Does diagnostic delay result in decreased survival in paediatric brain tumours?

To study the hypothesis that a delay in the diagnosis of paediatric brain tumours results in decreased survival outcome probability, we compared the prediagnostic period of 315 brain tumour patients (median age 6.7 years, range, 0 to 16 years) with progression-free and overall survival. The median prediagnostic symptomatic interval was 60 days (range, 0 to 3,480 days), with a median parental delay of 14 days (range, 0 to 1,835 days) and a median doctor's delay of 14 days (range, 0 to 3,480 days). The prediagnostic symptomatic interval correlated significantly with the patient age, tumour histology, tumour location and year of diagnosis, but not with gender. We then grouped the patients according to histology (low-grade glioma [n=77], medulloblastoma [n=57], high-grade glioma [n=40], craniopharyngioma [n=27], ependymoma [n=20] and germ cell tumours [n=18]). Contrary to common belief, long prediagnostic symptomatic interval or long doctor's delay did not result in decreased survival outcome probability in any of these groups. The effect of tumour biology on survival seems to be dominant and overwhelms any possible opposing effect on survival of a delay in diagnosis.

Parametric combustion modeling for ethanol-gasoline fuelled spark ignition engines

Ethanol-gasoline fuel blends are increasingly being used in spark ignition (SI) engines due to continued growth in renewable fuels as part of a growing renewable portfolio standard (RPS). This leads to the need for a simple and accurate ethanol-gasoline blends combustion model that is applicable to one-dimensional engine simulation. A parametric combustion model has been developed, integrated into an engine simulation tool, and validated using SI engine experimental data. The parametric combustion model was built inside a user compound in GT-Power. In this model, selected burn durations were computed using correlations as functions of physically based non-dimensional groups that have been developed using the experimental engine database over a wide range of ethanol-gasoline blends, engine geometries, and operating conditions. A coefficient of variance (COV) of gross indicated mean effective pressure (IMEP) correlation was also added to the parametric combustion model. This correlation enables the cycle combustion variation modeling as a function of engine geometry and operating conditions. The computed burn durations were then used to fit single and double Wiebe functions. The single-Wiebe parametric combustion compound used the least squares method to compute the single-Wiebe parameters, while the double-Wiebe parametric combustion compound used an analytical solution to compute the double-Wiebe parameters. These compounds were then integrated into the engine model in GT-Power through the multi-Wiebe combustion template in which the values of Wiebe parameters (single-Wiebe or double-Wiebe) were sensed via RLT-dependence. The parametric combustion models were validated by overlaying the simulated pressure trace from GT-Power on to experimentally measured pressure traces. A thermodynamic engine model was also developed to study the effect of fuel blends, engine geometries and operating conditions on both the burn durations and COV of gross IMEP simulation results.

STUDY OF SPARK IGNITION ENGINE COMBUSTION MODEL FOR THE ANALYSIS OF CYCLIC VARIATION AND COMBUSTION STABILITY AT LEAN OPERATING CONDITIONS

A fundamental combustion model for spark-ignition engine is studied in this report. The model is implemented in SIMULINK to simulate engine outputs (mass fraction burn and in-cylinder pressure) under various engine operation conditions. The combustion model includes a turbulent propagation and eddy burning processes based on literature [1]. The turbulence propagation and eddy burning processes are simulated by zero-dimensional method and the flame is assumed as sphere. To predict pressure, temperature and other in-cylinder variables, a two-zone thermodynamic model is used. The predicted results of this model match well with the engine test data under various engine speeds, loads, spark ignition timings and air fuel mass ratios. The developed model is used to study cyclic variation and combustion stability at lean (or diluted) combustion conditions. Several variation sources are introduced into the combustion model to simulate engine performance observed in experimental data. The relations between combustion stability and the introduced variation amount are analyzed at various lean combustion levels.

IMPROVING STARTABILITY AND REDUCING EMISSIONS IN FLEXFUEL SPARK IGNITION DIRECT INJECTION VARIABLE CAM TIMING ENGINE

Experimental work and analysis was done to investigate engine startup robustness and emissions of a flex-fuel spark ignition (SI) direct injection (DI) engine. The vaporization and other characteristics of ethanol fuel blends present a challenge at engine startup. Strategies to reduce the enrichment requirements for the first engine startup cycle and emissions for the second and third fired cycle at 25°C ± 1°C engine and intake air temperature were investigated. Research work was conducted on a single cylinder SIDI engine with gasoline and E85 fuels, to study the effect on first fired cycle of engine startup. Piston configurations that included a compression ratio change (11 vs 15.5) and piston geometry change (flattop vs bowl) were tested, along with changes in intake cam timing (95,110,125) and fuel pressure (0.4 MPa vs 3 MPa). The goal was to replicate the engine speed, manifold pressure, fuel pressure and testing temperature from an engine startup trace for investigating the first fired cycle for the engine. Results showed bowl piston was able to enable lower equivalence ratio engine starts with gasoline fuel, while also showing lower IMEP at the same equivalence ratio compared to flat top piston. With E85, bowl piston showed reduced IMEP as compression ratio increased at the same equivalence ratio. A preference for constant intake valve timing across fuels seemed to indicate that flattop piston might be a good flex-fuel piston. Significant improvements were seen with higher CR bowl piston with high fuel pressure starts, but showed no improvement with low fuel pressures. Simulation work was conducted to analyze initial three cycles of engine startup in GT-POWER for the same set of hardware used in the experimentations. A steady state validated model was modified for startup conditions. The results of which allowed an understanding of the relative residual levels and IMEP at the test points in the cam phasing space. This allowed selecting additional test points that enable use of higher residual levels, eliminating those with smaller trapped mass incapable of producing required IMEP for proper engine turnover. The second phase of experimental testing results for 2nd and 3rd startup cycle revealed both E10 and E85 prefer the same SOI of 240°bTDC at second and third startup cycle for the flat top piston and high injection pressures. E85 fuel optimal cam timing for startup showed that it tolerates more residuals compared to E10 fuel. Higher internal residuals drives down the Ø requirement for both fuels up to their combustion stability limit, this is thought to be direct benefit to vaporization due to increased cycle start temperature. Benefits are shown for an advance IMOP and retarded EMOP strategy at engine startup. Overall the amount of residuals preferred by an engine for E10 fuel at startup is thought to be constant across engine speed, thus could enable easier selection of optimized cam positions across the startup speeds.

Information processing in long delay memory-guided saccades: further insights from TMS

The performance of memory-guided saccades with two different delays (3 s and 30 s of memorisation) was studied in eight subjects. Single pulse transcranial magnetic stimulation (TMS) was applied simultaneously over the left and right dorsolateral prefrontal cortex (DLPFC) 1 s after target presentation. In both delays, stimulation significantly increased the percentage of error in amplitude of memory-guided saccades. Furthermore, the interfering effect of TMS was significantly higher in the short delay compared to that of the long delay paradigm. The results are discussed in the context of a mixed model of spatial working memory control including two components: First, serial information processing with a predominant role of the DLPFC during the early period of memorisation and, second, parallel information processing, which is independent from the DLPFC, operating during longer delays.

Application of Time-Delay Estimation to Mixed Reality Multisensor Tracking

Spatial tracking is one of the most challenging and important parts of Mixed Reality environments. Many applications, especially in the domain of Augmented Reality, rely on the fusion of several tracking systems in order to optimize the overall performance. While the topic of spatial tracking sensor fusion has already seen considerable interest, most results only deal with the integration of carefully arranged setups as opposed to dynamic sensor fusion setups. A crucial prerequisite for correct sensor fusion is the temporal alignment of the tracking data from several sensors. Tracking sensors are typically encountered in Mixed Reality applications, are generally not synchronized. We present a general method to calibrate the temporal offset between different sensors by the Time Delay Estimation method which can be used to perform on-line temporal calibration. By applying Time Delay Estimation on the tracking data, we show that the temporal offset between generic Mixed Reality spatial tracking sensors can be calibrated. To show the correctness and the feasibility of this approach, we have examined different variations of our method and evaluated various combinations of tracking sensors. We furthermore integrated this time synchronization method into our UBITRACK Mixed Reality tracking framework to provide facilities for calibration and real-time data alignment.

Development of a Mathematical Model for the Calculation of the Tool Appropriation Delay depending on the Tool Inventory

Compliance with punctual delivery under the high pressure of costs can be implemented through the optimization of the in-house tool supply. Within the Transfer Project 13 of the Collaborative Research Centre 489 using the example of the forging industry, a mathematical model was developed which determines the minimum inventory of forging tools required for production, considering the tool appropriation delay.

Diagnostic delay in Crohn's disease is associated with a complicated disease course and increased operation rate

OBJECTIVES The impact of diagnostic delay (a period from appearance of first symptoms to diagnosis) on the clinical course of Crohn's disease (CD) is unknown. We examined whether length of diagnostic delay affects disease outcomes. METHODS Data from the Swiss IBD cohort study were analyzed. Patients were recruited from university centers (68%), regional hospitals (14%), and private practices (18%). The frequencies of occurrence of bowel stenoses, internal fistulas, perianal fistulas, and CD-related surgery (intestinal and perianal) were analyzed. RESULTS A total of 905 CD patients (53.4% female, median age at diagnosis 26 (20-36) years) were stratified into four groups according to the quartiles of diagnostic delay (0-3, 4-9, 10-24, and ≥25 months, respectively). Median diagnostic delay was 9 (3-24) months. The frequency of immunomodulator and/or antitumor necrosis factor drug use did not differ among the four groups. The length of diagnostic delay was positively correlated with the occurrence of bowel stenosis (odds ratio (OR) 1.76, P=0.011 for delay of ≥25 months) and intestinal surgery (OR 1.76, P=0.014 for delay of 10-24 months and OR 2.03, P=0.003 for delay of ≥25 months). Disease duration was positively associated and non-ileal disease location was negatively associated with bowel stenosis (OR 1.07, P<0.001, and OR 0.41, P=0.005, respectively) and intestinal surgery (OR 1.14, P<0.001, and OR 0.23, P<0.001, respectively). CONCLUSIONS The length of diagnostic delay is correlated with an increased risk of bowel stenosis and CD-related intestinal surgery. Efforts should be undertaken to shorten the diagnostic delay.

Delay in diagnosis of eosinophilic esophagitis increases risk for stricture formation in a time-dependent manner

BACKGROUND & AIMS Development of strictures is a major concern for patients with eosinophilic esophagitis (EoE). At diagnosis, EoE can present with an inflammatory phenotype (characterized by whitish exudates, furrows, and edema), a stricturing phenotype (characterized by rings and stenosis), or a combination of these. Little is known about progression of stricture formation; we evaluated stricture development over time in the absence of treatment and investigated risk factors for stricture formation. METHODS We performed a retrospective study using the Swiss EoE Database, collecting data on 200 patients with symptomatic EoE (153 men; mean age at diagnosis, 39 ± 15 years old). Stricture severity was graded based on the degree of difficulty associated with passing of the standard adult endoscope. RESULTS The median delay in diagnosis of EoE was 6 years (interquartile range, 2-12 years). With increasing duration of delay in diagnosis, the prevalence of fibrotic features of EoE, based on endoscopy, increased from 46.5% (diagnostic delay, 0-2 years) to 87.5% (diagnostic delay, >20 years; P = .020). Similarly, the prevalence of esophageal strictures increased with duration of diagnostic delay, from 17.2% (diagnostic delay, 0-2 years) to 70.8% (diagnostic delay, >20 years; P < .001). Diagnostic delay was the only risk factor for strictures at the time of EoE diagnosis (odds ratio = 1.08; 95% confidence interval: 1.040-1.122; P < .001). CONCLUSIONS The prevalence of esophageal strictures correlates with the duration of untreated disease. These findings indicate the need to minimize delay in diagnosis of EoE.

Delay discounting task in pigs reveals response strategies related to dopamine metabolite.

We developed a novel delay discounting task to investigate outcome impulsivity in pigs. As impulsivity can affect aggression, and might also relate to proactive and reactive coping styles, eight proactive (HR) and eight reactive (LR) pigs identified in a manual restraint test ("Backtest", after Bolhuis et al., 2003) were weaned and mixed in four pens of four unfamiliar pigs, so that each pen had two HR and two LR pigs, and aggression was scored in the 9h after mixing. In the delay discounting task, each pig chose between two levers, one always delivering a small immediate reward, the other a large delayed reward with daily increasing delays, impulsive individuals being the ones discounting the value of the large reward quicker. Two novel strategies emerged: some pigs gradually switched their preference towards the small reward ('Switchers') as predicted, but others persistently preferred the large reward until they stopped making choices ('Omitters'). Outcome impulsivity itself was unrelated to these strategies, to urinary serotonin metabolite (5-HIAA) or dopamine metabolite (HVA) levels, aggression at weaning, or coping style. However, HVA was relatively higher in Omitters than Switchers, and positively correlated with behavioural measures of indecisiveness and frustration during choosing. The delay discounting task thus revealed two response strategies that seemed to be related to the activity of the dopamine system and might indicate a difference in execution, rather than outcome, impulsivity.

Impact of delay in reducing carbon dioxide emissions

Recent downward revisions in the climate response to rising CO2 levels, and opportunities for reducing non-CO2 climate warming, have both been cited as evidence that the case for reducing CO2 emissions is less urgent than previously thought. Evaluating the impact of delay is complicated by the fact that CO2 emissions accumulate over time, so what happens after they peak is as relevant for long-term warming as the size and timing of the peak itself. Previous discussions have focused on how the rate of reduction required to meet any given temperature target rises asymptotically the later the emissions peak. Here we focus on a complementary question: how fast is peak CO2-induced warming increasing while mitigation is delayed, assuming no increase in rates of reduction after the emissions peak? We show that this peak-committed warming is increasing at the same rate as cumulative CO2 emissions, about 2% per year, much faster than observed warming, independent of the climate response.

Decoding Delay Minimization in Inter-Session Network Coding

Intra-session network coding has been shown to offer significant gains in terms of achievable throughput and delay in settings where one source multicasts data to several clients. In this paper, we consider a more general scenario where multiple sources transmit data to sets of clients over a wireline overlay network. We propose a novel framework for efficient rate allocation in networks where intermediate network nodes have the opportunity to combine packets from different sources using randomized network coding. We formulate the problem as the minimization of the average decoding delay in the client population and solve it with a gradient-based stochastic algorithm. Our optimized inter-session network coding solution is evaluated in different network topologies and is compared with basic intra-session network coding solutions. Our results show the benefits of proper coding decisions and effective rate allocation for lowering the decoding delay when the network is used by concurrent multicast sessions.