Patterns in blood pressure medication use in US incident dialysis patients over the first 6 months.

BACKGROUND: Several observational studies have evaluated the effect of a single exposure window with blood pressure (BP) medications on outcomes in incident dialysis patients, but whether BP medication prescription patterns remain stable or a single exposure window design is adequate to evaluate effect on outcomes is unclear. METHODS: We described patterns of BP medication prescription over 6 months after dialysis initiation in hemodialysis and peritoneal dialysis patients, stratified by cardiovascular comorbidity, diabetes, and other patient characteristics. The cohort included 13,072 adult patients (12,159 hemodialysis, 913 peritoneal dialysis) who initiated dialysis in Dialysis Clinic, Inc., facilities January 1, 2003-June 30, 2008, and remained on the original modality for at least 6 months. We evaluated monthly patterns in BP medication prescription over 6 months and at 12 and 24 months after initiation. RESULTS: Prescription patterns varied by dialysis modality over the first 6 months; substantial proportions of patients with prescriptions for beta-blockers, renin angiotensin system agents, and dihydropyridine calcium channel blockers in month 6 no longer had prescriptions for these medications by month 24. Prescription of specific medication classes varied by comorbidity, race/ethnicity, and age, but little by sex. The mean number of medications was 2.5 at month 6 in hemodialysis and peritoneal dialysis cohorts. CONCLUSIONS: This study evaluates BP medication patterns in both hemodialysis and peritoneal dialysis patients over the first 6 months of dialysis. Our findings highlight the challenges of assessing comparative effectiveness of a single BP medication class in dialysis patients. Longitudinal designs should be used to account for changes in BP medication management over time, and designs that incorporate common combinations should be considered.

I can see it both ways: first- and third-person visual perspectives at retrieval.

The number of studies examining visual perspective during retrieval has recently grown. However, the way in which perspective has been conceptualized differs across studies. Some studies have suggested perspective is experienced as either a first-person or a third-person perspective, whereas others have suggested both perspectives can be experienced during a single retrieval attempt. This aspect of perspective was examined across three studies, which used different measurement techniques commonly used in studies of perspective. Results suggest that individuals can experience more than one perspective when recalling events. Furthermore, the experience of the two perspectives correlated differentially with ratings of vividness, suggesting that the two perspectives should not be considered in opposition of one another. We also found evidence of a gender effect in the experience of perspective, with females experiencing third-person perspectives more often than males. Future studies should allow for the experience of more than one perspective during retrieval.

Enhancing the Hodgkin-Huxley Equations: Simulations Based on the First Publication in the Biophysical Journal.

The experiments in the Cole and Moore article in the first issue of the Biophysical Journal provided the first independent experimental confirmation of the Hodgkin-Huxley (HH) equations. A log-log plot of the K current versus time showed that raising the HH variable n to the sixth power provided the best fit to the data. Subsequent simulations using n(6) and setting the resting potential at the in vivo value simplifies the HH equations by eliminating the leakage term. Our article also reported that the K current in response to a depolarizing step to ENa was delayed if the step was preceded by a hyperpolarization. While the interpretation of this phenomenon in the article was flawed, subsequent simulations show that the effect completely arises from the original HH equations.

CT Scan Dosimetric Parameters Routine Monitoring: First Results of Radiation Dose Optimization Strategies Promptly Provided by a Multidisciplinary Team

CONCLUSION Radiation dose reduction, while saving image quality could be easily implemented with this approach. Furthermore, the availability of a dosimetric data archive provides immediate feedbacks, related to the implemented optimization strategies. Background JCI Standards and European Legislation (EURATOM 59/2013) require the implementation of patient radiation protection programs in diagnostic radiology. Aim of this study is to demonstrate the possibility to reduce patients radiation exposure without decreasing image quality, through a multidisciplinary team (MT), which analyzes dosimetric data of diagnostic examinations. Evaluation Data from CT examinations performed with two different scanners (Siemens DefinitionTM and GE LightSpeed UltraTM) between November and December 2013 are considered. CT scanners are configured to automatically send images to DoseWatch© software, which is able to store output parameters (e.g. kVp, mAs, pitch ) and exposure data (e.g. CTDIvol, DLP, SSDE). Data are analyzed and discussed by a MT composed by Medical Physicists and Radiologists, to identify protocols which show critical dosimetric values, then suggest possible improvement actions to be implemented. Furthermore, the large amount of data available allows to monitor diagnostic protocols currently in use and to identify different statistic populations for each of them. Discussion We identified critical values of average CTDIvol for head and facial bones examinations (respectively 61.8 mGy, 151 scans; 61.6 mGy, 72 scans), performed with the GE LightSpeed CTTM. Statistic analysis allowed us to identify the presence of two different populations for head scan, one of which was only 10% of the total number of scans and corresponded to lower exposure values. The MT adopted this protocol as standard. Moreover, the constant output parameters monitoring allowed us to identify unusual values in facial bones exams, due to changes during maintenance service, which the team promptly suggested to correct. This resulted in a substantial dose saving in CTDIvol average values of approximately 15% and 50% for head and facial bones exams, respectively. Diagnostic image quality was deemed suitable for clinical use by radiologists.

Modulation of the infant immune responses by the first pertussis vaccination

info:eu-repo/semantics/nonPublished

Modulation of the infant immune responses by the first pertussis vaccination

info:eu-repo/semantics/nonPublished

Modulation of the infant immune responses by the first pertussis vaccine administrations.

Many efforts are currently made to prepare combined vaccines against most infectious pathogens, that may be administered early in life to protect infants against infectious diseases as early as possible. However, little is known about the general immune modulation induced by early vaccination. Here, we have analyzed the cytokine secretion profiles of two groups of 6-month-old infants having received as primary immunization either a whole-cell (Pw) or an acellular (Pa) pertussis vaccine in a tetravalent formulation of pertussis-tetanus-diphtheria-poliomyelitis vaccines. Both groups of infants secreted IFN-gamma in response to the Bordetella pertussis antigens filamentous haemagglutinin and pertussis toxin, and this response was correlated with antigen-specific IL-12p70 secretion, indicating that both pertussis vaccines induced Th1 cytokines. However, Pa recipients also developed a strong Th2-type cytokine response to the B. pertussis antigens, as noted previously. In addition, they induced Th2-type cytokines to the co-administrated antigen tetanus toxoïd, as well as to the food antigen beta-lactoglobulin. Furthermore, the general cytokine profile of the Pa recipients was strongly Th2-skewed at 6 months, as indicated by the cytokines induced by the mitogen phytohaemagglutinin. These data demonstrate that the cytokine profile of 6-month-old infants is influenced by the type of formulation of the pertussis vaccine they received at 2, 3 and 4 months of life. Large prospective studies would be warranted to evaluate the possible long-term consequences of this early modulation of the cytokine responses in infants.

First High-Resolution Analysis of the Absorption Spectrum of Propane in the 6.7-7.5 μm Spectral Region

info:eu-repo/semantics/published

Is intracytoplasmic sperm injection (ICSI) a safe procedure: What do we learn first trimester data in ICSI pregnancies ?

info:eu-repo/semantics/nonPublished

The numerical simulation of enclosure fires using a Cfd fire field model coupled with a pyrolysis based solid fuel combustion submodel—a first approximation

In this paper, we present some early work concerned with the development of a simple solid fuel combustion model incorporated within a Computational Fluid Dynamics (CFD) framework. The model is intended for use in engineering applications of fire field modeling and represents an extension of this technique to situations involving the combustion of solid cellulosic fuels. A simple solid fuel combustion model consisting of a thermal pyrolysis model, a six flux radiation model and an eddy-dissipation model for gaseous combustion have been developed and implemented within the CFD code CFDS-FLOW3D. The model is briefly described and demonstrated through two applications involving fire spread in a compartment with a plywood lined ceiling. The two scenarios considered involve a fire in an open and closed compartment. The model is shown to be able to qualitatively predict behaviors similar to "flashover"—in the case of the open room—and "backdraft"— in the case of the initially closed room.

[Book review] Chance encounters: a first course in data analysis and inference

Book review of: Chance Encounters: A First Course in Data Analysis and Inference by Christopher J. Wild and George A.F. Seber 2000, John Wiley & Sons Inc. Hard-bound, xviii + 612 pp ISBN 0-471-32936-3

Methodologies employed in the collection, retrieval and storage of human factors information derived from first hand accounts of survivors of the WTC disaster of 11 September 2001

This article provides a broad overview of project HEED (High-rise Evacuation Evaluation Database) and the methodologies employed in the collection and storage of first-hand accounts of evacuation experiences derived from face-to-face interviews of evacuees from the World Trade Center (WTC) Twin Towers complex on September 11, 2001. In particular, the article describes the development of the HEED database. This is a flexible research tool which contains qualitative type data in the form of coded evacuee experiences along with the full interview transcripts. The data and information captured and stored in the HEED database is not only unique, but provides a means to address current and emerging issues relating to human factors associated with the evacuation of high-rise buildings

The Great War on the small screen: Representing the First World War in contemporary Britain

In Britain since the 1960s television has been the most influential medium of popular culture. Television is also the site where the Western Front of popular culture clashes with the Western Front of history. This book examines the ways in which those involved in the production of historical documentaries for this most influential media have struggled to communicate the stories of the First World War to British audiences. Documents in the BBC Written Archives Centre at Caversham, Berkshire, the Imperial War Museum, and the Liddell Hart Centre for Military Archives all inform the analysis. Interviews and correspondence with television producers, scriptwriters and production crew, as well as two First World War veterans who appeared in several recent documentaries provide new insights for the reader. Emma Hanna takes the reader behind the scenes of the making of the most influential documentaries from the landmark epic series The Great War (BBC, 1964) up to more recent controversial productions such as The Trench (BBC, 2002) and Not Forgotten: The Men Who Wouldn't Fight (BBC, 2008). By examining the production, broadcast and reception of a number of British television documentaries this book examines the difficult relationship between the war's history and its popular memory.