Fill Pattern Research Articles

Influence of Esophagogastroduodenoscopy (EGD) on Prescription (Rx) Fill Patterns for Proton Pump Inhibitors (PPIs) and Nonselective Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) among Type-2 Diabetic (T2D) and Nondiabetic Patients

Purpose: To examine the effect of EGD on Rx fill patterns for PPIs and nonselective NSAIDs in T2D and nondiabetic patients. Methods: Data on patients aged ≥18 y in the MarketScan administrative claims database with full enrollment data for 180 d pre- and post-EGD from 2000–2005 were extracted (D9612L00108). EGD was identified by CPT codes; T2D patients were identified as having ≥2 medical claims for T2D by ICD-9 codes or ≥2 oral antidiabetic Rxs; and nondiabetic patients were identified as having no ICD-9 codes for any type of diabetes or Rxs for antidiabetic medications. PPI and nonselective NSAID use were defined by national drug codes. T2D patients who underwent EGD were matched 1:1 with nondiabetic patients by age and gender. McNemar's test was used for proportion differences pre- and post-EGD; χ2 tests were used for differences between independent cohorts. Results: Of the 10,546,828 patients in the MarketScan database, 9,373,650 had no diabetes; 953,766 had T2D; 219,412 had other types of diabetes. In the matched population (N = 39,636 for each group), post-EGD, Rx fills increased for PPIs and decreased for nonselective NSAIDs (Table). Among patients already taking PPIs, 80.3% continued to use them post-EGD. Among patients not taking PPIs pre-EGD, 38.3% began using them post-EGD. The percentage of patients adding a PPI post-EGD was higher (P < .0001) for patients using (44.6%) than not using nonselective NSAIDs (37.9%). Of patients who took nonselective NSAIDs, 56.7% discontinued use post-EGD, and this proportion was lower (P < .0001) in patients who took (52.4%) than those who did not take concomitant PPIs (59.9%). No meaningful differences were seen between the T2D and nondiabetic groups. Conclusion: PPI use increased and nonselective NSAID use decreased post-EGD. Most patients who took only a nonselective NSAID pre-EGD discontinued NSAID use or had a PPI added to their regimen post-EGD. These results suggest that EGD findings had a direct effect on Rx fill patterns.Table: Rx Fills for PPIs and Nonselective NSAIDs Pre- and Post-EGD

Time evolution of coupled-bunch modes from beta function variation in storage rings

We present an analytical and numerical study of the equations of motion for bunches coupled by transverse wakefields. We base our study on a recent lattice design for the damping rings in the baseline configuration of the International Linear Collider. Using the macroparticle model, and assuming resistive wall wakefield coupling, we present numerical results on the time evolution of the multibunch modes. Decay modes display growth after initial decay, and mode amplitudes exhibit high-frequency oscillations. These phenomena are not expected if the beta function is assumed to have a constant, averaged value. We show analytically that they can come from coupling between modes caused by variation of the beta function in a real lattice. The effect is shown to be comparable to the effect of a nonuniform fill pattern and significantly larger than that of the higher-order mode wakefield localized in the rf cavities. Turning to the case of constant beta function, we develop a more complete treatment of the equations of motion. We derive general formulas for the bunch trajectories, and show that such formulas can only be valid in the limit of small wakefield coupling.

Automation of Vegetation Symbol Placement on Ordnance Survey® 1:50 000 Scale Maps

The subject of this article is automated symbolization of area features using cartographic symbol fills. The work strives to improve upon the standard 'wallpaper' fill patterns available inmost GIS. Research focuses, specifically on automation of vegetation symbol placement for Ordnance Survey 1:50 000 scale maps. Algorithms are developed for optimising the diagonal grid and semi-random placement patterns, based on an analysis of the current mapping. The algorithms are tested on a large dataset containing woodland polygons. The initial results are evaluated by Ordnance Survey cartographers, the parameters are fine-tuned and the final output is demonstrated to be cartographically sound.

Energy-dispersive diffraction with synchrotron radiation and a germanium detector

The response of an intrinsic Ge detector in energy-dispersive diffraction measurements with synchrotron radiation is studied with model calculations and diffraction from perfect Si single-crystal samples. The high intensity and time-structure of the synchrotron radiation beam leads to pile-up of the output pulses, and the energy distribution of the pile-up pulses is characteristic of the fill pattern of the storage ring. The pile-up distribution has a single peak and long tail when the interval of the radiation bunches is small, as in the uniform fill pattern, but there are many pile-up peaks when the bunch distance is a sizable fraction of the length of the shaping amplifier output pulse. A model for the detecting chain response is used to resolve the diffraction spectrum from a perfect Si crystal wafer in the symmetrical Laue case. In the 16-bunch fill pattern of the ESRF storage ring the spectrum includes a large number of ;extra reflections' owing to pile-up, and the model parameters are refined by a fit to the observed energy spectrum. The model is used to correct for the effects of pile-up in a measurement with the 1/3 fill pattern of the storage ring. Si reflections (2h,2h,0) are resolved up to h = 7. The pile-up corrections are very large, but a perfect agreement with the integrated intensities calculated from dynamical diffraction theory is achieved after the corrections. The result also demonstrates the convergence of kinematical and dynamical theories at the limit where the extinction length is much larger than the effective thickness of the perfect crystal. The model is applied to powder diffraction using different fill patterns in simulations of the diffraction pattern, and it is demonstrated that the regularly spaced pile-up peaks might be misinterpreted to arise from superlattices or phase transitions. The use of energy-dispersive diffraction in strain mapping in polycrystalline materials is discussed, and it is shown that low count rates but still good statistical accuracy are needed for reliable results.

Transmitral Flow Patterns and the Presence of Chronic Kidney Disease Provide Independent and Incremental Prognostic Information in Patients with Heart Failure and Systolic Dysfunction

Transmitral flow patterns derived from Doppler echocardiography carry prognostic information in patients with chronic heart failure and systolic dysfunction. In such patients, chronic kidney disease (CKD) defined as a reduction in estimated glomerular filtration rate less than 60 mL/min/1.73 m(2) is frequent, but its prognostic impact relative to that of transmitral flow patterns is unknown. This prospective study enrolled 292 patients with stable chronic heart failure and systolic dysfunction (mean ejection fraction 30 +/- 10), of whom 148 had CKD. Echocardiographic measurements comprised left ventricular dimensions/volumes, ejection fraction, the ratio of early (E) to late (A) transmitral flow velocity, deceleration time, and tissue Doppler mitral annular velocities. The mitral filling pattern (FP) was classified as either restrictive FP (RFP) or non-RFP. A cardiac event (cardiac death or urgent cardiac transplantation) was defined as combined study end point. During a follow-up of 497 +/- 373 days, 45 patients had a cardiac event (cardiac death, n = 42; urgent cardiac transplantation, n = 3). On multivariate Cox analysis including clinical and echocardiographic variables, independent prognostic predictors were RFP (hazard ratio: 2.77, 95% confidence interval 1.28-6.09), CKD (hazard ratio: 2.79, 95% confidence interval 1.24-6.28), and left atrial diameter. In patients with RFP, the prognosis was markedly worse in the presence of CKD as compared with the absence (event-free survival of 23% vs 83%, P = .03). Similarly, in patients with non-RFP, outcome was worse in the presence of CKD (event-free survival of 71% vs 88%, P = .003). In patients with chronic heart failure and systolic dysfunction, the presence of CKD adds incremental value to transmitral flow patterns in determining the prognosis.

Restrictive Filling Pattern is a Powerful Predictor of Heart Failure Events Postacute Myocardial Infarction and in Established Heart Failure: A Literature-Based Meta-Analysis

Two recent literature-based meta-analyses revealed that restrictive filling pattern (RFP) was associated with a 4-fold increase in the risk of death in patients with heart failure (HF) and postacute myocardial infarction (AMI). This similar but unique analysis evaluated the link between RFP and morbidity. Prospective echocardiographic studies of patients post-AMI and with HF that reported HF morbidity were identified. Events (post-AMI: development of HF; HF: HF readmission) were compared between patients with and without RFP in both patient groups. Review Manager version 4.2.7 software was used for the analysis. Twelve post-AMI studies (1286 patients, 271 events) and 5 HF studies (647 patients, 176 events) were identified. RFP was associated with HF readmission in the HF patients (OR 2.96 [2.02-4.33] and development of HF post-AMI (OR 10.10 [7.02-14.51]). The event rate in the RFP group was the same regardless of disease category (49% post-AMI, 42% HF); however, RFP was less prevalent in the post-AMI group (22% versus 39%). This literature-based meta-analysis confirms that RFP is a powerful predictor of HF hospitalization in patients with HF and especially the development of HF post-AMI. This is an important prognostic sign and should be incorporated into routine clinical practice.

The Use of 2 Contrast Filling Patterns in the Diagnosis of a Giant Coronary Aneurysm

A 75-year-old woman was admitted for exertional dyspnea and chest pain that had been present for several months. She denied any past history of medical illness such as hypertension or diabetes, as well as any past history of significant trauma. On physical examination, no definite cardiac murmur was auscultated. A chest x-ray showed a bulging silhouette at the right border of the heart. Electrocardiographic findings showed no significant abnormalities. Two-dimensional echocardiography showed an abnormal echolucent large mass lesion at the right atrial side, suggesting an intraright atrial mass, pericardial cyst, or aneurysm. To determine the exact location of the mass and its relation to the right atrium, a contrast echocardiogram with intravenous agitated …

Investigations of Bunch Filling Patterns to Suppress the Longitudinal Coupled-Bunch Instability at the Pohang Light Source

A longitudinal coupled-bunch instability may be generated at the 2.5 GeV Pohang Light Source (PLS), depending on the parameters of the rf system and the machine parameters of the storage ring. In the near future, one more rf cavity will be inserted into the storage ring to raise stored beam current. Then, the performance of the storage ring may be limited by the longitudinal coupled-bunch instability due to the higher-order modes in the rf cavities as the beam current increases. Accordingly, in order to suppress the longitudinal coupled-bunch instability, the dependence of the longitudinal coupled-bunch instability in the higher beam current on the bunch filling patterns in the ring were intensively investigated by using a simulation method. Our simulation shows that the beam energy spread due to the longitudinal coupled-bunch instability in the ring can be suppressed by choosing optimal bunch filling patterns with empty buckets between bunches and gap buckets.

Volcanic facies architecture of an intra-arc strike-slip basin, Santa Rita Mountains, Southern Arizona

The three-dimensional arrangement of volcanic deposits in strike-slip basins is not only the product of volcanic processes, but also of tectonic processes. We use a strike-slip basin within the Jurassic arc of southern Arizona (Santa Rita Glance Conglomerate) to construct a facies model for a strike-slip basin dominated by volcanism. This model is applicable to releasing-bend strike-slip basins, bounded on one side by a curved and dipping strike-slip fault, and on the other by curved normal faults. Numerous, very deep unconformities are formed during localized uplift in the basin as it passes through smaller restraining bends along the strike-slip fault. In our facies model, the basin fill thins and volcanism decreases markedly away from the master strike-slip fault (“deep” end), where subsidence is greatest, toward the basin-bounding normal faults (“shallow” end). Talus cone-alluvial fan deposits are largely restricted to the master fault-proximal (deep) end of the basin. Volcanic centers are sited along the master fault and along splays of it within the master fault-proximal (deep) end of the basin. To a lesser degree, volcanic centers also form along the curved faults that form structural highs between sub-basins and those that bound the distal ends of the basin. Abundant volcanism along the master fault and its splays kept the deep (master fault-proximal) end of the basin overfilled, so that it could not provide accommodation for reworked tuffs and extrabasinally-sourced ignimbrites that dominate the shallow (underfilled) end of the basin. This pattern of basin fill contrasts markedly with that of nonvolcanic strike-slip basins on transform margins, where clastic sedimentation commonly cannot keep pace with subsidence in the master fault-proximal end. Volcanic and subvolcanic rocks in the strike-slip basin largely record polygenetic (explosive and effusive) small-volume eruptions from many vents in the complexly faulted basin, referred to here as multi-vent complexes. Multi-vent complexes like these reflect proximity to a continuously active fault zone, where numerous strands of the fault frequently plumb small batches of magma to the surface. Releasing-bend extension promotes small, multivent styles of volcanism in preference to caldera collapse, which is more likely to form at releasing step-overs along a strike-slip fault.

Development of Measurement Method for Melt Filling Patterns in Injection Mold by Gate Shutting System

In this study, the authors aimed to develop a simple and highly precise method of measuring inmold melt filling patterns in order to verify the accuracy of CAE analysis in injection molding. Specifically, the measurement method proposed obtains accurate melt filling patterns in the mold by forcibly stopping melt flow at the mold gate using a small air pressure cylinder in the short-shot molding process to prevent melt flow into the cavity after injection process completes. Experiments were then conducted to evaluate the method. The results of measuring melt pressure in the runner and cavity confirmed that the gate shutting system works accurately. From the measurement of the melt filling patterns, it was confirmed that when the conventional short-shot method is applied, errors may occur in the flow front length and shape. These results verify the validity of the short-shot method using the gate shutting system developed.

Modelling and experimental verification of pressure prediction in the in-mould coating (IMC) process for injection moulded parts

In-mould coating (IMC) is carried out by injecting a liquid low viscosity thermosetting material onto the surface of the injection moulded part after it has solidified, while it is still in the mould. The coating then cures and adheres to the substrate. Due to its successful application to exterior body panels made from compression moulded sheet moulding compound, IMC is being developed as an environmentally friendly technology that would ultimately replace painting of injection moulded thermoplastic parts. In the short term, however, we believe IMC has the potential of being a substitute for primers. In a previous paper, we presented a Hele–Shaw based mathematical model to simulate the coating flow during the IMC process assuming the coating to be a power law fluid and using the traditional no-slip boundary condition. This model adequately predicted the fill patterns but did not predict pressures correctly. This deviation has been attributed to slip (or apparent slip) at the wall, as often found in flow through microchannels, due to the microscopic length scale of the flow, and the existence of a high shear rate Newtonian plateau for the coating viscosity. In this paper we present a mathematical model that includes the slip boundary condition and the Carreau viscosity model to properly describe the rheological behaviour of the coating material at high shear rates. The rheological and slip parameters of the coating material were measured using a customized micro slit rheometer. The predicted pressures are compared with experimental results obtained using our IMC pilot facility. It was found that the predicted pressures and coating thickness agree well with the measured values.

What are the Optimal Parameters to Define a Restrictive Filling Pattern in Chronic Heart Failure?

What are the Optimal Parameters to Define a Restrictive Filling Pattern in Chronic Heart Failure?

Doppler Restrictive Filling Pattern is an Independent Predictor of Survival in Patients with Heart Failure of Both Ischaemic and Non-Ischaemic Aetiology—Results from an Individual Patient Meta-Analysis (MeRGE)

Doppler Restrictive Filling Pattern is an Independent Predictor of Survival in Patients with Heart Failure of Both Ischaemic and Non-Ischaemic Aetiology—Results from an Individual Patient Meta-Analysis (MeRGE)

On the design of ultrafast shutters for time-resolved synchrotron experiments

A comprehensive treatment of the limitations and possibilities for single-pulse selection in synchrotron operating modes with approximately 150 ns bunch separation, as occurs in the standard operating mode at the Advanced Photon Source, is presented. It is shown that the strength of available materials and allowable kinetic energy build-up limit single-bunch selection for this separation to sample sizes of approximately 100 microm, and that for minimization of kinetic energy build-up it is preferable to increase the r.p.m. within physically acceptable limits rather than increase the disc radius to obtain a desirable peripheral speed. A slight modification of the equal-bunch spacing standard fill patterns is proposed that allows use of samples as large as 500 microm. The corresponding peripheral speed of the chopper wheel is approximately 600 m s(-1), which is within the limits of high-strength titanium alloys. For smaller samples, peripheral speeds are proportionally lower. Versatility can be achieved with interchangeable chopper wheels and the use of different orientations of the rotation axis relative to the X-ray beam, which opens the possibility of larger, rather than one-of-a-kind, production runs.

Left Ventricular Diastolic Filling Pattern at Doppler Echocardiography and Apoptotic Rate in Fatal Acute Myocardial Infarction

Heart failure is a complex syndrome characterized by impaired emptying and/or impaired filling of the heart chambers. The use of parameters of diastolic function has provided novel tools for risk stratification and management of patients with heart failure. This study evaluated the potential correlation between apoptosis at time of death and left ventricular (LV) diastolic function after acute myocardial infarction. We selected, at routine postmortem examination, 14 subjects who died 10 to 62 days after an acute myocardial infarction and had an available echocardiographic report from the most recent hospital admission. The apoptotic rate was calculated at the region bordering the infarct, using co-localization of in situ end-labeling for deoxyribonucleic acid fragmentation and immunohistochemistry for caspase-3. Transthoracic echocardiographic studies were retrospectively reevaluated and pulse-wave Doppler spectra of mitral inflow were analyzed. LV diastolic function was assessed by measuring the ratio of E peak velocity to A peak velocity and E-wave deceleration time; a ratio of E peak velocity to A peak velocity >or=2 and deceleration time <115 ms were considered a restrictive filling pattern. A restrictive pattern was found in 4 cases (29%). All subjects with a restrictive pattern were symptomatic for New York Heart Association class IV heart failure (100% vs 20%, p = 0.015) and had larger transverse heart diameters at pathology (p = 0.014). The apoptotic rate in the peri-infarct region was significantly higher in patients with a restrictive versus nonrestrictive diastolic pattern (13%, 10 to 14, vs 3%, 1 to 6, p = 0.014). At multivariable analysis that included the restrictive pattern, class IV heart failure, and cardiac diameters, the restrictive pattern remained an independent predictor of increased apoptosis (p = 0.030). In conclusion, patients with severe postinfarction LV diastolic dysfunction had significantly higher rates of cardiomyocyte loss by apoptosis, which may partly explain their unfavorable outcome.

Bunch purity measurement for Diamond

Measurement of the fill pattern of synchrotron storage rings is important for several reasons, including checking the quality of the injection system and the generation of special fill patterns for time-resolved experiments. For the new national X-ray facility based on the Diamond 3 GeV electron storage ring, it is planned to measure the beam quality in a short time of several minutes by using a time-correlated single photon counting method. The method has very good time resolution (50 ps) and high dynamic range (more than six orders of magnitude). In this paper, we describe our experimental setup, a series of tests to evaluate the system limitations using short pulse lasers on laboratory test benches, the existing SRS national X-ray facility, and the third-generation synchrotron radiation facility SLS. Taking all these results together, we are able to predict the system performance for Diamond.

Restrictive Filling Pattern Is a Powerful Predictor of Progression of Heart Failure in Patients with Chronic Heart Failure and Post-Acute Myocardial Infarction: A Literature-Based Meta-Analysis

Background: Restrictive filling pattern (RFP) has been linked to prognosis in patients with chronic heart failure (CHF) and post-AMI. We recently showed in two literature-based meta-analyses (LMA) that the presence of RFP was associated with a 4-fold increase in the risk of death in both groups. This similar analysis evaluated the link between RFP and morbidity. Methods: We searched online databases for prospective studies of patients post-AMI and with CHF. HF events, defined as development of HF for patients post-AMI and HF readmission in patients with existing CHF, were compared between RFP and non-RFP.

Restrictive Filling Pattern Is Independent of Ejection Fraction in Predicting Mortality in Patients with Chronic Heart Failure: Results from an Individual Patient Meta-Analysis (MeRGE)

Restrictive Filling Pattern Is Independent of Ejection Fraction in Predicting Mortality in Patients with Chronic Heart Failure: Results from an Individual Patient Meta-Analysis (MeRGE)

Predictive Value of C-Reactive Protein and Left Ventricular Diastolic Filling Pattern after a Non-ST Elevation Myocardial Infarction

Recent studies have shown that the odds ratio for high-sensitivity C-reactive protein (CRP) in predicting a coronary events in healthy subjects is 1.4, a value substantially less than previously reported. It is unclear whether this extends to acute coronary syndrome patients or if CRP would predict long-term events in this population. We evaluated the predictive value of CRP in patients with non-ST segment elevation myocardial infarction (NSTEMI) as their first manifestation of coronary artery disease and compared it with that of left ventricle diastolic function. Serum CRP concentration measurement and left ventricle diastolic function evaluation were performed in 51 consecutive patients with NSTEMI 48 hours, 3 months, and 6 months after infarction. Patients were followed for 1 year and events comprising the endpoints of death, new myocardial infarction, percutaneous coronary intervention, and coronary artery bypass grafting were reported. Thirty of 51 patients developed the endpoints. Mean CRP concentration in patients who developed any endpoint and those who did not was similar at 48 hours, 3 months, and 6 months. A strong correlation between the presence of impaired relaxation 6 months after the infarction and development of the combined endpoints was noted (P < 0.001). CRP has limited value in predicting future cardiovascular events in subjects with NSTEMI. Other biomarkers or a combination of other biomarkers may be needed to identify patients at high risk. Evaluation of diastolic left ventricular function not during the acute phase but 6 months later could predict adverse outcome in our series.

Single-beat Differentiation Among Left Ventricular Filling Patterns by Pulsed Wave Doppler Echocardiography

We sought to evaluate whether the combination of phantom E wave peak velocity (Ep) to phantom A wave peak velocity (Ap) ratio at the apex (Ep/Ap) and pulsed wave Doppler left ventricular (LV) inflow propagation velocity (LVIPVpw) or the combination of Ep/Ap and Ep/LVIPVpw obtained from the same heartbeat can effectively differentiate LV filling patterns. The study population included 132 patients. They were classified into normal, abnormal relaxation, and pseudonormal/restrictive groups according to the ratio of early to late transmittal filling wave peak velocity (E/A), color M-mode Doppler LV inflow propagation velocity, and E/color M-mode Doppler LV inflow propagation velocity. Standard Doppler parameters of LV filling such as E, A, E/A, and E-wave deceleration time had a bimodal distribution, but LVIPVpw decreased and Ep/LVIPVpw increased progressively with worsening of LV diastolic function (both P < .001). The sensitivity and specificity of combination of Ep/Ap 1 or greater and LVIPVpw less than 77 cm/s or of Ep/Ap 1 or greater and Ep/LVIPVpw greater than 0.87 from the same heartbeat in identifying the pseudonormal/restrictive LV filling pattern were 81% and 95% or 81% and 93%, respectively. In conclusion, with application of range ambiguity phenomenon, it is simple and feasible to differentiate LV filling patterns on the same cardiac cycle by pulsed wave Doppler echocardiography.