Why people experiencing acute myocardial infarction delay seeking medical assistance

Background: Delay time from onset of symptoms of myocardial infarction to seeking medical assistance can have life- 31 threatening consequences. A number of factors have been associated with delay, but there is little evidence regarding the predictive 32 value of these indices. Aim: To explore potential predictors of patient delay from onset of symptoms to time medical assistance 33 was sought in a consecutive sample of patients admitted to CCU with acute myocardial infarction. Methods: The Cardiac Denial 34 of Impact Scale, Health Locus of Control Scale, Health Value Scale and Pennebaker Inventory of Limbic Languidness were 35 administered to 62 patients between 3 and 6 days after admission. Results: Attribution of symptoms to heart disease and health 36 locus of control had a significant predictive effect on patients seeking help within 60 min, while previous experience of heart 37 disease did not. Conclusion: Assisting individuals to recognise the potential for symptoms to have a cardiac origin is an important 38 objective. Interventions should take into account the variety of cognitive and behavioural factors involved in decision making.

Ultrafast coherent control and quantum encoding of molecular vibrations in D2+ using intense laser pulses

Intense, few-femtosecond pulse technology has enabled studies of the fastest vibrational relaxation processes. The hydrogen group vibrations can be imaged and manipulated using intense infrared pulses. Through numerical simulation, we demonstrate an example of ultrafast coherent control that could be effected with current experimental facilities, and observed using high-resolution time-of-flight spectroscopy. The proposal is a pump-probe-type technique to manipulate the D2+ ion with ultrashort pulse sequences. The simulations presented show that vibrational selection can be achieved through pulse delay. We find that the vibrational system can be purified to a two-level system thus realizing a vibrational qubit. A novel scheme for the selective transfer of population between these two levels, based on a Raman process and conditioned upon the delay time of a second control-pulse is outlined, and may enable quantum encoding with this system.

An agent-based control mechanism for WFQ in IP networks

This paper presents a new packet scheduling scheme called agent-based WFQ to control and maintain QoS parameters in virtual private networks (VPNs) within the confines of adaptive networks. Future networks are expected to be open heterogeneous environments consisting of more than one network operator. In this adaptive environment, agents act on behalf of users or third-party operators to obtain the best service for their clients and maintain those services through the modification of the scheduling scheme in routers and switches spanning the VPN. In agent-based WFQ, an agent on the router monitors the accumulated queuing delay for each service. In order to control and to keep the end-to-end delay within the bounds, the weights for services are adjusted dynamically by agents on the routers spanning the VPN. If there is an increase or decrease in queuing delay of a service, an agent on a downstream router informs the upstream routers to adjust the weights of their queues. This keeps the end-to-end delay of services within the specified bounds and offers better QoS compared to VPNs using static WFQ. This paper also describes the algorithm for agent-based WFQ, and presents simulation results. (C) 2003 Elsevier Science Ltd. All rights reserved.

Pathways to state-selective control of vibrational wavepackets in the deuterium molecular ion

The capability of intense ultrashort laser pulses to initiate, control and image vibrational wavepacket dynamics in the deuterium molecular ion has been simulated with a view to inform and direct future femtosecond pump-control-probe experiments. The intense-field coherent control of the vibrational superposition has been studied as a function of pulse intensity and delay time, to provide an indication of key constraints for experimental studies. For selected cases of the control mechanism, probing of the subsequent vibrational wavepacket dynamics has been simulated via the photodissociation (PD) channel. Such PD probing is shown to elucidate the modified wavepacket dynamics where the position of the quantum revival is sensitive to the control process. Through Fourier transform analysis the PD yield is also shown to provide a characterisation of the vibrational distribution. It has been shown that a simple 'critical R cut-off' approximation can be used to reproduce the effect of a probe pulse interaction, providing a convenient and efficient alternative to intensive computer simulations of the PD mechanism in the deuterium molecular ion.

Quasiexperimental Study of the Effects of Antibiotic Use, Gastric Acid-Suppressive Agents, and Infection Control Practices on the Incidence of Clostridium difficile-Associated Diarrhea in Hospitalized Patients

The objective of this study was to evaluate the effects of antimicrobial drug use, gastric acid-suppressive agent use, and infection control practices on the incidence of Clostridium difficile-associated diarrhea (CDAD) in a 426-bed general teaching hospital in Northern Ireland. The study was retrospective and ecological in design. A multivariate autoregressive integrated moving average (time-series analysis) model was built to relate CDAD incidence with antibiotic use, gastric acid-suppressive agent use, and infection control practices within the hospital over a 5-year period (February 2002 to March 2007). The findings of this study showed that temporal variation in CDAD incidence followed temporal variations in expanded-spectrum cephalosporin use (average delay = 2 months; variation of CDAD incidence = 0.01/100 bed-days), broad-spectrum cephalosporin use (average delay = 2 months; variation of CDAD incidence = 0.02/100 bed-days), fluoroquinolone use (average delay = 3 months; variation of CDAD incidence = 0.004/100 bed-days), amoxicillin-clavulanic acid use (average delay = 1 month; variation of CDAD incidence = 0.002/100 bed-days), and macrolide use (average delay = 5 months; variation of CDAD incidence = 0.002/100 bed-days). Temporal relationships were also observed between CDAD incidence and use of histamine-2 receptor antagonists (H2RAs; average delay = 1 month; variation of CDAD incidence = 0.001/100 bed-days). The model explained 78% of the variance in the monthly incidence of CDAD. The findings of this study highlight a temporal relationship between certain classes of antibiotics, H2RAs, and CDAD incidence. The results of this research can help hospitals to set priorities for restricting the use of specific antibiotic classes, based on the size-effect of each class and the delay necessary to observe an effect.

Predictive Current Control of Doubly Fed Induction Generators

This paper presents a predictive current control strategy for doubly-fed induction generators (DFIG). The method predicts the DFIG’s rotor current variations in the synchronous reference frame fixed to the stator flux within a fixed sampling period. This is then used to directly calculate the required rotor voltage to eliminate the current errors at the end of the following sampling period. Space vector modulation is used to generate the required switching pulses within the fixed sampling period. The impact of sampling delay on the accuracy of the sampled rotor current is analyzed and detailed compensation methods are proposed to improve the current control accuracy and system stability. Experimental results for a 1.5 kW DFIG system illustrate the effectiveness and robustness of the proposed control strategy during rotor current steps and rotating speed variation. Tests during negative sequence current injection further demonstrate the excellent dynamic performance of the proposed PCC method.

Availability of stage at diagnosis, cancer treatment delay and compliance with cancer guidelines as cancer registry indicators for cancer care in Europe:Results of EUROCHIP-3 survey

EUROCHIP (European Cancer Health Indicators Project) focuses on understanding inequalities in the cancer burden, care and survival by the indicators "stage at diagnosis," "cancer treatment delay" and "compliance with cancer guidelines" as the most important indicators. Our study aims at providing insight in whether cancer registries collect well-defined variables to determine these indicators in a comparative way. Eighty-six general European population-based cancer registries (PBCR) from 32 countries responded to the questionnaire, which was developed by EUROCHIP in collaboration with ENCR (European Network of Cancer Registries) and EUROCOURSE. Only 15% of all the PBCR in EU had all three indicators available. The indicator "stage at diagnosis" was gathered for at least one cancer site by 81% (using TNM in 39%). Variables for the indicator "cancer treatment delay" were collected by 37%. Availability of type of treatment (30%), surgery date (36%), starting date of radiotherapy (26%) and starting date of chemotherapy (23%) resulted in 15% of the PBCRs to be able to gather the indicator "compliance to guidelines". Lack of data source access and qualified staff were the major reasons for not collecting all the variables. In conclusion, based on self-reporting, a few of the participating PBCRs had data available which could be used for clinical audits, evaluation of cancer care projects, survival and for monitoring national cancer control strategies. Extra efforts should be made to improve this very efficient tool to compare cancer burden and the effects of the national cancer plans over Europe and to learn from each other. © 2012 UICC.

Control of the AtMAP65-1 interaction with microtubules through the cell cycle

Cell division depends on the fine control of both microtubule dynamics and microtubule organisation. The microtubule bundling protein MAP65 is a 'midzone MAP' essential for the integrity of the anaphase spindle and cell division. Arabidopsis thaliana MAP65-1 (AtMAP65-1) binds and bundles microtubules by forming 25 nm cross-bridges. Moreover, as AtMAP65-1 bundles microtubules in interphase, anaphase and telophase but does not bind microtubules in prophase or metaphase, its activity through the cell cycle must be under tight control. Here we show that AtMAP65-1 is hyperphosphorylated during prometaphase and metaphase and that CDK and MAPK are involved in this phosphorylation. This phosphorylation inhibits AtMAP65-1 activity. Expression of nonphosphorylatable AtMAP65-1 has a negative effect on mitotic progression resulting in excessive accumulation of microtubules in the metaphase spindle midzone causing a delay in mitosis. We conclude that normal metaphase spindle organisation and the transition to anaphase is dependent on inactivation of AtMAP65-1.