800 resultados para NICHD Protocol
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Background: The public health burden of coronary artery disease (CAD) is important. Perfusion cardiac magnetic resonance (CMR) is generally accepted to detect and monitor CAD. Few studies have so far addressed its costs and costeffectiveness. Objectives: To compare in a large CMR registry the costs of a CMR-guided strategy vs two hypothetical invasive strategies for the diagnosis and the treatment of patients with suspected CAD. Methods: In 3'647 patients with suspected CAD included prospectively in the EuroCMR Registry (59 centers; 18 countries) costs were calculated for diagnostic examinations, revascularizations as well as for complication management over a 1-year follow-up. Patients with ischemia-positive CMR underwent an invasive X-ray coronary angiography (CXA) and revascularization at the discretion of the treating physician (=CMR+CXA strategy). Ischemia was found in 20.9% of patients and 17.4% of them were revascularized. In ischemia-negative patients by CMR, cardiac death and non-fatal myocardial infarctions occurred in 0.38%/y. In a hypothetical invasive arm the costs were calculated for an initial CXA followed by FFR testing in vessels with ≥50% diameter stenoses (=CXA+FFR strategy). To model this hypothetical arm, the same proportion of ischemic patients and outcome was assumed as for the CMR+CXA strategy. The coronary stenosis - FFR relationship reported in the literature was used to derive the proportion of patients with ≥50% diameter stenoses (Psten) in the study cohort. The costs of a CXA-only strategy were also calculated. Calculations were performed from a third payer perspective for the German, UK, Swiss, and US healthcare systems.
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Validation ofan Ice Skating Protocol to Predict Aerobic Power in Hockey Players In assessing the physiological capacity of ice hockey players, researchers have often reported the outcomes from different anaerobic skate tests, and the general physical fitness of participants. However, with respect to measuring the aerobic power of ice hockey players, few studies have reported a sport-specific protocol, and currently there is a lack of cohort-specific information describing aerobic power based on evaluations using an on-ice protocol. The Faught Aerobic Skating Test (FAST) uses an on-ice continuous skating protocol to induce a physical stress on a participant's aerobic energy system. The FAST incorporates the principle of increasing workloads at measured time intervals during a continuous skating exercise. Regression analysis was used to determine the estimate of aerobic power within gender and age level. Data were collected on 532 hockey players, (males=384, females=148) ranging in age between 9 and 25 years. Participants completed a laboratory test to measure aerobic power using a modified Bruce protocol, and the on-ice FAST. Regression equations were developed for six male and female, age-specific cohorts separately. The most consistent predictors were weight and final stage completed on the FAST. These results support the application of the FAST to estimate aerobic power among hockey players with R^ values ranging from 0.174 to 0.396 and SEE ranging from 5.65 to 8.58 ml kg' min'' depending on the cohort. Thus we conclude that FAST to be an accurate predictor of aerobic power in age and gender-specific hockey playing cohorts.
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In 2003, prostate cancer (PCa) is estimated to be the most commonly diagnosed cancer and third leading cause of cancer death in Canada. During PCa population screening, approximately 25% of patients with a normal digital rectal examination (DRE) and intermediate serum prostate specific antigen (PSA) level have PCa. Since all patients typically undergo biopsy, it is expected that approximately 75% of these procedures are unnecessary. The purpose of this study was to compare the degree of efficacy of clinical tests and algorithms in stage II screening for PCa while preventing unnecessary biopsies from occurring. The sample consisted of 201 consecutive men who were suspected of PCa based on the results of a DRE and serum PSA. These men were referred for venipuncture and transrectal ultrasound (TRUS). Clinical tests included TRUS, agespecific reference range PSA (Age-PSA), prostate specific antigen density (PSAD), and free-to-total prostate specific antigen ratio (%fPSA). Clinical results were evaluated individually and within algorithms. Cutoffs of 0.12 and 0.15 ng/ml/cc were employed for PSAD. Cutoffs that would provide a minimum sensitivity of 0.90 and 0.95, respectively were utilized for %fPSA. Statistical analysis included ROC curve analysis, calculated sensitivity (Sens), specificity (Spec), and positive likelihood ratio (LR), with corresponding confidence intervals (Cl). The %fPSA, at a 23% cutoff ({ Sens=0.92; CI, 0.06}, {Spec=0.4l; CI, 0.09}, {LR=1.56; CI, O.ll}), proved to be the most efficacious independent clinical test. The combination of PSAD (cutoff 0.15 ng/ml/cc) and %fPSA (cutoff 23%) ({Sens=0.93; CI, 0.06}, {Spec=0.38; CI, 0.08}, {LR=1.50; CI, 0.10}) was the most efficacious clinical algorithm. This study advocates the use of %fPSA at a cutoff of 23% when screening patients with an intermediate serum PSA and benign DRE.
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The human neuromuscular system is susceptible to changes within the thermal environment. Cold extrinsic temperatures can significantly reduce muscle and nervous system function and communication, which can have consequences for motor performance. A repeated measures design protocol exposed participants to a 12°C cold water immersion (CWI) up to the ankle, knee, and hip to determine the effect that reduced skin and muscle temperature had on balance and strength task execution. Although a linear reduction in the ability to perform balance tasks was seen from the control condition through to the hip CWI, results from the study indicated a significant reduction in dynamic balance (Star Excursion Balance Test reach distance) performance from only the hip CWI (P<0.05). This reduced performance could have been due to an increase in joint stiffness, increased agonist-antagonist co-contraction, and/or reduced isokinetic muscular strength. Reduced physical performance due to cold temperature could negatively impact outdoor recreational athletics.
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Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal
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Depuis les années 1990, de nombreuses recherches ont porté sur le dévoilement de l’agression sexuelle chez l’enfant et sur les caractéristiques y étant associées. Outre les facteurs liés à l’enfant et au contexte, le type de questions utilisé par l’intervieweur (notamment les invitations et les questions ouvertes) est une variable déterminante pour le dévoilement de l’enfant et la quantité de détails qui sera fournie entourant l’agression sexuelle. Bien que plusieurs enquêteurs reçoivent une formation sur l’utilisation des questions ouvertes dans les entrevues avec les enfants, peu d’entre eux utilisent un style de question approprié une fois sur le terrain. L’objectif de cette recherche vise à déterminer si certaines caractéristiques personnelles des enquêteurs sont associées à leur adhésion à un protocole d’entrevue structuré pour lequel ils ont été formés, à l’utilisation de questions ouvertes dans des entrevues d’enquête auprès d’enfants soupçonnés d’avoir vécu une agression sexuelle et à la quantité de détails dévoilés par l’enfant lors de ces entrevues. Deux études ont été menées pour répondre à cette question. La première étude a été effectuée à l'École nationale de police du Québec auprès de 24 enquêteurs de police ayant suivi une formation d'une semaine visant l’apprentissage du protocole d’entrevue structuré du National Institute of Child Health and Human Development (NICHD). Le genre féminin, les habiletés cognitives et le trait de personnalité Ouverture à l’expérience sont trois caractéristiques personnelles qui ont été reliées positivement à la performance des enquêteurs lors d’une entrevue simulée avec un comédien jouant le rôle d’un enfant victime d’agression sexuelle, tandis que le nombre d’années d’expérience et la capacité de gestion du stress de ces enquêteurs ont montré une relation négative avec cette performance. Dans la seconde étude effectuée sur le terrain auprès de 13 enquêteurs du Service de police de la Ville de Montréal, 114 entrevues conduites auprès d’enfants ayant dévoilé une agression sexuelle ont été recueillies et cotées pour mesurer l’adhésion au protocole d’entrevue du NICHD, le ratio de questions ouvertes et la quantité de détails dévoilés par l’enfant par question posée par l’enquêteur. L’intelligence émotionnelle et les traits de personnalité Extraversion, Esprit consciencieux et Agréabilité ont été trouvés comme des caractéristiques personnelles positivement associées à l’adhésion au protocole d’entrevue et à l’utilisation de questions ouvertes, tandis que le nombre d’années d’expérience et le trait de personnalité Névrosisme ont été négativement associés à ces deux critères de performance. Le niveau d’habiletés cognitives des enquêteurs a quant à lui montré une association positive avec la quantité de détails dévoilés par l’enfant. La signification et l’interprétation de ces résultats, de même que les implications potentielles pour la sélection et la formation des enquêteurs sont finalement discutées.
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A single-feed rectangular-ring microstrip antenna is proposed for indoor communication under the Bluetooth protocol. The dimensions of the antenna together with the location of the feed point are optimized through field simulations in order to cover the Bluetooth bandwidth and to avoid linear polarization. The performance and the efficiency of the antenna are illustrated in a real indoor environment
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Cluster based protocols like LEACH were found best suited for routing in wireless sensor networks. In mobility centric environments some improvements were suggested in the basic scheme. LEACH-Mobile is one such protocol. The basic LEACH protocol is improved in the mobile scenario by ensuring whether a sensor node is able to communicate with its cluster head. Since all the nodes, including cluster head is moving it will be better to elect a node as cluster head which is having less mobility related to its neighbours. In this paper, LEACH-Mobile protocol has been enhanced based on a mobility metric “remoteness” for cluster head election. This ensures high success rate in data transfer between the cluster head and the collector nodes even though nodes are moving. We have simulated and compared our LEACH-Mobile-Enhanced protocol with LEACHMobile. Results show that inclusion of neighbouring node information improves the routing protocol.
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In wireless sensor networks, the routing algorithms currently available assume that the sensor nodes are stationary. Therefore when mobility modulation is applied to the wireless sensor networks, most of the current routing algorithms suffer from performance degradation. The path breaks in mobile wireless networks are due to the movement of mobile nodes, node failure, channel fading and shadowing. It is desirable to deal with dynamic topology changes with optimal effort in terms of resource and channel utilization. As the nodes in wireless sensor medium make use of wireless broadcast to communicate, it is possible to make use of neighboring node information to recover from path failure. Cooperation among the neighboring nodes plays an important role in the context of routing among the mobile nodes. This paper proposes an enhancement to an existing protocol for accommodating node mobility through neighboring node information while keeping the utilization of resources to a minimum.
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Cooperative caching is an attractive solution for reducing bandwidth demands and network latency in mobile ad hoc networks. Deploying caches in mobile nodes can reduce the overall traffic considerably. Cache hits eliminate the need to contact the data source frequently, which avoids additional network overhead. In this paper we propose a data discovery and cache management policy for cooperative caching, which reduces the caching overhead and delay by reducing the number of control messages flooded in to the network. A cache discovery process based on location of neighboring nodes is developed for this. The cache replacement policy we propose aims at increasing the cache hit ratio. The simulation results gives a promising result based on the metrics of studies
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In Wireless Sensor Networks (WSN), neglecting the effects of varying channel quality can lead to an unnecessary wastage of precious battery resources and in turn can result in the rapid depletion of sensor energy and the partitioning of the network. Fairness is a critical issue when accessing a shared wireless channel and fair scheduling must be employed to provide the proper flow of information in a WSN. In this paper, we develop a channel adaptive MAC protocol with a traffic-aware dynamic power management algorithm for efficient packet scheduling and queuing in a sensor network, with time varying characteristics of the wireless channel also taken into consideration. The proposed protocol calculates a combined weight value based on the channel state and link quality. Then transmission is allowed only for those nodes with weights greater than a minimum quality threshold and nodes attempting to access the wireless medium with a low weight will be allowed to transmit only when their weight becomes high. This results in many poor quality nodes being deprived of transmission for a considerable amount of time. To avoid the buffer overflow and to achieve fairness for the poor quality nodes, we design a Load prediction algorithm. We also design a traffic aware dynamic power management scheme to minimize the energy consumption by continuously turning off the radio interface of all the unnecessary nodes that are not included in the routing path. By Simulation results, we show that our proposed protocol achieves a higher throughput and fairness besides reducing the delay
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The evolution of wireless sensor network technology has enabled us to develop advanced systems for real time monitoring. In the present scenario wireless sensor networks are increasingly being used for precision agriculture. The advantages of using wireless sensor networks in agriculture are distributed data collection and monitoring, monitor and control of climate, irrigation and nutrient supply. Hence decreasing the cost of production and increasing the efficiency of production. This paper describes the security issues related to wireless sensor networks and suggests some techniques for achieving system security. This paper also discusses a protocol that can be adopted for increasing the security of the transmitted data
Resumo:
Cluster based protocols like LEACH were found best suited for routing in wireless sensor networks. In mobility centric environments some improvements were suggested in the basic scheme. LEACH-Mobile is one such protocol. The basic LEACH protocol is improved in the mobile scenario by ensuring whether a sensor node is able to communicate with its cluster head. Since all the nodes, including cluster head is moving it will be better to elect a node as cluster head which is having less mobility related to its neighbours. In this paper, LEACH-Mobile protocol has been enhanced based on a mobility metric “remoteness” for cluster head election. This ensures high success rate in data transfer between the cluster head and the collector nodes even though nodes are moving. We have simulated and compared our LEACH-Mobile-Enhanced protocol with LEACHMobile. Results show that inclusion of neighbouring node information improves the routing protocol.
Resumo:
In wireless sensor networks, the routing algorithms currently available assume that the sensor nodes are stationary. Therefore when mobility modulation is applied to the wireless sensor networks, most of the current routing algorithms suffer from performance degradation. The path breaks in mobile wireless networks are due to the movement of mobile nodes, node failure, channel fading and shadowing. It is desirable to deal with dynamic topology changes with optimal effort in terms of resource and channel utilization. As the nodes in wireless sensor medium make use of wireless broadcast to communicate, it is possible to make use of neighboring node information to recover from path failure. Cooperation among the neighboring nodes plays an important role in the context of routing among the mobile nodes. This paper proposes an enhancement to an existing protocol for accommodating node mobility through neighboring node information while keeping the utilization of resources to a minimum.