Statins and myasthenia gravis

Introduction. 3-hydroxy-3-methylglutaryl CoA reductase inhibitor ("statin") have been widely used for hypercholesteroremia and Statin induced myopathy is well known. Whether Statins contribute to exacerbation of Myasthenia Gravis (MG) requiring hospitalization is not well known. ^ Objectives. To determine the frequency of statin use in patients with MG seen at the neuromuscular division at University of Alabama in Birmingham (UAB) and to evaluate any association between use of statins and MG exacerbations requiring hospitalization in patients with an established diagnosis of Myasthenia Gravis. ^ Methods. We reviewed records of all current MG patients at the UAB neuromuscular department to obtain details on use of statins and any hospitalizations due to exacerbation of MG over the period from January 1, 2003 to December 31, 2006. ^ Results. Of the 113 MG patients on whom information was available for this period, 40 were on statins during at least one clinic visit. Statin users were more likely to be older (mean age 60.2 vs 53.8, p = 0.029), male (70.0% vs 43.8%, p = 0.008), and had a later onset of myasthenia gravis (mean age in years at onset 49.8 versus 42.9, p = 0.051). The total number of hospitalizations or the proportion of subjects who had at least one hospitalization during the study period did not differ in the statin versus no-statin group. However, when hospitalizations which occurred from a suspected precipitant were excluded ("event"), the proportion of subjects who had at least one such event during the study period was higher in the group using statins. In the final Cox proportional hazard model for cumulative time to event, statin use (OR = 6.44, p <0.01) and baseline immunosuppression (OR = 3.03, p = 0.07) were found to increase the odds of event. ^ Conclusions. Statin use may increase the rate of hospitalizations due to MG exacerbation, when excluding exacerbations precipitated by other suspected factors.^

Investigations on the Chilean kelp crab Taliepus dentatus

Physiological responses of larval stages can differ from those of the adults, affecting key ecological processes. Therefore, developing a mechanistic understanding of larval responses to environmental conditions is essential vis-à-vis climate change. We studied the thermal tolerance windows, defined by lower and upper pejus (Tp) and critical temperatures (Tc), of zoea I, II, and megalopa stages of the Chilean kelp crab Taliepus dentatus. Tp limits determine the temperature range where aerobic scope is maximal and functioning of the organism is unrestrained and were estimated from direct observations of larval activity. Tc limits define the transition from aerobic to anaerobic metabolism, and were estimated from the relationship between standard metabolic rate and temperature. Zoea I showed the broadest, Zoea II an intermediate, and megalopae the narrowest tolerance window (Tp). Optimum performance in megalopae was limited to Tp between 11 and 15°C, while their Tc ranged between 7 and 19°C. Although Tc may be seldom encountered by larvae, the narrower Tp temperatures can frequently expose larvae to unfavorable conditions that can drastically constrain their performance. Temperatures beyond the Tp range of megalopae have been observed in most spring and summer months in central Chile, and can have important consequences for larval swimming performance and impair their ability to avoid predators or settle successfully. Besides the well-documented effects of temperature on development time, variability in field temperatures beyond Tp can affect performance of particular larval stages, which could drive large-scale variability in recruitment and population dynamics of T. dentatus and possibly other invertebrate species.

Analysis for the use of cumulative plots for travel time estimation on signalized network

This paper provides fundamental understanding for the use of cumulative plots for travel time estimation on signalized urban networks. Analytical modeling is performed to generate cumulative plots based on the availability of data: a) Case-D, for detector data only; b) Case-DS, for detector data and signal timings; and c) Case-DSS, for detector data, signal timings and saturation flow rate. The empirical study and sensitivity analysis based on simulation experiments have observed the consistency in performance for Case-DS and Case-DSS, whereas, for Case-D the performance is inconsistent. Case-D is sensitive to detection interval and signal timings within the interval. When detection interval is integral multiple of signal cycle then it has low accuracy and low reliability. Whereas, for detection interval around 1.5 times signal cycle both accuracy and reliability are high.

Association between diastolic blood pressure and cumulative work time

A pressão arterial diastólica foi analisada enquanto indicador genérico de envelhecimento, e sua associação com o tempo de serviço foi estudada após o controle da idade como possível fator de confundimento. O estudo foi realizado entre operários de um curtume brasileiro em julho de 1993. Foi testada a associação entre pressão diastólica e tempo de serviço, ajustando um modelo de regressão linear de segunda ordem, em que a pressão diastólica era função da idade e do tempo de serviço do operário. Ao ajustar o modelo, pode-se prever que, no início do trabalho no curtume, em média, cada período de um ano está associado com um aumento de cerca de 1,5 mmHg na pressão diastólica. O ajuste obtido realça um componente diretamente associado ao trabalho como parte do coeficiente de aumento da pressão no grupo estudado. Esse componente é o dobro daquele diretamente associado com a idade.

Characterization of time-resolved laser differential phase using 3D complementary cumulative distribution functions

An experimental method for characterizing the time-resolved phase noise of a fast switching tunable laser is discussed. The method experimentally determines a complementary cumulative distribution function of the laser's differential phase as a function of time after a switching event. A time resolved bit error rate of differential quadrature phase shift keying formatted data, calculated using the phase noise measurements, was fitted to an experimental time-resolved bit error rate measurement using a field programmable gate array, finding a good agreement between the time-resolved bit error rates.

Urban network travel time estimation from stop-line loop detector data and signal controller data

This paper presents a model to estimate travel time using cumulative plots. Three different cases considered are i) case-Det, for only detector data; ii) case-DetSig, for detector data and signal controller data and iii) case-DetSigSFR: for detector data, signal controller data and saturation flow rate. The performance of the model for different detection intervals is evaluated. It is observed that detection interval is not critical if signal timings are available. Comparable accuracy can be obtained from larger detection interval with signal timings or from shorter detection interval without signal timings. The performance for case-DetSig and for case-DetSigSFR is consistent with accuracy generally more than 95% whereas, case-Det is highly sensitive to the signal phases in the detection interval and its performance is uncertain if detection interval is integral multiple of signal cycles.

Assessment of lifetime cumulative sun exposure using a self-administered questionnaire : reliability of two approaches

Few studies have evaluated the reliability of lifetime sun exposure estimated from inquiring about the number of hours people spent outdoors in a given period on a typical weekday or weekend day (the time-based approach). Some investigations have suggested that women have a particularly difficult task in estimating time outdoors in adulthood due to their family and occupational roles. We hypothesized that people might gain additional memory cues and estimate lifetime hours spent outdoors more reliably if asked about time spent outdoors according to specific activities (an activity-based approach). Using self-administered, mailed questionnaires, test-retest responses to time-based and to activity-based approaches were evaluated in 124 volunteer radiologic technologist participants from the United States: 64 females and 60 males 48 to 80 years of age. Intraclass correlation coefficients (ICC) were used to evaluate the test-retest reliability of average number of hours spent outdoors in the summer estimated for each approach. We tested the differences between the two ICCs, corresponding to each approach, using a t test with the variance of the difference estimated by the jackknife method. During childhood and adolescence, the two approaches gave similar ICCs for average numbers of hours spent outdoors in the summer. By contrast, compared with the time-based approach, the activity-based approach showed significantly higher ICCs during adult ages (0.69 versus 0.43, P = 0.003) and over the lifetime (0.69 versus 0.52, P = 0.05); the higher ICCs for the activity-based questionnaire were primarily derived from the results for females. Research is needed to further improve the activity-based questionnaire approach for long-term sun exposure assessment. (Cancer Epidemiol Biomarkers Prev 2009;18(2):464–71)

Analytical modeling and sensitivity analysis for travel time estimation on signalized urban networks

This paper presents a model for estimation of average travel time and its variability on signalized urban networks using cumulative plots. The plots are generated based on the availability of data: a) case-D, for detector data only; b) case-DS, for detector data and signal timings; and c) case-DSS, for detector data, signal timings and saturation flow rate. The performance of the model for different degrees of saturation and different detector detection intervals is consistent for case-DSS and case-DS whereas, for case-D the performance is inconsistent. The sensitivity analysis of the model for case-D indicates that it is sensitive to detection interval and signal timings within the interval. When detection interval is integral multiple of signal cycle then it has low accuracy and low reliability. Whereas, for detection interval around 1.5 times signal cycle both accuracy and reliability are high.

Estimation of travel time on urban networks with midlink sources and sinks

This paper presents a methodology for estimation of average travel time on signalized urban networks by integrating cumulative plots and probe data. This integration aims to reduce the relative deviations in the cumulative plots due to midlink sources and sinks. During undersaturated traffic conditions, the concept of a virtual probe is introduced, and therefore, accurate travel time can be obtained when a real probe is unavailable. For oversaturated traffic conditions, only one probe per travel time estimation interval—360 s or 3% of vehicles traversing the link as a probe—has the potential to provide accurate travel time.

Arterial travel time estimation : revisiting the classical procedure

Travel time is an important network performance measure and it quantifies congestion in a manner easily understood by all transport users. In urban networks, travel time estimation is challenging due to number of reasons such as, fluctuations in traffic flow due to traffic signals, significant flow to/from mid link sinks/sources, etc. The classical analytical procedure utilizes cumulative plots at upstream and downstream locations for estimating travel time between the two locations. In this paper, we discuss about the issues and challenges with classical analytical procedure such as its vulnerability to non conservation of flow between the two locations. The complexity with respect to exit movement specific travel time is discussed. Recently, we have developed a methodology utilising classical procedure to estimate average travel time and its statistic on urban links (Bhaskar, Chung et al. 2010). Where, detector, signal and probe vehicle data is fused. In this paper we extend the methodology for route travel time estimation and test its performance using simulation. The originality is defining cumulative plots for each exit turning movement utilising historical database which is self updated after each estimation. The performance is also compared with a method solely based on probe (Probe-only). The performance of the proposed methodology has been found insensitive to different route flow, with average accuracy of more than 94% given a probe per estimation interval which is more than 5% increment in accuracy with respect to Probe-only method.

Fusing loop detector and probe vehicle data to estimate travel time statistics on signalized urban networks

This article presents a methodology that integrates cumulative plots with probe vehicle data for estimation of travel time statistics (average, quartile) on urban networks. The integration reduces relative deviation among the cumulative plots so that the classical analytical procedure of defining the area between the plots as the total travel time can be applied. For quartile estimation, a slicing technique is proposed. The methodology is validated with real data from Lucerne, Switzerland and it is concluded that the travel time estimates from the proposed methodology are statistically equivalent to the observed values.

Average travel time estimations for urban routes that consider exit turning movements

This paper presents a methodology for real-time estimation of exit movement-specific average travel time on urban routes by integrating real-time cumulative plots, probe vehicles, and historic cumulative plots. Two approaches, component based and extreme based, are discussed for route travel time estimation. The methodology is tested with simulation and is validated with real data from Lucerne, Switzerland, that demonstrate its potential for accurate estimation. Both approaches provide similar results. The component-based approach is more reliable, with a greater chance of obtaining a probe vehicle in each interval, although additional data from each component is required. The extreme-based approach is simple and requires only data from upstream and downstream of the route, but the chances of obtaining a probe that traverses the entire route might be low. The performance of the methodology is also compared with a probe-only method. The proposed methodology requires only a few probes for accurate estimation; the probe-only method requires significantly more probes.

Cumulative and comparative social media analytics for crisis communication

This paper draws on comparative analyses of Twitter data sets – over time and across different kinds of natural disasters and different national contexts – to demonstrate the value of shared, cumulative approaches to social media analytics in the context of crisis communication.

Hybrid model for motorway travel time estimation considering increased detector spacing

Travel time estimation and prediction on motorways has long been a topic of research. Prediction modeling generally assumes that the estimation is perfect. No matter how good is the prediction modeling- the errors in estimation can significantly deteriorate the accuracy and reliability of the prediction. Models have been proposed to estimate travel time from loop detector data. Generally, detectors are closely spaced (say 500m) and travel time can be estimated accurately. However, detectors are not always perfect, and even during normal running conditions few detectors malfunction, resulting in increase in the spacing between the functional detectors. Under such conditions, error in the travel time estimation is significantly large and generally unacceptable. This research evaluates the in-practice travel time estimation model during different traffic conditions. It is observed that the existing models fail to accurately estimate travel time during large detector spacing and congestion shoulder periods. Addressing this issue, an innovative Hybrid model that only considers loop data for travel time estimation is proposed. The model is tested using simulation and is validated with real Bluetooth data from Pacific Motorway Brisbane. Results indicate that during non free flow conditions and larger detector spacing Hybrid model provides significant improvement in the accuracy of travel time estimation.