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At least 1,495 records · Page 83Linked to original sources
PubMed2001

Ethical dilemmas, good intentions, and the road to hell: a clinical-ethical perspective on Yalom's depiction of Trotter's therapy.

Fiction in literature can assist in the analysis of therapeutic and ethical dilemmas in psychotherapy. Lying on the Couch (Harper Collins, 1997), Yalom's account of Dr. Seymour Trotter and Mrs. Belle Felini's therapeutic encounter, describes a complex series of issues and dilemmas. In the present article a reanalysis of the case from the perspective of a clinical and ethical consultation is presented. The therapeutic crisis that preceded the sexual relationship and the initial presentation of the client are considered in detail. Following the discussion of each of these periods, alternative modes of understanding and intervening in the treatment are presented. The in-depth exploration of a fictional case such as this one allows therapists to critically evaluate the decisions that underlie problems in the therapeutic encounter. The article concludes with specific recommendations for clinical and ethical practice.

Ethics, Professional↗
PubMed2005

Molecular, structural, and functional characterization of Alzheimer's disease: evidence for a relationship between default activity, amyloid, and memory.

Alzheimer's disease (AD) and antecedent factors associated with AD were explored using amyloid imaging and unbiased measures of longitudinal atrophy in combination with reanalysis of previous metabolic and functional studies. In total, data from 764 participants were compared across five in vivo imaging methods. Convergence of effects was seen in posterior cortical regions, including posterior cingulate, retrosplenial, and lateral parietal cortex. These regions were active in default states in young adults and also showed amyloid deposition in older adults with AD. At early stages of AD progression, prominent atrophy and metabolic abnormalities emerged in these posterior cortical regions; atrophy in medial temporal regions was also observed. Event-related functional magnetic resonance imaging studies further revealed that these cortical regions are active during successful memory retrieval in young adults. One possibility is that lifetime cerebral metabolism associated with regionally specific default activity predisposes cortical regions to AD-related changes, including amyloid deposition, metabolic disruption, and atrophy. These cortical regions may be part of a network with the medial temporal lobe whose disruption contributes to memory impairment.

Adolescent↗
PubMed2001

Toward a consensus on reference values for thyroid volume in iodine-replete schoolchildren: results of a workshop on inter-observer and inter-equipment variation in sonographic measurement of thyroid volume.

OBJECTIVE: Interpretation of thyroid ultrasonography for assessing goiter prevalence requires valid reference criteria from iodine-sufficient populations. Reports have suggested the current reference criteria for thyroid volume (T(vol)) of WHO/ICCIDD (International Council for the Control of Iodine Deficiency Disorders) may be too high. Our objective was to determine if inter-observer and/or inter-equipment variability contributes to the disagreement in sonographic T(vol) in children reported from iodine-sufficient areas. DESIGN: A 2-day workshop in which four experienced ultrasound examiners from around Europe measured T(vol) in 45 6--12-year-old Swiss schoolchildren using four different portable ultrasound machines. One of the participating examiners (observer A) had generated the T(vol) data in European children that are the basis for the WHO/ICCIDD reference criteria. METHODS: Sonographic T(vol) was measured in each child by all four examiners on all four machines. Six hundred and eighty-four examinations were completed, with examiners having no knowledge of one another's results. Inter-observer and inter-equipment variation was calculated. RESULTS: Mean inter-equipment variation in T(vol) was 15.2% (95% CI: 14.1, 16.3%). There were no significant differences in T(vol) between equipment (P=0.51). For all observers, the mean inter-observer variation in T(vol) was 25.6% (95% CI: 23.9, 27.2%). At all ages and all body surface areas, there was a large systematic measurement bias (+30% volume) between the mean T(vol) of observer A and the mean Tvol of observers B, C and D. Reanalysis using data from observers B, C and D reduced the mean inter-observer variation in T(vol) to 13.3% (95% CI: 11.9, 14.7%). A correction factor for the systematic difference of operator A for the P50 and P97 of T(vol) was estimated using analysis of covariance. When applied to the WHO/ICCIDD reference data, it sharply reduced the discrepancy between the WHO/ICCIDD criteria and those from other iodine-sufficient children around the world. CONCLUSIONS: Inter-equipment error contributes minimally to reported differences in sonographic T(vol). Even among experienced examiners, inter-observer variation in sonographic T(vol) in children can be high, and probably contributes to the current disagreement on normative values in iodine-sufficient children. A systematic bias at least partially explains why the WHO/ICCIDD reference data differ from those reported from other iodine-sufficient children around the world. The findings argue strongly for the standardization of methods used for sonographic measurement of T(vol) in children.

Child↗
PubMed1983

Flow microfluorometric analysis of living spermatozoa stained with Hoechst 33342.

Bovine spermatozoa were stained with Hoechst 33342. The fluorescence distribution of stained spermatozoa was complex. Non-motile spermatozoa displayed a higher fluorescence than did motile spermatozoa. The fluorescence profile of the motile spermatozoa was bimodal. Sort and reanalysis, and orientation experiments suggested that there are two distinct populations of motile spermatozoa.

Animals↗
PubMed2004

Tree scanning: a method for using haplotype trees in phenotype/genotype association studies.

We use evolutionary trees of haplotypes to study phenotypic associations by exhaustively examining all possible biallelic partitions of the tree, a technique we call tree scanning. If the first scan detects significant associations, additional rounds of tree scanning are used to partition the tree into three or more allelic classes. Two worked examples are presented. The first is a reanalysis of associations between haplotypes at the Alcohol Dehydrogenase locus in Drosophila melanogaster that was previously analyzed using a nested clade analysis, a more complicated technique for using haplotype trees to detect phenotypic associations. Tree scanning and the nested clade analysis yield the same inferences when permutation testing is used with both approaches. The second example is an analysis of associations between variation in various lipid traits and genetic variation at the Apolipoprotein E (APOE) gene in three human populations. Tree scanning successfully identified phenotypic associations expected from previous analyses. Tree scanning for the most part detected more associations and provided a better biological interpretative framework than single SNP analyses. We also show how prior information can be incorporated into the tree scan by starting with the traditional three electrophoretic alleles at APOE. Tree scanning detected genetically determined phenotypic heterogeneity within all three electrophoretic allelic classes. Overall, tree scanning is a simple, powerful, and flexible method for using haplotype trees to detect phenotype/genotype associations at candidate loci.

Alcohol Dehydrogenase↗
PubMed2004

Accuracy and power of statistical methods for detecting adaptive evolution in protein coding sequences and for identifying positively selected sites.

The parsimony method of Suzuki and Gojobori (1999) and the maximum likelihood method developed from the work of Nielsen and Yang (1998) are two widely used methods for detecting positive selection in homologous protein coding sequences. Both methods consider an excess of nonsynonymous (replacement) substitutions as evidence for positive selection. Previously published simulation studies comparing the performance of the two methods show contradictory results. Here we conduct a more thorough simulation study to cover and extend the parameter space used in previous studies. We also reanalyzed an HLA data set that was previously proposed to cause problems when analyzed using the maximum likelihood method. Our new simulations and a reanalysis of the HLA data demonstrate that the maximum likelihood method has good power and accuracy in detecting positive selection over a wide range of parameter values. Previous studies reporting poor performance of the method appear to be due to numerical problems in the optimization algorithms and did not reflect the true performance of the method. The parsimony method has a very low rate of false positives but very little power for detecting positive selection or identifying positively selected sites.

Algorithms↗
PubMed2005

Model selection in binary trait locus mapping.

Quantitative trait locus (QTL) mapping methodology for continuous normally distributed traits is the subject of much attention in the literature. Binary trait locus (BTL) mapping in experimental populations has received much less attention. A binary trait by definition has only two possible values, and the penetrance parameter is restricted to values between zero and one. Due to this restriction, the infinitesimal model appears to come into play even when only a few loci are involved, making selection of an appropriate genetic model in BTL mapping challenging. We present a probability model for an arbitrary number of BTL and demonstrate that, given adequate sample sizes, the power for detecting loci is high under a wide range of genetic models, including most epistatic models. A novel model selection strategy based upon the underlying genetic map is employed for choosing the genetic model. We propose selecting the "best" marker from each linkage group, regardless of significance. This reduces the model space so that an efficient search for epistatic loci can be conducted without invoking stepwise model selection. This procedure can identify unlinked epistatic BTL, demonstrated by our simulations and the reanalysis of Oncorhynchus mykiss experimental data.

Animals↗
PubMed2006

Molecular evolution and population genetic analysis of candidate female reproductive genes in Drosophila.

Molecular analyses in several taxa have consistently shown that genes involved in reproduction are rapidly evolving and subjected to positive selection. The mechanism behind this evolution is not clear, but several proposed hypotheses involve the coevolution between males and females. In Drosophila, several male reproductive proteins (Acps) involved in male-male and male-female interactions show evidence of rapid adaptive evolution. What has been missing from the Drosophila literature is the identification and analysis of female reproductive genes. Recently, an evolutionary expressed sequence tag analysis of Drosophila female reproductive tract genes identified 169 candidate female reproductive genes. Many of these candidate genes still await further molecular analysis and independent verification of positive selection. Our goal was to expand our understanding of the molecular evolution of Drosophila female reproductive genes with a detailed polymorphism and divergence study on seven additional candidate female reproductive genes and a reanalysis of two genes from the above study. We demonstrate that 6 candidate female genes of the 9 genes surveyed show evidence of positive selection using both polymorphism and divergence data. One of these proteins (CG17012) is modeled to reveal that the sites under selection fall around and within the active site of this protease, suggesting potential differences between species. We discuss our results in light of potential function as well as interaction with male reproductive proteins.

Animals↗
PubMed1999

Risk factors for early-onset group B streptococcal sepsis: estimation of odds ratios by critical literature review.

OBJECTIVE: To identify and to establish the prevalence of ORs factors associated with increased risk for early-onset group B streptococcal (EOGBS) infection in neonates. streptococcal (EOGBS) infection in neonates. STUDY DESIGN: Literature review and reanalysis of published data. RESULTS: Risk factors for EOGBS infection include group B streptococcal (GBS)-positive vaginal culture at delivery (OR: 204), GBS-positive rectovaginal culture at 28 (OR: 9.64) or 36 weeks gestation (OR: 26. 7), vaginal Strep B OIA test positive at delivery (OR: 15.4), birth weight </= 2500 g (OR: 7.37), gestation <37 weeks (OR: 4.83), gestation <28 weeks (OR: 21.7), prolonged rupture of membranes (PROM) >18 hours (OR: 7.28), intrapartum fever >37.5 degrees C (OR: 4.05), intrapartum fever, PROM, or prematurity (OR: 9.74), intrapartum fever or PROM at term (OR: 11.5), chorioamnionitis (OR: 6.43). Chorioamnionitis is reported in most (88%) cases in which neonatal infection occurred despite intrapartum maternal antibiotic therapy. ORs could not be estimated for maternal GBS bacteriuria during pregnancy, with preterm premature rupture of membranes, or with a sibling or twin with invasive GBS disease, but these findings seem to be associated with a very high risk. Multiple gestation is not an independent risk factor for GBS infection. CONCLUSIONS: h Mothers with GBS bacteriuria during pregnancy, with another child with GBS disease, or with chorioamnionitis should receive empirical intrapartum antibiotic treatment. Their infants should have complete diagnostic evaluations and receive empirical treatment until infection is excluded by observation and negative cultures because of their particularly high risk for EOGBS infection. Either screening with cultures at 28 weeks gestation or identification of clinical risk factors, ie, PROM, intrapartum fever, or prematurity, may identify parturients whose infants include 65% of those with EOGBS infection. Intrapartum screening using the Strep B OIA rapid test identifies more at-risk infants (75%) than any other method. These risk identifiers may permit judicious selection of patients for prophylactic interventions.

Age of Onset↗
PubMed1999

Antimicrobial prevention of early-onset group B streptococcal sepsis: estimates of risk reduction based on a critical literature review.

OBJECTIVE: To identify interventions that reduce the attack rate for early-onset group B streptococcal (GBS) sepsis in neonates. STUDY DESIGN: Literature review and reanalysis of published data. RESULTS: The rate of early-onset GBS sepsis in high-risk neonates can be reduced by administration of antibiotics. Treatment during pregnancy (antepartum prophylaxis) fails to reduce maternal GBS colonization at delivery. With the administration of intravenous ampicillin, the risk of early-onset infection in infants born to women with preterm premature rupture of membranes is reduced by 56% and the risk of GBS infection is reduced by 36%; addition of gentamicin may increase the efficacy of ampicillin. Treatment of women with chorioamnionitis with ampicillin and gentamicin during labor reduces the likelihood of neonatal sepsis by 82% and reduces the likelihood of GBS infection by 86%. Universal administration of penicillin to neonates shortly after birth (postpartum prophylaxis) reduces the early-onset GBS attack rate by 68% but is associated with a 40% increase in overall mortality and therefore is contraindicated. Intrapartum prophylaxis, alone or combined with postnatal prophylaxis for the infants, reduces the early-onset GBS attack rate by 80% or 95%, respectively. CONCLUSIONS: Women with chorioamnionitis or premature rupture of membranes and their infants should be treated with intravenous ampicillin and gentamicin. Intrapartum antimicrobial prophylaxis may be appropriate for other women whose infants are at increased but less extreme risk, and supplemental postpartum prophylaxis may be indicated for some of their infants. Selection of appropriate candidates and prophylaxis strategies requires careful consideration of costs and benefits for each patient. group B streptococcus, neonatal sepsis, early-onset sepsis, prevention, prophylaxis.

Age of Onset↗
PubMed2005

Pediatric residents' responses that discourage discussion of psychosocial problems in primary care.

OBJECTIVE: Studies spanning nearly 4 decades demonstrate that doctors ignore or dismiss many patient bids for discussion of psychosocial topics. We sought to understand characteristics of doctors, patients, and visits in which this occurs. METHODS: Reanalysis of 167 audiotapes from 2 studies of parent-doctor communication in a pediatric residents' continuity clinic was performed. Tapes included visits by 100 mothers or female guardians to 55 residents who were the children's primary care providers. Coders identified mentions of psychosocial topics and noted the content and the doctor's response. Responses were classified with an adaptation of a previously described, psychoanalytically derived typology of avoidant or discouraging responses. RESULTS: Discouraging responses occurred in 34 (77%) of 44 discussions that involved corporal punishment and 51 (34%) of 64 discussions that involved other psychosocial topics. The particular topic (parent/family versus routine parenting issue) and how the topic was framed (as a problem versus simply mentioned) were associated with doctors' discouraging responses (OR: 3.07; 95% confidence interval: 1.56-6.05; and OR: 7.57; 95% confidence interval: 3.50-16.44; respectively). Discouraging responses were not related to the doctor's gender, parent's ethnicity, length of the parent-doctor relationship, or doctor's overall interview style (patient-centeredness). Discouraging responses to routine problems tended to be dismissive, but 41% of discouraging responses to parent/family problems were failed attempts to provide advice. CONCLUSIONS: Discouraging responses seem to be related less to doctor or patient characteristics than to the type and acuity of the psychosocial topic. These responses may originate with doctors' discomfort with particular subject areas and thus might be approached with training that combines communication and emotion-handling skills with clinical tools such as Bright Futures in Practice: Mental Health or the International Classification of Diseases, 10th Revision, Primary Care.

Adolescent↗
PubMed2004

Effect of aggregation of horn fly populations within cattle herds and consequences for sampling to obtain unbiased estimates of abundance.

Reanalysis of counts of horn fly, Hematobia irritans (L.), obtained from a variety of cattle herds indicated that aggregation of the flies within herds decreased as mean fly density increased. Aggregation was also related to the proportion of fly-resistant and fly-susceptible cattle in a herd. Herds were grouped according to their degree of horn fly aggregation. Low aggregation herds included larger framed Angus, Horned Hereford, Polled Hereford, and Red Poll breeds. Moderate aggregation occurred with Brahman, Charolais, small-framed Angus, mixed cows, and Hereford x Charolais cross. High aggregation occurred with Chianina and mixed herds. Relationships between the sample means and variances varied among aggregation groups. A resampling approach was used to determine the influence of random sampling of a herd on the proportion of horn fly population estimates within fixed percentages of the true mean. The proportion of sample means within +/- 5, 10, 15, and 20% of the true means varied with the proportion of the herd sampled, the mean and variance of fly density, and herd size. Recommendations for obtaining sample size to estimate fly density within a fixed percentage of the true mean are given.

Alberta↗
PubMed2000

Intraerythrocytic development of species of Hepatozoon infecting ranid frogs: evidence for convergence of life cycle characteristics among apicomplexans.

Intraerythrocytic development of the adeleorin apicomplexans Hepatozoon clamatae and Hepatozoon catesbianae were investigated in the bullfrog, Rana catesbeiana, the green frog, Rana clamitans melanota, and the Northern leopard frog, Rana pipiens. Merozoites emerging from hepatic meronts penetrated erythrocytes and underwent 1-3 rounds of binary fission to produce 2-8 merozoites. Following their release from infected erythrocytes, individual merozoites entered new cells and transformed into gamonts. Although this is the first report of intraerythrocytic development for a fully described species of Hepatozoon, a phylogenetic reanalysis of 11 species of Hepatozoon, 6 species representative of the 5 other hemogregarine taxa, 2 species of dactylosomatids, and 2 species of piroplasms, indicates that asexual reproduction of parasites within blood cells of vertebrates has arisen at least 3 times in the apicomplexan lineage that includes adeleorins and piroplasms. This method of asexual development, which is also observed in species of hemospororin genera such as Plasmodium, is discussed in the context of the evolution of apicomplexan life cycles. In addition to supporting the paraphyly of the genus Hepatozoon determined in an earlier study, this phylogenetic analysis featured a monophyletic group, consisting of the sister taxa Hemolivia and Karyolysus, that was the sister group to a clade consisting of the more derived hemogregarines, the dactylosomatids, and the piroplasms.

Animals↗
PubMed2026

STRONGYLID COINFECTIONS IN SYMPATRIC CHIMPANZEES AND GORILLAS FROM THE REPUBLIC OF THE CONGO REVEALED BY FECAL METAGENOMICS.

Soil-transmitted strongylid nematodes are common intestinal parasites of African great apes, yet most surveys have relied on microscopy or targeted PCR assays that are limited in taxonomic breadth and comparability across hosts. I reanalyzed 46 publicly available shotgun fecal metagenomes from sympatric central chimpanzees (Pan troglodytes troglodytes; n = 18) and western lowland gorillas (Gorilla gorilla gorilla; n = 28) in the Goualougo Triangle, Nouabal&#xe9;-Ndoki National Park, Republic of the Congo, to test whether host species structures genus-level strongylid community composition and relative read signal. Non-host reads were classified against a custom strongylid-focused database targeting 4 genera repeatedly reported from African apes: Ancylostoma, Necator, Oesophagostomum, and Trichostrongylus. All 4 focal genera were detected in every library under baseline filtering, and multi-genus detection remained robust under increasingly stringent read-count thresholds. However, host species differed strongly in community composition. Chimpanzee libraries had relatively even genus-level profiles, whereas gorilla libraries were consistently Necator-dominated. Gorillas also had substantially higher relative strongylid read abundance. The results show that shotgun metagenomic reanalysis can recover host-structured strongylid community signals from wildlife samples and can complement targeted parasitological surveys in conservation and One Health surveillance.

Animals↗
PubMed2001

Renal function and intensive lowering of blood pressure in hypertensive participants of the hypertension optimal treatment (HOT) study.

This article reports further analyses of the Hypertension Optimal Treatment (HOT) Study data with the aim to describe (1) the value of baseline serum creatinine and its clearance (estimated by Cockroft and Gault formula) as predictors of cardiovascular events, (2) the effects of intensive lowering of BP on cardiovascular events and renal function in patients with reduced renal function, and (3) the effects on cardiovascular events of adding acetylsalicylic acid to antihypertensive therapy in patients with reduced renal function. The results show that (1) baseline elevation in serum creatinine and a reduction in estimated creatinine clearance are powerful predictors of cardiovascular events and death. (2) Reduced renal function at baseline did not preclude the desired control of BP. In contrast to patients with normal renal function, the incidence of major cardiovascular events did not differ in the three groups of patients with mild renal insufficiency randomized to different diastolic BP targets. No significant changes in serum creatinine were seen at the end of the 3.8-yr treatment period in the great majority of patients. However, there was a small group of patients (0.58% of the total study population) whose renal function deteriorated (increase > or =30% over baseline and final serum creatinine concentration > or =2 mg/dl) despite satisfactory reduction of diastolic BP. (3) The results of this reanalysis of the HOT Study suggest though do not prove that the association of acetylsalicylic acid with intensive antihypertensive therapy offers additional benefit in hypertensive patients with reduced renal function.

Aged↗
PubMed2006

Implicating an introduced generalist parasitoid in the invasive browntail moth's enigmatic demise.

Recent attention has focused on the harmful effects of introduced biological control agents on nontarget species. The parasitoid Compsilura concinnata is a notable example of such biological control gone wrong. Introduced in 1906 primarily for control of gypsy moth, Lymantria dispar, this tachinid fly now attacks more than 180 species of native Lepidoptera in North America. While it did not prevent outbreaks or spread of gypsy moth, we present reanalyzed historical data and experimental findings suggesting that parasitism by C. concinnata is the cause of the enigmatic near-extirpation of another of North America's most successful invaders, the browntail moth (Euproctis chrysorrhoea). From a range of approximately 160,000 km2 a century ago, browntail moth (BTM) populations currently exist only in two spatially restricted coastal enclaves, where they have persisted for decades. We experimentally established BTM populations within this area and found that they were largely free of mortality caused by C. concinnata. Experimental populations of BTM at inland sites outside of the currently occupied coastal enclaves were decimated by C. concinnata, a result consistent with our reanalysis of historical data on C. concinnata parasitism of the browntail moth. The role of C. concinnata in the disappearance of browntail moth outside these enclaves has not been reported before. Despite the beneficial role played by C. concinnata in reversing the browntail moth invasion, we do not advocate introduction of generalist biological control agents. Our findings illustrate that the impact of such organisms can be both unpredictable and far-reaching.

Animals↗
PubMed2005

Use and toxicity of pyrethroid pesticides in the Central Valley, California, USA.

The use of pyrethroid insecticides is increasing for agriculture, commercial pest control, and residential consumer use. In addition, there is a trend toward the use of newer and more potent compounds. Little is known about the toxicity of sediment-associated pyrethroid residues to aquatic organisms, yet recent work has shown they commonly are found in aquatic sediments in the heavily agricultural Central Valley of California, USA. Minimal data exist on the sensitivity of standard sediment toxicity testing species to pyrethroids, despite two or more decades of agricultural use of these compounds. Sediment concentrations causing acute toxicity and growth impairment to the amphipod Hyalella azteca were determined for six pyrethroids in three sediments, ranging from 1.1 to 6.5% organic carbon (OC). In order of decreasing toxicity of sediment-associated residues, the compounds tested were bifenthrin (average 10-d median lethal concentration [LC50] = 0.18 microg/g OC), lambda-cyhalothrin (0.45 microg/g OC), deltamethrin (0.79 microg/g OC), esfenvalerate (0.89 microg/g OC), cyfluthrin (1.08 microg/g OC), and permethrin (4.87 microg/g OC). In a sediment containing about 1% OC, most pyrethroids, except permethrin, would be acutely toxic to H. azteca at concentrations of 2 to 10 ng/g dry weight, a concentration only slightly above current analytical detection limits. Growth typically was inhibited at concentrations below the LC50; animal biomass on average was 38% below controls when exposed to pyrethroid concentrations roughly one-third to one-half the LC50. Survival data are consistent with current theory that exposure occurs primarily via the interstitial water rather than the particulate phase. A reanalysis of previously reported field data using these toxicity data confirms that the compounds are exceeding concentrations acutely toxic to sensitive species in many agriculture-dominated water bodies.

Amphipoda↗
PubMed1978

Effects on choice of reinforcement delay and conditioned reinforcement.

Pigeons chose between fixed-interval schedules of different durations presented in the terminal links of concurrent-chains schedules. The pair of schedules was always in the ratio of 2:1, but the absolute duration of the fixed intervals varied. In one set of conditions, the different terminal-link schedules were associated with different keylight stimuli (cued conditions). In a second set of conditions, the different terminal-link schedules were associated with the same stimulus (uncued conditions). Results from the cued conditions replicated previous findings that preference for the shorter fixed-interval schedule increased with fixed-interval duration. Preferences in the uncued conditions were lower than in the corresponding cued conditions but also increased with fixed-interval length. In addition, the degree of control under the uncued conditions was correlated with the extent to which the schedule during the terminal link was discriminated immediately upon entry into the terminal link. The pattern of results in both conditions was inconsistent with the notion that choice behavior matches relative immediacy of reinforcement. Reanalysis of previous evidence for matching (Chung and Herrnstein, 1967) showed that matching in fact did not occur, as the preferences of their subjects for the shorter of two delays also increased with the absolute size of the delays.

Journal Article↗