887 resultados para peri-operative delay
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Lucas Holstenius Hamburgens. Latine vertit ; dissertationem de vita & scriptis Porphyrii & ad vitam Pythagoræ observationes adjecit
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Nebent.: Kokbē jiṣhāq
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in memoriam optimi patris Io. Frider. Iugler ... (Elogium Io. Friderici Iugler) separatim et emendatius ed. notisque et aliorum et suis illustr. Io. Henr. Iugler [Johann Heinrich Jugler]
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Signatur des Originals: S 36/G11008
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Objective. To identify how an individual's finances and health insurance coverage affects their decision whether to avoid or delay medical care. Methods. Secondary data analysis of The Effects of Financial and Insurance Considerations on Health Care Utilization 2007 telephone survey data. Study inclusion criteria. 18 years old, Harris County resident, and had a need for medical care within the past year. Post weighing was done to correct for non-response bias. Results. Survey decision makers were predominately minorities (60%), Female (70%), and insured (71%). Ninety-two percent of participants sought care when needed, however, of this population 39% delayed medical care. Fifty-six percent of participants who delayed medical care sought care in the Doctor's office. For those who replied "Yes" to considering health insurance and finances in deciding to avoid medical care, 61% stated that they were confused about their insurance coverage as the explanation why. Fifty-five percent of Respondents indicated that delaying medical care was due to not knowing whether medical care was necessary. Conclusion. Additional research needs to be conducted to examine the relationship between onset of medical symptoms and final medical diagnosis to identify whether survey participants who delayed or avoided medical care actions were appropriate responses to their initial medical symptoms and final diagnosis. ^
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Background. Cardiac risk assessment in cancer patients has not extensively been studied. We evaluated the role of stress myocardial perfusion imaging (MPI) in predicting cardiovascular outcomes in cancer patients undergoing non-cardiac surgery. ^ Methods. A retrospective chart review was performed on 507 patients who had a MPI from 01/2002 - 03/2003 and underwent non-cardiac surgery. Median follow-up duration was 1.5 years. Cox proportional hazard model was used to determine the time-to-first event. End points included total cardiac events (cardiac death, myocardial infarction (MI) and coronary revascularization), cardiac death, and all cause mortality. ^ Results. Of all 507 MPI studies 146 (29%) were abnormal. There were significant differences in risk factors between normal and abnormal MPI groups. Mean age was 66±11 years, with 60% males and a median follow-up duration of 1.8 years (25th quartile=0.8 years, 75th quartile=2.2 years). The majority of patients had an adenosine stress study (53%), with fewer exercise (28%) and dobutamine stress (16%) studies. In the total group there were 39 total cardiac events, 31 cardiac deaths, and 223 all cause mortality events during the study. Univariate predictors of total cardiac events included CAD (p=0.005), previous MI (p=0.005), use of beta blockers (p=0.002), and not receiving chemotherapy (p=0.012). Similarly, the univariate predictors of cardiac death included previous MI (p=0.019) and use of beta blockers (p=0.003). In the multivariate model for total cardiac events, age at surgery (HR 1.04, p=0.030), use of beta blockers (HR 2.46; p=0.011), dobutamine MPI (HR 3.08; p=0.018) and low EF (HR 0.97; p=0.02) were significant predictors of worse outcomes. In the multivariate model for predictors of cardiac death, beta blocker use (HR=2.74; p=0.017) and low EF (HR=0.95; p<0.003) were predictors of cardiac death. The only univariate MPI predictor of total cardiac events was scar severity (p=0.005). While MPI predictors of cardiac death were scar severity (p= 0.001) and ischemia severity (p=0.02). ^ Conclusions. Stress MPI is a useful tool in predicting long term outcomes in cancer patients undergoing surgery. Ejection fraction and severity of myocardial scar are important factors determining long term outcomes in this group.^
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Delays in diagnosis of pulmonary tuberculosis have detrimental effects on the health of the ailing patient as well as the people around him or her. These effects are magnified in highly-travelled parts of the world. Identifying factors predictive of diagnostic delay is challenging, as these vary widely by culture and geography. Predictors of delay for tuberculosis patients living in the Northeastern Mexican city of Matamoros, a binationally-transited area, have yet to be described. Using secondary analysis of a retrospective survey, this study sought to identify predictors of diagnostic delay in a sample of culture-positive tuberculosis patients in Matamoros. Sociodemographic, behavioral, and health-related factors were measured and compared. Using bivariate and step-wise regression analyses at an alpha level of 0.05, the author found the following to be statically significant predictors for this sample (R 2=0.171): prior treatment of diabetes, recurrence of tuberculosis, and having ever used cocaine. A question assessing knowledge of immunocompromised subgroups was also identified as a predictor, although its implications are unclear. Notably, the instrument did not distinguish between patient and health system delay. In summary, more research should be conducted in the Matamoros area in order to fully understand the dynamics of delayed diagnosis and its application to public health practice.^
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Increasing atmospheric CO2 equilibrates with surface seawater, elevating the concentration of aqueous hydrogen ions. This process, ocean acidification, is a future and contemporary concern for aquatic organisms, causing failures in Pacific oyster (Crassostrea gigas) aquaculture. This experiment determines the effect of elevated pCO2 on the early development of C. gigas larvae from a wild Pacific Northwest population. Adults were collected from Friday Harbor, Washington, USA (48°31.7' N, 12°1.1' W) and spawned in July 2011. Larvae were exposed to Ambient (400 µatm CO2), MidCO2 (700 µatm), or HighCO2 (1,000 µatm). After 24 h, a greater proportion of larvae in the HighCO2 treatment were calcified as compared to Ambient. This unexpected observation is attributed to increased metabolic rate coupled with sufficient energy resources. Oyster larvae raised at HighCO2 showed evidence of a developmental delay by 3 days post-fertilization, which resulted in smaller larvae that were less calcified.
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The delay caused by the reflected ray in broadband communication has a great influence on the communications in subway tunnel. This paper presents measurements taken in subway tunnels at 2.4 GHz, with 5 MHz bandwidth. According to propagation characteristics of tunnel, the measurements were carried out with a frequency domain channel sounding technique, in three typical scenarios: line of sight (LOS), Non-line-of-sight (NLOS) and far line of sight (FLOS), which lead to different delay distributions. Firstly IFFT was chosen to get channel impulse response (CIR) h(t) from measured three-dimensional transfer functions. Power delay profile (PDP) was investigated to give an overview of broadband channel model. Thereafter, a long delay caused by the obturation of tunnel is observed and investigated in all the scenarios. The measurements show that the reflection can be greatly remained by the tunnel, which leads to long delay cluster where the reflection, but direct ray, makes the main contribution for radio wave propagation. Four important parameters: distribution of whole PDP power, first peak arriving time, reflection cluster duration and PDP power distribution of reflection cluster were studied to give a detailed description of long delay characteristic in tunnel. This can be used to ensure high capacity communication in tunnels
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Graphics Processing Units have become a booster for the microelectronics industry. However, due to intellectual property issues, there is a serious lack of information on implementation details of the hardware architecture that is behind GPUs. For instance, the way texture is handled and decompressed in a GPU to reduce bandwidth usage has never been dealt with in depth from a hardware point of view. This work addresses a comparative study on the hardware implementation of different texture decompression algorithms for both conventional (PCs and video game consoles) and mobile platforms. Circuit synthesis is performed targeting both a reconfigurable hardware platform and a 90nm standard cell library. Area-delay trade-offs have been extensively analyzed, which allows us to compare the complexity of decompressors and thus determine suitability of algorithms for systems with limited hardware resources.
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We propose a pulse shaping and shortening technique for pulses generated from gain switched single mode semiconductor lasers, based on a Mach Zehnder interferometer with variable delay. The spectral and temporal characteristics of the pulses obtained with the proposed technique are investigated with numerical simulations. Experiments are performed with a Distributed Feedback laser and a Vertical Cavity Surface Emitting Laser, emitting at 1.5 µm, obtaining pulse duration reduction of 25-30%. The main asset of the proposed technique is that it can be applied to different devices and pulses, taking advantage of the flexibility of the gain switching technique.
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A technique to implement an electrically tunable delay line with high bandwidth for trains of ultrashort optical pulses is presented. The system is based on the temporal self-imaging effect in fiber gratings and electrooptic modulation.
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We propose a systematic method for the synthesis of arbitrary group delay responses by using allpass structures of coupled optical cavities. Optimum structure parameters design, in terms of filter order and accuracy, are obtained.
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The employment of nonlinear analysis techniques for automatic voice pathology detection systems has gained popularity due to the ability of such techniques for dealing with the underlying nonlinear phenomena. On this respect, characterization using nonlinear analysis typically employs the classical Correlation Dimension and the largest Lyapunov Exponent, as well as some regularity quantifiers computing the system predictability. Mostly, regularity features highly depend on a correct choosing of some parameters. One of those, the delay time �, is usually fixed to be 1. Nonetheless, it has been stated that a unity � can not avoid linear correlation of the time series and hence, may not correctly capture system nonlinearities. Therefore, present work studies the influence of the � parameter on the estimation of regularity features. Three � estimations are considered: the baseline value 1; a � based on the Average Automutual Information criterion; and � chosen from the embedding window. Testing results obtained for pathological voice suggest that an improved accuracy might be obtained by using a � value different from 1, as it accounts for the underlying nonlinearities of the voice signal.
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We report numerical evidence of the effects of a periodic modulation in the delay time of a delayed dynamical system. By referring to a Mackey-Glass equation and by adding a modula- tion in the delay time, we describe how the solution of the system passes from being chaotic to shadow periodic states. We analyze this transition for both sinusoidal and sawtooth wave mod- ulations, and we give, in the latter case, the relationship between the period of the shadowed orbit and the amplitude of the modulation. Future goals and open questions are highlighted.