiation-induced mitotic delay on registered chromosomal aberration yield. 10 refs.; 2 figs.; 3 tabs

Existence and asymptotic stability of a viscoelastic wave equation with a delay

KAUST Repository

Kirane, Mokhtar

2011-07-07

In this paper, we consider the viscoelastic wave equation with a delay term in internal feedbacks; namely, we investigate the following problem, together with initial conditions and boundary conditions of Dirichlet type. Here (x, t) ∈ Ω × (0, ∞), g is a positive real valued decreasing function and μ1, μ2 are positive constants. Under an hypothesis between the weight of the delay term in the feedback and the weight of the term without delay, using the Faedo-Galerkin approximations together with some energy estimates, we prove the global existence of the solutions. Under the same assumptions, general decay results of the energy are established via suitable Lyapunov functionals. © 2011 Springer Basel AG.

Existence and asymptotic stability of a viscoelastic wave equation with a delay

KAUST Repository

Kirane, Mokhtar; Said-Houari, Belkacem

2011-01-01

In this paper, we consider the viscoelastic wave equation with a delay term in internal feedbacks; namely, we investigate the following problem, together with initial conditions and boundary conditions of Dirichlet type. Here (x, t) ∈ Ω × (0, ∞), g is a positive real valued decreasing function and μ1, μ2 are positive constants. Under an hypothesis between the weight of the delay term in the feedback and the weight of the term without delay, using the Faedo-Galerkin approximations together with some energy estimates, we prove the global existence of the solutions. Under the same assumptions, general decay results of the energy are established via suitable Lyapunov functionals. © 2011 Springer Basel AG.

The value of delay in tidal energy development

International Nuclear Information System (INIS)

MacDougall, Shelley L.

2015-01-01

Despite robust research, prototype development and demonstration of in-stream tidal energy devices, progress to the commercialization stage has been slow. Some of this can be attributed to a lack readiness or financing. However, when uncertainty is high, a developer may choose to delay a project until more is known. The option to delay has value for a company. This study applies the real option valuation model to an investment in a 10 MW array of in-stream tidal energy conversion devices at the Fundy Ocean Research Centre for Energy (FORCE) in the Bay of Fundy, Nova Scotia, Canada. The values of investing and the option to delay are calculated. A sensitivity analysis of key drivers and scenarios with various input values to the option model are constructed to observe the impact on the 'invest versus delay' decision. The analysis suggests there is value in owning the option to develop, by leasing a FORCE berth, but waiting while uncertainty is resolved. Implications for policy-setting are discussed. - Highlights: • Analyze an invest-vs-delay decision in tidal energy conversion using real options. • Assess whether conditions are conducive to an economically rational decision to delay. • Identify aspects of the decision that can be influenced by government policy.

On minimizing the maximum broadcast decoding delay for instantly decodable network coding

KAUST Repository

Douik, Ahmed S.

2014-09-01

In this paper, we consider the problem of minimizing the maximum broadcast decoding delay experienced by all the receivers of generalized instantly decodable network coding (IDNC). Unlike the sum decoding delay, the maximum decoding delay as a definition of delay for IDNC allows a more equitable distribution of the delays between the different receivers and thus a better Quality of Service (QoS). In order to solve this problem, we first derive the expressions for the probability distributions of maximum decoding delay increments. Given these expressions, we formulate the problem as a maximum weight clique problem in the IDNC graph. Although this problem is known to be NP-hard, we design a greedy algorithm to perform effective packet selection. Through extensive simulations, we compare the sum decoding delay and the max decoding delay experienced when applying the policies to minimize the sum decoding delay and our policy to reduce the max decoding delay. Simulations results show that our policy gives a good agreement among all the delay aspects in all situations and outperforms the sum decoding delay policy to effectively minimize the sum decoding delay when the channel conditions become harsher. They also show that our definition of delay significantly improve the number of served receivers when they are subject to strict delay constraints.

Modeling delayed neutron monitoring systems for fast breeder reactors

International Nuclear Information System (INIS)

Bunch, W.L.; Tang, E.L.

1983-10-01

The purpose of the present work was to develop a general expression relating the count rate of a delayed neutron monitoring system to the introduction rate of fission fragments into the sodium coolant of a fast breeder reactor. Most fast breeder reactors include a system for detecting the presence of breached fuel that permits contact between the sodium coolant and the mixed oxide fuel. These systems monitor for the presence of fission fragments in the sodium that emit delayed neutrons. For operational reasons, the goal is to relate the count rate of the delayed neutron monitor to the condition of the breach in order that appropriate action might be taken

A Cucker--Smale Model with Noise and Delay

KAUST Repository

Erban, Radek

2016-08-09

A generalization of the Cucker-Smale model for collective animal behavior is investigated. The model is formulated as a system of delayed stochastic differential equations. It incorporates two additional processes which are present in animal decision making, but are often neglected in modeling: (i) stochasticity (imperfections) of individual behavior and (ii) delayed responses of individuals to signals in their environment. Sufficient conditions for flocking for the generalized Cucker-Smale model are derived by using a suitable Lyapunov functional. As a by-product, a new result regarding the asymptotic behavior of delayed geometric Brownian motion is obtained. In the second part of the paper, results of systematic numerical simulations are presented. They not only illustrate the analytical results, but hint at a somehow surprising behavior

A Cucker--Smale Model with Noise and Delay

KAUST Repository

Erban, Radek; Haskovec, Jan; Sun, Yongzheng

2016-01-01

A generalization of the Cucker-Smale model for collective animal behavior is investigated. The model is formulated as a system of delayed stochastic differential equations. It incorporates two additional processes which are present in animal decision making, but are often neglected in modeling: (i) stochasticity (imperfections) of individual behavior and (ii) delayed responses of individuals to signals in their environment. Sufficient conditions for flocking for the generalized Cucker-Smale model are derived by using a suitable Lyapunov functional. As a by-product, a new result regarding the asymptotic behavior of delayed geometric Brownian motion is obtained. In the second part of the paper, results of systematic numerical simulations are presented. They not only illustrate the analytical results, but hint at a somehow surprising behavior

Overview of Treatment and Conditioning Practices in Goesgen NPP

International Nuclear Information System (INIS)

Aebi, Patrick

2008-01-01

Radioactive waste of the Goesgen Nuclear Power Plant is collected and stored in an appropriate form for external conditioning or for direct in-house conditioning procedures. Different waste treatment and conditioning technologies have been used since plant start up in 1979. The main conditioning technology used in-house is bituminization. Reactor internal components, contaminated filter elements of cooling circuits or radioactive sludge from the liquid waste tanks have been treated by dedicated equipment and methods. These methods are under water cutting and manipulation of core components, remote dismantling and compressing of filter elements into cartridges or filtration of sludge with a one-chamber filtration system. (authors)

Stabilization of Networked Control Systems with Variable Delays and Saturating Inputs

Directory of Open Access Journals (Sweden)

M. Mahmodi Kaleybar

2014-06-01

Full Text Available In this paper, improved conditions for the synthesis of static state-feedback controller are derived to stabilize networked control systems (NCSs subject to actuator saturation. Both of the data packet latency and dropout which deteriorate the performance of the closed-loop system are considered in the NCS model via variable delays. Two different techniques are employed to incorporate actuator saturation in the system description. Utilizing Lyapunov-Krasovskii Theorem, delay-dependent conditions are obtained in terms of linear matrix inequalities (LMIs to determine the static feedback gain. Moreover, an optimization problem is formulated in order to find the less conservative estimate for the region of attraction corresponding to different maximum allowable delays. Numerical examples are introduced to demonstrate the effectiveness and advantages of the proposed schemes.

Global exponential stability for discrete-time neural networks with variable delays

International Nuclear Information System (INIS)

Chen Wuhua; Lu Xiaomei; Liang Dongying

2006-01-01

This Letter provides new exponential stability criteria for discrete-time neural networks with variable delays. The main technique is to reduce exponential convergence estimation of the neural network solution to that of one component of the corresponding solution by constructing Lyapunov function based on M-matrix. By introducing the tuning parameter diagonal matrix, the delay-independent and delay-dependent exponential stability conditions have been unified in the same mathematical formula. The effectiveness of the new results are illustrated by three examples

Complex Dynamics of Delay-Coupled Neural Networks

Science.gov (United States)

Mao, Xiaochen

2016-09-01

This paper reveals the complicated dynamics of a delay-coupled system that consists of a pair of sub-networks and multiple bidirectional couplings. Time delays are introduced into the internal connections and network-couplings, respectively. The stability and instability of the coupled network are discussed. The sufficient conditions for the existence of oscillations are given. Case studies of numerical simulations are given to validate the analytical results. Interesting and complicated neuronal activities are observed numerically, such as rest states, periodic oscillations, multiple switches of rest states and oscillations, and the coexistence of different types of oscillations.

Discrete-Time Sliding-Mode Control of Uncertain Systems with Time-Varying Delays via Descriptor Approach

Directory of Open Access Journals (Sweden)

Maode Yan

2008-01-01

Full Text Available This paper considers the problem of robust discrete-time sliding-mode control (DT-SMC design for a class of uncertain linear systems with time-varying delays. By applying a descriptor model transformation and Moon's inequality for bounding cross terms, a delay-dependent sufficient condition for the existence of stable sliding surface is given in terms of linear matrix inequalities (LMIs. Based on this existence condition, the synthesized sliding mode controller can guarantee the sliding-mode reaching condition of the specified discrete-time sliding surface for all admissible uncertainties and time-varying delays. An illustrative example verifies the effectiveness of the proposed method.

A dynamic model for infectious diseases: The role of vaccination and treatment

International Nuclear Information System (INIS)

Raja Sekhara Rao, P.; Naresh Kumar, M.

2015-01-01

Understanding dynamics of an infectious disease helps in designing appropriate strategies for containing its spread in a population. Recent mathematical models are aimed at studying dynamics of some specific types of infectious diseases. In this paper we propose a new model for infectious diseases spread having susceptible, infected, and recovered populations and study its dynamics in presence of incubation delays and relapse of the disease. The influence of treatment and vaccination efforts on the spread of infection in presence of time delays are studied. Sufficient conditions for local stability of the equilibria and change of stability are derived in various cases. The problem of global stability is studied for an important special case of the model. Simulations carried out in this study brought out the importance of treatment rate in controlling the disease spread. It is observed that incubation delays have influence on the system even under enhanced vaccination. The present study has clearly brought out the fact that treatment rate even in presence of time delays would contain the disease as compared to popular belief that eradication can only be done through vaccination

Changing Delay Discounting in the Light of the Competing Neurobehavioral Decision Systems Theory: A Review

Science.gov (United States)

Koffarnus, Mikhail N.; Jarmolowicz, David P.; Mueller, E. Terry; Bickel, Warren K.

2013-01-01

Excessively devaluing delayed reinforcers co-occurs with a wide variety of clinical conditions such as drug dependence, obesity, and excessive gambling. If excessive delay discounting is a trans-disease process that underlies the choice behavior leading to these and other negative health conditions, efforts to change an individual's discount rate…

Speech and language delay in two children: an unusual presentation of hyperthyroidism.

Science.gov (United States)

Sohal, Aman P S; Dasarathi, Madhuri; Lodh, Rajib; Cheetham, Tim; Devlin, Anita M

2013-01-01

Hyperthyroidism is rare in pre-school children. Untreated, it can have a profound effect on normal growth and development, particularly in the first 2 years of life. Although neurological manifestations of dysthyroid states are well known, specific expressive speech and language disorder as a presentation of hyperthyroidism is rarely documented. Case reports of two children with hyperthyroidism presenting with speech and language delay. We report two pre-school children with hyperthyroidism, who presented with expressive speech and language delay, and demonstrated a significant improvement in their language skills following treatment with anti-thyroid medication. Hyperthyroidism must be considered in all children presenting with speech and language difficulties, particularly expressive speech delay. Prompt recognition and early treatment are likely to improve outcome.

Negative group delay for Dirac particles traveling through a potential well

International Nuclear Information System (INIS)

Chen Xi; Li Chunfang

2003-01-01

The properties of group delay for Dirac particles traveling through a potential well are investigated. A necessary condition is put forward for the group delay to be negative. It is shown that this negative group delay is closely related to its anomalous dependence on the width of the potential well. In order to demonstrate the validity of stationary-phase approach, numerical simulations are made for a Gaussian-shaped temporal wave packet. A restriction to the potential-well's width is obtained that is necessary for the wave packet to remain distortionless in the traveling. Numerical comparison shows that the relativistic group delay is larger than its corresponding nonrelativistic one

Pattern Formation in Predator-Prey Model with Delay and Cross Diffusion

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Xinze Lian

2013-01-01

Full Text Available We consider the effect of time delay and cross diffusion on the dynamics of a modified Leslie-Gower predator-prey model incorporating a prey refuge. Based on the stability analysis, we demonstrate that delayed feedback may generate Hopf and Turing instability under some conditions, resulting in spatial patterns. One of the most interesting findings is that the model exhibits complex pattern replication: the model dynamics exhibits a delay and diffusion controlled formation growth not only to spots, stripes, and holes, but also to spiral pattern self-replication. The results indicate that time delay and cross diffusion play important roles in pattern formation.

Vitamin D for the treatment of chronic painful conditions in adults.

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Straube, Sebastian; Derry, Sheena; Straube, Carmen; Moore, R Andrew

2015-05-06

This review is an update of a previously published review in the Cochrane Database of Systematic Reviews (Issue 1, 2010) on 'Vitamin D for the treatment of chronic painful conditions in adults'.Vitamin D is produced in the skin after exposure to sunlight and can be obtained through food. Vitamin D deficiency has been linked with a range of conditions, including chronic pain. Observational and circumstantial evidence suggests that there may be a role for vitamin D deficiency in the aetiology of chronic painful conditions. To assess the efficacy and safety of vitamin D supplementation in chronic painful conditions when tested against placebo or against active comparators. For this update, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASE to February 2015. This was supplemented by searching the reference lists of retrieved articles, reviews in the field, and online trial registries. We included studies if they were randomised double-blind trials of vitamin D supplementation compared with placebo or with active comparators for the treatment of chronic painful conditions in adults. Two review authors independently selected the studies for inclusion, assessed methodological quality, and extracted data. We did not undertake pooled analysis due to the heterogeneity of the data. Primary outcomes of interest were pain responder outcomes, and secondary outcomes were treatment group average pain outcomes and adverse events. We included six new studies (517 participants) in this review update, bringing the total of included studies to 10 (811 participants). The studies were heterogeneous with regard to study quality, the chronic painful conditions that were investigated, the dose of vitamin D given, co-interventions, and the outcome measures reported. Only two studies reported responder pain outcomes; the other studies reported treatment group average outcomes only. Overall, there was no consistent pattern that vitamin D treatment was

Combination of butylphthalide with umbilical mesenchymal stem cells for the treatment of delayed encephalopathy after carbon monoxide poisoning.

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Wang, Huanjun; Li, Yan; Wu, Qiang; Xu, Chenglong; Liu, Qingran

2016-12-01

Delayed encephalopathy after carbon monoxide (CO) poisoning (DEACMP) is still a clinical challenge. This study aimed to investigate the efficacy of combined therapy of mesenchymal stem cell (MSC) transplantation and butylphthalide in DEACMP patients.Forty-two DEACMP patients were treated with 1 of the 3 therapies: combined therapy of MSC transplantation and butylphthalide; MSC transplantation alone; or hyperbaric oxygen therapy. The MSCs were alternatively injected into the subarachnoid space and the carotid artery using a self-made high-pressure injector. The Mini-Mental State Examination and the Barthel index of activities of daily living were administered before the treatment, and at 1 month, 3 months, and 6 months after the treatment. Computed tomography and magnetic resonance imaging results before and after the treatment were compared.At 1 month, 3 months, and 6 months after the treatment, the Mini-Mental State Examination scores and the Barthl scores were significantly higher in patients with the combined therapy of MSC transplantation and butylphthalide than those in patients with MSC transplantation alone or hyperbaric oxygen therapy (all P < 0.0001). No significant adverse events occurred.The combination of MSC transplantation and butylphthalide is safe and effective in treating DEACMP.

Global robust stability of delayed recurrent neural networks

International Nuclear Information System (INIS)

Cao Jinde; Huang Deshuang; Qu Yuzhong

2005-01-01

This paper is concerned with the global robust stability of a class of delayed interval recurrent neural networks which contain time-invariant uncertain parameters whose values are unknown but bounded in given compact sets. A new sufficient condition is presented for the existence, uniqueness, and global robust stability of equilibria for interval neural networks with time delays by constructing Lyapunov functional and using matrix-norm inequality. An error is corrected in an earlier publication, and an example is given to show the effectiveness of the obtained results

Abdominal CT findings of delayed postoperative complications

Energy Technology Data Exchange (ETDEWEB)

Zissin, R.; Osadchy, A. [Sapir Medical Center, Dept. of Diagnostic Imaging, Kfar Saba (Israel)]. E-mail: zisinrivka@clalit.org.il; Gayer, G. [Assaf Harofe Medical Center, Dept. of Diagnostic Imaging, Zrifin (Israel)

2007-10-15

Despite progress in surgical techniques and modern medical treatment, postoperative complications occur not infrequently and vary according to type of surgery, clinical setting, and time elapsed since surgery. In general, they can be divided into early and delayed complications. Delayed postoperative complications can be classified as specific and nonspecific. The common nonspecific delayed complications are incisional hernia and postoperative bowel obstruction. Bowel obstruction can be further categorized as obstruction related to benign or neoplastic etiology, the latter occurring in oncology patients in whom the primary surgery was related to an underlying abdominal neoplasm. Gossypiboma is another, fortunately rare, postoperative complication. Specific complications appear after specific operations and include the following: Splenosis - following splenectomy. Retained gallstones and spilled gallstones - following cholecystectomy, mainly laparoscopic. Dropped appendicolith and stump appendicitis - following appendectomy, mainly laparoscopic. Obturation obstruction by a bezoar - following gastric surgery. Afferent loop syndrome (ALS) - following Bilroth II gastrectomy. (author)

Fuzzy delay model based fault simulator for crosstalk delay fault test ...

Indian Academy of Sciences (India)

In this paper, a fuzzy delay model based crosstalk delay fault simulator is proposed. As design trends move towards nanometer technologies, more number of new parameters affects the delay of the component. Fuzzy delay models are ideal for modelling the uncertainty found in the design and manufacturing steps.

Oral Health Characteristics and Dental Rehabilitation of Children with Global Developmental Delay

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Saurabh Kumar

2017-01-01

Full Text Available Global developmental delay (GDD is a chronic neurological disturbance which includes defects in one or more developmental domains. The developmental domain can be motor, cognitive, daily activities, speech or language, and social or personal development. The etiology for GDD can be prenatal, perinatal, or postnatal. It can be diagnosed early in childhood as the delay or absence of one or more developmental milestones. Hence the role of pedodontist and pediatricians becomes more crucial in identifying this condition. The diagnosis of GDD requires a detailed history including family history and environmental risk factors followed by physical and neurological examinations. Investigations for GDD include diagnostic laboratory tests, brain imaging, and other evidence-based evaluations. GDD affects multiple developmental domains that not only have direct bearing on maintenance of oral health, but also require additional behavior management techniques to deliver optimal dental care. This paper describes two different spectra of children with GDD. Since the severity of GDD can vary, this paper also discusses the different behavior management techniques that were applied to provide dental treatment in such children.

Oral Health Characteristics and Dental Rehabilitation of Children with Global Developmental Delay.

Science.gov (United States)

Kumar, Saurabh; Pai, Deepika; Saran, Runki

2017-01-01

Global developmental delay (GDD) is a chronic neurological disturbance which includes defects in one or more developmental domains. The developmental domain can be motor, cognitive, daily activities, speech or language, and social or personal development. The etiology for GDD can be prenatal, perinatal, or postnatal. It can be diagnosed early in childhood as the delay or absence of one or more developmental milestones. Hence the role of pedodontist and pediatricians becomes more crucial in identifying this condition. The diagnosis of GDD requires a detailed history including family history and environmental risk factors followed by physical and neurological examinations. Investigations for GDD include diagnostic laboratory tests, brain imaging, and other evidence-based evaluations. GDD affects multiple developmental domains that not only have direct bearing on maintenance of oral health, but also require additional behavior management techniques to deliver optimal dental care. This paper describes two different spectra of children with GDD. Since the severity of GDD can vary, this paper also discusses the different behavior management techniques that were applied to provide dental treatment in such children.

Synchronization of Different Fractional Order Time-Delay Chaotic Systems Using Active Control

Directory of Open Access Journals (Sweden)

Jianeng Tang

2014-01-01

Full Text Available Chaos synchronization of different fractional order time-delay chaotic systems is considered. Based on the Laplace transform theory, the conditions for achieving synchronization of different fractional order time-delay chaotic systems are analyzed by use of active control technique. Then numerical simulations are provided to verify the effectiveness and feasibility of the developed method. At last, effects of the fraction order and the time delay on synchronization are further researched.

How do patients access the private sector in Chennai, India? An evaluation of delays in tuberculosis diagnosis.