Initial D: First Stage Episode 3
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The ICP time series were downloaded from a Phillips Intellivue MP40 multiparametric monitor (Philips Healthcare, Inc., Andover, MA) during the experiment (first, second, and third stages) using custom-made software based on the open-source application VSCapture . VSCaptureMP uses the C# .NET/Mono programming platform, and the data capture is based on an event-triggering programming paradigm at the corresponding port. It currently uses either UDP/IP protocol via the LAN or the MIB/RS232 port on the monitor for data logging. It is freely available from , accessed on 3 October 2022), It has been used several times in previously published research [48,50,51,52,53,54,55,56]. The sampling frequency for ICP was 200 Hz. After downloading, the ICP signal was filtered using a band-stop Butterworth filter to remove the power-line noise frequency at 50 Hz. Finally, a low-pass Butterworth filter with a cut-off frequency 60 Hz was applied in order to remove high-frequency noise. The filter order was 4 for all filters used. All data are downloaded to a csv (comma-separated value) format and are accessible from the corresponding author given a reasonable request. All computations were done using Python libraries. Unfortunately, during the first experiment, there were problems in the interface between the monitor and the software, so the first pig experiment was excluded from this paper because its sampling frequency (1 Hz) is not suitable for the tools proposed here.
The NMP is the number of patterns that do not appear in an actual time series and may be related to the ability of a physiological system to adapt to environmental change . We computed normalized NMP for each window and normalized them over 720 in order to obtain a scale bounded between 0 and 1. Figure 5 shows the normalized NMP (red line) along with the ICP waveform (blue line, left y-axis) and ICC (red line, right y-axis) for the four pigs analyzed. In stage 1 (first column), NMP remains almost constant with similar values between pigs (0.92, 0.91, 0.92, and 0.88 for pigs 1, 2, 3, and 4 respectively). During the second stage (second column), ICC and NMP have opposite behavior, one ICC growth, NMP decreases, and vice versa. is correlated with ICP; when ICP increases, the proportion of NMP also increases. However, this association is not as robust as the relationship with PE suggesting that the later fluctuation is not being fully explained solely by an increasing NMP. This is expected since the MPN could show the adaptive capacity of the system and the ICC is the ability of the cranial-spine system to adapt to volume additions. In pig 2 (first row), ICC behaves differently from the rest of the pigs because the ICC does not reach values as low as in the others. This is because the brain was more compliant and was better able to contain volume changes.
Background: Little is known regarding parental preference for a one-stage complete repair versus a two-staged approach with initial palliation, followed by repair, of the congenital cardiac malformation. Methods: We interviewed 103 parents of healthy children referred to a clinic for pediatric cardiology. Participants were presented with a hypothetical scenario in which their children had a cardiac lesion requiring surgery. The surgery could be performed either by means of one-stage complete repair, or using a two-stage approach, with palliation first followed by complete repair a year later. The mortality rate for the one-stage repair was set at 5%. Participants were asked to choose between the one- and two-stage approaches, with differing mortality rates for the two-stage approach. The scenarios included options when the two-stage combined mortality rate was lower than the one-stage mortality, and the first stage mortality rate was at 1% and 3%, and when the two-stage combined mortality rate was the same as that for one-stage mortality, these being set at 1% and 3%. Results: When the two-stage combined mortality rate was lower than that of the one-stage repair, participants were more likely to choose the two-stage approach if the first stage mortality rate was 1% as compared to 3% (57% and 44%, respectively, p = 0.04). When the two-stage combined mortality rate was the same as the one-stage approach, participants choosing the two-stage approach when the mortality rate was set at 1%, and when it was raised to 3%, were not significantly different (42% and 34%, respectively, p = 0.24). When the combined two-stage mortality was the same as that set for one-stage repair, participants with no insurance were less likely to choose the two-stage approach than those covered by insurance (p = 0.03). Conclusions: In the chosen scenarios, when the mortality for a two-stage combined approach is the same as that for one-staged repair, more parents choose the one-staged repair. If the two-stage combined mortality is lower than that for one-staged repair, parents are more likely to choose the two-stage repair if the mortality for the first stage is lower. When the mortality rates for the one-stage and two-stage approaches are the same, people without insurance are more likely to choose one-staged repair.
We designed a multi-hospital prospective study of children less than 12 years to determine the comparative clinical profile, severity of carditis, and outcome on follow up of patients suffering an initial and recurrent episodes of acute rheumatic fever. The study extended over a period of 3 years, with diagnosis based on the Jones criteria. We included 161 children in the study, 57 having only one episode and 104 with recurrent episodes. Those seen in the first episode were differentiated from those with recurrent episodes on the basis of the history. The severity of carditis was graded by clinical and echocardiographic means. In those suffering their first episode, carditis was significantly less frequent (61.4%) compared to those having recurrent episodes (96.2%). Arthritis was more marked in the first episode (61.4%) compared to recurrent episodes (36.5%). Chorea was also significantly higher in the first episode (15.8%) compared to recurrent episodes (3.8%). Sub-cutaneous nodules were more-or-less the same in those suffering the first (7%) as opposed to recurrent episodes (5.8%), but Erythema marginatum was more marked during the first episode (3.5%), being rare in recurrent episodes at 0.9%. Fever was recorded in approximately the same numbers in first (45.6%) and recurrent episodes (48.1%). Arthralgia, in contrast, was less frequent in first (21.1%) compared to recurrent episodes (32.7%). A history of sore throat was significantly increased amongst those suffering the first episode (54.4%) compared to recurrent episodes (21.2%). When we compared the severity of carditis in the first versus recurrent episodes, at the start of study mild carditis was found in 29.8% versus 10.6%, moderate carditis in 26.3% versus 53.8%, and severe carditis in 5.3% versus 31.8% of cases, respectively. At the end of study, 30.3% of patients suffering their first episode were completely cured of carditis, and all others showed significant improvement compared to those with recurrent episodes, where only 6.8% were cured, little improvement or deterioration being noted in the remainder of the patients. We conclude that the clinical profile of acute rheumatic fever, especially that of carditis, is milder in those suffering their first attack compared to those with recurrent episodes. 781b155fdc