Frequent Intervals Research Articles

Pharmacometric and Electrocardiographic Evaluation of Chloroquine and Azithromycin in Healthy Volunteers.

Chloroquine and azithromycin were developed in combination for the preventive treatment of malaria in pregnancy, and more recently were proposed as coronavirus disease 2019 (COVID‐19) treatment options. Billions of doses of chloroquine have been administered worldwide over the past 70 years but concerns regarding cardiotoxicity, notably the risk of torsades de pointes (TdP), remain. This investigation aimed to characterize the pharmacokinetics and electrocardiographic effects of chloroquine and azithromycin observed in a large previously conducted healthy volunteer study. Healthy adult volunteers (n = 119) were randomized into 5 arms: placebo, chloroquine alone (600 mg base), or chloroquine with either 500 mg, 1,000 mg, or 1,500 mg of azithromycin all given daily for 3 days. Chloroquine and azithromycin levels, measured using liquid‐chromatography tandem mass spectrometry, and electrocardiograph intervals were recorded at frequent intervals. Time‐matched changes in the PR, QRS, and heart rate‐corrected JT, and QT intervals were calculated and the relationship with plasma concentrations was evaluated using linear and nonlinear mixed‐effects modeling. Chloroquine and azithromycin pharmacokinetics were described satisfactorily by two‐ and three‐compartment distribution models, respectively. No drug–drug interaction between chloroquine and azithromycin was observed. Chloroquine resulted in concentration‐dependent prolongation of the PR, QRS, JTc and QTc intervals with a minimal additional effect of azithromycin. QRS widening contributed ~ 28% of the observed QT prolongation. Chloroquine causes significant concentration‐dependent delays in both ventricular depolarization and repolarization. Co‐administration of azithromycin did not significantly increase these effects. The arrhythmogenic risk of TdP associated with chloroquine may have been substantially overestimated in studies which did not separate electrocardiograph QRS and JT prolongation.

Impact of 2015 Earthquake on Educational Attainment of Children in Nepal

Background: Natural disaster has far-reaching consequences on the economic development of low-income economies due to the damage to physical and human capital and their poor resilience toward such damages. Nepal faces such disasters at frequent intervals without much effort to account for its consequences, particularly on human capital.
 Objective: This study assesses the short-term impact of Nepal's 2015 earthquake on children's educational attainment. The study also conducts heterogeneous analysis to analyze how the impact varies by gender. Secondary school completion is chosen as a measure of educational attainment.
 Method: The study utilizes second and third rounds of household survey data taken from the Nepal Risk and Vulnerability Survey (NHRVS) conducted by the World Bank. The study uses child fixed effects combined with the difference-in-difference method to account for issues relating to identifying the earthquake's impact on educational attainment.
 Results: The study finds that the cohorts exposed to the earthquake had an adverse effect on the probability of secondary school completion. A heterogeneous analysis by gender further reveals that the male children experienced a significant drop in their secondary school completion probability while female children essentially had no impact.
 Implication: The quality of human resources depends upon the quality of health and education in any country. The findings of this research draw the attention of the policymakers to the serious consequences that natural disaster has on human capital and help make informed policy decisions not only during the recovery process but also during the planning and policy formulation stage.
 Originality: This paper is original and has not been published anywhere else.

A STUDY TO ASSESS THE KNOWLEDGE REGARDING RISK OF COMPLICATION AND THEIR PREVENTION AMONG PATIENTS UNDERGOING HAEMODIALYSIS AT TERTIARY CARE HOSPITAL, JODHPUR

INTRODUCTION: Haemodialysis is a method for removing waste products such as potassium and urea, as well as free water from the blood when the kidneys are in renal failure. Haemodialysis is one of three renal replacement therapies1. Accuracy of figures on RRT prevalence may vary, as few countries have comprehensive dialysis and transplant registries, hence underreporting may be an issue. It is clear, however, that large numbers of people in low- and middle-income countries LMIC die from kidney failure without receiving any treatment. AIM OF THE STUDY: Assess the knowledge regarding risk of complication and their prevention among patients undergoing haemodialysis at tertiary care hospital. MATERIAL AND METHOD: A descriptive study was carried out on 60 patients undergoing hemodialysis at tertiary care hospital Jodhpur. Samples were selected by using Non Probability Purposive Sampling Technique. Data was collected using structured knowledge questionnaire and analyzed by using descriptive and inferential statistics. RESULT: The findings of the study reveals that (53.33%) of patients undergoing haemodialysis had average level of knowledge, the remaining (33.33%) had poor level of knowledge, (13.33%) had good level of knowledge regarding risk of complication and their prevention among patients undergoing haemodialysis. However there was no significant association found between knowledge and selected demographic variables except qualification, types of residence. CONCLUSION: It can be reiterated that patient have average knowledge regarding risk of complication and their prevention as per current research recommendations. They require Regular education program for patients in frequent intervals should be carried out regarding risk of complication and their prevention. KEY WORDS: Knowledge, risk of complication, patients undergoing hemodialysis,

All-cause mortality prediction in T2D patients with iTirps

Mortality in the type II diabetic elderly population can sometimes be prevented through intervention, for which risk assessment through predictive modeling is required. Since Electronic Health Records data are typically heterogeneous and sparse, the use of Temporal Abstraction and time intervals mining to discover frequent Time Intervals Related Patterns (TIRPs) is employed. While TIRPs are used as features for a predictive model, the temporal relations between them in general, and among each TIRP's instances are not represented. We introduce a novel TIRP based representation called integer-TIRP (iTirp) in which the TIRPs become channels containing values that represent the TIRP instances that were detected at each time point. Then the iTirp representation is fed into a Deep Learning architecture, that learns this kind of temporal relations, using a Recurrent Neural Network or a Convolutional Neural Network. Additionally, a predictive committee is introduced in which raw data and iTirp data are concatenated as inputs. Our results show that iTirps based models outperform the use of deep learning with raw data, resulting in 82% AUC.

Impact of the Dates of Input Image Pairs on Spatio-Temporal Fusion for Time Series with Different Temporal Variation Patterns

Dense time series of remote sensing images with high spatio-temporal resolution are critical for monitoring land surface dynamics in heterogeneous landscapes. Spatio-temporal fusion is an effective solution to obtaining such time series images. Many spatio-temporal fusion methods have been developed for producing high spatial resolution images at frequent intervals by blending fine spatial images and coarse spatial resolution images. Previous studies have revealed that the accuracy of fused images depends not only on the fusion algorithm, but also on the input image pairs being used. However, the impact of input images dates on the fusion accuracy for time series with different temporal variation patterns remains unknown. In this paper, the impact of input image pairs on the fusion accuracy for monotonic linear change (MLC), monotonic non-linear change (MNLC), and non-monotonic change (NMC) time periods were evaluated, respectively, and the optimal selection strategies of input image dates for different situations were proposed. The 16-day composited NDVI time series (i.e., Collection 6 MODIS NDVI product) were used to present the temporal variation patterns of land surfaces in the study areas. To obtain sufficient observation dates to evaluate the impact of input image pairs on the spatio-temporal fusion accuracy, we utilized the Harmonized Landsat-8 Sentinel-2 (HLS) data. The ESTARFM was selected as the spatio-temporal fusion method for this study. The results show that the impact of input image date on the accuracy of spatio-temporal fusion varies with the temporal variation patterns of the time periods being fused. For the MLC period, the fusion accuracy at the prediction date (PD) is linearly correlated to the time interval between the change date (CD) of the input image and the PD, but the impact of the input image date on the fusion accuracy at the PD is not very significant. For the MNLC period, the fusion accuracy at the PD is non-linearly correlated to the time interval between the CD and the PD, the impact of the time interval between the CD and the PD on the fusion accuracy is more significant for the MNLC than for the MLC periods. Given the similar change of time intervals between the CD and the PD, the increments of R2 of fusion result for the MNLC is over ten times larger than those for the MLC. For the NMC period, a shorter time interval between the CD and the PD does not lead to higher fusion accuracies. On the contrary, it may lower the fusion accuracy. This study suggests that temporal variation patterns of the data must be taken into account when selecting optimal dates of input images in the fusion model.

On the Effectiveness of Stock Index Futures for Tail Risk Protection

This paper examines the effectiveness of using stock index futures contracts as substitutes for fixed-income securities in implementing expected shortfall targeting strategy. We find that the futures-based implementation outperforms its index-and-bill counterpart both in terms of downside protection and risk-adjusted performance at daily rebalancing frequency. This outperformance is driven not only by the transaction cost advantage, but also by the replication imperfections due to futures mispricing providing over the long term a better participation in upward market movements. When less frequent rebalancing intervals are used, the futures-based implementation becomes less effective at protecting the downside risk but still capture better the upside potential of the index.

Durable and dynamic hTERT immune responses following vaccination with the long-peptide cancer vaccine UV1: long-term follow-up of three phase I clinical trials

BackgroundTherapeutic cancer vaccines represent a promising approach to improve clinical outcomes with immune checkpoint inhibition. UV1 is a second generation telomerase-targeting therapeutic cancer vaccine being investigated across multiple indications. Although...

Trans-Renal Cell-Free Tumor DNA for Urine-Based Liquid Biopsy of Cancer.

Cancer biomarkers are a promising tool for cancer detection, personalization of therapy, and monitoring of treatment response or recurrence. “Liquid biopsy” commonly refers to minimally invasive or non-invasive sampling of a bodily fluid (i.e., blood, urine, saliva) for detection of cancer biomarkers such as circulating tumor cells or cell-free tumor DNA (ctDNA). These methods offer a means to collect frequent tumor assessments without needing surgical biopsies. Despite much progress with blood-based liquid biopsy approaches, there are limitations—including the limited amount of blood that can be drawn from a person and challenges with collecting blood samples at frequent intervals to capture ctDNA biomarker kinetics. These limitations are important because ctDNA is present at extremely low levels in plasma and there is evidence that measuring ctDNA biomarker kinetics over time can be useful for clinical prediction. Additionally, blood-based assays require access to trained phlebotomists and often a trip to a healthcare facility. In contrast, urine is a body fluid that can be self-collected from a patient’s home, at frequent intervals, and mailed to a laboratory for analysis. Multiple reports indicate that fragments of ctDNA pass from the bloodstream through the kidney’s glomerular filtration system into the urine, where they are known as trans-renal ctDNA (TR-ctDNA). Accumulating studies indicate that the limitations of blood based ctDNA approaches for cancer can be overcome by measuring TR-ctDNA. Here, we review current knowledge about TR-ctDNA in urine as a cancer biomarker approach, and discuss its clinical potential and open questions in this research field.

Characterizing the Over-indebted: An Event History Analysis of Financial Diaries

Low-income households (HHs) face vagaries in income and expenses. These often require the HH to borrow and can cause the HH to become over-indebted. Financial Diaries capture information on incomes, expenses, loans, and shocks with fine granularity and at frequent intervals. In this article, such a dataset is analyzed using the event history analysis approach in order to quantify the risk of HHs becoming over-indebted. Over-indebtedness is defined using two rubrics: monthly debt-to-income ratio and sacrifices made by the HH. The results of this analysis may be used by institutions to customize financial instruments based on the characteristics of an HH. JEL Codes: C410, C810, C830

Intraperitoneal Instillation of Ropivacaine 0.375% with Dexmedetomidine vs Ropivacaine 0.375% with Clonidine for Postoperative Analgesia in Laproscopic Cholecystectomy: A Comparative Study

Introduction: Laproscopic Cholecystectomy is a standard technique for symptomatic cholelithiasis. It is most commonly performed day care surgery. On the day of surgery pt experiences vague abdominal and shoulder pain. As the discharge is delayed due to lack of adequate analgesia, provision of adequate analgesia is of utmost importance. Objective: To compare the efficacy of postoperative analgesia after intraperitoneal instillation of 0.375% Ropivacaine with Dexmedetomidine vs 0.375% Ropivacaine with Clonidine Materials and Methods: 40 patients posted for laproscopic cholecystectomy were randomly divided into two groups A and B. Group A received 20 ml of 0.375% Ropivacaine with 1mcg/ kg of Dexmedetomididne and Group B received 0.375% Ropivacaine with 1mcg/Kg Clonidine intraperitoneally through the 10mm supraumbilical port before closure. Pain was recorded on Visual Analog Scale at frequent intervals for 24 hrs postoperatively and categorised as either mild, moderate or severe. Inj. Diclofenac 75mg iv was administered as rescue analgesic in pts with moderate to severe pain. Results: PostoperativeVAS score showed a statistically significant difference between both groups with lower values in Group A compared to Group B. (P< 0.05 ). The amount of rescue analgesia used was also less with dexmedetomidine as adjuvant. Conclusion: Ropivacaine 0.375% with 1mcg/kg Dexmedetomidine provided better postoperative analgesia and significantly less requirement of rescue analgesia as compared to 0.375% Ropivacaine with 1mcg/kg clonidine.

The Real-World Characteristics of Gender-Affirming Hormonal Use Among Transgender People in Thailand.

BackgroundMost Thai transgender people (TG) do not use gender-affirming hormone therapy (GAHT) under medical supervision.AimTo understand the current real-world characteristics of GAHT among TG.MethodsA cross-sectional survey was conducted using an online questionnaire between September and December 2020. TG, who resided in Thailand for more than 1 year, were included. Self-reported demographic data and characteristics of GAHT were obtained. The reported GAHT were compared to the reference regimen recommended by the 2017 Endocrine Society Clinical Practice Guideline.OutcomesThe characteristics of GAHT used among TG and factors associated with hormonal use outside the reference regimen were reported.ResultsA total of 401 TG were included in the analysis. Of these, 249 (62%) were transgender men (TM). Most TM (81%) and transgender women (88%) were using GAHT. Only 297 TG provided a complete hormone regimen. A total of 224 TG (75%) used GAHT outside the reference regimen. The main reasons in TM were using intramuscular testosterone with a higher dose per injection and less frequent intervals. In transgender women, using oral contraceptive pills and cyproterone acetate 12.5 mg/d were the two most common reasons. A univariate analysis revealed factors associated with hormonal use outside the reference regimen, including age at a survey participation (OR 1.04, 95%CI 1.00–1.08, P = .047), age at hormone initiation (OR 1.04, 95%CI 1.01–1.08, P = .015), TM (OR 2.08, 95%CI 1.22–3.56, P = .007) and using GAHT, not under medical supervision (OR 1.78, 95%CI 1.04–3.05, P = .037). The multivariate analysis showed that only living outside the capital city was solely statistically significant (AOR 1.77, 95%CI 1.02–3.05, P = .041).Clinical ImplicationsEnhancing health literacy in GAHT among TG is crucial, especially TG not living in the capital city.Strengths and LimitationsThis study demonstrates a current real-world practice of GAHT use among TG, both under and not under medical care. However, the causality could not be concluded due to the nature of the cross-sectional observation study, and results come with a recall bias.ConclusionThere is a high prevalence of GAHT use outside the reference regimen. The only factor associated with hormonal use outside the reference regimen is living outside the capital city.Ittiphisit S, Amponnavarat S, Manaboriboon N, et al. The Real-World Characteristics of Gender-Affirming Hormonal Use Among Transgender People in Thailand. Sex Med 2022;10:100513.

Insight into the uptake, accumulation, and metabolism of the fungicide phenamacril in lettuce (Lactuca sativa L.) and radish (Raphanus sativus L.)

The fungal species Fusarium can cause devastating disease in agricultural crops. Phenamacril is an extremely specific cyanoacrylate fungicide and a strobilurine analog that has excellent efficacy against Fusarium. To date, information on the mechanisms involved in the uptake, accumulation, and metabolism of phenamacril in plants is scarce. In this study, lettuce and radish were chosen as model plants for a comparative analysis of the absorption, accumulation, and metabolic characteristics of phenamacril from a polluted environment. We determined the total amount of phenamacril in the plant-water system by measuring the concentrations in the solution and plant tissues at frequent intervals over the exposure period. Phenamacril was readily taken up by the plant roots with average root concentration factor ranges of 60.8–172.7 and 16.4–26.9 mL/g for lettuce and radish, respectively. However, it showed limited root-to-shoot translocation. The lettuce roots had a 2.8–12.4-fold higher phenamacril content than the shoots; whereas the radish plants demonstrated the opposite, with the shoots having 1.5 to 10.0 times more phenamacril than the roots. By the end of the exposure period, the mass losses from the plant-water systems reached 72.0% and 66.3% for phenamacril in lettuce and radish, respectively, suggesting evidence of phenamacril biotransformation. Further analysis confirmed that phenamacril was metabolized via hydroxylation, hydrolysis of esters, demethylation, and desaturation reactions, and formed multiple transformation products. This study furthers our understanding of the fate of phenamacril when it passes from the environment to plants and provides an important reference for its scientific use and risk assessment.

Acaricide Resistance in Field-Collected Two-Spotted Spider Mite Tetranychus urticae Koch

Two spotted spider mite Tetranychus urticae Koch is an economically serious pest posing threat to major vegetable crops. Roving survey in and around Coimbatore region revealed that farmers do not target mites with acaricides instead they use higher dose of insecticides at frequent intervals which results in development of resistance. The bioassay results revealed that fenpropathrin (2.07 to 6.86-folds) and fenazaquin (2.74 to 7.13-folds) exhibit higher susceptibility, whereas diafenthiuron (5.35 to 12.25-folds) revealed a low to moderate level of resistance. The propargite (43.80 to 60.63-folds) and chlorfenapyr (61.01 to 75.10-folds) exhibited high resistance, followed by spiromesifen (222.28 to 300.26-folds) and buprofezin (382.60 to 417.87-folds), with extremely high level of resistance. The higher specific activity of GST (4.54-folds), MFO (10.06-folds) and CarE (15.06-folds) in Puthupalayam population suggested the role of biochemical resistance. A significant positive correlation was observed between diafenthiuron and CarE activity (r = 0.981*), fenpropathrin and MFO activity (r = 0.964*).

​Effect of Moisture Regimes, FYM and Levels of Phosphorus Carriers on Growth, Yield Attributes and Yield by Potato (Solanum tuberosum L.)

Background: Potato (Solanum tuberosum L.) ranks fourth in terms of worldwide production. The states of Uttar Pradesh, West Bengal, Bihar and Gujarat accounted for more than 80 per cent share in total production; India ranks second, next to China in global production of potato. Potato crop is extremely sensitive to the deficit or surplus moisture and requires an optimum amount of irrigation at frequent intervals for its proper growth. Phosphorus (P) is an element that is potatoes require in large amounts following Nitrogen and Potassium, P application rates influence on the P efficiency for tuber yield and P uptake. Methods: In field study, total 36 treatment combinations consisting of three moisture regimes as main plot treatment and 12 combinations of two levels of FYM, three levels of P, carriers as sub-plot treatments evaluated in split plot design with three replications using potato variety Kufri pukhraj as test crop. Result: Among different moisture regimes tested, the treatment receiving maintenance of moisture between 100 and 75 per cent availability at 0-30 cm soil depth (W1) gave significantly higher plant height (52.24 cm), number of tubers per plant (6.74), total tuber yield (335.74 q/ha) and haulm yield (16.64 q/ha) during pooled results. Combinations of FYM and levels of P carriers tested, the treatment combinations FYM and application of P @ 180 kg P2O5/ha in the form of MAP(P3S1M1) showed significantly higher plant height (50.04 cm), tuber per plant (6.87), total tuber yield (323.98 q/ha) and haulm yield (17.16 q/ha) gave during pooled results.

A study of microalbuminuria in patients with type 2 diabetes mellitus, visiting tertiary care center Sangli

Diabetic nephropathy is accompanied with significant micro vascular risk and is the leading cause of kidney disease. Hence there is an immense need to detect early for better quality of the care of affected patients and treat effectively those at high risk of diabetic kidney disease. Our study was aimed to assess the levels of microalbuminuria, glycated hemoglobin, urinary creatinine, urinary albumin to creatinine ratio (ACR) along with blood urea and serum creatinine in patients with type 2 DM, and to observe the incidence of microalbuminuria at tertiary care center; and correlate the presence of microalbuminuria to the duration of DM as well as with ACR. : Estimation of Blood sugar, Blood Urea, Serum Creatinine, Glycosylated hemoglobin (HbA1c), Urinary micro albumin and creatinine was done. Values of urinary creatinine, microalbumin, urinary albumin to creatinine ratio (ACR) showed highly significant (p<0.000) difference between the two age groups a) below 60 years and b) above 60 years of the age. Highly significant difference (p<0.000) was found among the results of the three groups based on duration of diabetes. We found microalbuminuria was more predominant in patients having age more than 60 years as well as in patients having more than 10 years of duration of DM. Routine screening for microalbuminuria in type 2 diabetic patients will certainly helpful for early detection of renal damage and thus to minimize the burden of diabetic complications due to renal involvement. Hence addition of microalbuminuria along with diabetic profile for medical checkup will help to assess microalbuminuria at frequent intervals.

Outcomes of a home telemonitoring program for SARS-CoV-2 viral infection at a large academic medical center

Introduction Telemedicine serves as a viable option during the COVID-19 pandemic to provide in-home care, maintain home isolation precautions, reduce unnecessary healthcare exposures, and de-burden hospitals. Methods We created a novel telemedicine program to closely monitor patients infected with SARS-CoV-2 (COVID-19) at home. Adult patients with COVID-19 were enrolled in the program at the time of documented infection. Patients were followed by a team of providers via telephone or video visits at frequent intervals until resolution of their acute illness. Additionally, patients were stratified into high-risk and low-risk categories based on demographics and underlying comorbidities. The primary outcome was hospitalization after enrollment in the home monitoring program, including 30 days after discharge from the program. Results Over a 3.5-month period, 1128 patients met criteria for enrollment in the home monitoring program. 30.7% were risk stratified as high risk for poor outcomes based on their comorbidities and age. Of the 1128 patients, 6.2% required hospitalization and 1.2% required ICU admission during the outcome period. Hospitalization was more frequent in patients identified as high risk (14.2% vs 2.7%, P < 0.001). Discussion Enrollment in a home monitoring program appears to be an effective and sustainable modality for the ambulatory management of COVID-19.

Noninvasive Hemoglobin Measurement Reduce Invasive Procedures in Thalassemia Patients

This study was conducted to investigate the agreement between laboratory hemoglobin (LabHb) measured in venous blood and noninvasive, spectrophotometric hemoglobin (SpHb) measurement and the usability of SpHb measurement in the transfusion decision-making in patients with thalassemia whose hemoglobin (Hb) was monitored by taking blood samples at frequent intervals and who were transfused. Cardiac pulse, oxygen saturation, Pleth variability index (PVI), and SpHb values were measured in patients who came to the hematology outpatient clinic for a control visit and whose Hb levels were planned to be measured. Venous blood samples were taken for LabHb measurement, which we accept as the gold standard. Cohen’s kappa value was calculated for the agreement between SpHb measurements and LabHb values. The relationship and predictability between both measurement methods were evaluated by Pearson correlation analysis, a modified Bland-Altman plot and the linear regression model. In the study conducted with a total of 110 children with thalassemia, a moderate level of agreement between the two measurement methods (kappa = 0.370, p < 0.0001) and a significantly high correlation between the two tests (r = 0.675) were found. The mean bias between the differences was found to be 0.3 g/dL (–1.27 to 1.86 g/dL). The sensitivity and the specificity of SpHb in identifying patients who needed transfusions (Hb <10.0 g/dL) were calculated as 92.2 and 57.1%, respectively. Our results suggest SpHb measurement may be used to screen anemia in hemodynamically stable hemoglobinopathy patients and even for transfusion decision-making with combination clinical findings.

Recurrent births (multiparity) lead to permanent changes in cardiac structure.

Although the effects of pregnancy on the cardiovascular system have been covered by many studies, permanent changes in the hearts of multiparous women have not been investigated. This study therefore aimed to examine the permanent structural changes in the cardiac structure of multiparous women via transthoracic echocardiography (TTE). This case-control study included 366 females who had given birth to 1-21 children, and 218 females with no previous deliveries. Anamnesis, physical examination, electrocardiography (ECG), TTE, and exercise stress tests were used to determine whether the cases had additional systemic pathologies. The structural cardiac parameters of all cases were recorded with TTE. The study revealed that LV mass, LV mass index, left ventricular end diastolic volume (LVEDV), left ventricular end diastolic volume index (LVEDVI) were observed higher in women with five or more deliveries when compared to nulliparous women. On the other hand, ejection fraction (EF) was significantly lower in the same group. Receiver operating curve (ROC) analysis demonstrated that the prediction sensitivity for the presence of eccentric hypertrophy was 74% among women who had given >10.5 births, and its specificity was 97.8% (AUC: 0.949, 95% CI 0.905-0.993; p < 0.0001). The results showed that women with recurrent births had increased left ventricular end diastolic volume, left ventricular total mass in myocardium and decreased EF due to increased end diastolic volume. The results also showed delivering at frequent intervals (especially the birth of 11 or more) may be one of the causes of eccentric hypertrophy, in women of the low-to-middle income countries.

Quantification of Vasoactive Medications and the "Pharmaco-Mechanical Continuum" in Cardiogenic Shock.

Quantification of Vasoactive Medications and the "Pharmaco-Mechanical Continuum" in Cardiogenic Shock.

Evaluation of earth rotation parameters from modernized GNSS navigation messages

Modernized navigation messages of global navigation satellite systems like GPS CNAV include earth rotation parameters (ERPs), namely the pole coordinates and UT1-UTC (∆UT1) as well as their rates. Broadcast ERPs are primarily needed for space-borne GNSS applications that require transformations between earth-fixed and inertial reference frames like navigation in earth orbit as well as to the moon. Based on a global tracking network of 23 stations, broadcast ERP values are obtained for the global systems GPS and BeiDou as well as the regional QZSS and IRNSS. Subsequent data sets at daily intervals show polar motion discontinuities of 0.4 to 0.7 mas for GPS, QZSS, and IRNSS, whereas BDS is worse by a factor of about two. Discontinuities in ∆UT1 range from 0.17 to 0.45 ms. External comparison with the C04 series of the International Earth Rotation and Reference Systems Service results in polar motion RMS differences of 0.3 to 1.0 mas and ∆UT1 differences of about 0.13 ms for GPS, QZSS, and IRNSS. Due to less frequent update intervals, BDS performs worse by a factor of 2 – 4. In view of the current GNSS-based positioning errors at geostationary or even lunar distances, the accuracy of GPS, QZSS, and IRNSS broadcast ERPs is sufficient to support autonomous spacecraft navigation without the need for external data.