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At least 109 records · Page 6Linked to original sources
PubMed2006

Freedom from atrial arrhythmias after classic maze III surgery: a 10-year experience.

OBJECTIVES: We studied the persistence of favorable outcome, the occurrence of new atrial arrhythmias, and sinus node dysfunction in patients who underwent the maze III procedure. METHODS: Preoperative, in-hospital, and follow-up data of 203 patients who underwent the maze III procedure between June 1993 and June 2003 were collected. A total of 139 patients underwent the maze procedure for lone atrial fibrillation, and 64 patients underwent the maze procedure and concomitant cardiac surgery. RESULTS: There was no 30-day postoperative mortality. During a mean follow-up of 4.0 +/- 2.6 years, 12 patients (6%) died (2 cardiac related). At the end of follow-up, freedom from supraventricular arrhythmias was 80% for the lone atrial fibrillation group and 64% for the concomitant atrial fibrillation group. Freedom from stroke during follow-up was 100% in the lone atrial fibrillation group and 97% in the concomitant group. Multivariate analysis revealed that rhythm at 1-year follow-up (P < .001; odds ratio 9.56, 95% confidence limits 3.92-23.31) and preoperative left atrium dimension (P = .028; odds ratio 1.06 for every millimeter, 95% confidence limits 1.01-1.12) were predictors of success at the end of follow-up. CONCLUSIONS: This study shows that the favorable results of the maze III procedure in terms of freedom from supraventricular arrhythmias persist in most patients for at least 4 years.

Arrhythmias, Cardiac↗
PubMed2007

Demonstrating freedom from disease using multiple complex data sources 1: a new methodology based on scenario trees.

Current methods to demonstrate zone or country freedom from disease are based on either quantitative analysis of the results of structured representative surveys, or qualitative assessments of multiple sources of evidence (including complex non-representative sources). This paper presents a methodology for objective quantitative analysis of multiple complex data sources to support claims of freedom from disease. Stochastic scenario tree models are used to describe each component of a surveillance system (SSC), and used to estimate the sensitivity of each SSC. The process of building and analysing the models is described, as well as techniques to take into account any lack of independence between units at different levels within a SSC. The combination of sensitivity estimates from multiple SSCs into a single estimate for the entire surveillance system is also considered, again taking into account lack of independence between components. A sensitivity ratio is used to compare different components of a surveillance system. Finally, calculation of the probability of country freedom from the estimated sensitivity of the surveillance system is illustrated, incorporating the use and valuation of historical surveillance evidence.

Animal Diseases↗
PubMed2006

Analysis of national serological surveys for the documentation of freedom from porcine reproductive and respiratory syndrome in Switzerland.

Results of national serological surveys for porcine reproductive and respiratory syndrome (PRRS) conducted in Switzerland in 2001 and 2004 were analyzed. In 2001, 41,124 breeding sows from 2,540 herds out of 6,406 were sampled, and in 2004, 7,498 animals were sampled from 1,074 herds out of 5,320. All serum samples were tested for PRRS using an ELISA developed at the Institute of Virology and Immunoprophylaxis (IVI), Switzerland with a sensitivity (Se) and specificity (Sp) of 94 and 97%, respectively. Positive samples were re-tested with a commercial ELISA (IDEXX) with Se of 100% and Sp of 99%. Samples positive in the second test were confirmed with the fluorescent antibody test (FAT). A stochastic model using data from the main survey conducted in 2001 was done to verify whether the sampling scheme used could detect at least one infected herd with 99% confidence level if the herd designed prevalence was at 0.1 or 0.2%. Additionally, a Bayesian approach was conducted to calculate the post-survey probability of freedom from PRRS using data from the 2001 and 2004 surveys. A Monte Carlo simulation with 5000 iteration was run for each model. Eleven samples in 2001 and six in 2004, all from different farms, could not be conclusively confirmed as negative by the FAT. All other samples were negative. Truly infected animals and herds were not predicted by a stochastic model at the 99% confidence level and 0.1% herd prevalence using data from the 2001 survey. However, it was demonstrated that the prior probability of freedom from PRRS increased from 89.3 to 99.2% after the 2001 survey. Upon completion of the 2004 survey, the probability of freedom from PRRS reached a value of 99.7%. Based on our results, we could conclude that the pig industry in Switzerland is free of PRRS virus with this level of confidence. Restricted import activities over the last decades are a possible explanation for the continuing absence of PRRS-infection in the Swiss swine population. Import requirements defined by the pig industry minimize the risk of introduction of PRRS-infected animals in the future.

Animals↗
PubMed2003

What does postradiotherapy PSA nadir tell us about freedom from PSA failure and progression-free survival in patients with low and intermediate-risk localized prostate cancer?

OBJECTIVES: To determine whether the post-external beam radiotherapy (RT) prostate-specific antigen nadir (nPSA) improves our ability to predict freedom from PSA failure, progression-free survival (PFS), and overall survival. Controversy regarding the importance of nPSA after external beam RT as a prognostic indicator for patients with localized prostate cancer has continued. METHODS: This analysis was based on the data from 748 patients with low and intermediate-risk localized prostate cancer treated with external beam RT alone. Patients were categorized by nPSA quartile groups with cutpoints of less than 0.3, 0.3 to less than 0.6, 0.6 to less than 1.2, and 1.2 ng/mL or greater. Both univariate and multivariate analyses were used to determine the significance of nPSA on PSA failure (American Society for Therapeutic Radiology Oncology consensus definition), PFS (death after PSA failure), and overall survival (death from any cause). RESULTS: Freedom from PSA failure was strongly associated with nadir quartile groups (P <0.0001). PFS was also significantly different statistically among nadir quartile groups (P = 0.02). No statistically significant difference was found in overall survival associated with nPSA at this point. CONCLUSIONS: nPSA is a strong independent predictor of freedom from PSA failure and PFS in patients with low and intermediate-risk localized prostate cancer treated with RT alone. Longer follow-up and larger patient numbers are required to confirm these observations.

Adenocarcinoma↗
PubMed2000

Investigations on the mobility of the glycosidic linkage in sucrose by study of the phase space structure of a two-degrees of freedom model.

Using the theoretical Ramachandran (phi, psi) maps reported in the literature for sucrose in vacuo and in aqueous solution, we constructed a two-degrees of freedom model in which the glucose and fructose units are substituted by pseudo-atoms. The complete dynamics of this model is studied numerically at fixed energies. Use is made of the graphic method of the Poincaré surfaces of section in phase space and of the Lissajous maps in configuration space. The reduction to just two degrees of freedom allows one to deal with all initial conditions in phase space, whereas the results of molecular dynamics calculations with all internal degrees of freedoms and with the explicit consideration of solvent molecules are taken into account via effective kinetic and potential energy terms. The conformational isomerization mechanism is investigated by singling out the most reactive trajectories in phase space that are associated with the so-called reactive islands and with the resonances found between the phi and psi motions.

Carbohydrate Conformation↗
PubMed1993

Impact of interpretation on associative freedom.

Seventy hours from the psychoanalytic case of Mrs. C, covering the full course of treatment, were scored for associative freedom, number of interventions, and a variety of clinical phenomena such as clarifications, interpretations, different forms of resistance, transference manifestations, and the like. Associative freedom significantly increased over the course of treatment and was significantly related to the number of analyst interventions per hour. The relationship was particularly strong in the latter stages of treatment. Three specific types of interventions were found to increase associative freedom in the latter stages of treatment. The effect of each type was found to influence both the session containing the interpretation and the next 3 sessions. This carryover effect was specific to the latter stages of the analysis.

Adult↗
PubMed2005

An eight-degree-of-freedom quantum dynamics study for the H2+C2H system.

An eight-degree-of-freedom (8DOF) time-dependent wave-packet approach has been developed to study the H(2)+C(2)H-->H+C(2)H(2) reaction system. The 8DOF model is obtained by fixing one of the Jacobi torsion angle in the nine-degree-of-freedom AB+CDE reaction system. This study is an extension of the previous seven-degree-of-freedom (7DOF) computation [J. Chem. Phys. 119, 12057 (2003)] of this reaction system. This study shows that vibrational excitations of H(2) enhance the reaction probability, whereas the stretching vibrational excitations of C(2)H have only a small effect on the reactivity. Furthermore, the bending excitation of C(2)H, compared to the ground-state reaction probability, hinders the reactivity. A comparison of the rate constant between the 7DOF calculation and the present 8DOF results has been made. The theoretical and experimental results agree with each other very well when the present 8DOF results are adjusted to account for the lower transition state barrier heights found in recent ab initio calculations.

Journal Article↗
PubMed1991

Explicit distance geometry: identification of all the degrees of freedom in a large RNA molecule.

An alternative approach to distance geometry ("explicit" distance geometry) is being developed for problems, such as the modeling of RNA folding in the ribosome, where relatively few distances are known. The approach explicitly identifies minimal sets of additional distances that can be added to a distance matrix in order to calculate structures that are consistent with all the known information without distorting the original input data. These additional distances are bounded to the extent possible by the known distances. These explicitly added distances can be treated as degrees of freedom and used to explore the full range of alternative foldings consistent with the original input in an organized way. The present paper establishes that it is practical to explicitly determine such degrees of freedom for even very large RNAs. To demonstrate the feasibility of the approach tRNA was represented as a simple undirected graph containing all relevant information represented in the usual cloverleaf secondary structure and nine base-base tertiary interactions. Using a three atom representation for each residue a total of 206 degrees of freedom are explicitly identified. To accomplish this a graph theoretic approach was used in which a minimal covering cycle basis was determined.

Algorithms↗
PubMed2005

Non-inducibility post-pulmonary vein isolation achieving exit block predicts freedom from atrial fibrillation.

AIMS: This study evaluates whether non-inducibility of atrial fibrillation (AF) after achieving bi-directional electrical pulmonary vein (PV) isolation is a useful predictor of freedom from AF recurrence. METHODS AND RESULTS: This study included 102 consecutive patients who underwent PV isolation for symptomatic paroxysmal (59%), persistent (32%), or permanent (9%) AF. Patients were followed for 16+/-10 months. Complete isolation of all four PVs was confirmed by demonstration of bi-directional block, defined by both loss of PV potentials and failure to capture the LA by pacing (at 10 mA) 10-14 bipolar pairs of electrodes on a circumferential catheter positioned at the entrance of the PV. Induction of AF by burst pacing on/off isoproterenol was attempted after PV isolation. Freedom from recurrent symptomatic or asymptomatic AF was present in 70% of patients at 6 months and 62% of patients at 12 months. In multi-variable analysis, non-inducibility post-PV isolation (OR=3.84, P=0.047) and paroxysmal AF (OR=4.80, P=0.012) predicted freedom from AF at 12 months. CONCLUSION: Non-inducibility of AF after bi-directional PV isolation predicts maintenance of sinus rhythm. This finding suggests that routine extensive left atrial ablation may be unnecessary.

Atrial Fibrillation↗
PubMed2004

Preliminary report of multi degrees of freedom forceps for endoscopic surgery.

Laparoscopic suturing requires more complex techniques than conventional open surgery, because of the limited degrees of freedom of endoscopic devices. The prototype multi degrees of freedom forceps was developed with a concept of a flexibility that frees us from the restriction on suturing during endoscopic surgery. It was designed for a needle holder. We calculated the movement of the forceps' distal joint at the time of horizontal suturing. The learning curve was also investigated for ten surgeons. The device was clinically applied in several surgeries. We could perform suturing freely using this prototype forceps at any point and in any directions. The learning curve had its peak within five training sessions, and may be mastered during about ten training sessions. All clinical applications were successfully achieved. With the increased degree of freedom for forceps, the operability for endoscopic surgery was improved.

Analysis of Variance↗
PubMed2000

Driven electron transfer in an environment with slow and fast degrees of freedom.

Driven electron transfer in a polar medium with slow and fast degrees of freedom is studied in the framework of a spin-boson Hamiltonian. Evolution dynamics is rigorously found when omega(s)(c)/(Gamma(a))sqrt[E(rs)/kT]<<1, where omega(s)(c) is the Debye cutoff frequency in the spectral function for the slow modes, E(rs) is the reorganization energy of slow degrees of freedom, and Gamma(-1)(a) is the reaction time dependent on the laser intensity parameter a=muE(0)/Planck's over 2piomega. Here omega and E0 are the frequency and the amplitude of a cw electric field, and mu is the electron dipole moment difference between the initial and final states. The master equation is derived for an arbitrary driving force affecting both the transition matrix element and the potential energy. For a cw electric field, the time dependent probability of staying at the product state, P1(t), is shown to be strongly dependent on the field intensity parameter a: P1(a,t) approximately (Gamma(m(1),m(2))t)(-E(rf)/E(rs)) or P1(a,t) approximately (Gamma(m(0))t)(-E(rf)/E(rs)), double or single resonances, respectively. Here E(rf) is the reorganization energy of fast degrees of freedom, Gamma(m(1),m(2)) approximately J(2)(m(1))(a)+J(2)(m(2))(a), and Gamma(m(0)) approximately J(2)(m(0))(a), where J(a) is a Bessel function. By changing the parameter a, one is able to manipulate the rate and direction of the reaction. When J(2)(m(0))(a) is close to zero the reaction is slow. Hence, slow modes turn out to be fast. This changes the character of the evolution dynamics from non- to mono- exponential decay, respectively. For the double resonance, the equilibrium constant is studied with the field intensity. It is shown that the reaction is almost insensitive to temperature. However, it strongly depends on the reaction heat, which provides a condition for the resonance.

Journal Article↗
PubMed2002

Dominance of Milnor attractors in globally coupled dynamical systems with more than 7+/-2 degrees of freedom.

The prevalence of Milnor attractors has recently been reported in a class of high-dimensional dynamical systems. We study how this prevalence depends on the number of degrees of freedom by using a globally coupled map and show that the basin fraction of Milnor attractors increases drastically around 5-10 degrees of freedom, saturating for higher numbers of degrees of freedom. It is argued that this dominance of Milnor attractors in the basin arises from a combinatorial explosion of the basin boundaries. In addition, the dominance is also found in a system without permutation symmetry, i.e., a coupled dynamical system of nonidentical elements. Possible relevance to the magic number 7+/-2 in psychology is briefly discussed.

Journal Article↗
PubMed2005

Density of states of classical spin systems with continuous degrees of freedom.

In the last years different studies have revealed the usefulness of a microcanonical analysis of finite systems when dealing with phase transitions. In this approach the quantities of interest are exclusively expressed as derivatives of the entropy S=ln Omega where Omega is the density of states. Obviously, the density of states has to be known with very high accuracy for this kind of analysis. Important progress has been achieved recently in the computation of the density of states of classical systems, as new types of algorithms have been developed. Here we extend one of these methods, originally formulated for systems with discrete degrees of freedom, to systems with continuous degrees of freedom. As an application we compute the density of states of the three-dimensional XY model and demonstrate that critical quantities can directly be determined from the density of states of finite systems in cases where the degrees of freedom take continuous values.

Journal Article↗
PubMed1983

Joint models, degrees of freedom, and anatomical motion measurement.

When the motion associated with an anatomical joint is to be measured, a kinematic model for the joint must first be established. The joint model will have from one to six degrees of freedom, and both the measurement technique and the means used to describe the motion will be influenced by the model and its degrees of freedom. This paper discusses the modeling and measurement of anatomical joint motion from a kinematics viewpoint. A review of the literature pertaining to measurement techniques, kinematic assumptions, and motion descriptions for anatomical joint motion is presented. One, two, three and six degree-of-freedom models for various anatomical joints have appeared in the literature, and the applicability of these models is compared and discussed.

Joints↗
PubMed2002

Training in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes: dose adjustment for normal eating (DAFNE) randomised controlled trial.

OBJECTIVES: To evaluate whether a course teaching flexible intensive insulin treatment combining dietary freedom and insulin adjustment can improve both glycaemic control and quality of life in type 1 diabetes. DESIGN: Randomised design with participants either attending training immediately (immediate DAFNE) or acting as waiting list controls and attending "delayed DAFNE" training 6 months later. SETTING: Secondary care diabetes clinics in three English health districts. PARTICIPANTS: 169 adults with type 1 diabetes and moderate or poor glycaemic control. MAIN OUTCOME MEASURES: Glycated haemoglobin (HbA(1c)), severe hypoglycaemia, impact of diabetes on quality of life (ADDQoL). RESULTS: At 6 months, HbA(1c) was significantly better in immediate DAFNE patients (mean 8.4%) than in delayed DAFNE patients (9.4%) (t=6.1, P<0.0001). The impact of diabetes on dietary freedom was significantly improved in immediate DAFNE patients compared with delayed DAFNE patients (t=-5.4, P<0.0001), as was the impact of diabetes on overall quality of life (t=2.9, P<0.01). General wellbeing and treatment satisfaction were also significantly improved, but severe hypoglycaemia, weight, and lipids remained unchanged. Improvements in "present quality of life" did not reach significance at 6 months but were significant by 1 year. CONCLUSION: Skills training promoting dietary freedom improved quality of life and glycaemic control in people with type 1 diabetes without worsening severe hypoglycaemia or cardiovascular risk. This approach has the potential to enable more people to adopt intensive insulin treatment and is worthy of further investigation.

Adult↗
PubMed1982

Ethics in psychiatry--the patient's freedom and bondage.

Ethics is defined as the realm of the 'ought', the realm of conscience which postulates that Man has the freedom to carry out what he judges to be morally right. By such acts he realizes his freedom of making himself into a truer, more authentic person than he was before. A libertarian psychotherapy, based on this ethic, is outlined. Medical science (as all science) belongs to the realm of the 'is' and postulates that the phenomena which it studies follow a necessary course. It is therefore deterministic. In psychiatry, allowance is made for a neurological determinism in cases in which personal freedom has been diminished or abolished by mental illness, but the determinisms of behaviour therapy and of psycho-analysis are rejected by the author.

Ethics, Medical↗
PubMed1986

Three degree of freedom description of movement of the human chest wall.

A three degree of freedom description of movement of the human chest wall is presented. In addition to the standard variables representing surface displacements of the rib cage and abdominal wall in transverse planes, the description includes a variable representing axial displacements of the chest wall associated with postural movements of the spine and pelvis. A simple technique was developed for quantifying the axial displacements using a single measurement by magnetometry of changes in the distance between a point on the anterior surface of the rib cage near the xiphisternum and a point on the abdominal surface near the pubic symphysis. It was found that axial displacements produced by either flexion-extension of the spine or rotation of the pelvis in the standing postures can be treated as a single degree of freedom. The chest wall displacements induced over the range of axial displacement examined were as large as those normally accompanying a change in lung volume on the order of 30-50% of the vital capacity. It is concluded, however, that although this additional degree of freedom can cause large chest wall displacements, it probably cannot independently change lung volume. This implies that the system is constrained so that there are only a limited number of independent modes of chest wall movement that are capable of producing significant changes in lung volume. It also suggests that the system is constructed so that lung volume can be relatively independent of certain postural distortions of the chest wall.

Humans↗
PubMed2000

Opening Pandora's box? Freedom of information and health services research.

The introduction, or extension, of freedom of information legislation in Britain and other Western countries seems certain to influence the climate for health services research. However, researchers should be clear that, although such legislation may improve access to certain types of data, it will also create new problems and dilemmas. Statutory freedom of information regimes are likely to raise difficult issues of adaptation and compliance for health service bodies. Researchers may find that this translates into reluctance to agree access and accentuates difficulties in managing field relationships. They may, inter alia, face difficult dilemmas in deciding whether, or how, to report non-compliance, judging whether to extend research into areas where consent has not been obtained and weighing the benefits of using the official rules to insist on disclosure against the dis-benefits of jeopardising relationships. Health services researchers should regard freedom of information legislation, not simply as a resource, but a topic deserving study in its own right.

Confidentiality↗