Standard Time Research Articles

A robust time scale for space applications using the student’s t-distribution

Abstract In this article, the principles of robust estimation are applied to the standard basic time scale equation to obtain a new method of assigning weights to clocks. Specifically, the Student's t-distribution is introduced as a new statistical model for an ensemble of clocks that are experiencing phase jumps, frequency jumps or anomalies in their measurement links. The proposed robust time scale is designed to mitigate the effects of these anomalies without necessarily identifying them, but through applying a method of robust estimation for the parameters of a Student's t-distribution. The proposed time scale algorithm using the Student's t-distribution (ATST) is shown to achieve comparable robustness to phase jumps, frequency jumps, and anomalies in the measurements with respect to the AT1 oracle time scale. The AT1 oracle is a special realization of the AT1 time scale which corrects all anomalies by having prior knowledge of their occurrences. The similar performance of ATST and AT1 oracle suggests that the ATST algorithm is efficient for obtaining robustness with no prior knowledge or detection of the occurrences of anomalies.

Conducting two evidence syntheses in six weeks – experiences with and evaluation of a pilot project

BackgroundEvidence synthesis organisations are trying to meet commissioners’ needs for rapid responses to their evidence synthesis commissions. In this project we piloted an intensive process, working to complete evidence syntheses within six-weeks, rather than the standard lead time of 4–6 months. Our objective was to explore how researchers experience working intensively, identify barriers and facilitators, and determine how a more intensive approach to evidence synthesis could be more systematically introduced in the future.MethodsIn a pre-planning phase, an intensive work group was established, and two commissions were selected for this pilot project. The evidence synthesis process was divided into two phases: planning and intensive. The planning phase, involved scheduling the intensive phase, exploring new digital tools, and identifying peer reviewers. The intensive phase encompassed the entire evidence synthesis process. Two review teams were formed, each with a team lead supported by a process lead and leadership contact point. Throughout the project, teams engaged in reflective meetings to evaluate and adjust processes as needed.ResultsDuring the planning phase, teams identified significant uncertainties regarding scopes, research questions, and inclusion criteria. To address this, they engaged with commissioners earlier than originally planned, clarified these aspects, and prepared protocols. Despite some minor deviations from the original plan, both reviews were completed on schedule, with one team expanding their scope due to the absence of eligible studies. Teams operated flexibly, held regular meetings, and found the process seamless due to fewer interruptions. Machine learning tools facilitated rapid study selection. The process lead role, created to guide and evaluate the project, proved beneficial, providing structure and support, although clearer role delineation with the leadership contact point could have improved efficiency.ConclusionsOverall, the intensive process fostered focus and productivity, allowing teams to manage short-term deliverables effectively. The researchers preferred working intensively with one evidence synthesis over being involved with many projects at the same time. They felt that time use was more effective, and they were able to complete the tasks in a focused way. However, there are several implications that should be considered before implementing an intensive approach in future evidence syntheses.

Synergistic interactions between urban heat islands and heat waves in the Greater Kuala Lumpur and surrounding areas

AbstractThe synergistic interactions between urban heat islands (UHI) and heat waves (HW) continue to be debated. Despite the expectations of UHI intensification during HW, several studies have demonstrated variations. Notably, there is a dearth of investigations concerning the UHI–HW synergy in tropical climate cities amidst the escalating trend of more frequent and severe HW in Southeast Asia. To address this gap, our study aimed to investigate the synergies between the UHI and HW phenomena in Greater Kuala Lumpur (GKL) and its surrounding areas. We employed the advanced research version 4.2.2 of the Weather Research and Forecasting (WRF) model, coupled with a single‐layer Urban Canopy Model (UCM), to examine the impact of UHI during two heat wave events in 2016 (Case 1) and 2020 (Case 2), against the periods immediately before and after these events, which we refer to as Pre‐Post HW (PPHW), in GKL. An elevated UHI intensity (UHII) was evident during the HW in both observations and simulations, with a noticeable distinction particularly observed in Case 1. During HW, observed data indicates average UHII peaks at 1.8°C (0100 LST (UTC+8)) and 1.7°C (1500 LST) in Cases 1 and 2, respectively. In contrast, those for PPHW days for Cases 1 and 2 are 1.5°C (0000 LST) and 1.2°C (0100 LST), respectively. The maximum observed heat loads are likely to occur at noon, reaching 2.3°C at 1600 LST in Case 1 and 3.7°C at 1500 LST in Case 2. LST stands for local standard time. Heat flux component analysis from the surface energy balance model confirmed the UHI–HW synergy. A notable difference in the Bowen Ratio between urban and rural areas highlights the effect of urbanisation on heat fluxes, potentially exacerbating urban discomfort during HW. Consistent across all measurement methods, the evidence indicates a clear and positive synergy between the UHI and HW in the GKL. This study can potentially deliver valuable insights, especially in urban planning, where the implications of weather events are substantial.

Evaluating Thrombolysis Rates and Emergency Department Time Targets in Acute Ischemic Stroke: Need for Personalized Medicine.

In the era of personalized medicine, standard protocols regarding the management of acute ischemic stroke (AIS) focus on time targets alone without tailoring the protocol to the specific patient and hospital characteristics to increase IV thrombolysis rates and improve outcomes for these patients by considering organizational differences and patient-related factors that influence adherence to target times at the emergency department level. With this in mind, we evaluate the effect of achieving ED time targets from standard protocol and patient-related risk factors on the intravenous (IV) thrombolysis rate in patients with AIS in the therapeutic window. For our research, we enrolled people who arrived at the ED with signs of recent AIS with an onset of less than 4.5 h. Initially, 355 patients were included in the study, but through careful screening, only 258 were considered eligible to participate. Of the final group of 258 patients, only 46 received intravenous thrombolysis treatment. In our study, when we are analyzing ED times in patients admitted with stroke symptoms in the therapeutic window, we found statistically significantly decreased ED times for patients that performed IV thrombolysis compared to patients not performing as follows: a median of 100 min in onset-to-ED door time (p < 0.001), a door-to-physician time (ED doctor) of 4 min (p = 0.009), door-to-blood-samples of 5 min (p = 0.026), a door-to-CT time of 15.5 min (p = 0.009), and door-to-CT results of 37 min (p < 0.001). In addition, patients who received intravenous thrombolysis were found to be significantly older (p < 0.001), with lower height and weight (p < 0.001 for both) and lower Glasgow Coma Scale (GCS) scores (9 ± 4.94 vs. 13.85 ± 2.41, p < 0.001). The logistic regression analysis indicated that the onset-to-ED time (p < 0.001) and the door-to-physician time (p = 0.014) for emergency medicine physicians are significant predictors of the likelihood of administering thrombolysis. By analyzing the impact of comorbidities, we observed that dyslipidemia, chronic arterial hypertension, and diabetes mellitus are significant predictive factors for performing IV thrombolysis (the presence of dyslipidemia and diabetes mellitus are predictive factors for performing IV thrombolysis, while the presence of arterial hypertension is not). The ED time targets that significantly influenced IV thrombolysis in our study were the onset-to-ED door time and the time it takes for the ED doctor to assess the AIS patient (door-to-physician time). The IV thrombolysis rate for these patients was 17.83%, lower than expected despite achieving most ED time targets, with the presence of chronic arterial hypertension as a significant predictive patient-related factor for not performing it. Even though our reported hospital's thrombolysis rate is favorable compared to international reports, there is always room for improvement. Based on our study results, it is necessary that new protocols to customized standard protocols and ED time targets for increasing IV thrombolysis rate in patients with AIS in the therapeutic window, focusing more on patient-related factors and type of hospitals, granting personalized medicine its right. Based on our study results, it is necessary that new protocols customize standard protocols and ED time targets for increasing IV thrombolysis rate in patients with AIS in the therapeutic window, focusing more on patient-related factors and type of hospitals, granting personalized medicine its right.

Interaction of Chicken Heterophils and Eimeria tenella Results in Different Phenotypes of Heterophil Extracellular Traps (HETs)

Chicken coccidiosis causes annual losses exceeding GBP 10 billion globally. The most pathogenic species for domestic fowls including Eimeria tenella, E. acervulina, and E. maxima, can lead to gastrointestinal issues ranging from mild to fatal. In this study, stages of E. tenella and freshly isolated chicken heterophils were co-cultured for 180 min. These interactions were analyzed using live 3D holotomographic and confocal microscopy. We observed that E. tenella stages were entrapped by heterophils and heterophil extracellular traps (HETs). Notably, different HET phenotypes, specifically sprHETs and aggHETs, were induced regardless of the stage. Furthermore, the quantification of extracellular DNA release from co-cultures of heterophils and sporozoites (ratio 1:1) for 180 min demonstrated a significantly higher release (p = 0.04) compared to negative controls. In conclusion, research on the chicken innate immune system, particularly fowl-derived HETs, remains limited. More detailed investigations are needed, such as exploring the time-dependent triggering of HETs, to establish a standard incubation time for this pathogen defense mechanism. This will enhance our understanding of its role in parasite survival or death during HET confrontation.

Compositional Elements of Photographic Coverage of the Westgate Mall Terrorist Attack

Purpose: Terrorism is a global threat that has prompted extensive research, with mass media playing a crucial role in reporting such events. This study investigated the compositional elements of photographic coverage of the Westgate Mall terrorist attack in Nairobi, Kenya, on September 21, 2013. Methodology: Photographs from the Daily Nation, Standard, and New York Times were analysed. Using qualitative descriptive research and content analysis through MaxQDA software, the study identified patterns and themes in the images, focusing on denotative, stylistic-semiotic, connotative, and ideological representations. Findings: It was found that camera angles, shot proximity, and image sizes were strategically used by photojournalists to convey messages and emotions. Large images on front pages provided visual appeal, while medium and small images added content and facilitated sensationalized storytelling. Shot proximity varied to deliver specific messages, with few close-ups used to avoid evoking sombre emotions or aiding terrorist propaganda. Unique Contribution to Theory, Practice and Policy: The study contributes to the existing mass media research by highlighting the importance of thoughtful image selection and composition in responsible photojournalism to balance accurate reporting with mitigating potential harm.

A timeliness analysis of emergency services and cardiovascular outcomes in cardiac patients referred through prehospital emergency services between 2020 and 2023: a cross-sectional study in Iran

ObjectiveEffective time management is crucial for the survival of all patients, particularly those with cardiovascular conditions. This is especially true in the context of pre-hospital emergency services, where prompt intervention can significantly impact outcomes. This study delves into the timeliness of emergency services and the subsequent outcomes for hospitalized cardiovascular patients in EMS center in Fasa University of Medical Sciences, southern Iran.ResultsA total of 4972 emergency calls related to cardiac diagnoses were received between 2020 and 2023. The transport time was significantly correlated with age, location of the mission, and type of mission. Of the total, 86 underwent angioplasty within the standard time of less than 90 min, of which 81 were discharged and 5 died. 51 patients underwent angioplasty after more than 90 min, of which 47 were discharged and 4 died. In addition, 124 of these patients experienced cardiopulmonary resuscitation, of which 63 were successful and 61 were unsuccessful.

Magnetically targeted lidocaine sustained-release microspheres: optimization, pharmacokinetics, and pharmacodynamic radius of effect

ObjectiveThis study aimed to optimize the formulation of magnetically targeted lidocaine microspheres, reduce the microsphere particle size, and increase the drug loading and encapsulation rate of lidocaine. The optimized microspheres...

Percutaneous Balloon Compression Guided by a Compression-Time Effect in Trigeminal Nerve Branches.

Percutaneous balloon compression (PBC) is an important treatment for trigeminal neuralgia (TN). Establishing the duration of balloon compression involves a tradeoff between outcome and postoperative complications. We aimed to explore the effect of the duration of balloon compression on the numbness response in areas innervated by the branches of the trigeminal nerve. Thirty-three patients with TN were included as an exploratory cohort, and the response area and compression time to the onset of facial numbness were recorded intraoperatively. Seventy-six patients with TN were then randomly divided into experimental (EG) and control groups (CG) for validation. The EG was treated with balloon compression times adjusted to reflect the compression-time effect observed in the initial investigation, whereas the CG was treated with a standardized compression time of 180 s. Patients were followed up postoperatively for pain relief and facials to verify the reliability of the effect. We found that the mean compression time to numbness in the region innervated by the ophthalmic meridian (V1) was 89.09 ± 8.99 s; by V1 and the maxillary nerve (V2), 123.52 ± 7.97 s; and by V1, V2, and the mandibular nerve (V3), 181.33 ± 10.29 s. All 76 patients used to verify the effect had complete relief of pain, and the EG had significantly less numbness than the CG. In PBC, with the extension of balloon compression time, the numbness response of each branch of the trigeminal nerve appears in a certain order. This effect can guide PBC in mitigating complications while ensuring efficacy.

Abstract 47: Deletion of PRR in AgRP Neurons of the Arcuate Nucleus Contributes to the Development of DOCA-Salt Hypertension

Agouti-related protein (AgRP) neurons, a key neuronal population within the arcuate nucleus (ARC), are known for their pivotal roles in regulating energy- and glucose homeostasis. However, their involvement in cardiovascular regulation remains poorly understood. Using RNAscope in situ hybridization, we found that 95.4% of the ARC AgRP neurons express the (pro)renin receptor (PRR), a component of the brain renin-angiotensin system that is crucial for blood pressure (BP) regulation. We therefore hypothesized that PRR signaling in the ARC AgRP neurons plays a regulatory role in the development of hypertension. To test this hypothesis, we selectively deleted PRR in ARC AgRP neurons by crossing AgRP-IRES-Cre mice with PRR fl/fl mice. Using RNAscope, as expected, AgRP Cre+ PRR fl/y mice displayed a significantly lower PRR mRNA in the ARC AgRP neurons than WT mice (76.3 ± 6.1 vs. 127.7 ± 2.9 AFU, p &lt; 0.05), indicating efficient ablation of PRR in ARC AgRP neurons. To examine the impact of PRR deletion in the ARC AgRP neurons on BP, the AgRP Cre+ PRR fl/y and control mice were implanted with telemetry probes to monitor BP continuously. After baseline recording, mice received DOCA-salt treatment (50 mg DOCA + saline as drinking water) for two weeks. BP variability and standard time domain heart rate variability (HRV) parameters, including overall HRV (SDNN) and short-term HRV (rMSSD), were analyzed from beat-to-beat intervals (n = 2-7 mice/group). At baseline, there was no difference between the two groups in BP, BP variability, and HRV. Two weeks of DOCA-salt induced a significantly higher BP in AgRP Cre+ PRR fl/y mice than the controls (156.2 ± 6 vs. 119.4 ± 3 mmHg, p &lt; 0.05), while BP variability did not differ between the two groups. Noteworthy, AgRP Cre+ PRR fl/y mice exhibited lower SDNN than the controls (13.3 ± 4 vs. 19.4 ± 4 ms), indicating increased sympathetic and/or reduced parasympathetic nervous activity. This lower SDNN suggests impaired cardiac autonomic function and adaptability to physiological demands in AgRP Cre+ PRR fl/y mice. Concurrently, AgRP Cre+ PRR fl/y mice showed a lower rMSSD (4.7 ± 0.5 vs. 10.8 ± 3.5 ms), implying reduced parasympathetic activity. In conclusion, deletion of PRR in the ARC AgRP neurons results in compromised cardiac autonomic function associated with the development of hypertension. Our findings underscore a novel protective role of PRR signaling in the ARC AgRP neurons in BP regulation.

Development and validation of a prediction model for rebound hyperbilirubinemia: a Chinese neonatal cohort study.

Rebound hyperbilirubinemia (HBB) is still present in as high as 10% of newborn babies. However, the applicability of established prediction models for rebound HBB to Chinese newborns is unclear. This study aimed to establish a model to predict HBB rebound after phototherapy among Chinese neonates. A retrospective cohort study was conducted on 1,035 HBB infants receiving phototherapy. Rebound HBB was defined as total serum bilirubin (TSB) returning to or above the American Academy of Pediatrics (AAP) phototherapy threshold within 72 hours after the end of phototherapy. The predictive effects of previously published two- and three-variable scores were verified. Neonates were randomly assigned in a 6:4 ratio to the training (n=621) group and the testing (n=414) group. All variables in the training set were used to select predictors by least absolute shrinkage and selection operator (LASSO) regression analysis. The internal validation of the prediction model was performed using the testing set. The model's predictive performance was evaluated by area under the curve (AUC), accuracy, sensitivity, and specificity, each with 95% confidence intervals (CIs). Receiver operating characteristic (ROC) and calibration curves were constructed to evaluate the discrimination ability and fitting effect of the prediction model, respectively. Rebound HBB was observed in 210 patients (20.3%). The AUC for the two- and three-variable scores were 0.498 (95% CI: 0.455-0.540) and 0.498 (95% CI: 0.457-0.540), respectively. Predictive factors for the risk of rebound HBB included formula feeding (>3 times/day), standard phototherapy irradiation time, TSB levels and age at termination of phototherapy, neonatal weight, and differences between TSB levels at the phototherapy termination and phototherapy threshold. The prediction model's AUC was 0.935 (95% CI: 0.911-0.958), the sensitivity was 0.880 (95% CI: 0.809-0.950), the specificity was 0.831 (95% CI: 0.790-0.871), and the accuracy was 0.841 (95% CI: 0.805-0.876). The established model performed well in predicting rebound risk among Chinese infants with HBB, which may be beneficial in treating and managing HBB in infants.

Highly sensitive protection scheme considering the PV operation control models

The integration of distributed generation (DG) based on inverters into power systems has increased significantly, necessitating a thorough understanding of its impact on fault analysis and the performance of distribution networks' protection mechanisms. This study addresses this issue by examining how various inverter management modes influence protective relay systems within IEEE 9-bus redial and mesh networks, CIGRE and IEEE 33-bus networks featuring Photovoltaic (PV) farms and Battery Energy Storage Systems (BESS), by IEEE1547–2018 and German grid code standards. By analyzing grid-connected scenarios with five distinct PV control modes, the research introduces a novel protection methodology termed the Photovoltaic Overcurrent Relay (PVOCR). This method introduces a current-voltage characteristic to optimally coordinate Overcurrent Relays (OCRs), aiming to reduce their operational time and eliminate mis-coordination events. The proposed PVOCR is evaluated against standard inverse time, SOCR, and modern adaptive voltage, VOCR, relay schemes across various fault scenarios differing in type and location. Furthermore, the PVOCR scheme effectively operates across all PV inverter modes without experiencing miscoordination events, whereas the SOCR and VOCR schemes encountered such issues during the operation of Control 4. These results underscore the potential utility of the PVOCR methodology in enhancing the reliability and efficiency of protection systems in inverter-based DG networks.

A Meta-Analysis Methodology in Stan to Estimate Population Pharmacokinetic Parameters from Multiple Aggregate Concentration-Time Datasets: Application to Gevokizumab mPBPK Model.

The aim of the present study was to develop and evaluate the performance of a methodology to estimate the population pharmacokinetic (PK) parameters along with the inter-individual variabilities (IIVs) from patients' reported aggregate concentration-time data, in particular, mean plasma concentrations and their standard deviations (SDs) versus time, such as those often found in published graphs. This method was applied to the published data of gevokizumab, a novel monoclonal anti-interleukin-1β antibody, in order to estimate the drug's population pharmacokinetic (PopPK) parameters of a second-generation minimal physiologically based pharmacokinetic (mPBPK) model. Assuming this mPBPK model, a mixed effects approach was utilized to allow accounting for the random inter-group variability (IGV) that was assumed among different dosage groups. The entire analysis was performed using R software (Rstudio) and the Bayesian software tool RStan was used for the application of Bayesian priors on the parameters. Conclusively, the proposed method could be applied to monoclonal antibodies for which the second-generation mPBPK model has been proposed as well as to other drugs with different PK models when only a published graph with aggregate concentration-time data is available. In addition, the method could be used when multiple aggregate datasets from different sources need to be combined in a meta-analysis approach in order to estimate the PopPK parameters of a drug.

Computational fluid dynamic analysis of the effect of inlet valve closing timing on common rail diesel engines fueled with butanol–diesel blends

The inlet valve closing (IVC) timing plays a crucial role in engine combustion, which impacts engine performance and emissions. This study attempts to measure the potential to use n-butanol (Bu) and its blends with the neat diesel in a common rail direct injection (CRDI) engine. The computational fluid dynamics (CFD) simulation is carried out to estimate the performance, combustion, and exhaust emission characteristics of n-butanol–diesel blends (0%–30% by volume) for variable valve timings. An experimental study is carried out using standard valve timing and blends to validate the CFD model (ESE AVL FIRE). After validation, the CFD model is employed to study the effect of variable valve timings for different n-butanol–diesel blends. Extended coherent flame model-3 zone (ECFM-3Z) is implemented to conduct combustion analysis, and the kappa–zeta–f (k–ζ–f) model is employed for turbulence modeling. The inlet valve closing (IVC) time is varied (advanced and retarded) from standard conditions, and optimized valve timing is obtained. Advancing IVC time leads to lower cylinder pressure during compression due to reduced trapped air mass. The brake thermal efficiency (BTE) is increased by 4.5%, 6%, and 8% for Bu10, Bu20, and Bu30, respectively, compared to Bu0. Based on BTE, optimum injection timings are obtained at 12° before the top dead center (BTDC) for Bu0 and 15° BTDC for Bu10, Bu20, and Bu30. Nitrogen oxide (NOx) emissions increase due to complete combustion. Due to IVC timing, further carbon monoxide and soot formation decreased with blends and had an insignificant effect.

A comprehensive numerical approach to coil placement in cerebral aneurysms: mathematical modeling and in silico occlusion classification.

Endovascular coil embolization is one of the primary treatment techniques for cerebral aneurysms. Although it is a well-established and minimally invasive method, it bears the risk of suboptimal coil placement which can lead to incomplete occlusion of the aneurysm possibly causing recurrence. One of the key features of coils is that they have an imprinted natural shape supporting the fixation within the aneurysm. For the spatial discretization, our mathematical coil model is based on the discrete elastic rod model which results in a dimension-reduced 1D system of differential equations. We include bending and twisting responses to account for the coils natural curvature and allow for the placement of several coils having different material parameters. Collisions between coil segments and the aneurysm wall are handled by an efficient contact algorithm that relies on an octree based collision detection. In time, we use a standard symplectic semi-implicit Euler time stepping method. Our model can be easily incorporated into blood flow simulations of embolized aneurysms. In order to differentiate optimal from suboptimal placements, we employ a suitable in silico Raymond-Roy-type occlusion classification and measure the local packing density in the aneurysm at its neck, wall region and core. We investigate the impact of uncertainties in the coil parameters and embolization procedure. To this end, we vary the position and the angle of insertion of the micro-catheter, and approximate the local packing density distributions by evaluating sample statistics.

Pulmonary Adenocarcinoma with Enteric Differentiation without TTF-1 Expression Is a Very Rare Subtype with Limited Treatment Options and Poor Prognosis

Plain Language SummaryPulmonary adenocarcinoma with enteric differentiation (PAED) without expression of thyroid transcription factor-1 (TTF-1) is an extremely rare and hard-to-treat variant of lung cancer. We collected clinicopathological data of 121 Caucasian patients with pulmonary adenocarcinoma without TTF-1 expression, their systemic therapy options, and the efficacy of their systemic treatment including 79 cases without a PAED and 42 cases with a PAED, compared these subgroups, and investigated patients’ response to chemotherapy and immunotherapy as first-line treatment. A comparison of clinicopathological data of TTF-1-negative PAED and non-PAED patients revealed a significantly lower frequency of high programmed death receptor ligand 1 (PD-L1) expression in PAED resulting in the lack of single-agent immunotherapy (p = 0.032) in this subgroup. Frequencies of an activating Kirsten rat sarcoma viral oncogene homolog (KRAS) gene mutation were high in both groups (46.7% and 50.0%), but a G12C gene mutation was seldomly noted (in 6.7% and 18.5% of patients with evaluable data). Median overall survival (OS) was poor in both groups (10 and 12 months). The majority of PAED patients received platinum-based and taxane-containing chemotherapy or chemo-/immunotherapy with an objective response rate of 31.6% and a disease control rate of 57.9%. Median progression-free survival (PFS) and OS of PAED patients with systemic therapy were very poor (3.9 months and 5.9 months). Caucasian patients with a TTF-1-negative PAED have a poor prognosis with reduced response rates to standard first-line systemic therapy and short survival times (PFS and OS).

Allowing ad libitum sleep during overnight polysomnography impacts Multiple Sleep Latency Test results in patients being assessed for hypersomnolence.

The Multiple Sleep Latency Test (MSLT) is a key diagnostic component in the diagnosis of central disorders of hypersomnolence. Due to time constraints, it is common practice to wake patients at a standard time from overnight polysomnography (PSG) prior to the MSLT. This has the potential to influence MSLT results due to sleep deprivation. We describe the impact of allowing ad libitum sleep on the night prior to the MSLT in patients being assessed for hypersomnolence. 580 consecutive patients undergoing PSG/MSLT for assessment of hypersomnolence were analyzed: 290 either side of a change in laboratory protocol which allowed patients ad libitum sleep during the PSG, rather than being woken at a pre-specified time. Baseline characteristics, PSG and MSLT results were compared between the groups. Groups were similar at baseline, other than there being more females in the ad libitum group. After adjusting for confounding variables, ad libitum patients had later sleep offset time (+58.7 minutes; p<0.001), longer PSG total sleep time (+47.8 minutes; p<0.001), longer MSLT mean sleep latency (+1.3 minutes; p=0.002) and 23% fewer MSLT with mean sleep latency less than 8 minutes (p=0.004) when compared with patients who were woken at a standard time. The common practice of waking patients from their PSG at a standard time has the potential to curtail sleep and impact MSLT results by reducing mean sleep latency. Patients being assessed for hypersomnolence should be allowed ad libitum sleep during the PSG on the night prior to their MSLT.

Evaluation of Standard Times for Some Local Blacksmith’s Products

The practice of menial farming in the southwestern part of Nigeria have necessitated the need for the blacksmith industry to produce farm implements for the need of their immediate environment (farmers). With increased cost and time of production, coupled with demand size, reduced productivity and in order to meet the customer’s schedule, the study was conceived to evaluate the standard time to start and finish a product to manage production time and to estimate the optimum production capacity of the blacksmith workstation. After a careful survey of the local blacksmiths and with the aid of a stopwatch and study time chart, standard time was evaluated for harvester, digger and axe. These implements are the most commonly used items by the locals. The standard time for the local blacksmith’s axe, digger and harvester production was estimated to be 1458.35, 1931.44 and 936.66 Seconds respectively. It can therefore be concluded that the blacksmiths working for 8 hours a day will produce either (i) about 20 units of axe per day, (ii) 15 units of digger per day, or (iii) 31 units of harvester per day, or (iv) 7 units each, of the products per day

Combined Supine-Prone Myocardial Perfusion Imaging: Enhancing Diagnostic Accuracy.

The combined supine-prone imaging protocol for SPECT myocardial perfusion imaging offers significant advantages over supine imaging alone. By comparing supine and prone images, one can distinguish attenuation artifacts in the inferior and anterior walls from true perfusion defects, thus improving specificity and diagnostic accuracy. The recommended protocol is to perform prone imaging after supine stress imaging when perfusion defects are noted. The additional prone imaging time is 20%-40% less than the standard supine imaging time. Implementing prone imaging can optimize patient care and provide substantial benefits for nuclear cardiology labs, especially those without attenuation correction.

Evaluation for The Production Process of The Cover Plate Components Using Time Study Technique: A Case Study

Time study plays a crucial role in optimizing production efficiency and resource utilization in manufacturing processes. Time study helps to counter problems that occurred in the production industry such as uneven task distribution, bottlenecks, idle time, complexity, and time constraints. In this case study, a manufacturing company has been selected as a case study for time study which focused on packing department that produced cover plate component in order to identify the task time, normal time and standard time. There are 12 work elements that were identified in this case study and these work elements were grouped into 5 different workstations based on cycle time. As a result, among of 12 work elements, the first 7 work elements indicates that the processes did not show any delay, where the processes can be done in range of 12% to 31% faster than the expected standard time. Meanwhile the other 5 work elements indicates a delay in task completion, which is up to 43.63 seconds. In case of workstation analysis, workstation 1, 2 and 3 showcasing effective performance in terms of task completion, with 14.6% to 31.1% faster than the standard time. However, for workstation 4 and 5 were recorded a procrastinate process time about 8% and 11%, which can translated as 30.3 secondsand 77.7 seconds, respectively.As a conclusion, the analysis of manufacturing task efficiency identified elements H, I, J, K, and L as needing improvement. Conversely, elements A, B, C, D, E, F, and G are performing well. Workstations 4 and 5 are bottlenecks that hinder overall production efficiency. Addressing these bottlenecks is crucial for achieving optimal output