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Search Results: 1 - 10 of 208542 matches for " Welch Verna L "
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Evaluation of intravenous voriconazole in patients with compromised renal function
Lilly Craig M,Welch Verna L,Mayer Thomas,Ranauro Paul
BMC Infectious Diseases , 2013, DOI: 10.1186/1471-2334-13-14
Abstract: Background Incorporation of the solubilizing excipient, sulfobutylether-β-cyclodextrin (SBECD), in the intravenous (IV) formulation of voriconazole has resulted in the recommendation that this formulation be used with caution in patients with creatinine clearances (Clcr) < 50 mL/min. This study evaluated the safety of IV voriconazole compared with two other IV antifungals not containing SBECD in patients with compromised renal function. Methods A total of 128 patients aged 11–93 years who had a baseline Clcr < 50 mL/min between January 1, 2007 and December 31, 2010 were identified from a database of a university-affiliated inpatient healthcare system; of these, 55 patients received caspofungin, 54 patients received fluconazole, and 19 patients received voriconazole. Changes in serum creatinine (Scr) and Clcr levels while on therapy were compared with baseline values and between groups. Results The groups had similar characteristics apart from the larger proportion of females that received fluconazole. Baseline Scr was higher in those receiving caspofungin, but maximal increases of Scr and decreases in Clcr were greatest for the fluconazole group. Acute kidney injury (AKI), assessed by RIFLE criteria, was more frequent in the fluconazole vs. the caspofungin group (p < 0.01); incidence of AKI in the voriconazole group was not significantly different than found in the other two groups. The infecting organism was a predictor of AKI and formulation with SBECD was not. Conclusions Treatment of fungal infections in patients with compromised renal function with an SBECD-containing antifungal agent was not associated with AKI in clinical practice. Since the infecting organism was associated with AKI, decision on which antifungal to use should be determined by susceptibilities to the organism and not the incorporation of SBECD in the IV formulation.
Interaction of sleep quality and psychosocial stress on obesity in African Americans: the Cardiovascular Health Epidemiology Study (CHES)
Aurelian Bidulescu, Rebecca Din-Dzietham, Dorothy L Coverson, Zhimin Chen, Yuan-Xiang Meng, Sarah G Buxbaum, Gary H Gibbons, Verna L Welch
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-581
Abstract: A sample of 1,515 AA residents of metropolitan Atlanta, aged 30-65 years, was recruited by a random-digit-dialing method in 2007-08. The outcome obesity was defined by BMI (kg/m2) continuously and categorically (BMI ≥ 30 versus BMI < 30). Global sleep quality (GSQ) score was computed as the sum of response values for the seven components of the Pittsburgh Sleep Quality Index (PSQI) scale. GSQ score was defined as a continuous variable (range 0-21) and as tertiles. The general perceived stress (GPS), derived from the validated Cohen scale, was categorized into tertiles to test the interaction. Chi-square tests, correlation coefficients and weighted multiple linear and logistic regression were used to assess the associations of GSQ, GPS and obesity.The mean (standard deviation) age was 47.5 (17.0) years, and 1,096 (72%) were women. GSQ score categorized into tertiles was associated with BMI. Among women, after multivariable adjustment that included age, gender, physical activity, smoking status, education, total family income, financial stress and history of hypertension, hypercholesterolemia, diabetes and myocardial infarction, obesity was associated with sleep quality as assessed by GSQ continuous score, [odds ratio, OR (95% C.I.): 1.08 (1.03 - 1.12)], and with a worse sleep disturbance subcomponent score [OR (95% C.I.): 1.48 (1.16 - 1.89)]. Among all participants, stress modified the association between obesity and sleep quality; there was an increased likelihood of obesity in the medium stress category, OR (95% C.I.): 1.09 (1.02 - 1.17).Sleep quality was associated with obesity in women. The association of sleep quality with obesity was modified by perceived stress. Our results indicate the need for simultaneous assessment of sleep and stress.Long-term sleep deprivation may increase the risk of obesity through multiple metabolic and endocrine alterations [1-11]. Previous studies have showed that, compared with whites, African Americans (AA) have greater sleep depr
Development and implementation of a performance improvement project in adult intensive care units: overview of the Improving Medicine Through Pathway Assessment of Critical Therapy in Hospital-Acquired Pneumonia (IMPACT-HAP) study
Julie E Mangino, Paula Peyrani, Kimbal D Ford, Daniel H Kett, Marcus J Zervos, Verna L Welch, Ernesto G Scerpella, Julio A Ramirez, the IMPACT-HAP Study Group
Critical Care , 2011, DOI: 10.1186/cc9988
Abstract: The project was conducted in three phases over 18 consecutive months beginning 1 February 2006: 1) a three-month planning period for literature review to create the consensus pathway for managing nosocomial pneumonia in these ICUs, a data collection form, quality performance indicators, and internet-based repository; 2) a six-month implementation period for customizing ATS/IDSA guidelines into center-specific guidelines via educational forums; and 3) a nine-month post-implementation period for continuing education and data collection. Data from the first two phases were combined (pre-implementation period) and compared with data from the post-implementation period.We developed a consensus pathway based on ATS/IDSA guidelines and customized it at the local level to accommodate formulary and microbiologic considerations. We implemented multimodal educational activities to teach ICU staff about the guidelines and continued education throughout post-implementation. We registered 432 patients (pre- vs post-implementation, 274 vs 158). Diagnostic criteria for nosocomial pneumonia were more likely to be met during post-implementation (247/257 (96.1%) vs 150/151 (99.3%); P = 0.06). Similarly, empiric antibiotics were more likely to be compliant with ATS/IDSA guidelines during post-implementation (79/257 (30.7%) vs 66/151 (43.7%); P = 0.01), an effect that was sustained over quarterly intervals (P = 0.0008). Between-period differences in compliance with obtaining cultures and use of de-escalation were not statistically significant.Developing a multi-center performance improvement project to operationalize ATS/IDSA guidelines for HAP, VAP, and HCAP is feasible with local consensus pathway directives for implementation and with quality indicators for monitoring compliance with guidelines.The American Thoracic Society and Infectious Diseases Society of America (ATS/IDSA) published guidelines for the management of hospital-acquired pneumonia (HAP), ventilator-associated pneumoni
On the Smoothness of the Horizons of Multi-Black Hole Solutions
Dean L. Welch
Physics , 1995, DOI: 10.1103/PhysRevD.52.985
Abstract: In a recent paper it was suggested that some multi-black hole solutions in five or more dimensions have horizons that are not smooth. These black hole configurations are solutions to $d$-dimensional Einstein gravity (with no dilaton) and are extremally charged with a magnetic type $(d-2)$-form. In this work these solutions will be investigated further. It will be shown that although the curvature is bounded as the horizon of one of the black holes is approached, some derivatives of the curvature are not. This shows that the metric is not $C^{\infty },$ but rather it is only $C^k$ with $k$ finite. These solutions are static so their lack of smoothness cannot be attributed to the presence of radiation.
Timelike Duality
Dean L. Welch
Physics , 1994, DOI: 10.1103/PhysRevD.50.6404
Abstract: Several stationary solutions of the low energy string equations are dualized with respect to their timelike symmetry. Many of the duals have simple physical interpretations. Those of the nonextremal three dimensional black hole and black string are negative mass black strings. The extremal cases of these, and extremal higher dimensional black strings also, give negative energy plane fronted waves. In fact, all of the duals of positive mass solutions that will be considered here have nonpositive energies, but an argument is given which suggests that this is not true in general.
A Near-Infrared Variant of the Barnes-Evans Method For Finding Cepheid Distances Calibrated with High-Precision Angular Diameters
D. L. Welch
Physics , 1994, DOI: 10.1086/117164
Abstract: The advantages of a near-infrared variant of the Barnes-Evans method for estimating distances to Cepheid variables are described and quantified. A surface brightness-color relation for $K$ photometry and the $(V-K)_0$ color index is established using modern, high-precision angular diameters from optical interferometers. Applied to data for the galactic (cluster) Cepheid U Sgr, this method yields a distance of 0.660 $\pm$ 0.024 kpc and a true distance modulus of 9.10 $\pm$ 0.07 mag. This estimate compares with the true distance modulus of 9.37 $\pm$ 0.22 mag estimated by Gieren, Barnes, and Moffett (1993) using the classical Barnes-Evans technique. The possibility of estimating distances of LMC and SMC Cepheids directly -- without intermediate steps -- is discussed. The feasibility of determining the distance of M31 or M33 using this technique is examined and is probably within the reach of 8m-class telescopes.
New Observing Techniques
D. L. Welch
Physics , 1997,
Abstract: The influence of new techniques on the discovery and characterization of pulsating variables has been enormous. In this paper, I will review the methods and results of a number of research programmes which have dramatically altered our ability to study variable stars and will likely bear fruit for many years into the future. Specifically, I will touch on results from the MACHO and EROS Projects, the HIPPARCOS mission, "flux difference" photometry and a handful of new algorithmic advances which I consider to be important.
Real Time Estimation of Bayesian Networks
Robert L. Welch
Computer Science , 2013,
Abstract: For real time evaluation of a Bayesian network when there is not sufficient time to obtain an exact solution, a guaranteed response time, approximate solution is required. It is shown that nontraditional methods utilizing estimators based on an archive of trial solutions and genetic search can provide an approximate solution that is considerably superior to the traditional Monte Carlo simulation methods.
Macho Proper Motions From Optical/Infrared Photometry
Andrew Gould,Douglas L. Welch
Physics , 1995, DOI: 10.1086/177312
Abstract: Optical/infrared photometry can double the number of proper motion measurements of Massive Compact Objects (MACHOs) relative to single band photometry. The proper motion of a MACHO can be measured by finding the ratio $q$ of the (known) radius of the source star to the Einstein radius of the MACHO, $q=\theta_s/\theta_e$. A classic method for doing this is to look for the effect on the light curve of the finite size of the source. A modification of this method proposed by Witt (1995) is to look for color changes in the light curve due to the fact that the limb darkening of the source is different in different bands. We demonstrate that the ``classical'' method is not feasible unless the MACHO actually transits the source: if the MACHO passes at say 1.5 source radii, there is still a sizable $\sim 5\%$ effect, but the light curve cannot be distinguished from point-source light curves with different parameters. However, color measurements in $V$ $(0.55\,\mu$m) and $H$ $(1.65\,\mu$m) reduce the errors by a factor $\sim 120$ and permit proper motion measurements at impact parameters of up to 2 source radii. Color maps in $V-H$ are also useful in the detection of planetary systems. Giant stars have a ``red ring'' in such maps. A planet which transits this ring gives rise to a distinctive signature which can help in the measurement of the planetary system's proper motion.
A Study of RR1 Lightcurve Modulation in OGLE_III Bulge Time-series
Douglas L. Welch,Grant Foster
Physics , 2013,
Abstract: We report the results of our study of lightcurve modulation in a sample of 493 RR1 variables from the OGLE-III survey of galactic bulge fields. Each object in this list has 1500 or more I-band observations. We compare our findings with earlier studies regarding lightcurve modulation in LMC and galactic field RR1 stars. We also report the discovery of the modulated-Blazhko RR1 star OGLE-BLG-RRLYR-03825 which has a Blazhko period of 16.469 d which itself is modulated with a period of 339.2 d.
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