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Implications of rotational kinematics for the oculomotor system in three dimensions.

1. This paper develops three-dimensional models for the vestibuloocular reflex (VOR) and the internal feedback loop of the saccadic system. The models differ qualitatively from previous, one-dimensional versions, because the commutative algebra used in previous models does not apply to the three-dimensional rotations of the eye. 2. The hypothesis that eye position signals are generated by an eye velocity integrator in the indirect path of the VOR must be rejected because in three dimensions the integral of angular velocity does not specify angular position. Computer simulations using eye velocity integrators show large, cumulative gaze errors and post-VOR drift. We describe a simple velocity to position transformation that works in three dimensions. 3. In the feedback control of saccades, eye position error is not the vector difference between actual and desired eye positions. Subtractive feedback models must continuously adjust the axis of rotation throughout a saccade, and they generate meandering, dysmetric gaze saccades. We describe a multiplicative feedback system that solves these problems and generates fixed-axis saccades that accord with Listing's law. 4. We show that Listing's law requires that most saccades have their axes out of Listing's plane. A corollary is that if three pools of short-lead burst neurons code the eye velocity command during saccades, the three pools are not yoked, but function independently during visually triggered saccades. 5. In our three-dimensional models, we represent eye position using four-component rotational operators called quaternions. This is not the only algebraic system for describing rotations, but it is the one that best fits the needs of the oculomotor system, and it yields much simpler models than do rotation matrix or other representations. 6. Quaternion models predict that eye position is represented on four channels in the oculomotor system: three for the vector components of eye position and one inversely related to gaze eccentricity and torsion. 7. Many testable predictions made by quaternion models also turn up in models based on other mathematics. These predictions are therefore more fundamental than the specific models that generate them. Among these predictions are 1) to compute eye position in the indirect path of the VOR, eye or head velocity signals are multiplied by eye position feedback and then integrated; consequently 2) eye position signals and eye or head velocity signals converge on vestibular neurons, and their interaction is multiplicative.(ABSTRACT TRUNCATED AT 400 WORDS)

Computer Simulation↗

Testing models of the oculomotor velocity-to-position transformation.

1. Do neural computations in premotor circuits mirror the physical properties of the systems they control? In 1987, Tweed and Vilis showed that oculomotor theories where a neural integrator converts eye angular velocity commands into position commands cannot be correct, because angular position is not the integral of angular velocity. Recently Schnabolk and Raphan proposed that an angular velocity integrator is nevertheless used to generate tonic commands in the oculomotor system. Here we test the Schnabolk-Raphan (S-R) model against Tweed and Vilis's quaternion (Q) model of the velocity to position transformation. 2. The S-R model predicts large (up to 7 degrees) transient (approximately 700 ms) deviations ("blips") in torsional eye position during attempted horizontal and vertical saccades. The Q model predicts no blips. Search coil recordings of saccades by 7 normal human subjects showed no large blips. 3. For approximately 200 saccades by each subject, we plotted the area under the torsional blip versus the product of saccade eccentricity and magnitude. According to the S-R model, this graph should form a straight line with slope 1.00. According to the Q model, the slope should be zero. Measured slopes averaged 0.016 (range -0.073 to 0.061) for saccade targets at 20 degrees eccentricity and 0.040 (range 0.004-0.076) for targets at 40 degrees. 4. No parameter change can significantly improve the S-R model, but lowering one parameter eradicates the tiny inaccuracy in the Q model. We show that the fundamental reason for the S-R model's failure is its use of a commutative controller to steer a noncommutative plant.

Attention↗

A model for the harmonisation of test results of different quantitative D-dimer methods.

The numerical test results of different D-dimer assays vary widely. Because of the complexity of the analyte of target as well as the variability in specificity of different D-dimer assays, only harmonisation of the test results seems to be feasible. The use of a single conversion factor does not take into account for several methods the lack of commutability between test results and consensus values at different D-dimer levels. This is probably related to the mutually different response of methods to high and low levels. We therefore designed a harmonisation model based on the transformation of a method-specific regression line to a reference regression line. We used the data for the measurement of a set of plasma samples with different D-dimer levels by 353 different laboratories using 7 of the most frequently used quantitative D-dimer methods. For each method we calculated the method-specific consensus value for each sample. The overall median value was also estimated. Per method linear regression was applied throughout the method-specific consensus values using the amount of patient pooled plasma added to the different plasma samples as the independent variable. The line through the overall median values of all 7 methods was used as the reference line. Harmonisation between the methods was obtained by transformation of the method-specific regression line to the reference line. This harmonisation resulted in a reduction of the variability between the method-specific consensus values from about 75% to about 5.5%. Clinical validation of this concept had shown significant improvement of the test result comparability. We conclude that this model is a feasible approach in the harmonisation of D-dimer methods. If the harmonisation procedure is included in the calibration procedure by the manufacturers, customers will automatically obtain harmonised test results.

Biomarkers↗

Particulate levels are associated with early asthma worsening in children with persistent disease.

RATIONALE: Ambient particulate concentrations have been associated with variable physiologic effects in children with persistent asthma taking controller medications. OBJECTIVE: To determine whether exposure to particulate matter has immediate effects on asthma control in children with persistent disease. METHODS AND MEASUREMENTS: In a school-based cohort, 73 children, primarily with moderate and severe asthma, were followed daily over one or two winters (2001-2002, 2002-2003) in Denver, Colorado. The association among ambient fine particulate, bronchodilator use, and urinary leukotriene E4 levels was assessed. RESULTS: Daily concentrations of fine particulate peaked in the morning hours when children were commuting to school. In a multivariable analysis that controlled for meteorology, time trends, and upper respiratory infections, an increase of one interquartile range in morning maximum fine particulate levels was related to an average increase of 3.8% in bronchodilator usage at school (95% confidence interval [CI], 0.2-7.4; p = 0.04). Children with severe asthma demonstrated significantly stronger associations (8.1% increase; 95% CI, 2.9-13.4; p = 0.003) than those with mild/moderate disease (1.6% increase; 95% CI, -2.2-5.4; p = 0.41; p = 0.03 for difference between groups). Morning maximum fine particulate levels were also associated with urinary leukotriene E4 measured during school hours (average increase of 6.2% per interquartile range increase; 95% CI, 1.9-10.5; p = 0.006). These associations were not discernable when 24-h averaged concentrations were used. CONCLUSIONS: Peak concentrations of ambient fine particulate are associated with early increases in bronchodilator use and urinary leukotriene E4 levels among children with persistent asthma, despite the use of controller medications.

Adolescent↗

Evidence for a pulley of the inferior oblique muscle.

PURPOSE: This study was undertaken to investigate evidence for a connective tissue pulley constraining the path of the inferior oblique (IO) muscle. METHODS: From magnetic resonance images, the cross-sectional area, path, and orbital relationships of the human IO were determined in multiple gaze positions. Rectus pulleys were directly imaged with intravenous gadodiamide contrast. Images were compared with serial histologic sections of IO muscles of humans and monkeys. RESULTS: The IO path from origin to the lateral border of the inferior rectus (IR) muscle was straight. Lateral to the IR, the IO curved to follow the globe. At the point of IR crossing, the IO moved anteriorly from infraduction to supraduction by approximately 53% of the IR insertion's travel. Gaze-related change in IO cross section was demonstrable near the IR center. The gaze-related inflection in IO path corresponded to its encirclement by a pulley consisting of a dense ring of collagen, stiffened by elastin and smooth muscle, and united with the IR pulley. Orbital layer fibers of the IO inserted on its pulley, the lateral rectus (LR) pulley, and associated connective tissues. CONCLUSIONS: Like the rectus muscles, the human and monkey IO has a connective tissue pulley serving as its functional origin. The position of the IO pulley is influenced by its coupling to the actively moving IR pulley, whereas in turn the IO orbital layer inserts on and presumably shifts the IR and LR pulleys. These intercouplings facilitate implementation by rectus extraocular muscle suspensions of a commutative ocular motor plant.

Adult↗

Rural and urban disparities in health-related quality of life among veterans with psychiatric disorders.

OBJECTIVE: The authors studied whether rural and urban disparities in health-related quality of life, demonstrated previously among veterans, persist among veterans with common psychiatric disorders. METHODS: A cohort of 748,216 users or anticipated users of Veterans Affairs services completed the Veterans Short Form Health Survey in 1999. From the survey, the authors determined health-related quality-of-life scores (physical [PCS] and mental [MCS] health component summaries) and used ICD-9-CM codes to identify veterans with six mental health disorders-depression, anxiety, posttraumatic stress disorder, alcohol dependence, schizophrenia, and bipolar disorder. With Rural-Urban Commuting Area codes to determine urban residency, the prevalence of psychiatric illness and health-related quality of life were compared across rural and urban groups. RESULTS: All psychiatric disorders except anxiety disorders not related to posttraumatic stress disorder were more prevalent in urban settings. However, rural veterans within mental illness cohorts had worse PCS and MCS scores. Differences in PCS scores were substantial, ranging between 2.27 for schizophrenia and 3.39 for alcohol dependence (p<.001 for all diagnoses). Differences in MCS scores were statistically significant but modest. In regression models, rural-urban disparities within psychiatric disorder cohorts persisted after sociodemographic factors were controlled for. CONCLUSIONS: Although less likely than their urban counterparts to have mental disorders, rural veterans with mental illness experienced a greater disease burden and were likely to incur greater health care costs. Improving access to mental health care for veterans in rural settings may narrow quality-of-life disparities among rural and urban veterans.

Adult↗

Congregate living for the mentally ill: patients as tenants.

The authors describe an apartment-living project for chronic mental patients released from the Hillside Division of the Long Island Jewish-Hillside Medical Center. The apartments, which are rented by the hospital and sublet to the patients, are located in modern, well-maintained high-rise buildings within commuting distance from the hospital. To avoid creating a psychiatric ghetto, the project rents no more than two apartments in buildings of a hundred or more units. The hospital was able to rent the apartments by assuring the landlords that the hospital would be a financially responsible tenant and that staff would be in continuing contact with the patients, would be available to the landlords if problems arose, and would remove troublesome tenants. Some of the problems encountered by the patients in the program are described, as are guidelines for selecting those who have a reasonable chance of benefiting from such a program.

Adult↗

Activity measurements support dimensional assessment.

The Diagnostic and Statistical Manual approach to motor excess has been to treat it as a categorical variable whose presence functions as an inclusion criterion. Motor excess is thought to occur primarily during structured settings that maximize attentional demands. Activity is rarely measured as a dimensional attribute despite availability of a wide variety of suitable instruments for more than a decade (Tryon, 1985). The present study measured activity using electronic step counters in structured and unstructured school settings, commuting from home to school and back home, and at home for 2 consecutive weeks in 60 children selected from 450 children using Factor IV (hyperactivity) scores from the Conners Teacher Rating Scale to represent three levels of hyperactivity. Results indicate that (a) children rated as hyperactive are measurably more active than children rated as normally active in unstructured as well as structured situations, (b) measured activity correlates consistently and substantially with rated activity in unstructured and structured situations, and (c) a single activity factor characterizes measured activity in all situations except for class transitions during school. These results and other published findings support a quantitative (dimensional) rather than qualitative (categorical) approach to motor excess.

Attention↗

Frequency domain processing for ultrasonic attenuation measurement in liver.

A frequency domain signal processing scheme is developed for measuring attenuation and attenuation slope in vivo, using equally spaced depth samples and linear regression techniques. The algorithm may be expressed in terms of linear, commuting operators acting on an array of log power spectra. By interchanging operators, a computationally efficient scheme may be developed, and the accuracy of the result assessed in terms of tissue uniformity and frequency linearity. Corresponding algorithms are demonstrated for measurement of attenuation at particular frequencies and attenuation in focal lesions. Measurements have been made using an Octoson water-delay echoscope on both normal and pathological livers. Variation of attenuation with a number of disease states has been found.

Colonic Neoplasms↗

Microchimeric cells in systemic lupus erythematosus: targets or innocent bystanders?

During pregnancy maternal and fetal cells commute back and forth leading to fetal microchimerism in the mother and maternal microchimerism in the child that can persist for years after the birth. Chimeric fetal and maternal cells can be hematopoietic or can differentiate into somatic cells in multiple organs, potentially acting as targets for 'autoimmunity' and so have been implicated in the pathogenesis of autoimmune diseases that resemble graft-versus-host disease after stem cell transplantation. Fetal cells have been found in women with systemic lupus erythematosus, both in the blood and a target organ, the kidney, suggesting that they may be involved in pathogenesis. Future studies will address how the host immune system normally tolerates maternal and fetal cells or how the balance may change during autoimmunity.

Alleles↗

Oxygen enrichment of room air to improve well-being and productivity at high altitude.

Increasingly, commercial activities, such as mines, and scientific facilities, such as telescopes, are being placed at very high altitudes, up to 5,000 m. Frequently workers commute to these locations from much lower altitudes, or even from sea level. In addition, large numbers of people permanently live and work at high altitudes. The hypoxia of high altitude impairs sleep quality, mental performance, productivity, and general well-being. Recently it has become feasible to raise the oxygen concentration of room air by injecting oxygen into the air conditioning. This is remarkably effective at reducing the equivalent altitude. For example, increasing the oxygen concentration by 1% (e.g., from 21% to 22%) reduces the equivalent altitude by about 300 m. In other words, a room at an altitude of 4,500 m containing 26% oxygen is effectively at an altitude of 3,000 m. Oxygen enrichment has now been tested in several studies and shown to improve sleep quality and cognitive function. The fire hazard is less than in air at sea level. This innovative technique promises to improve productivity and well-being at high altitude.

Air Conditioning↗

Socioeconomic deprivation and asthma prevalence and severity in young adolescents.

This study used the international study of asthma and allergies in childhood (ISAAC) to investigate the association between asthma and socioeconomic deprivation among young adolescents in Cape Town, South Africa. The completed ISAAC written and video questionnaires of 4,706 13-14-yr-old school pupils were used. The prevalence of asthma symptoms was analysed by a local index of socioeconomic deprivation, based on residential location and defined on a 10-category scale from least to most deprived. Linear trends were examined visually and the prevalence odds ratio was used to summarize overall trends. In general, the least socioeconomically deprived pupils reported higher prevalences of asthma symptoms "ever" and "in the last 12 months". In contrast, the most socioeconomically deprived pupils reported higher asthma-symptom occurrence monthly or more frequently in the previous 12 months. A subgroup of pupils from low-income areas commuting to better-off schools showed the highest symptom prevalences. The findings are consistent with a model in which an increase in the incidence of asthma is driven by factors associated with improved social circumstances, whereas severity is determined by factors associated with poverty. The impact of social mobility on asthma, including reporting of symptoms, deserves closer study.

Adolescent↗

Effects of intermittent hypoxia on pulmonary haemodynamics: animal models versus studies in humans.

The aim of this review was to analyse the effects of intermittent hypoxia (IH) on pulmonary haemodynamics, comparing results of animal experiments with results of clinical studies. In animal investigations even short hypoxic exposure, continuously or in short repeated episodes mimicking obstructive sleep apnoea (OSA), leads to pulmonary artery remodelling and to pulmonary hypertension (PH). Results of investigations on effects of nocturnal IH on pulmonary haemodynamics in patients with chronic obstructive pulmonary disease (COPD) are discordant. Earlier studies reported the development of mild PH in subjects desaturating during sleep, while more recent investigations did not confirm those findings. Alveolar IH developing during apnoeic episodes during sleep in OSA patients is a disease-induced model to study its effects on pulmonary haemodynamics. In the majority of studies in OSA patients pulmonary arterial pressure remained within normal values. PH was found in patients with OSA accompanied by COPD and/or extreme obesity. People commuting between lowland and high altitude due to their employment, are also repeatedly exposed to IH. Results of clinical investigations suggest that it did not lead to the development of permanent PH. The mechanisms of discrepancies between effects of intermittent hypoxia in animal models and in humans remain to be studied.

Animals↗

The unexpected importance of mosquito oviposition behaviour for malaria: non-productive larval habitats can be sources for malaria transmission.

BACKGROUND: Mosquitoes commute between blood-meal hosts and water. Thus, heterogeneity in human biting reflects underlying spatial heterogeneity in the distribution and suitability of larval habitat as well as inherent differences in the attractiveness, suitability and distribution of blood-meal hosts. One of the possible strategies of malaria control is to identify local vector species and then attack water bodies that contain their larvae. METHODS: Biting and host seeking, not oviposition, have been the focus of most previous studies of mosquitoes and malaria transmission. This study presents a mathematical model that incorporates mosquito oviposition behaviour. RESULTS: The model demonstrates that oviposition is one potential factor explaining heterogeneous biting and vector distribution in a landscape with a heterogeneous distribution of larval habitat. Adult female mosquitoes tend to aggregate around places where they oviposit, thereby increasing the risk of malaria, regardless of the suitability of the habitat for larval development. Thus, a water body may be unsuitable for adult mosquito emergence, but simultaneously, be a source for human malaria. CONCLUSION: Larval density may be a misleading indicator of a habitat's importance for malaria control. Even if mosquitoes could be lured to oviposit in sprayed larval habitats, this would not necessarily mitigate -- and might aggravate -- the risk of malaria transmission. Forcing mosquitoes to fly away from humans in search of larval habitat may be a more efficient way to reduce the risk of malaria than killing larvae. Thus, draining, fouling, or filling standing water where mosquitoes oviposit can be more effective than applying larvicide.

Animals↗

Psycho-social and environmental correlates of location-specific physical activity among 9- and 15- year-old Norwegian boys and girls: the European Youth Heart Study.

OBJECTIVE: Little is known about the existence of independent location- or context specific forms of physical activity. This study sought to identify location-specific forms of physical activity in a sample of 9 and 15 years-olds Norwegian boys and girls, and examined their associations to psycho-social and environmental factors. METHODS: A cross-sectional study of 9 and 15-year-olds (N = 760; 379 boys and 381 girls) was conducted in which participants responded to a computer-based questionnaire (PEACH) tapping potentially location specific forms of physical activity as well as psycho-social and environmental correlates. RESULTS: Exploratory factor analysis indicated that the nine and fifteen year-olds self-reported their physical activity as located in three separate and specific contexts: a) school commuting, b) informal games play at school and c) organized sport, structured exercise and games play in leisure time. Dependent of location, psycho-social and environmental correlates explained between 15 and 55 percent of the variance in physical activity. The impact of peer support, enjoyment and perceived competence in physical activity generalized across the three locations. Enjoyment of physical education classes, parental support and teacher support, in contrast, confined to particular location-specific forms of physical activity. Generally, behavioural beliefs and environmental factors represented marginal correlates of all location-specific forms of activity. CONCLUSION: Young peoples' physical activity was identified as taking place in multiply genuine locations, and the psychosocial correlates of their physical activity seem to some extent to be location specific. Results may inform intervention efforts suggesting that targeting specific sets of psycho-social factors may prove efficient across physical activity locations, gender and age groups. Others, in contrast may prove effective in facilitating location specific physical activity, in which age may come to moderate the efficiency of intervention efforts.

Journal Article↗

11 March 2004: The terrorist bomb explosions in Madrid, Spain--an analysis of the logistics, injuries sustained and clinical management of casualties treated at the closest hospital.

At 07:39 on 11 March 2004, 10 terrorist bomb explosions occurred almost simultaneously in four commuter trains in Madrid, Spain, killing 177 people instantly and injuring more than 2000. There were 14 subsequent in-hospital deaths, bringing the ultimate death toll to 191. This report describes the organization of clinical management and patterns of injuries in casualties who were taken to the closest hospital, with an emphasis on the critically ill. A total of 312 patients were taken to the hospital and 91 patients were hospitalized, of whom 89 (28.5%) remained in hospital for longer than 24 hours. Sixty-two patients had only superficial bruises or emotional shock, but the remaining 250 patients had more severe injuries. Data on 243 of these 250 patients form the basis of this report. Tympanic perforation occurred in 41% of 243 victims with moderate-to-severe trauma, chest injuries in 40%, shrapnel wounds in 36%, fractures in 18%, first-degree or second-degree burns in 18%, eye lesions in 18%, head trauma in 12% and abdominal injuries in 5%. Between 08:00 and 17:00, 34 surgical interventions were performed in 32 patients. Twenty-nine casualties (12% of the total, or 32.5% of those hospitalized) were deemed to be in a critical condition, and two of these died within minutes of arrival. The other 27 survived to admission to intensive care units, and three of them died, bringing the critical mortality rate to 17.2% (5/29). The mean Injury Severity Score and Acute Physiology and Chronic Health Evaluation II scores for critically ill patients were 34 and 23, respectively. Among these critically ill patients, soft tissue and musculoskeletal injuries predominated in 85% of cases, ear blast injury was identified in 67% and blast lung injury was present in 63%. Fifty-two per cent suffered head trauma. Over-triage to the closest hospital probably occurred, and the time of the blasts proved to be crucial to the the adequacy of the medical and surgical response. The number of blast lung injuries seen is probably the largest reported by a single institution, and the critical mortality rate was reasonably low.

Adult↗

Flight performance during hunting excursions in Eleonora's falcon Falco eleonorae.

Among birds, falcons are high-performance flyers, in many cases adapted for aerial hunting and hence suitable targets for investigating limits to flight performance. Using an optical range finder, we measured flight tracks of Eleonora's falcon (Falco eleonorae), a species breeding in the Mediterranean region and specialised for hunting autumn passage bird migrants, when commuting between their nesting colony and offshore hunting areas (straight transportation flight) and when searching for prey (transecting and searching flight). Airspeed during searching flight was significantly slower than during straight transportation and transecting flight, but there was no significant difference in airspeed between the latter two flight modes. Straight transportation flight was significantly faster than predicted minimum power speed. Also, during straight transportation flight, the falcons responded to head- and tailwinds by increasing their airspeed when flying into the wind. However, they did not show any significant airspeed adjustments with respect to the angle between the track and the heading, as would be expected in birds trying to maintain a constant track direction. Mean sustainable climb rate (during (greater than or equal to) 240 s) was 1.4+/-0.31 m s-1 (mean +/- s.d., N=13), which is rather a high rate for a bird the size of an Eleonora's falcon. The climb rate was used to calculate maximum load-carrying capacity and maximum sustained horizontal flapping flight speed. The mean wingbeat frequency during powered climbing flight was 4.68 Hz, which was used to estimate the mass-specific muscle work. When falcons were leaving the colony for offshore hunting, they gained altitude by slope-soaring when there was an onshore wind. We formulated a simple criterion for the required gliding-flight rate of climb during an initial slope-soaring episode when minimizing the energy cost of reaching a certain altitude far out over the sea (which is where the prey is to be found). This climb rate was 0.36 m s-1, and our observations indicated that the falcons experienced climb rates above this value when soaring in slope-lift.

Animals↗

A new technique for monitoring the behaviour of free-ranging Adélie penguins.

Measurement of the time allocation of penguins at sea has been a major goal of researchers in recent years. Until now, however, no equipment has been available that would allow measurement of the aquatic and terrestrial behaviour of an Antarctic penguin while it is commuting between the colony and the foraging grounds. A new motion detector, based on the measurement of acceleration, has been used here in addition to current methods of inferring behaviour using data loggers that monitor depth and speed. We present data on the time allocation of Adélie penguins (Pygoscelis adeliae) according to the different types of behaviours they display during their foraging trips: walking, tobogganing, standing on land, lying on land, resting at the water surface, porpoising and diving. To illustrate the potential of this new technique, we compared the behaviour of Adélie penguins during the chick-rearing period in a fast sea-ice region and an ice-free region. The proportion of time spent standing, lying on land and walking during foraging trips was greater for penguins in the sea-ice region (37.6+/-13.3% standing, 21.6+/-15.6% lying and 5.9+/-6.3% walking) than for those in the ice-free region (12.0+/-15.8 % standing, 0.38+/-0.60% lying and 0 % walking), whereas the proportion of time spent resting at the water surface and porpoising was greater for birds in the ice-free region (38.1+/-6.4% resting and 1.1+/-1.1% porpoising) than for those in the sea-ice region (3.0+/-2.3% resting and 0% porpoising; means +/- s.d., N=7 for the sea-ice region, N=4 for the ice-free region). Using this new approach, further studies combining the monitoring of marine resources in different Antarctic sites and the measurement of the energy expenditure of foraging penguins, e.g. using heart rates, will constitute a powerful tool for investigating the effects of environmental conditions on their foraging strategy. This technique will expand our ability to monitor many animals in the field.

Animals↗