Hazard rate ratio and prospective epidemiological studies

Analysis of prospective follow-up data usually includes a Cox regression model. When a hazard rate ratio, obtained as the exponential of an estimated regression coefficient from the Cox model, is greater than 1.0, it consistently exceeds relative risk, and is exceeded by the odds ratio. The divergence of these distinct epidemiologic measures increases with the product of three factors: (1) the length of follow-up, (2) the average rate of the end point occurence over the follow-up period, and (3) the magnitude of risk, either above or below 1. Cornfield's rare disease assumption is basically the product of the first two of these factors. However, risks in excess of 2.5 have a powerful effect on the divergence of these measures, and this point has received less emphasis. Conversely, and as seen frequently in applications, relative risk, hazard rate ratio, and odds ratio numerically approximate one another with shorter follow-up, rarer end points, and risks closer to 1. Although the hazard rate ratio is not always distinguished from relative risk, it is commonly close to, and is always between, relative risk and the odds ratio. Consistent and accurate terminology would have us use hazard rate ratio with Cox regression and odds ratio with logistic regression. The term "relative risk" seems to be a default choice, regardless of the model being used. However, when relative risk is the object of the model chosen, as in a Poisson regression approximation of two binomial proportions or an equivalent weighted least squares, then for us, relative risk is the accurate terminology.

Birefringence in gradient-index rod lenses: a direct measurement method and interferometric polarization effects

Gradient-index (GRIN) media can contain stress birefringence resulting from the variation in material composition. Anisotropy in a GRIN rod lens affects ray propagation and can degrade image quality. A technique, believed to be new, for measuring birefringence in GRIN rod lenses has been developed. The change in optical path difference (OPD) for orthogonal polarizations is measured directly. With this method, effects on OPD from standard imaging aberrations are excluded. Birefringence measurements for various GRIN rod samples are presented. The data are compared with results obtained previously by use of a Twyman-Green measurement method. Also, the polarization effects on tilt fringes observed with the direct measurement method and the Twyman-Green method are presented and modeled theoretically. Tilt fringes for large birefringence test cases are also modeled.

Probing the structure of metal cluster-adsorbate systems with high-resolution infrared spectroscopy

High-resolution infrared laser spectroscopy was used to obtain rotationally resolved infrared spectra of adsorbate-metal complexes. The method involves forming the bare metal clusters in helium nanodroplets and then adding a molecular adsorbate (HCN) and recording the infrared spectrum associated with the C-H stretching vibration. Rotationally resolved spectra were obtained for HCN-Mg(n) (n = 1 to 4). The results suggest a qualitative change in the adsorbate-metal cluster bonding with cluster size.

The NIEHS Xenopus maternal EST project: interim analysis of the first 13,879 ESTs from unfertilized eggs

The sequencing of expressed sequence tags (ESTs) from Xenopus laevis has lagged behind efforts on many other common experimental organisms and man, partly because of the pseudotetraploid nature of the Xenopus genome. Nonetheless, large collections of Xenopus ESTs would be useful in gene discovery, oligonucleotide-based knockout studies, gene chip analyses of normal and perturbed development, mapping studies in the related diploid frog X. tropicalis, and for other reasons. We have created a normalized library of cDNAs from unfertilized Xenopus eggs. These cells contain all of the information necessary for the first several cell divisions in the early embryo, as well as much of the information needed for embryonic pattern formation and cell fate determination. To date, we have successfully sequenced 13,879 ESTs out of 16,607 attempts (83.6% success rate), with an average sequence read length of 508 bp. Using a fragment assembly program, these ESTs were assembled into 8,985 'contigs' comprised of up to 11 ESTs each. When these contigs were used to search publicly available databases, 46.2% bore no relationship to protein or DNA sequences in the database at the significance level of 1e-6. Examination of a sample of 100 of the assembled contigs revealed that most ( approximately 87%) were comprised of two apparent allelic variants. Expression profiles of 16 of the most prominent contigs showed that 12 exhibited some degree of zygotic expression. These findings have implications for sequence-specific applications for Xenopus ESTs, particularly the use of allele-specific oligonucleotides for knockout studies, differential hybridization techniques such as gene chip analysis, and the establishment of accurate nomenclature and databases for this species.

Quiet time: a nursing intervention to promote sleep in neurocritical care units

BACKGROUND

Patients in intensive care units are often sleep deprived, yet little research exists on the impact of nursing care on promoting sleep.

OBJECTIVES

To determine if implementing a "quiet time" protocol to reduce external environmental stimuli is associated with increased frequency of sleep among patients in a neurocritical care unit.

METHODS

Patients were observed 8 times each day before and after implementation of a protocol in which environmental sounds and lights were decreased from 2 AM to 4 AM and from 2 PM to 4 PM. Data collected at 2:45 AM, 3:30 AM, 2:45 PM, and 3:30 PM on patients with scores of 10 or greater on the Glasgow Coma Scale were analyzed. A total of 2975 observations were made on a total of 239 patients: 1446 observations on 118 patients in the control group and 1529 observations on 121 patients in the intervention group.

RESULTS

The percentage of patients observed asleep was significantly higher during the months the quite-time period was implemented than during the control period before the intervention was started. The increase in sleep behavior was associated with decreased sound and light levels achieved during the quiet time. Patients observed during the intervention period were 1.6 times more likely to be asleep during the quiet time than were patients observed during the control period (P < .001).

CONCLUSIONS

A concentrated effort by staff to reduce environmental stimuli at discrete preset intervals increases the likelihood of sleep during scheduled quiet time in the neurocritical care unit.

Quiet time: a nursing intervention to promote sleep in neurocritical care units

BACKGROUND: Patients in intensive care units are often sleep deprived, yet little research exists on the impact of nursing care on promoting sleep. OBJECTIVES: To determine if implementing a "quiet time" protocol to reduce external environmental stimuli is associated with increased frequency of sleep among patients in a neurocritical care unit. METHODS: Patients were observed 8 times each day before and after implementation of a protocol in which environmental sounds and lights were decreased from 2 AM to 4 AM and from 2 PM to 4 PM. Data collected at 2:45 AM, 3:30 AM, 2:45 PM, and 3:30 PM on patients with scores of 10 or greater on the Glasgow Coma Scale were analyzed. A total of 2975 observations were made on a total of 239 patients: 1446 observations on 118 patients in the control group and 1529 observations on 121 patients in the intervention group. RESULTS: The percentage of patients observed asleep was significantly higher during the months the quite-time period was implemented than during the control period before the intervention was started. The increase in sleep behavior was associated with decreased sound and light levels achieved during the quiet time. Patients observed during the intervention period were 1.6 times more likely to be asleep during the quiet time than were patients observed during the control period (P &lt; .001). CONCLUSIONS: A concentrated effort by staff to reduce environmental stimuli at discrete preset intervals increases the likelihood of sleep during scheduled quiet time in the neurocritical care unit.

Measurement and calibration of interferometric imaging aberrations

Phase-shifting interferometry is the standard method for testing figure error on optical surfaces. Instruments measuring spheres and flats are readily available, but the accurate measurement of aspheres requires null correction. One problem with the general (nonull) testing of aspheres is the loss of common path. Systematic errors are introduced into the measurement by the fringe imaging optics. The sources and types of error are reviewed, as well as their effect on a wave-front measurement. These nonnull errors are predicted generally, with third-order analytic expressions derived for a tilted or a defocused test surface. An interferometer is built to test the expressions. The imaging system is a single lens, nominally image telecentric. Measurements are performed on a test surface defocused from -5 to 5 mm. The resulting measurement bias is shown to be in good agreement with third-order aberration theory predictions.

The life readiness program: a physical rehabilitation program for patients on hemodialysis

Patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) are typically sedentary and functionally limited as a consequence of their condition. The purpose of this study is to test the effect of a lifestyle physical rehabilitation program (The Life Readiness Program) on physical function in patients with ESRD undergoing HD. Physical function was measured by the Kidney Disease Quality of Life Short Form (KDQOL-SF) physical function score (range, 0 to 100). Eighty-two patients were randomly assigned to a 6-month rehabilitation program (intervention; n = 39) or to standard clinical management alone (control; n = 43). The groups were frequency matched by age, sex, ethnicity, and diabetes as the cause of ESRD. General linear modeling of the change in physical function score was used for multivariate analysis. Physical function scores were not different between groups at baseline. Change in physical function score increased significantly in the intervention group compared with the control group when data were adjusted for the matching variables and adequacy of dialysis (3.2, -3.6; P = 0.04). Additionally, the control group reported more problems with work or daily functions because of emotional problems (P: </= 0.05). In this brief 6-month intervention, The Life Readiness Program showed the therapeutic benefit of a lifestyle rehabilitation program on functional outcomes and health-related quality of life for patients with ESRD undergoing hemodialysis.

Design and manufacture of a gradient-index axicon

A gradient-index axicon with its initial focus offset from the back surface was designed with the thin-lens approximation. Two samples were fabricated by means of the time-varying boundary condition diffusion method, which is based on the modified quasi-chemical diffusion model. Intensity profile measurements were taken along the focal region of the axicons. The samples produced extended line foci. From the intensity measurements, the central spot widths and back focal lengths were determined. The peak widths matched theoretical predictions made with the diffraction theory for the samples and showed good agreement with the predicted widths for a pseudo-Bessel beam, showing that the axicon produced a pseudo-diffractionless beam.

Interference imaging for aspheric surface testing

Peak-valley accuracy of lambda/20 over a range of 2lambda is not unusual in an interferometric null test. For the larger dynamic ranges of a nonnull test, however, the fringe-imaging optics degrades the accuracy. We classify the errors introduced and analyze them in the context of both general and third-order aberration theory. We can predict the measurement error from known interferometer parameters, and we illustrate this for a single mirror. The errors are tabulated for the specific case of a fourth-order asphere with 100 mum of sag. We show that the third-order approximation is comparable with exact ray-trace results for this case.

Birefringence measurements in gradient-index rod lenses

Stress birefringence can be found in gradient-index (GRIN) materials because they contain a variation in composition. GRIN glass fabricated by ion exchange may contain stress from two different processes. These include a size difference between the exchange and the diffusing ions and a variation in the thermal-expansion coefficient across the gradient region. The optical properties of the stressed material are polarization dependent, and therefore image quality is directly affected. We examine birefringence in GRIN rod lenses that have lengths more than ten times greater than their diameters. The effects are more easily observed in long rod lenses because of the large optical path lengths.

Interferometric chromatic dispersion measurements of long, gradient-index rod lenses in the visible and the near infrared

A new procedure is presented for testing long, radial-gradient-index rod lenses in a phase-stepping Twyman-Green interferometer. In addition, a method for converting the measured optical phase data to the rod's index of refraction profile is reviewed. This procedure was used to measure refractive-index profile dispersions over the wavelength range of 441 to 1064 nm. These measurements provide the first data for refractive-index profiles of rod lenses in the infrared and show the existence of positive dispersion, negative dispersion, and near-infrared dispersion reversal in some samples. The dispersion results suggest the need for modifications to the current glass model.

Design of three-element night-vision goggle objectives

Night-vision goggle objectives are often composed of six or more conventional lens elements with spherical surfaces and homogeneous refractive indices. Special elements such as aspheres, diffractive optics, and gradient-index materials can be used to reduce the total number of lenses required to meet military design specifications. A study was performed to examine the use of various combinations of these special surfaces to determine the minimum number of elements that can be used to construct the objective system. We present and compare the best resulting designs.