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Sample records for cumulative 5-year delivery

  1. Determinants and Outcomes of Emergency Caesarean Section following Failed Instrumental Delivery: 5-Year Observational Review at a Tertiary Referral Centre in London

    PubMed Central

    McDonnell, Sian; Chandraharan, Edwin

    2015-01-01

    Objectives. To review the determinants for a failed operative vaginal delivery and to examine associated fetal and maternal morbidity. Design. Retrospective observational study. Setting. Large London Teaching Hospital. Method. A retrospective review of case notes during a 5-year period was carried out. Results. Overall 119 women (0.44%) out of 26,856 births had a caesarean section following a failed instrumental delivery, which comprised 5.1% of all operative vaginal births. 73% had a spontaneous onset of labour and 63% required syntocinon at some time prior to delivery. 71.5% of deliveries were complicated by malposition. Only 20% of deliveries were attended by a consultant obstetrician. Almost 50% of women and 8.4% of neonates sustained trauma at the time of either their failed instrumental delivery or the caesarean section. Conclusions. Emergency caesarean section during the second stage of labour is associated with maternal and fetal complications. A ‘failed instrumental delivery score' (FIDS) may aid practitioners in predicting an increased likelihood of a failed operative vaginal birth and therefore to consider a trial of operative vaginal delivery in the theatre. Senior input should also be sought because a failed operative vaginal birth is associated with increased maternal and fetal morbidity. PMID:26078882

  2. Use of a Cumulative Exposure Index to Estimate the Impact of Tap Water Lead Concentration on Blood Lead Levels in 1- to 5-Year-Old Children (Montréal, Canada)

    PubMed Central

    Ngueta, Gerard; Abdous, Belkacem; Tardif, Robert; St-Laurent, Julie; Levallois, Patrick

    2015-01-01

    Background Drinking water is recognized as a source of lead (Pb) exposure. However, questions remain about the impact of chronic exposure to lead-contaminated water on internal dose. Objective Our goal was to estimate the relation between a cumulative water Pb exposure index (CWLEI) and blood Pb levels (BPb) in children 1–5 years of ages. Methods Between 10 September 2009 and 27 March 2010, individual characteristics and water consumption data were obtained from 298 children. Venous blood samples were collected (one per child) and a total of five 1-L samples of water per home were drawn from the kitchen tap. A second round of water collection was performed between 22 June 2011 and 6 September 2011 on a subsample of houses. Pb analyses used inductively coupled plasma mass spectroscopy. Multiple linear regressions were used to estimate the association between CWLEI and BPb. Results Each 1-unit increase in CWLEI multiplies the expected value of BPb by 1.10 (95% CI: 1.06, 1.15) after adjustment for confounders. Mean BPb was significantly higher in children in the upper third and fourth quartiles of CWLEI (0.7–1.9 and ≥ 1.9 μg/kg of body weight) compared with the first (< 0.2 μg/kg) after adjusting for confounders (19%; 95% CI: 0, 42% and 39%; 95% CI: 15, 67%, respectively). The trends analysis yielded a p-value < 0.0001 after adjusting for confounders suggesting a dose–response relationship between percentiles of CWLEI and BPb. Conclusions In children 1–5 years of age, BPb was significantly associated with water lead concentration with an increase starting at a cumulative lead exposure of ≥ 0.7 μg Pb/kg of body weight. In this age group, an increase of 1 μg/L in water lead would result in an increase of 35% of BPb after 150 days of exposure. Citation Ngueta G, Abdous B, Tardif R, St-Laurent J, Levallois P. 2016. Use of a cumulative exposure index to estimate the impact of tap water lead concentration on blood lead levels in 1- to 5-year-old children

  3. Cumulative dose on fractional delivery of tomotherapy to periodically moving organ: A phantom QA suggestion

    SciTech Connect

    Shin, Eunhyuk; Han, Youngyih; Park, Hee-Chul; Sung Kim, Jin; Hwan Ahn, Sung; Suk Shin, Jung; Gyu Ju, Sang; Ho Choi, Doo; Lee, Jaiki

    2013-01-01

    This study was conducted to evaluate the cumulative dosimetric error that occurs in both target and surrounding normal tissues when treating a moving target in multifractional treatment with tomotherapy. An experiment was devised to measure cumulative error in multifractional treatments delivered to a horseshoe-shaped clinical target volume (CTV) surrounding a cylinder shape of organ at risk (OAR). Treatments differed in jaw size (1.05 vs 2.5 cm), pitch (0.287 vs 0.660), and modulation factor (1.5 vs 2.5), and tumor motion characteristics differing in amplitude (1 to 3 cm), period (3 to 5 second), and regularity (sinusoidal vs irregular) were tested. Treatment plans were delivered to a moving phantom up to 5-times exposure. Dose distribution on central coronal plane from 1 to 5 times exposure was measured with GAFCHROMIC EBT film. Dose differences occurring across 1 to 5 times exposure of treatment and between treatment plans were evaluated by analyzing measurements of gamma index, gamma index histogram, histogram changes, and dose at the center of the OAR. The experiment showed dose distortion due to organ motion increased between multiexposure 1 to 3 times but plateaued and remained constant after 3-times exposure. In addition, although larger motion amplitude and a longer period of motion both increased dosimetric error, the dose at the OAR was more significantly affected by motion amplitude rather than motion period. Irregularity of motion did not contribute significantly to dosimetric error when compared with other motion parameters. Restriction of organ motion to have small amplitude and short motion period together with larger jaw size and small modulation factor (with small pitch) is effective in reducing dosimetric error. Pretreatment measurements for 3-times exposure of treatment to a moving phantom with patient-specific tumor motion would provide a good estimation of the delivered dose distribution.

  4. 5-Year Budget Forecasting.

    ERIC Educational Resources Information Center

    Conyers, John G.; Lingel, George; Piekarski, Robert

    2000-01-01

    Financial planning is the key to providing a high-quality instructional plan. A 5-year financial plan is typically updated by looking at district financial history, future instructional plans, staffing requirements, and revenue projections. Planning assumptions must be clearly understood by the financial team and the community. (MLH)

  5. What is the most relevant standard of success in assisted reproduction?: The cumulated singleton/twin delivery rates per oocyte pick-up: the CUSIDERA and CUTWIDERA.

    PubMed

    Germond, Marc; Urner, Françoise; Chanson, Alain; Primi, Marie-Pierre; Wirthner, Daniel; Senn, Alfred

    2004-11-01

    National and international registries are essential tools for establishing new standards and comparing success rates, but they do not take into account the total pregnancy/delivery rate per oocyte recovery. In Switzerland and Germany, because of legal constraints, a maximum of three two-pronuclear zygotes are allocated for transfer whereas all the supernumerary pronuclear zygotes are immediately cryopreserved, preventing selection of the transferred embryos. We report on a 10 years' experience (1993-2002) of our centre which performs transfers of unselected embryos and cryopreservation at the two-pronuclear zygote stage. As approximately 30% of all deliveries are from cryo cycles, it is essential to take into account the contribution of the cryo transfers, and we propose therefore to evaluate, as a measure of IVF performance, the cumulated delivery rate per oocyte pick-up. This delivery rate is broken down further into the cumulated singleton delivery rate (CUSIDERA) and the cumulated twin delivery rate (CUTWIDERA). The sum (S) of these two rates is a measure of efficacy while the ratio CUTWIDERA/S as a percentage is a measure of safety of IVF treatments. Using these new indexes, the average 10 year efficacy and safety of our IVF programme were 26 and 19%, respectively. Both CUSIDERA and CUTWIDERA can be calculated easily in any clinical situation and yield useful parameters for patient counselling and internal/external benchmarking purposes. PMID:15358719

  6. Developmental milestones record - 5 years

    MedlinePlus

    ... milestones for children - 5 years References Feigelman S. The preschool years. In: Kliegman RM, Behrman RE, Jenson HB, ... Duplication for commercial use must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map ...

  7. Magnetic cumulation

    NASA Astrophysics Data System (ADS)

    Pavlovskij, A. I.

    1990-08-01

    The second half of 40-th -finish of 60-th of the XX-th Century were prolific y ears of scientific activity of A.D. Sakharov (1921-1990), when his unique creati ve aptitudes and inventivity has found a wide manifestation. Besides of his decis ive contribution to creation of Soviet thermonuclear weapons, in the area of his interests entered various problems of tehrmonuclaer energetics. In 1950 I.E. Tam m and A.D. Sakharov formulated the principles of magnetic thermoisolation of High temperature Plasmas, which put a beginning to controlled thermonuclear synthesis in the U.S.S.R. In 1951 A.D. Sakharov developed the theory of magnetic stationa ry thermonuclear reactor, which are closed to modern Tokamaks. Approximately in 1960-1961 He examined the possibility of thermonuclear synthesis on the basis of L aser compression of a spherical target. The idea of magnetic cumulation was forwrded by A.D. Sakharov as one of the ways of the obtaining of a controlled impulse thermonuclear reaction.

  8. Prone Breast Intensity Modulated Radiation Therapy: 5-Year Results

    SciTech Connect

    Osa, Etin-Osa O.; DeWyngaert, Keith; Roses, Daniel; Speyer, James; Guth, Amber; Axelrod, Deborah; Fenton Kerimian, Maria; Goldberg, Judith D.; Formenti, Silvia C.

    2014-07-15

    Purpose: To report the 5-year results of a technique of prone breast radiation therapy delivered by a regimen of accelerated intensity modulated radiation therapy with a concurrent boost to the tumor bed. Methods and Materials: Between 2003 and 2006, 404 patients with stage I-II breast cancer were prospectively enrolled into 2 consecutive protocols, institutional trials 03-30 and 05-181, that used the same regimen of 40.5 Gy/15 fractions delivered to the index breast over 3 weeks, with a concomitant daily boost to the tumor bed of 0.5 Gy (total dose 48 Gy). All patients were treated after segmental mastectomy and had negative margins and nodal assessment. Patients were set up prone: only if lung or heart volumes were in the field was a supine setup attempted and chosen if found to better spare these organs. Results: Ninety-two percent of patients were treated prone, 8% supine. Seventy-two percent had stage I, 28% stage II invasive breast cancer. In-field lung volume ranged from 0 to 228.27 cm{sup 3}, mean 19.65 cm{sup 3}. In-field heart volume for left breast cancer patients ranged from 0 to 21.24 cm{sup 3}, mean 1.59 cm{sup 3}. There was no heart in the field for right breast cancer patients. At a median follow-up of 5 years, the 5-year cumulative incidence of isolated ipsilateral breast tumor recurrence was 0.82% (95% confidence interval [CI] 0.65%-1.04%). The 5-year cumulative incidence of regional recurrence was 0.53% (95% CI 0.41%-0.69%), and the 5-year overall cumulative death rate was 1.28% (95% CI 0.48%-3.38%). Eighty-two percent (95% CI 77%-85%) of patients judged their final cosmetic result as excellent/good. Conclusions: Prone accelerated intensity modulated radiation therapy with a concomitant boost results in excellent local control and optimal sparing of heart and lung, with good cosmesis. Radiation Therapy Oncology Group protocol 1005, a phase 3, multi-institutional, randomized trial is ongoing and is evaluating the equivalence of a similar dose and

  9. Periampullary adenocarcinoma: analysis of 5-year survivors.

    PubMed Central

    Yeo, C J; Sohn, T A; Cameron, J L; Hruban, R H; Lillemoe, K D; Pitt, H A

    1998-01-01

    OBJECTIVE: This single-institution experience retrospectively reviews the outcomes in a group of patients treated 5 or more years ago by pancreaticoduodenectomy for periampullary adenocarcinoma. SUMMARY BACKGROUND DATA: Controversy exists regarding the benefit of resection for periampullary adenocarcinoma, particularly for pancreatic tumors. Many series report only Kaplan-Meier actuarial 5-year survival rates. There are believed to be discrepancies between the actuarial 5-year survival data and the actual 5-year survival rates. METHODS: From April 1970 through May 1992, 242 patients underwent pancreaticoduodenal resection for periampullary adenocarcinoma at The Johns Hopkins Hospital. Follow-up was complete through May 1997. All pathology specimens were reviewed and categorized. Actual 5-year survival rates were calculated. The demographic, intraoperative, pathologic, and postoperative features of patients surviving > or =5 years were compared with those of patients who survived <5 years. RESULTS: Of the 242 patients with resected periampullary adenocarcinoma, 149 (62%) were pancreatic primaries, 46 (19%) arose in the ampulla, 30 (12%) were distal bile duct cancers, and 17 (7%) were duodenal cancers. There was a 5.3% operative mortality rate during the 22 years of the review, with a 2% operative mortality rate in the last 100 patients. There were 58 5-year survivors, 28 7-year survivors, and 7 10-year survivors. The tumor-specific 5-year actual survival rates were pancreatic 15%, ampullary 39%, distal bile duct 27%, and duodenal 59%. When compared with patients who did not survive 5 years, the 5-year survivors had a significantly higher percentage of well-differentiated tumors (14% vs. 4%; p = 0.02) and higher incidences of negative resection margins (98% vs. 73%, p < 0.0001) and negative nodal status (62% vs. 31%, p < 0.0001). The tumor-specific 10-year actuarial survival rates were pancreatic 5%, ampullary 25%, distal bile duct 21%, and duodenal 59%. CONCLUSIONS

  10. A 5-year retrospective clinical study of the Dentium implants

    PubMed Central

    Lee, Jeong-Yol; Park, Hyo-Jin; Kim, Jong-Eun; Choi, Yong-Geun; Kim, Young-Soo; Huh, Jung-Bo

    2011-01-01

    PURPOSE The aim of this retrospective study was to evaluate cumulative survival rate (CSR) of Implantium implants followed for 5 years and association between risk factors and the CSR. MATERIALS AND METHODS A total of two hundred forty-nine Implantium Implants System (Dentium, Seoul, Korea) placed in ninety-five patients from 2004 to 2009 were investigated with several identified risk factors (sex, systemic disease, smoking, alchohol, reason of tooth loss, length, arch (maxilla or mandible), replace tooth type (incisor, canine, premolar or molar) Kennedy classification, prosthodontic type, prosthodontic design, opposite dentition, abutment type, occlusal material, occlusal unit, splint to tooth, cantilever, other surgery). Clinical examination (mobility, percussion, screw loosening, discomfort, etc.) and radiographic examination data were collected from patient records including all problems during follow-up period according to protocols described earlier. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR. RESULTS Five of 249 implants were failed. Four of these were lost before loading. The 5-year implant cumulative survival rate was 97.37%. Cox regression analysis demonstrated a significant predictive association between overall CSR and systemic disease, smoking, reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The screw related complication was rare. Two abutment screw fractures were found. Another complications of prosthetic components were porcelain fracture, resin facing fracture and denture fracture (n=19). CONCLUSION The 5-year CSR of Implantium implants was 97.37%. Implant survival may be dependent upon systemic disease, smoking reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The presence of systemic diseases and combination of other surgical procedures may be associated

  11. The first 5 years after the dissertation.

    PubMed

    Hodges, L C; Poteet, G W

    1992-01-01

    To succeed in academia, nursing faculty members must devote the first 5 years following the dissertation to achieving a standard to tenure characteristic of the profession. Most institutions in the country adhere to the American Association of University Professors' guidelines for tenure. These guidelines mandate excellence in teaching, scholarship, and service. A fourth characteristic, leadership, is increasingly considered in tenure decisions. The expectations of an academic career in nursing serve as the foundation for a framework to evaluate the likelihood of success in a particular setting. A detailed 5-year plan for achieving tenure is proposed. PMID:1634654

  12. Cumulants, free cumulants and half-shuffles

    PubMed Central

    Ebrahimi-Fard, Kurusch; Patras, Frédéric

    2015-01-01

    Free cumulants were introduced as the proper analogue of classical cumulants in the theory of free probability. There is a mix of similarities and differences, when one considers the two families of cumulants. Whereas the combinatorics of classical cumulants is well expressed in terms of set partitions, that of free cumulants is described and often introduced in terms of non-crossing set partitions. The formal series approach to classical and free cumulants also largely differs. The purpose of this study is to put forward a different approach to these phenomena. Namely, we show that cumulants, whether classical or free, can be understood in terms of the algebra and combinatorics underlying commutative as well as non-commutative (half-)shuffles and (half-) unshuffles. As a corollary, cumulants and free cumulants can be characterized through linear fixed point equations. We study the exponential solutions of these linear fixed point equations, which display well the commutative, respectively non-commutative, character of classical and free cumulants.

  13. Spontaneous Pneumothorax: A 5-Year Experience

    PubMed Central

    Sousa, Cristiana; Neves, Joao; Sa, Nuno; Goncalves, Fabienne; Oliveira, Julio; Reis, Ernestina

    2011-01-01

    Background Spontaneous pneumothorax (SP) is defined by the presence of air in the pleural space without history of trauma. It is classified as secondary if coexisting with underlying pulmonary disease. Its an entity with considerable incidence and treatment particularities which give reason for a reflection on the subject. We present a 5-year casuistry, characterizing the SP epidemiology, clinical presentation, investigation and therapeutic choices. Methods Sixty-six patients were included in the study, corresponding to 93 episodes of SP. Results We have found male predominance and the mean age was 34.5 years old. In 60.6% of cases there was history of tobacco use; 36.4% of cases were classified as secondary; 30.1% of patients with secondary SP and 21.7% with primary SP recurred; 89.2% had an acute presentation. The most frequent initial symptom was chest pain (90.3%) and 81.7% had diminished breath sounds. In 17.3% it was documented a physical strain associated. We did not identify statistically significant association between the SP occurrence and the variation of the atmospheric pressure, on the first day of symptoms. In 12.9% of episodes the initial treatment option was observation. In most of the episodes the lung totally expanded. However, in 29.1% of the episodes surgical treatment was needed. Conclusions Our results are similar to the literature. Some clinical records are incomplete, demanding the implementation of rules to improve knowledge about this matter. Keywords Spontaneous pneumothorax; Primary spontaneous pneumothorax; Secondary spontaneous pneumothorax; Epidemiology PMID:21811541

  14. Microbiological monitoring of endoscopes: 5-year review.

    PubMed

    Gillespie, Elizabeth E; Kotsanas, Despina; Stuart, Rhonda L

    2008-07-01

    Periodic microbiological monitoring of endoscopes is a recommendation of the Gastroenterological Society of Australia (GENSA). The aim of monitoring has been to provide quality assurance of the cleaning and disinfection of endoscopes; however, there is controversy regarding its frequency. This lack of consensus stimulated a review of the experience within our health service. At Southern Health, routine microbiological sampling has involved 4-weekly monitoring of bronchoscopes, duodenoscopes and automated flexible endoscope reprocessors (AFER), and 3-monthly monitoring of all other gastrointestinal endoscopes. Records of testing were reviewed from 1 January 2002 until 31 December 2006. A literature review was conducted, cost analysis performed and positive cultures investigated. There were 2374 screening tests performed during the 5-year period, including 287 AFER, 631 bronchoscopes for mycobacteria and 1456 endoscope bacterial screens. There were no positive results of the AFER or bronchoscopes for mycobacteria. Of the 1456 endoscopic bacterial samples, six were positive; however, retesting resulted in no growth. The overall cost of tests performed and cost in time for nursing staff to collect the samples was estimated at $AUD 100,400. Periodic monitoring of endoscopes is both time-consuming and costly. Our review demonstrates that AFER (Soluscope) perform well in cleaning endoscopes. Based on our 5-year experience, assurance of quality for endoscopic use could be achieved through process control as opposed to product control. Maintenance of endoscopes and AFER should be in accordance with the manufacturer's instructions and microbiological testing performed on commissioning, annually and following repair. Initial prompt manual leak testing and manual cleaning followed by mechanical leak testing, cleaning and disinfection should be the minimum standard in reprocessing of endoscopes. PMID:18086113

  15. Cumulative Poisson Distribution Program

    NASA Technical Reports Server (NTRS)

    Bowerman, Paul N.; Scheuer, Ernest M.; Nolty, Robert

    1990-01-01

    Overflow and underflow in sums prevented. Cumulative Poisson Distribution Program, CUMPOIS, one of two computer programs that make calculations involving cumulative Poisson distributions. Both programs, CUMPOIS (NPO-17714) and NEWTPOIS (NPO-17715), used independently of one another. CUMPOIS determines cumulative Poisson distribution, used to evaluate cumulative distribution function (cdf) for gamma distributions with integer shape parameters and cdf for X (sup2) distributions with even degrees of freedom. Used by statisticians and others concerned with probabilities of independent events occurring over specific units of time, area, or volume. Written in C.

  16. Delivery

    PubMed Central

    Miller, Thomas A

    2013-01-01

    Enthusiasm greeted the development of synthetic organic insecticides in the mid-twentieth century, only to see this give way to dismay and eventually scepticism and outright opposition by some. Regardless of how anyone feels about this issue, insecticides and other pesticides have become indispensable, which creates something of a dilemma. Possibly as a result of the shift in public attitude towards insecticides, genetic engineering of microbes was first met with scepticism and caution among scientists. Later, the development of genetically modified crop plants was met with an attitude that hardened into both acceptance and hard-core resistance. Transgenic insects, which came along at the dawn of the twenty-first century, encountered an entrenched opposition. Those of us responsible for studying the protection of crops have been affected more or less by these protagonist and antagonistic positions, and the experiences have often left one thoughtfully mystified as decisions are made by non-participants. Most of the issues boil down to concerns over delivery mechanisms. © 2013 Society of Chemical Industry PMID:23852646

  17. The Alcohol Warning and Adolescents: 5-Year Effects.

    ERIC Educational Resources Information Center

    MacKinnon, David P.; Nohre, Liva; Pentz, Mary Ann; Stacy, Alan W.

    2000-01-01

    Examined the effect of alcohol warning labels on adolescents during the first 5 years that the warning was required. Surveys of 10th and 12th grade students over 5 years indicated that the initial positive effects of the labels on adolescents leveled off after 3.5 years. The labels have not affected adolescents' beliefs about alcohol or…

  18. Cumulative fatigue damage models

    NASA Technical Reports Server (NTRS)

    Mcgaw, Michael A.

    1988-01-01

    The problem of calculating expected component life under fatigue loading conditions is complicated by the fact that component loading histories contain, in many cases, cyclic loads of widely varying amplitudes. In such a case a cumulative damage model is required, in addition to a fatigue damage criterion, or life relationship, in order to compute the expected fatigue life. The traditional cumulative damage model used in design is the linear damage rule. This model, while being simple to use, can yield grossly unconservative results under certain loading conditions. Research at the NASA Lewis Research Center has led to the development of a nonlinear cumulative damage model, named the double damage curve approach (DDCA), that has greatly improved predictive capability. This model, which considers the life (or loading) level dependence of damage evolution, was applied successfully to two polycrystalline materials, 316 stainless steel and Haynes 188. The cumulative fatigue behavior of the PWA 1480 single-crystal material is currently being measured to determine the applicability of the DDCA for this material.

  19. The Mental Effort Requirement of Cumulative Rehearsal: A Developmental Study.

    ERIC Educational Resources Information Center

    Guttentag, Robert E.

    1984-01-01

    Examines the relationship between the mental effort requirement of cumulative rehearsal and spontaneous utilization of the strategy by three groups of children (mean ages 7.6, 8.7, and 11.5 years). Results showed that the mental effort requirement of strategy use may influence children's strategy selection on memory tasks. (Author/CI)

  20. CUMBIN - CUMULATIVE BINOMIAL PROGRAMS

    NASA Technical Reports Server (NTRS)

    Bowerman, P. N.

    1994-01-01

    The cumulative binomial program, CUMBIN, is one of a set of three programs which calculate cumulative binomial probability distributions for arbitrary inputs. The three programs, CUMBIN, NEWTONP (NPO-17556), and CROSSER (NPO-17557), can be used independently of one another. CUMBIN can be used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. The program has been used for reliability/availability calculations. CUMBIN calculates the probability that a system of n components has at least k operating if the probability that any one operating is p and the components are independent. Equivalently, this is the reliability of a k-out-of-n system having independent components with common reliability p. CUMBIN can evaluate the incomplete beta distribution for two positive integer arguments. CUMBIN can also evaluate the cumulative F distribution and the negative binomial distribution, and can determine the sample size in a test design. CUMBIN is designed to work well with all integer values 0 < k <= n. To run the program, the user simply runs the executable version and inputs the information requested by the program. The program is not designed to weed out incorrect inputs, so the user must take care to make sure the inputs are correct. Once all input has been entered, the program calculates and lists the result. The CUMBIN program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly with most C compilers. The program format is interactive. It has been implemented under DOS 3.2 and has a memory requirement of 26K. CUMBIN was developed in 1988.

  1. Cumulative Timers for Microprocessors

    NASA Technical Reports Server (NTRS)

    Battle, John O.

    2007-01-01

    It has been proposed to equip future microprocessors with electronic cumulative timers, for essentially the same reasons for which land vehicles are equipped with odometers (total-distance-traveled meters) and aircraft are equipped with Hobbs meters (total-engine-operating time meters). Heretofore, there has been no way to determine the amount of use to which a microprocessor (or a product containing a microprocessor) has been subjected. The proposed timers would count all microprocessor clock cycles and could only be read by means of microprocessor instructions but, like odometers and Hobbs meters, could never be reset to zero without physically damaging the chip.

  2. CROSSER - CUMULATIVE BINOMIAL PROGRAMS

    NASA Technical Reports Server (NTRS)

    Bowerman, P. N.

    1994-01-01

    The cumulative binomial program, CROSSER, is one of a set of three programs which calculate cumulative binomial probability distributions for arbitrary inputs. The three programs, CROSSER, CUMBIN (NPO-17555), and NEWTONP (NPO-17556), can be used independently of one another. CROSSER can be used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. The program has been used for reliability/availability calculations. CROSSER calculates the point at which the reliability of a k-out-of-n system equals the common reliability of the n components. It is designed to work well with all integer values 0 < k <= n. To run the program, the user simply runs the executable version and inputs the information requested by the program. The program is not designed to weed out incorrect inputs, so the user must take care to make sure the inputs are correct. Once all input has been entered, the program calculates and lists the result. It also lists the number of iterations of Newton's method required to calculate the answer within the given error. The CROSSER program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly with most C compilers. The program format is interactive. It has been implemented under DOS 3.2 and has a memory requirement of 26K. CROSSER was developed in 1988.

  3. NEWTONP - CUMULATIVE BINOMIAL PROGRAMS

    NASA Technical Reports Server (NTRS)

    Bowerman, P. N.

    1994-01-01

    The cumulative binomial program, NEWTONP, is one of a set of three programs which calculate cumulative binomial probability distributions for arbitrary inputs. The three programs, NEWTONP, CUMBIN (NPO-17555), and CROSSER (NPO-17557), can be used independently of one another. NEWTONP can be used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. The program has been used for reliability/availability calculations. NEWTONP calculates the probably p required to yield a given system reliability V for a k-out-of-n system. It can also be used to determine the Clopper-Pearson confidence limits (either one-sided or two-sided) for the parameter p of a Bernoulli distribution. NEWTONP can determine Bayesian probability limits for a proportion (if the beta prior has positive integer parameters). It can determine the percentiles of incomplete beta distributions with positive integer parameters. It can also determine the percentiles of F distributions and the midian plotting positions in probability plotting. NEWTONP is designed to work well with all integer values 0 < k <= n. To run the program, the user simply runs the executable version and inputs the information requested by the program. NEWTONP is not designed to weed out incorrect inputs, so the user must take care to make sure the inputs are correct. Once all input has been entered, the program calculates and lists the result. It also lists the number of iterations of Newton's method required to calculate the answer within the given error. The NEWTONP program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly with most C compilers. The program format is interactive. It has been implemented under DOS 3.2 and has a memory requirement of 26K. NEWTONP was developed in 1988.

  4. 2001 IFT Education Standards: A 5-Year Perspective

    ERIC Educational Resources Information Center

    Hartel, Richard W.

    2006-01-01

    The current IFT Education Standards used to evaluate Food Science programs for IFT approval have been in place now for 5 years. Most Food Science programs in the United States (as well as some in Mexico and Canada) have been reviewed according to these standards. The transition to instruction based on assessment of student learning outcomes, in…

  5. True or False: Do 5-Year-Olds Understand Belief?

    ERIC Educational Resources Information Center

    Fabricius, William V.; Boyer, Ty W.; Weimer, Amy A.; Carroll, Kathleen

    2010-01-01

    In 3 studies (N = 188) we tested the hypothesis that children use a perceptual access approach to reason about mental states before they understand beliefs. The perceptual access hypothesis predicts a U-shaped developmental pattern of performance in true belief tasks, in which 3-year-olds who reason about reality should succeed, 4- to 5-year-olds…

  6. Upper Body Muscular Endurance Among Children 2-5 Years.

    ERIC Educational Resources Information Center

    Gabbard, Carl P.; And Others

    The upper body muscular endurance of males and females 2-5 years of age was assessed, and relationships relative to sex, age, endurance and selected anthropometric measures were investigated. None of the relationships were found to be of practical predicative value; while upper body muscular strength increased with age, no significant differences…

  7. Stimulant Treatment over 5 Years: Effects on Growth

    ERIC Educational Resources Information Center

    Charach, Alice; Figueroa, Max; Chen, Shirley; Ickowicz, Abel; Schachar, Russell

    2006-01-01

    Objective: Long-term effects of psychostimulants on growth in height and in weight are investigated in children with attention-deficit/hyperactivity disorder. Method: Participants were 79 children, 6 to 12 years of age, with attention-deficit/hyperactivity disorder, who were followed annually for up to 5 years, between the years 1993 and 1994 and…

  8. Survival Rate of Short, Locking Taper Implants with a Plateau Design: A 5-Year Retrospective Study

    PubMed Central

    Demiralp, Kemal Özgür; Akbulut, Nihat; Kursun, Sebnem; Argun, Didem; Bagis, Nilsun; Orhan, Kaan

    2015-01-01

    Background. Short implants have become popular in the reconstruction of jaws, especially in cases with limited bone height. Shorter implants, those with locking tapers and plateau root shapes, tend to have longer survival times. We retrospectively investigated the cumulative survival rates of Bicon short implants (<8 mm) according to patient variables over a 5-year period. Materials and Methods. This study included 111 consecutively treated patients with 371 implants supporting fixed or removable prosthetics. Data were evaluated to acquire cumulative survival rates according to gender, age, tobacco use, surgical procedure, bone quality, and restoration type. Statistics were performed using chi-square, Mann-Whitney, and Kruskal Wallis H tests. Results. The survival rate was 97.3% with, on average, 22.8 months of follow-up. Patients older than 60 years had higher failure rate than the other age groups (P < 0.05). Placed region, age, and bone quality had adverse effects on survival rate in the <8 mm implant group with statistically significant difference (P < 0.05). Conclusions. Approximately 23-month follow-up data indicate that short implants with locking tapers and plateau-type roots have comparable survival rates as other types of dental implants. However, due to limitations of study, these issues remain to be further investigated in future randomized controlled clinical trials. PMID:25961004

  9. Failure to immunize children under 5 years: a literature review.

    PubMed

    Lochhead, Y J

    1991-02-01

    This paper aims to provide a critical review of the current literature related to immunization default in children under 5 years of age. The author has used a health belief model as the framework for analysis, examining each area in detail. The principle recommendations for practice are addressed and critically evaluated with a concluding summary of the main points raised and the author's recommendation for practice. PMID:2013653

  10. Modified Mandibulotomy Technique to Reduce Postoperative Complications: 5-Year Results

    PubMed Central

    Na, Hye-Young; Choi, Eun-Joo; Kim, Hyung Jun; Cha, In-Ho

    2013-01-01

    Purpose To review the 5-year outcomes of our modified mandibulotomy technique. Retrospective review of a tertiary level oral cancer center. Materials and Methods During a 5-year period, 30 patients who had a uniform surgical technique consisting of a lower lip-splitting, modified stair-step osteotomy with thin saw blade and osteotome after plate-precontouring and combination fixation with monocortical osteosynthesis (miniplate) and bicortical osteosynthesis (maxiplate and bicortical screws), with at least 14 months postoperative follow-up, were selected and reviewed retrospectively. Results There were 8 women and 22 men with an average age of 56.5 years. All the patients involved malignancies were squamous cell carcinoma. The main primary sites of the those who underwent a mandibulotomy were the tonsil, the base of tongue, the oral tongue, the retromolar pad area, and others. Others included buccal cheek, floor of mouth, and soft palate. 23 patients received postoperative radiation therapy, and among whom 8 patients also received chemotherapy. Total four (13%) mandibulotomy-related complications occurred, only two (6.7%) requiring additional operation under general anesthesia. Conclusion Our modified mandibulotomy meets the criteria for an ideal mandibulotomy technique relatively well because it requires no intermaxillary fixation, can precise preserve the occlusion in a precise way, allows early function, requires no secondary procedures, and has few complications. PMID:23918577

  11. Circumcision: a refined technique and 5 year review.

    PubMed Central

    Tucker, S. C.; Cerqueiro, J.; Sterne, G. D.; Bracka, A.

    2001-01-01

    The vast majority of circumcisions currently performed in the UK are for phimosis or balanitis and the patients are not looking for the denuded glans appearance of a ritual circumcision. We present a refinement of the sleeve technique of circumcision, which involves Horton's test to define the proximal incision margin, and bipolar electro-dissection. A review of all patients undergoing circumcision at the Wordsley Plastic Surgery Unit, in a 5-year period, has shown this technique to be safe with a haematoma rate of only 1.4%, and an overall complication rate of 3%. Images Figure 1 Figure 1 (G,H) Figure 2 PMID:11320921

  12. Migration of the Duraloc cup after 5 years.

    PubMed

    Stihsen, Christoph; Pabinger, Christof; Radl, Roman; Rehak, Peter; Windhager, Reinhard

    2008-12-01

    The Duraloc cup is a frequently used metal-backed, porous-coated, hemispherical, press-fit acetabular component. Published data on loosening rates are contradictory. In this study we investigated migration patterns with computer-assisted Einzel-Bild-Roentgen-Analyse (EBRA) of 67 Duraloc 100 cups. Cup migration and clinical scores were analysed over a 5-year follow-up period. Median total migration of the Duraloc 100 cup was 1.21 mm at 5 years. Seventy-five percent of implants were radiologically stable at 2 years and 90% at 4 years. One cup loosened aseptically at 60 months, requiring revision. Cup diameters > or = 54 mm migrated significantly more than cups < 54 mm in diameter (p = 0.029 at 4 years). There was a significant correlation between high polyethylene wear and further migrating cups within the first post-operative year (p = 0.035 at 12 months). Our analysis revealed significantly higher wear in males (p = 0.029 at 4 years). Radiological loosening at two years could be calculated using receiver-operating characteristic curve analysis, and 1.2 mm as an adequate threshold value (sensitivity = 100%, specificity = 89%). PMID:17609953

  13. Predictive 5-Year Survivorship Model of Cystic Fibrosis

    PubMed Central

    Liou, Theodore G.; Adler, Frederick R.; FitzSimmons, Stacey C.; Cahill, Barbara C.; Hibbs, Jonathan R.; Marshall, Bruce C.

    2007-01-01

    The objective of this study was to create a 5-year survivorship model to identify key clinical features of cystic fibrosis. Such a model could help researchers and clinicians to evaluate therapies, improve the design of prospective studies, monitor practice patterns, counsel individual patients, and determine the best candidates for lung transplantation. The authors used information from the Cystic Fibrosis Foundation Patient Registry (CFFPR), which has collected longitudinal data on approximately 90% of cystic fibrosis patients diagnosed in the United States since 1986. They developed multivariate logistic regression models by using data on 5,820 patients randomly selected from 11,630 in the CFFPR in 1993. Models were tested for goodness of fit and were validated for the remaining 5,810 patients for 1993. The validated 5-year survivorship model included age, forced expiratory volume in 1 second as a percentage of predicted normal, gender, weight-for-age z score, pancreatic sufficiency, diabetes mellitus, Staphylococcus aureus infection, Burkerholderia cepacia infection, and annual number of acute pulmonary exacerbations. The model provides insights into the complex nature of cystic fibrosis and supplies a rigorous tool for clinical practice and research. PMID:11207152

  14. Aeronautical Engineering: 1983 cumulative index

    NASA Technical Reports Server (NTRS)

    1984-01-01

    This bibliography is a cumulative index to the abstracts contained in NASA SP-7037 (158) through NASA SP-7037 (169) of Aeronautical Engineering: A Continuing Bibliography. NASA SP-7037 and its supplements have been compiled through the cooperative efforts of the American Institute of Aeronautics and Astronautics (AIAA) and the National Aeronautics and Space Administration (NASA). This cumulative index includes subject, personal author, corporate source, contract, report number, and accession number indexes.

  15. Understanding persistence in bulimia nervosa: a 5-year naturalistic study.

    PubMed

    Fairburn, Christopher G; Stice, Eric; Cooper, Zafra; Doll, Helen A; Norman, Patricia A; O'Connor, Marianne E

    2003-02-01

    Bulimia nervosa shows a marked tendency to persist, suggesting that powerful maintaining mechanisms operate. Using data from a prospective, 5-year, study of the natural course of 102 people with bulimia nervosa, the authors sought to identify predictors of persistence and to test specific hypotheses derived from the cognitive-behavioral theory of the persistence of bulimia nervosa. The results of both sets of analyses were consistent with the theory, with the degree of overevaluation of shape and weight and a history of childhood obesity predicting a persistent course. There was also support for the central prediction of the cognitive-behavioral theory. These findings suggest that the mechanisms specified by the theory influence its longer term natural course. PMID:12602430

  16. Pyomyositis in a 5-year-old child.

    PubMed

    Romeo, S; Sunshine, S

    2000-07-01

    We present a case of pyomyositis in an otherwise healthy 5-year-old child that underscores the potential for serious, life-threatening complications. Pyomyositis of the gluteal, psoas, and iliacus muscles was associated with osteomyelitis, septic arthritis, a large inferior vena cava thrombus, septic pulmonary emboli, and eventual pneumonia. Primary pyomyositis is a purulent infection of striated muscle thought to be caused by seeding from a transient bacteremia. The focal infection typically forms an abscess that generally responds to intravenous antibiotics and occasionally requires adjunctive computed tomography-guided aspiration and drainage. This localized infectious process rarely produces further sequelae unless treatment is delayed. Pyomyositis is rare in healthy individuals and requires a high clinical suspicion in patients who present with fever, leukocytosis, and localized pain. PMID:10910315

  17. Modifiable diarrhoea risk factors in Egyptian children aged <5 years.

    PubMed

    Mansour, A M; Mohammady, H El; Shabrawi, M El; Shabaan, S Y; Zekri, M Abou; Nassar, M; Salem, M E; Mostafa, M; Riddle, M S; Klena, J D; Messih, I A Abdel; Levin, S; Young, S Y N

    2013-12-01

    By conducting a case-control study in two university hospitals, we explored the association between modifiable risk behaviours and diarrhoea. Children aged <5 years attending outpatient clinics for diarrhoea were matched by age and sex with controls. Data were collected on family demographics, socioeconomic indicators, and risk behaviour practices. Two rectal swabs and a stool specimen were collected from cases and controls. Samples were cultured for bacterial pathogens using standard techniques and tested by ELISA to detect rotavirus and Cryptosporidium spp. Four hundred cases and controls were enrolled between 2007 and 2009. The strongest independent risk factors for diarrhoea were: presence of another household member with diarrhoea [matched odds ratio (mOR) 4.9, 95% CI 2.8-8.4] in the week preceding the survey, introduction to a new kind of food (mOR 3, 95% CI 1.7-5.4), and the child being cared for outside home (mOR 2.6, 95% CI 1.3-5.2). While these risk factors are not identifiable, in some age groups more easily modifiable risk factors were identified including: having no soap for handwashing (mOR 6.3, 95% CI 1.2-33.9) for children aged 7-12 months, and pacifier use (mOR 1.9, 95% CI 1.0-3.5) in children aged 0-6 months. In total, the findings of this study suggest that community-based interventions to improve practices related to sanitation and hygiene, handwashing and food could be utilized to reduce the burden of diarrhoea in Egyptian children aged <5 years. PMID:23433452

  18. Use of endocrinological and neurological medication among 5-year survivors of young onset brain tumors.

    PubMed

    Gunn, Mirja Erika; Lähdesmäki, Tuire; Malila, Nea; Arola, Mikko; Grönroos, Marika; Matomäki, Jaakko; Lähteenmäki, Päivi Maria

    2016-07-01

    The burden of late-effects for young onset brain tumor (BT) survivors needs more careful evaluation. Our aim was to assess the need for endocrinological and neurological medication among this specific group. We identified 5-year survivors diagnosed at the age of 0-24 years between 1988 and 2004 from the Finnish Cancer Registry (N = 602). Data on endocrinological and neurological drug purchases were collected from the Social Insurance Institution of Finland. Five years after diagnosis the most commonly purchased drugs had been: antiepileptics (44.8 %), systemic hydrocortisone (18.3 %), female sex hormones (17.6 %), thyroid hormones (11.2 %), and growth hormone (10.0 %). The survivors showed an increased hazard ratio (HR) for a need for new types of drugs still 5 years after diagnosis. Thyroid hormones (HR 10.6, 95 % CI 5.1-21.4), estrogens (HR 8.0, 95 % CI 2.1-25.7), and antiepileptics (HR 6.3, 95 % CI 3.4-11.2) were bought with high frequencies. Irradiation increased the hazard for drug-purchases other than antiepileptics. Cumulative incidence of purchases of estrogens or androgens increased still 15 years after diagnosis. The cumulative incidence of purchasing thyroid hormones and antiepileptics showed continuous increase for the youngest group, whereas survivors diagnosed at 15-24 years of age reached stable level before 15 years from diagnosis. The need for new medication continued more than a decade after BT diagnosis. Especially the need for new thyroid or sex hormone medication among childhood BT survivors may emerge long after diagnosis. PMID:27115743

  19. Configuring Balanced Scorecards for Measuring Health System Performance: Evidence from 5 Years' Evaluation in Afghanistan

    PubMed Central

    Edward, Anbrasi; Kumar, Binay; Kakar, Faizullah; Salehi, Ahmad Shah; Burnham, Gilbert; Peters, David H.

    2011-01-01

    Background In 2004, Afghanistan pioneered a balanced scorecard (BSC) performance system to manage the delivery of primary health care services. This study examines the trends of 29 key performance indicators over a 5-year period between 2004 and 2008. Methods and Findings Independent evaluations of performance in six domains were conducted annually through 5,500 patient observations and exit interviews and 1,500 provider interviews in >600 facilities selected by stratified random sampling in each province. Generalized estimating equation (GEE) models were used to assess trends in BSC parameters. There was a progressive improvement in the national median scores scaled from 0–100 between 2004 and 2008 in all six domains: patient and community satisfaction of services (65.3–84.5, p<0.0001); provider satisfaction (65.4–79.2, p<0.01); capacity for service provision (47.4–76.4, p<0.0001); quality of services (40.5–67.4, p<0.0001); and overall vision for pro-poor and pro-female health services (52.0–52.6). The financial domain also showed improvement until 2007 (84.4–95.7, p<0.01), after which user fees were eliminated. By 2008, all provinces achieved the upper benchmark of national median set in 2004. Conclusions The BSC has been successfully employed to assess and improve health service capacity and service delivery using performance benchmarking during the 5-year period. However, scorecard reconfigurations are needed to integrate effectiveness and efficiency measures and accommodate changes in health systems policy and strategy architecture to ensure its continued relevance and effectiveness as a comprehensive health system performance measure. The process of BSC design and implementation can serve as a valuable prototype for health policy planners managing performance in similar health care contexts. Please see later in the article for the Editors' Summary PMID:21814499

  20. CUMPOIS- CUMULATIVE POISSON DISTRIBUTION PROGRAM

    NASA Technical Reports Server (NTRS)

    Bowerman, P. N.

    1994-01-01

    The Cumulative Poisson distribution program, CUMPOIS, is one of two programs which make calculations involving cumulative poisson distributions. Both programs, CUMPOIS (NPO-17714) and NEWTPOIS (NPO-17715), can be used independently of one another. CUMPOIS determines the approximate cumulative binomial distribution, evaluates the cumulative distribution function (cdf) for gamma distributions with integer shape parameters, and evaluates the cdf for chi-square distributions with even degrees of freedom. It can be used by statisticians and others concerned with probabilities of independent events occurring over specific units of time, area, or volume. CUMPOIS calculates the probability that n or less events (ie. cumulative) will occur within any unit when the expected number of events is given as lambda. Normally, this probability is calculated by a direct summation, from i=0 to n, of terms involving the exponential function, lambda, and inverse factorials. This approach, however, eventually fails due to underflow for sufficiently large values of n. Additionally, when the exponential term is moved outside of the summation for simplification purposes, there is a risk that the terms remaining within the summation, and the summation itself, will overflow for certain values of i and lambda. CUMPOIS eliminates these possibilities by multiplying an additional exponential factor into the summation terms and the partial sum whenever overflow/underflow situations threaten. The reciprocal of this term is then multiplied into the completed sum giving the cumulative probability. The CUMPOIS program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly on most C compilers. The program format is interactive, accepting lambda and n as inputs. It has been implemented under DOS 3.2 and has a memory requirement of 26K. CUMPOIS was

  1. Equine-associated maxillofacial injuries: retrospective 5-year analysis.

    PubMed

    Islam, Shofiq; Gupta, Benjamin; Taylor, Christopher J; Chow, Jeffrey; Hoffman, Gary R

    2014-02-01

    We explored the relation between the causes of facial injuries in equestrians and the presence or absence of associated injuries. Over a 5-year period we retrospectively reviewed all patients who presented to the John Hunter Hospital, New South Wales, with facial injuries that had resulted from activity with horses. We analysed the rates of hard and soft tissue injuries, and of associated injuries by sex and mechanism. A total of 85 patients were included (50 female and 35 male) with an age range of 2-88 years. There was a significant difference in the rate of maxillofacial and associated injuries when groups were analysed for sex and mechanism of injury. Facial injuries caused by falling from a horse were more often associated with other injuries in men than in women (p<0.05), and men were 4 times more likely to present with associated injuries than women (OR 3.9; 95% CI 1.1 to 14) We also found significant differences in the rates of facial fracture. Women who had been kicked by a horse were more likely to sustain bony injuries than men (p<0.05). Our data confirm the association between kicks and facial fracture, and this may provide an impetus for the development of appropriate protective equipment. Patients who sustain facial injuries when falling from a horse often present with associated injuries and this has practical implications for clinicians involved in their management. PMID:24168759

  2. NASA Infrared Telescope Facility- The Next 5 Years

    NASA Astrophysics Data System (ADS)

    Tokunaga, A. T.; Bus, S. J.; Tollestrup, E. V.; Rayner, J. T.

    2005-08-01

    The NASA Infrared Telescope Facility (IRTF) is a 3-meter optical/IR telescope dedicated to NASA-related programs of mission support and basic solar system research. All of the funding for IRTF operations comes from the Planetary Astronomy Program. We are preparing the Cooperative Agreement with NASA for the next 5 years (Feb. 2006 -- Jan. 2011). We will strive to refurbish the telescope in order to provide mission support and to allow the IRTF to provide fundamental data for future missions to Mars, comets, satellites, Near-Earth Objects, and asteroids. A major component of our activities will be to improve the image quality of the telescope and to provide high dynamic imaging on the IRTF. Details of our plans can be obtained at: http://irtfweb.ifa.hawaii.edu/Documents/pdf/1_plan_mar04C.pdf We acknowledge the support of NASA Cooperative Agreement no. NCC 5-538 with the National Aeronautics and Space Administration, Planetary Astronomy Program.

  3. Prediction of 5-Year Survival with Data Mining Algorithms.

    PubMed

    Sailer, Fabian; Pobiruchin, Monika; Bochum, Sylvia; Martens, Uwe M; Schramm, Wendelin

    2015-01-01

    Survival time prediction at the time of diagnosis is of great importance to make decisions about treatment and long-term follow-up care. However, predicting the outcome of cancer on the basis of clinical information is a challenging task. We now examined the ability of ten different data mining algorithms (Perceptron, Rule Induction, Support Vector Machine, Linear Regression, Naïve Bayes, Decision Tree, k-nearest Neighbor, Logistic Regression, Neural Network, Random Forest) to predict the dichotomous attribute "5-year-survival" based on seven attributes (sex, UICC-stage, etc.) which are available at the time of diagnosis. For this study we made use of the nationwide German research data set on colon cancer provided by the Robert Koch Institute. To assess the results a comparison between data mining algorithms and physicians' opinions was performed. Therefore, physicians guessed the survival time by leveraging the same seven attributes. The average accuracy of the physicians' opinion was 59%, the average accuracy of the machine learning algorithms was 67.7%. PMID:26152957

  4. Measurement of primordial non-Gaussianity using the WMAP 5-year temperature skewness power spectrum

    SciTech Connect

    Smidt, Joseph; Amblard, Alexandre; Serra, Paolo; Cooray, Asantha

    2009-12-15

    We constrain the primordial non-Gaussianity parameter of the local model f{sub NL} using the skewness power spectrum associated with the two-to-one cumulant correlator of cosmic microwave background temperature anisotropies. This bispectrum-related power spectrum was constructed after weighting the temperature map with the appropriate window functions to form an estimator that probes the multipolar dependence of the underlying bispectrum associated with the primordial non-Gaussianity. We also estimate a separate skewness power spectrum sensitive more strongly to unresolved point sources. When compared to previous attempts at measuring the primordial non-Gaussianity with WMAP data, our estimators have the main advantage that we do not collapse information to a single number. When model fitting the two-to-one skewness power spectrum, we make use of bispectra generated by the primordial non-Gaussianity, radio point sources, and lensing-secondary correlation. We analyze Q, V, and W-band WMAP 5-year data using the KQ75 mask out to l{sub max}=600. Using V and W-band data and marginalizing over model parameters related to point sources and lensing-secondary bispectrum, our overall and preferred constraint on f{sub NL} is 11.0{+-}23.7 at the 68% confidence level (-36.4

  5. Blunt traumatic cardiac rupture. A 5-year experience.

    PubMed

    Brathwaite, C E; Rodriguez, A; Turney, S Z; Dunham, C M; Cowley, R

    1990-12-01

    Blunt traumatic cardiac rupture is associated with a high rate of mortality. A review of the computerized trauma registry (1983 to 1988) identified 32 patients with this injury (ages 19 to 65 years; mean age, 39.5 years; 21 men and 11 women). Twenty-one patients (65.6%) were injured in vehicular crashes, 3 (9.4%) in pedestrian accidents, 3 (9.4%) in motorcycle accidents; 3 (9.4%) sustained crush injury; 1 (3.1%) was injured by a fall; and 1 (3.1%) was kicked in the chest by a horse. Anatomic injuries included right atrial rupture (13[40.6%]), left atrial rupture (8 [25%]), right ventricular rupture (10[31.3%]), left ventricular rupture (4[12.5%]), and rupture of two cardiac chambers (3 [9.4%]). Diagnosis was made by thoracotomy in all 20 patients presenting in cardiac arrest. In the remaining 12 patients, the diagnosis was established in seven by emergency left anterolateral thoracotomy and in five by subxyphoid pericardial window. Seven of these 12 patients (58.3%) had clinical cardiac tamponade and significant upper torso cyanosis. The mean Injury Severity Score (ISS), Trauma Score (TS), and Glasgow Coma Scale (GCS) score were 33.8, 13.2, and 14.3, respectively, among survivors and 51.5, 8.3, and 7.0 for nonsurvivors. The overall mortality rate was 81.3% (26 of 32 patients), the only survivors being those presenting with vital signs (6 of 12 patients [50%]). All patients with rupture of two cardiac chambers or with ventricular rupture died. The mortality rate from myocardial rupture is very high. Rapid prehospital transportation, a high index of suspicion, and prompt surgical intervention contribute to survival in these patients. PMID:2256761

  6. Working with Workflows: Highlights from 5 years Building Scientific Workflows

    SciTech Connect

    Critchlow, Terence J.; Altintas, Ilkay; Chin, George; Crawl, Daniel; Iyer, H.; Khan, Ayla; Klasky, S.; Koehler, Sven; Ludaescher, Bertram T.; Mouallem, Pierre; Nagappan, Mie; Podhorszki, Norbert; Shoshani, Arie; Silva, C.; Tchoua, Roselynne; Vouk, M.

    2011-07-30

    In 2006, the SciDAC Scientific Data Management (SDM) Center proposed to continue its work deploying leading edge data management and analysis capabilities to scientific applications. One of three thrust areas within the proposed center was focused on Scientific Process Automation (SPA) using workflow technology. As a founding member of the Kepler consortium [LAB+09], the SDM Center team was well positioned to begin deploying workflows immediately. We were also keenly aware of some of the deficiencies in Kepler when applied to high performance computing workflows, which allowed us to focus our research and development efforts on critical new capabilities which were ultimately integrated into the Kepler open source distribution, benefiting the entire community. Significant work was required to ensure Kepler was capable of supporting large-scale production runs for SciDAC applications. Our work on generic actors and templates have improved the portability of workflows across machines and provided a higher level of abstraction for workflow developers. Fault tolerance and provenance tracking were obvious areas for improvement within Kepler given the longevity and complexity of our target workflows. To monitor workflow execution, we developed and deployed a web-based dashboard. We then generalized this interface and released it so it could be deployed at other locations. Outreach has always been a primary focus of our work and we had many successful deployments across a number of scientific domains while continually publishing and presenting our work. This short paper describes our most significant accomplishments over the past 5 years. Additional information about the SDM Center can be found in the companion paper: The Scientific Data Management Center: Available Technologies and Highlights.

  7. DEFENSE FACILITIES CUMULATIVE INDEX ANALYSIS

    EPA Science Inventory

    Environmental vulnerability, socio-economic, and compliance issues for Federal Facilities in Region 6 can be evaluated using a GIS based risk screening tool. The GIS tool is part of a larger system for cumulative risk study. The system uses data available from EPA, State agenc...

  8. Cumulative effects analysis (CEA) tools

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Effective rangeland management requires careful consideration of the possible cumulative effects of different management options prior to making major management decisions. State-and-transition (S/T) models, based on ecological sites, capture our understanding ecosystem functioning and can be used t...

  9. Clinical spectrum and outcome of pulmonary nocardiosis: 5-year experience

    PubMed Central

    Singh, Akashdeep; Chhina, Deepinder; Soni, RK; Kakkar, Chandan; Sidhu, US

    2016-01-01

    Background: Pulmonary nocardiosis is a rare but a life-threatening infection caused by Nocardia spp. The diagnosis is often missed and delayed resulting in delay in appropriate treatment and thus higher mortality. Aim: In this study, we aim to evaluate the clinical spectrum and outcome of patients with pulmonary nocardiosis. Methods: A retrospective, 5-year (2009–2014) review of demographic profile, risk factors, clinical manifestations, imaging findings, treatment, and outcome of patients with pulmonary nocardiosis admitted to a tertiary care hospital. Results: The median age of the study subjects was 54 years (range, 16–76) and majority of them (75%) were males. The risk factors for pulmonary nocardiosis identified in our study were long-term steroid use (55.6%), chronic lung disease (52.8%), diabetes (27.8%), and solid-organ transplantation (22.2%). All the patients were symptomatic, and the most common symptoms were cough (91.7%), fever (78%), and expectoration (72%). Almost two-third of the patients were initially misdiagnosed and the alternative diagnosis included pulmonary tuberculosis (n = 7), community-acquired pneumonia (n = 5), lung abscess (n = 4), invasive fungal infection (n = 3), lung cancer (n = 2), and Wegener's granulomatosis (n = 2). The most common radiographic features were consolidation (77.8%) and nodules (56%). The mortality rate for indoor patients was 33% despite treatment. Higher mortality rate was observed among those who had brain abscess (100.0%), HIV positivity (100%), need for mechanical ventilation (87.5%), solid-organ transplantation (50%), and elderly (age > 60 years) patients (43%). Conclusion: The diagnosis of pulmonary nocardiosis is often missed and delayed resulting in delay in appropriate treatment and thus high mortality. A lower threshold for diagnosing pulmonary nocardiosis needs to be exercised, in chest symptomatic patients with underlying chronic lung diseases or systemic immunosuppression, for the early diagnosis

  10. A 5-year experience with an elective scholarly concentrations program

    PubMed Central

    George, Paul; Green, Emily P.; Park, Yoon S.; Gruppuso, Philip A.

    2015-01-01

    Problem Programs that encourage scholarly activities beyond the core curriculum and traditional biomedical research are now commonplace among US medical schools. Few studies have generated outcome data for these programs. The goal of the present study was to address this gap. Intervention The Scholarly Concentration (SC) Program, established in 2006 at the Warren Alpert Medical School of Brown University, is a 4-year elective program that not only encourages students to pursue scholarly work that may include traditional biomedical research but also seeks to broaden students’ focus to include less traditional areas. We compared characteristics and academic performance of SC students and non-SC students for the graduating classes of 2010–2014. Context Approximately one-third of our students opt to complete an SC during their 4-year undergraduate medical education. Because this program is additional to the regular MD curriculum, we sought to investigate whether SC students sustained the academic achievement of non-SC students while at the same time producing scholarly work as part of the program. Outcome Over 5 years, 35% of students elected to enter the program and approximately 81% of these students completed the program. The parameters that were similar for both SC and non-SC students were age at matriculation, admission route, proportion of undergraduate science majors, and number of undergraduate science courses. Most academic indicators, including United States Medical Licensing Examinations scores, were similar for the two groups; however, SC students achieved more honors in the six core clerkships and were more likely to be inducted into the medical school's two honor societies. Residency specialties selected by graduates in the two groups were similar. SC students published an average of 1.3 peer-reviewed manuscripts per student, higher than the 0.8 manuscripts per non-SC student (p=0.013). Conclusions An elective, interdisciplinary scholarly program with

  11. Cumulative Risk, Cumulative Outcome: A 20-Year Longitudinal Study

    PubMed Central

    Atkinson, Leslie; Beitchman, Joseph; Gonzalez, Andrea; Young, Arlene; Wilson, Beth; Escobar, Michael; Chisholm, Vivienne; Brownlie, Elizabeth; Khoury, Jennifer E.; Ludmer, Jaclyn; Villani, Vanessa

    2015-01-01

    Cumulative risk (CR) models provide some of the most robust findings in the developmental literature, predicting numerous and varied outcomes. Typically, however, these outcomes are predicted one at a time, across different samples, using concurrent designs, longitudinal designs of short duration, or retrospective designs. We predicted that a single CR index, applied within a single sample, would prospectively predict diverse outcomes, i.e., depression, intelligence, school dropout, arrest, smoking, and physical disease from childhood to adulthood. Further, we predicted that number of risk factors would predict number of adverse outcomes (cumulative outcome; CO). We also predicted that early CR (assessed at age 5/6) explains variance in CO above and beyond that explained by subsequent risk (assessed at ages 12/13 and 19/20). The sample consisted of 284 individuals, 48% of whom were diagnosed with a speech/language disorder. Cumulative risk, assessed at 5/6-, 12/13-, and 19/20-years-old, predicted aforementioned outcomes at age 25/26 in every instance. Furthermore, number of risk factors was positively associated with number of negative outcomes. Finally, early risk accounted for variance beyond that explained by later risk in the prediction of CO. We discuss these findings in terms of five criteria posed by these data, positing a “mediated net of adversity” model, suggesting that CR may increase some central integrative factor, simultaneously augmenting risk across cognitive, quality of life, psychiatric and physical health outcomes. PMID:26030616

  12. 24 CFR 903.6 - What information must a PHA provide in the 5-Year Plan?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... in the 5-Year Plan? 903.6 Section 903.6 Housing and Urban Development REGULATIONS RELATING TO HOUSING... must a PHA provide in the 5-Year Plan? (a) A PHA must include in its 5-Year Plan a statement of: (1... domestic violence, dating violence, sexual assault, or stalking. (b) After submitting its first 5-Year...

  13. 24 CFR 903.6 - What information must a PHA provide in the 5-Year Plan?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... in the 5-Year Plan? 903.6 Section 903.6 Housing and Urban Development REGULATIONS RELATING TO HOUSING... must a PHA provide in the 5-Year Plan? (a) A PHA must include in its 5-Year Plan a statement of: (1... domestic violence, dating violence, sexual assault, or stalking. (b) After submitting its first 5-Year...

  14. 24 CFR 903.6 - What information must a PHA provide in the 5-Year Plan?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... in the 5-Year Plan? 903.6 Section 903.6 Housing and Urban Development REGULATIONS RELATING TO HOUSING... must a PHA provide in the 5-Year Plan? (a) A PHA must include in its 5-Year Plan a statement of: (1... domestic violence, dating violence, sexual assault, or stalking. (b) After submitting its first 5-Year...

  15. Fasting Plasma Insulin at 5 Years of Age Predicted Subsequent Weight Increase in Early Childhood over a 5-Year Period—The Da Qing Children Cohort Study

    PubMed Central

    Chen, Yan Yan; Wang, Jin Ping; Jiang, Ya Yun; Li, Hui; Hu, Ying Hua; Lee, Kok Onn; Li, Guang Wei

    2015-01-01

    Background The association between hyperinsulinemia and obesity is well known. However, it is uncertain especially in childhood obesity, if initial fasting hyperinsulinemia predicts obesity, or obesity leads to hyperinsulinemia through insulin resistance. Objective To investigate the predictive effect of fasting plasma insulin on subsequent weight change after a 5-year interval in childhood. Methods 424 Children from Da Qing city, China, were recruited at 5 years of age and followed up for 5 years. Blood pressure, anthropometric measurements, fasting plasma insulin, glucose and triglycerides were measured at baseline and 5 years later. Results Fasting plasma insulin at 5 years of age was significantly correlated with change of weight from 5 to 10 years (ΔWeight). Children in the lowest insulin quartile had ΔWeight of 13.08±0.73 kg compare to 18.39±0.86 in the highest insulin quartile (P<0.0001) in boys, and similarly 12.03±0.71 vs 15.80±0.60 kg (P<0.0001) in girls. Multivariate analysis showed that the predictive effect of insulin at 5 years of age on subsequent weight gain over 5 years remained statistically significant even after the adjustment for age, sex, birth weight, TV-viewing time and weight (or body mass index) at baseline. By contrast, the initial weight at 5 years of age did not predict subsequent changes in insulin level 5 years later. Children who had both higher fasting insulin and weight at 5 years of age showed much higher levels of systolic blood pressures, fasting plasma glucose, the homeostasis model assessment for insulin resistance (HOMA-IR) and triglycerides at 10 years of age. Conclusions Fasting plasma insulin at 5 years of age predicts weight gain and cardiovascular risk factors 5 year later in Chinese children of early childhood, but the absolute weight at 5 years of age did not predict subsequent change in fasting insulin. PMID:26047327

  16. Cumulative life damage in dermatology

    PubMed Central

    Ibler, Kristina; Jemec, Gregor B.E.

    2011-01-01

    Cumulative life damage is an old concept of considerable face validity, which has attracted more scientific interest in the fields of sociology and psychology than in medicine over the years. The research examines the interconnectivity of the many factors which shape the development of individuals or institutions over time. By focussing on time, context and process, life course research highlights the different effects seemingly similar events may have at different points in time and in different contexts. PMID:25386260

  17. Cumulative psychosocial stress, coping resources, and preterm birth.

    PubMed

    McDonald, Sheila W; Kingston, Dawn; Bayrampour, Hamideh; Dolan, Siobhan M; Tough, Suzanne C

    2014-12-01

    Preterm birth constitutes a significant international public health issue, with implications for child and family well-being. High levels of psychosocial stress and negative affect before and during pregnancy are contributing factors to shortened gestation and preterm birth. We developed a cumulative psychosocial stress variable and examined its association with early delivery controlling for known preterm birth risk factors and confounding environmental variables. We further examined this association among subgroups of women with different levels of coping resources. Utilizing the All Our Babies (AOB) study, an ongoing prospective pregnancy cohort study in Alberta, Canada (n = 3,021), multinomial logistic regression was adopted to examine the independent effect of cumulative psychosocial stress and preterm birth subgroups compared to term births. Stratified analyses according to categories of perceived social support and optimism were undertaken to examine differential effects among subgroups of women. Cumulative psychosocial stress was a statistically significant risk factor for late preterm birth (OR = 1.73; 95 % CI = 1.07, 2.81), but not for early preterm birth (OR = 2.44; 95 % CI = 0.95, 6.32), controlling for income, history of preterm birth, pregnancy complications, reproductive history, and smoking in pregnancy. Stratified analyses showed that cumulative psychosocial stress was a significant risk factor for preterm birth at <37 weeks gestation for women with low levels of social support (OR = 2.09; 95 % CI = 1.07, 4.07) or optimism (OR = 1.87; 95 % CI = 1.04, 3.37). Our analyses suggest that early vulnerability combined with current anxiety symptoms in pregnancy confers risk for preterm birth. Coping resources may mitigate the effect of cumulative psychosocial stress on the risk for early delivery. PMID:24948100

  18. Prognosis of HIV-1-infected patients up to 5 years after initiation of HAART: collaborative analysis of prospective studies

    PubMed Central

    2012-01-01

    Objective To estimate the prognosis over 5 years of HIV-1-infected, treatment-naive patients starting HAART, taking into account the immunological and virological response to therapy. Design A collaborative analysis of data from 12 cohorts in Europe and north America on 20 379 adults who started HAART between 1995 and 2003. Methods Parametric survival models were used to predict the cumulative incidence at 5 years of a new AIDS-defining event or death, and death alone, first from the start of HAART and second from 6 months after the start of HAART. Data were analysed by intention-to-continue-treatment, ignoring treatment changes and interruptions. Results During 61 798 person-years of follow-up, 1005 patients died and an additional 1303 developed AIDS. A total of 10 046 (49%) patients started HAART either with a CD4 cell count of less than 200 cells/μl or with a diagnosis of AIDS. The 5-year risk of AIDS or death (death alone) from the start of HAART ranged from 5.6 to 77% (1.8–65%), depending on age, CD4 cell count, HIV-1-RNA level, clinical stage, and history of injection drug use. From 6 months the corresponding figures were 4.1–99% for AIDS or death and 1.3–96% for death alone. Conclusion On the basis of data collected routinely in HIV care, prognostic models with high discriminatory power over 5 years were developed for patients starting HAART in industrialized countries. A risk calculator that produces estimates for progression rates at years 1 to 5 after starting HAART is available from www.art-cohort-collaboration.org. PMID:17502729

  19. Cumulant expansions for atmospheric flows

    NASA Astrophysics Data System (ADS)

    Ait-Chaalal, Farid; Schneider, Tapio; Meyer, Bettina; Marston, J. B.

    2016-02-01

    Atmospheric flows are governed by the equations of fluid dynamics. These equations are nonlinear, and consequently the hierarchy of cumulant equations is not closed. But because atmospheric flows are inhomogeneous and anisotropic, the nonlinearity may manifest itself only weakly through interactions of nontrivial mean fields with disturbances such as thermals or eddies. In such situations, truncations of the hierarchy of cumulant equations hold promise as a closure strategy. Here we show how truncations at second order can be used to model and elucidate the dynamics of turbulent atmospheric flows. Two examples are considered. First, we study the growth of a dry convective boundary layer, which is heated from below, leading to turbulent upward energy transport and growth of the boundary layer. We demonstrate that a quasilinear truncation of the equations of motion, in which interactions of disturbances among each other are neglected but interactions with mean fields are taken into account, can capture the growth of the convective boundary layer. However, it does not capture important turbulent transport terms in the turbulence kinetic energy budget. Second, we study the evolution of two-dimensional large-scale waves, which are representative of waves seen in Earth's upper atmosphere. We demonstrate that a cumulant expansion truncated at second order (CE2) can capture the evolution of such waves and their nonlinear interaction with the mean flow in some circumstances, for example, when the wave amplitude is small enough or the planetary rotation rate is large enough. However, CE2 fails to capture the flow evolution when strongly nonlinear eddy-eddy interactions that generate small-scale filaments in surf zones around critical layers become important. Higher-order closures can capture these missing interactions. The results point to new ways in which the dynamics of turbulent boundary layers may be represented in climate models, and they illustrate different classes

  20. 40 CFR 1508.7 - Cumulative impact.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Cumulative impact. 1508.7 Section 1508... Cumulative impact. Cumulative impact is the impact on the environment which results from the incremental impact of the action when added to other past, present, and reasonably foreseeable future...

  1. 40 CFR 1508.7 - Cumulative impact.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Cumulative impact. 1508.7 Section 1508... Cumulative impact. Cumulative impact is the impact on the environment which results from the incremental impact of the action when added to other past, present, and reasonably foreseeable future...

  2. Bachelor of Midwifery: reflections on the first 5 years from two Victorian universities.

    PubMed

    McKenna, Lisa; Rolls, Colleen

    2007-06-01

    Bachelor of Midwifery programs in the state of Victoria, Australia commenced in 2002 through an affiliation of three universities in Melbourne named the 'Werna Naloo Bachelor of Midwifery consortium'. The approach allowed for collaborative synergies in program delivery through offering online 'consortium' units each semester in addition to on-campus content at each university. It is now 5 years since the first cohort of students commenced the course. During those years, members of the consortium have experienced a range of challenges and tensions. This paper provides a reflection by the course coordinators from two remaining members of the consortium, Australian Catholic University and Monash University. It explores issues confronted, regulation and registration, educational and clinical practice issues. In addition, the authors discuss course outcomes in terms of employment of graduates and their integration into the workforce, career development pathways and demand for the course. The authors conclude that the consortium has been successful and course outcomes positive with graduates successful in securing employment. Overall, the future for the Bachelor of Midwifery at both universities appears positive. PMID:17499037

  3. 24 CFR 257.303 - Prohibition on subordinate liens during first 5 years.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... CFR 226.2). ... during first 5 years. 257.303 Section 257.303 Housing and Urban Development Regulations Relating to... Prohibition on subordinate liens during first 5 years. (a) Prohibition on subordinate liens during first...

  4. A paradox of cumulative culture.

    PubMed

    Kobayashi, Yutaka; Wakano, Joe Yuichiro; Ohtsuki, Hisashi

    2015-08-21

    Culture can grow cumulatively if socially learnt behaviors are improved by individual learning before being passed on to the next generation. Previous authors showed that this kind of learning strategy is unlikely to be evolutionarily stable in the presence of a trade-off between learning and reproduction. This is because culture is a public good that is freely exploited by any member of the population in their model (cultural social dilemma). In this paper, we investigate the effect of vertical transmission (transmission from parents to offspring), which decreases the publicness of culture, on the evolution of cumulative culture in both infinite and finite population models. In the infinite population model, we confirm that culture accumulates largely as long as transmission is purely vertical. It turns out, however, that introduction of even slight oblique transmission drastically reduces the equilibrium level of culture. Even more surprisingly, if the population size is finite, culture hardly accumulates even under purely vertical transmission. This occurs because stochastic extinction due to random genetic drift prevents a learning strategy from accumulating enough culture. Overall, our theoretical results suggest that introducing vertical transmission alone does not really help solve the cultural social dilemma problem. PMID:25979371

  5. Cumulative Carbon and Anthropocene Climate

    NASA Astrophysics Data System (ADS)

    Matthews, D.; Pierrehumbert, R.; Solomon, S.

    2010-12-01

    In this presentation we will highlight a few of the key findings of the recently completed National Research Council Study Climate Stabilization Targets: Emissions, Concentrations and Impacts over Decades to Millennia (NRC, 2010), and discuss their implications for planetary stewardship. A synthesis of published results shows that the single number which most characterizes the magnitude of the human imprint on the climate of the coming millennia is the net amount of carbon released as CO2 by fossil fuel burning and land use changes during the time over which humanity continues such activities. Details of emissions scenarios are not important; rather it is the net carbon released by the time the emissions have been brought to essentially zero that controls long-term climate changes. In this report, we estimate that global temperatures increase by about 1 degree for approximately every 570 Pg of carbon emitted. Each degree of global temperature change is associated with quantifiable impacts on human and natural systems, including loss of arctic sea ice, decreased productivity of several major food crops, decreased precipitation in dry regions, and increases in area burnt by wildfire. Furthermore, the long timescale of temperature changes due to cumulative carbon emissions entails a lock-in to many centuries of continued sea-level rise, as well as the possibility of substantial contributions to sea-level rise from both Greenland and the West-Antarctic ice sheet. Reductions in methane or other short-lived greenhouse gas emissions can be of benefit in mitigating the near term climate changes, but CO2 is unique among major greenhouse gases in its ability to disrupt climate on multi-millennial time scales. This implies a need for correspondingly special treatment of this gas in emissions control protocols, for example by setting targets for allowable cumulative carbon emissions over time. The authoring committee was composed of Susan Solomon, Chair, David Battisti, Scott

  6. Cumulative Exams in the Introductory Psychology Course

    ERIC Educational Resources Information Center

    Lawrence, Natalie K.

    2013-01-01

    Many teachers require their students to take cumulative exams, but there are surprisingly few studies that examine the benefits of such exams. The purpose of this study was to determine whether introductory psychology students who take cumulative exams throughout the semester would have better long-term retention than students who take a…

  7. Moments from Cumulants and Vice Versa

    ERIC Educational Resources Information Center

    Withers, Christopher S.; Nadarajah, Saralees

    2009-01-01

    Moments and cumulants are expressed in terms of each other using Bell polynomials. Inbuilt routines for the latter make these expressions amenable to use by algebraic manipulation programs. One of the four formulas given is an explicit version of Kendall's use of Faa di Bruno's chain rule to express cumulants in terms of moments.

  8. A Photographic View of Cumulative Distribution Functions

    ERIC Educational Resources Information Center

    Jernigan, Robert W.

    2008-01-01

    This article shows a concrete and easy recognizable view of a cumulative distribution function(cdf). Photograph views of the search tabs on dictionaries are used to increase students' understanding and facility with the concept of a cumulative distribution function. Projects for student investigations are also given. This motivation and view helps…

  9. 32 CFR 651.16 - Cumulative impacts.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) National Environmental Policy Act and the Decision Process... parties must be considered (40 CFR 1508.7). (b) The scoping process should be used to identify possible... cumulative effects analysis. (c) A suggested cumulative effects approach is as follows: (1) Identify...

  10. 32 CFR 651.16 - Cumulative impacts.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) National Environmental Policy Act and the Decision Process... parties must be considered (40 CFR 1508.7). (b) The scoping process should be used to identify possible... cumulative effects analysis. (c) A suggested cumulative effects approach is as follows: (1) Identify...

  11. 32 CFR 651.16 - Cumulative impacts.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) National Environmental Policy Act and the Decision Process... parties must be considered (40 CFR 1508.7). (b) The scoping process should be used to identify possible... cumulative effects analysis. (c) A suggested cumulative effects approach is as follows: (1) Identify...

  12. Cumulate Fragments in Silicic Ignimbrites

    NASA Astrophysics Data System (ADS)

    Bachmann, O.; Ellis, B. S.; Wolff, J.

    2014-12-01

    Increasingly, studies are concluding that silicic ignimbrites are the result of the amalgamation of multiple discrete magma batches. Yet the existence of discrete batches presents a conundrum for magma generation and storage; if silicic magma batches are not generated nearly in situ in the upper crust, they must traverse, and reside within, a thermally hostile environment with large temperature gradients, resulting in low survivability in their shallow magmatic hearths. The Snake River Plain (Idaho, USA) is a type example of this 'multi-batch' assembly with ignimbrites containing multiple populations of pyroxene crystals, glass shards, and crystal aggregates. The ubiquitous crystal aggregates hint at a mechanism to facilitate the existence of multiple, relatively small batches of rhyolite in the upper crust. These aggregates contain the same plagioclase, pyroxene, and oxide mineral compositions as single phenocrysts of the same minerals in their host rocks, but they have significantly less silicic bulk compositions and lack quartz and sanidine, which occur as single phenocrysts in the deposits. This implies significant crystallization followed by melt extraction from mushy reservoir margins. The extracted melt then continues to evolve (crystallizing sanidine and quartz) while the melt-depleted margins provide an increasingly rigid and refractory network segregating the crystal-poor batches of magma. The hot, refractory, margins insulate the crystal-poor lenses, allowing (1) extended residence in the upper crust, and (2) preservation of chemical heterogeneities among batches. In contrast, systems that produce cumulates richer in low-temperature phases (quartz, K-feldspars, and/or biotite) favour remelting upon recharge, leading to less segregation of eruptible melt pockets and the formation of gradationally zoned ignimbrites. The occurrence of similar crystal aggregates from a variety of magmatic lineages suggests the generality of this process.

  13. Cumulative early life adversity predicts longevity in wild baboons

    PubMed Central

    Tung, Jenny; Archie, Elizabeth A.; Altmann, Jeanne; Alberts, Susan C.

    2016-01-01

    In humans and other animals, harsh circumstances in early life predict morbidity and mortality in adulthood. Multiple adverse conditions are thought to be especially toxic, but this hypothesis has rarely been tested in a prospective, longitudinal framework, especially in long-lived mammals. Here we use prospective data on 196 wild female baboons to show that cumulative early adversity predicts natural adult lifespan. Females who experience ≥3 sources of early adversity die a median of 10 years earlier than females who experience ≤1 adverse circumstances (median lifespan is 18.5 years). Females who experience the most adversity are also socially isolated in adulthood, suggesting that social processes partially explain the link between early adversity and adult survival. Our results provide powerful evidence for the developmental origins of health and disease and indicate that close ties between early adversity and survival arise even in the absence of health habit and health care-related explanations. PMID:27091302

  14. Cumulative early life adversity predicts longevity in wild baboons.

    PubMed

    Tung, Jenny; Archie, Elizabeth A; Altmann, Jeanne; Alberts, Susan C

    2016-01-01

    In humans and other animals, harsh circumstances in early life predict morbidity and mortality in adulthood. Multiple adverse conditions are thought to be especially toxic, but this hypothesis has rarely been tested in a prospective, longitudinal framework, especially in long-lived mammals. Here we use prospective data on 196 wild female baboons to show that cumulative early adversity predicts natural adult lifespan. Females who experience ≥3 sources of early adversity die a median of 10 years earlier than females who experience ≤1 adverse circumstances (median lifespan is 18.5 years). Females who experience the most adversity are also socially isolated in adulthood, suggesting that social processes partially explain the link between early adversity and adult survival. Our results provide powerful evidence for the developmental origins of health and disease and indicate that close ties between early adversity and survival arise even in the absence of health habit and health care-related explanations. PMID:27091302

  15. Cumulative Use of Strong Anticholinergic Medications and Incident Dementia

    PubMed Central

    Gray, Shelly L.; Anderson, Melissa L.; Dublin, Sascha; Hanlon, Joseph T.; Hubbard, Rebecca; Walker, Rod; Yu, Onchee; Crane, Paul; Larson, Eric B.

    2015-01-01

    IMPORTANCE Many medications have anticholinergic effects. The general view is that anticholinergic-induced cognitive impairment is reversible upon medication discontinuation. However, a few studies suggest that anticholinergic medications may be associated with increased dementia risk. OBJECTIVE To examine whether cumulative anticholinergic medication use is associated with a higher risk of incident dementia. DESIGN Prospective population-based cohort study using data from the Adult Changes in Thought Study. SETTING Group Health, an integrated health-care delivery system, Seattle, Washington PARTICIPANTS 3,434 participants aged 65 and older with no dementia at study entry. Initial recruitment occurred between 1994 and 1996 or 2000 and 2003. Beginning in 2004, continuous replacement for deaths occurred. All participants received follow-up every two years. EXPOSURE Using computerized pharmacy dispensing data, cumulative anticholinergic exposure was defined as the total standardized daily doses (TSDD) dispensed in the past 10 years. The most recent 12 months of use was excluded to avoid use related to prodromal symptoms. Cumulative exposure was time-varying. MAIN OUTCOMES AND MEASURES Incident dementia and Alzheimer’s disease using standard diagnostic criteria. Statistical analyses used Cox proportional hazards models, adjusted for demographic, health behaviors and health status including comorbidities. RESULTS The most common anticholinergic drug classes used were tricyclic antidepressants, first generation antihistamines and bladder antimuscarinics. Over a mean follow-up of 7.3 years, 797 participants (23%) developed dementia (637 developed Alzheimer’s). A 10-year cumulative dose-response relationship was observed for both dementia and Alzheimer’s disease (test for trend, p<0.001). For dementia, adjusted hazard ratios (HRs) and 95% confidence interval (CI) for cumulative anticholinergic use was 0.92 (95% CI, 0.74-1.16) for 1-90 TSDD; 1.19 (CI, 0.94-1.51) for

  16. Rethinking cumulative exposure in epidemiology, again.

    PubMed

    de Vocht, Frank; Burstyn, Igor; Sanguanchaiyakrit, Nuthchyawach

    2015-01-01

    The use of cumulative exposure, the product of intensity and duration, has enjoyed great popularity in epidemiology of chronic diseases despite numerous known caveats in its interpretation. We briefly review the history of use of cumulative exposure in epidemiology and propose an alternative method for relating time-integrated exposures to health risks. We argue, as others before us have, that cumulative exposure metrics obscures the interplay of exposure intensity and duration. We propose to use a computationally simple alternative in which duration and intensity of exposure are modelled as a main effect and their interaction, cumulative exposure, only be added if there is evidence of deviation from this additive model. We also consider the Lubin-Caporaso model of interplay of exposure intensity and duration. The impact of measurement error in intensity on model selection was also examined. The value of this conceptualization is demonstrated using a simulation study and further illustrated in the context of respiratory health and occupational exposure to latex dust. We demonstrate why cumulative exposure has been so popular because the cumulative exposure metric per se gives a robust answer to the existence of an association, regardless of the underlying true mechanism of disease. Treating cumulative exposure as the interaction of main effects of exposure duration and intensity enables epidemiologists to derive more information about mechanism of disease then fitting cumulative exposure metric by itself, and without the need to collect additional data. We propose that the practice of fitting duration, intensity and cumulative exposure separately to epidemiologic data should lead to conceptualization of cumulative exposure as interaction of main effects of duration and intensity of exposure. PMID:25138292

  17. 77 FR 64959 - Endangered and Threatened Species; Initiation of 5-Year Review for the Southern Distinct...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-24

    ... update, if necessary, the Northern DPS' status in five years time (70 FR 17386; April 6, 2005). Therefore...; Initiation of 5-Year Review for the Southern Distinct Population Segment of North American Green Sturgeon... 5-year review of the Southern Distinct Population Segment (DPS) of North American green...

  18. 77 FR 5491 - Endangered and Threatened Species; Initiation of 5-Year Review for Sei Whales

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-03

    ...; Initiation of 5-Year Review for Sei Whales AGENCY: National Marine Fisheries Service (NMFS), National Oceanic...; request for information. SUMMARY: NMFS announces a 5-year review of sei whales (Balaenoptera borealis... of any such information on sei whales that has become available since that has become available...

  19. Only the Best: Preschool-Grade 12. The Cumulative Guide to Highest-Rated Educational Software, 1985-89.

    ERIC Educational Resources Information Center

    Neill, Shirley Boes; Neill, George W.

    This cumulative guide lists the 550 highest rated programs identified by "Only the Best" from the evaluation reports of 37 evaluation services over a 5-year period. The introduction describes the selection criteria used as well as the individual evaluation services whose evaluations were used, and lists sources where the evaluations originally…

  20. Gestational diabetes and the incidence of diabetes in the 5 years following the index pregnancy in South Indian women.

    PubMed

    Krishnaveni, Ghattu V; Hill, Jacqueline C; Veena, Sargoor R; Geetha, Suguna; Jayakumar, Magudilu N; Karat, Chitra L S; Fall, Caroline H D

    2007-12-01

    This study was carried out to examine the incidence of diabetes and the factors associated with this in a cohort of South Indian women 5 years after they were examined for gestational diabetes (GDM). Women (N=630) whose GDM status was determined (Carpenter-Coustan criteria; GDM: N=41) delivered live babies without major anomalies at the Holdsworth Memorial Hospital, Mysore. Of these, 526 women (GDM: N=35) available for follow-up after 5 years underwent a 2-h oral glucose tolerance test and detailed anthropometry. Diabetes was determined using WHO criteria, and Metabolic Syndrome using IDF criteria recommended for south Asian women. The incidence of diabetes (37% versus 2%) and Metabolic Syndrome (60% versus 26%) was considerably higher in women with previous GDM compared to non-GDM women. GDM women who developed diabetes had lower gestational insulin area-under-the-curve (P=0.05). They had larger waist-to-hip ratio, skinfolds, body mass index, and lower 30-min insulin increment at follow-up than other GDM women. In all, history of diabetes in first-degree relatives was independently associated with higher incidence of diabetes (P<0.001). Our findings suggest high diabetes and cardiovascular risks in women with previous GDM. Follow-up of these women after delivery would provide opportunities to modify adverse lifestyle factors. PMID:17640759

  1. Does early establishment of favorable oral health behavior influence caries experience at age 5 years?

    PubMed Central

    Wigen, Tove I.; Wang, Nina J.

    2015-01-01

    Objective The purpose was to study associations between tooth brushing frequency, use of fluoride lozenges and consumption of sugary drinks at 1.5 year of age and having caries experience at 5 years of age. Methods This study was based on data from the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health and by the Public Dental Services. A total of 1095 children were followed from pregnancy to the age of 5 years. Questionnaires regarding oral health behavior were completed by the parents at 1.5 and 5 years of age. Clinical and radiographic examination of the children was performed at the age of 5 years. Results In multiple logistic regression, having caries experience at 5 years of age was associated with; at 1.5 year of age having the teeth brushed less than twice daily (OR 2.1, CI 1.3–3.6) and being offered sugary drinks at least once a week (OR 1.8, CI 1.1–2.9) when controlled for family characteristics and oral health behavior at 5 years of age. Conclusions Tooth brushing frequency and consumption of sugary drinks in early childhood were related to caries development during preschool age independent of family characteristics and oral health behavior at 5 years of age. The results indicate that early established habits regarding tooth brushing and consumption of sugary drinks have long term effects on caries development. Parents encountering difficulties in establishing favorable oral health behavior in children’s first years of life should receive special attention from health personnel. PMID:25385683

  2. EVALUATION PARADIGM FOR CUMULATIVE IMPACT ANALYSIS

    EPA Science Inventory

    Cumulative impact analysis is examined from a conceptual decisionmaking perspectives focusing on its implicit and explicit purposes as suggested within the policy end procedures for environmental impact analysis of the National Environmental Policy Act of 1969 (NEPA) end ita impl...

  3. Aerospace Medicine and Biology: Cumulative index, 1979

    NASA Technical Reports Server (NTRS)

    1980-01-01

    This publication is a cumulative index to the abstracts contained in the Supplements 190 through 201 of 'Aerospace Medicine and Biology: A Continuing Bibliography.' It includes three indexes-subject, personal author, and corporate source.

  4. Cumulative human impacts on marine predators.

    PubMed

    Maxwell, Sara M; Hazen, Elliott L; Bograd, Steven J; Halpern, Benjamin S; Breed, Greg A; Nickel, Barry; Teutschel, Nicole M; Crowder, Larry B; Benson, Scott; Dutton, Peter H; Bailey, Helen; Kappes, Michelle A; Kuhn, Carey E; Weise, Michael J; Mate, Bruce; Shaffer, Scott A; Hassrick, Jason L; Henry, Robert W; Irvine, Ladd; McDonald, Birgitte I; Robinson, Patrick W; Block, Barbara A; Costa, Daniel P

    2013-01-01

    Stressors associated with human activities interact in complex ways to affect marine ecosystems, yet we lack spatially explicit assessments of cumulative impacts on ecologically and economically key components such as marine predators. Here we develop a metric of cumulative utilization and impact (CUI) on marine predators by combining electronic tracking data of eight protected predator species (n=685 individuals) in the California Current Ecosystem with data on 24 anthropogenic stressors. We show significant variation in CUI with some of the highest impacts within US National Marine Sanctuaries. High variation in underlying species and cumulative impact distributions means that neither alone is sufficient for effective spatial management. Instead, comprehensive management approaches accounting for both cumulative human impacts and trade-offs among multiple stressors must be applied in planning the use of marine resources. PMID:24162104

  5. DEVELOPMENT OF APPROACHES FOR CUMULATIVE RISK ASSESSMENT

    EPA Science Inventory

    A population focused cumulative health risk assessment of a contaminated site or situation can include the evaluation of toxic risk from multiple chemicals, by multiple pathways, over different time frames of exposure, with multiple sensitive population subgroups, and possibly ot...

  6. Quantal Cumulant Dynamics for Dissipative Systems

    SciTech Connect

    Shigeta, Yasuteru

    2007-12-26

    We develop a quantal cumulant dynamics method for the quantum tunneling in dissipative environment. Reduced equations of motion of classical and quantal cumulant variables without bath degrees of freedom are derived. We observed suppression of the tunneling that depends on the sign of a friction constant for an Ohmic approximation and on the magnitude of a bath frequency for a single bath mode approximation. A possible mechanism of the suppression is explored by analyzing an effective quantal potential of the tunneling path.

  7. Cumulative creep damage for polycarbonate and polysulfone

    NASA Technical Reports Server (NTRS)

    Zhang, M.; Brinson, H. F.

    1985-01-01

    The literature for creep to failure cumulative damage laws are reviewed. Creep to failure tests performed on polycarbonate and polysulfone under single and two step loadings are discussed. A cumulative damage law or modified time fraction rule is developed using a power law for transient creep response as the starting point. Experimental results are approximated well by the new rule. Damage and failure mechanisms associated with the two materials are suggested.

  8. Human cumulative culture: a comparative perspective.

    PubMed

    Dean, Lewis G; Vale, Gill L; Laland, Kevin N; Flynn, Emma; Kendal, Rachel L

    2014-05-01

    Many animals exhibit social learning and behavioural traditions, but human culture exhibits unparalleled complexity and diversity, and is unambiguously cumulative in character. These similarities and differences have spawned a debate over whether animal traditions and human culture are reliant on homologous or analogous psychological processes. Human cumulative culture combines high-fidelity transmission of cultural knowledge with beneficial modifications to generate a 'ratcheting' in technological complexity, leading to the development of traits far more complex than one individual could invent alone. Claims have been made for cumulative culture in several species of animals, including chimpanzees, orangutans and New Caledonian crows, but these remain contentious. Whilst initial work on the topic of cumulative culture was largely theoretical, employing mathematical methods developed by population biologists, in recent years researchers from a wide range of disciplines, including psychology, biology, economics, biological anthropology, linguistics and archaeology, have turned their attention to the experimental investigation of cumulative culture. We review this literature, highlighting advances made in understanding the underlying processes of cumulative culture and emphasising areas of agreement and disagreement amongst investigators in separate fields. PMID:24033987

  9. Marginal bone preservation in single-tooth replacement: a 5-year prospective clinical multicenter study.

    PubMed

    2016-06-10

    Although this study heralded that over half the implants gained bone, this was between 1 and 5 years after placement, the amounts were trivial, and this has to be balanced with loss of bone during the first year. PMID:27283560

  10. Perceived Control and Intellectual Functioning in the Elderly: A 5-Year Longitudinal Study.

    ERIC Educational Resources Information Center

    Lachman, Margie E.; Leff, Rona

    1989-01-01

    Examined the relation of control beliefs to individual differences in 63 elderly adults in 1981 and 1986. Over the 5 years, generalized control and intellectual performance did not change, but intellectual control beliefs did. (RJC)

  11. The temporal outcomes of open versus arthroscopic knotted and knotless rotator cuff repair over 5 years

    PubMed Central

    Lucena, Thomas R; Lam, Patrick H; Millar, Neal L

    2015-01-01

    Background The present study aimed to determine how repair technique influenced structural and clinical outcomes at 5 years post-surgery. Methods Three cohorts of patients had repair of a symptomatic rotator cuff tear using (i) an open double-row mattress repair technique (n = 25); (ii) arthroscopic single-row simple suture knotted technique (n = 25); or (iii) arthroscopic single-row inverted mattress knotless technique (n = 36) by one surgeon. Standardized patient- and examiner-determined outcomes were obtained pre-operatively and postoperatively with a validated protocol, ultrasound were also performed at the same time. Results Retear occurred more often after open repair (48%) at 5 years than after arthroscopic knotted (33%) and arthroscopic knotless (26%) repair. Retear was associated with increasing age, pre-operative tear size and weaker pre-operative and 5 years postoperative cuff strength. Between 2 years and 5 years, the open repair group experienced an increase in the frequency of pain during activity, as well as in the difficulty experienced and the severity of pain during overhead activities (p < 0.05) and, at 5 years, also experienced more difficulty with overhead activities, compared to the arthroscopic knotless repair group. Conclusions At 5-year follow-up, arthroscopic rotator cuff repair techniques resulted in fewer retears and better outcomes compared to an open double-row technique.

  12. A Screening Method for Assessing Cumulative Impacts

    PubMed Central

    Alexeeff, George V.; Faust, John B.; August, Laura Meehan; Milanes, Carmen; Randles, Karen; Zeise, Lauren; Denton, Joan

    2012-01-01

    The California Environmental Protection Agency (Cal/EPA) Environmental Justice Action Plan calls for guidelines for evaluating “cumulative impacts.” As a first step toward such guidelines, a screening methodology for assessing cumulative impacts in communities was developed. The method, presented here, is based on the working definition of cumulative impacts adopted by Cal/EPA [1]: “Cumulative impacts means exposures, public health or environmental effects from the combined emissions and discharges in a geographic area, including environmental pollution from all sources, whether single or multi-media, routinely, accidentally, or otherwise released. Impacts will take into account sensitive populations and socio-economic factors, where applicable and to the extent data are available.” The screening methodology is built on this definition as well as current scientific understanding of environmental pollution and its adverse impacts on health, including the influence of both intrinsic, biological factors and non-intrinsic socioeconomic factors in mediating the effects of pollutant exposures. It addresses disparities in the distribution of pollution and health outcomes. The methodology provides a science-based tool to screen places for relative cumulative impacts, incorporating both the pollution burden on a community- including exposures to pollutants, their public health and environmental effects- and community characteristics, specifically sensitivity and socioeconomic factors. The screening methodology provides relative rankings to distinguish more highly impacted communities from less impacted ones. It may also help identify which factors are the greatest contributors to a community’s cumulative impact. It is not designed to provide quantitative estimates of community-level health impacts. A pilot screening analysis is presented here to illustrate the application of this methodology. Once guidelines are adopted, the methodology can serve as a screening

  13. Managing cumulative impacts: A key to sustainability?

    SciTech Connect

    Hunsaker, C.T.

    1994-12-31

    This paper addresses how science can be more effectively used in creating policy to manage cumulative effects on ecosystems. The paper focuses on the scientific techniques that we have to identify and to assess cumulative impacts on ecosystems. The term ``sustainable development`` was brought into common use by the World Commission on Environment and Development (The Brundtland Commission) in 1987. The Brundtland Commission report highlighted the need to simultaneously address developmental and environmental imperatives simultaneously by calling for development that ``meets the needs of the present generation without compromising the needs of future generations.`` We cannot claim to be working toward sustainable development until we can quantitatively assess cumulative impacts on the environment: The two concepts are inextricibally linked in that the elusiveness of cumulative effects likely has the greatest potential of keeping us from achieving sustainability. In this paper, assessment and management frameworks relevant to cumulative impacts are discussed along with recent literature on how to improve such assessments. When possible, examples are given for marine ecosystems.

  14. Two new constraints for the cumulant matrix

    SciTech Connect

    Ramos-Cordoba, Eloy; Salvador, Pedro; Matito, Eduard; Piris, Mario

    2014-12-21

    We suggest new strict constraints that the two-particle cumulant matrix should fulfill. The constraints are obtained from the decomposition of 〈S-^{sup 2}〉, previously developed in our laboratory, and the vanishing number of electrons shared by two non-interacting fragments. The conditions impose stringent constraints into the cumulant structure without any need to perform an orbital optimization procedure thus carrying very small or no computational effort. These constraints are tested on the series of Piris natural orbital functionals (PNOF), which are among the most accurate ones available in the literature. Interestingly, even though all PNOF cumulants ensure correct overall 〈S{sup ^2}〉 values, none of them is consistent with the local spin structure of systems that dissociate more than one pair of electrons. A careful analysis of the local spin components reveals the most important missing contributions in the cumulant expression thus suggesting a means to improve PNOF5. The constraints provide an inexpensive tool for the construction and testing of cumulant structures that complement previously known conditions such as the N-representability or the square of the total spin angular momentum, 〈S{sup ^2}〉.

  15. Exact cumulant Kramers-Moyal-like expansion

    NASA Astrophysics Data System (ADS)

    Morgado, W. A. M.

    2015-11-01

    We derive an exact equation, a Cumulant Kramers-Moyal Equation (CKME), quite similar to the Kramers-Moyal Equation (KME), for the probability distribution of a Markovian dynamical system. It can be applied to any well behaved (converging cumulants) continuous time systems, such as Langevin equations or other models. An interesting but significant difference with respect to the KME is that their jump-moments are proportional to cumulants of the dynamical variables, but not proportional to central moments, as is the case for the KME. In fact, they still obey a weaker version of Pawula's theorem, namely Marcinkiewicz's theorem. We compare the results derived from the equations herein with the ones obtained by computing via Gaussian and biased, and unbiased, Poisson Langevin dynamics and a Poisson non-Langevin model. We obtain the exact CKME time-evolution equation for the systems, and in several cases, those are distinct from the Fokker-Planck equation or the KME.

  16. Flow analysis with cumulants: Direct calculations

    SciTech Connect

    Bilandzic, Ante; Snellings, Raimond; Voloshin, Sergei

    2011-04-15

    Anisotropic flow measurements in heavy-ion collisions provide important information on the properties of hot and dense matter. These measurements are based on analysis of azimuthal correlations and might be biased by contributions from correlations that are not related to the initial geometry, so-called nonflow. To improve anisotropic flow measurements, advanced methods based on multiparticle correlations (cumulants) have been developed to suppress nonflow contribution. These multiparticle correlations can be calculated by looping over all possible multiplets, however, this quickly becomes prohibitively CPU intensive. Therefore, the most used technique for cumulant calculations is based on generating functions. This method involves approximations, and has its own biases, which complicates the interpretation of the results. In this paper we present a new exact method for direct calculations of multiparticle cumulants using moments of the flow vectors.

  17. Cumulative Culture and Future Thinking: Is Mental Time Travel a Prerequisite to Cumulative Cultural Evolution?

    ERIC Educational Resources Information Center

    Vale, G. L.; Flynn, E. G.; Kendal, R. L.

    2012-01-01

    Cumulative culture denotes the, arguably, human capacity to build on the cultural behaviors of one's predecessors, allowing increases in cultural complexity to occur such that many of our cultural artifacts, products and technologies have progressed beyond what a single individual could invent alone. This process of cumulative cultural evolution…

  18. A Longitudinal Analysis of Cumulative Risks, Cumulative Promotive Factors, and Adolescent Violent Behavior

    ERIC Educational Resources Information Center

    Stoddard, Sarah A.; Zimmerman, Marc A.; Bauermeister, Jose A.

    2012-01-01

    This study examined the effects of cumulative risk and promotive factors on violent behavior across the high school years of adolescence in a sample of predominately African American urban adolescents (N = 750). Cumulative risk and promotive factor indices represented individual characteristics, and peer, parental, and familial influences. Using…

  19. The effects of oil pollution on Antarctic benthic diatom communities over 5 years.

    PubMed

    Polmear, R; Stark, J S; Roberts, D; McMinn, A

    2015-01-15

    Although considered pristine, Antarctica has not been impervious to hydrocarbon pollution. Antarctica's history is peppered with oil spills and numerous abandoned waste disposal sites. Both spill events and constant leakages contribute to previous and current sources of pollution into marine sediments. Here we compare the response of the benthic diatom communities over 5 years to exposure to a commonly used standard synthetic lubricant oil, an alternative lubricant marketed as more biodegradable, in comparison to a control treatment. Community composition varied significantly over time and between treatments with some high variability within contaminated treatments suggesting community stress. Both lubricants showed evidence of significant effects on community composition after 5 years even though total petroleum hydrocarbon reduction reached approximately 80% over this time period. It appears that even after 5 years toxicity remains high for both the standard and biodegradable lubricants revealing the temporal scale at which pollutants persist in Antarctica. PMID:25499184

  20. Efficient formulas for efficiency correction of cumulants

    NASA Astrophysics Data System (ADS)

    Kitazawa, Masakiyo

    2016-04-01

    Formulas connecting cumulants of particle numbers observed with efficiency losses with the original ones are derived based on the binomial model. These formulas can be applied to quantities given by a linear combination of particle numbers observed with different efficiencies in a compact form. Compared with the presently suggested ones based on factorial moments, these formulas would drastically reduce the numerical cost for the efficiency corrections when the order of the cumulant and the number of different efficiencies are large. The efficiency correction with realistic pT-dependent efficiency would be carried out with the aid of these formulas.

  1. A practice-based clinical evaluation of the survival and success of metal-ceramic and zirconia molar crowns: 5-year results.

    PubMed

    Rinke, S; Kramer, K; Bürgers, R; Roediger, M

    2016-02-01

    This practice-based study evaluates the survival and success of conventionally luted metal-ceramic and zirconia molar crowns fabricated by using a prolonged cooling period for the veneering porcelain. Fifty-three patients were treated from 07/2008 to 07/2009 with either metal-ceramic crowns (MCC) or zirconia crowns (ZC). Forty-five patients (26 female) with 91 restorations (obser-vational period: 64.0 ± 4.8 months) participated in a clinical follow-up examination and were included in the study. Estimated cumulative survival (ECSv), success (ECSc) and veneering ceramic success (ECVCSc) were calculated (Kaplan-Meier) and analysed by the crown fabrication technique and the position of the restoration (Cox regression model) (P < 0.05). Five complete failures (MCC: 2, ZC: 3) were recorded (5-year ECSv: MCC: 97.6%, (95% confidence interval (95%-CI): [93%; 100%]/ZC: 94.0%, (95%-CI): [87%; 100%]). Of the MCCs (n = 41), 85.0%, [95%-CI: (77%; 96%)] remained event-free, whereas the ECSc for the ZCs (n = 50) was 74.3% (95%-CI): [61%; 87%]. No significant differences in ECSv (P = 0.51), ECSc (P = 0.43) and ECVCSc (P = 0.36) were detected between the two fabrication techniques. Restorations placed on terminal abutments (n = 44) demonstrated a significantly lower ECVCSc (P = 0.035), (5-year VCF-rate: 14.8%) than crowns placed on tooth-neighboured abutments (n = 47), (5-year VCF-rate: 4.3%). In the present study, zirconia molar crowns demonstrated a 5-year ECSv, ECSc and ECVCSc comparable to MCCs. Irrespective of the fabrication technique, crowns on terminal abutments bear a significantly increased risk for VCFs. Clinical investigations with an increased number of restorations are needed. PMID:26393865

  2. Ranibizumab in neovascular age-related macular degeneration: a 5-year follow-up

    PubMed Central

    Cvetkova, Nadezhda P; Hölldobler, Kristina; Prahs, Philipp; Radeck, Viola; Helbig, Horst; Märker, David

    2016-01-01

    Purpose Our aim was to evaluate an optical coherence tomography (OCT) and visual acuity (VA)-guided, variable-dosing regimen with intravitreal ranibizumab injection for treating patients with neovascular age-related macular degeneration (AMD) from 2007 to 2012. Design This was a retrospective clinical study of 5 years follow-up in a tertiary eye center. Patients and methods In this study, 66 patients with neovascular AMD (mean age of 74 years, SD 8.7 years) were included. We investigated the development of best-corrected visual acuity (BCVA), the number of intravitreal injections, and the central retinal thickness measured with OCT (OCT Spectralis) over 5 years of intravitreal treatment. Results The mean number of intravitreal ranibizumab injections over 5 years was 8.8. The mean BCVA before therapy was 0.4 logarithm of the minimum angle of resolution (logMAR). After 5 years of therapy, the mean BCVA was 0.6 logMAR. In all, 16% of treated patients had stable VA over 5 years and 10% of study eyes approved their VA. The mean OCT-measured central retinal thickness at the beginning of this study was 295 µm; after 5 years of treatment, the mean central retinal thickness was 315 µm. There was an increase in central retinal thickness in 47.5% of examined eyes. Conclusion Other studies showed VA improvement in OCT-guided variable-dosing regimens. Our study revealed a moderate decrease in VA after a total mean injection number as low as 8.8 injections over 5 years. In OCT, an increase in central retinal thickness over 5 years could be observed. Probably, this is due to deficient treatment when comparing the total injection number to other treatment regimens. Anti-VEGF therapy helps to keep the VA stable for a period of time, but cannot totally stop the progression of the disease completely. Patients with late stages of neovascular AMD can maintain VA even if they are relatively undertreated. PMID:27354758

  3. Cumulative Intertrial Inhibition in Repeated Visual Search

    ERIC Educational Resources Information Center

    Takeda, Yuji

    2007-01-01

    In the present study the author examined visual search when the items remain visible across trials but the location of the target varies. Reaction times for inefficient search cumulatively increased with increasing numbers of repeated search trials, suggesting that inhibition for distractors carried over successive trials. This intertrial…

  4. CUMULATIVE RISK ASSESSMENT FOR QUANTITATIVE RESPONSE DATA

    EPA Science Inventory

    The Relative Potency Factor approach (RPF) is used to normalize and combine different toxic potencies among a group of chemicals selected for cumulative risk assessment. The RPF method assumes that the slopes of the dose-response functions are all equal; but this method depends o...

  5. Cumulative creep damage for polycarbonate and polysulfone

    NASA Technical Reports Server (NTRS)

    Zhang, M. J.; Straight, M. R.; Brinson, H. F.

    1985-01-01

    Creep to failure tests performed on polycarbonate and polysulfone under single and two step loadings are discussed. A cumulative damage law or modified time fraction rule is developed using a power law for transient creep response as the starting point. Experimental results are approximated well by the new rule. Damage and failure mechanisms associated with the two materials are suggested.

  6. LANDSAT 1 US cumulative catalog, 1975 - 1976

    NASA Technical Reports Server (NTRS)

    1976-01-01

    The LANDSAT 1 U.S. Cumulative Catalog lists U.S. imagery acquired by LANDSAT 1 which has been processed and input to the data files during the referenced year. Data, such as date acquired, cloud cover and image quality are given for each scene. The microfilm roll and frame on which the scene may be found is also given.

  7. HUMAN EXPOSURE MODELING FOR CUMULATIVE RISK

    EPA Science Inventory

    US EPA's Office of Research and Development (ORD) has identified cumulative risk assessment as a priority research area. This is because humans and other organisms are exposed to a multitude of chemicals, physical agents, and other stressors through multiple pathways, routes, an...

  8. Aerospace Medicine and Biology: 1983 cumulative index

    NASA Technical Reports Server (NTRS)

    1984-01-01

    This publication is a cumulative index to the abstracts contained in the Supplements 242 through 253 of Aerospace Medicine and Biology: A Continuing Bibliography. It includes six indexes--subject, personal author, corporate source, contract number, report number, and accession number.

  9. Calculation of the Poisson cumulative distribution function

    NASA Technical Reports Server (NTRS)

    Bowerman, Paul N.; Nolty, Robert G.; Scheuer, Ernest M.

    1990-01-01

    A method for calculating the Poisson cdf (cumulative distribution function) is presented. The method avoids computer underflow and overflow during the process. The computer program uses this technique to calculate the Poisson cdf for arbitrary inputs. An algorithm that determines the Poisson parameter required to yield a specified value of the cdf is presented.

  10. Cumulative Language Deficit Among Indian Children.

    ERIC Educational Resources Information Center

    Mickelson, Norma I.; Galloway, Charles G.

    The present language study, carried out by the University of Victoria and the Department of Indian Affairs during the summer of 1968, was based on the Deutsch "cumulative deficit hypothesis." (This theory has as one of its bases the idea that the lack of appropriate language stimulation in early home and school life makes success in school…

  11. CUMULATIVE RISK ANALYSIS FOR ORGANOPHOSPHORUS PESTICIDES

    EPA Science Inventory

    Cumulative Risk Analysis for Organophosphorus Pesticides
    R. Woodrow Setzer, Jr. NHEERL MD-74, USEPA, RTP, NC 27711

    The US EPA has recently completed a risk assessment of the effects of exposure to 33 organophosphorous pesticides (OPs) through the diet, water, and resi...

  12. Episodic Memory and Episodic Foresight in 3- and 5-Year-Old Children

    ERIC Educational Resources Information Center

    Hayne, Harlene; Gross, Julien; McNamee, Stephanie; Fitzgibbon, Olivia; Tustin, Karen

    2011-01-01

    In the present study, we examined the development of episodic memory and episodic foresight. Three- and 5-year-olds were interviewed individually using a personalised timeline that included photographs of them at different points in their life. After constructing the timeline with the experimenter, each child was asked to discuss a number of…

  13. Changes in Exercise Capacity of Cardiac Asymptomatic Hereditary Hemochromatosis Subjects over 5-Year Follow up

    PubMed Central

    Shizukuda, Yukitaka; Smith, Kevin P.; Tripodi, Dorothy J.; Arena, Ross; Yau, Yu-Ying; Bolan, Charles D.; Waclawiw, Myron A.; Leitman, Susan F.; Rosing, Douglas R.

    2012-01-01

    Objective A long-term effect of hereditary hemochromatosis (HH) on aerobic exercise capacity (AEC) has not been well described. Design Forty-three HH and 21 volunteer control (VC) subjects who were asymptomatic underwent cardiopulmonary exercise testing using the Bruce protocol. AEC was assessed with minute ventilation (VE), oxygen uptake (VO2), and carbon dioxide production (VCO2) at baseline (BL) at a 5-year follow up (5Y) assessment. A paired t-test was used for analyses of normality data; otherwise, a Wilcoxon singed rank sum test was used. Results Thirty-three HH subjects and 18 VC subjects returned for a repeat CPX at 5Y (80% overall return rate). At 5Y, AEC was not different between the two groups. As compared with BL measurements, exercise time, peak VO2, and the VE/VCO2 slope did not differ statistically at 5Y between both groups. Iron depletion by phlebotomy for 5 years did not significantly affect AEC in newly diagnosed HH subjects at baseline (n=14) and cardiac arrhythmias during exercise tended to decrease after 5 years of therapy in this group. Conclusions The AEC of asymptomatic HH subjects treated with conventional therapy is not statistically affected by the disease over a 5-year period. PMID:22311055

  14. How Do 5-Year-Olds Understand Questions? Differences in Languages across Europe

    ERIC Educational Resources Information Center

    Sauerland, Uli; Grohmann, Kleanthes K.; Guasti, Maria Teresa; Andelkovic, Darinka; Argus, Reili; Armon-Lotem, Sharon; Arosio, Fabrizio; Avram, Larisa; Costa, João; Dabašinskiene, Ineta; de López, Kristine; Gatt, Daniela; Grech, Helen; Haman, Ewa; van Hout, Angeliek; Hrzica, Gordana; Kainhofer, Judith; Kamandulyte-Merfeldiene, Laura; Kunnari, Sari; Kovacevic, Melita; Kuvac Kraljevic, Jelena; Lipowska, Katarzyna; Mejias, Sandrine; Popovic, Maša; Ruzaite, Jurate; Savic, Maja; Sevcenco, Anca; Varlokosta, Spyridoula; Varnava, Marina; Yatsushiro, Kazuko

    2016-01-01

    The comprehension of constituent questions is an important topic for language acquisition research and for applications in the diagnosis of language impairment. This article presents the results of a study investigating the comprehension of different types of questions by 5-year-old, typically developing children across 19 European countries, 18…

  15. Ready, Set, Grow! Health Education for 3-5 Year Olds.

    ERIC Educational Resources Information Center

    Peterson, Paula J.

    Intended for use in family day care, preschool centers, professional preparation institutions, and in homes, this comprehensive health education curriculum for 3- through 5-year-old children contains units designed to sequentially teach concepts about physical health, mental health, family living, and safety. Contents include the following…

  16. Secondary Science Teachers' Use of Technology in the Classroom during Their First 5 Years

    ERIC Educational Resources Information Center

    Bang, EunJin; Luft, Julie A.

    2013-01-01

    This study examined the technology use of beginning secondary science teachers and explored factors facilitating or inhibiting their use of technology. The researchers collected and analyzed interviews and observational data from 95 teachers over a 5-year period. The results show that teachers used PowerPoint the most and other software the least…

  17. A Multidimensional Scaling Study of Visual Memory of 5-Year Olds and Adults

    ERIC Educational Resources Information Center

    Arabie, Phipps; And Others

    1975-01-01

    An investigation of memory development using nonmetric multidimensional scaling. Judgments of similarities between complex objects were obtained from 5-year-olds and adults under two conditions: (1) when objects were simultaneously present at the time of comparison, and (2) when the objects were not simultaneously present and had to be compared on…

  18. Predictors of ADHD Persistence in Girls at 5-Year Follow-Up

    ERIC Educational Resources Information Center

    Mick, Eric; Byrne, Deirdre; Fried, Ronna; Monuteaux, Michael; Faraone, Stephen V.; Biederman, Joseph

    2011-01-01

    Objective: The main aim of this study was to examine the age-dependent remission from ADHD in girls transitioning through childhood into adolescence and early adulthood. Method: We conducted a 5-year prospective follow-up study of 123 girls with ADHD and 106 non-ADHD control girls aged between 6 and 17 years at ascertainment. ADHD was considered…

  19. Effectiveness of Multipurpose Unit Early Classroom Intervention Program for 4-5-Year-Old Children

    ERIC Educational Resources Information Center

    Celebioglu Morkoc, Ozlem; Aktan Acar, Ebru

    2014-01-01

    This research examined the effectiveness of Multipurpose Unit Early Classroom Intervention Program (MUECIP) prepared for 4-5-year-old (48-60 months) children whose development is at risk because of their families' socioeconomic conditions. The research adopted a preliminary test-final test control group trial model. The research participants…

  20. A Case Series of Marijuana Exposures in Pediatric Patients Less than 5 Years of Age

    ERIC Educational Resources Information Center

    Wang, George Sam; Narang, Sandeep K.; Wells, Kathryn; Chuang, Ryan

    2011-01-01

    Objective: In Colorado, there has been a large increase in medical marijuana dispensaries and licenses for the use of medical marijuana over the past year. This is a retrospective case series of marijuana exposures that have presented to the emergency department (ED) in children less than 5 years of age. Methods: We performed a retrospective chart…

  1. The Use of Psychological State Words by Late Talkers at Ages 3, 4, and 5 Years

    ERIC Educational Resources Information Center

    Lee, Eliza Carlson; Rescorla, Leslie

    2008-01-01

    The use of four types of psychological state words (physiological, emotional, desire, and cognitive) during mother-child play sessions at ages 3, 4, and 5 years was examined in 30 children diagnosed with delayed expressive language at 24-31 months and 15 age-matched comparison children with typical development. The children's mean length of…

  2. Cognitive and Temperament Clusters in 3- to 5-Year-Old Children with Aggressive Behavior

    ERIC Educational Resources Information Center

    Sakimura, Jean N.; Dang, Michelle T.; Ballard, Kelley B.; Hansen, Robin L.

    2008-01-01

    Background: This study assessed the co-occurrence of cognitive problems and difficult temperament characteristics in children aged 3 to 5 years exhibiting aggressive behavior. Methods: Thirty-one children with high ratings on the Aggressive Behavior subscale of the Achenbach Child Behavior Checklist or Teacher Report Form were recruited from a…

  3. 24 CFR 903.6 - What information must a PHA provide in the 5-Year Plan?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What information must a PHA provide in the 5-Year Plan? 903.6 Section 903.6 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN...

  4. Early Book Stages, 0-5 Years [and] Creciendo con Libros (Growing [up] with Books). [Videotape.

    ERIC Educational Resources Information Center

    Holguin, Roxanna

    Using a lighthearted and simple approach, this 23-minute videotape in English and Spanish versions presents interactions between parents and children while reading books. The children in the videotape range in age from 0 to 5 years. The video is introduced by scenes of children enjoying books while narration discussing the impact of reading to…

  5. Renal adenoma in a 5-year-old Labrador retriever: Big is not always bad

    PubMed Central

    Lillakas, Kristina

    2013-01-01

    A 5-year-old Labrador retriever was presented with anorexia, hematuria, and a 3-week history of mild lethargy, periodic inappetance, and weight loss. A firm mass in the cranial abdomen was discovered on physical examination. Following clinical work-up the owners elected euthanasia. On postmortem examination, histopathology determined that the mass was a benign renal adenoma. PMID:23904644

  6. Therapeutic Community in a California Prison: Treatment Outcomes after 5 Years

    ERIC Educational Resources Information Center

    Zhang, Sheldon X.; Roberts, Robert E. L.; McCollister, Kathryn E.

    2011-01-01

    Therapeutic communities have become increasingly popular among correctional agencies with drug-involved offenders. This quasi-experimental study followed a group of inmates who participated in a prison-based therapeutic community in a California state prison, with a comparison group of matched offenders, for more than 5 years after their initial…

  7. Ensemble Perception of Size in 4-5-Year-Old Children

    ERIC Educational Resources Information Center

    Sweeny, Timothy D.; Wurnitsch, Nicole; Gopnik, Alison; Whitney, David

    2015-01-01

    Groups of objects are nearly everywhere we look. Adults can perceive and understand the "gist" of multiple objects at once, engaging ensemble-coding mechanisms that summarize a group's overall appearance. Are these group-perception mechanisms in place early in childhood? Here, we provide the first evidence that 4-5-year-old children use…

  8. Structural Priming as Learning: Evidence from Mandarin-Learning 5-Year-Olds

    ERIC Educational Resources Information Center

    Hsu, Dong-Bo

    2014-01-01

    Three experiments on structural priming in Mandarin-speaking 5-year-olds were conducted to test the priming as implicit learning hypothesis. It describes a learning mechanism that acts on a shared abstract syntactic representation in response to linguistic input using an equi-biased Mandarin SVO-"ba" alternation. The first two…

  9. Introducing Engineering in Elementary Education: A 5-Year Study of Teachers and Students

    ERIC Educational Resources Information Center

    Diefes-Dux, Heidi A.

    2015-01-01

    Engineering, when integrated into K-12 education, may offer a number of potential student learning and future success benefits. In a 5-year study, four cohorts of elementary teachers of grades 2 to 4 in a single US school district were provided with teacher professional development with engineering education. Teachers were prepared to teach…

  10. 5-year mortality in hemodialysis patients: a single center study in Tripoli.

    PubMed

    Buargub, Mahdia A

    2008-03-01

    To investigate the 5-year mortality of patients undergoing maintenance hemo-dialysis (HD) at Al-Shat center Tripoli, we reviewed during June 2007 the records of all the HD patients initiated on HD from Jun 2000 and Jan 2002. There were 124 patients in the study, 77 males (63.6%) and 47 (36.4%) females, with a mean age of 49 +/- 14 years. Diabetic nephropathy (DN) was the underlying kidney disease in 34 (27.4%) patients. After 5 years; 3 patients were transferred to other centers, 18 (14.9%) patients underwent kidney transplan-tation. Out of the 103 patients who continued on hemodialysis, 53 (51.4%) expired during the 5-year follow-up. Mortality was associated with older age (p 50 years) and DN (p< 0.002 and OR of 3.9). Mortality rate in diabetics was 74.1% and significantly associated with male sex (p< 0.0067 and OR of 2.4), older age (p< 0.004), presence of hypertension (p< 0.003 and OR of 3.9), type 1 diabetes (OR 1.6), and elevated mean body weight (p< 0.046). Mortality was also relatively higher in black patients (OR of 2.0) and smokers (OR of 1.39). In conclusion, the overall 5- year mortality for dialysis patients was elevated and higher in the diabetics. PMID:18310882

  11. 24 CFR 903.6 - What information must a PHA provide in the 5-Year Plan?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false What information must a PHA provide in the 5-Year Plan? 903.6 Section 903.6 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT...

  12. Verbal Competence in Narrative Retelling in 5-Year-Olds with Unilateral Cleft Lip and Palate

    ERIC Educational Resources Information Center

    Klintö, Kristina; Salameh, Eva-Kristina; Lohmander, Anette

    2015-01-01

    Background: Research regarding expressive language performance in children born with cleft palate is sparse. The relationship between articulation/phonology and expressive language skills also needs to be further explored. Aims: To investigate verbal competence in narrative retelling in 5-year-old children born with unilateral cleft lip and palate…

  13. Hands as Companions of the Mind: Essential Practical Life for the 5-Year-Old

    ERIC Educational Resources Information Center

    Gilder, Sharon Allen

    2012-01-01

    Numerous observations in Montessori classrooms led veteran Montessorians Pamela W. Trumble and Eleni Bokas to the conclusion that a universal need exists to bring integrity back to Practical Life, especially for 5-year-olds. Maria Montessori's observations over a century ago revealed the importance of Practical Life and its relationship to the…

  14. 76 FR 70156 - Draft Programmatic Environmental Impact Study (PEIS) for Proposed 5-Year Outer Continental Shelf...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-10

    ... Bureau of Ocean Energy Management Draft Programmatic Environmental Impact Study (PEIS) for Proposed 5-Year Outer Continental Shelf (OCS) Oil and Gas Leasing Program for 2012-2017 AGENCY: Bureau of Ocean... FURTHER INFORMATION CONTACT: Bureau of Ocean Energy Management, Headquarters, 381 Elden Street,...

  15. Treatment of Sleep Problems in a 5-Year-Old Boy with Autism Using Behavioural Principles.

    ERIC Educational Resources Information Center

    Weiskop, Sophie; Matthews, Jan; Richdale, Amanda

    2001-01-01

    This article describes the successful treatment of sleep problems in a 5-year-old boy with autism. The intervention was based on behavioral principles and involved the parents attending an individually run parent training program. The parents learned how to use a bedtime routine, reinforcement, effective instructions, partner support strategies,…

  16. Wakefulness (Not Sleep) Promotes Generalization of Word Learning in 2.5-Year-Old Children

    ERIC Educational Resources Information Center

    Werchan, Denise M.; Gómez, Rebecca L.

    2014-01-01

    Sleep enhances generalization in adults, but this has not been examined in toddlers. This study examined the impact of napping versus wakefulness on the generalization of word learning in toddlers when the contextual background changes during learning. Thirty 2.5-year-old children (M = 32.94, SE = 0.46) learned labels for novel categories of…

  17. Guidelines for Health Assessment and Intervention Techniques for 3, 4, and 5 Year Old Children.

    ERIC Educational Resources Information Center

    Bentley, Judy K.

    These guidelines were developed to help registered nurses identify preschoolers with potential handicaps in the course of health assessments. Contents include guidelines on 3-, 4-, and 5-year-olds. Contents are organized within age levels in terms of functioning levels and anticipatory guidance. Functional areas covered include physical,…

  18. The Development of Regulatory Functions from Birth to 5 Years: Insights from Premature Infants

    ERIC Educational Resources Information Center

    Feldman, Ruth

    2009-01-01

    This study examined physiological, emotional, and attentional regulatory functions as predictors of self-regulation in 125 infants followed 7 times from birth to 5 years. Physiological regulation was assessed by neonatal vagal tone and sleep-wake cyclicity; emotion regulation by response to stress at 3, 6, and 12 months; and attention regulation…

  19. Effects of A 2.5-Year Campus-Wide Intervention to Reduce College Drinking

    ERIC Educational Resources Information Center

    Seo, Dong-Chul; Owens, Dee; Gassman, Ruth; Kingori, Caroline

    2013-01-01

    Objective: The present study reports on the results of a 2.5-year college-wide, coordinated intervention that was implemented from June 2007 to December 2009 to reduce the amount and frequency of students' alcohol consumption. Design: Quasi-experimental study using a one-group (freshmen living on campus) pretest/posttest design ("N"…

  20. Influence of Emotional Facial Expressions on 3-5-Year-Olds' Face Recognition

    ERIC Educational Resources Information Center

    Freitag, Claudia; Schwarzer, Gudrun

    2011-01-01

    Three experiments examined 3- and 5-year-olds' recognition of faces in constant and varied emotional expressions. Children were asked to identify repeatedly presented target faces, distinguishing them from distractor faces, during an immediate recognition test and during delayed assessments after 10 min and one week. Emotional facial expression…

  1. 76 FR 50447 - Endangered and Threatened Species; 5-Year Reviews for 5 Evolutionarily Significant Units of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-15

    ..., Oregon, Washington, and Idaho (75 FR 13082). Both ESUs and DPSs are treated as ``species'' under the ESA... FR 37204). The 5-year review reports prepared by the Southwest Region, the Southwest Science Center's... since they were previously reviewed in 2005 (70 FR 37160) and 2006 (71 FR 834), respectively....

  2. 76 FR 50448 - Endangered and Threatened Species; 5-Year Reviews for 17 Evolutionarily Significant Units and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-15

    ... Regional Offices announced initiation of 5-year reviews of Pacific salmon ESUs and steelhead DPSs (75 FR... Salmon and Steelhead in Listing Determinations under the ESA (70 FR 37204) to complete this evaluation...-promulgating the threatened listing for Oregon Coast coho salmon (76 FR 35755). This notice also addresses...

  3. An evaluation paradigm for cumulative impact analysis

    NASA Astrophysics Data System (ADS)

    Stakhiv, Eugene Z.

    1988-09-01

    Cumulative impact analysis is examined from a conceptual decision-making perspective, focusing on its implicit and explicit purposes as suggested within the policy and procedures for environmental impact analysis of the National Environmental Policy Act of 1969 (NEPA) and its implementing regulations. In this article it is also linked to different evaluation and decision-making conventions, contrasting a regulatory context with a comprehensive planning framework. The specific problems that make the application of cumulative impact analysis a virtually intractable evaluation requirement are discussed in connection with the federal regulation of wetlands uses. The relatively familiar US Army Corps of Engineers' (the Corps) permit program, in conjunction with the Environmental Protection Agency's (EPA) responsibilities in managing its share of the Section 404 regulatory program requirements, is used throughout as the realistic context for highlighting certain pragmatic evaluation aspects of cumulative impact assessment. To understand the purposes of cumulative impact analysis (CIA), a key distinction must be made between the implied comprehensive and multiobjective evaluation purposes of CIA, promoted through the principles and policies contained in NEPA, and the more commonly conducted and limited assessment of cumulative effects (ACE), which focuses largely on the ecological effects of human actions. Based on current evaluation practices within the Corps' and EPA's permit programs, it is shown that the commonly used screening approach to regulating wetlands uses is not compatible with the purposes of CIA, nor is the environmental impact statement (EIS) an appropriate vehicle for evaluating the variety of objectives and trade-offs needed as part of CIA. A heuristic model that incorporates the basic elements of CIA is developed, including the idea of trade-offs among social, economic, and environmental protection goals carried out within the context of environmental

  4. Respiratory Viruses Associated Hospitalization among Children Aged <5 Years in Bangladesh: 2010-2014

    PubMed Central

    Homaira, Nusrat; Luby, Stephen P.; Hossain, Kamal; Islam, Kariul; Ahmed, Makhdum; Rahman, Mustafizur; Rahman, Ziaur; Paul, Repon C.; Bhuiyan, Mejbah Uddin; Brooks, W. Abdullah; Sohel, Badrul Munir; Banik, Kajal Chandra; Widdowson, Marc-Alain; Willby, Melisa; Rahman, Mahmudur; Bresee, Joseph; Ramirez, Katharine-Sturm; Azziz-Baumgartner, Eduardo

    2016-01-01

    Background We combined hospital-based surveillance and health utilization survey data to estimate the incidence of respiratory viral infections associated hospitalization among children aged < 5 years in Bangladesh. Methods Surveillance physicians collected respiratory specimens from children aged <5 years hospitalized with respiratory illness and residing in the primary hospital catchment areas. We tested respiratory specimens for respiratory syncytial virus, parainfluenza viruses, human metapneumovirus, influenza, adenovirus and rhinoviruses using rRT-PCR. During 2013, we conducted a health utilization survey in the primary catchment areas of the hospitals to determine the proportion of all hospitalizations for respiratory illness among children aged <5 years at the surveillance hospitals during the preceding 12 months. We estimated the respiratory virus-specific incidence of hospitalization by dividing the estimated number of hospitalized children with a laboratory confirmed infection with a respiratory virus by the population aged <5 years of the catchment areas and adjusted for the proportion of children who were hospitalized at the surveillance hospitals. Results We estimated that the annual incidence per 1000 children (95% CI) of all cause associated respiratory hospitalization was 11.5 (10–12). The incidences per 1000 children (95% CI) per year for respiratory syncytial virus, parainfluenza, adenovirus, human metapneumovirus and influenza infections were 3(2–3), 0.5(0.4–0.8), 0.4 (0.3–0.6), 0.4 (0.3–0.6), and 0.4 (0.3–0.6) respectively. The incidences per 1000 children (95%CI) of rhinovirus-associated infections among hospitalized children were 5 (3–7), 2 (1–3), 1 (0.6–2), and 3 (2–4) in 2010, 2011, 2012 and 2013, respectively. Conclusion Our data suggest that respiratory viruses are associated with a substantial burden of hospitalization in children aged <5 years in Bangladesh. PMID:26840782

  5. Extended Long-Term (5 Years) Outcomes of Triangle Tilt Surgery in Obstetric Brachial Plexus Injury

    PubMed Central

    Nath, Rahul K; Somasundaram, Chandra

    2013-01-01

    Objective: We evaluated the "extended" long-term (5 years) functional outcomes in obstetric brachial plexus injury (OBPI) patients, who underwent triangle tilt surgery between February 2005 and January 2008. Methods: Twenty two children (9 girls and 13 boys, mean age at surgery was 5.8 years; ranging 2.1-11.8 years old), who initially presented with medial rotation contracture and scapula deformity secondary to obstetric brachial plexus injury were included in this study. Functional movements were evaluated pre-operatively, and 5 years following triangle tilt surgery by modified Mallet scale. Results: Here, we report long-term (5 years) follow-up of triangle tilt surgery for 22 OBPI patients. Upper extremity functional movements such as, external rotation (2.5±0.6 to 4.1±0.8, p<0.0001), hand-to-spine (2.6±0.6 to 3.4±1.1, p<0.005), hand-to-neck (2.7±0.7 to 4.3±0.7, p<0.0001), hand-to-mouth (2.3±0.9 (92º±33) to 4.2±0.5 (21º±16), p<0.0001), and supination (2.6±1.1 (-8.2º ±51) to 4.1±0.7 (61±32)) were significantly improved (p<0.0001), and maintained over the extended long-term (5 years). Total modified Mallet functional score was also shown to improve from 14.1±2.7 to 20.3±2.5. Conclusions: The triangle tilt surgery improved all shoulder functions significantly, and maintained over the extended long-term (5 years) in these patients. PMID:23730369

  6. Spatial and temporal changes in cumulative human impacts on the world's ocean.

    PubMed

    Halpern, Benjamin S; Frazier, Melanie; Potapenko, John; Casey, Kenneth S; Koenig, Kellee; Longo, Catherine; Lowndes, Julia Stewart; Rockwood, R Cotton; Selig, Elizabeth R; Selkoe, Kimberly A; Walbridge, Shaun

    2015-01-01

    Human pressures on the ocean are thought to be increasing globally, yet we know little about their patterns of cumulative change, which pressures are most responsible for change, and which places are experiencing the greatest increases. Managers and policymakers require such information to make strategic decisions and monitor progress towards management objectives. Here we calculate and map recent change over 5 years in cumulative impacts to marine ecosystems globally from fishing, climate change, and ocean- and land-based stressors. Nearly 66% of the ocean and 77% of national jurisdictions show increased human impact, driven mostly by climate change pressures. Five percent of the ocean is heavily impacted with increasing pressures, requiring management attention. Ten percent has very low impact with decreasing pressures. Our results provide large-scale guidance about where to prioritize management efforts and affirm the importance of addressing climate change to maintain and improve the condition of marine ecosystems. PMID:26172980

  7. Spatial and temporal changes in cumulative human impacts on the world's ocean

    PubMed Central

    Halpern, Benjamin S.; Frazier, Melanie; Potapenko, John; Casey, Kenneth S.; Koenig, Kellee; Longo, Catherine; Lowndes, Julia Stewart; Rockwood, R. Cotton; Selig, Elizabeth R.; Selkoe, Kimberly A.; Walbridge, Shaun

    2015-01-01

    Human pressures on the ocean are thought to be increasing globally, yet we know little about their patterns of cumulative change, which pressures are most responsible for change, and which places are experiencing the greatest increases. Managers and policymakers require such information to make strategic decisions and monitor progress towards management objectives. Here we calculate and map recent change over 5 years in cumulative impacts to marine ecosystems globally from fishing, climate change, and ocean- and land-based stressors. Nearly 66% of the ocean and 77% of national jurisdictions show increased human impact, driven mostly by climate change pressures. Five percent of the ocean is heavily impacted with increasing pressures, requiring management attention. Ten percent has very low impact with decreasing pressures. Our results provide large-scale guidance about where to prioritize management efforts and affirm the importance of addressing climate change to maintain and improve the condition of marine ecosystems. PMID:26172980

  8. Situational analysis and future directions of AYUSH: An assessment through 5-year plans of India

    PubMed Central

    Samal, Janmejaya

    2015-01-01

    AYUSH is an acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy. These are the six indigenous systems of medicine practiced in India. A department called Department of Indian System of medicine was created in March 1995 and renamed to AYUSH in November 2003 with a focus to provide increased attention for the development of these systems. Very recently, in 2014, a separate ministry was created under the union Government of India, which is headed by a minister of state. Planning regarding these systems of medicine was a part of 5-year planning process since 1951. Since then many developments have happened in this sector albeit the system was struggling with a great degree of uncertainty at the time of 1st5-year plan. A progressive path of development could be observed since the first to the 12th5-year plan. It was up to the 7thplan the growth was little sluggish and from 8thplan onward the growth took its pace and several innovative development processes could be observed thereafter. The system is gradually progressing ahead with a vision to be a globally accepted system, as envisaged in 11th5-year plan. Currently, AYUSH system is a part of mainstream health system implemented under National Rural Health Mission (NRHM). NRHM came into play in 2005 but implemented at ground level in 2006 and introduced the scheme of “Mainstreaming of AYUSH and revitalization of local health traditions” to strengthen public health services. This scheme is currently in operation in its second phase, since 1stApril 2012, with the 12th5-year plan. The scheme was primarily brought in to operation with three important objectives; choice of treatment system to the patients, strengthen facility functionally and strengthen the implementation of national health programmes, however, in some places it seems to be a forced medical pluralism owing to a top-down approach by the union government without considerable involvement of the concerned community. In this study, the

  9. Fracture Prediction After Discontinuation of 4 to 5 Years of Alendronate Therapy

    PubMed Central

    Bauer, Douglas C.; Schwartz, Ann; Palermo, Lisa; Cauley, Jane; Hochberg, Marc; Santora, Art; Cummings, Steven R.; Black, Dennis M.

    2015-01-01

    IMPORTANCE Discontinuation of bisphosphonate therapy after 3 to 5 years is increasingly considered, but methods to monitor fracture risk after discontinuation have not been established. OBJECTIVE To test methods of predicting fracture risk among women who have discontinued alendronate therapy after 4 to 5 years. DESIGN, SETTING, AND PARTICIPANTS The prospective Fracture Intervention Trial Long-term Extension (FLEX) study randomized postmenopausal women aged 61 to 86 years previously treated with 4 to 5 years of alendronate therapy to 5 more years of alendronate or placebo from 1998 through 2003; the present analysis includes only the placebo group. Hip and spine dual-energy x-ray absorptiometry (DXA) were measured when placebo was begun (FLEX baseline) and after 1 to 3 years of follow-up. Two biochemical markers of bone turnover, urinary type 1 collagen cross-linked N-telopeptide (NTX) and serum bone-specific alkaline phosphatase (BAP), were measured at FLEX baseline and after 1 and 3 years. MAIN OUTCOMES AND MEASURES Symptomatic spine and nonspine fractures occurring after the follow-up measurement of DXA or bone turnover. RESULTS During 5 years of placebo, 94 of 437 women (22%) experienced 1 or more symptomatic fractures; 82 had fractures after 1 year. One-year changes in hip DXA, NTX, and BAP were not related to subsequent fracture risk, but older age and lower hip DXA at time of discontinuation were significantly related to increased fracture risk (lowest tertile of baseline femoral neck DXA vs other 2 tertiles relative hazard ratio, 2.17 [95%CI, 1.38–3.41]; total hip DXA relative hazard ratio, 1.87 [95%CI, 1.20–2.92]). CONCLUSIONS AND RELEVANCE Among postmenopausal women who discontinue alendronate therapy after 4 to 5 years, age and hip BMD at discontinuation predict clinical fractures during the subsequent 5 years. Follow-up measurements of DXA 1 year after discontinuation and of BAP or NTX 1 to 2 years after discontinuation are not associated with

  10. Situational analysis and future directions of AYUSH: An assessment through 5-year plans of India.

    PubMed

    Samal, Janmejaya

    2015-01-01

    AYUSH is an acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy. These are the six indigenous systems of medicine practiced in India. A department called Department of Indian System of medicine was created in March 1995 and renamed to AYUSH in November 2003 with a focus to provide increased attention for the development of these systems. Very recently, in 2014, a separate ministry was created under the union Government of India, which is headed by a minister of state. Planning regarding these systems of medicine was a part of 5-year planning process since 1951. Since then many developments have happened in this sector albeit the system was struggling with a great degree of uncertainty at the time of 1(st)5-year plan. A progressive path of development could be observed since the first to the 12(th)5-year plan. It was up to the 7(th)plan the growth was little sluggish and from 8(th)plan onward the growth took its pace and several innovative development processes could be observed thereafter. The system is gradually progressing ahead with a vision to be a globally accepted system, as envisaged in 11(th)5-year plan. Currently, AYUSH system is a part of mainstream health system implemented under National Rural Health Mission (NRHM). NRHM came into play in 2005 but implemented at ground level in 2006 and introduced the scheme of "Mainstreaming of AYUSH and revitalization of local health traditions" to strengthen public health services. This scheme is currently in operation in its second phase, since 1(st)April 2012, with the 12(th)5-year plan. The scheme was primarily brought in to operation with three important objectives; choice of treatment system to the patients, strengthen facility functionally and strengthen the implementation of national health programmes, however, in some places it seems to be a forced medical pluralism owing to a top-down approach by the union government without considerable involvement of the concerned community. In this

  11. 24 CFR 903.19 - When is the 5-Year Plan or Annual Plan ready for submission to HUD?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false When is the 5-Year Plan or Annual Plan ready for submission to HUD? 903.19 Section 903.19 Housing and Urban Development REGULATIONS... is the 5-Year Plan or Annual Plan ready for submission to HUD? A PHA may adopt its 5-Year Plan or...

  12. 24 CFR 903.19 - When is the 5-Year Plan or Annual Plan ready for submission to HUD?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false When is the 5-Year Plan or Annual Plan ready for submission to HUD? 903.19 Section 903.19 Housing and Urban Development Regulations... is the 5-Year Plan or Annual Plan ready for submission to HUD? A PHA may adopt its 5-Year Plan or...

  13. 24 CFR 903.19 - When is the 5-Year Plan or Annual Plan ready for submission to HUD?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false When is the 5-Year Plan or Annual Plan ready for submission to HUD? 903.19 Section 903.19 Housing and Urban Development REGULATIONS... is the 5-Year Plan or Annual Plan ready for submission to HUD? A PHA may adopt its 5-Year Plan or...

  14. 24 CFR 903.19 - When is the 5-Year Plan or Annual Plan ready for submission to HUD?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false When is the 5-Year Plan or Annual Plan ready for submission to HUD? 903.19 Section 903.19 Housing and Urban Development REGULATIONS... is the 5-Year Plan or Annual Plan ready for submission to HUD? A PHA may adopt its 5-Year Plan or...

  15. 24 CFR 903.19 - When is the 5-Year Plan or Annual Plan ready for submission to HUD?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false When is the 5-Year Plan or Annual Plan ready for submission to HUD? 903.19 Section 903.19 Housing and Urban Development REGULATIONS... is the 5-Year Plan or Annual Plan ready for submission to HUD? A PHA may adopt its 5-Year Plan or...

  16. Developmental potential in the first 5 years for children in developing countries.

    PubMed

    Grantham-McGregor, Sally; Cheung, Yin Bun; Cueto, Santiago; Glewwe, Paul; Richter, Linda; Strupp, Barbara

    2007-01-01

    Many children younger than 5 years in developing countries are exposed to multiple risks, including poverty, malnutrition, poor health, and unstimulating home environments, which detrimentally affect their cognitive, motor, and social-emotional development. There are few national statistics on the development of young children in developing countries. We therefore identified two factors with available worldwide data--the prevalence of early childhood stunting and the number of people living in absolute poverty--to use as indicators of poor development. We show that both indicators are closely associated with poor cognitive and educational performance in children and use them to estimate that over 200 million children under 5 years are not fulfilling their developmental potential. Most of these children live in south Asia and sub-Saharan Africa. These disadvantaged children are likely to do poorly in school and subsequently have low incomes, high fertility, and provide poor care for their children, thus contributing to the intergenerational transmission of poverty. PMID:17208643

  17. Clinical Case Report on Treatment of Generalized Aggressive Periodontitis: 5-Year Follow-up.

    PubMed

    Hu, Kai-Fang; Ho, Ya-Ping; Ho, Kun-Yen; Wu, Yi-Min; Wang, Wen-Chen; Chou, Yu-Hsiang

    2015-01-01

    Generalized aggressive periodontitis (GAgP) is a distinct type of periodontal disease associated with considerably more rapid periodontal tissue destruction than chronic periodontitis. This study presents the 5-year follow-up of a patient with GAgP. A 29-year-old man reported experiencing increasing gingival recession. He was treated using cause-related therapy, provisional splints, and flap surgery combined with allograft grafting and was followed up for 5 years. This case study shows that elimination of infectious microorganisms and meticulous long-term maintenance provide an effective treatment modality for aggressive periodontitis cases. This treatment modality can restore the masticatory function and provide the GAgP patient with improved quality of life. PMID:25909527

  18. GEOPHYSICS, ASTRONOMY, AND ASTROPHYSICS: Reconstructing Quintom from WMAP 5-year Observations: Generalized Ghost Condensate

    NASA Astrophysics Data System (ADS)

    Zhang, Jing-Fei; Gui, Yuan-Xing

    2010-08-01

    In the 5-year WMAP data analysis, a new parametrization form for dark energy equation-of-state was used, and it has been shown that the equation-of-state, w(z), crosses the cosmological-constant boundary w = -1. Based on this observation, in this paper, we investigate the reconstruction of quintom dark energy model. As a single-real-scalarfield model of dark energy, the generalized ghost condensate model provides us with a successful mechanism for realizing the quintom-like behavior. Therefore, we reconstruct this scalar-field quintom dark energy model from the WMAP 5-year observational results. As a comparison, we also discuss the quintom reconstruction based on other specific dark energy ansatzs, such as the CPL parametrization and the holographic dark energy scenarios.

  19. Synovial Sarcoma in the Foot of a 5-Year-Old ChildA Case Report.

    PubMed

    Lepow, Gary M; Grimmer, Daniel L; Lemar, Onya V; Bridges, Evan A

    2016-07-01

    The purpose of this case report is to present a rare finding of synovial sarcoma in a 5-year-old child. Most soft-tissue masses of the foot are too often presumed to be small and benign; therefore, compared with soft-tissue sarcomas, they are difficult to clinically differentiate and treat. A 5-year-old girl presented with a painful lesion that was diagnosed as synovial sarcoma after an excisional biopsy was performed. This was an unexpected finding of synovial sarcoma involving the tibialis posterior tendon of her right foot. The patient presented with an 8-month history of tenderness and an antalgic gait. We would like to encourage that all soft-tissue tumors of the foot be preoperatively evaluated with the aid of diagnostic imaging so that a well-planned biopsy assessment can be performed, with adequate margins excised. PMID:27489968

  20. Surveillance of lymphatic filariasis 5 years after stopping mass drug administration in Menoufiya Governorate, Egypt.

    PubMed

    Moustafa, M A; Thabet, H S; Saad, G A; El-Setouhy, M; Mehrez, M; Hamdy, D M

    2014-05-01

    The World Health Organization recommends that before lymphatic filariasis elimination in an area can be confirmed, an additional survey should be performed at least 5 years after stopping mass drug administration. The current study aimed to determine the status of lymphatic filariasis 5 years after cessation ofthe mass drug administration in 3 sentinel Egyptian villages in Menoufiya Governorate. The rapid immunochromatographic card test (ICT) and a new commercial antibody detection kit (CELISA®) were used. All 1321 primary-school children aged 6-7 years old were ICT negative but 27 children were antibody positive. All households surveyed in one village with the highest antibody prevalence were ICT negative, indicating an absence of lymphatic filariasis. The CELISA antibody kit needs more standardization and development to be useful under field conditions. We conclude that lymphatic filariasis is no longer a public health problem in these villages and other villages with similar epidemiological conditions. PMID:24952286

  1. Regulation of emotion and behavior among 3- and 5-year-olds.

    PubMed

    Kalpidou, Maria D; Power, Thomas G; Cherry, Katie E; Gottfried, Nathan W

    2004-04-01

    In this cross-sectional study, the authors examined the relationship between emotion and behavior regulation in 3- and 5-year olds. Eighty-seven children performed a compliance sorting task. The authors manipulated the demand for emotion regulation by presenting and then hiding toys (low) or making toys visible (high). Mothers and teachers rated children's coping responses. Five-year-olds sorted less in the high condition than in the low condition, and 3-year-olds spent equal time sorting in both conditions. Compliance was positively correlated with problem-focused coping and negatively correlated with emotion-focused coping. Correlations between emotion and behavior regulation were stronger for the 5-year-olds. Age groups were differently affected by the higher demands of emotion regulation, indicating that the child's resources for regulation interact with the task demands to determine behavioral outcome. PMID:15088868

  2. OLFACTION AND THE 5-YEAR INCIDENCE OF COGNITIVE IMPAIRMENT IN AN EPIDEMIOLOGIC STUDY OF OLDER ADULTS

    PubMed Central

    Schubert, Carla R.; Carmichael, Lakeesha L.; Murphy, Claire; Klein, Barbara E.K.; Klein, Ronald; Cruickshanks, Karen J.

    2008-01-01

    Objectives To determine if odor identification ability is associated with the 5-year incidence of cognitive impairment in a large population of older adults with normal cognition at baseline and if olfactory impairment contributes to the prediction of cognitive decline in a population. Design Population-based longitudinal study. Setting Beaver Dam, WI. Participants 1920 participants in the Epidemiology of Hearing Loss Study (mean age = 66.9 years). Measurements Olfaction was measured by the San Diego Odor Identification Test (SDOIT). Incident cognitive impairment was defined as a Mini-Mental State Exam Score (MMSE) < 24 or reported diagnosis of dementia or Alzheimer’s disease (AD) at the follow-up among people with MMSE ≥ 24 and no diagnosis of dementia or AD at baseline. Results There was a significant association between olfactory impairment at baseline and the 5-year incidence of cognitive impairment (Odds Ratio (O.R.) = 6.62, 95% Confidence Interval (C.I.) = 4.36, 10.05). The association remained significant after adjusting for possible confounders (O.R. = 3.72, 95% C.I. = 2.31, 5.99). The Positive Predictive Value of the SDOIT was 15.9%, the Negative Predictive Value was 97.2% and the sensitivity and specificity were 55.1% and 84.4%, respectively, for the 5-year incidence of cognitive impairment. Conclusion Olfactory impairment at baseline was strongly associated with the 5-year incidence of cognitive impairment as measured by the MMSE. Odor identification testing may be useful in high risk settings, but not in the general population, to identify patients at risk for cognitive decline. PMID:18662205

  3. Mercury toxicity presenting as acrodynia and a papulovesicular eruption in a 5-year-old girl.

    PubMed

    Lai, Olivia; Parsi, Kory K; Wu, Davina; Konia, Thomas H; Younts, Alexandra; Sinha, Natasha; McNelis, Amy; Sharon, Victoria R

    2016-01-01

    Acrodynia is a reaction that occurs in children who have been exposed to mercury. Mercury toxicity has systemic manifestations as well as cutaneous manifestations, which can appear similar to those found in a number of other diseases. We present a case of acrodynia caused by mercury exposure in a previously healthy 5-year-old girl who developed hypertension, palmoplantar pruritus, and a papulovesicular eruption. PMID:27136627

  4. Equatorial Annual Oscillation with QBO-driven 5-year Modulation in NCEP Data

    NASA Technical Reports Server (NTRS)

    Mayr, H. G.; Mengel, J. G.; Huang, F. T.; Nash, E. R.

    2007-01-01

    An analysis is presented of the zonal wind and temperature variations supplied by the National Center for Environmental Prediction (NCEP), which have been assimilated in the Reanalysis and the Climate Prediction Center (CCP) data sets. The derived zonal-mean variations are employed. Stimulated by modeling studies, the data are separated into the hemispherically symmetric and anti-symmetric components, and spectral analysis is applied to study the annual 12-month oscillation and Quasi-biennial Oscillation (QBO). For data samples that cover as much as 40 years, the results reveal a pronounced 5-year modulation of the symmetric AO in the lower stratosphere, which is confined to equatorial latitudes. This modulation is also inferred for the temperature variations but extends to high latitudes, qualitatively consistent with published model results. A comparison between different data samples indicates that the signature of the 5-year oscillation is larger when the QBO of 30 months is more pronounced. Thus there is circumstantial evidence that this periodicity of the QBO is involved in generating the oscillation. The spectral analysis shows that there is a weak anti-symmetric 5-year oscillation in the zonal winds, which could interact with the large antisymmetric A0 to produce the modulation of the symmetric AO as was shown in earlier modeling studies. According to these studies, the 30-month QBO tends to be synchronized by the equatorial Semi-annual Oscillation (SAO), and this would explain why the inferred 5-year modulation is observed to persist and is phase locked over several cycles.

  5. Intraindividual variation in plasma 25-hydroxyvitamin D measures 5 years apart among postmenopausal women

    PubMed Central

    Meng, Jennifer E.; Hovey, Kathleen M.; Wactawski-Wende, Jean; Andrews, Christopher A; LaMonte, Michael J.; Horst, Ronald L.; Genco, Robert J.; Millen, Amy E.

    2012-01-01

    Background Current literature examining associations between vitamin D and chronic disease generally use a single assessment of 25-hydroxyvitamin D (25(OH)D), assuming an individual’s 25(OH)D concentration is consistent over time. Methods We investigated the intraindividual variability between two measures of plasma 25(OH)D concentrations collected ~5 years apart (1997-2000 to 2002-2005) in 672 postmenopausal women participating in the Women’s Health Initiative. Plasma 25(OH)D was assessed using the DiaSorin LIAISON® chemiluminescence immunoassay. The within-pair coefficient of variation (CV) was 4.9% using blinded quality control samples. Mean and standard deviations (SD) of 25(OH)D at the two time points were compared using a paired t-test. An intraindividual CV and intra-class correlation coefficient (ICC) were used to assess intraindividual variability. A Spearman correlation coefficient (r) assessed the strength of the association between the two measures and concordance in vitamin D status at two time points Results Mean 25(OH)D concentrations (nmol/L) significantly increased over time from 60.0 (SD=22.2) to 67.8 (SD=22.2) (p<0.05). The CV was 24.6%, the ICC (95% Confidence Interval (CI)) was 0.59 (0.54-0.64), and the Spearman r was 0.61 (95% CI=0.56-0.66). Greater concordance over 5 years was observed in participants with sufficient compared to deficient or inadequate baseline 25(OH)D concentrations (weighted kappa=0.39). Reliability measures were moderately influenced by season of blood draw and vitamin D supplement use. Conclusion There is moderate intraindividual variation in 25(OH)D concentrations over approximately 5 years. Impact These data support the use of a one-time measure of blood 25(OH)D in prospective studies with ≤ 5 years of follow-up. PMID:22523182

  6. A 5-year Journey with Cutis Laxa in an Indian Child: The De Barsy Syndrome Revisited

    PubMed Central

    Dutta, Abhijit; Ghosh, Sudip Kumar; Ghosh, Arghyaprasun; Roy, Sutirtha

    2016-01-01

    De Barsy syndrome (DBS), synonymously known as autosomal recessive cutis laxa type III, is an extremely rare condition clinically characterized by cutis laxa, a progeroid appearance, and ophthalmologic abnormalities. We present here an account of 5-year follow-up since the birth of an Indian boy with DBS, who had a few rare and unusual manifestations. In addition, our case probably represents the first reported case of DBS from India. PMID:26955101

  7. The prevalence of dental erosion in 5-year-old preschoolers in Sharjah, United Arab Emirates

    PubMed Central

    Gopinath, Vellore Kannan

    2016-01-01

    Objective: The aim of this study was to determine the percentage of 5-year-old preschoolers in Sharjah, affected by dental erosion and to assess the predictors. Materials and Methods: A total of 403 5-year-old children were examined of which 48.14% (n = 194) were boys and 51.86% (n = 209) were girls; 31.27% (n = 126) were Emirati and 68.73% (n = 277) were non-Emirati Arabs. Examination of dental erosion was confined to palatal surfaces of maxillary incisors using the erosion index described in the UK National Survey of Children's Dental Health, 1993. Dental caries was charted using the World Health Organization 1997 criteria. Results: In the sample of 403 5-year-old preschoolers examined, dental erosion was apparent in 237 (58.80%) children, with 55.09% showing the dissolution of enamel and 3.72% exhibiting exposed dentin. Predictors of dental erosion as determined by logistic regression concluded that compared to Emirati citizens other Arab nationalities have 0.27 times the odds (95% confidence interval [CI] =0.18–0.42) of having tooth erosion (P < 0.05). Children with caries experience have 0.28 times the odds (95% CI = 0.16–0.51) of having tooth erosion compared to children with no caries experience (P < 0.05). Children who drink sugary or carbonated beverages have 0.30 times the odds (95% CI = 0.19–0.41) of having dental erosion compared to children who drink water (P < 0.05). Conclusions: The findings of this study indicate that 58.80% of 5-year-old preschoolers in Sharjah, United Arab Emirates, were affected by dental erosion. Caries experience and consumption of acidic drinks were associated with dental erosion. PMID:27095899

  8. Bifocal Spinal Cord Injury without Radiographic Abnormalities in a 5-Year Old Boy: A Case Report.

    PubMed

    Snoek, K G; Jacobsohn, M; van As, A B

    2012-01-01

    We present the extremely unusual case of a 5-year-old boy with a bifocal (cervical as well as lumbar) spinal cord injury without radiographic abnormalities (SCIWORAs). The MRI showed cord oedema at the level of C2 and T10. We propose that during the motor vehicle crash severe propulsion of the head with a flexed lumbar region resulted in a traction injury to the lower thoracic and lumbar spine and maximum flexion caused SCIWORA in C2. PMID:22649746

  9. Development and verification of child observation sheet for 5-year-old children.

    PubMed

    Fujimoto, Keiko; Nagai, Toshisaburo; Okazaki, Shin; Kawajiri, Mie; Tomiwa, Kiyotaka

    2014-02-01

    The aim of the study was to develop a newly devised child observation sheet (COS-5) as a scoring sheet, based on the Childhood Autism Rating Scale (CARS), for use in the developmental evaluation of 5-year-old children, especially focusing on children with autistic features, and to verify its validity. Seventy-six children were studied. The children were recruited among participants of the Japan Children's Cohort Study, a research program implemented by the Research Institute of Science and Technology for Society (RISTEX) from 2004 to 2009. The developmental evaluation procedure was performed by doctors, clinical psychologists, and public health nurses. The COS-5 was also partly based on the Kyoto Scale of Psychological Development 2001 (Kyoto Scale 2001). Further, the Developmental Disorders Screening Questionnaire for 5-Years-Olds, PDD-Autism Society Japan Rating Scale (PARS), doctor interview questions and neurological examination for 5-year-old children, and the Draw-a-Man Test (DAM) were used as evaluation scales. Eighteen (25.4%) children were rated as Suspected, including Suspected PDD, Suspected ADHD and Suspected MR. The COS-5 was suggested to be valid with favorable reliability (α=0.89) and correlation with other evaluation scales. The COS-5 may be useful, with the following advantages: it can be performed within a shorter time frame; it facilitates the maintenance of observation quality; it facilitates sharing information with other professions; and it is reliable to identify the autistic features of 5-year-old children. In order to verify its wider applications including the screening of infants (18months to 3years old) by adjusting the items of younger age, additional study is needed. PMID:23415454

  10. Modeling neural activity with cumulative damage distributions.

    PubMed

    Leiva, Víctor; Tejo, Mauricio; Guiraud, Pierre; Schmachtenberg, Oliver; Orio, Patricio; Marmolejo-Ramos, Fernando

    2015-10-01

    Neurons transmit information as action potentials or spikes. Due to the inherent randomness of the inter-spike intervals (ISIs), probabilistic models are often used for their description. Cumulative damage (CD) distributions are a family of probabilistic models that has been widely considered for describing time-related cumulative processes. This family allows us to consider certain deterministic principles for modeling ISIs from a probabilistic viewpoint and to link its parameters to values with biological interpretation. The CD family includes the Birnbaum-Saunders and inverse Gaussian distributions, which possess distinctive properties and theoretical arguments useful for ISI description. We expand the use of CD distributions to the modeling of neural spiking behavior, mainly by testing the suitability of the Birnbaum-Saunders distribution, which has not been studied in the setting of neural activity. We validate this expansion with original experimental and simulated electrophysiological data. PMID:25998210

  11. Conceptual models for cumulative risk assessment.

    PubMed

    Linder, Stephen H; Sexton, Ken

    2011-12-01

    In the absence of scientific consensus on an appropriate theoretical framework, cumulative risk assessment and related research have relied on speculative conceptual models. We argue for the importance of theoretical backing for such models and discuss 3 relevant theoretical frameworks, each supporting a distinctive "family" of models. Social determinant models postulate that unequal health outcomes are caused by structural inequalities; health disparity models envision social and contextual factors acting through individual behaviors and biological mechanisms; and multiple stressor models incorporate environmental agents, emphasizing the intermediary role of these and other stressors. The conclusion is that more careful reliance on established frameworks will lead directly to improvements in characterizing cumulative risk burdens and accounting for disproportionate adverse health effects. PMID:22021317

  12. Experimental approaches to studying cumulative cultural evolution

    PubMed Central

    Caldwell, Christine A.; Atkinson, Mark; Renner, Elizabeth

    2016-01-01

    In humans, cultural traditions often change in ways which increase efficiency and functionality. This process, widely referred to as cumulative cultural evolution, sees beneficial traits preferentially retained, and it is so pervasive that we may be inclined to take it for granted. However, directional change of this kind appears to distinguish human cultural traditions from behavioural traditions that have been documented in other animals. Cumulative culture is therefore attracting an increasing amount of attention within psychology, and researchers have begun to develop methods of studying this phenomenon under controlled conditions. These studies have now addressed a number of different questions, including which learning mechanisms may be implicated, and how the resulting behaviours may be influenced by factors such as population structure. The current article provides a synopsis of some of these studies, and highlights some of the unresolved issues in this field. PMID:27397972

  13. Avoiding Program-Induced Cumulative Overload (PICO).

    PubMed

    Orr, Robin; Knapik, Joseph J; Pope, Rodney

    2016-01-01

    This article defines the concept of program-induced cumulative overload (PICO), provides examples, and advises ways to mitigate the adverse effects. PICO is the excessive cumulative physical workload that can be imparted to military personnel by a military training program with an embedded physical training component. PICO can be acute (accumulating within a single day) or chronic (accumulating across the entirety of the program) and results in adverse outcomes for affected personnel, including detrimental fatigue, performance degradation, injuries, or illness. Strategies to mitigate PICO include focusing administration and logistic practices during the development and ongoing management of a trainee program and implementing known musculoskeletal injury prevention strategies. More training is not always better, and trainers need to consider the total amount of physical activity that military personnel experience across both operational training and physical training if PICO is to be mitigated. PMID:27450610

  14. Localized and cumulative nonlinearity in wind instruments

    NASA Astrophysics Data System (ADS)

    Gilbert, Joel

    2003-10-01

    Nonlinearities are very common in wind instruments. A crucial one localized at the input of the wind instrument is responsible for the sound production mechanism. As an illustration, some recent measurements done at clarinet mouthpieces will be shown. Some other localized nonlinear effects take place at the open tube ends. They imply extra losses whose amount depends on the internal geometry of the termination. They control the sound extinction phenomena. It will be shown how the playing range of a clarinet-like instrument is determined by these extra losses. Besides localized nonlinearity, cumulative nonlinearity effects are present as well. The cumulative nonlinear propagation phenomena along the tube of brass instruments can lead to shock waves obtained when the player is playing very loudly with a ``brassy sound.''

  15. Incorporating Nonchemical Stressors Into Cumulative Risk Assessments

    PubMed Central

    Rider, Cynthia V.; Dourson, Michael L.; Hertzberg, Richard C.; Mumtaz, Moiz M.; Price, Paul S.; Simmons, Jane Ellen

    2012-01-01

    The role of nonchemical stressors in modulating the human health risk associated with chemical exposures is an area of increasing attention. On 9 March 2011, a workshop titled “Approaches for Incorporating Nonchemical Stressors into Cumulative Risk Assessment” took place during the 50th Anniversary Annual Society of Toxicology Meeting in Washington D.C. Objectives of the workshop included describing the current state of the science from various perspectives (i.e., regulatory, exposure, modeling, and risk assessment) and presenting expert opinions on currently available methods for incorporating nonchemical stressors into cumulative risk assessments. Herein, distinct frameworks for characterizing exposure to, joint effects of, and risk associated with chemical and nonchemical stressors are discussed. PMID:22345310

  16. Study on Rotavirus Infection and Its Genotyping in Children Below 5 Years in South West Iran

    PubMed Central

    Azaran, Azarakhsh; Makvandi, Manoochehr; Samarbafzadeh, Alireza; Neisi, Niloofar; Hoseinzadeh, Mohsen; Rasti, Mojtaba; Teymurirad, Majid; Teimoori, Ali; Varnaseri, Mehran; Makvandi, Kamyar

    2016-01-01

    Background Human rotaviruses are the most important agents for severe dehydrating diarrhea in children below 5 years old. Rotaviruses (RV) is a serious public health problem in developing and developed countries. Objectives The aim of this study was to determine the prevalence of rotavirus infection and their genotypes in children younger than 5 years of age with acute diarrhea in Ahvaz, Iran. Materials and Methods For this study, 200 stool samples from children below 5 years of age with acute diarrhea were collected between October 2011 and March 2012. Initially all stool samples were tested for rotavirus antigen by ELISA, and positive samples were confirmed by RT-PCR targeting the VP6 rotavirus gene. Determination of rotavirus genotypes was carried out by performing RT-PCR for G and P types. Altogether, 15 samples were sequenced. Results Out of 200 stool samples, 100 (50%) had rotavirus antigen detected by ELISA and 73 (36.5%) were found positive by RT-PCR. Of the rotavirus strains identified, only 63 (86.3%) were positive for both VP7 and VP4 while 10 (13.7%) strains were found nontypeable. Rotavirus infection accounts for 36.5% of gastroenteritis cases in samples from symptomatic children. The most prevalent rotavirus genotypes were G1P [8] (80%) followed by G2P [4] (20%). Conclusions Our results suggest that group A rotavirus is a major pathogene of acute diarrhea in Ahvaz city. The genotypes circulating are similar with those of other countries. PMID:27307959

  17. Cryobanking of human ovarian tissue: Do women still want their tissue stored beyond 5 years?

    PubMed

    Macklon, Kirsten Tryde; Ernst, Erik; Andersen, Anders Nyboe; Andersen, Claus Yding

    2014-10-01

    Cryopreservation of ovarian tissue is one way of preserving fertility in young women with a malignant disease or other disorders that require gonadotoxic treatment. The purpose of the study was to explore how many women remained interested in continued cryostorage of their ovarian tissue beyond an initial 5-year period. Between 1999 and 2006, a total of 201 girls and young women had one ovary cryopreserved for fertility preservation in Denmark. One hundred of these met our inclusion criteria, which included a follow-up period of at least 5 years, and were mailed a questionnaire. The response rate was 95%. Sixteen of the patients (17%) stated that they wanted disposal of their tissue; the main reason was completion of family (63%). The mean age of those requesting disposal was 36.6 years, whereas those still wanting their tissue stored were significantly younger, with a mean age of 33.0 years (P < 0.008). In conclusion, most women with ovarian tissue cryobanked requested continued cryostorage after an initial period of at least 5 years. The main reason for requesting disposal was successful completion of a family. PMID:25129692

  18. The Treatment of Parasomnias with Hypnosis: a 5-Year Follow-Up Study

    PubMed Central

    Hauri, Peter J.; Silber, Michael H.; Boeve, Bradley F.

    2007-01-01

    Study Objectives: This study involves a replication and extension of a previous one reported by Hurwitz et al (1991) on the treatment of certain parasomnias with hypnosis. Methods: Thirty-six patients (17 females), mean age 32.7 years (range 6–71). Four were children aged 6 to 16. All had chronic, “functionally autonomous” (self-sustaining) parasomnias. All underwent 1 or 2 hypnotherapy sessions and were then followed by questionnaire for 5 years. Results: Of the 36 patients, 45.4% were symptom-free or at least much improved at the 1-month follow-up, 42.2% at the 18-month follow-up, and 40.5% at the 5-year follow-up. Conclusions: One or 2 sessions of hypnotherapy might be an efficient first-line therapy for patients with certain types of parasomnias. Citation: Hauri PJ; Silber MH; Boeve BF. The treatment of parasomnias with hypnosis: a 5-year follow-up study. J Clin Sleep Med 2007;3(4):369-373. PMID:17694725

  19. Endocrine dysfunction following traumatic brain injury: a 5-year follow-up nationwide-based study

    PubMed Central

    Yang, Wei-Hsun; Chen, Pau-Chung; Wang, Ting-Chung; Kuo, Ting-Yu; Cheng, Chun-Yu; Yang, Yao-Hsu

    2016-01-01

    Post-traumatic endocrine dysfunction is a complication of traumatic brain injury (TBI). However, there is lack of long-term follow-up and large sample size studies. This study included patients suffering from TBI registered in the Health Insurance Database. Endocrine disorders were identified using the ICD codes: 244 (acquired hypothyroidism), 253 (pituitary dysfunction), 255 (disorders of the adrenal glands), 258 (polyglandular dysfunction), and 259 (other endocrine disorders) with at least three outpatient visits within 1 year or one admission diagnosis. Overall, 156,945 insured subjects were included in the final analysis. The 1- and 5-year incidence rates of post-traumatic endocrinopathies were 0.4% and 2%, respectively. The risks of developing a common endocrinopathy (p < 0.001) or pituitary dysfunction (P < 0.001) were significantly higher in patients with a TBI history. Patients with a skull bone fracture had a higher risk of developing pituitary dysfunction at the 1-year follow up (p value < 0.001). At the 5-year follow up, the association between intracranial hemorrhage and pituitary dysfunction (p value: 0.002) was significant. The risk of developing endocrine dysfunction after TBI increased during the entire 5-year follow-up period. Skull bone fracture and intracranial hemorrhage may be associated with short and long-term post-traumatic pituitary dysfunction, respectively. PMID:27608606

  20. Prevalence and Factors Associated with Anemia Among Children Under 5 Years of Age--Uganda, 2009.

    PubMed

    Menon, Manoj P; Yoon, Steven S

    2015-09-01

    Anemia in children under 5 years of age, defined by the World Health Organization as a hemoglobin concentration < 11 g/dL, is a global public health problem. According to the 2006 Demographic Health Survey, the prevalence of anemia among children under five in Uganda was 72% in 2006. The 2009 Uganda Malaria Indicator Survey was conducted in late 2009 and revealed that over 60% of children less than 5 years of age were anemic and that over half of children tested positive for malaria via a rapid diagnostic test. Children with concomitant malaria infection, and in households without any type of mosquito net were more likely to be anemic, confirming that children under 5 years, are vulnerable to both the threat of malaria and anemia and the beneficial effect of malaria prevention tools. However, prevention and treatment of other factors associated with the etiology of anemia (e.g., iron deficiency) are likely necessary to combat the toll of anemia in Uganda. PMID:26055748

  1. Outcomes 5 years after response to rituximab therapy in children and adults with immune thrombocytopenia

    PubMed Central

    Mahévas, Matthieu; Lee, Soo Y.; Stasi, Roberto; Cunningham-Rundles, Susanna; Godeau, Bertrand; Kanter, Julie; Neufeld, Ellis; Taube, Tillmann; Ramenghi, Ugo; Shenoy, Shalini; Ward, Mary J.; Mihatov, Nino; Patel, Vinay L.; Bierling, Philippe; Lesser, Martin; Cooper, Nichola; Bussel, James B.

    2012-01-01

    Treatments for immune thrombocytopenic purpura (ITP) providing durable platelet responses without continued dosing are limited. Whereas complete responses (CRs) to B-cell depletion in ITP usually last for 1 year in adults, partial responses (PRs) are less durable. Comparable data do not exist for children and 5-year outcomes are unavailable. Patients with ITP treated with rituximab who achieved CRs and PRs (platelets > 150 × 109/L or 50-150 × 109/L, respectively) were selected to be assessed for duration of their response; 72 adults whose response lasted at least 1 year and 66 children with response of any duration were included. Patients had baseline platelet counts < 30 × 109/L; 95% had ITP of > 6 months in duration. Adults and children each had initial overall response rates of 57% and similar 5-year estimates of persisting response (21% and 26%, respectively). Children did not relapse after 2 years from initial treatment whereas adults did. Initial CR and prolonged B-cell depletion predicted sustained responses whereas prior splenectomy, age, sex, and duration of ITP did not. No novel or substantial long-term clinical toxicity was observed. In summary, 21% to 26% of adults and children with chronic ITP treated with standard-dose rituximab maintained a treatment-free response for at least 5 years without major toxicity. These results can inform clinical decision-making. PMID:22566601

  2. Endocrine dysfunction following traumatic brain injury: a 5-year follow-up nationwide-based study.

    PubMed

    Yang, Wei-Hsun; Chen, Pau-Chung; Wang, Ting-Chung; Kuo, Ting-Yu; Cheng, Chun-Yu; Yang, Yao-Hsu

    2016-01-01

    Post-traumatic endocrine dysfunction is a complication of traumatic brain injury (TBI). However, there is lack of long-term follow-up and large sample size studies. This study included patients suffering from TBI registered in the Health Insurance Database. Endocrine disorders were identified using the ICD codes: 244 (acquired hypothyroidism), 253 (pituitary dysfunction), 255 (disorders of the adrenal glands), 258 (polyglandular dysfunction), and 259 (other endocrine disorders) with at least three outpatient visits within 1 year or one admission diagnosis. Overall, 156,945 insured subjects were included in the final analysis. The 1- and 5-year incidence rates of post-traumatic endocrinopathies were 0.4% and 2%, respectively. The risks of developing a common endocrinopathy (p < 0.001) or pituitary dysfunction (P < 0.001) were significantly higher in patients with a TBI history. Patients with a skull bone fracture had a higher risk of developing pituitary dysfunction at the 1-year follow up (p value < 0.001). At the 5-year follow up, the association between intracranial hemorrhage and pituitary dysfunction (p value: 0.002) was significant. The risk of developing endocrine dysfunction after TBI increased during the entire 5-year follow-up period. Skull bone fracture and intracranial hemorrhage may be associated with short and long-term post-traumatic pituitary dysfunction, respectively. PMID:27608606

  3. Prediction of glucuronidated drug clearance in pediatrics (≤5 years): An allometric approach.

    PubMed

    Mahmood, Iftekhar

    2015-03-01

    Children are not small adults. The differences between children of different age groups and adults are not merely due to body weight, but also due to physiological and biochemical differences resulting in different rates of drug metabolism or renal clearance. Glucuronidation is an important pathway of drug metabolism. Therefore, the objective of this study is to evaluate the predictive performance of several allometric exponents in children of ≤5 years for the total clearance of drugs which are mainly metabolized by glucuronidation. Four exponents (0.75, 1.0, 1.2, or 1.4) on the body weights and an allometric model developed from adults were evaluated. The four exponents and the allometric model were examined to determine the suitability of the method(s) to predict the clearances of drugs which are glucuronidated in children ≤5 years of age. Based on the analysis of ten drugs, it was noted that the combination of two allometric exponents 1.2 (for children ≤3 months) and 1.0 (for children ≥3 months ≤5 years) can be used to predict mean clearances of drugs which are mainly metabolized by glucuronidation. The suggested approach may be used to estimate a first-in-pediatric dose to initiate a pediatric clinical trial. PMID:24519316

  4. Total wrist arthroplasty: a systematic review of the evidence from the last 5 years.

    PubMed

    Yeoh, D; Tourret, L

    2015-06-01

    We reviewed evidence on total wrist replacement from the last 5 years. Eight articles met a minimum set standard. The results of 405 prostheses were available, including seven different manufacturers. The mean follow up was 2.3-7.3 years with an average age of 52-63. Rheumatoid arthritis was the indication in 42% of patients. Motec demonstrated the best post-operative DASH scores. Only Maestro achieved a defined functional range of motion post-operatively. Universal 2 displayed the highest survival rates (100% at 3-5 years), while Elos had the lowest (57% at 5 years). Biaxial had the highest complication rates (68.7%), while Remotion had the lowest (11%). Wrist arthroplasty preserves some range of motion. Functional scores improved and were maintained over the mid- to long-term. Complication rates were higher than wrist fusion, with reports of radiological loosening and osteolysis. The evidence does not support the widespread use of arthroplasty over arthrodesis, and careful patient selection is essential. PMID:24963082

  5. Cumulative Index to NASA Tech Briefs

    NASA Technical Reports Server (NTRS)

    1969-01-01

    Tech Briefs are short announcements of new technology derived from the R&D activities of the National Aeronautics and Space Administration. This Index to NASA Tech Briefs lists the technological innovations derived from the U.S. space program and published during the period January through December 1968. A new five year cycle of cumulative indexes begins with this index. The main section is arranged in six categories: Electrical (Electronic); Physical Sciences (Energy Sources); Materials (Chemistry); Life Sciences; Mechanical; and Computer Programs.

  6. Expansive soil crack depth under cumulative damage.

    PubMed

    Shi, Bei-xiao; Chen, Sheng-shui; Han, Hua-qiang; Zheng, Cheng-feng

    2014-01-01

    The crack developing depth is a key problem to slope stability of the expansive soil and its project governance and the crack appears under the roles of dry-wet cycle and gradually develops. It is believed from the analysis that, because of its own cohesion, the expansive soil will have a certain amount of deformation under pulling stress but without cracks. The soil body will crack only when the deformation exceeds the ultimate tensile strain that causes cracks. And it is also believed that, due to the combined effect of various environmental factors, particularly changes of the internal water content, the inherent basic physical properties of expansive soil are weakened, and irreversible cumulative damages are eventually formed, resulting in the development of expansive soil cracks in depth. Starting from the perspective of volumetric strain that is caused by water loss, considering the influences of water loss rate and dry-wet cycle on crack developing depth, the crack developing depth calculation model which considers the water loss rate and the cumulative damages is established. Both the proposal of water loss rate and the application of cumulative damage theory to the expansive soil crack development problems try to avoid difficulties in matrix suction measurement, which will surely play a good role in promoting and improving the research of unsaturated expansive soil. PMID:24737974

  7. Expansive Soil Crack Depth under Cumulative Damage

    PubMed Central

    Shi, Bei-xiao; Chen, Sheng-shui; Han, Hua-qiang; Zheng, Cheng-feng

    2014-01-01

    The crack developing depth is a key problem to slope stability of the expansive soil and its project governance and the crack appears under the roles of dry-wet cycle and gradually develops. It is believed from the analysis that, because of its own cohesion, the expansive soil will have a certain amount of deformation under pulling stress but without cracks. The soil body will crack only when the deformation exceeds the ultimate tensile strain that causes cracks. And it is also believed that, due to the combined effect of various environmental factors, particularly changes of the internal water content, the inherent basic physical properties of expansive soil are weakened, and irreversible cumulative damages are eventually formed, resulting in the development of expansive soil cracks in depth. Starting from the perspective of volumetric strain that is caused by water loss, considering the influences of water loss rate and dry-wet cycle on crack developing depth, the crack developing depth calculation model which considers the water loss rate and the cumulative damages is established. Both the proposal of water loss rate and the application of cumulative damage theory to the expansive soil crack development problems try to avoid difficulties in matrix suction measurement, which will surely play a good role in promoting and improving the research of unsaturated expansive soil. PMID:24737974

  8. Orbital-optimized density cumulant functional theory

    SciTech Connect

    Sokolov, Alexander Yu. Schaefer, Henry F.

    2013-11-28

    In density cumulant functional theory (DCFT) the electronic energy is evaluated from the one-particle density matrix and two-particle density cumulant, circumventing the computation of the wavefunction. To achieve this, the one-particle density matrix is decomposed exactly into the mean-field (idempotent) and correlation components. While the latter can be entirely derived from the density cumulant, the former must be obtained by choosing a specific set of orbitals. In the original DCFT formulation [W. Kutzelnigg, J. Chem. Phys. 125, 171101 (2006)] the orbitals were determined by diagonalizing the effective Fock operator, which introduces partial orbital relaxation. Here we present a new orbital-optimized formulation of DCFT where the energy is variationally minimized with respect to orbital rotations. This introduces important energy contributions and significantly improves the description of the dynamic correlation. In addition, it greatly simplifies the computation of analytic gradients, for which expressions are also presented. We offer a perturbative analysis of the new orbital stationarity conditions and benchmark their performance for a variety of chemical systems.

  9. Survivorship after Arthroscopic Management of Glenohumeral Osteoarthritis with a Minimum 5 year Follow-up

    PubMed Central

    Mitchell, Justin; Horan, Marilee P.; Greenspoon, Joshua A.; Menge, Travis; Tahal, Dimitri S.; Millett, Peter J.

    2016-01-01

    Objectives: We previously reported clinical improvement and pain relief following arthroscopic management of glenohumeral osteoarthritis (GHOA) at 2 years. The purpose of this study was to determine 5 year survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA. Methods: This study had prior IRB approval. The CAM procedure was performed on a consecutive series of 42 young patients (44 shoulders) with GHOA who otherwise met criteria for shoulder arthroplasty but instead opted for joint preservation. The procedure included glenohumeral chondroplasty, capsular release, and synovectomy, humeral osteoplasty, axillary nerve neurolysis, subacromial decompression, loose body removal, microfracture and biceps tenodesis. Only patients who were a minimum of 5 years out from surgery were included in the study. Patients completed a subjective questionnaire, and further surgical intervention of the index shoulder was noted for survivorship analysis. Failure was defined as progression to TSA. Kaplan Meier survivorship analysis was performed. Results: Forty-two patients (with 44 shoulders) underwent a CAM procedure between 1/2006-12/2009 and were included. All patients were self-described recreational athletes. Seven patients were former collegiate or professional athletes. Mean follow-up was 5.9 years (range, 5 years to 8.1 years). Mean age at surgery was 52 (range 27- 68) years old in 13 women and 29 men. Eleven shoulders (26%) failed and progressed to TSA at a mean of 2.9 years (1.0-5.4 years). Shoulder status (progression to TSA or not) at minimum 5 years (range 5.3 - 9.4 years) was known for 95% (42/44). One patient progressed to another surgery for stiffness at a mean of 5.6 months and another patient underwent a revision CAM procedure at 7.9 years. From this cohort, Kaplan Meier survivorship was 92% at 1 year, 85.7% at 3 years, and 75.3% survivorship at 5 years. Conclusion: The long term durability of arthroscopic management for

  10. Studying cumulative ozone exposures in Europe during a 7-year period

    NASA Astrophysics Data System (ADS)

    Bastrup-Birk, Annemarie; Brandt, JøRgen; Zlatev, Zahari; Uria, Ignacio

    1997-10-01

    Ozone is one of the most harmful pollutants in the troposphere. High ozone concentrations can damage plants, animals and humans. The damaging effects depend on the magnitude of a critical level of a special parameter, the cumulative ozone exposure. This is why cumulative ozone exposures must be carefully studied. It is important to determine the relationships between relevant emissions (NOx emissions, human-made VOC emissions, and/or a combination of NOx emissions and human-made VOC emissions) and cumulative ozone exposures. All these issues are discussed in this paper. Meteorological data from seven consecutive years, from 1989 to 1995, have been used in the experiments with different scenarios for varying the emissions (the NOx emissions, the human-made VOC emissions, as well as both the NOx emissions and the human-made VOC emissions). The particular air pollution model used in this study is the Danish Eulerian Model. Several hundred runs with different input data (meteorological data and/or emission data) have been performed. Advanced visualization techniques are used to interpret the large amount of digital data collected in these runs and to show clearly different trends and relationships that are normally hidden behind millions and millions of numbers. The model results were compared with measurements taken at more than 80 stations located in different European countries. The experiments indicate that it is sufficient to carry out computations over 5 consecutive years in order to eliminate the influence of extreme meteorological conditions (very warm or very cold summer months) on the cumulative ozone exposures, while this effect is clearly seen if less than 5 years are used in the experiments. It is shown that the relationship between the emissions (NOx and/or human-made VOC emissions) and the cumulative ozone exposures is in general nonlinear. Finally, it is illustrated that the critical values for ozone exposures are exceeded in most of Europe (in many

  11. 5-Year Longitudinal Follow-up after Retropubic and Transobturator Midurethral Slings

    PubMed Central

    Kenton, Kimberly; Stoddard, Anne M.; Zyczynski, Halina; Albo, Michael; Rickey, Leslie; Norton, Peggy; Wai, Clifford; Kraus, Stephen R.; Sirls, Larry T.; Kusek, John W.; Litman, Heather J.; Chang, Robert P.; Richter, Holly E.

    2014-01-01

    Background Few studies have characterized longer-term outcomes after retropubic and transobturator midurethral slings. Methods Women completing 2-year participation in a randomized equivalence trial who had not received surgical retreatment for stress urinary incontinence were invited to participate in a 5-year observational cohort. The primary outcome, treatment success, was defined as no retreatment or self-reported stress incontinence symptoms. Secondary outcomes included urinary symptoms and quality of life, satisfaction, sexual function and adverse events. Results 404 of 597 (68%) women from the original trial enrolled. Five-years after surgical treatment, success was 7.9% greater in women assigned to retropubic-sling compared to transobturator-sling (51.3% vs 43.4%, 95% CI −1.4%, 17.2%) not meeting pre-specified criteria for equivalence. Satisfaction decreased over 5-years, but remained high and similar between arms (79%, retropubic-sling vs 85%, transobturator-sling groups, p=0.15). Urinary symptoms and quality of life worsened over time (p<0.001), and women with retropubic-sling reported greater urinary urgency (P=0.001), more negative quality of life impact (p=0.02), and worse sexual function (P=0.001). There was no difference in proportion of women experiencing at least 1 adverse event (p=0.17). Seven new mesh erosions were noted (retropubic-sling-3, transobturator-sling-4). Conclusion Treatment success declined over 5-years for retropubic and transobturator-slings and did not meet pre-specified criteria for equivalence with retropubic demonstrating a slight benefit. However, satisfaction remained high in both arms. Women undergoing transobturator-sling reported more sustained improvement in urinary symptoms and sexual function. New mesh erosions occurred in both arms over time, although at a similarly low rate. PMID:25158274

  12. Traditional endodontic surgery versus modern technique: a 5-year controlled clinical trial.

    PubMed

    Tortorici, Silvia; Difalco, Paolo; Caradonna, Luigi; Tetè, Stefano

    2014-05-01

    In this study, we compared outcomes of traditional apicoectomy versus modern apicoectomy, by means of a controlled clinical trial with a 5-year follow-up. The study investigated 938 teeth in 843 patients. On the basis of the procedure performed, the teeth were grouped in 3 groups. Differences between the groups were the method of osteotomy (type of instruments used), type of preparation of retrograde cavity (different apicoectomy angles and instruments used for root-end preparation), and root-end filling material used (gray mineral trioxide aggregate or silver amalgam). Outcome (tooth healing) was estimated after 1 and 5 years, postoperatively. Clinical success rates after 1 year were 67% (306 teeth), 90% (186 teeth), and 94% (256 teeth) according to traditional apicoectomy (group 1), modern microsurgical apicoectomy using burns for osteotomy (group 2) or using piezo-osteotomy (group 3), respectively. After 1 year, group comparison results were statistically significant (P < 0.0001). Linear trend test was also statistically significant (P < 0.0001), pointing out larger healing from group 1 to group 3. After 5 years, teeth were classified into 2 groups on the basis of root-end filling material used. Clinical success was 90.8% (197 teeth) in the silver amalgam group versus 96% (309 teeth) in the mineral trioxide aggregate group (P < 0.00214). Multiple logistic regression analysis found that surgical technique was independently associated to tooth healing. In conclusion, modern apicoectomy resulted in a probability of success more than 5 times higher (odds ratio, 5.20 [95% confidence interval, 3.94-6.92]; P < 0.001) compared with the traditional technique. PMID:24469371

  13. Calcineurin activity in tacrolimus-treated renal transplant patients early after and 5 years after transplantation.

    PubMed

    Mortensen, D M; Koefoed-Nielsen, P B; Jørgensen, K A

    2006-10-01

    The pharmacodynamic (PD) action of tacrolimus (FK) within the T-cell is inhibition of calcineurin phosphatase (CaN). Determination of CaN activity provides us with an important PD marker. Eleven renal transplant patients treated with FK were investigated on day 14 following transplantation and 5 years later. Blood samples drawn before as well as 1, 2, 3, and 4 hours after oral intake of FK were analyzed for CaN activity and blood FK concentrations. Twenty healthy subjects had one blood sample drawn for CaN activity, which was measured as the release of (32)P from a phosphorylated peptide. Radioactivity of (32)P was quantitated by liquid scintillation counting with the results converted to units of CaN utilizing a calibration curve. On day 14, we observed significant inhibition of CaN activity at T:1, 2, and 3 compared with the predose level (P = .002; P = .015; P = .015). Furthermore, all measured CaN activities were significantly different from those observed in healthy nonmedicated subjects. In contrast, at 5 years posttransplant only the CaN activity at T:2 was significantly inhibited compared with the predose level (P = .02). Additionally, all CaN activities at this time were not significantly different from CaN activities in the healthy subjects. We were not able to demonstrate individual CaN activity profiles in the patients. The lack of CaN inhibition at 5 years after transplantation despite relevant drug concentrations, probably reflected the lower drug dose used long after transplantation. This result raises the question of whether CaN inhibition is necessary to hold graft function and whether FK possess CaN-independent mechanisms of action. PMID:17098028

  14. Clinical treatment of a ruptured temporomandibular joint disc: morphological changes at 5-year follow-up.

    PubMed

    Cardinal, Lucas; Porto, Felipe; Agarwal, Sachin; Grossman, Eduardo

    2014-01-01

    Osteoarthrosis is a disease that affects the temporomandibular joint (TMJ). This case report chronicles the diagnosis and treatment of a patient for whom this pathological condition was accompanied by a rupture of the articular disc. The patient presented with loud sounds in the left TMJ and an irregular mandibular occlusal plane due to condylar intrusion in the glenoid fossa on the ipsilateral side. A noninvasive treatment was selected. A 4-month follow-up revealed remission of the articular sounds, and tissue regeneration was noted. These improvements remained visible at 5-year follow-up. PMID:24598507

  15. Small bowel obstruction 5 years following the ingestion of serrated scissors

    PubMed Central

    Limb, Richard; Karam, Edward; Lingam, Krishna M.

    2016-01-01

    Ingested foreign bodies are common in the cohort of psychiatric patients, however clinical quiescence in this group is rare. We present a case of a 45-year-old female with emotionally unstable personality disorder (borderline type) presenting with partial intestinal obstruction 5 years after the known ingestion of serrated metallic scissors. In the asymptomatic interim a conservative approach of tracking the blades radiologically was taken. Following discussion, we conclude the following: early surgical intervention is encouraged if natural passage does not occur within 3 days following ingestion, and that any concurrent surgical needs should be addressed at this time. PMID:27190200

  16. Drifter-based estimate of the 5 year dispersal of Fukushima-derived radionuclides

    NASA Astrophysics Data System (ADS)

    Rypina, I. I.; Jayne, S. R.; Yoshida, S.; Macdonald, A. M.; Buesseler, K.

    2014-11-01

    Employing some 40 years of North Pacific drifter-track observations from the Global Drifter Program database, statistics defining the horizontal spread of radionuclides from Fukushima nuclear power plant into the Pacific Ocean are investigated over a time scale of 5 years. A novel two-iteration method is employed to make the best use of the available drifter data. Drifter-based predictions of the temporal progression of the leading edge of the radionuclide distribution are compared to observed radionuclide concentrations from research surveys occupied in 2012 and 2013. Good agreement between the drifter-based predictions and the observations is found.

  17. Maintenance pharmacotherapy for recurrent major depressive disorder: 5-year follow-up study.

    PubMed

    Holma, Irina A K; Holma, K Mikael; Melartin, Tarja K; Isometsä, Erkki T

    2008-08-01

    Practice guidelines endorse maintenance antidepressant treatment for recurrent major depressive disorder. In the Vantaa Depression Study, we followed 218 psychiatric patients with major depressive disorder for up to 5 years with a life-chart. Of these patients, 86 (39.4%) had more than three lifetime episodes and an indication for maintenance pharmacotherapy. However, of these, only 57% received treatment and only for 16% of the time indicated. Good adherence to pharmacotherapy in the acute phase independently predicted maintenance treatment. The tertiary preventive impact of maintenance treatment may remain limited, as many patients with major depressive disorder either do not receive it, or receive it for too short a period. PMID:18670005

  18. Malnutrition Among Children Younger Than 5 Years-Old in Conflict Zones of Chiapas, Mexico

    PubMed Central

    Sánchez-Pérez, Héctor Javier; Hernán, Miguel A.; Ríos-González, Adriana; Arana-Cedeño, Marcos; Navarro, Albert; Ford, Douglas; Micek, Mark A.; Brentlinger, Paula

    2007-01-01

    We performed a cross-sectional, community-based survey, supplemented by interviews with community leaders in Chiapas, Mexico, to examine the prevalence and predictors of child malnutrition in regions affected by the Zapatista conflict. The prevalence rates of stunting, wasting, and underweight were 54.1%, 2.9%, and 20.3%, respectively, in 2666 children aged younger than 5 years. Stunting was associated with indigenous ethnicity, poverty, region of residence, and intracommunity division. The results indicate that malnutrition is a serious public health problem in the studied regions. PMID:17194868

  19. Infantile fibrosarcoma of ethmoid sinus, misdiagnosed as an adenoid in a 5-year-old child

    PubMed Central

    Geramizadeh, Bita; Khademi, Bijan; Karimi, Mehran; Shekarkhar, Golsa

    2015-01-01

    Infantile fibrosarcoma of head and neck is rare and the presence of this tumor in ethmoid sinus is even more uncommon. To the best of our knowledge, <5 cases have been reported in the last 20 years in the English literature, so far, only one of which has been infantile type in a 15 months old girl. In this case report, we will explain our experience with a rare case of infantile fibrosarcoma originating from ethmoid sinus in a 5-year-old boy who presented with dyspnea and epistaxis. After biopsy, it was diagnosed as fibrosarcoma of sinus origin. PMID:26604519

  20. Meningitis in infancy in England and Wales: follow up at age 5 years

    PubMed Central

    Bedford, Helen; de Louvois, John; Halket, Susan; Peckham, Catherine; Hurley, Rosalinde; Harvey, David

    2001-01-01

    Objective To describe important sequelae occurring among a cohort of children aged 5 years who had had meningitis during the first year of life and who had been identified by a prospective national study of meningitis in infancy in England and Wales between 1985 and 1987. Design Follow up questionnaires asking about the children's health and development were sent to general practitioners and parents of the children and to parents of matched controls. The organism that caused the infection and age at infection were also recorded. Setting England and Wales. Participants General practitioners and parents of children who had had meningitis before the age of 1 year and of matched controls. Main outcome measures The prevalence of health and developmental problems and overall disability among children who had had meningitis compared with controls. Results Altogether, 1584 of 1717 (92.2%) children who had had meningitis and 1391 of 1485 (93.6%) controls were successfully followed up. Among children who survived to age 5 years 247 of 1584 (15.6%) had a disability; there was a 10-fold increase in the risk of severe or moderate disability at 5 years of age among children who had had meningitis (relative risk 10.3, 95% confidence interval 6.7 to 16.0, P<0.001). There was considerable variation in the rates of severe or moderate disability in children infected with different organisms. Conclusion The long term consequences of having meningitis during the first year of life are significant: 32 of 1717 (1.8%) children died within five years. Not only did almost a fifth of children with meningitis have a permanent, severe or moderately severe disability, but subtle deficits were also more prevalent. What is already known on this topicMeningitis in infancy is associated with important long term consequencesThere is considerable variation in outcome depending on which organism caused the infectionWhat this study addsThis follow up study of 1717 children who had meningitis in infancy

  1. Symptoms of Central Anticholinergic Syndrome After Glycopyrrolate Administration in a 5-Year-Old Child.

    PubMed

    Toksvang, Linea Natalie; Plovsing, Ronni R

    2016-01-15

    Anesthesia-related central anticholinergic syndrome (CAS) is most commonly associated with administration of atropine or scopolamine, whereas glycopyrrolate is an extremely rare cause of CAS. Here, we report a case of CAS in a 5-year-old boy admitted to the intensive care unit. Immediately after the administration of glycopyrrolate, he became agitated and developed apnea, hypertension, tachycardia, and anuria. Although the present case describes a rare cause of CAS, it is an important reminder of an iatrogenic condition that is presumably underdiagnosed in the operating theater as well as the intensive care unit. PMID:26513676

  2. Bilateral renal leiomyoma with 5 year follow-up: Case report.

    PubMed

    Goren, Mehmet Resit; Erbay, Gurcan; Ozer, Cevahir; Goren, Vinil; Bal, Nebil

    2015-01-01

    Renal leiomyomas are exceptionally rare benign tumours of the kidney. Although the renal leiomyomas usually do not metastasize, the differential diagnosis between renal leiomyomas and malign lesions (leiomyosarcoma or renal cell carcinoma) cannot be done by radiological examinations, but is possible by histological examination. Surgery is the preferred treatment. After surgery, the prognosis is excellent without recurrence. Although uterine leiomyomas can be multicentric, renal leiomyomas have been single lesions. We report an incidentally detected case of bilateral renal leiomyoma in a 50-year-old woman with a 5-year follow-up. We also review the literature and discuss clinical, radiological and histological features of renal leiomyomas. PMID:26664510

  3. Meckel's diverticulum with intussusception in a 5-year-old patient with Down's syndrome.

    PubMed

    Anwar, Mohammed Omer; Ahmed, Hamza Ibn; Al Hindi, Saeed; Al Omran, Yasser

    2014-01-01

    Meckel's diverticulum is understood to be the commonest congenital malformation within the gastrointestinal tract with a prevalence of 2%, as found on autopsy studies. Although many cases are asymptomatic, complications can occur including haemorrhage, diverticulitis, chronic ulceration and intestinal obstruction. Intussusception is also a complication, but extremely rare. We present a rare case of Meckel's diverticulum causing intussusception, which was surgically resolved, in a 5-year-old girl. Our aim through this case report is to generate greater awareness of this complication and to provide some potential guidance towards its treatment. PMID:25540213

  4. Stage I carcinoma of the endometrium: a 5-year experience utilizing preoperative cesium

    SciTech Connect

    Belinson, J.L.; Spirou, B.; McClure, M.; Badger, G.; Pretorius, R.G.; Roland, T.A.

    1985-03-01

    A treatment protocol for the management of stage I endometrial carcinoma utilizing preoperative cesium is evaluated. One hundred and twelve consecutive patients were treated according to this protocol over a 5-year period. Based on this experience and a literature review a new protocol is recommended. The significant changes include primary surgery without preoperative cesium, primary treatment based on grade without regard to uterine size, modified radical hysterectomy for G3 tumors, pelvic radiotherapy for clear cell carcinoma confined to the pelvis regardless of depth of invasion, cytoxan, adriamycin, and cis-platinum for papillary serous tumors, and postoperative vaginal cuff cesium for G2 and G3 tumors not requiring pelvic radiotherapy.

  5. Small bowel obstruction 5 years following the ingestion of serrated scissors.

    PubMed

    Limb, Richard; Karam, Edward; Lingam, Krishna M

    2016-01-01

    Ingested foreign bodies are common in the cohort of psychiatric patients, however clinical quiescence in this group is rare. We present a case of a 45-year-old female with emotionally unstable personality disorder (borderline type) presenting with partial intestinal obstruction 5 years after the known ingestion of serrated metallic scissors. In the asymptomatic interim a conservative approach of tracking the blades radiologically was taken. Following discussion, we conclude the following: early surgical intervention is encouraged if natural passage does not occur within 3 days following ingestion, and that any concurrent surgical needs should be addressed at this time. PMID:27190200

  6. Early Onset Bipolar Disorder in a 5.5 Years- Old Child

    PubMed Central

    Zarei, Mina; Bidaki, Reza; Hakim-Shooshtari, Mitra

    2011-01-01

    Bipolar disorder is a mental disease that can be presented as irritable mood with affective storms, mixed symptoms of depression and mania, rapid cycles, emotional labiality and irritability during all episodes. A confirmed positive familial history of the disease is the single most robust risk factor for developing the illness. This report presents 5.5 years-old girl with the symptoms of bipolar disorder and with the purpose to draw attention to the diversity of possible symptoms of mood disorders in childhood. PMID:24644461

  7. Drifter-based estimate of the 5-year dispersal of Fukushima-derived radionuclides

    NASA Astrophysics Data System (ADS)

    Rypina, I.; Jayne, S. R.; Yoshida, S.; Macdonald, A. M.; Buesseler, K. O.

    2014-12-01

    Employing some 40 years of North Pacific drifter-track observations from the Global Drifter Program database, statistics defining the horizontal spread of radionuclides from Fukushima nuclear power plant into the Pacific Ocean are investigated over a time-scale of 5 years. A novel two-iteration method is employed to make the best use of the available drifter data. Drifter-based predictions of the temporal progression of the leading edge of the radionuclide distribution are compared to observed radionuclide concentrations from research surveys occupied in 2012 and 2013. Excellent agreement between the drifter-based predictions and the observations is found.

  8. Angiomyolipoma of donor kidney: Successful transplantation and 5-year follow-up

    PubMed Central

    Gopalakrishnan, N.; Dhanapriya, J.; Sakthirajan, R.; Dineshkumar, T.; Balasubramaniyan, T.; Haris, Md.

    2016-01-01

    Angiomyolipomas (AML) of the kidney are non-encapsulated benign neoplasms with the incidence of 45-80% in patients with tuberous sclerosis and 1-3% in sporadic cases. There are very few case reports in the literature in which kidneys with AML have been used for transplantation. We report here a 27-year-old female patient who received a live related renal transplant from her mother with isolated angiomyolipoma in donor kidney and on follow-up after 5 years, has stable graft function and tumor size. PMID:27051138

  9. Towards Greenland Glaciation: cumulative or abrupt transition?

    NASA Astrophysics Data System (ADS)

    Tan, Ning; Dumas, Christophe; Ladant, Jean-Baptiste; Ramstein, Gilles; Contoux, Camille

    2016-04-01

    During the mid-Pliocene warming period (3-3.3 Ma BP), global annual mean temperature is warmer by 2-3 degree than pre-industrial. Greenland ice sheet volume is supposed to be a 50% reduction compared to nowadays [Haywood et al. 2010]. Around 2.7-2.6 Ma BP, just ~ 500 kyr after the warming peak of mid-Pliocene, there is already full Greenland Glaciation [Lunt et al. 2008]. How does Greenland ice sheet evolve from a half size to a glaciation level during 3 Ma - 2.5 Ma? Data show that there is a decreasing trend of atmospheric CO2 concentration from 3 Ma to 2.5 Ma [Seki et al.2010; Bartoli et al. 2011; Martinez et al. 2015]. However, a recent study [Contoux et al. 2015] suggests that a lowering of CO2 is not sufficient to initiate a perennial glaciation on Greenland and must be combined to low summer insolation, to preserve the ice sheet during insolation maximum, suggesting a cumulative process. In order to diagnose whether the ice sheet build-up is an abrupt event or a cumulative process, we carry on, for the first time, a transient simulation of climate and ice sheet evolutions from 3 Ma to 2.5 Ma. This strategy enables to investigate waxing and waning of the ice sheet during several orbital cycles. To reach this goal, we use a tri-dimensional interpolation method designed by Ladant et al. (2014) which combines the evolution of CO2 concentration, orbital parameters and Greenland ice sheet sizes in an off-line way by interpolating snapshots simulations. Thanks to this new method, we can build a transient like simulation through asynchronous coupling between GCM and ice sheet model. With this method, we may consistently answer the question of the build-up of Greenland: abrupt or cumulative process.

  10. Earth system responses to cumulative carbon emissions

    NASA Astrophysics Data System (ADS)

    Steinacher, M.; Joos, F.

    2015-07-01

    Information on the relationship between cumulative fossil carbon emissions and multiple climate targets are essential to design emission mitigation and climate adaptation strategies. In this study, the transient responses in different climate variables are quantified for a large set of multi-forcing scenarios extended to year 2300 towards stabilization and in idealized experiments using the Bern3D-LPJ carbon-climate model. The model outcomes are constrained by 26 physical and biogeochemical observational data sets in a Bayesian, Monte-Carlo type framework. Cumulative fossil emissions of 1000 Gt C result in a global mean surface air temperature change of 1.88 °C (68 % confidence interval (c.i.): 1.28 to 2.69 °C), a decrease in surface ocean pH of 0.19 (0.18 to 0.22), and in steric sea level rise of 20 cm (13 to 27 cm until 2300). Linearity between cumulative emissions and transient response is high for pH and reasonably high for surface air and sea surface temperatures, but less pronounced for changes in Atlantic Meridional Overturning, Southern Ocean and tropical surface water saturation with respect to biogenic structures of calcium carbonate, and carbon stocks in soils. The slopes of the relationships change when CO2 is stabilized. The Transient Climate Response is constrained, primarily by long-term ocean heat observations, to 1.7 °C (68 % c.i.: 1.3 to 2.2 °C) and the Equilibrium Climate Sensitivity to 2.9 °C (2.0 to 4.2 °C). This is consistent with results by CMIP5 models, but inconsistent with recent studies that relied on short-term air temperature data affected by natural climate variability.

  11. A Missing Link in the Evolution of the Cumulative Recorder

    ERIC Educational Resources Information Center

    Asano, Toshio; Lattal, Kennon A.

    2012-01-01

    A recently recovered cumulative recorder provides a missing link in the evolution of the cumulative recorder from a modified kymograph to a reliably operating, scientifically and commercially successful instrument. The recorder, the only physical evidence of such an early precommercial cumulative recorder yet found, was sent to Keio University in…

  12. Critical concentrations of cumulative scattered damage

    SciTech Connect

    Ignatovich, S.R.

    1995-12-01

    A statistical model is constructed to describe the formation of associations (clusters) of several defects randomly scattered within a limited region of the material. The dependence of the number of such clusters on the total concentration of defects is determined. Two criteria of the limiting state are established for multiple fracture, these criteria corresponding to the critical concentrations of cumulative scattered damage. The critical concentrations are the threshold concentration at which individual defects begin to merge and the concentration characterizing the transition to the stage in which defects coalesce on a massive scale.

  13. Epidemiology of invasive pneumococcal disease in Saudi Arabian children younger than 5years of age.

    PubMed

    Almazrou, Yagob; Shibl, Atef M; Alkhlaif, Riyadh; Pirçon, Jean-Yves; Anis, Sameh; Kandeil, Walid; Hausdorff, William P

    2016-06-01

    This study evaluated the incidence, serotype distribution, and antimicrobial susceptibility of invasive pneumococcal disease (IPD) in Saudi Arabian children. This multicenter, prospective, clinical surveillance study included children under 5years of age, residents of one of the seven study health areas, who were brought to a study hospital with suspicion of IPD. Bacterial isolates from sterile site samples, collected less than 24h after hospital visit/admission, were identified, serotyped, and tested for antibiotic susceptibility. Between June 2007 and January 2009, 631 episodes of suspected IPD were recorded, and 623 were included in the analysis. One child (0.2%) had previously received one dose of a pneumococcal vaccine. Forty-seven episodes were positive for Streptococcus pneumoniae and three for Haemophilus influenzae. The incidence of confirmed IPD cases was estimated to be 2.5-21.6 per 100,000 children (<5years). Among the 46 S. pneumoniae isolates serotyped and tested for antibiotic susceptibility, the most common serotypes were 5 and 23F (20% each), 6B (17%), and 1 and 14 (11% each). Sixty-three percent of isolates were multidrug-resistant. Vaccination of Saudi Arabian children with expanded-coverage conjugate pneumococcal vaccines containing serotypes 1 and 5 could have a substantial impact to prevent IPD in this population. PMID:26368823

  14. The relationship between clinical periodontal status and insulin-dependent diabetes mellitus. Results after 5 years.

    PubMed

    Firatli, E

    1997-02-01

    The clinical periodontal status of 44 insulin-dependent diabetic children and adolescents and 20 healthy control subjects was compared for a period of approximately 5 years. Fasting blood glucose, fructosamine, and glycosylated hemoglobin (HbA1) values were determined at baseline and 5 years later. The differences in the clinical and laboratory parameters were compared during the study period. The differences between the two groups were also evaluated. The only statistically significant difference observed in the diabetic group was clinical attachment loss (CAL). The CAL was statistically significantly higher in the diabetic group compared to the controls, and a statistically significantly higher in the diabetic group compared to the controls, and a statistically significant positive correlation was observed between the duration of diabetes and CAL. Fructosamine was also correlated with the gingival index in the diabetic group while there was no correlation in the controls. It may be concluded that diabetes modifies the clinical status of the periodontal tissues and increases clinical attachment loss. PMID:9058330

  15. The 5-Year Onset and Regression of Diabetic Retinopathy in Chinese Type 2 Diabetes Patients

    PubMed Central

    Jin, Peiyao; Peng, Jinjuan; Zou, Haidong; Wang, Weiwei; Fu, Jiong; Shen, Binjie; Bai, Xuelin; Xu, Xun; Zhang, Xi

    2014-01-01

    Purpose To determine the rate and risk factors of diabetic retinopathy (DR) onset and regression in Chinese type 2 diabetes mellitus patients. Methods This is a 5-year community-based prospective study. The demographic information, systemic examination results and ophthalmological test results of each participant were collected. The study outcomes were DR incidence, defined as the onset of DR in at least one eye, and DR regression, defined as full regression from existing DR to no retinopathy without invasive treatments. The associations between each potential risk factor and the outcomes were studied. Results In total, 778 participants were enrolled. There were 322 patients without DR at baseline, of which 151 participants developed DR during follow-up (DR incidence rate = 46.89%). Baseline hyperglycemia and high blood pressure were two independent risk factors associated with DR incidence. Among the 456 participants with existing DR at entry, 110 fully recovered after 5 years (DR regression rate = 24.12%). Low baseline glucose and low serum triglyceride were two independent factors associated with DR regression. Conclusions DR incidence occurred more frequently in patients with hyperglycemia and high blood pressure. DR regression occurred mostly in patients with lower glucose and lower serum triglyceride levels among Chinese type 2 diabetes patients. PMID:25402474

  16. Body composition during fetal development and infancy through the age of 5 years.

    PubMed

    Toro-Ramos, T; Paley, C; Pi-Sunyer, F X; Gallagher, D

    2015-12-01

    Fetal body composition is an important determinant of body composition at birth, and it is likely to be an important determinant at later stages in life. The purpose of this work is to provide a comprehensive overview by presenting data from previously published studies that report on body composition during fetal development in newborns and the infant/child through 5 years of age. Understanding the changes in body composition that occur both in utero and during infancy and childhood, and how they may be related, may help inform evidence-based practice during pregnancy and childhood. We describe body composition measurement techniques from the in utero period to 5 years of age, and identify gaps in knowledge to direct future research efforts. Available literature on chemical and cadaver analyses of fetal studies during gestation is presented to show the timing and accretion rates of adipose and lean tissues. Quantitative and qualitative aspects of fetal lean and fat mass accretion could be especially useful in the clinical setting for diagnostic purposes. The practicality of different pediatric body composition measurement methods in the clinical setting is discussed by presenting the assumptions and limitations associated with each method that may assist the clinician in characterizing the health and nutritional status of the fetus, infant and child. It is our hope that this review will help guide future research efforts directed at increasing the understanding of how body composition in early development may be associated with chronic diseases in later life. PMID:26242725

  17. A 5-Year Analysis of Peer-Reviewed Journal Article Publications of Pharmacy Practice Faculty Members

    PubMed Central

    Spivey, Christina; Martin, Jennifer R.; Wyles, Christina; Ehrman, Clara; Schlesselman, Lauren S.

    2012-01-01

    Objectives. To evaluate scholarship, as represented by peer-reviewed journal articles, among US pharmacy practice faculty members; contribute evidence that may better inform benchmarking by academic pharmacy practice departments; and examine factors that may be related to publication rates. Methods. Journal articles published by all pharmacy practice faculty members between January 1, 2006, and December 31, 2010, were identified. College and school publication rates were compared based on public vs. private status, being part of a health science campus, having a graduate program, and having doctor of pharmacy (PharmD) faculty members funded by the National Institutes of Health (NIH). Results. Pharmacy practice faculty members published 6,101 articles during the 5-year study period, and a pharmacy practice faculty member was the primary author on 2,698 of the articles. Pharmacy practice faculty members published an average of 0.51 articles per year. Pharmacy colleges and schools affiliated with health science campuses, at public institutions, with NIH-funded PharmD faculty members, and with graduate programs had significantly higher total publication rates compared with those that did not have these characteristics (p<0.006). Conclusion. Pharmacy practice faculty members contributed nearly 6,000 unique publications over the 5-year period studied. However, this reflects a rate of less than 1 publication per faculty member per year, suggesting that a limited number of faculty members produced the majority of publications. PMID:23049099

  18. Factors associated with vaccination coverage in children < 5 years in Angola

    PubMed Central

    de Oliveira, Manuel Falcão Saturnino; Martinez, Edson Zangiacomi; Rocha, Juan Stuardo Yazlle

    2014-01-01

    OBJECTIVE To analyze vaccination coverage and factors associated with a complete immunization scheme in children < 5 years old. METHODS This cross-sectional household census survey evaluated 1,209 children < 5 years old living in Bom Jesus, Angola, in 2010. Data were obtained from interviews, questionnaires, child immunization histories, and maternal health histories. The statistical analysis used generalized linear models, in which the dependent variable followed a binary distribution (vaccinated, unvaccinated) and the association function was logarithmic and had the children’s individual, familial, and socioeconomic factors as independent variables. RESULTS Vaccination coverage was 37.0%, higher in children < 1 year (55.0%) and heterogeneous across neighborhoods; 52.0% of children of both sexes had no immunization records. The prevalence rate of vaccination significantly varied according to child age, mother’s level of education, family size, ownership of household appliances, and destination of domestic waste. CONCLUSIONS Vulnerable groups with vaccination coverage below recommended levels continue to be present. Some factors indicate inequalities that represent barriers to full immunization, indicating the need to implement more equitable policies. The knowledge of these factors contributes to planning immunization promotion measures that focus on the most vulnerable groups. PMID:26039393

  19. Stability of Pediatric Migraine Subtype After a 5-year Follow-Up.

    PubMed

    Cuvellier, Jean-Christophe; Tourte, Mathilde; Lucas, Christian; Vallée, Louis

    2016-08-01

    The study assessed the 5-year follow-up outcome and possible prognostic factors of migraine subtypes with onset in childhood or adolescence. A total of 343 patients meeting the International Classification of Headache Disorders (ICHD)-II criteria for migraine without aura (MO), migraine with aura (MA), or both MO+MA (ie, 1.1, 1.2) were contacted by phone and underwent structured follow-up headache interviews. Of the original sample patients, 22.7% were headache-free at follow-up, 14.1% had a transformed headache diagnosis (tension-type headache: 8.2%, chronic daily headache: 5.8%), and 63.3% still had migraine fulfilling the criteria for ICHD-II 1.1. or 1.2, but those who were still migraineurs at follow-up were older at baseline (respectively 12.93, 9.99, and 11.02 years for MO, MA and MO+MA, P = .0005). The probability of having the same migraine subtype diagnosis at baseline and at 5-year follow-up was 55.2%, 95.1%, and 31.1% for ICHD-II 1.1, 1.2, and both 1.1 and 1.2, respectively. PMID:27071466

  20. Factors associated with vaccination coverage in children < 5 years in Angola.

    PubMed

    Oliveira, Manuel Falcão Saturnino de; Martinez, Edson Zangiacomi; Rocha, Juan Stuardo Yazlle

    2014-12-01

    OBJECTIVE To analyze vaccination coverage and factors associated with a complete immunization scheme in children < 5 years old. METHODS This cross-sectional household census survey evaluated 1,209 children < 5 years old living in Bom Jesus, Angola, in 2010. Data were obtained from interviews, questionnaires, child immunization histories, and maternal health histories. The statistical analysis used generalized linear models, in which the dependent variable followed a binary distribution (vaccinated, unvaccinated) and the association function was logarithmic and had the children's individual, familial, and socioeconomic factors as independent variables. RESULTS Vaccination coverage was 37.0%, higher in children < 1 year (55.0%) and heterogeneous across neighborhoods; 52.0% of children of both sexes had no immunization records. The prevalence rate of vaccination significantly varied according to child age, mother's level of education, family size, ownership of household appliances, and destination of domestic waste. CONCLUSIONS Vulnerable groups with vaccination coverage below recommended levels continue to be present. Some factors indicate inequalities that represent barriers to full immunization, indicating the need to implement more equitable policies. The knowledge of these factors contributes to planning immunization promotion measures that focus on the most vulnerable groups. PMID:26039393

  1. Developmental potential in the first 5 years for children in developing countries

    PubMed Central

    Grantham-McGregor, Sally; Cheung, Yin Bun; Cueto, Santiago; Glewwe, Paul; Richter, Linda; Strupp, Barbara

    2007-01-01

    Summary Many children younger than 5 years in developing countries are exposed to multiple risks, including poverty, malnutrition, poor health, and unstimulating home environments, which detrimentally affect their cognitive, motor, and social-emotional development. There are few national statistics on the development of young children in developing countries. We therefore identified two factors with available worldwide data—the prevalence of early childhood stunting and the number of people living in absolute poverty—to use as indicators of poor development. We show that both indicators are closely associated with poor cognitive and educational performance in children and use them to estimate that over 200 million children under 5 years are not fulfilling their developmental potential. Most of these children live in south Asia and sub-Saharan Africa. These disadvantaged children are likely to do poorly in school and subsequently have low incomes, high fertility, and provide poor care for their children, thus contributing to the intergenerational transmission of poverty. PMID:17208643

  2. HIV rapid testing in a Veterans Affairs hospital ED setting: a 5-year sustainability evaluation.

    PubMed

    Knapp, Herschel; Hagedorn, Hildi; Anaya, Henry D

    2014-08-01

    Routine HIV testing in primary care settings is now recommended in the United States. The US Department of Veterans Affairs (VA) has increased the number of patients tested for HIV, but overall HIV testing rates in VA remain low. A proven strategy for increasing such testing involves nurse-initiated HIV rapid testing (HIV RT). The purpose of this work was to use a mixed methodology approach to evaluate the 5-year sustainability of an intervention that implemented HIV RT in a VA emergency department setting in a large, urban VA medical center to reduce missed diagnostic and treatment opportunities in this vulnerable patient population. In-person semistructured interviews were conducted with providers and stakeholders. Interview notes were qualitatively coded for emerging themes. Quarterly testing rates were evaluated for a 5-year time span starting from the launch in July 2008. Findings indicate that HIV RT was sustained by the enthusiasm of 2 clinical champions who oversaw the registered nurses responsible for conducting the testing. The departure of the clinical champions was correlated with a substantial drop-off in testing. Findings also indicate potential strategies for improving sustainability including engaging senior leadership in the project, engaging line staff in the implementation planning from the start to increase ownership over the innovation, incorporating information into initial training explaining the importance of the innovation to quality patient care, providing ongoing training to maintain skills, and providing routine progress reports to staff to demonstrate the ongoing impact of their efforts. PMID:24908442

  3. The understanding and experience of mixed emotions in 3-5-year-old children.

    PubMed

    Smith, Joshua P; Glass, Daniel J; Fireman, Gary

    2015-01-01

    The term mixed emotions refers to the presence of two opposite-valence emotions toward a single target. Identifying when children begin to report experiencing and understanding mixed emotions is critical in identifying how skills such as adaptive functioning, coping strategies, environmental understanding, and socioemotional competence emerge. Prior research has shown that children as young as 5 years old can understand and experience mixed emotion, but perhaps appropriately sensitive methodologies can reveal these abilities in younger children. The present study evaluated 57 children between 3 and 5 years old for mixed emotion experience and understanding using an animated video clip in which a character experiences a mixed emotional episode. Ordinal logistic regression was utilized to examine the relation of gender, attention, and understanding of content to experience and understanding of mixed emotion. While only 12% of children reported experiencing mixed emotion while watching the clip, 49% of children-some as young as 3 years old-were able to recognize the mixed emotional experience of the character. Thus, mixed emotion understanding emerges earlier than previously identified and the expression of understanding may develop independently of the ability to report mixed emotion experience. These findings are discussed in relation to cognitive and developmental considerations. PMID:25695201

  4. Radiometric calibration stability of the EO-1 advanced land imager: 5 years on-orbit

    USGS Publications Warehouse

    Markham, B.L.; Ong, L.; Barsi, J.A.; Mendenhall, J.A.; Lencioni, D.E.; Helder, D.L.; Hollaren, D.M.; Morfitt, R.

    2006-01-01

    The Advanced Land Imager (ALI) was developed as a prototype sensor for follow on missions to Landsat-7. It was launched in November 2000 on the Earth Observing One (EO-1) satellite as a nominal one-year technology demonstration mission. As of this writing, the sensor has continued to operate in excess of 5 years. Six of the ALl's nine multi-spectral (MS) bands and the panchromatic band have similar spectral coverage as those on the Landsat-7 ETM+. In addition to on-board lamps, which have been significantly more stable than the lamps on ETM+, the ALI has a solar diffuser and has imaged the moon monthly since launch. This combined calibration dataset allows understanding of the radiometric stability of the ALI system, its calibrators and some differentiation of the sources of the changes with time. The solar dataset is limited as the mechanism controlling the aperture to the solar diffuser failed approximately 18 months after launch. Results over 5 years indicate that: the shortest wavelength band (443 nm) has degraded in response about 2%; the 482 nm and 565 nm bands decreased in response about 1%; the 660 nm, 790 nm and 868 nm bands each degraded about 5%; the 1250 nm and 1650 nm bands did not change significantly and the 2215 nm band increased in response about 2%.

  5. Longitudinal study of dental caries increment in Malaysian school children: a 5-year cohort study.

    PubMed

    Masood, Mohd; Yusof, Norashikin; Hassan, Mohamed I A; Jaafar, Nasaruddin

    2014-05-01

    The aim of this 5-year longitudinal cohort study was to assess the prevalence, severity, and trends in caries increment and impact of the School Dental Incremental Care Programme (SDICP). Data were gathered from school dental records as part of the SDICP. A sample of 1830 children were included and checked for caries experience annually using World Health Organization criteria. In total, 95.4% of the children were caries free in 2004, and caries experience declined to 70.5% in 2009 with an average of 4.9% annually. At baseline, the mean DMFT (confidence interval [CI]) was 0.06 (0.05-0.08) and increased to 0.58 (0.53-0.63) in 2009. Children with active caries were 4.4% in 2004, and figures rose to 9.6% in 2009. The FT component increased most rapidly during these 5 years from 0.2% to 25.1%. Overall caries prevalence and increment was low in this study. Proportions of FT component were higher as compared with DT component with low rate of extractions during the latter years of the study. PMID:22218936

  6. Fatal head injuries in children under the age of 5 years in Pretoria.

    PubMed

    du Toit-Prinsloo, Lorraine; Saayman, Gert

    2014-09-01

    The incidence of fatal injuries in children has been reported to be highest among children aged 1 to 4 years. Major causes of head injury include road traffic accidents, falls, and intentional or inflicted injury (such as nonaccidental injury syndrome). This study reviewed the profile of children (under 5 years of age) who had been admitted to a large urban medicolegal mortuary (in Pretoria, the capital city of South Africa), after having suffered fatal head injuries. This study was conducted over a 5-year period (from January 2004 through December 2008), and a total of 107 cases were identified for inclusion. These cases constituted nearly a fifth of admissions in this age group. The male-to-female ratio was 56%:44%, and the peak age of injury was less than 1 year. Most head injuries were sustained in road traffic accidents (70%) followed by falls (10%) and other types of blunt force injuries (9%). Only 1 case of nonaccidental injury syndrome (child abuse) was found. The great majority of deaths were deemed to have been accidental in nature (91%) with 6 (6%) homicides. Urgent review pertaining to the use of child restraint devices and the safety of pedestrians is required, and the institution of childhood injury registers could aid in reducing childhood fatalities in South Africa. PMID:25072811

  7. Separable Sustained and Selective Attention Factors Are Apparent in 5-Year-Old Children

    PubMed Central

    Underbjerg, Mette; George, Melanie S.; Thorsen, Poul; Kesmodel, Ulrik S.; Mortensen, Erik L.; Manly, Tom

    2013-01-01

    In adults and older children, evidence consistent with relative separation between selective and sustained attention, superimposed upon generally positive inter-test correlations, has been reported. Here we examine whether this pattern is detectable in 5-year-old children from the healthy population. A new test battery (TEA-ChJ) was adapted from measures previously used with adults and older children and administered to 172 5-year-olds. Test-retest reliability was assessed in 60 children. Ninety-eight percent of the children managed to complete all measures. Discrimination of visual and auditory stimuli were good. In a factor analysis, the two TEA-ChJ selective attention tasks (one visual, one auditory) loaded onto a common factor and diverged from the two sustained attention tasks (one auditory, one motor), which shared a common loading on the second factor. This pattern, which suggests that the tests are indeed sensitive to underlying attentional capacities, was supported by the relationships between the TEA-ChJ factors and Test of Everyday Attention for Children subtests in the older children in the sample. It is possible to gain convincing performance-based estimates of attention at the age of 5 with the results reflecting a similar factor structure to that obtained in older children and adults. The results are discussed in light of contemporary models of attention function. Given the potential advantages of early intervention for attention difficulties, the findings are of clinical as well as theoretical interest. PMID:24376591

  8. A 5-Year Investigation of Children's Adaptive Functioning Following Conformal Radiation Therapy for Localized Ependymoma

    SciTech Connect

    Netson, Kelli L.; Conklin, Heather M.; Wu Shengjie; Xiong Xiaoping; Merchant, Thomas E.

    2012-09-01

    Purpose: Conformal and intensity modulated radiation therapies have the potential to preserve cognitive outcomes in children with ependymoma; however, functional behavior remains uninvestigated. This longitudinal investigation prospectively examined intelligence quotient (IQ) and adaptive functioning during the first 5 years after irradiation in children diagnosed with ependymoma. Methods and Materials: The study cohort consisted of 123 children with intracranial ependymoma. Mean age at irradiation was 4.60 years (95% confidence interval [CI], 3.85-5.35). Serial neurocognitive evaluations, including an age-appropriate IQ measure and the Vineland Adaptive Behavior Scales (VABS), were completed before irradiation, 6 months after treatment, and annually for 5 years. A total of 579 neurocognitive evaluations were included in these analyses. Results: Baseline IQ and VABS were below normative means (P<.05), although within the average range. Linear mixed models revealed stable IQ and VABS across the follow-up period, except for the VABS Communication Index, which declined significantly (P=.015). Annual change in IQ (-.04 points) did not correlate with annual change in VABS (-.90 to +.44 points). Clinical factors associated with poorer baseline performance (P<.05) included preirradiation chemotherapy, cerebrospinal fluid shunt placement, number and extent of surgical resections, and younger age at treatment. No clinical factors significantly affected the rate of change in scores. Conclusions: Conformal and intensity modulated radiation therapies provided relative sparing of functional outcomes including IQ and adaptive behaviors, even in very young children. Communication skills remained vulnerable and should be the target of preventive and rehabilitative interventions.

  9. An implantable neuroprosthesis for standing and walking in paraplegia: 5-year patient follow-up

    NASA Astrophysics Data System (ADS)

    Guiraud, David; Stieglitz, Thomas; Koch, Klaus Peter; Divoux, Jean-Louis; Rabischong, Pierre

    2006-12-01

    We present the results of a 5-year patient follow-up after implantation of an original neuroprosthesis. The system is able to stimulate both epimysial and neural electrodes in such a way that the complete flexor-extensor chain of the lower limb can be activated without using the withdrawal reflex. We demonstrate that standing and assisted walking are possible, and the results have remained stable for 5 years. Nevertheless, some problems were noted, particularly regarding the muscle response on the epimysial channels. Analysis of the electrical behaviour and thresholds indicated that the surgical phase is crucial because of the sensitivity of the functional responses to electrode placement. Neural stimulation proved to be more efficient and more stable over time. This mode requires less energy and provides more selective stimulation. This FES system can be improved to enable balanced standing and less fatiguing gait, but this will require feedback on event detection to trigger transitions between stimulation sequences, as well as feedback to the patient about the state of his lower limbs.

  10. Evaluation of 5-Year Trends in Knee Society Scores Stratified by Comorbidities: A Prospective, Longitudinal Study.

    PubMed

    Jauregui, Julio J; Issa, Kimona; Cherian, Jeffrey J; Harwin, Steven F; Given, Kristin; Mont, Michael A

    2016-01-01

    Total knee arthroplasties (TKAs) are reliable procedures for treating end-stage knee osteoarthritis with excellent long-term outcomes. The purpose of this study was to longitudinally evaluate temporal trends of Knee Society Scores (KSS) after TKA and to identify potential demographic and comorbid factors that affect these outcomes. This prospective study evaluated 281 patients (108 men and 173 women) with a mean age of 66 years (range, 39-80 years) who underwent primary TKA (minimum follow-up 5 years). During each follow-up visit, KS objective, function, and total scores were evaluated. The effects of different demographics and comorbidities on outcomes were further analyzed using multivariate regression analysis. Following TKA, peak mean KSS were observed at 1-year follow-up (mean, 92 points), after which there was no significant difference in scores at 5 years compared with 1-year follow-up (mean, 92 points). KS function scores were observed to be unchanged from preoperative levels (mean, 53 points) and at 6 weeks (mean, 56 points). These were significantly higher at 3 months (mean, 78 points) and reached a maximum mean peak at 1 year (mean, 85 points). KS objective scores increased earlier than function scores. The demographic variables and comorbidities that demonstrated a significantly negative impact in KS function scores were increased age, female gender, higher body mass index, and several medical comorbidities including immunological and neurological disease, and neoplasm. Race was the only variable that significantly decreased the KS objective scores. KSS after TKA follow temporal trends with scores initially unchanged from preoperative levels for the objective component, but the scores increased for the functional component. All components demonstrated higher levels compared with preoperative scores by 3 months and peaked at 1-year follow-up. At 5-year follow-up, all mean KSS were unchanged relative to peak scores seen at 1 year. Various patient

  11. Renal Stone Associated with the Ketogenic Diet in a 5-Year Old Girl with Intractable Epilepsy

    PubMed Central

    Choi, Ji Na; Song, Ji Eun; Shin, Jae Il; Kim, Heung Dong; Kim, Myung Joon

    2010-01-01

    In this paper, we report on a 5-year-old girl who developed a renal stone while following the ketogenic diet to treat refractory seizure disorder. Three months after initiating the ketogenic diet, she developed severe abdominal pain and vomiting. The spot urine calcium-to-creatinine (Ca/Cr) ratio and 24-hour urine evaluation showed hypercalciuria. Computed tomography (CT) imaging revealed a stone in the right ureteropelvic junction, resulting in hydronephrosis of the right kidney. The renal stone disappeared 5 days after conservative treatment; the patien's microscopic hematuria resolved concurrently. In light of this case report, we recommend regularly monitoring the urine Ca/Cr ratio with ultrasonography for further development of renal stones in patients following the ketogenic diet. If these patients exhibit evidence of symptomatic hypercalciuria or cyristalluria, liberalization of fluid restriction and urine alkalization using oral potassium citrate should be considered. PMID:20376903

  12. Constraints on the Time Variation of the Fine Structure Constant by the 5-Year WMAP Data

    NASA Astrophysics Data System (ADS)

    Nakashima, M.; Nagata, R.; Yokoyama, J.

    2008-12-01

    The constraints on the time variation of the fine structure constant at recombination epoch relative to its present value, Δα/α ≡ (α_{rec} - α_{now})/α_{now}, are obtained from the analysis of the 5-year WMAP cosmic microwave background data. As a result of Markov-Chain Monte-Carlo analysis, it is found that, contrary to the analysis based on the previous WMAP data, the mean value of Δα/α = -0.0009 does not change significantly whether we use the Hubble Space Telescope (HST) measurement of the Hubble parameter as a prior or not. The resultant 95% confidence ranges of Δα/α are -0.028 < Δα/α < 0.026 with HST prior and -0.050 < Δα/α < 0.042 without HST prior.

  13. The thermoregulatory theory of yawning: what we know from over 5 years of research

    PubMed Central

    Gallup, Andrew C.; Eldakar, Omar T.

    2012-01-01

    Over the past 5 years numerous reports have confirmed and replicated the specific brain cooling and thermal window predictions derived from the thermoregulatory theory of yawning, and no study has found evidence contrary to these findings. Here we review the comparative research supporting this model of yawning among homeotherms, while highlighting a recent report showing how the expression of contagious yawning in humans is altered by seasonal climate variation. The fact that yawning is constrained to a thermal window of ambient temperature provides unique and compelling support in favor of this theory. Heretofore, no existing alternative hypothesis of yawning can explain these results, which have important implications for understanding the potential functional role of this behavior, both physiologically and socially, in humans and other animals. In discussion we stress the broader applications of this work in clinical settings, and counter the various criticisms of this theory. PMID:23293583

  14. Performance of the MIR Cooperative Solar Array After 2.5 Years in Orbit

    NASA Technical Reports Server (NTRS)

    Kerslake, Thomas W.; Hoffman, David J.

    1999-01-01

    The Mir Cooperative Solar Array (MCSA) was developed jointly by the United States and Russia to produce 6 kW of power for the Russian space station Mir. Four, multi-orbit test sequences were executed between June 1996 and December 1998 to measure MCSA electrical performance. A dedicated Fortran computer code was developed to analyze the detailed thermal-electrical performance of the MCSA. The computational performance results compared very favorably with the measured flight data in most cases. Minor performance degradation was detected in one current generating section of the MCSA. Yet overall, the flight data indicated the MCSA was meeting and exceeding performance expectations. There was no precipitous performance loss due to contamination or other causes after 2.5 years of operation. In this paper, we review the MCSA flight electrical performance tests, data and computational modeling and discuss findings from data comparisons with the computational results.

  15. 5 years of experience with a large-scale mentoring program for medical students

    PubMed Central

    Pinilla, Severin; Pander, Tanja; von der Borch, Philip; Fischer, Martin R.; Dimitriadis, Konstantinos

    2015-01-01

    In this paper we present our 5-year-experience with a large-scale mentoring program for undergraduate medical students at the Ludwig Maximilians-Universität Munich (LMU). We implemented a two-tiered program with a peer-mentoring concept for preclinical students and a 1:1-mentoring concept for clinical students aided by a fully automated online-based matching algorithm. Approximately 20-30% of each student cohort participates in our voluntary mentoring program. Defining ideal program evaluation strategies, recruiting mentors from beyond the academic environment and accounting for the mentoring network reality remain challenging. We conclude that a two-tiered program is well accepted by students and faculty. In addition the online-based matching seems to be effective for large-scale mentoring programs. PMID:25699108

  16. Neurological Recovery of Upper Extremity in Stroke Woman after 5 Years: A Case Report.

    PubMed

    Vejabhuti, Chayanin

    2016-02-01

    Strokes are common neurological disorders in Thailand. Rehabilitation programs significantly improve arm function outcomes if performed during the sub-acute period of stroke rehabilitation, within 6 months of the attack. This report describes the case of a stroke patient who gained upper extremity motor recovery after 5 years, which is beyond the normal recovery period. Although the patient does not have functionality, she has partial motor recovery, and she is enthusiastic about learning to gain better use of her hand. However there is still limited evidence to use in designing effective intervention and proper timing of rehabilitation administered by personnel in training chronic stroke patients. Therefore, evidence based on neuroplasticity and neurological recovery in chronic stroke patients, including rehabilitation intervention, is presented in this report. PMID:27266238

  17. A 5-year-old male child with late infantile metachromatic leukodystrophy: a case report.

    PubMed

    Mahmood, Afreen; Chacham, Swathi; Reddy, Uppin Narayan; Rao, Jillalla Narsing; Rao, S Pratap

    2015-03-01

    Metachromatic leukodystrophy is a rare disorder of myelin metabolism. This degenerative disorder results from the accumulation of cerebroside sulfatide within the myelin sheath of central and peripheral nervous system, due to deficiency of aryl sulfatase A enzyme. We report a 5-year-old male child, who presented with regression of milestones, recurrent seizures and spasticity from second year of life. Initially neurodegenerative disorder was considered and the case was investigated with neuroimaging and enzyme levels. Computed tomography (CT) of the brain showed hypodensities in the corpus callosum and bilateral periventricular and deep cerebral white matter suggestive of neurodegenerative disorder. Subsequently, magnetic resonance imaging (MRI) of the brain was done, which showed symmetrical hyperintensities in the periventricular white matter with classical sparing of subcortical "U" fibers. The β-galactosidase enzyme activity was normal; however, the activity of aryl sulfatase A enzyme was undetectable, confirming the diagnosis of late infantile variant of metachromatic leukodystrophy. PMID:25117420

  18. A student-centred, problem-based curriculum: 5 years' experience.

    PubMed Central

    Des Marchais, J E

    1993-01-01

    In 1987, the University of Sherbrooke's school of medicine implemented a student-centred, problem-based learning (PBL) curriculum. The experience of the first 5 years is reviewed; program goals, the schedule of learning activities, the instructional format and assessment of student learning are described. The new program is more demanding of teachers and requires better faculty training in pedagogy. No new financial resources have been available. The preclinical reform has led to revision of the clerkship, where sessions on clinical reasoning are now based on the PBL philosophy. Student reactions to the program are reported. The Sherbrooke experience has demonstrated that it is both possible and feasible to shift from a traditional to a problem-based curriculum. PMID:8477383

  19. The 5-Year Scientific Achievement of NASA's Chandra X-Ray Observatory

    NASA Technical Reports Server (NTRS)

    2004-01-01

    NASA's Chandra X-Ray Observatory (CXO) was launched July 22, 1999 aboard the Space Shuttle Columbia, STS-93 mission. This image was produced by combining a dozen CXO observations made of a 130 light-year region in the center of the Milky Way over the last 5 years. The colors represent low (red), medium (green) and high (blue) energy x-rays. Thanks to Chandra's unique resolving power, astronomers have now been able to identify thousands of point-like x-ray sources due to neutron stars, black holes, white dwarfs, foreground stars, and background galaxies. What remains is a diffuse x-ray glow extending from the upper left to the lower right, along the direction of the disk of the galaxy. NASA's Marshall Space Flight Center in Huntsville, Alabama manages the Chandra program. (NASA/CXC/UCLA/M. Muno et al.)

  20. [The geriatric psychiatric day hospital: an analysis of 5 years of activities].

    PubMed

    Trifonov, E G; Ognev, A E

    1997-01-01

    233 patients (53 men and 180 women) at the age of 60 years and older were treated in day gerontopsychiatric out-patient clinic for 5 years. 60-69 year old patients prevailed (146 individuals). Nearly all mental diseases characteristic for the old age were found in such patients; majority of patients suffered from schizophrenia (31.3%) and affective pathology (25.8%). Vascular form of dementia prevailed among the patients with dementia while atrophic degenerative dementia was rarely observed (2 patients). Syndromological distribution revealed that the main groups were formed by patients with depressions (41.6%) as well as individuals with neurosis- and psychopathic-like conditions (37.3%). Mental disorders with paranoid syndromes were observed in 8.6% of the patients. It is shown that day gerontopsychiatric out-patient clinic had some preferences in comparison with usual mental hospitals and psychoneurological out-patient clinic. PMID:9157762

  1. Full-mouth rehabilitation of Class II deep-bite patient: A 5-year clinical report

    PubMed Central

    Ergun, Gulfem; Bozkaya, Erdal

    2016-01-01

    This case report demonstrates the full-mouth rehabilitation of a 45-year-old male patient with severe deep-bite by increasing vertical dimension. The technique of anterior maxillary osteotomy performed in the present situation has been found to be effective, requiring anterior and inferior repositioning of the anterior maxilla to provide an esthetic and functional implant supported fixed prosthesis. Four months after surgery, the fixation system was removed, and 6 dental implants were placed. The anterior and inferior movements of the segment allowed for natural tooth anatomy and size in the definitive implant supported partial fixed prosthesis. A satisfactory functional and esthetic result was obtained after 5 years of follow-up. PMID:27403066

  2. Central venous catheters for chemotherapy of solid tumors--our results in the last 5 years.

    PubMed

    Zganjer, Mirko; Cizmić, Ante; Butković, Diana; Matolić, Martina; Karaman-Ilić, Maja; Stepan, Jasminka

    2008-09-01

    Central venous catheters provide an easy access for intravenous medications. Having a central line in place will relieve a child from the discomfort and danger of multiple regular intravenous lines for chemotherapy. The use of indwelling central venous catheters has become commonplace in the management of children undergoing oncological treatment. There are two types of central lines commonly used. There are Broviac catheters and Port-A-Cath (PAC) catheters. In the last 5 years we inserted 194 catheters in 175 children. We inserted 121 Broviac catheters and 73 PAC catheters. During the follow up of 39382 catheter days 44 complications were observed. In Broviac group the median follow up was 155 days and in PAC group was 230 days. We observed differences in the incidence between two devices. In Broviac group infections were more frequent and in PAC group other complications were more frequent than infections. PMID:18982750

  3. Atlantoaxial rotatory subluxation as a cause of torticollis in a 5-year-old girl.

    PubMed

    Bagouri, Elmunzar; Deshmukh, Sandeep; Lakshmanan, Palaniappan

    2014-01-01

    Many patients present to the emergency department complaining of a sore or stiff neck and lateral flexion of the neck with contralateral rotation. Under the pressure of the breaching time and busy shifts some of the patients are discharged to the care of their general practitioners without adequate investigations. While most of the cases are due to benign causes, torticollis can be due to many congenital and acquired pathologies, some of which may need further investigation and urgent management. Atlantoaxial subluxation (AAS), tumours of the base of the skull and infections are among these causes. Delayed diagnosis may lead to worsening neurology and complicate the management. We report a case of a 5-year-old girl who presented to our fracture clinic with a fractured clavicle and torticollis; her subsequent investigations confirmed the diagnosis of AAS. Our patient responded to non-operative treatment and improved with no neurological complications. PMID:24832710

  4. Superselective radioembolization of hepatocellular carcinoma: 5-year results of a prospective study.

    PubMed

    Rösler, H; Triller, J; Baer, H U; Geiger, L; Beer, H F; Becker, C; Blumgart, L H

    1994-10-01

    Twenty patients with unresectable hepatocellular carcinoma (HCC) were followed up to 5 years after transarterial radiotherapy with 90Y-resin particles. Diagnostic radioembolizations of 99mTc-macroaggregates facilitated scintigraphic assessment of activity distribution, dose evaluation and final procedural verification. The overall survival rates were 56, 38 and 14% (after 1, 2 and 3 years, resp.). Patients with unifocal HCC and a single feeding artery (n = 7) even presented 83, 67 and 40% (2 alive after 2.75 and 4 years). With multiple arteries (n = 7), the longest survival was 26 months. Patients with multifocal HCC survived up to 33 months after selective radioembolization. Quality of life was improved in all. Survival was positively correlated with absorbed dose but residual/recurrent tumour occurred even after > or = 300 Gy. Post-treatment symptoms were minimal (35 applications), pulmonary shunt rates were correctly predicted and pulmonary complications avoided. PMID:7997379

  5. [Research review on apoplectic urinary incontinence treated with acupuncture-moxibustion in recent 5 years].

    PubMed

    Song, Feng-Jun; Zhang, Hong; Zheng, Shi-Li; Fang, Jun-Hui; Liu, Hai-Fei

    2011-10-01

    The relevant documents of apoplectic urinary incontinence treated with acupuncture-moxibustion in recent 5 years have been collated and analyzed in aspect of current situation of acupuncture-moxibustion treatment, acupoint selection, manipulation and problems. The result indicates that the main therapy for this disease is acupuncture-moxibustion combined with electroacupuncture or other methods, and the acupuncture-moxibustion therapy is superior to the medicine. The clinical research has made considerable progress and the great importance has been attached to the research method. The main problems are low credibility of total quality, inconsistent curative course, incomplete case of illness, missing of quality control, disordered standards of clinical diagnosis and curative effect evaluation, varied observation index and phatic discussion of mechanism. It is suggested to carry on scientific research, enhance research lever, expand mind, innovate ideas, and establish uniformed standards of diagnosis and curative effect evaluation and observation index. PMID:22043698

  6. A 5-year experience of the changing management of ectopic pregnancy.

    PubMed

    Berry, Janet; Davey, Mark; Hon, Mei-See; Behrens, Renée

    2016-07-01

    This retrospective audit reviewed all ectopic pregnancies over a 5-year period in a district general hospital setting. Of 215 ectopic pregnancies identified, notes were available for 208 (97%). 202 cases were determined to have been diagnosed and managed as ectopic pregnancies. Six cases were excluded as they were pregnancies of unknown location managed as such. The proportion of patients managed non-surgically has increased following the introduction of our consultant-led early pregnancy assessment unit from 25% prior to 31% currently. The success rates have improved in both those managed expectantly (50%-73%) and those with methotrexate (75%-90%). There has been a corresponding drop in those managed surgically from 75% to 69%, and a reduction in negative laparoscopies from 13% to 6%. Provided recommended criteria and follow-up are adhered to, non-surgical management has been shown to have comparative safety to traditional surgical management with acceptable efficacy and patient acceptability. PMID:27012598

  7. The impact patient-specific instrumentation has had on my practice in the last 5 years.

    PubMed

    Collins, Michael J

    2014-03-01

    I have performed total knee arthroplasty (TKA) using patient- specific instrumentation (PSI) (TRUMATCH® Personalized Solutions, DePuy Synthes Joint Reconstruction, Warsaw, Indiana) since July 2009. Since that time, I have performed over 600 of these procedures, all at the same hospital and all using the same personnel I worked with before I began using PSI. I do not have a physician assistant, but I do have a surgical assistant who scrubs with and assists me on all TKAs. There are a number of reasons why a surgeon may decide to use PSI. This paper discusses the effect PSI has had on my practice in the last 5 years, including my experiences and conclusions. PMID:24911641

  8. Delayed tumor resection in a 5-year-old child with bilateral Wilms tumor.

    PubMed

    Carmichael, Samuel P; Pulliam, Joseph F; D'Orazio, John A

    2013-01-01

    We describe the case of a 5-year-old girl whose abdominal pain and distension were caused by Wilms tumor of the kidney. Because of the bilateral nature of her disease, she was spared biopsy or initial nephrectomy as part of her treatment course. Rather, she was treated presumptively for Wilms tumor based primarily on radiologic findings. Neoadjuvant chemotherapy consisting of vincristine, dactinomycin and doxorubicin was given to facilitate nephron-sparing surgery for tumor resection. Her initial chemotherapeutic course was complicated by tumor lysis syndrome manifested by elevated serum uric acid and was treated effectively with hyperhydration and alkalization of intravenous fluids. The patient's disease responded well to chemotherapy, and she underwent successful tumor excision after 12 weeks of chemotherapy. The resected tumor was identified as anaplastic Wilms tumor, illustrating that pathologic identification of Wilms tumor is possible even after multiple cycles of neoadjuvant chemotherapy and marked tumor shrinkage. PMID:24964423

  9. 5 years of experience with a large-scale mentoring program for medical students.

    PubMed

    Pinilla, Severin; Pander, Tanja; von der Borch, Philip; Fischer, Martin R; Dimitriadis, Konstantinos

    2015-01-01

    In this paper we present our 5-year-experience with a large-scale mentoring program for undergraduate medical students at the Ludwig Maximilians-Universität Munich (LMU). We implemented a two-tiered program with a peer-mentoring concept for preclinical students and a 1:1-mentoring concept for clinical students aided by a fully automated online-based matching algorithm. Approximately 20-30% of each student cohort participates in our voluntary mentoring program. Defining ideal program evaluation strategies, recruiting mentors from beyond the academic environment and accounting for the mentoring network reality remain challenging. We conclude that a two-tiered program is well accepted by students and faculty. In addition the online-based matching seems to be effective for large-scale mentoring programs. PMID:25699108

  10. The magnetosphere, ionosphere, and atmosphere as a system - Dynamics Explorer 5 years later

    NASA Technical Reports Server (NTRS)

    Hoffman, R. A.

    1988-01-01

    The Dynamics Explorer (DE) program summarizes its accomplishments during the first 5 years since the launch of the two DE satellites. This introduction to six review articles provides background information and a brief history of the program, especially citing the contributions of many people to its development. The principal investigators who had primary responsibility to implement the program are listed, together with the instruments they provided. Orbital information and approaches and constraints to data acquisition are explained. The brief description of the ground data processing and analysis system provides information on access to data catalogs and data sets. Each review article is then placed in the context of the categories of scientific objectives of the program.

  11. Department of Energy Resource Assessment Program 5-year plan, FY 1991--FY 1995

    SciTech Connect

    Not Available

    1990-10-01

    The US Department of Energy's (DOE) Resource Assessment Program produces scientific descriptions and assessments of the nation's renewable energy resources, such as solar energy. Information about the resources --- for example, how solar energy varies with location and climate --- is required to develop energy conversion technologies, design and site systems, and forecast the systems' performance. With information about resource availability and renewable energy system performance, DOE can assess the potential for renewable energy to contribute to the nation's energy supply as part of the long-term national energy strategy. This 5-year plan for fiscal years (FY) 1991 through 1995 gives the strategy to produce solar radiation resource characterizations and assessments under the DOE project at SERI. It is consistent with the mini-multiyear plan for resource assessment prepared by DOE in 1989 and incorporates the comments received at a project overview held in April 1990 at DOE Headquarters. 7 figs.

  12. Predictors and consequences of childhood depressive symptoms: a 5-year longitudinal study.

    PubMed

    Nolen-Hoeksema, S; Girgus, J S; Seligman, M E

    1992-08-01

    A 5-year longitudinal study investigated the interrelationships among children's experiences of depressive symptoms, negative life events, explanatory style, and helplessness behaviors in social and achievement situations. The results revealed that early in childhood, negative events, but not explanatory style, predicted depressive symptoms; later in childhood, a pessimistic explanatory style emerged as a significant predictor of depressive symptoms, alone and in conjunction with negative events. When children suffered periods of depression, their explanatory styles not only deteriorated but remained pessimistic even after their depression subsided, presumably putting them at risk for future episodes of depression. Some children seem repeatedly prone to depressive symptoms over periods of at least 2 years. Depressed children consistently showed helpless behaviors in social and achievement settings. PMID:1500598

  13. A 5-year activity report from the Oral Cancer Center, Tokyo Dental College.

    PubMed

    Yamamoto, Nobuharu; Sato, Kazumichi; Yamauchi, Tomohiro; Suzuki, Taiki; Osaka, Ryuta; Kin, Mira; Yoshida, Yoshifumi; Noguchi, Sunaki; Ishizaki, Ken; Takano, Masayuki; Katakura, Akira; Tanaka, Yoichi; Shibahara, Takahiko; Takano, Nobuo

    2013-01-01

    The Tokyo Dental College Oral Cancer Center was established on April 1st, 2006 at our Ichikawa General Hospital for the purpose of providing multimodal treatment for oral cancer. This report summarizes the Center's activities over the last 5 years. The total number of oral cancer patients treated was 360 (April 2006 to March 2011), with 205 primary cases. We investigated the following treatment-related items: 1) site, 2) age, 3) sex, 4) pathological examination, 5) staging, 6) systemic disorder, 7) double cancer, 8) treatment, and 9) prognosis. Out of 205 patients, 60% were men and 40% were women. Men in their 60s and women in their 80s were seen the most. The most common site was the tongue, at 42%, followed by the mandibular gingiva, maxillary gingiva, oral floor, and buccal mucosa. Squamous cell carcinomas were seen most frequently, at 94% (15% were stage I, 33% stage II, 15% stage III, and 34% stage IV). The most common treatment method was surgical treatment, at 83%. The 5-year survival rate at all stages was 85.4%. At the Oral Cancer Center, oral surgeons take the initiative in establishing treatment in cooperation with other departments and branches. Since the establishment of the Ambulatory Center for Maxillary Prosthetics in October 2011, 26 patients have undergone treatment. Related departments and branches work in teams, enabling comprehensive treatment, from the preoperative state to postoperative functional recovery. We wish to use these strengths to improve oral cancer treatment in Japan and will continue to work toward providing the best possible care for our patients. PMID:24521553

  14. 5 Years review of periocular basal cell carcinoma and proposed follow-up protocol

    PubMed Central

    Ho, S F; Brown, L; Bamford, M; Sampath, R; Burns, J

    2013-01-01

    Aim (1) To investigate the recurrence of periocular basal cell carcinoma (BCC) reported as completely excised on histology. (2) To identify risks associated with recurrence. (3) To recommend a rational follow-up protocol. Methods This is a cohort study by case note review of consecutive patients undergoing excision of periocular BCC between 2000 and 2006 at University Hospitals of Leicester. All lesions were excised with 3 mm clinical margin and the defect reconstructed only after the excision margin was declared clear. Results A total of 413 episodes of surgical excision were recorded for 270 patients over the 7-year period of 2000–2006. All of them have 5 years follow-up. Mean age 73.7 (±12.5). In all, 67% were nodular BCC and 45.4% located in the lower eyelid. The main outcome measure was the recurrence rate. None of the patients with primary nodular BCC suffered recurrence. The recurrence rate for primary morphoeaform BCC following complete excision is 3.8%. In total, 8.1% of patients had several lesions simultaneously whereas 7.8% patients had BCC in multiple locations subsequently (metachronous). Three patients who had previously recurrent BCC (rBCC) treated elsewhere or not using this method had orbital/lacrimal drainage system involvement requiring exenteration. Conclusion We recommend that patients with a single, completely excised primary solid or nodular BCC can be discharged after one 6-monthly review, although they should be instructed to monitor for the development of further lesions. The incidence of recurrence for primary morphoeaform BCC is 3.8% and for rBCC is 3.6% over 5 years and these patients should stay under review for this period. PMID:23154501

  15. POSTTRAUMATIC STRESS DISORDER AMONG INDONESIAN CHILDREN 5 YEARS AFTER THE TSUNAMI.

    PubMed

    Irwantol; Faisal; Zulfa, Hendra

    2015-09-01

    Children are at risk for developing posttraumatic stress disorder (PTSD) due to experiencing or living in a disaster area. The factors that increase the likelihood of a child developing PTSD need further clarification. We studied the factors associated with PTSD among children who experienced the tsunami in Sumatra, Indonesia. We conducted a cross sectional study in 2 subdistricts of Sumatra 5 years after experiencing a tsunami. Children aged 7-13 years were enrolled using stratified cluster sampling. A tsunami-modified version of The PsySTART Rapid Triage System was used to question children about their tsunami-specific traumatic experiences. Trauma symptoms were evaluated using the Trauma Symptom Checklist For Children (TSCC). The diagnosis of PTSD was made using the Child PTSD Symptom Scale (CPSS) and DSM-IV criteria. The data were analyzed with chi-square tests and multivariate logistic regression analysis with 95% confidence intervals (CI). A total of 262 children were enrolled in this study. The prevalence of PTSD in these children was 20.6%. On multivariate analysis, having experienced a delay in evacuation (PR = 4.5; 95% CI: 2.794-13.80; p < 0.001) and being unable to escape (PR = 13.07; 95% CI: 5.884-64; p < 0.001) were significantly associated with PTSD 5 years after the tsunami. Children who experienced a traumatic event in which they were unable to escape or when there is a delay in evacuation are at risk of developing PTSD and need appropriate treatment. PMID:26863863

  16. Smoking in pregnancy and children's mental and motor development at age 1 and 5 years.

    PubMed

    Trasti, N; Vik, T; Jacobsen, G; Bakketeig, L S

    1999-06-01

    We used data from a Scandinavian prospective multicenter study to investigate if smoking in pregnancy may have an adverse effect on the child's mental and motor abilities. Eligible for enrolment were para I and 2 women with a singleton pregnancy, who resided in one of the study areas and could be registered before the 20th gestational week. Women were classified as 'smokers' or 'non-smokers' at study start. At 13 months, 376 children (124 children of smokers) were evaluated with the Bayley Scales of Infant Development. At this age, children of smokers and non-smokers performed equally well. At 5 years, 369 children (132 children of smokers) were tested with the Wechsler Preschool and Primary Scales of Intelligence Revised (WPPSI-R), and 362 children with the Peabody Developmental Motor Scales (PDMS). Children of smokers had an increased risk of getting a WPPSI-R score below the median value of the population (OR = 2.1, 95% CI: 1.2-3.3), but the risk was reduced when we adjusted for maternal education (OR = 1.6, 95% CI: 0.9-3.7). Children of smokers had an increased risk of getting a test score below the median population value on the subscale 'balance' from PDMS (OR = 1.8, 95% CI: 1.2-2.8). Thus, we found that smoking in pregnancy was associated with a small, but demonstrable adverse effect on the child's balance at 5 years, whereas the negative effect on cognitive function did not reach statistical significance, when we adjusted for the mother's level of education. PMID:10390089

  17. Endoscopic removal of foreign bodies from the upper gastrointestinal tract: 5-year experience

    PubMed Central

    Emara, Mohamed H; Darwiesh, Ehab M; Refaey, Mohamed M; Galal, Sherif M

    2014-01-01

    Background Foreign bodies (FBs) in the upper gastrointestinal tract are produced chiefly by accidental swallowing but rarely produce symptoms. Removal of FBs is not an infrequent challenge for upper gastrointestinal endoscopy. The aim of this study is to elicit our experience in a 5-year period in dealing with FBs in the upper gastrointestinal tract using upper endoscopy. Methods This retrospective study was conducted at Zagazig University Hospitals, Egypt, over a 5-year period. We reviewed all patients’ files with full notations on age, sex, type of FB and its anatomical location, treatments, and outcomes (complications, success rates, and mortalities). Patients with incomplete files and those with FBs not identified at the endoscopic examination were excluded. Results A total of 45 patients were identified. Their ages ranged from 6 months to 102 years. Slight male predominance was noticed (53.3%). The most frequent presentation was a history of FB ingestion without any associated manifestations (44.4%). Coins were the most commonly encountered FBs (14/45). Esophagus was the most common site of trapping (27/45). The overall success rate was 95.6% (43/45). Upper endoscopy successfully resolved the problem by either FB removal (41/43) or dislodgment of the impacted fleshy meat to the stomach (2/43). Two cases were referred for surgical removal. The rate of complications was 6.7%. Furthermore, no mortalities due to FB ingestion or removal had been reported throughout the study. Conclusion Our experience with FB removal emphasizes its importance and ease when performed by experienced hands, at well-equipped endoscopy units, and under conscious sedation in most cases, with high success rates and minor complications. PMID:25053889

  18. Radiologically Isolated Syndrome: 5-Year Risk for an Initial Clinical Event

    PubMed Central

    Okuda, Darin T.; Siva, Aksel; Kantarci, Orhun; Inglese, Matilde; Katz, Ilana; Tutuncu, Melih; Keegan, B. Mark; Donlon, Stacy; Hua, Le H.; Vidal-Jordana, Angela; Montalban, Xavier; Rovira, Alex; Tintoré, Mar; Amato, Maria Pia; Brochet, Bruno; de Seze, Jérôme; Brassat, David; Vermersch, Patrick; De Stefano, Nicola

    2014-01-01

    Objective To report the 5-year risk and to identify risk factors for the development of a seminal acute or progressive clinical event in a multi-national cohort of asymptomatic subjects meeting 2009 RIS Criteria. Methods Retrospectively identified RIS subjects from 22 databases within 5 countries were evaluated. Time to the first clinical event related to demyelination (acute or 12-month progression of neurological deficits) was compared across different groups by univariate and multivariate analyses utilizing a Cox regression model. Results Data were available in 451 RIS subjects (F: 354 (78.5%)). The mean age at from the time of the first brain MRI revealing anomalies suggestive of MS was 37.2 years (y) (median: 37.1 y, range: 11–74 y) with mean clinical follow-up time of 4.4 y (median: 2.8 y, range: 0.01–21.1 y). Clinical events were identified in 34% (standard error = 3%) of individuals within a 5-year period from the first brain MRI study. Of those who developed symptoms, 9.6% fulfilled criteria for primary progressive MS. In the multivariate model, age [hazard ratio (HR): 0.98 (95% CI: 0.96–0.99); p = 0.03], sex (male) [HR: 1.93 (1.24–2.99); p = 0.004], and lesions within the cervical or thoracic spinal cord [HR: 3.08 (2.06–4.62); p = <0.001] were identified as significant predictors for the development of a first clinical event. Interpretation These data provide supportive evidence that a meaningful number of RIS subjects evolve to a first clinical symptom. An age <37 y, male sex, and spinal cord involvement appear to be the most important independent predictors of symptom onset. PMID:24598783

  19. Food assistance programmes are indirectly associated with anaemia status in children <5 years old in Mexico.

    PubMed

    Shamah-Levy, Teresa; Méndez-Gómez-Humarán, Ignacio; Gaona-Pineda, Elsa B; Cuevas-Nasu, Lucia; Villalpando, Salvador

    2016-09-01

    Anaemia in children is a public health concern in Mexico; Federal food assistance programmes are being implemented to prevent it. We undertook this research to investigate the indirect association between food assistance programmes (FAP) and anaemia through dietary and socio-economic conditions of beneficiary children. A structural equation model (SEM) was constructed to assess associations among FAP, dietary and socio-economic conditions, as well as anaemia. A cross-sectional comparative study was conducted based on a sample of 1214 households with children <5 years old, beneficiaries of two FAP: Prospera and rescue from malnutrition with amaranth (RMA) and a comparison group in San Luis Potosí, Mexico. The SEM and a decomposition effect analysis revealed the existence of a significant indirect association of FAP on the prevalence of anaemia via dietary and socio-economic conditions in children under 5 years old. The Prospera assistance programme showed a significant indirect positive association with the prevalence of anaemia (standard coefficient=0·027, P<0·031), and the RMA programme showed a significant indirect negative association with the prevalence of anaemia (standard coefficient=-0·029, P=0·047). There was a direct association between FAP and dietary and socio-economic conditions. FAP could indirectly modify the prevalence of anaemia in young children with a direct improvement on dietary and socio-economic conditions. The unexpected finding of the association between RMA, dietary and socio-economic conditions and the prevalence of anaemia reflects differences in the focus of the programmes. PMID:27545977

  20. Status of medical education reform at Saga Medical School 5 years after introducing PBL.

    PubMed

    Oda, Yasutomo; Koizumi, Shunzo

    2008-03-01

    In Japan, problem-based learning (PBL) is a relatively new method of educating medical students that is reforming the face of medical education throughout the world, including Asia. It shifts from teacher-centered learning strategies (for example, lectures in large auditoriums) to student-centered, self-directed learning methods (for example, active discussions and problem-solving by students in small groups under the guidance of faculty tutors). Upon a recommendation by the Japan Model Core Curriculum, Saga Medical School introduced a PBL curriculum 5 years ago. A full PBL curriculum was adopted from the McMaster model through Hawaii. A description of how PBL was implemented into the 3rd and 4th year (Phase III curriculum) is given. The overall result has been good. Students who experienced PBL had increased scores on the National Medical License Exam, and Saga increased its ranking from 56th to 19th of the 80 medical schools in Japan. A key step was introduction of the educational scaffolding in PBL Step 0. Students were allowed to see page one of the PBL case, containing the chief complaint, on the weekend before meeting in small groups. Despite a perceived overall benefit to student learning, symptoms of superficial discussions by students have been observed recently. How this may be caused by poor case design is discussed. Other problems, including "silent tutors" and increased faculty workload, are discussed. It is concluded that after 5 years, Saga's implementation of a PBL curriculum has been successful. However, many additional issues, including motivation of students and preparation for PBL in the first 2 years, must still be resolved in the future. This is the first description of the positive and negative outcomes associated with the reform of medical education and the introduction of PBL to a traditional medical school curriculum in Japan. PMID:18364287

  1. Stereopsis Results at 4.5 Years of Age in the Infant Aphakia Treatment Study

    PubMed Central

    Hartmann, E. Eugenie; Stout, Ann U.; Lynn, Michael J.; Yen, Kimberly G.; Kruger, Stacey J.; Lambert, Scott R.

    2014-01-01

    Purpose To determine whether stereopsis of infants treated for monocular cataracts varies with the type of optical correction used. Design Randomized prospective clinical trial Methods The Infant Aphakia Treatment Study randomized 114 patients with unilateral cataracts at age 1 to 7 months to either primary intraocular lens (IOL) or contact lens correction. At 4.5 years of age a masked examiner assessed stereopsis on these patients using three different tests: 1) Frisby; 2) Randot Preschool; and 3) Titmus fly. Results Twenty-eight patients (25%) had a positive response to at least one of the stereopsis tests. There was no statistically significant difference in stereopsis between the two treatment groups. Frisby (contact lens, 6 (11%); IOL, 7 (13%); p=0.99), Randot (contact lens, 3 (6%); IOL, 1 (2%); p=0.62) or Titmus: (contact lens, 8 (15%); IOL, 13 (23%); p=0.34). The median age at surgery for patients with stereopsis was younger than for those without stereopsis (1.2 versus 2.4 months; p=0.002). The median visual acuity for patients with stereopsis was better than for those without stereopsis (20/40 vs. 20/252; p=0.0003). Conclusion The type of optical correction did not influence stereopsis outcomes. However, two other factors did: age at surgery and visual acuity in the treated eye at age 4.5 years. Early surgery for unilateral congenital cataract and the presence of visual acuity better than or equal to 20/40 appear to be more important than the type of initial optical correction used for the development of stereopsis. PMID:25261241

  2. Specialist Pediatric Palliative Care Referral Practices in Pediatric Oncology: A Large 5-year Retrospective Audit

    PubMed Central

    Ghoshal, Arunangshu; Salins, Naveen; Damani, Anuja; Deodhar, Jayita; Muckaden, MaryAnn

    2016-01-01

    Purpose: To audit referral practices of pediatric oncologists referred to specialist pediatric palliative care services. Patients and Methods: Retrospective review of medical case records of pediatric palliative care patients over a period of 5 years from January 1, 2010 to December 31, 2014. Descriptive summaries of demographic, clinical variables, and patient circumstances at the time of referral and during end-of-life care were examined. Results: A total of 1135 patients were referred from pediatric oncology with a gradual increasing trend over 5 years. About 84.6% consultations took place in the outpatient setting. In 97.9% of the cases, parents were the primary caregivers. Availability of specialist pediatric health-care services at local places was available in 21.2% cases and 48% families earned <5000 INR (approximately 73 USD) in a month. Around 28.3% of the referrals were from leukemia clinic and maximum references were late with 72.4% patients having advanced disease at presentation. 30.3% of the referrals were made for counseling and communication and 54.2% had high symptom burden during referral. After referral, 21.2% patients continued with oral metronomic chemotherapy and 10.5% were referred back to oncology services for palliative radiotherapy. Only 4.9% patients had more than 2 follow-ups. 90.8% of the patients were cared for at home in the last days of illness by local general practitioners. 70.6% of the deaths were anticipated. Conclusions: Oncologists referred patients late in the course of disease trajectory. Most of the referrals were made for counseling and communication, but many patients had high symptom burden during referral. PMID:27559254

  3. A 5-year scientometric analysis of research centers affiliated to Tehran University of Medical Sciences

    PubMed Central

    Yazdani, Kamran; Rahimi-Movaghar, Afarin; Nedjat, Saharnaz; Ghalichi, Leila; Khalili, Malahat

    2015-01-01

    Background: Since Tehran University of Medical Sciences (TUMS) has the oldest and highest number of research centers among all Iranian medical universities, this study was conducted to evaluate scientific output of research centers affiliated to Tehran University of Medical Sciences (TUMS) using scientometric indices and the affecting factors. Moreover, a number of scientometric indicators were introduced. Methods: This cross-sectional study was performed to evaluate a 5-year scientific performance of research centers of TUMS. Data were collected through questionnaires, annual evaluation reports of the Ministry of Health, and also from Scopus database. We used appropriate measures of central tendency and variation for descriptive analyses. Moreover, uni-and multi-variable linear regression were used to evaluate the effect of independent factors on the scientific output of the centers. Results: The medians of the numbers of papers and books during a 5-year period were 150.5 and 2.5 respectively. The median of the "articles per researcher" was 19.1. Based on multiple linear regression, younger age centers (p=0.001), having a separate budget line (p=0.016), and number of research personnel (p<0.001) had a direct significant correlation with the number of articles while real properties had a reverse significant correlation with it (p=0.004). Conclusion: The results can help policy makers and research managers to allocate sufficient resources to improve current situation of the centers. Newly adopted and effective scientometric indices are is suggested to be used to evaluate scientific outputs and functions of these centers. PMID:26157724

  4. Midterm survivorship and clinical outcome of INDUS knee prosthesis: 5 year followup study

    PubMed Central

    Sancheti, Kantilal H; Sancheti, Parag K; Joshi, Rajeev S; Patil, Kailash R; Shyam, Ashok K; Bhaskar, Raja R

    2016-01-01

    Background: INDUS knee implant has been designed as per the anatomical morphology of the Indian population and has shown good clinical outcome in short term studies. The purpose of the present study was to report the midterm survivorship and clinical outcome of this implant. Materials and Methods: Two hundred and twenty three primary total knee arthroplasties in 209 consecutive patients using the INDUS knee prosthesis were prospectively enrolled. There were 145 females (155 knees) and 64 males (68 knees) with a mean age of 69.95 years (range 42–86 years). Annual followup with clinical and radiological examination was conducted, and a survivorship analysis was done using the Kaplan–Meier analysis. Results: Mean followup was 5.8 years (range 5–6.5 years). Eleven patients died while eight were lost to followup and a total of 204 knees were available for followup. The mean knee flexion improved from preoperative 110.4° ± 11.24° (range 60°–130°) to 128.17° ± 8.32° (range 100°–140°) at the final followup. The mean knee score improved from 40.1 ± 10.7 to 90.3 ± 5.34 while the function score improved from 44.35 ± 12.9 to 89.58 ± 7.43. Two patient developed infection and required revision. The Kaplan–Meier analysis reported a survivorship of 98.6% (confidence interval 95.7–99.6%) at the end for 5 years for INDUS knee prosthesis. Conclusion: INDUS knee prosthesis has excellent survivorship with a good clinical outcome and low failure rate. PMID:27053801

  5. Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International

    PubMed Central

    Duvall, Susan; Thurston, Sarah; Weinberger, Michelle; Nuccio, Olivia; Fuchs-Montgomery, Nomi

    2014-01-01

    Contraceptive implants offer promising opportunities for addressing the high and growing unmet need for modern contraceptives in sub-Saharan Africa. Marie Stopes International (MSI) offers implants as one of many family planning options. Between 2008 and 2012, MSI scaled up voluntary access to implants in 15 sub-Saharan African countries, from 80,041 implants in 2008 to 754,329 implants in 2012. This 9-fold increase amounted to more than 1.7 million implants delivered cumulatively over the 5-year period. High levels of client satisfaction were attained alongside service provision scale up by using existing MSI service delivery channels—mobile outreach, social franchising, and clinics—to implement strategies that broadened access for underserved clients and maintained service quality. Use of adaptive and context-specific service delivery models and attention to key operational components, including sufficient numbers of trained providers, strong supply chains, diverse financing mechanisms, and implant removal services, underpinned our service delivery efforts. Accounting for 70% of the implants delivered by MSI in 2012, mobile outreach services through dedicated MSI provider teams played a central role in scale-up efforts, fueled in part by the provision of free or heavily subsidized services. Social franchising also demonstrated promise for future program growth, along with MSI clinics. Continued high growth in implant provision between 2011 and 2012 in all sub-Saharan African countries indicates the region's capacity for further service delivery expansion. Meeting the expected rising demand for implants and ensuring long-term sustainable access to the method, as part of a comprehensive method mix, will require continued use of appropriate service delivery models, effective operations, and ongoing collaboration between the private, public, and nongovernmental sectors. MSI's experience can be instructive for future efforts to ensure contraceptive access and

  6. Midlife Ankylosing Spondylitis Increases the Risk of Cardiovascular Diseases in Males 5 Years Later

    PubMed Central

    Hung, Yao-Min; Chang, Wei-Pin; Wei, James Cheng-Chung; Chou, Pesus; Wang, Paul Yung-Pou

    2016-01-01

    Abstract There are limited studies describing the association between ankylosing spondylitis (AS) and cardiovascular disease (CVD) in patients over 40 years old. We aimed to focus on the incident AS patients in those aged 40 years or older and to investigate whether events of CVD occurred more than the general population. We conducted a nationwide cohort study between 2000 and 2005 using the Taiwan National Health Insurance Research Database. The risk of newly diagnosed CVD was compared between incident AS patients and matched age- and sex-matched subjects without AS. Events of CVDs were classified into 1 of 5 subcategories: hypertensive heart disease, coronary heart disease, congestive heart failure, cerebrovascular disease, or “other” CVD according to the ICD-9-CM codes. Cumulative incidences and hazard ratios (HRs) were calculated after adjusting for demographic and comorbid medical disorders. Multivariate analyses were performed using Cox proportional hazards model. We compared 537 AS and 2685 non-AS patients and found that the cumulative incidence rate of CVD during follow-up period was higher in the AS cohort than the non-AS cohort. The crude HR of CVD for the AS group was 1.24 [95% confidence interval (95% CI), 1.05–1.46; P = 0.01] and the adjusted HR was 1.20 with 95% CI 1.02 to 1.42 (P = 0.03). When stratified by age, AS cohort at age 60 to 69 years exhibited a significantly higher HR for all CVD than the general population cohort (adjusted HR 1.48, 95% CI 1.06–2.08, P < 0.05). When stratified by gender, male AS group had a significantly higher HR for all CVD than the general population cohort with the adjusted HR 1.28 (95% CI 1.01–1.63, P < 0.05). There was no statistically significant difference for females. Patients with AS, especially age 60 to 69 years male patients, had a higher risk of CVDs than non-AS controls. PMID:27149491

  7. Evaluation of a commercial electronic medical record (EMR) by primary care physicians 5 years after implementation.

    PubMed

    Kaelber, David; Greco, Peter; Cebul, Randall D

    2005-01-01

    Electronic medical records (EMRs) are gaining increasing prominence in the delivery of healthcare, although the focus is primarily on deploying EMRs. Relatively little research has studied the post-implementation of commercial EMRs. Here we present the results of a web-based survey of all the primary care clinicians in our university affiliated, tertiary care health system. The survey evaluated primary care clinician demographics, usage, and ideas for enhancement of the EpicCare EMR, five year after its initial deployment throughout our healthcare system. PMID:16779289

  8. Evaluation of a Commercial Electronic Medical Record (EMR) by Primary Care Physicians 5 Years after Implementation

    PubMed Central

    Kaelber, David; Greco, Peter; Cebul, Randall D

    2005-01-01

    Electronic medical records (EMRs) are gaining increasing prominence in the delivery of healthcare, although the focus is primarily on deploying EMRs. Relatively little research has studied the post-implementation of commercial EMRs. Here we present the results of a web-based survey of all the primary care clinicians in our university affiliated, tertiary care health system. The survey evaluated primary care clinician demographics, usage, and ideas for enhancement of the EpicCare EMR, five year after its initial deployment throughout our healthcare system. PMID:16779289

  9. A cumulative scale of severe sexual sadism.

    PubMed

    Nitschke, Joachim; Osterheider, Michael; Mokros, Andreas

    2009-09-01

    The article assesses the scale properties of the criterion set for severe sexual sadism in a sample of male forensic patients (N = 100). Half of the sample consists of sexual sadists; the remainder is sampled at random from the general group of nonsadistic sex offenders. Eleven of 17 criteria (plus the additional item of inserting objects into the victim's bodily orifices) of Marshall, Kennedy, Yates, and Serran's list form a cumulative scale. More specifically, this scale comprises all the 5 core criteria that Marshall and his colleagues considered particularly relevant. The resulting 11-item scale of severe sexual sadism is highly reliable (r(tt) = .93) and represents a strong scale (H = .83) of the Guttman type (coefficient of reproducibility = .97). The 11-item scale distinguishes perfectly between sexual sadists and nonsadistic sex offenders in the sample. PMID:19605691

  10. Elemental composition of two cumulate rocks

    SciTech Connect

    Naeem, A.; Almohandis, A.A.

    1983-04-01

    Two cumulate rock samples K-185, K-250 from the Kapalagulu intrusion, W. Tanzania, were analyzed using X-ray fluorescence (XRF), wet chemical and neutron activation analysis (NAA) techniques. Major element oxides were determined by XRF and wet chemical methods, while the concentration of trace elements were measured by NAA, using high resolution Ge(Li) detector, minicomputer-based data acquisition system and off-line computer. The percentage of major oxides and sixteen trace elements have been reported. It has been found that Cr, Ni, and Co are highly concentrated in K-250 while Sc, and most of the major elements are more concentrated in K-185. The variation of major and trace elements in these two samples have been discussed.

  11. Implant failure: regional versus cumulative evaluation.

    PubMed

    Lauc, T; Krnić, D; Katanec, D

    2000-07-01

    In this paper the success rate of implant therapy in various bone regions is discussed. The objective is to determine whether differences existed in success rates of cylinder implants placed in different areas in the both maxilla and mandible. Forty four patients have been treated and reviewed five years after the placement of the fixed prosthetic restoration. The patients were provided with a total of 92 implants. Results from this study show very low survival rate for implants placed in anterior region of maxilla (55.6%) after five years. It is concluded that simple cumulative follow up studies do not entirely correspond to actual situations, positioning the implants has an important role in the planning of the implant therapy and that important factor for force compensation is not only the surrounding bone density, but also the region of the jaw where the implants are placed. PMID:10946471

  12. 75 FR 57492 - Notice of Submission of Proposed Information Collection to OMB Public Housing 5 Year Annual PHA Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-21

    ... URBAN DEVELOPMENT Notice of Submission of Proposed Information Collection to OMB Public Housing 5 Year... public comments on the subject proposal. PHAs are required to submit annual and 5-Year Plans to HUD as required by section 5A of the United States Housing Act of 1937 (42 U.S.C. 1437c-1) The purpose of the...

  13. 75 FR 38979 - Endangered and Threatened Species; Initiation of a 5-Year Review of the Eastern Distinct...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-07

    ... for the eastern Distinct Population Segment of the Steller sea lion (75 FR 37385). NMFS inadvertently... of a 5-Year Review of the Eastern Distinct Population Segment of the Steller Sea Lion AGENCY... of a 5-year review of the eastern Distinct Population Segment (DPS) of the Steller Sea...

  14. Cumulative life course impairment in vitiligo.

    PubMed

    Krüger, Christian; Schallreuter, Karin Uta

    2013-01-01

    Vitiligo is an acquired, idiopathic skin disease characterized by the mostly progressive loss of the inherited skin color leading to white patches and in some cases to total depigmentation. The course of this ancient disease is still unknown. The worldwide prevalence range is 0.5-1%. The disease burden includes stigmatization, depression, impaired quality of life, lack of self-confidence, embarrassment and self-consciousness. To the best of our knowledge, the extent to which this chronic disease may exert an influence upon the life course of affected individuals has, to date, not been investigated. The material presented herein is the result of an accurate analysis of published literature. Moreover, we included our own data collected in two studies. To apply the concept of cumulative life course impairment in vitiligo, we looked at possible trigger factors, role of patient's age and the age at disease onset, disease duration and stigmatization. Stigmatization had the strongest impact. It is common in patients with an early disease onset, often leading to other disturbances. Our data revealed that older patients or those with a disease onset later in life adjust better to this chronic skin disorder and that they are less socially avoidant. However, long disease duration can also lead to impaired quality of life and obsession, while this group seems to be less depressed or embarrassed. Results from our own work with peer groups of these patients strongly support a positive long-lasting effect of treatment on quality of life of children, adolescents and adults. To which extent vitiligo may contribute to a cumulative life course impairment remains to be shown. PMID:23796814

  15. Relapse and Late Mortality in 5-Year Survivors of Myeloablative Allogeneic Hematopoietic Cell Transplantation for Chronic Myeloid Leukemia in First Chronic Phase

    PubMed Central

    Goldman, John M.; Majhail, Navneet S.; Klein, John P.; Wang, Zhiwei; Sobocinski, Kathleen A.; Arora, Mukta; Horowitz, Mary M.; Rizzo, J. Douglas

    2010-01-01

    Purpose Allogeneic hematopoietic cell transplantation (HCT) is curative therapy for chronic myeloid leukemia (CML), but its long-term outcomes are not well described. We studied the long-term outcomes of CML patients in first chronic phase who receive an allogeneic HCT. Patients and Methods Our study included 2,444 patients who received myeloablative HCT for CML in first chronic phase between 1978 and 1998 and survived in continuous complete remission for at least 5 years (median follow-up, 11 years; range, 5 to 25 years). Donor sources were human leukocyte antigen–matched siblings in 1,692 patients, unrelated donors in 639 patients, and other related donors in 113 patients. Results Overall survival rates at 15 years were 88% (95% CI, 86% to 90%) for sibling HCT and 87% (95% CI, 83% to 90%) for unrelated donor HCT. Corresponding cumulative incidences of relapse were 8% (95% CI, 7% to 10%) and 2% (95% CI, 1% to 4%), respectively. The latest relapse was reported 18 years post-HCT. In multivariable analyses, history of chronic graft-versus-host disease increased risks of late overall mortality and nonrelapse mortality but reduced risks of relapse. In comparison with age-, race-, and sex-adjusted normal populations, the mortality of HCT recipients was significantly higher until 14 years post-HCT; thereafter, mortality rates were similar to those of the general population (relative mortality ratio at 15 years, 2.3; 95% CI, 0 to 4.9). Conclusion Recipients of allogeneic HCT for CML in first chronic phase who remain in remission for at least 5 years have favorable subsequent long-term survival, and their mortality rates eventually approach those of the general population. PMID:20212247

  16. Surgical treatment of cardiac tumors: a 5-year experience from a single cardiac center

    PubMed Central

    Yin, Liang; He, Dengke; Shen, Hua; Ling, Xinyu; Li, Wei; Xue, Qian

    2016-01-01

    Background Cardiac tumors are rare but manifested with various clinical presentations and often cause unexpected symptoms or sudden death. The objective is to review the clinical presentation, histopathological spectrum, mortality and follow-up data of patients with cardiac tumors following surgery treatment over a period of 5 years. Methods We retrospectively collected the medical records of all patients diagnosed of cardiac tumors in the period between January 2008 and December 2013 at the cardiac center of our university. Clinical histories, perioperative data, surgical findings, efficacy and follow-up data were reviewed in our study. Patients were divided into two groups according to site distribution of the tumors in the heart. Results A total of 131 patients underwent surgical treatment of cardiac tumors were enrolled in this study, with a mean age of 51.39±16.37. The result of analysis showed that 79.47% (n=104) of the primary intracardiac tumors were benign, while primary malignant neoplasms accounted for 16.03% (n=21) of all patients, with the remainder (n=6, 4.6%) metastatic tumors transferred from other organs. Among all patients there were 2 in-hospital deaths and the survival rate in all patients at 1-year, 3-year and 5-year follow up was 83.20%, 78.62% and 66.41% respectively. Both patients with tumors in the left and right heart had similar basic characteristics except sex gender (P=0.002), BSA (P=0.045) and weight (P=0.033). Compared with patients with tumors in the right heart, patients with tumors in the left heart had significant higher CPB time (P<0.001), cross clamp time (P<0.001) and time of mechanical ventilation (P<0.001), and they also had longer ICU stay (P<0.001) but not total hospital stay (P=0.434). Conclusions Surgical resection represents an effective protocol in treating cardiac tumors. Data in our study of cardiac tumors on frequency and allocation were consistent with previous reports which may provide useful clinical evidence on

  17. A 5 Year Study of Carbon Fluxes from a Restored English Blanket Bog

    NASA Astrophysics Data System (ADS)

    Worrall, F.; Dixon, S.; Evans, M.

    2014-12-01

    This study aimed to measure the effects of ecological restoration on blanket peat water table depths, DOC concentrations and CO2 fluxes. In April 2003 the Bleaklow Plateau, an extensive area of deep blanket peat in the Peak District National Park, northern England, was devegetated by a wildfire. As a result the area was selected for large scale restoration. In this study we considered a 5-year study of four restored sites in comparison to both an unrestored, bare peat control and to vegetated control that did not require restoration. Results suggested that sites with revegetation alongside slope stabilisation had the highest rates of photosynthesis and were the largest net (daylight hours) sinks of CO2. Bare sites were the largest net sources of CO2 and had the deepest water table depths. Sites with gully wall stabilisation were between 5-8 times more likely to be net CO2 sinks than the bare sites. Revegetation without gully flow blocking using plastic dams did not have a large effect on water table depths in and around the gullies investigated whereas a blocked gully had water table depths comparable to a naturally revegetating gully. A ten centimetre lowering in water table depth decreased the probability of observing a net CO2 sink, on a given site, by up to 30%. With respect to DOC the study showed that the average soil porewater DOC concentration on the restored sites rose significantly over the 5 year study representing a 34% increase relative to the vegetated control and an 11% increase relative to the unrestored, bare control. Soil pore water concentrations were not significantly different from surface runoff DOC concentrations and therefore restoration as conducted by this study would have contributed to water quality deterioration in the catchment. The most important conclusion of this research was that restoration interventions were apparently effective at increasing the likelihood of net CO2 sink behaviour and raising water tables on degraded

  18. Steps and pips in the history of the cumulative recorder.

    PubMed

    Lattal, Kennon A

    2004-11-01

    From its inception in the 1930s until very recent times, the cumulative recorder was the most widely used measurement instrument in the experimental analysis of behavior. It was an essential instrument in the discovery and analysis of schedules of reinforcement, providing the first real-time analysis of operant response rates and patterns. This review traces the evolution of the cumulative recorder from Skinner's early modified kymographs through various models developed by Skinner and his colleagues to its perfection in the 1950s, and then into the 1960s when it proliferated as different scientific instrument companies began marketing their own models of the cumulative recorder. With the rise of digital computers, the demise of the cumulative recorder as a scientific instrument was inevitable; however, the value of the cumulative record as a monitoring device to assess schedule control of behavior continues. The cumulative recorder remains, along with the operant conditioning chamber, an icon of Skinner's approach to psychology. PMID:15693527

  19. Steps and pips in the history of the cumulative recorder.

    PubMed Central

    Lattal, Kennon A

    2004-01-01

    From its inception in the 1930s until very recent times, the cumulative recorder was the most widely used measurement instrument in the experimental analysis of behavior. It was an essential instrument in the discovery and analysis of schedules of reinforcement, providing the first real-time analysis of operant response rates and patterns. This review traces the evolution of the cumulative recorder from Skinner's early modified kymographs through various models developed by Skinner and his colleagues to its perfection in the 1950s, and then into the 1960s when it proliferated as different scientific instrument companies began marketing their own models of the cumulative recorder. With the rise of digital computers, the demise of the cumulative recorder as a scientific instrument was inevitable; however, the value of the cumulative record as a monitoring device to assess schedule control of behavior continues. The cumulative recorder remains, along with the operant conditioning chamber, an icon of Skinner's approach to psychology. PMID:15693527

  20. Hyperpigmented Torpedo Maculopathy with Pseudo-Lacuna: A 5-Year Follow-Up

    PubMed Central

    Rohl, Austin; Vance, Sushma

    2016-01-01

    Purpose The aim of the study was to describe a case of globally hyperpigmented torpedo maculopathy that also contained a novel central lesion resembling a ‘pseudo-lacuna’. We compare the morphology of the lesion after 5 years of follow-up. Case Presentation An asymptomatic 10-year-old Caucasian male was referred by his optometrist after having found a hyperpigmented lesion on routine dilated examination in 2010. Color fundus photography OS from October 2015 showed a 1.74 × 0.67 mm hyperpigmented oval-shaped lesion temporal to the macula. Since June 2010, the hyperpigmented torpedo lesion appeared to have assumed a more ovoid shape and increased in size in the vertical axis. Centrally, there was a small pearlescent-colored pseudo-lacuna lesion that seemed to also have significantly increased in size since June 2010. Enhanced depth imaging optical coherence tomography of this pseudo-lacuna showed retinal pigment epithelium clumping and migration. Fundus autofluorescence revealed reduced autofluorescence of the torpedo lesion and marked hyperautofluorescence of the pseudo-lacuna. Fluorescein angiography shows no neovascular disease or leakage. Conclusion Torpedo maculopathy has been described previously as a hypopigmented, nonprogressive lesion of unknown etiology. The findings of global hyperpigmentation, pseudo-lacuna formation, and morphologic changes over time in this lesion challenge these classically held descriptions, and necessitate long-term follow-up with multimodal imaging. PMID:27462244

  1. Disease Management Project Breast Cancer in Hesse – 5-Year Survival Data

    PubMed Central

    Jackisch, C.; Funk, A.; König, K.; Lubbe, D.; Misselwitz, B.; Wagner, U.

    2014-01-01

    Introduction: The Disease Management Project Breast Cancer (DMP Breast Cancer) was first launched in Hesse in 2004. The project is supported by the health insurance companies in Hesse and the Professional Association of Gynaecologists in Hesse. The aim is to offer structured treatment programmes to all women diagnosed with breast cancer in Hesse by creating intersectoral cooperations between coordinating clinics, associated hospitals and gynaecologists in private practice who registered in the DMP programme. Method: Between 1 January 2005 and 30 June 2011, 13 973 women were enrolled in the DMP programme. Results: After data cleansing, survival rates were calculated for a total of 11 214 women. The 5-year overall survival (OS) rate was 86.3 %; survival rates according to tumour stage on presentation were 92.2 % (pT1) and 82.3 % (pT2), respectively. The impact of steroid hormone receptor status on survival (87.8 % for receptor-positive cancers vs. 78.9 % for receptor-negative cancers) and of age at first diagnosis on survival (≤ 35 years = 91 %) were calculated. Conclusion: The project showed that intersectoral cooperation led to significant improvements in the quality of treatment over time, as measured by quality indicators and outcomes after treatment. PMID:24882878

  2. Oral glucose retention, saliva viscosity and flow rate in 5-year-old children.

    PubMed

    Negoro, M; Nakagaki, H; Tsuboi, S; Adachi, K; Hanaki, M; Tanaka, D; Takami, Y; Nakano, T; Kuwahara, M; Thuy, T T

    2000-11-01

    There are significant differences of glucose retention in site-specificity and individuals. Sixty-two 5-year-old nursery schoolchildren participated in this study on the relation between the viscosity of saliva and flow rate and glucose retention. Each child was instructed to rinse his/her mouth with a glucose solution (0.5 M, 5 ml) and then to spit out. Three minutes after rinsing, glucose retention was determined. Resting saliva was collected by a natural outflow method, then the flow rate was determined. A rotational viscometer was used to determine the viscosity. Glucose retention and flow rate were correlated at the left maxillary primary molars, and glucose retention and viscosity were correlated at the maxillary central primary incisors. It was concluded that glucose retention after glucose mouth rinsing was site-specific, and that glucose retention and the index of decayed, missing and filled primary teeth (dmft) were slightly correlated with the salivary viscosity and flow rate. PMID:11000387

  3. Vitamin A deficiency and attributable mortality among under-5-year-olds.

    PubMed Central

    Humphrey, J. H.; West, K. P.; Sommer, A.

    1992-01-01

    Reported are estimates of the prevalence in developing countries of physiologically significant vitamin A deficiency and the number of attributable deaths. The WHO classification of countries by the severity and extent of xerophthalmia was used to categorize developing countries by likely risk of subclinical vitamin A deficiency. Using vital statistics compiled by UNICEF, we derived population figures and mortality rates for under-5-year-olds. The findings of vitamin A supplementation trials were applied to populations at-risk of endemic vitamin A deficiency to estimate the potential impact of improved vitamin A nutriture in reducing mortality during preschool years. Worldwide, over 124 million children are estimated to be vitamin A deficient. Improved vitamin A nutriture would be expected to prevent approximately 1-2 million deaths annually among children aged 1-4 years. An additional 0.25-0.5 million deaths may be averted if improved vitamin A nutriture can be achieved during the latter half of infancy. Improved vitamin A nutriture alone could prevent 1.3-2.5 million of the nearly 8 million late infancy and preschool-age child deaths that occur each year in the highest-risk developing countries. PMID:1600583

  4. Continuous improvement of arterial compliance beyond blood pressure decrease after 5 years of antihypertensive treatment.

    PubMed

    Bellido, Claudio A; Iavicoli, Oscar R; Rusak, Eduardo J; Vazquez, Sonia T; Piñeiro, Daniel J; Lerman, Jorge

    2006-08-01

    Pulse wave velocity is a reliable marker of arterial compliance. Stiffness of large and elastic arteries leads to a faster propagation of pulse wave. The aim of this study was to evaluate changes in arterial distensibility using antihypertensive drugs. This treatment focused on the inhibition of the renin-angiotensin-aldosterone system and the changes produced in blood pressure. Measurements were taken at baseline and throughout 60 months in 66 previously untreated hypertensive patients (22 men and 44 women, aged 54 +/- 9.5 years, range 38-73 years at baseline). All patients received either angiotensin-converting enzyme inhibitors or, in case of adverse effects, angiotensin receptor blockers. To control blood pressure, diuretics, calcium channel blocking agents, or beta blockers were added when appropriate. Statistical analysis was performed by means of ANOVA with alpha = 0.05. Systolic and diastolic blood pressure decreased during the first year without significant changes thereafter. There were no significant changes in pulse pressure. Pulse wave velocity showed a continuous and significant decrease throughout the follow-up period, but its reduction since the third year was more evident than the decrease in systolic and diastolic blood pressure (p < 0.0001 for both). This observation could be related to changes in arterial remodeling probably due to angiotensin-converting enzyme inhibition or renin angiotensin system blockade. Further investigations are needed to establish this relationship. PMID:16896271

  5. DRAWING SKILLS IN CHILDREN WITH NEURODEVELOPMENTAL DELAY AGED 2-5 YEARS.

    PubMed

    Morović, Maja Lang; Matijević, Valentina; Divljaković, Kristina; Kraljević, Marija; Dimić, Zdenka

    2015-06-01

    In typically developing children, drawing development occurs in stages from uncontrolled strokes to complex drawing. In this study, we examined drawing development in children with neurodevelopmental delay (NDD). In order to do so, we observed the influence of age, intraventricular hemorrhage (IVH) and gender on the development of drawing skills. The sample consisted of 52 children with NDD, aged 2 years and 6 months to 5 years. All children were hospitalized for multidisciplinary team monitoring and developmental support. The evaluation of drawing development was administered by giving each child a blank A4 paper and the instruction to draw anything they wanted. All of the drawings were scored satisfactory or unsatisfactory. Descriptive statistics was employed on all relevant data to show results in frequencies and percentages. In order to determine differences between groups, the χ2-test was administered. The results showed greatest difference in drawing in children aged from 3 years to 3 years and 11 months. Children with lower IVH had better drawing scores than children with higher IVH levels. According to gender dissimilarities, a difference was found showing girls to have better drawing skills than boys. All study results pointed to the importance of early rehabilitation and continuous structured work with children with NDD. PMID:26415307

  6. A 2-year longitudinal nutritional survey of 405 Northumberland children initially aged 11.5 years.

    PubMed

    Hackett, A F; Rugg-Gunn, A J; Appleton, D R; Eastoe, J E; Jenkins, G N

    1984-01-01

    Children (405), initially of average age 11.5 years, recorded all food and drinks consumed for three consecutive days (with an interview on the fourth day) on five separate occasions over a 2-year period. Food tables (Paul & Southgate, 1978) enabled nutrient intakes to be calculated. The data collected were found to be of high reliability (Hackett et al. 1983). The mean energy intakes showed broad agreement with other recent British dietary surveys but were well below those recorded in the prewar study by Widdowson (1947) and the FAO/WHO (1973) recommended levels. They were slightly below the current Department of Health and Social Security (DHSS; 1979) recommended intakes. Over the 2-year period, the energy intake of the boys increased by 13% compared with an increase of only 7% in the girls. The iron and vitamin A intakes of all groups of children were low compared with current recommendations (DHSS, 1979). This seems to be a result of falling energy intake. Mean calcium intakes were also only marginally in excess of the recommended intake, and those of most of the girls would fall below the recommendation if the proposal to end the fortification of flour (DHSS, 1981) is implemented. PMID:6317011

  7. Procedural Metacognition and False Belief Understanding in 3- to 5-Year-Old Children

    PubMed Central

    Bernard, Stéphane; Proust, Joëlle; Clément, Fabrice

    2015-01-01

    Some studies, so far limited in number, suggest the existence of procedural metacognition in young children, that is, the practical capacity to monitor and control one’s own cognitive activity in a given task. The link between procedural metacognition and false belief understanding is currently under theoretical discussion. If data with primates seem to indicate that procedural metacognition and false belief understanding are not related, no study in developmental psychology has investigated this relation in young children. The present paper aims, first, to supplement the findings concerning young children’s abilities to monitor and control their uncertainty (procedural metacognition) and, second, to explore the relation between procedural metacognition and false belief understanding. To examine this, 82 3- to 5-year-old children were presented with an opt-out task and with 3 false belief tasks. Results show that children can rely on procedural metacognition to evaluate their perceptual access to information, and that success in false belief tasks does not seem related to success in the task we used to evaluate procedural metacognition. These results are coherent with a procedural view of metacognition, and are discussed in the light of recent data from primatology and developmental psychology. PMID:26517260

  8. EFFECTS OF PRENATAL METHAMPHETAMINE EXPOSURE ON BEHAVIORAL AND COGNITIVE FINDINGS AT 7.5 YEARS

    PubMed Central

    Diaz, Sabrina D.; Smith, Lynne M.; LaGasse, Linda L.; Derauf, Chris; Newman, Elana; Shah, Rizwan; Arria, Amelia; Huestis, Marilyn A.; Grotta, Sheri Della; Dansereau, Lynne M.; Neal, Charles; Lester, Barry M.

    2014-01-01

    Objective To examine child behavioral and cognitive outcomes after prenatal exposure to methamphetamine. Study design 412 mother-infant pairs (204 methamphetamine-exposed and 208 unexposed matched comparisons) were enrolled in the Infant Development, Environment and Lifestyle (IDEAL) study. The 151 children exposed to methamphetamine and 147 comparisons who attended the 7.5 year visit were included. Exposure was determined by maternal self-report and/or positive meconium toxicology. Maternal interviews assessed behavioral and cognitive outcomes using the Conner’s Parent Rating Scale – Revised: Short Form (CPRS-R:S). Results After adjusting for covariates, children exposed to methamphetamine had significantly higher cognitive problems subscale scores than comparisons and were 2.8 times more likely to have cognitive problems scores that were above average on the CPRS-R:S No association between prenatal methamphetamine exposure and behavioral problems, measured by the oppositional, hyperactivity and ADHD Index subscales, were found. Conclusion Prenatal methamphetamine exposure was associated with increased cognitive problems which may impact academic achievement and lead to increased negative behavioral outcomes. PMID:24630350

  9. Characterization of corrosion products from atmospheric exposures for up to 5 years

    SciTech Connect

    Hernandez, L.S.; Miranda, J.M.; Narvaez, L.; Garcia, G.

    1998-12-31

    Four metallic materials of economic significance were exposed to an urban atmosphere up to five years. These materials were low carbon steel, zinc (as galvanized steel), copper and aluminum all of commercial quality. The corrosion rate was measured after 1, 2, 3 and 5 years using a weight loss method. Sulfur dioxide deposition rate and climatological parameters were determined monthly. At the same time, different techniques were used to characterize the corrosion products developed on the above materials. Results obtained by polarization resistance technique (Rp) in a 0.1 M Na{sub 2}SO{sub 4} solution revealed that, the longer the exposure time, the greater the corrosion products protection, as result of broadening and compactness of such products, this was verified by scanning electron microscopy (SEM). Through x-rays diffraction (XRD), the expected crystalline compounds on steel and copper were identified and also, the transformation of middling protective initial products into other more protective was followed. For aluminum and zinc it was not possible to identify the crystalline compounds perhaps due to the very thin corrosion products layers. So, these materials were analyzed by means of Raman spectroscopy. a-Al{sub 2}O, was identified on an aluminum sample whereas on zinc any corrosion product could not be identified due to excessive fluorescence.

  10. Growth of tumor-infiltrating lymphocytes from human solid cancers: summary of a 5-year experience.

    PubMed

    Yannelli, J R; Hyatt, C; McConnell, S; Hines, K; Jacknin, L; Parker, L; Sanders, M; Rosenberg, S A

    1996-02-01

    Between 1989 and 1993, 255 tumor biopsies representing 4 tumor histologies (melanoma, breast cancer, colon cancer and renal cell cancer) were received by the Surgery Branch of the National Cancer Institute. Tumor-infiltrating lymphocytes (TIL) were grown from single-cell suspensions of tumor biopsies over the course of 30-45 days. The TIL were grown in medium containing IL-2. To obtain numbers suitable for therapy (>10(11)), TIL were expanded using a large-scale system of cell culture and harvesting. While the largest number of biopsies was obtained from melanoma patients, TIL were successfully grown from 160 of 255 tumor biopsies representing all 4 histologies. Under the culture conditions employed, several characteristics of TIL expansion were observed. The cell surface phenotype of TIL which grew out from the tumor biopsies was generally a mix of CD3+/CD4+ or CD3+/CD8+ lymphocytes. Only TIL from melanoma biopsies were found to be consistently cytolytic and, in many cases, lysed autologous tumor cells preferentially. Interestingly, TIL derived from extra-nodal sites of metastatic melanoma biopsies (subcutaneous, lung, bowel; 36 of 67, 54%) were more likely to have these cytolytic characteristics than TIL derived from tumor-involved lymph node biopsies (7 of 39, 18%). The present study summarizes 5 years of laboratory effort and validates the technologies developed for the large-scale growth and harvesting of TIL. In addition, it summarizes the laboratory effort supporting previously published clinical reports on TIL from our group. PMID:8621219

  11. Municipal solid waste management in Tehran: Changes during the last 5 years.

    PubMed

    Malmir, Tahereh; Tojo, Yasumasa

    2016-05-01

    The situation of waste management in Tehran was a typical example of it in developing countries. The amount of municipal solid waste has been increasing and the city has depended on landfill for municipal solid waste management. However, in recent years, various measures have been taken by the city, such as collecting recyclables at the source and increasing the capacity of waste-processing facilities. As a result, significant changes in the waste stream are starting to occur. This study investigated the nature of, and reasons for, the marked changes in the waste stream from 2008 to 2012 by analysing the municipal solid waste statistics published by the Tehran Waste Management Organization in 2013 and survey data on the physical composition of the municipal solid waste. The following trends were identified: Although the generation of municipal solid waste increased by 10% during the 5-year period, the amount of waste directly disposed of to landfill halved and resource recovery almost doubled. An increase in the capacity of a waste-processing facility contributed significantly to these changes. The biodegradable fraction going to landfill was estimated by using the quantity and the composition of each input to the landfill. The estimated result in 2012 decreased to 49% of its value in 2008. PMID:26922086

  12. Results of proximal gastric vagotomy over 1-5 years in a district general hospital.

    PubMed

    Makey, D A; Tovey, F I; Heald, R J

    1979-01-01

    One hundred and seventy-three underwent proximal gastric vagotomy for duodenal ulceration over a 6-year period. One hundred and fifteen of these have been followed up for 1-5 years. The operative mortality was nil and the result was satisfactory in 91 per cent. The incidence of side effects was small, notably that of dumping being 2.4 per cent and of diarrhoea, 3.6 per cent. Incidence of postoperative heartburn was reduced from 13 per cent to 4 per cent by the introduction of hepatic interposition. The incidence of recurrent ulceration was 5.1 per cent after an average interval of 2 years and that of new gastric ulceration 2.6 per cent after an average of 4 years. There were no recurrent ulcers in those who had peroperative Burge tests, although secretory studies showed no difference between those tested and those not tested. Most recurrences occurred in the earliest cases operated on before Burge testing was introduced and when only 2 cm of the lower oesophagus were exposed. PMID:420970

  13. Dimensionality and Reliability of Letter Writing in 3- to 5-Year-Old Preschool Children

    PubMed Central

    Puranik, Cynthia S.; Petscher, Yaacov; Lonigan, Christopher J.

    2015-01-01

    The primary purpose of this study was to examine the dimensionality and reliability of letter writing skills in preschool children with the aim of determining whether a sequence existed in how children learn to write the letters of the alphabet. Additionally, we examined gender differences in the development of letter writing skills. 471 children aged 3 to 5 years old completed a letter writing task. Results from factor analyses indicated that letter writing represented a unidimensional skill. Similar to research findings that the development of letter-names and letter-sound knowledge varies in acquisition, our findings indicate that the ability to write some letters is acquired earlier than the ability to write other letters. Although there appears to be an approximate sequence for the easiest and most difficult letters, there appears to be a less clear sequence for letters in the middle stages of development. Overall, girls had higher letter writing scores compared to boys. Gender differences regarding difficulty writing specific letters was less conclusive; however, results indicated that when controlling for ability level, girls had a higher probability of writing a letter correctly than boys. Implications of these findings for the assessment and instruction of letter writing are discussed. PMID:26346443

  14. The South American Land Data Assimilation System (SALDAS) 5-Year Retrospective Atmospheric Forcing Datasets

    NASA Technical Reports Server (NTRS)

    deGoncalves, Luis Gustavo G.; Shuttleworth, William J.; Vila, Daniel; Larroza, Elaine; Bottino, Marcus J.; Herdies, Dirceu L.; Aravequia, Jose A.; De Mattos, Joao G. Z.; Toll, David L.; Rodell, Matthew; Houser, Paul

    2008-01-01

    The definition and derivation of a 5-year, 0.125deg, 3-hourly atmospheric forcing dataset for the South America continent is described which is appropriate for use in a Land Data Assimilation System and which, because of the limited surface observational networks available in this region, uses remotely sensed data merged with surface observations as the basis for the precipitation and downward shortwave radiation fields. The quality of this data set is evaluated against available surface observations. There are regional difference in the biases for all variables in the dataset, with biases in precipitation of the order 0-1 mm/day and RMSE of 5-15 mm/day, biases in surface solar radiation of the order 10 W/sq m and RMSE of 20 W/sq m, positive biases in temperature typically between 0 and 4 K, depending on region, and positive biases in specific humidity around 2-3 g/Kg in tropical regions and negative biases around 1-2 g/Kg further south.

  15. The results of photorefractive keratectomy with Mitomycin-C in myopia correction after 5 years

    PubMed Central

    Hashemi, Masih; Amiri, Mohammad Aghazadeh; Tabatabaee, Mehdi; Ayatollahi, Ali

    2016-01-01

    Objective: To evaluate the results of photorefractive keratectomy (PRK) with mitomycin C in myopia correction after five years. Methods: This is a cross sectional study which included 145 eyes of 74 patients in 18 to 51 years age group that were undergoing Photorefractive keratectomy with mitomycin C using Allegretto Wave Eye-Q 400-Hz excimer laser platform in Markazi Eye Center, Tehran, Iran. All the surgical procedures were performed by the same surgeon. After five years follow-up evaluation including BCVA, UCVA, Refractive error measurement and external eye examination was performed. Results: The mean diopter of spherical equivalent before surgery was -3.40±1.73. The following findings were obtained after 5 years follow up visit: The mean spherical equivalent value: -0.08±0.40, the mean: Log MARUCVA: 0.02±0.07, the mean Log MAR BCVA: 0.00±0.04. Conclusion: PRK is an effective, safe and predictable method used to correct myopia. The wave front-optimized algorithm of the Allegretto Wave Eye-Q 400-Hz excimer laser platform demonstrated good refractive and visual results. Presence of variables such as gender, age and astigmatism before operation have no significant impact on the result of this operation. PMID:27022380

  16. LC-MS/MS in endocrinology: what is the profit of the last 5 years?

    PubMed

    Ackermans, Mariëtte Theodora; Endert, Erik

    2014-01-01

    Currently, chromatography (GC but more commonly HPLC) is the analytical method of choice for several hormones, either because the immunoassays suffer from extensive crossreactivity or because chromatography permits simultaneous measurements of hormones. However, sometimes the conventional detection systems with HPLC methods do not meet desired specificity. With the increase of robust and affordable LC-MS/MS systems, the next step forward in specificity was taken. LC-MS/MS is rapidly being incorporated in the endocrine laboratories. To be useful in the clinical diagnostic practice, it is of utmost importance that methods are both analytically and clinically vaidated, as until now, the majority of applications of LC-MS/MS in the clinical laboratories are 'home-made' methods, therefore special case must be taken. This review aims to focus on Clinical and Laboratory Standards Institute or comparable validated LC-MS/MS methods for targeted hormone analysis used for diagnostic purposes in human samples, published in the last 5 years. PMID:24341494

  17. Who Stays and Who Leaves? Father Accessibility Across Children's First 5 Years.

    PubMed

    Shannon, Jacqueline D; Cabrera, Natasha J; Tamis-Lemonda, Catherine; Lamb, Michael E

    2009-01-01

    OBJECTIVE: This longitudinal investigation examines whether fathers' prenatal involvement (e.g., attending doctor appointments and discussing pregnancy with mother) and residence status at infant's birth predict the first time a father becomes inaccessible to his child (defined as seeing child fewer than a few times per month) at six developmental time points in children's first 5 years. DESIGN: Data were gathered from 2,160 ethnically diverse mothers (i.e., European American, African American, and Latin American) who participated in the National Early Head Start Research and Evaluation Project. Survival analysis was used to predict the timing of father inaccessibility based on interviews. RESULTS: By prekindergarten, fathers' residence at birth and prenatal involvement decreased their risk of being inaccessible to their children for the first time by 71% and 47%, respectively, after adjusting for all other variables in the model. Residence at birth was a stronger predictor of the timing of father inaccessibility than was prenatal involvement for European American and Latin American fathers; for African American fathers, prenatal involvement was a stronger predictor of the timing of father inaccessibility than nonresidential status at birth. Nearly 65% of fathers who were engaged in both prenatal activities remained consistently accessible to their child through child age of 63 months, whereas nearly 50% of fathers who were not prenatally involved were already inaccessible by the time infants were 3 months. CONCLUSION: These findings have implications for early intervention programs aimed at strengthening the role of fathers in their families from the prenatal period. PMID:20333276

  18. Facebook as a medium for promoting statement of intent for organ donation: 5-years of experience.

    PubMed

    Brzeziński, Michał; Klikowicz, Paweł

    2015-01-01

    The number of potential registered organ donors does not cover the actual demand in most developed countries. Therefore, methods increasing awareness and interest in organ donation, including modern tools of social marketing, are being researched worldwide. The aim of this paper is to present our 5-year experiences with a Facebook networking campaign - the Dawca.pl Club. The mission of the campaign is to raise awareness and educate Polish society on tissue, cell, and organ transplants, to increase public acceptance for transplants as a treatment method, and to increase the number of voluntary donors signing consents for organ donation. The project is based on the idea of creating a community promoting transplantation, focused around the Dawca.pl Club. At present the club has over 48,000 registered members - people who declared willingness to donate their organs after death. We present a description of members of this social networking service, the possibilities of using it to promote transplants and organ donation, and the efficacy of selected schemes for creating and publishing content on Facebook. The example of Dawca.pl shows that 2-way relations, spread over time, are required for social media to effectively engage and exert influence in a chosen sphere of public health and medicine. Unfortunately, at this time it is difficult to assess how such campaigns, apart from raising social awareness and acceptance, will affect the number of transplantations of organs from living and deceased donors. PMID:25761524

  19. The use of modern quality improvement approaches to strengthen African health systems: a 5-year agenda.

    PubMed

    Heiby, James

    2014-04-01

    There is a growing international consensus that African health systems need to improve, but no agreement on how to accomplish this. From the perspective of modern quality improvement (QI), a central issue for low performance in these health systems is the relative neglect of health-care processes. Both health system leaders and international donors have focused their efforts elsewhere, producing noteworthy health gains. But these gains are at risk if health systems do not develop the capacity to study and improve care processes. Substantial experience with QI in Africa shows impressive potential for broad-based process improvement. But this experience also highlights the need for modifying these growing programs to incorporate a more rigorous learning component to address challenges that have emerged recently. The addition of a region-wide knowledge management program could increase the efficiency of each country's QI program by learning from the experiences of other programs. With a coordinated donor initiative, it is reasonable to project that within 5 years, evidence-based improvement will become a norm in health services, and African health systems will approach the model of a learning organization. PMID:24481053

  20. Residual strength of repaired graphite/epoxy laminates after 5 years of outdoor exposure

    NASA Technical Reports Server (NTRS)

    Deaton, Jerry W.

    1990-01-01

    The NASA Langley Research Center has sponsored research to develop generic repair techniques and processes for advanced graphite/epoxy (Gr/Ep) composites applicable to secondary structures for commercial transport aircraft. The long-term durability of such repairs is being addressed in a 10-year outdoor exposure program at the Langley Research Center. Details of the program and results of residual strength tests after 5 years of outdoor exposure are presented. Four repair methods are being evaluated. These include: (1) externally bolted aluminum-plus adhesive; (2) precured, bonded external Gr/Ep; (3) cure-in-place external Gr/Ep; and (4) cure-in-place flush Gr/Ep. Repaired specimens as well as undamaged and damaged unrepaired controls are being exposed outdoors for 1, 3, 5, 7, and 10 years. The residual tensile strength of stressed, unstressed, and fatigue specimens from each group is reported and compared with the tensile strength of baseline specimens which received no outdoor exposure. Identification of the commercial products and companies is used to describe adequately the test materials. The identification of these commercial products does not constitute endorsement, expressed or implied, of such products by the National Aeronautics and Space Administration.

  1. Improving executive function in childhood: evaluation of a training intervention for 5-year-old children.

    PubMed

    Traverso, Laura; Viterbori, Paola; Usai, Maria Carmen

    2015-01-01

    Executive function (EF) refers to a set of higher order cognitive processes that control and modulate cognition under continuously changing and multiple task demands. EF plays a central role in early childhood, is associated and predictive of important cognitive achievements and has been recognized as a significant aspect of school readiness. This study examines the efficacy of a group based intervention for 5-year-old children that focuses on basic components of EF (working memory, inhibitory control, cognitive flexibility). The intervention included 12 sessions, lasted 1 month and used low-cost materials. Seventy-five children took part in the study. The results indicate that the children who attended the intervention outperformed controls in simple and more complex EF tasks. Specifically, these children exhibited increased abilities to delay gratification, to control on-going responses, to process and update information, and to manage high cognitive conflict. These results suggest the possibility that this intervention, which may be easily implemented in educational services, can promote EF during preschool period before the entrance in primary school. PMID:25983706

  2. Diarrhea Prevalence, Care, and Risk Factors Among Poor Children Under 5 Years of Age in Mesoamerica.

    PubMed

    Colombara, Danny V; Hernández, Bernardo; McNellan, Claire R; Desai, Sima S; Gagnier, Marielle C; Haakenstad, Annie; Johanns, Casey; Palmisano, Erin B; Ríos-Zertuche, Diego; Schaefer, Alexandra; Zúñiga-Brenes, Paola; Zyznieuski, Nicholas; Iriarte, Emma; Mokdad, Ali H

    2016-03-01

    Care practices and risk factors for diarrhea among impoverished communities across Mesoamerica are unknown. Using Salud Mesoamérica Initiative baseline data, collected 2011-2013, we assessed the prevalence of diarrhea, adherence to evidence-based treatment guidelines, and potential diarrhea correlates in poor and indigenous communities across Mesoamerica. This study surveyed 14,500 children under 5 years of age in poor areas of El Salvador, Guatemala, Mexico (Chiapas State), Nicaragua, and Panama. We compared diarrhea prevalence and treatment modalities using χ(2) tests and used multivariable Poisson regression models to calculate adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) for potential correlates of diarrhea. The 2-week point prevalence of diarrhea was 13% overall, with significant differences between countries (P < 0.05). Approximately one-third of diarrheal children were given oral rehydration solution and less than 3% were given zinc. Approximately 18% were given much less to drink than usual or nothing to drink at all. Antimotility medication was given to 17% of diarrheal children, while antibiotics were inappropriately given to 36%. In a multivariable regression model, compared with children 0-5 months, those 6-23 months had a 49% increased risk for diarrhea (aRR = 1.49, 95% CI = 1.15, 1.95). Our results call for programs to examine and remedy low adherence to evidence-based treatment guidelines. PMID:26787152

  3. ‘Workshops in healing’ for senior medical students: a 5-year overview and appraisal

    PubMed Central

    Kearsley, John H; Lobb, Elizabeth A

    2014-01-01

    We report upon the design, content and feedback from an interactive, experiential series of Workshops in Healing for senior medical students. Fifty-six final year medical students enrolled in 2×3 h workshops designed around the core themes of ‘physician know thyself’ (Workshop 1) and ‘confronting suffering’ (Workshop 2). Of the 56 students who initially enrolled, 48 students completed both workshops and provided a written open-ended reflection of their learning experience. The study, undertaken over a consecutive 5-year period (2008–2012), employed an emergent, qualitative design using thematic analysis of the reflective comments. We found that the design and content of both workshops promoted transformative learning for these final year medical students. Students identified the following benefits: (1) the opportunity to reaffirm their commitment to their chosen career path; (2) the value of listening to other students share their stories; (3) the importance of the timing of the workshops to occur after exams; (4) the use of various mediums such as art, poetry, music and contemporary/classic literature to present concepts of suffering and healing; and (5) the creation of a safe and confidential space. Students reported that these innovative workshops gave them a renewed sense of drive and enthusiasm for their chosen career. They highlighted the importance of addressing an aspect of medicine (healing) not covered in the traditional medical curriculum. Workshops in Healing helped them to rediscover a deeper meaning to medicine and their roles as future healthcare professionals. PMID:24473159

  4. Caustic Agent Ingestion by a 1.5-Year-Old Boy.

    PubMed

    Gharib, Behdad; Mohammadpour, Masoud; Yaghmaie, Bahareh; Sharifzadeh, Meisam; Mehdizadeh, Mehrzad; Zamani, Fatemeh; Edalatkhah, Rouhollah; Mohsenipour, Reihaneh

    2016-07-01

    We present a case of caustic ingestion by a 1.5-year-old boy. The caustic agent was drain opener which is a strong alkaline substance. Children in Iran and many other countries are still exposed to not "child proof" (child resistant packaging) toxic substance containers. Ingestion of caustic agents may lead to necrosis, perforation, and strictures. Substances that are ingested more frequently are liquid alkali material which causes severe, deep liquefaction necrosis. Common signs and symptoms of caustic agents are vomiting, drooling, refusal to drink, oral burns, stridor, hematemesis, dyspnea, dysphagia and abdominal pain. Even if no oropharyngeal lesion is seen, a significant esophageal injury which can lead to perforation and stricture cannot be ruled out. If abdominal pain or rigidity, substernal, chest or back pain exists, visceral perforation should be considered. The first thing to be checked is airway assessment. A lot of patients should be admitted to intensive care unit, and endoscopic evaluation, surgical intervention, long-term hospitalization, and worsening quality of life or among the complications. Preventive measures especially at the country level and approving proper legislation for obligating the related industries to produce child proof containers for house hold toxic products are the urgent measures to be followed by all of us. PMID:27424019

  5. Epidemiology and mortality of burns in the Lucknow Region, India--a 5 year study.

    PubMed

    Kumar, Sachil; Ali, Wahid; Verma, Anoop K; Pandey, Abhishek; Rathore, Shiuli

    2013-12-01

    Nearly 95% of global burn deaths and disabilities are estimated to occur in low and middle income countries of the world. Burns are extremely common and are a major public health problem in a developing country like India. The purpose of this study was to record and evaluate the causes and the magnitude of the fatal burns retrospectively. An analysis of autopsy records revealed 2225 (10.7%) cases of burns among the total autopsies done over 5 years period (1st January 2008-27th November 2012) in the mortuary of Forensic Medicine & Toxicology, K.G.M.U., Lucknow. The majority of deaths (88.8%) occurred between 10 and 49 years of age group with a preponderance of females (87.5%). The flame burns were seen in 60.1% of the victims. The majority of burn incidents were suicidal (38.6%) in nature followed by accidental (37.3%) and homicidal (24.1%) deaths. The percentages of burns with a total body surface area (TBSA) over 50% were observed in most of the cases (82.5%). In most of the cases deaths occurred within a week (82%) and most of the victims died from septicaemia and pneumonia (43.7%) followed by neurogenic shock (28.5%). The results of this study provide the necessary information to implement programmes for health education relating to prevention of burns focusing on the domestic setting. PMID:23663899

  6. A 5-year follow-up study of an atypical case of myotonic dystrophy.

    PubMed

    Macniven, J A B; Graham, N L; Davies, R R; Wilson, B A

    2005-12-20

    This study presents 5-year follow-up data on NG, a woman with adult onset myotonic dystrophy and progressive cognitive decline who was first described by Wilson et al. The extent of the cognitive impairment is atypical of symptom-onset in adulthood and of paternal inheritance, both of which apply to this case. Together, the present and earlier studies report the results of regular neuropsychological assessments over a 16-year period. Severe impairment in executive functioning, episodic and semantic memory were apparent early in the history, while visuospatial skills and working memory were only mildly impaired after 16 years of follow-up. There was also a progressive dyslexia, initially characterized by the regularization errors typical of surface dyslexia, but subsequently dominated by visual/phonological reading errors. This pattern of impairment is not typical of myotonic dystrophy but resembles semantic dementia. Whilst the deficits may be attributable wholly to myotonic dystrophy pathology, the co-existence of a form of semantic dementia is also possible. It is noted that the aggregation of tau protein is a neuropathological feature common to both diseases. PMID:16286337

  7. Friability and aggregate stability of loamy soil after 5 years of biochar application

    NASA Astrophysics Data System (ADS)

    Utomo, Wani; Ganika, Shaory; Wisnubroto, Erwin; Islami, Titiek

    2016-04-01

    The effect of biochar application on soil friability and aggregate stability of loamy soil was studied at Brawijaya University field experimental station, Jatikerto, Malang, Indonesia. The soil has been planted with cassava for 4 years continuously and 1 year planted with maiz. The biochar applied was made from cassava stem and farm yard manure. It was found that biochar application, either made from cassava stem or farm yard manure improved soil qualities. Soil applied with biochar was more friable compared to that of the no biochar soil, although biochar application did not influence Atterberg limits. It seems that the higher friability of biochar applied soil was associated with the higher soil organic matter. It was found that until 5 years application, the biochar treated soil had a higher soil organic matter content. Soil applied with biochar possessed a better soil aggregate stability, both dry and wet stability. This was shown by the higher aggregate mean weight diameter (MWD) of biochar applied soil. The cassava biochar applied soil had MWD of 2.22 mm (dry stability) and 1.56 mm (wet stability), whereas the control soil had MWD of 1.45 mm (dry stability) and 1.25 (wet stability). There was a significant positive correlation between soil friability and dry aggregate stability. The biochar applied soils also had higher soil permeability. Key words: soil qualities, soil physical properties, Atterberg limits, hydraulic conductivity

  8. Translating weight loss into agency: Men's experiences 5 years after bariatric surgery

    PubMed Central

    Natvik, Eli; Gjengedal, Eva; Moltu, Christian; Råheim, Målfrid

    2015-01-01

    Fewer men than women with severe obesity undergo bariatric surgery for weight loss, and knowledge about men's situation after surgery, beyond medical status, is lacking. Our aim was to explore men's experiences with life after bariatric surgery from a long-term perspective. We conducted in-depth interviews with 13 men, aged 28–60 years, between 5 and 7 years after surgery. The analysis was inspired by Giorgi's phenomenological method. We found that agency was pivotal for how the men understood themselves and their lives after surgery. Weight loss meant regaining opportunities for living and acting in unrestricted and independent daily lives, yet surgery remained a radical treatment with complex consequences. Turning to surgery had involved conceptualizing their own body size as illness, which the men had resisted doing for years. After surgery, the rapid and major weight loss and the feelings of being exhausted, weak, and helpless were intertwined. The profound intensity of the weight loss process took the men by surprise. Embodying weight loss and change involved an inevitable renegotiating of experiences connected to the large body. Having bariatric surgery was a long-term process that seemed unfinished 5 years after surgery. Restrictions and insecurity connected to health and illness persist, despite successful weight loss and embodied change. Bariatric surgery initiated a complex and long-lasting life-changing process, involving both increased capacity for agency and illness-like experiences. PMID:26066518

  9. METEO in the TALNET project after 5 years - meteorology for talented high schools students

    NASA Astrophysics Data System (ADS)

    Pisoft, P.; Miksovsky, J.

    2010-09-01

    TALNET is a project aiming to systematically identify and work with gifted youth (13-19 years). Specifically, it applies online educational activities combined with face to face activities. It has been organised by the Faculty of Maths and Physics (MFF) of Charles University in Prague (UK) and National Institute for Youth (NIDM) since 2003, later in cooperation with other faculties, e.g. Natural Sciences (PrF UK), universities and science and research institutes in the Czech Republic and abroad, e.g. DLR, Germany. Topics of the educational activities come from natural sciences (such as physics, astronomy, biology, chemistry, meteorology etc.) and mathematics. The presented project's part METEO embraces lessons primarily focused on basics of meteorology and atmospheric physics in general and it has been part of the Talnet project for 5 years. The meteorological lectures consist of description of, e.g., climate system, meteorological quantities, weather forecasting, ozone and the stratosphere, climate change or atmospheric optics. On top of the lectures, the students are encouraged to work on enclosed homework such as meteorological time series analysis, clouds observation and classification, halo simulation and so on. The METEO course lasts one semester and the students make their seminar thesis at the end. The presented materials will consist of examples of the contemporary lectures and their organization, homeworks or seminar theses.

  10. Recurrent pretibial ganglion cyst formation over 5 years after anterior cruciate ligament reconstruction.

    PubMed

    Sekiya, Jon K; Elkousy, Hussein A; Fu, Freddie H

    2004-03-01

    Although ganglion cysts of the anterior cruciate ligament have been described in the literature, they are a relatively rare phenomenon. Cyst formation after anterior cruciate ligament reconstruction is even less frequent, with only a few reported cases. The proposed etiology of these cysts has been attributed to a number of causes, including the use of bioabsorbable screws, Gore-Tex (W. L. Gore and Associates, Flagstaff, AZ) grafts, extra-articular fluid extravasation secondary to direct tibial tunnel communication, allografts with or without ethylene oxide sterilization, and the use of nonabsorbable suture. We report an unusual case of a recurrent pretibial ganglion cyst that initially formed more than 5 years after an anterior cruciate ligament reconstruction and recurred 2 years after resection of the mass. We believe the initial surgical resection was unsuccessful probably because the foreign body irritant was not identified. Only after resection of the entire stalk of the cyst and removal of all of the inciting suture material that was found near the entrance of the tibial tunnel were we able to definitively eradicate the ganglion cyst. PMID:15007323

  11. Towson University's Professional Science Master's Program in Applied Physics: The first 5 years

    NASA Astrophysics Data System (ADS)

    Kolagani, Rajeswari

    It is a well-established fact that the scientific knowledge and skills acquired in the process of obtaining a degree in physics meet the needs of a variety of positions in multiple science and technology sectors. However, in addition to scientific competence, challenging careers often call for skills in advanced communication, leadership and team functions. The professional science master's degree, which has been nick-named as the `Science MBA', aims at providing science graduates an edge both in terms of employability and earning levels by imparting such skills. Our Professional Science Master's Program in Applied Physics is designed to develop these `plus' skills through multiple avenues. In addition to advanced courses in Applied Physics, the curriculum includes graduate courses in project management, business and technical writing, together with research and internship components. I will discuss our experience and lessons learned over the 5 years since the inception of the program in 2010. The author acknowledges support from the Elkins Professorship of the University System of Maryland.

  12. 'Workshops in healing' for senior medical students: a 5-year overview and appraisal.

    PubMed

    Kearsley, John H; Lobb, Elizabeth A

    2014-12-01

    We report upon the design, content and feedback from an interactive, experiential series of Workshops in Healing for senior medical students. Fifty-six final year medical students enrolled in 2×3 h workshops designed around the core themes of 'physician know thyself' (Workshop 1) and 'confronting suffering' (Workshop 2). Of the 56 students who initially enrolled, 48 students completed both workshops and provided a written open-ended reflection of their learning experience. The study, undertaken over a consecutive 5-year period (2008-2012), employed an emergent, qualitative design using thematic analysis of the reflective comments. We found that the design and content of both workshops promoted transformative learning for these final year medical students. Students identified the following benefits: (1) the opportunity to reaffirm their commitment to their chosen career path; (2) the value of listening to other students share their stories; (3) the importance of the timing of the workshops to occur after exams; (4) the use of various mediums such as art, poetry, music and contemporary/classic literature to present concepts of suffering and healing; and (5) the creation of a safe and confidential space. Students reported that these innovative workshops gave them a renewed sense of drive and enthusiasm for their chosen career. They highlighted the importance of addressing an aspect of medicine (healing) not covered in the traditional medical curriculum. Workshops in Healing helped them to rediscover a deeper meaning to medicine and their roles as future healthcare professionals. PMID:24473159

  13. French brain tumor database: 5-year histological results on 25 756 cases.

    PubMed

    Rigau, Valérie; Zouaoui, Sonia; Mathieu-Daudé, Hélène; Darlix, Amélie; Maran, Aurélie; Trétarre, Brigitte; Bessaoud, Faiza; Bauchet, Fabienne; Attaoua, Redha; Fabbro-Peray, Pascale; Fabbro, Michel; Kerr, Christine; Taillandier, Luc; Duffau, Hugues; Figarella-Branger, Dominique; Costes, Valérie; Bauchet, Luc

    2011-11-01

    This work aimed to prospectively record all primary central nervous system tumor (PCNST) cases in France, for which histological diagnosis is available. The objectives were to (i) create a national registry and a network to perform epidemiological studies; (ii) implement clinical and basic research protocols; and (iii) harmonize the health care of patients affected by PCNST. For 5 years, 25 756 cases of newly diagnosed and histologically confirmed PCNST have been recorded. Histological diagnoses included glioma (48.9%), all other neuroepithelial tumors (5%), meningioma (28.8%), nerve sheath tumors (8.4%), lymphoma (3.2%) and others (5.7%). Cryopreservation was reported for 6018 PCNST specimens. Tumor resections (R) were performed in 78% cases, while biopsies accounted for 22%. Median age (MA), sex, percentage R and number of cryopreserved tumors were detailed for each histology; for example, out of 6053 glioblastomas (MA 63 years, male 59.4%, R 62%, 1611 were cryopreserved), and out of 37 atypical teratoid/rhabdoid tumors (MA 2 years, male 56.8%, R 94%, 17 were cryopreserved). This database or databank dedicated to PCNST cases contains detailed data on clinical, histological and other characteristics, such as the inclusion of data on cryopreserved specimens that are not available in other European registries. Therefore, this is a valuable resource that can be used for planning future epidemiological and clinical research. PMID:21554472

  14. Research from the Model Spinal Cord Injury Systems: findings from the current 5-year grant cycle.

    PubMed

    Lammertse, Daniel P; Jackson, Amie B; Sipski, Marca L

    2004-11-01

    This issue of the Archives of Physical Medicine and Rehabilitation is dedicated to current research findings of the Model Spinal Cord Injury Systems (MSCIS) program. The MSCIS grants were established by the Rehabilitation Services Administration in the 1970s. Now administered by the National Institute on Disability and Rehabilitation Research within the Office of Special Education and Rehabilitation Services in the US Department of Education, the program has included 27 spinal cord injury centers in the United States over the years. In the current 5-year grant cycle (2000-2005), there are 16 designated regional MSCIS centers. In addition to establishing a comprehensive system of care, the grantees contribute patient data to the National Spinal Cord Injury Database (which now contains data on 30,532 subjects with follow-up of up to 30 y). In addition, the MSCIS grants enable the conduct of site-specific and collaborative research projects. To highlight the research findings of the program, the MSCIS have produced a special dissemination effort during each of the previous 5 grant cycles, with this issue of the Archives representing the latest of these endeavors. This article provides a brief history of the MSCIS program and highlights the important findings of the 17 original research articles contained in this issue. PMID:15520967

  15. Bilateral, tumorlike diabetic mastopathy-progression and regression of the disease during 5-year follow up.

    PubMed

    Bayer, U; Horn, L C; Schulz, H G

    1998-02-01

    Diabetic mastopathy is a recently described collection of radiographical and histological features found in dense fibrous masses of the breast in long standing Type I diabetes. We describe the first case of bilateral disease with the alternate progression and regression of the disease over a 5 year period. A 45-year-old woman has been affected of insulin dependent diabetes mellitus (IDDM) for 21 years. She developed palpable mass retromamillar of the right side, indistinguishable radiographically from cancer. The histology showed a diabetic mastopathy (DMP) with B-lymphocytic ductitis and lobulitis, a discrete monocellular vasculitis and a keloid-like fibrosis. After 22 months she developed a suspicious palpable mass contralateral on the left side. The FNAB presented an identical morphology on histology. Additionally 10 months later there were no palpable masses of both mammae. Mammographically no suspect alterations were observed. One year later the clinical and mammographical examination showed similar findings, mentioned before. The pathogenesis is still obscure and includes the hypothesis of extracellular accumulation, secondary to prolonged hyperglycemia in IDDM, production of alternated non-enzymatic glycosylated end products with neoantigen formation, B cell predominant inflammation with autoimmune response against neoantigens and cytokine release secondary to the autoimmune response. PMID:9587750

  16. Improving executive function in childhood: evaluation of a training intervention for 5-year-old children

    PubMed Central

    Traverso, Laura; Viterbori, Paola; Usai, Maria Carmen

    2015-01-01

    Executive function (EF) refers to a set of higher order cognitive processes that control and modulate cognition under continuously changing and multiple task demands. EF plays a central role in early childhood, is associated and predictive of important cognitive achievements and has been recognized as a significant aspect of school readiness. This study examines the efficacy of a group based intervention for 5-year-old children that focuses on basic components of EF (working memory, inhibitory control, cognitive flexibility). The intervention included 12 sessions, lasted 1 month and used low-cost materials. Seventy-five children took part in the study. The results indicate that the children who attended the intervention outperformed controls in simple and more complex EF tasks. Specifically, these children exhibited increased abilities to delay gratification, to control on-going responses, to process and update information, and to manage high cognitive conflict. These results suggest the possibility that this intervention, which may be easily implemented in educational services, can promote EF during preschool period before the entrance in primary school. PMID:25983706

  17. Prenatal Drug Exposure: Effects on Cognitive Functioning at 5 Years of Age

    PubMed Central

    Pulsifer, Margaret B.; Butz, Arlene M.; Foran, Megan O’Reilly; Belcher, Harolyn M. E.

    2008-01-01

    The goal of this cross-sectional study was to compare cognitive functioning at age 5 years in prenatal drug-exposed children with nondrug-exposed children from a comparable inner-city environment. Children with prenatal drug exposure scored significantly lower on measures of language, school readiness skills, impulse control, and visual attention span/sequencing than controls matched for age and socioeconomic status. Intelligence, visual-motor, manual dexterity, and sustained attention scores were not significantly different between groups. The total sample scored significantly below the normative mean on standardized measures of intelligence, language, school readiness, visual-motor skills, impulse control, and sustained attention, with 40% scoring at least 1 standard deviation below the mean (IQ <85) on a measure of intelligence. Findings suggest that children with prenatal drug exposure are at increased risk for learning and attention problems and are in need of close developmental surveillance and possible intervention to support school success and improve behavioral outcome. PMID:17766581

  18. Improving cumulative effects assessment in Alberta: Regional strategic assessment

    SciTech Connect

    Johnson, Dallas Lalonde, Kim; McEachern, Menzie; Kenney, John; Mendoza, Gustavo; Buffin, Andrew; Rich, Kate

    2011-09-15

    The Government of Alberta, Canada is developing a regulatory framework to better manage cumulative environmental effects from development in the province. A key component of this effort is regional planning, which will lay the primary foundation for cumulative effects management into the future. Alberta Environment has considered the information needs of regional planning and has concluded that Regional Strategic Assessment may offer significant advantages if integrated into the planning process, including the overall improvement of cumulative environmental effects assessment in the province.

  19. Analysis of Memory Codes and Cumulative Rehearsal in Observational Learning

    ERIC Educational Resources Information Center

    Bandura, Albert; And Others

    1974-01-01

    The present study examined the influence of memory codes varying in meaningfulness and retrievability and cumulative rehearsal on retention of observationally learned responses over increasing temporal intervals. (Editor)

  20. Mission Availability for Bounded-Cumulative-Downtime System

    PubMed Central

    Zhou, Yu; Kou, Gang; Ergu, Daji; Peng, Yi

    2013-01-01

    In this research, a mathematics model is proposed to describe the mission availability for bounded-cumulative-downtime system. In the proposed model, the cumulative downtime and cumulative uptime are considered as constraints simultaneously. The mission availability can be defined as the probability that all repairs do not exceed the bounded cumulative downtime constraint of such system before the cumulative uptime has accrued. There are two mutually exclusive cases associated with the probability. One case is the system has not failed, where the probability can be described by system reliability. The other case is the system has failed and the cumulative downtime does not exceed the constraint before the cumulative uptime has accrued. The mathematic description of the probability under the second case is very complex. And the cumulative downtime in a mission can be set as a random variable, whose cumulative distribution means the probability that the failure system can be restored to the operating state. Giving the dependence in the scheduled mission, a mission availability model with closed form expression under this assumption is proposed. Numerical simulations are presented to illustrate the effectiveness of the proposed model. The results indicate that the relative errors are acceptable and the proposed model is effective. Furthermore, three important applications of the proposed mission availability model are discussed. PMID:23843940

  1. Standardization of the cumulative absolute velocity

    SciTech Connect

    O'Hara, T.F.; Jacobson, J.P. )

    1991-12-01

    EPRI NP-5930, A Criterion for Determining Exceedance of the Operating Basis Earthquake,'' was published in July 1988. As defined in that report, the Operating Basis Earthquake (OBE) is exceeded when both a response spectrum parameter and a second damage parameter, referred to as the Cumulative Absolute Velocity (CAV), are exceeded. In the review process of the above report, it was noted that the calculation of CAV could be confounded by time history records of long duration containing low (nondamaging) acceleration. Therefore, it is necessary to standardize the method of calculating CAV to account for record length. This standardized methodology allows consistent comparisons between future CAV calculations and the adjusted CAV threshold value based upon applying the standardized methodology to the data set presented in EPRI NP-5930. The recommended method to standardize the CAV calculation is to window its calculation on a second-by-second basis for a given time history. If the absolute acceleration exceeds 0.025g at any time during each one second interval, the earthquake records used in EPRI NP-5930 have been reanalyzed and the adjusted threshold of damage for CAV was found to be 0.16g-set.

  2. Children neglected: Where cumulative risk theory fails.

    PubMed

    O'Hara, Mandy; Legano, Lori; Homel, Peter; Walker-Descartes, Ingrid; Rojas, Mary; Laraque, Danielle

    2015-07-01

    Neglected children, by far the majority of children maltreated, experience an environment most deficient in cognitive stimulation and language exchange. When physical abuse co-occurs with neglect, there is more stimulation through negative parent-child interaction, which may lead to better cognitive outcomes, contrary to Cumulative Risk Theory. The purpose of the current study was to assess whether children only neglected perform worse on cognitive tasks than children neglected and physically abused. Utilizing LONGSCAN archived data, 271 children only neglected and 101 children neglected and physically abused in the first four years of life were compared. The two groups were assessed at age 6 on the WPPSI-R vocabulary and block design subtests, correlates of cognitive intelligence. Regression analyses were performed, controlling for additional predictors of poor cognitive outcome, including socioeconomic variables and caregiver depression. Children only neglected scored significantly worse than children neglected and abused on the WPPSI-R vocabulary subtest (p=0.03). The groups did not differ on the block design subtest (p=0.4). This study shows that for neglected children, additional abuse may not additively accumulate risk when considering intelligence outcomes. Children experiencing only neglect may need to be referred for services that address cognitive development, with emphasis on the linguistic environment, in order to best support the developmental challenges of neglected children. PMID:25869185

  3. SEVIRI Cloud mask by Cumulative Discriminant Analysis

    NASA Astrophysics Data System (ADS)

    Blasi, M. G.; Serio, C.; Masiello, G.; Venafra, S.; Liuzzi, G.

    2015-09-01

    In the context of cloud detection for satellite observations we want to use the method of Cumulative Discriminant Analysis (CDA) as a tool to distinguish between clear and cloudy sky applied to Spinning Enhanced Visible and Infrared Imager (SEVIRI) data. The methodology is based on the choice of several statistics related to the cloud properties, whose correlation has been analyzed by Principal Component Analysis (PCA). Results have been compared with the SEVIRI reference cloud mask provided by the European Centre for the Exploitation of Meteorological Satellite (EUMETSAT), in order to find suitable thresholds able to discriminate between clear or cloudy conditions. We trained the statistics on a selected region, the Basilicata area, located in the south of Italy, in different periods of the year 2012, in order to take into account the seasonal variability. Moreover we separated land and sea surface and distinguished between day-time or night-time. The validation of thresholds, obtained through SEVIRI observations analysis, shows a good agreement with the reference cloud mask.

  4. The cumulative reaction probability as eigenvalue problem

    NASA Astrophysics Data System (ADS)

    Manthe, Uwe; Miller, William H.

    1993-09-01

    It is shown that the cumulative reaction probability for a chemical reaction can be expressed (absolutely rigorously) as N(E)=∑kpk(E), where {pk} are the eigenvalues of a certain Hermitian matrix (or operator). The eigenvalues {pk} all lie between 0 and 1 and thus have the interpretation as probabilities, eigenreaction probabilities which may be thought of as the rigorous generalization of the transmission coefficients for the various states of the activated complex in transition state theory. The eigenreaction probabilities {pk} can be determined by diagonalizing a matrix that is directly available from the Hamiltonian matrix itself. It is also shown how a very efficient iterative method can be used to determine the eigenreaction probabilities for problems that are too large for a direct diagonalization to be possible. The number of iterations required is much smaller than that of previous methods, approximately the number of eigenreaction probabilities that are significantly different from zero. All of these new ideas are illustrated by application to three model problems—transmission through a one-dimensional (Eckart potential) barrier, the collinear H+H2→H2+H reaction, and the three-dimensional version of this reaction for total angular momentum J=0.

  5. Continuously Cumulating Meta-Analysis and Replicability.

    PubMed

    Braver, Sanford L; Thoemmes, Felix J; Rosenthal, Robert

    2014-05-01

    The current crisis in scientific psychology about whether our findings are irreproducible was presaged years ago by Tversky and Kahneman (1971), who noted that even sophisticated researchers believe in the fallacious Law of Small Numbers-erroneous intuitions about how imprecisely sample data reflect population phenomena. Combined with the low power of most current work, this often leads to the use of misleading criteria about whether an effect has replicated. Rosenthal (1990) suggested more appropriate criteria, here labeled the continuously cumulating meta-analytic (CCMA) approach. For example, a CCMA analysis on a replication attempt that does not reach significance might nonetheless provide more, not less, evidence that the effect is real. Alternatively, measures of heterogeneity might show that two studies that differ in whether they are significant might have only trivially different effect sizes. We present a nontechnical introduction to the CCMA framework (referencing relevant software), and then explain how it can be used to address aspects of replicability or more generally to assess quantitative evidence from numerous studies. We then present some examples and simulation results using the CCMA approach that show how the combination of evidence can yield improved results over the consideration of single studies. PMID:26173268

  6. Trends of CT utilisation in an emergency department in Taiwan: a 5-year retrospective study

    PubMed Central

    Hu, Sung-Yuan; Hsieh, Ming-Shun; Lin, Meng-Yu; Hsu, Chiann-Yi; Lin, Tzu-Chieh; How, Chorng-Kuang; Wang, Chen-Yu; Tsai, Jeffrey Che-Hung; Wu, Yu-Hui; Chang, Yan-Zin

    2016-01-01

    Objectives To investigate the association between the trends of CT utilisation in an emergency department (ED) and changes in clinical imaging practice and patients' disposition. Setting A hospital-based retrospective observational study of a public 1520-bed referral medical centre in Taiwan. Participants Adult ED visits (aged ≥18 years) during 2009–2013, with or without receiving CT, were enrolled as the study participants. Main outcome measures For all enrolled ED visits, we retrospectively analysed: (1) demographic characteristics, (2) triage categories, (3) whether CT was performed and the type of CT scan, (4) further ED disposition, (5) ED cost and (6) ED length of stay. Results In all, 269 239 adult ED visits (148 613 male patients and 120 626 female patients) were collected during the 5-year study period, comprising 38 609 CT scans. CT utilisation increased from 11.10% in 2009 to 17.70% in 2013 (trend test, p<0.001). Four in 5 types of CT scan (head, chest, abdomen and miscellaneous) were increasingly utilised during the study period. Also, CT was increasingly ordered annually in all age groups. Although ED CT utilisation rates increased markedly, the annual ED visits did not actually increase. Moreover, the subsequent admission rate, after receiving ED CT, declined (59.9% in 2009 to 48.2% in 2013). Conclusions ED CT utilisation rates increased significantly during 2009–2013. Emergency physicians may be using CT for non-emergent studies in the ED. Further investigation is needed to determine whether increasing CT utilisation is efficient and cost-effective. PMID:27279477

  7. QTC TENDENCY IN PACEMAKER DEPENDENT PATIENTS - PROGNOSTIC MEANING OF LONG QTC DURING 5 YEAR FOLLOW UP.

    PubMed

    Tsetskhladze, E; Khintibidze, I

    2016-04-01

    Prolongation of ventricular repolarization, which is represented by QTc prolongation on the standard ECG can be considered as increased risk for fatal arrhythmia. However, in pacemaker dependency (with ventricular pacing from the right apex) Ventricular Pacemaker causes abnormal steps of ventricular activation and therefore widens QRS complex and alters ventricular repolarization. It is still questionable whether QTc prolongation in right ventricular-paced patients is associated with increased risk of fatal arrhythmia or other cardiac complications. The other important question is whether the pacemaker dependent patient with long QTc interval may safely receive medications with known potential to prolong ventricular repolarization. The aim of the study was to determine whether QTc prolongation in VP (ventricular pacemaker) patients is associated with increased risk of fatal arrhythmia or other cardiac complications and whether these patients can safely receive medications with known potential to prolong ventricular repolarization. The study is based on retrospective analysis of the QTc interval prior and after pacemaker insertion; dynamic changes of QTc interval and possible influence of the medications, with known potential to prolong ventricular repolarization. Study population consisted 76 patients with narrow native QRS complexes and QTcF/QTcB <500 ms for both male and female patients. QTc prolongation in VP patients most likely does not represent true repolarization abnormalities and is not associated with risk of fatal arrhythmia. While analysis of group receiving medications with known potency of QTc increase we found no additional tendency of QTc increase. Based on our data receiving the medications with known potency of QTc prolongation in VP patients should be considered as safe approach. Long-term follow up data (5 years) assessed retrospectively shows that in patients with widened QRS after VP are at increased risk of development of HF and HF

  8. Who Stays and Who Leaves? Father Accessibility Across Children’s First 5 Years

    PubMed Central

    Shannon, Jacqueline D.; Cabrera, Natasha J.; Tamis-LeMonda, Catherine; Lamb, Michael E.

    2010-01-01

    SYNOPSIS Objective This longitudinal investigation examines whether fathers’ prenatal involvement (e.g., attending doctor appointments and discussing pregnancy with mother) and residence status at infant’s birth predict the first time a father becomes inaccessible to his child (defined as seeing child fewer than a few times per month) at six developmental time points in children’s first 5 years. Design Data were gathered from 2,160 ethnically diverse mothers (i.e., European American, African American, and Latin American) who participated in the National Early Head Start Research and Evaluation Project. Survival analysis was used to predict the timing of father inaccessibility based on interviews. Results By prekindergarten, fathers’ residence at birth and prenatal involvement decreased their risk of being inaccessible to their children for the first time by 71% and 47%, respectively, after adjusting for all other variables in the model. Residence at birth was a stronger predictor of the timing of father inaccessibility than was prenatal involvement for European American and Latin American fathers; for African American fathers, prenatal involvement was a stronger predictor of the timing of father inaccessibility than nonresidential status at birth. Nearly 65% of fathers who were engaged in both prenatal activities remained consistently accessible to their child through child age of 63 months, whereas nearly 50% of fathers who were not prenatally involved were already inaccessible by the time infants were 3 months. Conclusion These findings have implications for early intervention programs aimed at strengthening the role of fathers in their families from the prenatal period. PMID:20333276

  9. Fulminate Hepatic Failure in a 5 Year Old Female after Inappropriate Acetaminophen Treatment

    PubMed Central

    Kasmi, Irena; Sallabanda, Sashenka; Kasmi, Gentian

    2015-01-01

    BACKGROUND: Acetaminophen is a drug widely used in children because of its safety and efficacy. Although the risk of its toxicity is lower in children such reactions occur in pediatric patients from intentional overdoses and less frequently attributable to unintended inappropriate dosing. The aim of reporting this case is to attract the attention to the risk of the acetaminophen toxicity when administered in high doses. CASE PRESENTATION: We report here a 5 year old girl who developed fulminate liver failure with renal impairment and acute pancreatitis, as a result of acetaminophen toxicity caused from unintentional repeated supratherapeutic ingestion, with a total administered dose of 4800 mg in three consecutive days, 1600 mg/day, approximately 90 mg/kg/day. The blood level of acetaminophen after 10 hours of the last administered dose was 32 mg/l. The patient presented with high fever, jaundice, lethargic, agitating with abdominal pain accompanied by encephalopathy. The liver function test revealed with high level of alanine aminotransferase 5794 UI/l and aspartate aminotransferase 6000 UI/l. Early initiation of oral N-acetylcysteine (NAC) after biochemical evidence of liver toxicity was beneficial with rapid improvement of liver enzymes, hepatic function and encephalopathy. During the course of the illness the child developed acute pancreatitis with hyperamylasemia 255 UI/L and hyperlypasemia 514 UI/L. Patient totally recovered within 29 days. CONCLUSION: Healthcare providers should considered probable acetaminophen toxicity in any child who has received the drug and presented with liver failure. When there is a high index of suspicion of acetaminophen toxicity NAC should be initiated and continued until there are no signs of hepatic dysfunction.

  10. Insertion of Balloon Retained Gastrostomy Buttons: A 5-Year Retrospective Review of 260 Patients

    SciTech Connect

    Power, Sarah Kavanagh, Liam N.; Shields, Mary C.; Given, Mark F.; Keeling, Aoife N.; McGrath, Frank P.; Lee, Michael J.

    2013-04-15

    Radiologically inserted gastrostomy (RIG) is an established way of maintaining enteral nutrition in patients who cannot maintain nutrition orally. The purpose of this study was to evaluate the safety and efficacy of primary placement of a wide bore button gastrostomy in a large, varied patient population through retrospective review. All patients who underwent gastrostomy placement from January 1, 2004 to January 1, 2009 were identified. 18-Fr gastrostomy buttons (MIC-Key G) were inserted in the majority. Follow-up ranged from 6 months to 4.5 years. A total of 260 patients (M:F 140:120, average age 59.2 years) underwent gastrostomy during the study period. Overall success rate for RIG placement was 99.6 %, with success rate of 95.3 % for primary button insertion. Indications included neurological disorders (70 %), esophageal/head and neck malignancy (21 %), and other indications (9 %). Major and minor complication rates were 1.2 and 12.8 %, respectively. Thirty-day mortality rate was 6.8 %. One third of patients underwent gastrostomy reinsertion during the study period, the main indication for which was inadvertent catheter removal. Patency rate was high at 99.5 %. The maximum number of procedures in any patient was 8 (n = 2), and the average tube dwell time was 125 days. Primary radiological insertion of a wide bore button gastrostomy is a safe technique, with high success rate, high patency rate, and low major complication rate. We believe that it is feasible to attempt button gastrostomy placement in all patients, once tract length is within limits of tube length. If difficulty is encountered, then a standard tube may simply be placed instead.

  11. Hypospadias repair and outcome in Abuja, Nigeria: A 5-year single-centre experience

    PubMed Central

    Aisuodionoe-Shadrach, Oseremen Inokhoife; Atim, Terkaa; Eniola, Bolarinwa Sefiu; Ohemu, Alexander Akogwu

    2015-01-01

    Background: To determine the outcome of hypospadias repair in children. Patients and Methods: This was a retrospective study of all patients with hypospadias managed at the University of Abuja Teaching Hospital, Abuja, Nigeria from January 2009 to December 2013. Results: Twenty-four cases of hypospadias had corrective surgery during the 5-year period under review. Seventy-five percent of the patients (n = 18) were seen after the 1st year of life. There were two peaks of ages at corrective repair; 45.8% between age 1 and 3 years and 29.1% between age 5 and 10 years. The average age at time of surgery was 44.9 months. Distal hypospadias were more common (58.4%), followed by glanular (20.8%) and proximal (20.8%) hypospadias. Associated anomalies included chordee, maldescended testicles and inguinal hernia in 20.8%, 4.1% and 8.3% cases, respectively. Operative techniques were single-stage procedures in 79.1% of patients consisting of simple circumcision in two cases (10.5%), Mathieu's peri-meatal based flap in four cases (21%), meatal advancement and glanuloplasty incorporated in three cases (16%) and Snodgrass tubularised incised urethral plate tubularised incised plate in 10 cases (52.5%). The remaining 20.9% (n = 5) had multi-staged procedures. The most common post-operative complications were urethrocutenous fistula in nine patients (33.3%) and metal stenosis in 3 patients (12.5%). Conclusions: Our results show that hypospadia repair is froth with attendant high complications in our setting. PMID:25659549

  12. Salvage HDR Brachytherapy for Recurrent Prostate Cancer After Previous Definitive Radiation Therapy: 5-Year Outcomes

    SciTech Connect

    Chen, Chien Peter; Weinberg, Vivian; Shinohara, Katsuto; Roach, Mack; Nash, Marc; Gottschalk, Alexander; Chang, Albert J.; Hsu, I-Chow

    2013-06-01

    Purpose: Evaluate efficacy and toxicity of salvage high-dose-rate brachytherapy (HDRB) for locally recurrent prostate cancer after definitive radiation therapy (RT). Methods and Materials: We retrospectively analyzed 52 consecutively accrued patients undergoing salvage HDRB between 1998 and 2009 for locally recurrent prostate cancer after previous definitive RT. After pathologic confirmation of locally recurrent disease, patients received 36 Gy in 6 fractions. Twenty-four patients received neoadjuvant hormonal therapy before salvage, and no patients received adjuvant hormonal therapy. Determination of biochemical failure after salvage HDRB was based on the Phoenix definition. Overall survival (OS) and bF distributions were calculated using the Kaplan-Meier method. Univariate analyses were performed to identify predictors of biochemical control. Acute and late genitourinary (GU) and gastrointestinal (GI) toxicities, based on Common Terminology Criteria for Adverse Events (version 4), were documented. Results: Median follow-up after salvage HDRB was 59.6 months. The 5-year OS estimate was 92% (95% confidence interval [CI]: 80%-97%) with median survival not yet reached. Five-year biochemical control after salvage was 51% (95% CI: 34%-66%). Median PSA nadir postsalvage was 0.1 (range: 0-7.2) reached at a median of 10.2 months after completing HDRB. As for complications, acute and late grade 3 GU toxicities were observed in only 2% and 2%, respectively. No grade 2 or higher acute GI events and 4% grade 2 GI late events were observed. On univariate analysis, disease-free interval after initial definitive RT (P=.07), percent of positive cores at the time of diagnosis (P=.08), interval from first recurrence to salvage HDRB (P=.09), and pre-HDRB prostate-specific antigen (P=.07) were each of borderline significance in predicting biochemical control after salvage HDRB. Conclusions: Prostate HDRB is an effective salvage modality with relatively few long-term toxicities. We

  13. Differential changes in quality of life components over 5 years in chronic obstructive pulmonary disease patients

    PubMed Central

    Nagai, Katsura; Makita, Hironi; Suzuki, Masaru; Shimizu, Kaoruko; Konno, Satoshi; Ito, Yoichi M; Nishimura, Masaharu

    2015-01-01

    Background The aim of the study was to examine the longitudinal change in quality of life components of patients with chronic obstructive pulmonary disease (COPD). Methods In the Hokkaido COPD Cohort Study, 261 subjects were appropriately treated and followed over 5 years with a 74% follow-up rate at the end. The longitudinal changes in St George’s Respiratory Questionnaire (SGRQ) scores were annually evaluated with forced expiratory volume in 1 second (FEV1). The subjects were classified into the rapid decliners, slow decliners, and sustainers based on ΔFEV1/year. Results The activity component of SGRQ generally deteriorated over time, and its annual decline was the greatest in the rapid decliners (<25th percentile). In contrast, the symptom component improved significantly year by year in the sustainers (>75 percentile), and it did not deteriorate even in the rapid decliners. Of the baseline data, predictors for worsening of the activity component were older age and lower body mass index. Larger reversibility was related to symptom component improvement. Of the follow-up data, ΔFEV1/year was the best predictor for worsening of the components of SGRQ. Continuous smoking was another factor for worsening of the activity component. For the symptom component, a history of exacerbation by admission definition was the determinant of its deterioration, whereas use of beta agonists was related to improvement. Conclusion The longitudinal changes of quality of life and their determinants are markedly different and independent between its components. The activity component of SGRQ generally deteriorated over years, while the symptom component rather improved in some patients with COPD under appropriate treatment. PMID:25914531

  14. WHO global rotavirus surveillance network: a strategic review of the first 5 years, 2008-2012.

    PubMed

    Agócs, Mary M; Serhan, Fatima; Yen, Catherine; Mwenda, Jason M; de Oliveira, Lúcia H; Teleb, Nadia; Wasley, Annemarie; Wijesinghe, Pushpa R; Fox, Kimberley; Tate, Jacqueline E; Gentsch, Jon R; Parashar, Umesh D; Kang, Gagandeep

    2014-07-25

    Since 2008, the World Health Organization (WHO) has coordinated the Global Rotavirus Surveillance Network, a network of sentinel surveillance hospitals and laboratories that report to ministries of health (MoHs) and WHO clinical features and rotavirus testing data for children aged <5 years hospitalized with acute gastroenteritis. In 2013, WHO conducted a strategic review to assess surveillance network performance, provide recommendations for strengthening the network, and assess the network's utility as a platform for other vaccine-preventable disease surveillance. The strategic review team determined that during 2011 and 2012, a total of 79 sites in 37 countries met reporting and testing inclusion criteria for data analysis. Of the 37 countries with sites meeting inclusion criteria, 13 (35%) had introduced rotavirus vaccine nationwide. All 79 sites included in the analysis were meeting 2008 network objectives of documenting presence of disease and describing disease epidemiology, and all countries were using the rotavirus surveillance data for vaccine introduction decisions, disease burden estimates, and advocacy; countries were in the process of assessing the use of this surveillance platform for other vaccine-preventable diseases. However, the review also indicated that the network would benefit from enhanced management, standardized data formats, linkage of clinical data with laboratory data, and additional resources to support network functions. In November 2013, WHO's Strategic Advisory Group of Experts on Immunization (SAGE) endorsed the findings and recommendations made by the review team and noted potential opportunities for using the network as a platform for other vaccine-preventable disease surveillance. WHO will work to implement the recommendations to improve the network's functions and to provide higher quality surveillance data for use in decisions related to vaccine introduction and vaccination program sustainability. PMID:25055187

  15. Abdominal computed tomography during pregnancy for suspected appendicitis: a 5-year experience at a maternity hospital.

    PubMed

    Shetty, Mahesh K; Garrett, Nan M; Carpenter, Wendy S; Shah, Yogesh P; Roberts, Candace

    2010-02-01

    The objective of this article is to evaluate the role of computed tomography (CT) in a pregnant patient with right lower quadrant pain in whom there was a clinical suspicion of acute appendicitis. During a 5-year period the clinical records of all pregnant women who underwent imaging examination for clinically suspected appendicitis were reviewed. The imaging findings were correlated with patient management and final outcome. Thirty-nine pregnant patients were referred for imaging, of which 35 underwent initial evaluation with sonography, 23 of these women underwent a computed tomographic examination, and an additional 4 patients were directly imaged with CT without earlier sonographic assessment. Surgery confirmed appendicitis in all 5 patients who were operated on on the basis of findings of appendicitis on a CT scan. Two patients underwent surgery based on an alternate diagnosis suggested preoperatively (tubal torsion = 1, ovarian torsion = 1). All patients with negative findings at CT had an uneventful clinical course. In those patients who were evaluated only with ultrasound, a diagnosis of appendicitis was missed in 5 patients. The sensitivity of CT in the diagnosis of appendicitis in our study group was 100%, compared with a sensitivity of 46.1% for ultrasound. CT provides an accurate diagnosis in patients suspected to have acute appendicitis and is of value in avoiding false negative exploratory laparatomy with its consequent risk of maternal and fetal mortality and morbidity. Although sonography is the preferred initial imaging modality as its lack of ionizing radiation, CT is more accurate in providing a timely diagnosis and its use is justified to reduce maternal mortality and mortality in patients with appendicitis. PMID:20102691

  16. Molecular Typing of Treponema pallidum: a 5-Year Surveillance in Shanghai, China

    PubMed Central

    Dai, Ting; Li, Kang; Lu, Haikong; Gu, Xin

    2012-01-01

    Previously, a small study showed that 14f was the predominant subtype of Treponema pallidum in Shanghai, China. The result was quite different from the genotype distribution in other areas of China. This study aimed to identify the strain types of Treponema pallidum in samples collected over a 5-year period in Shanghai. From 2007 to 2011, genital swabs were collected from patients with syphilis from the Shanghai Skin Disease Hospital. Positive specimens were typed by the enhanced typing method by adding a tp0548 gene to the existing arp and tpr genotype system. In total, 304 of the 372 enrolled patients yielded fully typeable DNA. Ten arp types (4, 6, 8, 9, 11, 12, 13, 14, 15, and 19), 3 tpr types (a, d, and o), and 5 tp0548 types (a, c, f, g, and i) were identified. In total, 12 subtypes were identified with a combination of the arp and tpr genes. Subtype 14d was found in 270 samples (88.8%). When the combination included the tp0548 gene, the 12 CDC subtypes identified were divided into 14 strain types. The predominant type was 14d/f (88.8%), followed by 15d/f (3.6%), 13d/f (1.3%), and 19d/c (1.3%). Two of the 44 14d/f-infected patients and both of the 19d/c-infected patients who underwent a lumbar puncture were diagnosed with neurosyphilis. This study showed that the predominant type in Shanghai was 14d/f. While this is in keeping with data from other areas in China, it is different from an earlier report showing that 14f is the most common genotype in Shanghai. Further studies are needed to better understand the association between strain types and neurosyphilis. PMID:22972832

  17. Global surgery in a postconflict setting - 5-year results of implementation in the Russian North Caucasus

    PubMed Central

    Lunze, Fatima I.; Lunze, Karsten; Tsorieva, Zemfira M.; Esenov, Constantin T.; Reutov, Alexandr; Eichhorn, Thomas; Offergeld, Christian

    2015-01-01

    Background Collaborations for global surgery face many challenges to achieve fair and safe patient care and to build sustainable capacity. The 2004 terrorist attack on a school in Beslan in North Ossetia in the Russian North Caucasus left many victims with complex otologic barotrauma. In response, we implemented a global surgery partnership between the Vladikavkaz Children's Hospital, international surgical teams, the North Ossetian Health Ministry, and civil society organizations. This study's aim was to describe the implementation and 5-year results of capacity building for complex surgery in a postconflict, mid-income setting. Design We conducted an observational study at the Children's Hospital in Vladikavkaz in the autonomous Republic of North Ossetia-Alania, part of the Russian Federation. We assessed the outcomes of 15 initial patients who received otologic surgeries for complex barotrauma resulting from the Beslan terrorism attack and for other indications, and report the incidence of intra- and postoperative complications. Results Patients were treated for trauma related to terrorism (53%) and for indications not related to violence (47%). None of the patients developed peri- or postoperative complications. Three patients (two victims of terrorism) who underwent repair of tympanic perforations presented with re-perforations. Four junior and senior surgeons were trained on-site and in Germany to perform and teach similar procedures autonomously. Conclusions In mid-income, postconflict settings, complex surgery can be safely implemented and achieve patient outcomes comparable to global standards. Capacity building can build on existing resources, such as operation room management, nursing, and anesthesia services. In postconflict environments, substantial surgical burden is not directly attributable to conflict-related injury and disease, but to health systems weakened by conflicts. Extending training and safe surgical care to include specialized

  18. The Clinicopathologic Characteristics and 5-year Survival Rate of Epithelial Ovarian Cancer in Yazd, Iran

    PubMed Central

    Karimi-Zarchi, Mojgan; Mortazavizadeh, Seyed Mohammad Reza; Bashardust, Nasrollah; Zakerian, Neda; Zaidabadi, Mahbube; Yazdian-Anari, Pouria; Teimoori, Soraya

    2015-01-01

    Introduction Ovarian cancer is the second most common malignancy in women, the most common cause of gynecologic cancer deaths, and most patients have advanced stage disease at the time of diagnosis. The purpose of this study was to estimate the 5-year survival of patients with epithelial ovarian cancer based on age, tumor histology, stage of disease, and type of treatment. Methods This study was conducted on 120 patients with epithelial ovarian cancer referred to Shahid Sadoughi hospital and Shah Vali oncology clinic of Yazd from 2006 to 2012. Demographic data and patient records were studied to evaluate the treatment outcome, pathology of the tumor, and stage of disease. Finally, the overall survival rate and tumor-free survival of patients was assessed. Results The mean patient age was 53.87± 14.11 years. Most participants had stage I (36.7%) or stage II (35%) disease. Serous adenocarcinoma (57.6%) was the most common pathology found in patients with epithelial ovarian cancer. The overall survival of patients in this study was significantly associated with the histological tumor type (p = 0.000) and disease stage (p = 0.0377). Stage I (84.18%) and serous adenocarcinoma (72.81%) demonstrated the best survival. The tumor-free survival rates were not associated with histology types (p = 0.079), surgical procedure (p = 0.18), or chemotherapy (p = 0.18). Conclusion The survival of patients with epithelial ovarian cancer was significantly associated with disease stage. Serous adenocarcinoma also had the best prognosis among the pathologies studied. Therefore, early detection of ovarian cancer can substantially increase the survival rate. PMID:26516450

  19. Omnifit-HA stem in total hip arthroplasty. A 2- to 5-year followup.

    PubMed

    D'Lima, D D; Walker, R H; Colwell, C W

    1999-06-01

    Outcomes of the first 60 noncemented Omnifit-HA total hip arthroplasties in 56 patients were studied prospectively for 2 to 5 years. The femoral prosthesis had a proximal third circumferential hydroxyapatite coated surface treatment. The acetabular component was a hemispheric modular, porous, nonhydroxyapatite press fit cup, supplemented with screw fixation. One cup was revised for recurrent dislocation, with no femoral revisions. The mean Harris hip score was 54 (range, 20-76) before surgery and 96 (range, 83-100) at final followup, with all patients having an excellent or good outcome. Mild thigh pain occurred in 6% of hips. Subsidence occurred in 9% of hips (range, 1-2.8 mm); in all cases, subsidence was nonprogressive after 1 year. Stable bone ingrowth fixation was evident at the hydroxyapatite coated portion in 100%. A sclerotic reactive line adjacent to the nonhydroxyapatite portion of the stem occurred in 81% but was not adjacent to the hydroxyapatite coated portion of any stem. Endosteal condensation occurred in 90% and correlated with a higher Harris hip score (mean score, 96 with, 91 without). Endosteal lysis adjacent to or distal to the hydroxyapatite coating did not occur. Lytic lesions at the calcar occurred in 19% and correlated with a greater linear acetabular polyethylene wear rate (mean, 0.30 mm/year with lytic lesions, 0.17 mm/year without). This noncemented stem with proximal third hydroxyapatite coating showed excellent short term clinical and radiographic outcome. Absence of distal endosteal lysis, along with correlation of calcar erosion to polyethylene wear, suggests that early circumferential bony ingrowth afforded by hydroxyapatite coating prevents distal endosteal access to polyethylene debris at short term followup. PMID:10379318

  20. 5 years of continuous seismic monitoring of snowmelt cycles in a Pyrenean valley

    NASA Astrophysics Data System (ADS)

    Diaz, Jordi; Sánchez-Pastor, Pilar; Gallart, Josep

    2016-04-01

    In recent years the analysis of background seismic noise variations in the proximity of river channels has revealed as a useful tool to monitor river flow, even for modest discharges. We will focus here in the application of this methodology to study the snowmelt cycle in an Pyrenean valley during the last 5 years, using data from the seismic geophysical station located inside the Canfranc Underground Laboratory (Central Pyrenees). Diaz et al. (2014) first identified in the seismic data the signature of river flow increases associated to snowmelt episodes in the catchment area of the Aragon River, based on the marked correlation between the seismic energy variations in the 2-8 Hz frequency band and the estimated variations in water resources from snowfall. The analysis of seismic data during the snowmelt periods allows to identify a clear 24h cycle, with energy increasing from about 14:00 GMT, remaining at a relatively high level for 12 hours and then smoothly vanishing. The spectrogram reveals richer information, as clear variations in the frequency content can be detected during the time intervals in which the amplitude of the seismic signal remains constant. The data available so far allow to compare the evolution of snowmelt in five seasons with very different hydrological behavior. The 2011 and 2012 seasons have been dry, with snow volumes 30-50 % beneath the average values, while the 2013, 2014 and in particular the 2015 seasons have been largely above the mean. Those variations are reflected in the seismic data, which allow to monitor the time occurrence of the main snowmelt stages for each season and to estimate the intensity of the different snowmelt episodes. Therefore, seismic data can be useful for long term monitoring of snowmelt in Alpine-style mountains.

  1. Insight, psychopathology, explanatory models and outcome of schizophrenia in India: a prospective 5-year cohort study

    PubMed Central

    2012-01-01

    Background The sole focus of models of insight on bio-medical perspectives to the complete exclusion of local, non-medical and cultural constructs mandates review. This study attempted to investigate the impact of insight, psychopathology, explanatory models of illness on outcome of first episode schizophrenia. Method Patients diagnosed to have DSM IV schizophrenia (n = 131) were assessed prospectively for insight, psychopathology, explanatory models of illness at baseline, 6, 12 and 60 months using standard instruments. Multiple linear and logistic regression and generalized estimating equations (GEE) were employed to assess predictors of outcome. Results We could follow up 95 (72.5%) patients. Sixty-five of these patients (68.4%) achieved remission. There was a negative relationship between psychosis rating and insight scores. Urban residence, fluctuating course of the initial illness, and improvement in global functioning at 6 months and lower psychosis rating at 12 months were significantly related to remission at 5 years. Insight scores, number of non-medical explanatory models and individual explanatory models held during the later course of the illness were significantly associated with outcome. Analysis of longitudinal data using GEE showed that women, rural residence, insight scores and number of non-medical explanatory models of illness held were significantly associated with BPRS scores during the study period. Conclusions Insight, the disease model and the number of non-medical model positively correlated with improvement in psychosis arguing for a complex interaction between the culture, context and illness variables. These finding argue that insight and explanatory models are secondary to psychopathology, course and outcome of the illness. The awareness of mental illness is a narrative act in which people make personal sense of the many challenges they face. The course and outcome of the illness, cultural context, acceptable cultural explanations

  2. Specialist Pediatric Palliative Care Prescribing Practices: A Large 5-year Retrospective Audit

    PubMed Central

    Damani, Anuja; Salins, Naveen; Ghoshal, Arunangshu; Muckaden, MaryAnn

    2016-01-01

    Introduction: There is a gradual increasing trend in childhood cancers in India and pediatric palliative care in India is an emerging specialty. Prescribing pain and symptom control drugs in children with cancer requires knowledge of palliative care formulary, dosing schedules, and prescription guidelines. This study is a retrospective audit of prescribing practices of a specialist palliative care service situated in a tertiary cancer center. Methods: A total of 1135 medication records of children receiving specialist pediatric palliative care services were audited for 5 years (2010–2014) to evaluate prescribing practices in children with advanced cancer. Results: A total of 51 types of drugs were prescribed with an average of 4.2 drugs per prescription. 66.9% of the prescriptions had paracetamol, and 33.9% of the prescriptions had morphine. Most common nonsteroidal anti-inflammatory drugs prescribed was ibuprofen (23.9%), and more than 50% of the prescriptions had aperients. The most commonly prescribed aperient was a combination of liquid paraffin and sodium-picosulfate. Dexamethasone was prescribed in 51.9% of patients and in most cases this was part of oral chemotherapy regimen. Generic names in prescription were used only in 33% of cases, and adverse effects of the drugs were documented in only 9% of cases. In 25% of cases, noncompliance to the WHO prescription guidelines was seen, and patient compliance to prescription was seen in 40% of cases. Conclusions: Audit of the prescribing practices in specialist pediatric palliative care service shows that knowledge of pediatric palliative care formulary, rational drug use, dosing, and prescribing guidelines is essential for symptom control in children with advanced life-limiting illness. Noncompliance to WHO prescribing guidelines in one fourth of cases and using nongeneric names in two-thirds of prescription indicates poor prescribing practices and warrants prescriber education. Prescription noncompliance by

  3. Supporting countries in establishing and strengthening NITAGs: lessons learned from 5 years of the SIVAC initiative.

    PubMed

    Adjagba, Alex; Senouci, Kamel; Biellik, Robin; Batmunkh, Nyambat; Faye, Pape Coumba; Durupt, Antoine; Gessner, Bradford D; da Silva, Alfred

    2015-01-29

    To empower governments to formulate rational policies without pressure from any group, and to increase the use of evidence-based decision-making to adapt global recommendations on immunization to their local context, the WHO has recommended on multiple occasions that countries should establish National Immunization Technical Advisory Groups (NITAGs). The World Health Assembly (WHA) reinforced those recommendations in 2012 when Member States endorsed the Decade of Vaccines Global Vaccine Action Plan (GVAP). NITAGs are multidisciplinary groups of national experts responsible for providing independent, evidence-informed advice to health authorities on all policy-related issues for all vaccines across all populations. In 2012, according to the WHO-UNICEF Joint Reporting Form, among 57 countries eligible for immunization program financial support from the GAVI Alliance, only 9 reported having a functional NITAG. Since 2008, the Supporting Independent Immunization and Vaccine Advisory Committees (SIVAC) Initiative (at the Agence de Médecine Préventive or AMP) in close collaboration with the WHO and other partners has been working to accelerate and systematize the establishment of NITAGs in low- and middle-income countries. In addition to providing direct support to countries to establish advisory groups, the initiative also supports existing NITAGs to strengthen their capacity in the use of evidence-based processes for decision-making aligned with international standards. After 5 years of implementation and based on lessons learned, we recommend that future efforts should target both expanding new NITAGs and strengthening existing NITAGs in individual countries, along three strategic lines: (i) reinforce NITAG institutional integration to promote sustainability and credibility, (ii) build technical capacity within NITAG secretariats and evaluate NITAG performance, and (iii) increase networking and regional collaborations. These should be done through the development

  4. Uremic Pruritus, Dialysis Adequacy, and Metabolic Profiles in Hemodialysis Patients: A Prospective 5-Year Cohort Study

    PubMed Central

    Chen, Hung-Yuan; Chiu, Yen-Ling; Hsu, Shih-Ping; Pai, Mei-Fen; Ju-YehYang; Lai, Chun-Fu; Lu, Hui-Min; Huang, Shu-Chen; Yang, Shao-Yu; Wen, Su-Yin; Chiu, Hsien-Ching; Hu, Fu-Chang; Peng, Yu-Sen; Jee, Shiou-Hwa

    2013-01-01

    Background Uremic pruritus is a common and intractable symptom in patients on chronic hemodialysis, but factors associated with the severity of pruritus remain unclear. This study aimed to explore the associations of metabolic factors and dialysis adequacy with the aggravation of pruritus. Methods We conducted a 5-year prospective cohort study on patients with maintenance hemodialysis. A visual analogue scale (VAS) was used to assess the intensity of pruritus. Patient demographic and clinical characteristics, laboratory parameters, dialysis adequacy (assessed by Kt/V), and pruritus intensity were recorded at baseline and follow-up. Change score analysis of the difference score of VAS between baseline and follow-up was performed using multiple linear regression models. The optimal threshold of Kt/V, which is associated with the aggravation of uremic pruritus, was determined by generalized additive models and receiver operating characteristic analysis. Results A total of 111 patients completed the study. Linear regression analysis showed that lower Kt/V and use of low-flux dialyzer were significantly associated with the aggravation of pruritus after adjusting for the baseline pruritus intensity and a variety of confounding factors. The optimal threshold value of Kt/V for pruritus was 1.5 suggested by both generalized additive models and receiver operating characteristic analysis. Conclusions Hemodialysis with the target of Kt/V ≥1.5 and use of high-flux dialyzer may reduce the intensity of pruritus in patients on chronic hemodialysis. Further clinical trials are required to determine the optimal dialysis dose and regimen for uremic pruritus. PMID:23940749

  5. Relationship between Angiographic Late Loss and 5-Year Clinical Outcome after Drug-Eluting Stent Implantation

    PubMed Central

    Yang, Young-June; Shin, Sanghoon; Kim, Byeong-Keuk; Kim, Jung-Sun; Shin, Dong-Ho; Ko, Young-Guk; Choi, Donghoon; Jang, Yangsoo

    2013-01-01

    Purpose Currently, insufficient data exist to evaluate the relationship between angiographic late loss (LL) and long-term clinical outcome after drug-eluting stent (DES) implantation. In this study, we hypothesized that angiographic LL between 0.3 and 0.6 mm correlate with favorable long-term clinical outcomes. Materials and Methods Patients were enrolled in the present study if they had undergone both DES implantation in single coronary vessel and a subsequent follow-up angiogram (n=634). These individuals were then subdivided into three groups based on their relative angiographic LL: group I (angiographic LL <0.3 mm, n=378), group II (angiographic LL between 0.3 and 0.6 mm, n=124), and group III (angiographic LL >0.6 mm, n=134). During a 5-year follow-up period, all subjects were tracked for critical events, defined as any cause of death or myocardial infarction, which were then compared among the three groups. Results Mean follow-up duration was 63.0±10.0 months. Critical events occurred in 25 subjects in group I (6.6%), 5 in group II (4.0%), and 17 in group III (12.7%), (p=0.020; group I vs. group II, p=0.293; group II vs. group III, p=0.013). In a subsequent multivariate logistic regression analysis, chronic renal failure [odds ratio (OR)=3.29, 95% confidence interval (CI): 1.48-7.31, p=0.003] and long lesion length, defined as lesion length >28 mm (OR=1.88, 95% CI: 1.02-3.46, p=0.042) were independent predictors of long-term critical events. Conclusion This retrospective analysis fails to demonstrate that post-DES implantation angiographic LL between 0.3 and 0.6 mm is protective against future critical events. PMID:23225797

  6. The Burden of Health Care Costs in the Last 5 Years of Life

    PubMed Central

    Kelley, Amy S.; McGarry, Kathleen; Gorges, Rebecca; Skinner, Jonathan S.

    2016-01-01

    Background Common diseases, particularly dementia, entail large social costs, previously well described for the U.S. population. Less is known about end-of-life costs of specific diseases and the associated financial risk for individual households. Objective To examine social costs and financial risks faced by Medicare beneficiaries five years before death. Design Retrospective cohort. Setting Health and Retirement Study. Participants Medicare fee-for-service beneficiaries, aged 70 years or older, who died 2005-2010 (N = 1702), stratified into four cohorts: individuals with high probability of dementia, or with either heart disease, cancer, or other causes of death. Measurements Total social costs and its components: Medicare, Medicaid, private insurance, out-of-pocket, and informal care, measured over the last 5 years of life; and out-of-pocket spending as a proportion of household wealth. Results Average total cost per decedent for dementia ($287,038) was significantly greater than for those who died of heart disease ($175,136), cancer ($173,383), or other causes ($197,286), p<0.001. While Medicare expenditures were similar across groups, average out-of-pocket spending for dementia patients ($61,522) was 81% higher than for non-dementia patients ($34,068); a similar pattern held for informal care. Out-of-pocket spending for the dementia group (median, $36,919) represented 32% of wealth measured five years before death, compared to 11% for non-dementia decedents (p<0.001). This proportion was greater for Blacks (84%), those with less than high school education (48%), and unmarried/widowed women (58%). Limitations Imputed Medicaid, private insurance and informal care costs Conclusions Healthcare expenditures among those with dementia were substantially larger than for other diseases, with much of those expenses uninsured, thus placing a large financial burden on families. These burdens are particularly pronounced among demographic groups least prepared for

  7. Cumulative impacts in environmental assessments: How well are they considered?

    SciTech Connect

    McCold, L.; Holman, J.

    1995-03-01

    The usual reason for preparing an environmental assessment (EA) is to ``provide sufficient evidence and analysis to determine whether to prepare a finding of no significant impact or an environmental impact statement`` (40 CFR 1508.9). Significant impacts may result from direct, indirect, or cumulative impacts. Thus, in addition to assessing direct and indirect impacts, EAs should give enough evidence and analysis to determine whether or not the action contributes to a cumulatively significant impact. Consideration of cumulative impacts in NEPA documents in general, and EAs in particular, is less fully developed than consideration of impacts resulting solely from the proposed action. The authors analyzed 89 EAs to determine the extent to which their treatment of cumulative impacts met the requirements of 40 CFR 1508. Only 35 EAs (39 %) mentioned cumulative impacts. Of these, 8 stated that there were no cumulative impacts without supporting evidence; 5 identified a potential for cumulative impacts and concluded they were insignificant but presented no evidence or analysis to support the conclusion; 19 addressed cumulative impacts of some resources but not others; and 18 EAs identified past, present, and future actions that could, with the proposed action, contribute to cumulative impacts, but only actions of a similar type were identified, usually those in the agency`s area of responsibility. The paper presents several recommendations: (1) Past, present, and reasonably foreseeable actions that could affect resources affected by the proposed action should be identified at the same time as, and listed with, the proposed action. (2) For each resource, the discussion of cumulative impacts should follow immediately after the discussion of direct impacts to that resource. (3) Conclusions about cumulative impacts should be supported by data and analyses. (4) Agencies need a central review function to ensure the quality of their EAs.

  8. Donor Age and Corneal Endothelial Cell Loss 5 Years after Successful Corneal Transplantation: Specular Microscopy Ancillary Study Results

    PubMed Central

    2010-01-01

    Objective To determine whether endothelial cell loss 5 years after successful corneal transplantation is related to the age of the donor. Design Multicenter, prospective, double-masked clinical trial. Participants Three hundred forty-seven subjects participating in the Cornea Donor Study who had not experienced graft failure 5 years after corneal transplantation for a moderate-risk condition (principally Fuchs’ dystrophy or pseudophakic corneal edema). Testing Specular microscopic images of donor corneas obtained before surgery and postoperatively at 6 months, 12 months, and then annually through 5 years were submitted to a central reading center to measure endothelial cell density (ECD). Main Outcome Measure Endothelial cell density at 5 years. Results At 5 years, there was a substantial decrease in ECD from baseline for all donor ages. Subjects who received a cornea from a donor 12 to 65 years old experienced a median cell loss of 69% in the study eye, resulting in a 5-year median ECD of 824 cells/mm2 (interquartile range, 613–1342), whereas subjects who received a cornea from a donor 66 to 75 years old experienced a cell loss of 75%, resulting in a median 5-year ECD of 654 cells/mm2 (interquartile range, 538–986) (P [adjusted for baseline ECD] = 0.04). Statistically, there was a weak negative association between ECD and donor age analyzed as a continuous variable (r [adjusted for baseline ECD] = −0.19; 95% confidence interval, −0.29 to −0.08). Conclusions Endothelial cell loss is substantial in the 5 years after corneal transplantation. There is a slight association between cell loss and donor age. This finding emphasizes the importance of longer-term follow-up of this cohort to determine if this relationship affects graft survival. PMID:18387408

  9. Category-specific face prototypes are emerging, but not yet mature, in 5-year-old children.

    PubMed

    Short, Lindsey A; Lee, Kang; Fu, Genyue; Mondloch, Catherine J

    2014-10-01

    Adults' expertise in face recognition has been attributed to norm-based coding. Moreover, adults possess separable norms for a variety of face categories (e.g., race, sex, age) that appear to enhance recognition by reducing redundancy in the information shared by faces and ensuring that only relevant dimensions are used to encode faces from a given category. Although 5-year-old children process own-race faces using norm-based coding, little is known about the organization and refinement of their face space. The current study investigated whether 5-year-olds rely on category-specific norms and whether experience facilitates the development of dissociable face prototypes. In Experiment 1, we examined whether Chinese 5-year-olds show race-contingent opposing aftereffects and the extent to which aftereffects transfer across face race among Caucasian and Chinese 5-year-olds. Both participant races showed partial transfer of aftereffects across face race; however, there was no evidence for race-contingent opposing aftereffects. To examine whether experience facilitates the development of category-specific prototypes, we investigated whether race-contingent aftereffects are present among Caucasian 5-year-olds with abundant exposure to Chinese faces (Experiment 2) and then tested separate groups of 5-year-olds with two other categories with which they have considerable experience: sex (male/female faces) and age (adult/child faces) (Experiment 3). Across all three categories, 5-year-olds showed no category-contingent opposing aftereffects. These results demonstrate that 5 years of age is a stage characterized by minimal separation in the norms and associated coding dimensions used for faces from different categories and suggest that refinement of the mechanisms that underlie expert face processing occurs throughout childhood. PMID:24937629

  10. Predictors of long term survival after hepatic resection for hilar cholangiocarcinoma: A retrospective study of 5-year survivors

    PubMed Central

    Abd ElWahab, Mohamed; El Nakeeb, Ayman; El Hanafy, Ehab; Sultan, Ahmad M; Elghawalby, Ahmed; Askr, Waleed; Ali, Mahmoud; Abd El Gawad, Mohamed; Salah, Tarek

    2016-01-01

    AIM: To determine predictors of long term survival after resection of hilar cholangiocarcinoma (HC) by comparing patients surviving > 5 years with those who survived < 5 years. METHODS: This is a retrospective study of patients with pathologically proven HC who underwent surgical resection at the Gastroenterology Surgical Center, Mansoura University, Egypt between January 2002 and April 2013. All data of the patients were collected from the medical records. Patients were divided into two groups according to their survival: Patients surviving less than 5 years and those who survived > 5 years. RESULTS: There were 34 (14%) long term survivors (5 year survivors) among the 243 patients. Five-year survivors were younger at diagnosis than those surviving less than 5 years (mean age, 50.47 ± 4.45 vs 54.59 ± 4.98, P = 0.001). Gender, clinical presentation, preoperative drainage, preoperative serum bilirubin, albumin and serum glutamic-pyruvic transaminase were similar between the two groups. The level of CA 19-9 was significantly higher in patients surviving < 5 years (395.71 ± 31.43 vs 254.06 ± 42.19, P = 0.0001). Univariate analysis demonstrated nine variables to be significantly associated with survival > 5 year, including young age (P = 0.001), serum CA19-9 (P = 0.0001), non-cirrhotic liver (P = 0.02), major hepatic resection (P = 0.001), caudate lobe resection (P = 0.006), well differentiated tumour (P = 0.03), lymph node status (0.008), R0 resection margin (P = 0.0001) and early postoperative liver cell failure (P = 0.02). CONCLUSION: Liver status, resection of caudate lobe, lymph node status, R0 resection and CA19-9 were demonstrated to be independent risk factors for long term survival. PMID:27358676

  11. 78 FR 33113 - Publication of the 5-Year Research and Evaluation Strategic Plan Program Years 2012-2017

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-03

    ...Notice is hereby given of the publication of the U.S. Department of Labor, Employment and Training Administration's (USDOL/ ETA) 5-Year Research and Evaluation Strategic Plan for 2012-2017. Under Section 171 of the Workforce Investment Act, every 2 years the Secretary of Labor is required to transmit to Congress a strategic plan for pilots, demonstrations, and research over the next 5 years in......

  12. Income, cumulative risk, and longitudinal profiles of hypothalamic-pituitary-adrenal axis activity in preschool-age children.

    PubMed

    Zalewski, Maureen; Lengua, Liliana J; Thompson, Stephanie F; Kiff, Cara J

    2016-05-01

    Environmental risk predicts disrupted basal cortisol levels in preschool children. However, little is known about the stability or variability of diurnal cortisol morning levels or slope patterns over time in young children. This study used latent profile analysis to identify patterns of the hypothalamic-pituitary-adrenal axis activity during the preschool period. Using a community sample (N = 306), this study measured income, cumulative risk, and children's diurnal cortisol (morning level and slope) four times across 2.5 years, starting when children were 36 months old. Latent profile analysis profiles indicated that there were predominantly stable patterns of diurnal cortisol level and slope over time and that these patterns were predicted by income and cumulative risk. In addition, there were curvilinear relations of income and cumulative risk to profiles of low morning cortisol level and flattened diurnal slope across time, suggesting that both lower and higher levels of income and cumulative risk were associated with a stress-sensitive physiological system. Overall, this study provides initial evidence for the role of environmental risk in predicting lower, flattened basal cortisol patterns that remain stable over time. PMID:26040201

  13. A Framework for Treating Cumulative Trauma with Art Therapy

    ERIC Educational Resources Information Center

    Naff, Kristina

    2014-01-01

    Cumulative trauma is relatively undocumented in art therapy practice, although there is growing evidence that art therapy provides distinct benefits for resolving various traumas. This qualitative study proposes an art therapy treatment framework for cumulative trauma derived from semi-structured interviews with three art therapists and artistic…

  14. Cumulative Estrogen Exposure and Prospective Memory in Older Women

    ERIC Educational Resources Information Center

    Hesson, Jacqueline

    2012-01-01

    This study looked at cumulative lifetime estrogen exposure, as estimated with a mathematical index (Index of Cumulative Estrogen Exposure (ICEE)) that included variables (length of time on estrogen therapy, age at menarche and menopause, postmenopausal body mass index, time since menopause, nulliparity and duration of breastfeeding) known to…

  15. CUMULATIVE AND AGGREGATE RISK EVALUATION SYSTEM (CARES) MODEL REVIEW

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The 1996 Food Quality Protection Act (FQPA) changed the way the U.S. Environmental Protection Agency (USEPA) assesses risks of pesticide use. Both cumulative and aggregate exposures must now be considered. They are cumulative since consumption of residues in food and drinking water and incidental co...

  16. A cumulative index to Aeronautical Engineering: A special bibliography

    NASA Technical Reports Server (NTRS)

    1978-01-01

    This publication is a cumulative index to the abstracts contained in NASA SP-7037 (80) through NASA SP-7037 (91) of Aeronautical Engineering: A Special Bibliography. NASA SP-7037 and its supplements have been compiled through the cooperative efforts of the American Institute of Aeronautics (AIAA) and Space Administration (NASA). This cumulative index includes subject, personal author, corporate source, contract, and report number indexes.

  17. Partial Breast Radiation Therapy With Proton Beam: 5-Year Results With Cosmetic Outcomes

    SciTech Connect

    Bush, David A.; Do, Sharon; Lum, Sharon; Garberoglio, Carlos; Mirshahidi, Hamid; Patyal, Baldev; Grove, Roger; Slater, Jerry D.

    2014-11-01

    Purpose: We updated our previous report of a phase 2 trial using proton beam radiation therapy to deliver partial breast irradiation (PBI) in patients with early stage breast cancer. Methods and Materials: Eligible subjects had invasive nonlobular carcinoma with a maximal dimension of 3 cm. Patients underwent partial mastectomy with negative margins; axillary lymph nodes were negative on sampling. Subjects received postoperative proton beam radiation therapy to the surgical bed. The dose delivered was 40 Gy in 10 fractions, once daily over 2 weeks. Multiple fields were treated daily, and skin-sparing techniques were used. Following treatment, patients were evaluated with clinical assessments and annual mammograms to monitor toxicity, tumor recurrence, and cosmesis. Results: One hundred subjects were enrolled and treated. All patients completed the assigned treatment and were available for post-treatment analysis. The median follow-up was 60 months. Patients had a mean age of 63 years; 90% had ductal histology; the average tumor size was 1.3 cm. Actuarial data at 5 years included ipsilateral breast tumor recurrence-free survival of 97% (95% confidence interval: 100%-93%); disease-free survival of 94%; and overall survival of 95%. There were no cases of grade 3 or higher acute skin reactions, and late skin reactions included 7 cases of grade 1 telangiectasia. Patient- and physician-reported cosmesis was good to excellent in 90% of responses, was not changed from baseline measurements, and was well maintained throughout the entire 5-year follow-up period. Conclusions: Proton beam radiation therapy for PBI produced excellent ipsilateral breast recurrence-free survival with minimal toxicity. The treatment proved to be adaptable to all breast sizes and lumpectomy cavity configurations. Cosmetic results appear to be excellent and unchanged from baseline out to 5 years following treatment. Cosmetic results may be improved over those reported with photon

  18. Lung function and respiratory symptoms among female hairdressers in Palestine: a 5-year prospective study

    PubMed Central

    Nemer, Maysaa; Kristensen, Petter; Nijem, Khaldoun; Bjertness, Espen; Skare, Øivind; Skogstad, Marit

    2015-01-01

    Objectives Hairdressers are exposed to chemicals at the workplace which are known to cause respiratory symptoms and asthma. This study aimed to examine changes in self-reported respiratory symptoms over 5 years, as well as to examine the lung function decline and determine whether it is within the expected range, to assess the dropout rate and reasons for leaving the profession, and to examine the associations between occupational factors and lung function changes at follow-up. Design Prospective study. Setting Female hairdressing salons in Hebron city, Palestine. Participants 170 female hairdressers who participated in a baseline survey in 2008 were followed up in 2013. A total of 161 participants participated in 2013. Outcome measures Change in reported respiratory symptoms and change in lung function over follow-up. Dropout from the profession and reasons for it. Differences between current and former hairdressers in respiratory symptoms and lung function at follow-up. Ambient air ammonia levels in 13 salons. Results Current hairdressers reported more respiratory symptoms in 2013 compared with baseline. Former hairdressers reported fewer symptoms at follow-up. At follow-up, current hairdressers showed a significant decrease in forced vital capacity of 35 mL/year (95% CI 26 to 44 mL/year) and of 31 mL/year (95% CI 25 to 36 mL/year) for forced expiratory volume in 1 s (FEV1). 28 (16%) of the hairdressers quit the job during the 5-year follow-up, 8 (28%) because of health problems. Hairdressers who had been working for 4 years or more at baseline showed a stronger decline in FEV1 compared with those who worked less than 4 years (difference 13, 95% CI 1 to 25). Conclusions Current hairdressers developed more respiratory symptoms and larger lung function decline than former hairdressers during follow-up. Few hairdressers left their profession because of respiratory health problems. Working for more years is associated with lung function decline among

  19. Participation in an Intensive Longitudinal Study with Weekly Web Surveys Over 2.5 Years

    PubMed Central

    Barber, Jennifer; Kusunoki, Yasamin; Schulz, Paul

    2016-01-01

    Background Technological advances have made it easier for researchers to collect more frequent longitudinal data from survey respondents via personal computers, smartphones, and other mobile devices. Although technology has led to an increase in data-intensive longitudinal studies, little is known about attrition from such studies or the differences between respondents who complete frequently administered surveys in a timely manner, and respondents who do not. Objective We examined respondent characteristics and behaviors associated with continued and on-time participation in a population-based intensive longitudinal study, using weekly web-based survey interviews over an extended period. Methods We analyzed data from the Relationship Dynamics and Social Life study, an intensive longitudinal study that collected weekly web-based survey interviews for 2.5 years from 1003 18- and 19-year-olds to investigate factors shaping the dynamics of their sexual behavior, contraceptive use, and pregnancies. Results Ordinary least squares and logistic regression analyses showed background respondent characteristics measured at baseline were associated with the number of days respondents remained enrolled in the study, the number of interviews they completed, and the odds that they were late completing interviews. In addition, we found that changes in pregnancy-related behaviors reported in the weekly interviews were associated with late completion of interviews. Specifically, after controlling for sociodemographic, personality, contact information, and prior experience variables, we found that weekly reports such as starting to have sex (odds ratio [OR] 1.17, 95% CI 1.03-1.32, P=.01), getting a new partner (OR 1.76, 95% CI 1.53-2.03, P<.001), stopping the use of contraception (OR 1.28, 95% CI 1.10-1.49, P=.001), and having a new pregnancy (OR 5.57, 95% CI 4.26-7.29, P<.001) were significantly associated with late survey completion. However, young women who reported changes in

  20. Vertical distribution of the Saharan Air Layer from 5 years of CALIPSO observations

    NASA Astrophysics Data System (ADS)

    Tsamalis, C.; Chédin, A.

    2012-04-01

    The Saharan Air Layer (SAL) forms as dry and hot air moves across the Sahara desert. SAL, containing substantial amounts of mineral dust, is a dominant feature that influences the large scale environment from West Africa to eastern tropical America, inhibiting tropical cyclogenesis and Atlantic hurricane formation. Furthermore, SAL dust aerosols have a strong impact on the energy budget through the so-called direct and indirect effects. The SAL has been studied with dedicated campaigns at the two sides of the Atlantic or using space observations due to lack of systematic in situ measurements away from the continents. However the campaigns are restricted in time, while satellite observations of thermodynamic variables are affected by the presence of dust. Moreover, satellite measurements of aerosols, particularly in the visible, mostly provide column integrated properties like the optical depth, without information about the vertical distribution. On the other hand, new generation infrared sounders now bring reliable information on the dust layer mean altitude, but their new established results need further validation. However, the two-wavelength lidar CALIOP, launched on board CALIPSO in April 2006, permits an accurate determination of the aerosol vertical distribution, on a global scale. Thanks to depolarisation at 532 nm, CALIOP is able to discriminate between dust and other types of aerosols, which generally do not depolarize light. Here, the L2 5 km aerosol layer product (version 3.01) is used to calculate the vertical distribution of the dust aerosols above the Atlantic during the last 5 years (June 2006 - May 2011) with a horizontal resolution of 1 degree for the four seasons. More specifically, two classes of aerosols are used from the L2 product: dust and polluted dust, in order to take into account the change of dust aerosols optical properties with transport. Results show the latitudinal displacement of the SAL between winter [-5, 15]°N and summer [10

  1. Behavior of 60Co and 134Cs in a Canadian Shield lake over 5 years.

    PubMed

    Bird, G A; Schwartz, W J; Motycka, M; Rosentreter, J

    1998-04-01

    Radionuclides were added to the anoxic hypolimnion of a Canadian Shield lake to simulate the nuclear fuel waste disposal scenario where radionuclides might enter the bottom waters of a lake. The radionuclides remained in the hypolimnion until lake mixing at autumn turnover after which 60Co was rapidly lost and 134Cs was slowly lost from the water. Only 0.4% of the 60Co and 0.6% of the 134Cs remained in the water at year 5. Highest concentrations occurred in periphyton and filter feeders, Holopedium gibberum and clams (Anodonata grandis grandis). From maximum annual concentrations in clam tissues, it was estimated that the availability of 60Co for uptake had a half-time (t1/2) of 835 days in the lake, whereas that for 134Cs was 780 days. Loss rate coefficients, k, for the radionuclides from taxa ranged from 0.0008 to 0.0043 day-1 (t1/2 = 161-866 days) for 60Co and from 0.0009 to 0.005 day-1 (t1/2 = 139-770 days) for 134Cs. Cobalt-60 concentrations in forage fish were low, whereas 134Cs concentrations increased over the first year or two, then slowly declined. On the basis of k values measured for forage fish, the biological half-time of 134Cs in forage fish ranged from 428 to 630 days. Maximum 134Cs concentrations in forage fish were higher following hypolimnetic addition than epilimnetic addition. Relatively high 134Cs concentrations in periphyton at year 5 point to the importance of benthic pathways in the recycling of contaminants to higher trophic levels. The presence of 134Cs in biota 5 years after the addition, long after concentrations were no longer detectable in surface waters, is evidence of the persistence of Cs in aquatic systems. The k values (or t1/2 values) for the loss of 60Co and 134Cs from water and their uptake and loss from biota can be used to establish parameter values for assessment models. The results demonstrate that assessment models should account for the release of radionuclides from sediment and their subsequent recycling in the food

  2. Cumulative impacts in environmental assessments: How well are they considered

    SciTech Connect

    McCold, L. ); Holman, J. )

    1993-01-01

    The authors analyzed 89 environmental assessments published in the Federal Register from January 1 through June 30, 1992, to determine the extent to which their treatment of cumulative impacts met the requirements of 40 CFR 1500-1508. Only 35 (39%) EAs mentioned cumulative impacts. Nineteen EAs addressed cumulative impacts of some resources, but not others. The paper presents several recommendations: (1) past, present and reasonable foreseeable actions that could affect resources affected by the proposed action should be identified at the same time as, and be listed with, the proposed action. (2) for each resource, the discussion of cumulative impacts should follow immediately after the discussion of direct impacts to that resource. (3) conclusions about cumulative impacts should be supported by data and analyses. (4) agencies need a central review function to ensure the quality of their EAs.

  3. Cumulative frequency distribution of past species extinctions

    NASA Technical Reports Server (NTRS)

    Raup, D. M.

    1991-01-01

    Analysis of Sepkoski's compendium of the time ranges of 30,000+ taxa yields a mean duration of 28.4 ma for genera of fossil invertebrates. This converts to an average extinction rate of 3.5 percent per million years or about one percent every 286,000 years. Using survivorship techniques, these estimates can be converted to the species level, yielding a Phanerozoic average of one percent species extinction every 40,000 years. Variation in extinction rates through time is far greater than the null expectation of a homogeneous birth-death model and this reflects the well-known episodicity of extinction ranging from a few large mass extinctions to so-called background extinction. The observed variation in rates can be used to construct a cumulative frequency distribution of extinction intensity, and this distribution, in the form of a kill curve for species, shows the expected waiting times between extinction events of a given intensity. The kill curve is an average description of the extinction events of a given intensity. The kill curve is an average description of the extinction record and does not imply any cause or causes of extinction. The kill curve shows, among other things, that only about five percent of total species extinctions in the Phanerozoic were involved in the five largest mass extinctions. The other 95 percent were distributed among large and small events not normally called mass extinctions. As an exploration of the possibly absurd proposition that most past extinctions were produced by the effects of large-body impact, the kill curve for species was mapped on the comparable distribution for comet and asteroid impacts. The result is a curve predicting the species kill for a given size of impacting object (expressed as crater size). The results are reasonable in that impacts producing craters less than 30 km (diameter) cause negligible extinction but those producing craters 100-150 km (diameter) cause extinction of species in the range of 45

  4. Cumulative disease activity predicts incidental hearing impairment in patients with rheumatoid arthritis (RA).

    PubMed

    Pascual-Ramos, Virginia; Contreras-Yáñez, Irazú; Rivera-Hoyos, Paula; Enríquez, Lorena; Ramírez-Anguiano, Jaqueline

    2014-03-01

    We previously reported that 24% of 113 rheumatoid arthritis (RA) patients had hearing impairment (HI). We investigated if disease activity was a predictor of incidental HI. One hundred and four patients completed three consecutive 6 months-apart rheumatic evaluations and concomitant audiometric evaluations which included at least an interview, an otoscopic evaluation, and a pure tone audiometry. HI was defined if the average thresholds for at least one of low-, mid-, or high-frequency ranges were ≥25 decibels (dB) hearing level in one or both ears. Appropriated statistics was used. Internal review board approval was obtained. Patients were most frequently middle-aged (43.4 ± 13.3 years), female (89.4%), and had median disease duration of 5 years and low disease activity. All were receiving RA treatment. At inclusion, 24 patients had HI which was sensorineural in 91.7% of them. Among the 80 patients without HI at baseline, 10 (12.5%) developed incidental HI, and they had more disease activity either at baseline ([median, range] disease activity score-28 joints evaluated-C-reactive protein [DAS28-CRP], 3.9 [1.6-7.3] vs. 2.1 [1-8.7], p = 0.006) or cumulative previous incidental HI (3.4 [1.8-4.8] vs. 2 [1-6.2], p = 0.007) and were more frequently on combined methotrexate and sulfasalazine (20 vs. 1.4%, p = 0.05) than their counterparts. In the adjusted Cox proportional model, cumulative DAS28-CRP was the only variable to predict incidental HI (odds ratio, 1.8; 95% confidence interval, 1.1-2.7; p = 0.01). Almost 13% of RA patients with short disease duration and low disease activity developed incidental HI during 1 year. Cumulative disease activity predicted incidental HI. PMID:24435352

  5. Spanish Network on Effects of Wildfires on Soils. The view after 5 years of networking

    NASA Astrophysics Data System (ADS)

    Jordán, Antonio; Mataix-Solera, Jorge; Cerdà, Artemi

    2013-04-01

    1. WHAT IS FUEGORED? The Spanish Thematic Network "Effects of Wildfires on Soils" (FUEGORED, http://grupo.us.es/fuegored) has been working for over 5 years at becoming a point of reference for the study of fire-affected soils and restoration strategies. FUEGORED started in 2007, originally scheduled to run three years, as a result of the interest of Spanish researchers for developing better strategies and scientific interchange of ideas, people and collaboration between research groups. The first steps towards the establishment of a working group were a series of fieldtrips through Spain (2003), USA (2004) and Portugal (2005), where discussions about problems and research strategies arised. In its early years the network was supported by the former Ministry of Science and Innovation. This is a project to review scientific knowledge developed to date and discuss and propose future developments in scientific research about the effects of wildfires on soils. The objectives of the network are to promote and disseminate scientific research findings, provide technical and management information, and facilitate transference of knowledge between scientists, forest managers, students and society. 2. WHO IS IN THE NETWORK? The research group consists of the leading names of Spanish science in the topic and young talents, which are currently developing the most innovative research lines. Currently, the network is formed by 245 members, researchers from over 30 Spanish universities and research centers to provide the experience of decades of scientific and technical work in areas affected by forest fires and outstanding foreign researchers from Europe, Australia and America, including countries such as Australia, Italy, Lithuania, Portugal, UK, USA and others. Forest managers and technicians from various institutions are also present. 3. MAIN ACHIEVEMENTS Four international congresses have been promoted by the network in Valencia, 2008, Seville, 2009, Santiago de Compostela

  6. Risk Factors for Long-Term Mortality after Hospitalization for Community-Acquired Pneumonia: A 5-Year Prospective Follow-Up Study

    PubMed Central

    Holter, Jan C.; Ueland, Thor; Jenum, Pål A.; Müller, Fredrik; Brunborg, Cathrine; Frøland, Stig S.; Aukrust, Pål; Husebye, Einar; Heggelund, Lars

    2016-01-01

    Background Contributors to long-term mortality in patients with community-acquired pneumonia (CAP) remain unclear, with little attention paid to pneumonia etiology. We examined long-term survival, causes of death, and risk factors for long-term mortality in adult patients who had been hospitalized for CAP, with emphasis on demographic, clinical, laboratory, and microbiological characteristics. Methods Two hundred and sixty-seven consecutive patients admitted in 2008–2011 to a general hospital with CAP were prospectively recruited and followed up. Patients who died during hospital stay were excluded. Demographic, clinical, and laboratory data were collected within 48 hours of admission. Extensive microbiological work-up was performed to establish the etiology of CAP in 63% of patients. Mortality data were obtained from the Norwegian Cause of Death Registry. Cox regression models were used to identify independent risk factors for all-cause mortality. Results Of 259 hospital survivors of CAP (median age 66 years), 79 (30.5%) died over a median of 1,804 days (range 1–2,520 days). Cumulative 5-year survival rate was 72.9% (95% CI 67.4–78.4%). Standardized mortality ratio was 2.90 for men and 2.05 for women. The main causes of death were chronic obstructive pulmonary disease (COPD), vascular diseases, and malignancy. Independent risk factors for death were the following (hazard ratio, 95% CI): age (1.83 per decade, 1.47–2.28), cardiovascular disease (2.63, 1.61–4.32), COPD (2.09, 1.27–3.45), immunocompromization (1.98, 1.17–3.37), and low serum albumin level at admission (0.75 per 5g/L higher, 0.58–0.96), whereas active smoking was protective (0.32, 0.14–0.74); active smokers were younger than non-smokers (P < 0.001). Microbial etiology did not predict mortality. Conclusions Results largely confirm substantial comorbidity-related 5-year mortality after hospitalization for CAP and the impact of several well-known risk factors for death, and extend

  7. Epidemiology of Severe Acute Respiratory Illness (SARI) among Adults and Children Aged ≥5 Years in a High HIV-Prevalence Setting, 2009–2012

    PubMed Central

    Cohen, Cheryl; Walaza, Sibongile; Moyes, Jocelyn; Groome, Michelle; Tempia, Stefano; Pretorius, Marthi; Hellferscee, Orienka; Dawood, Halima; Haffejee, Summaya; Variava, Ebrahim; Kahn, Kathleen; Tshangela, Akhona; von Gottberg, Anne; Wolter, Nicole; Cohen, Adam L.; Kgokong, Babatyi; Venter, Marietjie; Madhi, Shabir A.

    2015-01-01

    Objective There are few published studies describing severe acute respiratory illness (SARI) epidemiology amongst older children and adults from high HIV-prevalence settings. We aimed to describe SARI epidemiology amongst individuals aged ≥5 years in South Africa. Methods We conducted prospective surveillance for individuals with SARI from 2009–2012. Using polymerase chain reaction, respiratory samples were tested for ten viruses, and blood for pneumococcal DNA. Cumulative annual SARI incidence was estimated at one site with population denominators. Findings We enrolled 7193 individuals, 9% (621/7067) tested positive for influenza and 9% (600/6519) for pneumococcus. HIV-prevalence was 74% (4663/6334). Among HIV-infected individuals with available data, 41% of 2629 were receiving antiretroviral therapy (ART). The annual SARI hospitalisation incidence ranged from 325-617/100,000 population. HIV-infected individuals experienced a 13–19 times greater SARI incidence than HIV-uninfected individuals (p<0.001). On multivariable analysis, compared to HIV-uninfected individuals, HIV-infected individuals were more likely to be receiving tuberculosis treatment (odds ratio (OR):1.7; 95%CI:1.1–2.7), have pneumococcal infection (OR 2.4; 95%CI:1.7–3.3) be hospitalised for >7 days rather than <2 days (OR1.7; 95%CI:1.2–2.2) and had a higher case-fatality ratio (8% vs 5%;OR1.7; 95%CI:1.2–2.3), but were less likely to be infected with influenza (OR 0.6; 95%CI:0.5–0.8). On multivariable analysis, independent risk indicators associated with death included HIV infection (OR 1.8;95%CI:1.3–2.4), increasing age-group, receiving mechanical ventilation (OR 6.5; 95%CI:1.3–32.0) and supplemental-oxygen therapy (OR 2.6; 95%CI:2.1–3.2). Conclusion The burden of hospitalized SARI amongst individuals aged ≥5 years is high in South Africa. HIV-infected individuals are the most important risk group for SARI hospitalization and mortality in this setting. PMID:25706880

  8. Independent evaluation of tolerance of therapeutic plasma inactivated by amotosalen-HCl-UVA (Intercept ™) over a 5-year period of extensive delivery.

    PubMed

    Bost, V; Chavarin, P; Boussoulade, F; Fabrigli, P; Chabre, C; Benamara, H; Odent-Malaure, H; Legrand, D; Cognasse, F; Garraud, O

    2015-11-01

    Amotosalen-HCl-UVA (AI) is a process to inactivate pathogens in therapeutic plasma (FFP). Tolerance is the main residual issue in FFP transfusion, and only large series observations are powered enough to identify significantly elevated levels of hazards. We report here on 15,133 new transfusions of AI-FFP, over the previously published 36,035, which in all represents one of the largest series observed by means of a highly standardized surveillance (51.168 observations). There is no noticeable difference in terms of tolerance of AI-FFP compared to 5875 transfusions of Quarantine (Q)-FFP. There was no significant difference in terms of advance events, between the two types of FFP (P = 0.98); further, no difference was recorded either when the total number of AI-FFP (51,168) was compared to the corresponding number of Q-FFP (5875; P = 0.62). PMID:26031441

  9. A missing link in the evolution of the cumulative recorder.

    PubMed

    Asano, Toshio; Lattal, Kennon A

    2012-09-01

    A recently recovered cumulative recorder provides a missing link in the evolution of the cumulative recorder from a modified kymograph to a reliably operating, scientifically and commercially successful instrument. The recorder, the only physical evidence of such an early precommercial cumulative recorder yet found, was sent to Keio University in Tokyo, Japan, in 1952 at the behest of B. F. Skinner at Harvard University. Last used in research in the late 1960s, the cumulative recorder remained locked in a storage room until 2007, when it was found again. A historical context for the recorder is followed by a description of the recorder and a comparison between it and the commercially successful Gerbrands Model C-1 recorder. Labeled the Keio recorder, it is a testament to Skinner's persistence in developing a reliable means of quantifying the behavior of living organisms in real time. PMID:23008524

  10. Petrology of the Cumulate Eucrite Serra de Magi

    NASA Technical Reports Server (NTRS)

    Treiman, A. H.; Goldman, K.

    2002-01-01

    Serra de Magi is a cumulate eucrite, with bizarrely shaped pyroxene crystals. One section contains a veinlet of fine-grained silica, probably chalcedony. Additional information is contained in the original extended abstract.

  11. Effect of Cumulative Damage on Rocket Motor Service Life

    NASA Astrophysics Data System (ADS)

    Gligorijević, Nikola; Živković, Saša; Subotić, Sredoje; Rodić, Vesna; Gligorijević, Ivan

    2015-10-01

    Two series of antihail rocket propellant grains failed only 3 months after production, due to the appearance of cracks in the grain channel. Structural integrity analysis demonstrated sufficient reliability at the beginning of service life. Further analysis showed that under temperature loads, cumulative damage during the short period in field stocks caused the grain failure, despite the established opinion that such failure can become significant only after lengthy storage. A linear cumulative damage law is evaluated by exposing a number of hydroxyl-terminated polybutadiene (HTPB) composite propellant specimens to different but constant stress levels. The analysis showed that cumulative damage must not be overlooked at the design stage. Further, a positive correlation between the propellant cumulative damage law and tensile strength is strongly indicated.

  12. GENERAL CONCEPTS FOR MEASURING CUMULATIVE IMPACTS ON WETLAND ECOSYSTEMS

    EPA Science Inventory

    Because environmental impacts accumulate over space and time, their analysis is difficult, and we must incorporate the most recent scientifically defensible information and methods into the process. Methods designed to deal specifically with cumulative impacts have included check...

  13. Cumulative Environmental Impacts: Science and Policy to Protect Communities.

    PubMed

    Solomon, Gina M; Morello-Frosch, Rachel; Zeise, Lauren; Faust, John B

    2016-03-18

    Many communities are located near multiple sources of pollution, including current and former industrial sites, major roadways, and agricultural operations. Populations in such locations are predominantly low-income, with a large percentage of minorities and non-English speakers. These communities face challenges that can affect the health of their residents, including limited access to health care, a shortage of grocery stores, poor housing quality, and a lack of parks and open spaces. Environmental exposures may interact with social stressors, thereby worsening health outcomes. Age, genetic characteristics, and preexisting health conditions increase the risk of adverse health effects from exposure to pollutants. There are existing approaches for characterizing cumulative exposures, cumulative risks, and cumulative health impacts. Although such approaches have merit, they also have significant constraints. New developments in exposure monitoring, mapping, toxicology, and epidemiology, especially when informed by community participation, have the potential to advance the science on cumulative impacts and to improve decision making. PMID:26735429

  14. A MISSING LINK IN THE EVOLUTION OF THE CUMULATIVE RECORDER

    PubMed Central

    Asano, Toshio; Lattal, Kennon A

    2012-01-01

    A recently recovered cumulative recorder provides a missing link in the evolution of the cumulative recorder from a modified kymograph to a reliably operating, scientifically and commercially successful instrument. The recorder, the only physical evidence of such an early precommercial cumulative recorder yet found, was sent to Keio University in Tokyo, Japan, in 1952 at the behest of B. F. Skinner at Harvard University. Last used in research in the late 1960s, the cumulative recorder remained locked in a storage room until 2007, when it was found again. A historical context for the recorder is followed by a description of the recorder and a comparison between it and the commercially successful Gerbrands Model C-1 recorder. Labeled the Keio recorder, it is a testament to Skinner's persistence in developing a reliable means of quantifying the behavior of living organisms in real time. PMID:23008524

  15. Cumulative Risk: Toxicity and Interactions of Physical and Chemical Stressors

    EPA Science Inventory

    ABSTRACT Recent efforts to update cumulative risk assessment procedures to incorporate nonchemical stressors ranging from physical to psychosocial, reflect increased interest in consideratio of the totality of variables affecting human health and the growing desire to develop co...

  16. REGION 6 EPA CUMULATIVE RISK SCREENING ASSESSMENT SYSTEM USING GIS

    EPA Science Inventory

    Region 6 EPA has developed a GIS based System to address cumulative risk. The System evaluates data for human health, ecological vulnerability, habitat fragmentation, industry regulatory compliance, and socio-economics. All criteria are mathematically associated allowing the dat...

  17. Considering Environmental and Occupational Stressors in Cumulative Risk Assessments

    EPA Science Inventory

    While definitions vary across the global scientific community, cumulative risk assessments (CRAs) typically are described as exhibiting a population focus and analyzing the combined risks posed by multiple stressors. CRAs also may consider risk management alternatives as an anal...

  18. Tools to Assess Community-Based Cumulative Risk and Exposures

    EPA Science Inventory

    Multiple agents and stressors can interact in a given community to adversely affect human and ecological conditions. A cumulative risk assessment (CRA) analyzes, characterizes, and potentially quantifies the effects from multiple stressors, which include chemical agents (for exam...

  19. A cumulative index to a continuing bibliography on aeronautical engineering

    NASA Technical Reports Server (NTRS)

    1986-01-01

    This bibliography is a cumulative index to the abstracts contained in NASA-SP-7037(184) through NASA-SP-7037(195) of Aeronautical Engineering: A Continuing Bibliography. NASA SP-7037 and its supplements have been compiled through the cooperative efforts of the American Institute of Aeronautics and Astronautics (AIAA) and the National Aeronautics and Space Administration (NASA). This cumulative index includes subject, personal author, corporate source, foreign technology, contract, report number, and accession number indexes.

  20. Aeronautical engineering: A cumulative index to a continuing bibliography

    NASA Technical Reports Server (NTRS)

    1988-01-01

    This bibliography is a cumulative index to the abstracts contained in NASA SP-7037(210) through NASA SP-7037(221) of Aeronautical Engineering: A Continuing Bibliography. NASA SP-7037 and its supplements have been compiled through the cooperative efforts of the American Institute of Aeronautics and Astronautics (AIAA) and the National Aeronautics and Space Administration (NASA). This cumulative index includes subject, personal author, corporate source, foreign technology, contract number, report number, and accession number indexes.

  1. Cumulative Query Method for Influenza Surveillance Using Search Engine Data

    PubMed Central

    Seo, Dong-Woo; Sohn, Chang Hwan; Shin, Soo-Yong; Lee, JaeHo; Yu, Maengsoo; Kim, Won Young; Lim, Kyoung Soo; Lee, Sang-Il

    2014-01-01

    Background Internet search queries have become an important data source in syndromic surveillance system. However, there is currently no syndromic surveillance system using Internet search query data in South Korea. Objectives The objective of this study was to examine correlations between our cumulative query method and national influenza surveillance data. Methods Our study was based on the local search engine, Daum (approximately 25% market share), and influenza-like illness (ILI) data from the Korea Centers for Disease Control and Prevention. A quota sampling survey was conducted with 200 participants to obtain popular queries. We divided the study period into two sets: Set 1 (the 2009/10 epidemiological year for development set 1 and 2010/11 for validation set 1) and Set 2 (2010/11 for development Set 2 and 2011/12 for validation Set 2). Pearson’s correlation coefficients were calculated between the Daum data and the ILI data for the development set. We selected the combined queries for which the correlation coefficients were .7 or higher and listed them in descending order. Then, we created a cumulative query method n representing the number of cumulative combined queries in descending order of the correlation coefficient. Results In validation set 1, 13 cumulative query methods were applied, and 8 had higher correlation coefficients (min=.916, max=.943) than that of the highest single combined query. Further, 11 of 13 cumulative query methods had an r value of ≥.7, but 4 of 13 combined queries had an r value of ≥.7. In validation set 2, 8 of 15 cumulative query methods showed higher correlation coefficients (min=.975, max=.987) than that of the highest single combined query. All 15 cumulative query methods had an r value of ≥.7, but 6 of 15 combined queries had an r value of ≥.7. Conclusions Cumulative query method showed relatively higher correlation with national influenza surveillance data than combined queries in the development and validation

  2. Aeronautical Engineering: A continuing bibliography, 1982 cumulative index

    NASA Technical Reports Server (NTRS)

    1983-01-01

    This bibliography is a cumulative index to the abstracts contained in NASA SP-7037 (145) through NASA SP-7037 (156) of Aeronautical Engineering: A Continuing Bibliography. NASA SP-7037 and its supplements have been compiled through the cooperative efforts of the American Institute of Aeronautics and Astronautics (AIAA) and the National Aeronautics and Space Administration (NASA). This cumulative index includes subject, personal author, corporate source, contract, and report number indexes.

  3. Cumulant moments in hadron-nucleus collisions and stochastic processes

    NASA Astrophysics Data System (ADS)

    Suzuki, N.; Biyajima, M.; Wilk, G.; Wlodarczyk, Z.

    1998-09-01

    Cumulant moments of negatively charged particles observed in hadron-nulceus collisions are analyzed by a leading particle cascade model. A modified negative binomial distribution (MNBD) or a negative binomial distribution (NBD) is used for multiplicity distribution from each participant hadron. If multiplicity distributions are truncated, both calculated results with the MNBD and the NBD can explain the oscillation of cumulant moments obtained from the data.

  4. A cumulative index to Aeronautical Engineering: A continuing bibliography

    NASA Technical Reports Server (NTRS)

    1982-01-01

    This bibliography is a cumulated index to the abstracts contained in NASA SP-7037(132) through NASA SP-7037(143) of Aeronautical Engineering: A continuing bibliography. NASA SP-7037 and its supplements have been compiled through the cooperative efforts of the American Institute of Aeronautics and Astronautics (AIAA) and the National Aeronautics and Space Administration (NASA). This cumulative index includes subject, personal author, corporate source, contract, and report number indexes.

  5. Aeronautical engineering: A cumulative index to a continuing bibliography

    NASA Technical Reports Server (NTRS)

    1987-01-01

    This bibliography is a cumulative index to the abstracts contained in NASA SP-7037 (197) through NASA SP-7037 (208) of Aeronautical Engineering: A Continuing Bibliography. NASA SP-7037 and its supplements have been compiled through the cooperative efforts of the American Institute of Aeronautics and Astronautics (AIAA) and the National Aeronautics and Space Administration (NASA). This cumulative index includes subject, personal author, corporate source, foreign technology, contract, report number, and accession number indexes.

  6. 75 FR 42684 - Endangered and Threatened Species; Initiation of a 5-year Review of the Baiji/Chinese River...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-22

    ... of a 5-year Review of the Baiji/Chinese River Dolphin/Yangtze River Dolphin AGENCY: National Marine... the Baiji/Chinese River Dolphin/Yangtze River Dolphin (Lipotes vexillifer) under the Endangered... Baiji/Chinese River Dolphin/Yangtze River Dolphin that has become available. Based on the results...

  7. A 3.5 year diary study: Remembering and life story importance are predicted by different event characteristics.

    PubMed

    Thomsen, Dorthe Kirkegaard; Jensen, Thomas; Holm, Tine; Olesen, Martin Hammershøj; Schnieber, Anette; Tønnesvang, Jan

    2015-11-01

    Forty-five participants described and rated two events each week during their first term at university. After 3.5 years, we examined whether event characteristics rated in the diary predicted remembering, reliving, and life story importance at the follow-up. In addition, we examined whether ratings of life story importance were consistent across a three year interval. Approximately 60% of events were remembered, but only 20% of these were considered above medium importance to life stories. Higher unusualness, rehearsal, and planning predicted whether an event was remembered 3.5 years later. Higher goal-relevance, importance, emotional intensity, and planning predicted life story importance 3.5 years later. There was a moderate correlation between life story importance rated three months after the diary and rated at the 3.5 year follow-up. The results suggest that autobiographical memory and life stories are governed by different mechanisms and that life story memories are characterized by some degree of stability. PMID:26164104

  8. Early Developmental Assessment of Children with Major Non-Cardiac Congenital Anomalies Predicts Development at the Age of 5 Years

    ERIC Educational Resources Information Center

    Mazer, Petra; Gischler, Saskia J.; van der Cammen-van Zijp, Monique H. M.; Tibboel, Dick; Bax, Nicolaas M. A.; Ijsselstijn, Hanneke; van Dijk, Monique; Duivenvoorden, Hugo J.

    2010-01-01

    Aim: The aim of this study was to evaluate cognitive and motor development in children with major congenital anomalies and the predictability of development at age 5 years. Method: A prospective, longitudinal follow-up study was undertaken. The Dutch version of the Bayley Scales of Infant Development--Mental Developmental Index (MDI) and…

  9. Are Story Preferences Sex-Linked for 2 and 3 Year Olds and for 4 and 5 Year Olds?

    ERIC Educational Resources Information Center

    Ross, Martha

    This study attempted to determine: (1) whether 2-, 3-, 4-, and 5-year-old children have sex typed story preferences; and (2) whether an attempt on the part of parents to prevent sex stereotyping would affect sex typed preferences. A review of previous research discusses measures used to determine sex linked responses and the implications of…

  10. Cognitive Based Programming for the 3, 4, and 5 Year Old and Application to Later Reading Skills.

    ERIC Educational Resources Information Center

    Range, Dale G.; And Others

    Parents and teachers are encouraged in this paper to provide home and school cognitive science activities to help their preschool-age children develop prereading skills. Many of the activities mentioned could be introduced prior to the age of 3 years and all by the age of 5 years. In general, activities that develop cognitive skills should precede…

  11. Reduced levodopa-induced complications after 5 years of subthalamic stimulation in Parkinson's disease: a second honeymoon.

    PubMed

    Simonin, Clemence; Tir, M; Devos, D; Kreisler, A; Dujardin, K; Salleron, J; Delval, A; Blond, S; Defebvre, L; Destée, A; Krystkowiak, P

    2009-10-01

    The purpose of this paper is to describe the effect of 5 years of subthalamic nucleus deep brain stimulation (STN DBS) on levodopa-induced complications, both in everyday life and during an acute challenge with levodopa. Thirty three patients were evaluated during an acute levodopa challenge before surgery and then 1 and 5 years afterwards (both off stim and on stim), using the UPDRS III scale and the CAPSIT-PD scales for dystonia and peak-dose dyskinesia. The UPDRS IV scale was used to assess motor complications in everyday life. The levodopa daily dose and DBS parameters were also recorded. Levodopa-induced complications in everyday life (UPDRS IV) and during an acute levodopa challenge had improved markedly after 1 year (both on and off stim) and still further at 5 years. Peak-dose dyskinesia decreased between the 1- and 5-year measurements. STN DBS decreases levodopa-induced motor complications over the long term. This phenomenon may be explained by (a) overall stabilization of the basal ganglia network and (b) striatal synaptic changes. Our results suggest that DBS leads to both qualitative and quantitative modulations in the corticostriatal loops. PMID:19536584

  12. Traumatic fracture through the neurocentral synchondroses of L3 vertebra in a 5-year-old child.

    PubMed

    Shapira, Gali; Militianu, Daniela

    2015-09-01

    Neurocentral synchondroses (NCS) are growth plates that contribute to the transverse growth of the vertebra. Fractures through these NCS are very rare and none have been reported in the lumbar spine. We present a rare case of a traumatic fracture through the neurocentral synchondroses of L3 vertebra in a 5-year-old child. PMID:25975183

  13. 75 FR 37385 - Endangered and Threatened Species; Initiation of a 5-Year Review of the Eastern Distinct...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-29

    ... the Recognition of Distinct Vertebrate in Population Segments (61 FR 4722). For a population to be...) under the Endangered Species Act of 1973, as amended (ESA). A 5-year review is a periodic process... law. If you wish us to withhold your name or address, you must state this request clearly at...

  14. 75 FR 16833 - Preliminary Revised 5-Year Outer Continental Shelf (OCS) Oil and Gas Leasing Program for 2007-2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-02

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR Minerals Management Service Preliminary Revised 5-Year Outer Continental Shelf (OCS) Oil and Gas Leasing... original environmental sensitivity analysis relied on only two studies conducted by Continental...

  15. A Study of the Utilization Patterns of an Elementary School-Based Health Clinic over a 5-Year Period

    ERIC Educational Resources Information Center

    Johnson, Veda; Hutcherson, Valerie

    2006-01-01

    The purpose of this study was to determine the utilization pattern of an elementary school-based clinic over a 5-year period. It involved a retrospective analysis of computer-based data for all patient visits during this study period. Results revealed high clinic utilization with an average of over 5 encounters for all users each year. The most…

  16. Trajectories of Symptoms and Impairment for Pediatric Patients with Functional Abdominal Pain: A 5-Year Longitudinal Study

    ERIC Educational Resources Information Center

    Mulvaney, Shelagh; Lambert, E. Warren; Garber, Judy; Walker, Lynn S.

    2006-01-01

    Objective: This prospective study characterizes trajectories of symptoms and impairment in pediatric patients with abdominal pain not associated with identifiable organic disease. Method: The Children's Somatization Inventory and the Functional Disability Inventory were administered four times over 5 years to 132 patients (6-18 years old) seen in…

  17. 76 FR 70156 - Proposed 5-Year Outer Continental Shelf (OCS) Oil and Gas Leasing Program for 2012-2017

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-10

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR Bureau of Ocean Energy Management Proposed 5-Year Outer Continental Shelf (OCS) Oil and Gas Leasing... Continental Shelf Lands Act (OCSLA) specifies a multi-step process of consultation and analysis that must...

  18. 77 FR 61573 - Endangered and Threatened Species; Initiation of 5-Year Review for Kemp's Ridley, Olive Ridley...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-10

    ...; Initiation of 5-Year Review for Kemp's Ridley, Olive Ridley, Leatherback, and Hawksbill Sea Turtles AGENCY... (Dermochelys coriacea), and hawksbill (Eretmochelys imbricata) sea turtles under the Endangered Species Act of... sea turtles that has become available since that has become available since their last status...

  19. Asperger Syndrome and Autism: A Comparative Longitudinal Follow-Up Study More than 5 Years after Original Diagnosis

    ERIC Educational Resources Information Center

    Cederlund, Mats; Hagberg, Bibbi; Billstedt, Eva; Gillberg, I. Carina; Gillberg, Christopher

    2008-01-01

    Prospective follow-up study of 70 males with Asperger syndrome (AS), and 70 males with autism more than 5 years after original diagnosis. Instruments used at follow-up included overall clinical assessment, the Diagnostic Interview for Social and Communication Disorders, Wechsler Intelligence Scales, Vineland Adaptive Behavior Scales, and Global…

  20. SVI implantation for carcinoma of the prostate: 5-year survival free of disease and incidence of local failure

    SciTech Connect

    Schellhammer, P.F.; el-Mahdi, A.E.; Ladaga, L.E.; Schultheiss, T.

    1985-12-01

    Interstitial implantation with the iodine isotope, SVI has been used as definitive treatment in 115 patients with localized carcinoma of the prostate. The disease was staged surgically by bilateral pelvic lymphadenectomy in all of the patients. Followup has been for a minimum of 1 year and 64 patients have been followed for a minimum of 5 years. There has been no operative mortality in this series. Mean patient age at implantation was 63 years. Potency has been maintained in 31 of 46 patients (78 per cent) followed for a minimum of 5 years and 15 of 26 (58 per cent) followed for a minimum of 7 years. At 5 years the actuarial survival free of disease by surgical stage was 100, 81, 49 and 41 per cent for patients with stages A2, B, C and D1 disease, respectively. Local failure was defined as palpable evidence of prostatic enlargement or irregularity with biopsy confirmation of neoplasm. The actuarial probability of local failure at 5 years was 0, 13, 27 and 44 per cent for patients with surgical stages A2, B, C and D1 disease, respectively, and 5, 23 and 43 per cent for those with well, moderately and poorly differentiated tumors, respectively. Based on our experience, interstitial implantation with SVI is reserved for patients with well or moderately differentiated stage B lesions. The ultimate success of this treatment modality awaits 10 and 15 years of followup.

  1. Epidemiology of Speech and Language Impairment in a Nationally Representative Sample of 4- to 5-Year-Old Children

    ERIC Educational Resources Information Center

    McLeod, Sharynne; Harrison, Linda J.

    2009-01-01

    Purpose: To draw on multiple sources of information to determine prevalence of speech and language impairment in young Australian children. Method: Information about 4,983 children (ages 4-5 years) from Growing Up in Australia: The Longitudinal Study of Australian Children (Australian Institute of Family Studies, 2007) was obtained via parent…

  2. 75 FR 53272 - Endangered and Threatened Species; Initiation of 5-Year Review of the Eastern Distinct Population...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-31

    ... requesting information related to that review (75 FR 37385). A notice correcting the email address and fax number to which comments and information should be sent was published July 7, 2010 (75 FR 38979). Written... of 5-Year Review of the Eastern Distinct Population Segment of the Steller Sea Lion AGENCY:...

  3. The Effect of Inversion on 3- to 5-Year-Olds' Recognition of Face and Nonface Visual Objects

    ERIC Educational Resources Information Center

    Picozzi, Marta; Cassia, Viola Macchi; Turati, Chiara; Vescovo, Elena

    2009-01-01

    This study compared the effect of stimulus inversion on 3- to 5-year-olds' recognition of faces and two nonface object categories matched with faces for a number of attributes: shoes (Experiment 1) and frontal images of cars (Experiments 2 and 3). The inversion effect was present for faces but not shoes at 3 years of age (Experiment 1). Analogous…

  4. 77 FR 16538 - Endangered and Threatened Species; Initiation of 5-Year Review for the North Atlantic Right Whale...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-21

    ...; Initiation of 5-Year Review for the North Atlantic Right Whale and the North Pacific Right Whale AGENCY... review of North Atlantic right whale (Eubalaena glacialis) and North Pacific right whale (Eubalaena... of any such information on these whales that has become available since the last status review...

  5. Changes in Weight over the School Year and Summer Vacation: Results of a 5-Year Longitudinal Study

    ERIC Educational Resources Information Center

    Moreno, Jennette P.; Johnston, Craig A.; Woehler, Deborah

    2013-01-01

    Background: Evidence suggests that children gain more weight during the summer months compared with the school year. To examine the impact of the school and summer environment on children's weight further, we conducted a 5-year longitudinal study examining changes in standardized BMI (zBMI) of students entering kindergarten. Methods: Heights…

  6. 76 FR 20698 - Notice of Proposed Information Collection for Public Comment; Public Housing Agency (PHA) 5-Year...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-13

    ... URBAN DEVELOPMENT Notice of Proposed Information Collection for Public Comment; Public Housing Agency (PHA) 5-Year and Annual Plan AGENCY: Office of the Assistant Secretary for Public and Indian Housing.... This Notice also lists the following information: Title of Proposal: Public Housing Agency (PHA)...

  7. Changes in weight over the school year and summer vacation: Results of a 5-year longitudinal study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Evidence suggests that children gain more weight during the summer months compared with the school year. In order to further examine the impact of the school and summer environment on children's weight, we conducted a 5-year longitudinal study examining changes in standardized BMI (zBMI) of students...

  8. Interactive Reading Experiences of African American Fathers and Social Fathers and Their 4- and 5-Year-Old Children

    ERIC Educational Resources Information Center

    Jackson, Clarissa R.

    2012-01-01

    The purpose of this mixed-methods study was to investigate the patterns of book choice and interaction during book reading sessions of six African American fathers and social fathers and their 4- to 5-year-old children. The fathers/social fathers selected and read aloud expository text, narrative text, and poetry to their children while…

  9. Point Vowel Duration in Children with Hearing Aids and Cochlear Implants at 4 and 5 Years of Age

    ERIC Educational Resources Information Center

    Vandam, Mark; Ide-Helvie, Dana; Moeller, Mary Pat

    2011-01-01

    This work investigates the developmental aspects of the duration of point vowels in children with normal hearing compared with those with hearing aids and cochlear implants at 4 and 5 years of age. Younger children produced longer vowels than older children, and children with hearing loss (HL) produced longer and more variable vowels than their…

  10. False-Belief Understanding in 2.5-Year-Olds: Evidence from Two Novel Verbal Spontaneous-Response Tasks

    ERIC Educational Resources Information Center

    Scott, Rose M.; He, Zijing; Baillargeon, Renee; Cummins, Denise

    2012-01-01

    Recent research indicates that toddlers and infants succeed at various "non-verbal" spontaneous-response false-belief tasks; here we asked whether toddlers would also succeed at verbal spontaneous-response false-belief tasks that imposed significant linguistic demands. We tested 2.5-year-olds using two novel tasks: a "preferential-looking" task in…

  11. 78 FR 24767 - Endangered and Threatened Wildlife and Plants; Announcement of Active 5-Year Status Review of the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-26

    ... for this DPS of the northern sea otter was published on August 9, 2005 (70 FR 46366). A draft recovery... Status Review of the Southwest Alaska Distinct Population Segment of the Northern Sea Otter AGENCY: Fish...) of ] the northern sea otter (Enhydra lutris kenyoni). A 5-year status review is based on the...

  12. Storyline and Associations Pyramid as Methods of Creativity Enhancement: Comparison of Effectiveness in 5-Year-Old Children

    ERIC Educational Resources Information Center

    Smogorzewska, Joanna

    2012-01-01

    This article presents the results of a study comparing the originality, the length, the number of neologisms and the syntactic complexity of fairy tales created with "Storyline" and "Associations Pyramid." Both methods were developed to enhance children's language abilities and their creative thinking. One hundred twenty eight 5-year-old children…

  13. The Influence of Two Cognitive-Linguistic Variables on Incidental Word Learning in 5-Year-Olds

    ERIC Educational Resources Information Center

    Abel, Alyson D.; Schuele, C. Melanie

    2014-01-01

    The relation between incidental word learning and two cognitive-linguistic variables--phonological memory and phonological awareness--is not fully understood. Thirty-five typically developing, 5-year-old, preschool children participated in a study examining the association between phonological memory, phonological awareness, and incidental word…

  14. Changes in weight over the school year and summer vacation: Results of a 5-year longitudinal study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Some evidence suggests that children have relatively higher increases in weight during the summer months compared to the school year. In order to further examine the impact of the school and summer environment on children's weight, we conducted a 5-year longitudinal study examining changes in standa...

  15. 8 CFR 319.4 - Persons continuously employed for 5 years by United States organizations engaged in disseminating...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Persons continuously employed for 5 years by United States organizations engaged in disseminating information. 319.4 Section 319.4 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY NATIONALITY REGULATIONS SPECIAL CLASSES OF PERSONS WHO MAY...

  16. 8 CFR 319.4 - Persons continuously employed for 5 years by United States organizations engaged in disseminating...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Persons continuously employed for 5 years by United States organizations engaged in disseminating information. 319.4 Section 319.4 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY NATIONALITY REGULATIONS SPECIAL CLASSES OF PERSONS WHO MAY...

  17. Imitation of Causally Opaque versus Causally Transparent Tool Use by 3- and 5-Year-Old Children

    ERIC Educational Resources Information Center

    McGuigan, Nicola; Whiten, Andrew; Flynn, Emma; Horner, Victoria

    2007-01-01

    We investigated whether the tendency to imitate or emulate is influenced by the availability of causal information, and the amount of information available in a display. Three and 5-year-old children were shown by either a live or video model how to obtain a reward from either a clear or an opaque puzzle box. Some of the actions in the sequence…

  18. Early Childhood: Where Learning Begins. Geography. With Activities for Children Ages 2 to 5 Years of Age.

    ERIC Educational Resources Information Center

    Fromboluti, Carol Sue; Seefeldt, Carol

    This resource book is intended to aid parents of children aged 2 to 5 years in teaching geography. The book offers ideas about how to encourage and give direction to enable young children to develop the vocabulary, awareness, and curiosity necessary to lay the foundation for the study of geography. Suggested activities are included and are…

  19. Human Figure Drawing as a Representative Medium of Perceptual Motor Development among 3- to 5-Year-Old Children.

    ERIC Educational Resources Information Center

    Numminen, Pirkko; And Others

    This study examined characteristics of human figures representing the self as drawn by 3-, 4-, and 5-year-olds and the presence of age or gender differences. A total of 150 children who were selected randomly from day care centers drew themselves on paper with crayons. There were equal numbers of boys and girls in each age group. Human figure…

  20. 78 FR 18302 - Fisheries in the Western Pacific; 5-Year Extension of Moratorium on Harvest of Gold Corals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-26

    ... moratorium on harvesting gold corals (September 12, 2008, 78 FR 47098). The Council and NMFS established the... Pacific; 5-Year Extension of Moratorium on Harvest of Gold Corals AGENCY: National Marine Fisheries... of gold corals in the U.S. Pacific Islands through June 30, 2018. NMFS intends this proposed rule...

  1. Childhood Cumulative Risk Exposure and Adult Amygdala Volume and Function.

    PubMed

    Evans, Gary W; Swain, James E; King, Anthony P; Wang, Xin; Javanbakht, Arash; Ho, S Shaun; Angstadt, Michael; Phan, K Luan; Xie, Hong; Liberzon, Israel

    2016-06-01

    Considerable work indicates that early cumulative risk exposure is aversive to human development, but very little research has examined the neurological underpinnings of these robust findings. This study investigates amygdala volume and reactivity to facial stimuli among adults (mean 23.7 years of age, n = 54) as a function of cumulative risk exposure during childhood (9 and 13 years of age). In addition, we test to determine whether expected cumulative risk elevations in amygdala volume would mediate functional reactivity of the amygdala during socioemotional processing. Risks included substandard housing quality, noise, crowding, family turmoil, child separation from family, and violence. Total and left hemisphere adult amygdala volumes were positively related to cumulative risk exposure during childhood. The links between childhood cumulative risk exposure and elevated amygdala responses to emotionally neutral facial stimuli in adulthood were mediated by the corresponding amygdala volumes. Cumulative risk exposure in later adolescence (17 years of age), however, was unrelated to subsequent adult amygdala volume or function. Physical and socioemotional risk exposures early in life appear to alter amygdala development, rendering adults more reactive to ambiguous stimuli such as neutral faces. These stress-related differences in childhood amygdala development might contribute to the well-documented psychological distress as a function of early risk exposure. © 2015 Wiley Periodicals, Inc. PMID:26469872

  2. Cumulative exposure to traumatic events in older adults

    PubMed Central

    Ogle, Christin M.; Rubin, David C.; Siegler, Ilene C.

    2014-01-01

    Objectives The present study examined the impact of cumulative trauma exposure on current posttraumatic stress disorder (PTSD) symptom severity in a nonclinical sample of adults in their 60s. The predictive utility of cumulative trauma exposure was compared to other known predictors of PTSD, including trauma severity, personality traits, social support, and event centrality. Method Community-dwelling adults (n = 2,515) from the crest of the Baby Boom generation completed the Traumatic Life Events Questionnaire, the PTSD Checklist, the NEO Personality Inventory, the Centrality of Event Scale, and rated their current social support. Results Cumulative trauma exposure predicted greater PTSD symptom severity in hierarchical regression analyses consistent with a dose-response model. Neuroticism and event centrality also emerged as robust predictors of PTSD symptom severity. In contrast, the severity of individuals’ single most distressing life event, as measured by self-report ratings of the A1 PTSD diagnostic criterion, did not add explanatory variance to the model. Analyses concerning event categories revealed that cumulative exposure to childhood violence and adulthood physical assaults were most strongly associated with PTSD symptom severity in older adulthood. Moreover, cumulative self-oriented events accounted for a larger percentage of variance in symptom severity compared to events directed at others. Conclusion Our findings suggest that the cumulative impact of exposure to traumatic events throughout the life course contributes significantly to post-traumatic stress in older adulthood above and beyond other known predictors of PTSD. PMID:24011223

  3. Observational clinical study of 22 adult-onset Pompe disease patients undergoing enzyme replacement therapy over 5years.

    PubMed

    Stepien, Karolina M; Hendriksz, Christian J; Roberts, Mark; Sharma, Reena

    2016-04-01

    Pompe disease is an autosomal recessive disease resulting from deficiency of the acid alpha-glucosidase (GAA). The late-onset Pompe Disease (LOPD) patients develop muscular and respiratory complications later in life. We describe a retrospective observational cohort study including 22 patients with LOPD. The cohort was assessed at baseline before Enzyme Replacement Therapy (ERT) with alglucosidase alpha (20mg/kg biweekly) was commenced and subsequently relevant information was collected at 2, 4 and 5years later. The median age of the patients at study entry was 44years (16-64years), with median disease duration of 11.5years (4-31years). At baseline, 10 patients (45%) could walk without support, 12 (55%) could walk with unilateral or bilateral support including 3/12 were wheelchair bound. Mean predicted FVC % was 55.7 (95% CI 45-66) of predicted normal at baseline and showed no significant change after 5years (54.6 (95% CI 43-66)), (all p=0.9815). Mean FVC % supine was 41.8 (95% CI 33.8-49) of predicted normal at baseline and remained significantly unchanged at 5years (48.4 (95% CI 37-59.6)), (all p=0.8680). The overnight non-invasive ventilator dependence increased by 18.2% as compared with baseline and requirement of mobility aids increased during this period by 5.2% as compared with the baseline. Mean walking distance at 6min walk test was 411.5 (95% CI 338-485) at baseline, 266.5 (95% CI 187-346) m at 2years, 238.6 (95% CI 162-315) m at 4years and 286.8 (95% CI 203-370) m at 5years (p=0.1981; ANOVA was completed only for 14 patients). A gradual decline in FVC% predicted was noted only in four cases and a decline in FVC% supine in two other. Only one patient showed a decline in both pulmonary function tests. In all remaining cases (17/22) respiratory function remains stable. In conclusion overall pulmonary function tests and mobility remained stable for 5years in majority of patients on ERT. However, in some patients they continued to decline in spite of ERT

  4. 76 FR 69726 - Pyrethrins/Pyrethroid Cumulative Risk Assessment; Notice of Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-09

    ... AGENCY Pyrethrins/Pyrethroid Cumulative Risk Assessment; Notice of Availability AGENCY: Environmental... cumulative risk assessment for the naturally occurring pyrethrins and synthetic pyrethroid pesticides (often... synthetic pyrethroid pesticides, and has conducted a screening-level cumulative risk assessment for...

  5. The Amphiolite Layers In The Cumulate Gabbros, (Northern-Turkey)

    NASA Astrophysics Data System (ADS)

    Özkan, Mutlu; Faruk Çelik, Ömer; Altıntaş, İsmail Emir; Sherlock, Sarah; Chelle-Michou, Cyril; Marzoli, Andrea; Ulianov, Alexey; Melih Çörtük, Rahmi; Topuz, Gültekin

    2016-04-01

    The Early-Middle Jurassic SSZ type dismembered ophiolite sequence, which is remnants of the Tethyan oceanic lithosphere, crop out in the accretionary complex around Tokat-Çamlıbel region (Northern Turkey). The main lithology of the ophiolite sequence are cumulate gabbros, isotropic gabbros and basalts. The amphibolite layers, which their thickness are up to 2 m, are observed in the cumulate gabbros. In this study, we aim to discuss a possible formation mechanism of the amphibolitic rocks in the cumulate gabbros, based on the field, mineralogical, geochemical and geochronological data. The cumulate gabbros (olivine-gabbro, gabbro-norite and gabbro) have generally well developed magmatic layers and they show cumulate texture. They are cross cut by pegmatite gabbros, dolerites and plagiogranite dikes. In terms of the mechanism of formation, the amphibolite layers in the cumulate gabbros are different from dolerite, pegmatite gabbro and plagiogranite dikes crosscutting the cumulate gabbros. Although the cumulate gabbros, the mafic and felsic dikes have not undergone any metamorphism (except the hydrothermal metamorphism), the amphibolite layers show well developed foliation and banded structure. Moreover, field and petrographic observations showed that the amphibolitic rocks were highly subjected to shearing. The amphibolitic rocks are mainly composed of magnesio-hornblende + plagioclase (andesine), ± biotite and opaque minerals and they exhibit nematoblastic texture. The amphibolite layers in the cumulate gabbros are crosscut by the plagiogranite dikes. The plagiogranites consist mainly of quartz, plagioclase, biotite and opaque minerals and they show granular texture. Undulose extinction and sub-grain formation in quartz minerals indicate to the presence of deformation phase affecting the plagiogranite dikes. LA-ICP-MS dating on zircon from plagiogranite dikes which is cross-cutting of the amphibolite layers, yielded Middle Jurassic ages. 40Ar/39Ar dating of

  6. The effects of intergroup competition on prosocial behaviors in young children: a comparison of 2.5–3.5 year-olds with 5.5–6.5 year-olds

    PubMed Central

    Zhu, Yi; Guan, Xian; Li, Yansong

    2015-01-01

    Group-based competition is considered to be a ubiquitous social context in human society. However, little is known about its potential effects on children’s prosocial behaviors. To this end, we designed an experiment in which two age groups (2.5–3.5 years of age and 5.5–6.5 years of age) engaged in an intergroup competition task where they did a so-called “game” where each child transferred table tennis balls with a spoon from one container to the other. The non-intergroup competition condition was identical to the intergroup competition condition with one exception—no intergroup competition manipulation was involved. Then, they were required to perform two economic games used to measure their prosocial behaviors. We found that under the non-intergroup competition condition, as children aged, their behaviors tended to be more fairness-oriented (such as an increase in egalitarian behaviors). However, under the intergroup competition condition, children at 2.5–3.5 years of age tended to behave prosocially towards their ingroup members compared with those who are at 5.5–6.5 years of age. The behavioral pattern under the intergroup competition condition reflects strengthening prosocial tendencies driven by the intergroup competition in younger children and simultaneously weakening intergroup competition-driven prosocial tendencies possibly due to the development of fairness-oriented behaviors in older children. Taken together, these results point to the importance of considering the effects of competitive contexts on children’s social behaviors and may have important implications for further research on the role of competitive contexts in the development of human prosocial behaviors. PMID:25729357

  7. The effects of intergroup competition on prosocial behaviors in young children: a comparison of 2.5-3.5 year-olds with 5.5-6.5 year-olds.

    PubMed

    Zhu, Yi; Guan, Xian; Li, Yansong

    2015-01-01

    Group-based competition is considered to be a ubiquitous social context in human society. However, little is known about its potential effects on children's prosocial behaviors. To this end, we designed an experiment in which two age groups (2.5-3.5 years of age and 5.5-6.5 years of age) engaged in an intergroup competition task where they did a so-called "game" where each child transferred table tennis balls with a spoon from one container to the other. The non-intergroup competition condition was identical to the intergroup competition condition with one exception-no intergroup competition manipulation was involved. Then, they were required to perform two economic games used to measure their prosocial behaviors. We found that under the non-intergroup competition condition, as children aged, their behaviors tended to be more fairness-oriented (such as an increase in egalitarian behaviors). However, under the intergroup competition condition, children at 2.5-3.5 years of age tended to behave prosocially towards their ingroup members compared with those who are at 5.5-6.5 years of age. The behavioral pattern under the intergroup competition condition reflects strengthening prosocial tendencies driven by the intergroup competition in younger children and simultaneously weakening intergroup competition-driven prosocial tendencies possibly due to the development of fairness-oriented behaviors in older children. Taken together, these results point to the importance of considering the effects of competitive contexts on children's social behaviors and may have important implications for further research on the role of competitive contexts in the development of human prosocial behaviors. PMID:25729357

  8. Improvement of Renal Functions After Embolization of Renal AVF in a Patient Who had been on Dialysis for 5 Years

    SciTech Connect

    Ulusoy, Suekrue Oezkan, Guelsuem; Dinc, Hasan; Kaynar, Kuebra; Oeztuerk, Mehmet Halil; Guel, Semih; Kaplan, Safiye Tuba

    2011-02-15

    Recently, ultrasound-guided percutaneous renal biopsy has been used in the diagnosis of renal diseases. Development of an arteriovenous fistula (AVF), which is one of the post-biopsy complications, is not frequently encountered. AVFs are usually asymptomatic; however, they may lead to serious outcomes. We report a 21-year-old patient, who had been on dialysis for 5 years. Due to high blood pressure (230/160 mmHg) and a thrill in the lumbar area detected on physical examination, Doppler examination was performed and a renal AVF was detected. Because the patient had a history of renal biopsy 5 years previously, the fistula was thought to be secondary to the biopsy. After embolization of the AVF, renal functions improved enough to terminate dialysis treatment.

  9. Comparing single and cumulative dosing procedures in human triazolam discriminators.

    PubMed Central

    Smith, B J; Bickel, W K

    1999-01-01

    This study evaluated a cumulative dosing procedure for drug discrimination with human participants. Four participants learned to discriminate triazolam (0.35 mg/70 kg) from placebo. A crossover design was used to compare the results under a single dosing procedure with results obtained under a cumulative dosing procedure. Under the single dosing procedure, a dose of triazolam (0, 0.05, 0.15, or 0.35 mg/70 kg) or secobarbital (0, 25, 75, or 175 mg/70 kg) was administered 45 min before assessment. Determining each dose-effect curve thus required four sessions. Under the cumulative dosing procedure, four doses of triazolam (0, 0.05, 0.10, and 0.20 mg/70 kg) or secobarbital (0, 25, 50, and 100 mg/70 kg) were administered approximately 55 min apart, producing a complete dose-effect curve in one four-trial session. Regardless of procedure, triazolam and secobarbital produced discriminative stimulus and self-reported effects similar to previous single dosing studies in humans. Shifts to the right in cumulative dose-effect curves compared to single dose-effect curves occurred on several self-report measures. When qualitative stimulus functions rather than quantitative functions are of interest, application of cumulative dosing may increase efficiency in human drug discrimination. PMID:10344022

  10. Intelligence and Visual Motor Integration in 5-Year-Old Children with 22q11-Deletion Syndrome

    ERIC Educational Resources Information Center

    Duijff, Sasja; Klaassen, Petra; Beemer, Frits; Swanenburg de Veye, Henriette; Vorstman, Jacob; Sinnema, Gerben

    2012-01-01

    The purpose of this study was to explore the relationship between intelligence and visual motor integration skills in 5-year-old children with 22q11-deletion syndrome (22q11DS) (N = 65, 43 females, 22 males; mean age 5.6 years (SD 0.2), range 5.23-5.99 years). Sufficient VMI skills seem a prerequisite for IQ testing. Since problems related to…

  11. Comprehensive Comparison of the 5-Year Results of All-on-4 Mandibular Implant Systems With Acrylic and Ceramic Suprastructures.

    PubMed

    Ayna, Mustafa; Gülses, Aydin; Açil, Yahya

    2015-12-01

    The objective of the present study was to evaluate the comprehensive 5-year results of fixed mandibular dentures fabricated from metal-acrylic or metal-ceramics according to the All-on-4 protocol. Twenty-seven patients who received immediately loaded All-on-4 fixed mandibular dentures in 2006 were included in the study, and they were evaluated up to 5 years after denture integration. Endpoints were chosen in accordance with the 2007 Pisa consensus and included bone resorption, the Oral Health Impact Profile (OHIP), the sulcus fluid flow rate (SFFR), and prosthodontic complications. The initial situation in both groups was largely identical. Bone loss remained under 2 mm after 5 years in all implants and showed no group difference. The SFFR showed a gradual increase in both groups, and acrylic-bearing implants showed a substantially and significantly higher flow rate from the third year onward. The subjective improvement as expressed by the OHIP score was immediate and dramatic, and it showed no group differences. All acrylic restorations showed some extent of abrasion, and veneer fractures occurred in 4 patients (28.6%). Besides a single fracture of a fixation screw, there were no prosthetic complications in patients with ceramic suprastructures. According to bone loss and subjective outcome, acrylic and ceramic suprastructures appeared to be equivalent after 5 years; however, sulcus flow and prosthodontic complications suggest that the economic advantage of acrylic dentures may be specious. The rational choice of implant suprastructures requires comprehensive, long-term observation. Short-term economic benefits might be cancelled out in the long term. PMID:24712706

  12. Alveolar Ridge Contouring with Free Connective Tissue Graft at Implant Placement: A 5-Year Consecutive Clinical Study.

    PubMed

    Hanser, Thomas; Khoury, Fouad

    2016-01-01

    This study evaluated volume stability after alveolar ridge contouring with free connective tissue grafts at implant placement in single-tooth gaps. A total of 52 single-tooth gaps with labial volume deficiencies in the maxilla (incisors, canines, and premolars) were consecutively treated with implants and concomitant free palatal connective tissue grafts in 46 patients between 2006 and 2009. Implants had to be covered with at least 2 mm peri-implant local bone after insertion. At implant placement, a free connective tissue graft from the palate was fixed inside a labial split-thickness flap to form an existing concave buccal alveolar ridge contour due to tissue volume deficiency into a convex shape. Standardized volumetric measurements of the labial alveolar contour using a template were evaluated before connective tissue grafting and at 2 weeks, 1 year, and 5 years after implantprosthetic incorporation. Tissue volume had increased significantly (P < .05) in all six reference points representing the outer alveolar soft tissue contour of the implant before connective tissue grafting to baseline (2 weeks after implant-prosthetic incorporation). Statistically, 50% of the reference points (P > .05) kept their volume from baseline to 1 year after prosthetic incorporation and from baseline to 5 years after prosthetic incorporation, respectively, whereas reference points located within the area of the implant sulcus showed a significant (P < .05) decrease in volume. Clinically, 5 years after prosthetic incorporation the originally concave buccal alveolar contour was still convex in all implants, leading to a continuous favorable anatomical shape and improved esthetic situation. Intraoral radiographs confirmed osseointegration and stable peri-implant parameters with a survival rate of 100% after a follow-up of approximately 5 years. Implant placement with concomitant free connective tissue grafting appears to be an appropriate long-term means to contour preexisting buccal

  13. Cognitive and Neuropsychological Outcomes at 5 Years of Age in Preterm Children Born in the 2000s

    ERIC Educational Resources Information Center

    Lind, Annika; Korkman, Marit; Lehtonen, Liisa; Lapinleimu, Helena; Parkkola, Riitta; Matomaki, Jaakko; Haataja, Leena

    2011-01-01

    Aim: The aim of this study was to assess the cognitive level and neuropsychological performance at 5 years of age in children with a very low birthweight (VLBW; birthweight less than 1501g) born in 2001 to 2003. Method: A regional cohort of 97 children with a VLBW (mean gestational age 28wks [SD 3wks]; mean birthweight 1054g [SD 259g]; 50 male; 47…

  14. SU-E-J-52: Decreasing Frequency of Performing TG-142 Imaging QA – 5 Year Experience

    SciTech Connect

    Lin, T; Ma, C

    2015-06-15

    Purpose This study is an update to check if the frequency of imaging QA suggested by AAPM Task Group Report 142 (TG142) is necessary with our 5 year experience. TG142 presents recommendations for QA criteria of IGRT treatment. ACR has adopted it to be the requirements for any radiatiotherapy practices; however, we propose to reduce the frequency on image quality QA according to this 5 year study.Method and Materials: This study uses VarianIX2100 and Siemens Artiste Linacs to perform QAs on KV, MV, CBCT modalities. The QA was designed following under the recommendations of TG142. This study reports the daily imaging positioning/repositioning and imaging and treatment coordinate coincidence. QA results on kV, MV and CBCT from 4/7/2010∼3/11/15 are analyzed. KV, MV, CBCT images are taken with the Varian isocube localized at the isocenter. Digital graticule is used in the software to verify the isocenter position. CBCT images are taken with the cube placed at 1cm superior, lateral and anterior of the isocenter. In-line fusion software is used to verify the contrived shift. Digital ruler provided at the on-board-imaging software or adaptive-targeting software was used to measure the position differences. The position differences were recorded at AP,LR,SI directions. Results 5 year records on kV, MV, CBCT show the shifts in all three directions are within the tolerance of 1mm suggested in TG142 for stereotactic radiation treatment(SRS/SRT). There is no occasion where shifts are outside 1mm tolerance. Conclusions The daily imaging QA suggested in TG142 is useful in ensuring the accuracy needed for SRS/SRT in IGRT. 5 year measurements presented suggest that decreasing the frequency of imaging QA may be acceptable, in particular for institutions reporting no violation of tolerance over periods of few years.

  15. Low-Dose Atypical Antipsychotic Risperidone Improves the 5-Year Outcome in Alzheimer's Disease Patients with Sleep Disturbances.

    PubMed

    Yin, You; Liu, Yan; Zhuang, Jianhua; Pan, Xiao; Li, Peng; Yang, Yuechang; Li, Yan-Peng; Zhao, Zheng-Qing; Huang, Liu-Qing; Zhao, Zhong-Xin

    2015-01-01

    Sleep disturbances (SD) accelerate the progression of Alzheimer's disease (AD) and increase the stress of caregivers. However, the long-term outcome of disturbed nocturnal sleep/wake patterns in AD and on increased stress of spousal caregivers is unclear. This study assessed the 5-year effect of nocturnal SD on the long-term outcome in AD patients. A total of 156 donepezil-treated mild-moderate AD patients (93 AD + SD and 63 AD - SD as a control group) were recruited. The AD + SD patients were formed into 4 subgroups according to the preferences of spousal caregivers for treatment with atypical antipsychotics (0.5-1 mg risperidone, n = 22), non-benzodiazepine hypnotic (5-10 mg zolpidem tartrate, n = 33), melatonin (2.55 mg, n = 9), or no-drug treatment (n = 29). SD were evaluated by polysomnography, sleep scale, and cognitive scale examinations. Moreover, all spousal caregivers of AD patients were assessed using a series of scales, including sleep, anxiety, mood, and treatment attitude scales. Our data showed that nocturnal sleep/wake disturbances were significantly associated with lower 5-year outcomes for AD patients, earlier nursing home placement, and more negative emotions of spousal caregivers. Treatment with low-dose atypical antipsychotic risperidone improved the 5-year outcome in AD + SD patients. In conclusion, low-dose atypical antipsychotic risperidone improves the 5-year outcome in AD patients with SD. Moreover, improvement of nocturnal sleep problems in AD patients will also bring better emotional stability for AD caregivers. PMID:26279176

  16. Total Knee Arthroplasty Using a Posterior Cruciate Ligament Sacrificing Medial Pivot Knee: Minimum 5-year Follow-up Results

    PubMed Central

    Youm, Yoon-Seok; Lee, Seon-Ho; Cho, Hye-Yong

    2014-01-01

    Purpose To evaluate minimum 5-year follow-up clinical and radiological results of total knee arthroplasty (TKA) using a posterior cruciate ligament sacrificing (PS), non-substituting Advance Medial Pivot Knee. Materials and Methods One hundred and twenty knees in 80 patients who could be followed up for more than 5 years after TKA using the PS Advance Medial Pivot Knee were evaluated retrospectively. The evaluations included the preoperative and postoperative range of motion (ROM), tibiofemoral angle, Knee Society (KS) knee and function scores, and Western Ontario and McMaster Universities Arthritis Index (WOMAC) score. The Kaplan-Meier method was used for survival analysis. Results The ROM increased from a preoperative mean flexion contracture of 7.6° and further flexion of 115.1° to a postoperative mean flexion contracture of 1.5° and further flexion of 120.5°. The tibiofemoral angle was changed from 4.6° varus preoperatively to 5.8° valgus postoperatively. The KS knee and function scores as well as WOMAC score significantly improved after surgery (p<0.05). Complications developed in 4 cases (3.3%): 2 cases of periprosthetic patellar fracture (1.7%) and 2 cases of aseptic loosening (1.7%). The seven-year survival rate was 98.1% in the Kaplan-Meier survival analysis. Conclusions The minimum 5-year follow-up results of TKA using the PS Medial Pivot Knee were satisfactory. PMID:25229042

  17. Polyethylene wear with an entirely HA-coated total hip replacement: 79 hips followed for 5 years.

    PubMed

    Røkkum, M; Reigstad, A

    1998-06-01

    We measured the eccentricity of the femoral head in the metal backing annually during 5 years in 79 consecutive total hip replacements (73 patients). The mean age of the patients was 57 (32-73) years and the female/male ratio 63/22. The prostheses were entirely coated with hydroxyapatite. Modular 32 mm stainless steel heads and hemispherical, self-tapping screw cups with polyethylene liners were used. We found accelerating eccentricity throughout the observation period. The mean eccentricity at 5 years was 0.71 mm (95% CI 0.53-0.90), resulting in a mean eccentricity rate of 0.14 mm (0.11-0.18) per year. The 5-year eccentricity was 0.5 mm or less in 45 hips and more than 1.5 mm in 13 hips, 2 in the latter group apparently having worn through the polyethylene liner. The true wear may be twice as great. The use of 32 mm stainless steel heads and thin polyethylene inlays may have aggravated the wear problems. These HA-coated prostheses must all be checked regularly, so that cases with excessive polyethylene wear can be reoperated on before wear-through of the liner. PMID:9703398

  18. Continuous cytogenetic follow-up, over 5 years, of three individuals accidentally irradiated by a cobalt-60 source.

    PubMed

    Wang, Zhi-Dong; Zhang, Xue-Qing; Du, Jie; Lu, Xue; Wang, Yuan; Tian, Rong; Liu, Qing-Jie; Chen, Ying

    2015-02-01

    A cobalt-60 irradiation accident occurred in Shanxi, China, on April 11, 2008. Five people were exposed to total-body irradiation ranging from 1.7 to 14.5 Gy. Two victims died post-irradiation, due to acute intestinal radiation sickness (at 62 days) and tuberculosis (at 1.5 year). The other three victims received medical follow-ups and were monitored for 5 years with multiple cytogenetic analyses. Unstable chromosome aberrations, including dicentric and centric rings (dic+r) and the micronucleus frequency in binucleated lymphocytes, were monitored. In addition, G-banding karyotype and fluorescence in situ hybridization (FISH) methods were used to analyze translocations, for exploring chromosome stability and for retrospective dosimetry. The results show that unstable chromosome aberrations (dic+r) declined each year, dropping to about 20-40% of initial levels by the 5th year. A similar trend was observed for the micronucleus frequency. Our results show that the translocation frequencies of the three victims, detected by G-banding karyotype, remained stable for the 5 years. Five years after irradiation, the translocation rates of the three victims (G-banding and FISH analyses) were similar. The retrospective estimated doses, reconstructed based on the translocation frequencies, were consistent with the biological doses estimated at the first day post-irradiation using dic+r. The results of this study indicate that chromosome translocation frequencies can be used as a biological dosimeter and are an excellent index for dose reconstruction. PMID:25813720

  19. The Risk of Reported Cryptosporidiosis in Children Aged <5 Years in Australia is Highest in Very Remote Regions

    PubMed Central

    Lal, Aparna; Fearnley, Emily; Kirk, Martyn

    2015-01-01

    The incidence of cryptosporidiosis is highest in children <5 years, yet little is known about disease patterns across urban and rural areas of Australia. In this study, we examine whether the risk of reported cryptosporidiosis in children <5 years varies across an urban-rural gradient, after controlling for season and gender. Using Australian data on reported cryptosporidiosis from 2001 to 2012, we spatially linked disease data to an index of geographic remoteness to examine the geographic variation in cryptosporidiosis risk using negative binomial regression. The Incidence Risk Ratio (IRR) of reported cryptosporidiosis was higher in inner regional (IRR 1.4 95% CI 1.2–1.7, p < 0.001), and outer regional areas (IRR 2.4 95% CI 2.2–2.9, p < 0.001), and in remote (IRR 5.2 95% CI 4.3–6.2, p < 0.001) and very remote (IRR 8.2 95% CI 6.9–9.8, p < 0.001) areas, compared to major cities. A linear test for trend showed a statistically significant trend with increasing remoteness. Remote communities need to be a priority for future targeted health promotion and disease prevention interventions to reduce cryptosporidiosis in children <5 years. PMID:26393636

  20. Effect of three types of light-curing units on 5-year colour changes of light-cured composite.

    PubMed

    Tak, Onjen; Altintas, Subutay Han; Ozturk, Nilgun; Usumez, Aslihan

    2009-03-01

    The purpose of this study was to determine colour changes in a composite cured with tungsten-halogen, light-emitting diode (LED) or a plasma arc after 5 years. Five specimens 10 mm in diameter and 2 mm in height were prepared using Hybrid (Clearfil AP-X) composite for each test group. The corresponding specimens were cured with a tungsten-halogen curing light, a LED unit or with a plasma arc. Specimens were stored in light-proof boxes for 5 years after the curing procedure to avoid further exposure to light and stored in 37 degrees C in 100% humidity. Colorimetric values of the specimens immediately after curing and after 5 years were measured using colorimeter. The DeltaE*( ab ) values varied significantly depending on the curing unit used (p < 0.001). Curing time did not affect the colour changes of the specimens (p = 0.4). The results of this study suggest that composite materials undergo measurable changes due to the curing unit exposure. PMID:18769947

  1. Stereotactic body radiation therapy for nonmetastatic lung cancer: An analysis of 75 patients treated over 5 years

    SciTech Connect

    Beitler, Jonathan J. . E-mail: jbeitler92@alumni.gsb.columbia.edu; Badine, Edgard A.; El-Sayah, Danny; Makara, Denise; Friscia, Phillip; Silverman, Phillip; Terjanian, Terenig

    2006-05-01

    Purpose: Non-small-cell lung cancer (NSCLC) may not be medically operable even in patients with surgically resectable disease. For patients who either refuse surgery or are medically inoperable, radiation therapy may be the best therapeutic choice. Stereotactic body radiation therapy (SBRT) employs external fixation and hypofractionation to deliver a high dose per fraction of radiation to a small target volume. Methods and Materials: Retrospective review of 75 patients treated over 5 years at Staten Island University Hospital as definitive treatment for NSCLC or presumed NSCLC. Patients received a median of 5 fractions of 8 Gy per fraction over 27 days. Results: Overall 1-, 2-, and 5-year actuarial survivals were 63%, 45%, and 17%. Patients with a gross tumor volume (GTV) less than 65 cm{sup 3} enjoyed a longer median survival (25.7 vs. 9.9 months, p < 0.003), and at 5 years, the actuarial survival for the patients with GTVs less than 65 cm{sup 3} was 24% vs. 0% for those with GTVs larger than 65 cm{sup 3}. Conclusions: Stereotactic body radiation therapy as delivered was ineffective for curing the patients whose GTVs were larger than 65 cm{sup 3}. SBRT was promising for those with GTVs less than 65 cm{sup 3}.

  2. Long-term (5 years), high daily dosage of dietary agmatine--evidence of safety: a case report.

    PubMed

    Gilad, Gad M; Gilad, Varda H

    2014-11-01

    There is presently a great interest in the therapeutic potential of agmatine, decarboxylated arginine, for various diseases. Recent clinical studies have already shown that oral agmatine sulfate given for up to 3 weeks provides a safe and, as compared with current therapeutics, more effective treatment for neuropathic pain. These studies have ushered in the use of dietary agmatine as a nutraceutical. However, in view of information paucity, assessment of long-term safety of oral agmatine treatment is now clearly required. The authors of this report undertook to assess their own health status during ongoing consumption of a high daily dosage of oral agmatine over a period of 4-5 years. A daily dose of 2.67 g agmatine sulfate was encapsulated in gelatin capsules; the regimen consists of six capsules daily, each containing 445 mg, three in the morning and three in the evening after meals. Clinical follow-up consists of periodic physical examinations and laboratory blood and urine analyses. All measurements thus far remain within normal values and good general health status is sustained throughout the study period, up to 5 years. This case study shows for the first time that the recommended high dosage of agmatine may be consumed for at least 5 years without evidence of any adverse effects. These initial findings are highly important as they provide significant evidence for the extended long-term safety of a high daily dosage of dietary agmatine--a cardinal advantage for its utility as a nutraceutical. PMID:25247837

  3. Low frequency of axial involvement in Caucasian pediatric patients with seronegative enthesopathy and arthropathy syndrome after 5 years of disease.

    PubMed

    Olivieri, I; Foto, M; Ruju, G P; Gemignani, G; Giustarini, S; Pasero, G

    1992-03-01

    In order to establish how many children with seronegative spondyloarthropathy (SpA) starting with peripheral arthritis and/or enthesitis will develop ankylosing spondylitis (AS), 13 consecutive Caucasian pediatric patients, (11 with the seronegative enthesopathy and arthropathy (SEA) syndrome and 2 with isolated B27 associated peripheral arthritis or enthesitis at entry), were followed prospectively with no loss for more than 5 years. Sacroiliac joint plain films obtained at the last visit were mixed with those of 14 control subjects and read blindly. The course of SpA was self-limiting in 6 patients and recurrent in the other 7. Six patients had episodes of inflammatory cervical and/or lumbar pain during followup. However, none showed any limitation of spinal movement in the asymptomatic periods. Only one patient (9.1%) of 11 with the SEA syndrome showed bilateral sacroiliitis and met New York criteria for AS after 5 years of disease. Our results suggest that the proportion of Caucasian children with the SEA syndrome developing AS is much lower than the 75% found in a similar study on Mexican children. Lack of evaluation of all patients after 5 years, the reading of pelvic plain films without reducing observer error, and the male predominance in the Mexican study, probably in addition to ethnic or environmental factors, may account for differences. PMID:1578464

  4. Soft tissue stability after segmental distraction of the anterior mandibular alveolar process: a 5.5 year follow-up.

    PubMed

    Joss, C U; Triaca, A; Antonini, M; Kiliaridis, S; Kuijpers-Jagtman, A M

    2013-03-01

    Soft tissue changes were analysed retrospectively in 17 patients following distraction osteogenesis (DO) of the mandibular anterior alveolar process. Lateral cephalograms were traced by hand, digitized, superimposed, and evaluated at T1 (17.0 days), after DO at T2 (mean 6.5 days), at T3 (mean 24.4 days), at T4 (mean 2.0 years), and at T5 (mean 5.5 years). Statistical analysis was carried out using Kolmogorov-Smirnov test, paired t-test, Pearson's correlation coefficient, and linear backward regression analysis. 5.5 years postoperatively, the net effect for the soft tissue at point B' was 88% of the advancement at point B while the lower lip (labrale inferior) followed the advancement of incision inferior to 24%. Increased preoperative age was correlated (p<0.05) with more horizontal backward movement (T5-T3) for labrale inferior and pogonion'. Higher NL/ML' angles were significantly correlated (p<0.05) to smaller horizontal soft tissue change at labrale inferior (T5-T3). The amount of advancement at point B was significantly correlated with an upward movement (T5-T3) of labrale inferior (p<0.01) and stomion inferior (p<0.05). It can be concluded that further change in soft tissues occurred between 2.0 and 5.5 years postoperatively. The physiological process of ageing and loss of soft tissue elasticity should be considered as possible reasons. PMID:23182400

  5. Transdermal delivery: product and patent update.

    PubMed

    Gupta, Himanshu; Babu, R J

    2013-12-01

    Transdermal drug delivery is an attractive alternative to the oral and parenteral drug delivery. Drugs which are prone to first-pass metabolism can be delivered easily in small doses with sustained blood levels through this method. An update to available products along with a review of clinical trials and patents are discussed in this study. In this review, we have compiled 16 drugs, i.e. Buprenorphine, Clonidine, Estradiol, Fentanyl, Granisetron, Lidocaine, Methylphenidate, Nicotine, Nitroglycerin, Oxybutynin, Rivastigmine, Rotigotine, Scopolamine, Selegiline, Testosterone, Influenza virus vaccine (Microneedle) and covering about 22 marketed products on the transdermal system. We present instrumental information on them along with the compilation of current clinical trials on transdermal systems. We summarize the contents of patents granted in last 5 years under different pharmacological categories. This article serves, accordingly as a source of available information focused on transdermal drug delivery research. PMID:24025130

  6. Wick polynomials and time-evolution of cumulants

    NASA Astrophysics Data System (ADS)

    Lukkarinen, Jani; Marcozzi, Matteo

    2016-08-01

    We show how Wick polynomials of random variables can be defined combinatorially as the unique choice, which removes all "internal contractions" from the related cumulant expansions, also in a non-Gaussian case. We discuss how an expansion in terms of the Wick polynomials can be used for derivation of a hierarchy of equations for the time-evolution of cumulants. These methods are then applied to simplify the formal derivation of the Boltzmann-Peierls equation in the kinetic scaling limit of the discrete nonlinear Schödinger equation (DNLS) with suitable random initial data. We also present a reformulation of the standard perturbation expansion using cumulants, which could simplify the problem of a rigorous derivation of the Boltzmann-Peierls equation by separating the analysis of the solutions to the Boltzmann-Peierls equation from the analysis of the corrections. This latter scheme is general and not tied to the DNLS evolution equations.

  7. Session: What do we know about cumulative or population impacts

    SciTech Connect

    Kerlinger, Paul; Manville, Al; Kendall, Bill

    2004-09-01

    This session at the Wind Energy and Birds/Bats workshop consisted of a panel discussion followed by a discussion/question and answer period. The panelists were Paul Kerlinger, Curry and Kerlinger, LLC, Al Manville, U.S. Fish and Wildlife Service, and Bill Kendall, US Geological Service. The panel addressed the potential cumulative impacts of wind turbines on bird and bat populations over time. Panel members gave brief presentations that touched on what is currently known, what laws apply, and the usefulness of population modeling. Topics addressed included which sources of modeling should be included in cumulative impacts, comparison of impacts from different modes of energy generation, as well as what research is still needed regarding cumulative impacts of wind energy development on bird and bat populations.

  8. Cumulant t-expansion for strongly correlated fermions

    NASA Astrophysics Data System (ADS)

    Zhuravlev, A. K.

    2016-05-01

    A systematic nonperturbative scheme is implemented to calculate the ground state energy for a wide class of strongly correlated fermion models. The scheme includes: (a) a method of automatic calculations of the cumulants of the model Hamiltonian, (b) a method of the ground state energy calculation from these cumulants using the t-expansion proposed by Horn and Weinstein (1984) [9] with new procedure of its extrapolation to t → ∞. As an example of application of the scheme all cumulants up to the 8-th order for spinless fermion model are calculated exactly, and converging sequences of approximations to the ground state energy are obtained for one-, two- and three-dimensional versions of the model.

  9. Triggering of major eruptions recorded by actively forming cumulates

    PubMed Central

    Stock, Michael J.; Taylor, Rex N.; Gernon, Thomas M.

    2012-01-01

    Major overturn within a magma chamber can bring together felsic and mafic magmas, prompting de-volatilisation and acting as the driver for Plinian eruptions. Until now identification of mixing has been limited to analysis of lavas or individual crystals ejected during eruptions. We have recovered partially developed cumulate material (‘live’ cumulate mush) from pyroclastic deposits of major eruptions on Tenerife. These samples represent “frozen” clumps of diverse crystalline deposits from all levels in the developing reservoir, which are permeated with the final magma immediately before eruptions. Such events therefore record the complete disintegration of the magma chamber, leading to caldera collapse. Chemical variation across developing cumulus crystals records changes in melt composition. Apart from fluctuations reflecting periodic influxes of mafic melt, crystal edges consistently record the presence of more felsic magmas. The prevalence of this felsic liquid implies it was able to infiltrate the entire cumulate pile immediately before each eruption. PMID:23066500

  10. Triggering of major eruptions recorded by actively forming cumulates.

    PubMed

    Stock, Michael J; Taylor, Rex N; Gernon, Thomas M

    2012-01-01

    Major overturn within a magma chamber can bring together felsic and mafic magmas, prompting de-volatilisation and acting as the driver for Plinian eruptions. Until now identification of mixing has been limited to analysis of lavas or individual crystals ejected during eruptions. We have recovered partially developed cumulate material ('live' cumulate mush) from pyroclastic deposits of major eruptions on Tenerife. These samples represent "frozen" clumps of diverse crystalline deposits from all levels in the developing reservoir, which are permeated with the final magma immediately before eruptions. Such events therefore record the complete disintegration of the magma chamber, leading to caldera collapse. Chemical variation across developing cumulus crystals records changes in melt composition. Apart from fluctuations reflecting periodic influxes of mafic melt, crystal edges consistently record the presence of more felsic magmas. The prevalence of this felsic liquid implies it was able to infiltrate the entire cumulate pile immediately before each eruption. PMID:23066500

  11. Cumulative impacts on water-quality functions of wetlands

    SciTech Connect

    Hemond, H.F.; Benoit, J.

    1988-01-01

    Cumulative impacts on the water-quality function of wetlands are impacts whose total effect cannot be predicted from the sum of the effects of individual impacts. The wetland is not a simple filter; it embodies chemical, physical, and biotic processes that can detain, transform, release, or produce a wide variety of substances. Because wetland water-quality functions result from the operation of many individual, distinct, and quite dissimilar mechanisms, it is necessary to consider the nature of each individual process. Given knowledge of the various wetland processes, it is possible to make more-guided judgments about the effects a suite of impacts is likely to have. When considered in this light, many common wetland alterations seem likely to involve cumulative impact. The wetland manager may be guided further by appropriate field measurements at specific sites; such data can aid in predicting cumulative impact or assessing the results of past wetland management.

  12. Effect of correlations on cumulants in heavy-ion collisions

    NASA Astrophysics Data System (ADS)

    Mishra, D. K.; Garg, P.; Netrakanti, P. K.

    2016-02-01

    We study the effects of correlations on cumulants and their ratios of net-proton multiplicity distributions which have been measured for central (0%-5%) Au+Au collisions at the Relativistic Heavy Ion Collider (RHIC). This effect has been studied by assuming individual proton and antiproton distributions as a Poisson or negative binomial distribution (NBD). In spite of significantly correlated production due to baryon number, electric charge conservation, and kinematical correlations of protons and antiprotons, the measured cumulants of the net-proton distribution follow the independent-production model. In the present work we demonstrate how the introduction of the correlations will affect the cumulants and their ratios for the difference distributions. We have also demonstrated this study using the proton and antiproton distributions obtained from the hijing event generator.

  13. 5-year Follow-up of a Randomized Controlled Trial of Immediate versus Delayed Zoledronic Acid for Prevention of Bone Loss in Postmenopausal Women with Breast Cancer Starting Letrozole after Tamoxifen: N03CC (Alliance)

    PubMed Central

    Wagner-Johnston, Nina D.; Sloan, Jeff A.; Liu, Heshan; Kearns, Ann E.; Hines, Stephanie L.; Puttabasavaiah, Suneetha; Dakhil, Shaker R.; Lafky, Jacqueline M.; Perez, Edith A.; Loprinzi, Charles L.

    2015-01-01

    Background Postmenopausal women with breast cancer (BC) receiving aromatase inhibitors are at increased risk for bone loss. The current study was undertaken to determine whether upfront versus delayed treatment with zoledronic acid (ZA) impacted bone loss. This report describes the 5-year follow-up results. Methods 551 postmenopausal women with BC completing tamoxifen and undergoing daily letrozole treatment were randomized to upfront (274) or delayed (277) ZA 4 mg IV every 6 months. In the delayed arm, ZA was initiated for post-baseline bone mineral density (BMD) T-score < -2.0 or fracture. Results The incidence of a 5% decrease in total lumbar spine BMD at 5 years was 10.2% in the upfront arm versus 41.2% in the delayed arm, p < 0.0001. 41 patients in the delayed arm were eventually started on ZA. With the exception of increased grade 1/2 elevated creatinine and fever in the upfront arm and cerebrovascular ischemia in the delayed arm, there were no significant differences between arms with respect to the most common adverse events of arthralgia and back pain. Osteoporosis occurred less frequently in the upfront arm (2 versus 8 cumulative cases) though this difference was not statistically significant. Bone fractures occurred in 24 patients in the upfront arm versus 25 patients in the delayed arm. Conclusions Immediate treatment with ZA prevented bone loss compared with delayed treatment in postmenopausal women on letrozole and these differences were maintained at 5 years. The incidence of osteoporosis or fractures was not different between arms. PMID:25930719

  14. A study of cumulative fatigue damage in AISI 4130 steel

    NASA Technical Reports Server (NTRS)

    Jeelani, S.; Musial, M.

    1986-01-01

    Experimental data were obtained using AISI 4130 steel under stress ratios of -1 and 0. A study of cumulative fatigue damage using Miner's and Kramer's equations for stress ratios of -1 and 0 for low-high, low-high-mixed, high-low, and high-low-mixed stress sequences has revealed that there is a close agreement between the theoretical and experimental values of fatigue damage and fatigue life. Kramer's equation predicts less conservative and more realistic cumulative fatigue damage than the popularly used Miner's rule does.

  15. Model for Cumulative Solar Heavy Ion Energy and LET Spectra

    NASA Technical Reports Server (NTRS)

    Xapsos, Mike; Barth, Janet; Stauffer, Craig; Jordan, Tom; Mewaldt, Richard

    2007-01-01

    A probabilistic model of cumulative solar heavy ion energy and lineary energy transfer (LET) spectra is developed for spacecraft design applications. Spectra are given as a function of confidence level, mission time period during solar maximum and shielding thickness. It is shown that long-term solar heavy ion fluxes exceed galactic cosmic ray fluxes during solar maximum for shielding levels of interest. Cumulative solar heavy ion fluences should therefore be accounted for in single event effects rate calculations and in the planning of space missions.

  16. Cumulative Exposure to Lead in Relation to Cognitive Function in Older Women

    PubMed Central

    Weuve, Jennifer; Korrick, Susan A.; Weisskopf, Marc A.; Ryan, Louise M.; Schwartz, Joel; Nie, Huiling; Grodstein, Francine; Hu, Howard

    2009-01-01

    Background Recent data indicate that chronic low-level exposure to lead is associated with accelerated declines in cognition in older age, but this has not been examined in women. Objective We examined biomarkers of lead exposure in relation to performance on a battery of cognitive tests among older women. Methods Patella and tibia bone lead—measures of cumulative exposure over many years—and blood lead, a measure of recent exposure, were assessed in 587 women 47–74 years of age. We assessed their cognitive function 5 years later using validated telephone interviews. Results Mean ± SD lead levels in tibia, patella, and blood were 10.5 ± 9.7 μg/g bone, 12.6 ± 11.6 μg/g bone, and 2.9 ± 1.9 μg/dL, respectively, consistent with community-level exposures. In multivariable-adjusted analyses of all cognitive tests combined, levels of all three lead biomarkers were associated with worse cognitive performance. The association between bone lead and letter fluency score differed dramatically from the other bone lead-cognitive score associations, and exclusion of this particular score from the combined analyses strengthened the associations between bone lead and cognitive performance. Results were statistically significant only for tibia lead: one SD increase in tibia lead corresponded to a 0.051-unit lower standardized summary cognitive score (95% confidence interval: −0.099 to −0.003; p = 0.04), similar to the difference in cognitive scores we observed between women who were 3 years apart in age. Conclusions These findings suggest that cumulative exposure to lead, even at low levels experienced in community settings, may have adverse consequences for women’s cognition in older age. PMID:19440496

  17. Baseline ambulatory knee kinematics are associated with changes in cartilage thickness in osteoarthritic patients over 5 years.

    PubMed

    Favre, Julien; Erhart-Hledik, Jennifer C; Chehab, Eric F; Andriacchi, Thomas P

    2016-06-14

    Although kinematic alterations during walking have been reported with knee osteoarthritis (OA), there is a paucity of longitudinal data, therefore limiting our understanding of the role of kinematics in OA development. This study tested the hypothesis that less knee extension angle and less posterior displacement of the femur relative to the tibia during the heel-strike portion of the gait cycle are associated with greater loss of medial cartilage thickness during a follow-up period of five years. This study also tested for associations between flexion-extension angle and anterior-posterior displacement during other periods of the gait cycle and 5-year cartilage thinning. 16 subjects with moderate medial knee OA were tested with gait analysis and MRI at baseline and had a follow-up MRI after 5 years. Linear regressions were used to assess the relationship between changes in cartilage thickness and baseline kinematics using Pearson correlation coefficients. Multivariate regressions were also performed to adjust for gender, baseline age, BMI, walking speed, Kellgren/Lawrence grade, and baseline knee pain score. As hypothesized, baseline knee flexion angle and femoral displacement during heel-strike and other gait cycle periods were significantly associated with medial femoral and tibial cartilage thinning at the 5 year follow-up; these associations were strengthened after adjustment for covariates. This study provided new insight into the pathogenesis of knee OA where baseline knee kinematics were associated with longitudinal disease progression. These results could serve as a basis for developing newer gait modification interventions to reduce the risk for developing knee OA. PMID:27178021

  18. Poorly Cited Articles in Peer-Reviewed Cardiovascular Journals from 1997–2007: Analysis of 5-Year Citation Rates

    PubMed Central

    Ranasinghe, Isuru; Shojaee, Abbas; Bikdeli, Behnood; Gupta, Aakriti; Chen, Ruijun; Ross, Joseph S.; Masoudi, Frederick; Spertus, John A.; Nallamothu, Brahmajee K.; Krumholz, Harlan M.

    2015-01-01

    Background The extent to which articles are cited is a surrogate of the impact and importance of the research conducted; poorly cited papers may identify research of limited use and potential wasted investments. We assessed trends in the rates of poorly cited articles and journals in the cardiovascular literature from 1997–2007. Methods and Results We identified original articles published in cardiovascular journals and indexed in the Scopus citation database from 1997–2007. We defined poorly cited articles as those with ≤5 citations in the 5 years following publication and poorly cited journals as those with >75% of journal content poorly cited. We identified 164,377 articles in 222 cardiovascular journals from 1997–2007. From 1997–2007, the number of cardiovascular articles and journals increased by 56.9% and 75.2% respectively. Of all the articles, 75,550 (46.0%) were poorly cited, of which 25,650 (15.6% overall) had no citations. From 1997–2007, the proportion of poorly cited articles declined slightly (52.1% to 46.2%, trend P<0.001), although the absolute number of poorly cited articles increased by 2,595 (trend P<0.001). At a journal level, 44% of cardiovascular journals had more than three quarters of the journal’s content poorly cited at 5 years. Conclusion Nearly half of all peer-reviewed articles published in cardiovascular journals are poorly cited 5 years after publication, and many are not cited at all. The cardiovascular literature, and the number of poorly cited articles, have both increased substantially from 1997–2007. The high proportion of poorly cited articles and journals suggest inefficiencies in the cardiovascular research enterprise. PMID:25812573

  19. Retrospective hospital-based analysis of age-related macular degeneration patterns in India: 5-year follow-up

    PubMed Central

    Sudhalkar, Aditya; Sethi, Vaibhav; Gogte, Priyanka; Bondalapati, Sailaja; Khodani, Mitali; Chhablani, Jay Kumar

    2015-01-01

    Purpose: To provide a detailed analysis of age-related macular degeneration (AMD) with a 5-year follow-up at a Tertiary Eye Care Center in India. Methods: In this retrospective institutional study, 408 eyes of 204 subjects (100 males) with a diagnosis of AMD with minimum 5-year follow-up were included. Data collected included demographics, details of the ocular exam, special investigations performed, treatment offered, complications, and systemic diseases, if any. Results: The median age was 74.24 ± 8.23 years. Median follow-up was 5.77 years. The visual acuity (VA) at baseline and last visit was 0.74 ± 0.12 (Snellen's equivalent 20/100) and 0.54 ± 0.12 logarithm of the minimum angle of resolution (Snellen's equivalent 20/50; P = 0.032) in patients with choroidal neovascular membrane (CNVM). The most common complaint was decreased vision (94.5%). AMD (any stage) was found to be bilateral in 93% of patients at baseline and 197 patients (96.56%) at 5 years. Seventeen eyes had active CNVM (12 of these were occult) at presentation. At baseline, 43 eyes had a disciform scar. Three hundred twenty-one eyes had dry AMD at baseline (geographic atrophy - 12 [3.7%] eyes). Five-year conversion rate into wet AMD and geographic atrophy was 2.87% and 3.12%. Median number of anti-vascular endothelial growth factor injections administered per patient was 2.8 ± 1.2. CNVM bilaterality was low (7.5%). Conclusion: Patients with AMD in India presented later in the course of the disease. Bilateral advanced AMD and geographic atrophy were uncommon. Five-year conversion rate into wet AMD and geographic atrophy was 2.87% and 3.12%. PMID:26862094

  20. Baseline Characteristics of the Infant Aphakia Treatment Study Population: Predicting Recognition Acuity at 4.5 Years of Age

    PubMed Central

    Hartmann, E. Eugenie; Lynn, Michael J.; Lambert, Scott R.

    2015-01-01

    Purpose. To identify patient baseline characteristics that predict recognition acuity at 4.5 years of age in the Infant Aphakia Treatment Study, a study of patients with monocular infantile cataracts. Methods. We analyzed baseline characteristics of the 114 infants enrolled in the Infant Aphakia Treatment Study to determine which were most predictive of visual outcome at 4.5 years of age. All infants underwent cataract surgery between 1 and 7 months of age. Monocular acuity was assessed at 4.5 years of age by a traveling examiner using the Amblyopia Treatment Study HOTV protocol. Results. Age at cataract surgery was weakly associated with visual acuity (Spearman rank correlation coefficient = 0.19, P = 0.041) with median visual acuity better among the younger patients (28–48 days: 0.50 logMAR, 49–210 days: 1.10 logMAR, P = 0.046). Patients from families with private insurance had significantly better median visual acuity (0.60 vs. 1.40 logMAR, P = 0.0004). No other baseline characteristic revealed a significant bivariate relationship with visual acuity. A multiple linear regression relating visual acuity to all baseline characteristics demonstrated that only the availability of private insurance was statistically significant, accounting for 12% of the variance. Conclusions. This analysis concurs with previous studies that early surgery is important for good visual outcomes in patients with unilateral infantile cataracts. The fact that only one baseline variable (private insurance) contributed to the multivariate analysis, accounting for 12% of the variance, suggests that predicting visual outcome for these patients is complicated at best, and cannot be estimated from baseline characteristics alone. (ClinicalTrials.gov number, NCT00212134.) PMID:25503455

  1. Dental Caries and Their Treatment Needs in 3-5 Year Old Preschool Children in a Rural District of India

    PubMed Central

    Gupta, Devanand; Momin, Rizwan K; Mathur, Ayush; Srinivas, Kavuri Teja; Jain, Ankita; Dommaraju, Neelima; Dalai, Deepak Ranjan; Gupta, Rajendra Kumar

    2015-01-01

    Background: Dental problems in the preschool children are neglected by their parents as the deciduous teeth are going to shed off, and hence considered to be of no importance and more of economic burden if attended to them. Aims: This study was to determine the caries prevalence in preschool children (3-5-year-old) of rural Moradabad district, to analyze the specific pattern of dental caries experience in this population and to assess the treatment needs among them. Material and Methods: Children within the age group of 3-5 years attending Anganwadi centers of rural Moradabad district were included in the study. Caries diagnosis was based on decayed, extracted, filled surface (defs) and the treatment needs were recorded using World Health Organization (WHO) oral health assessment form 1997. Results: Out of 1,500 children examined, 48.7% males and 52.6% females did not require any treatment. The mean decayed, extracted, filled teeth (deft) value was found to be significantly high in 5-year-old participants when compared to 3-year-old participants (P < 0.01). Majority of the children required one surface filling followed by two surface fillings, caries arresting sealant care, extraction, crown bridge element, pulp care, and space maintainer. Conclusion: The most common pattern was pit and fissure, then maxillary anterior pattern, posterior proximal pattern, and posterior buccal lingual smooth surface pattern. The mean deft value was higher in males as compared to females. There is a greater need for oral health education among parents and teachers. PMID:25973401

  2. Long-term Follow-up of Percutaneous Vertebroplasty in Osteoporotic Compression Fracture: Minimum of 5 Years Follow-up

    PubMed Central

    Kim, Jin Hwan; Yoo, Si Hoon

    2012-01-01

    Study Design This was designed as a retrospective study. Purpose We assessed the radiographic and clinical outcome of patients who underwent percutaneous vertebroplasty (PVP) in osteoporotic compression fractures with a minimum of 5 years follow-up. Overview of Literature Percutaneous vertebroplasty is effective surgical method for treating osteoporotic compression fracture. Methods Between January 2000 and August 2005, 159 patients were treated with PVP for osteoporotic compression fracture at our department; 43 patients died during follow-up, and 69 patients (121 vertebras) were available for follow-up for over 5 years. We analyzed the clinical and radiologic outcome including cement feature. Results The mean follow-up period was 5.7 years. Clinical outcome by mean visual analogue scale (VAS) score revealed a decreased 4.9 points perioperatively. A decreased score was maintained over 5 years in 46% of patients. A new adjacent vertebral fracture was documented by 33 vertebral bodies in 22 patients. During the follow-up period, 43 patients (38%) in 112 patients died. Anterior body heig ht in the last follow-up was improved about 0.3 mm compared with the preprocedural value, but was not statistically significant. Also, the focal kyphotic angle was reduced from 12.3° at the preprocedural state to 11.7° at the postprocedural state, but was not statistically significant (p > 0.05). Conclusions PVP for osteoporotic compression fracture is an efficient procedure for pain relief by long term follow-up. The cement injected vertebrae showed stable radiologic progression without significant changes in vertebral height or kyphotic angle. PMID:22439082

  3. Respiratory Syncytial Virus Bronchiolitis in Children up to 5 Years of Age in Spain: Epidemiology and Comorbidities

    PubMed Central

    Gil-Prieto, Ruth; Gonzalez-Escalada, Alba; Marín-García, Patricia; Gallardo-Pino, Carmen; Gil-de-Miguel, Angel

    2015-01-01

    Abstract This epidemiological survey in Spain estimates the burden of respiratory syncytial virus (RSV) infection in children up to 5 year of age during a 15-year period (1997–2011). Observational retrospective survey was conducted by reviewing data of the National Surveillance System for Hospital Data, including >98% of Spanish hospitals. All hospitalizations related to RSV infection for children up to 5 years, reported during 1997–2011 period, were analyzed. Codes were selected by using the International Classification of Diseases 9th Clinical Modification 466.0–466.19, 480.1, and 079.6. A total of 326,175 and 286,007 hospital discharges for children up to 5 and 2 years of age were reported during the study period. The annual incidence was 1072 and 2413 patients per 100,000, respectively. The average length of hospital stay was 5.7 (standard deviation 8.2) days. Four hundred forty-six deaths were reported; of those, 403 occurred in children <2 years and 355 (80%) occurred in children <12 months of age. Hospitalization and mortality rates were significantly higher in boys and decrease significantly with age. The higher rate of hospitalization and mortality rates were found in the first year of life. Annual average cost for National Health Care System was € 47 M with a mean hospitalization cost of €2162. The average length of hospitalization and costs were significantly higher in high-risk children. RSV infections in children up to 5 year of age still pose a significant health threat in Spain, especially in the infants. The development of preventive, diagnostic, and therapeutic guidelines focused in children with comorbidities may help reduce the hospital and economic burden of the disease. PMID:26020386

  4. Prenatal Adversities and Latino Children’s Autonomic Nervous System Reactivity Trajectories from 6 Months to 5 Years of Age

    PubMed Central

    Alkon, Abbey; Boyce, W. Thomas; Tran, Linh; Harley, Kim G.; Neuhaus, John; Eskenazi, Brenda

    2014-01-01

    The purpose of the study was to determine whether mothers’ adversities experienced during early pregnancy are associated with offspring’s autonomic nervous system (ANS) reactivity trajectories from 6 months to 5 years of age. This cohort study of primarily Latino families included maternal interviews at 13–14 weeks gestation about their experience of a range of adversities: father’s absence, general social support, poverty level, and household density. ANS measures of heart rate, respiratory sinus arrhythmia (parasympathetic nervous system) and preejection period (sympathetic nervous system) were collected during resting and challenging conditions on children at 6 months and 1, 3.5 and 5 years of age. Reactivity measures were calculated as the mean of the responses to challenging conditions minus a resting condition. Fixed effects models were conducted for the 212 children with two or more timepoints of ANS measures. Interactions between maternal prenatal adversity levels and child age at time of ANS protocol were included in the models, allowing the calculation of separate trajectories or slopes for each level of adversity. Results showed no significant relations between mothers’ prenatal socioeconomic or social support adversity and offspring’s parasympathetic nervous system trajectories, but there was a statistically significant relationship between social support adversity and offspring’s heart rate trajectories (p<.05) and a borderline significant relationship between socioeconomic adversity and offspring’s sympathetic nervous system trajectories (p = .05). Children whose mothers experienced one, not two, social support adversity had the smallest increases in heart rate reactivity compared to children whose mothers experienced no adversity. The children whose mothers experienced no social support and no socioeconomic adversity had the largest increases in heart rate and preejection period respectively from 6 months to 5 years showing the

  5. A Handling Study to Assess Use of the Respimat® Soft Mist™ Inhaler in Children Under 5 Years Old

    PubMed Central

    Frank, Marion; Kattenbeck, Sabine; Moroni-Zentgraf, Petra; Wachtel, Herbert; Zielen, Stefan

    2015-01-01

    Abstract Background: Respimat® Soft Mist™ Inhaler (SMI) is a hand-held device that generates an aerosol with a high, fine-particle fraction, enabling efficient lung deposition. The study objective was to assess inhalation success among children using Respimat SMI, and the requirement for assistance by the parent/caregiver and/or a valved holding chamber (VHC). Methods: This open-label study enrolled patients aged <5 years with respiratory disease and history of coughing and/or recurrent wheezing. Patients inhaled from the Respimat SMI (air only; no aerosol) using a stepwise configuration: “1” (dose released by child); “2” (dose released by parent/caregiver), and “3” (Respimat SMI with VHC, facemask, and parent/caregiver help). Co-primary endpoints included the ability to perform successful inhalation as assessed by the investigators using a standardized handling questionnaire and evaluation of the reasons for success. Inhalation profile in the successful handling configuration was verified with a pneumotachograph. Patient satisfaction and preferences were investigated in a questionnaire. Results: Of the children aged 4 to <5 years (n=27) and 3 to <4 years (n=30), 55.6% and 30.0%, respectively, achieved success without a VHC or help; with assistance, another 29.6% and 10.0%, respectively, achieved success, and the remaining children were successful with VHC. All children aged 2 to <3 years (n=20) achieved success with the Respimat SMI and VHC. Of those aged <2 years (n=22), 95.5% had successful handling of the Respimat SMI with VHC and parent/caregiver help. Inhalation flow profiles generally confirmed the outcome of the handling assessment by the investigators. Most parent/caregiver and/or child respondents were satisfied with operation, instructions for use, handling, and ease of holding the Respimat SMI with or without a VHC. Conclusions: The Respimat SMI is suitable for children aged <5 years; however, children aged <5 years are advised to add a

  6. A case of primary spinal atypical teratoid/rhabdoid tumor in a 5-year-old child

    PubMed Central

    Mankotia, Dipanker Singh; Tandon, Vivek; Sharma, Bhawani Shankar; Rajeshwari, Madhu; Sharma, Mehar Chand

    2016-01-01

    Atypical teratoid/rhabdoid tumor (AT/RT) is a rare central nervous system neoplasm affecting children, and isolated primary spinal involvement is extremely rare. Authors describe a case of spinal AT/RT in a 5-year-old male child presenting with rapidly progressing quadriparesis diagnosed and managed surgically and medically. Biopsy revealed large, rhabdoid cells with prominent nucleoli in nest and immunohistochemistry further showed loss of integrase integrator 1 expression considered to be gold standard for diagnosis. AT/RT has extremely poor prognosis with median survival being 6 months. PMID:27606020

  7. Treatment of Class II Division 2 Malocclusion Using the Forsus Fatigue Resistance Device and 5-Year Follow-Up

    PubMed Central

    Atik, Ezgi; Kocadereli, Ilken

    2016-01-01

    This case report presents the treatment of a 14-year-and-8-month-old boy with Class II division 2 mandibular retrusion, severe deep bite, and concave profile. The Forsus fatigue resistance device (FRD) was effective in correcting both skeletal and dental parameters. At 5-year posttreatment follow-up, the teeth were well aligned and the occlusion was stable. FRD application with appropriate treatment time can result with prominent changes in the facial profile and dentition, and the outcomes can be maintained at the long-term follow-up periods. PMID:27034855

  8. A case of primary spinal atypical teratoid/rhabdoid tumor in a 5-year-old child.

    PubMed

    Mankotia, Dipanker Singh; Tandon, Vivek; Sharma, Bhawani Shankar; Rajeshwari, Madhu; Sharma, Mehar Chand

    2016-01-01

    Atypical teratoid/rhabdoid tumor (AT/RT) is a rare central nervous system neoplasm affecting children, and isolated primary spinal involvement is extremely rare. Authors describe a case of spinal AT/RT in a 5-year-old male child presenting with rapidly progressing quadriparesis diagnosed and managed surgically and medically. Biopsy revealed large, rhabdoid cells with prominent nucleoli in nest and immunohistochemistry further showed loss of integrase integrator 1 expression considered to be gold standard for diagnosis. AT/RT has extremely poor prognosis with median survival being 6 months. PMID:27606020

  9. Interferon-gamma release assay performance for diagnosing tuberculosis disease in 0- to 5-year-old children.

    PubMed

    Debord, Camille; De Lauzanne, Agathe; Gourgouillon, Nadège; Guérin-El Khourouj, Valérie; Pédron, Béatrice; Gaudelus, Joel; Faye, Albert; Sterkers, Ghislaine

    2011-11-01

    QuantiFERON-TB Gold In-Tube performance was evaluated in 19 French immunocompetent children (0.29-5.36 years; median: 1.52) with active tuberculosis. The rate of indeterminates results was 0/19 and the rates of positivity were 6/10 and 9/9 in <2 and 2- to 5-year-old children, respectively. QuantiFERON-TB Gold In-Tube in association with tuberculin skin test could improve diagnosis of tuberculosis even in young children. PMID:21694659

  10. Trisomy 3 mosaicism in a 5-year-old boy with multiple anomalies: A very rare case.

    PubMed

    Yang, Yong-Jia; Yao, Xu; Guo, Jihong; Zhao, Liu; Tu, Ming; Qiou, Jun; Zhao, Rui; Luo, Yongqi; Zhu, Yi-Min

    2016-06-01

    Trisomy 3 mosaicism in live birth is exceedingly rare. In this study, we report a 5-year-old boy with trisomy 3 mosaicism who exhibits skeletal anomalies, atypical form of ectodermal dysplasias, refractory diarrhea, and normal intelligence. Fluorescence in situ hybridization and microsatellite marker analyses confirmed the existence of trisomy 3 mosaicism and suggested that the parental origin of the additional chromosome 3 in the trisomic cells was maternal. This report further delineated the trisomy 3 mosaicism in live births. The authors propose that both common phenotypes and phenotypic diversity exist on cases with trisomy 3 mosaicism. © 2016 Wiley Periodicals, Inc. PMID:27004455

  11. Penile vascular evaluation and sexual function before and after radical retropubic prostatectomy: 5-year follow-up.

    PubMed

    Dubbelman, Yvette D; Wildhagen, Mark F; Dohle, Gert R

    2008-09-01

    Sexual dysfunction is common after surgery for prostate cancer. The aetiology of changes in sexual potency after radical prostatectomy is probably multifactorial, including neurogenic, vascular and psychosexual factors. A prospective study was designed to investigate haemodynamic and psychosexual changes before and after radical retropubic prostatectomy (RRP) for organ-confined prostate cancer. Penile haemodynamic evaluation and an assessment of sexual excitement were performed preoperatively and 3 months after RRP by colour Doppler ultrasonography (CDU) with visual erotic stimulation combined with a single intracavernous injection of a mixture of papaverine/phentolamine. Questionnaires on sexual function [International Index of Erectile Function (IIEF)], general health and quality of life were sent to the patients preoperative, 3 months and 5 years after operation. Forty-eight men participated in the study. Mean age was 62.6 years (range 55-69). CDU did not show any significant reduction in mean peak systolic flow velocity and mean resistance index. From the men who preoperatively had normal arterial inflow 18% developed arteriogenic insufficiency. Some form of veno-occlusive insufficiency and low resistance indices were already present in the majority of normal potent men preoperatively. Surgical technique did not influence penile arterial blood flow after the operation. Three months and 5 years postoperatively, there was a highly significant reduction in erectile function, intercourse satisfaction, overall satisfaction, orgasmic function and sexual desire. However, with respect to the outcome at 3 months there was a significant improvement of orgasmic function 5 years after operation, especially after a bilateral nerve sparing procedure. Erections sufficient for vaginal penetration (questions 3 and 4 of the IIEF, score >or=8) improved from 2% to 11% 3 months and 5 years after RRP respectively. Total IIEF score was significantly better after a bilateral nerve

  12. Prenatal Polybrominated Diphenyl Ether Exposures and Neurodevelopment in U.S. Children through 5 Years of Age: The HOME Study

    PubMed Central

    Yolton, Kimberly; Rauch, Stephen A.; Webster, Glenys M.; Hornung, Richard; Sjödin, Andreas; Dietrich, Kim N.; Lanphear, Bruce P.

    2014-01-01

    Background: Polybrominated diphenyl ethers (PBDEs) are persistent chemicals that have been widely used as flame retardants in furniture, carpet padding, car seats, and other consumer products during the past three decades. Objective: We examined whether in utero exposure to PBDEs is associated with child cognitive function and behavior in a U.S. study sample. Methods: In a prospective birth cohort, we measured maternal serum concentrations of BDE-47 and other PBDE congeners in 309 women at 16 weeks of gestation during 2003–2006 and followed their children in Cincinnati, Ohio. We measured cognitive and motor abilities using the Bayley Scales of Infant Development-II at ages 1, 2, and 3 years; intelligence using the Wechsler Preschool and Primary Scale of Intelligence-III at age 5 years; and children’s behaviors using the Behavioral Assessment System for Children-2 annually at ages 2–5 years. We used linear mixed models or generalized estimating equations with adjustment for potential confounders to estimate associations between these outcomes and log10-transformed PBDE concentrations. Results: The geometric mean of BDE-47 in maternal serum (20.1 ng/g lipid) was comparable with U.S. adult national reference values. Prenatal BDE-47 was not significantly associated with Bayley Mental or Psychomotor Development Indices at 1–3 years, but a 10-fold increase in prenatal BDE-47 was associated with a 4.5-point decrease (95% CI: –8.8, –0.1) in Full-Scale IQ and a 3.3-point increase (95% CI: 0.3, 6.3) in the hyperactivity score at age 5 years. Conclusions: Prenatal exposure to PBDEs was associated with lower IQ and higher hyperactivity scores in children. Citation: Chen A, Yolton K, Rauch SA, Webster GM, Hornung R, Sjödin A, Dietrich KN, Lanphear BP. 2014. Prenatal polybrominated diphenyl ether exposures and neurodevelopment in U.S. children through 5 years of age: the HOME study. Environ Health Perspect 122:856–862; http://dx.doi.org/10.1289/ehp.1307562 PMID

  13. A 5-year-old boy with only fever and giant coronary aneurysms: the enigma of Kawasaki disease?

    PubMed

    Vignesh, Pandiarajan; Bhattad, Sagar; Singhal, Manphool; Singh, Surjit

    2016-08-01

    Epidemiological case definition of Kawasaki disease (KD) by the American Heart Association requires the presence of fever and four of the following: eye signs, oral mucosal changes, skin rashes, limb edema, and unilateral cervical lymphadenopathy. Incomplete KD is a well-known entity where there is lack of some of mucocutaneous features, and this occurs more often in infants. We report a 5-year-old boy with KD and giant coronary aneurysms, who presented only with fever and there is complete lack of skin and mucosal manifestations at presentation. PMID:27154559

  14. Modeling of cumulative ash curve in hard red spring wheat

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Analysis of cumulative ash curves (CAC) is very important for evaluation of milling quality of wheat and blending different millstreams for specific applications. The aim of this research was to improve analysis of CAC. Five hard red spring wheat genotype composites from two regions were milled on...

  15. The Use of the Cumulative Rehearsal Strategy: A Developmental Study.

    ERIC Educational Resources Information Center

    Allik, Judith P.; Siegel, Alexander W.

    This study was designed to address two issues: "At what age do children spontaneously use a cumulative rehearsal strategy?" and "What effect does the use of the strategy have on their performance?" The subjects, 28 children at each of five grade levels (nursery, kindergarten, first, third, and fifth), were tested in a serial-position recall task.…

  16. Aeronautical Engineering: A cumulative index to the 1980 issue

    NASA Technical Reports Server (NTRS)

    1981-01-01

    This bibliography is a cumulative index to reports, articles, and other documents introduced into the NASA scientific and technical information system. Abstracts for the entries cited appeared in issues 119 through 130 of Aeronautical Engineering: A Continuing Bibliography (NASA SP-7037). Subject, personal author, corporate author, contract number, and report/accession number indexes are provided.

  17. The effects of cumulative practice on mathematics problem solving.

    PubMed Central

    Mayfield, Kristin H; Chase, Philip N

    2002-01-01

    This study compared three different methods of teaching five basic algebra rules to college students. All methods used the same procedures to teach the rules and included four 50-question review sessions interspersed among the training of the individual rules. The differences among methods involved the kinds of practice provided during the four review sessions. Participants who received cumulative practice answered 50 questions covering a mix of the rules learned prior to each review session. Participants who received a simple review answered 50 questions on one previously trained rule. Participants who received extra practice answered 50 extra questions on the rule they had just learned. Tests administered after each review included new questions for applying each rule (application items) and problems that required novel combinations of the rules (problem-solving items). On the final test, the cumulative group outscored the other groups on application and problem-solving items. In addition, the cumulative group solved the problem-solving items significantly faster than the other groups. These results suggest that cumulative practice of component skills is an effective method of training problem solving. PMID:12102132

  18. LANDSAT 1 cumulative US standard catalog, 1976/1977

    NASA Technical Reports Server (NTRS)

    1977-01-01

    The LANDSAT 1 U.S. Cumulative Catalog lists U.S. imagery acquired by LANDSAT 1 which has been processed and input to the data files during the referenced year. Data, such as data acquired, cloud cover and image quality are given for each scene. The microfilm roll and frame on which the scene may be found are also given.

  19. Steps and Pips in the History of the Cumulative Recorder

    ERIC Educational Resources Information Center

    Lattal, Kennon A.

    2004-01-01

    From its inception in the 1930s until very recent times, the cumulative recorder was the most widely used measurement instrument in the experimental analysis of behavior. It was an essential instrument in the discovery and analysis of schedules of reinforcement, providing the first real-time analysis of operant response rates and patterns. This…

  20. Cumulative Experiences of Violence among High-Risk Urban Youth

    ERIC Educational Resources Information Center

    Taylor, Catherine A.; Boris, Neil W.; Heller, Sherryl Scott; Clum, Gretchen A.; Rice, Janet C.; Zeanah, Charles H.

    2008-01-01

    This study examines type-specific and cumulative experiences of violence among a vulnerable population of youth. Sixty high-risk, shelter-dwelling, urban youth were interviewed regarding their history of childhood maltreatment, exposure to community violence (ECV), and experience with intimate partner violence (IPV). Results show a high prevalence…

  1. 1980 Cumulative Supplement, "Higher Education and the Law".

    ERIC Educational Resources Information Center

    Edwards, Harry T.; Nordin, Virginia Davis

    A 1980 cumulative supplement to the basic text, "Higher Education and the Law," is presented. Contents include: edited reports of five United States Supreme Court cases, important lower court cases, regulations and reports; and citations to numerous law review articles, additional cases, and other secondary sources. The following broad topics are…

  2. Cumulative creep damage for unidirectional composites under step loading

    NASA Astrophysics Data System (ADS)

    Guedes, Rui Miranda

    2012-11-01

    The creep lifetime prediction of unidirectional composite materials under step loading, based on constant loading durability diagram, is analyzed for the two-step creep loading condition. For this purpose different nonlinear cumulative-damage laws are revisited and applied to predict creep lifetime. One possible approach to accounting for damage accumulation is provided by the continuum-damage mechanics (CDM). However, the CDM lifetime expression obtained for constant loading condition presents some drawbacks. Specifically, the upper stress range is not accommodated by CDM form. A modification of CDM is proposed, forcing the CDM to capture the short-term creep failure. It is proven that this modified CDM (MCDM) does not yield the same predictions as the Linear Cumulative-damage law (Miner's law). Predictions obtained from the nonlinear cumulative-damage laws are compared against synthetic lifetime generated by a micromechanical model that simulates unidirectional composites under two-step creep loading condition. Comparable deviations from Miner's law are obtained by the nonlinear cumulative-damage laws.

  3. HESI EXPOSURE FACTORS DATABASE FOR AGGREGATE AND CUMULATIVE RISK ASSESSMENT

    EPA Science Inventory

    In recent years, the risk analysis community has broadened its use of complex aggregate and cumulative residential exposure models (e.g., to meet the requirements of the 1996 Food Quality Protection Act). The value of these models is their ability to incorporate a range of inp...

  4. NATURE OF CUMULATIVE IMPACTS ON BIOTIC DIVERSITY OF WETLAND VERTEBRATES

    EPA Science Inventory

    There is no longer any doubt that cumulative impacts have important effects on wetland vertebrates. he interactions of species diversity and community structure produce a complex pattern in which environmental impacts can play a highly significant role. ariety of examples shows h...

  5. Cumulative Risk, Maternal Responsiveness, and Allostatic Load among Young Adolescents

    ERIC Educational Resources Information Center

    Evans, Gary W.; Kim, Pilyoung; Ting, Albert H.; Tesher, Harris B.; Shannis, Dana

    2007-01-01

    The purpose of this study was to examine the impact of cumulative risk exposure in concert with maternal responsiveness on physiological indicators of chronic stress in children and youth. Middle-school children exposed to greater accumulated psychosocial (e.g., family turmoil, poverty) and physical (e.g., crowding, substandard housing) risk…

  6. Physical intelligence does matter to cumulative technological culture.

    PubMed

    Osiurak, François; De Oliveira, Emmanuel; Navarro, Jordan; Lesourd, Mathieu; Claidière, Nicolas; Reynaud, Emanuelle

    2016-08-01

    Tool-based culture is not unique to humans, but cumulative technological culture is. The social intelligence hypothesis suggests that this phenomenon is fundamentally based on uniquely human sociocognitive skills (e.g., shared intentionality). An alternative hypothesis is that cumulative technological culture also crucially depends on physical intelligence, which may reflect fluid and crystallized aspects of intelligence and enables people to understand and improve the tools made by predecessors. By using a tool-making-based microsociety paradigm, we demonstrate that physical intelligence is a stronger predictor of cumulative technological performance than social intelligence. Moreover, learners' physical intelligence is critical not only in observational learning but also when learners interact verbally with teachers. Finally, we show that cumulative performance is only slightly influenced by teachers' physical and social intelligence. In sum, human technological culture needs "great engineers" to evolve regardless of the proportion of "great pedagogues." Social intelligence might play a more limited role than commonly assumed, perhaps in tool-use/making situations in which teachers and learners have to share symbolic representations. (PsycINFO Database Record PMID:27454039

  7. Administrative Promotion within a University: The Cumulative Impact of Gender.

    ERIC Educational Resources Information Center

    Johnsrud, Linda K.; Heck, Ronald H.

    1994-01-01

    A study explored the relative importance of three explanations for gender stratification in college administrative employment by modeling their separate and cumulative effects on increase in status, responsibility, and salary achieved with promotion. Findings indicate gender has a substantial negative impact on women's attainment, and the impact…

  8. Insulin glargine use and breast cancer risk: Associations with cumulative exposure

    PubMed Central

    Peeters, Paul J. H. L.; Bazelier, Marloes T.; Leufkens, Hubert G. M.; Auvinen, Anssi; van Staa, Tjeerd P.; de Vries, Frank; De Bruin, Marie L.

    2016-01-01

    Abstract Background: This study was aimed to assess the risk of breast cancer associated with exposure to insulin glargine in women with type 2 diabetes and evaluate whether the pattern of risk concurs with the hypothesized trend of an increase in risk with longer duration of use, taking into account previous cumulative exposure to other types of insulin. Methods: We performed a restrospective cohort study (2002–2013) in the Clinical Practice Research Datalink among adult female patients with a first ever insulin prescription (n = 12 468). Time-dependent exposure measures were used to assess associations with duration of use of: (1) other insulin types before glargine was first prescribed (i.e. among switchers); and (2) of glargine during follow-up. Analyses were performed separately for insulin-naïve glargine users and patients switched to glargine. Cox proportional hazards models were used to derive p-trends, hazard ratios (HR) and 95% confidence intervals (CI) for breast cancer associated with glargine use. Results: During 66 151 person years, 186 breast cancer cases occurred; 76 in glargine users (3.0/1000 years) and 110 in users of other insulins (2.7/1000 years). Among insulin-naïve women, no association with cumulative glargine use was observed (p-trend = 0.91), even after ≥5 years (HR = 1.06, 95% CI 0.48–2.33). Among switchers, a linear trend with years of prior exposure to other insulins was found (p-trend = 0.02). An increased risk was observed in glargine users with extensive (>3 years) past exposure to other insulins (HR = 3.17, 95% CI 1.28–7.84). A non-significant trend with cumulative glargine exposure was found among switchers (p-trend = 0.24). Conclusions: Exposure to glargine was not associated with an increased breast cancer risk in insulin-naïve patients. Exposure to other insulins prior to the start of glargine appears to be relevant when studying breast cancer risk associated with glargine use. PMID:27150973

  9. Evolution of costly explicit memory and cumulative culture.

    PubMed

    Nakamaru, Mayuko

    2016-06-21

    Humans can acquire new information and modify it (cumulative culture) based on their learning and memory abilities, especially explicit memory, through the processes of encoding, consolidation, storage, and retrieval. Explicit memory is categorized into semantic and episodic memories. Animals have semantic memory, while episodic memory is unique to humans and essential for innovation and the evolution of culture. As both episodic and semantic memory are needed for innovation, the evolution of explicit memory influences the evolution of culture. However, previous theoretical studies have shown that environmental fluctuations influence the evolution of imitation (social learning) and innovation (individual learning) and assume that memory is not an evolutionary trait. If individuals can store and retrieve acquired information properly, they can modify it and innovate new information. Therefore, being able to store and retrieve information is essential from the perspective of cultural evolution. However, if both storage and retrieval were too costly, forgetting and relearning would have an advantage over storing and retrieving acquired information. In this study, using mathematical analysis and individual-based simulations, we investigate whether cumulative culture can promote the coevolution of costly memory and social and individual learning, assuming that cumulative culture improves the fitness of each individual. The conclusions are: (1) without cumulative culture, a social learning cost is essential for the evolution of storage-retrieval. Costly storage-retrieval can evolve with individual learning but costly social learning does not evolve. When low-cost social learning evolves, the repetition of forgetting and learning is favored more than the evolution of costly storage-retrieval, even though a cultural trait improves the fitness. (2) When cumulative culture exists and improves fitness, storage-retrieval can evolve with social and/or individual learning, which

  10. Ocular delivery of macromolecules

    PubMed Central

    Kim, Yoo-Chun; Chiang, Bryce; Wu, Xianggen; Prausnitz, Mark R.

    2014-01-01

    Biopharmaceuticals are making increasing impact on medicine, including treatment of indications in the eye. Macromolecular drugs are typically given by physician-administered invasive delivery methods, because non--invasive ocular delivery methods, such as eye drops, and systemic delivery, have low bioavailability and/or poor ocular targeting. There is a need to improve delivery of biopharmaceuticals to enable less-invasive delivery routes, less-frequent dosing through controlled-release drug delivery and improved drug targeting within the eye to increase efficacy and reduce side effects. This review discusses the barriers to drug delivery via various ophthalmic routes of administration in the context of macromolecule delivery and discusses efforts to develop controlled-release systems for delivery of biopharmaceuticals to the eye. The growing number of macromolecular therapies in the eye needs improved drug delivery methods that increase drug efficacy, safety and patient compliance. PMID:24998941

  11. Effects of Le Fort I Osteotomy on Maxillary Anterior Teeth: A 5-Year Follow Up of 42 Cases

    PubMed Central

    Mesgarzadeh, Abolhasan; Motamedi, Mohammad Hosein Kalantar; Akhavan, Hengameh; Tousi, Tara Sarvghad; Mehrvarzfar, Peyman; Eshkevari, Pooyan Sadr

    2010-01-01

    Aim: The aim of this study was to assess the vitality of maxillary anterior teeth following Le Fort I osteotomy. Materials and Methods: A total of 245 maxillary anterior teeth in 42 patients were examined by several pulp vitality tests before surgery and 1 to 5 years postoperatively. Data were recorded in SPSS and were statistically analyzed by using Pearson, χ2, and Fisher exact tests. Results: This study showed a significant number (91%) of the maxillary anterior teeth to be sensitive to cold, 88.8% to electrical pulp test, and 89.4% to heat tests 12 months to 5 years following Le Fort I osteotomy. A total of 8 teeth (3.2%) had undergone root canal therapy (RCT) because they were nonvital and had developed apical lesions. Pain on percussion was observed in 5.7% of the teeth. External resorption was significantly associated with insensitivity (P < .05). Orthodontic therapy adds to this especially if excessive force is applied. Conclusion: A significant number of teeth had sensitivity after Le Fort I osteotomy. Only 3.2% needed RCT. When all vitality tests were negative, we used periapical radiolucency as the main criterion for judging pulp necrosis requiring RCT. It should be stressed that the outcomes of a single test cannot be considered as a reliable indicator for the presence or absence of pulpal or periapical disease or for RCT. Although the complications following Le Fort I osteotomy are few, follow-up is mandatory. PMID:20090842

  12. Surgical and Non-Surgical Procedures Associated with Recurrence of Periodontitis in Periodontal Maintenance Therapy: 5-Year Prospective Study

    PubMed Central

    Cota, Luís Otávio Miranda; Cyrino, Renata Magalhães; Lages, Eugênio José Pereira

    2015-01-01

    Background and Objective Prospective studies that investigated the influence of surgical and nonsurgical procedures in the recurrence of periodontitis and tooth loss in periodontal maintenance therapy (PMT) programs have not been previously reported. The objective of this study was to evaluate longitudinally the recurrence of periodontitis in regular compliers (RC) and irregular compliers (IC) individuals undergoing surgical and non-surgical procedures over 5 years in a program of PMT. Materials and Methods A total of 212 individuals participated in this study. Full-mouth periodontal examination including bleeding on probing, probing depth, and clinical attachment level were determined at all PMT visits over 5 years. The recurrence of periodontitis was evaluated in RC and IC individuals undergoing surgical and non-surgical procedures in PMT. The influences of risk variables of interest were tested through univariate analysis and multivariate logistic regression. Results Recurrence of periodontitis was significantly lower among RC when compared to IC. Individuals with recurrence of periodontitis and undergoing surgical procedures showed higher probing depth and clinical attachment loss than those who received non-surgical procedures. Recurrence of periodontitis was higher in individual undergoing surgical procedures and irregular compliance during PMT. Conclusions Irregular compliance and surgical procedures in individuals undergoing PMT presented higher rates of recurrence of periodontitis when compared to regular compliant patients undergoing non-surgical procedures. PMID:26496187

  13. Role of Enterotoxigenic Bacteroides fragilis in Children Less Than 5 Years of Age With Diarrhea in Tabriz, Iran

    PubMed Central

    Akhi, Mohammad Taghi; Jedari Seifi, Sirus; Asgharzadeh, Mohammad; Ahangarzadeh Rezaee, Mohammad; Abdoli Oskuei, Shahram; Pirzadeh, Tahereh; Memar, Mohammad Yousef; Alizadeh, Naser; Seifi Yarijan Sofla, Hasan

    2016-01-01

    Background Diarrhea is the most frequent health problem among children in developing countries. Defining the etiology of acute diarrhea is critical to disease therapy and prevention. Some anaerobic bacteria such as Enterotoxigenic Bacteroides fragilis (ETBF) strains cause diarrheal disease by production of enterotoxin in children less than 5 years old. Objectives This study aimed to evaluate the prevalence of ETBF among common bacteria and viruses causing diarrhea in children aged less than five years. Materials and Methods One hundred diarrheal stools were cultured for detection of aerobic and anaerobic pathogen bacteria by direct plating on selective media and antibiotic susceptibility tests were performed according to clinical and laboratory standards institute (CLSI) guidelines on isolates of ETBF. The enterotoxigenic gene among B. fragilis isolates was also investigated using the polymerase chain reaction (PCR) method. Detection of viral pathogens was carried out using the latex agglutination test. Results Ten B. fragilis were isolated from 100 diarrheal fecal specimens. All isolates were susceptible to metronidazole, while 10% were susceptible to clindamycin. Four (40%) ETBF were isolated. Rotaviruses (57.2%) and adenoviruses (18.6%) were the most frequently detected etiological agents. Conclusions ETBF is one of the etiological agents that may cause diarrhea in children but it is not the commonest of them. Metronidazole is still an effective antibiotic against B. fragilis. Viruses are the most important etiological agents of diarrhea in children less than 5 years of age.

  14. Transvenous Embolization of a Spontaneous Femoral AVF 5 Years After an Incomplete Treatment with Arterial Stent-Grafts

    SciTech Connect

    Peynircioglu, Bora Ozkan, Murat; Dogan, Omer Faruk; Cil, Barbaros E.; Dogan, Riza

    2008-03-15

    A 66-year-old man with complex left femoral arterio-venous fistula (AVF) was first diagnosed after a deep venous thrombosis incident approximately 5 years ago. Partial treatment was performed by means of endografts along the superficial femoral artery, which remained patent for 5 years. The patient had been doing well until a couple of months ago when he developed severe venous stasis and ulcers of the left cruris, due to a high-flow nonhealing complex AVF with additional iliac vein occlusion. Therefore; the definitive treatment was performed by a unique endovascular technique combined with surgical venous bypass (femoro-femoral crossover saphenous bypass, the Palma operation). A novel percutaneous transvenous technique for occlusion of a complex high-flow AVF is reported with a review of the literature. The case is unique with spontaneous AVF, transvenous embolization with detachable coils and ONYX, and the hybrid treatment technique as well as the long-term patency of superficial femoral artery stent-grafts.

  15. Effects of a Randomized Reading Intervention Study Aimed at 9-Year-Olds: A 5-Year Follow-up.

    PubMed

    Wolff, Ulrika

    2016-05-01

    The present paper reports on a 5-year follow-up of a randomized reading intervention in grade 3 in Sweden. An intervention group (n = 57) received daily training for 12 weeks in phoneme/grapheme mapping, reading comprehension and reading speed, whereas a control group (n = 55) participated in ordinary classroom activities. The main aim was to investigate if there were remaining effects of the intervention on reading-related skills. Previous analyses showed that the intervention group performed significantly better than the control group on spelling, reading speed, reading comprehension and phoneme awareness at the immediate post-test with sustained effects 1 year later. Results from the 5-year follow-up show that the only significant difference between the intervention (n = 47) and the control group (n = 37) was on word decoding. There was also a significant interaction effect of group assignment and initial word decoding, in the way that the lowest-performing students benefitted the most from the intervention. Another aim was to examine if the children identified in a screening (n = 2212) as poor readers in grade 2 still performed worse than typical readers. The analyses showed that the typically developing students (n = 66) outperformed the students identified as poor readers in grade 2 on working memory, spelling, reading comprehension and word decoding. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27146373

  16. A Longitudinal Assessment of the Relation between Executive Function and Theory of Mind at 3, 4, and 5 Years

    PubMed Central

    Marcovitch, Stuart; O’Brien, Marion; Calkins, Susan D.; Leerkes, Esther M.; Weaver, Jennifer M.; Levine, Douglas W.

    2014-01-01

    This longitudinal study contributes to the growing literature on the predictive nature of the relation between executive function (EF) and theory of mind (ToM). A latent variable model was fit to the data acquired from 226 socioeconomically and racially diverse children (52% female) at 3, 4, and 5 years of age on a number of age-appropriate tasks designed to assess EF and ToM. After controlling for sex, income-to-needs, and receptive language ability, there was substantial stability within each construct as children aged. In addition, EF at 3 years predicted ToM at 4 years but ToM did not predict EF, replicating earlier results. This pattern also appeared from 4 to 5 years of age, suggesting that the developmental precedence of EF persists later in development. Implications of these findings are discussed in terms of contemporary cognitive development theories, as well as the relation between EF and social reasoning in general. PMID:25642021

  17. Raised Speed Limits, Speed Spillover, Case-Fatality Rates, and Road Deaths in Israel: A 5-Year Follow-Up

    PubMed Central

    Richter, Elihu D.; Barach, Paul; Friedman, Lee; Krikler, Samuel; Israeli, Abraham

    2004-01-01

    Objectives. We assessed the 5-year, nationwide impact on road deaths of the raise in the speed limit (November 1, 1993) on 3 major interurban highways in Israel from 90 to 100 kph. Methods. We compared before–after trends in deaths as well as case fatality—an outcome independent of exposure (defined as vehicle-kilometers traveled). Results. After the raise, speeds rose by 4.5%–9.1%. Over 5 years, there was a sustained increase in deaths (15%) and case fatality rates (38%) on all interurban roads. Corresponding increases in deaths (13%) and case fatality (24%) on urban roads indicated “speed spillover.” Conclusions. Immediate increases in case fatality predicted and tracked the sustained increase in deaths from increased speeds of impact. Newtonian fourth power models predicted the effects of “small” increases in speed on large rises in case fatality rates. Countermeasures and congestion reduced the impact on deaths and case-fatality rates by more than half. PMID:15054007

  18. Treatment of neovascular age-related macular degeneration with anti-VEGF agents: retrospective analysis of 5-year outcomes

    PubMed Central

    Pedrosa, Ana Catarina; Reis-Silva, Adriana; Pinheiro-Costa, João; Beato, João; Freitas-da-Costa, Paulo; Falcão, Manuel S; Falcão-Reis, Fernando; Carneiro, Ângela

    2016-01-01

    Purpose To evaluate the 5-year results obtained in clinical practice in the treatment of neovascular age-related macular degeneration (nAMD) with anti-VEGF agents. Materials and methods We retrospectively analyzed all patients with nAMD who initiated anti-VEGF treatment before October 2009. We collected data regarding visual and anatomical outcomes. Results A total of 278 patients met the selection criteria. The mean number of intravitreal injections was 5.7 in the first year and 3.7 in the fifth year. A positive mean visual acuity variation of +3.7 Early Treatment Diabetic Retinopathy Study letters occurred in the first year, but no significant differences relative to baseline were observed thereafter. The majority of patients (71%) maintained stable visual acuity throughout follow-up. At 5 years, mean central macular thickness remained substantially inferior to baseline (−96.6 μm), and 56% of patients maintained dry retinas. Conclusion Anti-VEGF therapy leads to long-term visual stabilization in the great majority of patients. PMID:27099460

  19. 2.5-year-olds use cross-situational consistency to learn verbs under referential uncertainty

    PubMed Central

    Scott, Rose M.; Fisher, Cynthia

    2011-01-01

    Recent evidence shows that children can use cross-situational statistics to learn new object labels under referential ambiguity (e.g., Smith & Yu, 2008). Such evidence has been interpreted as support for proposals that statistical information about word-referent co-occurrence plays a powerful role in word learning. But object labels represent only a fraction of the vocabulary children acquire, and arguably represent the simplest case of word learning based on observations of world scenes. Here we extended the study of cross-situational word learning to a new segment of the vocabulary, action verbs, to permit a stronger test of the role of statistical information in word learning. In two experiments, on each trial 2.5-year-olds encountered two novel intransitive (e.g., “She’s pimming!”; Experiment 1) or transitive verbs (e.g., “She’s pimming her toy!”; Experiment 2) while viewing two action events. The consistency with which each verb accompanied each action provided the only source of information about the intended referent of each verb. The 2.5-year-olds used cross-situational consistency in verb learning, but also showed significant limits on their ability to do so as the sentences and scenes became slightly more complex. These findings help to define the role of cross-situational observation in word learning. PMID:22104489

  20. Medial Patellofemoral Ligament Reconstruction: A Longitudinal Study Comparison of 2 Techniques with 2 and 5-Years Follow-Up

    PubMed Central

    Astur, Diego C; Gouveia, Gustavo B; Borges, José H. de Souza; Astur, Nelson; Arliani, Gustavo G; Kaleka, Camila C; Cohen, Moises

    2015-01-01

    Background : The purpose of this study was to compare the results of two popular surgical techniques for medial patellofemoral ligament MPFL reconstruction with a minimum of two-year follow-up. Methods : Fifty-eight patients with traumatic tear of the medial patellofemoral ligament were included in one of the two surgical groups. Group 1 MPFLs were reconstructed through graft endobutton fixation and Group 2 through graft anchor fixation into the patella. After two to five-year follow-up, patients were asked to answer knee function questionnaires (Fulkerson and Kujala) as well as the SF-36 life quality score. Results : There were no statistical difference among postoperative Kujala, Fulkerson, and SF-36 questionnaires scores between Groups 1 and 2. There were statistical significant differences favorable to patients in Group 1 with a shorter follow-up length (2-5 years) compared to those with a longer period of 5-10 years for both Kujala and Fulkerson scores and no difference for group 2. Conclusion : Both medial patellofemoral ligament reconstruction techniques had similar results in a two to ten-year follow-up according to functions and life quality questionnaires. Furthermore, endobutton fixation for the patellar edge of the graft had better results in patients with 2 years of follow-up than those with 5 years. Gender was not significant for surgical results. Moreover, group 1 patients had higher number of complications. PMID:26161157