Application of Signal Advance Technology to Electrophysiology

Medical instrumentation used in diagnosis and treatment relies on the accurate detection and processing of various physiological events and signals. While signal detection technology has improved greatly in recent years, there remain inherent delays in signal detection/ processing. These delays may have significant negative clinical consequences during various pathophysiological events. Reducing or eliminating such delays would increase the ability to provide successful early intervention in certain disorders thereby increasing the efficacy of treatment. In recent years, a physical phenomenon referred to as Negative Group Delay (NGD), demonstrated in simple electronic circuits, has been shown to temporally advance the detection of analog waveforms. Specifically, the output is temporally advanced relative to the input, as the time delay through the circuit is negative. The circuit output precedes the complete detection of the input signal. This process is referred to as signal advance (SA) detection. An SA circuit model incorporating NGD was designed, developed and tested. It imparts a constant temporal signal advance over a pre-specified spectral range in which the output is almost identical to the input signal (i.e., it has minimal distortion). Certain human patho-electrophysiological events are good candidates for the application of temporally-advanced waveform detection. SA technology has potential in early arrhythmia and epileptic seizure detection and intervention. Demonstrating reliable and consistent temporally advanced detection of electrophysiological waveforms may enable intervention with a pathological event (much) earlier than previously possible. SA detection could also be used to improve the performance of neural computer interfaces, neurotherapy applications, radiation therapy and imaging. In this study, the performance of a single-stage SA circuit model on a variety of constructed input signals, and human ECGs is investigated. The data obtained is used to quantify and characterize the temporal advances and circuit gain, as well as distortions in the output waveforms relative to their inputs. This project combines elements of physics, engineering, signal processing, statistics and electrophysiology. Its success has important consequences for the development of novel interventional methodologies in cardiology and neurophysiology as well as significant potential in a broader range of both biomedical and non-biomedical areas of application.

The Most Extensive Holocene Advance in the Stauning Alper, East Greenland, Occurred in the Little Ice Age

We present glacial geologic and chronologic data concerning the Holocene ice extent in the Stauning Alper of East Greenland. The retreat of ice from the late-glacial position back into the mountains was accomplished by at least 11 000 cal years B.P. The only recorded advance after this time occurred during the past few centuries (the Little Ice Age). Therefore, we postulate that the Little Ice Age event represents the maximum Holocene ice extent in this part of East Greenland.

Treatment of aortic stenosis with a self-expanding transcatheter valve: the International Multi-centre ADVANCE Study.

AIM Transcatheter aortic valve implantation has become an alternative to surgery in higher risk patients with symptomatic aortic stenosis. The aim of the ADVANCE study was to evaluate outcomes following implantation of a self-expanding transcatheter aortic valve system in a fully monitored, multi-centre 'real-world' patient population in highly experienced centres. METHODS AND RESULTS Patients with severe aortic stenosis at a higher surgical risk in whom implantation of the CoreValve System was decided by the Heart Team were included. Endpoints were a composite of major adverse cardiovascular and cerebrovascular events (MACCE; all-cause mortality, myocardial infarction, stroke, or reintervention) and mortality at 30 days and 1 year. Endpoint-related events were independently adjudicated based on Valve Academic Research Consortium definitions. A total of 1015 patients [mean logistic EuroSCORE 19.4 ± 12.3% [median (Q1,Q3), 16.0% (10.3, 25.3%)], age 81 ± 6 years] were enrolled. Implantation of the CoreValve System led to a significant improvement in haemodynamics and an increase in the effective aortic valve orifice area. At 30 days, the MACCE rate was 8.0% (95% CI: 6.3-9.7%), all-cause mortality was 4.5% (3.2-5.8%), cardiovascular mortality was 3.4% (2.3-4.6%), and the rate of stroke was 3.0% (2.0-4.1%). The life-threatening or disabling bleeding rate was 4.0% (2.8-6.3%). The 12-month rates of MACCE, all-cause mortality, cardiovascular mortality, and stroke were 21.2% (18.4-24.1%), 17.9% (15.2-20.5%), 11.7% (9.4-14.1%), and 4.5% (2.9-6.1%), respectively. The 12-month rates of all-cause mortality were 11.1, 16.5, and 23.6% among patients with a logistic EuroSCORE ≤10%, EuroSCORE 10-20%, and EuroSCORE >20% (P< 0.05), respectively. CONCLUSION The ADVANCE study demonstrates the safety and effectiveness of the CoreValve System with low mortality and stroke rates in higher risk real-world patients with severe aortic stenosis.

Transfusion efficacy of apheresis platelet concentrates irradiated at the day of transfusion is significantly superior compared to platelets irradiated in advance.

BACKGROUND Gamma irradiation is currently the standard care to avoid transfusion-associated graft-versus-host disease. Guidelines on gamma irradiation of blood components state that platelets (PLTs) can be irradiated at any stage in their 5-day storage and can thereafter be stored up to their normal shelf life of 5 days after collection. In this study, we explored whether the timing of irradiation has an effect on transfusion efficacy of apheresis PLT concentrates (APCs). METHODS Based on the 1-hour percent PLT recovery (PPR1h), transfusion efficacy of 1,000 eligible APCs transfused to 144 children were evaluated retrospectively. PPR1h was compared in transfused APCs irradiated at the day of transfusion and APCs irradiated in advance. RESULTS In univariate analysis, transfusion efficacy of APCs irradiated in advance was significantly lower than that of APCs irradiated at the day of transfusion (mean PPR1h 27.7 vs. 35.0%; p = 0.007). This was confirmed in multivariate analysis (p = 0.030). Compared to non-irradiated APCs, transfusion efficacy of APCs irradiated at the day of transfusion was not significantly inferior (mean difference -2.8%; 95% CI -6.1 to 0.5%; p = 0.092), but APCs irradiated in advance were clearly less efficient (mean difference -8.1%; 95% CI -12.2 to -4.0%; p < 0.001). CONCLUSION Our data strongly support that APCs should not be irradiated in advance, 1.e., ≥24 h before transfusion.

Advance P. Chem. Problems (I) Populations, Partition Functions, Particle in Box, Harmonic Oscillators, Angular Momentum and Rigid Rotor

This is a set of P. Chem. problems posed at slightly higher than the normal text book level, for students who are continuing in the study of this subject.

Advance provision of emergency contraception for pregnancy prevention (Review)

Background Emergency contraception can prevent pregnancy when taken after unprotected intercourse.Obtaining emergency contraception within the recommended time frame is difficult for many women. Advance provision could circumvent some obstacles to timely use. Objectives To summarize randomized controlled trials evaluating advance provision of emergency contraception to explore effects on pregnancy rates, sexually transmitted infections, and sexual and contraceptive behaviors. Search strategy In November 2009, we searched CENTRAL, EMBASE, POPLINE,MEDLINE via PubMed, and a specialized emergency contraception article database. We also searched reference lists and contacted experts to identify additional published or unpublished trials. Selection criteria We included randomized controlled trials comparing advance provision and standard access (i.e., counseling whichmay ormay not have included information about emergency contraception, or provision of emergency contraception on request at a clinic or pharmacy). Data collection and analysis Two reviewers independently abstracted data and assessed study quality. We entered and analyzed data using RevMan 5.0.23. Main results Eleven randomized controlled trials met our criteria for inclusion, representing 7695 patients in the United States, China, India and Sweden. Advance provision did not decrease pregnancy rates (odds ratio (OR) 0.98, 95% confidence interval (CI) 0.76 to 1.25 in studies for which we included twelve-month follow-up data; OR 0.48, 95% CI 0.18 to 1.29 in a study with seven-month follow-up data; OR 0.92, 95% CI 0.70 to 1.20 in studies for which we included six-month follow-up data; OR 0.49, 95% CI 0.09 to 2.74 in a study with three-month follow-up data), despite reported increased use (single use: OR 2.47, 95% CI 1.80 to 3.40; multiple use: OR 4.13, 95% CI 1.77 to 9.63) and faster use (weighted mean difference (WMD) -12.98 hours, 95% CI -16.66 to -9.31 hours). Advance provision did not lead to increased rates of sexually transmitted infections (OR 1.01, 95% CI 0.75 to 1.37), increased frequency of unprotected intercourse, or changes in contraceptive methods.Women who received emergency contraception in advance were equally likely to use condoms as other women. Authors’ conclusions Advance provision of emergency contraception did not reduce pregnancy rates when compared to conventional provision. Results from primary analyses suggest that advance provision does not negatively impact sexual and reproductive health behaviors and outcomes. Women should have easy access to emergency contraception, because it can decrease the chance of pregnancy.However, the interventions tested thus far have not reduced overall pregnancy rates in the populations studied.

Timing of the most recent Neoglacial advance and retreat in Potter Cove, Antarctic Peninsula

The timing of the most recent Neoglacial advance in the Antarctic Peninsula is important for establishing global climate teleconnections and providing important post-glacial rebound corrections to gravity-based satellite measurements of ice loss. However, obtaining accurate ages from terrestrial geomorphic and sedimentary indicators of the most recent Neoglacial advance in Antarctica has been hampered by the lack of historical records and the difficulty of dating materials in Antarctica. Here we use a new approach to dating flights of raised beaches in the South Shetland Islands of the northern Antarctic Peninsula to bracket the age of a Neoglacial advance that occurred between 1500 and 1700 AD, broadly synchronous with compilations for the timing of the Little Ice Age in the northern hemisphere. Our approach is based on optically stimulated luminescence of the underside of buried cobbles to obtain the age of beaches previously shown to have been deposited immediately inside and outside the moraines of the most recent Neoglacial advance. In addition, these beaches mark the timing of an apparent change in the rate of isostatic rebound thought to be in response to the same glacial advance within the South Shetland Islands. We use a Maxwell viscoelastic model of glacial-isostatic adjustment (GIA) to determine whether the rates of uplift calculated from the raised beaches are realistic given the limited constraints on the ice advance during this most recent Neoglacial advance. Our rebound model suggests that the subsequent melting of an additional 16-22% increase in the volume of ice within the South Shetland Islands would result in a subsequent uplift rate of 12.5 mm/yr that lasted until 1840 AD resulting in a cumulative uplift of 2.5 m. This uplift rate and magnitude are in close agreement with observed rates and magnitudes calculated from the raised beaches since the most recent Neoglacial advance along the South Shetland Islands and falls within the range of uplift rates from similar settings such as Alaska.

Simulation analysis of the EU ELV/RoHS directives based on an applied general equilibrium model with Melitz-type trade specification

This paper explores the potential usefulness of an AGE model with the Melitz-type trade specification to assess economic effects of technical regulations, taking the case of the EU ELV/RoHS directives as an example. Simulation experiments reveal that: (1) raising the fixed exporting cost to make sales in the EU market brings results that exports of the targeted commodities (motor vehicles and parts for ELV and electronic equipment for RoHS) to the EU from outside regions/countries expand while the domestic trade in the EU shrinks when the importer's preference for variety (PfV) is not strong; (2) if the PfV is not strong, policy changes that may bring reduction in the number of firms enable survived producers with high productivity to expand production to be large-scale mass producers fully enjoying the fruit of economies of scale; and (3) When the strength of the importer's PfV is changed from zero to unity, there is the value that totally changes simulation results and their interpretations.

Directives for a Correct Diagnosis

A special Working Group, to study and develop standars related to Building Restoration, Rehabilitation and Maintenance, was formed in January 2001 in AENOR (Spanish Association for Codes and Standars) under the management of the Department of Building Construction of the School of Architecture of Madrid (DCTA-UPM). Three groups were organized to deal with different topics: Diagnosis, Techiques and Materials, and Maintenance. In this paper the differents topics in which the Diagnosis Subgroup is working are described: historical studies, constructive description of the building and building pathology. These will be basic to carry out a correct diagnosis of any type of building, whether it is historic or not. In the development of such topics, the recognizable architectural values are justified as they are prior to the diagnosis stage. As an example of the subgroup work, several pathology cards are shown which include: longitudinal cracks of mechanical origin in beams of concrete structures, façade closings and claddings, and general symptoms of installation services.

Effects of Conservation Interventions on the Archaeological Roman Site of Merida (Spain). Advance of Research

Efectos derivados de tratamientos de conservación y restauración sobre material inorgánico en yacimientos arqueológicos. Caso de estudio: Mérida.

Effects of conservation interventions on the archaeological Roman site of Merida (Spain). Advance of research.

Research on the assessment of the effects of conservation/restoration treatments on stone material has been significant in recent years, with focus on the early observation of decay caused by the application of these treatments. However, in the case of archaeological sites, research is still scarce and few studies on the subject have been published. Restoration, as everything else, has changed according to trends, mainly guided by the release of new products and technologies, an experimental field where scientific assessment of suitability, efficacy and durability pre-evaluations of treatments are not always conducted. Some efforts have been made to solve this problem in the architectural field, where functional needs and technical requirements force to set clear standards. Unfortunately, archaeological sites, unlike historic buildings, have specific features that preclude the extrapolation of these results. A critical review of the methodologies, products and restoration materials is necessary, coupled with deeper research on degradation mechanisms caused by these treatments in the mid- and long-term. The aim of this paper is to introduce the research on the above issues using Merida as a case study.