Role Of Delay Research Articles

Delays from neoadjuvant chemotherapy to interval debulking surgery and survival in ovarian cancer.

5552 Background: Prolonged time from primary surgery to chemotherapy is associated with worse survival in ovarian cancer (OC); however, the impact of prolonged time from neoadjuvant chemotherapy (NACT) to interval debulking surgery (IDS) is unknown. Given increasing utilization of NACT, we seek to evaluate the role of delays from NACT to IDS (TIDS) on survival. Methods: At a single center, we prospectively identified 224 women with newly diagnosed stage III/IV OC given NACT from 7/1/15 to 12/1/17. Clinical characteristics were abstracted by two independent reviewers. Delays in TIDS were defined as time from last preoperative carboplatin to IDS > 6 weeks. Fisher’s exact/Wilcoxon rank sum tests were used to compare clinical characteristics by delay in TIDS. Kaplan Meier method was used to estimate progression-free (PFS) and overall survival (OS) from date of IDS. Log-rank test/multivariate CoxPH models were used to examine differences by delay groups, adjusting for covariates. Results: Of the 224 women, 159 underwent IDS, and 34 (21%) experienced TIDS delays. These women were older (median 68 vs. 65 years, p = 0.05) and had more preoperative NACT cycles (median 6 vs. 4, p = 0.003). Patients with delays in TIDS also had a longer interval from pathological diagnosis to start of NACT (TNACT), median 22 vs. 17 days, p = 0.01, and interval from IDS to postoperative chemotherapy (TPOC), median 37 vs. 30 days, p = 0.01; however, neither TNACT nor TPOC predicted survival, p > 0.05. On univariate analysis, delays in TIDS were significantly associated with worse OS (HR 2.4 95% CI 1.2-4.8, p = 0.01); however, this was attenuated in multivariate models (HR 1.66 95% CI 0.8-3.4, p = 0.17), adjusting for age, stage and complete gross resection (CGR). On univariate analysis, delays in TIDS were not associated with PFS (HR 1.55 95% CI 0.97-2.5, p = 0.062), and in multivariate models, increase in number of preoperative NACT cycles (p = 0.005) and lack of CGR (p < 0.001) were the only variables predictive of worse PFS. Conclusions: Delays in TIDS are associated with OS, but not after adjustment for age, stage and CGR, suggesting a need to maximize cytoreduction regardless of delays in NACT. The role of preoperative NACT cycles on survival should be further studied.

Mothers' perception of neonatal jaundice in Jazan Region, KSA

Background: Jaundice is a yellow discoloration of the skin and sclera resulted from an increased level of bilirubin in the blood. Neonatal morbidity from neonatal jaundice has a huge impact and burden on family and health resources. The majority of cases are resolved with no intervention while some need some assessment and intervention either follow-up or management. Inadequate awareness and understanding of this common neonatal problem by the family can play a role in delays and complications. Aim: The aim of this study is to assess mothers' perception toward neonatal jaundice in Jazan region in Saudi Arabia. Subjects and Methods: Cross-sectional study that was performed through online survey and completed by mothers during the period from July to August 2018. Results: There were 60.4% of mothers had poor knowledge, whereas 39.6% had good knowledge, the most common source of knowledge was physicians (83.8%). Several factors affected the level of mother's knowledge, including age (P = 0.01), education level (P = 0.001), parity (P = 0.002), or history of their infants developed neonatal jaundice (P = 0.009). Conclusion: Mothers who participated in the study showed inadequate and misconception knowledge toward neonatal jaundice, which must be considered to reduce the consequences of this common condition. We advocate for improved maternal knowledge during antenatal follow-up and well-baby clinic visits.

The roles of delay and probability discounting in texting while driving: Toward the development of a translational scientific program.

A sample of 109 college students completed a survey to assess how frequently they send or read text messages while driving. In a novel discounting task with a hypothetical scenario in which participants receive a text message while driving, they rated the likelihood of replying to a text message immediately versus waiting to reply until arriving at a destination. The scenario presented several delays to a destination and probabilities of a motor vehicle crash. The likelihood of waiting to reply decreased as a function of both the delay until the destination and the probability of a motor vehicle crash. Self-reported higher frequencies of texting while driving were associated with greater rates of both delay and probability discounting. The degree of delay discounting was altered as a function of the probability of a motor vehicle crash and vice versa. These results suggest that both delay and probability discounting are important underlying mechanisms of drivers' decision to text while driving.

Hypermnesia and the Role of Delay between Study and Test.

Hypermnesia is increased recall across repeated tests in the absence of any further study opportunities. Although over the years many factors have been identified that influence hypermnesia, to date not much is known about the role of delay between study and test for the effect. This study addressed the issue in four experiments. Employing both words and pictures as study material, we compared hypermnesia after shorter delay (3 min or 11.5 min) and longer delay (24 h or 1 week) between study and test. Recall occurred over three successive tests, using both free recall (Experiments1,2, and4) and forced recall testing (Experiment3). In forced recall tests, subjects are instructed to recall as many items as possible, but if unable to remember all studied items, to fill in the remaining spaces with their best guesses. With free recall testing, hypermnesia increased with delay and the effect was driven mainly by reduced item losses between tests. These results suggest a link between hypermnesia and the testing effect, which shows that demanding retrieval practice, as it happens after longer delay, can improve recall by reducing the forgetting of the practiced items. In contrast, with forced recall testing, hypermnesia decreased with delay and was even absent after longer delay. The findings indicate that recall format can influence hypermnesia and different mechanisms may mediate the effects of repeated testing in the two recall conditions.

Taking Time for the Environment: On Timing and the Role of Delays in Environmental and Resource Economics

Ecosystem transformation and climate change evolve over long time scales. The effects of the economic decisions on the natural environment are also of a long-run character because they relate to investment decisions and capital stocks. At the same time, the economy is short-sighted and subject to different kinds of market failures. The time it takes to notice the changes and adequately address the associated problems affects the dynamics and inertia of the process. We discuss some recent contributions and new research questions that deal with time and timing in environmental and resource economics.

Characteristics of Successful and Unsuccessful Appeals Against Conviction for Child Sexual Abuse

The current study investigated (a) the effect of legislative reforms and amendments to judges’ directions to juries in the success of appeals against conviction for child sexual abuse and (b) the role of delay between the offence(s) and the trial in these appeals. Appeals listed in the Victorian Court of Appeal in Australia between 2004 and 2014 were identified. Data were extracted for a number of variables including the appeal's success and the delay between the first offence and the trial. Of the 238 appeals identified, 118 (49.6%) were successful. Legislative reform showed the only significant difference between successful and unsuccessful appeals: There were more successful appeals than expected following legislative changes in 2006. Delay was raised as a ground for appeal in 11 of the 118 successful cases. Delay was associated with the ages of the victims and offenders, sex of the victims, and the victim–offender relationship. Overall, the results do not appear consistent with the goal of the reforms, which was to avoid appeals and retrials that may have occurred as a result of judicial error. Future research should determine whether the trend towards higher success of appeals is continuing, particularly in light of further legislative changes.

Forgetting and Heterogeneity in Task Delay: Evidence from New York City Parking-Ticket Recipients

We study response behavior of New York City parking-ticket recipients by analyzing administrative data on 6.6 million tickets issued to 2 million individuals over two years. Exploiting variation (from a policy change and a field experiment) in letters sent to recipients, we find that forgetting plays a major role in delay – letters seem to act mostly as reminders, with their content mattering little. Moreover, by studying an individual’s behavior across multiple tickets, we find significant heterogeneity in underlying types, with different types reacting differently to deadlines and reminders. Failure to account for this heterogeneity yields biased – and sometimes incorrect – conclusions.

Cocaine administration dose-dependently increases sexual desire and decreases condom use likelihood: The role of delay and probability discounting in connecting cocaine with HIV.

Although cocaine use has been linked to sexual HIV risk behavior for decades, the direct effects of cocaine on sexual desire and sexual decision-making are unexamined. Research suggests delay discounting (devaluation of future outcomes) and probability discounting (devaluation of uncertain outcomes) play roles in condom use decisions. This study examined the effect of cocaine administration on sexual desire, hypothetical condom use, and discounting tasks. This double-blind, within-subjects study compared the effects of 0, 125, and 250mg/70kg oral cocaine HCl in 12 cocaine users. Measures included sexual desire and other subjective ratings, the Sexual Delay Discounting Task, the Sexual Probability Discounting Task, and monetary delay and probability discounting tasks. Cocaine caused dose-related increases in sexual desire and prototypical stimulant abuse-liability ratings. Relative to placebo, cocaine did not significantly alter condom use likelihood when condoms were immediately available or when sex was associated with 100% certainty of sexually transmitted infection (STI). In contrast, cocaine dose-dependently strengthened the effect of delay (sexual delay discounting) and STI uncertainty (sexual probability discounting) in decreasing condom use likelihood. Cocaine caused no significant change in monetary delay and probability discounting. This is the first study showing thatcocaine administration increases sexual desire. Detrimental effects of cocaine on sexual risk were only observed when safer sex required delay, or STI risk was uncertain (representative of many real-world scenarios), suggesting a critical role of discounting processes. Lack of monetary effects highlights the importance of studying clinically relevant outcomes when examining drug effects on behavioral processes.

Are disparities of waiting times for breast cancer care related to socio-economic factors? A regional population-based study (France).

The increasing number of breast cancer cases may induce longer waiting times (WT), which can be a source of anxiety for patients and may play a role in survival. The aim of this study was to examine the factors, in particular socio-economic factors, related to treatment delays. Using French Cancer Registry databases and self-administered questionnaires, we included 1,152 women with invasive non-metastatic breast cancer diagnosed in 2007. Poisson regression analysis was used to identify WTs' influencing factors. For 973 women who had a malignant tissue sampling, the median of overall WT between the first imaging procedure and the first treatment was 44 days (9 days for pathological diagnostic WT and 31 days for treatment WT). The medical factors mostly explained inequalities in WTs. Socio-economic and behavioral factors had a limited impact on WTs except for social support which appeared to be a key point. Better identifying the factors associated with increase in WTs will make it possible to develop further interventional or prospective studies to confirm their causal role in delay and at last reduce disparities in breast cancer management.

Feedforward Neural Network Models for FPGA Routing Channel Width Estimation

Since interconnects play the increasingly important role in delay and area of the Field-programmable gate array (FPGA) implementations, routing architecture design has become the focus of much work related to FPGA architecture development. This paper leverages feedforward neural networks to derive accurate models of the routing channel width in homogeneous FPGA architecture with two advanced intelligence learning techniques: Gradient-based learning algorithm (GLA) and Extreme learning machine (ELM). The resultant models can be used in the early stages of FPGA architecture development to facilitate fast design space exploration which is difficult to achieve in the traditional experiment-based method. The proposed models are evaluated by comparing the estimated channel widths to the real values generated from a CAD tool VTR over IWLS2005 benchmark circuits. Results show that the GLA model achieves the estimation accuracy 3.98% and the ELM model has the accuracy 3.91%, which show significant improvement over existing estimation approaches.

FACTORS OF TREATMENT EFFIENCY OF INOPERABLE STAGE III NON-SMALL CELL LUNG CANCER (REVIEW OF LITERATURE)

In this review, the latest data on factors influencing efficiency of the treatment of locally advanced inoperable stage III non-small cell lung cancer (NSCLC) are analyzed. Concomitant chemoradiotherapy (CRT) is a current standard of treatment with the 5-year overall survival rate of 20–30 % and median survival time of 17–28 months. However, only a small proportion of patients (13–35 % by the data from population-based studies) can receive CRT. Radiotherapy is currently progressing towards new approaches, including IMRT and IGRT, showing promising results, however, these approaches are still experimental. Accelerated repopulation of clonogens is biological factor necessitating intensification of both RT and chemotherapy. For RT, accelerated hyperfractionation is an optimal way for that. There is some data evidencing negative role of delays in the radiation treatment to overall efficacy and even survival. Therefore, the optimal approach to the treatment of Stage III NSCLC seems to be early beginning of RT and short overall time for both RT and chemotherapy.

‘For a mere cough, men must just chew Conjex, gain strength, and continue working’: the provider construction and tuberculosis care-seeking implications in Blantyre, Malawi

BackgroundDelay by men in seeking healthcare results in their higher mortality while on HIV or tuberculosis (TB) treatment and contributes to ongoing community-level disease transmission before going on treatment.ObjectiveTo understand masculinity's role in delay in healthcare seeking for men, with a focus on TB-suggestive symptoms.DesignData were collected between March 2011 and March 2012 in low-income suburbs in urban Blantyre using focus group discussions with community members (n=8) and health workers (n=2), in-depth interviews with 20 TB patients (female=14) and 20 uninvestigated chronic coughers (female=8), and a 3-day participatory workshop with 27 health stakeholder representatives. The research process drew to a large extent on grounded theory principles in the manner of Strauss and Corbin (1998) and also Charmaz (1995).ResultsRole descriptions by both men and women in the study universally assigned men as primary material providers for their immediate family, that is, the ones earning and bringing livelihood and additional material needs. In a context where collectivism was valued, men were also expected to lead the provision of support to wider kin. Successful role enactment was considered key to achieving recognition as an adequate man; at the same time, job scarcity and insecurity, and low earnings gravely impeded men. Pressures to generate continuing income then meant constantly looking for jobs, or working continuously to retain insecure jobs or to raise money through self-employment. All this led men to relegate their health considerations.ConclusionsEarly engagement with formal healthcare is critical to dealing with TB and HIV. However, role constructions as portrayed for men in this study, along with the opportunity costs of acknowledging illness seem, in conditions of vulnerability, important barriers to care-seeking. There is a need to address hidden care-seeking costs and to consider more complex interventions, including reducing precarity, in efforts to improve men's engagement with their health.

The Role of Delay and Connectivity in Throughput Reduction of Cooperative Decentralized Wireless Networks

We proposed a multiple relay selection protocol for decentralized wireless networks. The proposed relays selection protocol aims to address three issues: (1) selecting relays within the coverage area of the source and destination to ensure that the relays are positioned one hop away from the destination, (2) ensuring that the best node (best relays with less distance and attenuation from the destination) access the channel first, and (3) ensuring that the proposed relays selection is collision-free. Our analysis also considers three important characteristics of decentralized wireless networks that are directly affected by cooperation: delay, connectivity, and throughput. The main goal of this paper is to demonstrate that improving connectivity and increasing number of relays reduce the throughput of cooperative decentralized wireless networks; consequently, a trade-off equation has been derived.

Global Stability, Bifurcation, and Chaos Control in a Delayed Neural Network Model

Conditions for the global asymptotic stability of delayed artificial neural network model of n (≥3) neurons have been derived. For bifurcation analysis with respect to delay we have considered the model with three neurons and used suitable transformation on multiple time delays to reduce it to a system with single delay. Bifurcation analysis is discussed with respect to single delay. Numerical simulations are presented to verify the analytical results. Using numerical simulation, the role of delay and neuronal gain parameter in changing the dynamics of the neural network model has been discussed.

Persistence Aspect of a Predator–Prey Model with Disease in the Prey

This paper analyzes a prey–predator system where the prey population is infected by a microparasite. The predator functional response is of a Holling type II. We study three cases for the predator food choice. Persistence conditions are derived when predators attack the healthy and infected prey simultaneously. A persistence condition is also derived when predators consume infected prey only. It is shown that when predators attack healthy prey only, then the system cannot be uniformly persistent. The role of delay is also discussed for a system with the predator consuming both types of prey. The parameters are identified which influence the persistence of all the populations as well as impermanence. Numerical examples are provided to support our results.

Stability switches and global Hopf bifurcation in a nutrient-plankton model

This paper is devoted to the analysis of a nutrient-plankton model with delayed nutrient cycling. Firstly, stability and Hopf bifurcation of the positive equilibrium are given, and the direction and stability of Hopf bifurcation are also studied. We show that delay, which is considered in the decomposition of dead phytoplankton, can induce stability switches, such that the positive equilibrium switches from stability to instability, to stability again and so on. One can observe that the influence of delay on the system dynamics is essential. Then, we prove that there exists at least one positive periodic solution as the time delay varies in some regions using the global Hopf bifurcation result of Wu (1998, Trans Am Math Soc 350:4799–4838) for functional differential equations. Furthermore, the impact of input rate of nutrient is discussed along with numerical results, and the role of delay in the nutrient cycling is interpreted ecologically. Finally, several groups of illustrations are performed to justify analytical findings.

Persistent fluctuations in a dual model with frictions: The role of delays

This article studies the dynamics in a simple dual model where agents may shift from the traditional sector to the manufacturing one. We show that a delay between the exit from the traditional sector and the possibility to be employed in the manufacturing one is a source of endogenous fluctuations. In particular, by choosing time delay as the bifurcation parameter, it is proved that the system may lose stability and a supercritical Hopf bifurcation occurs when time delay passes through a critical value.

Bifurcation and Chaos in Delayed Cellular Neural Network Model

This paper deals with control of chaotic behavior of a delayed Cellular Neural Network (DCNN) model which is a one-dimensional regular array of four cells with continuous activation function. We investigate different dynamical behaviors including limit cycle, torus, and chaos for different range of weight parameters of the system. Regarding synaptic weight as parameter, Hopf bifurcations are obtained in the system without delay. In the delayed model condition for the Global asymptotic stability of the equilibrium point is presented. Numerical simulation and results are given to show the role of delay in chaos control of the CNNs.

The roles of delay and retroactive interference in retrieval-induced forgetting

When subjects study items from different categories and then repeatedly retrieve some of the items from some of the categories, retrieval practice typically improves recall of the practiced items but impairs recall of related but unpracticed items, relative to control items from unpracticed categories. Here, we report the results of three experiments, in which we examined practiced and unpracticed items' delay-induced forgetting (Exp. 1) and their susceptibility to retroactive interference (Exps. 2 and 3). Control items showed the expected memory impairment after longer delay between practice and test and in the presence of retroactive interference. In contrast, both the practiced and the related unpracticed items showed hardly any forgetting under these conditions. The findings are consistent with the results from recent testing-effect studies, which have reported reduced delay-induced forgetting and reduced susceptibility to interference for retrieval-practiced items, and generalize the results to related unpracticed items. The findings are discussed with respect to the inhibitory and noninhibitory accounts of retrieval-induced forgetting, as well as the possible role of selective segregation processes, which may be induced by retrieval practice.

Retrieval-induced forgetting, delay, and sleep

Retrieval-induced forgetting (RIF) refers to the finding that retrieval of a subset of previously studied material can cause forgetting of related unpractised material. Prior work on the role of delay between practice and test for RIF reported mixed results. Whereas some studies found RIF to be a relatively transient phenomenon, others found RIF to persist over time. We examined whether the persistence of RIF can depend on whether wakefulness or sleep follows retrieval practice. We employed a variant of the retrieval-practice paradigm with short (20 minutes) and long (12 hours) delay conditions. In all conditions participants studied a perceptually categorised list followed by retrieval practice on some of the items from some of the categories. Participants studied and practised the material in the morning or the evening. RIF was present in the short-delay conditions, and it was present in the long-delay condition if the delay included nocturnal sleep; if the long delay was filled with diurnal wakefulness, RIF was absent. Results show that whether delay eliminates RIF or not can depend on whether sleep or wake follows retrieval practice. Connections of the results to recent findings about the role of delay and sleep for RIF are discussed.